Adaptive Allocation of Decision Making Responsibility Between Human and Computer in Multi-Task Situations. Ph.D. Thesis

NASA Technical Reports Server (NTRS)

Chu, Y. Y.

1978-01-01

A unified formulation of computer-aided, multi-task, decision making is presented. Strategy for the allocation of decision making responsibility between human and computer is developed. The plans of a flight management systems are studied. A model based on the queueing theory was implemented.

The limits of parental responsibility regarding medical treatment decisions.

PubMed

Woolley, Sarah L

2011-11-01

Parental responsibility (PR) was a concept introduced by the Children Act (CA) 1989 which aimed to replace the outdated notion of parental rights and duties which regarded children as parental possessions. Section 3(1) CA 1989 defines PR as 'all the rights, duties, powers, responsibilities and authority which by law a parent of a child has in relation to the child'. In exercising PR, individuals may make medical treatment decisions on children's behalf. Medical decision-making is one area of law where both children and the state can intercede and limit parental decision-making. Competent children can consent to treatment and the state can interfere if parental decisions are not seemingly in the child's 'best interests'. This article examines the concept, and limitations, of PR in relation to medical treatment decision-making.

The amygdala and decision-making.

PubMed

Gupta, Rupa; Koscik, Timothy R; Bechara, Antoine; Tranel, Daniel

2011-03-01

Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Career Decision-Making Competence: A New Construct for the Career Realm

ERIC Educational Resources Information Center

Ceschi, Andrea; Costantini, Arianna; Phillips, Susan D.; Sartori, Riccardo

2017-01-01

Purpose: This paper aims to link findings from laboratory-based decision-making research and decision-making competence (DMC) aspects that may be central for career-related decision-making processes. Past research has identified individual differences in rational responses in decision situations, which the authors refer to as DMC. Although there…

Interpersonal relationship modulates the behavioral and neural responses during moral decision-making.

PubMed

Zhan, Youlong; Xiao, Xiao; Li, Jin; Liu, Lei; Chen, Jie; Fan, Wei; Zhong, Yiping

2018-04-13

Interpersonal relationship (IR) may play an important role in moral decision-making. However, it is little known about how IR influences neural and behavioral responses during moral decision-making. The present study utilized the dilemma scenario-priming paradigm to examine the time course of the different intimate IR (friend, acquaintance, or stranger) impacts on the emotional and cognitive processes during moral decision-making. Results showed that participants made less altruistic decisions with increased decision times and experienced more unpleasure for strangers versus friends and acquaintances. Moreover, at the early moral intuitional process, there was no significance difference observed at N1 under different intimate IR; however, at the emotional process, larger P260 which reflects the dilemma conflicts and negative emotional responses, was elicited when moral decision-making for strangers; at the later cognitive process, such difference was also observed at LPP (300-450 ms) which indexes the later top-down cognitive appraisal and reasoning processes. However, such differences were not observed between friends and acquaintances. Results indicate that IR modulates the emotional and cognitive processes during moral decision-making, suggesting that the closer the IR is, the weaker the dilemma conflicts and emotional responses are, and the more efficient this conflicts are solved. Copyright © 2018 Elsevier B.V. All rights reserved.

Stimulus and response conflict processing during perceptual decision making.

PubMed

Wendelken, Carter; Ditterich, Jochen; Bunge, Silvia A; Carter, Cameron S

2009-12-01

Encoding and dealing with conflicting information is essential for successful decision making in a complex environment. In the present fMRI study, stimulus conflict and response conflict are contrasted in the context of a perceptual decision-making dot-motion discrimination task. Stimulus conflict was manipulated by varying dot-motion coherence along task-relevant and task-irrelevant dimensions. Response conflict was manipulated by varying whether or not competing stimulus dimensions provided evidence for the same or different responses. The right inferior frontal gyrus was involved specifically in the resolution of stimulus conflict, whereas the dorsal anterior cingulate cortex was shown to be sensitive to response conflict. Additionally, two regions that have been linked to perceptual decision making with dot-motion stimuli in monkey physiology studies were differentially engaged by stimulus conflict and response conflict. The middle temporal area, previously linked to processing of motion, was strongly affected by the presence of stimulus conflict. On the other hand, the superior parietal lobe, previously associated with accumulation of evidence for a response, was affected by the presence of response conflict. These results shed light on the neural mechanisms that support decision making in the presence of conflict, a cognitive operation fundamental to both basic survival and high-level cognition.

Family and physician influence on asthma research participation decisions for adolescents: the effects of adolescent gender and research risk.

PubMed

Brody, Janet L; Scherer, David G; Annett, Robert D; Turner, Charles; Dalen, Jeanne

2006-08-01

There is considerable ethical and legal ambiguity surrounding the role of adolescents in the decision-making process for research participation. Depending on the nature of the study and the regulations involved, adolescents may have independent responsibility for providing informed consent, they may be asked to provide their assent, or they may be completely excluded from the decision-making process. This study examined parent and adolescent perceptions of decision-making authority and sources of influence on adolescent research participation decisions, and examined whether perceptions of influence differed based on adolescent gender and level of research risk. Adolescents (n = 36) with asthma and their parents reviewed 9 pediatric research protocols, decided whether they would choose to participate, rated the extent they would be responsible for the actual decision, and indicated the ability of family and physician to influence their decisions. Multivariate analyses of variance were used to evaluate differences in perceptions of decision-making authority and sources of influence on the decisions. Adolescents were less willing to cede decision making authority to parents than parents anticipated. Parents and adolescents acknowledged a greater openness to influence from physicians than from family for above minimal risk studies. Parents were more willing to consider opinions from male adolescents. Adolescents desire responsibility for research participation decisions, though parents may not share these views. Physicians' views on research participation are important to families, especially for above minimal risk studies. Parents may grant more decision-making autonomy to adolescent males than to females. Researchers, physicians, and institutions play a key role in facilitating the ethical enrollment of adolescents into biomedical research. Educational, policy, and oversight processes that support both adolescent autonomy and parental responsibility for research participation decision-making in biomedical research are discussed.

Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feldman, D.L.; Dobson, J.E.

1990-08-01

This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

Sleep deprivation elevates expectation of gains and attenuates response to losses following risky decisions.

PubMed

Venkatraman, Vinod; Chuah, Y M Lisa; Huettel, Scott A; Chee, Michael W L

2007-05-01

Using a gambling task, we investigated how 24 hours of sleep deprivation modulates the neural response to the making of risky decisions with potentially loss-bearing outcomes. Two experiments involving sleep-deprived subjects were performed. In the first, neural responses to decision making and reward outcome were evaluated. A second control experiment evaluated responses to reward outcome only. Healthy right-handed adults participated in these experiments (26 [mean age 21.3 years] in Experiment 1 and 13 [mean age 21.7 years] in Experiment 2.) Following sleep deprivation, choices involving higher relative risk elicited greater activation in the right nucleus accumbens, signifying an elevated expectation of the higher reward once the riskier choice was made. Concurrently, activation for losses in the insular and orbitofrontal cortices was reduced, denoting a diminished response to losses. This latter finding of reduced insular activation to losses was also true when volunteers were merely shown the results of the computer's decision, that is, without having to make their own choice. These results suggest that sleep deprivation poses a dual threat to competent decision making by modulating activation in nucleus accumbens and insula, brain regions associated with risky decision making and emotional processing.

Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government-Industry Collaboration for the Development of Game-Based Training Tools

DTIC Science & Technology

2016-05-05

Training for IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based Training Tools R.M. Seater...Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based...unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY Game -based training tools, sometimes called “serious games ,” are becoming

Assessing the Effects of Financial Literacy on Patient Engagement.

PubMed

Meyer, Melanie A; Hudak, Ronald P

2016-07-01

We investigated the relationship between financial literacy and patient engagement while considering the possible interaction effects due to patient financial responsibility and patient-physician shared decision making, and the impact of personal attributes. Participants consisted of an Internet-based sample of American adults (N = 160). Hierarchical multiple linear regression analysis was conducted to examine the relationship of the study variables on patient engagement. We found that patient financial responsibility (β = -.19, p < .05) and patient-physician shared decision-making (β = .17, p < .05) predicted patient engagement. However, there was no statistically significant relationship between patient financial literacy and patient engagement; moreover, the moderation effects of patient financial responsibility and shared decision making with financial literacy also were not statistically significant. Increasing patient financial responsibility and patient-physician shared decision making can impact patient engagement. Understanding the predictors of patient engagement and the factors that influence financial behaviors may allow for the development of interventions to enable patients to make better healthcare decisions, and ultimately, improve health outcomes.

Transcranial Direct Current Stimulation Does Not Influence the Speed-Accuracy Tradeoff in Perceptual Decision-making: Evidence from Three Independent Studies.

PubMed

de Hollander, Gilles; Labruna, Ludovica; Sellaro, Roberta; Trutti, Anne; Colzato, Lorenza S; Ratcliff, Roger; Ivry, Richard B; Forstmann, Birte U

2016-09-01

In perceptual decision-making tasks, people balance the speed and accuracy with which they make their decisions by modulating a response threshold. Neuroimaging studies suggest that this speed-accuracy tradeoff is implemented in a corticobasal ganglia network that includes an important contribution from the pre-SMA. To test this hypothesis, we used anodal transcranial direct current stimulation (tDCS) to modulate neural activity in pre-SMA while participants performed a simple perceptual decision-making task. Participants viewed a pattern of moving dots and judged the direction of the global motion. In separate trials, they were cued to either respond quickly or accurately. We used the diffusion decision model to estimate the response threshold parameter, comparing conditions in which participants received sham or anodal tDCS. In three independent experiments, we failed to observe an influence of tDCS on the response threshold. Additional, exploratory analyses showed no influence of tDCS on the duration of nondecision processes or on the efficiency of information processing. Taken together, these findings provide a cautionary note, either concerning the causal role of pre-SMA in decision-making or on the utility of tDCS for modifying response caution in decision-making tasks.

43 CFR 46.20 - How to use this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

....4501505.2 (b) The Responsible Official will ensure that the decision making process for proposals subject to this part includes appropriate NEPA review. (c) During the decision making process for each... the relevant environmental document. The Responsible Official's decision may combine elements of...

14 CFR § 1216.302 - Responsibilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... responsible for overseeing and guiding NASA's integration of NEPA into the Agency's planning and decision... NEPA analysis into Agency planning and decision-making processes. The SEO shall monitor this process to... Agency's planning and decision making for all NASA activities. The HQ/EMD provides advice and...

Patterns of decision making by wives of patients with life-threatening cardiac disease.

PubMed

Hall, Patricia; Sanford, Julie T; Demi, Alice S

2008-08-01

Implementation of the Patient Self-Determination Act (PSDA) in the United States has transferred decision making from the responsibility of health care professionals to the responsibility of family members. Dilemmas occurring as a result of this responsibility may cause stress and conflict among family members. The purpose of this study is to describe the patterns of decision making by family members of patients with life-threatening cardiac disease. Purposive sampling is used to select 10 wives of patients with life-threatening cardiovascular disease. Data are gathered through unstructured interviews and are analyzed using grounded theory and theory triangulation. Analysis of the data reveal three patterns of decision making: advocacy, acquiescence, and abdication.

Mental fatigue impairs soccer-specific decision-making skill.

PubMed

Smith, Mitchell R; Zeuwts, Linus; Lenoir, Matthieu; Hens, Nathalie; De Jong, Laura M S; Coutts, Aaron J

2016-07-01

This study aimed to investigate the impact of mental fatigue on soccer-specific decision-making. Twelve well-trained male soccer players performed a soccer-specific decision-making task on two occasions, separated by at least 72 h. The decision-making task was preceded in a randomised order by 30 min of the Stroop task (mental fatigue) or 30 min of reading from magazines (control). Subjective ratings of mental fatigue were measured before and after treatment, and mental effort (referring to treatment) and motivation (referring to the decision-making task) were measured after treatment. Performance on the soccer-specific decision-making task was assessed using response accuracy and time. Visual search behaviour was also assessed throughout the decision-making task. Subjective ratings of mental fatigue and effort were almost certainly higher following the Stroop task compared to the magazines. Motivation for the upcoming decision-making task was possibly higher following the Stroop task. Decision-making accuracy was very likely lower and response time likely higher in the mental fatigue condition. Mental fatigue had unclear effects on most visual search behaviour variables. The results suggest that mental fatigue impairs accuracy and speed of soccer-specific decision-making. These impairments are not likely related to changes in visual search behaviour.

The Neurobiology of Decision-Making and Responsibility: Reconciling Mechanism and Mindedness

PubMed Central

Shadlen, Michael N.; Roskies, Adina L.

2012-01-01

This essay reviews recent developments in neurobiology which are beginning to expose the mechanisms that underlie some elements of decision-making that bear on attributions of responsibility. These “elements” have been mainly studied in simple perceptual decision tasks, which are performed similarly by humans and non-human primates. Here we consider the role of neural noise, and suggest that thinking about the role of noise can shift the focus of discussions of randomness in decision-making away from its role in enabling alternate possibilities and toward a potential grounding role for responsibility. PMID:22536171

Motivation alters response bias and neural activation patterns in a perceptual decision-making task.

PubMed

Reckless, G E; Bolstad, I; Nakstad, P H; Andreassen, O A; Jensen, J

2013-05-15

Motivation has been demonstrated to affect individuals' response strategies in economic decision-making, however, little is known about how motivation influences perceptual decision-making behavior or its related neural activity. Given the important role motivation plays in shaping our behavior, a better understanding of this relationship is needed. A block-design, continuous performance, perceptual decision-making task where participants were asked to detect a picture of an animal among distractors was used during functional magnetic resonance imaging (fMRI). The effect of positive and negative motivation on sustained activity within regions of the brain thought to underlie decision-making was examined by altering the monetary contingency associated with the task. In addition, signal detection theory was used to investigate the effect of motivation on detection sensitivity, response bias and response time. While both positive and negative motivation resulted in increased sustained activation in the ventral striatum, fusiform gyrus, left dorsolateral prefrontal cortex (DLPFC) and ventromedial prefrontal cortex, only negative motivation resulted in the adoption of a more liberal, closer to optimal response bias. This shift toward a liberal response bias correlated with increased activation in the left DLPFC, but did not result in improved task performance. The present findings suggest that motivation alters aspects of the way perceptual decisions are made. Further, this altered response behavior is reflected in a change in left DLPFC activation, a region involved in the computation of perceptual decisions. Copyright © 2013 IBRO. Published by Elsevier Ltd. All rights reserved.

Culturally Responsive Teaching and Decision Making in Schools

ERIC Educational Resources Information Center

Wairia, Charles

2017-01-01

The purpose of this qualitative exploratory case study was to explore how teachers and administrators are culturally responsive in their teaching and decision-making in a school district in eastern United States. This study was guided by two concepts; culturally responsive teaching and culturally responsive pedagogy. The researcher conducted…

Individual differences in decision making: Drive and Reward Responsiveness affect strategic bargaining in economic games.

PubMed

Scheres, Anouk; Sanfey, Alan G

2006-10-18

In the growing body of literature on economic decision making, the main focus has typically been on explaining aggregate behavior, with little interest in individual differences despite considerable between-subject variability in decision responses. In this study, we were interested in asking to what degree individual differences in fundamental psychological processes can mediate economic decision-making behavior. Specifically, we studied a personality dimension that may influence economic decision-making, the Behavioral Activation System, (BAS) which is composed of three components: Reward Responsiveness, Drive, and Fun Seeking. In order to assess economic decision making, we utilized two commonly-used tasks, the Ultimatum Game and Dictator Game. Individual differences in BAS were measured by completion of the BIS/BAS Scales, and correlations between the BAS scales and monetary offers made in the two tasks were computed. We found that higher scores on BAS Drive and on BAS Reward Responsiveness were associated with a pattern of higher offers on the Ultimatum Game, lower offers on the Dictator Game, and a correspondingly larger discrepancy between Ultimatum Game and Dictator Game offers. These findings are consistent with an interpretation that high scores on Drive and Reward Responsiveness are associated with a strategy that first seeks to maximize the likelihood of reward, and then to maximize the amount of reward. More generally, these results suggest that there are additional factors other than empathy, fairness and selfishness that contribute to strategic decision-making.

Resolving response, decision, and strategic control: evidence for a functional topography in dorsomedial prefrontal cortex.

PubMed

Venkatraman, Vinod; Rosati, Alexandra G; Taren, Adrienne A; Huettel, Scott A

2009-10-21

The dorsomedial prefrontal cortex (DMPFC) plays a central role in aspects of cognitive control and decision making. Here, we provide evidence for an anterior-to-posterior topography within the DMPFC using tasks that evoke three distinct forms of control demands--response, decision, and strategic--each of which could be mapped onto independent behavioral data. Specifically, we identify three spatially distinct regions within the DMPFC: a posterior region associated with control demands evoked by multiple incompatible responses, a middle region associated with control demands evoked by the relative desirability of decision options, and an anterior region that predicts control demands related to deviations from an individual's preferred decision-making strategy. These results provide new insight into the functional organization of DMPFC and suggest how recent controversies about its role in complex decision making and response mapping can be reconciled.

Resolving Response, Decision, and Strategic Control: Evidence for a Functional Topography in Dorsomedial Prefrontal Cortex

PubMed Central

Venkatraman, Vinod; Rosati, Alexandra G.; Taren, Adrienne A.; Huettel, Scott A.

2009-01-01

The dorsomedial prefrontal cortex (DMPFC) plays a central role in aspects of cognitive control and decision making. Here, we provide evidence for an anterior-to-posterior topography within the DMPFC using tasks that evoke three distinct forms of control demands – response, decision, and strategic – each of which could be mapped on to independent behavioral data. Specifically, we identify three spatially distinct regions within the DMPFC: a posterior region associated with control demands evoked by multiple incompatible responses, a middle region associated with control demands evoked by the relative desirability of decision options, and an anterior region that predicts control demands related to deviations from an individual's preferred decision-making strategy. These results provide new insight into the functional organization of DMPFC, and suggest how recent controversies about its role in complex decision making and response mapping can be reconciled. PMID:19846703

Individual differences in bodily freezing predict emotional biases in decision making

PubMed Central

Ly, Verena; Huys, Quentin J. M.; Stins, John F.; Roelofs, Karin; Cools, Roshan

2014-01-01

Instrumental decision making has long been argued to be vulnerable to emotional responses. Literature on multiple decision making systems suggests that this emotional biasing might reflect effects of a system that regulates innately specified, evolutionarily preprogrammed responses. To test this hypothesis directly, we investigated whether effects of emotional faces on instrumental action can be predicted by effects of emotional faces on bodily freezing, an innately specified response to aversive relative to appetitive cues. We tested 43 women using a novel emotional decision making task combined with posturography, which involves a force platform to detect small oscillations of the body to accurately quantify postural control in upright stance. On the platform, participants learned whole body approach-avoidance actions based on monetary feedback, while being primed by emotional faces (angry/happy). Our data evidence an emotional biasing of instrumental action. Thus, angry relative to happy faces slowed instrumental approach relative to avoidance responses. Critically, individual differences in this emotional biasing effect were predicted by individual differences in bodily freezing. This result suggests that emotional biasing of instrumental action involves interaction with a system that controls innately specified responses. Furthermore, our findings help bridge (animal and human) decision making and emotion research to advance our mechanistic understanding of decision making anomalies in daily encounters as well as in a wide range of psychopathology. PMID:25071491

The perfect family: decision making in biparental care.

PubMed

Akçay, Erol; Roughgarden, Joan

2009-10-13

Previous theoretical work on parental decisions in biparental care has emphasized the role of the conflict between evolutionary interests of parents in these decisions. A prominent prediction from this work is that parents should compensate for decreases in each other's effort, but only partially so. However, experimental tests that manipulate parents and measure their responses fail to confirm this prediction. At the same time, the process of parental decision making has remained unexplored theoretically. We develop a model to address the discrepancy between experiments and the theoretical prediction, and explore how assuming different decision making processes changes the prediction from the theory. We assume that parents make decisions in behavioral time. They have a fixed time budget, and allocate it between two parental tasks: provisioning the offspring and defending the nest. The proximate determinant of the allocation decisions are parents' behavioral objectives. We assume both parents aim to maximize the offspring production from the nest. Experimental manipulations change the shape of the nest production function. We consider two different scenarios for how parents make decisions: one where parents communicate with each other and act together (the perfect family), and one where they do not communicate, and act independently (the almost perfect family). The perfect family model is able to generate all the types of responses seen in experimental studies. The kind of response predicted depends on the nest production function, i.e. how parents' allocations affect offspring production, and the type of experimental manipulation. In particular, we find that complementarity of parents' allocations promotes matching responses. In contrast, the relative responses do not depend on the type of manipulation in the almost perfect family model. These results highlight the importance of the interaction between nest production function and how parents make decisions, factors that have largely been overlooked in previous models.

Are Sex Effects on Ethical Decision-Making Fake or Real? A Meta-Analysis on the Contaminating Role of Social Desirability Response Bias.

PubMed

Yang, Jianfeng; Ming, Xiaodong; Wang, Zhen; Adams, Susan M

2017-02-01

A meta-analysis of 143 studies was conducted to explore how the social desirability response bias may influence sex effects on ratings on measures of ethical decision-making. Women rated themselves as more ethical than did men; however, this sex effect on ethical decision-making was no longer significant when social desirability response bias was controlled. The indirect questioning approach was compared with the direct measurement approach for effectiveness in controlling social desirability response bias. The indirect questioning approach was found to be more effective.

Does the community want devolved authority? Results of deliberative polling in Ontario.

PubMed Central

Abelson, J; Lomas, J; Eyles, J; Birch, S; Veenstra, G

1995-01-01

OBJECTIVE: To obtain and contrast the informed opinions of people in five decision-making groups that could have a role in devolved governance of health care and social services. DESIGN: Deliberative polling. SETTING: Three rural and three urban communities selected from the 32 areas covered by a district health council in Ontario. PARTICIPANTS: A total of 280 citizens from five potential decision-making groups: randomly selected citizens, attendees at town-hall meetings, appointees to district health councils, elected officials and experts in health care and social services. INTERVENTION: Participants' opinions were polled during 29 structured 2-hour meetings. MAIN OUTCOME MEASURES: Participants' opinions on their personal willingness and their group's suitability to be involved in devolved decision making, desired type of decision-making involvement, information preferences, preferred areas of decision-making involvement and preferred composition of decision-making bodies. RESULTS: Mean attendance at each meeting was 9.6 citizens. Although there were some significant differences in opinion among the five potential decision-making groups, there were few differences among citizens from different geographic areas. A total of 189 (72%) of people polled were personally willing to take on a role involving responsibility for overall decision-making, but far fewer thought that their group was suited to taking on responsibility (30%) or a consulting role (55%). Elected officials were the most willing (85% personally willing, 50% thought their group was suitable) and randomly selected citizens the least willing (60% personally willing, 17% thought their group was suitable) to take responsibility for overall decision making. Most citizens polled indicated less interest in involvement in specific types of decisions, except for planning and setting priorities, than in overall decision making. Only 24 participants (9%) rated their own group as suitable to take responsibility for raising revenue, 91 (33%) deemed their group suited to distribution of funds and 108 (39%) felt their group was suitable for management of services. People in all five groups ranked health care needs (mean rank 1.5 out of four options) as the most important and preferences (mean rank 3.6) as the least important information. They rated a combination body involving several community groups as the most suitable overall decision-making body (8.8 on 10-point scale). Participants favoured the representation of elected officials, the provincial government and experts on combination bodies responsible for the specific types of decisions. Overall, as the complexity of devolved decision making became clear, participants tended to assign authority to traditional decision makers such as elected officials, experts and the provincial government, but also favoured a consulting role for attendees at town-hall meetings (i.e., interested citizens). CONCLUSION: There are significant differences among groups in the community in their willingness to be involved, desired roles and representation in devolved decision making on health care and social services in Ontario. PMID:7634217

Team-Based Learning Instruction for Responsible Conduct of Research Positively Impacts Ethical Decision-Making

PubMed Central

McCormack, Wayne T.; Garvan, Cynthia W.

2013-01-01

Common practices for responsible conduct of research (RCR) instruction have recently been shown to have no positive impact on and possibly to undermine ethical decision-making (EDM). We show that a team-based learning (TBL) RCR curriculum results in some gains in decision ethicality, the use of more helpful meta-cognitive reasoning strategies in decision-making, and elimination of most negative effects of other forms of RCR instruction on social–behavioral responses. TBL supports the reasoning strategies and social mechanisms that underlie EDM and ethics instruction, and may provide a more effective method for RCR instruction than lectures and small group discussion. PMID:24073606

Adolescents' Neural Processing of Risky Decisions: Effects of Sex and Behavioral Disinhibition.

PubMed

Crowley, Thomas J; Dalwani, Manish S; Mikulich-Gilbertson, Susan K; Young, Susan E; Sakai, Joseph T; Raymond, Kristen M; McWilliams, Shannon K; Roark, Melissa J; Banich, Marie T

2015-01-01

Accidental injury and homicide, relatively common among adolescents, often follow risky behaviors; those are done more by boys and by adolescents with greater behavioral disinhibition (BD). Neural processing during adolescents' risky decision-making will differ in youths with greater BD severity, and in males vs. females, both before cautious behaviors and before risky behaviors. 81 adolescents (PATIENTS with substance and conduct problems, and comparison youths (Comparisons)), assessed in a 2 x 2 design ( Comparisons x Male:Female) repeatedly decided between doing a cautious behavior that earned 1 cent, or a risky one that either won 5 or lost 10 cents. Odds of winning after risky responses gradually decreased. Functional magnetic resonance imaging captured brain activity during 4-sec deliberation periods preceding responses. Most neural activation appeared in known decision-making structures. PATIENTS, who had more severe BD scores and clinical problems than Comparisons, also had extensive neural hypoactivity. Comparisons' greater activation before cautious responses included frontal pole, medial prefrontal cortex, striatum, and other regions; and before risky responses, insula, temporal, and parietal regions. Males made more risky and fewer cautious responses than females, but before cautious responses males activated numerous regions more than females. Before risky behaviors female-greater activation was more posterior, and male-greater more anterior. Neural processing differences during risky-cautious decision-making may underlie group differences in adolescents' substance-related and antisocial risk-taking. Patients reported harmful real-life decisions and showed extensive neural hypoactivity during risky-or-cautious decision-making. Males made more risky responses than females; apparently biased toward risky decisions, males (compared with females) utilized many more neural resources to make and maintain cautious decisions, indicating an important risk-related brain sexual dimorphism. The results suggest new possibilities for prevention and management of excessive, dangerous adolescent risk-taking.

Evidence accumulation detected in BOLD signal using slow perceptual decision making.

PubMed

Krueger, Paul M; van Vugt, Marieke K; Simen, Patrick; Nystrom, Leigh; Holmes, Philip; Cohen, Jonathan D

2017-04-01

We assessed whether evidence accumulation could be observed in the BOLD signal during perceptual decision making. This presents a challenge since the hemodynamic response is slow, while perceptual decisions are typically fast. Guided by theoretical predictions of the drift diffusion model, we slowed down decisions by penalizing participants for incorrect responses. Second, we distinguished BOLD activity related to stimulus detection (modeled using a boxcar) from activity related to integration (modeled using a ramp) by minimizing the collinearity of GLM regressors. This was achieved by dissecting a boxcar into its two most orthogonal components: an "up-ramp" and a "down-ramp." Third, we used a control condition in which stimuli and responses were similar to the experimental condition, but that did not engage evidence accumulation of the stimuli. The results revealed an absence of areas in parietal cortex that have been proposed to drive perceptual decision making but have recently come into question; and newly identified regions that are candidates for involvement in evidence accumulation. Previous fMRI studies have either used fast perceptual decision making, which precludes the measurement of evidence accumulation, or slowed down responses by gradually revealing stimuli. The latter approach confounds perceptual detection with evidence accumulation because accumulation is constrained by perceptual input. We slowed down the decision making process itself while leaving perceptual information intact. This provided a more sensitive and selective observation of brain regions associated with the evidence accumulation processes underlying perceptual decision making than previous methods. Copyright © 2017 Elsevier B.V. All rights reserved.

Career Decision-Making and Corporate Responsibility

ERIC Educational Resources Information Center

Sainty, Rosemary

2008-01-01

This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…

Field and Experience Influences on Ethical Decision-Making in the Sciences

PubMed Central

Mumford, Michael D.; Connelly, Shane; Murphy, Stephen T.; Devenport, Lynn D.; Antes, Alison L.; Brown, Ryan P.; Hill, Jason H.; Waples, Ethan P.

2009-01-01

Differences across fields and experience levels are frequently considered in discussions of ethical decision-making and ethical behavior. In the present study, doctoral students in the health, biological, and social sciences completed measures of ethical decision-making. The effects of field and level of experience with respect to ethical decision-making, metacognitive reasoning strategies, social-behavioral responses, and exposure to unethical events were examined. Social and biological scientists performed better than health scientists with respect to ethical decision-making. Furthermore, the ethical decision-making of health science students decreased as experience increased. Moreover, these effects appeared to be linked to the specific strategies underlying participants' ethical decision-making. The implications of these findings for ethical decision-making are discussed. PMID:19750129

Neural responses to feedback information produced by self-generated or other-generated decision-making and their impairment in schizophrenia.

PubMed

Toyomaki, Atsuhito; Hashimoto, Naoki; Kako, Yuki; Murohashi, Harumitsu; Kusumi, Ichiro

2017-01-01

Several studies of self-monitoring dysfunction in schizophrenia have focused on the sense of agency to motor action using behavioral and psychophysiological techniques. So far, no study has ever tried to investigate whether the sense of agency or causal attribution for external events produced by self-generated decision-making is abnormal in schizophrenia. The purpose of this study was to investigate neural responses to feedback information produced by self-generated or other-generated decision-making in a multiplayer gambling task using even-related potentials and electroencephalogram synchronization. We found that the late positive component and theta/alpha synchronization were increased in response to feedback information in the self-decision condition in normal controls, but that these responses were significantly decreased in patients with schizophrenia. These neural activities thus reflect the self-reference effect that affects the cognitive appraisal of external events following decision-making and their impairment in schizophrenia.

Gunslingers, poker players, and chickens 3: Decision making under mental performance pressure in junior elite athletes.

PubMed

Parkin, Beth L; Walsh, Vincent

2017-01-01

Having investigated the decision making of world class elite and subelite athletes (see Parkin and Walsh, 2017; Parkin et al., 2017), here the abilities of those at the earliest stage of entry to elite sport are examined. Junior elite athletes have undergone initial national selection and are younger than athletes examined previously (mean age 13 years). Decision making under mental pressure is explored in this sample. During performance an athlete encounters a wide array of mental pressures; these include the psychological impact of errors, negative feedback, and requirements for sustained attention in a dynamic environment (Anshel and Wells, 2000; Mellalieu et al., 2009). Such factors increase the cognitive demands of the athletes, inducing distracting anxiety-related thoughts known as rumination (Beilock and Gray, 2007). Mental pressure has been shown to reduce performance of decision-making tasks where reward and loss contingencies are explicit, with a shift toward increased risk taking (Pabst et al., 2013; Starcke et al., 2011). Mental pressure has been shown to be detrimental to decision-making speed in comparison to physical stress, highlighting the importance of considering a range of different pressures encountered by athletes (Hepler, 2015). To investigate the influence of mental pressure on key indicators of decision making in junior elite athletes. This chapter concludes a wider project examining decision making across developmental stages in elite sport. The work further explores how psychological insights can be applied in an elite sporting environment and in particular tailored to the requirements of junior athletes. Seventeen junior elite athletes (10 males, mean age: 13.80 years) enrolled on a national youth athletic development program participated in the study. Performance across three categories of decision making was assessed under conditions of low and high mental pressure. Decision making under risk was measured via the Cambridge Gambling Task (CGT; Rogers et al., 1999), decision making under uncertainty via the Balloon Analogue Risk Task (BART; Lejuez et al., 2002), and fast reactive responses to perceptual stimuli via the Visual Search Task (Treisman, 1982). Mental pressure was induced with the addition of a concurrent verbal memory task, used to increase cognitive load and mimic the distracting effects of anxiety-related rumination. In junior elite athletes, fast reactive responses to perceptual stimuli (on the Visual Search Task) were slower under conditions of mental pressure. For decision making under risk there was an interaction of mental pressure and gender on the amount of points gambled, under pressure there was a higher level of risk taking in male athletes compared to females. There was no influence of mental pressure on decision making under uncertainity. There were no significant correlations in the degree to which individual's responses changed under pressure across the three measures of decision making. When assessing the applicability of results based on group averages there were no junior elite athletes who showed an "average" response (within 1SD of the mean) to mental pressure across all the three decision-making tasks. Mental pressure affects decision making in a sample of junior elite athletes, with a slowing of response times, and modulations to performance of decision making under risk that have a high requirement for working memory. In relation to sport, these findings suggest that novel situations that place high cognitive demands on the athlete may be particularly influenced by mental pressure. The application of this work in junior elite athletes included the feedback of individual results and the implementation of a decision-making taxonomy. © 2017 Elsevier B.V. All rights reserved.

32 CFR Enclosure 1 - Requirements for Environmental Considerations-Global Commons

Code of Federal Regulations, 2010 CFR

2010-07-01

... the responsible decision-making official to be informed of pertinent environmental considerations. The... making an appropriate record with respect to this requirement is for the decision-maker to sign and date...-making process. Other means of making an appropriate record are also acceptable. 9. Timing. No decision...

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.

Experts in offside decision making learn to compensate for their illusory perceptions.

PubMed

Put, Koen; Baldo M, V C; Cravo, André M; Wagemans, Johan; Helsen, Werner F

2013-12-01

In association football, the flash-lag effect appears to be a viable explanation for erroneous offside decision making. Due to this spatiotemporal illusion, assistant referees (ARs) perceive the player who receives the ball ahead of his real position. In this experiment, a laboratory decision-making task was used to demonstrate that international top-class ARs, compared with amateur soccer players, do not have superior perceptual sensitivity. They clearly modify their decision criterion according to the contextual needs and, therefore, show a higher response bias toward not responding to the stimulus, in particular in the most difficult situations. Thus, international ARs show evidence for response-level compensation, resulting in a specific cost (i.e., more misses), which clearly reflects the use of particular (cognitive) strategies. In summary, it appears that experts in offside decision making can be distinguished from novices more on the cognitive or decision-making level than on the perceptual level.

The Role of the Lateral Intraparietal Area in (the Study of) Decision Making.

PubMed

Huk, Alexander C; Katz, Leor N; Yates, Jacob L

2017-07-25

Over the past two decades, neurophysiological responses in the lateral intraparietal area (LIP) have received extensive study for insight into decision making. In a parallel manner, inferred cognitive processes have enriched interpretations of LIP activity. Because of this bidirectional interplay between physiology and cognition, LIP has served as fertile ground for developing quantitative models that link neural activity with decision making. These models stand as some of the most important frameworks for linking brain and mind, and they are now mature enough to be evaluated in finer detail and integrated with other lines of investigation of LIP function. Here, we focus on the relationship between LIP responses and known sensory and motor events in perceptual decision-making tasks, as assessed by correlative and causal methods. The resulting sensorimotor-focused approach offers an account of LIP activity as a multiplexed amalgam of sensory, cognitive, and motor-related activity, with a complex and often indirect relationship to decision processes. Our data-driven focus on multiplexing (and de-multiplexing) of various response components can complement decision-focused models and provides more detailed insight into how neural signals might relate to cognitive processes such as decision making.

Hippocampal Damage Increases Deontological Responses during Moral Decision Making.

PubMed

McCormick, Cornelia; Rosenthal, Clive R; Miller, Thomas D; Maguire, Eleanor A

2016-11-30

Complex moral decision making is associated with the ventromedial prefrontal cortex (vmPFC) in humans, and damage to this region significantly increases the frequency of utilitarian judgments. Since the vmPFC has strong anatomical and functional links with the hippocampus, here we asked how patients with selective bilateral hippocampal damage would derive moral decisions on a classic moral dilemmas paradigm. We found that the patients approved of the utilitarian options significantly less often than control participants, favoring instead deontological responses-rejecting actions that harm even one person. Thus, patients with hippocampal damage have a strikingly opposite approach to moral decision making than vmPFC-lesioned patients. Skin-conductance data collected during the task showed increased emotional arousal in the hippocampal-damaged patients and they stated that their moral decisions were based on emotional instinct. By contrast, control participants made moral decisions based on the integration of an adverse emotional response to harming others, visualization of the consequences of one's action, and the rational re-evaluation of future benefits. This integration may be disturbed in patients with either hippocampal or vmPFC damage. Hippocampal lesions decreased the ability to visualize a scenario and its future consequences, which seemed to render the adverse emotional response overwhelmingly dominant. In patients with vmPFC damage, visualization might also be reduced alongside an inability to detect the adverse emotional response, leaving only the utilitarian option open. Overall, these results provide insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions. The ventromedial prefrontal cortex (vmPFC) is closely associated with the ability to make complex moral judgements. When this area is damaged, patients become more utilitarian (the ends justify the means) and have decreased emotional arousal during moral decision making. The vmPFC is closely connected with another brain region-the hippocampus. In this study we found that patients with selective bilateral hippocampal damage show a strikingly opposite response pattern to those with vmPFC damage when making moral judgements. They rejected harmful actions of any kind (thus their responses were deontological) and showed increased emotional arousal. These results provide new insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions. Copyright © 2015 McCormick et al.

The impact of geographic information systems on emergency management decision making at the U.S. Department of Homeland Security

NASA Astrophysics Data System (ADS)

King, Steven Gray

Geographic information systems (GIS) reveal relationships and patterns from large quantities of diverse data in the form of maps and reports. The United States spends billions of dollars to use GIS to improve decisions made during responses to natural disasters and terrorist attacks, but precisely how GIS improves or impairs decision making is not known. This research examined how GIS affect decision making during natural disasters, and how GIS can be more effectively used to improve decision making for emergency management. Using a qualitative case study methodology, this research examined decision making at the U.S. Department of Homeland Security (DHS) during a large full-scale disaster exercise. This study indicates that GIS provided decision makers at DHS with an outstanding context for information that would otherwise be challenging to understand, especially through the integration of multiple data sources and dynamic three-dimensional interactive maps. Decision making was hampered by outdated information, a reliance on predictive models based on hypothetical data rather than actual event data, and a lack of understanding of the capabilities of GIS beyond cartography. Geospatial analysts, emergency managers, and other decision makers who use GIS should take specific steps to improve decision making based on GIS for disaster response and emergency management.

Psychopharmacology decision-making among pregnant and postpartum women and health providers: informing compassionate and collaborative care women's health.

PubMed

Price, Sarah Kye; Bentley, Kia J

2013-01-01

Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision-making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 83) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity.

Frequencies of decision making and monitoring in adaptive resource management

PubMed Central

Johnson, Fred A.

2017-01-01

Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management implications and extensions. PMID:28800591

Frequencies of decision making and monitoring in adaptive resource management

USGS Publications Warehouse

Williams, Byron K.; Johnson, Fred A.

2017-01-01

Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management implications and extensions.

A queueing model of pilot decision making in a multi-task flight management situation

NASA Technical Reports Server (NTRS)

Walden, R. S.; Rouse, W. B.

1977-01-01

Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

Neural substrates of reward magnitude, probability, and risk during a wheel of fortune decision-making task.

PubMed

Smith, Bruce W; Mitchell, Derek G V; Hardin, Michael G; Jazbec, Sandra; Fridberg, Daniel; Blair, R James R; Ernst, Monique

2009-01-15

Economic decision-making involves the weighting of magnitude and probability of potential gains/losses. While previous work has examined the neural systems involved in decision-making, there is a need to understand how the parameters associated with decision-making (e.g., magnitude of expected reward, probability of expected reward and risk) modulate activation within these neural systems. In the current fMRI study, we modified the monetary wheel of fortune (WOF) task [Ernst, M., Nelson, E.E., McClure, E.B., Monk, C.S., Munson, S., Eshel, N., et al. (2004). Choice selection and reward anticipation: an fMRI study. Neuropsychologia 42(12), 1585-1597.] to examine in 25 healthy young adults the neural responses to selections of different reward magnitudes, probabilities, or risks. Selection of high, relative to low, reward magnitude increased activity in insula, amygdala, middle and posterior cingulate cortex, and basal ganglia. Selection of low-probability, as opposed to high-probability reward, increased activity in anterior cingulate cortex, as did selection of risky, relative to safe reward. In summary, decision-making that did not involve conflict, as in the magnitude contrast, recruited structures known to support the coding of reward values, and those that integrate motivational and perceptual information for behavioral responses. In contrast, decision-making under conflict, as in the probability and risk contrasts, engaged the dorsal anterior cingulate cortex whose role in conflict monitoring is well established. However, decision-making under conflict failed to activate the structures that track reward values per se. Thus, the presence of conflict in decision-making seemed to significantly alter the pattern of neural responses to simple rewards. In addition, this paradigm further clarifies the functional specialization of the cingulate cortex in processes of decision-making.

Evaluating the Effects that Existing Instruction on Responsible Conduct of Research Has on Ethical Decision Making

PubMed Central

Antes, Alison L.; Wang, Xiaoqian; Mumford, Michael D.; Brown, Ryan P.; Connelly, Shane; Devenport, Lynn D.

2015-01-01

Purpose To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social–behavioral responses). Method In 2005–2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. Results A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others’ perspectives. Participants also increased in their endorsement of detrimental social–behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. Conclusions These findings indicated that RCR instruction may not be as effective as intended, and in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction. PMID:20182131

Evaluating the effects that existing instruction on responsible conduct of research has on ethical decision making.

PubMed

Antes, Alison L; Wang, Xiaoqian; Mumford, Michael D; Brown, Ryan P; Connelly, Shane; Devenport, Lynn D

2010-03-01

To examine the effects that existing courses on the responsible conduct of research (RCR) have on ethical decision making by assessing the ethicality of decisions made in response to ethical problems and the underlying processes involved in ethical decision making. These processes included how an individual thinks through ethical problems (i.e., meta-cognitive reasoning strategies) and the emphasis placed on social dimensions of ethical problems (i.e., social-behavioral responses). In 2005-2007, recruitment announcements were made, stating that a nationwide, online study was being conducted to examine the impact of RCR instruction on the ethical decision making of scientists. Recruitment yielded contacts with over 200 RCR faculty at 21 research universities and medical schools; 40 (20%) RCR instructors enrolled their courses in the current study. From those courses, 173 participants completed an ethical decision-making measure. A mixed pattern of effects emerged. The ethicality of decisions did not improve as a result of RCR instruction and even decreased for decisions pertaining to business aspects of research, such as contract bidding. Course participants improved on some meta-cognitive reasoning strategies, such as awareness of the situation and consideration of personal motivations, but declined for seeking help and considering others' perspectives. Participants also increased their endorsement of detrimental social-behavioral responses, such as deception, retaliation, and avoidance of personal responsibility. These findings indicated that RCR instruction may not be as effective as intended and, in fact, may even be harmful. Harmful effects might result if instruction leads students to overstress avoidance of ethical problems, be overconfident in their ability to handle ethical problems, or overemphasize their ethical nature. Future research must examine these and other possible obstacles to effective RCR instruction.

Counterfactual Processing of Economic Action-Outcome Alternatives in Obsessive-Compulsive Disorder: Further Evidence of Impaired Goal-Directed Behavior

PubMed Central

Gillan, Claire M.; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A.; Sule, Akeem; Sahakian, Barbara J.; Cardinal, Rudolf N.; Robbins, Trevor W.

2014-01-01

Background Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. Methods We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. Results The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Conclusions Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. PMID:23452663

Altered moral decision-making in patients with idiopathic Parkinson's disease.

PubMed

Rosen, Jan B; Rott, Elisa; Ebersbach, Georg; Kalbe, Elke

2015-10-01

Moral decision-making essentially contributes to social conduct. Although patients with Parkinson's disease (PD) show deficits in (non-moral) decision making and related neuropsychological functions, i.e. executive functions, theory of mind (ToM), and empathy, moral decision-making has rarely been examined in PD patients. We examined possible alterations of moral decision-making and associated functions in PD. Twenty non-demented PD patients and 23 age- and education-matched healthy control participants were examined with tests that assess reasoning, executive functions (set-shifting and planning), ToM and empathy, decision-making under risk, and moral intuitions. Moral decision-making was assessed with a close-to-everyday moral dilemma paradigm that opposes socially oriented "altruistic" choices to self-beneficial "egoistic" choices in 20 moral dilemma short stories (10 high and 10 low emotional). Concurrently, electrodermal activity was recorded. PD patients made more egoistic moral decisions than healthy controls. Remarkably, while reasoning, planning and empathy correlated with moral decision-making in the control group, in the PD group neuropsychological functions and dopaminergic medication did not correlate with moral decisions. No evidence for reduced skin conductance responses in PD patients and no relationships between skin conductance responses and moral decisions were observed. This study provides evidence for moral decision-making dysfunctions in PD patients who made more egoistic moral decisions. As a possible underlying mechanism, reduced exercise of attentional control due to a dysfunctional interplay between the prefrontal cortex and the basal ganglia is discussed. Future research will have to determine the impact of PD patients' moral decision-making dysfunctions on everyday life and further determine correlates of the deficits. Copyright © 2015 Elsevier Ltd. All rights reserved.

Braving difficult choices alone: children's and adolescents' medical decision making.

PubMed

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

The influence of emotion regulation on decision-making under risk.

PubMed

Martin, Laura N; Delgado, Mauricio R

2011-09-01

Cognitive strategies typically involved in regulating negative emotions have recently been shown to also be effective with positive emotions associated with monetary rewards. However, it is less clear how these strategies influence behavior, such as preferences expressed during decision-making under risk, and the underlying neural circuitry. That is, can the effective use of emotion regulation strategies during presentation of a reward-conditioned stimulus influence decision-making under risk and neural structures involved in reward processing such as the striatum? To investigate this question, we asked participants to engage in imagery-focused regulation strategies during the presentation of a cue that preceded a financial decision-making phase. During the decision phase, participants then made a choice between a risky and a safe monetary lottery. Participants who successfully used cognitive regulation, as assessed by subjective ratings about perceived success and facility in implementation of strategies, made fewer risky choices in comparison with trials where decisions were made in the absence of cognitive regulation. Additionally, BOLD responses in the striatum were attenuated during decision-making as a function of successful emotion regulation. These findings suggest that exerting cognitive control over emotional responses can modulate neural responses associated with reward processing (e.g., striatum) and promote more goal-directed decision-making (e.g., less risky choices), illustrating the potential importance of cognitive strategies in curbing risk-seeking behaviors before they become maladaptive (e.g., substance abuse).

Administrative Leadership. Effective and Responsive Decision Making in Higher Education.

ERIC Educational Resources Information Center

Dressel, Paul L.

Administrative leadership is examined with focus on the processes and problems of campus decision-making. Chapters include: the need for administrators; morals, ethics, and values in higher education; improving administrative communication; conceptions of decision-making; focusing administration interest; understanding external influences,…

Evidence Accumulation and Choice Maintenance Are Dissociated in Human Perceptual Decision Making

PubMed Central

Pedersen, Mads Lund; Endestad, Tor; Biele, Guido

2015-01-01

Perceptual decision making in monkeys relies on decision neurons, which accumulate evidence and maintain choices until a response is given. In humans, several brain regions have been proposed to accumulate evidence, but it is unknown if these regions also maintain choices. To test if accumulator regions in humans also maintain decisions we compared delayed and self-paced responses during a face/house discrimination decision making task. Computational modeling and fMRI results revealed dissociated processes of evidence accumulation and decision maintenance, with potential accumulator activations found in the dorsomedial prefrontal cortex, right inferior frontal gyrus and bilateral insula. Potential maintenance activation spanned the frontal pole, temporal gyri, precuneus and the lateral occipital and frontal orbital cortices. Results of a quantitative reverse inference meta-analysis performed to differentiate the functions associated with the identified regions did not narrow down potential accumulation regions, but suggested that response-maintenance might rely on a verbalization of the response. PMID:26510176

Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak.

PubMed

Schemann, K; Gillespie, J A; Toribio, J-A L M L; Ward, M P; Dhand, N K

2014-10-01

Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy issues regarding policy modifications or differing interpretations by different state agencies. Data on factors influencing the decision-making process for these six issues and on stakeholder interaction were collected using a pre-tested, semi-structured questionnaire. Face-to-face interviews were conducted with 24 individuals representing 12 industry and government organizations. Quantitative data were analysed using social network analysis. Qualitative data were coded and patterns matched to test a pre-determined general theory using a method called theory-oriented process-tracing. Results revealed that technical policy decisions were framed by social, political, financial, strategic and operational considerations. Industry stakeholders had influence through formal pre-existing channels, yet specific gaps in stakeholder interaction were overcome by reactive alliances formed during the outbreak response but outside the established system. Overall, the crisis management system and response were seen as positive, and 75-100% of individuals interviewed were supportive of, had interest in and considered the outcome as good for the majority of policy decisions, yet only 46-75% of those interviewed considered that they had influence on these decisions. Training to increase awareness and knowledge of emergency animal diseases (EADs) and response systems will improve stakeholder participation in emergency disease management and preparedness for future EAD incursions. © 2012 Blackwell Verlag GmbH.

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 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 relations between leadership, communication, decision making and overall crew performance. Implications of these findings for training will be discussed.

7 CFR 400.90 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... Agency. RMA or FCIC, including the RO, FAOB or any other division within the Agency with decision making... the responsibility by the Agency of making a decision on a request for administrative review by the... an adverse decision. Adverse decision. A decision by an employee or Director of the Agency that is...

Risky Decision Making in Juvenile Myoclonic Epilepsy.

PubMed

Unterberger, Iris; Zamarian, Laura; Prieschl, Manuela; Bergmann, Melanie; Walser, Gerald; Luef, Gerhard; Javor, Andrija; Ransmayr, Gerhard; Delazer, Margarete

2018-01-01

It is not known whether patients with juvenile myoclonic epilepsy (JME) differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years) and a group of 38 healthy controls (mean age 26.03/SD 4.84 years). Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.

Can promoting patient decision making be exclusionary? Moral expectations and cultural difference in the narratives of UK maternity clinicians.

PubMed

Davies, Myfanwy; Elwyn, Glyn; Papadopoulos, Irena; Fleming, Lon; Williams, Gareth

2009-01-01

Patient autonomy in health care decision making is increasingly advocated as a means of promoting patients' 'responsibilities' for treatments and costs. However, little is known with regard to clinicians' understanding of patients' potential responsibilities in decision making. We explore how clinicians may view decision making as a 'moral' obligation and examine how moral virtue is discursively constructed in this context and in the face of ethnic and social difference. Data reported are derived from an interview study that examined perceptions of maternity decision making among Arab Muslim women and clinicians. Results reported here are from the clinician sample which includes obstetricians, general practitioners (GPs) and midwives. Clinicians perceived that a key element of their role involved imparting relevant information to their clients and, increasingly, involving them in making autonomous decisions about their care. However, by analysing and assessing the attribution of specific cultural differences in clinicians' discussion of decision making processes with minority group women, we demonstrate how some clinicians justified their failure to promote autonomy through shared decision making with women from these groups. We will demonstrate these attributes to be those of passivity and non-rationality which entail some negative moral judgements and which have a complex relationship to gender and power

14 CFR 1216.302 - Responsibilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... overseeing and guiding NASA's integration of NEPA into the Agency's planning and decision making. The SEO... Agency planning and decision-making processes. The SEO shall monitor this process to ensure that these... functions and guiding NASA's integration of NEPA into the Agency's planning and decision making for all NASA...

FRAMEWORK FOR ENVIRONMENTAL DECISION-MAKING, FRED: A TOOL FOR ENVIRONMENTALLY-PREFERABLE PURCHASING

EPA Science Inventory

In support of the Environmentally Preferable Purchasing Program of the US EPA, the Systems Analysis Branch has developed a decision-making tool based on life cycle assessment. This tool, the Framework for Responsible Environmental Decision-making or FRED streamlines LCA by choosi...

Community College Faculty Involvement in Decision-Making.

ERIC Educational Resources Information Center

Thaxter, Lynn P.; Graham, Steven W.

1999-01-01

Explores community college faculty's perception of their involvement in decision making. Reports the responses of 70 Midwest community college instructors in five areas: finance, instruction, personnel, goals, and students. Finds that respondents feel little sense of decision-making involvement. Warns that presidents may alienate the faculty if…

Conflicting contraceptive norms for men: equal responsibility versus women's bodily autonomy.

PubMed

James-Hawkins, Laurie; Dalessandro, Cristen; Sennott, Christie

2018-05-15

Most research investigating how men and women in heterosexual relationships negotiate contraceptive use focuses on the women's point of view. Using a sample of 44 interviews with men attending a western US university, this study examines norms governing men's participation in contraceptive use and pregnancy prevention and their responses to those norms. The paper demonstrates how competing norms around sexual health decision-making and women's bodily autonomy contribute to unintended outcomes that undermine young people's quest for egalitarian sexual relationships. While men largely agree that responsibility for sexual health decision-making should be shared with women, they also believe that women should have power over their own bodies and sexual health. However, the coexistence of these two competing norms - which call for both equal responsibility in decision-making and women's bodily autonomy - results in a disconnect between men saying that sexual health decision-making should be equal, but not always participating equally. Thus, men largely give contraceptive decision-making power over to women, putting the burden of pregnancy prevention onto women and letting men off the hook. It is concluded that men's negotiation of these competing norms reinforces unequal power and inequality in sexual relationships.

Decision Making in Action: Applying Research to Practice

NASA Technical Reports Server (NTRS)

Orasanu, Judith; Hart, Sandra G. (Technical Monitor)

1994-01-01

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 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 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 relations between leadership, communication, decision making and overall crew performance. Implications of these findings for training will be discussed.

A Response-Time Approach to Comparing Generalized Rational and Take-the-Best Models of Decision Making

ERIC Educational Resources Information Center

Bergert, F. Bryan; Nosofsky, Robert M.

2007-01-01

The authors develop and test generalized versions of take-the-best (TTB) and rational (RAT) models of multiattribute paired-comparison inference. The generalized models make allowances for subjective attribute weighting, probabilistic orders of attribute inspection, and noisy decision making. A key new test involves a response-time (RT)…

A decision-making model based on a spiking neural circuit and synaptic plasticity.

PubMed

Wei, Hui; Bu, Yijie; Dai, Dawei

2017-10-01

To adapt to the environment and survive, most animals can control their behaviors by making decisions. The process of decision-making and responding according to cues in the environment is stable, sustainable, and learnable. Understanding how behaviors are regulated by neural circuits and the encoding and decoding mechanisms from stimuli to responses are important goals in neuroscience. From results observed in Drosophila experiments, the underlying decision-making process is discussed, and a neural circuit that implements a two-choice decision-making model is proposed to explain and reproduce the observations. Compared with previous two-choice decision making models, our model uses synaptic plasticity to explain changes in decision output given the same environment. Moreover, biological meanings of parameters of our decision-making model are discussed. In this paper, we explain at the micro-level (i.e., neurons and synapses) how observable decision-making behavior at the macro-level is acquired and achieved.

Hippocampal Damage Increases Deontological Responses during Moral Decision Making

PubMed Central

Rosenthal, Clive R.; Miller, Thomas D.

2016-01-01

Complex moral decision making is associated with the ventromedial prefrontal cortex (vmPFC) in humans, and damage to this region significantly increases the frequency of utilitarian judgments. Since the vmPFC has strong anatomical and functional links with the hippocampus, here we asked how patients with selective bilateral hippocampal damage would derive moral decisions on a classic moral dilemmas paradigm. We found that the patients approved of the utilitarian options significantly less often than control participants, favoring instead deontological responses—rejecting actions that harm even one person. Thus, patients with hippocampal damage have a strikingly opposite approach to moral decision making than vmPFC-lesioned patients. Skin-conductance data collected during the task showed increased emotional arousal in the hippocampal-damaged patients and they stated that their moral decisions were based on emotional instinct. By contrast, control participants made moral decisions based on the integration of an adverse emotional response to harming others, visualization of the consequences of one's action, and the rational re-evaluation of future benefits. This integration may be disturbed in patients with either hippocampal or vmPFC damage. Hippocampal lesions decreased the ability to visualize a scenario and its future consequences, which seemed to render the adverse emotional response overwhelmingly dominant. In patients with vmPFC damage, visualization might also be reduced alongside an inability to detect the adverse emotional response, leaving only the utilitarian option open. Overall, these results provide insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions. SIGNIFICANCE STATEMENT The ventromedial prefrontal cortex (vmPFC) is closely associated with the ability to make complex moral judgements. When this area is damaged, patients become more utilitarian (the ends justify the means) and have decreased emotional arousal during moral decision making. The vmPFC is closely connected with another brain region—the hippocampus. In this study we found that patients with selective bilateral hippocampal damage show a strikingly opposite response pattern to those with vmPFC damage when making moral judgements. They rejected harmful actions of any kind (thus their responses were deontological) and showed increased emotional arousal. These results provide new insights into the processes involved in moral decision making and highlight the complementary roles played by two closely connected brain regions. PMID:27903725

The neural correlates of moral decision-making: A systematic review and meta-analysis of moral evaluations and response decision judgements.

PubMed

Garrigan, Beverley; Adlam, Anna L R; Langdon, Peter E

2016-10-01

The aims of this systematic review were to determine: (a) which brain areas are consistently more active when making (i) moral response decisions, defined as choosing a response to a moral dilemma, or deciding whether to accept a proposed solution, or (ii) moral evaluations, defined as judging the appropriateness of another's actions in a moral dilemma, rating moral statements as right or wrong, or identifying important moral issues; and (b) shared and significantly different activation patterns for these two types of moral judgements. A systematic search of the literature returned 28 experiments. Activation likelihood estimate analysis identified the brain areas commonly more active for moral response decisions and for moral evaluations. Conjunction analysis revealed shared activation for both types of moral judgement in the left middle temporal gyrus, cingulate gyrus, and medial frontal gyrus. Contrast analyses found no significant clusters of increased activation for the moral evaluations-moral response decisions contrast, but found that moral response decisions additionally activated the left and right middle temporal gyrus and the right precuneus. Making one's own moral decisions involves different brain areas compared to judging the moral actions of others, implying that these judgements may involve different processes. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.

PubMed

Gillan, Claire M; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A; Sule, Akeem; Sahakian, Barbara J; Cardinal, Rudolf N; Robbins, Trevor W

2014-04-15

Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Response inhibition and impulsive decision-making in sexual offenders against children.

PubMed

Turner, Daniel; Laier, Christian; Brand, Matthias; Bockshammer, Tamara; Welsch, Robin; Rettenberger, Martin

2018-05-31

Current theories view impulsivity as an important factor in the explanation of sexual offending. While impulsivity itself is a multidimensional construct, response inhibition and impulsive decision-making are frequently discussed subcomponents. Impulsivity in sexual offenders could be triggered by sexual cues with high emotional significance. The present study compared response inhibition abilities and the degree of impulsive decision-making between 63 child sexual abusers and 63 nonoffending controls. A Go/No-Go task was used to assess response inhibition, while the Iowa Gambling Task (IGT) and the Game of Dice Task (GDT) were used for the assessment of decision-making. In contrast to previous studies, modified versions of the Go/No-Go task and the IGT were used, including pictures of the Not Real People-Set depicting nude adults and children. Child sexual abusers showed more deficits in response inhibition in the Go/No-Go task. Furthermore, decision-making was especially impaired by the presence of child images in child sexual abusers with more intense pedophilic sexual interests. In contrast, in the nonoffending controls the presence of preferred sexual cues (pictures of women) improved decision-making performance. No differences in overall GDT performance were found between the groups; however, child sexual abusers chose the riskiest option more frequently than nonoffending controls. In line with theoretical assumptions about the processes underlying sexual offending, child sexual abusers show more deficits in neuropsychological functioning, which may be related to more impulsive behaviors. These impairments could be triggered by the presence of sexually relevant cues. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Comparative analysis of nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks: a discussion paper.

PubMed

Kennedy, Catriona; O'Reilly, Pauline; Fealy, Gerard; Casey, Mary; Brady, Anne-Marie; McNamara, Martin; Prizeman, Geraldine; Rohde, Daniela; Hegarty, Josephine

2015-08-01

To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Discussion paper. Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction. © 2015 John Wiley & Sons Ltd.

Psychopharmacology Decision-Making Among Pregnant and Postpartum Women and Health Providers: Informing Compassionate and Collaborative Care Women's Health

PubMed Central

Price, Sarah Kye; Bentley, Kia J.

2013-01-01

Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision–making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 3) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity. PMID:23517513

Calcium dynamics regulating the timing of decision-making in C. elegans.

PubMed

Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

2017-05-23

Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans . We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca 2+ ] i ), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca 2+ ] i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making.

Calcium dynamics regulating the timing of decision-making in C. elegans

PubMed Central

Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

2017-01-01

Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans. We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca2+]i), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca2+]i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making. DOI: http://dx.doi.org/10.7554/eLife.21629.001 PMID:28532547

Conflict between place and response navigation strategies: effects on vicarious trial and error (VTE) behaviors.

PubMed

Schmidt, Brandy; Papale, Andrew; Redish, A David; Markus, Etan J

2013-02-15

Navigation can be accomplished through multiple decision-making strategies, using different information-processing computations. A well-studied dichotomy in these decision-making strategies compares hippocampal-dependent "place" and dorsal-lateral striatal-dependent "response" strategies. A place strategy depends on the ability to flexibly respond to environmental cues, while a response strategy depends on the ability to quickly recognize and react to situations with well-learned action-outcome relationships. When rats reach decision points, they sometimes pause and orient toward the potential routes of travel, a process termed vicarious trial and error (VTE). VTE co-occurs with neurophysiological information processing, including sweeps of representation ahead of the animal in the hippocampus and transient representations of reward in the ventral striatum and orbitofrontal cortex. To examine the relationship between VTE and the place/response strategy dichotomy, we analyzed data in which rats were cued to switch between place and response strategies on a plus maze. The configuration of the maze allowed for place and response strategies to work competitively or cooperatively. Animals showed increased VTE on trials entailing competition between navigational systems, linking VTE with deliberative decision-making. Even in a well-learned task, VTE was preferentially exhibited when a spatial selection was required, further linking VTE behavior with decision-making associated with hippocampal processing.

Adults' decision-making about the electronic waste issue: The role of the nature of science conceptualizations and moral concerns in socio-scientific decision-making

NASA Astrophysics Data System (ADS)

Yu, Yuqing

Socio-scientific issues have become increasingly important in Science-Technology-Society (STS) education as a means to make science learning more relevant to students' lives. This study used the e-waste issue as a context to investigate two aspects of socio-scientific decision-making: (1) the relationship between the nature of science (NOS) conceptualizations and decision-making; and (2) moral concerns involved in the process of decision-making. This study contributes to the field of socio-scientific issue research and STS education in the following ways. First, it is the first study that performed meta-analysis to seek the relationship between the NOS understanding and decision-making. This study concludes that valuable NOS conceptualizations that are highly related to the socio-scientific issue under investigation, rather than general NOS understanding, exert statistically significant influences on decision-making. Second, this study empirically examined the Multiple Responses Model (MRM), which enables the transfer of qualitative NOS responses into quantitative data, and hence, inferential statistics. The current study justifies the significance of unidimensionality to the application of the MRM. It addresses the limitations associated with the MRM and provides implications for future use of the MRM in other contexts. Finally, the study explores the role of moral concerns in socio-scientific decision-making. Eight participants engaged in interviews that were designed to elicit their reactions and feelings regarding the issue of exporting e-waste to poor countries. Qualitative analyses demonstrated that moral considerations were significant influences on decision-making. In addition, participants' action responses revealed that they were motivated to take action to help the environment. The study has implications for socio-scientific issue studies in other contexts and for teacher education programs that use socio-scientific issues to advance teachers' reasoning and discourse skills.

The Influence of Emotion Regulation on Decision-making under Risk

PubMed Central

Martin, Laura N.; Delgado, Mauricio R.

2011-01-01

Cognitive strategies typically involved in regulating negative emotions have recently been shown to also be effective with positive emotions associated with monetary rewards. However, it is less clear how these strategies influence behavior, such as preferences expressed during decision-making under risk, and the underlying neural circuitry. That is, can the effective use of emotion regulation strategies during presentation of a reward-conditioned stimulus influence decision-making under risk and neural structures involved in reward processing such as the striatum? To investigate this question, we asked participants to engage in imagery-focused regulation strategies during the presentation of a cue that preceded a financial decision-making phase. During the decision phase, participants then made a choice between a risky and a safe monetary lottery. Participants who successfully used cognitive regulation, as assessed by subjective ratings about perceived success and facility in implementation of strategies, made fewer risky choices in comparison to trials where decisions were made in the absence of cognitive regulation. Additionally, blood-oxygen-level-dependent (BOLD) responses in the striatum were attenuated during decision-making as a function of successful emotion regulation. These findings suggest that exerting cognitive control over emotional responses can modulate neural responses associated with reward processing (e.g., striatum), and promote more goal-directed decision-making (e.g., less risky choices), illustrating the potential importance of cognitive strategies in curbing risk-seeking behaviors before they become maladaptive (e.g., substance abuse). PMID:21254801

Braving Difficult Choices Alone: Children's and Adolescents' Medical Decision Making

PubMed Central

Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

2014-01-01

Objective What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Methods Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Results Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Conclusions Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process. PMID:25084274

The use of decision analysis to examine ethical decision making by critical care nurses.

PubMed

Hughes, K K; Dvorak, E M

1997-01-01

To examine the extent to which critical care staff nurses make ethical decisions that coincide with those recommended by a decision analytic model. Nonexperimental, ex post facto. Midwestern university-affiliated 500 bed tertiary care medical center. One hundred critical care staff nurses randomly selected from seven critical care units. Complete responses were obtained from 82 nurses (for a final response rate of 82%). The dependent variable--consistent decision making--was measured as staff nurses' abilities to make ethical decisions that coincided with those prescribed by the decision model. Subjects completed two instruments, the Ethical Decision Analytic Model, a computer-administered instrument designed to measure staff nurses' abilities to make consistent decisions about a chemically-impaired colleague; and a Background Inventory. The results indicate marked consensus among nurses when informal methods were used. However, there was little consistency between the nurses' informal decisions and those recommended by the decision analytic model. Although 50% (n = 41) of all nurses chose a course of action that coincided with the model's least optimal alternative, few nurses agreed with the model as to the most optimal course of action. The findings also suggest that consistency was unrelated (p > 0.05) to the nurses' educational background or years of clinical experience; that most subjects reported receiving little or no education in decision making during their basic nursing education programs; but that exposure to decision-making strategies was related to years of nursing experience (p < 0.05). The findings differ from related studies that have found a moderate degree of consistency between nurses and decision analytic models for strictly clinical decision tasks, especially when those tasks were less complex. However, the findings partially coincide with other findings that decision analysis may not be particularly well-suited to the critical care environment. Additional research is needed to determine whether critical care nurses use the same decision-making methods as do other nurses; and to clarify the effects of decision task (clinical versus ethical) on nurses' decision making. It should not be assumed that methods used to study nurses' clinical decision making are applicable for all nurses or all types of decisions, including ethical decisions.

Empirically and Clinically Useful Decision Making in Psychotherapy: Differential Predictions with Treatment Response Models

ERIC Educational Resources Information Center

Lutz, Wolfgang; Saunders, Stephen M.; Leon, Scott C.; Martinovich, Zoran; Kosfelder, Joachim; Schulte, Dietmar; Grawe, Klaus; Tholen, Sven

2006-01-01

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research…

Dynamic afferent synapses to decision-making networks improve performance in tasks requiring stimulus associations and discriminations

PubMed Central

Bourjaily, Mark A.

2012-01-01

Animals must often make opposing responses to similar complex stimuli. Multiple sensory inputs from such stimuli combine to produce stimulus-specific patterns of neural activity. It is the differences between these activity patterns, even when small, that provide the basis for any differences in behavioral response. In the present study, we investigate three tasks with differing degrees of overlap in the inputs, each with just two response possibilities. We simulate behavioral output via winner-takes-all activity in one of two pools of neurons forming a biologically based decision-making layer. The decision-making layer receives inputs either in a direct stimulus-dependent manner or via an intervening recurrent network of neurons that form the associative layer, whose activity helps distinguish the stimuli of each task. We show that synaptic facilitation of synapses to the decision-making layer improves performance in these tasks, robustly increasing accuracy and speed of responses across multiple configurations of network inputs. Conversely, we find that synaptic depression worsens performance. In a linearly nonseparable task with exclusive-or logic, the benefit of synaptic facilitation lies in its superlinear transmission: effective synaptic strength increases with presynaptic firing rate, which enhances the already present superlinearity of presynaptic firing rate as a function of stimulus-dependent input. In linearly separable single-stimulus discrimination tasks, we find that facilitating synapses are always beneficial because synaptic facilitation always enhances any differences between inputs. Thus we predict that for optimal decision-making accuracy and speed, synapses from sensory or associative areas to decision-making or premotor areas should be facilitating. PMID:22457467

Four Factors of Clinical Decision Making: A Teaching Model.

ERIC Educational Resources Information Center

Leist, James C.; Konen, Joseph C.

1996-01-01

Four factors of clinical decision making identified by medical students include quality of care, cost, ethics, and legal concerns. This paper argues that physicians have two responsibilities in the clinical decision-making model: to be the primary advocate for quality health care and to ensure balance among the four factors, working in partnership…

76 FR 8737 - Notice of Public Information Collection(s) Being Reviewed by the Federal Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-15

... parties have not been given notice and an opportunity to be present) to decision-making personnel in... responses may then be used by the Commission in its decision-making. The availability of the ex parte... decision-making officials. Federal Communications Commission. Marlene H. Dortch, Secretary, Office of the...

Applying a Systemic Procedure to Locate Career Decision-Making Difficulties

ERIC Educational Resources Information Center

Gati, Itamar; Amir, Tamar

2010-01-01

Locating clients' career decision-making difficulties is one of the first steps in career counseling. The authors demonstrate the feasibility and utility of a systematic 4-stage procedure for locating and interpreting career decision-making difficulties by analyzing responses of 626 college students (collected by Tai, 2007) to the Career…

Criminal decision making: the development of adolescent judgment, criminal responsibility, and culpability.

PubMed

Fried, C S; Reppucci, N D

2001-02-01

Theories of judgment in decision making hypothesize that throughout adolescence, judgment is impaired because the development of several psychosocial factors that are presumed to influence decision making lags behind the development of the cognitive capacities that are required to make mature decisions. This study uses an innovative video technique to examine the role of several psychosocial factors--temporal perspective, peer influence, and risk perception--in adolescent criminal decision making. Results based on data collected from 56 adolescents between the ages of 13 and 18 years revealed that detained youth were more likely to think of future-oriented consequences of engaging in the depicted delinquent act and less likely to anticipate pressure from their friends than nondetained youth. Examination of the developmental functions of the psychosocial factors indicates age-based differences on standardized measures of temporal perspective and resistance to peer influence and on measures of the role of risk perception in criminal decision making. Assessments of criminal responsibility and culpability were predicted by age and ethnicity. Implications for punishment in the juvenile justice system are discussed.

FRAMEWORK FOR RESPONSIBLE ENVIRONMENTAL DECISION-MAKING (FRED): USING LIFE CYCLE ASSESSMENT TO EVALUATE PREFERABILITY OF PRODUCTS

EPA Science Inventory

Framework for Responsible Environmental Decision-Making (FRED) demonstrates how the life-cycle concept can be used to quantify competing products' environmental performance so that this information may be integrated with considerations of total ownership cost and technical perfor...

Understanding and Interpreting Career Decision-Making Difficulties

ERIC Educational Resources Information Center

Amir, Tamar; Gati, Itamar; Kleiman, Tali

2008-01-01

This research develops and tests a procedure for interpreting individuals' responses in multiscale career assessments, using the Career Decision-Making Difficulties Questionnaire (CDDQ). In Study 1, criteria for ascertaining the credibility of responses were developed, based on the judgments of 39 career-counseling experts. In Study 2, the…

Option Generation Techniques for Command and Control.

DTIC Science & Technology

1983-01-01

and discuss some reasons why decision making is often less than perfect. 3.2. The Process of Decision Making Figure 3.1 shows a model of the various...responses to changes in the problem context. Most of these potential reasons for poor decision making stem from the human decision maker’s cognitive...several advantages: (1) It provides a mechanism for quickly estimating the scope of the effort that should be involved in making the decison and a road map

Aircraft accident investigation: the decision-making in initial action scenario.

PubMed

Barreto, Marcia M; Ribeiro, Selma L O

2012-01-01

In the complex aeronautical environment, the efforts in terms of operational safety involve the adoption of proactive and reactive measures. The process of investigation begins right after the occurrence of the aeronautical accident, through the initial action. Thus, it is in the crisis scenario, that the person responsible for the initial action makes decisions and gathers the necessary information for the subsequent phases of the investigation process. Within this scenario, which is a natural environment, researches have shown the fragility of rational models of decision making. The theoretical perspective of naturalistic decision making constitutes a breakthrough in the understanding of decision problems demanded by real world. The proposal of this study was to verify if the initial action, after the occurrence of an accident, and the decision-making strategies, used by the investigators responsible for this activity, are characteristic of the naturalistic decision making theoretical approach. To attend the proposed objective a descriptive research was undertaken with a sample of professionals that work in this activity. The data collected through individual interviews were analyzed and the results demonstrated that the initial action environment, which includes restricted time, dynamic conditions, the presence of multiple actors, stress and insufficient information is characteristic of the naturalistic decision making. They also demonstrated that, when the investigators make their decisions, they use their experience and the mental simulation, intuition, improvisation, metaphors and analogues cases, as strategies, all of them related to the naturalistic approach of decision making, in order to satisfy the needs of the situation and reach the objectives of the initial action in the accident scenario.

Respiratory therapists' attitudes about participative decision making: relationship between managerial decision-making style and job satisfaction.

PubMed

Blake, Shane S; Kester, Lucy; Stoller, James K

2004-08-01

Studies of non-health-care work environments indicate that non-managerial employee job satisfaction is higher in companies that use participative (as opposed to autocratic) decision making. It has not been determined whether managerial decision-making style influences job satisfaction among respiratory therapists (RTs) and which managerial decision-making style RTs prefer. We surveyed Nebraska RTs' attitudes regarding their job satisfaction, their perceptions of their managers' decision-making styles (autocratic, consultative, and/or delegative), and which decision-making style they would prefer their managers to use. We sought to determine whether there is a significant correlation between RTs' perceptions of their managers' decision-making styles and the RTs' job satisfaction. The study population was 792 licensed and practicing non-managerial RTs in Nebraska, from which we randomly selected 565 RTs to survey. The self-administered, descriptive survey used 2 Likert scales (one for decision-making style and one for job satisfaction) and inquired about 57 items. The survey was mailed on October 1, 1999. On October 28, 1999, we sent a second mailing to RTs who had not responded. We received 271 responses (response rate 47.9%). The respondents were generally satisfied with their jobs (mean +/- SD Minnesota Satisfaction Questionnaire score 73.46 +/- 11.63). The sub-scale scores ranged from 20 ("very dissatisfied") to 100 ("very satisfied"). The respondents did not want autocratic managerial decision making (mean +/- SD autocratic sub-scale score 4.29 +/- 0.60). Autocratic decision making was associated with lower job satisfaction (r = 0.49), whereas consultative and delegative decision making were associated with higher job satisfaction (r = -0.31 and -0.48, respectively). RTs who worked in departments that had < 25 RT employees reported higher job satisfaction than did RTs in larger departments (p = 0.029). Our survey data indicate that (1) RTs prefer delegative and consultative managerial decision making, (2) job satisfaction was highest in departments that had < 25 RTs in the department and in which the manager practiced participative decision making. These findings offer guidance for organizing optimal work environments for RTs.

Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening

PubMed Central

2011-01-01

Background Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Discussion Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Summary Our proposal to augment IDM and SDM approaches with libertarian paternalism strategies is intended to guide patients toward a better decision about testing while maintaining personal freedom of choice. While PSA screening remains controversial and evidence conflicting, a libertarian-paternalism influenced approach to decision making can help prevent the overdiagnosis and overtreatment of prostate cancer. PMID:21510865

Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening.

PubMed

Wheeler, David C; Szymanski, Konrad M; Black, Amanda; Nelson, David E

2011-04-21

Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Our proposal to augment IDM and SDM approaches with libertarian paternalism strategies is intended to guide patients toward a better decision about testing while maintaining personal freedom of choice. While PSA screening remains controversial and evidence conflicting, a libertarian-paternalism influenced approach to decision making can help prevent the overdiagnosis and overtreatment of prostate cancer.

Moral decision-making and theory of mind in patients with idiopathic Parkinson's disease.

PubMed

Rosen, Jan B; Brand, Matthias; Polzer, Christin; Ebersbach, Georg; Kalbe, Elke

2013-09-01

Cognitive impairments in theory of mind (ToM), executive processing, and decision-making are frequent and highly relevant symptoms in patients with Parkinson's disease (PD). These functions have been related to moral decision-making. Their association to moral decision-making in PD, however, has not been studied yet. It was hypothesized that moral decisions in patients with PD differ from those in healthy control participants, and that more egoistic decisions are related to ToM as well as executive dysfunctions in patients with PD. Nineteen patients with PD and 20 healthy control participants were examined with an everyday moral decision-making task, comprised of 10 low and 10 high emotional forced-choice moral dilemma short stories with egoistic and altruistic options. All participants received an elaborate neuropsychological test battery. Electrodermal skin conductance responses were recorded to examine possible unconscious emotional reactions during moral decision-making. The groups performed comparably in total scores of moral decision-making. Although ToM did not differ between groups, it was inversely related to altruistic moral decisions in the healthy control group, but not in patients with PD. Executive functions were not related to moral decision-making. No differences were found for skin conductance responses, yet they differed from zero in both groups. Our findings indicate that moral decisions do not differ between patients with PD and healthy control participants. However, different underlying processes in both groups can be presumed. While healthy control participants seem to apply ToM to permit egoistic moral decisions in low emotional dilemmas, patients with PD seem to decide independently from ToM. These mechanisms as well as neuropsychological and neurophysiological correlates are discussed.

Decision making in the ageing brain: changes in affective and motivational circuits.

PubMed

Samanez-Larkin, Gregory R; Knutson, Brian

2015-05-01

As the global population ages, older decision makers will be required to take greater responsibility for their own physical, psychological and financial well-being. With this in mind, researchers have begun to examine the effects of ageing on decision making and associated neural circuits. A new 'affect-integration-motivation' (AIM) framework may help to clarify how affective and motivational circuits support decision making. Recent research has shed light on whether and how ageing influences these circuits, providing an interdisciplinary account of how ageing can alter decision making.

Decision making in the ageing brain: Changes in affective and motivational circuits

PubMed Central

Samanez-Larkin, Gregory R.; Knutson, Brian

2017-01-01

As the global population ages, older decision makers will be required to take greater responsibility for their own physical, psychological and financial well-being. With this in mind, researchers have begun to examine the effects of ageing on decision making and associated neural circuits. A new “affect, integration, motivation” (or AIM) framework may help clarify how affective and motivational circuits support decision making. Recent research has shed light on whether and how ageing influences these circuits, providing an interdisciplinary account of how ageing can alter decision making. PMID:25873038

Cognitive Reflection, Decision Biases, and Response Times

PubMed Central

Alós-Ferrer, Carlos; Garagnani, Michele; Hügelschäfer, Sabine

2016-01-01

We present novel evidence on response times and personality traits in standard questions from the decision-making literature where responses are relatively slow (medians around half a minute or above). To this end, we measured response times in a number of incentivized, framed items (decisions from description) including the Cognitive Reflection Test, two additional questions following the same logic, and a number of classic questions used to study decision biases in probability judgments (base-rate neglect, the conjunction fallacy, and the ratio bias). All questions create a conflict between an intuitive process and more deliberative thinking. For each item, we then created a non-conflict version by either making the intuitive impulse correct (resulting in an alignment question), shutting it down (creating a neutral question), or making it dominant (creating a heuristic question). For CRT questions, the differences in response times are as predicted by dual-process theories, with alignment and heuristic variants leading to faster responses and neutral questions to slower responses than the original, conflict questions. For decision biases (where responses are slower), evidence is mixed. To explore the possible influence of personality factors on both choices and response times, we used standard personality scales including the Rational-Experiential Inventory and the Big Five, and used them as controls in regression analysis. PMID:27713710

Cognitive Reflection, Decision Biases, and Response Times.

PubMed

Alós-Ferrer, Carlos; Garagnani, Michele; Hügelschäfer, Sabine

2016-01-01

We present novel evidence on response times and personality traits in standard questions from the decision-making literature where responses are relatively slow (medians around half a minute or above). To this end, we measured response times in a number of incentivized, framed items (decisions from description) including the Cognitive Reflection Test, two additional questions following the same logic, and a number of classic questions used to study decision biases in probability judgments (base-rate neglect, the conjunction fallacy, and the ratio bias). All questions create a conflict between an intuitive process and more deliberative thinking. For each item, we then created a non-conflict version by either making the intuitive impulse correct (resulting in an alignment question), shutting it down (creating a neutral question), or making it dominant (creating a heuristic question). For CRT questions, the differences in response times are as predicted by dual-process theories, with alignment and heuristic variants leading to faster responses and neutral questions to slower responses than the original, conflict questions. For decision biases (where responses are slower), evidence is mixed. To explore the possible influence of personality factors on both choices and response times, we used standard personality scales including the Rational-Experiential Inventory and the Big Five, and used them as controls in regression analysis.

Making assessments while taking repeated risks: a pattern of multiple response pathways.

PubMed

Pleskac, Timothy J; Wershbale, Avishai

2014-02-01

Beyond simply a decision process, repeated risky decisions also require a number of cognitive processes including learning, search and exploration, and attention. In this article, we examine how multiple response pathways develop over repeated risky decisions. Using the Balloon Analogue Risk Task (BART) as a case study, we show that 2 different response pathways emerge over the course of the task. The assessment pathway is a slower, more controlled pathway where participants deliberate over taking a risk. The 2nd pathway is a faster, more automatic process where no deliberation occurs. Results imply the slower assessment pathway is taken as choice conflict increases and that the faster automatic response is a learned response. Based on these results, we modify an existing formal cognitive model of decision making during the BART to account for these dual response pathways. The slower more deliberative response process is modeled with a sequential sampling process where evidence is accumulated to a threshold, while the other response is given automatically. We show that adolescents with conduct disorder and substance use disorder symptoms not only evaluate risks differently during the BART but also differ in the rate at which they develop the more automatic response. More broadly, our results suggest cognitive models of judgment decision making need to transition from treating observed decisions as the result of a single response pathway to the result of multiple response pathways that change and develop over time.

Patient participation in decision-making about cardiovascular preventive drugs - resistance as agency.

PubMed

Hultberg, Josabeth; Rudebeck, Carl Edvard

2017-09-01

The aim of the study was to describe and explore patient agency through resistance in decision-making about cardiovascular preventive drugs in primary care. Six general practitioners from the southeast of Sweden audiorecorded 80 consultations. From these, 28 consultations with proposals from GPs for cardiovascular preventive drug treatments were chosen for theme-oriented discourse analysis. The study shows how patients participate in decision-making about cardiovascular preventive drug treatments through resistance in response to treatment proposals. Passive modes of resistance were withheld responses and minimal unmarked acknowledgements. Active modes were to ask questions, contest the address of an inclusive we, present an identity as a non-drugtaker, disclose non-adherence to drug treatments, and to present counterproposals. The active forms were also found in anticipation to treatment proposals from the GPs. Patients and GPs sometimes displayed mutual renouncement of responsibility for decision-making. The decision-making process appeared to expand both beyond a particular phase in the consultations and beyond the single consultation. The recognition of active and passive resistance from patients as one way of exerting agency may prove valuable when working for patient participation in clinical practice, education and research about patient-doctor communication about cardiovascular preventive medication. We propose particular attentiveness to patient agency through anticipatory resistance, patients' disclosures of non-adherence and presentations of themselves as non-drugtakers. The expansion of the decision-making process beyond single encounters points to the importance of continuity of care. KEY POINTS Guidelines recommend shared decision-making about cardiovascular preventive treatment. We need an understanding of how this is accomplished in actual consultations.This paper describes how patient agency in decision-making is displayed through different forms of resistance to treatment proposals. •The decision-making process expands beyond particular phases in consultations and beyond single encounters, implying the importance of continuity of care. •Attentiveness to patient participation through resistance in treatment negotiations is warranted in clinical practice, research and education about prescribing communication.

Orbitofrontal cortex, emotional decision-making and response to cognitive behavioural therapy for psychosis

PubMed Central

Premkumar, Preethi; Fannon, Dominic; Sapara, Adegboyega; Peters, Emmanuelle R.; Anilkumar, Anantha P.; Simmons, Andrew; Kuipers, Elizabeth; Kumari, Veena

2015-01-01

Grey matter volume (GMV) in the orbitofrontal cortex (OFC) may relate to better response to cognitive behavioural therapy for psychosis (CBTp) because of the region׳s role in emotional decision-making and cognitive flexibility. This study aimed to determine the relation between pre-therapy OFC GMV or asymmetry, emotional decision-making and CBTp responsiveness. Emotional decision-making was measured by the Iowa Gambling task (IGT). Thirty patients received CBTp+standard care (CBTp+SC; 25 completers) for 6–8 months. All patients (before receiving CBTp) and 25 healthy participants underwent structural magnetic resonance imaging. Patients׳ symptoms were assessed before and after therapy. Pre-therapy OFC GMV was measured using a region-of-interest approach, and IGT performance was measured as overall learning, attention to reward, memory for past outcomes and choice consistency. Both these measures, were comparable between patient and healthy groups. In the CBTp+SC group, greater OFC GMV correlated with positive symptom improvement, specifically hallucinations and persecution. Greater rightward OFC asymmetry correlated with improvement in several negative and general psychopathology symptoms. Greater left OFC GMV was associated with lower IGT attention to reward. The findings suggest that greater OFC volume and rightward asymmetry, which maintain the OFC׳s function in emotional decision-making and cognitive flexibility, are beneficial for CBTp responsiveness. PMID:25659473

Psychophysiological arousal and inter‐ and intraindividual differences in risk‐sensitive decision making

PubMed Central

Scheibehenne, Benjamin; Clark, Luke

2016-01-01

Abstract The current study assessed peripheral responses during decision making under explicit risk, and tested whether intraindividual variability in choice behavior can be explained by fluctuations in peripheral arousal. Electrodermal activity (EDA) and heart rate (HR) were monitored in healthy volunteers (N = 68) during the Roulette Betting Task. In this task, participants were presented with risky gambles to bet on, with the chances of winning varying across trials. Hierarchical Bayesian analyses demonstrated that EDA and HR acceleration responses during the decision phase were sensitive to the chances of winning. Interindividual differences in this peripheral reactivity during risky decision making were related to trait sensitivity to punishment and trait sensitivity to reward. Moreover, trial‐by‐trial variation in EDA and HR acceleration responses predicted a small portion of intraindividual variability in betting choices. Our results show that psychophysiological responses are sensitive to explicit risk and can help explain intraindividual heterogeneity in choice behavior. PMID:26927730

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 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 relations between leadership, communication, decision making and overall crew performance. Implications of these findings for spaceflight and training for offshore installations will be discussed.

Decision Making in Action: Applying Research to Practice

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 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 relations between leadership, communication, decision making and overall crew performance. Implications of these findings for spaceflight and training for offshore installations will be discussed.

Conflict between Place and Response Navigation Strategies: Effects on Vicarious Trial and Error (VTE) Behaviors

ERIC Educational Resources Information Center

Schmidt, Brandy; Papale, Andrew; Redish, A. David; Markus, Etan J.

2013-01-01

Navigation can be accomplished through multiple decision-making strategies, using different information-processing computations. A well-studied dichotomy in these decision-making strategies compares hippocampal-dependent "place" and dorsal-lateral striatal dependent "response" strategies. A place strategy depends on the ability to flexibly respond…

24 CFR 576.404 - Conflicts of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... section who exercises or has exercised any functions or responsibilities with respect to activities assisted under the ESG program, or who is in a position to participate in a decision-making process or gain... withdrawn from his or her functions, responsibilities or the decision-making process with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2013 CFR

2013-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2014 CFR

2014-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

24 CFR 1003.606 - Conflict of interest.

Code of Federal Regulations, 2012 CFR

2012-04-01

... functions or responsibilities with respect to ICDBG activities assisted under this part or who are in a position to participate in a decision-making process or gain inside information with regard to such... his or her functions or responsibilities, or from the decision-making process, with reference to the...

24 CFR 585.503 - Conflict of interest.

Code of Federal Regulations, 2011 CFR

2011-04-01

... any functions or responsibilities with respect to assisted activities, or who is in a position to participate in a decision-making process or gain inside information with regard to such activities, may obtain... withdrawn from his or her functions or responsibilities, or the decision-making process, with respect to the...

Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder.

PubMed

De Bellis, Michael D; Wang, Lihong; Bergman, Sara R; Yaxley, Richard H; Hooper, Stephen R; Huettel, Scott A

2013-11-01

Neural mechanisms of decision-making and reward response in adolescent cannabis use disorder (CUD) are underexplored. Three groups of male adolescents were studied: CUD in full remission (n=15); controls with psychopathology without substance use disorder history (n=23); and healthy controls (n=18). We investigated neural processing of decision-making and reward under conditions of varying risk and uncertainty with the Decision-Reward Uncertainty Task while participants were scanned using functional magnetic resonance imaging. Abstinent adolescents with CUD compared to controls with psychopathology showed hyperactivation in one cluster that spanned left superior parietal lobule/left lateral occipital cortex/precuneus while making risky decisions that involved uncertainty, and hypoactivation in left orbitofrontal cortex to rewarded outcomes compared to no-reward after making risky decisions. Post hoc region of interest analyses revealed that both control groups significantly differed from the CUD group (but not from each other) during both the decision-making and reward outcome phase of the Decision-Reward Uncertainty Task. In the CUD group, orbitofrontal activations to reward significantly and negatively correlated with total number of individual drug classes the CUD patients experimented with prior to treatment. CUD duration significantly and negatively correlated with orbitofrontal activations to no-reward. The adolescent CUD group demonstrated distinctly different activation patterns during risky decision-making and reward processing (after risky decision-making) compared to both the controls with psychopathology and healthy control groups. These findings suggest that neural differences in risky decision-making and reward processes are present in adolescent addiction, persist after remission from first CUD treatment, and may contribute to vulnerability for adolescent addiction. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Distinct roles of dopamine and subthalamic nucleus in learning and probabilistic decision making.

PubMed

Coulthard, Elizabeth J; Bogacz, Rafal; Javed, Shazia; Mooney, Lucy K; Murphy, Gillian; Keeley, Sophie; Whone, Alan L

2012-12-01

Even simple behaviour requires us to make decisions based on combining multiple pieces of learned and new information. Making such decisions requires both learning the optimal response to each given stimulus as well as combining probabilistic information from multiple stimuli before selecting a response. Computational theories of decision making predict that learning individual stimulus-response associations and rapid combination of information from multiple stimuli are dependent on different components of basal ganglia circuitry. In particular, learning and retention of memory, required for optimal response choice, are significantly reliant on dopamine, whereas integrating information probabilistically is critically dependent upon functioning of the glutamatergic subthalamic nucleus (computing the 'normalization term' in Bayes' theorem). Here, we test these theories by investigating 22 patients with Parkinson's disease either treated with deep brain stimulation to the subthalamic nucleus and dopaminergic therapy or managed with dopaminergic therapy alone. We use computerized tasks that probe three cognitive functions-information acquisition (learning), memory over a delay and information integration when multiple pieces of sequentially presented information have to be combined. Patients performed the tasks ON or OFF deep brain stimulation and/or ON or OFF dopaminergic therapy. Consistent with the computational theories, we show that stopping dopaminergic therapy impairs memory for probabilistic information over a delay, whereas deep brain stimulation to the region of the subthalamic nucleus disrupts decision making when multiple pieces of acquired information must be combined. Furthermore, we found that when participants needed to update their decision on the basis of the last piece of information presented in the decision-making task, patients with deep brain stimulation of the subthalamic nucleus region did not slow down appropriately to revise their plan, a pattern of behaviour that mirrors the impulsivity described clinically in some patients with subthalamic nucleus deep brain stimulation. Thus, we demonstrate distinct mechanisms for two important facets of human decision making: first, a role for dopamine in memory consolidation, and second, the critical importance of the subthalamic nucleus in successful decision making when multiple pieces of information must be combined.

Avoidant decision making in social anxiety: the interaction of angry faces and emotional responses

PubMed Central

Pittig, Andre; Pawlikowski, Mirko; Craske, Michelle G.; Alpers, Georg W.

2014-01-01

Recent research indicates that angry facial expressions are preferentially processed and may facilitate automatic avoidance response, especially in socially anxious individuals. However, few studies have examined whether this bias also expresses itself in more complex cognitive processes and behavior such as decision making. We recently introduced a variation of the Iowa Gambling Task which allowed us to document the influence of task-irrelevant emotional cues on rational decision making. The present study used a modified gambling task to investigate the impact of angry facial expressions on decision making in 38 individuals with a wide range of social anxiety. Participants were to find out which choices were (dis-) advantageous to maximize overall gain. To create a decision conflict between approach of reward and avoidance of fear-relevant angry faces, advantageous choices were associated with angry facial expressions, whereas disadvantageous choices were associated with happy facial expressions. Results indicated that higher social avoidance predicted less advantageous decisions in the beginning of the task, i.e., when contingencies were still uncertain. Interactions with specific skin conductance responses further clarified that this initial avoidance only occurred in combination with elevated responses before choosing an angry facial expressions. In addition, an interaction between high trait anxiety and elevated responses to early losses predicted faster learning of an advantageous strategy. These effects were independent of intelligence, general risky decision-making, self-reported state anxiety, and depression. Thus, socially avoidant individuals who respond emotionally to angry facial expressions are more likely to show avoidance of these faces under uncertainty. This novel laboratory paradigm may be an appropriate analog for central features of social anxiety. PMID:25324792

Avoidant decision making in social anxiety: the interaction of angry faces and emotional responses.

PubMed

Pittig, Andre; Pawlikowski, Mirko; Craske, Michelle G; Alpers, Georg W

2014-01-01

Recent research indicates that angry facial expressions are preferentially processed and may facilitate automatic avoidance response, especially in socially anxious individuals. However, few studies have examined whether this bias also expresses itself in more complex cognitive processes and behavior such as decision making. We recently introduced a variation of the Iowa Gambling Task which allowed us to document the influence of task-irrelevant emotional cues on rational decision making. The present study used a modified gambling task to investigate the impact of angry facial expressions on decision making in 38 individuals with a wide range of social anxiety. Participants were to find out which choices were (dis-) advantageous to maximize overall gain. To create a decision conflict between approach of reward and avoidance of fear-relevant angry faces, advantageous choices were associated with angry facial expressions, whereas disadvantageous choices were associated with happy facial expressions. Results indicated that higher social avoidance predicted less advantageous decisions in the beginning of the task, i.e., when contingencies were still uncertain. Interactions with specific skin conductance responses further clarified that this initial avoidance only occurred in combination with elevated responses before choosing an angry facial expressions. In addition, an interaction between high trait anxiety and elevated responses to early losses predicted faster learning of an advantageous strategy. These effects were independent of intelligence, general risky decision-making, self-reported state anxiety, and depression. Thus, socially avoidant individuals who respond emotionally to angry facial expressions are more likely to show avoidance of these faces under uncertainty. This novel laboratory paradigm may be an appropriate analog for central features of social anxiety.

Understandings of the nature of science and decision making on science and technology-based issues

NASA Astrophysics Data System (ADS)

Bell, Randy Lee

Current reforms emphasize the development of scientific literacy as the principal goal of science education. The nature of science is considered a critical component of scientific literacy and is assumed to be an important factor in decision making on science and technology based issues. However, little research exists that delineates the role of the nature of science in decision making. The purpose of this investigation was to explicate the role of the nature of science in decision making on science and technology based issues and to delineate the reasoning and factors associated with these types of decisions. The 15-item, open-ended "Decision Making Questionnaire" (DMQ) based on four different scenarios concerning science and technology issues was developed to assess decision making. Twenty-one volunteer participants purposively selected from the faculty of geographically diverse universities completed the questionnaire and follow-up interviews. Participants were subsequently grouped according to their understandings of the nature of science, based on responses to a second open-ended questionnaire and follow-up interview. Profiles of each group's decision making were constructed, based on their previous responses to the DMQ and follow-up interviews. Finally, the two groups' decisions, decision making factors, and decision making strategies were compared. No differences were found between the decisions of the two groups, despite their disparate views of the nature of science. While their reasoning did not follow formal lines of argumentation, several influencing factors and general reasoning patterns were identified. Participants in both groups based their decisions primarily on personal values, morals/ethics, and social concerns. While all participants said they considered scientific evidence in their decision making, most did not require absolute "proof," even though Group B participants held more absolute conceptions of the nature of science. Overall, the nature of science did not figure prominently in either group's decisions. These findings contrast with the assumptions of the science education community and current reform efforts and call for a reexamination of the goals of nature of science instruction. Developing better decision making skills---even on science and technology based issues---may involve other factors, including more values-based instruction and attention to intellectual/moral development.

Using Covert Response Activation to Test Latent Assumptions of Formal Decision-Making Models in Humans.

PubMed

Servant, Mathieu; White, Corey; Montagnini, Anna; Burle, Borís

2015-07-15

Most decisions that we make build upon multiple streams of sensory evidence and control mechanisms are needed to filter out irrelevant information. Sequential sampling models of perceptual decision making have recently been enriched by attentional mechanisms that weight sensory evidence in a dynamic and goal-directed way. However, the framework retains the longstanding hypothesis that motor activity is engaged only once a decision threshold is reached. To probe latent assumptions of these models, neurophysiological indices are needed. Therefore, we collected behavioral and EMG data in the flanker task, a standard paradigm to investigate decisions about relevance. Although the models captured response time distributions and accuracy data, EMG analyses of response agonist muscles challenged the assumption of independence between decision and motor processes. Those analyses revealed covert incorrect EMG activity ("partial error") in a fraction of trials in which the correct response was finally given, providing intermediate states of evidence accumulation and response activation at the single-trial level. We extended the models by allowing motor activity to occur before a commitment to a choice and demonstrated that the proposed framework captured the rate, latency, and EMG surface of partial errors, along with the speed of the correction process. In return, EMG data provided strong constraints to discriminate between competing models that made similar behavioral predictions. Our study opens new theoretical and methodological avenues for understanding the links among decision making, cognitive control, and motor execution in humans. Sequential sampling models of perceptual decision making assume that sensory information is accumulated until a criterion quantity of evidence is obtained, from where the decision terminates in a choice and motor activity is engaged. The very existence of covert incorrect EMG activity ("partial error") during the evidence accumulation process challenges this longstanding assumption. In the present work, we use partial errors to better constrain sequential sampling models at the single-trial level. Copyright © 2015 the authors 0270-6474/15/3510371-15$15.00/0.

Game theory and neural basis of social decision making

PubMed Central

Lee, Daeyeol

2008-01-01

Decision making in a social group displays two unique features. First, humans and other animals routinely alter their behaviors in response to changes in their physical and social environment. As a result, the outcomes of decisions that depend on the behaviors of multiple decision makers are difficult to predict, and this requires highly adaptive decision-making strategies. Second, decision makers may have other-regarding preferences and therefore choose their actions to improve or reduce the well-beings of others. Recently, many neurobiological studies have exploited game theory to probe the neural basis of decision making, and found that these unique features of social decision making might be reflected in the functions of brain areas involved in reward evaluation and reinforcement learning. Molecular genetic studies have also begun to identify genetic mechanisms for personal traits related to reinforcement learning and complex social decision making, further illuminating the biological basis of social behavior. PMID:18368047

Evaluating the Intervention of an Ethics Class in Students' Ethical Decision-Making

ERIC Educational Resources Information Center

Walker, Marquita

2011-01-01

In this pilot study, the author evaluated the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to elicit changes in ethical decision-making by comparing students' cognitive and affective perceptions about…

Decision-Making in Elementary School-Age Children: Effects Upon Motor Learning and Self-Concept Development.

ERIC Educational Resources Information Center

Lydon, Mary C.; Cheffers, John T. F.

1984-01-01

This article reports on a study that sought to determine the effects of variable decision-making teaching models upon the development of body coordination and self-concept of elementary school children. Results indicated that level of motor skill achievement was maintained when students were given decision-making responsibility. (Author/DF)

Toward a Democratic Ethic of Curricular Decision-Making: A Guide for Educational Practitioners

ERIC Educational Resources Information Center

Simpson, Douglas J.; Jackson, Michael J. B.; Bunuan, Rommel L.; Chan, Yoke-Meng; Collins, B. Renee; King, Erica L.; Mosley, Linder K.

2004-01-01

In this article, the authors present a philosophical exploration of the import of a democratic ethic in making decisions concerning curricula. Specifically, the authors offer a guide for ethical decision making that is concerned with promoting fairness and acting on social justice principles. The ethical responsibilities of educators are explored,…

Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision model for Managing an Effective, Timely, and Balanced Response

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coleman, C. Norman; Blumenthal, Daniel J.

2013-05-01

Based on experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, a real-time, medical decision model is presented by which to make key health-related decisions given the central role of health and medical issues in such disasters. Focus is on response and recovery activities that are safe, timely, effective, and well-organized. This approach empowers on-site decision makers to make interim decisions without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Key features of this approach include ongoing assessment, consultation, information, and adaption to the changing conditions. This medical decision model presented ismore » compatible with the existing US National Response Framework structure.« less

Genital surgery for disorders of sex development: implementing a shared decision-making approach.

PubMed

Karkazis, Katrina; Tamar-Mattis, Anne; Kon, Alexander A

2010-08-01

Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear "best-choice" treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: (1) Set the stage and develop an appropriate team; (2) Establish preferences for information and roles in decision-making; (3) Perceive and address emotions; (4) Define concerns and values; (5) Identify options and present evidence; and (6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.

32 CFR 651.4 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... operational testers, producers, users, and disposers) into the decision-making process. (v) Initiate the... environmental perspective, and to ensure that these determinations are part of the Army decision process. (p... agency input into the decision-making process. (5) Ensure that NEPA analysis is prepared and staffed...

Response to Intervention Blueprints: District Level Edition

ERIC Educational Resources Information Center

Elliott, Judy; Morrison, Diane

2008-01-01

Response to Intervention (RtI) is the practice of providing high quality instruction and interventions matched to student need, monitoring progress frequently to make decisions about changes in instruction or goals and applying student response data to important educational decisions. RtI should be applied to decisions in general, remedial and…

Response to Intervention Blueprints: School Building Level Edition

ERIC Educational Resources Information Center

Kurns, Sharon; Tilly, W. David

2008-01-01

Response to Intervention (RtI) is the practice of providing high quality instruction and interventions matched to student need, monitoring progress frequently to make decisions about changes in instruction or goals and applying student response data to important educational decisions. RtI should be applied to decisions in general, remedial and…

A Decision Support System for effective use of probability forecasts

NASA Astrophysics Data System (ADS)

De Kleermaeker, Simone; Verkade, Jan

2013-04-01

Often, water management decisions are based on hydrological forecasts. These forecasts, however, are affected by inherent uncertainties. It is increasingly common for forecasting agencies to make explicit estimates of these uncertainties and thus produce probabilistic forecasts. Associated benefits include the decision makers' increased awareness of forecasting uncertainties and the potential for risk-based decision-making. Also, a stricter separation of responsibilities between forecasters and decision maker can be made. However, simply having probabilistic forecasts available is not sufficient to realise the associated benefits. Additional effort is required in areas such as forecast visualisation and communication, decision making in uncertainty and forecast verification. Also, revised separation of responsibilities requires a shift in institutional arrangements and responsibilities. A recent study identified a number of additional issues related to the effective use of probability forecasts. When moving from deterministic to probability forecasting, a dimension is added to an already multi-dimensional problem; this makes it increasingly difficult for forecast users to extract relevant information from a forecast. A second issue is that while probability forecasts provide a necessary ingredient for risk-based decision making, other ingredients may not be present. For example, in many cases no estimates of flood damage, of costs of management measures and of damage reduction are available. This paper presents the results of the study, including some suggestions for resolving these issues and the integration of those solutions in a prototype decision support system (DSS). A pathway for further development of the DSS is outlined.

Neural correlates of decision making with explicit information about probabilities and incentives in elderly healthy subjects.

PubMed

Labudda, Kirsten; Woermann, Friedrich G; Mertens, Markus; Pohlmann-Eden, Bernd; Markowitsch, Hans J; Brand, Matthias

2008-06-01

Recent functional neuroimaging and lesion studies demonstrate the involvement of the orbitofrontal/ventromedial prefrontal cortex as a key structure in decision making processes. This region seems to be particularly crucial when contingencies between options and consequences are unknown but have to be learned by the use of feedback following previous decisions (decision making under ambiguity). However, little is known about the neural correlates of decision making under risk conditions in which information about probabilities and potential outcomes is given. In the present study, we used functional magnetic resonance imaging to measure blood-oxygenation-level-dependent (BOLD) responses in 12 subjects during a decision making task. This task provided explicit information about probabilities and associated potential incentives. The responses were compared to BOLD signals in a control condition without information about incentives. In contrast to previous decision making studies, we completely removed the outcome phase following a decision to exclude the potential influence of feedback previously received on current decisions. The results indicate that the integration of information about probabilities and incentives leads to activations within the dorsolateral prefrontal cortex, the posterior parietal lobe, the anterior cingulate and the right lingual gyrus. We assume that this pattern of activation is due to the involvement of executive functions, conflict detection mechanisms and arithmetic operations during the deliberation phase of decisional processes that are based on explicit information.

Gunslingers, poker players, and chickens 1: Decision making under physical performance pressure in elite athletes.

PubMed

Parkin, Beth L; Warriner, Katie; Walsh, Vincent

2017-01-01

The cognitive skills required during sport are highly demanding; accurate decisions based on the processing of dynamic environments are made in a fraction of a second (Walsh, 2014). Optimal decision-making abilities are crucial for success in sporting competition (Bar-Eli et al., 2011; Kaya, 2014). Moreover, for the elite athlete, decision making is required under conditions of intense mental and physical pressure (Anshel and Wells, 2000), yet much of the work in this area has largely ignored the highly stressful context in which athletes operate. A number of studies have shown that conditions of elevated pressure influence athletes' decision quality (Kinrade et al., 2015; Smith et al., 2016), response times (Hepler, 2015; Smith et al., 2016) and risk taking (Pighin et al., 2015). However, almost all of this work has been undertaken in nonelite athletes and participants who do not routinely operate under conditions of high stress. Thus, there is very little known about the influence of pressure on decision making in elite athletes. This study investigated the influence of physical performance pressure on decision making in a sample of world-class elite athletes. This allowed an examination of whether findings from the previous work in nonelite athletes extend to those who routinely operate under conditions of high stress. How this work could be applied to improve insight and understanding of decision making among sport professionals is examined. We sought to introduce a categorization of decision making useful to practitioners in sport: gunslingers, poker players, and chickens. Twenty-three elite athletes who compete and have frequent success at an international level (including six Olympic medal winners) performed tasks relating to three categories of decision making under conditions of low and high physical pressure. Decision making under risk was measured with performance on the Cambridge Gambling Task (CGT; Rogers et al., 1999), decision making under uncertainty with the Balloon Analogue Risk Task (BART; Lejuez et al., 2002), and fast reactive responses and interference with the Stroop Task (Stroop, 1935). Performance pressures of physical exhaustion was induced via an exercise protocol consisting of intervals of maximal exertion undertaken on a watt bike. At a group level, under physical pressure elite athletes were faster to respond to control trials on the Stroop Task and to simple probabilistic choices on the CGT. Physical pressure was also found to increase risk taking for decisions where probability outcomes were explicit (on the CGT), but did not affect risk taking when probability outcomes were unknown (on the BART). There were no significant correlations in the degree to which individuals' responses changed under pressure across the three tasks, suggesting that elite athletes did not show consistent responses to physical pressure across measures of decision making. When assessing the applicability of results based on group averages to individual athletes, none of the sample showed an "average" response (within 1 SD of the mean) to pressure across all three decision-making tasks. There are three points of conclusion. First, an immediate scientific point that highlights a failure of transfer of work reported from nonelite athletes to elite athletes in the area of decision making under pressure. Second, a practical conclusion with respect to the application of this work to the elite sporting environment, which highlights the limitations of statistical approaches based on group averages and thus the beneficial use of individualized profiling in feedback sessions. Third, the application of this work in a sports setting is described, in particular the development and implementation of a decision-making taxonomy as a framework to conceptualize and communicate psychological skills among elite sporting professionals. © 2017 Elsevier B.V. All rights reserved.

Agency and responsibility in adolescent students: A challenge for the societies of tomorrow.

PubMed

Mameli, Consuelo; Molinari, Luisa; Passini, Stefano

2018-02-23

The literature in educational psychology converges on the idea that students should take an active and accountable position in their learning processes. Nevertheless, there is still a lack of research that has systematically put the constructs of agency and responsibility at the core of their interests. In this study, we explore whether good experiences at school - here conceptualized as the general level of basic needs fulfilment and interpersonal justice - impact on student agency and responsibility, which in turn are considered as possible mediators between a good educational experience and two outcome measures, that is, academic achievement and career decision-making self-efficacy. The study was held on a sample of 911 high school students equally distributed between males and females. Data were collected through the use of a questionnaire comprising six measures assessing students' basic psychological need fulfilment, interpersonal justice, agentic engagement, responsibility for learning, academic achievement, and career decision-making self-efficacy. Structural equation modelling indicated that basic needs fulfilment positively predicts agency, responsibility, academic achievement, and career decision-making self-efficacy. Interpersonal justice positively predicts responsibility. The indirect effect from basic psychological needs on career decision-making self-efficacy through the mediating effects of student agentic engagement and student responsibility was significant. The indirect effect from interpersonal justice on career decision-making self-efficacy through the mediating effect of student responsibility for learning was significant. These results are commented at the light of their implications for teacher practices, as they emphasize the importance of good experiences at school for promoting in students an active civic sense and a greater accountability. © 2018 The British Psychological Society.

On-line social decision making and antisocial behavior: some essential but neglected issues.

PubMed

Fontaine, Reid Griffith

2008-01-01

The last quarter century has witnessed considerable progress in the scientific study of social information processing (SIP) and aggressive behavior in children. SIP research has shown that social decision making in youth is particularly predictive of antisocial behavior, especially as children enter and progress through adolescence. In furtherance of this research, more sophisticated, elaborate models of on-line social decision making have been developed, by which various domains of evaluative judgment are hypothesized to account for both responsive decision making and behavior, as well as self-initiated, instrumental functioning. However, discussions of these models have neglected a number of key issues. In particular, the roles of nonconscious cognitive factors, learning and development, impulsivity and behavioral disinhibition, emotion, and other internal and external factors (e.g., pharmacological influences and audience effects) have been largely absent from scholarly writings. In response, this article introduces discussion of these factors and reviews their possible roles in on-line social decision making and antisocial behavior in youth.

Patients' participation in decision-making in the medical field--'projectification' of patients in a neoliberal framed healthcare system.

PubMed

Glasdam, Stinne; Oeye, Christine; Thrysoee, Lars

2015-10-01

This article focuses on patients' participation in decision-making in meetings with healthcare professionals in a healthcare system, based on neoliberal regulations and ideas. Drawing on two constructed empirical cases, primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a Foucauldian perspective. Patients' participation in decision-making can be seen as an offshoot of respect for patient autonomy. A treatment must be chosen, when patients consult physicians. From the perspective of patients, there is a tendency for healthcare professionals to supply the patients with the information that they think are necessary for them to make their own decision. But patients do not always want to be a 'customer' in the healthcare system; they want to be a patient, consulting an expert for help and advice, which creates resistance to some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A 'projectification' of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own situations from a humanistic perspective. © 2015 John Wiley & Sons Ltd.

Women's autonomy in decision making for health care in South Asia.

PubMed

Senarath, Upul; Gunawardena, Nalika Sepali

2009-04-01

This article aims to discuss women's autonomy in decision making on health care, and its determinants in 3 South Asian countries, using nationally representative surveys. Women's participation either alone or jointly in household decisions on their own health care was considered as an indicator of women's autonomy in decision making. The results revealed that decisions of women's health care were made without their participation in the majority of Nepal (72.7%) and approximately half of Bangladesh (54.3%) and Indian (48.5%) households. In Sri Lanka, decision making for contraceptive use was a collective responsibility in the majority (79.7%). Women's participation in decision making significantly increased with age, education, and number of children. Women who were employed and earned cash had a stronger say in household decision making than women who did not work or worked not for cash. Rural and poor women were less likely to be involved in decision making than urban or rich women.

Legal responsibilities of physicians when making participation decisions in athletes with cardiac disorders: Do guidelines provide a solid legal footing?

PubMed

Panhuyzen-Goedkoop, Nicole M; Smeets, Joep L R M

2014-08-01

Safe sports participation involves protecting athletes from injury and life-threatening situations. Preparticipation cardiovascular screening (PPS) in athletes is intended to prevent exercise-related sudden cardiac death by medical management of athletes at risk, which may include disqualification from sports participation. The screening physician relies on current guidelines and expert recommendations for management and decision-making. There is concern about false-positive screening results and wrongly grounding an athlete. Similarly, there is a concern about false-negative screening results and athletes participating with potentially lethal disorders. Who is legally responsible if an athlete suddenly dies after a proper PPS resulting in low risk? Several consensus documents based on expert opinion describe only a few lines on legal responsibilities in eligibility screening and disqualification decision-making in athletes. This article discusses legal responsibilities and concerns in eligibility decision-making for physicians. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

24 CFR 58.4 - Assumption authority.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., decision-making, and action that would otherwise apply to HUD under NEPA and other provisions of law that... environmental review, decision-making and action for programs authorized by the Native American Housing... separate decision regarding assumption of responsibilities for each of these Acts and communicate that...

Increasing independent decision-making skills of women with mental retardation in simulated interpersonal situations of abuse.

PubMed

Khemka, I

2000-09-01

The effectiveness of two decision-making training approaches in increasing independent decision-making skills of 36 women with mild mental retardation in response to hypothetical social interpersonal situations involving abuse was evaluated. Participants were randomly assigned to a control or one of two training conditions (a decision-making training approach that either addressed both cognitive and motivational aspects of decision-making or included only instruction on the cognitive aspect of decision-making). Although both approaches were effective relative to a control condition, the combined cognitive and motivational training approach was superior to the cognitive only training approach. The superiority of this approach was also reflected on a verbally presented generalization task requiring participants to respond to a decision-making situation involving abuse from their own perspective and on a locus of control scale that measured perceptions of control.

When irrelevance matters: Stimulus-response binding in decision making under uncertainty.

PubMed

Nett, Nadine; Bröder, Arndt; Frings, Christian

2015-11-01

According to distractor-based response retrieval (Frings, Rothermund, & Wentura, 2007), irrelevant information will be integrated with the response to the relevant stimuli and further, the immediate repetition of irrelevant information can retrieve the previously executed response thereby influencing responding to the current target (leading either to benefits or costs if the retrieved response is compatible or incompatible, respectively, to the currently demanded response). We analyzed whether this effect also holds for decisions rather than simple motoric reactions. The hypothesis was tested in 4 experiments in which participants had to decide as fast as possible which disease an imagined patient suffered from. The decisions were based on 2 cues; 1 did not give any hint for a disease (the irrelevant cue), whereas the other did (the relevant cue). We found a significant influence of repeating the irrelevant cue on decision behavior. That is, participants tended to repeat their decision if the irrelevant cue was repeated in the following decision situation. Thus, stimulus-response binding which typically is discussed in basic processes of perception and action has also implications for arguably more deliberative cognitive processes in decision making under uncertainty. (c) 2015 APA, all rights reserved).

The potential for shared decision-making and decision aids in rehabilitation medicine.

PubMed

van Til, Janine A; Drossaert, Constance H C; Punter, R Annemiek; Ijzerman, Maarten J

2010-06-01

Shared decision-making and the use of decision aids are increasingly promoted in various healthcare settings. The extent of their current use and potential in rehabilitation medicine is unknown. The aim of the present study was to explore the barriers to and facilitators of shared decision-making and use of decision aids in daily practice, and to explore the perceptions of physical and rehabilitation medicine (PRM) physicians toward them. A cross-sectional survey of 408 PRM physicians was performed (response rate 31%). PRM physicians expressed the highest levels of comfort with shared decision-making as opposed to paternalistic and informed decision-making. The majority reported that shared decision-making constituted their usual approach. The most important barriers to shared decision-making were cases in which the patient received conflicting recommendations and when the patient had difficulty accepting the disease. Key facilitators were the patient's trust in the PRM physician and the patient being knowledgeable about the disease and about treatment options. PRM physicians' attitudes towards the use of decision aids to inform patients were moderately positive. Shared decision-making appears to have great potential in the rehabilitation setting. Increasing the use of decision aids may contribute to the further implementation of shared decision-making.

Goal-Directed Decision Making with Spiking Neurons.

PubMed

Friedrich, Johannes; Lengyel, Máté

2016-02-03

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. Copyright © 2016 the authors 0270-6474/16/361529-18$15.00/0.

Goal-Directed Decision Making with Spiking Neurons

PubMed Central

Lengyel, Máté

2016-01-01

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. SIGNIFICANCE STATEMENT Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. PMID:26843636

Evaluating the Intervention of an Ethics' Class in Students' Ethical Decision-Making: A Summative Review

ERIC Educational Resources Information Center

Walker, Marquita

2013-01-01

This summative evaluation is the result of two years' of data reflecting the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to measure changes in ethical decision-making by comparing students' cognitive…

Contrasting models of driver behaviour in emergencies using retrospective verbalisations and network analysis.

PubMed

Banks, Victoria A; Stanton, Neville A

2015-01-01

Automated assistance in driving emergencies aims to improve the safety of our roads by avoiding or mitigating the effects of accidents. However, the behavioural implications of such systems remain unknown. This paper introduces the driver decision-making in emergencies (DDMiEs) framework to investigate how the level and type of automation may affect driver decision-making and subsequent responses to critical braking events using network analysis to interrogate retrospective verbalisations. Four DDMiE models were constructed to represent different levels of automation within the driving task and its effects on driver decision-making. Findings suggest that whilst automation does not alter the decision-making pathway (e.g. the processes between hazard detection and response remain similar), it does appear to significantly weaken the links between information-processing nodes. This reflects an unintended yet emergent property within the task network that could mean that we may not be improving safety in the way we expect. This paper contrasts models of driver decision-making in emergencies at varying levels of automation using the Southampton University Driving Simulator. Network analysis of retrospective verbalisations indicates that increasing the level of automation in driving emergencies weakens the link between information-processing nodes essential for effective decision-making.

Genetic Factors of Individual Differences in Decision Making in Economic Behavior: A Japanese Twin Study using the Allais Problem.

PubMed

Shikishima, Chizuru; Hiraishi, Kai; Yamagata, Shinji; Ando, Juko; Okada, Mitsuhiro

2015-01-01

Why does decision making differ among individuals? People sometimes make seemingly inconsistent decisions with lower expected (monetary) utility even when objective information of probabilities and reward are provided. It is noteworthy, however, that a certain proportion of people do not provide anomalous responses, choosing the alternatives with higher expected utility, thus appearing to be more "rational." We investigated the genetic and environmental influences on these types of individual differences in decision making using a classical Allais problem task. Participants were 1,199 Japanese adult twins aged 20-47. Univariate genetic analysis revealed that approximately a third of the Allais problem response variance was explained by genetic factors and the rest by environmental factors unique to individuals and measurement error. The environmental factor shared between families did not contribute to the variance. Subsequent multivariate genetic analysis clarified that decision making using the expected utility theory was associated with general intelligence and that the association was largely mediated by the same genetic factor. We approach the mechanism underlying two types of "rational" decision making from the perspective of genetic correlations with cognitive abilities.

Patient and provider perceptions of decision making about use of epidural analgesia during childbirth: a thematic analysis.

PubMed

Goldberg, Holly Bianca; Shorten, Allison

2014-01-01

This study examines the nature of differences in perceptions of decision making between patients and providers about use of epidural analgesia during labor. Thematic analysis was used to identify patterns in written survey responses from 14 patients, 13 labor nurses, and 7 obstetrician-gynecologists. Results revealed patients attempted to place themselves in an informed role in decision making and sought respect for their decisions. Some providers demonstrated paternalism and a tendency to steer patients in the direction of their own preferences. Nurses observed various pressures on decision making, reinforcing the importance of patients being supported to make an informed choice. Differences in perceptions suggest need for improvement in communication and shared decision-making practices related to epidural analgesia use in labor.

Decision making within a community provider organization.

PubMed

Berggren, Ingela; Carlstrom, Eric

2010-12-01

To explore community nurses' experiences of decision making within the community provider organization. Recent changes in health care with an increasing number of patients being cared for outside of institutions can put considerable pressure on the nurse with respect to decision making. In-depth interviews were performed with 6 registered nurses in two communities. The interviews were analysed by means of phenomenological hermeneutics. The community nurses' experiences of decision making were interpreted as spiders or octopuses, consultants and troubleshooters. The subthemes were; networking and structuring, responsibility, availability and knowledge, assessment power, information selection, avoiding rules and bypassing managers. In accordance with hermeneutical phenomenology, the findings were discussed and explained with reference to Ofstad's philosophy of freedom to make decisions. In their decision making, community nurses are committed to finding administrative solutions that satisfy patient needs.

45 CFR 1629.3 - Criteria for determining handling.

Code of Federal Regulations, 2010 CFR

2010-10-01

... relationships such as those which involve access to funds or other property or decision-making powers with... supervisory or decision-making responsibility involves factors in relationship to funds discussed in...

Couples’ reports of household decision-making and the utilization of maternal health services in Bangladesh

PubMed Central

Story, William T.; Burgard, Sarah A.

2012-01-01

This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service use focus on women’s reports; however, men are often involved in these decisions as well. Recently, studies have started to explore the association between health outcomes and reports of household decision-making from both husbands and wives as matched pairs. Many studies of household decision-making emphasize the importance of the wife alone making decisions; however, some have argued that joint decision-making between husbands and wives may yield better reproductive health outcomes than women making decisions without input or agreement from their partners. Husbands’ involvement in decision-making is particularly important in Bangladesh because men often dominate household decisions related to large, health-related purchases. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and skilled delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives give concordant responses about who makes household decisions since discordant reports about who makes these decisions are negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and skilled delivery care. Finally, associations between household decision-making arrangements and health service utilization vary depending on whose report is used and the type of health service utilized. PMID:23068556

Couples' reports of household decision-making and the utilization of maternal health services in Bangladesh.

PubMed

Story, William T; Burgard, Sarah A

2012-12-01

This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service utilization focus on women's reports; however, men are often involved in these decisions as well. Recently, studies have started to explore the association between health outcomes and reports of household decision-making from both husbands and wives as matched pairs. Many studies of household decision-making emphasize the importance of the wife alone making decisions; however, some have argued that joint decision-making between husbands and wives may yield better reproductive health outcomes than women making decisions without input or agreement from their partners. Husbands' involvement in decision-making is particularly important in Bangladesh because men often dominate household decisions related to large, health-related purchases. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and skilled delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives give concordant responses about who makes household decisions since discordant reports about who makes these decisions are negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and skilled delivery care. Finally, associations between household decision-making arrangements and health service utilization vary depending on whose report is used and the type of health service utilized. Copyright © 2012 Elsevier Ltd. All rights reserved.

Parents' information needs and influential factors when making decisions about TNF-α inhibitors.

PubMed

Lipstein, Ellen A; Lovell, Daniel J; Denson, Lee A; Kim, Sandra C; Spencer, Charles; Britto, Maria T

2016-09-15

Parents struggle when making treatment decisions for children with arthritis or other chronic conditions. Understanding their decision-making process is an essential step towards improving the decision-making experience. The objective of this study was to describe parents' information needs and the influences on their decision making about treatment with TNF-α inhibitors. Survey domains were developed based on qualitative data and cognitive interviewing. We mailed the survey to parents of children with juvenile idiopathic arthritis or inflammatory bowel disease who had initiated treatment with TNF-α inhibitors in the prior 2 years. Data were analyzed using descriptive and non-parametric statistics. Survey response rate was 54.9 %. Each item had <2 % missing responses. Parents used an array of information sources when deciding about treatment with TNF-α inhibitors. Resources other than their child's specialist were most often used to increase confidence in parents' decisions or because they wanted to know more about other people's experiences being treated with TNF-α inhibitors, rather than due to a lack of understanding. All but two (cost and route of administration) of the influential decision factors were very or extremely important to the majority of participants with factors related to long-term side effects, treatment efficacy, and disease impact being most important. This study describes parents' information needs and influential factors in treatment decision making. Results suggest that future work should be aimed at helping families weigh risks and benefits, such as through decision support interventions, as well as developing opportunities to include people beyond the family and physician in the decision-making process.

Self-esteem and risky decision-making: an ERP study.

PubMed

Yang, Juan; Dedovic, Katarina; Zhang, Qinglin

2010-12-01

Self-esteem, a value one places on oneself, influences one's cognitive, emotional and behavioral responses across various situations. In the case of risky decision-making, high self-esteem (SE) individuals rely on their positive self-views and tend to be less defensive in response to a risky task; low SE individuals, on the contrary, tend to have fewer accessible positive resources and thus, are more prone to risk-aversion. While past studies have provided evidence for a link between self-esteem and a behaviorally-risky response, no study has explored the relation between self-esteem and the electrophysiological correlates of risky response. Therefore, the current study investigated the correlates of risky decision-making in high SE compared to low SE participants using event-related potentials (ERP) technology in 28 undergraduate students playing a blackjack game. The results showed that there was no difference between the high SE participants and the low SE participants with respect to the behavioral assessments of the risk-taking decision-making. However, for the electrophysiological data, we observed that the amplitude of P2 (150-300 ms) was more positive in the high SE participants compared to the low SE participants over the central-posterior scalp region. Dipole source analysis indicated that this positive component was generated in posterior cingulate cortex (PCC). These findings suggest that the high SE participants experienced more emotional signals than the low SE participants during decision-making.

Orbitofrontal cortex, emotional decision-making and response to cognitive behavioural therapy for psychosis.

PubMed

Premkumar, Preethi; Fannon, Dominic; Sapara, Adegboyega; Peters, Emmanuelle R; Anilkumar, Anantha P; Simmons, Andrew; Kuipers, Elizabeth; Kumari, Veena

2015-03-30

Grey matter volume (GMV) in the orbitofrontal cortex (OFC) may relate to better response to cognitive behavioural therapy for psychosis (CBTp) because of the region׳s role in emotional decision-making and cognitive flexibility. This study aimed to determine the relation between pre-therapy OFC GMV or asymmetry, emotional decision-making and CBTp responsiveness. Emotional decision-making was measured by the Iowa Gambling task (IGT). Thirty patients received CBTp+standard care (CBTp+SC; 25 completers) for 6-8 months. All patients (before receiving CBTp) and 25 healthy participants underwent structural magnetic resonance imaging. Patients׳ symptoms were assessed before and after therapy. Pre-therapy OFC GMV was measured using a region-of-interest approach, and IGT performance was measured as overall learning, attention to reward, memory for past outcomes and choice consistency. Both these measures, were comparable between patient and healthy groups. In the CBTp+SC group, greater OFC GMV correlated with positive symptom improvement, specifically hallucinations and persecution. Greater rightward OFC asymmetry correlated with improvement in several negative and general psychopathology symptoms. Greater left OFC GMV was associated with lower IGT attention to reward. The findings suggest that greater OFC volume and rightward asymmetry, which maintain the OFC׳s function in emotional decision-making and cognitive flexibility, are beneficial for CBTp responsiveness. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Parents and end-of-life decision-making for their child: roles and responsibilities.

PubMed

Sullivan, Jane; Gillam, Lynn; Monagle, Paul

2015-09-01

Whether parents want to be and should be the decision-maker for their child in end-of-life matters are contested clinical and ethical questions. Previous research outcomes are equivocal. A qualitative interview method was used to examine the views and experiences of 25 bereaved parents in end-of-life decision-making for their child. Data were analysed thematically. Three types of decision-making roles were identified: self-determined, guided (both involving active decision-making) and acquiescent (passive).The majority of parents had been active in the decision-making process for their child. They perceived themselves as the ultimate end-of-life decision-maker. This was perceived as part of their parental responsibility. A minority of parents did not consider that they had been an active, ultimate decision-maker. Generally, parents in the self-determined and guided groups reported no negative consequences from their decision-making involvement. Importantly, parents in the acquiescent group described their experience as difficult at the time and subsequently, although not all difficulties related directly to decision-making. Parents considered that in principle parents should be the end-of-life decision-maker for their child, but understood personal characteristics and preference could prevent some parents from taking this role. This study unequivocally supports parents' desire to fulfil the end-of-life decision-making role. It provides a nuanced understanding of parents' roles and contributes evidence for the ethical position that parents should be the end-of-life decision-makers for their child, unless not in the child's best interests. On the whole, parents want this role and can manage its consequences. Indeed, not being the end-of-life decision-maker could be detrimental to parents' well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Limbic Justice—Amygdala Involvement in Immediate Rejection in the Ultimatum Game

PubMed Central

Fransson, Peter; Petrovic, Predrag; Johannesson, Magnus; Ingvar, Martin

2011-01-01

Imaging studies have revealed a putative neural account of emotional bias in decision making. However, it has been difficult in previous studies to identify the causal role of the different sub-regions involved in decision making. The Ultimatum Game (UG) is a game to study the punishment of norm-violating behavior. In a previous influential paper on UG it was suggested that frontal insular cortex has a pivotal role in the rejection response. This view has not been reconciled with a vast literature that attributes a crucial role in emotional decision making to a subcortical structure (i.e., amygdala). In this study we propose an anatomy-informed model that may join these views. We also present a design that detects the functional anatomical response to unfair proposals in a subcortical network that mediates rapid reactive responses. We used a functional MRI paradigm to study the early components of decision making and challenged our paradigm with the introduction of a pharmacological intervention to perturb the elicited behavioral and neural response. Benzodiazepine treatment decreased the rejection rate (from 37.6% to 19.0%) concomitantly with a diminished amygdala response to unfair proposals, and this in spite of an unchanged feeling of unfairness and unchanged insular response. In the control group, rejection was directly linked to an increase in amygdala activity. These results allow a functional anatomical detection of the early neural components of rejection associated with the initial reactive emotional response. Thus, the act of immediate rejection seems to be mediated by the limbic system and is not solely driven by cortical processes, as previously suggested. Our results also prompt an ethical discussion as we demonstrated that a commonly used drug influences core functions in the human brain that underlie individual autonomy and economic decision making. PMID:21559322

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. © 2016 Royal College of Physicians.

Parents' roles in decision making for children with cancer in the first year of cancer treatment.

PubMed

Mack, Jennifer W; Wolfe, Joanne; Cook, E Francis; Grier, Holcombe E; Cleary, Paul D; Weeks, Jane C

2011-05-20

To evaluate the extent to which parents of children with cancer are involved in decision making in the ways they prefer during the first year of treatment. We conducted a cross-sectional survey of 194 parents of children with cancer (response rate, 70%) in their first year of cancer treatment at the Dana-Farber Cancer Institute and Children's Hospital (Boston, MA) and the children's physicians. We measured parents' preferred and actual roles in decision making and physician perceptions of parents' preferred roles. Most parents (127 of 192; 66%) wanted to share responsibility for decision making with their children's physician. Although most parents (122 of 192; 64%) reported that they had their preferred role in decision making, those who did not tended to have more passive roles than they wished (47 of 70; 67%; P < .001). Parents were no more likely to hold their ideal roles in decision making when the physician accurately identified the parents' preferred role (odds ratio [OR], 1.04; P = .92). Parents were less likely to hold more passive roles than they wished in decision making when they felt that physician communication (OR, 0.39; P = .04) and information received (OR, 0.45; P = .04) had been of high quality. Parents who held more passive roles than they wished in decision making were less likely to trust their physicians' judgments (OR, 0.46; P = .03). Most parents of children in their first year of cancer treatment participate in decision making to the extent that they wish; although, nearly one fourth hold more passive roles than desired. High-quality physician communication is associated with attainment of one's preferred role.

Do social norms play a role in explaining involvement in medical decision-making?

PubMed

Brabers, Anne E M; van Dijk, Liset; Groenewegen, Peter P; de Jong, Judith D

2016-12-01

Patients' involvement in medical decision-making is crucial to provide good quality of care that is respectful of, and responsive to, patients' preferences, needs and values. Whether people want to be involved in medical decision-making is associated with individual patient characteristics, and health status. However, the observation of differences in whether people want to be involved does not in itself provide an explanation. Insight is necessary into mechanisms that explain people's involvement. This study aims to examine one mechanism, namely social norms. We make a distinction between subjective norms, that is doing what others think one ought to do, and descriptive norms, doing what others do. We focus on self-reported involvement in medical decision-making. A questionnaire was sent to members of the Dutch Health Care Consumer Panel in May 2015 (response 46%; N = 974). A regression model was used to estimate the relationship between socio-demographics, social norms and involvement in medical decision-making. In line with our hypotheses, we observed that the more conservative social norms are, the less people are involved in medical decision-making. The effects for both types of norms were comparable. This study indicates that social norms play a role as a mechanism to explain involvement in medical decision-making. Our study offers a first insight into the possibility that the decision to be involved in medical decision-making is not as individual as it at first seems; someone's social context also plays a role. Strategies aimed at emphasizing patient involvement have to address this social context. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Gunslingers, poker players, and chickens 2: Decision-making under physical performance pressure in subelite athletes.

PubMed

Parkin, Beth L; Walsh, Vincent

2017-01-01

Having investigated the influence of acute physical exhaustion on decision-making in world-class elite athletes in Parkin et al. (2017), here a similar method is applied to subelite athletes. These subelite athletes were enrolled on a Team GB talent development program and were undergoing training for possible Olympic competition in 4-8 years. They differ from elite athletes examined previously according to expertise and age. While considered elite (Swann et al., 2015), the subelite athletes had approximately 8 years fewer sporting experience and were yet to obtain sustained success on the international stage. Additionally, the average age of the subelite sample is 20 years; thus, they are still undergoing the behavioral, cognitive, and neuronal changes that occur during the transition from late adolescence to young adulthood (Blakemore and Robbins, 2012). Previous work has used broad definitions of elite status in sport, and as such overlooked different categories within the spectrum of elite athletes (Swann et al., 2015). Therefore it is important to consider subelite athletes as a discrete point on the developmental trajectory of elite sporting expertise. This work aims to investigate the influence of physical pressure on key indicators of decision-making in subelite athletes. It forms part of a wider project examining decision-making across different stages of the developmental trajectory in elite sport. In doing so, it aims to examine how to apply and develop psychological insights useful to an elite sporting environment. 32 subelite athletes (18 males, mean age: 20 years) participated in the study. Performance across three categories of decision-making was assessed under conditions of low and high physical pressure. Decision-making under risk was measured with performance of the Cambridge Gambling Task (CGT; Rogers et al., 1999), decision-making under uncertainty with the Balloon Analogue Risk Task (BART; Lejuez et al., 2002), and fast reactive responses and inhibition via the Stop Signal Reaction Time Task (SSRT; Logan, 1994). Physical exhaustion was induced via intervals of maximal exertion exercise on a wattbike. Under pressure subelite athletes showed increased risk taking for both decisions where probability outcomes were explicit (on the CGT), and those where probability outcomes were unknown (on the BART). Despite making quicker decisions under pressure, with fewer errors, on the CGT, subelite athletes showed a reduced ability to optimally adjust betting behavior according to reward and loss contingencies. Fast reactive responses to perceptual stimuli and response inhibition did not change as a result of physical pressure. Individual responses to pressure showed a negative correlation in that a decrease in reaction times on the SSRT Task under pressure was associated with an increase in risk taking on the BART. When assessing the applicability of results based on group averages to individual athletes, 17% of the sample showed an "average" response (within 1 SD of the mean) to pressure across all three decision-making tasks. Indicators of decision-making in a sample of subelite athletes are influenced by physical pressure, with a shift toward increased indiscriminate risk taking. The influence that physical pressure has on decision-making was different to that observed in world-class elite athletes; this highlights the importance of distinguishing between athletes at the elite level (Swann et al., 2015). The application of this work to a novel subgroup of elite athletes, including the implementation of a decision-making taxonomy, is discussed. © 2017 Elsevier B.V. All rights reserved.

Self-Regulation Principles Underlying Risk Perception and Decision Making within the Context of Genomic Testing

PubMed Central

Cameron, Linda D.; Biesecker, Barbara Bowles; Peters, Ellen; Taber, Jennifer M.; Klein, William M. P.

2017-01-01

Advances in theory and research on self-regulation and decision-making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk-related decisions. We examine how self-regulation theory can be applied to inform our understanding of decision-making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life-altering decisions. After presenting key principles of self-regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self-regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self-regulation theory. PMID:29225669

Self-Regulation Principles Underlying Risk Perception and Decision Making within the Context of Genomic Testing.

PubMed

Cameron, Linda D; Biesecker, Barbara Bowles; Peters, Ellen; Taber, Jennifer M; Klein, William M P

2017-05-01

Advances in theory and research on self-regulation and decision-making processes have yielded important insights into how cognitive, emotional, and social processes shape risk perceptions and risk-related decisions. We examine how self-regulation theory can be applied to inform our understanding of decision-making processes within the context of genomic testing, a clinical arena in which individuals face complex risk information and potentially life-altering decisions. After presenting key principles of self-regulation, we present a genomic testing case example to illustrate how principles related to risk representations, approach and avoidance motivations, emotion regulation, defensive responses, temporal construals, and capacities such as numeric abilities can shape decisions and psychological responses during the genomic testing process. We conclude with implications for using self-regulation theory to advance science within genomic testing and opportunities for how this research can inform further developments in self-regulation theory.

Beyond shared decision-making: Collaboration in the age of recovery from serious mental illness.

PubMed

Treichler, Emily B H; Spaulding, William D

2017-01-01

The role that people with serious mental illness (SMI) play in making decisions about their own treatment and rehabilitation is attracting increasing attention and scrutiny. This attention is embedded in a broader social/consumer movement, the recovery movement , whose agenda includes extensive reform of the mental health system and advancing respect for the dignity and autonomy of people with SMI. Shared decision-making (SDM) is an approach for enhancing consumer participation in health-care decision-making. SDM translates straightforwardly to specific clinical procedures that systematically identify domains of decision-making and guide the practitioner and consumer through making the decisions. In addition, Collaborative decision-making (CDM) is a set of guiding principles that avoids the connotations and limitations of SDM. CDM looks broadly at the range of decisions to be made in mental health care, and assigns consumers and providers equal responsibility and power in the decision-making process. It recognizes the diverse history, knowledge base, and values of each consumer by assuming patients can lead and contribute to decision-making, contributing both value-based information and technical information. This article further discusses the importance of CDM for people with SMI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Rationality in the Academy: Why Responsibility Center Budgeting Is a Wrong Step Down the Wrong Road.

ERIC Educational Resources Information Center

Adams, E. M.

1997-01-01

Responsibility Center Budgeting/Management in higher education places at the heart of the university a mode of rationality in decision making that subverts educational policy and weakens the institution's ability for corrective cultural criticism. Academic leaders should make academic and research decisions based on students' and society's…

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

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stern, Marc J., E-mail: mjstern@vt.ed; Predmore, S. Andrew, E-mail: sapredmo@vt.ed

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 withmore » 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.« less

Informed Decision-Making in the Context of Prenatal Chromosomal Microarray.

PubMed

Baker, Jessica; Shuman, Cheryl; Chitayat, David; Wasim, Syed; Okun, Nan; Keunen, Johannes; Hofstedter, Renee; Silver, Rachel

2018-03-07

The introduction of chromosomal microarray (CMA) into the prenatal setting has involved considerable deliberation due to the wide range of possible outcomes (e.g., copy number variants of uncertain clinical significance). Such issues are typically discussed in pre-test counseling for pregnant women to support informed decision-making regarding prenatal testing options. This research study aimed to assess the level of informed decision-making with respect to prenatal CMA and the factor(s) influencing decision-making to accept CMA for the selected prenatal testing procedure (i.e., chorionic villus sampling or amniocentesis). We employed a questionnaire that was adapted from a three-dimensional measure previously used to assess informed decision-making with respect to prenatal screening for Down syndrome and neural tube defects. This measure classifies an informed decision as one that is knowledgeable, value-consistent, and deliberated. Our questionnaire also included an optional open-ended question, soliciting factors that may have influenced the participants' decision to accept prenatal CMA; these responses were analyzed qualitatively. Data analysis on 106 participants indicated that 49% made an informed decision (i.e., meeting all three criteria of knowledgeable, deliberated, and value-consistent). Analysis of 59 responses to the open-ended question showed that "the more information the better" emerged as the dominant factor influencing both informed and uninformed participants' decisions to accept prenatal CMA. Despite learning about the key issues in pre-test genetic counseling, our study classified a significant portion of women as making uninformed decisions due to insufficient knowledge, lack of deliberation, value-inconsistency, or a combination of these three measures. Future efforts should focus on developing educational approaches and counseling strategies to effectively increase the rate of informed decision-making among women offered prenatal CMA.

Philosophy versus Student Need? A Reply to Smith and Hilton.

ERIC Educational Resources Information Center

Rainforth, Beverly

1994-01-01

This response to Smith and Hilton (1994) suggests that those authors reject philosophical bases for decision making regarding program design for students with mental retardation while actually proposing their own philosophical base for such decision making. The importance of philosophy in guiding decisions and practice over the last several…

Legal Considerations in Clinical Decision Making.

ERIC Educational Resources Information Center

Ursu, Samuel C.

1992-01-01

Discussion of legal issues in dental clinical decision making looks at the nature and elements of applicable law, especially malpractice, locus of responsibility, and standards of care. Greater use of formal decision analysis in clinical dentistry and better research on diagnosis and treatment are recommended, particularly in light of increasing…

The Space Shuttle Disaster: Ethical Issues in Organizational Decision-Making.

ERIC Educational Resources Information Center

Kramer, Ronald C.; Jaksa, James A.

Arguing that the issue of organizational decision making and bureaucratic responsibility in the use of technologies with potential for creating social harm should concern everyone, this paper explores the ethical issues raised by organizational decisions concerning the launch of the space shuttle "Challenger." The paper first describes a…

The Adoption Alternative for Pregnant Adolescents: Decision Making, Consequences, and Policy Implications.

ERIC Educational Resources Information Center

Sobol, Michael P.; Daly, Kerry J.

1992-01-01

Reviews issues surrounding adoption as an option for resolving teen crisis pregnancies. Examines the decision-making processes and social psychological consequences of adoption as a distinct phenomenon, including adoption rates and characteristics, factors influencing the adoption decision, birth mother response to adoption placement, and social…

A decision framework for coordinating bioterrorism planning: lessons from the BioNet program.

PubMed

Manley, Dawn K; Bravata, Dena M

2009-01-01

Effective disaster preparedness requires coordination across multiple organizations. This article describes a detailed framework developed through the BioNet program to facilitate coordination of bioterrorism preparedness planning among military and civilian decision makers. The authors and colleagues conducted a series of semistructured interviews with civilian and military decision makers from public health, emergency management, hazardous material response, law enforcement, and military health in the San Diego area. Decision makers used a software tool that simulated a hypothetical anthrax attack, which allowed them to assess the effects of a variety of response actions (eg, issuing warnings to the public, establishing prophylaxis distribution centers) on performance metrics. From these interviews, the authors characterized the information sources, technologies, plans, and communication channels that would be used for bioterrorism planning and responses. The authors used influence diagram notation to describe the key bioterrorism response decisions, the probabilistic factors affecting these decisions, and the response outcomes. The authors present an overview of the response framework and provide a detailed assessment of two key phases of the decision-making process: (1) pre-event planning and investment and (2) incident characterization and initial responsive measures. The framework enables planners to articulate current conditions; identify gaps in existing policies, technologies, information resources, and relationships with other response organizations; and explore the implications of potential system enhancements. Use of this framework could help decision makers execute a locally coordinated response by identifying the critical cues of a potential bioterrorism event, the information needed to make effective response decisions, and the potential effects of various decision alternatives.

A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

PubMed

Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona

2018-02-01

Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

Patient participation in decision-making about cardiovascular preventive drugs – resistance as agency

PubMed Central

Hultberg, Josabeth; Rudebeck, Carl Edvard

2017-01-01

Objective The aim of the study was to describe and explore patient agency through resistance in decision-making about cardiovascular preventive drugs in primary care. Design Six general practitioners from the southeast of Sweden audiorecorded 80 consultations. From these, 28 consultations with proposals from GPs for cardiovascular preventive drug treatments were chosen for theme-oriented discourse analysis. Results The study shows how patients participate in decision-making about cardiovascular preventive drug treatments through resistance in response to treatment proposals. Passive modes of resistance were withheld responses and minimal unmarked acknowledgements. Active modes were to ask questions, contest the address of an inclusive we, present an identity as a non-drugtaker, disclose non-adherence to drug treatments, and to present counterproposals. The active forms were also found in anticipation to treatment proposals from the GPs. Patients and GPs sometimes displayed mutual renouncement of responsibility for decision-making. The decision-making process appeared to expand both beyond a particular phase in the consultations and beyond the single consultation. Conclusions The recognition of active and passive resistance from patients as one way of exerting agency may prove valuable when working for patient participation in clinical practice, education and research about patient–doctor communication about cardiovascular preventive medication. We propose particular attentiveness to patient agency through anticipatory resistance, patients’ disclosures of non-adherence and presentations of themselves as non-drugtakers. The expansion of the decision-making process beyond single encounters points to the importance of continuity of care. KEY POINTS Guidelines recommend shared decision-making about cardiovascular preventive treatment. We need an understanding of how this is accomplished in actual consultations.This paper describes how patient agency in decision-making is displayed through different forms of resistance to treatment proposals. •The decision-making process expands beyond particular phases in consultations and beyond single encounters, implying the importance of continuity of care. •Attentiveness to patient participation through resistance in treatment negotiations is warranted in clinical practice, research and education about prescribing communication. PMID:28277056

Fairness decisions in response to emotions: a functional MRI study among criminal justice-involved boys with conduct disorder

PubMed Central

Lelieveld, Gert-Jan; Aghajani, Moji; Boon, Albert E.; van der Wee, Nic J. A.; Popma, Arne; Vermeiren, Robert R. J. M.; Colins, Olivier F.

2016-01-01

Research suggests that individuals with conduct disorder (CD) are marked by social impairments, such as difficulties in processing the affective reactions of others. Little is known, though, about how they make decisions during social interactions in response to emotional expressions of others. In this study, we therefore investigated the neural mechanisms underlying fairness decisions in response to communicated emotions of others in aggressive, criminal justice-involved boys with CD (N = 32) compared with typically developing (TD) boys (N = 33), aged 15–19 years. Participants received written emotional responses (angry, disappointed or happy) from peers in response to a previous offer and then had to make fairness decisions in a version of the Dictator Game. Behavioral results showed that CD boys did not make differential fairness decisions in response to the emotions, whereas the TD boys did show a differentiation and also responded more unfair to happy reactions than the CD boys. Neuroimaging results revealed that when receiving happy vs disappointed and angry reactions, the CD boys showed less activation than the TD boys in the temporoparietal junction and supramarginal gyrus, regions involved in perspective taking and attention. These results suggest that boys with CD have difficulties with processing explicit emotional cues from others on behavioral and neural levels. PMID:26926604

Intra-household relations and treatment decision-making for childhood illness: a Kenyan case study.

PubMed

Molyneux, C S; Murira, G; Masha, J; Snow, R W

2002-01-01

This study, conducted on the Kenyan coast, assesses the effect of intra-household relations on maternal treatment-seeking. Rural and urban Mijikenda mothers' responses to childhood fevers in the last 2 weeks (n=317), and to childhood convulsions in the previous year (n=43), were documented through survey work. The intra-household relations and decision-making dynamics surrounding maternal responses were explored through in-depth individual and group interviews, primarily with women (n=223). Responses to convulsions were more likely than responses to fevers to include a healer consultation (p<0.0001), and less likely to include the purchase of over-the-counter medications (p<0.0001). Mothers received financial or advisory assistance from others in 71% (n=236) of actions taken outside the household in response to fevers. In-depth interviews suggested that general agreement on appropriate therapy results in relatively few intra-household conflicts over the treatment of fevers. Disputes over perceived cause and appropriate therapy of convulsions, however, highlighted the importance of age, gender and relationship to household head in intra-household relations and treatment decision-making. Although mothers' treatment-seeking preferences are often circumscribed by these relations, a number of strategies can be drawn upon to circumvent 'inappropriate' decisions, sometimes with implications for future household responses to similar syndromes. The findings highlight the complexity of intra-household relations and treatment decision-making dynamics. Tentative implications for interventions aimed at improving the home management of malaria, and for further research, are presented.

Defining decision making: a qualitative study of international experts' views on surgical trainee decision making.

PubMed

Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H

2011-06-01

Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

Applying the Wildland Fire Decision Support System (WFDSS) to support risk-informed decision making: The Gold Pan Fire, Bitterroot National Forest, Montana, USA

Treesearch

Erin K. Noonan-Wright; Tonja S. Opperman

2015-01-01

In response to federal wildfire policy changes, risk-informed decision-making by way of improved decision support, is increasingly becoming a component of managing wildfires. As fire incidents escalate in size and complexity, the Wildland Fire Decision Support System (WFDSS) provides support with different analytical tools as fire conditions change. We demonstrate the...

Incongruence between women's survey- and interview-determined decision control preferences: A mixed methods study of decision-making in metastatic breast cancer.

PubMed

Ejem, Deborah; Dionne-Odom, J Nicholas; Turkman, Yasemin; Knight, Sara J; Willis, Dan; Kaufman, Peter A; Bakitas, Marie

2018-04-30

Women with metastatic breast cancer face numerous, complex treatment and advance care planning (ACP) decisions. Our aim was to develop a better understanding of women with metastatic breast cancer's decision-making preferences overtime and relative to specific types of decisions. Convergent, parallel mixed-methods study. Participants completed the Control Preferences Scale (CPS) and a semi-structured interview of decision-making experiences at enrollment (T1; n = 22) and when facing a decision or 3 months later (T2; n = 19). We categorized women's decision-making experience descriptions into one of the CPS decisional styles and compared them to their CPS response. We constructed an analytic grid that aligned the interview-determined treatment and ACP decisional preferences with the CPS categories at T1 and T2 and calculated Cohen's kappa coefficient and congruence percentages. Participants (n = 22) were White (100%), averaged 62 years, married (54%), retired (45%), and had a bachelor's degree (45%). Congruence between CPS response and interview-determined treatment preferences at T1 was 32% (kappa = 0.083) and 33% (kappa = 0.120) at T2. Congruence between CPS survey response and interview-determined ACP preferences at T1 was 22.7% (kappa =0.092) at T1 and 11% (kappa = 0.011) at T2. Although women selected a "shared" treatment decision-making style using the CPS validated tool, when interviewed their descriptions generally reflected a passive process in which they followed the oncologists' treatment suggestions. Future research should explore whether the incongruence between stated and actual decision-making style is a function of misinterpreting the CPS choices or a true inconsistency that could lead to adverse consequences such as decisional regret. Copyright © 2018 John Wiley & Sons, Ltd.

Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies.

PubMed

Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

2016-08-18

The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the "shortcuts" that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a "user-pays" model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making.

THE RELATIONSHIP BETWEEN MEASURES OF IMPULSIVITY AND ALCOHOL MISUSE: AN INTEGRATIVE STRUCTURAL EQUATION MODELING APPROACH

PubMed Central

Courtney, Kelly E.; Arellano, Ryan; Barkley-Levenson, Emily; Gálvan, Adriana; Poldrack, Russell A.; MacKillop, James; Jentsch, J. David; Ray, Lara A.

2011-01-01

Background Higher levels of impulsivity have been implicated in the development of alcohol use disorders. Recent findings suggest that impulsivity is not a unitary construct, highlighted by the diverse ways in which the various measures of impulsivity relate to alcohol use outcomes. This study simultaneously tested the following dimensions of impulsivity as determinants of alcohol use and alcohol problems: risky decision-making, self-reported risk attitudes, response inhibition, and impulsive decision-making. Method Participants were a community sample of non-treatment seeking problem drinkers (N = 158). Structural Equation Modeling (SEM) analyses employed behavioral measures of impulsive decision-making (Delay Discounting Task, DDT), response inhibition (Stop Signal Task, SST), and risky decision-making (Balloon Analogue Risk Task, BART), and a self-report measure of risk attitudes (Domain-specific Risk-attitude Scale, DOSPERT), as predictors of alcohol use and of alcohol-related problems in this sample. Results The model fit well, accounting for 38% of the variance in alcohol problems, and identified two impulsivity dimensions that significantly loaded onto alcohol outcomes: (1) impulsive decision-making, indexed by the DDT; and (2) risky decision-making, measured by the BART. Conclusions The impulsive decision-making dimension of impulsivity, indexed by the DDT, was the strongest predictor of alcohol use and alcohol pathology in this sample of problem drinkers. Unexpectedly, a negative relationship was found between risky decision-making and alcohol problems. The results highlight the importance of considering the distinct facets of impulsivity in order to elucidate their individual and combined effects on alcohol use initiation, escalation, and dependence. PMID:22091877

Decision making from economic and signal detection perspectives: development of an integrated framework

PubMed Central

Lynn, Spencer K.; Wormwood, Jolie B.; Barrett, Lisa F.; Quigley, Karen S.

2015-01-01

Behavior is comprised of decisions made from moment to moment (i.e., to respond one way or another). Often, the decision maker cannot be certain of the value to be accrued from the decision (i.e., the outcome value). Decisions made under outcome value uncertainty form the basis of the economic framework of decision making. Behavior is also based on perception—perception of the external physical world and of the internal bodily milieu, which both provide cues that guide decision making. These perceptual signals are also often uncertain: another person's scowling facial expression may indicate threat or intense concentration, alternatives that require different responses from the perceiver. Decisions made under perceptual uncertainty form the basis of the signals framework of decision making. Traditional behavioral economic approaches to decision making focus on the uncertainty that comes from variability in possible outcome values, and typically ignore the influence of perceptual uncertainty. Conversely, traditional signal detection approaches to decision making focus on the uncertainty that arises from variability in perceptual signals and typically ignore the influence of outcome value uncertainty. Here, we compare and contrast the economic and signals frameworks that guide research in decision making, with the aim of promoting their integration. We show that an integrated framework can expand our ability to understand a wider variety of decision-making behaviors, in particular the complexly determined real-world decisions we all make every day. PMID:26217275

ERP Correlates of Simulated Purchase Decisions

PubMed Central

Gajewski, Patrick D.; Drizinsky, Jessica; Zülch, Joachim; Falkenstein, Michael

2016-01-01

Decision making in economic context is an everyday activity but its neuronal correlates are poorly understood. The present study aimed at investigating the electrophysiological brain activity during simulated purchase decisions of technical products for a lower or higher price relative to a mean price estimated in a pilot study. Expectedly, participants mostly decided to buy a product when it was cheap and not to buy when it was expensive. However, in some trials they made counter-conformity decisions to buy a product for a higher than the average price or not to buy it despite an attractive price. These responses took more time and the variability of the response latency was enhanced relative to conformity responses. ERPs showed enhanced conflict related fronto-central N2 during both types of counter-conformity compared to conformity decisions. A reverse pattern was found for the P3a and P3b. The response-locked P3 (r-P3) was larger and the subsequent CNV smaller for counter-conformity than conformity decisions. We assume that counter-conformity decisions elevate the response threshold (larger N2), intensify response evaluation (r-P3) and attenuate the preparation for the next trial (CNV). These effects were discussed in the framework of the functional role of the fronto-parietal cortex in economic decision making. PMID:27551258

ERP Correlates of Simulated Purchase Decisions.

PubMed

Gajewski, Patrick D; Drizinsky, Jessica; Zülch, Joachim; Falkenstein, Michael

2016-01-01

Decision making in economic context is an everyday activity but its neuronal correlates are poorly understood. The present study aimed at investigating the electrophysiological brain activity during simulated purchase decisions of technical products for a lower or higher price relative to a mean price estimated in a pilot study. Expectedly, participants mostly decided to buy a product when it was cheap and not to buy when it was expensive. However, in some trials they made counter-conformity decisions to buy a product for a higher than the average price or not to buy it despite an attractive price. These responses took more time and the variability of the response latency was enhanced relative to conformity responses. ERPs showed enhanced conflict related fronto-central N2 during both types of counter-conformity compared to conformity decisions. A reverse pattern was found for the P3a and P3b. The response-locked P3 (r-P3) was larger and the subsequent CNV smaller for counter-conformity than conformity decisions. We assume that counter-conformity decisions elevate the response threshold (larger N2), intensify response evaluation (r-P3) and attenuate the preparation for the next trial (CNV). These effects were discussed in the framework of the functional role of the fronto-parietal cortex in economic decision making.

Brain network response underlying decisions about abstract reinforcers.

PubMed

Mills-Finnerty, Colleen; Hanson, Catherine; Hanson, Stephen Jose

2014-12-01

Decision making studies typically use tasks that involve concrete action-outcome contingencies, in which subjects do something and get something. No studies have addressed decision making involving abstract reinforcers, where there are no action-outcome contingencies and choices are entirely hypothetical. The present study examines these kinds of choices, as well as whether the same biases that exist for concrete reinforcer decisions, specifically framing effects, also apply during abstract reinforcer decisions. We use both General Linear Model as well as Bayes network connectivity analysis using the Independent Multi-sample Greedy Equivalence Search (IMaGES) algorithm to examine network response underlying choices for abstract reinforcers under positive and negative framing. We find for the first time that abstract reinforcer decisions activate the same network of brain regions as concrete reinforcer decisions, including the striatum, insula, anterior cingulate, and VMPFC, results that are further supported via comparison to a meta-analysis of decision making studies. Positive and negative framing activated different parts of this network, with stronger activation in VMPFC during negative framing and in DLPFC during positive, suggesting different decision making pathways depending on frame. These results were further clarified using connectivity analysis, which revealed stronger connections between anterior cingulate, insula, and accumbens during negative framing compared to positive. Taken together, these results suggest that not only do abstract reinforcer decisions rely on the same brain substrates as concrete reinforcers, but that the response underlying framing effects on abstract reinforcers also resemble those for concrete reinforcers, specifically increased limbic system connectivity during negative frames. Copyright © 2014 Elsevier Inc. All rights reserved.

Hesitant Fuzzy Thermodynamic Method for Emergency Decision Making Based on Prospect Theory.

PubMed

Ren, Peijia; Xu, Zeshui; Hao, Zhinan

2017-09-01

Due to the timeliness of emergency response and much unknown information in emergency situations, this paper proposes a method to deal with the emergency decision making, which can comprehensively reflect the emergency decision making process. By utilizing the hesitant fuzzy elements to represent the fuzziness of the objects and the hesitant thought of the experts, this paper introduces the negative exponential function into the prospect theory so as to portray the psychological behaviors of the experts, which transforms the hesitant fuzzy decision matrix into the hesitant fuzzy prospect decision matrix (HFPDM) according to the expectation-levels. Then, this paper applies the energy and the entropy in thermodynamics to take the quantity and the quality of the decision values into account, and defines the thermodynamic decision making parameters based on the HFPDM. Accordingly, a whole procedure for emergency decision making is conducted. What is more, some experiments are designed to demonstrate and improve the validation of the emergency decision making procedure. Last but not the least, this paper makes a case study about the emergency decision making in the firing and exploding at Port Group in Tianjin Binhai New Area, which manifests the effectiveness and practicability of the proposed method.

Expectations Do Not Alter Early Sensory Processing during Perceptual Decision-Making.

PubMed

Rungratsameetaweemana, Nuttida; Itthipuripat, Sirawaj; Salazar, Annalisa; Serences, John T

2018-06-13

Two factors play important roles in shaping perception: the allocation of selective attention to behaviorally relevant sensory features, and prior expectations about regularities in the environment. Signal detection theory proposes distinct roles of attention and expectation on decision-making such that attention modulates early sensory processing, whereas expectation influences the selection and execution of motor responses. Challenging this classic framework, recent studies suggest that expectations about sensory regularities enhance the encoding and accumulation of sensory evidence during decision-making. However, it is possible, that these findings reflect well documented attentional modulations in visual cortex. Here, we tested this framework in a group of male and female human participants by examining how expectations about stimulus features (orientation and color) and expectations about motor responses impacted electroencephalography (EEG) markers of early sensory processing and the accumulation of sensory evidence during decision-making (the early visual negative potential and the centro-parietal positive potential, respectively). We first demonstrate that these markers are sensitive to changes in the amount of sensory evidence in the display. Then we show, counter to recent findings, that neither marker is modulated by either feature or motor expectations, despite a robust effect of expectations on behavior. Instead, violating expectations about likely sensory features and motor responses impacts posterior alpha and frontal theta oscillations, signals thought to index overall processing time and cognitive conflict. These findings are inconsistent with recent theoretical accounts and suggest instead that expectations primarily influence decisions by modulating post-perceptual stages of information processing. SIGNIFICANCE STATEMENT Expectations about likely features or motor responses play an important role in shaping behavior. Classic theoretical frameworks posit that expectations modulate decision-making by biasing late stages of decision-making including the selection and execution of motor responses. In contrast, recent accounts suggest that expectations also modulate decisions by improving the quality of early sensory processing. However, these effects could instead reflect the influence of selective attention. Here we examine the effect of expectations about sensory features and motor responses on a set of electroencephalography (EEG) markers that index early sensory processing and later post-perceptual processing. Counter to recent empirical results, expectations have little effect on early sensory processing but instead modulate EEG markers of time-on-task and cognitive conflict. Copyright © 2018 the authors 0270-6474/18/385632-17$15.00/0.

The development of moral emotions and decision-making from adolescence to early adulthood: a 6-year longitudinal study.

PubMed

Krettenauer, Tobias; Colasante, Tyler; Buchmann, Marlis; Malti, Tina

2014-04-01

Adolescents' emotions in the context of moral decision-making repeatedly have been shown to predict actual behaviour. However, little systematic information on developmental change regarding these emotion expectancies has been available thus far. This longitudinal study investigated anticipated moral emotions and decision-making between the ages of 15 and 21 in a representative sample of Swiss adolescents (N = 1,258; 54 % female; M = 15.30 years). Anticipated moral emotions and decision-making were assessed through a semi-structured interview procedure. Using Bernoulli hierarchical linear modeling, it was found that positive feelings after a moral transgression (i.e., "happy victimizer" responses) decreased over time, whereas positive feelings after a moral decision (i.e., "happy moralist" responses) increased. However, this pattern was contingent upon the moral scenario presented. Systematic relationships between anticipated moral emotions and moral personality characteristics of sympathy, conscientiousness, and agreeableness were found, even when controlling for socio-demographic characteristics and cognitive ability. Overall, this study demonstrates that the development of anticipated moral emotions is not limited to childhood. Furthermore, our findings suggest that moral emotions serve as an important link between moral personality development and decision-making processes that are more proximal to everyday moral behavior.

Decision Making under Ambiguity and Objective Risk in Higher Age - A Review on Cognitive and Emotional Contributions.

PubMed

Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

2017-01-01

The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors - responsible for age-related differences in decision making - are additionally pointed out.

Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

PubMed Central

Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

2017-01-01

The ability of decision making plays a highly relevant role in our survival, but is adversely affected during the process of aging. The present review aims to provide a better understanding of age-related differences in decision making and the role of cognitive and emotional factors in this context. We reviewed the literature about age-effects on decision-making performance, focusing on decision making under ambiguous and objective risk. In decisions under ambiguous risks, as measured by the Iowa Gambling Task, decisions are based on the experiences with consequences. In this case, many articles have attributed age-related impairments in decision making to changes in emotional and somatic reward- and punishment processing. In decisions under objective risks, as measured for example by the Game of Dice Task, decisions can be based on explicit information about risks and consequences. In this case, age-related changes have been attributed mainly to a cognitive decline, particularly impaired executive functions. However, recent findings challenge these conclusions. The present review summarizes neuropsychological and neurophysiological findings of age-related differences in decision making under ambiguous and objective risk. In this context, the relevance of learning, but also of cognitive and emotional contributors – responsible for age-related differences in decision making – are additionally pointed out. PMID:29270145

Informing the Gestalt: An Ethical Framework for Allocating Scarce Federal Public Health and Medical Resources to States During Disasters

PubMed Central

Knebel, Ann R.; Sharpe, Virginia A.; Danis, Marion; Toomey, Lauren M.; Knickerbocker, Deborah K.

2017-01-01

During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters. PMID:24612854

Promoting the rights and responsibilities of children: a South Australian example.

PubMed

George, Emma; Schmidt, Casey; Vella, Grace; McDonagh, Imelda

2017-03-01

In 2014, the Parafield Gardens Children's Centre for Early Childhood Development and Parenting was recognised as a Global Peace School - Early Years (GPSEY). During the recognition process, a project promoting the rights and responsibilities of children and families was facilitated. Partnering with children and families in decision making was a project priority. Young children had an active role in decision making. Through age-appropriate activities and discussions, children and families developed deeper understanding of child rights, peace building, global awareness and social inclusion. Educational staff were supported to enhance this child rights focus. A GPSEY recognition celebration acknowledged child rights and the community's cultural diversity. The outcome of GPSEY recognition is significant but the process that fostered community ownership, participation and social inclusion is worth noting. Involving children in decision making and development promotes their rights and responsibilities; this can make a positive difference for children locally, and globally.

Attitudes towards poverty, organizations, ethics and morals: Israeli social workers' shared decision making.

PubMed

Levin, Lia; Schwartz-Tayri, Talia

2017-06-01

Partnerships between service users and social workers are complex in nature and can be driven by both personal and contextual circumstances. This study sought to explore the relationship between social workers' involvement in shared decision making with service users, their attitudes towards service users in poverty, moral standards and health and social care organizations' policies towards shared decision making. Based on the responses of 225 licensed social workers from health and social care agencies in the public, private and third sectors in Israel, path analysis was used to test a hypothesized model. Structural attributions for poverty contributed to attitudes towards people who live in poverty, which led to shared decision making. Also, organizational support in shared decision making, and professional moral identity, contributed to ethical behaviour which led to shared decision making. The results of this analysis revealed that shared decision making may be a scion of branched roots planted in the relationship between ethics, organizations and Stigma. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

The cognitive processes underpinning clinical decision in triage assessment: a theoretical conundrum?

PubMed

Noon, Amy J

2014-01-01

High quality clinical decision-making (CDM) has been highlighted as a priority across the nursing profession. Triage nurses, in the Accident and Emergency (A&E) department, work in considerable levels of uncertainty and require essential skills including: critical thinking, evaluation and decision-making. The content of this paper aims to promote awareness of how triage nurses make judgements and decisions in emergency situations. By exploring relevant literature on clinical judgement and decision-making theory, this paper demonstrates the importance of high quality decision-making skills underpinning the triage nurse's role. Having an awareness of how judgements and decisions are made is argued as essential, in a time where traditional nurse boundaries and responsibilities are never more challenged. It is hoped that the paper not only raises this awareness in general but also, in particular, engages the triage nurse to look more critically at how they make their own decisions in their everyday practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

Establishing School Decision-Making Groups: Problems Confronted by Three Secondary Schools in Australia.

ERIC Educational Resources Information Center

Dellar, Graham B.

Central to restructuring efforts in Australia was the establishment of school decision-making groups (SDMGs), which gave school staff and community representatives more autonomy over decisions concerning educational policy and school development. This paper presents findings of a study that examined the responses of three secondary schools to the…

The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

PubMed

Kelly, B D

2015-03-01

Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.

Why shared decision making is not good enough: lessons from patients.

PubMed

Olthuis, Gert; Leget, Carlo; Grypdonck, Mieke

2014-07-01

A closer look at the lived illness experiences of medical professionals themselves shows that shared decision making is in need of a logic of care. This paper underlines that medical decision making inevitably takes place in a messy and uncertain context in which sharing responsibilities may impose a considerable burden on patients. A better understanding of patients' lived experiences enables healthcare professionals to attune to what individual patients deem important in their lives.This will contribute to making medical decisions in a good and caring manner, taking into account the lived experience of being ill.

Sharing intelligence: Decision-making interactions between users and software in MAESTRO

NASA Technical Reports Server (NTRS)

Geoffroy, Amy L.; Gohring, John R.; Britt, Daniel L.

1991-01-01

By combining the best of automated and human decision-making in scheduling many advantages can accrue. The joint performance of the user and system is potentially much better than either alone. Features of the MAESTRO scheduling system serve to illustrate concepts of user/software cooperation. MAESTRO may be operated at a user-determinable and dynamic level of autonomy. Because the system allows so much flexibility in the allocation of decision-making responsibilities, and provides users with a wealth of information and other support for their own decision-making, better overall schedules may result.

Modeling Confidence Judgments, Response Times, and Multiple Choices in Decision Making: Recognition Memory and Motion Discrimination

PubMed Central

Ratcliff, Roger; Starns, Jeffrey J.

2014-01-01

Confidence in judgments is a fundamental aspect of decision making, and tasks that collect confidence judgments are an instantiation of multiple-choice decision making. We present a model for confidence judgments in recognition memory tasks that uses a multiple-choice diffusion decision process with separate accumulators of evidence for the different confidence choices. The accumulator that first reaches its decision boundary determines which choice is made. Five algorithms for accumulating evidence were compared, and one of them produced proportions of responses for each of the choices and full response time distributions for each choice that closely matched empirical data. With this algorithm, an increase in the evidence in one accumulator is accompanied by a decrease in the others so that the total amount of evidence in the system is constant. Application of the model to the data from an earlier experiment (Ratcliff, McKoon, & Tindall, 1994) uncovered a relationship between the shapes of z-transformed receiver operating characteristics and the behavior of response time distributions. Both are explained in the model by the behavior of the decision boundaries. For generality, we also applied the decision model to a 3-choice motion discrimination task and found it accounted for data better than a competing class of models. The confidence model presents a coherent account of confidence judgments and response time that cannot be explained with currently popular signal detection theory analyses or dual-process models of recognition. PMID:23915088

Response threshold variance as a basis of collective rationality

PubMed Central

Yamamoto, Tatsuhiro

2017-01-01

Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only ‘yes/no’ responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism. A larger number of units respond ‘yes’ to the best option available to a collective decision-maker using only the yes/no mechanism; thus, the best option is always selected by majority decision. Colonies of the ant Myrmica kotokui preferred the better option in a binary choice experiment. The preference of a colony was demonstrated by the workers, which exhibited variable thresholds between two options' qualities. Our results demonstrate how a collective decision-maker comprising simple yes/no judgement units achieves collective rationality without using quality-graded responses. This mechanism has broad applicability to collective decision-making in brain neurons, swarm robotics and human societies. PMID:28484636

Response threshold variance as a basis of collective rationality.

PubMed

Yamamoto, Tatsuhiro; Hasegawa, Eisuke

2017-04-01

Determining the optimal choice among multiple options is necessary in various situations, and the collective rationality of groups has recently become a major topic of interest. Social insects are thought to make such optimal choices by collecting individuals' responses relating to an option's value (=a quality-graded response). However, this behaviour cannot explain the collective rationality of brains because neurons can make only 'yes/no' responses on the basis of the response threshold. Here, we elucidate the basic mechanism underlying the collective rationality of such simple units and show that an ant species uses this mechanism. A larger number of units respond 'yes' to the best option available to a collective decision-maker using only the yes/no mechanism; thus, the best option is always selected by majority decision. Colonies of the ant Myrmica kotokui preferred the better option in a binary choice experiment. The preference of a colony was demonstrated by the workers, which exhibited variable thresholds between two options' qualities. Our results demonstrate how a collective decision-maker comprising simple yes/no judgement units achieves collective rationality without using quality-graded responses. This mechanism has broad applicability to collective decision-making in brain neurons, swarm robotics and human societies.

"Utilizing" signal detection theory.

PubMed

Lynn, Spencer K; Barrett, Lisa Feldman

2014-09-01

What do inferring what a person is thinking or feeling, judging a defendant's guilt, and navigating a dimly lit room have in common? They involve perceptual uncertainty (e.g., a scowling face might indicate anger or concentration, for which different responses are appropriate) and behavioral risk (e.g., a cost to making the wrong response). Signal detection theory describes these types of decisions. In this tutorial, we show how incorporating the economic concept of utility allows signal detection theory to serve as a model of optimal decision making, going beyond its common use as an analytic method. This utility approach to signal detection theory clarifies otherwise enigmatic influences of perceptual uncertainty on measures of decision-making performance (accuracy and optimality) and on behavior (an inverse relationship between bias magnitude and sensitivity optimizes utility). A "utilized" signal detection theory offers the possibility of expanding the phenomena that can be understood within a decision-making framework. © The Author(s) 2014.

“UTILIZING” SIGNAL DETECTION THEORY

PubMed Central

Lynn, Spencer K.; Barrett, Lisa Feldman

2014-01-01

What do inferring what a person is thinking or feeling, deciding to report a symptom to your doctor, judging a defendant’s guilt, and navigating a dimly lit room have in common? They involve perceptual uncertainty (e.g., a scowling face might indicate anger or concentration, which engender different appropriate responses), and behavioral risk (e.g., a cost to making the wrong response). Signal detection theory describes these types of decisions. In this tutorial we show how, by incorporating the economic concept of utility, signal detection theory serves as a model of optimal decision making, beyond its common use as an analytic method. This utility approach to signal detection theory highlights potentially enigmatic influences of perceptual uncertainty on measures of decision-making performance (accuracy and optimality) and on behavior (a functional relationship between bias and sensitivity). A “utilized” signal detection theory offers the possibility of expanding the phenomena that can be understood within a decision-making framework. PMID:25097061

A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

PubMed

Edwin, Ama Kyerewaa; Johnson McGee, Summer; Opare-Lokko, Edwina Addo; Gyakobo, Mawuli Kotope

2016-03-01

To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying. © The Author(s) 2014.

Response time in economic games reflects different types of decision conflict for prosocial and proself individuals.

PubMed

Yamagishi, Toshio; Matsumoto, Yoshie; Kiyonari, Toko; Takagishi, Haruto; Li, Yang; Kanai, Ryota; Sakagami, Masamichi

2017-06-13

Behavioral and neuroscientific studies explore two pathways through which internalized social norms promote prosocial behavior. One pathway involves internal control of impulsive selfishness, and the other involves emotion-based prosocial preferences that are translated into behavior when they evade cognitive control for pursuing self-interest. We measured 443 participants' overall prosocial behavior in four economic games. Participants' predispositions [social value orientation (SVO)] were more strongly reflected in their overall game behavior when they made decisions quickly than when they spent a longer time. Prosocially (or selfishly) predisposed participants behaved less prosocially (or less selfishly) when they spent more time in decision making, such that their SVO prosociality yielded limited effects in actual behavior in their slow decisions. The increase (or decrease) in slower decision makers was prominent among consistent prosocials (or proselfs) whose strong preference for prosocial (or proself) goals would make it less likely to experience conflict between prosocial and proself goals. The strong effect of RT on behavior in consistent prosocials (or proselfs) suggests that conflict between prosocial and selfish goals alone is not responsible for slow decisions. Specifically, we found that contemplation of the risk of being exploited by others (social risk aversion) was partly responsible for making consistent prosocials (but not consistent proselfs) spend longer time in decision making and behave less prosocially. Conflict between means rather than between goals (immediate versus strategic pursuit of self-interest) was suggested to be responsible for the time-related increase in consistent proselfs' prosocial behavior. The findings of this study are generally in favor of the intuitive cooperation model of prosocial behavior.

Temporal characteristics of decisions in hospital encounters: a threshold for shared decision making? A qualitative study.

PubMed

Ofstad, Eirik H; Frich, Jan C; Schei, Edvin; Frankel, Richard M; Gulbrandsen, Pål

2014-11-01

To identify and characterize physicians' statements that contained evidence of clinically relevant decisions in encounters with patients in different hospital settings. Qualitative analysis of 50 videotaped encounters from wards, the emergency room (ER) and outpatient clinics in a department of internal medicine at a Norwegian university hospital. Clinical decisions could be grouped in a temporal order: decisions which had already been made, and were brought into the encounter by the physician (preformed decisions), decisions made in the present (here-and-now decisions), and decisions prescribing future actions given a certain course of events (conditional decisions). Preformed decisions were a hallmark in the ward and conditional decisions a main feature of ER encounters. Clinical decisions related to a patient-physician encounter spanned a time frame exceeding the duration of the encounter. While a distribution of decisions over time and space fosters sharing and dilution of responsibility between providers, it makes the decision making process hard to access for patients. In order to plan when and how to involve patients in decisions, physicians need increased awareness of when clinical decisions are made, who usually makes them, and who should make them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

HTA and decision-making processes in Central, Eastern and South Eastern Europe: Results from a survey.

PubMed

García-Mochón, Leticia; Espín Balbino, Jaime; Olry de Labry Lima, Antonio; Caro Martinez, Araceli; Martin Ruiz, Eva; Pérez Velasco, Román

2017-03-31

To gain knowledge and insights on health technology assessment (HTA) and decision-making processes in Central, Eastern and South Eastern Europe (CESEE) countries. A cross-sectional study was performed. Based on the literature, a questionnaire was developed in a multi-stage process. The questionnaire was arranged according to 5 broad domains: (i) introduction/country settings; (ii) use of HTA in the country; (iii) decision-making process; (iv) implementation of decisions; and (v) HTA and decision-making: future challenges. Potential survey respondents were identified through literature review-with a total of 118 contacts from the 24 CESEE countries. From March to July 2014, the survey was administered via e-mail. A total of 22 questionnaires were received generating an 18.6% response rate, including 4 responses indicating that their institutions had no involvement in HTA. Most of the CESEE countries have entities under government mandates with advisory functions and different responsibilities for decision-making, but mainly in charge of the reimbursement and pricing of medicines. Other areas where discrepancies across countries were found include criteria for selecting technologies to be assessed, stakeholder involvement, evidence requirements, use of economic evaluation, and timeliness of HTA. A number of CESEE countries have created formal decision-making processes for which HTA is used. However, there is a high level of heterogeneity related to the degree of development of HTA structures, and the methods and processes followed. Further studies focusing on the countries from which information is scarcer and on the HTA of health technologies other than medicines are warranted. Reviews/comparative analyses. Copyright © 2017 Elsevier B.V. All rights reserved.

Shared Decision-Making and Patient Empowerment in Preventive Cardiology.

PubMed

Kambhampati, Swetha; Ashvetiya, Tamara; Stone, Neil J; Blumenthal, Roger S; Martin, Seth S

2016-05-01

Shared decision-making, central to evidence-based medicine and good patient care, begins and ends with the patient. It is the process by which a clinician and a patient jointly make a health decision after discussing options, potential benefits and harms, and considering the patient's values and preferences. Patient empowerment is crucial to shared decision-making and occurs when a patient accepts responsibility for his or her health. They can then learn to solve their own problems with information and support from professionals. Patient empowerment begins with the provider acknowledging that patients are ultimately in control of their care and aims to increase a patient's capacity to think critically and make autonomous, informed decisions about their health. This article explores the various components of shared decision-making in scenarios such as hypertension and hyperlipidemia, heart failure, and diabetes. It explores barriers and the potential for improving medication adherence, disease awareness, and self-management of chronic disease.

Risk Communication Emergency Response Preparedness: Contextual Assessment of the Protective Action Decision Model.

PubMed

Heath, Robert L; Lee, Jaesub; Palenchar, Michael J; Lemon, Laura L

2018-02-01

Studies are continuously performed to improve risk communication campaign designs to better prepare residents to act in the safest manner during an emergency. To that end, this article investigates the predictive ability of the protective action decision model (PADM), which links environmental and social cues, predecision processes (attention, exposure, and comprehension), and risk decision perceptions (threat, alternative protective actions, and stakeholder norms) with protective action decision making. This current quasi-longitudinal study of residents (N = 400 for each year) in a high-risk (chemical release) petrochemical manufacturing community investigated whether PADM core risk perceptions predict protective action decision making. Telephone survey data collected at four intervals (1995, 1998, 2002, 2012) reveal that perceptions of protective actions and stakeholder norms, but not of threat, currently predict protective action decision making (intention to shelter in place). Of significance, rather than threat perceptions, perception of Wally Wise Guy (a spokes-character who advocates shelter in place) correlates with perceptions of protective action, stakeholder norms, and protective action decision making. Wally's response-efficacy advice predicts residents' behavioral intentions to shelter in place, thereby offering contextually sensitive support and refinement for PADM. © 2017 Society for Risk Analysis.

Abstinent adult daily smokers show reduced anticipatory but elevated saccade-related brain responses during a rewarded antisaccade task.

PubMed

Geier, Charles F; Sweitzer, Maggie M; Denlinger, Rachel; Sparacino, Gina; Donny, Eric C

2014-08-30

Chronic smoking may result in reduced sensitivity to non-drug rewards (e.g., money), a phenomenon particularly salient during abstinence. During a quit attempt, this effect may contribute to biased decision-making (smoking>alternative reinforcers) and relapse. Although relevant for quitting, characterization of reduced reward function in abstinent smokers remains limited. Moreover, how attenuated reward function affects other brain systems supporting decision-making has not been established. Here, we use a rewarded antisaccade (rAS) task to characterize non-drug reward processing and its influence on inhibitory control, key elements underlying decision-making, in abstinent smokers vs. non-smokers. Abstinent (12-hours) adult daily smokers (N=23) and non-smokers (N=11) underwent fMRI while performing the rAS. Behavioral performances improved on reward vs. neutral trials. Smokers showed attenuated activation in ventral striatum during the reward cue and in superior precentral sulcus and posterior parietal cortex during response preparation, but greater responses during the saccade response in posterior cingulate and parietal cortices. Smokers' attenuated anticipatory responses suggest reduced motivation from monetary reward, while heightened activation during the saccade response suggests that additional circuitry may be engaged later to enhance inhibitory task performance. Overall, this preliminary study highlights group differences in decision-making components and the utility of the rAS to characterize these effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Humans Optimize Decision-Making by Delaying Decision Onset

PubMed Central

Teichert, Tobias; Ferrera, Vincent P.; Grinband, Jack

2014-01-01

Why do humans make errors on seemingly trivial perceptual decisions? It has been shown that such errors occur in part because the decision process (evidence accumulation) is initiated before selective attention has isolated the relevant sensory information from salient distractors. Nevertheless, it is typically assumed that subjects increase accuracy by prolonging the decision process rather than delaying decision onset. To date it has not been tested whether humans can strategically delay decision onset to increase response accuracy. To address this question we measured the time course of selective attention in a motion interference task using a novel variant of the response signal paradigm. Based on these measurements we estimated time-dependent drift rate and showed that subjects should in principle be able trade speed for accuracy very effectively by delaying decision onset. Using the time-dependent estimate of drift rate we show that subjects indeed delay decision onset in addition to raising response threshold when asked to stress accuracy over speed in a free reaction version of the same motion-interference task. These findings show that decision onset is a critical aspect of the decision process that can be adjusted to effectively improve decision accuracy. PMID:24599295

Factors that impact on emergency nurses' ethical decision-making ability.

PubMed

Alba, Barbara

2016-11-10

Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.

40 CFR 71.27 - Public participation and appeal.

Code of Federal Regulations, 2010 CFR

2010-07-01

... raised at the hearing. All comments shall be considered in making the final decision and shall be... issuance. (j) Response to comments. (1) At the time that any final permit decision is issued, the... written response giving a reason for the decision. Denials of requests for revision, revocation and...

Neural correlates of value, risk, and risk aversion contributing to decision making under risk.

PubMed

Christopoulos, George I; Tobler, Philippe N; Bossaerts, Peter; Dolan, Raymond J; Schultz, Wolfram

2009-10-07

Decision making under risk is central to human behavior. Economic decision theory suggests that value, risk, and risk aversion influence choice behavior. Although previous studies identified neural correlates of decision parameters, the contribution of these correlates to actual choices is unknown. In two different experiments, participants chose between risky and safe options. We identified discrete blood oxygen level-dependent (BOLD) correlates of value and risk in the ventral striatum and anterior cingulate, respectively. Notably, increasing inferior frontal gyrus activity to low risk and safe options correlated with higher risk aversion. Importantly, the combination of these BOLD responses effectively decoded the behavioral choice. Striatal value and cingulate risk responses increased the probability of a risky choice, whereas inferior frontal gyrus responses showed the inverse relationship. These findings suggest that the BOLD correlates of decision factors are appropriate for an ideal observer to detect behavioral choices. More generally, these biological data contribute to the validity of the theoretical decision parameters for actual decisions under risk.

Police response to domestic violence: making decisions about risk and risk management.

PubMed

Perez Trujillo, Monica; Ross, Stuart

2008-04-01

Assessing and responding to risk are key elements in how police respond to domestic violence. However, relatively little is known about the way police make judgments about the risks associated with domestic violence and how these judgments influence their actions. This study examines police decisions about risk in domestic violence incidents when using a risk assessment instrument. Based on a sample of 501 risk assessments completed by police in Australia, this study shows that a limited number of items on the risk assessment instrument are important in police officers' decisions about risk. Statistical analyses show that the victim's level of fear contributes to police officers' judgment on the level of risk and their decisions on which risk management strategy should be used. These findings suggest that research on police responses to domestic violence needs to pay greater attention to situational dynamics and the task requirements of risk-based decision making.

How the risky features of previous selection affect subsequent decision-making: evidence from behavioral and fMRI measures.

PubMed

Dong, Guangheng; Zhang, Yifen; Xu, Jiaojing; Lin, Xiao; Du, Xiaoxia

2015-01-01

Human decision making is rarely conducted in temporal isolation. It is often biased and affected by environmental variables, particularly prior selections. In this study, we used a task that simulates a real gambling process to explore the effect of the risky features of a previous selection on subsequent decision making. Compared with decision making after an advantageous risk-taking situation (Risk_Adv), that after a disadvantageous risk-taking situation (Risk_Disadv) is associated with a longer response time (RT, the time spent in making decisions) and higher brain activations in the caudate and the dorsolateral prefrontal cortex (DLPFC). Compared with decisions after Risk_Adv, those after Risk_Disadv in loss trials are associated with higher brain activations in the left superior temporal gyrus (STG) and the precuneus. Brain activity and relevant RTs significantly correlated. Overall, people who experience disadvantageous risk-taking selections tend to focus on current decision making and engage cognitive endeavors in value evaluation and in the regulation of their risk-taking behaviors during decision making.

Waste Management Decision-Making Process During a Homeland Security Incident Response

EPA Pesticide Factsheets

A step-by-step guide on how to make waste management-related decisions including how waste can be minimized, collected and treated, as well as where waste can be sent for staging, storage and final disposal.

High Levels of Decisional Conflict and Decision Regret When Making Decisions About Biologics.

PubMed

Lipstein, Ellen A; Lovell, Daniel J; Denson, Lee A; Kim, Sandra C; Spencer, Charles; Ittenbach, Richard F; Britto, Maria T

2016-12-01

The aim of the study was to understand the association between parents' perceptions of the decision process and the decision outcomes in decisions about the use of biologics in pediatric chronic conditions. We mailed surveys to parents of children with inflammatory bowel disease or juvenile idiopathic arthritis who had started treatment with biologics in the prior 2 years and were treated at either of 2 children's hospitals. The survey included measures of the decision process, including decision control and physician engagement, and decision outcomes, including conflict and regret. We used means and frequencies to assess the response distributions. General linear models were used to test the associations between decision process and decision outcomes. We had 201 respondents (response rate 54.9%). Approximately 47.0% reported using shared decision making. Each physician engagement behavior was experienced by the majority of parents, with the highest percentage reporting that their child's physician used language they understood and listened to them. Approximately 48.5% of parents had decisional conflict scores of 25 or greater, indicating high levels of conflict. Approximately 28.2% had no regret, 31.8% had mild regret, and the remaining 40.0% had moderate to severe regret. Shared decision making was not associated with improved decisional conflict, but physician engagement behaviors were associated with both decisional conflict and regret. Improving decision outcomes will require more than just focusing on who parents perceive as controlling the final decision. Developing interventions that facilitate specific physician engagement behaviors may decrease parents' distress around decision making and improve decision outcomes.

The factors facilitating and inhibiting effective clinical decision-making in nursing: a qualitative study

PubMed Central

Hagbaghery, Mohsen Adib; Salsali, Mahvash; Ahmadi, Fazlolah

2004-01-01

Background Nurses' practice takes place in a context of ongoing advances in research and technology. The dynamic and uncertain nature of health care environment requires nurses to be competent decision-makers in order to respond to clients' needs. Recently, the public and the government have criticized Iranian nurses because of poor quality of patient care. However nurses' views and experiences on factors that affect their clinical function and clinical decision-making have rarely been studied. Methods Grounded theory methodology was used to analyze the participants' lived experiences and their viewpoints regarding the factors affecting their clinical function and clinical decision-making. Semi-structured interviews and participant observation methods were used to gather the data. Thirty-eight participants were interviewed and twelve sessions of observation were carried out. Constant comparative analysis method was used to analyze the data. Results Five main themes emerged from the data. From the participants' points of view, "feeling competent", "being self-confident", "organizational structure", "nursing education", and "being supported" were considered as important factors in effective clinical decision-making. Conclusion As participants in this research implied, being competent and self-confident are the most important personal factors influencing nurses clinical decision-making. Also external factors such as organizational structure, access to supportive resources and nursing education have strengthening or inhibiting effects on the nurses' decisions. Individual nurses, professional associations, schools of nursing, nurse educators, organizations that employ nurses and government all have responsibility for developing and finding strategies that facilitate nurses' effective clinical decision-making. They are responsible for identifying barriers and enhancing factors within the organizational structure that facilitate nurses' clinical decision-making. PMID:15068484

Reward-related decision making in older adults: relationship to clinical presentation of depression.

PubMed

McGovern, Amanda R; Alexopoulos, George S; Yuen, Genevieve S; Morimoto, Sarah Shizuko; Gunning-Dixon, Faith M

2014-11-01

Impairment in reward processes has been found in individuals with depression and in the aging population. The purpose of this study was twofold: (1) to use an affective neuroscience probe to identify abnormalities in reward-related decision making in late-life depression; and (2) to examine the relationship of reward-related decision making abnormalities in depressed, older adults to the clinical expression of apathy in depression. We hypothesized that relative to older, healthy subjects, depressed, older patients would exhibit impaired decision making and that apathetic, depressed patients would show greater impairment in decision making than non-apathetic, depressed patients. We used the Iowa Gambling Task to examine reward-related decision making in 60 non-demented, older patients with non-psychotic major depression and 36 older, psychiatrically healthy participants. Apathy was quantified using the Apathy Evaluation Scale. Of those with major depression, 18 individuals reported clinically significant apathy, whereas 42 participants did not have apathy. Older adults with depression and healthy comparison participants did not differ in their performance on the Iowa Gambling Task. However, apathetic, depressed older adults adopted an advantageous strategy and selected cards from the conservative decks compared with non-apathetic, depressed older adults. Non-apathetic, depressed patients showed a failure to adopt a conservative strategy and persisted in making risky decisions throughout the task. This study indicates that apathy in older, depressed adults is associated with a conservative response style on a behavioral probe of the systems involved in reward-related decision making. This conservative response style may be the result of reduced sensitivity to rewards in apathetic individuals. Copyright © 2014 John Wiley & Sons, Ltd.

Collaborative Brain-Computer Interface for Aiding Decision-Making

PubMed Central

Poli, Riccardo; Valeriani, Davide; Cinel, Caterina

2014-01-01

We look at the possibility of integrating the percepts from multiple non-communicating observers as a means of achieving better joint perception and better group decisions. Our approach involves the combination of a brain-computer interface with human behavioural responses. To test ideas in controlled conditions, we asked observers to perform a simple matching task involving the rapid sequential presentation of pairs of visual patterns and the subsequent decision as whether the two patterns in a pair were the same or different. We recorded the response times of observers as well as a neural feature which predicts incorrect decisions and, thus, indirectly indicates the confidence of the decisions made by the observers. We then built a composite neuro-behavioural feature which optimally combines the two measures. For group decisions, we uses a majority rule and three rules which weigh the decisions of each observer based on response times and our neural and neuro-behavioural features. Results indicate that the integration of behavioural responses and neural features can significantly improve accuracy when compared with the majority rule. An analysis of event-related potentials indicates that substantial differences are present in the proximity of the response for correct and incorrect trials, further corroborating the idea of using hybrids of brain-computer interfaces and traditional strategies for improving decision making. PMID:25072739

Fairness decisions in response to emotions: a functional MRI study among criminal justice-involved boys with conduct disorder.

PubMed

Klapwijk, Eduard T; Lelieveld, Gert-Jan; Aghajani, Moji; Boon, Albert E; van der Wee, Nic J A; Popma, Arne; Vermeiren, Robert R J M; Colins, Olivier F

2016-04-01

Research suggests that individuals with conduct disorder (CD) are marked by social impairments, such as difficulties in processing the affective reactions of others. Little is known, though, about how they make decisions during social interactions in response to emotional expressions of others. In this study, we therefore investigated the neural mechanisms underlying fairness decisions in response to communicated emotions of others in aggressive, criminal justice-involved boys with CD (N = 32) compared with typically developing (TD) boys (N = 33), aged 15-19 years. Participants received written emotional responses (angry, disappointed or happy) from peers in response to a previous offer and then had to make fairness decisions in a version of the Dictator Game. Behavioral results showed that CD boys did not make differential fairness decisions in response to the emotions, whereas the TD boys did show a differentiation and also responded more unfair to happy reactions than the CD boys. Neuroimaging results revealed that when receiving happy vs disappointed and angry reactions, the CD boys showed less activation than the TD boys in the temporoparietal junction and supramarginal gyrus, regions involved in perspective taking and attention. These results suggest that boys with CD have difficulties with processing explicit emotional cues from others on behavioral and neural levels. © The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Political ideology and labor arbitrators' decision making in work-family conflict cases.

PubMed

Biernat, Monica; Malin, Martin H

2008-07-01

Labor arbitrators were asked to render decisions about grievances brought by employees who had been fired because of problems created by work conflicts with family responsibilities. The study examined the effects of experimentally manipulated grievant attributes (gender, type of work-family conflict) as well as arbitrator attributes (gender, political ideology) on decision making. When employees were depicted as having had child care problems, liberal arbitrators tended to favor female over male grievants, and political conservatism predicted more favorable judgments rendered toward male grievants. Overall, the data suggest that child care responsibilities cue different patterns of gender bias among liberal and conservative decision makers.

45 CFR 1336.66 - Procedures and criteria for administration of the Revolving Loan Fund: Responsibilities of the...

Code of Federal Regulations, 2010 CFR

2010-10-01

... package. (d) Loan decision-making process. Decision-making on a loan application includes the recommendations of the staff, the review by the loan review committee and the decision by the Board. (e) Loan closing process. The guidelines for the loan closing process include the finalization of loan terms...

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…

Exploring differences in the use of the statin choice decision aid and diabetes medication choice decision aid in primary care.

PubMed

Ballard, Aimee Yu; Kessler, Maya; Scheitel, Marianne; Montori, Victor M; Chaudhry, Rajeev

2017-08-10

Shared decision making is essential to patient centered care, but can be difficult for busy clinicians to implement into practice. Tools have been developed to aid in shared decision making and embedded in electronic medical records (EMRs) to facilitate use. This study was undertaken to explore the patterns of use and barriers and facilitators to use of two decision aids, the Statin Choice Decision Aid (SCDA) and the Diabetes Medication Choice Decision Aid (DMCDA), in primary care practices where the decision aids are embedded in the EMR. A survey exploring factors that influenced use of each decision aid was sent to eligible primary care clinicians affiliated with the Mayo Clinic in Rochester, MN. Survey data was collected and clinician use of each decision aid via links from the EMR was tracked. The survey response rate was 40% (105/262). Log file data indicated 51% of clinicians used the SCDA and 9% of clinicians used the DMCDA. Reasons for lack of use included lack of knowledge of the EMR link, not finding the decision aids helpful, and time constraints. Survey responses indicated that use of the tool as intended was low, with many clinicians only discussing decision aid topics that they found relevant. Although guidelines for both the treatment of blood cholesterol with a statin and for the treatment of hyperglycemia in type 2 diabetes recommend shared decision making, tools that facilitate shared decision making are not routinely used even when embedded in the EMR. Even when decision aids are used, their use may not reflect patient centered care.

A Decision Making Analysis of Persuasive Argumentation and the Choice Shift Effect

ERIC Educational Resources Information Center

Vinokur, Amiram; And Others

1975-01-01

A subjective expected utility (SEU) decision-making analysis was performed on the content of arguments generated by subjects privately or during group discussion in response to choice-dilemmas shown to shift toward risk and caution. (Editor)

Decision-Making Alignment: Respecting Natural Consequences

ERIC Educational Resources Information Center

Quinby, Lee

2016-01-01

Many organizations have a tendency toward misalignment of "authority," "responsibility," and "accountability" that causes poor decision-making. There are natural consequences that result, similar to touching fire and getting burned. When those key elements are not properly aligned, the organization can experience…

MoCog1: A computer simulation of recognition-primed human decision making, considering emotions

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1992-01-01

The successful results of the first stage of a research effort to develop a versatile computer model of motivated human cognitive behavior are reported. Most human decision making appears to be an experience-based, relatively straightforward, largely automatic response to situations, utilizing cues and opportunities perceived from the current environment. The development, considering emotions, of the architecture and computer program associated with such 'recognition-primed' decision-making is described. The resultant computer program (MoCog1) was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

The results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior are described. Most human decision making is an experience-based, relatively straight-forward, largely automatic response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. The development of the architecture and computer program (MoCog1) associated with such 'recognition-primed' decision making is discussed. The resultant computer program was successfully utilized as a vehicle to simulate earlier findings that relate how an individual's implicit theories orient the individual toward particular goals, with resultant cognitions, affects, and behavior in response to their environment.

Can decision-making skills affect responses to psychological stress in healthy women?

PubMed

Santos-Ruiz, Ana; Garcia-Rios, M Carmen; Fernandez-Sanchez, José Carlos; Perez-Garcia, Miguel; Muñoz-García, Miguel Angel; Peralta-Ramirez, Maria Isabel

2012-12-01

In recent studies showing how stress can affect an individual's decision-making process, the cognitive component of decision-making could also be considered a coping resource available to individuals when faced with a stressful situation. The Iowa Gambling Task (IGT) constitutes the standard test for the assessment of decision-making skills under conditions of uncertainty. Responses of the hypothalamic-pituitary-adrenal (HPA) axis to psychosocial stress, in turn, have been estimated by means of cortisol measurements. Our main objective in this study was to test if good and bad IGT performers show distinct HPA axis responses, when challenged in a classic psychosocial stress test. Because women have been shown to outperform men on the IGT under the influence of psychosocial stress, we chose a sample of 40 women to take the IGT before they were exposed to a public speaking task in a virtual environment. The activation of the HPA axis, involved in the stress response, was assessed by examining the levels of cortisol in the subjects' saliva at the following four stages: before the challenge, after the challenge, and 10 and 20 min after the task. Participants were divided into two groups according to their level of performance, good or poor, on the IGT. Results showed statistically significant differences between the groups for pre-exposure cortisol levels and for cortisol levels 20 min after exposure. Overall cortisol levels were significantly higher in the group with poor performance on the IGT. It appears that good decision-making, which may be an important resource for coping with stress, is associated with a lower HPA axis response to a psychosocial stressor. Copyright © 2012 Elsevier Ltd. All rights reserved.

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

PubMed

Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

2014-12-14

The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making. This study makes an important contribution to understanding how evidence is used within the public health LG context. ACTRN12609000953235.

Men's perceptions of their roles and responsibilities regarding sex, contraception and childrearing.

PubMed

Grady, W R; Tanfer, K; Billy, J O; Lincoln-Hanson, J

1996-01-01

Data from the 1991 National Survey of Men examine men's perceptions about their roles in relation to those of women in a couple's decision-making about sex, contraception and the rearing of children. A majority of men (61%) perceive that there is gender quality in sexual decision-making, and more than three-quarters (78%) believe that men and women share equal responsibility for decisions about contraception. However, men are three times as likely to say that women play a greater role in a couple's decisions about sex as they are to believe that men have the greater voice (30% compared with 9%). In contrast, men are more than twice as likely to perceive than men have a greater responsibility in contraceptive decisions as they are to say that women do (15% compared with 7%). Finally, 88% of men strongly agree that a man has the same responsibilities as a woman for the children they have together.

Colorectal cancer patients' attitudes towards involvement in decision making.

PubMed

Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A; Susnerwala, Shabbir S

2009-03-01

To design and administer an attitude rating scale, exploring colorectal cancer patients' views of involvement in decision making. To examine the impact of socio-demographic and/or treatment-related factors on decision making. To conduct principal components analysis to determine if the scale could be simplified into a number of factors for future clinical utility. An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross-sectional survey approach. 375 questionnaires were returned (81.7% response). For patients it was important to be informed and involved in the decision-making process. Information was not always used to make decisions as patients placed their trust in medical expertise. Women had more positive opinions on decision making and were more likely to want to make decisions. Written information was understood to a greater degree than verbal information. The scale could be simplified to a number of factors, indicating clinical utility. Few studies have explored the attitudes of colorectal cancer patients towards involvement in decision making. This study presents new insights into how patients view the concept of participation; important when considering current policy imperatives in the UK of involving service users in all aspects of care and treatment.

Decision-making and evacuation planning for flood risk management in the Netherlands.

PubMed

Kolen, Bas; Helsloot, Ira

2014-07-01

A traditional view of decision-making for evacuation planning is that, given an uncertain threat, there is a deterministic way of defining the best decision. In other words, there is a linear relation between threat, decision, and execution consequences. Alternatives and the impact of uncertainties are not taken into account. This study considers the 'top strategic decision-making' for mass evacuation owing to flooding in the Netherlands. It reveals that the top strategic decision-making process itself is probabilistic because of the decision-makers involved and their crisis managers (as advisers). The paper concludes that deterministic planning is not sufficient, and it recommends probabilistic planning that considers uncertainties in the decision-making process itself as well as other uncertainties, such as forecasts, citizens responses, and the capacity of infrastructure. This results in less optimistic, but more realistic, strategies and a need to pay attention to alternative strategies. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Peer referencing in adolescent decision making as a function of perceived parenting style.

PubMed

Bednar, Dell Elaine; Fisher, Terri D

2003-01-01

This study examined the relationship between parenting style and adolescent decision making. Two hundred sixty-two college students completed a decision-making scale as well as a parenting scale in an effort to determine if the child-rearing style of their parents was related to the tendency of these late adolescents to reference peers rather than parents or other adults in decision making. The results indicated that adolescents raised by authoritative parents tended to refer to their parents for moral and informational decisions, while adolescents raised by authoritarian, permissive, or neglecting-rejecting parents more often referenced their peers for moral and informational decisions. Adolescents referred to their peers for social decisions regardless of how they were raised. Parental responsiveness was a significant factor in determining the source of adolescent decision-making assistance, but parental demandingness was not. It was concluded that less orientation toward peers during late adolescence seems to be another advantage of authoritative parenting.

Determining criminal responsibility: How relevant are insight and personal attitudes to mock jurors?

PubMed

Jung, Sandy

2015-01-01

High levels of insight are interpreted as indications of a treatment compliance and good outcome by clinical professionals. However, it is unclear whether a defendant's insight plays a role in the decision-making of jurors when determining criminal responsibility. It may be the case that personal biases and attitudes toward the mentally ill and the insanity defense are more relevant in such decisions. This study examines the influence of two core dimensions of insight and personal attitudes on juror decision-making. Participants read trial scenarios describing a defendant who is accused of a violent crime and is diagnosed with schizophrenia. Assigning a verdict of not criminally responsible to the defendant was not influenced by insight, but instead, by supportive attitudes of the insanity defense and higher attributions of blame to external factors and to psychological factors. These findings highlight the need for continued investigation in the area of extra-legal factors that guide legal decision-making when defendants have a mental disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

Neural representations of relevant and irrelevant features in perceptual decision making

PubMed Central

Kayser, Andrew S.; Erickson, Drew T.; Buchsbaum, Bradley R.; D'Esposito, Mark

2010-01-01

Although perceptual decision-making activates a network of brain areas involved in sensory, integrative, and motor functions, circuit activity can clearly be modulated by factors beyond the stimulus. Of particular interest is to understand how the network is modulated by top-down factors such as attention. Here we demonstrate in a motion coherence task that selective attention produces marked changes in the BOLD response in a subset of regions within a human perceptual decision-making circuit. Specifically, when motion is attended, the BOLD response decreases with increasing motion coherence in many regions, including the motion-sensitive area MT+, the intraparietal sulcus (IPS), and the inferior frontal sulcus (IFS). However, when motion is ignored, the negative parametric response in a subset of this circuit becomes positive. Through both modeling and connectivity analyses, we demonstrate that this inversion both reflects a top-down influence and segregates attentional from accumulation regions, thereby permitting us to further delineate the contributions of different regions to the perceptual decision. PMID:21106817

The impact of emotion on perception, attention, memory, and decision-making.

PubMed

Brosch, Tobias; Scherer, Klaus R; Grandjean, Didier; Sander, David

2013-05-14

Reason and emotion have long been considered opposing forces. However, recent psychological and neuroscientific research has revealed that emotion and cognition are closely intertwined. Cognitive processing is needed to elicit emotional responses. At the same time, emotional responses modulate and guide cognition to enable adaptive responses to the environment. Emotion determines how we perceive our world, organise our memory, and make important decisions. In this review, we provide an overview of current theorising and research in the Affective Sciences. We describe how psychological theories of emotion conceptualise the interactions of cognitive and emotional processes. We then review recent research investigating how emotion impacts our perception, attention, memory, and decision-making. Drawing on studies with both healthy participants and clinical populations, we illustrate the mechanisms and neural substrates underlying the interactions of cognition and emotion.

An entropic barriers diffusion theory of decision-making in multiple alternative tasks

PubMed Central

Sigman, Mariano; Cecchi, Guillermo A.

2018-01-01

We present a theory of decision-making in the presence of multiple choices that departs from traditional approaches by explicitly incorporating entropic barriers in a stochastic search process. We analyze response time data from an on-line repository of 15 million blitz chess games, and show that our model fits not just the mean and variance, but the entire response time distribution (over several response-time orders of magnitude) at every stage of the game. We apply the model to show that (a) higher cognitive expertise corresponds to the exploration of more complex solution spaces, and (b) reaction times of users at an on-line buying website can be similarly explained. Our model can be seen as a synergy between diffusion models used to model simple two-choice decision-making and planning agents in complex problem solving. PMID:29499036

Developmental changes in autonomic responses are associated with future reward/punishment expectations: A study of sympathetic skin responses in the Markov decision task.

PubMed

Hosaka, Hiromi; Aoyagi, Kakuro; Kaga, Yoshimi; Kanemura, Hideaki; Sugita, Kanji; Aihara, Masao

2017-08-01

Autonomic nervous system activity is recognized as a major component of emotional responses. Future reward/punishment expectations depend upon the process of decision making in the frontal lobe, which is considered to play an important role in executive function. The aim of this study was to investigate the relationship between autonomic responses and decision making during reinforcement tasks using sympathetic skin responses (SSR). Nine adult and 9 juvenile (mean age, 10.2years) volunteers were enrolled in this study. SSRs were measured during the Markov decision task (MDT), which is a reinforcement task. In this task, subjects must endure a small immediate loss to ultimately get a large reward. The subjects had to undergo three sets of tests and their scores in these tests were assessed and evaluated. All adults showed gradually increasing scores for the MDT from the first to third set. As the trial progressed from the first to second set in adults, SSR appearance ratios remarkably increased for both punishment and reward expectations. In comparison with adults, children showed decreasing scores from the first to second set. There were no significant inter-target differences in the SSR appearance ratio in the first and second set in children. In the third set, the SSR appearance ratio for reward expectations was higher than that in the neutral condition. In reinforcement tasks, such as MDT, autonomic responses play an important role in decision making. We assume that SSRs are elicited during efficient decision making tasks associated with future reward/punishment expectations, which demonstrates the importance of autonomic function. In contrast, in children around the age of 10years, the autonomic system does not react as an organized response specific to reward/punishment expectations. This suggests the immaturity of the future reward/punishment expectations process in children. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Response time in economic games reflects different types of decision conflict for prosocial and proself individuals

PubMed Central

Matsumoto, Yoshie; Kiyonari, Toko; Takagishi, Haruto; Li, Yang; Kanai, Ryota; Sakagami, Masamichi

2017-01-01

Behavioral and neuroscientific studies explore two pathways through which internalized social norms promote prosocial behavior. One pathway involves internal control of impulsive selfishness, and the other involves emotion-based prosocial preferences that are translated into behavior when they evade cognitive control for pursuing self-interest. We measured 443 participants’ overall prosocial behavior in four economic games. Participants’ predispositions [social value orientation (SVO)] were more strongly reflected in their overall game behavior when they made decisions quickly than when they spent a longer time. Prosocially (or selfishly) predisposed participants behaved less prosocially (or less selfishly) when they spent more time in decision making, such that their SVO prosociality yielded limited effects in actual behavior in their slow decisions. The increase (or decrease) in slower decision makers was prominent among consistent prosocials (or proselfs) whose strong preference for prosocial (or proself) goals would make it less likely to experience conflict between prosocial and proself goals. The strong effect of RT on behavior in consistent prosocials (or proselfs) suggests that conflict between prosocial and selfish goals alone is not responsible for slow decisions. Specifically, we found that contemplation of the risk of being exploited by others (social risk aversion) was partly responsible for making consistent prosocials (but not consistent proselfs) spend longer time in decision making and behave less prosocially. Conflict between means rather than between goals (immediate versus strategic pursuit of self-interest) was suggested to be responsible for the time-related increase in consistent proselfs’ prosocial behavior. The findings of this study are generally in favor of the intuitive cooperation model of prosocial behavior. PMID:28559334

Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making.

PubMed

Baskin-Sommers, Arielle; Stuppy-Sullivan, Allison M; Buckholtz, Joshua W

2016-12-13

Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost-benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior.

Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making

PubMed Central

Baskin-Sommers, Arielle; Stuppy-Sullivan, Allison M.; Buckholtz, Joshua W.

2016-01-01

Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost–benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior. PMID:27911790

Stress alters personal moral decision making.

PubMed

Youssef, Farid F; Dookeeram, Karine; Basdeo, Vasant; Francis, Emmanuel; Doman, Mekaeel; Mamed, Danielle; Maloo, Stefan; Degannes, Joel; Dobo, Linda; Ditshotlo, Phatsimo; Legall, George

2012-04-01

While early studies of moral decision making highlighted the role of rational, conscious executive processes involving frontal lobe activation more recent work has suggested that emotions and gut reactions have a key part to play in moral reasoning. Given that stress can activate many of the same brain regions that are important for and connected to brain centres involved in emotional processing we sought to evaluate if stress could influence moral decision making. Sixty-five undergraduate volunteers were randomly assigned to control (n=33) and experimental groups (n=32). The latter underwent the Trier Social Stress Test (TSST) and induction of stress was assessed by measurement of salivary cortisol levels. Subjects were then required to provide a response to thirty moral dilemmas via a computer interface that recorded both their decision and reaction time. Three types of dilemmas were used: non-moral, impersonal moral and personal moral. Using a binary logistic model there were no significant predicators of utilitarian response in non-moral and impersonal moral dilemmas. However the stressed group and females were found to predict utilitarian responses to personal moral dilemmas. When comparing percentage utilitarian responses there were no significant differences noted for the non-moral and impersonal moral dilemmas but the stressed group showed significantly less utilitarian responses compared to control subjects. The stress response was significantly negatively correlated with utilitarian responses. Females also showed significantly less utilitarian responses than males. We conclude that activation of the stress response predisposed participants to less utilitarian responses when faced with high conflict personal moral dilemmas and suggest that this offers further support for dual process theory of moral judgment. We also conclude that females tend to make less utilitarian personal moral decisions compared to males, providing further evidence that there are gender differences in moral reasoning. Copyright © 2011 Elsevier Ltd. All rights reserved.

Attitudes towards informed consent, confidentiality, and substitute treatment decisions in southern African medical students: a case study from Zimbabwe.

PubMed

Hipshman, L

1999-08-01

This study explored the attitudes of biomedical science students (medical students) in a non-Western setting towards three medical ethics concepts that are based on fundamental Western culture ethical principles. A dichotomous (agree/disagree) response questionnaire was constructed using Western ethnocentric culture (WEC) based perspectives of informed consent, confidentiality, and substitute decision-making. Hypothesized WEC-Biased responses were assigned to the questionnaire's questions or propositions. A number of useful responses (169) were obtained from a large, cross-sectional, convenience sample of the MBChB students at the University of Zimbabwe Medical School. Statistical analysis described the differences in response patterns between the student's responses compared to the hypothesized WEC-Biased response. The effect of the nine independent variables on selected dependent variables (responses to certain questionnaire questions) was analyzed by stepwise logistic regression. Students concurred with the hypothesized WEC-Biased responses for two-thirds of the questionnaire items. This agreement included support for the role of legal advocacy in the substitute decision-making process. The students disagreed with the hypothesized WEC-Biased responses in several important medical ethics aspects. Most notably, the students indicated that persons with mental dysfunctions, as a class, were properly considered incompetent to make treatment decisions. None of the studied independent variables was often associated with students' responses, but training year was more frequently implicated than either ethnicity or gender. In order to develop internationally and culturally relevant medical ethics standards, non-Western perspectives ought to be acknowledged and incorporated. Two main areas for further efforts include: curriculum development in ethics reasoning and related clinical (medico-legal) decision-making processes that would be relevant to medical students from various cultures, and; the testing of models that could increase legal system input in the clinical process in societies with limited jurisprudence resources.

Serotonin and decision making processes.

PubMed

Homberg, Judith R

2012-01-01

Serotonin (5-HT) is an important player in decision making. Serotonergic antidepressant, anxiolytic and antipsychotic drugs are extensively used in the treatment of neuropsychiatric disorders characterized by impaired decision making, and exert both beneficial and harmful effects in patients. Detailed insight into the serotonergic mechanisms underlying decision making is needed to strengthen the first and weaken the latter. Although much remains to be done to achieve this, accumulating studies begin to deliver a coherent view. Thus, high central 5-HT levels are generally associated with improved reversal learning, improved attentional set shifting, decreased delay discounting, and increased response inhibition, but a failure to use outcome representations. Based on 5-HT's evolutionary role, I hypothesize that 5-HT integrates expected, or changes in, relevant sensory and emotional internal/external information, leading to vigilance behaviour affecting various decision making processes. 5-HT receptor subtypes play distinctive roles in decision making. 5-HT(2A) agonists and 5-HT2c antagonists decrease compulsivity, whereas 5-HT(2A) antagonists and 5-HT(2C) agonists decrease impulsivity. 5-HT(6) antagonists univocally affect decision making processes. Copyright © 2011 Elsevier Ltd. All rights reserved.

Decision-Making Deficits Among Maltreated Children

PubMed Central

Weller, Joshua A.; Fisher, Philip A.

2013-01-01

Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to these behaviors. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as a global construct, maltreated children’s decision making was examined in two contexts in the present study: potential gains and potential losses. Comparing maltreated children (n = 25) and a nonmaltreated community group (n = 112), it was found that the maltreated children showed decision-making impairments for both domains: This impairment was especially prominent in the loss domain. The maltreated children took excessive risks and were insensitive to changes in expected value. Follow-up analyses revealed that these differences were primarily associated with insensitivity to changes in outcome magnitude for the risky option. Finally, response latency analyses indicated that the maltreated children were slower to make choices, reinforcing underlying differences in decision processes between groups. These results have implications for basic and translational science. PMID:23220788

Cognitive level and health decision-making in children: A preliminary study.

PubMed

Okwumabua, J O; Okwumabua, T M; Hayes, A; Stovall, K

1994-06-01

The study examines children's stage of cognitive development in relation to their patterns of health decision-making, including their cognitive capabilities in integrating the sequential stages of the decision-making process. A sample of 81 male (N=33) and female (N=48) students were drawn from two urban public schools in West Tennessee. All participants in the study were of African-American descent. The Centers for Disease Control Decision-Making Instrument was used to assess students' decision-making as well as their understanding of the decision-making process. The children's cognitive level was determined by their performance on three Piagetian conservation tasks. Findings revealed that both the preoperational and concrete operational children performed significantly below the formal operational children in terms of total correct responses to the decision-making scenarios. Error type analyses indicated that the preoperational children made more errors involving "skipped step" than did either the concrete or formal operational children. There were no significant differences between children's level of cognitive development and any other error type. Implications for health promotion and disease prevention programs among prevention practitioners who work regularly with children are discussed.

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

PubMed Central

Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

2016-01-01

In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

fMRI evidence for a dual process account of the speed-accuracy tradeoff in decision-making.

PubMed

Ivanoff, Jason; Branning, Philip; Marois, René

2008-07-09

The speed and accuracy of decision-making have a well-known trading relationship: hasty decisions are more prone to errors while careful, accurate judgments take more time. Despite the pervasiveness of this speed-accuracy trade-off (SAT) in decision-making, its neural basis is still unknown. Using functional magnetic resonance imaging (fMRI) we show that emphasizing the speed of a perceptual decision at the expense of its accuracy lowers the amount of evidence-related activity in lateral prefrontal cortex. Moreover, this speed-accuracy difference in lateral prefrontal cortex activity correlates with the speed-accuracy difference in the decision criterion metric of signal detection theory. We also show that the same instructions increase baseline activity in a dorso-medial cortical area involved in the internal generation of actions. These findings suggest that the SAT is neurally implemented by modulating not only the amount of externally-derived sensory evidence used to make a decision, but also the internal urge to make a response. We propose that these processes combine to control the temporal dynamics of the speed-accuracy trade-off in decision-making.

Surviving Surrogate Decision-Making: What Helps and Hampers the Experience of Making Medical Decisions for Others

PubMed Central

Starks, Helene; Taylor, Janelle S.; Hopley, Elizabeth K.; Fryer-Edwards, Kelly

2007-01-01

BACKGROUND A majority of end-of-life medical decisions are made by surrogate decision-makers who have varying degrees of preparation and comfort with their role. Having a seriously ill family member is stressful for surrogates. Moreover, most clinicians have had little training in working effectively with surrogates. OBJECTIVES To better understand the challenges of decision-making from the surrogate’s perspective. DESIGN Semistructured telephone interview study of the experience of surrogate decision-making. PARTICIPANTS Fifty designated surrogates with previous decision-making experience. APPROACH We asked surrogates to describe and reflect on their experience of making medical decisions for others. After coding transcripts, we conducted a content analysis to identify and categorize factors that made decision-making more or less difficult for surrogates. RESULTS Surrogates identified four types of factors: (1) surrogate characteristics and life circumstances (such as coping strategies and competing responsibilities), (2) surrogates’ social networks (such as intrafamily discord about the “right” decision), (3) surrogate–patient relationships and communication (such as difficulties with honoring known preferences), and (4) surrogate–clinician communication and relationship (such as interacting with a single physician whom the surrogate recognizes as the clinical spokesperson vs. many clinicians). CONCLUSIONS These data provide insights into the challenges that surrogates encounter when making decisions for loved ones and indicate areas where clinicians could intervene to facilitate the process of surrogate decision-making. Clinicians may want to include surrogates in advance care planning prior to decision-making, identify and address surrogate stressors during decision-making, and designate one person to communicate information about the patient’s condition, prognosis, and treatment options. PMID:17619223

Considering a family systems approach to surrogate decision-making.

PubMed

Vig, Elizabeth K; Taylor, Janelle S; O'Hare, Ann M

2017-03-01

Comments on the original article by Rolland, Emanuel, and Torke (see record 2017-05300-001) regarding a family systems approach to medical decision-making by proxy. The authors expanded the focus of clinicians beyond the patient to a more comprehensive understanding of the patient's family. They assert that a better understanding of family dynamics may help clinicians to engage with families more effectively when decision-making is needed for seriously ill loved ones, and may lessen the emotional challenges families and clinicians face when decisions are needed. However, the current authors point out surrogate decision-making can be an onerous responsibility. Rolland, Emanuel, and Torke identify the growing body of research on the high prevalence of posttraumatic stress disorder, anxiety, and depression among those who have been in the position of making medical decisions for loved ones. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Form and Objective of the Decision Rule in Absolute Identification

NASA Technical Reports Server (NTRS)

Balakrishnan, J. D.

1997-01-01

In several conditions of a line length identification experiment, the subjects' decision making strategies were systematically biased against the responses on the edges of the stimulus range. When the range and number of the stimuli were small, the bias caused the percentage of correct responses to be highest in the center and lowest on the extremes of the range. Two general classes of decision rules that would explain these results are considered. The first class assumes that subjects intend to adopt an optimal decision rule, but systematically misrepresent one or more parameters of the decision making context. The second class assumes that subjects use a different measure of performance than the one assumed by the experimenter: instead of maximizing the chances of a correct response, the subject attempts to minimize the expected size of the response error (a "fidelity criterion"). In a second experiment, extended experience and feedback did not diminish the bias effect, but explicitly penalizing all response errors equally, regardless of their size, did reduce or eliminate it in some subjects. Both results favor the fidelity criterion over the optimal rule.

Expert-novice differences in cognitive and execution skills during tennis competition.

PubMed

Del Villar, Fernando; García González, Luis; Iglesias, Damián; Perla Moreno, M; Cervelló, Eduardo M

2007-04-01

This study deals with decision and execution behavior of tennis players during competition. The study is based on the expert-novice paradigm and aims to identify differences between both groups in the decision-making and execution variables in serve and shot actions in tennis. Six expert players (elite Spanish tennis players) and six novice players (grade school tennis players) took part in this study. To carry out this study, the observation protocol defined by McPherson and Thomas in 1989, in which control, decision-making and execution variables were included, was used, where it was applied to the performance of the tennis player in a real match situation. In the analysis, significant differences between experts and novices in decision-making and execution variables are found wherein it can be observed that experts display a greater ability to make the appropriate decisions, selecting the most tactical responses to put pressure on the opponent. Expert tennis players were also able to carry out forceful executions to their opponent with greater efficiency, making the opponent's response to a large extent more difficult. These findings are in accordance with those of McPherson and colleagues.

16 CFR 1031.12 - Membership criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... responsibility for making final decisions, or advise those who make final decisions, on whether to rely on a... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria. (a) The Commissioners, their special assistants, and Commission officials and employees holding the...

Diminished caudate and superior temporal gyrus responses to effort-based decision making in patients with first-episode major depressive disorder.

PubMed

Yang, Xin-hua; Huang, Jia; Lan, Yong; Zhu, Cui-ying; Liu, Xiao-qun; Wang, Ye-fei; Cheung, Eric F C; Xie, Guang-rong; Chan, Raymond C K

2016-01-04

Anhedonia, the loss of interest or pleasure in reward processing, is a hallmark feature of major depressive disorder (MDD), but its underlying neurobiological mechanism is largely unknown. The present study aimed to examine the underlying neural mechanism of reward-related decision-making in patients with MDD. We examined behavioral and neural responses to rewards in patients with first-episode MDD (N=25) and healthy controls (N=25) using the Effort-Expenditure for Rewards Task (EEfRT). The task involved choices about possible rewards of varying magnitude and probability. We tested the hypothesis that individuals with MDD would exhibit a reduced neural response in reward-related brain structures involved in cost-benefit decision-making. Compared with healthy controls, patients with MDD showed significantly weaker responses in the left caudate nucleus when contrasting the 'high reward'-'low reward' condition, and blunted responses in the left superior temporal gyrus and the right caudate nucleus when contrasting high and low probabilities. In addition, hard tasks chosen during high probability trials were negatively correlated with superior temporal gyrus activity in MDD patients, while the same choices were negatively correlated with caudate nucleus activity in healthy controls. These results indicate that reduced caudate nucleus and superior temporal gyrus activation may underpin abnormal cost-benefit decision-making in MDD. Copyright © 2015 Elsevier Inc. All rights reserved.

Relational autonomy: moving beyond the limits of isolated individualism.

PubMed

Walter, Jennifer K; Ross, Lainie Friedman

2014-02-01

Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.

A three-talk model for shared decision making: multistage consultation process

PubMed Central

Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-01-01

Objectives To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design Multistage consultation process. Setting Key informant group, communities of interest, and survey of clinical specialties. Participants 19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on “team talk,” “option talk,” and “decision talk,” to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. PMID:29109079

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

PubMed

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.

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

Place your bets: psychophysiological correlates of decision-making under risk.

PubMed

Studer, Bettina; Clark, Luke

2011-06-01

Emotions and their psychophysiological correlates are thought to play an important role in decision-making under risk. We used a novel gambling task to measure psychophysiological responses during selection of explicitly presented risky options and feedback processing. Active-choice trials, in which the participant had to select the size of bet, were compared to fixed-bet, no-choice trials. We further tested how the chances of winning and bet size affected choice behavior and psychophysiological arousal. Individual differences in impulsive and risk-taking traits were assessed. The behavioral results showed sensitivity to the choice requirement and to the chances of winning: Participants were faster to make a response on no-choice trials and when the chances of winning were high. In active-choice trials, electrodermal activity (EDA) increased with bet size during both selection and processing of losses. Cardiac responses were sensitive to choice uncertainty: Stronger selection-related heart rate (HR) decelerations were observed in trials with lower chances of winning, particularly on active-choice trials. Finally, betting behavior and psychophysiological responsiveness were moderately correlated with self-reported impulsivity-related traits. In conclusion, we demonstrate that psychophysiological arousal covaries with risk-sensitive decision-making outside of a learning context. Our results further highlight the differential sensitivities of EDA and HR to psychological features of the decision scenario.

Is patient autonomy a critical determinant of quality of life in Korea? End-of-life decision making from the perspective of the patient.

PubMed

Mo, Ha Na; Shin, Dong Wook; Woo, Jae Ha; Choi, Jin Young; Kang, Jina; Baik, Young Ji; Huh, Yu Rae; Won, Joo Hee; Park, Myung Hee; Cho, Sang Hee

2012-04-01

We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea. A multi-center, cross-sectional survey was performed on 93 terminal cancer patients. The questionnaire solicited their opinions regarding participation in treatment decision making, as well as quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care) and quality of death (Good Death Inventory-Patient Version). A total of 78.5% of the patients had awareness of their terminal status, while 21.5% did not; 42.4% stated that they knew their condition and shared the decision-making responsibility with the medical staff and their family, while 21.7% made decisions on their own, and 35.9% left the decision-making responsibility to others. Patients who were aware of their illness and who actively participated in the decision making did not score higher than others on outcome measures of quality of life and quality of death. Moreover, the former even showed lower scores in some domains, including the 'physical and psychological comfort' (4.99 versus 5.61, p = 0.03), 'environmental comfort' (5.51 versus 6.04, p = 0.08), and 'emotional functioning' (55.70 versus 71.01, p = 0.06). in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture.

Acute stress affects risk taking but not ambiguity aversion

PubMed Central

Buckert, Magdalena; Schwieren, Christiane; Kudielka, Brigitte M.; Fiebach, Christian J.

2014-01-01

Economic decisions are often made in stressful situations (e.g., at the trading floor), but the effects of stress on economic decision making have not been systematically investigated so far. The present study examines how acute stress influences economic decision making under uncertainty (risk and ambiguity) using financially incentivized lotteries. We varied the domain of decision making as well as the expected value of the risky prospect. Importantly, no feedback was provided to investigate risk taking and ambiguity aversion independent from learning processes. In a sample of 75 healthy young participants, 55 of whom underwent a stress induction protocol (Trier Social Stress Test for Groups), we observed more risk seeking for gains. This effect was restricted to a subgroup of participants that showed a robust cortisol response to acute stress (n = 26). Gambling under ambiguity, in contrast to gambling under risk, was not influenced by the cortisol response to stress. These results show that acute psychosocial stress affects economic decision making under risk, independent of learning processes. Our results further point to the importance of cortisol as a mediator of this effect. PMID:24834024

Acute stress affects risk taking but not ambiguity aversion.

PubMed

Buckert, Magdalena; Schwieren, Christiane; Kudielka, Brigitte M; Fiebach, Christian J

2014-01-01

Economic decisions are often made in stressful situations (e.g., at the trading floor), but the effects of stress on economic decision making have not been systematically investigated so far. The present study examines how acute stress influences economic decision making under uncertainty (risk and ambiguity) using financially incentivized lotteries. We varied the domain of decision making as well as the expected value of the risky prospect. Importantly, no feedback was provided to investigate risk taking and ambiguity aversion independent from learning processes. In a sample of 75 healthy young participants, 55 of whom underwent a stress induction protocol (Trier Social Stress Test for Groups), we observed more risk seeking for gains. This effect was restricted to a subgroup of participants that showed a robust cortisol response to acute stress (n = 26). Gambling under ambiguity, in contrast to gambling under risk, was not influenced by the cortisol response to stress. These results show that acute psychosocial stress affects economic decision making under risk, independent of learning processes. Our results further point to the importance of cortisol as a mediator of this effect.

Sexuality Education: Building an Evidence- and Rights-Based Approach to Healthy Decision-Making

ERIC Educational Resources Information Center

Bridges, Emily; Hauser, Debra

2014-01-01

As they grow up, young people face important decisions about relationships, sexuality, and sexual behavior. The decisions they make can impact their health and well-being for the rest of their lives. Young people have the right to lead healthy lives, and society has the responsibility to prepare youth by providing them with comprehensive sexual…

A review of challenges to determining and demonstrating efficiency of large fire management

Treesearch

Matthew P. Thompson; Francisco Rodriguez y Silva; David E. Calkin; Michael S. Hand

2017-01-01

Characterising the impacts of wildland fire and fire suppression is critical information for fire management decision-making. Here, we focus on decisions related to the rare larger and longer-duration fire events, where the scope and scale of decision-making can be far broader than initial response efforts, and where determining and demonstrating efficiency of...

Principals Value-Informed Decision Making, Intrapersonal Moral Discord, and Pathways to Resolution: The Complexities of Moral Leadership Praxis

ERIC Educational Resources Information Center

Frick, William C.

2009-01-01

Purpose: This research seeks to explore the inevitable internal struggle experienced by school leaders when making ethically-informed judgments. The study acquired principals' intimate reflections about professional decision making in response to personal versus organizational and/or professional value discrepancy as identified in the ethic of the…

Applying Research to Making Life-Affecting Judgments and Decisions

ERIC Educational Resources Information Center

Gibbs, Leonard

2007-01-01

This keynote address argues that in order for baccalaureate and masters degree students to apply research to make better judgments and decisions in their life-affecting practice and in response to the information revolution, the helping professions need to redesign (from the bottom up) not overhaul (make a few changes in) the way research methods…

Affective decision making under uncertainty during a plausible aviation task: an fMRI study.

PubMed

Causse, Mickaël; Péran, Patrice; Dehais, Frédéric; Caravasso, Chiara Falletta; Zeffiro, Thomas; Sabatini, Umberto; Pastor, Josette

2013-05-01

In aeronautics, plan continuation error (PCE) represents failure to revise a flight plan despite emerging evidence suggesting that it is no longer safe. Assuming that PCE may be associated with a shift from cold to hot reasoning, we hypothesized that this transition may result from a large range of strong negative emotional influences linked with the decision to abort a landing and circle for a repeat attempt, referred to as a "go-around". We investigated this hypothesis by combining functional neuroimaging with an ecologically valid aviation task performed under contextual variation in incentive and situational uncertainty. Our goal was to identify regional brain activity related to the sorts of conservative or liberal decision-making strategies engaged when participants were both exposed to a financial payoff matrix constructed to bias responses in favor of landing acceptance, while they were simultaneously experiencing maximum levels of uncertainty related to high levels of stimulus ambiguity. Combined with the observed behavioral outcomes, our neuroimaging results revealed a shift from cold to hot decision making in response to high uncertainty when participants were exposed to the financial incentive. Most notably, while we observed activity increases in response to uncertainty in many frontal regions such as dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC), less overall activity was observed when the reward was combined with uncertainty. Moreover, participants with poor decision making, quantified as a lower discriminability index d', exhibited riskier behavior coupled with lower activity in the right DLPFC. These outcomes suggest a disruptive effect of biased financial incentive and high uncertainty on the rational decision-making neural network, and consequently, on decision relevance. Copyright © 2013 Elsevier Inc. All rights reserved.

What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews.

PubMed

Moreau, Alain; Carol, Laurent; Dedianne, Marie Cécile; Dupraz, Christian; Perdrix, Corinne; Lainé, Xavier; Souweine, Gilbert

2012-05-01

To understand patients' perceptions of decision making and identify relationships among decision-making models. This qualitative study was made up of four focus group interviews (elderly persons, users of health support groups, students, and rural inhabitants). Participants were asked to report their perceptions of decision making in three written clinical scenarios (hypertension, breast cancer, prostate cancer). The analysis was based on the principles of grounded theory. Most patients perceived decision making as shared decision making, a deliberative question-response interaction with the physician that allowed patients to be experts in obtaining clearer information, participating in the care process, and negotiating compromises with physician preferences. Requesting second opinions allowed patients to maintain control, even within the paternalistic model preferred by elderly persons. Facilitating factors (trust, qualitative non-verbal communication, time to think) and obstacles (serious/emergency situations, perceived inadequate scientific competence, problems making requests, fear of knowing) were also part of shared decision making. In the global concept of patient-centered care, shared decision making can be flexible and can integrate paternalistic and informative models. Physicians' expertise should be associated with biomedical and relational skills through listening to, informing, and advising patients, and by supporting patients' choices. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Different profiles of decision making and physiology under varying levels of stress in trained military personnel.

PubMed

Gamble, Katherine R; Vettel, Jean M; Patton, Debra J; Eddy, Marianna D; Caroline Davis, F; Garcia, Javier O; Spangler, Derek P; Thayer, Julian F; Brooks, Justin R

2018-03-23

Decision making is one of the most vital processes we use every day, ranging from mundane decisions about what to eat to life-threatening choices such as how to avoid a car collision. Thus, the context in which our decisions are made is critical, and our physiology enables adaptive responses that account for how environmental stress influences our performance. The relationship between stress and decision making can additionally be affected by one's expertise in making decisions in high-threat environments, where experts can develop an adaptive response that mitigates the negative impacts of stress. In the present study, 26 male military personnel made friend/foe discriminations in an environment where we manipulated the level of stress. In the high-stress condition, participants received a shock when they incorrectly shot a friend or missed shooting a foe; in the low-stress condition, participants received a vibration for an incorrect decision. We characterized performance using signal detection theory to investigate whether a participant changed their decision criterion to avoid making an error. Results showed that under high-stress, participants made more false alarms, mistaking friends as foes, and this co-occurred with increased high frequency heart rate variability. Finally, we examined the relationship between decision making and physiology, and found that participants exhibited adaptive behavioral and physiological profiles under different stress levels. We interpret this adaptive profile as a marker of an expert's ingrained training that does not require top down control, suggesting a way that expert training in high-stress environments helps to buffer negative impacts of stress on performance. Published by Elsevier B.V.

How well-run boards make decisions.

PubMed

Useem, Michael

2006-11-01

In the aftermath of seismic debacles like those that toppled Enron and WorldCom, corporate boards have been shaken up and made over. More directors are independent these days, for instance, and corporations now disclose directors' salaries and committee members' names. Research shows that most of the changes are having a positive effect on companies' performance. They are primarily structural, though, and don't go to the heart of a board's work: making the choices that shape a firm's future. Which decisions boards own and how those calls are made are largely hidden from the public. As a result, boards are often unable to learn from the best governance practices of their counterparts at other companies. This article pulls back the curtain and provides an inside look. Drawing on interviews with board members and executives at 31 companies, along with a close examination of three boardroom decisions, the author identifies several formal processes that can help companies improve their decision making: creating calendars that specify when the board and the standing committees will consider key items; drafting charters that define the decisions committees are responsible for; and developing decision protocols that divvy up responsibilities between directors and executives. The author also identifies a number of informal decision-making principles: Items that are strategically significant and touch on the firm's core values should go to the board. Large decisions should be divided into small pieces, so the board can devote sufficient attention to each one. Directors must remain vigilant to ensure that their decisions are effectively implemented. The CEO and either the nonexecutive chair or the lead director should engage in ongoing dialogue regarding which decisions to take to the full board and when. And directors should challenge assumptions before making yes-or-no decisions on management proposals.

Working in partnership: the application of shared decision-making to health visitor practice.

PubMed

Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen

2017-01-01

To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework to structure planning, as application of a framework identified the processes that support a collaborative approach in practice. © 2016 John Wiley & Sons Ltd.

How to Choose? Using the Delphi Method to Develop Consensus Triggers and Indicators for Disaster Response.

PubMed

Lis, Rebecca; Sakata, Vicki; Lien, Onora

2017-08-01

To identify key decisions along the continuum of care (conventional, contingency, and crisis) and the critical triggers and data elements used to inform those decisions concerning public health and health care response during an emergency. A classic Delphi method, a consensus-building survey technique, was used with clinicians around Washington State to identify regional triggers and indicators. Additionally, using a modified Delphi method, we combined a workshop and single-round survey with panelists from public health (state and local) and health care coalitions to identify consensus state-level triggers and indicators. In the clinical survey, 122 of 223 proposed triggers or indicators (43.7%) reached consensus and were deemed important in regional decision-making during a disaster. In the state-level survey, 110 of 140 proposed triggers or indicators (78.6%) reached consensus and were deemed important in state-level decision-making during a disaster. The identification of consensus triggers and indicators for health care emergency response is crucial in supporting a comprehensive health care situational awareness process. This can inform the creation of standardized questions to ask health care, public health, and other partners to support decision-making during a response. (Disaster Med Public Health Preparedness. 2017;11:467-472).

Linking Theoretical Decision-making Mechanisms in the Simon Task with Electrophysiological Data: A Model-based Neuroscience Study in Humans.

PubMed

Servant, Mathieu; White, Corey; Montagnini, Anna; Burle, Borís

2016-10-01

A current challenge for decision-making research is in extending models of simple decisions to more complex and ecological choice situations. Conflict tasks (e.g., Simon, Stroop, Eriksen flanker) have been the focus of much interest, because they provide a decision-making context representative of everyday life experiences. Modeling efforts have led to an elaborated drift diffusion model for conflict tasks (DMC), which implements a superimposition of automatic and controlled decision activations. The DMC has proven to capture the diversity of behavioral conflict effects across various task contexts. This study combined DMC predictions with EEG and EMG measurements to test a set of linking propositions that specify the relationship between theoretical decision-making mechanisms involved in the Simon task and brain activity. Our results are consistent with a representation of the superimposed decision variable in the primary motor cortices. The decision variable was also observed in the EMG activity of response agonist muscles. These findings provide new insight into the neurophysiology of human decision-making. In return, they provide support for the DMC model framework.

Decision-making about complementary and alternative medicine by cancer patients: integrative literature review.

PubMed

Weeks, Laura; Balneaves, Lynda G; Paterson, Charlotte; Verhoef, Marja

2014-01-01

Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decision-making by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework. We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts. Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of information-seeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented. CAM-related decision-making by patients with cancer occurs as a nonlinear, complex, dynamic process. The conceptual framework presented here identifies influential factors within that process, as well as patients' unique needs during different phases. The framework can guide the development and evaluation of theory-based decision-support programs that are responsive to patients' beliefs and preferences.

A new web-based framework development for fuzzy multi-criteria group decision-making.

PubMed

Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

2016-01-01

Fuzzy multi-criteria group decision making (FMCGDM) process is usually used when a group of decision-makers faces imprecise data or linguistic variables to solve the problems. However, this process contains many methods that require many time-consuming calculations depending on the number of criteria, alternatives and decision-makers in order to reach the optimal solution. In this study, a web-based FMCGDM framework that offers decision-makers a fast and reliable response service is proposed. The proposed framework includes commonly used tools for multi-criteria decision-making problems such as fuzzy Delphi, fuzzy AHP and fuzzy TOPSIS methods. The integration of these methods enables taking advantages of the strengths and complements each method's weakness. Finally, a case study of location selection for landfill waste in Morocco is performed to demonstrate how this framework can facilitate decision-making process. The results demonstrate that the proposed framework can successfully accomplish the goal of this study.

Market analysis of collecting fundamental roadway data elements to support the highway safety improvement program.

DOT National Transportation Integrated Search

2011-06-01

Quality data are the foundation for making important decisions regarding the design, operation, and safety of : roadways. Using roadway and traffic data together with crash data can help agencies to make decisions that are : fiscally responsible and ...

A Framework for Facilitating Ecosystem Services-based Decision-making and the Development of Decision-making Tools

EPA Science Inventory

There is an increasing understanding that top-down regulatory and technology driven responses are not sufficient to address current and emerging environmental challenges such as climate change, sustainable communities, and environmental justice. The vast majority of environmenta...

Decisions Based on Science.

ERIC Educational Resources Information Center

Campbell, Vincent; Lofstrom, Jocelyn; Jerome, Brian

This guide makes the case for a decision-making focus in the science curriculum as a response to concern over preparing scientifically literate students. The student activities are organized by guided activities and independent exercises. Themes of the guided activities include xenotransplants, immunizations, household cleaning products, ozone,…

Piéron’s Law and Optimal Behavior in Perceptual Decision-Making

PubMed Central

van Maanen, Leendert; Grasman, Raoul P. P. P.; Forstmann, Birte U.; Wagenmakers, Eric-Jan

2012-01-01

Piéron’s Law is a psychophysical regularity in signal detection tasks that states that mean response times decrease as a power function of stimulus intensity. In this article, we extend Piéron’s Law to perceptual two-choice decision-making tasks, and demonstrate that the law holds as the discriminability between two competing choices is manipulated, even though the stimulus intensity remains constant. This result is consistent with predictions from a Bayesian ideal observer model. The model assumes that in order to respond optimally in a two-choice decision-making task, participants continually update the posterior probability of each response alternative, until the probability of one alternative crosses a criterion value. In addition to predictions for two-choice decision-making tasks, we extend the ideal observer model to predict Piéron’s Law in signal detection tasks. We conclude that Piéron’s Law is a general phenomenon that may be caused by optimality constraints. PMID:22232572

Application of a computational decision model to examine acute drug effects on human risk taking.

PubMed

Lane, Scott D; Yechiam, Eldad; Busemeyer, Jerome R

2006-05-01

In 3 previous experiments, high doses of alcohol, marijuana, and alprazolam acutely increased risky decision making by adult humans in a 2-choice (risky vs. nonrisky) laboratory task. In this study, a computational modeling analysis known as the expectancy valence model (J. R. Busemeyer & J. C. Stout, 2002) was applied to individual-participant data from these studies, for the highest administered dose of all 3 drugs and corresponding placebo doses, to determine changes in decision-making processes that may be uniquely engendered by each drug. The model includes 3 parameters: responsiveness to rewards and losses (valence or motivation); the rate of updating expectancies about the value of risky alternatives (learning/memory); and the consistency with which trial-by-trial choices match expected outcomes (sensitivity). Parameter estimates revealed 3 key outcomes: Alcohol increased responsiveness to risky rewards and decreased responsiveness to risky losses (motivation) but did not alter expectancy updating (learning/memory); both marijuana and alprazolam produced increases in risk taking that were related to learning/memory but not motivation; and alcohol and marijuana (but not alprazolam) produced more random response patterns that were less consistently related to expected outcomes on the 2 choices. No significant main effects of gender or dose by gender interactions were obtained, but 2 dose by gender interactions approached significance. These outcomes underscore the utility of using a computational modeling approach to deconstruct decision-making processes and thus better understand drug effects on risky decision making in humans.

Anticipatory stress restores decision-making deficits in heavy drinkers by increasing sensitivity to losses.

PubMed

Gullo, Matthew J; Stieger, Adam A

2011-09-01

Substance abusers are characterized by hypersensitivity to reward. This leads to maladaptive decisions generally, as well as those on laboratory-based decision-making tasks, such as the Iowa Gambling Task (IGT). Negative affect has also been shown to disrupt the decision-making of healthy individuals, particularly decisions made under uncertainty. Neuropsychological theories of learning, including the Somatic Marker Hypothesis (SMH), argue this occurs by amplifying affective responses to punishment. In substance abusers, this might serve to rebalance their sensitivity to reward with punishment, and improve decision-making. Before completing the IGT, 45 heavy and 47 light drinkers were randomly assigned to a control condition, or led to believe they had to give a stressful public speech. IGT performance was analyzed with the Expectancy-Valence (EV) learning model. Working memory and IQ were also assessed. Heavy drinkers made more disadvantageous decisions than light drinkers, due to higher attention to gains (versus losses) on the IGT. Anticipatory stress increased participants' attention to losses, significantly improving heavy drinkers' decision-making. Anticipatory stress increased attention to losses, effectively restoring decision-making deficits in heavy drinkers by rebalancing their reward sensitivity with punishment sensitivity. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

A Bayesian Attractor Model for Perceptual Decision Making

PubMed Central

Bitzer, Sebastian; Bruineberg, Jelle; Kiebel, Stefan J.

2015-01-01

Even for simple perceptual decisions, the mechanisms that the brain employs are still under debate. Although current consensus states that the brain accumulates evidence extracted from noisy sensory information, open questions remain about how this simple model relates to other perceptual phenomena such as flexibility in decisions, decision-dependent modulation of sensory gain, or confidence about a decision. We propose a novel approach of how perceptual decisions are made by combining two influential formalisms into a new model. Specifically, we embed an attractor model of decision making into a probabilistic framework that models decision making as Bayesian inference. We show that the new model can explain decision making behaviour by fitting it to experimental data. In addition, the new model combines for the first time three important features: First, the model can update decisions in response to switches in the underlying stimulus. Second, the probabilistic formulation accounts for top-down effects that may explain recent experimental findings of decision-related gain modulation of sensory neurons. Finally, the model computes an explicit measure of confidence which we relate to recent experimental evidence for confidence computations in perceptual decision tasks. PMID:26267143

Logical-Rule Models of Classification Response Times: A Synthesis of Mental-Architecture, Random-Walk, and Decision-Bound Approaches

ERIC Educational Resources Information Center

Fific, Mario; Little, Daniel R.; Nosofsky, Robert M.

2010-01-01

We formalize and provide tests of a set of logical-rule models for predicting perceptual classification response times (RTs) and choice probabilities. The models are developed by synthesizing mental-architecture, random-walk, and decision-bound approaches. According to the models, people make independent decisions about the locations of stimuli…

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

Acute psychosocial stress and everyday moral decision-making in young healthy men: The impact of cortisol.

PubMed

Singer, Nina; Sommer, Monika; Döhnel, Katrin; Zänkert, Sandra; Wüst, Stefan; Kudielka, Brigitte M

2017-07-01

In everyday life, moral decisions must frequently be made under acute stress. Although there is increasing evidence that both stress and cortisol affect moral judgment and behavior as well as decision-making in various domains unrelated to morality, surprisingly few attempts have been made to explore the effects of stress on everyday moral decision-making. Therefore, in the present study, we exposed 50 young healthy men to the Trier Social Stress Test (TSST) or its non-stressful placebo version (PTSST). We investigated the impact of acute stress exposure and stress-related cortisol levels on decision-making, decision certainty, and emotions in 28 everyday moral conflict situations with altruistic versus egoistic response alternatives. Results showed that the TSST-exposed group made more altruistic decisions than the non-stress control group, while groups did not differ in decision certainty and emotion ratings. Moreover, in correlational as well as regression analyses, additionally controlling for confounding variables, we observed significant positive associations between cortisol levels and altruistic decision-making. Further analyses revealed that altruistic decisions came along with significantly higher decision certainty and significantly more positive emotion ratings than egoistic decisions. Notably, our data also raise the idea that the personality trait agreeableness plays an important role in everyday moral decision-making. In sum, our findings provide initial evidence that both acute stress exposure and cortisol levels have prosocial effects on everyday moral decision-making in young healthy men. Copyright © 2017 Elsevier Inc. All rights reserved.

Embodied choice: how action influences perceptual decision making.

PubMed

Lepora, Nathan F; Pezzulo, Giovanni

2015-04-01

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.

Regret and adaptive decision making in young children.

PubMed

O'Connor, Eimear; McCormack, Teresa; Beck, Sarah R; Feeney, Aidan

2015-07-01

In line with the claim that regret plays a role in decision making, O'Connor, McCormack, and Feeney (Child Development, 85 (2014) 1995-2010) found that children who reported feeling sadder on discovering they had made a non-optimal choice were more likely to make a different choice the next time around. We examined two issues of interpretation regarding this finding: whether the emotion measured was indeed regret and whether it was the experience of this emotion, rather than the ability to anticipate it, that affected decision making. To address the first issue, we varied the degree to which children aged 6 or 7 years were responsible for an outcome, assuming that responsibility is a necessary condition for regret. The second issue was addressed by examining whether children could accurately anticipate that they would feel worse on discovering they had made a non-optimal choice. Children were more likely to feel sad if they were responsible for the outcome; however, even if they were not responsible, children were more likely than chance to report feeling sadder. Moreover, across all conditions, feeling sadder was associated with making a better subsequent choice. In a separate task, we demonstrated that children of this age cannot accurately anticipate feeling sadder on discovering that they had not made the best choice. These findings suggest that although children may feel regret following a non-optimal choice, even if they were not responsible for an outcome, they may experience another negative emotion such as frustration. Experiencing either of these emotions seems to be sufficient to support better decision making. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Recovery and resilience after a nuclear power plant disaster: a medical decision model for managing an effective, timely, and balanced response.

PubMed

Coleman, C Norman; Blumenthal, Daniel J; Casto, Charles A; Alfant, Michael; Simon, Steven L; Remick, Alan L; Gepford, Heather J; Bowman, Thomas; Telfer, Jana L; Blumenthal, Pamela M; Noska, Michael A

2013-04-01

Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents.

Assessing potential future environmental legal events

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tonn, B.; Petrich, C.

1997-10-28

This report addresses the topic of environmental citizenship in the United States. The term refers to responsibilities each of us have with respect to helping our communities and nation make sound environmental decisions. This research centers on the citizens and what we ought to be doing, as opposed to what the government ought to be doing for us, to improve environmental citizenship. This report examines four central questions: What are the requirements (i.e., responsibilities) of citizenship vis-a-vis environmental decision- making processes; what constraints limit people`s ability to meet these requirements; what does our form of governance do to help ormore » hinder in meeting these requirements; and what recommendations can be put forth to improve public participation in environmental decision making?« less

Pilot interaction with automated airborne decision making systems

NASA Technical Reports Server (NTRS)

Rouse, W. B.; Chu, Y. Y.; Greenstein, J. S.; Walden, R. S.

1976-01-01

An investigation was made of interaction between a human pilot and automated on-board decision making systems. Research was initiated on the topic of pilot problem solving in automated and semi-automated flight management systems and attempts were made to develop a model of human decision making in a multi-task situation. A study was made of allocation of responsibility between human and computer, and discussed were various pilot performance parameters with varying degrees of automation. Optimal allocation of responsibility between human and computer was considered and some theoretical results found in the literature were presented. The pilot as a problem solver was discussed. Finally the design of displays, controls, procedures, and computer aids for problem solving tasks in automated and semi-automated systems was considered.

Expert decision-making strategies

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.

1991-01-01

A recognition-primed decisions (RPD) model is employed as a framework to investigate crew decision-making processes. The quality of information transfer, a critical component of the team RPD model and an indicator of the team's 'collective consciouness', is measured and analyzed with repect to crew performance. As indicated by the RPD model, timing and patterns of information search transfer were expected to reflect extensive and continual situation assessment, and serial evaluation of alternative states of the world or decision response options.

Strategic control in decision-making under uncertainty.

PubMed

Venkatraman, Vinod; Huettel, Scott A

2012-04-01

Complex economic decisions - whether investing money for retirement or purchasing some new electronic gadget - often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, evaluate outcomes against a variety of contexts, and flexibly match behavior to changes in the environment. In recent years, substantial research has implicated the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision-making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision-making. This region contains a functional topography such that the posterior dmPFC supports response-related control, whereas the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue for both generalized contributions of the dmPFC to cognitive control, and specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are likely to be critical for decision-making in other domains, including interpersonal interactions in social settings. © 2012 The Authors. European Journal of Neuroscience © 2012 Federation of European Neuroscience Societies and Blackwell Publishing Ltd.

Integrating Land Cover Modeling and Adaptive Management to Conserve Endangered Species and Reduce Catastrophic Fire Risk

NASA Technical Reports Server (NTRS)

Breininger, David; Duncan, Brean; Eaton, Mitchell; Johnson, Fred; Nichols, James

2014-01-01

Land cover modeling is used to inform land management, but most often via a two-step process where science informs how management alternatives can influence resources and then decision makers can use this to make decisions. A more efficient process is to directly integrate science and decision making, where science allows us to learn to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuels monitoring with decision making focused on dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy, but habitat trajectories suggest tradeoffs. Knowledge about system responses to actions can be informed by applying competing management actions to different land units in the same system state and by ideas about fire behavior. Monitoring and management integration is important to optimize state-specific management decisions and increase knowledge about system responses. We believe this approach has broad utility for and cover modeling programs intended to inform decision making.

Strategic Control in Decision Making under Uncertainty

PubMed Central

Venkatraman, Vinod; Huettel, Scott

2012-01-01

Complex economic decisions – whether investing money for retirement or purchasing some new electronic gadget – often involve uncertainty about the likely consequences of our choices. Critical for resolving that uncertainty are strategic meta-decision processes, which allow people to simplify complex decision problems, to evaluate outcomes against a variety of contexts, and to flexibly match behavior to changes in the environment. In recent years, substantial research implicates the dorsomedial prefrontal cortex (dmPFC) in the flexible control of behavior. However, nearly all such evidence comes from paradigms involving executive function or response selection, not complex decision making. Here, we review evidence that demonstrates that the dmPFC contributes to strategic control in complex decision making. This region contains a functional topography such that the posterior dmPFC supports response-related control while the anterior dmPFC supports strategic control. Activation in the anterior dmPFC signals changes in how a decision problem is represented, which in turn can shape computational processes elsewhere in the brain. Based on these findings, we argue both for generalized contributions of the dmPFC to cognitive control, and for specific computational roles for its subregions depending upon the task demands and context. We also contend that these strategic considerations are also likely to be critical for decision making in other domains, including interpersonal interactions in social settings. PMID:22487037

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game.

PubMed

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders' hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders' rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders' rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five.

Decision Making and Behavioral Choice during Predator Avoidance

PubMed Central

Herberholz, Jens; Marquart, Gregory D.

2012-01-01

One of the most important decisions animals have to make is how to respond to an attack from a potential predator. The response must be prompt and appropriate to ensure survival. Invertebrates have been important models in studying the underlying neurobiology of the escape response due to their accessible nervous systems and easily quantifiable behavioral output. Moreover, invertebrates provide opportunities for investigating these processes at a level of analysis not available in most other organisms. Recently, there has been a renewed focus in understanding how value-based calculations are made on the level of the nervous system, i.e., when decisions are made under conflicting circumstances, and the most desirable choice must be selected by weighing the costs and benefits for each behavioral choice. This article reviews samples from the current literature on anti-predator decision making in invertebrates, from single neurons to complex behaviors. Recent progress in understanding the mechanisms underlying value-based behavioral decisions is also discussed. PMID:22973187

Mission at Mubasi - A Simulation for Leadership Development

NASA Technical Reports Server (NTRS)

Cummings, Pau; Aude, Steven; Fallesen, Jon

2012-01-01

The United States Army is investing in simulations as a way of providing practice for leader decision making. Such simulations, grounded in lessons learned from deployment experienced leaders, place less experienced and more junior leaders in challenging situations they might soon be confronted with. And given increased demands on the Army to become more efficient, while maintaining acceptable levels of mission readiness, simulations offer a cost effective complement to live field training. So too, the design parameters of such a simulation can be made to reinforce specific behavior responses which teach leaders known theory and application of effective (and ineffective) decision making. With this in mind, the Center for Army Leadership (CAL) determined that decision-making was of critical importance. Specifically, the following aspects of decision-making were viewed as particularly important for today's Army leaders: 1) Decision dilemmas, in the form of equally appealing or equally unappealing choices, such that there is no clear "right" or "wrong" choice 2) Making decisions with incomplete or ambiguous information, and 3) Predicting and experiencing second- and third-order consequences of decisions. It is decision making in such a setting or environment that Army leaders are increasingly confronted with given the full spectrum of military operations they must be prepared for. This paper details the approach and development of this decision making simulation.

Frontal, Striatal, and Medial Temporal Sensitivity to Value Distinguishes Risk-Taking from Risk-Aversive Older Adults during Decision Making.

PubMed

Goh, Joshua O S; Su, Yu-Shiang; Tang, Yong-Jheng; McCarrey, Anna C; Tereshchenko, Alexander; Elkins, Wendy; Resnick, Susan M

2016-12-07

Aging compromises the frontal, striatal, and medial temporal areas of the reward system, impeding accurate value representation and feedback processing critical for decision making. However, substantial variability characterizes age-related effects on the brain so that some older individuals evince clear neurocognitive declines whereas others are spared. Moreover, the functional correlates of normative individual differences in older-adult value-based decision making remain unclear. We performed a functional magnetic resonance imaging study in 173 human older adults during a lottery choice task in which costly to more desirable stakes were depicted using low to high expected values (EVs) of points. Across trials that varied in EVs, participants decided to accept or decline the offered stakes to maximize total accumulated points. We found that greater age was associated with less optimal decisions, accepting stakes when losses were likely and declining stakes when gains were likely, and was associated with increased frontal activity for costlier stakes. Critically, risk preferences varied substantially across older adults and neural sensitivity to EVs in the frontal, striatal, and medial temporal areas dissociated risk-aversive from risk-taking individuals. Specifically, risk-averters increased neural responses to increasing EVs as stakes became more desirable, whereas risk-takers increased neural responses with decreasing EV as stakes became more costly. Risk preference also modulated striatal responses during feedback with risk-takers showing more positive responses to gains compared with risk-averters. Our findings highlight the frontal, striatal, and medial temporal areas as key neural loci in which individual differences differentially affect value-based decision-making ability in older adults. Frontal, striatal, and medial temporal functions implicated in value-based decision processing of rewards and costs undergo substantial age-related changes. However, age effects on brain function and cognition differ across individuals. How this normative variation relates to older-adult value-based decision making is unclear. We found that although the ability make optimal decisions declines with age, there is still much individual variability in how this deterioration occurs. Critically, whereas risk-averters showed increased neural activity to increasingly valuable stakes in frontal, striatal, and medial temporal areas, risk-takers instead increased activity as stakes became more costly. Such distinct functional decision-making processing in these brain regions across normative older adults may reflect individual differences in susceptibility to age-related brain changes associated with incipient cognitive impairment. Copyright © 2016 the authors 0270-6474/16/3612498-12$15.00/0.

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.

The Impact of Geographic Information Systems on Emergency Management Decision Making at the U.S. Department of Homeland Security

ERIC Educational Resources Information Center

King, Steven Gray

2012-01-01

Geographic information systems (GIS) reveal relationships and patterns from large quantities of diverse data in the form of maps and reports. The United States spends billions of dollars to use GIS to improve decisions made during responses to natural disasters and terrorist attacks, but precisely how GIS improves or impairs decision making is not…

Investigating the Decision-Making of Response to Intervention (RtI) Teams within the School Setting

ERIC Educational Resources Information Center

Thur, Scott M.

2015-01-01

The purpose of this study was to measure decision-making influences within RtI teams. The study examined the factors that influence school personnel involved in three areas of RtI: determining which RtI measures and tools teams select and implement (i.e. Measures and Tools), evaluating the data-driven decisions that are made based on the…

20 CFR 416.1866 - Deciding whether you are a child: Are you the head of a household?

Code of Federal Regulations, 2010 CFR

2010-04-01

... the head of a household. (b) If you share decision-making equally. If you live with one or more people and everyone has an equal voice in the decision-making (for example, a group of students who share off... are responsible for the day-to-day decisions on the operation of your own household. If you live with...

22 CFR 1508.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-04-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the... official's decision? 1508.860 Section 1508.860 Foreign Relations AFRICAN DEVELOPMENT FOUNDATION... debarring official's decision? This section lists the mitigating and aggravating factors that the debarring...

The Decision Tree: A Tool for Achieving Behavioral Change.

ERIC Educational Resources Information Center

Saren, Dru

1999-01-01

Presents a "Decision Tree" process for structuring team decision making and problem solving about specific student behavioral goals. The Decision Tree involves a sequence of questions/decisions that can be answered in "yes/no" terms. Questions address reasonableness of the goal, time factors, importance of the goal, responsibilities, safety,…

Theoretical aspects of cellular decision-making and information-processing.

PubMed

Kobayashi, Tetsuya J; Kamimura, Atsushi

2012-01-01

Microscopic biological processes have extraordinary complexity and variety at the sub-cellular, intra-cellular, and multi-cellular levels. In dealing with such complex phenomena, conceptual and theoretical frameworks are crucial, which enable us to understand seemingly different intra- and inter-cellular phenomena from unified viewpoints. Decision-making is one such concept that has attracted much attention recently. Since a number of cellular behavior can be regarded as processes to make specific actions in response to external stimuli, decision-making can cover and has been used to explain a broad range of different cellular phenomena [Balázsi et al. (Cell 144(6):910, 2011), Zeng et al. (Cell 141(4):682, 2010)]. Decision-making is also closely related to cellular information-processing because appropriate decisions cannot be made without exploiting the information that the external stimuli contain. Efficiency of information transduction and processing by intra-cellular networks determines the amount of information obtained, which in turn limits the efficiency of subsequent decision-making. Furthermore, information-processing itself can serve as another concept that is crucial for understanding of other biological processes than decision-making. In this work, we review recent theoretical developments on cellular decision-making and information-processing by focusing on the relation between these two concepts.

Shared decision-making as an existential journey: Aiming for restored autonomous capacity.

PubMed

Gulbrandsen, Pål; Clayman, Marla L; Beach, Mary Catherine; Han, Paul K; Boss, Emily F; Ofstad, Eirik H; Elwyn, Glyn

2016-09-01

We describe the different ways in which illness represents an existential problem, and its implications for shared decision-making. We explore core concepts of shared decision-making in medical encounters (uncertainty, vulnerability, dependency, autonomy, power, trust, responsibility) to interpret and explain existing results and propose a broader understanding of shared-decision making for future studies. Existential aspects of being are physical, social, psychological, and spiritual. Uncertainty and vulnerability caused by illness expose these aspects and may lead to dependency on the provider, which underscores that autonomy is not just an individual status, but also a varying capacity, relational of nature. In shared decision-making, power and trust are important factors that may increase as well as decrease the patient's dependency, particularly as information overload may increase uncertainty. The fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. Hence, we propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity. In doing shared decision-making, care is needed to encompass existential aspects; informing and exploring preferences is not enough. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Brain mechanisms for perceptual and reward-related decision-making.

PubMed

Deco, Gustavo; Rolls, Edmund T; Albantakis, Larissa; Romo, Ranulfo

2013-04-01

Phenomenological models of decision-making, including the drift-diffusion and race models, are compared with mechanistic, biologically plausible models, such as integrate-and-fire attractor neuronal network models. The attractor network models show how decision confidence is an emergent property; and make testable predictions about the neural processes (including neuronal activity and fMRI signals) involved in decision-making which indicate that the medial prefrontal cortex is involved in reward value-based decision-making. Synaptic facilitation in these models can help to account for sequential vibrotactile decision-making, and for how postponed decision-related responses are made. The randomness in the neuronal spiking-related noise that makes the decision-making probabilistic is shown to be increased by the graded firing rate representations found in the brain, to be decreased by the diluted connectivity, and still to be significant in biologically large networks with thousands of synapses onto each neuron. The stability of these systems is shown to be influenced in different ways by glutamatergic and GABAergic efficacy, leading to a new field of dynamical neuropsychiatry with applications to understanding schizophrenia and obsessive-compulsive disorder. The noise in these systems is shown to be advantageous, and to apply to similar attractor networks involved in short-term memory, long-term memory, attention, and associative thought processes. Copyright © 2012 Elsevier Ltd. All rights reserved.

20 CFR 416.927 - Evaluating opinion evidence.

Code of Federal Regulations, 2010 CFR

2010-04-01

... are responsible for making the determination or decision about whether you meet the statutory... rest of the relevant evidence we receive. (c) Making disability determinations. After we review all of... or decision based on that evidence. (2) If any of the evidence in your case record, including any...

ASSESSING THE EFFECTS OF DICHLOROACETIC ACID (DCA) USING A MULTI-ENDPOINT MEDAKA ASSAY

EPA Science Inventory

In regulating the safety of water, EPA makes decisions on what chemical contaminants to regulate and at what levels. To make these decisions, the EPA needs hazard identification and dose-response information. Current rodent methods for generating required information have limita...

Experienced General Music Teachers' Instructional Decision Making

ERIC Educational Resources Information Center

Johnson, Daniel C.; Matthews, Wendy K.

2017-01-01

The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…

Systematic review: the effect on surrogates of making treatment decisions for others.

PubMed

Wendler, David; Rid, Annette

2011-03-01

Clinical practice relies on surrogates to make or help to make treatment decisions for incapacitated adults; however, the effect of this practice on surrogates has not been evaluated. To assess the effect on surrogates of making treatment decisions for adults who cannot make their own decisions. Empirical studies published in English and listed in MEDLINE, EMBASE, CINAHL, BIOETHICSLINE, PsycINFO, or Scopus before 1 July 2010. Eligible studies provided quantitative or qualitative empirical data, by evaluating surrogates, regarding the effect on surrogates of making treatment decisions for an incapacitated adult. Information on study location, number and type of surrogates, timing of data collection, type of decisions, patient setting, methods, main findings, and limitations. 40 studies, 29 using qualitative and 11 using quantitative methods, provided data on 2854 surrogates, more than one half of whom were family members of the patient. Most surrogates were surveyed several months to years after making treatment decisions, the majority of which were end-of-life decisions. The quantitative studies found that at least one third of surrogates experienced a negative emotional burden as the result of making treatment decisions. The qualitative studies reported that many or most surrogates experienced negative emotional burden. The negative effects on surrogates were often substantial and typically lasted months or, in some cases, years. The most common negative effects cited by surrogates were stress, guilt over the decisions they made, and doubt regarding whether they had made the right decisions. Nine of the 40 studies also reported beneficial effects on a few surrogates, the most common of which were supporting the patient and feeling a sense of satisfaction. Knowing which treatment is consistent with the patient's preferences was frequently cited as reducing the negative effect on surrogates. Thirty-two of the 40 articles reported data collected in the United States. Because the study populations were relatively homogenous, it is unclear whether the findings apply to other groups. In some cases, the effect of making treatment decisions could not be isolated from that of other stressors, such as grief or prognostic uncertainty. Nine of the studies had a response rate less than 50%, and 9 did not report a response rate. Many of the studies had a substantial interval between the treatment decisions and data collection. Making treatment decisions has a negative emotional effect on at least one third of surrogates, which is often substantial and typically lasts months (or sometimes years). Future research should evaluate ways to reduce this burden, including methods to identify which treatment options are consistent with the patient's preferences. National Institutes of Health.

Optimal condition sampling for a network of infrastructure facilities.

DOT National Transportation Integrated Search

2011-12-31

In response to the developments in inspection technologies, infrastructure decision-making methods evolved whereby the optimum combination of inspection decisions on the one hand and maintenance and rehabilitation decisions on the other are determine...

Exploring patient involvement in healthcare decision making across different education and functional health literacy groups.

PubMed

Smith, Sian K; Dixon, Ann; Trevena, Lyndal; Nutbeam, Don; McCaffery, Kirsten J

2009-12-01

Education and health literacy potentially limit a person's ability to be involved in decisions about their health. Few studies, however, have explored understandings and experiences of involvement in decision making among patients varying in education and health literacy. This paper reports on a qualitative interview study of 73 men and women living in Sydney, Australia, with varying education and functional health literacy levels. Participants were recruited from a community sample with lower educational attainment, plus an educated sample of University of Sydney alumni. The transcripts were analysed using the 'Framework' approach, a matrix-based method of thematic analysis. We found that participants with different education conceptualised their involvement in decision making in diverse ways. Participants with higher education appeared to conceive their involvement as sharing the responsibility with the doctor throughout the decision-making process. This entailed verifying the credibility of the information and exploring options beyond those presented in the consultation. They also viewed themselves as helping others in their health decisions and acting as information resources. In contrast, participants with lower education appeared to conceive their involvement in terms of consenting to an option recommended by the doctor, and having responsibility for the ultimate decision, to agree or disagree with the recommendation. They also described how relatives and friends sought information on their behalf and played a key role in their decisions. Both education groups described how aspects of the patient-practitioner relationship (e.g. continuity, negotiation, trust) and the practitioner's interpersonal communication skills influenced their involvement. Health information served a variety of needs for all groups (e.g. supporting psychosocial, practical and decision support needs). These findings have practical implications for how to involve patients with different education and literacy levels in decision making, and highlight the important role of the patient-practitioner relationship in the process of decision making.

A judgment and decision-making model for plant behavior.

PubMed

Karban, Richard; Orrock, John L

2018-06-12

Recently plant biologists have documented that plants, like animals, engage in many activities that can be considered as behaviors, although plant biologists currently lack a conceptual framework to understand these processes. Borrowing the well-established framework developed by psychologists, we propose that plant behaviors can be constructively modeled by identifying four distinct components: 1) a cue or stimulus that provides information, 2) a judgment whereby the plant perceives and processes this informative cue, 3) a decision whereby the plant chooses among several options based on their relative costs and benefits, and 4) action. Judgment for plants can be determined empirically by monitoring signaling associated with electrical, calcium, or hormonal fluxes. Decision-making can be evaluated empirically by monitoring gene expression or differential allocation of resources. We provide examples of the utility of this judgment and decision-making framework by considering cases in which plants either successfully or unsuccessfully induced resistance against attacking herbivores. Separating judgment from decision-making suggests new analytical paradigms (i.e., Bayesian methods for judgment and economic utility models for decision-making). Following this framework, we propose an experimental approach to plant behavior that explicitly manipulates the stimuli provided to plants, uses plants that vary in sensory abilities, and examines how environmental context affects plant responses. The concepts and approaches that follow from the judgment and decision-making framework can shape how we study and understand plant-herbivore interactions, biological invasions, plant responses to climate change, and the susceptibility of plants to evolutionary traps. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A three-talk model for shared decision making: multistage consultation process.

PubMed

Elwyn, Glyn; Durand, Marie Anne; Song, Julia; Aarts, Johanna; Barr, Paul J; Berger, Zackary; Cochran, Nan; Frosch, Dominick; Galasiński, Dariusz; Gulbrandsen, Pål; Han, Paul K J; Härter, Martin; Kinnersley, Paul; Lloyd, Amy; Mishra, Manish; Perestelo-Perez, Lilisbeth; Scholl, Isabelle; Tomori, Kounosuke; Trevena, Lyndal; Witteman, Holly O; Van der Weijden, Trudy

2017-11-06

Objectives  To revise an existing three-talk model for learning how to achieve shared decision making, and to consult with relevant stakeholders to update and obtain wider engagement. Design  Multistage consultation process. Setting  Key informant group, communities of interest, and survey of clinical specialties. Participants  19 key informants, 153 member responses from multiple communities of interest, and 316 responses to an online survey from medically qualified clinicians from six specialties. Results  After extended consultation over three iterations, we revised the three-talk model by making changes to one talk category, adding the need to elicit patient goals, providing a clear set of tasks for each talk category, and adding suggested scripts to illustrate each step. A new three-talk model of shared decision making is proposed, based on "team talk," "option talk," and "decision talk," to depict a process of collaboration and deliberation. Team talk places emphasis on the need to provide support to patients when they are made aware of choices, and to elicit their goals as a means of guiding decision making processes. Option talk refers to the task of comparing alternatives, using risk communication principles. Decision talk refers to the task of arriving at decisions that reflect the informed preferences of patients, guided by the experience and expertise of health professionals. Conclusions  The revised three-talk model of shared decision making depicts conversational steps, initiated by providing support when introducing options, followed by strategies to compare and discuss trade-offs, before deliberation based on informed preferences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Family involvement for breast cancer decision making among Chinese-American women.

PubMed

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Decision-Making Style and Response to Parental Involvement in Brief Interventions for Adolescent Substance Use

PubMed Central

Piehler, Timothy F.; Winters, Ken C.

2016-01-01

Adolescent decision making has been previously identified as risk factor for substance abuse as well as a proximal intervention target. The study sought to extend this research by evaluating the role of decision-making style in response to parent involvement in brief substance abuse interventions. Adolescents (aged 12–18 years; n= 259) identified in a school setting as abusing alcohol and marijuana were randomly assigned to complete one of two brief interventions (BIs): either a 2-session adolescent-only program (BI-A) or the 2-session adolescent program with an additional parent session (BI-AP). Interventions were manualized and delivered in a school setting by trained counselors. Adolescent decision-making style was evaluated at intake, and alcohol and marijuana use were evaluated at intake and at a 6-month follow-up assessment. Supporting past research with these interventions, BI-AP demonstrated overall stronger outcomes for marijuana when compared to BI-A. Across both intervention models, an adaptive decision-making style (i.e., constructive, rational) assessed at intake predicted greater reductions in marijuana use. A significant moderation effect emerged for alcohol outcomes. Adolescents with maladaptive decision making tendencies (i.e., impulsive/careless, avoidant) demonstrated the largest benefit from the parental involvement in BI-AP, whereas those with a less impulsive style derived little additional benefit from parental involvement in regard to alcohol use outcomes. Implications for the tailoring of brief interventions for adolescent substance abuse are discussed. PMID:27929312

Decision-making style and response to parental involvement in brief interventions for adolescent substance use.

PubMed

Piehler, Timothy F; Winters, Ken C

2017-04-01

Adolescent decision making has been previously identified as risk factor for substance abuse as well as a proximal intervention target. The study sought to extend this research by evaluating the role of decision-making style in response to parent involvement in brief substance abuse interventions. Adolescents (aged 12 to 18 years; n = 259) identified in a school setting as abusing alcohol and marijuana were randomly assigned to complete 1 of 2 brief interventions (BIs), either a 2-session adolescent-only program (BI-A) or the 2-session adolescent program with an additional parent session (BI-AP). Interventions were manualized and delivered in a school setting by trained counselors. Adolescent decision-making style was evaluated at intake, and alcohol and marijuana use were evaluated at intake and at a 6-month follow-up assessment. Supporting past research with these interventions, BI-AP demonstrated overall stronger outcomes for marijuana when compared with BI-A. Across both intervention models, an adaptive decision-making style (i.e., constructive, rational) assessed at intake predicted greater reductions in marijuana use. A significant moderation effect emerged for alcohol outcomes. Adolescents with maladaptive decision-making tendencies (i.e., impulsive/careless, avoidant) demonstrated the largest benefit from the parental involvement in BI-AP, whereas those with a less impulsive style derived little additional benefit from parental involvement in regard to alcohol use outcomes. Implications for the tailoring of brief interventions for adolescent substance abuse are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

How attention influences perceptual decision making: Single-trial EEG correlates of drift-diffusion model parameters

PubMed Central

Nunez, Michael D.; Vandekerckhove, Joachim; Srinivasan, Ramesh

2016-01-01

Perceptual decision making can be accounted for by drift-diffusion models, a class of decision-making models that assume a stochastic accumulation of evidence on each trial. Fitting response time and accuracy to a drift-diffusion model produces evidence accumulation rate and non-decision time parameter estimates that reflect cognitive processes. Our goal is to elucidate the effect of attention on visual decision making. In this study, we show that measures of attention obtained from simultaneous EEG recordings can explain per-trial evidence accumulation rates and perceptual preprocessing times during a visual decision making task. Models assuming linear relationships between diffusion model parameters and EEG measures as external inputs were fit in a single step in a hierarchical Bayesian framework. The EEG measures were features of the evoked potential (EP) to the onset of a masking noise and the onset of a task-relevant signal stimulus. Single-trial evoked EEG responses, P200s to the onsets of visual noise and N200s to the onsets of visual signal, explain single-trial evidence accumulation and preprocessing times. Within-trial evidence accumulation variance was not found to be influenced by attention to the signal or noise. Single-trial measures of attention lead to better out-of-sample predictions of accuracy and correct reaction time distributions for individual subjects. PMID:28435173

How attention influences perceptual decision making: Single-trial EEG correlates of drift-diffusion model parameters.

PubMed

Nunez, Michael D; Vandekerckhove, Joachim; Srinivasan, Ramesh

2017-02-01

Perceptual decision making can be accounted for by drift-diffusion models, a class of decision-making models that assume a stochastic accumulation of evidence on each trial. Fitting response time and accuracy to a drift-diffusion model produces evidence accumulation rate and non-decision time parameter estimates that reflect cognitive processes. Our goal is to elucidate the effect of attention on visual decision making. In this study, we show that measures of attention obtained from simultaneous EEG recordings can explain per-trial evidence accumulation rates and perceptual preprocessing times during a visual decision making task. Models assuming linear relationships between diffusion model parameters and EEG measures as external inputs were fit in a single step in a hierarchical Bayesian framework. The EEG measures were features of the evoked potential (EP) to the onset of a masking noise and the onset of a task-relevant signal stimulus. Single-trial evoked EEG responses, P200s to the onsets of visual noise and N200s to the onsets of visual signal, explain single-trial evidence accumulation and preprocessing times. Within-trial evidence accumulation variance was not found to be influenced by attention to the signal or noise. Single-trial measures of attention lead to better out-of-sample predictions of accuracy and correct reaction time distributions for individual subjects.

Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease.

PubMed

Fumagalli, Manuela; Marceglia, Sara; Cogiamanian, Filippo; Ardolino, Gianluca; Picascia, Marta; Barbieri, Sergio; Pravettoni, Gabriella; Pacchetti, Claudio; Priori, Alberto

2015-07-01

The possibility that deep brain stimulation (DBS) in Parkinson's disease (PD) alters patients' decisions and actions, even temporarily, raises important clinical, ethical and legal questions. Abnormal moral decision-making can lead to ethical rules violations. Previous experiments demonstrated the subthalamic (STN) activation during moral decision-making. Here we aim to study whether STN DBS can affect moral decision-making in PD patients. Eleven patients with PD and bilateral STN DBS implant performed a computerized moral task in ON and OFF stimulation conditions. A control group of PD patients without DBS implant performed the same experimental protocol. All patients underwent motor, cognitive and psychological assessments. STN stimulation was not able to modify neither reaction times nor responses to moral task both when we compared the ON and the OFF state in the same patient (reaction times, p = .416) and when we compared DBS patients with those treated only with the best medical treatment (reaction times: p = .408, responses: p = .776). Moral judgment is the result of a complex process, requiring cognitive executive functions, problem-solving, anticipations of consequences of an action, conflict processing, emotional evaluation of context and of possible outcomes, and involving different brain areas and neural circuits. Our data show that STN DBS leaves unaffected moral decisions thus implying relevant clinical and ethical implications for DBS consequences on patients' behavior, on decision-making and on judgment ability. In conclusion, the technique can be considered safe on moral behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

Local dynamics in decision making: The evolution of preference within and across decisions

NASA Astrophysics Data System (ADS)

O'Hora, Denis; Dale, Rick; Piiroinen, Petri T.; Connolly, Fionnuala

2013-07-01

Within decisions, perceived alternatives compete until one is preferred. Across decisions, the playing field on which these alternatives compete evolves to favor certain alternatives. Mouse cursor trajectories provide rich continuous information related to such cognitive processes during decision making. In three experiments, participants learned to choose symbols to earn points in a discrimination learning paradigm and the cursor trajectories of their responses were recorded. Decisions between two choices that earned equally high-point rewards exhibited far less competition than decisions between choices that earned equally low-point rewards. Using positional coordinates in the trajectories, it was possible to infer a potential field in which the choice locations occupied areas of minimal potential. These decision spaces evolved through the experiments, as participants learned which options to choose. This visualisation approach provides a potential framework for the analysis of local dynamics in decision-making that could help mitigate both theoretical disputes and disparate empirical results.

'Gun! Gun! Gun!': An exploration of law enforcement officers' decision-making and coping under stress during actual events.

PubMed

Harris, Kevin R; Eccles, David W; Freeman, Carlos; Ward, Paul

2017-08-01

Research on decision-making under stress has mainly involved laboratory-based studies with few contextual descriptions of decision-making under stress in the natural ecology. We examined how police officers prepared for, coped with and made decisions under threat-of-death stress during real events. A delayed retrospective report method was used to elicit skilled police officers' thoughts and feelings during attempts to resolve such events. Reports were analysed to identify experiences of stress and coping, and thought processes underpinning decision-making during the event. Officers experienced a wide range of events, coped with stress predominantly via problem-focused strategies, and adapted their decision-making under stress based on the available context. Future officer training should involve a greater variety of training scenarios than is involved in current training, and expose trainees to the possible variants of each situation to foster better situational representation and, thus, a more reliable and adaptive mental model for use in decision-making. Practitioner Summary: This study concerns decision-making and coping strategies used by skilled police officers during real threat-of-death situations. Officers' decision-making strategies differed according to the complexity of the situation and they coped with the stress of these situations via attempts to resolve the situations (e.g. by planning responses) and, to a lesser extent, via attempts to deal with their emotions.

Decision-making among patients and their family in ALS care: a review.

PubMed

Foley, Geraldine; Hynes, Geralyn

2018-05-01

Practice guidelines in ALS care emphasise the role of the patient and their family in the decision-making process. We aimed to examine the ALS patient/family relationship in the decision-making process and to ascertain how patients and their family can shape one another's decisions pertaining to care. We conducted a review of peer-reviewed empirical research, published in full and in English between January 2007 and January 2017, relating to care decision-making among ALS patients and their family. Database sources included: Medline; CINAHL; AMED; PsycINFO; PsycARTICLES; and Social Sciences Full Text. A narrative synthesis was undertaken. Forty-seven studies from the empirical literature were extracted. The family viewpoint was captured primarily from family members with direct care-giving duties. Patients' cognitive status was not routinely assessed. The findings revealed that the decision-making process in ALS care can be contoured by patients' and family caregivers' perceived responsibilities to one another and to the wider family. Greater attention to family member roles beyond the primary caregiver role is needed. Strategies that integrate cognitively-impaired patients into the family decision-making process require investigation. Identification of the domains in which ALS patients and their family members support one another in the decision-making process could facilitate the development of patient/family decision-making tools in ALS care.

Chronic work stress and decreased vagal tone impairs decision making and reaction time in jockeys.

PubMed

Landolt, Kathleen; Maruff, Paul; Horan, Ben; Kingsley, Michael; Kinsella, Glynda; O'Halloran, Paul D; Hale, Matthew W; Wright, Bradley J

2017-10-01

The inverse relationship between acute stress and decision-making is well documented, but few studies have investigated the impact of chronic stress. Jockeys work exhaustive schedules and have extremely dangerous occupations, with safe performance requiring quick reaction time and accurate decision-making. We used the effort reward imbalance (ERI) occupational stress model to assess the relationship of work stress with indices of stress physiology and decision-making and reaction time. Jockeys (N=32) completed computerised cognitive tasks (Cogstate) on two occasions; September and November (naturally occurring lower and higher stress periods), either side of an acute stress test. Higher ERI was correlated with the cortisol awakening responses (high stress r=-0.37; low stress r=0.36), and with decrements in decision-making comparable to having a blood alcohol concentration of 0.08 in the high stress period (p<0.001) The LF/HF ratio of heart rate variability impacted the association of ERI with decision-making. Potentially, this may be attributed to a 'tipping point' whereby the higher ERI reported by jockeys in the high stress period decreases vagal tone, which may contribute to reduced decision-making abilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

22 CFR 208.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-04-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the... official's decision? 208.860 Section 208.860 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT... debarring official's decision? This section lists the mitigating and aggravating factors that the debarring...

22 CFR 1006.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-04-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the... official's decision? 1006.860 Section 1006.860 Foreign Relations INTER-AMERICAN FOUNDATION GOVERNMENTWIDE... official's decision? This section lists the mitigating and aggravating factors that the debarring official...

45 CFR 1309.12 - Timely decisions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Timely decisions. 1309.12 Section 1309.12 Public... PROGRAM HEAD START FACILITIES PURCHASE, MAJOR RENOVATION AND CONSTRUCTION Application Procedures § 1309.12 Timely decisions. The responsible HHS official shall promptly review and make final decisions regarding...

How do small groups make decisions? : A theoretical framework to inform the implementation and study of clinical competency committees.

PubMed

Chahine, Saad; Cristancho, Sayra; Padgett, Jessica; Lingard, Lorelei

2017-06-01

In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making. The search was conducted using Google Scholar, Web of Science, MEDLINE, ERIC, and PsycINFO for relevant literature. Using a thematic analysis, two researchers (SC & JP) met four times between April-June 2016 to consolidate the literature included in this review.Three theoretical orientations towards group decision-making emerged from the review: schema, constructivist, and social influence. Schema orientations focus on how groups use algorithms for decision-making. Constructivist orientations focus on how groups construct their shared understanding. Social influence orientations focus on how individual members influence the group's perspective on a decision. Moderators of decision-making relevant to all orientations include: guidelines, stressors, authority, and leadership.Clinical competency committees are the mechanisms by which groups of clinicians will be in charge of interpreting multiple assessment data points and coming to a shared decision about trainee competence. The way in which these committees make decisions can have huge implications for trainee progression and, ultimately, patient care. Therefore, there is a pressing need to build the science of how such group decision-making works in practice. This synthesis suggests a preliminary organizing framework that can be used in the implementation and study of clinical competency committees.

Virtual Characters: Visual Realism Affects Response Time and Decision-Making

ERIC Educational Resources Information Center

Sibuma, Bernadette

2012-01-01

This study integrates agent research with a neurocognitive technique to study how character faces affect cognitive processing. The N170 event-related potential (ERP) was used to study face processing during simple decision-making tasks. Twenty-five adults responded to facial expressions (fear/neutral) presented in three designs…

EVALUATING HYDROLOGICAL RESPONSE TO FORECASTED LAND-USE CHANGE: SCENARIO TESTING IN TWO WESTERN U.S. WATERSHEDS

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions ...

Engaging Pupils in Decision-Making about Biodiversity Conservation Issues

ERIC Educational Resources Information Center

Grace, Marcus; Byrne, Jenny

2010-01-01

Our pupils' generation will eventually have the daunting responsibility of making decisions about local and global biodiversity. School provides an early opportunity for them to enter into formal discussion about the science and values associated with biodiversity conservation; but the crowded curriculum offers little time for such activities.…

Demonstrating Empathy: A Phenomenological Study of Instructional Designers Making Instructional Strategy Decisions for Adult Learners

ERIC Educational Resources Information Center

Vann, Linda S.

2017-01-01

Instructional designers are tasked with making instructional strategy decisions to facilitate achievement of learning outcomes as part of their professional responsibilities. While the instructional design process includes learner analysis, that analysis alone does not embody opportunities to assist instructional designers with demonstrations of…

Effects of Social Psychological Phenomena on School Psychologists' Ethical Decision-Making: A Preliminary Empirical Analysis

ERIC Educational Resources Information Center

Klose, Laurie McGarry; Lasser, Jon; Reardon, Robert F.

2012-01-01

This preliminary, exploratory study examines the impact of select social psychological phenomena on school-based ethical decision-making of school psychologists. Responses to vignettes and hypothetical statements reflecting several social psychological phenomena were collected from 106 practicing school psychologists. Participants were asked to…

What Brain Sciences Reveal about Integrating Theory and Practice

ERIC Educational Resources Information Center

Patton, Michael Quinn

2014-01-01

Theory and practice are integrated in the human brain. Situation recognition and response are key to this integration. Scholars of decision making and expertise have found that people with great expertise are more adept at situational recognition and intentional about their decision-making processes. Several interdisciplinary fields of inquiry…

Neurally Constrained Modeling of Perceptual Decision Making

ERIC Educational Resources Information Center

Purcell, Braden A.; Heitz, Richard P.; Cohen, Jeremiah Y.; Schall, Jeffrey D.; Logan, Gordon D.; Palmeri, Thomas J.

2010-01-01

Stochastic accumulator models account for response time in perceptual decision-making tasks by assuming that perceptual evidence accumulates to a threshold. The present investigation mapped the firing rate of frontal eye field (FEF) visual neurons onto perceptual evidence and the firing rate of FEF movement neurons onto evidence accumulation to…

Factors Affecting Decision-Making by Young Adults with Intellectual Disabilities.

ERIC Educational Resources Information Center

Jenkinson, Josephine C.

1999-01-01

Forty-eight young adults with mental retardation were placed into high and low learned helplessness groups based on responses to a questionnaire. Participants were presented with vignettes and asked what they would do. Results found low learned helplessness participants obtained significantly higher decision-making scores. Additional information…

Training of perceptual-cognitive skills in offside decision making.

PubMed

Catteeuw, Peter; Gilis, Bart; Jaspers, Arne; Wagemans, Johan; Helsen, Werner

2010-12-01

This study investigates the effect of two off-field training formats to improve offside decision making. One group trained with video simulations and another with computer animations. Feedback after every offside situation allowed assistant referees to compensate for the consequences of the flash-lag effect and to improve their decision-making accuracy. First, response accuracy improved and flag errors decreased for both training groups implying that training interventions with feedback taught assistant referees to better deal with the flash-lag effect. Second, the results demonstrated no effect of format, although assistant referees rated video simulations higher for fidelity than computer animations. This implies that a cognitive correction to a perceptual effect can be learned also when the format does not correspond closely with the original perceptual situation. Off-field offside decision-making training should be considered as part of training because it is a considerable help to gain more experience and to improve overall decision-making performance.

Moral decision-making in university students with self-reported mild head injury.

PubMed

van Noordt, Stefon; Chiappetta, Katie; Good, Dawn

2017-10-01

Converging evidence shows that the prefrontal cortex is involved in moral decision-making. Individuals who have suffered injury to the ventromedial prefrontal cortex are more willing to endorse personal moral transgressions (e.g., make their decisions faster, and have attenuated sympathetic responses to those violations). We examined whether university students who have experienced a mild head injury (MHI), and are asymptomatic, present with a similar pattern of responding to moral dilemmas. Students reporting a history of MHI responded more quickly when making moral choices and exhibited less reticence toward the endorsement of personal moral transgressions than their non-MHI counterparts. Our results are consistent with studies involving persons with more serious, and evident, neuronal injury, and emphasize the important relationship between head injury and moral decision-making.

Decision-making under risk and ambiguity in low-birth-weight pigs.

PubMed

Murphy, Eimear; Kraak, Lynn; van den Broek, Jan; Nordquist, Rebecca E; van der Staay, Franz Josef

2015-03-01

Low birth weight (LBW) in humans is a risk factor for later cognitive, behavioural and emotional problems. In pigs, LBW is associated with higher mortality, but little is known about consequences for surviving piglets. Alteration in hypothalamic-pituitary-adrenal axis function in LBW pigs suggests altered emotionality, but no behavioural indicators have been studied. Decision-making under uncertain conditions, e.g., risk or ambiguity, is susceptible to emotional influences and may provide a means of assessing long-term effects of LBW in piglets. We tested LBW (N = 8) and normal-birth-weight (NBW; N = 8) male pigs in two decision-making tasks. For decision-making under risk, we developed a simple two-choice probabilistic task, the Pig Gambling Task (PGT), where an 'advantageous' option offered small but frequent rewards and a 'disadvantageous' option offered large but infrequent rewards. The advantageous option offered greater overall gain. For decision-making under ambiguity, we used a Judgement Bias Task (JBT) where pigs were trained to make an active response to 'positive' and 'negative' tone cues (signalling large and small rewards, respectively). Responses to ambiguous tone cues were rated as more or less optimistic. LBW pigs chose the advantageous option more often in later blocks of the PGT, and were scored as less optimistic in the JBT, than NBW pigs. Our findings demonstrate that LBW pigs have developed different behavioural strategies with respect to decision-making. We propose that this is guided by changes in emotionality in LBW piglets, and we provide behavioural evidence of increased negative affect in LBW piglets.

An integrated theory of attention and decision making in visual signal detection.

PubMed

Smith, Philip L; Ratcliff, Roger

2009-04-01

The simplest attentional task, detecting a cued stimulus in an otherwise empty visual field, produces complex patterns of performance. Attentional cues interact with backward masks and with spatial uncertainty, and there is a dissociation in the effects of these variables on accuracy and on response time. A computational theory of performance in this task is described. The theory links visual encoding, masking, spatial attention, visual short-term memory (VSTM), and perceptual decision making in an integrated dynamic framework. The theory assumes that decisions are made by a diffusion process driven by a neurally plausible, shunting VSTM. The VSTM trace encodes the transient outputs of early visual filters in a durable form that is preserved for the time needed to make a decision. Attention increases the efficiency of VSTM encoding, either by increasing the rate of trace formation or by reducing the delay before trace formation begins. The theory provides a detailed, quantitative account of attentional effects in spatial cuing tasks at the level of response accuracy and the response time distributions. (c) 2009 APA, all rights reserved

End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives.

PubMed

Wagemans, Annemieke M A; Van Schrojenstein Lantman-de Valk, Henny M J; Proot, Ireen M; Metsemakers, Job; Tuffrey-Wijne, Irene; Curfs, Leopold M G

2013-09-01

Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. A qualitative study based on semi-structured interviews, recorded digitally and transcribed verbatim. Data were analysed using Grounded Theory procedures. We interviewed 16 patient representatives after the deaths of 10 people with intellectual disabilities in the Netherlands. The core category 'Deciding for someone else' describes the context in which patient representatives took end-of-life decisions. The patient representatives felt highly responsible for the outcomes. They had not involved the patients in the end-of-life decision-making process, nor any professionals other than the doctor. The categories of 'Motives' and 'Support' were connected to the core category of 'Deciding for someone else'. 'Motives' refers to the patient representatives' ideas about quality of life, prevention from suffering, patients who cannot understand the burden of interventions and emotional reasons reported by patient representatives. 'Support' refers to the support that patient representatives wanted the doctors to give to them in the decision-making process. From the perspective of the patient representatives, the process of end-of-life decision-making can be improved by ensuring clear roles and an explicit description of the tasks and responsibilities of all participants. Regular discussion between everyone involved including people with intellectual disabilities themselves can improve knowledge about each other's motives for end-of-decisions and can clarify expectations towards each other.

The Australian funding debate on quadrivalent HPV vaccine: a case study for the national pharmaceutical policy.

PubMed

Roughead, Elizabeth Ellen; Gilbert, Andrew L; Vitry, Agnes I

2008-12-01

To analyse the media and political reactions to the initial decision of the Pharmaceutical Benefits Advisory Committee (PBAC) to reject funding of the quadrivalent human papilloma virus (HPV) vaccine in Australia. A case study, informed by media reports and government documents, was utilised to examine the reactions of key stakeholders; PBAC, consumers, consumer organisations, pharmaceutical industry, politicians, health professionals and the media to the initial decision to reject funding of HPV vaccine. The initial decision to reject funding of the HPV vaccine led to unprecedented public response with over 300 newspaper articles and calls by consumers, health professionals and politicians to intervene in the decision making process. Misunderstanding of the decision making process, particularly cost-effectiveness assessments, the need for an independent process, the legislated inability of a timely and transparent response from policy makers and the lack of a risk mitigation strategy all played a role in the public outcry. Despite 15 years of implementation of cost-effectiveness assessments there is still a need for improving stakeholder understanding of the decision making process and for timely transfer of complete information. Risk mitigation strategies should be considered as part of the communication plan for all decisions.

A dataset of human decision-making in teamwork management.

PubMed

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-17

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

A dataset of human decision-making in teamwork management

PubMed Central

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members’ capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches. PMID:28094787

A dataset of human decision-making in teamwork management

NASA Astrophysics Data System (ADS)

Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

2017-01-01

Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

A sequential sampling account of response bias and speed-accuracy tradeoffs in a conflict detection task.

PubMed

Vuckovic, Anita; Kwantes, Peter J; Humphreys, Michael; Neal, Andrew

2014-03-01

Signal Detection Theory (SDT; Green & Swets, 1966) is a popular tool for understanding decision making. However, it does not account for the time taken to make a decision, nor why response bias might change over time. Sequential sampling models provide a way of accounting for speed-accuracy trade-offs and response bias shifts. In this study, we test the validity of a sequential sampling model of conflict detection in a simulated air traffic control task by assessing whether two of its key parameters respond to experimental manipulations in a theoretically consistent way. Through experimental instructions, we manipulated participants' response bias and the relative speed or accuracy of their responses. The sequential sampling model was able to replicate the trends in the conflict responses as well as response time across all conditions. Consistent with our predictions, manipulating response bias was associated primarily with changes in the model's Criterion parameter, whereas manipulating speed-accuracy instructions was associated with changes in the Threshold parameter. The success of the model in replicating the human data suggests we can use the parameters of the model to gain an insight into the underlying response bias and speed-accuracy preferences common to dynamic decision-making tasks. © 2013 American Psychological Association

Evidence accumulation in obsessive-compulsive disorder: the role of uncertainty and monetary reward on perceptual decision-making thresholds.

PubMed

Banca, Paula; Vestergaard, Martin D; Rankov, Vladan; Baek, Kwangyeol; Mitchell, Simon; Lapa, Tatyana; Castelo-Branco, Miguel; Voon, Valerie

2015-03-13

The compulsive behaviour underlying obsessive-compulsive disorder (OCD) may be related to abnormalities in decision-making. The inability to commit to ultimate decisions, for example, patients unable to decide whether their hands are sufficiently clean, may reflect failures in accumulating sufficient evidence before a decision. Here we investigate the process of evidence accumulation in OCD in perceptual discrimination, hypothesizing enhanced evidence accumulation relative to healthy volunteers. Twenty-eight OCD patients and thirty-five controls were tested with a low-level visual perceptual task (random-dot-motion task, RDMT) and two response conflict control tasks. Regression analysis across different motion coherence levels and Hierarchical Drift Diffusion Modelling (HDDM) were used to characterize response strategies between groups in the RDMT. Patients required more evidence under high uncertainty perceptual contexts, as indexed by longer response time and higher decision boundaries. HDDM, which defines a decision when accumulated noisy evidence reaches a decision boundary, further showed slower drift rate towards the decision boundary reflecting poorer quality of evidence entering the decision process in patients under low uncertainty. With monetary incentives emphasizing speed and penalty for slower responses, patients decreased the decision thresholds relative to controls, accumulating less evidence in low uncertainty. These findings were unrelated to visual perceptual deficits and response conflict. This study provides evidence for impaired decision-formation processes in OCD, with a differential influence of high and low uncertainty contexts on evidence accumulation (decision threshold) and on the quality of evidence gathered (drift rates). It further emphasizes that OCD patients are sensitive to monetary incentives heightening speed in the speed-accuracy tradeoff, improving evidence accumulation.

“Do your homework…and then hope for the best”: the challenges that medical tourism poses to Canadian family physicians’ support of patients’ informed decision-making

PubMed Central

2013-01-01

Background Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism. Methods Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants’ perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians’ abilities to support medical tourists’ informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Results Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician’s role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician’s reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians’ concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Conclusions Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad. PMID:24053385

"Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

PubMed

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

2013-09-22

Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for Canadian family physicians who now find themselves needing to carefully negotiate their roles and responsibilities in the informed decision-making process of their patients who decide to seek private treatment abroad as medical tourists. These physicians can and should be educated to enable their patients to look critically at the information available about medical tourism providers and to ask critical questions of patients deciding to access care abroad.

"Making Do" Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards.

PubMed

Wills, Celia E; Polivka, Barbara J; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2016-04-01

This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of "making do" decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. © The Author(s) 2015.

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

“Making Do” Decisions: How Home Healthcare Personnel Manage Their Exposure to Home Hazards

PubMed Central

Wills, Celia E.; Polivka, Barbara J.; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2016-01-01

This study describes the decision-making processes home healthcare personnel (HHP) use to manage their personal health and safety when managing hazards in client homes. A professionally diverse national sample of 68 HHP participated in individual semi-structured interviews and focus group discussions, and described their decision making and strategies for hazard management in their work environments. HHP described 353 hazard management dilemmas within 394 specifically identified hazards, which were clustered within three broader categories: electrical/fire, slip/trip/lift, and environmental exposures. HHP described multiple types of “making do” decisions for hazard management solutions in which perceived and actual resource limitations constrained response options. A majority of hazard management decisions in the broader hazards categories (72.5%, 68.5%, and 63.5%, respectively) were classifiable as less than optimal. These findings stress the need for more support of HHPs, including comprehensive training, to improve HHP decision making and hazard management strategies, especially in context of resource constraints. PMID:26669605

Signal detection with criterion noise: applications to recognition memory.

PubMed

Benjamin, Aaron S; Diaz, Michael; Wee, Serena

2009-01-01

A tacit but fundamental assumption of the theory of signal detection is that criterion placement is a noise-free process. This article challenges that assumption on theoretical and empirical grounds and presents the noisy decision theory of signal detection (ND-TSD). Generalized equations for the isosensitivity function and for measures of discrimination incorporating criterion variability are derived, and the model's relationship with extant models of decision making in discrimination tasks is examined. An experiment evaluating recognition memory for ensembles of word stimuli revealed that criterion noise is not trivial in magnitude and contributes substantially to variance in the slope of the isosensitivity function. The authors discuss how ND-TSD can help explain a number of current and historical puzzles in recognition memory, including the inconsistent relationship between manipulations of learning and the isosensitivity function's slope, the lack of invariance of the slope with manipulations of bias or payoffs, the effects of aging on the decision-making process in recognition, and the nature of responding in remember-know decision tasks. ND-TSD poses novel, theoretically meaningful constraints on theories of recognition and decision making more generally, and provides a mechanism for rapprochement between theories of decision making that employ deterministic response rules and those that postulate probabilistic response rules.

Behavioral and Neural Adaptation in Approach Behavior.

PubMed

Wang, Shuo; Falvello, Virginia; Porter, Jenny; Said, Christopher P; Todorov, Alexander

2018-06-01

People often make approachability decisions based on perceived facial trustworthiness. However, it remains unclear how people learn trustworthiness from a population of faces and whether this learning influences their approachability decisions. Here we investigated the neural underpinning of approach behavior and tested two important hypotheses: whether the amygdala adapts to different trustworthiness ranges and whether the amygdala is modulated by task instructions and evaluative goals. We showed that participants adapted to the stimulus range of perceived trustworthiness when making approach decisions and that these decisions were further modulated by the social context. The right amygdala showed both linear response and quadratic response to trustworthiness level, as observed in prior studies. Notably, the amygdala's response to trustworthiness was not modulated by stimulus range or social context, a possible neural dynamic adaptation. Together, our data have revealed a robust behavioral adaptation to different trustworthiness ranges as well as a neural substrate underlying approach behavior based on perceived facial trustworthiness.

2 CFR 180.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the... official's decision? 180.860 Section 180.860 Grants and Agreements OFFICE OF MANAGEMENT AND BUDGET...'s decision? This section lists the mitigating and aggravating factors that the debarring official...

34 CFR 85.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-07-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the... decision? 85.860 Section 85.860 Education Office of the Secretary, Department of Education GOVERNMENTWIDE... official's decision? This section lists the mitigating and aggravating factors that the debarring official...

21 CFR 1404.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-04-01

... not necessarily determinative of your present responsibility. In making a debarment decision, the...'s decision? 1404.860 Section 1404.860 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY... debarring official's decision? This section lists the mitigating and aggravating factors that the debarring...

7 CFR 3017.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... your present responsibility. In making a debarment decision, the debarring official may consider the... decision? 3017.860 Section 3017.860 Agriculture Regulations of the Department of Agriculture (Continued... (NONPROCUREMENT) Debarment § 3017.860 What factors may influence the debarring official's decision? This section...

Understandings of the nature of science and decision making on science and technology based issues

NASA Astrophysics Data System (ADS)

Bell, Randy L.; Lederman, Norman G.

2003-05-01

The purpose of this investigation was to explicate the role of the nature of science in decision making on science and technology based issues and to delineate factors and reasoning associated with these types of decisions. Twenty-one volunteer participants purposively selected from the faculty of geographically diverse universities completed an open-ended questionnaire and follow-up interview designed to assess their decision making on science and technology based issues. Participants were subsequently placed in one of two groups based upon their divergent views of the nature of science as assessed by a second open-ended questionnaire and follow-up interview. Profiles of each group's decision making were then constructed, based on participants' previous responses to the decision making questionnaire and follow-up interviews. Finally, the two groups' decisions, decision influencing factors, and decision making strategies were compared. No differences were found between the decisions of the two groups, despite their disparate views of the nature of science. Participants in both groups based their decisions primarily on personal values, morals/ethics, and social concerns. While all participants considered scientific evidence in their decision making, most did not require absolute proof, even though many participants held absolute conceptions of the nature of science. Overall, the nature of science did not figure prominently in either group's decisions. These findings contrast with basic assumptions of current science education reform efforts and call for a re-examination of the goals of nature of science instruction. Developing better decision making skills - even on science and technology based issues - may involve other factors, including more value-based instruction and attention to intellectual/moral development.

Emotion and the law: a framework for inquiry.

PubMed

Wiener, Richard L; Bornstein, Brian H; Voss, Amy

2006-04-01

This paper draws on research in social and cognitive psychology to show how theories of judgment and decision making that incorporate decision makers' affective responses apply to legal contexts. It takes 2 widely used models of decision making, the rational actor and lens models, and illustrates their utility for understanding legal judgments by using them to interpret research findings on juror decision making, people's obedience to the law (e.g., paying taxes), and eyewitness memory. The paper concludes with a discussion of the advantages of modifying existing approaches to information processing to include the influence of affect on how legal actors reach judgments about law and legal process.

Neural correlates of decision making on a gambling task.

PubMed

Carlson, Stephanie M; Zayas, Vivian; Guthormsen, Amy

2009-01-01

Individual differences in affective decision making were examined by recording event-related potentials (ERPs) while 74 typically developing 8-year-olds (38 boys, 36 girls) completed a 4-choice gambling task (Hungry Donkey Task; E. A. Crone & M. W. van der Molen, 2004). ERP results indicated: (a) a robust P300 component in response to feedback (punishment vs. reward outcomes), (b) anticipation effects (stimulus-preceding negativity) prior to outcomes presented on frequent (vs. infrequent) punishment choices, (c) anticipation effects prior to selections associated with short and long-term losses (vs. gains), and (d) individual differences in ERP components were significantly correlated with behavioral performance and verbal ability. These findings suggest that neurophysiological responses may be an index of children's trait-based and/or developmental level of decision-making skills in affective-motivational situations.

MoCog1: A computer simulation of recognition-primed human decision making

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

This report describes the successful results of the first stage of a research effort to develop a 'sophisticated' computer model of human cognitive behavior. Most human decision-making is of the experience-based, relatively straight-forward, largely automatic, type of response to internal goals and drives, utilizing cues and opportunities perceived from the current environment. This report describes the development of the architecture and computer program associated with such 'recognition-primed' decision-making. The resultant computer program was successfully utilized as a vehicle to simulate findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior in response to their environment. The present work is an expanded version and is based on research reported while the author was an employee of NASA ARC.

DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

PubMed

Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

2015-01-01

Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

Savings sharing: rewarding staff for responsible decision-making.

PubMed

Jones, Debi

2005-04-01

Shortages of professional nurses create a "buyer's market" in which nurses accept temporary assignments for the highest rates and offer little additional time to the primary employer. Use of temporary personnel use salary dollars at an inordinate rate while offering little continuity or support for the organization's standards. Methods for placing decision-making in the hands of the nurses are needed along with a reward system for establishing a pattern of sound decision-making. The author describes a savings sharing program that is gaining credibility in one organization for addressing both objectives.

Colorectal cancer patients’ attitudes towards involvement in decision making

PubMed Central

Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A.; Susnerwala, Shabbir S.

2009-01-01

Abstract Objectives  To design and administer an attitude rating scale, exploring colorectal cancer patients’ views of involvement in decision making. To examine the impact of socio‐demographic and/or treatment‐related factors on decision making. To conduct principal components analysis to determine if the scale could be simplified into a number of factors for future clinical utility. Methods  An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross‐sectional survey approach. Results  375 questionnaires were returned (81.7% response). For patients it was important to be informed and involved in the decision‐making process. Information was not always used to make decisions as patients placed their trust in medical expertise. Women had more positive opinions on decision making and were more likely to want to make decisions. Written information was understood to a greater degree than verbal information. The scale could be simplified to a number of factors, indicating clinical utility. Conclusion  Few studies have explored the attitudes of colorectal cancer patients towards involvement in decision making. This study presents new insights into how patients view the concept of participation; important when considering current policy imperatives in the UK of involving service users in all aspects of care and treatment. PMID:19250150

Conditional responding is impaired in chronic alcoholics.

PubMed

Hildebrandt, Helmut; Brokate, B; Hoffmann, E; Kröger, B; Eling, P

2006-07-01

Bechara (2003) describes a model for disturbances in executive functions related to addiction. This model involves deficits in decision-making and in suppressing pre-potent representations or response patterns. We tested this model in 29 individuals with long-term heavy alcohol dependency and compared their performance with that of 20 control subjects. Only individuals without memory impairment, with normal intelligence and normal visual response times were included. We examined word fluency, object alternation, spatial stimulus-response incompatibility, extra-dimensional shift learning and decision-making using the Gambling task. We subtracted the performance in a control condition from that of the executive condition, in order to focus specifically on the executive component of each task. Only the object alternation and incompatibility tasks revealed significant differences between the group of alcoholics and the control group. Moreover, response times in the object alternation task correlated with duration of alcohol dependency. The results do not argue in favor of a specific deficit in decision-making or in shifting between relevant representations. We conclude that long-term alcohol abuse leads to an impairment in conditional responding, provided the response depends on former reactions or the inhibition of pre-potent response patterns.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback

PubMed Central

Whitney, Paul; Hinson, John M.; Jackson, Melinda L.; Van Dongen, Hans P.A.

2015-01-01

Study Objectives: To better understand the sometimes catastrophic effects of sleep loss on naturalistic decision making, we investigated effects of sleep deprivation on decision making in a reversal learning paradigm requiring acquisition and updating of information based on outcome feedback. Design: Subjects were randomized to a sleep deprivation or control condition, with performance testing at baseline, after 2 nights of total sleep deprivation (or rested control), and following 2 nights of recovery sleep. Subjects performed a decision task involving initial learning of go and no go response sets followed by unannounced reversal of contingencies, requiring use of outcome feedback for decisions. A working memory scanning task and psychomotor vigilance test were also administered. Setting: Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring. Subjects: Twenty-six subjects (22–40 y of age; 10 women). Interventions: Thirteen subjects were randomized to a 62-h total sleep deprivation condition; the others were controls. Results: Unlike controls, sleep deprived subjects had difficulty with initial learning of go and no go stimuli sets and had profound impairment adapting to reversal. Skin conductance responses to outcome feedback were diminished, indicating blunted affective reactions to feedback accompanying sleep deprivation. Working memory scanning performance was not significantly affected by sleep deprivation. And although sleep deprived subjects showed expected attentional lapses, these could not account for impairments in reversal learning decision making. Conclusions: Sleep deprivation is particularly problematic for decision making involving uncertainty and unexpected change. Blunted reactions to feedback while sleep deprived underlie failures to adapt to uncertainty and changing contingencies. Thus, an error may register, but with diminished effect because of reduced affective valence of the feedback or because the feedback is not cognitively bound with the choice. This has important implications for understanding and managing sleep loss-induced cognitive impairment in emergency response, disaster management, military operations, and other dynamic real-world settings with uncertain outcomes and imperfect information. Citation: Whitney P, Hinson JM, Jackson ML, Van Dongen HPA. Feedback blunting: total sleep deprivation impairs decision making that requires updating based on feedback. SLEEP 2015;38(5):745–754. PMID:25515105

Naturalistic decision-making in expert badminton players.

PubMed

Macquet, A C; Fleurance, P

2007-09-01

This paper reports on a study of naturalistic decision-making in expert badminton players. These decisions are frequently taken under time-pressured conditions, yet normally lead to successful performance. Two male badminton teams participated in this study. Self-confrontation interviews were used to collect data. Inductive data analysis revealed three types of intentions during a rally: to maintain the rally; to take the advantage; and to finish the point. It also revealed eight types of decision taken in this situation: to ensure an action; to observe the opponent's response to an action; to realize a limited choice; to influence the opponent's decision; to put pressure on an opponent; to surprise the opponent; to reproduce an efficient action; and to play wide. A frequent decision was to put pressure on the opponent. Different information and knowledge was linked to specific decisions. The results are discussed in relation to research that has considered naturalistic decision-making.

Spatiotemporal dynamics of random stimuli account for trial-to-trial variability in perceptual decision making

PubMed Central

Park, Hame; Lueckmann, Jan-Matthis; von Kriegstein, Katharina; Bitzer, Sebastian; Kiebel, Stefan J.

2016-01-01

Decisions in everyday life are prone to error. Standard models typically assume that errors during perceptual decisions are due to noise. However, it is unclear how noise in the sensory input affects the decision. Here we show that there are experimental tasks for which one can analyse the exact spatio-temporal details of a dynamic sensory noise and better understand variability in human perceptual decisions. Using a new experimental visual tracking task and a novel Bayesian decision making model, we found that the spatio-temporal noise fluctuations in the input of single trials explain a significant part of the observed responses. Our results show that modelling the precise internal representations of human participants helps predict when perceptual decisions go wrong. Furthermore, by modelling precisely the stimuli at the single-trial level, we were able to identify the underlying mechanism of perceptual decision making in more detail than standard models. PMID:26752272

Ethnic bias and clinical decision-making among New Zealand medical students: an observational study.

PubMed

Harris, Ricci; Cormack, Donna; Stanley, James; Curtis, Elana; Jones, Rhys; Lacey, Cameron

2018-01-23

Health professional racial/ethnic bias may impact on clinical decision-making and contribute to subsequent ethnic health inequities. However, limited research has been undertaken among medical students. This paper presents findings from the Bias and Decision-Making in Medicine (BDMM) study, which sought to examine ethnic bias (Māori (indigenous peoples) compared with New Zealand European) among medical students and associations with clinical decision-making. All final year New Zealand (NZ) medical students in 2014 and 2015 (n = 888) were invited to participate in a cross-sectional online study. Key components included: two chronic disease vignettes (cardiovascular disease (CVD) and depression) with randomized patient ethnicity (Māori or NZ European) and questions on patient management; implicit bias measures (an ethnicity preference Implicit Association Test (IAT) and an ethnicity and compliant patient IAT); and, explicit ethnic bias questions. Associations between ethnic bias and clinical decision-making responses to vignettes were tested using linear regression. Three hundred and two students participated (34% response rate). Implicit and explicit ethnic bias favoring NZ Europeans was apparent among medical students. In the CVD vignette, no significant differences in clinical decision-making by patient ethnicity were observed. There were also no differential associations by patient ethnicity between any measures of ethnic bias (implicit or explicit) and patient management responses in the CVD vignette. In the depression vignette, some differences in the ranking of recommended treatment options were observed by patient ethnicity and explicit preference for NZ Europeans was associated with increased reporting that NZ European patients would benefit from treatment but not Māori (slope difference 0.34, 95% CI 0.08, 0.60; p = 0.011), although this was the only significant finding in these analyses. NZ medical students demonstrated ethnic bias, although overall this was not associated with clinical decision-making. This study both adds to the small body of literature internationally on racial/ethnic bias among medical students and provides relevant and important information for medical education on indigenous health and ethnic health inequities in New Zealand.

Perceptual decision processes flexibly adapt to avoid change-of-mind motor costs

PubMed Central

Moher, Jeff; Song, Joo-Hyun

2014-01-01

The motor system is tightly linked with perception and cognition. Recent studies have shown that even anticipated biophysical action costs associated with competing response options can be incorporated into decision-making processes. As a result, choices associated with high energy costs are less likely to be selected. However, some action costs may be harder to predict. For example, a person choosing among apples at a grocery store may change his or her mind suddenly about which apple to put into the cart. This change of mind may be reflected in motor output as the initial decision triggers a motor response toward a Granny Smith that is subsequently redirected toward a Red Delicious. In the present study, to examine how motor costs associated with changes of mind affect perceptual decision making, participants performed a difficult random dot–motion discrimination task in which they had to indicate the direction of motion by reaching to one of two response options. Although each response box was always equidistant from the starting position, the physical distance between the two response options was varied. We found that when the boxes were far apart from one another, and thus changes of mind incurred greater redirection motor costs, change-of-mind frequency decreased while latency to initiate movement increased. This occurred even when response box distance varied randomly from trial to trial and was cued only 1 s before each trial began. Thus, we demonstrated that observers can dynamically adjust perceptual decision-making processes to avoid high motor costs incurred by a change of mind. PMID:24986186

Decision-Making Experiences of Patients with Implantable Cardioverter Defibrillators.

PubMed

Green, Ariel R; Jenkins, Amy; Masoudi, Frederick A; Magid, David J; Kutner, Jean S; Leff, Bruce; Matlock, Daniel D

2016-10-01

When patients are not adequately engaged in decision making, they may be at risk of decision regret. Our objective was to explore patients' perceptions of their decision-making experiences related to implantable cardioverter defibrillators (ICDs). Cross-sectional, mailed survey of 412 patients who received an ICD without cardiac resynchronization therapy for any indication between 2006 and 2009. Patients were asked about decision participation and decision regret. A total of 295 patients with ICDs responded (72% response rate). Overall, 79% reported that they were as involved in the decision as they wanted. However, 28% reported that they were not told of the option of not getting an ICD and 37% did not remember being asked if they wanted an ICD. In total, 19% reported not wanting their ICD at the time of implantation. Those who did not want the ICD were younger (<65 years; 74% vs 43%, P < 0.001), had higher decision regret (31/100 vs 11/100, P < 0.001), and reported less participation in decision making (the doctor "totally" made the decision, 9% vs 3%; P < 0.001). A considerable number of ICD recipients recalled not wanting their ICD at the time of implantation. While these findings may be prone to recall bias, they likely identify opportunities to improve ICD decision making. © 2016 Wiley Periodicals, Inc.

Factors influencing decision-making role preferences: A qualitative study of Malaysian patients with type 2 diabetes during insulin initiation.

PubMed

Lee, Yew Kong; Low, Wah Yun; Lee, Ping Yein; Ng, Chirk Jenn

2015-05-01

Patient decision-making role preference (DMRP) is a patient's preferred degree of control when making medical decisions. This descriptive qualitative study aimed to explore Malaysian patients' views on their DMRP. Between January 2011 and March 2012, 22 individual face-to-face in-depth interviews were conducted with patients with type 2 diabetes who were deciding about insulin initiation. The interviews were audio-recorded and analysed using a thematic approach. The age range of participants was 28-67 years old with 11 men. Ten patients preferred to make the decision themselves, six patients indicated that the clinician should make the decision and only one patient expressed a preference for a collaborative role. The following factors influenced DMRP: trust in clinicians, responsibility for diabetes care, level of knowledge and awareness, involvement of family and personal characteristics. In conclusion, the concept of shared decision-making is still alien, and a more participative communication style might help to facilitate patients' expression of DMRP. © 2014 Wiley Publishing Asia Pty Ltd.

End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

PubMed

Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

2018-05-01

End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

[How to decide with precision, justice, and equity? Reflections on decision-making in the context of extreme prematurity. Part two: moving toward making the best possible decision: defining conditions for putting decisions into practice].

PubMed

Azria, E; Tsatsaris, V; Moriette, G; Hirsch, E; Schmitz, T; Cabrol, D; Goffinet, F

2007-05-01

Extreme premature child's long-term prognostic is getting better and better known, and if a resuscitation procedure is possible at birth, it won't guarantee survival or a survival free of disability. Incertitude toward individual prognosis and outcome for those children remains considerable. In this field, we are at the frontier of medical knowledge and the answer to the question, "how to decide the ante and postnatal care" is crucial. This work is focused on this problematic of decision-making in the context of extreme prematurity. It attempts to deconstruct this concept and to explicit its stakes. Thus, with the support of the medical sources and of philosophical debates, we tried to build a decision-making procedure that complies with the ethical requirements of medical care, accuracy, justice and equity. This decision-making procedure is primarily concerned with the singularity of each decision situation and it intends to link it closely to the notions of rationality and responsibility.

Integrating land cover modeling and adaptive management to conserve endangered species and reduce catastrophic fire risk

USGS Publications Warehouse

Breininger, David; Duncan, Brean; Eaton, Mitchell J.; Johnson, Fred; Nichols, James

2014-01-01

Land cover modeling is used to inform land management, but most often via a two-step process, where science informs how management alternatives can influence resources, and then, decision makers can use this information to make decisions. A more efficient process is to directly integrate science and decision-making, where science allows us to learn in order to better accomplish management objectives and is developed to address specific decisions. Co-development of management and science is especially productive when decisions are complicated by multiple objectives and impeded by uncertainty. Multiple objectives can be met by the specification of tradeoffs, and relevant uncertainty can be addressed through targeted science (i.e., models and monitoring). We describe how to integrate habitat and fuel monitoring with decision-making focused on the dual objectives of managing for endangered species and minimizing catastrophic fire risk. Under certain conditions, both objectives might be achieved by a similar management policy; other conditions require tradeoffs between objectives. Knowledge about system responses to actions can be informed by developing hypotheses based on ideas about fire behavior and then applying competing management actions to different land units in the same system state. Monitoring and management integration is important to optimize state-specific management decisions and to increase knowledge about system responses. We believe this approach has broad utility and identifies a clear role for land cover modeling programs intended to inform decision-making.

Decision-making impairments in the context of intact reward sensitivity in schizophrenia.

PubMed

Heerey, Erin A; Bell-Warren, Kimberly R; Gold, James M

2008-07-01

Deficits in motivated behavior and decision-making figure prominently in the behavioral syndrome that characterizes schizophrenia and are difficult both to treat and to understand. One explanation for these deficits is that schizophrenia decreases sensitivity to rewards in the environment. An alternate explanation is that sensitivity to rewards is intact but that poor integration of affective with cognitive information impairs the ability to use this information to guide behavior. We tested reward sensitivity with a modified version of an existing signal detection task with asymmetric reinforcement and decision-making with a probabilistic decision-making task in 40 participants with schizophrenia and 26 healthy participants. Results showed normal sensitivity to reward in participants with schizophrenia but differences in choice patterns on the decision-making task. A logistic regression model of the decision-making data showed that participants with schizophrenia differed from healthy participants in the ability to weigh potential outcomes, specifically potential losses, when choosing between competing response options. Deficits in working memory ability accounted for group differences in ability to use potential outcomes during decision-making. These results suggest that the implicit mechanisms that drive reward-based learning are surprisingly intact in schizophrenia but that poor ability to integrate cognitive and affective information when calculating the value of possible choices might hamper the ability to use such information during explicit decision-making.

Risky decision making in adults with ADHD.

PubMed

Matthies, S; Philipsen, A; Svaldi, J

2012-09-01

Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD. In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT. In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction. Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression. Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research. Copyright © 2012 Elsevier Ltd. All rights reserved.

Key elements of optimal treatment decision-making for surgeons and older patients with colorectal or pancreatic cancer: A qualitative study.

PubMed

Geessink, Noralie H; Schoon, Yvonne; van Herk, Hanneke C P; van Goor, Harry; Olde Rikkert, Marcel G M

2017-03-01

To identify key elements of optimal treatment decision-making for surgeons and older patients with colorectal (CRC) or pancreatic cancer (PC). Six focus groups with different participants were performed: three with older CRC/PC patients and relatives, and three with physicians. Supplementary in-depth interviews were conducted in another seven patients. Framework analysis was used to identify key elements in decision-making. 23 physicians, 22 patients and 14 relatives participated. Three interacting components were revealed: preconditions, content and facilitators of decision-making. To provide optimal information about treatments' impact on an older patient's daily life, physicians should obtain an overall picture and take into account patients' frailty. Depending on patients' preferences and capacities, dividing decision-making into more sessions will be helpful and simultaneously emphasize patients' own responsibility. GPs may have a valuable contribution because of their background knowledge and supportive role. Stakeholders identified several crucial elements in the complex surgical decision-making of older CRC/PC patients. Structured qualitative research may also be of great help in optimizing other treatment directed decision-making processes. Surgeons should be trained in examining preconditions and useful facilitators in decision-making in older CRC/PC patients to optimize its content and to improve the quality of shared care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The role of the anterior cingulate cortex in women's sexual decision making.

PubMed

Rupp, Heather A; James, Thomas W; Ketterson, Ellen D; Sengelaub, Dale R; Janssen, Erick; Heiman, Julia R

2009-01-02

Women's sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with women's sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of men's faces. Face stimuli were accompanied by information regarding each man's potential risk as a sexual partner, indicated by a written description of the man's number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on women's attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with women's subjective evaluations of sex likelihood and response times during their evaluations of high, but not low risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.

PubMed Central

Weeks, Laura; Balneaves, Lynda G; Paterson, Charlotte

2014-01-01

Background: Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decisionmaking by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework. Methods: We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts. Results: Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of informationseeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented. Interpretation: CAM-related decision-making by patients with cancer occurs as a nonlinear, complex, dynamic process. The conceptual framework presented here identifies influential factors within that process, as well as patients' unique needs during different phases. The framework can guide the development and evaluation of theorybased decision-support programs that are responsive to patients' beliefs and preferences. PMID:25009685

Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

PubMed

Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

2015-02-01

Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

5 CFR 919.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-01-01

... responsibility. In making a debarment decision, the debarring official may consider the following factors: (a... official's decision? 919.860 Section 919.860 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT...) Debarment § 919.860 What factors may influence the debarring official's decision? This section lists the...

29 CFR 98.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-07-01

... your present responsibility. In making a debarment decision, the debarring official may consider the... 29 Labor 1 2010-07-01 2010-07-01 true What factors may influence the debarring official's decision... (NONPROCUREMENT) Debarment § 98.860 What factors may influence the debarring official's decision? This section...

The medical decision model and decision maker tools for management of radiological and nuclear incidents.

PubMed

Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

2014-06-01

Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

Rethinking autonomy: decision making between patient and surgeon in advanced illnesses

PubMed Central

Hinshaw, Daniel B.

2016-01-01

Patients with advanced illness such as advanced stage cancer presenting with the need for possible surgical intervention can be some of the most challenging cases for a surgeon. Often there are multiple factors influencing the decisions made. For patients they are facing not just the effects of the disease on their body, but the stark realization that the disease will also limit their life. Not only are these factors a consideration when patients are making decisions, but also the desire to make the decision that is best for themselves, the autonomous decision. Also included in this process for the patient facing the possible need for an intervention is the surgeon. While patient autonomy remains one of the main principles within medicine, guiding treatment decisions, there is also the surgeon’s autonomy to be considered. Surgeons determine if there is even a possible intervention to be offered to patients, a decision making process that respects surgeons’ autonomous choices and includes elements of paternalism as surgeons utilize their expertise to make decisions. Included in the treatment decisions that are made and the care of the patient is the impact patients’ outcomes have on the surgeon, the inherent drive to be the best for the patient and desire for good outcomes for the patient. While both the patient’s and surgeon’s autonomy are a dynamic interface influencing decision making, the main goal for the patient facing a palliative procedure is that of making treatment decisions based on the concept of shared decision making, always giving primary consideration to the patient’s goals and values. Lastly, regardless of the decision made, it is the responsibility of surgeons to their patients to be a source of support through this challenging time. PMID:27004224

Decision Processes and Determinants of Hospital Evacuation and Shelter-in-Place During Hurricane Sandy.

PubMed

McGinty, Meghan D; Burke, Thomas A; Resnick, Beth; Barnett, Daniel J; Smith, Katherine C; Rutkow, Lainie

Evacuation and shelter-in-place decision making for hospitals is complex, and existing literature contains little information about how these decisions are made in practice. To describe decision-making processes and identify determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. Semistructured interviews were conducted from March 2014 to February 2015 with key informants who had authority and responsibility for evacuation and shelter-in-place decisions for hospitals during Hurricane Sandy in 2012. Interviews were recorded, transcribed, and thematically analyzed. Interviewees included hospital executives and state and local public health, emergency management, and emergency medical service officials from Delaware, Maryland, New Jersey, and New York. Interviewees identified decision processes and determinants of acute care hospital evacuation and shelter-in-place during Hurricane Sandy. We interviewed 42 individuals from 32 organizations. Decisions makers reported relying on their instincts rather than employing guides or tools to make evacuation and shelter-in-place decisions during Hurricane Sandy. Risk to patient health from evacuation, prior experience, cost, and ability to maintain continuity of operations were the most influential factors in decision making. Flooding and utility outages, which were predicted to or actually impacted continuity of operations, were the primary determinants of evacuation. Evacuation and shelter-in-place decision making for hospitals can be improved by ensuring hospital emergency plans address flooding and include explicit thresholds that, if exceeded, would trigger evacuation. Comparative risk assessments that inform decision making would be enhanced by improved collection, analysis, and communication of data on morbidity and mortality associated with evacuation versus sheltering-in-place of hospitals. In addition, administrators and public officials can improve their preparedness to make evacuation and shelter-in-place decisions by practicing the use of decision-making tools during training and exercises.

Leadership emergence: the application of the Cynefin framework during a bio-social HIV/AIDS risk-reduction pilot.

PubMed

Burman, Christopher J; Aphane, Marota A

2016-09-01

This article focuses on the utility of a knowledge management heuristic called the Cynefin framework, which was applied during an ongoing pilot intervention in the Limpopo province, South Africa. The intervention aimed to identify and then consolidate low-cost, innovative bio-social responses to reinforce the biomedical opportunities that now have the potential to "end AIDS by 2030″. The Cynefin framework is designed to enable leaders to identify specific decision-making domain typologies as a mechanism to maximise the effectiveness of leadership responses to both opportunities and challenges that emerge during interventions. In this instance the Cynefin framework was used to: (1) provide an indication to the project managers whether the early stages of the intervention had been effective; (2) provide the participants an opportunity to identify emergent knowledge action spaces (opportunities and challenges); and (3) categorise them into appropriate decision-making domains in preparation for the next phases of the intervention. A qualitative methodology was applied to collect and analyse the findings. The findings indicate that applying the Cynefin framework enabled the participants to situate knowledge action spaces into appropriate decision-making domains. From this participatory evaluation a targeted management strategy was developed for the next phases of the initiative. The article concludes by arguing that the Cynefin framework was an effective mechanism for situating emergent knowledge action spaces into appropriate decision-making domains, which enabled them to prepare for the next phases of the intervention. This process of responsive decision making could have utility in other development related interventions.

Career Decision-Making Self-Efficacy, Integration, and the Likelihood of Managerial Retention in Governmental Agencies

ERIC Educational Resources Information Center

Peterson, Shari

2009-01-01

Results based on responses from 679 managers in three governmental agencies confirmed that career-related organizational practices and relationships impacted their staying in the organization. Specifically, managers who scored higher in career decision-making self efficacy, a relatively new variable to the turnover literature, career integration,…

The Call for Data-Driven Decision Making in the Midwest's Schools: NCREL's Response.

ERIC Educational Resources Information Center

Cromey, Allison; van der Ploeg, Arie; Masini, Blase

This report describes the efforts of the North Central Regional Educational Laboratory (NCREL) during the last several years to respond to direct requests from educational stakeholders to help integrate data into their decision-making processes related to school improvement. In some cases, NCREL cooperated in the development of educational…

EVALUATING HYDROLOGICAL RESPONSE TO FORECASTED LAND-USE CHANGE: SCENARIO TESTING WITH THE AUTOMATED GEOSPATIAL WATERSHED ASSESSMENT (AGWA) TOOL

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions...

Institutional Logics and Curriculum Decision Making: Enacting the "Australian Curriculum English" and NAPLAN Literacy

ERIC Educational Resources Information Center

Wall, Lynda

2017-01-01

This article, an initial report on a section of a larger research study, examines the institutional logics that underpin teacher decision making in response to changes in Australian curriculum and assessment. The research analyses secondary school teachers' accounts of their work enacting the "Australian Curriculum: English" and the…

Virtue Ethics in School Counseling: A Framework for Decision Making

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2011-01-01

Virtue ethics focus on the motives that guide ethical decision making and action, and as such, are critical to the competent application of the counseling profession's ethical codes. Knowledge of virtue ethics deepens understanding of moral responsibilities and ethical reasoning in professional practice. This paper is an overview of virtue ethics…

Principals' Moral Agency and Ethical Decision-Making: Toward a Transformational Ethics

ERIC Educational Resources Information Center

Cherkowski, Sabre; Walker, Keith D.; Kutsyuruba, Benjamin

2015-01-01

This descriptive study provides a rich portrait of moral agency and ethical decision-making processes among a sample of Canadian school principals. Using an ethical responsibility framework linking moral agency and transformational leadership, the researchers found that (1) modeling moral agency is important for encouraging others to engage their…

The Role of Research and Analysis in Resource Allocation Decisions

ERIC Educational Resources Information Center

Lea, Dennis; Polster, Patty Poppe

2011-01-01

In a time of diminishing resources and increased accountability, it is important for school leaders to make the most of every dollar they spend. One approach to ensuring responsible resource allocation is to closely examine the organizational culture surrounding decision making and provide a structure and process to incorporate research and data…

Scenario Analysis: Evaluating Biodiversity Response to Forecasted Land-Use Change in the San Pedro River Basin (U.S.-Mexico)

EPA Science Inventory

Envisioning and evaluating future scenarios has emerged as a critical component of both science and social decision-making. The ability to assess, report, map, and forecast the life support functions of ecosystems is absolutely critical to our capacity to make informed decisions...

Reason, Intuition, and Social Justice: Elaborating on Parson's Career Decision-Making Model.

ERIC Educational Resources Information Center

Hartung, Paul J.; Blustein, David L.

2002-01-01

Nearly a century ago, Frank Parsons established the Vocation Bureau in Boston and spawned the development of the counseling profession. Elaborating on Parsons's socially responsible vision for counseling, the authors examine contemporary perspectives on career decision making that include both rational and alternative models and propose that these…

Knowing Better: Improving Collective Decision Making in Higher Education Shared Governance

ERIC Educational Resources Information Center

Manick, Christopher J. D.

2016-01-01

This dissertation addresses the question: Should higher education governance and decision-making be an elite or collective responsibility? It brings into conversation (i) the debate over the future of shared (i.e. participatory, faculty) governance in higher education, and (ii) research in democratic theory, specifically the epistemic defense of…

Skill Transfer and Virtual Training for IND Response Decision-Making: Models for Government-Industry Collaboration for the Development of Game-Based Training Tools

DTIC Science & Technology

2016-04-01

IND Response Decision-Making: Models for Government–Industry Collaboration for the Development of Game -Based Training Tools R.M. Seater C.E. Rose...Models for Government–Industry Collaboration for the Development of Game -Based Training Tools C.E. Rose A.S. Norige Group 44 R.M. Seater K.C...Report 1208 Lexington Massachusetts This page intentionally left blank. iii EXECUTIVE SUMMARY Game -based training tools, sometimes called “serious

Executive control deficits in substance-dependent individuals: a comparison of alcohol, cocaine, and methamphetamine and of men and women.

PubMed

van der Plas, Ellen A A; Crone, Eveline A; van den Wildenberg, Wery P M; Tranel, Daniel; Bechara, Antoine

2009-08-01

Substance dependence is associated with executive function deficits, but the nature of these executive defects and the effect that different drugs and sex have on these defects have not been fully clarified. Therefore, we compared the performance of alcohol- (n = 33; 18 women), cocaine- (n = 27; 14 women), and methamphetamine-dependent individuals (n = 38; 25 women) with sex-matched healthy comparisons (n = 36; 17 women) on complex decision making as measured with the Iowa Gambling Task, working memory, cognitive flexibility, and response inhibition. Cocaine- and methamphetamine-dependent individuals were impaired on complex decision making, working memory, and cognitive flexibility, but not on response inhibition. The deficits in working memory and cognitive flexibility were milder than the decision-making deficits and did not change as a function of memory load or task switching. Interestingly, decision making was significantly more impaired in women addicted to cocaine or methamphetamine than in men addicted to these drugs. Together, these findings suggest that drug of choice and sex have different effects on executive functioning, which, if replicated, may help tailor intervention.

A Forward Genetic Screen in Zebrafish Identifies the G-Protein-Coupled Receptor CaSR as a Modulator of Sensorimotor Decision Making.

PubMed

Jain, Roshan A; Wolman, Marc A; Marsden, Kurt C; Nelson, Jessica C; Shoenhard, Hannah; Echeverry, Fabio A; Szi, Christina; Bell, Hannah; Skinner, Julianne; Cobbs, Emilia N; Sawada, Keisuke; Zamora, Amy D; Pereda, Alberto E; Granato, Michael

2018-05-07

Animals continuously integrate sensory information and select contextually appropriate responses. Here, we show that zebrafish larvae select a behavioral response to acoustic stimuli from a pre-existing choice repertoire in a context-dependent manner. We demonstrate that this sensorimotor choice is modulated by stimulus quality and history, as well as by neuromodulatory systems-all hallmarks of more complex decision making. Moreover, from a genetic screen coupled with whole-genome sequencing, we identified eight mutants with deficits in this sensorimotor choice, including mutants of the vertebrate-specific G-protein-coupled extracellular calcium-sensing receptor (CaSR), whose function in the nervous system is not well understood. We demonstrate that CaSR promotes sensorimotor decision making acutely through Gα i/o and Gα q/11 signaling, modulated by clathrin-mediated endocytosis. Combined, our results identify the first set of genes critical for behavioral choice modulation in a vertebrate and reveal an unexpected critical role for CaSR in sensorimotor decision making. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparing perceptual and preferential decision making.

PubMed

Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

Respecting Stakeholders and Their Engagement to Decision Making - The Way of Successful Corporate Social Responsibility Strategy

NASA Astrophysics Data System (ADS)

Drieniková, Katarína; Sakál, Peter

2012-12-01

Current world situation characterized by constant dynamic development and changes in all spheres enforced us to view the business not only as a profit creator but as creator of added value to the society. The paper deals with the stakeholders as the integral part of corporate social responsibility (CSR) concept. It mentions the topic of stakeholder theory and stakeholder management in consideration of sustainable development and sustainable competitiveness of business. Within the paper are mentioned outputs of pilot research carried on among Slovak companies focusing on stakeholders and decision making within responsible business.

Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task.

PubMed

Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F

2013-01-01

An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making.

Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

PubMed Central

Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F.

2014-01-01

An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making. PMID:24478664

Viewing sexual images is associated with reduced physiological arousal response to gambling loss.

PubMed

Lui, Ming; Hsu, Ming

2018-01-01

Erotic imagery is one highly salient emotional signal that exists everywhere in daily life. The impact of sexual stimuli on human decision-making, however, has rarely been investigated. This study examines the impact of sexual stimuli on financial decision-making under risk. In each trial, either a sexual or neutral image was presented in a picture categorization task before a gambling task. Thirty-four men made gambling decisions while their physiological arousal, measured by skin conductance responses (SCRs), was recorded. Behaviorally, the proportion of gambling decisions did not differ between the sexual and neutral image trials. Physiologically, participants had smaller arousal differences, measured in micro-siemen per dollar, between losses and gains in the sexual rather than in the neutral image trials. Moreover, participants' SCRs to losses relative to gains predicted the proportion of gambling decisions in the neutral image trials but not in the sexual image trials. The results were consistent with the hypothesis that the presence of emotionally salient sexual images reduces attentional and arousal-related responses to gambling losses. Our results are consistent with the theory of loss attention involving increased cognitive investment in losses compared to gains. The findings also have potential practical implications for our understanding of the specific roles of sexual images in human financial decision making in everyday life, such as gambling behaviors in the casino.

Viewing sexual images is associated with reduced physiological arousal response to gambling loss

PubMed Central

Hsu, Ming

2018-01-01

Erotic imagery is one highly salient emotional signal that exists everywhere in daily life. The impact of sexual stimuli on human decision-making, however, has rarely been investigated. This study examines the impact of sexual stimuli on financial decision-making under risk. In each trial, either a sexual or neutral image was presented in a picture categorization task before a gambling task. Thirty-four men made gambling decisions while their physiological arousal, measured by skin conductance responses (SCRs), was recorded. Behaviorally, the proportion of gambling decisions did not differ between the sexual and neutral image trials. Physiologically, participants had smaller arousal differences, measured in micro-siemen per dollar, between losses and gains in the sexual rather than in the neutral image trials. Moreover, participants’ SCRs to losses relative to gains predicted the proportion of gambling decisions in the neutral image trials but not in the sexual image trials. The results were consistent with the hypothesis that the presence of emotionally salient sexual images reduces attentional and arousal-related responses to gambling losses. Our results are consistent with the theory of loss attention involving increased cognitive investment in losses compared to gains. The findings also have potential practical implications for our understanding of the specific roles of sexual images in human financial decision making in everyday life, such as gambling behaviors in the casino. PMID:29649287

Rapid Decision-Making with Side-Specific Perceptual Discrimination in Ants

PubMed Central

Stroeymeyt, Nathalie; Guerrieri, Fernando J.; van Zweden, Jelle S.; d'Ettorre, Patrizia

2010-01-01

Background Timely decision making is crucial for survival and reproduction. Organisms often face a speed-accuracy trade-off, as fully informed, accurate decisions require time-consuming gathering and treatment of information. Optimal strategies for decision-making should therefore vary depending on the context. In mammals, there is mounting evidence that multiple systems of perceptual discrimination based on different neural circuits emphasize either fast responses or accurate treatment of stimuli depending on the context. Methodology/Principal Findings We used the ant Camponotus aethiops to test the prediction that fast information processing achieved through direct neural pathways should be favored in situations where quick reactions are adaptive. Social insects discriminate readily between harmless group-members and dangerous strangers using easily accessible cuticular hydrocarbons as nestmate recognition cues. We show that i) tethered ants display rapid aggressive reactions upon presentation of non-nestmate odor (120 to 160 ms); ii) ants' aggressiveness towards non-nestmates can be specifically reduced by exposure to non-nestmate odor only, showing that social interactions are not required to alter responses towards non-nestmates; iii) decision-making by ants does not require information transfer between brain hemispheres, but relies on side-specific decision rules. Conclusions/Significance Our results strongly suggest that first-order olfactory processing centers (up to the antennal lobes) are likely to play a key role in ant nestmate recognition. We hypothesize that the coarse level of discrimination achieved in the antennal lobes early in odor processing provides enough information to determine appropriate behavioral responses towards non-nestmates. This asks for a reappraisal of the mechanisms underlying social recognition in insects. PMID:20808782

Individual Differences in Risk Preference Predict Neural Responses during Financial Decision-Making

PubMed Central

Engelmann, Jan B.; Tamir, Diana

2009-01-01

We investigated the neural correlates of subjective valuations during a task involving risky choices about lotteries. Because expected value was held constant across all lotteries, decisions were influenced by subjective preferences, which manifest behaviorally as risk-seeking or risk-averse attitudes. To isolate structures encoding risk preference during choice, we probed for areas showing increased activation as a function of selected risk-level. Such response patterns were obtained in anterior (ACC) and posterior cingulate cortex (PCC), superior frontal gyrus, caudate nucleus, and substantia nigra. Behavioral results revealed the presence of risk-averse and risk-neutral individuals. In parallel, brain signals revealed modulation of activity by risk-attitude during choice. Correlations between risk-seeking attitudes and neural activity during risky choice were obtained in superior and inferior frontal gyri, medial and lateral orbitofrontal cortex, and parahippocampal gyrus, while correlations with risk-averse attitudes were found in the caudate. The dynamics of neural responses relevant to each stage of the task (decision, anticipation, outcome) were investigated via timeseries and conjunction analyses. Though the networks engaged in each of the task stages were mostly distinct, regions of ACC, PCC and caudate were consistently activated during each decision-making phase. These results demonstrate (1) that subjective assessments of risk, as well as individual attitudes toward risk, play a significant role in modulating activity within brain regions recruited during decision-making, and (2) that ACC, PCC and caudate are relevant during each phase of a decision-making task requiring subjective valuations, strengthening the role of these regions in self-referential subjective valuations during choice. PMID:19576868

The Neural Basis of Decision-Making and Reward Processing in Adults with Euthymic Bipolar Disorder or Attention-Deficit/Hyperactivity Disorder (ADHD)

PubMed Central

Ibanez, Agustin; Cetkovich, Marcelo; Petroni, Agustin; Urquina, Hugo; Baez, Sandra; Gonzalez-Gadea, Maria Luz; Kamienkowski, Juan Esteban; Torralva, Teresa; Torrente, Fernando; Strejilevich, Sergio; Teitelbaum, Julia; Hurtado, Esteban; Guex, Raphael; Melloni, Margherita; Lischinsky, Alicia; Sigman, Mariano; Manes, Facundo

2012-01-01

Background Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD. Methodology/Principal Findings We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD. Conclusions/Significance Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems. PMID:22624011

The neural basis of decision-making and reward processing in adults with euthymic bipolar disorder or attention-deficit/hyperactivity disorder (ADHD).

PubMed

Ibanez, Agustin; Cetkovich, Marcelo; Petroni, Agustin; Urquina, Hugo; Baez, Sandra; Gonzalez-Gadea, Maria Luz; Kamienkowski, Juan Esteban; Torralva, Teresa; Torrente, Fernando; Strejilevich, Sergio; Teitelbaum, Julia; Hurtado, Esteban; Guex, Raphael; Melloni, Margherita; Lischinsky, Alicia; Sigman, Mariano; Manes, Facundo

2012-01-01

Attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder (BD) share DSM-IV criteria in adults and cause problems in decision-making. Nevertheless, no previous report has assessed a decision-making task that includes the examination of the neural correlates of reward and gambling in adults with ADHD and those with BD. We used the Iowa gambling task (IGT), a task of rational decision-making under risk (RDMUR) and a rapid-decision gambling task (RDGT) which elicits behavioral measures as well as event-related potentials (ERPs: fERN and P3) in connection to the motivational impact of events. We did not observe between-group differences for decision-making under risk or ambiguity (RDMUR and IGT); however, there were significant differences for the ERP-assessed RDGT. Compared to controls, the ADHD group showed a pattern of impaired learning by feedback (fERN) and insensitivity to reward magnitude (P3). This ERP pattern (fERN and P3) was associated with impulsivity, hyperactivity, executive function and working memory. Compared to controls, the BD group showed fERN- and P3-enhanced responses to reward magnitude regardless of valence. This ERP pattern (fERN and P3) was associated with mood and inhibitory control. Consistent with the ERP findings, an analysis of source location revealed reduced responses of the cingulate cortex to the valence and magnitude of rewards in patients with ADHD and BD. Our data suggest that neurophysiological (ERPs) paradigms such as the RDGT are well suited to assess subclinical decision-making processes in patients with ADHD and BD as well as for linking the cingulate cortex with action monitoring systems.

A Pilot Study of Neonatologists' Decision-Making Roles in Delivery Room Resuscitation Counseling for Periviable Births.

PubMed

Tucker Edmonds, Brownsyne; McKenzie, Fatima; Panoch, Janet E; White, Douglas B; Barnato, Amber E

2016-07-01

Relatively little is known about neonatologists' roles in helping families navigate the difficult decision to attempt or withhold resuscitation for a neonate delivering at the threshold of viability. Therefore, we aimed to describe the "decision-making role" of neonatologists in simulated periviable counseling sessions. We conducted a qualitative content analysis of audio-recorded simulation encounters and post-encounter debriefing interviews collected as part of a single-center simulation study of neonatologists' resuscitation counseling practices in the face of ruptured membranes at 23 weeks gestation. We trained standardized patients to request a recommendation if the physician presented multiple treatment options. We coded each encounter for communication behaviors, applying an adapted, previously developed coding scheme to classify physicians into four decision-making roles (informative, facilitative, collaborative, or directive). We also coded post-simulation debriefing interviews for responses to the open-ended prompt: "During this encounter, what did you feel was your role in the management decision-making process?" Fifteen neonatologists (33% of the division) participated in the study; audio-recorded debriefing interviews were available for 13. We observed 9 (60%) take an informative role, providing medical information only; 2 (13%) take a facilitative role, additionally eliciting the patient's values; 3 (20%) take a collaborative role, additionally engaging the patient in deliberation and providing a recommendation; and 1 (7%) take a directive role, making a treatment decision independent of the patient. Almost all (10/13, 77%) of the neonatologists described their intended role as informative. Neonatologists did not routinely elicit preferences, engage in deliberation, or provide treatment recommendations-even in response to requests for recommendations. These findings suggest there may be a gap between policy recommendations calling for shared decision making and actual clinical practice.

Scrutinizing screening: a critical interpretive review of primary care provider perspectives on mammography decision-making with average-risk women.

PubMed

Siedlikowski, Sophia; Ells, Carolyn; Bartlett, Gillian

2018-01-01

A decision to undertake screening for breast cancer often takes place within the primary care setting, but current controversies such as overdiagnosis and inconsistent screening recommendations based on evolving evidence render this a challenging process, particularly for average-risk women. Given the responsibility of primary care providers in counseling women in this decision-making process, it is important to understand their thoughts on these controversies and how they manage uncertainty in their practice. To review the perspectives and approaches of primary care providers regarding mammography decision-making with average-risk women. This study is a critical interpretive review of peer-review literature that reports primary care provider perspectives on mammography screening decision-making. Ovid MEDLINE®, Ovid PsycInfo, and Scopus databases were searched with dates from 2002 to 2017 using search terms related to mammography screening, uncertainty, counseling, decision-making, and primary health care providers. Nine articles were included following a review process involving the three authors. Using an inductive and iterative approach, data were grouped into four thematic categories: (1) perceptions on the effectiveness of screening, screening initiation age, and screening frequency; (2) factors guiding primary care providers in the screening decision-making process, including both provider and patient-related factors, (3) uncertainty faced by primary care providers regarding guidelines and screening discussions with their patients; and (4) informed decision-making with average-risk women, including factors that facilitate and hinder this process. The discussion of results addresses several factors about the diversity of perspectives and practices of physicians counseling average-risk women regarding breast cancer screening. This has implications for the challenge of understanding and explaining evidence, what should be shared with average-risk women considering screening, the forms of knowledge that physicians value to guide screening decision-making, and the consent process for population-based screening initiatives. Within the data, there was little attention placed on how physicians coped with uncertainty in practice. Given the dual responsibility of physicians in caring for both individuals and the larger population, further research should probe more deeply into how they balance their duties to individual patients with those to the larger population they serve.

Transfer of Decision Making and Farm Tasks from Father to Son in Father-and-Son Farming Arrangements. RS-51, August 1976.

ERIC Educational Resources Information Center

Coughenour, C. Milton; And Others

The study examined the division of decision-making and farm tasks in a joint father and son enterprise, the extent to which the decisions tended to be shared equally, and the extent to which the principal operator had responsibility for those tasks not shared. Data were collected in 1974 from fathers and sons who were joint operators of 145 farms…

Skill Transfer and Virtual Training for IND Response Decision-Making: Analysis of Decision-Making Skills for Large Scale Incidents

DTIC Science & Technology

2016-01-01

issues comes from the Fukushima Daiichi nuclear disaster (2011). The local medical health professional on staff at the U.S. embassy in Tokyo was not...distribution unlimited. This page intentionally left blank. iii EXECUTIVE SUMMARY An improvised nuclear device (IND...from the phase one analysis are as follows : • There is strong consistency in both the key decisions and underlying skills emphasized by emergency

A Navy Officer Assignment Model

DTIC Science & Technology

1982-03-01

replace the routine administrative tasks required of both assignment and placement officers without reducing their role in making the essential decisions ...individual has no desire to serve there. This last aspect of the detailer’s job can be the most difficult, since he must both make the decision of who is...34Billet Fill Decision " has been made by a third party, an officer whose primary responsibility is to oversee this program, according to the previous

48 CFR 34.003 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... shall identify the key decision points of each major system acquisition and the agency official(s) for making those decisions. (c) Systems acquisitions normally designated as major are those programs that, as... management attention, including specific agency-head decisions. The agency procedures may establish...

The determinants of response time in a repeated constant-sum game: A robust Bayesian hierarchical dual-process model.

PubMed

Spiliopoulos, Leonidas

2018-03-01

The investigation of response time and behavior has a long tradition in cognitive psychology, particularly for non-strategic decision-making. Recently, experimental economists have also studied response time in strategic interactions, but with an emphasis on either one-shot games or repeated social-dilemmas. I investigate the determinants of response time in a repeated (pure-conflict) game, admitting a unique mixed strategy Nash equilibrium, with fixed partner matching. Response times depend upon the interaction of two decision models embedded in a dual-process framework (Achtziger and Alós-Ferrer, 2014; Alós-Ferrer, 2016). The first decision model is the commonly used win-stay/lose-shift heuristic and the second the pattern-detecting reinforcement learning model in Spiliopoulos (2013b). The former is less complex and can be executed more quickly than the latter. As predicted, conflict between these two models (i.e., each one recommending a different course of action) led to longer response times than cases without conflict. The dual-process framework makes other qualitative response time predictions arising from the interaction between the existence (or not) of conflict and which one of the two decision models the chosen action is consistent with-these were broadly verified by the data. Other determinants of RT were hypothesized on the basis of existing theory and tested empirically. Response times were strongly dependent on the actions chosen by both players in the previous rounds and the resulting outcomes. Specifically, response time was shortest after a win in the previous round where the maximum possible payoff was obtained; response time after losses was significantly longer. Strongly auto-correlated behavior (regardless of its sign) was also associated with longer response times. I conclude that, similar to other tasks, there is a strong coupling in repeated games between behavior and RT, which can be exploited to further our understanding of decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

Manipulating memory efficacy affects the behavioral and neural profiles of deterministic learning and decision-making.

PubMed

Tremel, Joshua J; Ortiz, Daniella M; Fiez, Julie A

2018-06-01

When making a decision, we have to identify, collect, and evaluate relevant bits of information to ensure an optimal outcome. How we approach a given choice can be influenced by prior experience. Contextual factors and structural elements of these past decisions can cause a shift in how information is encoded and can in turn influence later decision-making. In this two-experiment study, we sought to manipulate declarative memory efficacy and decision-making in a concurrent discrimination learning task by altering the amount of information to be learned. Subjects learned correct responses to pairs of items across several repetitions of a 50- or 100-pair set and were tested for memory retention. In one experiment, this memory test interrupted learning after an initial encoding experience in order to test for early encoding differences and associate those differences with changes in decision-making. In a second experiment, we used fMRI to probe neural differences between the two list-length groups related to decision-making across learning and assessed subsequent memory retention. We found that a striatum-based system was associated with decision-making patterns when learning a longer list of items, while a medial cortical network was associated with patterns when learning a shorter list. Additionally, the hippocampus was exclusively active for the shorter list group. Altogether, these behavioral, computational, and imaging results provide evidence that multiple types of mnemonic representations contribute to experienced-based decision-making. Moreover, contextual and structural factors of the task and of prior decisions can influence what types of evidence are drawn upon during decision-making. Copyright © 2018 Elsevier Ltd. All rights reserved.

Influences on Decision Making Identified by Parents of Children Receiving Pediatric Palliative Care.

PubMed

Carroll, Karen W; Mollen, Cynthia J; Aldridge, Sarah; Hexem, Kari R; Feudtner, Chris

2012-01-01

Parental decision making is a critical component in the provision of palliative and end-of-life care, yet factors that parents perceive as influencing this process, when they are making decisions for their children, have not been well characterized. As part of a mixed-methods cohort study, we interviewed 73 parents of 50 pediatric patients who were referred to the hospital's pediatric palliative care service. The semistructured interviews focused on "decision making for your child"; the interviews were recorded and transcribed. A random sample (n = 13) was first coded and analyzed for core themes, and these themes were then cross-validated with a second random sample (n = 3) of interviews. Four dominant interrelated themes permeated parents' discussions about the decisions they were making for their children and the process of decision making. First, Orientation and Direction (including the subthemes of Goals and Hopes, Spirituality and Meaning, and Purposeful Effort) connotes the parents' effort to establish and clarify the broad context of decision making. Second, Defining What Is Good for the Child (including the subthemes of Quality of Life and Suffering, and Normalcy and Normalization) conveys how the parents posed questions and pondered what decisions would be in the child's best interests. Third, the entwined theme of Relationships, Communication, and Support reflects how parents reported the social and interactive nature of decision making. Fourth, the theme of Feelings and Personal Accountability focuses inward as parents report efforts to deal with their emotional responses and self-judgments. Parents report grappling with several influences upon their decision-making processes that extend well beyond the standard discussions of medical information exchanges and the evaluation of risks and benefits. Decision support for these parents should account for these diverse influences.

Examining Challenges Related to the Production of Actionable Climate Knowledge for Adaptation Decision-Making: A Focus on Climate Knowledge System Producers

NASA Astrophysics Data System (ADS)

Ernst, K.; Preston, B. L.; Tenggren, S.; Klein, R.; Gerger-Swartling, Å.

2017-12-01

Many challenges to adaptation decision-making and action have been identified across peer-reviewed and gray literature. These challenges have primarily focused on the use of climate knowledge for adaptation decision-making, the process of adaptation decision-making, and the needs of the decision-maker. Studies on climate change knowledge systems often discuss the imperative role of climate knowledge producers in adaptation decision-making processes and stress the need for producers to engage in knowledge co-production activities and to more effectively meet decision-maker needs. While the influence of climate knowledge producers on the co-production of science for adaptation decision-making is well-recognized, hardly any research has taken a direct approach to analyzing the challenges that climate knowledge producers face when undertaking science co-production. Those challenges can influence the process of knowledge production and may hinder the creation, utilization, and dissemination of actionable knowledge for adaptation decision-making. This study involves semi-structured interviews, focus groups, and participant observations to analyze, identify, and contextualize the challenges that climate knowledge producers in Sweden face as they endeavor to create effective climate knowledge systems for multiple contexts, scales, and levels across the European Union. Preliminary findings identify complex challenges related to education, training, and support; motivation, willingness, and culture; varying levels of prioritization; professional roles and responsibilities; the type and amount of resources available; and professional incentive structures. These challenges exist at varying scales and levels across individuals, organizations, networks, institutions, and disciplines. This study suggests that the creation of actionable knowledge for adaptation decision-making is not supported across scales and levels in the climate knowledge production landscape. Additionally, enabling the production of actionable knowledge for adaptation decision-making requires multi-level effort beyond the individual level.

Societal values in the allocation of healthcare resources: is it all about the health gain?

PubMed

Stafinski, Tania; Menon, Devidas; Marshall, Deborah; Caulfield, Timothy

2011-01-01

Over the past decade, public distrust in unavoidable value-laden decisions on the allocation of resources to new health technologies has grown. In response, healthcare organizations have made considerable efforts to improve their acceptability by increasing transparency in decision-making processes. However, the social value judgments (distributive preferences of the public) embedded in them have yet to be defined. While the need to explicate such judgments has become widely recognized, the most appropriate approach to accomplishing this remains unclear. The aims of this review were to identify factors around which distributive preferences of the public have been sought, create a list of social values proposed or used in current resource allocation decision-making processes for new health technologies, and review approaches to eliciting such values from the general public. Social values proposed or used in making resource allocation decisions for new health technologies were identified through three approaches: (i) a comprehensive review of published, peer-reviewed, empirical studies of public preferences for the distribution of healthcare; (ii) an analysis of non-technical factors or social value statements considered by technology funding decision-making processes in Canada and abroad; and (iii) a review of appeals to funding decisions on grounds in part related to social value judgments. A total of 34 empirical studies, 10 technology funding decision-making processes, and 12 appeals to decisions were identified and reviewed. The key factors/patient characteristics addressed through policy statements and around which distributive preferences of the public have been sought included severity of illness, immediate need, age (and its relationship to lifetime health), health gain (amount and final outcome/health state), personal responsibility for illness, caregiving responsibilities, and number of patients who could benefit (rarity). Empirical studies typically examined the importance of these factors in isolation. Therefore, the extent to which preferences around one factor may be modified in the presence of others is still unclear. Research that seeks to clarify interactions among factors by asking the public to weigh several of them at once is needed to ensure the relevance of elicited preferences to real-world technology funding decisions.

Proposal Allocation Ratio as a Moderator of Interpersonal Responsibility Effects on Hostile Decision-Making in the Ultimatum Game

PubMed Central

Gong, Xinyu; Xia, Ling-Xiang; Sun, Yanlin; Guo, Lei; Carpenter, Vanessa C.; Fang, Yuan; Chen, Yunli

2017-01-01

Interpersonal responsibility is an indigenous Chinese personality construct, which is regarded to have positive social functions. Two studies were designed to explore the relationship among interpersonal responsibility, proposal allocation ratio, and responders’ hostile decisions in an ultimatum game. Study 1 was a scenario study using a hypothetical ultimatum game with a valid sample of 551 high school students. Study 2 was an experimental study which recruited 54 undergraduate students to play the incentivized ultimatum game online. The results of the two studies showed a significantly negative correlation between interpersonal responsibility and responders’ rejection responses only when the proposal allocation ratio was 3:7. In addition, in Study 2, interpersonal responsibility had negative effects on responders’ rejection responses under the offer of 3:7, even after controlling for the Big Five personality traits. Taken together, proposal allocation ratio might moderate the effects of interpersonal responsibility on hostile decision-making in the ultimatum game. The social function of interpersonal responsibility might be beyond the Big Five. PMID:29184518

Children's participation in shared decision-making: children, adolescents, parents and healthcare professionals' perspectives and experiences.

PubMed

Coyne, Imelda; Amory, Aislinn; Kiernan, Gemma; Gibson, Faith

2014-06-01

Despite decision-making featuring throughout the trajectory of cancer care, children's participation in decision-making remains an area much under-researched and complicated by conflicting opinions. This study explored children's participation in shared decision-making (SDM) from multiple perspectives from one haematology/oncology unit in Ireland. Qualitative research design was used to explore participants' experiences of children's decision-making. Interviews were conducted with children(1) aged 7-16 years (n = 20), their parents (n = 22) and healthcare professionals (n = 40). Data were managed with the aid of NVivo (version 8). Parents and children's roles in decision-making were significantly influenced by the seriousness of the illness. Cancer is a life-threatening illness and so the treatment 'had to be done'. Children were not involved in major decisions (treatment decisions) as refusal was not an option. They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, making treatment more palatable, giving back a sense of control and building trusting relationships. These choices were termed 'small' decisions that would not compromise the child's welfare. Some adolescents were aware that choices were not 'real' decisions since they were not allowed to refuse and expressed feelings of frustration. Healthcare professionals and parents controlled the process of SDM and the children's accounts revealed that they held a minimal role. Children appeared content that adults held responsibility for the major treatment decisions. However, they desired and valued receiving information, voicing their preferences and choosing how treatments were administered to them. Copyright © 2014 Elsevier Ltd. All rights reserved.

Experiences of Slovene ICU physicians with end-of-life decision making: a nation-wide survey.

PubMed

Groselj, Urh; Orazem, Miha; Kanic, Maja; Vidmar, Gaj; Grosek, Stefan

2014-10-21

Advances in intensive care medicine have enormously improved ability to successfully treat seriously ill patients. However, intensive treatment and prolongation of life is not always in the patient's best interest, and many ethical dilemmas arise in end-of-life (EOL) situations. We aimed to assess intensive care unit (ICU) physicians' experiences with EOL decision making and to compare the responses according to ICU type. A cross-sectional survey was performed in all 35 Slovene ICUs, using a questionnaire designed to assess ICU physician experiences with EOL decision making, focusing on limitations of life-sustaining treatments (LST). We distributed 370 questionnaires (approximating the number of Slovene ICU physicians) and 267 were returned (72% response rate). The great majority of ICU physicians reported using do-not-resuscitate (DNR) orders (97%), withholding LST (94%), and withdrawing antibiotics (86%) or inotropes (95%). Fewer ICU physicians reported withdrawing mechanical ventilation (52%) or extubating patients (27%). Hydration was reported to be only rarely terminated (76% of participants reported never terminating it). In addition, 63% of participants had never encountered advance directives, and 39% reported to "never" or "rarely" participating in decision making with relatives of patients. Nurses were reported to be "never" or "rarely" involved in the EOL decision making process by 84% of participants. Limitation of LST was regularly used by Slovene ICU physicians. DNR orders and withholding of LST were the most commonly used measures. Hydration was only rarely terminated. In addition, use of advance directives was almost non-existent in practice, and the patients' relatives and nurses only infrequently participated in the decision making.

Effects of disrupting medial prefrontal cortex GABA transmission on decision-making in a rodent gambling task.

PubMed

Paine, T A; O'Hara, A; Plaut, B; Lowes, D C

2015-05-01

Decision-making is a complex cognitive process that is mediated, in part, by subregions of the medial prefrontal cortex (PFC). Decision-making is impaired in a number of psychiatric conditions including schizophrenia. Notably, people with schizophrenia exhibit reductions in GABA function in the same PFC areas that are implicated in decision-making. For example, expression of the GABA-synthesizing enzyme GAD67 is reduced in the dorsolateral PFC of people with schizophrenia. The goal of this experiment was to determine whether disrupting cortical GABA transmission impairs decision-making using a rodent gambling task (rGT). Rats were trained on the rGT until they reached stable performance and then were implanted with guide cannulae aimed at the medial PFC. Following recovery, the effects of intra-PFC infusions of the GABAA receptor antagonist bicuculline methiodide (BMI) or the GABA synthesis inhibitor L-allylglycine (LAG) on performance on the rGT were assessed. Intracortical infusions of BMI (25 ng/μl/side), but not LAG (10 μg/μl/side), altered decision-making. Following BMI infusions, rats made fewer advantageous choices. Follow-up experiments suggested that the change in decision-making was due to a change in the sensitivity to the punishments, rather than a change in the sensitivity to reward magnitudes, associated with each outcome. LAG infusions increased premature responding, a measure of response inhibition, but did not affect decision-making. Blocking GABAA receptors, but not inhibiting cortical GABA synthesis, within the medial PFC affects decision-making in the rGT. These data provide proof-of-concept evidence that disruptions in GABA transmission can contribute to the decision-making deficits in schizophrenia.

Examining chronic care patient preferences for involvement in health-care decision making: the case of Parkinson's disease patients in a patient-centred clinic.

PubMed

Zizzo, Natalie; Bell, Emily; Lafontaine, Anne-Louise; Racine, Eric

2017-08-01

Patient-centred care is a recommended model of care for Parkinson's disease (PD). It aims to provide care that is respectful and responsive to patient preferences, values and perspectives. Provision of patient-centred care should entail considering how patients want to be involved in their care. To understand the participation preferences of patients with PD from a patient-centred care clinic in health-care decision-making processes. Mixed-methods study with early-stage Parkinson's disease patients from a patient-centred care clinic. Study involved a modified Autonomy Preference Index survey (N=65) and qualitative, semi-structured in-depth interviews, analysed using thematic qualitative content analysis (N=20, purposefully selected from survey participants). Interviews examined (i) the patient preferences for involvement in health-care decision making; (ii) patient perspectives on the patient-physician relationship; and (iii) patient preferences for communication of information relevant to decision making. Preferences for participation in decision making varied between individuals and also within individuals depending on decision type, relational and contextual factors. Patients had high preferences for communication of information, but with acknowledged limits. The importance of communication in the patient-physician relationship was emphasized. Patient preferences for involvement in decision making are dynamic and support shared decision making. Relational autonomy corresponds to how patients envision their participation in decision making. Clinicians may need to assess patient preferences on an on-going basis. Our results highlight the complexities of decision-making processes. Improved understanding of individual preferences could enhance respect for persons and make for patient-centred care that is truly respectful of individual patients' wants, needs and values. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Patient involvement in decision-making: a cross-sectional study in a Malaysian primary care clinic

PubMed Central

Ambigapathy, Ranjini; Ng, Chirk Jenn

2016-01-01

Objective Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients’ role preference in decision-making and the associated factors. Design A cross-sectional study. Setting Study was conducted at an urban primary care clinic in Malaysia in 2012. Participants Patients aged >21 years were chosen using systematic random sampling. Methods Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients’ role preference. The Control Preference Scale was used to assess patients’ role preference. Primary outcome Prevalence of patients’ preferred role in decision-making. Secondary outcomes (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients’ preferred role in decision-making. (3) Doctors’ perception of patients’ involvement in decision-making. Results The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors’ perception did not concur with patients’ preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006). Conclusions The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients’ preference to play an autonomous role. PMID:26729393

What influences patient decision-making in amyotrophic lateral sclerosis multidisciplinary care? A study of patient perspectives.

PubMed

Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

2012-01-01

Patients with amyotrophic lateral sclerosis (ALS) are required to make decisions concerning quality of life and symptom management over the course of their disease. Clinicians perceive that patients' ability to engage in timely decision-making is extremely challenging. However, we lack patient perspectives on this issue. This study aimed to explore patient experiences of ALS, and to identify factors influencing their decision-making in the specialized multidisciplinary care of ALS. An exploratory study was conducted. Fourteen patients from two specialized ALS multidisciplinary clinics participated in semistructured interviews that were audio recorded and transcribed. Data were analyzed for emergent themes. Decision-making was influenced by three levels of factors, ie, structural, interactional, and personal. The structural factor was the decision-making environment of specialized multidisciplinary ALS clinics, which supported decision-making by providing patients with disease-specific information and specialized care planning. Interactional factors were the patient experiences of ALS, including patients' reaction to the diagnosis, response to deterioration, and engagement with the multidisciplinary ALS team. Personal factors were patients' personal philosophies, including their outlook on life, perceptions of control, and planning for the future. Patient approaches to decision-making reflected a focus on the present, rather than anticipating future progression of the disease and potential care needs. Decision-making for symptom management and quality of life in ALS care is enhanced when the patient's personal philosophy is supported by collaborative relationships between the patient and the multidisciplinary ALS team. Patients valued the support provided by the multidisciplinary team; however, their focus on living in the present diverged from the efforts of health professionals to prepare patients and their carers for the future. The challenge facing health professionals is how best to engage each patient in decision-making for their future needs, to bridge this gap.

The role of emotion in clinical decision making: an integrative literature review.

PubMed

Kozlowski, Desirée; Hutchinson, Marie; Hurley, John; Rowley, Joanne; Sutherland, Joanna

2017-12-15

Traditionally, clinical decision making has been perceived as a purely rational and cognitive process. Recently, a number of authors have linked emotional intelligence (EI) to clinical decision making (CDM) and calls have been made for an increased focus on EI skills for clinicians. The objective of this integrative literature review was to identify and synthesise the empirical evidence for a role of emotion in CDM. A systematic search of the bibliographic databases PubMed, PsychINFO, and CINAHL (EBSCO) was conducted to identify empirical studies of clinician populations. Search terms were focused to identify studies reporting clinician emotion OR clinician emotional intelligence OR emotional competence AND clinical decision making OR clinical reasoning. Twenty three papers were retained for synthesis. These represented empirical work from qualitative, quantitative, and mixed-methods approaches and comprised work with a focus on experienced emotion and on skills associated with emotional intelligence. The studies examined nurses (10), physicians (7), occupational therapists (1), physiotherapists (1), mixed clinician samples (3), and unspecified infectious disease experts (1). We identified two main themes in the context of clinical decision making: the subjective experience of emotion; and, the application of emotion and cognition in CDM. Sub-themes under the subjective experience of emotion were: emotional response to contextual pressures; emotional responses to others; and, intentional exclusion of emotion from CDM. Under the application of emotion and cognition in CDM, sub-themes were: compassionate emotional labour - responsiveness to patient emotion within CDM; interdisciplinary tension regarding the significance and meaning of emotion in CDM; and, emotion and moral judgement. Clinicians' experienced emotions can and do affect clinical decision making, although acknowledgement of that is far from universal. Importantly, this occurs in the in the absence of a clear theoretical framework and educational preparation may not reflect the importance of emotional competence to effective CDM.

Feedback Blunting: Total Sleep Deprivation Impairs Decision Making that Requires Updating Based on Feedback.

PubMed

Whitney, Paul; Hinson, John M; Jackson, Melinda L; Van Dongen, Hans P A

2015-05-01

To better understand the sometimes catastrophic effects of sleep loss on naturalistic decision making, we investigated effects of sleep deprivation on decision making in a reversal learning paradigm requiring acquisition and updating of information based on outcome feedback. Subjects were randomized to a sleep deprivation or control condition, with performance testing at baseline, after 2 nights of total sleep deprivation (or rested control), and following 2 nights of recovery sleep. Subjects performed a decision task involving initial learning of go and no go response sets followed by unannounced reversal of contingencies, requiring use of outcome feedback for decisions. A working memory scanning task and psychomotor vigilance test were also administered. Six consecutive days and nights in a controlled laboratory environment with continuous behavioral monitoring. Twenty-six subjects (22-40 y of age; 10 women). Thirteen subjects were randomized to a 62-h total sleep deprivation condition; the others were controls. Unlike controls, sleep deprived subjects had difficulty with initial learning of go and no go stimuli sets and had profound impairment adapting to reversal. Skin conductance responses to outcome feedback were diminished, indicating blunted affective reactions to feedback accompanying sleep deprivation. Working memory scanning performance was not significantly affected by sleep deprivation. And although sleep deprived subjects showed expected attentional lapses, these could not account for impairments in reversal learning decision making. Sleep deprivation is particularly problematic for decision making involving uncertainty and unexpected change. Blunted reactions to feedback while sleep deprived underlie failures to adapt to uncertainty and changing contingencies. Thus, an error may register, but with diminished effect because of reduced affective valence of the feedback or because the feedback is not cognitively bound with the choice. This has important implications for understanding and managing sleep loss-induced cognitive impairment in emergency response, disaster management, military operations, and other dynamic real-world settings with uncertain outcomes and imperfect information. © 2015 Associated Professional Sleep Societies, LLC.

Emotion, decision-making and the brain.

PubMed

Chang, Luke J; Sanfey, Alan G

2008-01-01

Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.

Nurses' role and care practices in decision-making regarding artificial ventilation in late stage pulmonary disease.

PubMed

Jerpseth, Heidi; Dahl, Vegard; Nortvedt, Per; Halvorsen, Kristin

2017-11-01

Decisions regarding whether or not to institute mechanical ventilation during the later stages of chronic obstructive pulmonary disease is challenging both ethically, emotionally and medically. Caring for these patients is a multifaceted process where nurses play a crucial role. Research question and design: We have investigated how nurses experienced their own role in decision-making processes regarding mechanical ventilation in later stages of chronic obstructive pulmonary disease and how they consider the patients' role in these processes. We applied a qualitative approach, with six focus-group interviews of nurses (n = 26). Ethical considerations: The Regional Committees for Medical and Health Research Ethics approved the study. Voluntary informed consent was obtained. The nurses found themselves operating within a cure-directed treatment culture wherein they were unable to stand up for the caring values. They perceived their roles and responsibilities in decision-making processes regarding mechanical ventilation to patients as unclear and unsatisfactory. They also experienced inadequate interdisciplinary cooperation. Lack of communication skills, the traditional hierarchical hospital culture together with operating in a medical-orientated treatment culture where caring values is rated as less important might explain the nurses' absence in participation in the decision about mechanical ventilation. To be able to advocate for the patients' and their own right to be included in decision-making processes, nurses need an awareness of their own responsibilities. This requires personal courage, leadership who are capable of organising common interpersonal meetings and willingness on the part of the physicians to include and value the nurses' participation in decision-making processes.

Technical Adequacy of Response to Intervention Decisions

ERIC Educational Resources Information Center

VanDerHeyden, Amanda M.

2011-01-01

Perhaps the greatest value of response to intervention (RTI) as a decision framework is that it brings attention to variables (e.g., mastery of prerequisite skills, frequency of instructional corrective feedback, reinforcement schedules for correct responding) that if changed might make a meaningful difference for students (e.g., child rate of…

The Role of Epistemic Motivation in Individuals' Response to Decision Complexity

ERIC Educational Resources Information Center

Amit, Adi; Sagiv, Lilach

2013-01-01

Integrating findings on the effects of more alternatives with findings on the effects of more attributes, we offer a motivational decision-making model, suggesting that epistemic motivation moderates individuals' responses to complex information. Study 1 empirically investigated the shared essence of four conceptualizations of epistemic…

Applying Generalizability Theory for Making Quantitative RTI Progress-Monitoring Decisions

ERIC Educational Resources Information Center

Fan, Chung-Hau; Hansmann, Paul R.

2015-01-01

Language in the Individuals With Disabilities Education Improvement Act (IDEIA) allows the use of response-to-intervention (RTI) methodology in the identification of specific learning disabilities. However, there is no consensus on decision rules using curriculum-based measurement of oral reading fluency (CBM-R) for defining responsiveness. The…

An information processing/associative learning account of behavioral disinhibition in externalizing psychopathology.

PubMed

Endres, Michael J; Donkin, Chris; Finn, Peter R

2014-04-01

Externalizing psychopathology (EXT) is associated with low executive working memory (EWM) capacity and problems with inhibitory control and decision-making; however, the specific cognitive processes underlying these problems are not well known. This study used a linear ballistic accumulator computational model of go/no-go associative-incentive learning conducted with and without a working memory (WM) load to investigate these cognitive processes in 510 young adults varying in EXT (lifetime problems with substance use, conduct disorder, ADHD, adult antisocial behavior). High scores on an EXT factor were associated with low EWM capacity and higher scores on a latent variable reflecting the cognitive processes underlying disinhibited decision-making (more false alarms, faster evidence accumulation rates for false alarms [vFA], and lower scores on a Response Precision Index [RPI] measure of information processing efficiency). The WM load increased disinhibited decision-making, decisional uncertainty, and response caution for all subjects. Higher EWM capacity was associated with lower scores on the latent disinhibited decision-making variable (lower false alarms, lower vFAs and RPI scores) in both WM load conditions. EWM capacity partially mediated the association between EXT and disinhibited decision-making under no-WM load, and completely mediated this association under WM load. The results underline the role that EWM has in associative-incentive go/no-go learning and indicate that common to numerous types of EXT are impairments in the cognitive processes associated with the evidence accumulation-evaluation-decision process. PsycINFO Database Record (c) 2014 APA, all rights reserved.

An information processing/associative learning account of behavioral disinhibition in externalizing psychopathology

PubMed Central

Endres, Michael J.; Donkin, Chris; Finn, Peter R.

2014-01-01

Externalizing psychopathology (EXT) is associated with low executive working memory (EWM) capacity and problems with inhibitory control and decision-making; however, the specific cognitive processes underlying these problems are not well known. This study used a linear ballistic accumulator computational model of go/no-go associative-incentive learning conducted with and without a working memory (WM) load to investigate these cognitive processes in 510 young adults varying in EXT (lifetime problems with substance use, conduct disorder, ADHD, adult antisocial behavior). High scores on an EXT factor were associated with low EWM capacity and higher scores on a latent variable reflecting the cognitive processes underlying disinhibited decision making (more false alarms, faster evidence accumulation rates for false alarms (vFA), and lower scores on a Response Precision Index (RPI) measure of information processing efficiency). The WM load increased disinhibited decision making, decisional uncertainty, and response caution for all subjects. Higher EWM capacity was associated with lower scores on the latent disinhibited decision making variable (lower false alarms, lower vFAs and RPI scores) in both WM load conditions. EWM capacity partially mediated the association between EXT and disinhibited decision making under no-WM load, and completely mediated this association under WM load. The results underline the role that EWM has in associative – incentive go/no-go learning and indicate that common to numerous types of EXT are impairments in the cognitive processes associated with the evidence accumulation – evaluation – decision process. PMID:24611834

Pharmacy student decision making in over-the-counter medicine supply: A critical incident study.

PubMed

McMillan, Sara S; Thangarajah, Thachaayini; Anderson, Claire; Kelly, Fiona

2017-09-28

Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. To explore the factors that influence pharmacy students' decisions in relation to OTC consultations and choice of OTC medicine/s. Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training; greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Do neonatologists limit parental decision-making authority? A Canadian perspective.

PubMed

Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

2010-12-01

According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

Does STES-Oriented Science Education Promote 10th-Grade Students' Decision-Making Capability?

NASA Astrophysics Data System (ADS)

Levy Nahum, Tami; Ben-Chaim, David; Azaiza, Ibtesam; Herskovitz, Orit; Zoller, Uri

2010-07-01

Today's society is continuously coping with sustainability-related complex issues in the Science-Technology-Environment-Society (STES) interfaces. In those contexts, the need and relevance of the development of students' higher-order cognitive skills (HOCS) such as question-asking, critical-thinking, problem-solving and decision-making capabilities within science teaching have been argued by several science educators for decades. Three main objectives guided this study: (1) to establish "base lines" for HOCS capabilities of 10th grade students (n = 264) in the Israeli educational system; (2) to delineate within this population, two different groups with respect to their decision-making capability, science-oriented (n = 142) and non-science (n = 122) students, Groups A and B, respectively; and (3) to assess the pre-post development/change of students' decision-making capabilities via STES-oriented HOCS-promoting curricular modules entitled Science, Technology and Environment in Modern Society (STEMS). A specially developed and validated decision-making questionnaire was used for obtaining a research-based response to the guiding research questions. Our findings suggest that a long-term persistent application of purposed decision-making, promoting teaching strategies, is needed in order to succeed in affecting, positively, high-school students' decision-making ability. The need for science teachers' involvement in the development of their students' HOCS capabilities is thus apparent.

Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

PubMed

Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

2015-07-01

The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

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

Cognitive reflection vs. calculation in decision making.

PubMed

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.

More heads choose better than one: Group decision making can eliminate probability matching.

PubMed

Schulze, Christin; Newell, Ben R

2016-06-01

Probability matching is a robust and common failure to adhere to normative predictions in sequential decision making. We show that this choice anomaly is nearly eradicated by gathering individual decision makers into small groups and asking the groups to decide. The group choice advantage emerged both when participants generated responses for an entire sequence of choices without outcome feedback (Exp. 1a) and when participants made trial-by-trial predictions with outcome feedback after each decision (Exp. 1b). We show that the dramatic improvement observed in group settings stands in stark contrast to a complete lack of effective solitary deliberation. These findings suggest a crucial role of group discussion in alleviating the impact of hasty intuitive responses in tasks better suited to careful deliberation.

Decision-case mix model for analyzing variation in cesarean rates.

PubMed

Eldenburg, L; Waller, W S

2001-01-01

This article contributes a decision-case mix model for analyzing variation in c-section rates. Like recent contributions to the literature, the model systematically takes into account the effect of case mix. Going beyond past research, the model highlights differences in physician decision making in response to obstetric factors. Distinguishing the effects of physician decision making and case mix is important in understanding why c-section rates vary and in developing programs to effect change in physician behavior. The model was applied to a sample of deliveries at a hospital where physicians exhibited considerable variation in their c-section rates. Comparing groups with a low versus high rate, the authors' general conclusion is that the difference in physician decision tendencies (to perform a c-section), in response to specific obstetric factors, is at least as important as case mix in explaining variation in c-section rates. The exact effects of decision making versus case mix depend on how the model application defines the obstetric condition of interest and on the weighting of deliveries by their estimated "risk of Cesarean." The general conclusion is supported by an additional analysis that uses the model's elements to predict individual physicians' annual c-section rates.

[Decision making, empathy and morality in psychopaths: does empirical research offer new perspectives concerning legal responsibility?].

PubMed

Schmoll, D

2012-04-01

Psychopathy is a well explored dimensional construct only partially overlapping with dissocial personality disorder according to ICD-10. Until now, psychopaths have not been assessed as having diminished legal responsibility, unless they show impulsive or dissocial behaviour in an early stage of development, since they are considered able to adapt themselves to social norms. This forensic practice has been criticised from a deterministic-neurobiological point of view. This article discusses whether the latest empirical results on the psychopath's capacity for decision-making, empathy, and morality should lead to a new assessment of legal responsibility. The author shows that the psychopath's reduced capacities for decision-making, response reversal, and emotional empathy do not tell us much about the way such an individual arrives at decisions outside the laboratory since there has been no exploration of how compensation is made for psychophysiological deviation. Studies comparing criminal and non-criminal (so called "successful") psychopaths support the view that single physiological findings such as a hypoarousal do not necessarily lead to criminal behaviour. The moral knowledge of psychopaths is not disturbed. That is why criminality seems to be caused mainly by developed motivational factors (risk-seeking and hedonistic life-style). Empirical research into psychopathy may enlarge our knowledge about pathogenesis but does not offer new perspectives concerning legal responsibility. © Georg Thieme Verlag KG Stuttgart · New York.

The role of medial prefrontal cortex in memory and decision making.

PubMed

Euston, David R; Gruber, Aaron J; McNaughton, Bruce L

2012-12-20

Some have claimed that the medial prefrontal cortex (mPFC) mediates decision making. Others suggest mPFC is selectively involved in the retrieval of remote long-term memory. Yet others suggests mPFC supports memory and consolidation on time scales ranging from seconds to days. How can all these roles be reconciled? We propose that the function of the mPFC is to learn associations between context, locations, events, and corresponding adaptive responses, particularly emotional responses. Thus, the ubiquitous involvement of mPFC in both memory and decision making may be due to the fact that almost all such tasks entail the ability to recall the best action or emotional response to specific events in a particular place and time. An interaction between multiple memory systems may explain the changing importance of mPFC to different types of memories over time. In particular, mPFC likely relies on the hippocampus to support rapid learning and memory consolidation. Copyright © 2012 Elsevier Inc. All rights reserved.

Risky decisions and their consequences: neural processing by boys with Antisocial Substance Disorder.

PubMed

Crowley, Thomas J; Dalwani, Manish S; Mikulich-Gilbertson, Susan K; Du, Yiping P; Lejuez, Carl W; Raymond, Kristen M; Banich, Marie T

2010-09-22

Adolescents with conduct and substance problems ("Antisocial Substance Disorder" (ASD)) repeatedly engage in risky antisocial and drug-using behaviors. We hypothesized that, during processing of risky decisions and resulting rewards and punishments, brain activation would differ between abstinent ASD boys and comparison boys. We compared 20 abstinent adolescent male patients in treatment for ASD with 20 community controls, examining rapid event-related blood-oxygen-level-dependent (BOLD) responses during functional magnetic resonance imaging. In 90 decision trials participants chose to make either a cautious response that earned one cent, or a risky response that would either gain 5 cents or lose 10 cents; odds of losing increased as the game progressed. We also examined those times when subjects experienced wins, or separately losses, from their risky choices. We contrasted decision trials against very similar comparison trials requiring no decisions, using whole-brain BOLD-response analyses of group differences, corrected for multiple comparisons. During decision-making ASD boys showed hypoactivation in numerous brain regions robustly activated by controls, including orbitofrontal and dorsolateral prefrontal cortices, anterior cingulate, basal ganglia, insula, amygdala, hippocampus, and cerebellum. While experiencing wins, ASD boys had significantly less activity than controls in anterior cingulate, temporal regions, and cerebellum, with more activity nowhere. During losses ASD boys had significantly more activity than controls in orbitofrontal cortex, dorsolateral prefrontal cortex, brain stem, and cerebellum, with less activity nowhere. Adolescent boys with ASD had extensive neural hypoactivity during risky decision-making, coupled with decreased activity during reward and increased activity during loss. These neural patterns may underlie the dangerous, excessive, sustained risk-taking of such boys. The findings suggest that the dysphoria, reward insensitivity, and suppressed neural activity observed among older addicted persons also characterize youths early in the development of substance use disorders.

Emotion regulation reduces loss aversion and decreases amygdala responses to losses

PubMed Central

Sokol-Hessner, Peter; Camerer, Colin F.

2013-01-01

Emotion regulation strategies can alter behavioral and physiological responses to emotional stimuli and the neural correlates of those responses in regions such as the amygdala or striatum. The current study investigates the brain systems engaged when using an emotion regulation technique during financial decisions. In decision making, regulating emotion with reappraisal-focused strategies that encourage taking a different perspective has been shown to reduce loss aversion as observed both in choices and in the relative arousal responses to actual loss and gain outcomes. In the current study, we find using fMRI that behavioral loss aversion correlates with amygdala activity in response to losses relative to gains. Success in regulating loss aversion also correlates with the reduction in amygdala responses to losses but not to gains. Furthermore, across both decisions and outcomes, we find the reappraisal strategy increases baseline activity in dorsolateral and ventromedial prefrontal cortex and the striatum. The similarity of the neural circuitry observed to that seen in emotion regulation, despite divergent tasks, serves as further evidence for a role of emotion in decision making, and for the power of reappraisal to change assessments of value and thereby choices. PMID:22275168

[Quality of life or life expectancy? Criteria and sources of information in the decision-making of patients undergoing aortic valve surgery].

PubMed

Schmied, Wolfram; Barnick, Saskia; Heimann, Dierk; Schäfers, Hans-Joachim; Köllner, Volker

2015-01-01

Physicians are expected to involve patients adequately in the decision-making process prior to surgery. To this end, it is essential to have knowledge about the potential reasons for such a decision. In this study we investigated which information sources and decision criteria are important to patients prior to aortic valve surgery. A consecutive sample of 468 patients (70.1%m, aged 66.9±14.2 years) was examined 2 years after aortic valve replacement or reconstruction with a self-developed questionnaire. Preoperative discussion with a cardiologist or a cardiac surgeon was the information source patients used most frequently and felt to be the most helpful. The most important decision criterion was quality of life, followed by life expectancy and likelihood of reoperation. Two years postoperatively, 97.3% of the patients were satisfied with their decision. Preoperative counseling by a physician plays an essential role in the decision-making process prior to cardiac surgery. Patients want to be involved in decision-making, though they do not want to bear the full responsibility.

Retirement Savings Behavior of Higher Education Employees

ERIC Educational Resources Information Center

Dulebohn, James H.; Murray, Brian

2007-01-01

Higher education employees often participate in university-sponsored defined contribution pension plans that place the investment decision responsibility upon them. In order to examine investment decision-making behavior with retirement savings plans we investigated attitude-mediated, individual difference determinants of risky decision-making…

State- and trait-greed, its impact on risky decision-making and underlying neural mechanisms.

PubMed

Mussel, Patrick; Reiter, Andrea M F; Osinsky, Roman; Hewig, Johannes

2015-04-01

We investigated whether greed would predict risky decision-making and recorded neural responses during a monetary gambling task using the electroencephalogram. We found that individuals high in trait-greed took higher risks to maximize monetary outcome. Furthermore, this relation was moderated by state-greed; specifically, trait-greed had a stronger impact on risky decision-making when activated by situational characteristics. On the neural level, greedy individuals showed a specific response to favorable and unfavorable outcomes. Specifically, they had a reduced feedback-related negativity-difference score to these events, indicating that they might have difficulty in learning from experience, especially from mistakes and negative feedback. It is concluded that greed may explain risky and reckless behavior in diverse settings, such as investment banking, and may account for phenomena such as stock market bubbles.

Decisions under distress: stress profiles influence anchoring and adjustment.

PubMed

Kassam, Karim S; Koslov, Katrina; Mendes, Wendy Berry

2009-11-01

People frequently make decisions under stress. Understanding how stress affects decision making is complicated by the fact that not all stress responses are created equal. Challenge states, for example, occur when individuals appraise a stressful situation as demanding, but believe they have the personal resources to cope, and are characterized by efficient cardiovascular reactivity and approach motivation. Threat states, in contrast, occur when situational demands are perceived to outweigh resources and are characterized by less efficient cardiovascular reactivity and withdrawal motivation. We randomly assigned participants to social-feedback conditions (i.e., positive or negative feedback) designed to engender challenge or threat, or a no-stress condition. Participants then completed an anchoring-and-adjustment questionnaire. Those assigned to the challenge condition adjusted more from self-generated anchors than those assigned to the threat condition. Cardiovascular responses mediated the relationship between condition and adjustment. This study demonstrates the importance of considering profiles of cardiovascular reactivity when examining the influence of stress on decision making.

Decisions Under Distress Stress Profiles Influence Anchoring and Adjustment

PubMed Central

Kassam, Karim S.; Koslov, Katrina; Mendes, Wendy Berry

2009-01-01

People frequently make decisions under stress. Understanding how stress affects decision making is complicated by the fact that not all stress responses are created equal. Challenge states, for example, occur when individuals appraise a stressful situation as demanding, but believe they have the personal resources to cope, and are characterized by efficient cardiovascular reactivity and approach motivation. Threat states, in contrast, occur when situational demands are perceived to outweigh resources and are characterized by less efficient cardiovascular reactivity and withdrawal motivation. We randomly assigned participants to social-feedback conditions (i.e., positive or negative feedback) designed to engender challenge or threat, or a no-stress condition. Participants then completed an anchoring-and-adjustment questionnaire. Those assigned to the challenge condition adjusted more from self-generated anchors than those assigned to the threat condition. Cardiovascular responses mediated the relationship between condition and adjustment. This study demonstrates the importance of considering profiles of cardiovascular reactivity when examining the influence of stress on decision making. PMID:19843261

Social decision making mediates the association between anger and externalising problems in Chinese adolescents.

PubMed

Li, Nan; Hein, Sascha; Ye, Lin; Liu, Yangyang

2018-04-06

The goal of this study was to test the mediating effect of social decision making in the relations of anger and anger control to externalising and internalising problems. A sample of 174 Chinese adolescents (mean age = 15.36 years) completed self-reports of trait anger, anger control, externalising problems, internalising problems and social decision making, which was operationalized as situational judgement reflecting an individual's ability to interact effectively with parents, teachers and peers. Findings indicated that adolescents' trait anger and anger control were positively related to both externalising and internalising problems. In addition, path analysis revealed that social decision making mediated the relationship between trait anger, anger control and externalising problems. Findings on the mediating effect will be discussed by referencing appraisal tendency theory and response evaluation and decision. © 2018 International Union of Psychological Science.

Deliberation before determination: the definition and evaluation of good decision making.

PubMed

Elwyn, Glyn; Miron-Shatz, Talya

2010-06-01

In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post-hoc estimations and post-decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches. We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated. We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision's end results. We propose decision making comprises a pre-decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre-decisional deliberation process, the act of determination and post-decisional outcomes. Evaluating the deliberation process, we propose, should comprise of a subjective sufficiency of knowledge, as well as emotional processing and affective forecasting of the alternatives. This should form the basis for a good act of determination.

Trial-by-trial fluctuations in CNV amplitude reflect anticipatory adjustment of response caution.

PubMed

Boehm, Udo; van Maanen, Leendert; Forstmann, Birte; van Rijn, Hedderik

2014-08-01

The contingent negative variation, a slow cortical potential, occurs when humans are warned by a stimulus about an upcoming task. The cognitive processes that give rise to this EEG potential are not yet well understood. To explain these processes, we adopt a recently developed theoretical framework from the area of perceptual decision-making. This framework assumes that the basal ganglia control the tradeoff between fast and accurate decision-making in the cortex. It suggests that an increase in cortical excitability serves to lower response caution, which results in faster but more error prone responding. We propose that the CNV reflects this increased cortical excitability. To test this hypothesis, we conducted an EEG experiment in which participants performed the random dot motion task either under speed or under accuracy stress. Our results show that trial-by-trial fluctuations in participants' response speed as well as model-based estimates of response caution correlated with single-trial CNV amplitude under conditions of speed but not accuracy stress. We conclude that the CNV might reflect adjustments of response caution, which serves to enhance quick decision-making. Copyright © 2014 Elsevier Inc. All rights reserved.

Compulsory treatment and patient responsibility.

PubMed

Arya, Dinesh

2012-12-01

Current legislative provisions for compulsory treatment of people with mental illness allow decisions to treat people under compulsion to be made on the basis of presence of a mental illness or mental disorder without consideration of whether the patient has the capacity to make decisions that are in his/her best interest. Issues of autonomy, equity, justice and beneficence in relation to treatment of people with mental illness are explored to determine decision-making rules that should be applied for compulsory mental health treatment. It is proposed that assessment of the capacity of the individual to make decisions in his/her best interest, rather than presence of diagnosable mental illness, should be the key consideration for compulsory mental health treatment.

Chronic and Acute Stress Promote Overexploitation in Serial Decision Making

PubMed Central

Lenow, Jennifer K.; Constantino, Sara M.

2017-01-01

Many decisions that humans make resemble foraging problems in which a currently available, known option must be weighed against an unknown alternative option. In such foraging decisions, the quality of the overall environment can be used as a proxy for estimating the value of future unknown options against which current prospects are compared. We hypothesized that such foraging-like decisions would be characteristically sensitive to stress, a physiological response that tracks biologically relevant changes in environmental context. Specifically, we hypothesized that stress would lead to more exploitative foraging behavior. To test this, we investigated how acute and chronic stress, as measured by changes in cortisol in response to an acute stress manipulation and subjective scores on a questionnaire assessing recent chronic stress, relate to performance in a virtual sequential foraging task. We found that both types of stress bias human decision makers toward overexploiting current options relative to an optimal policy. These findings suggest a possible computational role of stress in decision making in which stress biases judgments of environmental quality. SIGNIFICANCE STATEMENT Many of the most biologically relevant decisions that we make are foraging-like decisions about whether to stay with a current option or search the environment for a potentially better one. In the current study, we found that both acute physiological and chronic subjective stress are associated with greater overexploitation or staying at current options for longer than is optimal. These results suggest a domain-general way in which stress might bias foraging decisions through changing one's appraisal of the overall quality of the environment. These novel findings not only have implications for understanding how this important class of foraging decisions might be biologically implemented, but also for understanding the computational role of stress in behavior and cognition more broadly. PMID:28483979

Classification images reveal decision variables and strategies in forced choice tasks

PubMed Central

Pritchett, Lisa M.; Murray, Richard F.

2015-01-01

Despite decades of research, there is still uncertainty about how people make simple decisions about perceptual stimuli. Most theories assume that perceptual decisions are based on decision variables, which are internal variables that encode task-relevant information. However, decision variables are usually considered to be theoretical constructs that cannot be measured directly, and this often makes it difficult to test theories of perceptual decision making. Here we show how to measure decision variables on individual trials, and we use these measurements to test theories of perceptual decision making more directly than has previously been possible. We measure classification images, which are estimates of templates that observers use to extract information from stimuli. We then calculate the dot product of these classification images with the stimuli to estimate observers' decision variables. Finally, we reconstruct each observer's “decision space,” a map that shows the probability of the observer’s responses for all values of the decision variables. We use this method to examine decision strategies in two-alternative forced choice (2AFC) tasks, for which there are several competing models. In one experiment, the resulting decision spaces support the difference model, a classic theory of 2AFC decisions. In a second experiment, we find unexpected decision spaces that are not predicted by standard models of 2AFC decisions, and that suggest intrinsic uncertainty or soft thresholding. These experiments give new evidence regarding observers’ strategies in 2AFC tasks, and they show how measuring decision variables can answer long-standing questions about perceptual decision making. PMID:26015584

Applied Empiricism: Ensuring the Validity of Causal Response to Intervention Decisions

ERIC Educational Resources Information Center

Kilgus, Stephen P.; Collier-Meek, Melissa A.; Johnson, Austin H.; Jaffery, Rose

2014-01-01

School personnel make a variety of decisions within multitiered problem-solving frameworks, including the decision to assign a student to group-based support, to design an individualized support plan, or classify a student as eligible for special education. Each decision is founded upon a judgment regarding whether the student has responded to…

41 CFR 105-68.860 - What factors may influence the debarring official's decision?

Code of Federal Regulations, 2010 CFR

2010-07-01

... responsibility. In making a debarment decision, the debarring official may consider the following factors: (a... influence the debarring official's decision? 105-68.860 Section 105-68.860 Public Contracts and Property...) Debarment § 105-68.860 What factors may influence the debarring official's decision? This section lists the...

40 CFR 147.2929 - Administrative permitting procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... making the final decision, and shall respond to comments after the decision is made. The response shall... tentative decision to deny was wrong, he shall withdraw the notice of intent to deny and prepare a draft... decision. (3) The statement of basis shall be sent to the applicant, and to any other person who requests a...

A SMALL FISH MULTI-ENDPOINT BIOASSAY FOR ASSESSING THE EFFECTS OF WATER CONTAMINANTS PRESENT IN LOW CONCENTRATIONS: MEDAKA AND DICHLOROACETIC ACID

EPA Science Inventory

In regulating the safety of water under SDWA and the CWA, the EPA makes decisions on what chemical contaminants to regulate and at what levels. To make these decisions the EPA needs hazard identification and dose-response information. Current methods that rely on rodent models fo...

Neural Correlates of Decision Making on a Gambling Task

ERIC Educational Resources Information Center

Carlson, Stephanie M.; Zayas, Vivian; Guthormsen, Amy

2009-01-01

Individual differences in affective decision making were examined by recording event-related potentials (ERPs) while 74 typically developing 8-year-olds (38 boys, 36 girls) completed a 4-choice gambling task (Hungry Donkey Task; E. A. Crone & M. W. van der Molen, 2004). ERP results indicated: (a) a robust P300 component in response to feedback…

Career Decision-Making Self-Efficacy and Career Commitment: Gender and Ethnic Differences among College Students.

ERIC Educational Resources Information Center

Chung, Y. Barry

2002-01-01

Analysis of responses from 165 undergraduates on the Career Decision Making Self Efficacy Scale revealed high internal consistency for the instrument and moderate correlation between it and the Career Commitment Scale. No gender or ethnic differences were found in this correlation. Blacks scored significantly higher than whites on both measures.…

Police Response to Domestic Violence: Making Decisions about Risk and Risk Management

ERIC Educational Resources Information Center

Perez Trujillo, Monica; Ross, Stuart

2008-01-01

Assessing and responding to risk are key elements in how police respond to domestic violence. However, relatively little is known about the way police make judgments about the risks associated with domestic violence and how these judgments influence their actions. This study examines police decisions about risk in domestic violence incidents when…

Lifestyles of the Student Leader: Making Decisions Based on the C.O.R.E.

ERIC Educational Resources Information Center

Hart, Falicia; Kean, Andy

1996-01-01

Key characteristics of an effective college student leader are defined: consistency in word and action; ownership of responsibility for actions and leadership position; development of healthy relationships with friends, coworkers, mentors, and mentees; and ethical decision making. It is argued that leadership is a full-time job and that student…

"It Was at the Library; Therefore It Must Be Credible": Mapping Patterns of Undergraduate Heuristic Decision-Making

ERIC Educational Resources Information Center

McGeough, Ryan; Rudick, C. Kyle

2018-01-01

In this study, we explore the heuristic decision-making skills of undergraduate students as they incorporate information into their persuasive speeches. We interviewed 26 students enrolled in an introductory communication course to ascertain their information literacy for vetting sources for their public speeches. From their responses, we…

77 FR 44613 - Notice of Availability of the External Review Draft of Framework for Human Health Risk Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-30

... External Review Draft of Framework for Human Health Risk Assessment To Inform Decision Making AGENCY: U.S... external review draft of ``A Framework for Human Health Risk Assessment to Inform Decision Making.'' This... a framework for conducting human health risk assessments that are responsive to the needs of...

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…

Who has the D? How clear decision roles enhance organizational performance.

PubMed

Rogers, Paul; Blenko, Marcia

2006-01-01

Decisions are the coin of the realm in business. But even in highly respected companies, decisions can get stuck inside the organization like loose change. As a result, the entire decision-making process can stall, usually at one of four bottlenecks: global versus local, center versus business unit, function versus function, and inside versus outside partners. Decision-making bottlenecks can occur whenever there is ambiguity or tension over who gets to decide what. For example, do marketers or product developers get to decide the features of a new product? Should a major capital investment depend on the approval of the business unit that will own it, or should headquarters make the final call? Which decisions can be delegated to an outsourcing partner, and which must be made internally? Bain consultants Paul Rogers and Marcia Blenko use an approach called RAPID (recommend, agree, perform, input, and decide) to help companies unclog their decision-making bottlenecks by explicitly defining roles and responsibilities. For example, British American Tobacco struck a new balance between global and local decision making to take advantage of the company's scale while maintaining its agility in local markets. At Wyeth Pharmaceuticals, a growth opportunity revealed the need to push more decisions down to the business units. And at the UK department-store chain John Lewis, buyers and sales staff clarified their decision roles in order to implement a new strategy for selling its salt and pepper mills. When revamping its decision-making process, a company must take some practical steps: Align decision roles with the most important sources of value, make sure that decisions are made by the right people at the right levels of the organization, and let the people who will live with the new process help design it.

Service users' experiences of participation in decision making in mental health services.

PubMed

Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

2015-11-01

Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a 'struggle to be perceived as a competent and equal person' while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions. © 2015 John Wiley & Sons Ltd.

Striatal activation reflects urgency in perceptual decision making.

PubMed

van Maanen, Leendert; Fontanesi, Laura; Hawkins, Guy E; Forstmann, Birte U

2016-10-01

Deciding between multiple courses of action often entails an increasing need to do something as time passes - a sense of urgency. This notion of urgency is not incorporated in standard theories of speeded decision making that assume information is accumulated until a critical fixed threshold is reached. Yet, it is hypothesized in novel theoretical models of decision making. In two experiments, we investigated the behavioral and neural evidence for an "urgency signal" in human perceptual decision making. Experiment 1 found that as the duration of the decision making process increased, participants made a choice based on less evidence for the selected option. Experiment 2 replicated this finding, and additionally found that variability in this effect across participants covaried with activation in the striatum. We conclude that individual differences in susceptibility to urgency are reflected by striatal activation. By dynamically updating a response threshold, the striatum is involved in signaling urgency in humans. Copyright © 2016 Elsevier Inc. All rights reserved.

Interoceptive awareness moderates neural activity during decision-making.

PubMed

Werner, Natalie S; Schweitzer, Nicola; Meindl, Thomas; Duschek, Stefan; Kambeitz, Joseph; Schandry, Rainer

2013-12-01

The current study examined the relationship between conscious perception of somatic feedback (interoceptive awareness) and neural responses preceding decision-making. Previous research has suggested that decision-making is influenced by body signals from the periphery or the central representation of the periphery. Using event-related fMRI, participants whose interoceptive awareness was assessed using a heartbeat perception paradigm performed the Iowa Gambling Task. The results show a positive relationship between the degree of interoceptive awareness and selection related activity in the right anterior insula and the left postcentral gyrus. Neural activity within the right anterior insula was associated with decision-making performance only in individuals with accurate but not in those with non-accurate interoceptive awareness. These findings support the role of somatic feedback in decision-making processes. They indicate that the right anterior insula holds a representation of somatic markers and that these are more strongly processed with increased interoceptive awareness. Copyright © 2013 Elsevier B.V. All rights reserved.

Value choices and considerations when limiting intensive care treatment: a qualitative study.

PubMed

Halvorsen, K; Førde, R; Nortvedt, P

2009-01-01

To shed light on the values and considerations that affect the decision-making processes and the decisions to limit intensive care treatment. Qualitative methodology with participant observation and in-depth interviews, with an emphasis on eliciting the underlying rationale of the clinicians' actions and choices when limiting treatment. Informants perceived over-treatment in intensive care medicine as a dilemma. One explanation was that the decision-making base was somewhat uncertain, complex and difficult. The informants claimed that those responsible for taking decisions from the admitting ward prolonged futile treatment because they may bear guilt or responsibility for something that had gone wrong during the course of treatment. The assessments of the patient's situation made by physicians from the admitting ward were often more organ-oriented and the expectations were less realistic than those of clinicians in the intensive care unit who frequently had a more balanced and overall perspective. Aspects such as the personality and the speciality of those involved, the culture of the unit and the degree of interdisciplinary cooperation were important issues in the decision-making processes. Under-communicated considerations jeopardise the principle of equal treatment. If intensive care patients are to be ensured equal treatment, strategies for interdisciplinary, transparent and appropriate decision-making processes must be developed in which open and hidden values are rendered visible, power structures disclosed, employees respected and the various perspectives of the treatment given their legitimate place.

Don't bet on it! Wagering as a measure of awareness in decision making under uncertainty.

PubMed

Konstantinidis, Emmanouil; Shanks, David R

2014-12-01

Can our decisions be guided by unconscious or implicit influences? According to the somatic marker hypothesis, emotion-based signals can guide our decisions in uncertain environments outside awareness. Postdecision wagering, in which participants make wagers on the outcomes of their decisions, has been recently proposed as an objective and sensitive measure of conscious content. In 5 experiments we employed variations of a classic decision-making assessment, the Iowa Gambling Task, in combination with wagering in order to investigate the role played by unconscious influences. We examined the validity of postdecision wagering by comparing it with alternative measures of conscious knowledge, specifically confidence ratings and quantitative questions. Consistent with a putative role for unconscious influences, in Experiments 2 and 3 we observed a lag between choice accuracy and the onset of advantageous wagering. However, the lag was eliminated by a change in the wagering payoff matrix (Experiment 2) and by a switch from a binary wager response to either a binary or a 4-point confidence response (Experiment 3), and wagering underestimated awareness compared to explicit quantitative questions (Experiments 1 and 4). Our results demonstrate the insensitivity of postdecision wagering as a direct measure of conscious knowledge and challenge the claim that implicit processes influence decision making under uncertainty. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Individual differences in attention influence perceptual decision making.

PubMed

Nunez, Michael D; Srinivasan, Ramesh; Vandekerckhove, Joachim

2015-01-01

Sequential sampling decision-making models have been successful in accounting for reaction time (RT) and accuracy data in two-alternative forced choice tasks. These models have been used to describe the behavior of populations of participants, and explanatory structures have been proposed to account for between individual variability in model parameters. In this study we show that individual differences in behavior from a novel perceptual decision making task can be attributed to (1) differences in evidence accumulation rates, (2) differences in variability of evidence accumulation within trials, and (3) differences in non-decision times across individuals. Using electroencephalography (EEG), we demonstrate that these differences in cognitive variables, in turn, can be explained by attentional differences as measured by phase-locking of steady-state visual evoked potential (SSVEP) responses to the signal and noise components of the visual stimulus. Parameters of a cognitive model (a diffusion model) were obtained from accuracy and RT distributions and related to phase-locking indices (PLIs) of SSVEPs with a single step in a hierarchical Bayesian framework. Participants who were able to suppress the SSVEP response to visual noise in high frequency bands were able to accumulate correct evidence faster and had shorter non-decision times (preprocessing or motor response times), leading to more accurate responses and faster response times. We show that the combination of cognitive modeling and neural data in a hierarchical Bayesian framework relates physiological processes to the cognitive processes of participants, and that a model with a new (out-of-sample) participant's neural data can predict that participant's behavior more accurately than models without physiological data.

“The problem often is that we do not have a family spokesperson but a spokesgroup”: Family Member Informal Roles in End-of-Life Decision-Making in Adult ICUs

PubMed Central

Quinn, Jill R.; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A.; Dombeck, Mary T.; Sellers, Craig R.

2013-01-01

Background To support the process of effective family decision-making, it is important to recognize and understand informal roles various family members may play in the end-of-life decision-making process. Objective The purpose of this study was to describe some informal roles consistently enacted by family members involved in the process of end-of-life decision-making in intensive care units (ICUs). Methods Ethnographic study. Data were collected via participant observation with field notes and semi-structured interviews on four ICUs in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical ICU, a surgical ICU, a burn and trauma ICU, and a cardiovascular ICU. Participants Participants included health care clinicians, patients, and family members. Results Informal roles for family members consistently observed were:, Primary Caregiver, Primary Decision Maker, Family Spokesperson, Out-of-Towner, Patient Wishes Expert, Protector, Vulnerable Member, and Health Care Expert. The identified informal roles were part of family decision making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision-making within the family system, and between the family and health care domains. Conclusions These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these family member informal roles can assist clinicians to recognize and understand the functions of these roles in family decision making at the end-of-life, and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes. PMID:22210699