Sample records for decision making strategy

  1. Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

    NASA Astrophysics Data System (ADS)

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2013-10-01

    Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

  2. How High School Students Construct Decision-Making Strategies for Choosing Colleges

    ERIC Educational Resources Information Center

    Govan, George V.; Patrick, Sondra; Yen, Cherng-Jyn

    2006-01-01

    This study examined how high school seniors construct decision-making strategies for choosing a college to attend. To comprehend their decision-making strategies, we chose to examine this process through the theoretical lens of bounded rationality, which brings to light the complexity in constructing a college choice decision-making strategy…

  3. Advancing in the Career Decision-Making Process: The Role of Coping Strategies and Career Decision-Making Profiles

    ERIC Educational Resources Information Center

    Perez, Maya; Gati, Itamar

    2017-01-01

    We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…

  4. Effects of Direct and Indirect Instruction on Fostering Decision-Making Competence in Socioscientific Issues

    NASA Astrophysics Data System (ADS)

    Böttcher, Florian; Meisert, Anke

    2013-04-01

    In this study the effects of different learning environments on the promotion of decision-making competence for the socioscientific issue of genetically modified crops is investigated. The comparison focuses on direct vs. indirect instructions. Therefore on the one hand a sophisticated decision-making strategy was presented to the directly instructed experimental group (1) and had to be applied correctly. On the other hand indirectly instructed students had to invent an appropriate strategy by themselves (2) based on the given information and the structure of the problem context. Group discussions are analysed qualitatively in order (1) to outline how the given strategy was understood and its results were reflected on by the students and (2) to explore the characteristics of invented strategies and their degree of complexity. Results indicate that the direct instruction of complex decision-making strategies may lead to a lack of understanding of the decision process when the given strategy is applied and therefore may cause rejection of the final decision. Indirectly instructed students were able to invent sophisticated decision-making strategies containing compensatory trade-offs. It is concluded that when directly instructing complex decision-making strategies, essential parts of reflection have to be integrated in order to gain greater transparency. Accordingly, empirical evidence has been found to consider indirect instruction as a possible way to foster decision-making strategies for complex socioscientific issues even if compensatory procedures are considered to be necessary.

  5. Preschool Teaching Students' Prediction of Decision Making Strategies and Academic Achievement on Learning Motivations

    ERIC Educational Resources Information Center

    Acat, M. Bahaddin; Dereli, Esra

    2012-01-01

    The purpose of this study was to identify problems and motivation sources and strategies of decision-making of the students' attending preschool education teacher department, was to determine the relationship between learning motivation and strategies of decision-making, academic achievement of students, was to determine whether strategies of…

  6. Cool Decision-Making in Adolescents with Behavior Disorder and/or Mild-to-Borderline Intellectual Disability.

    PubMed

    Bexkens, Anika; Jansen, Brenda R J; Van der Molen, Maurits W; Huizenga, Hilde M

    2016-02-01

    Adolescents with Behavior Disorders (BD), Mild-to-Borderline Intellectual Disability (MBID), and with both BD and MBID (BD + MBID) are known to take more risks than normal controls. To examine the processes underlying this increased risk-taking, the present study investigated cool decision-making strategies in 479 adolescents (12-18 years, 55.9 % male) from these four groups. Cool decision-making was assessed with the paper-and-pencil Gambling Machine Task. This task, in combination with advanced latent group analysis, allows for an assessment of decision strategies. Results indicated that adolescents with BD and controls were almost equivalent in their decision-making strategies, whereas adolescents with MBID and adolescents with BD + MBID were characterized by suboptimal decision-making strategies, with only minor differences between these two clinical groups. These findings may have important clinical implications, as they suggest that risk taking in adolescents with MBID and in adolescents with BD + MBID can be (partly) attributed to the strategies that these adolescents use to make their decisions. Interventions may therefore focus on an improvement of these strategies.

  7. The Relation between Career Decision-Making Strategies and Person-Job Fit: A Study of Job Changers

    ERIC Educational Resources Information Center

    Singh, Romila; Greenhaus, Jeffrey H.

    2004-01-01

    This study examined relations between three career decision-making strategies (rational, intuitive, and dependent) and person--job fit among 361 professionals who had recently changed jobs. We found that the relation between each decision-making strategy and fit was contingent upon the concurrent use of other strategies. A rational strategy…

  8. Self-reported strategies in decisions under risk: role of feedback, reasoning abilities, executive functions, short-term-memory, and working memory.

    PubMed

    Schiebener, Johannes; Brand, Matthias

    2015-11-01

    In decisions under objective risk conditions information about the decision options' possible outcomes and the rules for outcomes' occurrence are provided. Thus, deciders can base decision-making strategies on probabilistic laws. In many laboratory decision-making tasks, choosing the option with the highest winning probability in all trials (=maximization strategy) is probabilistically regarded the most rational behavior. However, individuals often behave less optimal, especially in case the individuals have lower cognitive functions or in case no feedback about consequences is provided in the situation. It is still unclear which cognitive functions particularly predispose individuals for using successful strategies and which strategies profit from feedback. We investigated 195 individuals with two decision-making paradigms, the Game of Dice Task (GDT) (with and without feedback), and the Card Guessing Game. Thereafter, participants reported which strategies they had applied. Interaction effects (feedback × strategy), effect sizes, and uncorrected single group comparisons suggest that feedback in the GDT tended to be more beneficial to individuals reporting exploratory strategies (e.g., use intuition). In both tasks, the self-reported use of more principled and more rational strategies was accompanied by better decision-making performance and better performances in reasoning and executive functioning tasks. The strategy groups did not significantly differ in most short-term and working-memory tasks. Thus, particularly individual differences in reasoning and executive functions seem to predispose individuals toward particular decision-making strategies. Feedback seems to be useful for individuals who rather explore the decision-making situation instead of following a certain plan.

  9. Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

    PubMed

    Gillespie, Mary

    2010-11-01

    Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  10. How can clinical practice guidelines be adapted to facilitate shared decision making? A qualitative key-informant study.

    PubMed

    van der Weijden, Trudy; Pieterse, Arwen H; Koelewijn-van Loon, Marije S; Knaapen, Loes; Légaré, France; Boivin, Antoine; Burgers, Jako S; Stiggelbout, Anne M; Faber, Marjan; Elwyn, Glyn

    2013-10-01

    To explore how clinical practice guidelines can be adapted to facilitate shared decision making. This was a qualitative key-informant study with group discussions and semi-structured interviews. First, 75 experts in guideline development or shared decision making participated in group discussions at two international conferences. Next, health professionals known as experts in depression or breast cancer, experts on clinical practice guidelines and/or shared decision making, and patient representatives were interviewed (N=20). Using illustrative treatment decisions on depression or breast cancer, we asked the interviewees to indicate as specifically as they could how guidelines could be used to facilitate shared decision making. Interviewees suggested some generic strategies, namely to include a separate chapter on the importance of shared decision making, to use language that encourages patient involvement, and to develop patient versions of guidelines. Recommendation-specific strategies, related to specific decision points in the guideline, were also suggested: These include structuring the presentation of healthcare options to increase professionals' option awareness; structuring the deliberation process between professionals and patients; and providing relevant patient support tools embedded at important decision points in the guideline. This study resulted in an overview of strategies to adapt clinical practice guidelines to facilitate shared decision making. Some strategies seemed more contentious than others. Future research should assess the feasibility and impact of these strategies to make clinical practice guidelines more conducive to facilitate shared decision making.

  11. Individual differences in intrinsic brain connectivity predict decision strategy.

    PubMed

    Barnes, Kelly Anne; Anderson, Kevin M; Plitt, Mark; Martin, Alex

    2014-10-15

    When humans are provided with ample time to make a decision, individual differences in strategy emerge. Using an adaptation of a well-studied decision making paradigm, motion direction discrimination, we probed the neural basis of individual differences in strategy. We tested whether strategies emerged from moment-to-moment reconfiguration of functional brain networks involved in decision making with task-evoked functional MRI (fMRI) and whether intrinsic properties of functional brain networks, measured at rest with functional connectivity MRI (fcMRI), were associated with strategy use. We found that human participants reliably selected one of two strategies across 2 days of task performance, either continuously accumulating evidence or waiting for task difficulty to decrease. Individual differences in decision strategy were predicted both by the degree of task-evoked activation of decision-related brain regions and by the strength of pretask correlated spontaneous brain activity. These results suggest that spontaneous brain activity constrains strategy selection on perceptual decisions.

  12. Strategies of Decision Making

    DTIC Science & Technology

    1989-05-01

    6.11.02.B 74F n/a n/a 11. TITLE (Include Security Classification) Strategies of Decision Making 12. PERSONAL AUTHOR(S) Gary A. Klein 13a. TYPE OF...NOTATION Judith Orasanu, contracting officer’s representative Arailability: Klein, G. Strategies of decision making . in Military Review. May 1989.(see...T.aIng pI(l( i ’I , / Decision making ) Com bat 19. ABSTRACT (Continue on reverse if necessary and identify by block number) This article posits that

  13. Decision-Making Strategies for College Students

    ERIC Educational Resources Information Center

    Morey, Janis T.; Dansereau, Donald F.

    2010-01-01

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

  14. Effect of regulating anger and sadness on decision-making.

    PubMed

    Szasz, Paul Lucian; Hofmann, Stefan G; Heilman, Renata M; Curtiss, Joshua

    2016-11-01

    The aim of the current study was to investigate the effects of reappraisal, acceptance, and rumination for regulating anger and sadness on decision-making. Participants (N = 165) were asked to recall two autobiographical events in which they felt intense anger and sadness, respectively. Participants were then instructed to reappraise, accept, ruminate, or not use any strategies to regulate their feelings of anger and sadness. Following this manipulation, risk aversion, and decision-making strategies were measured using a computer-based measure of risk-taking and a simulated real-life decision-making task. Participants who were instructed to reappraise their emotions showed the least anger and sadness, the most adaptive decision-making strategies, but the least risk aversion as compared to the participants in the other conditions. These findings suggest that emotion regulation strategies of negative affective states have an immediate effect on decision-making and risk-taking behaviors.

  15. Public Speaking Apprehension, Decision-Making Errors in the Selection of Speech Introduction Strategies and Adherence to Strategy.

    ERIC Educational Resources Information Center

    Beatty, Michael J.

    1988-01-01

    Examines the choice-making processes of students engaged in the selection of speech introduction strategies. Finds that the frequency of students making decision-making errors was a positive function of public speaking apprehension. (MS)

  16. Physician participation in hospital strategic decision making: the effect of hospital strategy and decision content.

    PubMed Central

    Ashmos, D P; McDaniel, R R

    1991-01-01

    An exploratory study examined variation in the participation of physicians in hospital strategic decision making as a function of (1) strategic decision content or (2) hospital strategy, or both. The findings revealed that who participates is a function of decision content while how physicians participate is a function of decision content and the interaction of decision content and hospital strategy. PMID:1869445

  17. Adaptive Strategy Selection in Decision Making.

    DTIC Science & Technology

    1986-07-31

    information processing capabilities of a decision maker, given any " reasonable " time limit for making the decision. If use of a more normative rule...DECISION MAKING JOHN W. PAYNE DTIC DUKE UNIVERSITY L.CT E AUG 13 JAMES R. BETTMAN DUKE. UNIVERSITY ERIC J. JOHNSON CARNEGIE-MELLON UNIVERSITY...REPORT & PERIOD COVERED ADAPTIVE STRATEGY SELECTION IN DECISION MAKING Research 6. PERFORMING ORO. REPORT NUMSER 7. AUTNORfe) e. CONTRACT ON GRANT

  18. Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

    PubMed

    Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

    2018-07-01

    We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

  19. A framework for designing and analyzing binary decision-making strategies in cellular systems†

    PubMed Central

    Porter, Joshua R.; Andrews, Burton W.; Iglesias, Pablo A.

    2015-01-01

    Cells make many binary (all-or-nothing) decisions based on noisy signals gathered from their environment and processed through noisy decision-making pathways. Reducing the effect of noise to improve the fidelity of decision-making comes at the expense of increased complexity, creating a tradeoff between performance and metabolic cost. We present a framework based on rate distortion theory, a branch of information theory, to quantify this tradeoff and design binary decision-making strategies that balance low cost and accuracy in optimal ways. With this framework, we show that several observed behaviors of binary decision-making systems, including random strategies, hysteresis, and irreversibility, are optimal in an information-theoretic sense for various situations. This framework can also be used to quantify the goals around which a decision-making system is optimized and to evaluate the optimality of cellular decision-making systems by a fundamental information-theoretic criterion. As proof of concept, we use the framework to quantify the goals of the externally triggered apoptosis pathway. PMID:22370552

  20. Command Decision-Making: Experience Counts

    DTIC Science & Technology

    2005-03-18

    USAWC STRATEGY RESEARCH PROJECT COMMAND DECISION - MAKING : EXPERIENCE COUNTS by Lieutenant Colonel Kelly A. Wolgast United States Army Colonel Charles...1. REPORT DATE 18 MAR 2005 2. REPORT TYPE 3. DATES COVERED - 4. TITLE AND SUBTITLE Command Decision Making Experience Counts 5a. CONTRACT...Colonel Kelly A. Wolgast TITLE: Command Decision - making : Experience Counts FORMAT: Strategy Research Project DATE: 18 March 2005 PAGES: 30 CLASSIFICATION

  1. 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

  2. Decision-Making Styles and Problem-Solving Appraisal.

    ERIC Educational Resources Information Center

    Phillips, Susan D.; And Others

    1984-01-01

    Compared decision-making style and problem-solving appraisal in 243 undergraduates. Results suggested that individuals who employ rational decision-making strategies approach problematic situations, while individuals who endorse dependent decisional strategies approach problematic situations without confidence in their problem-solving abilities.…

  3. Decision-making in Swiss home-like childbirth: A grounded theory study.

    PubMed

    Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

    2017-12-01

    Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  4. 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

  5. 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.

  6. Identifying Non-Sustainable Courses of Action: A Prerequisite for Decision-Making in Education for Sustainable Development

    NASA Astrophysics Data System (ADS)

    Gresch, Helge; Bögeholz, Susanne

    2013-04-01

    Students are faced with a multitude of decisions as consumers and in societal debates. Because of the scarcity of resources, the destruction of ecosystems and social injustice in a globalized world, it is vital that students are able to identify non-sustainable courses of action when involved in decision-making. The application of decision-making strategies is one approach to enhancing the quality of decisions. Options that do not meet ecological, social or economic standards should be excluded using non-compensatory strategies whereas other tasks may require a complete trade-off of all the evidence, following a compensatory approach. To enhance decision-making competence, a computer-based intervention study was conducted that focused on the use of decision-making strategies. While the results of the summative evaluation are reported by Gresch et al. (International Journal of Science Education, 2011), in-depth analyses of process-related data collected during the information processing are presented in this paper to reveal insights into the mechanisms of the intervention. The quality of high school students' ( n = 120) metadecision skills when selecting a decision-making strategy was investigated using qualitative content analyses combined with inferential statistics. The results reveal that the students offered elaborate reflections on the sustainability of options. However, the characteristics that were declared non-sustainable differed among the students because societal norms and personal values were intertwined. One implication for education for sustainable development is that students are capable of reflecting on decision-making tasks and on corresponding favorable decision-making strategies at a metadecision level. From these results, we offer suggestions for improving learning environments and constructing test instruments for decision-making competence.

  7. Satisficing in split-second decision making is characterized by strategic cue discounting.

    PubMed

    Oh, Hanna; Beck, Jeffrey M; Zhu, Pingping; Sommer, Marc A; Ferrari, Silvia; Egner, Tobias

    2016-12-01

    Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through satisficing, fast but "good-enough" heuristic decision making that prioritizes some sources of information (cues) while ignoring others. However, the decision-making strategies we adopt under uncertainty and time pressure, for example during emergencies that demand split-second choices, are presently unknown. To characterize these decision strategies quantitatively, the present study examined how people solve a novel multicue probabilistic classification task under varying time pressure, by tracking shifts in decision strategies using variational Bayesian inference. We found that under low time pressure, participants correctly weighted and integrated all available cues to arrive at near-optimal decisions. With increasingly demanding, subsecond time pressures, however, participants systematically discounted a subset of the cue information by dropping the least informative cue(s) from their decision making process. Thus, the human cognitive apparatus copes with uncertainty and severe time pressure by adopting a "drop-the-worst" cue decision making strategy that minimizes cognitive time and effort investment while preserving the consideration of the most diagnostic cue information, thus maintaining "good-enough" accuracy. This advance in our understanding of satisficing strategies could form the basis of predicting human choices in high time pressure scenarios. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Sensemaking Strategies for Ethical Decision-making.

    PubMed

    Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D

    2011-01-01

    The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.

  9. Sensemaking Strategies for Ethical Decision-making

    PubMed Central

    Caughron, Jay J.; Antes, Alison L.; Stenmark, Cheryl K.; Thiel, Chaise E.; Wang, Xiaoqian; Mumford, Michael D.

    2015-01-01

    The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies. PMID:26257505

  10. 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).

  11. Shared decision making: relevant concepts and facilitating strategies.

    PubMed

    Bae, Jong-Myon

    2017-01-01

    As the paradigm in healthcare nowadays is the evidence-based, patient-centered decision making, the issue of shared decision making (SDM) is highlighted. The aims of this manuscript were to look at the relevant concepts and suggest the facilitating strategies for overcoming barriers of conducting SDM. While the definitions of SDM were discordant, several concepts such as good communication, individual autonomy, patient participants, and patient-centered decision-making were involved. Further, the facilitating strategies of SDM were to educate and train physician, to apply clinical practice guidelines and patient decision aids, to develop valid measurement tools for evaluation of SDM processes, and to investigate the impact of SDM.

  12. Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making.

    PubMed

    Otto, Ashley S; Clarkson, Joshua J; Kardes, Frank R

    2016-07-01

    We all too often have to make decisions-from the mundane (e.g., what to eat for breakfast) to the complex (e.g., what to buy a loved one)-and yet there exists a multitude of strategies that allows us to make a decision. This work focuses on a subset of decision strategies that allows individuals to make decisions by bypassing the decision-making process-a phenomenon we term decision sidestepping. Critical to the present manuscript, however, we contend that decision sidestepping stems from the motivation to achieve closure. We link this proposition back to the fundamental nature of closure and how those seeking closure are highly bothered by decision making. As such, we argue that the motivation to achieve closure prompts a reliance on sidestepping strategies (e.g., default bias, choice delegation, status quo bias, inaction inertia, option fixation) to reduce the bothersome nature of decision making. In support of this framework, five experiments demonstrate that (a) those seeking closure are more likely to engage in decision sidestepping, (b) the effect of closure on sidestepping stems from the bothersome nature of decision making, and (c) the reliance on sidestepping results in downstream consequences for subsequent choice. Taken together, these findings offer unique insight into the cognitive motivations stimulating a reliance on decision sidestepping and thus a novel framework by which to understand how individuals make decisions while bypassing the decision-making process. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  13. Decision-making patterns and sensitivity to reward and punishment in children with attention-deficit hyperactivity disorder.

    PubMed

    Masunami, Taiji; Okazaki, Shinji; Maekawa, Hisao

    2009-06-01

    Earlier studies have demonstrated that attention-deficit hyperactivity disorder (ADHD) is associated with aberrant sensitivity to rewards and punishments. Although some studies have focused on real-life decision making in children with ADHD using the Iowa gambling task, the number of good deck choices, a frequently used index of decision-making ability in the gambling task, is insufficient for investigating the complex decision-making strategies in subjects. In the present study, we investigated decision-making strategies in ADHD children, analyzing T-patterns with rewards, with punishments, and without rewards and punishments during the gambling task, and examined the relationship between decision-making strategies and skin conductance responses (SCRs) to rewards and punishments. We hypothesized that ADHD children and normal children would employ different decision-making strategies depending on their sensitivity to rewards and punishments in the gambling task. Our results revealed that ADHD children had fewer T-patterns with punishments and exhibited a significant tendency to have many T-patterns with rewards, thus supporting our hypothesis. Moreover, in contrast to normal children, ADHD children failed to demonstrate differences between reward and punishment SCRs, supporting the idea that they had an aberrant sensitivity to rewards and punishments. Therefore, we concluded that ADHD children would be impaired in decision-making strategies depending on their aberrant sensitivity to rewards and punishments. However, we were unable to specify whether large reward SCRs or small punishment SCRs is generated in ADHD children.

  14. Results of our national survey. Current formulary decision-making strategies and new factors influencing the process.

    PubMed

    1995-08-01

    Formulary recently conducted a survey of 2,000 of its readers to uncover what forces are at play in their formulary decision-making processes. Topics included general philosophies toward formulary decision making, philosophies toward adding and deleting products, influences on the process, trends related to product reviews, formulary management strategies, drug information educational strategies, and new approaches to the formulary decision-making process. Some 295 surveys (14.75%) were returned. Highlights and analyses of the survey findings are presented for your review and comparison with your practice setting's approaches.

  15. 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.

  16. 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

  17. 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.

  18. Separate neural mechanisms underlie choices and strategic preferences in risky decision making.

    PubMed

    Venkatraman, Vinod; Payne, John W; Bettman, James R; Luce, Mary Frances; Huettel, Scott A

    2009-05-28

    Adaptive decision making in real-world contexts often relies on strategic simplifications of decision problems. Yet, the neural mechanisms that shape these strategies and their implementation remain largely unknown. Using an economic decision-making task, we dissociate brain regions that predict specific choices from those predicting an individual's preferred strategy. Choices that maximized gains or minimized losses were predicted by functional magnetic resonance imaging activation in ventromedial prefrontal cortex or anterior insula, respectively. However, choices that followed a simplifying strategy (i.e., attending to overall probability of winning) were associated with activation in parietal and lateral prefrontal cortices. Dorsomedial prefrontal cortex, through differential functional connectivity with parietal and insular cortex, predicted individual variability in strategic preferences. Finally, we demonstrate that robust decision strategies follow from neural sensitivity to rewards. We conclude that decision making reflects more than compensatory interaction of choice-related regions; in addition, specific brain systems potentiate choices depending on strategies, traits, and context.

  19. Separate neural mechanisms underlie choices and strategic preferences in risky decision making

    PubMed Central

    Venkatraman, Vinod; Payne, John W.; Bettman, James R.; Luce, Mary Frances; Huettel, Scott A.

    2011-01-01

    Adaptive decision making in real-world contexts often relies on strategic simplifications of decision problems. Yet, the neural mechanisms that shape these strategies and their implementation remain largely unknown. Using a novel economic decision-making task, we dissociate brain regions that predict specific choices from those predicting an individual’s preferred strategy. Choices that maximized gains or minimized losses were predicted by fMRI activation in ventromedial prefrontal cortex or anterior insula, respectively. However, choices that followed a simplifying strategy (i.e., attending to overall probability of winning) were associated with activation in parietal and lateral prefrontal cortices. Dorsomedial prefrontal cortex, through differential functional connectivity with parietal and insular cortex, predicted individual variability in strategic preferences. Finally, we demonstrate that robust decision strategies follow from neural sensitivity to rewards. We conclude that decision making reflects more than compensatory interaction of choice-related regions; in addition, specific brain systems potentiate choices depending upon strategies, traits, and context. PMID:19477159

  20. An electrophysiological index of changes in risk decision-making strategies.

    PubMed

    Zhang, Dandan; Gu, Ruolei; Wu, Tingting; Broster, Lucas S; Luo, Yi; Jiang, Yang; Luo, Yue-jia

    2013-07-01

    Human decision-making is significantly modulated by previously experienced outcomes. Using event-related potentials (ERPs), we examined whether ERP components evoked by outcome feedbacks could serve as biomarkers to signal the influence of current outcome evaluation on subsequent decision-making. In this study, 18 adult volunteers participated in a simple monetary gambling task, in which they were asked to choose between two options that differed in risk. Their decisions were immediately followed by outcome presentation. Temporospatial principle component analysis (PCA) was applied to the outcome-onset locked ERPs in the 200-1000 ms time window. The PCA factors that approximated classical ERP components (P2, feedback-related negativity, P3a, and P3b) in terms of time course and scalp distribution were tested for their association with subsequent decision-making strategies. Our results revealed that a fronto-central PCA factor approximating the classical P3a was related to changes of decision-making strategies on subsequent trials. The decision to switch between high- and low-risk options resulted in a larger P3a relative to the decision to retain the same choice. According to the results, we suggest that the amplitude of the fronto-central P3a is an electrophysiological index of the influence of current outcome on subsequent risk decision-making. Furthermore, the ERP source analysis indicated that the activations of the frontopolar cortex and sensorimotor cortex were involved in subsequent changes of strategies, which enriches our understanding of the neural mechanisms of adjusting decision-making strategies based on previous experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. An electrophysiological index of changes in risk decision-making strategies

    PubMed Central

    Zhang, Dandan; Gu, Ruolei; Wu, Tingting; Broster, Lucas S.; Luo, Yi; Jiang, Yang; Luo, Yue-jia

    2014-01-01

    Human decision-making is significantly modulated by previously experienced outcomes. Using event-related potentials (ERPs), we examined whether ERP components evoked by outcome feedbacks could serve as biomarkers to signal the influence of current outcome evaluation on subsequent decision-making. In this study, eighteen adult volunteers participated in a simple monetary gambling task, in which they were asked to choose between two options that differed in risk. Their decisions were immediately followed by outcome presentation. Temporospatial principle component analysis (PCA) was applied to the outcome-onset locked ERPs in the -200 – 1000 ms time window. The PCA factors that approximated classical ERP components (P2, feedback-related negativity, P3a, & P3b) in terms of time course and scalp distribution were tested for their association with subsequent decision-making strategies. Our results revealed that a fronto-central PCA factor approximating the classical P3a was related to changes of decision-making strategies on subsequent trials. The decision to switch between high- and low-risk options resulted in a larger P3a relative to the decision to retain the same choice. According to the results, we suggest the amplitude of the fronto-central P3a is an electrophysiological index of the influence of current outcome on subsequent risk decision-making. Furthermore, the ERP source analysis indicated that the activations of the frontopolar cortex and sensorimotor cortex were involved in subsequent changes of strategies, which enriches our understanding of the neural mechanisms of adjusting decision-making strategies based on previous experience. PMID:23643796

  2. 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

  3. 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…

  4. Parallel constraint satisfaction in memory-based decisions.

    PubMed

    Glöckner, Andreas; Hodges, Sara D

    2011-01-01

    Three studies sought to investigate decision strategies in memory-based decisions and to test the predictions of the parallel constraint satisfaction (PCS) model for decision making (Glöckner & Betsch, 2008). Time pressure was manipulated and the model was compared against simple heuristics (take the best and equal weight) and a weighted additive strategy. From PCS we predicted that fast intuitive decision making is based on compensatory information integration and that decision time increases and confidence decreases with increasing inconsistency in the decision task. In line with these predictions we observed a predominant usage of compensatory strategies under all time-pressure conditions and even with decision times as short as 1.7 s. For a substantial number of participants, choices and decision times were best explained by PCS, but there was also evidence for use of simple heuristics. The time-pressure manipulation did not significantly affect decision strategies. Overall, the results highlight intuitive, automatic processes in decision making and support the idea that human information-processing capabilities are less severely bounded than often assumed.

  5. The Effect of Sport on Decision Making Strategies

    ERIC Educational Resources Information Center

    Tozoglu, Erdogan

    2013-01-01

    The decisions people make in the face of circumstances they encounter influence their life in favourable or unfavourable ways. The aim of this study is to examine the relationship between sporting habits and decision making strategies among university students. The research involved 1298 students (526 women and 772 men) studying during 2011-2012…

  6. Decision Making Under Objective Risk Conditions-a Review of Cognitive and Emotional Correlates, Strategies, Feedback Processing, and External Influences.

    PubMed

    Schiebener, Johannes; Brand, Matthias

    2015-06-01

    While making decisions under objective risk conditions, the probabilities of the consequences of the available options are either provided or calculable. Brand et al. (Neural Networks 19:1266-1276, 2006) introduced a model describing the neuro-cognitive processes involved in such decisions. In this model, executive functions associated with activity in the fronto-striatal loop are important for developing and applying decision-making strategies, and for verifying, adapting, or revising strategies according to feedback. Emotional rewards and punishments learned from such feedback accompany these processes. In this literature review, we found support for the role of executive functions, but also found evidence for the importance of further cognitive abilities in decision making. Moreover, in addition to reflective processing (driven by cognition), decisions can be guided by impulsive processing (driven by anticipation of emotional reward and punishment). Reflective and impulsive processing may interact during decision making, affecting the evaluation of available options, as both processes are affected by feedback. Decision-making processes are furthermore modulated by individual attributes (e.g., age), and external influences (e.g., stressors). Accordingly, we suggest a revised model of decision making under objective risk conditions.

  7. A simple threshold rule is sufficient to explain sophisticated collective decision-making.

    PubMed

    Robinson, Elva J H; Franks, Nigel R; Ellis, Samuel; Okuda, Saki; Marshall, James A R

    2011-01-01

    Decision-making animals can use slow-but-accurate strategies, such as making multiple comparisons, or opt for simpler, faster strategies to find a 'good enough' option. Social animals make collective decisions about many group behaviours including foraging and migration. The key to the collective choice lies with individual behaviour. We present a case study of a collective decision-making process (house-hunting ants, Temnothorax albipennis), in which a previously proposed decision strategy involved both quality-dependent hesitancy and direct comparisons of nests by scouts. An alternative possible decision strategy is that scouting ants use a very simple quality-dependent threshold rule to decide whether to recruit nest-mates to a new site or search for alternatives. We use analytical and simulation modelling to demonstrate that this simple rule is sufficient to explain empirical patterns from three studies of collective decision-making in ants, and can account parsimoniously for apparent comparison by individuals and apparent hesitancy (recruitment latency) effects, when available nests differ strongly in quality. This highlights the need to carefully design experiments to detect individual comparison. We present empirical data strongly suggesting that best-of-n comparison is not used by individual ants, although individual sequential comparisons are not ruled out. However, by using a simple threshold rule, decision-making groups are able to effectively compare options, without relying on any form of direct comparison of alternatives by individuals. This parsimonious mechanism could promote collective rationality in group decision-making.

  8. Framing of task performance strategies: effects on performance in a multiattribute dynamic decision making environment.

    PubMed

    Nygren, T E

    1997-09-01

    It is well documented that the way a static choice task is "framed" can dramatically alter choice behavior, often leading to observable preference reversals. This framing effect appears to result from perceived changes in the nature or location of a person's initial reference point, but it is not clear how framing effects might generalize to performance on dynamic decision making tasks that are characterized by high workload, time constraints, risk, or stress. A study was conducted to examine the hypothesis that framing can introduce affective components to the decision making process and can influence, either favorably (positive frame) or adversely (negative frame), the implementation and use of decision making strategies in dynamic high-workload environments. Results indicated that negative frame participants were significantly impaired in developing and employing a simple optimal decision strategy relative to a positive frame group. Discussion focuses on implications of these results for models of dynamic decision making.

  9. Toolbox or Adjustable Spanner? A Critical Comparison of Two Metaphors for Adaptive Decision Making

    ERIC Educational Resources Information Center

    Söllner, Anke; Bröder, Arndt

    2016-01-01

    For multiattribute decision tasks, different metaphors exist that describe the process of decision making and its adaptation to diverse problems and situations. Multiple strategy models (MSMs) assume that decision makers choose adaptively from a set of different strategies (toolbox metaphor), whereas evidence accumulation models (EAMs) hold that a…

  10. Stop making plans; start making decisions.

    PubMed

    Mankins, Michael C; Steele, Richard

    2006-01-01

    Many executives have grown skeptical of strategic planning. Is it any wonder? Despite all the time and energy that go into it, strategic planning most often acts as a barrier to good decision making and does little to influence strategy. Strategic planning fails because of two factors: It typically occurs annually, and it focuses on individual business units. As such, the process is completely at odds with the way executives actually make important strategy decisions, which are neither constrained by the calendar nor defined by unit boundaries. Thus, according to a survey of 156 large companies, senior executives often make strategic decisions outside the planning process, in an ad hoc fashion and without rigorous analysis or productive debate. But companies can fix the process if they attack its root problems. A few forward-looking firms have thrown out their calendar-driven, business-unit-focused planning procedures and replaced them with continuous, issues-focused decision making. In doing so, they rely on several basic principles: They separate, but integrate, decision making and plan making. They focus on a few key themes. And they structure strategy reviews to produce real decisions. When companies change the timing and focus of strategic planning, they also change the nature of senior management's discussions about strategy--from "review and approve" to "debate and decide," in which top executives actively think through every major decision and its implications for the company's performance and value. The authors have found that these companies make more than twice as many important strategic decisions per year as companies that follow the traditional planning model.

  11. Brief Report: Risk-Aversion and Rationality in Autism Spectrum Disorders.

    PubMed

    Gosling, Corentin J; Moutier, Sylvain

    2018-05-30

    Risk-aversion and rationality have both been highlighted as core features of decision making in individuals with Autism Spectrum Disorders (ASD). This study tested whether risk-aversion is related to rational decision-making in ASD individuals. ASD and matched control adults completed a decision-making task that discriminated between the use of risk-averse and rational strategies. Results showed that overall, ASD participants were more risk-averse than control participants. Specifically, both groups made similar choices when risk-aversion was the less rational strategy but ASD participants chose more rational options than control participants when risk-aversion was the most rational strategy. This study confirmed that risk-aversion is a core feature of ASD and revealed that ASD individuals can switch their decision-making strategy adaptively to avoid negative consequences.

  12. The Minimal Control Principle Predicts Strategy Shifts in the Abstract Decision Making Task

    ERIC Educational Resources Information Center

    Taatgen, Niels A.

    2011-01-01

    The minimal control principle (Taatgen, 2007) predicts that people strive for problem-solving strategies that require as few internal control states as possible. In an experiment with the Abstract Decision Making task (ADM task; Joslyn & Hunt, 1998) the reward structure was manipulated to make either a low-control strategy or a high-strategy…

  13. Heuristic-based information acquisition and decision making among pilots.

    PubMed

    Wiggins, Mark W; Bollwerk, Sandra

    2006-01-01

    This research was designed to examine the impact of heuristic-based approaches to the acquisition of task-related information on the selection of an optimal alternative during simulated in-flight decision making. The work integrated features of naturalistic and normative decision making and strategies of information acquisition within a computer-based, decision support framework. The study comprised two phases, the first of which involved familiarizing pilots with three different heuristic-based strategies of information acquisition: frequency, elimination by aspects, and majority of confirming decisions. The second stage enabled participants to choose one of the three strategies of information acquisition to resolve a fourth (choice) scenario. The results indicated that task-oriented experience, rather than the information acquisition strategies, predicted the selection of the optimal alternative. It was also evident that of the three strategies available, the elimination by aspects information acquisition strategy was preferred by most participants. It was concluded that task-oriented experience, rather than the process of information acquisition, predicted task accuracy during the decision-making task. It was also concluded that pilots have a preference for one particular approach to information acquisition. Applications of outcomes of this research include the development of decision support systems that adapt to the information-processing capabilities and preferences of users.

  14. Information Search and Decision Making: The Effects of Age and Complexity on Strategy Use

    PubMed Central

    Queen, Tara L.; Hess, Thomas M.; Ennis, Gilda E.; Dowd, Keith; Grühn, Daniel

    2012-01-01

    The impact of task complexity on information search strategy and decision quality was examined in a sample of 135 young, middle-aged, and older adults. We were particularly interested in the competing roles of fluid cognitive ability and domain knowledge and experience, with the former being a negative influence and the latter being a positive influence on older adults’ performance. Participants utilized two decision matrices, which varied in complexity, regarding a consumer purchase. Using process tracing software and an algorithm developed to assess decision strategy, we recorded search behavior, strategy selection, and final decision. Contrary to expectations, older adults were not more likely than the younger age groups to engage in information-minimizing search behaviors in response to increases in task complexity. Similarly, adults of all ages used comparable decision strategies and adapted their strategies to the demands of the task. We also examined decision outcomes in relation to participants’ preferences. Overall, it seems that older adults utilize simpler sets of information primarily reflecting the most valued attributes in making their choice. The results of this study suggest that older adults are adaptive in their approach to decision making and this ability may benefit from accrued knowledge and experience. PMID:22663157

  15. Effects of Computer-Assisted Instruction in Using Formal Decision-Making Strategies to Choose a College Major.

    ERIC Educational Resources Information Center

    Mau, Wei-Cheng; Jepsen, David A.

    1992-01-01

    Compared decision-making strategies and college major choice among 113 first-year students assigned to Elimination by Aspects Strategy (EBA), Subjective Expected Utility Strategy (SEU), and control groups. "Rational" EBA students scored significantly higher on choice certainty; lower on choice anxiety and career indecision than "rational"…

  16. 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.

  17. '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.

  18. Mice learn to avoid regret.

    PubMed

    Sweis, Brian M; Thomas, Mark J; Redish, A David

    2018-06-01

    Regret can be defined as the subjective experience of recognizing that one has made a mistake and that a better alternative could have been selected. The experience of regret is thought to carry negative utility. This typically takes two distinct forms: augmenting immediate postregret valuations to make up for losses, and augmenting long-term changes in decision-making strategies to avoid future instances of regret altogether. While the short-term changes in valuation have been studied in human psychology, economics, neuroscience, and even recently in nonhuman-primate and rodent neurophysiology, the latter long-term process has received far less attention, with no reports of regret avoidance in nonhuman decision-making paradigms. We trained 31 mice in a novel variant of the Restaurant Row economic decision-making task, in which mice make decisions of whether to spend time from a limited budget to achieve food rewards of varying costs (delays). Importantly, we tested mice longitudinally for 70 consecutive days, during which the task provided their only source of food. Thus, decision strategies were interdependent across both trials and days. We separated principal commitment decisions from secondary reevaluation decisions across space and time and found evidence for regret-like behaviors following change-of-mind decisions that corrected prior economically disadvantageous choices. Immediately following change-of-mind events, subsequent decisions appeared to make up for lost effort by altering willingness to wait, decision speed, and pellet consumption speed, consistent with past reports of regret in rodents. As mice were exposed to an increasingly reward-scarce environment, we found they adapted and refined distinct economic decision-making strategies over the course of weeks to maximize reinforcement rate. However, we also found that even without changes in reinforcement rate, mice transitioned from an early strategy rooted in foraging to a strategy rooted in deliberation and planning that prevented future regret-inducing change-of-mind episodes from occurring. These data suggest that mice are learning to avoid future regret, independent of and separate from reinforcement rate maximization.

  19. Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

    ERIC Educational Resources Information Center

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2017-01-01

    Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on…

  20. A cognitive prosthesis for complex decision-making.

    PubMed

    Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

    2017-01-01

    While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Complexity science and participation in decision making among Taiwanese nurses.

    PubMed

    Liu, Yi

    2008-04-01

    The perspective of interconnection in complexity science is used to examine the concept of participation in decision making among Taiwanese nurses in the context of Chinese communication culture. Participation in decision making among nurses has been widely discussed and tested in the Western healthcare systems. Many studies have shown that participation in decision making relates to nurses' autonomy, job satisfaction and quality of care. However, participation in decision making has not been fully discussed in Taiwan's nursing community. In a different cultural environment, participation in decision making may have different effects. The concept of participation in decision making is analysed in three facets of Chinese communication culture: (1) hierarchical social relationship; (2) harmony maintenance; and (3) insider effects. Key issues Taiwanese nurses might establish different levels of participation and need to use different strategies to enhance participation in decision making for desired outcomes. While applying participation in decision making in a different context, it is very important to consider the social and cultural differences. Two implications are made. First, nursing leaders/managers who are working with a multicultural team should be aware of the cultural difference in the pattern of interaction in the process of participation in decision making. Second, leaders/managers should be creative and try to apply different strategies to encourage staff's participation in decision making.

  2. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

    PubMed

    Pieterse, Arwen H; de Vries, Marieke

    2013-09-01

    Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

  3. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis

    PubMed Central

    Pieterse, Arwen H.; de Vries, Marieke

    2011-01-01

    Abstract Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference‐sensitive health‐care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic‐based VCMs. Objective  To critically analyse the suitability of the ‘take the best’ (TTB) and ‘tallying’ fast and frugal heuristics in the context of patient decision making. Strategy  Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. Conclusion  The specific nature of patient preference‐sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. PMID:21902770

  4. "Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making": Correction to Otto et al. (2016).

    PubMed

    2016-09-01

    Reports an error in "Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making" by Ashley S. Otto, Joshua J. Clarkson and Frank R. Kardes ( Journal of Personality and Social Psychology , 2016[Jul], Vol 111[1], 1-16). In the article, the main heading for Experiment 3 was missing due to a production error, and the first sentence of the first paragraph of Experiment 3 should begin as follows: Experiment 2 offered support for the hypothesis that those seeking closure engage in decision sidestepping to reduce the bothersome nature of decision making. (The following abstract of the original article appeared in record 2016-30159-001.) We all too often have to make decisions—from the mundane (e.g., what to eat for breakfast) to the complex (e.g., what to buy a loved one)—and yet there exists a multitude of strategies that allows us to make a decision. This work focuses on a subset of decision strategies that allows individuals to make decisions by bypassing the decision-making process—a phenomenon we term decision sidestepping. Critical to the present manuscript, however, we contend that decision sidestepping stems from the motivation to achieve closure. We link this proposition back to the fundamental nature of closure and how those seeking closure are highly bothered by decision making. As such, we argue that the motivation to achieve closure prompts a reliance on sidestepping strategies (e.g., default bias, choice delegation, status quo bias, inaction inertia, option fixation) to reduce the bothersome nature of decision making. In support of this framework, five experiments demonstrate that (a) those seeking closure are more likely to engage in decision sidestepping, (b) the effect of closure on sidestepping stems from the bothersome nature of decision making, and (c) the reliance on sidestepping results in downstream consequences for subsequent choice. Taken together, these findings offer unique insight into the cognitive motivations stimulating a reliance on decision sidestepping and thus a novel framework by which to understand how individuals make decisions while bypassing the decision-making process. PsycINFO Database Record (c) 2016 APA, all rights reserved

  5. Decision Making Styles and Progress in Occupational Decision Making.

    ERIC Educational Resources Information Center

    Phillips, Susan D.; And Others

    1984-01-01

    Examined the role of rational, intuitive, and dependent decisional strategies in facilitating decisions about postcollege occupation among college students (N=71). Results indicated that the use of a dependent decision-making style was the single most powerful predictor of progress. (LLL)

  6. Crew decision making under stress

    NASA Technical Reports Server (NTRS)

    Orasanu, J.

    1992-01-01

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

  7. Fuzzy-based decision strategy in real-time strategic games

    NASA Astrophysics Data System (ADS)

    Volna, Eva

    2017-11-01

    The aim of this article is to describe our own gaming artificial intelligence for OpenTTD, which is a real-time building strategy game. A multi-agent system with fuzzy decision-making was used for the proposal itself. The multiagent system was chosen because real-time strategy games achieve great complexity and require decomposition of the problem into individual problems, which are then solved by individual cooperating agents. The system becomes then more stable and easily expandable. The fuzzy approach makes the decision-making process of strategies easier thanks to the use of uncertainty. In the conclusion, own experimental results were compared with other approaches.

  8. Acquisition and production of skilled behavior in dynamic decision-making tasks

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex

    1992-01-01

    Currently, two main approaches exist for improving the human-machine interface component of a system in order to improve overall system performance - display enhancement and intelligent decision making. Discussed here are the characteristic issues of these two decision-making strategies. Differences in expert and novice decision making are described in order to help determine whether a particular strategy may be better for a particular type of user. Research is outlined to compare and contrast the two technologies, as well as to examine the interaction effects introduced by the different skill levels and the different methods for training operators.

  9. Information search and decision making: effects of age and complexity on strategy use.

    PubMed

    Queen, Tara L; Hess, Thomas M; Ennis, Gilda E; Dowd, Keith; Grühn, Daniel

    2012-12-01

    The impact of task complexity on information search strategy and decision quality was examined in a sample of 135 young, middle-aged, and older adults. We were particularly interested in the competing roles of fluid cognitive ability and domain knowledge and experience, with the former being a negative influence and the latter being a positive influence on older adults' performance. Participants utilized 2 decision matrices, which varied in complexity, regarding a consumer purchase. Using process tracing software and an algorithm developed to assess decision strategy, we recorded search behavior, strategy selection, and final decision. Contrary to expectations, older adults were not more likely than the younger age groups to engage in information-minimizing search behaviors in response to increases in task complexity. Similarly, adults of all ages used comparable decision strategies and adapted their strategies to the demands of the task. We also examined decision outcomes in relation to participants' preferences. Overall, it seems that older adults utilize simpler sets of information primarily reflecting the most valued attributes in making their choice. The results of this study suggest that older adults are adaptive in their approach to decision making and that this ability may benefit from accrued knowledge and experience. 2013 APA, all rights reserved

  10. What does the new breed of decision-making methodologies mean for choices and norms in hydrological science?

    NASA Astrophysics Data System (ADS)

    Wikman-Svahn, Per

    2013-04-01

    Hydrological sciences are increasingly utilized in decision-making contexts that need to manage deep uncertainty, changing conditions and very long-lead times and lifetimes. Traditional optimizing approaches become problematic in such situations. For example, optimizing approaches may underestimate the importance of low probability outcomes, or very uncertain outcomes. Alternative decision-making strategies are therefore increasingly used in hydrological applications, including "bottom-up/top-down", "context-first", "decision-scaling", "assess risk of policy", "robust", "resilient" or "flexible" approaches. These kinds of strategies are typically designed to handle very uncertain and diverse outcomes, and often start from the particular decision-making context, in contrast to more traditional "predict-then-act" or "science first" approaches. Contemporary research in philosophy of science stress the influence of value judgments and norms in scientific assessments. In particular, this literature points out that implicit anticipated applications often influence choices made in scientific assessments. Furthermore, this literature also emphasize that choices made at within scientific assessments have consequences for decision-making later on. One reason is that it is often difficult for decision-makers to see what choices are made and the implications of these choices. Another reason is that information that could be of use for decision-makers are lost at an early stage. For example, the choice to focus on central estimates and not providing assessments on more unlikely outcomes is a choice that has consequences for what outcomes are taken into account in the decision-making process. This paper develops this argument and then analyzes the implications of these new developments for hydrological science. One implication of the increasing use of the new breed of planning strategies is that a broader range of uncertainty in scientific assessments becomes desirable in order to fully benefit from the power of the new decision-making strategies. Another implication is that bayesian probability assessments become more important. Finally, advantages and risks involved in changing scientific assessments in order to anticipate the new decision-making strategies are discussed.

  11. Cognitive Fatigue Destabilizes Economic Decision Making Preferences and Strategies.

    PubMed

    Mullette-Gillman, O'Dhaniel A; Leong, Ruth L F; Kurnianingsih, Yoanna A

    2015-01-01

    It is common for individuals to engage in taxing cognitive activity for prolonged periods of time, resulting in cognitive fatigue that has the potential to produce significant effects in behaviour and decision making. We sought to examine whether cognitive fatigue modulates economic decision making. We employed a between-subject manipulation design, inducing fatigue through 60 to 90 minutes of taxing cognitive engagement against a control group that watched relaxing videos for a matched period of time. Both before and after the manipulation, participants engaged in two economic decision making tasks (one for gains and one for losses). The analyses focused on two areas of economic decision making--preferences and choice strategies. Uncertainty preferences (risk and ambiguity) were quantified as premium values, defined as the degree and direction in which participants alter the valuation of the gamble in comparison to the certain option. The strategies that each participant engaged in were quantified through a choice strategy metric, which contrasts the degree to which choice behaviour relies upon available satisficing or maximizing information. We separately examined these metrics for alterations within both the gains and losses domains, through the two choice tasks. The fatigue manipulation resulted in significantly greater levels of reported subjective fatigue, with correspondingly higher levels of reported effort during the cognitively taxing activity. Cognitive fatigue did not alter uncertainty preferences (risk or ambiguity) or informational strategies, in either the gains or losses domains. Rather, cognitive fatigue resulted in greater test-retest variability across most of our economic measures. These results indicate that cognitive fatigue destabilizes economic decision making, resulting in inconsistent preferences and informational strategies that may significantly reduce decision quality.

  12. Serial, parallel and hierarchical decision making in primates

    PubMed Central

    Zylberberg, Ariel; Lorteije, Jeannette AM; Ouellette, Brian G; De Zeeuw, Chris I; Sigman, Mariano; Roelfsema, Pieter

    2017-01-01

    The study of decision-making has mainly focused on isolated decisions where choices are associated with motor actions. However, problem-solving often involves considering a hierarchy of sub-decisions. In a recent study (Lorteije et al. 2015), we reported behavioral and neuronal evidence for hierarchical decision making in a task with a small decision tree. We observed a first phase of parallel evidence integration for multiple sub-decisions, followed by a phase in which the overall strategy formed. It has been suggested that a 'flat' competition between the ultimate motor actions might also explain these results. A reanalysis of the data does not support the critical predictions of flat models. We also examined the time-course of decision making in other, related tasks and report conditions where evidence integration for successive decisions is decoupled, which excludes flat models. We conclude that the flexibility of decision-making implies that the strategies are genuinely hierarchical. DOI: http://dx.doi.org/10.7554/eLife.17331.001 PMID:28648172

  13. George Williams in Thailand: An Ethical Decision-Making Exercise

    ERIC Educational Resources Information Center

    James, Constance R.; Smith, J. Goosby

    2007-01-01

    This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…

  14. To Achieve or Not To Achieve: A Self-Regulation Perspective on Adolescents' Academic Decision Making.

    ERIC Educational Resources Information Center

    Miller, David C.; Byrnes, James P.

    2001-01-01

    This study investigated the utility of the self-regulation model of decision making for explaining and predicting adolescents' academic decision making. Measures included an assessment of decision-making skill; academic goals; select scales of Learning and Study Strategies Inventory; and teacher ratings of achievement behavior. Adolescents'…

  15. Integration of professional judgement and decision-making in high-level adventure sports coaching practice.

    PubMed

    Collins, Loel; Collins, Dave

    2015-01-01

    This study examined the integration of professional judgement and decision-making processes in adventure sports coaching. The study utilised a thematic analysis approach to investigate the decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. Results revealed that, in order to make judgements and decisions in practice, expert coaches employ a range of practical and pedagogic management strategies to create and opportunistically use time for decision-making. These approaches include span of control and time management strategies to facilitate the decision-making process regarding risk management, venue selection, aims, objectives, session content, and differentiation of the coaching process. The implication for coaches, coach education, and accreditation is the recognition and training of the approaches that "create time" for the judgements in practice, namely "creating space to think". The paper concludes by offering a template for a more expertise-focused progression in adventure sports coaching.

  16. I don't want to be the one saying 'we should just let him die': intrapersonal tensions experienced by surrogate decision makers in the ICU.

    PubMed

    Schenker, Yael; Crowley-Matoka, Megan; Dohan, Daniel; Tiver, Greer A; Arnold, Robert M; White, Douglas B

    2012-12-01

    Although numerous studies have addressed external factors associated with difficulty in surrogate decision making, intrapersonal sources of tension are an important element of decision making that have received little attention. To characterize key intrapersonal tensions experienced by surrogate decision makers in the intensive care unit (ICU), and explore associated coping strategies. Qualitative interview study. Thirty surrogates from five ICUs at two hospitals in Pittsburgh, Pennsylvania, who were actively involved in making life-sustaining treatment decisions for a critically ill loved one. We conducted in-depth, semi-structured interviews with surrogates, focused on intrapersonal tensions, role challenges, and coping strategies. We analyzed transcripts using constant comparative methods. Surrogates experience significant emotional conflict between the desire to act in accordance with their loved one's values and 1) not wanting to feel responsible for a loved one's death, 2) a desire to pursue any chance of recovery, and 3) the need to preserve family well-being. Associated coping strategies included 1) recalling previous discussions with a loved one, 2) sharing decisions with family members, 3) delaying or deferring decision making, 4) spiritual/religious practices, and 5) story-telling. Surrogates' struggle to reconcile personal and family emotional needs with their loved ones' wishes, and utilize common coping strategies to combat intrapersonal tensions. These data suggest reasons surrogates may struggle to follow a strict substituted judgment standard. They also suggest ways clinicians may improve decision making, including attending to surrogates' emotions, facilitating family decision making, and eliciting potential emotional conflicts and spiritual needs.

  17. Extending The P4P Agenda, Part 1: How Medicare Can Improve Patient Decision Making And Reduce Unnecessary Care

    PubMed Central

    Wennberg, John E.; O'Connor, Annette M.; Collins, E. Dale; Weinstein, James N.

    2008-01-01

    The decision to undergo many discretionary medical treatments should be based on informed patient choice. Shared decision making is an effective strategy for achieving this goal. The Centers for Medicare and Medicaid Services (CMS) should extend its pay-for-performance (P4P) agenda to assure that all Americans have access to a certified shared decision-making process. This paper outlines a strategy to achieve informed patient choice as the standard of practice for preference-sensitive care. PMID:17978377

  18. Nicotine and varenicline ameliorate changes in reward-based choice strategy and altered decision-making in methamphetamine-treated rats.

    PubMed

    Mizoguchi, Hiroyuki; Wang, Tian; Kusaba, Mizuki; Fukumoto, Kazuya; Yamada, Kiyofumi

    2018-06-20

    Patients suffering from neuropsychiatric disorders such as substance use and addiction disorders show impaired decision-making, which may be associated with their psychiatric disorders. Previously, using a gambling test for rodents, we demonstrated that methamphetamine-dependent rats showed alterations in their decision-making strategy. In this study, we investigated the effect of nicotine on impaired decision-making strategy in rats which have been treated repeatedly with methamphetamine. Nicotine has previously been shown to have therapeutic effects on attentional and cognitive abnormalities in psychosis. Rats were administered methamphetamine subcutaneously (sc) at 4 mg/kg once a day, for 30 days, and their decision-making was then assessed with a rodent gambling task. We found that methamphetamine-treated rats preferred the high-risk/high-return actions, which is consistent with our previous findings. Methamphetamine-induced impairment of decision-making was reversed by daily nicotine treatment (0.3 mg/kg, sc). This effect was associated with the reduction of lose-shift behavior after negative reward prediction error. Repeated treatment with nicotine had no effects on arm-choice behavior in naïve rats. Varenicline, an α4β2-nicotinic acetylcholine receptor partial agonist, also ameliorated the altered decision-making in methamphetamine-treated rats. Our findings suggest that nicotine treatment is useful for ameliorating the altered decision-making caused by methamphetamine treatment, and that the α4β2-nicotinic acetylcholine receptor is a therapeutic target for poor decision-making. Copyright © 2018. Published by Elsevier B.V.

  19. Torts to contract? Moving from informed consent to shared decision-making.

    PubMed

    Monico, Edward P; Calise, Arthur; Calabro, Joseph

    2008-01-01

    Many claims of medical malpractice arise from a breakdown in communication between physician and patient. As a result, medical decision-making may change from an informed consent model to a shared decision-making strategy. Shared decision-making, a contract derivative, will trigger contract obligations and change the face of medical malpractice from tort to contract.

  20. 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

  1. The Rational Adolescent: Strategic Information Processing during Decision Making Revealed by Eye Tracking.

    PubMed

    Kwak, Youngbin; Payne, John W; Cohen, Andrew L; Huettel, Scott A

    2015-01-01

    Adolescence is often viewed as a time of irrational, risky decision-making - despite adolescents' competence in other cognitive domains. In this study, we examined the strategies used by adolescents (N=30) and young adults (N=47) to resolve complex, multi-outcome economic gambles. Compared to adults, adolescents were more likely to make conservative, loss-minimizing choices consistent with economic models. Eye-tracking data showed that prior to decisions, adolescents acquired more information in a more thorough manner; that is, they engaged in a more analytic processing strategy indicative of trade-offs between decision variables. In contrast, young adults' decisions were more consistent with heuristics that simplified the decision problem, at the expense of analytic precision. Collectively, these results demonstrate a counter-intuitive developmental transition in economic decision making: adolescents' decisions are more consistent with rational-choice models, while young adults more readily engage task-appropriate heuristics.

  2. The Rational Adolescent: Strategic Information Processing during Decision Making Revealed by Eye Tracking

    PubMed Central

    Kwak, Youngbin; Payne, John W.; Cohen, Andrew L.; Huettel, Scott A.

    2015-01-01

    Adolescence is often viewed as a time of irrational, risky decision-making – despite adolescents' competence in other cognitive domains. In this study, we examined the strategies used by adolescents (N=30) and young adults (N=47) to resolve complex, multi-outcome economic gambles. Compared to adults, adolescents were more likely to make conservative, loss-minimizing choices consistent with economic models. Eye-tracking data showed that prior to decisions, adolescents acquired more information in a more thorough manner; that is, they engaged in a more analytic processing strategy indicative of trade-offs between decision variables. In contrast, young adults' decisions were more consistent with heuristics that simplified the decision problem, at the expense of analytic precision. Collectively, these results demonstrate a counter-intuitive developmental transition in economic decision making: adolescents' decisions are more consistent with rational-choice models, while young adults more readily engage task-appropriate heuristics. PMID:26388664

  3. Optimization as a Reasoning Strategy for Dealing with Socioscientific Decision-Making Situations

    ERIC Educational Resources Information Center

    Papadouris, Nicos

    2012-01-01

    This paper reports on an attempt to help 12-year-old students develop a specific optimization strategy for selecting among possible solutions in socioscientific decision-making situations. We have developed teaching and learning materials for elaborating this strategy, and we have implemented them in two intact classes (N = 48). Prior to and after…

  4. 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.

  5. Understanding Decision Making in Critical Care

    PubMed Central

    Lighthall, Geoffrey K.; Vazquez-Guillamet, Cristina

    2015-01-01

    Background Human decision making involves the deliberate formulation of hypotheses and plans as well as the use of subconscious means of judging probability, likely outcome, and proper action. Rationale There is a growing recognition that intuitive strategies such as use of heuristics and pattern recognition described in other industries are applicable to high-acuity environments in medicine. Despite the applicability of theories of cognition to the intensive care unit, a discussion of decision-making strategies is currently absent in the critical care literature. Content This article provides an overview of known cognitive strategies, as well as a synthesis of their use in critical care. By understanding the ways by which humans formulate diagnoses and make critical decisions, we may be able to minimize errors in our own judgments as well as build training activities around known strengths and limitations of cognition. PMID:26387708

  6. Cognitive Fatigue Destabilizes Economic Decision Making Preferences and Strategies

    PubMed Central

    Mullette-Gillman, O’Dhaniel A.; Leong, Ruth L. F.; Kurnianingsih, Yoanna A.

    2015-01-01

    Objective It is common for individuals to engage in taxing cognitive activity for prolonged periods of time, resulting in cognitive fatigue that has the potential to produce significant effects in behaviour and decision making. We sought to examine whether cognitive fatigue modulates economic decision making. Methods We employed a between-subject manipulation design, inducing fatigue through 60 to 90 minutes of taxing cognitive engagement against a control group that watched relaxing videos for a matched period of time. Both before and after the manipulation, participants engaged in two economic decision making tasks (one for gains and one for losses). The analyses focused on two areas of economic decision making—preferences and choice strategies. Uncertainty preferences (risk and ambiguity) were quantified as premium values, defined as the degree and direction in which participants alter the valuation of the gamble in comparison to the certain option. The strategies that each participant engaged in were quantified through a choice strategy metric, which contrasts the degree to which choice behaviour relies upon available satisficing or maximizing information. We separately examined these metrics for alterations within both the gains and losses domains, through the two choice tasks. Results The fatigue manipulation resulted in significantly greater levels of reported subjective fatigue, with correspondingly higher levels of reported effort during the cognitively taxing activity. Cognitive fatigue did not alter uncertainty preferences (risk or ambiguity) or informational strategies, in either the gains or losses domains. Rather, cognitive fatigue resulted in greater test-retest variability across most of our economic measures. These results indicate that cognitive fatigue destabilizes economic decision making, resulting in inconsistent preferences and informational strategies that may significantly reduce decision quality. PMID:26230404

  7. The Influence of Temporal Orientation and Affective Frame on use of Ethical Decision-Making Strategies

    PubMed Central

    Martin, Laura E.; Stenmark, Cheryl K.; Thiel, Chase E.; Antes, Alison L.; Mumford, Michael D.; Connelly, Shane; Devenport, Lynn D.

    2011-01-01

    This study examined the role of temporal orientation and affective frame in the execution of ethical decision-making strategies. In reflecting on a past experience or imagining a future experience, participants thought about experiences that they considered either positive or negative. The participants recorded their thinking about that experience by responding to several questions, and their responses were content-analyzed for the use of ethical decision-making strategies. The findings indicated that a future temporal orientation was associated with greater strategy use. Likewise, a positive affective frame was associated with greater strategy use. Future orientation may permit better strategy execution than a past orientation because it facilitates more objective, balanced contemplation of the reflected-upon situation, and minimizes potential self-threat associated with past behavior. A positive affective frame likely improves strategy execution because it facilitates active analysis of the experience. Future directions and implications of these findings are discussed. PMID:21572582

  8. Using multi-criteria decision making for selection of the optimal strategy for municipal solid waste management.

    PubMed

    Jovanovic, Sasa; Savic, Slobodan; Jovicic, Nebojsa; Boskovic, Goran; Djordjevic, Zorica

    2016-09-01

    Multi-criteria decision making (MCDM) is a relatively new tool for decision makers who deal with numerous and often contradictory factors during their decision making process. This paper presents a procedure to choose the optimal municipal solid waste (MSW) management system for the area of the city of Kragujevac (Republic of Serbia) based on the MCDM method. Two methods of multiple attribute decision making, i.e. SAW (simple additive weighting method) and TOPSIS (technique for order preference by similarity to ideal solution), respectively, were used to compare the proposed waste management strategies (WMS). Each of the created strategies was simulated using the software package IWM2. Total values for eight chosen parameters were calculated for all the strategies. Contribution of each of the six waste treatment options was valorized. The SAW analysis was used to obtain the sum characteristics for all the waste management treatment strategies and they were ranked accordingly. The TOPSIS method was used to calculate the relative closeness factors to the ideal solution for all the alternatives. Then, the proposed strategies were ranked in form of tables and diagrams obtained based on both MCDM methods. As shown in this paper, the results were in good agreement, which additionally confirmed and facilitated the choice of the optimal MSW management strategy. © The Author(s) 2016.

  9. Risk communication and decision-making in the prevention of invasive breast cancer.

    PubMed

    Partridge, Ann H

    2017-08-01

    Risk communication surrounding the prevention of invasive breast cancer entails not only understanding of the disease, risks and opportunities for intervention. But it also requires understanding and implementation of optimal strategies for communication with patients who are making these decisions. In this article, available evidence for the issues surrounding risk communication and decision making in the prevention of invasive breast cancer are reviewed and strategies for improvement are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Subjective costs drive overly patient foraging strategies in rats on an intertemporal foraging task.

    PubMed

    Wikenheiser, Andrew M; Stephens, David W; Redish, A David

    2013-05-14

    Laboratory studies of decision making often take the form of two-alternative, forced-choice paradigms. In natural settings, however, many decision problems arise as stay/go choices. We designed a foraging task to test intertemporal decision making in rats via stay/go decisions. Subjects did not follow the rate-maximizing strategy of choosing only food items associated with short delays. Instead, rats were often willing to wait for surprisingly long periods, and consequently earned a lower rate of food intake than they might have by ignoring long-delay options. We tested whether foraging theory or delay discounting models predicted the behavior we observed but found that these models could not account for the strategies subjects selected. Subjects' behavior was well accounted for by a model that incorporated a cost for rejecting potential food items. Interestingly, subjects' cost sensitivity was proportional to environmental richness. These findings are at odds with traditional normative accounts of decision making but are consistent with retrospective considerations having a deleterious influence on decisions (as in the "sunk-cost" effect). More broadly, these findings highlight the utility of complementing existing assays of decision making with tasks that mimic more natural decision topologies.

  11. Subjective costs drive overly patient foraging strategies in rats on an intertemporal foraging task

    PubMed Central

    Wikenheiser, Andrew M.; Stephens, David W.; Redish, A. David

    2013-01-01

    Laboratory studies of decision making often take the form of two-alternative, forced-choice paradigms. In natural settings, however, many decision problems arise as stay/go choices. We designed a foraging task to test intertemporal decision making in rats via stay/go decisions. Subjects did not follow the rate-maximizing strategy of choosing only food items associated with short delays. Instead, rats were often willing to wait for surprisingly long periods, and consequently earned a lower rate of food intake than they might have by ignoring long-delay options. We tested whether foraging theory or delay discounting models predicted the behavior we observed but found that these models could not account for the strategies subjects selected. Subjects’ behavior was well accounted for by a model that incorporated a cost for rejecting potential food items. Interestingly, subjects’ cost sensitivity was proportional to environmental richness. These findings are at odds with traditional normative accounts of decision making but are consistent with retrospective considerations having a deleterious influence on decisions (as in the “sunk-cost” effect). More broadly, these findings highlight the utility of complementing existing assays of decision making with tasks that mimic more natural decision topologies. PMID:23630289

  12. Risk perception & strategic decision making :general insights, a framework, and specific application to electricity generation using nuclear energy.

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

    Brewer, Jeffrey D.

    The objective of this report is to promote increased understanding of decision making processes and hopefully to enable improved decision making regarding high-consequence, highly sophisticated technological systems. This report brings together insights regarding risk perception and decision making across domains ranging from nuclear power technology safety, cognitive psychology, economics, science education, public policy, and neural science (to name a few). It forms them into a unique, coherent, concise framework, and list of strategies to aid in decision making. It is suggested that all decision makers, whether ordinary citizens, academics, or political leaders, ought to cultivate their abilities to separate themore » wheat from the chaff in these types of decision making instances. The wheat includes proper data sources and helpful human decision making heuristics; these should be sought. The chaff includes ''unhelpful biases'' that hinder proper interpretation of available data and lead people unwittingly toward inappropriate decision making ''strategies''; obviously, these should be avoided. It is further proposed that successfully accomplishing the wheat vs. chaff separation is very difficult, yet tenable. This report hopes to expose and facilitate navigation away from decision-making traps which often ensnare the unwary. Furthermore, it is emphasized that one's personal decision making biases can be examined, and tools can be provided allowing better means to generate, evaluate, and select among decision options. Many examples in this report are tailored to the energy domain (esp. nuclear power for electricity generation). The decision making framework and approach presented here are applicable to any high-consequence, highly sophisticated technological system.« less

  13. Linking science, public values, and decision-making: Case study development for public deliberations about climate change resilience

    NASA Astrophysics Data System (ADS)

    Weller, N.; Bennett, I.; Bernstein, M.; Farooque, M.; Lloyd, J.; Lowenthal, C.; Sittenfeld, D.

    2016-12-01

    Actionable science seeks to align scientific inquiry with decision-making priorities to overcome rifts between scientific knowledge and the needs of decision makers. Combining actionable science with explorations of public values and priorities creates useful support for decision makers facing uncertainty, tradeoffs, and limited resources. As part of a broader project to create public forums about climate change resilience, we convened workshops with decision makers, resilience experts, and community stakeholders to discuss climate change resilience. Our goals were 1) to create case studies of resilience strategies for use in public deliberations at science museums across 8 U.S. cities; and 2) to build relationships with decision makers and stakeholders interested in these public deliberations. Prior to workshops, we created summaries of resilience strategies using academic literature, government assessments, municipal resilience plans, and conversations with workshop participants. Workshops began with example deliberation activities followed by semi-structured discussions of resilience strategies centered on 4 questions: 1) What are the key decisions to be made regarding each strategy? 2) What stakeholders and perspectives are relevant to each strategy? 3) What available data are relevant to each strategy? 4) What visualizations or other resources are useful for communicating things about each strategy? Workshops yielded actionable dialogue regarding issues of justice, feasibility, and the socio-ecological-technical systems impacted by climate change hazards and resilience strategies. For example, discussions of drought revealed systemic and individual-level challenges and opportunities; discussions of sea level rise included ways to account for the cultural significance of many coastal communities. The workshops provide a model for identifying decision-making priorities and tradeoffs and building partnerships among stakeholders, scientists, and decision makers.

  14. Decision making in a human population living sustainably.

    PubMed

    Hicks, John S; Burgman, Mark A; Marewski, Julian N; Fidler, Fiona; Gigerenzer, Gerd

    2012-10-01

    The Tiwi people of northern Australia have managed natural resources continuously for 6000-8000 years. Tiwi management objectives and outcomes may reflect how they gather information about the environment. We qualitatively analyzed Tiwi documents and management techniques to examine the relation between the social and physical environment of decision makers and their decision-making strategies. We hypothesized that principles of bounded rationality, namely, the use of efficient rules to navigate complex decision problems, explain how Tiwi managers use simple decision strategies (i.e., heuristics) to make robust decisions. Tiwi natural resource managers reduced complexity in decision making through a process that gathers incomplete and uncertain information to quickly guide decisions toward effective outcomes. They used management feedback to validate decisions through an information loop that resulted in long-term sustainability of environmental use. We examined the Tiwi decision-making processes relative to management of barramundi (Lates calcarifer) fisheries and contrasted their management with the state government's management of barramundi. Decisions that enhanced the status of individual people and their attainment of aspiration levels resulted in reliable resource availability for Tiwi consumers. Different decision processes adopted by the state for management of barramundi may not secure similarly sustainable outcomes. ©2012 Society for Conservation Biology.

  15. Practical Strategies for Integrating Final Ecosystem Goods and Services into Community Decision-Making.

    EPA Science Inventory

    The concept of Final Ecosystem Goods and Services (FEGS) explicitly connects ecosystem services to the people that benefit from them. This report presents a number of practical strategies for incorporating FEGS, and more broadly ecosystem services, into the decision-making proces...

  16. The adaptive use of recognition in group decision making.

    PubMed

    Kämmer, Juliane E; Gaissmaier, Wolfgang; Reimer, Torsten; Schermuly, Carsten C

    2014-06-01

    Applying the framework of ecological rationality, the authors studied the adaptivity of group decision making. In detail, they investigated whether groups apply decision strategies conditional on their composition in terms of task-relevant features. The authors focused on the recognition heuristic, so the task-relevant features were the validity of the group members' recognition and knowledge, which influenced the potential performance of group strategies. Forty-three three-member groups performed an inference task in which they had to infer which of two German companies had the higher market capitalization. Results based on the choice data support the hypothesis that groups adaptively apply the strategy that leads to the highest theoretically achievable performance. Time constraints had no effect on strategy use but did have an effect on the proportions of different types of arguments. Possible mechanisms underlying the adaptive use of recognition in group decision making are discussed. © 2014 Cognitive Science Society, Inc.

  17. Heuristics: foundations for a novel approach to medical decision making.

    PubMed

    Bodemer, Nicolai; Hanoch, Yaniv; Katsikopoulos, Konstantinos V

    2015-03-01

    Medical decision-making is a complex process that often takes place during uncertainty, that is, when knowledge, time, and resources are limited. How can we ensure good decisions? We present research on heuristics-simple rules of thumb-and discuss how medical decision-making can benefit from these tools. We challenge the common view that heuristics are only second-best solutions by showing that they can be more accurate, faster, and easier to apply in comparison to more complex strategies. Using the example of fast-and-frugal decision trees, we illustrate how heuristics can be studied and implemented in the medical context. Finally, we suggest how a heuristic-friendly culture supports the study and application of heuristics as complementary strategies to existing decision rules.

  18. Strategies in Forecasting Outcomes in Ethical Decision-making: Identifying and Analyzing the Causes of the Problem

    PubMed Central

    Beeler, Cheryl K.; Antes, Alison L.; Wang, Xiaoqian; Caughron, Jared J.; Thiel, Chase E.; Mumford, Michael D.

    2010-01-01

    This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. PMID:20352056

  19. Magical thinking and decision-making strategies among late adolescent regular gamblers: A mediation model.

    PubMed

    Passanisi, Alessia; Craparo, Giuseppe; Pace, Ugo

    2017-08-01

    In the present study, the relation between the tendency to seek supernatural connections between external events and one's own thoughts, words, and actions and gambling among late adolescents has been studied. Psychologists have called this tendency magical thinking. The principal aim of the present study was to test the fit of an explanatory model of risk that starts from magical thinking and passes through maladaptive decision-making strategies, culminating with pathological gambling. Two hundred twenty-two Italian late adolescents, regularly attending bingo halls, aged between 19 and 21 years, completed measures on magical thinking, decision-making strategies, and gambling. Results highlight that young adults adopting dysfunctional modes of thought (i.e. magical thinking) tend to engage with maladaptive styles of decision-making that predispose them to gamble. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. Analyzing Individual Decision Making Versus Group Decision Making for Alternative Selection

    DTIC Science & Technology

    2008-06-01

    35 SDVF Single Dimensional Value Function . . . . . . . . . . . . . 44 ENAER Empresa Nacional de Aeronautica... de - viate further from balanced strategies than do individuals” [16]. Kocher and Sutter compared decisions by individuals and groups in beauty...Michaelsen, Watson, and Black de - termined that there have been no studies on individual versus group decision making that provided any significant

  1. SIGI: An Interactive Aid to Career Decision Making.

    ERIC Educational Resources Information Center

    Katz, Martin R.

    1980-01-01

    The System of Interactive Guidance and Information (SIGI) helps students make informed and rational career decisions. Interacting with a computer, students examine values, identify and explore options, gain and interpret relevant information, master strategies for decision making, and formulate plans of action. Extensively field-tested, SIGI has…

  2. 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…

  3. Office of Environmental Information (OEI) Tribal Strategy: Partnership to Support Environmental Information and Decision-Making in Indian Country and Alaska Native Villages

    EPA Pesticide Factsheets

    This draft strategy provides a description of goals OEI seeks to accomplish to support tribal information and environmental decision-making. States objectives to facilitate and strengthen tribal capacity to collect, analyze and share data.

  4. Single-process versus multiple-strategy models of decision making: evidence from an information intrusion paradigm.

    PubMed

    Söllner, Anke; Bröder, Arndt; Glöckner, Andreas; Betsch, Tilmann

    2014-02-01

    When decision makers are confronted with different problems and situations, do they use a uniform mechanism as assumed by single-process models (SPMs) or do they choose adaptively from a set of available decision strategies as multiple-strategy models (MSMs) imply? Both frameworks of decision making have gathered a lot of support, but only rarely have they been contrasted with each other. Employing an information intrusion paradigm for multi-attribute decisions from givens, SPM and MSM predictions on information search, decision outcomes, attention, and confidence judgments were derived and tested against each other in two experiments. The results consistently support the SPM view: Participants seemingly using a "take-the-best" (TTB) strategy do not ignore TTB-irrelevant information as MSMs would predict, but adapt the amount of information searched, choose alternative choice options, and show varying confidence judgments contingent on the quality of the "irrelevant" information. The uniformity of these findings underlines the adequacy of the novel information intrusion paradigm and comprehensively promotes the notion of a uniform decision making mechanism as assumed by single-process models. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  5. Postnatal Psychosocial Assessment and Clinical Decision-Making, a Descriptive Study.

    PubMed

    Sims, Deborah; Fowler, Cathrine

    2018-05-18

    The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making. A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirms that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. Knowledge of the information domains and the decision-making strategies that experienced nurses use for psychosocial assessment potentially improves practice by providing a framework for education and mentoring. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  6. Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

    PubMed Central

    Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

    2016-01-01

    Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

  7. Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

    PubMed

    Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

    2014-09-01

    Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

  8. Reinforcement learning and decision making in monkeys during a competitive game.

    PubMed

    Lee, Daeyeol; Conroy, Michelle L; McGreevy, Benjamin P; Barraclough, Dominic J

    2004-12-01

    Animals living in a dynamic environment must adjust their decision-making strategies through experience. To gain insights into the neural basis of such adaptive decision-making processes, we trained monkeys to play a competitive game against a computer in an oculomotor free-choice task. The animal selected one of two visual targets in each trial and was rewarded only when it selected the same target as the computer opponent. To determine how the animal's decision-making strategy can be affected by the opponent's strategy, the computer opponent was programmed with three different algorithms that exploited different aspects of the animal's choice and reward history. When the computer selected its targets randomly with equal probabilities, animals selected one of the targets more often, violating the prediction of probability matching, and their choices were systematically influenced by the choice history of the two players. When the computer exploited only the animal's choice history but not its reward history, animal's choice became more independent of its own choice history but was still related to the choice history of the opponent. This bias was substantially reduced, but not completely eliminated, when the computer used the choice history of both players in making its predictions. These biases were consistent with the predictions of reinforcement learning, suggesting that the animals sought optimal decision-making strategies using reinforcement learning algorithms.

  9. Ecological Rationality: A Framework for Understanding and Aiding the Aging Decision Maker

    PubMed Central

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people’s decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker. PMID:22347843

  10. Ecological rationality: a framework for understanding and aiding the aging decision maker.

    PubMed

    Mata, Rui; Pachur, Thorsten; von Helversen, Bettina; Hertwig, Ralph; Rieskamp, Jörg; Schooler, Lael

    2012-01-01

    The notion of ecological rationality sees human rationality as the result of the adaptive fit between the human mind and the environment. Ecological rationality focuses the study of decision making on two key questions: First, what are the environmental regularities to which people's decision strategies are matched, and how frequently do these regularities occur in natural environments? Second, how well can people adapt their use of specific strategies to particular environmental regularities? Research on aging suggests a number of changes in cognitive function, for instance, deficits in learning and memory that may impact decision-making skills. However, it has been shown that simple strategies can work well in many natural environments, which suggests that age-related deficits in strategy use may not necessarily translate into reduced decision quality. Consequently, we argue that predictions about the impact of aging on decision performance depend not only on how aging affects decision-relevant capacities but also on the decision environment in which decisions are made. In sum, we propose that the concept of the ecological rationality is crucial to understanding and aiding the aging decision maker.

  11. "To Thine Own Self Be True": Values, Framing, and Voter Decision-Making Strategies.

    ERIC Educational Resources Information Center

    Shah, Dhavan V.; And Others

    1996-01-01

    Builds on multidisciplinary research on framing, motivation, and decision making to examine the relationships among media frames, individual interpretations of issues, and voter decision making. Shows how two groups, evangelical Christians and undergraduates, responded to simulated newspaper articles on election candidates. Finds that media frames…

  12. Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

    NASA Astrophysics Data System (ADS)

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2017-02-01

    Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

  13. 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

  14. Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: a study protocol.

    PubMed

    Jull, Janet; Mazereeuw, Maegan; Sheppard, Amanada; Kewayosh, Alethea; Steiner, Richard; Graham, Ian D

    2018-01-01

    Tailoring and testing a peer support decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol.First Nations, Inuit and Métis (FNIM) people face higher risks for cancer compared to non-FNIM populations. They also face cultural barriers to health service use. Within non-FNIM populations an approach to health decision making, called shared decision making (SDM), has been found to improve the participation of people in their healthcare. Peer support with SDM further improves these benefits. The purpose of this study is to tailor and test a peer support SDM strategy with community support workers to increase FNIM people's participation in their cancer care.This project has two phases that will be designed and conducted with a Steering Committee that includes members of the FNIM and cancer care communities. First, a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings, and training in the SDM strategy developed for community support workers. Three communities will be supported for participation in the study and community support workers who are peers from each community will be trained to use the SDM strategy.Next, each community support worker will work with a community member who has a diagnosis of cancer or who has supported a family member with cancer. Each community support worker and community member pair will use the SDM strategy. The participation and experience of the community support worker and community member will be evaluated.The research will be used to develop strategies to support people who are making decisions about their health. Tailoring and field-testing the use of a knowledge translation peer support shared decision making strategy with First Nations, Inuit and Métis people making decisions about their cancer care: A study protocol Background First Nations, Inuit and Métis ("FNIM") people face increased cancer risks in relation to general populations and experience barriers to health service use. Shared decision making (SDM) has been found to improve peoples' participation and outcomes in healthcare and peer support with SDM further improves these benefits. The purpose of this study is to tailor and then field test, by and with FNIM communities, a peer support SDM strategy for use in cancer care. Methods This project has 2 theory-driven phases and 5 stages (a-e). A core research team that includes members of the Aboriginal Cancer Control Unit of Cancer Care Ontario communities and academic researchers, will work with a Steering Committee. In phase 1 , (stage a) a peer support SDM strategy will be tailored to meet the needs of cancer system users who are receiving care in urban settings and (stage b), training developed that will i) introduce participant communities to SDM, and ii) train community support workers (CSWs) within these communities. Next (stage c), three communities will be approached for voluntary participation in the study. These communities will be introduced to SDM in community meetings, and if in agreement then CSWs from each community will be recruited to participate in the study. One volunteer CSW from each community will be trained to use the peer support SDM strategy to enable phase 2 (field test of the peer support SDM strategy).During phase 2 (stage d), each CSW will be matched to a volunteer community member who has had a diagnosis of cancer or has supported a family member with cancer and is familiar with Ontario cancer systems. Each CSW-community member pair (3 to 4 pairs/community) will use the tailored peer support SDM strategy; their interaction will be audio-recorded and their participation and experience evaluated (total of 9 to 12 interviews). As well (stage e), data will be collected on health systems' factors related to the use of the peer support SDM strategy. Discussion Findings will develop peer support SDM strategies to enhance participation of FNIM people in cancer care decisions, advance knowledge translation science, and support a proposal to conduct a multi-site implementation trial.

  15. Adaptive leadership: a novel approach for family decision making.

    PubMed

    Adams, Judith; Bailey, Donald E; Anderson, Ruth A; Galanos, Anthony N

    2013-03-01

    Family members of intensive care unit (ICU) patients want to be involved in decision making, but they may not be best served by being placed in the position of having to solve problems for which they lack knowledge and skills. This case report presents an exemplar family meeting in the ICU led by a palliative care specialist, with discussion about the strategies used to improve the capacity of the family to make a decision consistent with the patient's goals. These strategies are presented through the lens of Adaptive Leadership.

  16. Deciding how to decide: ventromedial frontal lobe damage affects information acquisition in multi-attribute decision making.

    PubMed

    Fellows, Lesley K

    2006-04-01

    Ventromedial frontal lobe (VMF) damage is associated with impaired decision making. Recent efforts to understand the functions of this brain region have focused on its role in tracking reward, punishment and risk. However, decision making is complex, and frontal lobe damage might be expected to affect it at other levels. This study used process-tracing techniques to explore the effect of VMF damage on multi-attribute decision making under certainty. Thirteen subjects with focal VMF damage were compared with 11 subjects with frontal damage that spared the VMF and 21 demographically matched healthy control subjects. Participants chose rental apartments in a standard information board task drawn from the literature on normal decision making. VMF subjects performed the decision making task in a way that differed markedly from all other groups, favouring an 'alternative-based' information acquisition strategy (i.e. they organized their information search around individual apartments). In contrast, both healthy control subjects and subjects with damage predominantly involving dorsal and/or lateral prefrontal cortex pursued primarily 'attribute-based' search strategies (in which information was acquired about categories such as rent and noise level across several apartments). This difference in the pattern of information acquisition argues for systematic differences in the underlying decision heuristics and strategies employed by subjects with VMF damage, which in turn may affect the quality of their choices. These findings suggest that the processes supported by ventral and medial prefrontal cortex need to be conceptualized more broadly, to account for changes in decision making under conditions of certainty, as well as uncertainty, following damage to these areas.

  17. Pulmonologists' Reported Use of Guidelines and Shared Decision-making in Evaluation of Pulmonary Nodules: A Qualitative Study.

    PubMed

    Wiener, Renda Soylemez; Slatore, Christopher G; Gillespie, Chris; Clark, Jack A

    2015-12-01

    Selecting a strategy (surveillance, biopsy, resection) for pulmonary nodule evaluation can be complex given the absence of high-quality data comparing strategies and the important tradeoffs among strategies. Guidelines recommend a three-step approach: (1) assess the likelihood of malignancy, (2) evaluate whether the patient is a candidate for invasive intervention, and (3) elicit the patient's preferences and engage in shared decision-making. We sought to characterize how pulmonologists select a pulmonary nodule evaluation strategy and the extent to which they report following the guideline-recommended approach. We conducted semistructured qualitative interviews with 14 pulmonologists who manage patients with pulmonary nodules at four clinical sites. Transcripts of audiorecorded interviews were analyzed using the principles of grounded theory. Pulmonologists reported consistently performing steps 1 and 2 but described diverse approaches to step 3 that ranged from always engaging the patient in decision-making to never doing so. Many described incorporating patients' preferences only in particular circumstances, such as when the patient appeared particularly anxious or was aggressive in questioning management options. Indeed, other factors, including convenience, physician preferences, physician anxiety, malpractice concerns, and physician experience, appeared to drive decision-making as much as, if not more than, patient preferences. Although pulmonologists appear to routinely personalize pulmonary nodule evaluation strategies based on the individual patient's risk-benefit tradeoffs, they may not consistently take patient preferences into account during the decision-making process. In the absence of high-quality evidence regarding the optimal methods of pulmonary nodule evaluation, physicians should strive to ensure that management decisions are consistent with patients' values.

  18. [Affective and cognitive decision making in major depression: influence of the prefrontal cortex, serotonin transporter genotype and personality traits].

    PubMed

    Must, Anita; Horváth, Szatmár; Janka, Zoltán

    2008-05-30

    Patients with major depressive disorder (MDD) show neuropsychological impairments, including deficient executive functions and suboptimal decision-making strategies, which are mediated by several brain regions. In the development of these symptoms the pathology of the prefrontal cortex (PFC), including the dorsolateral, ventromedial and orbitofrontal regions, may also play an important role. Neuropsychological assessment is a useful tool in detecting and measuring these deficiencies, showing that patients with MDD exhibit altered sensitivity to reward and punishment. However, impairment of emotional decision-making strategies in MDD is influenced by genetic variations (5-HTTLPR polymorphism) and personality traits, which seem to have a higher predictive value on decision making performance than the clinical symptoms.

  19. "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.

  20. “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

  1. Entrepreneurial Decision Making Styles and Learning Strategies Preferences

    ERIC Educational Resources Information Center

    Hestand, Yana

    2012-01-01

    Scope and Method of Study: The scope of this study was the decision making styles and the learning strategies preferences among entrepreneurs. The study utilized a descriptive research design. Internet was utilized as a data collection tool, Participant in the study were 240 entrepreneurs from the Oklahoma state, Tulsa county members of the SBA.…

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

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2014-01-01

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

  3. Andrea Watson | NREL

    Science.gov Websites

    energy solutions for emission mitigation, international climate change strategies, and renewable energy technical decision making. Andrea's expertise lies in strategic planning, change strategies, and decision

  4. Risky decision-making under risk in schizophrenia: A deliberate choice?

    PubMed

    Pedersen, Anya; Göder, Robert; Tomczyk, Samuel; Ohrmann, Patricia

    2017-09-01

    Patients with schizophrenia reveal impaired decision-making strategies causing social, financial and health care problems. The extent to which deficits in decision-making reflect intentional risky choices in schizophrenia is still under debate. Based on previous studies we expected patients with schizophrenia to reveal a riskier performance on the GDT and to make more disadvantageous decisions on the IGT. In the present study, we investigated 38 patients with schizophrenia and 38 matched healthy control subjects with two competing paradigms regarding feedback: (1) The Game of Dice Task (GDT), in which the probabilities of winning or losing are stable and explicitly disclosed to the subject, to assess decision-making under risk and (2) the Iowa Gambling Task (IGT), which requires subjects to infer the probabilities of winning or losing from feedback, to investigate decision-making under ambiguity. Patients with schizophrenia revealed an overall riskier performance on the GDT; although they adjusted their strategy over the course of the GDT, they still made significantly more disadvantageous choices than controls. More positive symptoms in patients with schizophrenia indicated by higher PANSS positive scores were associated with riskier choices and less use of negative feedback. Compared to healthy controls, they were not impaired in net score but chose more disadvantageous cards than controls on the first block of the IGT. Effects of medication at the time of testing cannot be ruled out. Our findings suggest that patients with schizophrenia make riskier decisions and are less able to regulate their decision-making to implement advantageous strategies, even when the probabilities of winning or losing are explicitly disclosed. The dissociation between performance on the GDT and IGT suggests a pronounced impairment of executive functions related to the dorsolateral prefrontal cortex. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Model For Marketing Strategy Decision Based On Multicriteria Decicion Making: A Case Study In Batik Madura Industry

    NASA Astrophysics Data System (ADS)

    Anna, I. D.; Cahyadi, I.; Yakin, A.

    2018-01-01

    Selection of marketing strategy is a prominent competitive advantage for small and medium enterprises business development. The selection process is is a multiple criteria decision-making problem, which includes evaluation of various attributes or criteria in a process of strategy formulation. The objective of this paper is to develop a model for the selection of a marketing strategy in Batik Madura industry. The current study proposes an integrated approach based on analytic network process (ANP) and technique for order preference by similarity to ideal solution (TOPSIS) to determine the best strategy for Batik Madura marketing problems. Based on the results of group decision-making technique, this study selected fourteen criteria, including consistency, cost, trend following, customer loyalty, business volume, uniqueness manpower, customer numbers, promotion, branding, bussiness network, outlet location, credibility and the inovation as Batik Madura marketing strategy evaluation criteria. A survey questionnaire developed from literature review was distributed to a sample frame of Batik Madura SMEs in Pamekasan. In the decision procedure step, expert evaluators were asked to establish the decision matrix by comparing the marketing strategy alternatives under each of the individual criteria. Then, considerations obtained from ANP and TOPSIS methods were applied to build the specific criteria constraints and range of the launch strategy in the model. The model in this study demonstrates that, under current business situation, Straight-focus marketing strategy is the best marketing strategy for Batik Madura SMEs in Pamekasan.

  6. Differences in Biases and Compensatory Strategies Across Discipline, Rank, and Gender among University Academics

    PubMed Central

    Giorgini, Vincent; Gibson, Carter; Mecca, Jensen T.; Medeiros, Kelsey E.; Mumford, Michael D.; Connelly, Shane; Devenport, Lynn D.

    2014-01-01

    The study of ethical behavior and ethical decision making is of increasing importance in many fields, and there is a growing literature addressing the issue. However, research examining differences in ethical decision making across fields and levels of experience is limited. In the present study, biases that undermine ethical decision making and compensatory strategies that may aid ethical decision making were identified in a series of interviews with 63 faculty members across six academic fields (e.g. biological sciences, health sciences, social sciences) and three levels of rank (assistant professor, associate professor, and full professor) as well as across gender. The degree to which certain biases and compensatory strategies were used in justifications for responses to ethical situations was compared across fields, level of experience, and gender. Major differences were found across fields for several biases and compensatory strategies, including biases and compensatory strategies related to use of professional field principles and field-specific guidelines. Furthermore, full professors tend to differ greatly from assistant and associate professors on a number of constructs, and there were differences in the consistency with which biases and compensatory strategies were displayed within these various groups. Implications of these findings for ethics training and future research are discussed. PMID:25479960

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

    PubMed

    Cady, Phil

    2016-01-01

    The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems. © 2015 The Canadian College of Health Leaders.

  8. 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.

  9. Training in Decision-Making Strategies: An Approach to Enhance Students' Competence to Deal with Socio-Scientific Issues

    ERIC Educational Resources Information Center

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2013-01-01

    Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based…

  10. Effects of Direct and Indirect Instruction on Fostering Decision-Making Competence in Socioscientific Issues

    ERIC Educational Resources Information Center

    Bottcher, Florian; Meisert, Anke

    2013-01-01

    In this study the effects of different learning environments on the promotion of decision-making competence for the socioscientific issue of genetically modified crops is investigated. The comparison focuses on direct vs. indirect instructions. Therefore on the one hand a sophisticated decision-making strategy was presented to the directly…

  11. Framing matters: Effects of framing on older adults’ exploratory decision-making

    PubMed Central

    Cooper, Jessica A.; Blanco, Nathaniel; Maddox, W. Todd

    2016-01-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults’ decision-making performance was preserved when maximizing gains, but declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains-maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subjects behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss-minimization from Experiment 1, and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults’ performance in exploratory decision-making is hindered when framed as loss-minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. PMID:27977218

  12. Framing matters: Effects of framing on older adults' exploratory decision-making.

    PubMed

    Cooper, Jessica A; Blanco, Nathaniel J; Maddox, W Todd

    2017-02-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults' decision-making performance was preserved when maximizing gains, but it declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subject behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss minimization from Experiment 1 and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults' performance in exploratory decision-making is hindered when framed as loss minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  14. Learning to choose: Cognitive aging and strategy selection learning in decision making.

    PubMed

    Mata, Rui; von Helversen, Bettina; Rieskamp, Jörg

    2010-06-01

    Decision makers often have to learn from experience. In these situations, people must use the available feedback to select the appropriate decision strategy. How does the ability to select decision strategies on the basis of experience change with age? We examined younger and older adults' strategy selection learning in a probabilistic inference task using a computational model of strategy selection learning. Older adults showed poorer decision performance compared with younger adults. In particular, older adults performed poorly in an environment favoring the use of a more cognitively demanding strategy. The results suggest that the impact of cognitive aging on strategy selection learning depends on the structure of the decision environment. (c) 2010 APA, all rights reserved

  15. Decision making.

    PubMed

    Chambers, David W

    2011-01-01

    A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

  16. Memory-Based Decision-Making with Heuristics: Evidence for a Controlled Activation of Memory Representations

    ERIC Educational Resources Information Center

    Khader, Patrick H.; Pachur, Thorsten; Meier, Stefanie; Bien, Siegfried; Jost, Kerstin; Rosler, Frank

    2011-01-01

    Many of our daily decisions are memory based, that is, the attribute information about the decision alternatives has to be recalled. Behavioral studies suggest that for such decisions we often use simple strategies (heuristics) that rely on controlled and limited information search. It is assumed that these heuristics simplify decision-making by…

  17. Influence Strategies Used When Couples Make Work-Family Decisions and Their Importance for Marital Satisfaction.

    ERIC Educational Resources Information Center

    Zvonkovic, Anisa M.; And Others

    1994-01-01

    Investigated how marital partners influenced each other concerning work and family decisions and connected influence strategies to martial satisfaction in 61 married couples who had faced work-family decisions in past 6 months. Found that gender role ideology and indirect influence strategies were related to marital satisfaction. Variables related…

  18. Reasoning, learning, and creativity: frontal lobe function and human decision-making.

    PubMed

    Collins, Anne; Koechlin, Etienne

    2012-01-01

    The frontal lobes subserve decision-making and executive control--that is, the selection and coordination of goal-directed behaviors. Current models of frontal executive function, however, do not explain human decision-making in everyday environments featuring uncertain, changing, and especially open-ended situations. Here, we propose a computational model of human executive function that clarifies this issue. Using behavioral experiments, we show that unlike others, the proposed model predicts human decisions and their variations across individuals in naturalistic situations. The model reveals that for driving action, the human frontal function monitors up to three/four concurrent behavioral strategies and infers online their ability to predict action outcomes: whenever one appears more reliable than unreliable, this strategy is chosen to guide the selection and learning of actions that maximize rewards. Otherwise, a new behavioral strategy is tentatively formed, partly from those stored in long-term memory, then probed, and if competitive confirmed to subsequently drive action. Thus, the human executive function has a monitoring capacity limited to three or four behavioral strategies. This limitation is compensated by the binary structure of executive control that in ambiguous and unknown situations promotes the exploration and creation of new behavioral strategies. The results support a model of human frontal function that integrates reasoning, learning, and creative abilities in the service of decision-making and adaptive behavior.

  19. Reasoning, Learning, and Creativity: Frontal Lobe Function and Human Decision-Making

    PubMed Central

    Collins, Anne; Koechlin, Etienne

    2012-01-01

    The frontal lobes subserve decision-making and executive control—that is, the selection and coordination of goal-directed behaviors. Current models of frontal executive function, however, do not explain human decision-making in everyday environments featuring uncertain, changing, and especially open-ended situations. Here, we propose a computational model of human executive function that clarifies this issue. Using behavioral experiments, we show that unlike others, the proposed model predicts human decisions and their variations across individuals in naturalistic situations. The model reveals that for driving action, the human frontal function monitors up to three/four concurrent behavioral strategies and infers online their ability to predict action outcomes: whenever one appears more reliable than unreliable, this strategy is chosen to guide the selection and learning of actions that maximize rewards. Otherwise, a new behavioral strategy is tentatively formed, partly from those stored in long-term memory, then probed, and if competitive confirmed to subsequently drive action. Thus, the human executive function has a monitoring capacity limited to three or four behavioral strategies. This limitation is compensated by the binary structure of executive control that in ambiguous and unknown situations promotes the exploration and creation of new behavioral strategies. The results support a model of human frontal function that integrates reasoning, learning, and creative abilities in the service of decision-making and adaptive behavior. PMID:22479152

  20. Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM).

    PubMed

    Balneaves, Lynda G; Truant, Tracy L O; Kelly, Mary; Verhoef, Marja J; Davison, B Joyce

    2007-08-01

    The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.

  1. Teaching Strategies for Developing Students' Argumentation Skills about Socioscientific Issues in High School Genetics

    ERIC Educational Resources Information Center

    Dawson, Vaille Maree; Venville, Grady

    2010-01-01

    An outcome of science education is that young people have the understandings and skills to participate in public debate and make informed decisions about science issues that influence their lives. Toulmin's argumentation skills are emerging as an effective strategy to enhance the quality of evidence based decision making in science classrooms. In…

  2. A Time-Aware Routing Map for Indoor Evacuation †

    PubMed Central

    Zhao, Haifeng; Winter, Stephan

    2016-01-01

    Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making. PMID:26797610

  3. Supporting Informed Decision Making - Center for Research Strategy

    Cancer.gov

    CRS conducts portfolio analyses and collects data on scientific topics, funding mechanisms, and investigator characteristics to help NCI leadership make data-driven decisions about the scientific research enterprise.

  4. Stress-induced changes in human decision-making are reversible.

    PubMed

    Soares, J M; Sampaio, A; Ferreira, L M; Santos, N C; Marques, F; Palha, J A; Cerqueira, J J; Sousa, N

    2012-07-03

    Appropriate decision-making relies on the ability to shift between different behavioral strategies according to the context in which decisions are made. A cohort of subjects exposed to prolonged stress, and respective gender- and age-matched controls, performed an instrumental behavioral task to assess their decision-making strategies. The stressed cohort was reevaluated after a 6-week stress-free period. The behavioral analysis was complemented by a functional magnetic resonance imaging (fMRI) study to detect the patterns of activation in corticostriatal networks ruling goal-directed and habitual actions. Using structural MRI, the volumes of the main cortical and subcortical regions implicated in instrumental behavior were determined. Here we show that chronic stress biases decision-making strategies in humans toward habits, as choices of stressed subjects become insensitive to changes in outcome value. Using functional imaging techniques, we demonstrate that prolonged exposure to stress in humans causes an imbalanced activation of the networks that govern decision processes, shifting activation from the associative to the sensorimotor circuits. These functional changes are paralleled by atrophy of the medial prefrontal cortex and the caudate, and by an increase in the volume of the putamina. Importantly, a longitudinal assessment of the stressed individuals showed that both the structural and functional changes triggered by stress are reversible and that decisions become again goal-directed.

  5. Should I go with my gut? Investigating the benefits of emotion-focused decision making.

    PubMed

    Mikels, Joseph A; Maglio, Sam J; Reed, Andrew E; Kaplowitz, Lee J

    2011-08-01

    Deliberative decision strategies have historically been considered the surest path to sound decisions; however, recent evidence and theory suggest that affective strategies may be equally as effective. In four experiments we examined conditions under which affective versus deliberative decision strategies might result in higher decision quality. While consciously focusing on feelings versus details, participants made choices that varied in complexity, in extent of subsequent conscious deliberation allowed, and in domain. Results indicate that focusing on feelings versus details led to superior objective and subjective decision quality for complex decisions. However, when using a feeling-focused approach, subsequent deliberation after encoding resulted in reduced choice quality. These results suggest that affective decision strategies may be more effective relative to deliberative strategies for certain complex decisions. 2011 APA, all rights reserved

  6. Insecticide treated bednet strategy in rural settings: can we exploit women's decision making power?

    PubMed

    Tilak, Rina; Tilak, V W; Bhalwar, R

    2007-01-01

    Use of insecticide treated bednets in prevention of malaria is a widely propagated global strategy, however, its use has been reported to be influenced and limited by many variables especially gender bias. A cross sectional field epidemiological study was conducted in a rural setting with two outcome variables, 'Bednet use'(primary outcome variable) and 'Women's Decision Making Power' which were studied in reference to various predictor variables. Analysis reveals a significant effect on the primary outcome variable 'Bednet use' of the predictor variables- age, occupation, bednet purchase decision, women's decision making power, husband's education and knowledge about malaria and its prevention. The study recommends IEC on treated bednets to be disseminated through TV targeting the elderly women who have better decision making power and mobilizing younger women who were found to prefer bednets for prevention of mosquito bites for optimizing the use of treated bednets in similar settings.

  7. [Cognitive errors in diagnostic decision making].

    PubMed

    Gäbler, Martin

    2017-10-01

    Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

  8. Discussing uncertainty and risk in primary care: recommendations of a multi-disciplinary panel regarding communication around prostate cancer screening.

    PubMed

    Wilkes, Michael; Srinivasan, Malathi; Cole, Galen; Tardif, Richard; Richardson, Lisa C; Plescia, Marcus

    2013-11-01

    Shared decision making improves value-concordant decision-making around prostate cancer screening (PrCS). Yet, PrCS discussions remain complex, challenging and often emotional for physicians and average-risk men. In July 2011, the Centers for Disease Control and Prevention convened a multidisciplinary expert panel to identify priorities for funding agencies and development groups to promote evidence-based, value-concordant decisions between men at average risk for prostate cancer and their physicians. Two-day multidisciplinary expert panel in Atlanta, Georgia, with structured discussions and formal consensus processes. Sixteen panelists represented diverse specialties (primary care, medical oncology, urology), disciplines (sociology, communication, medical education, clinical epidemiology) and market sectors (patient advocacy groups, Federal funding agencies, guideline-development organizations). Panelists used guiding interactional and evaluation models to identify and rate strategies that might improve PrCS discussions and decisions for physicians, patients and health systems/society. Efficacy was defined as the likelihood of each strategy to impact outcomes. Effort was defined as the relative amount of effort to develop, implement and sustain the strategy. Each strategy was rated (1-7 scale; 7 = maximum) using group process software (ThinkTank(TM)). For each group, intervention strategies were grouped as financial/regulatory, educational, communication or attitudinal levers. For each strategy, barriers were identified. Highly ranked strategies to improve value-concordant shared decision-making (SDM) included: changing outpatient clinic visit reimbursement to reward SDM; development of evidence-based, technology-assisted, point-of-service tools for physicians and patients; reframing confusing prostate cancer screening messages; providing pre-visit decision support interventions; utilizing electronic health records to promote benchmarking/best practices; providing additional training for physicians around value-concordant decision-making; and using re-accreditation to promote training. Conference outcomes present an expert consensus of strategies likely to improve value-concordant prostate cancer screening decisions. In addition, the methodology used to obtain agreement provides a model of successful collaboration around this and future controversial cancer screening issues, which may be of interest to funding agencies, educators and policy makers.

  9. 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.

  10. The Defense Industrial Base: Prescription for a Psychosomatic Ailment

    DTIC Science & Technology

    1983-08-01

    The Decision- Making Process ------------------------- 65 Notes ---------------------------------------- FIGURE 4-1. The Decision [laking Process...the strategy and tactics process to make certain that we can attain out national security objectives. (IFP is also known as mobilization planning or...decision- making model that could improve the capacity and capability-of the military-industrial complex, thereby increasing the probability of success

  11. Shaping Strategy: An Institutional Analysis of Decision Making in the Middle Tier

    ERIC Educational Resources Information Center

    Vasquez, Alejandro

    2017-01-01

    The intent of this single-case study was to explore the effects of a competitive environment on organizational decision making. The study examines the decision making processes that resulted in the adoption of an undergraduate business major at a traditional, middle-tier Liberal Arts College and offers an analysis of academic leaders' perspectives…

  12. Research Practice Partnerships: A Strategy for Promoting Evidence-Based Decision-Making in Education

    ERIC Educational Resources Information Center

    Wentworth, Laura; Mazzeo, Christopher; Connolly, Faith

    2017-01-01

    Background: In the United States, an emphasis on evidence-based decision-making in education has received renewed interest with the recent passage of the Every Student Succeeds Act. However, how best, in practice, to support the use of evidence in educational decision-making remains unclear. Research Practice Partnerships (RPPs) are a popular…

  13. Age Differences in Information Use While Making Decisions: Resource Limitations or Processing Differences?

    PubMed

    Jacobs-Lawson, Joy M; Schumacher, Mitzi M; Wackerbarth, Sarah B

    2016-09-20

    Recent research on the decision-making abilities of older adults has shown that they use less information than young adults. One explanation ascribes this age difference to reductions in cognitive abilities with age. The article includes three experimental studies that focused on determining the conditions in which older and young adults would display dissimilar information processing characteristics. Findings from Studies 1 and 2 demonstrated that older adults are not necessarily at greater disadvantage than young adults in decision contexts that demand more information processing resources. Findings from Study 3 indicated that older adults when faced with decisions that require greater processing are likely to use a strategy that reduces the amount of information needed, whereas younger adults rely on strategies that utilize more resources. Combined the findings indicate that older adults change their decision-making strategies based on the context and information provided. Furthermore, support is provided for processing difference. © The Author(s) 2016.

  14. Shared Decision Making Interventions: Theoretical and Empirical Evidence with Implications for Health Literacy.

    PubMed

    Stacey, Dawn; Hill, Sophie; McCaffery, Kirsten; Boland, Laura; Lewis, Krystina B; Horvat, Lidia

    2017-01-01

    Basic health literacy is required for making health decisions. The aim of this chapter is to discuss the use of shared decision making interventions for supporting patient involvement in making health decisions. The chapter provides a definition of shared decision making and discusses the link between shared decision making and the three levels of health literacy: functional, communicative/interactive, and critical. The Interprofessional Shared Decision Making Model is used to identify the various players involved: the patient, the family/surrogate/significant others, decision coach, and health care professionals. When patients are involved in shared decision making, they have better health outcomes, better healthcare experiences, and likely lower costs. Yet, their degree of involvement is influenced by their level of health literacy. Interventions to facilitate shared decision making are patient decision aids, decision coaching, and question prompt lists. Patient decision aids have been shown to improve knowledge, accurate risk perceptions, and chosen options congruent with patients' values. Decision coaching improves knowledge and patient satisfaction. Question prompts also improve satisfaction. When shared decision making interventions have been evaluated with patients presumed to have lower health literacy, they appeared to be more beneficial to disadvantaged groups compared to those with higher literacy or better socioeconomic status. However, special attention needs to be applied when designing these interventions for populations with lower literacy. Two case exemplars are provided to illustrate the design and choice of interventions to better support patients with varying levels of health literacy. Despite evidence indicating these interventions are effective for involving patients in shared decision making, few are used in routine clinical practice. To increase their uptake, implementation strategies need to overcome barriers interfering with their use. Implementation strategies include training health care professionals, adopting SDM interventions that target patients, such as patient decision aids, and monitor patients' decisional comfort using the SURE test. Integrating health literacy principles is important when developing interventions that facilitate shared decision making and essential to avoid inadvertently producing higher inequalities between patients with varying levels of health literacy.

  15. A behavioural and neural evaluation of prospective decision-making under risk

    PubMed Central

    Symmonds, Mkael; Bossaerts, Peter; Dolan, Raymond J.

    2010-01-01

    Making the best choice when faced with a chain of decisions requires a person to judge both anticipated outcomes and future actions. Although economic decision-making models account for both risk and reward in single choice contexts there is a dearth of similar knowledge about sequential choice. Classical utility-based models assume that decision-makers select and follow an optimal pre-determined strategy, irrespective of the particular order in which options are presented. An alternative model involves continuously re-evaluating decision utilities, without prescribing a specific future set of choices. Here, using behavioral and functional magnetic resonance imaging (fMRI) data, we studied human subjects in a sequential choice task and use these data to compare alternative decision models of valuation and strategy selection. We provide evidence that subjects adopt a model of re-evaluating decision utilities, where available strategies are continuously updated and combined in assessing action values. We validate this model by using simultaneously-acquired fMRI data to show that sequential choice evokes a pattern of neural response consistent with a tracking of anticipated distribution of future reward, as expected in such a model. Thus, brain activity evoked at each decision point reflects the expected mean, variance and skewness of possible payoffs, consistent with the idea that sequential choice evokes a prospective evaluation of both available strategies and possible outcomes. PMID:20980595

  16. A behavioral and neural evaluation of prospective decision-making under risk.

    PubMed

    Symmonds, Mkael; Bossaerts, Peter; Dolan, Raymond J

    2010-10-27

    Making the best choice when faced with a chain of decisions requires a person to judge both anticipated outcomes and future actions. Although economic decision-making models account for both risk and reward in single-choice contexts, there is a dearth of similar knowledge about sequential choice. Classical utility-based models assume that decision-makers select and follow an optimal predetermined strategy, regardless of the particular order in which options are presented. An alternative model involves continuously reevaluating decision utilities, without prescribing a specific future set of choices. Here, using behavioral and functional magnetic resonance imaging (fMRI) data, we studied human subjects in a sequential choice task and use these data to compare alternative decision models of valuation and strategy selection. We provide evidence that subjects adopt a model of reevaluating decision utilities, in which available strategies are continuously updated and combined in assessing action values. We validate this model by using simultaneously acquired fMRI data to show that sequential choice evokes a pattern of neural response consistent with a tracking of anticipated distribution of future reward, as expected in such a model. Thus, brain activity evoked at each decision point reflects the expected mean, variance, and skewness of possible payoffs, consistent with the idea that sequential choice evokes a prospective evaluation of both available strategies and possible outcomes.

  17. Cellular and molecular basis of decision-making

    PubMed Central

    Yapici, Nilay; Zimmer, Manuel; Domingos, Ana I

    2014-01-01

    People think they are in control of their own decisions: what to eat or drink, whom to marry or pick a fight with, where to live, what to buy. Behavioural economists and neurophysiologists have long studied decision-making behaviours. However, these behaviours have only recently been studied through the light of molecular genetics. Here, we review recent research in mice, Drosophila melanogaster and Caenorhabditis elegans, that analyses the molecular and cellular mechanisms underlying decision-making. These studies interrogate decision-making about food, sexual behaviour, aggression or foraging strategies, and add molecular and cell biology understanding onto the consilience of brain and decision. PMID:25239948

  18. Dysfunctional decision-making in pathological gambling: pattern specificity and the role of impulsivity.

    PubMed

    Kräplin, Anja; Dshemuchadse, Maja; Behrendt, Silke; Scherbaum, Stefan; Goschke, Thomas; Bühringer, Gerhard

    2014-03-30

    Dysfunctional decision-making in individuals with pathological gambling (PGs) may result from dominating reward-driven processes, indicated by higher impulsivity. In the current study we examined (1) if PGs show specific decision-making impairments related to dominating reward-driven processes rather than to strategic planning deficits and (2) whether these impairments are related to impulsivity. Nineteen PGs according to DSM-IV and 19 matched control subjects undertook the Cambridge Gambling Task (CGT) to assess decision-making. The delay discounting paradigm (DDP) as well as the UPPS Impulsive Behavior Scale (measuring urgency, premeditation, perseverance and sensation seeking) were administered as multidimensional measures of impulsivity. Results revealed that (1) PGs exhibited higher risk seeking and an immediate reward focus in the CGT and, in contrast, comparable strategic planning to the control group. (2) Decision-making impairments were related to more severe delay discounting and, specifically, to increased urgency and less premeditation. Our findings suggest (1) the necessity to disentangle decision-making components in order to improve etiological models of PGs, and (2) that urgency and premeditation are specifically related to disadvantageous decision-making and should be tackled in intervention strategies focusing on emotion tolerance and control strategies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Pregnancy as Foreground in Cystic Fibrosis Carrier Testing Decisions in Primary Care

    PubMed Central

    Williams, Janet K.

    2009-01-01

    Cystic fibrosis carrier testing (CFCT) is among the first of the DNA tests offered prenatally in primary care settings. This paper from a descriptive qualitative study describes the influence of pregnancy in CFCT decisions by women receiving community-based prenatal care. Twenty-seven women receiving prenatal care in Midwestern U.S. primary care clinics completed semistructured interviews. Audiotaped interviews were analyzed using content analysis. Participants described decision-making influences and strategies from the perspective of “being pregnant.” Patterns of attitudes and beliefs include (1) dealing with emotions, (2) pregnancy is natural, and (3) thinking about the baby. Strategies in the decision-making process included (1) reducing stress, (2) choosing what is relevant, (3) doing everything right, (4) wanting to be prepared, (5) delaying information, and (6) trusting God. While other factors were mentioned by some women, major themes reflect the influence of currently being pregnant on the decision-making process. These findings suggest that pregnancy is a powerful influence on the decision-making process and may not be the optimal time to make fully informed decisions regarding genetic carrier testing. Further understanding of factors influencing the genetic testing decision-making process is needed. Offering CFCT prior to conception is advocated. PMID:19309287

  20. The Effect of Alternative Career Decision-Making Strategies on the Quality of Resulting Decisions. Final Report.

    ERIC Educational Resources Information Center

    Krumboltz, John D.; And Others

    A project studied whether methods used to make career decisions affect their outcomes. Part A describes the correlational study to discover how thoughts and actions of community college students related to their satisfaction with outcomes of their decisions. It focuses on the administration to 255 community college students of a Decision-Making…

  1. 29 CFR 2509.96-1 - Interpretive bulletin relating to participant investment education.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...., regarding general investment principles and strategies, to assist them in making investment decisions. 29..., whose investment decisions will directly affect their income at retirement, with information designed to assist them in making investment and retirement-related decisions appropriate to their particular...

  2. Evaluation and Institutional Research: Aids to Decision-Making and Innovation

    ERIC Educational Resources Information Center

    McIntosh, Naomi E.

    1977-01-01

    The traditional "test and measurement" approach to educational evaluation is contrasted with the "use of information for decision-making" developed in the industrial sector. Evaluation strategy should be determined by an analysis of the problem and the decisions to be made. (Author/LBH)

  3. Decision Making Perspectives of Young Children (K-5).

    ERIC Educational Resources Information Center

    Rogers, Linda J.; McDonald, Linda L.

    1999-01-01

    Applies Blumer's theory of symbolic interactionism to explore how normal children make meaning of their decision making world, both of their own acts and the labyrinthine world adults structure for them. Schema/narratives on friendship, sports, adults, and school reveal knowledge making strategies defined by immediate experiences and a capacity to…

  4. Diagnostic decision-making and strategies to improve diagnosis.

    PubMed

    Thammasitboon, Satid; Cutrer, William B

    2013-10-01

    A significant portion of diagnostic errors arises through cognitive errors resulting from inadequate knowledge, faulty data gathering, and/or faulty verification. Experts estimate that 75% of diagnostic failures can be attributed to clinician diagnostic thinking failure. The cognitive processes that underlie diagnostic thinking of clinicians are complex and intriguing, and it is imperative that clinicians acquire explicit appreciation and application of different cognitive approaches to make decisions better. A dual-process model that unifies many theories of decision-making has emerged as a promising template for understanding how clinicians think and judge efficiently in a diagnostic reasoning process. The identification and implementation of strategies for decreasing or preventing such diagnostic errors has become a growing area of interest and research. Suggested strategies to decrease diagnostic error incidence include increasing clinician's clinical expertise and avoiding inherent cognitive errors to make decisions better. Implementing Interventions focused solely on avoiding errors may work effectively for patient safety issues such as medication errors. Addressing cognitive errors, however, requires equal effort on expanding the individual clinician's expertise. Providing cognitive support to clinicians for robust diagnostic decision-making serves as the final strategic target for decreasing diagnostic errors. Clinical guidelines and algorithms offer another method for streamlining decision-making and decreasing likelihood of cognitive diagnostic errors. Addressing cognitive processing errors is undeniably the most challenging task in reducing diagnostic errors. While many suggested approaches exist, they are mostly based on theories and sciences in cognitive psychology, decision-making, and education. The proposed interventions are primarily suggestions and very few of them have been tested in the actual practice settings. Collaborative research effort is required to effectively address cognitive processing errors. Researchers in various areas, including patient safety/quality improvement, decision-making, and problem solving, must work together to make medical diagnosis more reliable. © 2013 Mosby, Inc. All rights reserved.

  5. Divergence and Convergence of Risky Decision Making Across Prospective Gains and Losses: Preferences and Strategies.

    PubMed

    Kurnianingsih, Yoanna A; Mullette-Gillman, O'Dhaniel A

    2015-01-01

    People choose differently when facing potential gains than when facing potential losses. Clear gross differences in decision making between gains and losses have been empirically demonstrated in numerous studies (e.g., framing effect, risk preference, loss aversion). However, theories maintain that there are strong underlying connections (e.g., reflection effect). We investigated the relationship between gains and losses decision making, examining risk preferences, and choice strategies (the reliance on option information) using a monetary gamble task with interleaved trials. For risk preferences, participants were on average risk averse in the gains domain and risk neutral/seeking in the losses domain. We specifically tested for a theoretically hypothesized correlation between individual risk preferences across the gains and losses domains (the reflection effect), but found no significant relationship in the predicted direction. Interestingly, despite the lack of reflected risk preferences, cross-domain risk preferences were still informative of individual choice behavior. For choice strategies, in both domains participants relied more heavily on the maximizing strategy than the satisficing strategy, with increased reliance on the maximizing strategy in the losses domain. Additionally, while there is no mathematical reliance between the risk preference and strategy metrics, within both domains there were significant relationships between risk preferences and strategies-the more participants relied upon the maximizing strategy the more risk neutral they were (equating value and utility maximization). These results demonstrate the complexity of gains and losses decision making, indicating the apparent contradiction that their underlying cognitive/neural processes are both dissociable and overlapping.

  6. An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making

    PubMed Central

    Jelihovschi, Ana P. G.; Cardoso, Ricardo L.; Linhares, Alexandre

    2018-01-01

    Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making. PMID:29375440

  7. An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making.

    PubMed

    Jelihovschi, Ana P G; Cardoso, Ricardo L; Linhares, Alexandre

    2017-01-01

    Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making.

  8. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

    PubMed Central

    2013-01-01

    Background Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences. Conclusion Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings. Trial registration Australia New Zealand Clinical Trials Register ACTRN12609000953235. PMID:24107358

  9. Unbending mind: Individuals with hoarding disorder do not modify decision strategy in response to feedback under risk.

    PubMed

    Pushkarskaya, Helen; Tolin, David F; Henick, Daniel; Levy, Ifat; Pittenger, Christopher

    2018-01-01

    Cognitive-behavioral models of hoarding disorder emphasize impairments in information processing and decision making in the genesis of hoarding symptomology. We propose and test the novel hypothesis that individuals with hoarding are maladaptively biased towards a deliberative decision style. While deliberative strategies are often considered normative, they are not always adaptable to the limitations imposed by many real-world decision contexts. We examined decision-making patterns in 19 individuals with hoarding and 19 healthy controls, using a behavioral task that quantifies selection of decision strategies in a novel environment with known probabilities (risk) in response to feedback. Consistent with prior literature, we found that healthy individuals tend to explore different decision strategies in the beginning of the experiment, but later, in response to feedback, they shift towards a compound strategy that balances expected values and risks. In contrast, individuals with hoarding follow a simple, deliberative, risk-neutral, value-based strategy from the beginning to the end of the task, irrespective of the feedback. This seemingly rational approach was not ecologically rational: individuals with hoarding and healthy individuals earned about the same amount of money, but it took individuals with hoarding a lot longer to do it: additional cognitive costs did not lead to additional benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Capital investment strategies in health care systems.

    PubMed

    Reiter, K L; Smith, D G; Wheeler, J R; Rivenson, H L

    2000-01-01

    Capital investment decisions are among the most important decisions made by firms. They determine the firm's capacity for providing services and commit the firm's cash for an extended period of time. Interviews with chief financial officers of leading health care systems reveal capital investment strategies that generally follow the recommendations of modern finance theory. Still, there is substantial variation in capital budgeting techniques, methods of risk adjustment, and the importance of qualitative considerations in investment decision making. There is also variation in delegation of investment decision making to operating units and methods of performance evaluation. Health care systems face the same challenges as other organizations in developing and implementing capital investment strategies that use consistent methods for evaluation of projects that have inconsistent aims and outcomes.

  11. Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital.

    PubMed

    Sepucha, Karen R; Simmons, Leigh H; Barry, Michael J; Edgman-Levitan, Susan; Licurse, Adam M; Chaguturu, Sreekanth K

    2016-04-01

    Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital's integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005-15, more than 900 clinicians and other staff members were trained in shared decision making, and more than 28,000 orders for one of about forty patient decision aids were placed to support informed patient-centered decisions. We profile two different implementation initiatives that increased the use of patient decision aids at the hospital's eighteen adult primary care practices, and we summarize key elements of the shared decision making program. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Exploratory Decision-Making as a Function of Lifelong Experience, Not Cognitive Decline

    PubMed Central

    2016-01-01

    Older adults perform worse than younger adults in some complex decision-making scenarios, which is commonly attributed to age-related declines in striatal and frontostriatal processing. Recently, this popular account has been challenged by work that considered how older adults’ performance may differ as a function of greater knowledge and experience, and by work showing that, in some cases, older adults outperform younger adults in complex decision-making tasks. In light of this controversy, we examined the performance of older and younger adults in an exploratory choice task that is amenable to model-based analyses and ostensibly not reliant on prior knowledge. Exploration is a critical aspect of decision-making poorly understood across the life span. Across 2 experiments, we addressed (a) how older and younger adults differ in exploratory choice and (b) to what extent observed differences reflect processing capacity declines. Model-based analyses suggested that the strategies used by the 2 groups were qualitatively different, resulting in relatively worse performance for older adults in 1 decision-making environment but equal performance in another. Little evidence was found that differences in processing capacity drove performance differences. Rather the results suggested that older adults’ performance might result from applying a strategy that may have been shaped by their wealth of real-word decision-making experience. While this strategy is likely to be effective in the real world, it is ill suited to some decision environments. These results underscore the importance of taking into account effects of experience in aging studies, even for tasks that do not obviously tap past experiences. PMID:26726916

  13. Decisions, Decisions: The Countless Times Instructional Practice and Reality Meet

    ERIC Educational Resources Information Center

    Miranda, Martina L.

    2014-01-01

    This article examines critical issues related to teacher decision-making in early childhood music classrooms. Through the story of one teacher's experience, we take a closer look at specific criteria to guide decision-making, and strategies to deepen awareness of young children's needs in the music classroom and guide instructional…

  14. Disclosing Mental Illness Information to a Friend: Exploring How the Disclosure Decision-Making Model Informs Strategy Selection.

    PubMed

    Venetis, Maria K; Chernichky-Karcher, Skye; Gettings, Patricia E

    2018-06-01

    Within the context of mental illness disclosure between friends, this study tested the disclosure decision-making model (DD-MM; Greene, 2009) to comprehensively investigate factors that predict disclosure enactment strategies. The DD-MM describes how individuals determine whether they will reveal or conceal non-visible health information. Processes of revealing, called disclosures, take various forms including preparation and rehearsal, directness, third-party disclosure, incremental disclosures, entrapment, and indirect mediums (Afifi & Steuber, 2009). We explore the disclosure decision-making process to understand how college students select to disclose their mental illness information with a friend. Participants were 144 students at a Midwestern university who had disclosed their mental illness information to a friend. Structural equation modeling analyses revealed that college students choose strategies based on their evaluation of information assessment and closeness, and that for some strategies, efficacy mediates the relationship between information assessment and strategy. This manuscript discusses implications of findings and suggests direction for future research.

  15. New perspectives for motivating better decisions in older adults

    PubMed Central

    Strough, JoNell; de Bruin, Wändi Bruine; Peters, Ellen

    2015-01-01

    Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood. PMID:26157398

  16. The influence of cueing on attentional focus in perceptual decision making.

    PubMed

    Yang, Cheng-Ta; Little, Daniel R; Hsu, Ching-Chun

    2014-11-01

    Selective attention has been known to play an important role in decision making. In the present study, we combined a cueing paradigm with a redundant-target detection task to examine how attention affects the decision process when detecting the redundant targets. Cue validity was manipulated in two experiments. The results showed that when the cue was 50 % valid in one experiment, the participants adopted a parallel self-terminating processing strategy, indicative of a diffuse attentional focus on both target locations. When the cue was 100 % valid in the second experiment, all of the participants switched to a serial self-terminating processing strategy, which in our study indicated focused attention to a single target location. This study demonstrates the flexibility of the decision mechanism and highlights the importance of top-down control in selecting a decision strategy.

  17. Integrated EPA Science for Decision-Making: Lawrence, MA Water Strategy

    EPA Science Inventory

    Powerpoint presentation on the Lawrence MA Making a Visible Difference in Communities project’s comprehensive water quality strategy, demonstrating a systems approach applying integrated EPA science

  18. Treatment decision-making strategies and influences in patients with localized prostate carcinoma.

    PubMed

    Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B

    2005-10-01

    Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P < 0.01) compared with patients who did not undergo prostatectomy. In multivariate analyses, compared with patients who received radical prostatectomy, patients who received brachytherapy were more likely to say that they chose this treatment because it was "the least invasive" and they "wanted to avoid surgery" (P < 0.0001). In general, patients who received brachytherapy chose this treatment because of quality of life considerations, whereas "cure" and complete removal of the tumor were the main motivations for patients selecting radical prostatectomy. Long-term data are needed to evaluate distress and decisional regret as patients experience treatment-related chronic side effects and efficacy outcomes. Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.

  19. Beyond Decision Making: Cultural Ideology as Heuristic Paradigmatic Models.

    ERIC Educational Resources Information Center

    Whitley, L. Darrell

    A paradigmatic model of cultural ideology provides a context for understanding the relationship between decision-making and personal and cultural rationality. Cultural rules or heuristics exist which indicate that many decisions can be made on the basis of established strategy rather than continual analytical calculations. When an optimal solution…

  20. Divergence and Convergence of Risky Decision Making Across Prospective Gains and Losses: Preferences and Strategies

    PubMed Central

    Kurnianingsih, Yoanna A.; Mullette-Gillman, O'Dhaniel A.

    2015-01-01

    People choose differently when facing potential gains than when facing potential losses. Clear gross differences in decision making between gains and losses have been empirically demonstrated in numerous studies (e.g., framing effect, risk preference, loss aversion). However, theories maintain that there are strong underlying connections (e.g., reflection effect). We investigated the relationship between gains and losses decision making, examining risk preferences, and choice strategies (the reliance on option information) using a monetary gamble task with interleaved trials. For risk preferences, participants were on average risk averse in the gains domain and risk neutral/seeking in the losses domain. We specifically tested for a theoretically hypothesized correlation between individual risk preferences across the gains and losses domains (the reflection effect), but found no significant relationship in the predicted direction. Interestingly, despite the lack of reflected risk preferences, cross-domain risk preferences were still informative of individual choice behavior. For choice strategies, in both domains participants relied more heavily on the maximizing strategy than the satisficing strategy, with increased reliance on the maximizing strategy in the losses domain. Additionally, while there is no mathematical reliance between the risk preference and strategy metrics, within both domains there were significant relationships between risk preferences and strategies—the more participants relied upon the maximizing strategy the more risk neutral they were (equating value and utility maximization). These results demonstrate the complexity of gains and losses decision making, indicating the apparent contradiction that their underlying cognitive/neural processes are both dissociable and overlapping. PMID:26733779

  1. Using cognitive task analysis to identify critical decisions in the laparoscopic environment.

    PubMed

    Craig, Curtis; Klein, Martina I; Griswold, John; Gaitonde, Krishnanath; McGill, Thomas; Halldorsson, Ari

    2012-12-01

    The aim of this study was to identify the critical decisions surgeons need to make regarding laparoscopic surgery, the information these decisions are based on, the strategies employed by surgeons to reach their objectives, and the difficulties experienced by novices. Laparoscopic training focuses on the development of technical skills. However, successful surgical outcomes are also dependent on appropriate decisions made during surgery, which are influenced by critical cues and the use of appropriate strategies. Novices might not be as adept at cue detection and strategy use. Participants were eight attending surgeons. The authors employed task-analytic techniques to identify critical decisions inherent in laparoscopy and the cues, strategies, and novice traps associated with these decisions. The authors used decision requirements tables to organize the data into the key decisions made during the preoperative, operative, and postoperative phases as well as the cues, strategies, and novice traps associated with these decisions. Key decisions identified for the preoperative phase included but were not limited to the decision of performing a laparoscopic versus open surgery, necessity to review the literature, practicing the procedure, and trocar placement. Some key decisions identified for the operative phase included converting to open surgery, performing angiograms, cutting tissue or organs, and reevaluation of the approach. Only one key decision was identified for the postoperative phrase: whether the surgeon's technique needs to be evaluated and revised. The laparoscopic environment requires complex decision making, and novices are prone to errors in their decisions. The information elicited in this study is applicable to laparoscopic training.

  2. Decision-making Strategies and Performance among Seniors1

    PubMed Central

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

    2011-01-01

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

  3. Modeling the value for money of changing clinical practice change: a stochastic application in diabetes care.

    PubMed

    Hoomans, Ties; Abrams, Keith R; Ament, Andre J H A; Evers, Silvia M A A; Severens, Johan L

    2009-10-01

    Decision making about resource allocation for guideline implementation to change clinical practice is inevitably undertaken in a context of uncertainty surrounding the cost-effectiveness of both clinical guidelines and implementation strategies. Adopting a total net benefit approach, a model was recently developed to overcome problems with the use of combined ratio statistics when analyzing decision uncertainty. To demonstrate the stochastic application of the model for informing decision making about the adoption of an audit and feedback strategy for implementing a guideline recommending intensive blood glucose control in type 2 diabetes in primary care in the Netherlands. An integrated Bayesian approach to decision modeling and evidence synthesis is adopted, using Markov Chain Monte Carlo simulation in WinBUGs. Data on model parameters is gathered from various sources, with effectiveness of implementation being estimated using pooled, random-effects meta-analysis. Decision uncertainty is illustrated using cost-effectiveness acceptability curves and frontier. Decisions about whether to adopt intensified glycemic control and whether to adopt audit and feedback alter for the maximum values that decision makers are willing to pay for health gain. Through simultaneously incorporating uncertain economic evidence on both guidance and implementation strategy, the cost-effectiveness acceptability curves and cost-effectiveness acceptability frontier show an increase in decision uncertainty concerning guideline implementation. The stochastic application in diabetes care demonstrates that the model provides a simple and useful tool for quantifying and exploring the (combined) uncertainty associated with decision making about adopting guidelines and implementation strategies and, therefore, for informing decisions about efficient resource allocation to change clinical practice.

  4. 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

  5. New approaches for real time decision support systems

    NASA Technical Reports Server (NTRS)

    Hair, D. Charles; Pickslay, Kent

    1994-01-01

    NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

  6. Association of a traditional vs shared meal decision-making and preparation style with eating behavior of Hispanic women in San Diego County.

    PubMed

    Arredondo, Elva M; Elder, John P; Ayala, Guadalupe X; Slymen, Donald; Campbell, Nadia R

    2006-01-01

    To examine the influence of meal decision-making and preparation on Hispanic women's dietary practices. One-on-one structured interviews were conducted, assessing meal decision-making and preparation practices, barriers, and behavioral strategies to eating low-fat and high-fiber diets, fat and fiber intake, demographic, and other psychosocial factors. The study population included 357 Hispanic women living in the southern or central regions of San Diego County. Participants were recruited via random-digit dialing to a tailored nutrition communication intervention. Household decision-making style (alone vs with family) by household activity (decides meals, prepares meals, and decides snacks). Multiple logistic regressions were used to evaluate associations between the predictors and dependent variable. All models included adjustments for potential confounders, such as marital status, education, employment, age, and acculturation. A positive statistical association between Hispanic women's acculturation level and shared decision-making style was found. Also, Hispanic women in shared decision-making households faced greater psychosocial barriers to healthful eating and reported less healthful eating compared with Hispanic women in traditional households. Women in shared decision-making households were more likely to eat at fast-food restaurants, less likely to engage in behavioral strategies promoting fiber consumption, eat more saturated fat, and encounter more barriers to reduce dietary fat as compared with Hispanic women in traditional households. Acculturation did not attenuate differences in psychosocial and dietary practices between shared decision-making and traditional households. Study findings suggest intervention efforts should focus on different aspects of healthful eating among Hispanic women in shared-decision, compared with traditional, households.

  7. Exploring the Learning from an Enterprise Simulation.

    ERIC Educational Resources Information Center

    Sawyer, John E.; Gopinath, C.

    1999-01-01

    A computer simulation used in teams by 151 business students tested their ability to translate strategy into decisions. Over eight weeks, the experiential learning activity encouraged strategic decision making and group behavior consistent with long-term strategy. (SK)

  8. Linking Effective Project Management to Business Strategy in Oil and Gas Industry through Decision-making Processes

    NASA Astrophysics Data System (ADS)

    Adeleke, Adeyinka

    The construction project in the oil and gas industry covers the entire spectrum of hydrocarbon production from the wellhead (upstream) to downstream facilities. In each of these establishments, the activities in a construction project include: consulting, studies, front-end engineering, detail engineering, procurement, program management, construction, installation, commissioning and start-up. Efficient management of each of the activities involved in construction projects is one of the driving forces for the successful completion of the project. Optimizing the crucial factors in project management during each phase of a project in an oil and gas industry can assist managers to maximize the use of available resources and drive the project to successful conclusions. One of these factors is the decision-making process in the construction project. Current research effort investigated the relationship between decision-making processes and business strategy in oil and gas industry using employee surveys. I recruited employees of different races, age group, genders, and years of experience in order understand their influence on the implementation of the decision-making process in oil and gas industry through a quantitative survey. Decision-making was assessed using five decision measures: (a) rational, (b) intuitive, (c) dependent, (d) avoidant, and (e) spontaneous. The findings indicated gender, age, years of work experience and job titles as primary variables with a negative relationship with decision-making approach for employees working in a major oil and gas industry. The study results revealed that the two most likely decision-making methods in oil and gas industry include: making a decision in a logical and systematic way and seek assistance from others when making a decision. Additionally, the two leading management approaches to decision-making in the oil and gas industry include: decision analysis is part of organization culture and management is committed to the decision-making process. Some recommendations for future studies were presented based on the need to intensify the importance of the current study and enlarge the body of knowledge regarding decision-making process in oil and gas industry.

  9. Comparative approaches to studying strategy: towards an evolutionary account of primate decision making.

    PubMed

    Brosnan, Sarah F; Beran, Michael J; Parrish, Audrey E; Price, Sara A; Wilson, Bart J

    2013-07-18

    How do primates, humans included, deal with novel problems that arise in interactions with other group members? Despite much research regarding how animals and humans solve social problems, few studies have utilized comparable procedures, outcomes, or measures across different species. Thus, it is difficult to piece together the evolution of decision making, including the roots from which human economic decision making emerged. Recently, a comparative body of decision making research has emerged, relying largely on the methodology of experimental economics in order to address these questions in a cross-species fashion. Experimental economics is an ideal method of inquiry for this approach. It is a well-developed method for distilling complex decision making involving multiple conspecifics whose decisions are contingent upon one another into a series of simple decision choices. This allows these decisions to be compared across species and contexts. In particular, our group has used this approach to investigate coordination in New World monkeys, Old World monkeys, and great apes (including humans), using identical methods. We find that in some cases there are remarkable continuities of outcome, as when some pairs in all species solved a coordination game, the Assurance game. On the other hand, we also find that these similarities in outcomes are likely driven by differences in underlying cognitive mechanisms. New World monkeys required exogenous information about their partners' choices in order to solve the task, indicating that they were using a matching strategy. Old World monkeys, on the other hand, solved the task without exogenous cues, leading to investigations into what mechanisms may be underpinning their responses (e.g., reward maximization, strategy formation, etc.). Great apes showed a strong experience effect, with cognitively enriched apes following what appears to be a strategy. Finally, humans were able to solve the task with or without exogenous cues. However, when given the chance to do so, they incorporated an additional mechanism unavailable to the other primates - language - to coordinate outcomes with their partner. We discuss how these results inform not only comparative psychology, but also evolutionary psychology, as they provide an understanding of the evolution of human economic behavior, and the evolution of decision making more broadly.

  10. Aging and loss decision making: increased risk aversion and decreased use of maximizing information, with correlated rationality and value maximization.

    PubMed

    Kurnianingsih, Yoanna A; Sim, Sam K Y; Chee, Michael W L; Mullette-Gillman, O'Dhaniel A

    2015-01-01

    We investigated how adult aging specifically alters economic decision-making, focusing on examining alterations in uncertainty preferences (willingness to gamble) and choice strategies (what gamble information influences choices) within both the gains and losses domains. Within each domain, participants chose between certain monetary outcomes and gambles with uncertain outcomes. We examined preferences by quantifying how uncertainty modulates choice behavior as if altering the subjective valuation of gambles. We explored age-related preferences for two types of uncertainty, risk, and ambiguity. Additionally, we explored how aging may alter what information participants utilize to make their choices by comparing the relative utilization of maximizing and satisficing information types through a choice strategy metric. Maximizing information was the ratio of the expected value of the two options, while satisficing information was the probability of winning. We found age-related alterations of economic preferences within the losses domain, but no alterations within the gains domain. Older adults (OA; 61-80 years old) were significantly more uncertainty averse for both risky and ambiguous choices. OA also exhibited choice strategies with decreased use of maximizing information. Within OA, we found a significant correlation between risk preferences and choice strategy. This linkage between preferences and strategy appears to derive from a convergence to risk neutrality driven by greater use of the effortful maximizing strategy. As utility maximization and value maximization intersect at risk neutrality, this result suggests that OA are exhibiting a relationship between enhanced rationality and enhanced value maximization. While there was variability in economic decision-making measures within OA, these individual differences were unrelated to variability within examined measures of cognitive ability. Our results demonstrate that aging alters economic decision-making for losses through changes in both individual preferences and the strategies individuals employ.

  11. Inside the Black Box: Exploring the Metacognitive Strategies Used by Principals in Border Community Schools When Making Ethical Decisions

    ERIC Educational Resources Information Center

    Faddis, Toni Osborn

    2017-01-01

    The purpose of this phenomenological study was to explore and describe the individual experiences of elementary principals' in Southern San Diego County when making ethical decisions that are unique to schools near the United States/Mexico border. Ethical decision-making, in this case, is the term used to depict an incident that calls for a…

  12. Signal Detection Analysis of Computer Enhanced Group Decision Making Strategies

    DTIC Science & Technology

    2007-11-01

    group decision making. 20 References American Psychological Association (2002). Ethical principles of psychologists and code of conduct. American... Creelman , C. D. (2005). Detection theory: A user’s guide (2nd ed.). Mahwah, NJ: Lawrence Erlbaum. Sorkin, R. D. (1998). Group performance depends on...the majority rule. Psychological Science, 9, 456-463. Sorkin, R. D. (2001). Signal-detection analysis of group decision making. Psychological

  13. Strategy selection in cue-based decision making.

    PubMed

    Bryant, David J

    2014-06-01

    People can make use of a range of heuristic and rational, compensatory strategies to perform a multiple-cue judgment task. It has been proposed that people are sensitive to the amount of cognitive effort required to employ decision strategies. Experiment 1 employed a dual-task methodology to investigate whether participants' preference for heuristic versus compensatory decision strategies can be altered by increasing the cognitive demands of the task. As indicated by participants' decision times, a secondary task interfered more with the performance of a heuristic than compensatory decision strategy but did not affect the proportions of participants using either type of strategy. A stimulus set effect suggested that the conjunction of cue salience and cue validity might play a determining role in strategy selection. The results of Experiment 2 indicated that when a perceptually salient cue was also the most valid, the majority of participants preferred a single-cue heuristic strategy. Overall, the results contradict the view that heuristics are more likely to be adopted when a task is made more cognitively demanding. It is argued that people employ 2 learning processes during training, one an associative learning process in which cue-outcome associations are developed by sampling multiple cues, and another that involves the sequential examination of single cues to serve as a basis for a single-cue heuristic.

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

    PubMed

    Trimble, Michael; Hamilton, Paul

    2016-08-01

    Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised. © 2016 Royal College of Physicians.

  15. Principles of shared decision-making within teams.

    PubMed

    Jacobs, Jeffrey P; Wernovsky, Gil; Cooper, David S; Karl, Tom R

    2015-12-01

    In the domain of paediatric and congenital cardiac care, the stakes are huge. Likewise, the care of these children assembles a group of "A+ personality" individuals from the domains of cardiac surgery, cardiology, anaesthesiology, critical care, and nursing. This results in an environment that has opportunity for both powerful collaboration and powerful conflict. Providers of healthcare should avoid conflict when it has no bearing on outcome, as it is clearly a squandering of individual and collective political capital. Outcomes after cardiac surgery are now being reported transparently and publicly. In the present era of transparency, one may wonder how to balance the following potentially competing demands: quality healthcare, transparency and accountability, and teamwork and shared decision-making. An understanding of transparency and public reporting in the domain of paediatric cardiac surgery facilitates the implementation of a strategy for teamwork and shared decision-making. In January, 2015, the Society of Thoracic Surgeons (STS) began to publicly report outcomes of paediatric and congenital cardiac surgery using the 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) Mortality Risk Model. The 2014 STS-CHSD Mortality Risk Model facilitates description of Operative Mortality adjusted for procedural and patient-level factors. The need for transparency in reporting of outcomes can create pressure on healthcare providers to implement strategies of teamwork and shared decision-making to assure outstanding results. A simple strategy of shared decision-making was described by Tom Karl and was implemented in multiple domains by Jeff Jacobs and David Cooper. In a critical-care environment, it is not unusual for healthcare providers to disagree about strategies of management of patients. When two healthcare providers disagree, each provider can classify the disagreement into three levels: • SDM Level 1 Decision: "We disagree but it really does not matter, so do whatever you desire!" • SDM Level 2 Decision: "We disagree and I believe it matters, but I am OK if you do whatever you desire!!" • SDM Level 3 Decision: "We disagree and I must insist (diplomatically and politely) that we follow the strategy that I am proposing!!!!!!" SDM Level 1 Decisions and SDM Level 2 Decisions typically do not create stress on the team, especially when there is mutual purpose and respect among the members of the team. SDM Level 3 Decisions are the real challenge. Periodically, the healthcare team is faced with such Level 3 Decisions, and teamwork and shared decision-making may be challenged. Teamwork is a learned behaviour, and mentorship is critical to achieve a properly balanced approach. If we agree to leave our egos at the door, then, in the final analysis, the team will benefit and we will set the stage for optimal patient care. In the environment of strong disagreement, true teamwork and shared decision-making are critical to preserve the unity and strength of the multi-disciplinary team and simultaneously provide excellent healthcare.

  16. Transforming clinical practice guidelines and clinical pathways into fast-and-frugal decision trees to improve clinical care strategies.

    PubMed

    Djulbegovic, Benjamin; Hozo, Iztok; Dale, William

    2018-02-27

    Contemporary delivery of health care is inappropriate in many ways, largely due to suboptimal Q5 decision-making. A typical approach to improve practitioners' decision-making is to develop evidence-based clinical practice guidelines (CPG) by guidelines panels, who are instructed to use their judgments to derive practice recommendations. However, mechanisms for the formulation of guideline judgments remains a "black-box" operation-a process with defined inputs and outputs but without sufficient knowledge of its internal workings. Increased explicitness and transparency in the process can be achieved by implementing CPG as clinical pathways (CPs) (also known as clinical algorithms or flow-charts). However, clinical recommendations thus derived are typically ad hoc and developed by experts in a theory-free environment. As any recommendation can be right (true positive or negative), or wrong (false positive or negative), the lack of theoretical structure precludes the quantitative assessment of the management strategies recommended by CPGs/CPs. To realize the full potential of CPGs/CPs, they need to be placed on more solid theoretical grounds. We believe this potential can be best realized by converting CPGs/CPs within the heuristic theory of decision-making, often implemented as fast-and-frugal (FFT) decision trees. This is possible because FFT heuristic strategy of decision-making can be linked to signal detection theory, evidence accumulation theory, and a threshold model of decision-making, which, in turn, allows quantitative analysis of the accuracy of clinical management strategies. Fast-and-frugal provides a simple and transparent, yet solid and robust, methodological framework connecting decision science to clinical care, a sorely needed missing link between CPGs/CPs and patient outcomes. We therefore advocate that all guidelines panels express their recommendations as CPs, which in turn should be converted into FFTs to guide clinical care. © 2018 John Wiley & Sons, Ltd.

  17. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

    PubMed

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-04-01

    To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

  18. A fuzzy gear shifting strategy for manual transmissions

    NASA Astrophysics Data System (ADS)

    Mashadi, B.; Kazemkhani, A.

    2005-12-01

    Governing parameters in decision making for gear changing of an automated manual transmission are discussed based on two different criteria, namely engine working conditions and driver's intention. By taking into consideration the effects of these parameters, gear shifting strategy is designed with the application of Fuzzy control method. The controller structure is formed in two layers. In the first layer two fuzzy inference modules are used to determine necessary outputs. In second layer a fuzzy inference module makes the decision of shifting by up-shift, downshift or maintain commands. The quality of Fuzzy controller behavior is examined by making use of ADVISOR software. It is shown that at different driving conditions the controller makes correct decisions for gear shifting accounting for dynamical requirements of vehicle. It is also shown that the controller based on both engine state and driver's intention eliminates unnecessary shiftings that are present when the intention is ignored. A micro-trip is designed in which a required speed in the form of a step function is demanded for the vehicle. Starting from rest both strategies change the gear to reach maximum speed more or less in a similar fashion. In deceleration phase, however, large differences are observed between the two strategies. The engine-state strategy is less sensitive to downshift, taking even unnecessary up shift decisions. The state-intention strategy, however, correctly interprets the driver's intention for decreasing speed and utilizes engine brake torque to reduce vehicle speed in a shorter time.

  19. [Clinical reasoning in undergraduate nursing education: a scoping review].

    PubMed

    Menezes, Sáskia Sampaio Cipriano de; Corrêa, Consuelo Garcia; Silva, Rita de Cássia Gengo E; Cruz, Diná de Almeida Monteiro Lopes da

    2015-12-01

    This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decision-making process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

  20. Strategy for optimum acquisition of information

    DOT National Transportation Integrated Search

    2006-10-01

    This note is a brief tutorial on a strategy optimizing the acquisition of information. It is a procedure well know to decision theorists but hardly understood or applied by those making decisions about spending dollars, time and other forms of capita...

  1. Consideration of Shared Decision Making in Nursing: A Review of Clinicians’ Perceptions and Interventions

    PubMed Central

    Clark, Noreen M; Nelson, Belinda W; Valerio, Melissa A; Gong, Z. Molly; Taylor-Fishwick, Judith C; Fletcher, Monica

    2009-01-01

    As the number of individuals with chronic illness increases so has the need for strategies to enable nurses to engage them effectively in daily management of their conditions. Shared decision making between patients and nurses is one approach frequently discussed in the literature. This paper reviews recent studies of shared decision making and the meaning of findings for the nurse-patient relationship. Patients likely to prefer to engage in shared decision making are younger and have higher levels of education. However, there is a lack of evidence for the effect of shared decision making on patient outcomes. Further, studies are needed to examine shared decision making when the patient is a child. Nurses are professionally suited to engage their patients fully in treatment plans. More evidence for how shared decision making affects outcomes and how nurses can successfully achieve such engagement is needed. PMID:19855848

  2. Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review.

    PubMed

    Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan

    2015-01-01

    Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, and finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Sleep deprivation alters choice strategy without altering uncertainty or loss aversion preferences

    PubMed Central

    Mullette-Gillman, O'Dhaniel A.; Kurnianingsih, Yoanna A.; Liu, Jean C. J.

    2015-01-01

    Sleep deprivation alters decision making; however, it is unclear what specific cognitive processes are modified to drive altered choices. In this manuscript, we examined how one night of total sleep deprivation (TSD) alters economic decision making. We specifically examined changes in uncertainty preferences dissociably from changes in the strategy with which participants engage with presented choice information. With high test-retest reliability, we show that TSD does not alter uncertainty preferences or loss aversion. Rather, TSD alters the information the participants rely upon to make their choices. Utilizing a choice strategy metric which contrasts the influence of maximizing and satisficing information on choice behavior, we find that TSD alters the relative reliance on maximizing information and satisficing information, in the gains domain. This alteration is the result of participants both decreasing their reliance on cognitively-complex maximizing information and a concomitant increase in the use of readily-available satisficing information. TSD did not result in a decrease in overall information use in either domain. These results show that sleep deprivation alters decision making by altering the informational strategies that participants employ, without altering their preferences. PMID:26500479

  4. Auditory attention and multiattribute decision-making during a 33 h sleep-deprivation period: mean performance and between-subject dispersions.

    PubMed

    Linde, L; Edland, A; Bergström, M

    1999-05-01

    One purpose of this study was to compare attention in the evening (22:00 h), in the late night (04:00 h), in the morning (10:00 h) and in the afternoon (16:00 h) during a period of complete wakefulness beginning at 08:00 h with a mean daytime performance without sleep deprivation. Another purpose was to investigate sleep deprivation effects on a multi-attribute decision-making task with and without time pressure. Twelve sleep-deprived male students were compared with 12 male non-sleep-deprived students. Both groups were tested five times with an auditory attention and a symbol coding task. Significant declines (p < 0.05) in mean level of performance on the auditory attention task were found at 04:00, 10:00 and 16:00 h for subjects forced to the vigil. However, the effect of the sleep deprivation manifested itself even more in increased between-subject dispersions. There were no differences between time pressure and no time pressure on the decision-making task and no significant differences between sleep-deprived and non-sleep-deprived subjects in decision strategies. In fact, the pattern of decision strategies among the sleep-deprived subject was more similar to a pattern of decision strategies typical for non-stressful conditions than the pattern of decision strategies among the non-sleep-deprived subjects. This result may have been due to the fact that the sleep loss acted as a dearouser. Here too, however, the variances differed significantly among sleep-deprived and non-sleep-deprived subjects, indicating that the sleep-deprived subjects were more variable in their decision strategy pattern than the control group.

  5. Spatially explicit multi-criteria decision analysis for managing vector-borne diseases

    PubMed Central

    2011-01-01

    The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular. PMID:22206355

  6. Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and Beyond

    PubMed Central

    Koonin, Lisa M.; Kohl, Katrin S.; Cetron, Martin

    2012-01-01

    Shortly after the influenza A (H1N1) 2009 pandemic began, the U.S. government provided guidance to state and local authorities to assist decision-making for the use of nonpharmaceutical strategies to minimize influenza spread. This guidance included recommendations for flexible decision-making based on outbreak severity, and it allowed for uncertainty and course correction as the pandemic progressed. These recommendations build on a foundation of local, collaborative planning and posit a series of questions regarding epidemiology, the impact on the health-care system, and locally determined feasibility and acceptability of nonpharmaceutical strategies. This article describes -recommendations and key questions for decision makers. PMID:23115381

  7. The CHOICE pilot project: Challenges of implementing a combined peer work and shared decision-making programme in an early intervention service.

    PubMed

    Simmons, Magenta B; Coates, Dominiek; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deborah

    2017-12-12

    Youth participation is central to early intervention policy and quality frameworks. There is good evidence for peer support (individuals with lived experience helping other consumers) and shared decision making (involving consumers in making decisions about their own care) in adult settings. However, youth programs are rarely tested or described in detail. This report aims to fill this gap by describing a consumer focused intervention in an early intervention service. This paper describes the development process, intervention content and implementation challenges of the Choices about Healthcare Options Informed by Client Experiences and Expectations (CHOICE) Pilot Project. This highly novel and innovative project combined both youth peer work and youth shared decision making. Eight peer workers were employed to deliver an online shared decision-making tool at a youth mental health service in New South Wales, Australia. The intervention development involved best practice principles, including international standards and elements of co-design. The implementation of the peer workforce in the service involved a number of targeted strategies designed to support this new service model. However, several implementation challenges were experienced which resulted in critical learning about how best to deliver these types of interventions. Delivering peer work and shared decision making within an early intervention service is feasible, but not without challenges. Providing adequate detail about interventions and implementation strategies fills a critical gap in the literature. Understanding optimal youth involvement strategies assists others to deliver acceptable and effective services to young people who experience mental ill health. © 2017 John Wiley & Sons Australia, Ltd.

  8. Comparing decision making between cancer patients and the general population: thoughts, emotions, or social influence?

    PubMed

    Yang, Z Janet; McComas, Katherine A; Gay, Geri K; Leonard, John P; Dannenberg, Andrew J; Dillon, Hildy

    2012-01-01

    This study extends a risk information seeking and processing model to explore the relative effect of cognitive processing strategies, positive and negative emotions, and normative beliefs on individuals' decision making about potential health risks. Most previous research based on this theoretical framework has examined environmental risks. Applying this risk communication model to study health decision making presents an opportunity to explore theoretical boundaries of the model, while also bringing this research to bear on a pressing medical issue: low enrollment in clinical trials. Comparative analysis of data gathered from 2 telephone surveys of a representative national sample (n = 500) and a random sample of cancer patients (n = 411) indicated that emotions played a more substantive role in cancer patients' decisions to enroll in a potential trial, whereas cognitive processing strategies and normative beliefs had greater influences on the decisions of respondents from the national sample.

  9. Lofty missions, down-to-earth plans.

    PubMed

    Rangan, V Kasturi

    2004-03-01

    Most nonprofits make program decisions based on a mission rather than a strategy. They rally under the banner of a particular cause, be it "fight homelessness" or "end hunger." And since their causes are so worthwhile, they support any programs that are related--even tangentially--to their core missions. It's hard to fault people for trying to improve the state of the world, but that approach to making decisions is misguided. Acting without a clear long-term strategy can stretch an agency's core capabilities and push it in unintended directions. The fundamental problem is that many nonprofits don't have a strategy; instead, they have a mission and a portfolio of programs. But they hardly make deliberate decisions about which programs to run, which to drop, and which to turn down for funding. What most nonprofits call "strategy" is really just an intensive exercise in resource allocation and program management. This article outlines for nonprofits a four-step process for developing strategy. The first step is to create a broad, inspiring mission statement. The second step is to translate that core mission into a smaller, quantifiable operational mission. For instance, an agency whose core mission is to fight homelessness must decide if its focus is rural or urban and if it should concentrate on low-income housing loans or on establishing more shelters. The third step is to create a strategy platform; that is, the nonprofit decides how it will achieve its operational mission. Decisions about funding and about client, program, and organizational development are all made here. Once that platform is established, the nonprofit is ready to move to step four--making reasoned, strategic decisions about which programs to run and how to run them. The agency that follows these steps will improve its focus and its effectiveness at fulfilling its mission.

  10. The relationship between work complexity and nurses' participation in decision making in hospitals.

    PubMed

    Bacon, Cynthia Thornton; Lee, Shoou-Yih Daniel; Mark, Barbara

    2015-04-01

    The aim of this study is to examine the relationship between work complexity and nurses' participation in decision making in hospital nursing units. Increasing nurses' participation in decision making has been used as a way to manage work complexity; however, the work of nurses in acute care hospitals has become highly complex, and strategies used to manage this complexity have not been fully explored. The relationship between work complexity and nurse participation in decision making was examined using data from the Outcomes Research in Nursing Administration project. The sample included 3,718 RNs in 278 medical-surgical units in 143 hospitals. When work complexity increased, nurses' participation in decision making decreased. When nurses have limited input into decision making, the information available to the care team may be incomplete. Barriers to nurses' participation in decision making should be explored and interventions developed so that nurses may be full participants in decision making affecting both patients and the work environment.

  11. The Linear Quadratic Gaussian Multistage Game with Nonclassical Information Pattern Using a Direct Solution Method

    NASA Astrophysics Data System (ADS)

    Clemens, Joshua William

    Game theory has application across multiple fields, spanning from economic strategy to optimal control of an aircraft and missile on an intercept trajectory. The idea of game theory is fascinating in that we can actually mathematically model real-world scenarios and determine optimal decision making. It may not always be easy to mathematically model certain real-world scenarios, nonetheless, game theory gives us an appreciation for the complexity involved in decision making. This complexity is especially apparent when the players involved have access to different information upon which to base their decision making (a nonclassical information pattern). Here we will focus on the class of adversarial two-player games (sometimes referred to as pursuit-evasion games) with nonclassical information pattern. We present a two-sided (simultaneous) optimization solution method for the two-player linear quadratic Gaussian (LQG) multistage game. This direct solution method allows for further interpretation of each player's decision making (strategy) as compared to previously used formal solution methods. In addition to the optimal control strategies, we present a saddle point proof and we derive an expression for the optimal performance index value. We provide some numerical results in order to further interpret the optimal control strategies and to highlight real-world application of this game-theoretic optimal solution.

  12. Strategies for memory-based decision making: Modeling behavioral and neural signatures within a cognitive architecture.

    PubMed

    Fechner, Hanna B; Pachur, Thorsten; Schooler, Lael J; Mehlhorn, Katja; Battal, Ceren; Volz, Kirsten G; Borst, Jelmer P

    2016-12-01

    How do people use memories to make inferences about real-world objects? We tested three strategies based on predicted patterns of response times and blood-oxygen-level-dependent (BOLD) responses: one strategy that relies solely on recognition memory, a second that retrieves additional knowledge, and a third, lexicographic (i.e., sequential) strategy, that considers knowledge conditionally on the evidence obtained from recognition memory. We implemented the strategies as computational models within the Adaptive Control of Thought-Rational (ACT-R) cognitive architecture, which allowed us to derive behavioral and neural predictions that we then compared to the results of a functional magnetic resonance imaging (fMRI) study in which participants inferred which of two cities is larger. Overall, versions of the lexicographic strategy, according to which knowledge about many but not all alternatives is searched, provided the best account of the joint patterns of response times and BOLD responses. These results provide insights into the interplay between recognition and additional knowledge in memory, hinting at an adaptive use of these two sources of information in decision making. The results highlight the usefulness of implementing models of decision making within a cognitive architecture to derive predictions on the behavioral and neural level. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Perception, Action, and Cognition of Football Referees in Extreme Temperatures: Impact on Decision Performance.

    PubMed

    Gaoua, Nadia; de Oliveira, Rita F; Hunter, Steve

    2017-01-01

    Different professional domains require high levels of physical performance alongside fast and accurate decision-making. Construction workers, police officers, firefighters, elite sports men and women, the military and emergency medical professionals are often exposed to hostile environments with limited options for behavioral coping strategies. In this (mini) review we use football refereeing as an example to discuss the combined effect of intense physical activity and extreme temperatures on decision-making and suggest an explicative model. In professional football competitions can be played in temperatures ranging from -5°C in Norway to 30°C in Spain for example. Despite these conditions, the referee's responsibility is to consistently apply the laws fairly and uniformly, and to ensure the rules are followed without waning or adversely influencing the competitiveness of the play. However, strenuous exercise in extreme environments imposes increased physiological and psychological stress that can affect decision-making. Therefore, the physical exertion required to follow the game and the thermal strain from the extreme temperatures may hinder the ability of referees to make fast and accurate decisions. Here, we review literature on the physical and cognitive requirements of football refereeing and how extreme temperatures may affect referees' decisions. Research suggests that both hot and cold environments have a negative impact on decision-making but data specific to decision-making is still lacking. A theoretical model of decision-making under the constraint of intense physical activity and thermal stress is suggested. Future naturalistic studies are needed to validate this model and provide clear recommendations for mitigating strategies.

  14. Perception, Action, and Cognition of Football Referees in Extreme Temperatures: Impact on Decision Performance

    PubMed Central

    Gaoua, Nadia; de Oliveira, Rita F.; Hunter, Steve

    2017-01-01

    Different professional domains require high levels of physical performance alongside fast and accurate decision-making. Construction workers, police officers, firefighters, elite sports men and women, the military and emergency medical professionals are often exposed to hostile environments with limited options for behavioral coping strategies. In this (mini) review we use football refereeing as an example to discuss the combined effect of intense physical activity and extreme temperatures on decision-making and suggest an explicative model. In professional football competitions can be played in temperatures ranging from -5°C in Norway to 30°C in Spain for example. Despite these conditions, the referee’s responsibility is to consistently apply the laws fairly and uniformly, and to ensure the rules are followed without waning or adversely influencing the competitiveness of the play. However, strenuous exercise in extreme environments imposes increased physiological and psychological stress that can affect decision-making. Therefore, the physical exertion required to follow the game and the thermal strain from the extreme temperatures may hinder the ability of referees to make fast and accurate decisions. Here, we review literature on the physical and cognitive requirements of football refereeing and how extreme temperatures may affect referees’ decisions. Research suggests that both hot and cold environments have a negative impact on decision-making but data specific to decision-making is still lacking. A theoretical model of decision-making under the constraint of intense physical activity and thermal stress is suggested. Future naturalistic studies are needed to validate this model and provide clear recommendations for mitigating strategies. PMID:28912742

  15. Conceptual Problems.

    ERIC Educational Resources Information Center

    Foley, Walter J.

    A systems theory approach to information requirements in education and in evaluation strategies is applied to decision making. Educational decision making itself involves long range planning, system structuring to implement goals, system allocation (cost), and system monitoring which provides the feedback. Each level requires differential…

  16. Testing take-the-best in new and changing environments.

    PubMed

    Lee, Michael D; Blanco, Gabrielle; Bo, Nikole

    2017-08-01

    Take-the-best is a decision-making strategy that chooses between alternatives, by searching the cues representing the alternatives in order of cue validity, and choosing the alternative with the first discriminating cue. Theoretical support for take-the-best comes from the "fast and frugal" approach to modeling cognition, which assumes decision-making strategies need to be fast to cope with a competitive world, and be simple to be robust to uncertainty and environmental change. We contribute to the empirical evaluation of take-the-best in two ways. First, we generate four new environments-involving bridge lengths, hamburger prices, theme park attendances, and US university rankings-supplementing the relatively limited number of naturally cue-based environments previously considered. We find that take-the-best is as accurate as rival decision strategies that use all of the available cues. Secondly, we develop 19 new data sets characterizing the change in cities and their populations in four countries. We find that take-the-best maintains its accuracy and limited search as the environments change, even if cue validities learned in one environment are used to make decisions in another. Once again, we find that take-the-best is as accurate as rival strategies that use all of the cues. We conclude that these new evaluations support the theoretical claims of the accuracy, frugality, and robustness for take-the-best, and that the new data sets provide a valuable resource for the more general study of the relationship between effective decision-making strategies and the environments in which they operate.

  17. Clinical Equipoise and Shared Decision-making in Pulmonary Nodule Management. A Survey of American Thoracic Society Clinicians.

    PubMed

    Iaccarino, Jonathan M; Simmons, James; Gould, Michael K; Slatore, Christopher G; Woloshin, Steven; Schwartz, Lisa M; Wiener, Renda Soylemez

    2017-06-01

    Guidelines for pulmonary nodule evaluation suggest a variety of strategies, reflecting the lack of high-quality evidence demonstrating the superiority of any one approach. It is unclear whether clinicians agree that multiple management options are appropriate at different levels of risk and whether this impacts their decision-making approaches with patients. To assess clinicians' perceptions of the appropriateness of various diagnostic strategies, approach to decision-making, and perceived clinical equipoise in pulmonary nodule evaluation. We developed and administered a web-based survey in March and April, 2014 to clinician members of the American Thoracic Society. The primary outcome was perceived appropriateness of pulmonary nodule evaluation strategies in three clinical vignettes with different malignancy risk. We compared responses to guideline recommendations and analyzed clinician characteristics associated with a reported shared decision-making approach. We also assessed clinicians' likelihood to enroll patients in hypothetical randomized trials comparing nodule evaluation strategies. Of 5,872 American Thoracic Society members e-mailed, 1,444 opened the e-mail and 428 eligible clinicians participated in the survey (response rate, 30.0% among those who opened the invitation; 7% overall). The mean number of options considered appropriate increased with pretest probability of cancer, ranging from 1.8 (SD, 1.2) for the low-risk case to 3.5 (1.1) for the high-risk case (P < 0.0001). As recommended by guidelines, the proportion that deemed surgical resection as an appropriate option also increased with cancer risk (P < 0.0001). One-half of clinicians (50.4%) reported engaging in shared decision-making with patients for pulmonary nodule management; this was more commonly reported by clinicians with more years of experience (P = 0.01) and those who reported greater comfort in managing pulmonary nodules (P = 0.005). Although one-half (49.9%) deemed the evidence for pulmonary nodule evaluation to be strong, most clinicians were willing to enroll patients in randomized trials to compare nodule management strategies in all risk categories (low risk, 87.6%; moderate risk, 89.7%; high risk, 63.0%). Consistent with guideline recommendations, clinicians embrace multiple options for pulmonary nodule evaluation and many are open to shared decision-making. Clinicians support the need for randomized clinical trials to strengthen the evidence for nodule evaluation, which will further improve decision-making.

  18. When Does Reward Maximization Lead to Matching Law?

    PubMed Central

    Sakai, Yutaka; Fukai, Tomoki

    2008-01-01

    What kind of strategies subjects follow in various behavioral circumstances has been a central issue in decision making. In particular, which behavioral strategy, maximizing or matching, is more fundamental to animal's decision behavior has been a matter of debate. Here, we prove that any algorithm to achieve the stationary condition for maximizing the average reward should lead to matching when it ignores the dependence of the expected outcome on subject's past choices. We may term this strategy of partial reward maximization “matching strategy”. Then, this strategy is applied to the case where the subject's decision system updates the information for making a decision. Such information includes subject's past actions or sensory stimuli, and the internal storage of this information is often called “state variables”. We demonstrate that the matching strategy provides an easy way to maximize reward when combined with the exploration of the state variables that correctly represent the crucial information for reward maximization. Our results reveal for the first time how a strategy to achieve matching behavior is beneficial to reward maximization, achieving a novel insight into the relationship between maximizing and matching. PMID:19030101

  19. Cloud E-Learning Service Strategies for Improving E-Learning Innovation Performance in a Fuzzy Environment by Using a New Hybrid Fuzzy Multiple Attribute Decision-Making Model

    ERIC Educational Resources Information Center

    Su, Chiu Hung; Tzeng, Gwo-Hshiung; Hu, Shu-Kung

    2016-01-01

    The purpose of this study was to address this problem by applying a new hybrid fuzzy multiple criteria decision-making model including (a) using the fuzzy decision-making trial and evaluation laboratory (DEMATEL) technique to construct the fuzzy scope influential network relationship map (FSINRM) and determine the fuzzy influential weights of the…

  20. Neural basis of quasi-rational decision making.

    PubMed

    Lee, Daeyeol

    2006-04-01

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

  1. Involving youth in program decision-making: how common and what might it do for youth?

    PubMed

    Akiva, Thomas; Cortina, Kai S; Smith, Charles

    2014-11-01

    The strategy of sharing program decision-making with youth in youth programs, a specific form of youth-adult partnership, is widely recommended in practitioner literature; however, empirical study is relatively limited. We investigated the prevalence and correlates of youth program decision-making practices (e.g., asking youth to help decide what activities are offered), using single-level and multilevel methods with a cross-sectional dataset of 979 youth attending 63 multipurpose after-school programs (average age of youth = 11.4, 53 % female). The prevalence of such practices was relatively high, particularly for forms that involved low power sharing such as involving youth in selecting the activities a program offers. Hierarchical linear modeling revealed positive associations between youth program decision-making practices and youth motivation to attend programs. We also found positive correlations between decision-making practices and youth problem-solving efficacy, expression efficacy, and empathy. Significant interactions with age suggest that correlations with problem solving and empathy are more pronounced for older youth. Overall, the findings suggest that involving youth in program decision-making is a promising strategy for promoting youth motivation and skill building, and in some cases this is particularly the case for older (high school-age) youth.

  2. Emergent collective decision-making: Control, model and behavior

    NASA Astrophysics Data System (ADS)

    Shen, Tian

    In this dissertation we study emergent collective decision-making in social groups with time-varying interactions and heterogeneously informed individuals. First we analyze a nonlinear dynamical systems model motivated by animal collective motion with heterogeneously informed subpopulations, to examine the role of uninformed individuals. We find through formal analysis that adding uninformed individuals in a group increases the likelihood of a collective decision. Secondly, we propose a model for human shared decision-making with continuous-time feedback and where individuals have little information about the true preferences of other group members. We study model equilibria using bifurcation analysis to understand how the model predicts decisions based on the critical threshold parameters that represent an individual's tradeoff between social and environmental influences. Thirdly, we analyze continuous-time data of pairs of human subjects performing an experimental shared tracking task using our second proposed model in order to understand transient behavior and the decision-making process. We fit the model to data and show that it reproduces a wide range of human behaviors surprisingly well, suggesting that the model may have captured the mechanisms of observed behaviors. Finally, we study human behavior from a game-theoretic perspective by modeling the aforementioned tracking task as a repeated game with incomplete information. We show that the majority of the players are able to converge to playing Nash equilibrium strategies. We then suggest with simulations that the mean field evolution of strategies in the population resemble replicator dynamics, indicating that the individual strategies may be myopic. Decisions form the basis of control and problems involving deciding collectively between alternatives are ubiquitous in nature and in engineering. Understanding how multi-agent systems make decisions among alternatives also provides insight for designing decentralized control laws for engineering applications from mobile sensor networks for environmental monitoring to collective construction robots. With this dissertation we hope to provide additional methodology and mathematical models for understanding the behavior and control of collective decision-making in multi-agent systems.

  3. The influences and neural correlates of past and present during gambling in humans.

    PubMed

    Sacré, Pierre; Subramanian, Sandya; Kerr, Matthew S D; Kahn, Kevin; Johnson, Matthew A; Bulacio, Juan; González-Martínez, Jorge A; Sarma, Sridevi V; Gale, John T

    2017-12-07

    During financial decision-making tasks, humans often make "rational" decisions, where they maximize expected reward. However, this rationality may compete with a bias that reflects past outcomes. That is, if one just lost money or won money, this may impact future decisions. It is unclear how past outcomes influence future decisions in humans, and how neural circuits encode present and past information. In this study, six human subjects performed a financial decision-making task while we recorded local field potentials from multiple brain structures. We constructed a model for each subject characterizing bets on each trial as a function of present and past information. The models suggest that some patients are more influenced by previous trial outcomes (i.e., previous return and risk) than others who stick to more fixed decision strategies. In addition, past return and present risk modulated with the activity in the cuneus; while present return and past risk modulated with the activity in the superior temporal gyrus and the angular gyrus, respectively. Our findings suggest that these structures play a role in decision-making beyond their classical functions by incorporating predictions and risks in humans' decision strategy, and provide new insight into how humans link their internal biases to decisions.

  4. A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

    PubMed

    Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T

    2017-06-01

    Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

  5. Multi Criteria Decision Making to evaluate control strategies of contagious animal diseases.

    PubMed

    Mourits, M C M; van Asseldonk, M A P M; Huirne, R B M

    2010-09-01

    The decision on which strategy to use in the control of contagious animal diseases involves complex trade-offs between multiple objectives. This paper describes a Multi Criteria Decision Making (MCDM) application to illustrate its potential support to policy makers in choosing the control strategy that best meets all of the conflicting interests. The presented application focused on the evaluation of alternative strategies to control Classical Swine Fever (CSF) epidemics within the European Union (EU) according to the preferences of the European Chief Veterinary Officers (CVO). The performed analysis was centred on the three high-level objectives of epidemiology, economics and social ethics. The appraised control alternatives consisted of the EU compulsory control strategy, a pre-emptive slaughter strategy, a protective vaccination strategy and a suppressive vaccination strategy. Using averaged preference weights of the elicited CVOs, the preference ranking of the control alternatives was determined for six EU regions. The obtained results emphasized the need for EU region-specific control. Individual CVOs differed in their views on the relative importance of the various (sub)criteria by which the performance of the alternatives were judged. Nevertheless, the individual rankings of the control alternatives within a region appeared surprisingly similar. Based on the results of the described application it was concluded that the structuring feature of the MCDM technique provides a suitable tool in assisting the complex decision making process of controlling contagious animal diseases. 2010 Elsevier B.V. All rights reserved.

  6. Adolescent Sexual Decision-Making: An Integrative Review.

    PubMed

    Hulton, Linda J.

    2001-10-03

    PURPOSE: The purpose of this integrative review was to summarize the present literature to identify factors associated with adolescent sexual decision-making. Thirty-eight salient research studies were selected as a basis of this review from the databases of Medline, CINAHL, and Psychinfo using the Cooper methodology. CONCLUSIONS: Two categories of decision-making were identified: 1) The research on factors related to the decisions that adolescents make to become sexually active or to abstain from sexual activity; 2) The research on factors related to contraceptive decision-making. The most consistent findings were that the factors of gender differences, cognitive development, perception of benefits, parental influences, social influences, and sexual knowledge were important variables in the decision-making processes of adolescents. IMPLICATIONS: Practice implications for nursing suggest that clinicians should assess adolescent sexual decision-making in greater detail and address the social and psychological context in which sexual experiences occur. Nurses must be aware of the differences between adolescent and adult decision-making processes and incorporate knowledge of growth and development into intervention strategies. Moreover, to the degree that adolescent sexual decision-making proves to be less than rational, interventions designed to improve competent sexual decision-making are needed.

  7. Ventral striatum and the evaluation of memory retrieval strategies.

    PubMed

    Badre, David; Lebrecht, Sophie; Pagliaccio, David; Long, Nicole M; Scimeca, Jason M

    2014-09-01

    Adaptive memory retrieval requires mechanisms of cognitive control that facilitate the recovery of goal-relevant information. Frontoparietal systems are known to support control of memory retrieval. However, the mechanisms by which the brain acquires, evaluates, and adapts retrieval strategies remain unknown. Here, we provide evidence that ventral striatal activation tracks the success of a retrieval strategy and correlates with subsequent reliance on that strategy. Human participants were scanned with fMRI while performing a lexical decision task. A rule was provided that indicated the likely semantic category of a target word given the category of a preceding prime. Reliance on the rule improved decision-making, as estimated within a drift diffusion framework. Ventral striatal activation tracked the benefit that relying on the rule had on decision-making. Moreover, activation in ventral striatum correlated with a participant's subsequent reliance on the rule. Taken together, these results support a role for ventral striatum in learning and evaluating declarative retrieval strategies.

  8. Dissociated neural processing for decisions in managers and non-managers.

    PubMed

    Caspers, Svenja; Heim, Stefan; Lucas, Marc G; Stephan, Egon; Fischer, Lorenz; Amunts, Katrin; Zilles, Karl

    2012-01-01

    Functional neuroimaging studies of decision-making so far mainly focused on decisions under uncertainty or negotiation with other persons. Dual process theory assumes that, in such situations, decision making relies on either a rapid intuitive, automated or a slower rational processing system. However, it still remains elusive how personality factors or professional requirements might modulate the decision process and the underlying neural mechanisms. Since decision making is a key task of managers, we hypothesized that managers, facing higher pressure for frequent and rapid decisions than non-managers, prefer the heuristic, automated decision strategy in contrast to non-managers. Such different strategies may, in turn, rely on different neural systems. We tested managers and non-managers in a functional magnetic resonance imaging study using a forced-choice paradigm on word-pairs. Managers showed subcortical activation in the head of the caudate nucleus, and reduced hemodynamic response within the cortex. In contrast, non-managers revealed the opposite pattern. With the head of the caudate nucleus being an initiating component for process automation, these results supported the initial hypothesis, hinting at automation during decisions in managers. More generally, the findings reveal how different professional requirements might modulate cognitive decision processing.

  9. Dissociated Neural Processing for Decisions in Managers and Non-Managers

    PubMed Central

    Caspers, Svenja; Heim, Stefan; Lucas, Marc G.; Stephan, Egon; Fischer, Lorenz; Amunts, Katrin; Zilles, Karl

    2012-01-01

    Functional neuroimaging studies of decision-making so far mainly focused on decisions under uncertainty or negotiation with other persons. Dual process theory assumes that, in such situations, decision making relies on either a rapid intuitive, automated or a slower rational processing system. However, it still remains elusive how personality factors or professional requirements might modulate the decision process and the underlying neural mechanisms. Since decision making is a key task of managers, we hypothesized that managers, facing higher pressure for frequent and rapid decisions than non-managers, prefer the heuristic, automated decision strategy in contrast to non-managers. Such different strategies may, in turn, rely on different neural systems. We tested managers and non-managers in a functional magnetic resonance imaging study using a forced-choice paradigm on word-pairs. Managers showed subcortical activation in the head of the caudate nucleus, and reduced hemodynamic response within the cortex. In contrast, non-managers revealed the opposite pattern. With the head of the caudate nucleus being an initiating component for process automation, these results supported the initial hypothesis, hinting at automation during decisions in managers. More generally, the findings reveal how different professional requirements might modulate cognitive decision processing. PMID:22927984

  10. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

    PubMed Central

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-01-01

    OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

  11. Teachers' Content Decisions: Potential for Conflict in Local Curriculum Development.

    ERIC Educational Resources Information Center

    Mason, Barbara L.

    The purpose of the study was to identify external and internal influences that affected the decision making of four secondary teachers regarding the content of a family living course and to describe their decision-making strategies. Because the course had been shortened and a new textbook and new state guidelines had been received, the teachers…

  12. An organizational intervention to influence evidence-informed decision making in home health nursing.

    PubMed

    Gifford, Wendy; Lefebre, Nancy; Davies, Barbara

    2014-01-01

    The aims of this study were to field test and evaluate a series of organizational strategies to promote evidence-informed decision making (EIDM) by nurse managers and clinical leaders in home healthcare. EIDM is central to delivering high-quality and effective healthcare. Barriers exist and organizational strategies are needed to support EIDM. Management and clinical leaders from 4 units participated in a 20-week organization-focused intervention. Preintervention (n = 32) and postintervention (n = 17) surveys and semistructured interviews (n = 15) were completed. Statistically significant increases were found on 4 of 31 survey items reflecting an increased organizational capacity for participants to acquire and apply research evidence in decision making. Support from designated facilitators with advanced skills in finding, appraising, and applying research was the highest rated intervention strategy. Results are useful to inform the development of organizational infrastructures to increase EIDM capacity in community-based healthcare organizations.

  13. How can we best respect patient autonomy in breast cancer treatment decisions?

    PubMed Central

    Martinez, Kathryn A; Kurian, Allison W

    2015-01-01

    SUMMARY Helping patients to maximize their autonomy in breast cancer decision-making is an important aspect of patient-centered care. Shared decision-making is a strategy that aims to maximize patient autonomy by integrating the values and preferences of the patient with the biomedical expertise of the physician. Application of this approach in breast cancer decision-making has not been uniform across cancer-specific interventions (e.g., surgery, chemotherapy), and in some circumstances may present challenges to evidence-based care delivery. Increasingly precise estimates of individual patients’ risk of recurrence and commensurate predicted benefit from certain therapies hold significant promise in helping patients exercise autonomous decision-making for their breast cancer care, yet will also likely complicate decision-making for certain subgroups of patients. PMID:25733982

  14. Charting the expansion of strategic exploratory behavior during adolescence.

    PubMed

    Somerville, Leah H; Sasse, Stephanie F; Garrad, Megan C; Drysdale, Andrew T; Abi Akar, Nadine; Insel, Catherine; Wilson, Robert C

    2017-02-01

    Although models of exploratory decision making implicate a suite of strategies that guide the pursuit of information, the developmental emergence of these strategies remains poorly understood. This study takes an interdisciplinary perspective, merging computational decision making and developmental approaches to characterize age-related shifts in exploratory strategy from adolescence to young adulthood. Participants were 149 12-28-year-olds who completed a computational explore-exploit paradigm that manipulated reward value, information value, and decision horizon (i.e., the utility that information holds for future choices). Strategic directed exploration, defined as information seeking selective for long time horizons, emerged during adolescence and maintained its level through early adulthood. This age difference was partially driven by adolescents valuing immediate reward over new information. Strategic random exploration, defined as stochastic choice behavior selective for long time horizons, was invoked at comparable levels over the age range, and predicted individual differences in attitudes toward risk taking in daily life within the adolescent portion of the sample. Collectively, these findings reveal an expansion of the diversity of strategic exploration over development, implicate distinct mechanisms for directed and random exploratory strategies, and suggest novel mechanisms for adolescent-typical shifts in decision making. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Thinking strategies used by Registered Nurses during emergency department triage.

    PubMed

    Göransson, Katarina E; Ehnfors, Margareta; Fonteyn, Marsha E; Ehrenberg, Anna

    2008-01-01

    This paper is a report of a study to describe and compare thinking strategies and cognitive processing in the emergency department triage process by Registered Nurses with high and low triage accuracy. Sound clinical reasoning and accurate decision-making are integral parts of modern nursing practice and are of vital importance during triage in emergency departments. Although studies have shown that individual and contextual factors influence the decisions of Registered Nurses in the triage process, others have failed to explain the relationship between triage accuracy and clinical experience. Furthermore, no study has shown the relationship between Registered Nurses' thinking strategies and their triage accuracy. Using the 'think aloud' method, data were collected in 2004-2005 from 16 RNs working in Swedish emergency departments who had previously participated in a study examining triage accuracy. Content analysis of the data was performed. The Registered Nurses used a variety of thinking strategies, ranging from searching for information, generating hypotheses to stating propositions. They structured the triage process in several ways, beginning by gathering data, generating hypotheses or allocating acuity ratings. Comparison of participants' use of thinking strategies and the structure of the triage process based on their previous triage accuracy revealed only slight differences. The wide range of thinking strategies used by Registered Nurses when performing triage indicates that triage decision-making is complex. Further research is needed to ascertain which skills are most important in triage decision-making.

  16. [Shared decision-making in acute psychiatric medicine : Contraindication or a challenge?

    PubMed

    Heres, S; Hamann, J

    2017-09-01

    The concept of shared decision-making (SDM) has existed since the 1990s in multiple fields of somatic medicine but has only been poorly applied in psychiatric clinical routine despite broad acceptance and promising outcomes in clinical studies on its positive effects. The concept itself and its practicability in mental health are carefully assessed and strategies for its future implementation in psychiatric medicine are presented in this article. Ongoing clinical studies probing some of those strategies are further outlined. On top of the ubiquitous shortage of time in clinical routine, psychiatrists report their concern about patients' limited abilities in sharing decisions and their own fear of potentially harmful decisions resulting from a shared process. Misinterpretation of shared decision-making restricting the health care professional to rather an informed choice scenario and their own adhesion to the traditional paternalistic decision-making approach further add to SDM's underutilization. Those hurdles could be overcome by communication skill workshops for all mental health care professionals, including nursing personnels, psychologists, social workers and physicians, as well as the use of decision aids and training courses for patients to motivate and empower them in sharing decisions with the medical staff. By this, the patient-centered treatment approach demanded by guidelines, carers and users could be further facilitated in psychiatric clinical routine.

  17. Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

    PubMed

    Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

    2017-12-01

    In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Decision analysis of emergency ventilation and evacuation strategies against suddenly released contaminant indoors by considering the uncertainty of source locations.

    PubMed

    Cai, Hao; Long, Weiding; Li, Xianting; Kong, Lingjuan; Xiong, Shuang

    2010-06-15

    In case hazardous contaminants are suddenly released indoors, the prompt and proper emergency responses are critical to protect occupants. This paper aims to provide a framework for determining the optimal combination of ventilation and evacuation strategies by considering the uncertainty of source locations. The certainty of source locations is classified as complete certainty, incomplete certainty, and complete uncertainty to cover all the possible situations. According to this classification, three types of decision analysis models are presented. A new concept, efficiency factor of contaminant source (EFCS), is incorporated in these models to evaluate the payoffs of the ventilation and evacuation strategies. A procedure of decision-making based on these models is proposed and demonstrated by numerical studies of one hundred scenarios with ten ventilation modes, two evacuation modes, and five source locations. The results show that the models can be useful to direct the decision analysis of both the ventilation and evacuation strategies. In addition, the certainty of the source locations has an important effect on the outcomes of the decision-making. Copyright 2010 Elsevier B.V. All rights reserved.

  19. Resilience Education.

    ERIC Educational Resources Information Center

    Brown, Joel H.; D'Emidio-Caston, Marianne; Benard, Bonnie

    This book examines how young people who struggle with life's worst conditions somehow manage to overcome adversity, identifying significant factors that contribute to their resilience. The book presents information and decision making skills students need to make good decisions in the face of adversity; learning strategies and teaching techniques…

  20. What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

    PubMed Central

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

    2016-01-01

    Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

  1. What Is a "Good" Treatment Decision? Decisional Control, Knowledge, Treatment Decision Making, and Quality of Life in Men with Clinically Localized Prostate Cancer.

    PubMed

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J; Homish, D Lynn

    2016-08-01

    We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision-making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision making is an advantageous model for studying patient treatment decision-making dynamics because there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Men with newly diagnosed clinically localized prostate cancer (N = 1529) completed measures of decisional control, prostate cancer knowledge, and decision-making experiences (decisional conflict and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed at 6 months after treatment. More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control, predicted better QOL 6 months after treatment. Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time that they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. © The Author(s) 2016.

  2. Key Elements of a Successful Drive toward Marketing Strategy Making

    ERIC Educational Resources Information Center

    Cann, Cynthia W.; George, Marie A.

    2003-01-01

    A conceptual model is presented that depicts the relationship between an internal marketing function and an organization's readiness to learn. Learning and marketing orientations are identified as components to marketing strategy making. Key organizational functions, including communication and decision-making, are utilized in a framework for…

  3. Age Differences in the Influence of Induced Negative Emotion on Decision-Making: The Role of Emotion Regulation.

    PubMed

    You, Xuqun; Ju, Chengting; Wang, Mo; Zhang, Baoshan; Liu, Pei

    2017-11-19

    In this study, we hypothesized that there is an age difference in the influence of negative emotion on decision-making and that this age difference is related to emotion regulation strategies. We carried out two studies. In the first, the older and younger adults completed the ultimatum game (UG) while in either an induced negative emotional or a neutral context. In the second, both the older and younger adults completed the UG while in an induced negative emotion while using either emotion reappraisal or expressive suppression to regulate their emotions during the task. The first study showed that, unlike younger adults, the older adults made similar choices in the neutral and negative induction groups. In addition, the older adults predominantly used a reappraisal strategy in both the negative and neutral emotional states, whereas the younger adults predominantly used a suppression strategy in the negative emotional state. In the second study, after the emotion regulation strategies were experimentally manipulated so that both age groups used the same strategy, we found no age difference in decision-making. Our findings indicated that the influence of negative emotion on decision-making differs between older and younger adults and that this age difference was associated with their different emotion regulation processes. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Protection, participation and protection through participation: young people with intellectual disabilities and decision making in the family context.

    PubMed

    Saaltink, R; MacKinnon, G; Owen, F; Tardif-Williams, C

    2012-11-01

    Research suggests that persons with intellectual disabilities (ID) are expected to be more compliant than persons without disabilities and that expectations for compliance begin in childhood. No study, however, seems yet to have included a primary focus on the participatory rights, or rights to express opinions, desires and preferences and to be heard and taken seriously in decision making among young people with ID who are not yet considered legally adult. The purpose of the two current studies was to explore how the right to participation is negotiated for young people with ID in a family context and to determine family members' recommendations for strategies to facilitate the participation of young people with ID. In the first study, four young people with ID, their mothers and two siblings from four families took part in semi-structured interviews about decision making in the family context. In the second study, a mother and daughter from the first study discussed and developed strategies to promote participation for young people with ID. In the first study, all participants communicated that young people with ID follow an age-typical yet restricted pattern of participation in decisions about their lives. Young people's participation was consistently framed by familial norms and values as well as their families' desire to protect them. In the second study, both participants suggested communication about the outcomes of real or imagined decisions would help young family members rehearse decision-making strategies that would facilitate their autonomy while remaining within the bounds of familial norms, values and perceptions of safety. Although young people with ID may make fewer independent decisions about their lives than typically developing peers, support in decision making can enable both increased protection and independence. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

  5. Bringing science to the table: Case studies in science-informed decision making on climate change and beyond

    NASA Astrophysics Data System (ADS)

    Goldman, G. T.; Phartiyal, P.; Mulvey, K.

    2016-12-01

    Federal government officials often rely on the research and advice of scientists to inform their decision making around climate change and other complex topics. Decision makers, however, are constrained by the time and accessibility needed to obtain and incorporate scientific information. At the same time, scientists have limited capacity and incentive to devote significant time to communicating their science to decision makers. The Union of Concerned Scientists has employed several strategies to produce policy-relevant scientific work and to facilitate engagement between scientists and decision makers across research areas. This talk will feature lessons learned and key strategies for science-informed decision making around climate change and other areas of the geosciences. Case studies will include conducting targeted sea level rise studies to inform rulemaking at federal agencies, bringing science to policy discussions on hydraulic fracturing, and leveraging the voice of the scientific community on specific policy proposals around climate change disclosure of companies. Recommendations and lessons learned for producing policy-relevant science and effectively communicating it with decision makers will be offered.

  6. Optimal healthcare decision making under multiple mathematical models: application in prostate cancer screening.

    PubMed

    Bertsimas, Dimitris; Silberholz, John; Trikalinos, Thomas

    2018-03-01

    Important decisions related to human health, such as screening strategies for cancer, need to be made without a satisfactory understanding of the underlying biological and other processes. Rather, they are often informed by mathematical models that approximate reality. Often multiple models have been made to study the same phenomenon, which may lead to conflicting decisions. It is natural to seek a decision making process that identifies decisions that all models find to be effective, and we propose such a framework in this work. We apply the framework in prostate cancer screening to identify prostate-specific antigen (PSA)-based strategies that perform well under all considered models. We use heuristic search to identify strategies that trade off between optimizing the average across all models' assessments and being "conservative" by optimizing the most pessimistic model assessment. We identified three recently published mathematical models that can estimate quality-adjusted life expectancy (QALE) of PSA-based screening strategies and identified 64 strategies that trade off between maximizing the average and the most pessimistic model assessments. All prescribe PSA thresholds that increase with age, and 57 involve biennial screening. Strategies with higher assessments with the pessimistic model start screening later, stop screening earlier, and use higher PSA thresholds at earlier ages. The 64 strategies outperform 22 previously published expert-generated strategies. The 41 most "conservative" ones remained better than no screening with all models in extensive sensitivity analyses. We augment current comparative modeling approaches by identifying strategies that perform well under all models, for various degrees of decision makers' conservativeness.

  7. Hierarchical decision processes that operate over distinct timescales underlie choice and changes in strategy

    PubMed Central

    Purcell, Braden A.; Kiani, Roozbeh

    2016-01-01

    Decision-making in a natural environment depends on a hierarchy of interacting decision processes. A high-level strategy guides ongoing choices, and the outcomes of those choices determine whether or not the strategy should change. When the right decision strategy is uncertain, as in most natural settings, feedback becomes ambiguous because negative outcomes may be due to limited information or bad strategy. Disambiguating the cause of feedback requires active inference and is key to updating the strategy. We hypothesize that the expected accuracy of a choice plays a crucial rule in this inference, and setting the strategy depends on integration of outcome and expectations across choices. We test this hypothesis with a task in which subjects report the net direction of random dot kinematograms with varying difficulty while the correct stimulus−response association undergoes invisible and unpredictable switches every few trials. We show that subjects treat negative feedback as evidence for a switch but weigh it with their expected accuracy. Subjects accumulate switch evidence (in units of log-likelihood ratio) across trials and update their response strategy when accumulated evidence reaches a bound. A computational framework based on these principles quantitatively explains all aspects of the behavior, providing a plausible neural mechanism for the implementation of hierarchical multiscale decision processes. We suggest that a similar neural computation—bounded accumulation of evidence—underlies both the choice and switches in the strategy that govern the choice, and that expected accuracy of a choice represents a key link between the levels of the decision-making hierarchy. PMID:27432960

  8. Hierarchical decision processes that operate over distinct timescales underlie choice and changes in strategy.

    PubMed

    Purcell, Braden A; Kiani, Roozbeh

    2016-08-02

    Decision-making in a natural environment depends on a hierarchy of interacting decision processes. A high-level strategy guides ongoing choices, and the outcomes of those choices determine whether or not the strategy should change. When the right decision strategy is uncertain, as in most natural settings, feedback becomes ambiguous because negative outcomes may be due to limited information or bad strategy. Disambiguating the cause of feedback requires active inference and is key to updating the strategy. We hypothesize that the expected accuracy of a choice plays a crucial rule in this inference, and setting the strategy depends on integration of outcome and expectations across choices. We test this hypothesis with a task in which subjects report the net direction of random dot kinematograms with varying difficulty while the correct stimulus-response association undergoes invisible and unpredictable switches every few trials. We show that subjects treat negative feedback as evidence for a switch but weigh it with their expected accuracy. Subjects accumulate switch evidence (in units of log-likelihood ratio) across trials and update their response strategy when accumulated evidence reaches a bound. A computational framework based on these principles quantitatively explains all aspects of the behavior, providing a plausible neural mechanism for the implementation of hierarchical multiscale decision processes. We suggest that a similar neural computation-bounded accumulation of evidence-underlies both the choice and switches in the strategy that govern the choice, and that expected accuracy of a choice represents a key link between the levels of the decision-making hierarchy.

  9. The impact of demand management strategies on parents’ decision-making for out-of-hours primary care: findings from a survey in The Netherlands

    PubMed Central

    Giesen, Marie-Jeanne; Keizer, Ellen; van de Pol, Julia; Knoben, Joris; Wensing, Michel; Giesen, Paul

    2017-01-01

    Objective To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. Design and methods We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy. Results The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; 95% CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; 95% CI 0.08 to 0.32). Overview of medical cost (OR 0.59; 95% CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; 95% CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions. Conclusion Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted. PMID:28487458

  10. The impact of demand management strategies on parents' decision-making for out-of-hours primary care: findings from a survey in The Netherlands.

    PubMed

    Giesen, Marie-Jeanne; Keizer, Ellen; van de Pol, Julia; Knoben, Joris; Wensing, Michel; Giesen, Paul

    2017-05-09

    To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years. We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy. The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; CI 0.08 to 0.32). Overview of medical cost (OR 0.59; CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions. Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  11. Family involvement in cancer treatment decision-making: A qualitative study of patient, family, and clinician attitudes and experiences.

    PubMed

    Laidsaar-Powell, Rebekah; Butow, Phyllis; Bu, Stella; Charles, Cathy; Gafni, Amiram; Fisher, Alana; Juraskova, Ilona

    2016-07-01

    Little is known about how family are involved in cancer treatment decision-making. This study aimed to qualitatively explore Australian oncology clinicians', patients', and family members' attitudes towards, and experiences of, family involvement in decision-making. Semi-structured interviews were conducted with 30 cancer patients, 33 family members, 10 oncology nurses and 11 oncologists. Framework analysis methods were used. Three main themes were uncovered: (i) how family are involved in the decision-making process: specific behaviours of family across 5 (extended) decision-making stages; (ii) attitudes towards family involvement in the decision-making process: balancing patient authority with the rights of the family; and (iii) factors influencing family involvement: patient, family, cultural, relationship, and decision. This study highlighted many specific behaviours of family throughout the decision-making process, the complex participant attitudes toward retaining patient authority whilst including the family, and insight into influencing factors. These findings will inform a conceptual framework describing family involvement in decision-making. Clinicians could ascertain participant preferences and remain open to the varying forms of family involvement in decision-making. Given the important role of family in the decision-making process, family inclusive consultation strategies are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Impaired decision-making and selective cortical frontal thinning in Cushing's syndrome.

    PubMed

    Crespo, Iris; Esther, Granell-Moreno; Santos, Alicia; Valassi, Elena; Yolanda, Vives-Gilabert; De Juan-Delago, Manel; Webb, Susan M; Gómez-Ansón, Beatriz; Resmini, Eugenia

    2014-12-01

    Cushing's syndrome (CS) is caused by a glucocorticoid excess. This hypercortisolism can damage the prefrontal cortex, known to be important in decision-making. Our aim was to evaluate decision-making in CS and to explore cortical thickness. Thirty-five patients with CS (27 cured, eight medically treated) and thirty-five matched controls were evaluated using Iowa gambling task (IGT) and 3 Tesla magnetic resonance imaging (MRI) to assess cortical thickness. The IGT evaluates decision-making, including strategy and learning during the test. Cortical thickness was determined on MRI using freesurfer software tools, including a whole-brain analysis. There were no differences between medically treated and cured CS patients. They presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (P < 0·05). They showed more difficulties than controls to learn the correct profiles of wins and losses for each card group (P < 0·05). In whole-brain analysis, patients with CS showed decreased cortical thickness in the left superior frontal cortex, left precentral cortex, left insular cortex, left and right rostral anterior cingulate cortex, and right caudal middle frontal cortex compared to controls (P < 0·001). Patients with CS failed to learn advantageous strategies and their behaviour was driven by short-term reward and long-term punishment, indicating learning problems because they did not use previous experience as a feedback factor to regulate their choices. These alterations in decision-making and the decreased cortical thickness in frontal areas suggest that chronic hypercortisolism promotes brain changes which are not completely reversible after endocrine remission. © 2014 John Wiley & Sons Ltd.

  13. 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.

  14. Strategic insight and age-related goal-neglect influence risky decision-making.

    PubMed

    Westbrook, Andrew; Martins, Bruna S; Yarkoni, Tal; Braver, Todd S

    2012-01-01

    Maximizing long-run gains often requires taking on some degree of risk, yet decision-makers often exhibit risk aversion (RA), rejecting risky prospects even when these have higher expected value (EV) than safer alternatives. We investigated whether explicit strategy instruction and practice can decrease prepotent RA, and whether aging impacts the efficacy of such an intervention. Participants performed a paired lottery task with options varying in risk and magnitude, both before and after practice with a similar task that encouraged maximization of EV and instruction to use this strategy in risky decisions. In both younger and older adults (OAs), strategy training reduced RA. Although RA was age-equivalent at baseline, larger training effects were observed in younger adults (YAs). These effects were not explained by risk-related (i.e., affective) interference effects or computation ability, but were consistent with a progressive, age-related neglect of the strategy across trials. Our findings suggest that strategy training can diminish RA, but that training efficacy is reduced among OAs, potentially due to goal neglect. We discuss implications for neural mechanisms that may distinguish older and YAs' risky decision-making.

  15. A Robust Decision-Making Technique for Water Management under Decadal Scale Climate Variability

    NASA Astrophysics Data System (ADS)

    Callihan, L.; Zagona, E. A.; Rajagopalan, B.

    2013-12-01

    Robust decision making, a flexible and dynamic approach to managing water resources in light of deep uncertainties associated with climate variability at inter-annual to decadal time scales, is an analytical framework that detects when a system is in or approaching a vulnerable state. It provides decision makers the opportunity to implement strategies that both address the vulnerabilities and perform well over a wide range of plausible future scenarios. A strategy that performs acceptably over a wide range of possible future states is not likely to be optimal with respect to the actual future state. The degree of success--the ability to avoid vulnerable states and operate efficiently--thus depends on the skill in projecting future states and the ability to select the most efficient strategies to address vulnerabilities. This research develops a robust decision making framework that incorporates new methods of decadal scale projections with selection of efficient strategies. Previous approaches to water resources planning under inter-annual climate variability combining skillful seasonal flow forecasts with climatology for subsequent years are not skillful for medium term (i.e. decadal scale) projections as decision makers are not able to plan adequately to avoid vulnerabilities. We address this need by integrating skillful decadal scale streamflow projections into the robust decision making framework and making the probability distribution of this projection available to the decision making logic. The range of possible future hydrologic scenarios can be defined using a variety of nonparametric methods. Once defined, an ensemble projection of decadal flow scenarios are generated from a wavelet-based spectral K-nearest-neighbor resampling approach using historical and paleo-reconstructed data. This method has been shown to generate skillful medium term projections with a rich variety of natural variability. The current state of the system in combination with the probability distribution of the projected flow ensembles enables the selection of appropriate decision options. This process is repeated for each year of the planning horizon--resulting in system outcomes that can be evaluated on their performance and resiliency. The research utilizes the RiverSMART suite of software modeling and analysis tools developed under the Bureau of Reclamation's WaterSMART initiative and built around the RiverWare modeling environment. A case study is developed for the Gunnison and Upper Colorado River Basins. The ability to mitigate vulnerability using the framework is gauged by system performance indicators that measure the ability of the system to meet various water demands (i.e. agriculture, environmental flows, hydropower etc.). Options and strategies for addressing vulnerabilities include measures such as conservation, reallocation and adjustments to operational policy. In addition to being able to mitigate vulnerabilities, options and strategies are evaluated based on benefits, costs and reliability. Flow ensembles are also simulated to incorporate mean and variance from climate change projections for the planning horizon and the above robust decision-making framework is applied to evaluate its performance under changing climate.

  16. Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

    PubMed

    Dhukaram, Anandhi Vivekanandan; Baber, Chris

    2015-06-01

    Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Insular neural system controls decision-making in healthy and methamphetamine-treated rats

    PubMed Central

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-01-01

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making. PMID:26150496

  18. Insular neural system controls decision-making in healthy and methamphetamine-treated rats.

    PubMed

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-07-21

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making.

  19. Coping with pregnancy resolution among never-married women.

    PubMed

    Bracken, Michael B; Klerman, Lorraine V; Bracken, Maryann

    1978-04-01

    The Janis-Mann model of decision-making provides the theoretical orientation for empirical analyses of decisions to deliver or abort in matched samples of never-married women. Results focus on four variables: happiness about pregnancy; initial acceptance of delivery or abortion; ease of decision-making; and satisfaction with final choice. Path analyses summarize findings, which are discussed in terms of conflict resolution strategies.

  20. Toward a Contingency Theory of Decision Making.

    ERIC Educational Resources Information Center

    Tarter, C. John; Hoy, Wayne K.

    1998-01-01

    There is no single best decision-making approach. This article reviews and compares six contemporary models (classical, administrative, incremental, mixed-scanning, garbage-can, and political) and develops a framework and 10 propositions to match strategies with circumstances. A contingency approach suggests that administrators use satisficing (a…

  1. Impaired strategic decision making in schizophrenia.

    PubMed

    Kim, Hyojin; Lee, Daeyeol; Shin, Young-Min; Chey, Jeanyung

    2007-11-14

    Adaptive decision making in dynamic social settings requires frequent re-evaluation of choice outcomes and revision of strategies. This requires an array of multiple cognitive abilities, such as working memory and response inhibition. Thus, the disruption of such abilities in schizophrenia can have significant implications for social dysfunctions in affected patients. In the present study, 20 schizophrenia patients and 20 control subjects completed two computerized binary decision-making tasks. In the first task, the participants played a competitive zero-sum game against a computer in which the predictable choice behavior was penalized and the optimal strategy was to choose the two targets stochastically. In the second task, the expected payoffs of the two targets were fixed and unaffected by the subject's choices, so the optimal strategy was to choose the target with the higher expected payoff exclusively. The schizophrenia patients earned significantly less money during the first task, even though their overall choice probabilities were not significantly different from the control subjects. This was mostly because patients were impaired in integrating the outcomes of their previous choices appropriately in order to maintain the optimal strategy. During the second task, the choices of patients and control subjects displayed more similar patterns. This study elucidated the specific components in strategic decision making that are impaired in schizophrenia. The deficit, which can be characterized as strategic stiffness, may have implications for the poor social adjustment in schizophrenia patients.

  2. Gaze data reveal distinct choice processes underlying model-based and model-free reinforcement learning

    PubMed Central

    Konovalov, Arkady; Krajbich, Ian

    2016-01-01

    Organisms appear to learn and make decisions using different strategies known as model-free and model-based learning; the former is mere reinforcement of previously rewarded actions and the latter is a forward-looking strategy that involves evaluation of action-state transition probabilities. Prior work has used neural data to argue that both model-based and model-free learners implement a value comparison process at trial onset, but model-based learners assign more weight to forward-looking computations. Here using eye-tracking, we report evidence for a different interpretation of prior results: model-based subjects make their choices prior to trial onset. In contrast, model-free subjects tend to ignore model-based aspects of the task and instead seem to treat the decision problem as a simple comparison process between two differentially valued items, consistent with previous work on sequential-sampling models of decision making. These findings illustrate a problem with assuming that experimental subjects make their decisions at the same prescribed time. PMID:27511383

  3. What is adaptive about adaptive decision making? A parallel constraint satisfaction account.

    PubMed

    Glöckner, Andreas; Hilbig, Benjamin E; Jekel, Marc

    2014-12-01

    There is broad consensus that human cognition is adaptive. However, the vital question of how exactly this adaptivity is achieved has remained largely open. Herein, we contrast two frameworks which account for adaptive decision making, namely broad and general single-mechanism accounts vs. multi-strategy accounts. We propose and fully specify a single-mechanism model for decision making based on parallel constraint satisfaction processes (PCS-DM) and contrast it theoretically and empirically against a multi-strategy account. To achieve sufficiently sensitive tests, we rely on a multiple-measure methodology including choice, reaction time, and confidence data as well as eye-tracking. Results show that manipulating the environmental structure produces clear adaptive shifts in choice patterns - as both frameworks would predict. However, results on the process level (reaction time, confidence), in information acquisition (eye-tracking), and from cross-predicting choice consistently corroborate single-mechanisms accounts in general, and the proposed parallel constraint satisfaction model for decision making in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. Repetitive transcranial magnetic stimulation over the right dorsolateral prefrontal cortex affects strategic decision-making.

    PubMed

    van 't Wout, Mascha; Kahn, René S; Sanfey, Alan G; Aleman, André

    2005-11-07

    Although decision-making is typically seen as a rational process, emotions play a role in tasks that include unfairness. Recently, activation in the right dorsolateral prefrontal cortex during offers experienced as unfair in the Ultimatum Game was suggested to subserve goal maintenance in this task. This is restricted to correlational evidence, however, and it remains unclear whether the dorsolateral prefrontal cortex is crucial for strategic decision-making. The present study used repetitive transcranial magnetic stimulation in order to investigate the causal role of the dorsolateral prefrontal cortex in strategic decision-making in the Ultimatum Game. The results showed that repetitive transcranial magnetic stimulation over the right dorsolateral prefrontal cortex resulted in an altered decision-making strategy compared with sham stimulation. We conclude that the dorsolateral prefrontal cortex is causally implicated in strategic decision-making in healthy human study participants.

  5. Internal stakeholder group participation in hospital strategic decision-making: making structure fit the moment.

    PubMed

    McDaniel, R R; Ashmos, D P

    1996-01-01

    This study examines the participation of six internal stakeholder groups in hospital strategic decision-making. Results show that internal stakeholder group participation is affected by strategic decision content and by the nature of the hospital's strategy. Results show that the participation of internal stakeholdergroups is associated with lower cost per full-time employee (fte). In particular, when the low participation stakeholder groups do participate, hospitals experience lower cost per fte.

  6. Multi-objective optimisation and decision-making of space station logistics strategies

    NASA Astrophysics Data System (ADS)

    Zhu, Yue-he; Luo, Ya-zhong

    2016-10-01

    Space station logistics strategy optimisation is a complex engineering problem with multiple objectives. Finding a decision-maker-preferred compromise solution becomes more significant when solving such a problem. However, the designer-preferred solution is not easy to determine using the traditional method. Thus, a hybrid approach that combines the multi-objective evolutionary algorithm, physical programming, and differential evolution (DE) algorithm is proposed to deal with the optimisation and decision-making of space station logistics strategies. A multi-objective evolutionary algorithm is used to acquire a Pareto frontier and help determine the range parameters of the physical programming. Physical programming is employed to convert the four-objective problem into a single-objective problem, and a DE algorithm is applied to solve the resulting physical programming-based optimisation problem. Five kinds of objective preference are simulated and compared. The simulation results indicate that the proposed approach can produce good compromise solutions corresponding to different decision-makers' preferences.

  7. Probabilistic vs. non-probabilistic approaches to the neurobiology of perceptual decision-making

    PubMed Central

    Drugowitsch, Jan; Pouget, Alexandre

    2012-01-01

    Optimal binary perceptual decision making requires accumulation of evidence in the form of a probability distribution that specifies the probability of the choices being correct given the evidence so far. Reward rates can then be maximized by stopping the accumulation when the confidence about either option reaches a threshold. Behavioral and neuronal evidence suggests that humans and animals follow such a probabilitistic decision strategy, although its neural implementation has yet to be fully characterized. Here we show that that diffusion decision models and attractor network models provide an approximation to the optimal strategy only under certain circumstances. In particular, neither model type is sufficiently flexible to encode the reliability of both the momentary and the accumulated evidence, which is a pre-requisite to accumulate evidence of time-varying reliability. Probabilistic population codes, in contrast, can encode these quantities and, as a consequence, have the potential to implement the optimal strategy accurately. PMID:22884815

  8. Presenting evidence and summary measures to best inform societal decisions when comparing multiple strategies.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2011-07-01

    Multiple strategy comparisons in health technology assessment (HTA) are becoming increasingly important, with multiple alternative therapeutic actions, combinations of therapies and diagnostic and genetic testing alternatives. Comparison under uncertainty of incremental cost, effects and cost effectiveness across more than two strategies is conceptually and practically very different from that for two strategies, where all evidence can be summarized in a single bivariate distribution on the incremental cost-effectiveness plane. Alternative methods for comparing multiple strategies in HTA have been developed in (i) presenting cost and effects on the cost-disutility plane and (ii) summarizing evidence with multiple strategy cost-effectiveness acceptability (CEA) and expected net loss (ENL) curves and frontiers. However, critical questions remain for the analyst and decision maker of how these techniques can be best employed across multiple strategies to (i) inform clinical and cost inference in presenting evidence, and (ii) summarize evidence of cost effectiveness to inform societal reimbursement decisions where preferences may be risk neutral or somewhat risk averse under the Arrow-Lind theorem. We critically consider how evidence across multiple strategies can be best presented and summarized to inform inference and societal reimbursement decisions, given currently available methods. In the process, we make a number of important original findings. First, in presenting evidence for multiple strategies, the joint distribution of costs and effects on the cost-disutility plane with associated flexible comparators varying across replicates for cost and effect axes ensure full cost and effect inference. Such inference is usually confounded on the cost-effectiveness plane with comparison relative to a fixed origin and axes. Second, in summarizing evidence for risk-neutral societal decision making, ENL curves and frontiers are shown to have advantages over the CEA frontier in directly presenting differences in expected net benefit (ENB). The CEA frontier, while identifying strategies that maximize ENB, only presents their probability of maximizing net benefit (NB) and, hence, fails to explain why strategies maximize ENB at any given threshold value. Third, in summarizing evidence for somewhat risk-averse societal decision making, trade-offs between the strategy maximizing ENB and other potentially optimal strategies with higher probability of maximizing NB should be presented over discrete threshold values where they arise. However, the probabilities informing these trade-offs and associated discrete threshold value regions should be derived from bilateral CEA curves to prevent confounding by other strategies inherent in multiple strategy CEA curves. Based on these findings, a series of recommendations are made for best presenting and summarizing cost-effectiveness evidence for reimbursement decisions when comparing multiple strategies, which are contrasted with advice for comparing two strategies. Implications for joint research and reimbursement decisions are also discussed.

  9. Evidence of different underlying processes in pattern recall and decision-making.

    PubMed

    Gorman, Adam D; Abernethy, Bruce; Farrow, Damian

    2015-01-01

    The visual search characteristics of expert and novice basketball players were recorded during pattern recall and decision-making tasks to determine whether the two tasks shared common visual-perceptual processing strategies. The order in which participants entered the pattern elements in the recall task was also analysed to further examine the nature of the visual-perceptual strategies and the relative emphasis placed upon particular pattern features. The experts demonstrated superior performance across the recall and decision-making tasks [see also Gorman, A. D., Abernethy, B., & Farrow, D. (2012). Classical pattern recall tests and the prospective nature of expert performance. The Quarterly Journal of Experimental Psychology, 65, 1151-1160; Gorman, A. D., Abernethy, B., & Farrow, D. (2013a). Is the relationship between pattern recall and decision-making influenced by anticipatory recall? The Quarterly Journal of Experimental Psychology, 66, 2219-2236)] but a number of significant differences in the visual search data highlighted disparities in the processing strategies, suggesting that recall skill may utilize different underlying visual-perceptual processes than those required for accurate decision-making performance in the natural setting. Performance on the recall task was characterized by a proximal-to-distal order of entry of the pattern elements with participants tending to enter the players located closest to the ball carrier earlier than those located more distal to the ball carrier. The results provide further evidence of the underlying perceptual processes employed by experts when extracting visual information from complex and dynamic patterns.

  10. A framework for sensitivity analysis of decision trees.

    PubMed

    Kamiński, Bogumił; Jakubczyk, Michał; Szufel, Przemysław

    2018-01-01

    In the paper, we consider sequential decision problems with uncertainty, represented as decision trees. Sensitivity analysis is always a crucial element of decision making and in decision trees it often focuses on probabilities. In the stochastic model considered, the user often has only limited information about the true values of probabilities. We develop a framework for performing sensitivity analysis of optimal strategies accounting for this distributional uncertainty. We design this robust optimization approach in an intuitive and not overly technical way, to make it simple to apply in daily managerial practice. The proposed framework allows for (1) analysis of the stability of the expected-value-maximizing strategy and (2) identification of strategies which are robust with respect to pessimistic/optimistic/mode-favoring perturbations of probabilities. We verify the properties of our approach in two cases: (a) probabilities in a tree are the primitives of the model and can be modified independently; (b) probabilities in a tree reflect some underlying, structural probabilities, and are interrelated. We provide a free software tool implementing the methods described.

  11. Cognitive processes in anesthesiology decision making.

    PubMed

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

    The quality and safety of health care are under increasing scrutiny. Recent studies suggest that medical errors, practice variability, and guideline noncompliance are common, and that cognitive error contributes significantly to delayed or incorrect diagnoses. These observations have increased interest in understanding decision-making psychology.Many nonrational (i.e., not purely based in statistics) cognitive factors influence medical decisions and may lead to error. The most well-studied include heuristics, preferences for certainty, overconfidence, affective (emotional) influences, memory distortions, bias, and social forces such as fairness or blame.Although the extent to which such cognitive processes play a role in anesthesia practice is unknown, anesthesia care frequently requires rapid, complex decisions that are most susceptible to decision errors. This review will examine current theories of human decision behavior, identify effects of nonrational cognitive processes on decision making, describe characteristic anesthesia decisions in this context, and suggest strategies to improve decision making.

  12. Research-based-decision-making in Canadian health organizations: a behavioural approach.

    PubMed

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

    Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build networks, develop partnerships between professionals locally, regionally and nationally, and also act as change agents in the dissemination and adoption of knowledge and innovations in health services. However, the research focused on knowledge use as a support to decision-making, further research is needed to identify and evaluate effective incentives and strategies to implement so as to enhance RBDM adoption among health decision makers and more theoretical development are to complete in this perspective.

  13. Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study.

    PubMed

    Jack, Susan M; Dobbins, Maureen; Sword, Wendy; Novotna, Gabriela; Brooks, Sandy; Lipman, Ellen L; Niccols, Alison

    2011-11-07

    Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions.

  14. Evidence-informed decision-making by professionals working in addiction agencies serving women: a descriptive qualitative study

    PubMed Central

    2011-01-01

    Background Effective approaches to the prevention and treatment of substance abuse among mothers have been developed but not widely implemented. Implementation studies suggest that the adoption of evidence-based practices in the field of addictions remains low. There is a need, therefore, to better understand decision making processes in addiction agencies in order to develop more effective approaches to promote the translation of knowledge gained from addictions research into clinical practice. Methods A descriptive qualitative study was conducted to explore: 1) the types and sources of evidence used to inform practice-related decisions within Canadian addiction agencies serving women; 2) how decision makers at different levels report using research evidence; and 3) factors that influence evidence-informed decision making. A purposeful sample of 26 decision-makers providing addiction treatment services to women completed in-depth qualitative interviews. Interview data were coded and analyzed using directed and summative content analysis strategies as well as constant comparison techniques. Results Across all groups, individuals reported locating and using multiple types of evidence to inform decisions. Some decision-makers rely on their experiential knowledge of addiction and recovery in decision-making. Research evidence is often used directly in decision-making at program management and senior administrative levels. Information for decision-making is accessed from a range of sources, including web-based resources and experts in the field. Individual and organizational facilitators and barriers to using research evidence in decision making were identified. Conclusions There is support at administrative levels for integrating EIDM in addiction agencies. Knowledge transfer and exchange strategies should be focussed towards program managers and administrators and include capacity building for locating, appraising and using research evidence, knowledge brokering, and for partnering with universities. Resources are required to maintain web-based databases of searchable evidence to facilitate access to research evidence. A need exists to address the perception that there is a paucity of research evidence available to inform program decisions. Finally, there is a need to consider how experiential knowledge influences decision-making and what guidance research evidence has to offer regarding the implementation of different treatment approaches within the field of addictions. PMID:22059528

  15. Probability or Reasoning: Current Thinking and Realistic Strategies for Improved Medical Decisions

    PubMed Central

    2017-01-01

    A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy. PMID:29209469

  16. Probability or Reasoning: Current Thinking and Realistic Strategies for Improved Medical Decisions.

    PubMed

    Nantha, Yogarabindranath Swarna

    2017-11-01

    A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting. An extensive literature review of cognitive psychology and medical decision-making theory was performed to illustrate how heuristics could be effectively utilized in daily practice. Since physicians often rely on heuristics in realistic situations, probabilistic estimation might not be a useful tool in everyday clinical practice. Improvements in the descriptive model of decision making (heuristics) may allow for greater diagnostic accuracy.

  17. Aging and loss decision making: increased risk aversion and decreased use of maximizing information, with correlated rationality and value maximization

    PubMed Central

    Kurnianingsih, Yoanna A.; Sim, Sam K. Y.; Chee, Michael W. L.; Mullette-Gillman, O’Dhaniel A.

    2015-01-01

    We investigated how adult aging specifically alters economic decision-making, focusing on examining alterations in uncertainty preferences (willingness to gamble) and choice strategies (what gamble information influences choices) within both the gains and losses domains. Within each domain, participants chose between certain monetary outcomes and gambles with uncertain outcomes. We examined preferences by quantifying how uncertainty modulates choice behavior as if altering the subjective valuation of gambles. We explored age-related preferences for two types of uncertainty, risk, and ambiguity. Additionally, we explored how aging may alter what information participants utilize to make their choices by comparing the relative utilization of maximizing and satisficing information types through a choice strategy metric. Maximizing information was the ratio of the expected value of the two options, while satisficing information was the probability of winning. We found age-related alterations of economic preferences within the losses domain, but no alterations within the gains domain. Older adults (OA; 61–80 years old) were significantly more uncertainty averse for both risky and ambiguous choices. OA also exhibited choice strategies with decreased use of maximizing information. Within OA, we found a significant correlation between risk preferences and choice strategy. This linkage between preferences and strategy appears to derive from a convergence to risk neutrality driven by greater use of the effortful maximizing strategy. As utility maximization and value maximization intersect at risk neutrality, this result suggests that OA are exhibiting a relationship between enhanced rationality and enhanced value maximization. While there was variability in economic decision-making measures within OA, these individual differences were unrelated to variability within examined measures of cognitive ability. Our results demonstrate that aging alters economic decision-making for losses through changes in both individual preferences and the strategies individuals employ. PMID:26029092

  18. 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.

  19. Decision strategies for handling the uncertainty of future extreme rainfall under the influence of climate change.

    PubMed

    Gregersen, I B; Arnbjerg-Nielsen, K

    2012-01-01

    Several extraordinary rainfall events have occurred in Denmark within the last few years. For each event, problems in urban areas occurred as the capacity of the existing drainage systems were exceeded. Adaptation to climate change is necessary but also very challenging as urban drainage systems are characterized by long technical lifetimes and high, unrecoverable construction costs. One of the most important barriers for the initiation and implementation of the adaptation strategies is therefore the uncertainty when predicting the magnitude of the extreme rainfall in the future. This challenge is explored through the application and discussion of three different theoretical decision support strategies: the precautionary principle, the minimax strategy and Bayesian decision support. The reviewed decision support strategies all proved valuable for addressing the identified uncertainties, at best applied together as they all yield information that improved decision making and thus enabled more robust decisions.

  20. How Business Intelligence and Social Interaction Amplify Organizational Cognition

    ERIC Educational Resources Information Center

    Penn, Stephen Paul

    2012-01-01

    This systematic literature review of current scholarship on business intelligence, individual decision-making behavior, strategy as practice, and strategic planning offers a roadmap for firms seeking to increase their competitive advantage through data driven decision-making. Planning, deciding, and using information is a single phenomenon where…

  1. Making informed capital investment decisions for clinical technology.

    PubMed

    Poplin, Brian

    2011-02-01

    Hospitals can make more-informed decisions related to clinical equipment purchases by using a variety of data sources in planning their investment strategies. Data sources generally fall into three buckets: Data that are internally generated by hospitals. Public data. Industry data that are available for purchase.

  2. Framing discrimination: effects of inclusion versus exclusion mind-sets on stereotypic judgments.

    PubMed

    Hugenberg, Kurt; Bodenhausen, Galen V; McLain, Melissa

    2006-12-01

    Three studies investigated how inclusion versus exclusion strategies differentially lead to stereotypic decisions. In inclusion strategies, suitable targets are selected from a list of candidates, whereas in exclusion strategies, unsuitable candidates are eliminated. Across 2 separate target domains (Study 1: male and female politicians; Studies 2 and 3: African American and European American basketball players), exclusion strategies, as compared with inclusion strategies, elicited higher levels of both sensitivity stereotyping (i.e., greater difficulty distinguishing among members of stereotyped groups) and criterion stereotyping (i.e., setting different decision thresholds for judging members of different groups; see M. R. Banaji & A. G. Greenwald, 1995). Thus, the strategy used during decision making can influence the final decision via 2 theoretically distinct stereotyping mechanisms. (c) 2006 APA, all rights reserved.

  3. Exploring Investor Decisions in a Behavioral Finance Framework

    ERIC Educational Resources Information Center

    Hayes, Suzanne K.

    2010-01-01

    The first objective of this article is to increase awareness and understanding of individual decision-making biases. The second is to provide FCS professionals with strategies to improve consumer financial decisions. Individual decision biases are presented within the context of a seven-stage decision process. Proactive consumer educators using a…

  4. Take-the-best in expert-novice decision strategies for residential burglary.

    PubMed

    Garcia-Retamero, Rocio; Dhami, Mandeep K

    2009-02-01

    We examined the decision strategies and cue use of experts and novices in a consequential domain: crime. Three participant groups decided which of two residential properties was more likely to be burgled, on the basis of eight cues such as location of the property. The two expert groups were experienced burglars and police officers, and the novice group was composed of graduate students. We found that experts' choices were best predicted by a lexicographic heuristic strategy called take-the-best that implies noncompensatory information processing, whereas novices' choices were best predicted by a weighted additive linear strategy that implies compensatory processing. The two expert groups, however, differed in the cues they considered important in making their choices, and the police officers were actually more similar to novices in this regard. These findings extend the literature on judgment, decision making, and expertise, and have implications for criminal justice policy.

  5. Emotion regulation and risk taking: predicting risky choice in deliberative decision making.

    PubMed

    Panno, Angelo; Lauriola, Marco; Figner, Bernd

    2013-01-01

    Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation strategies in risky choice involving deliberative decision making. We investigated the role of habitual use of emotion regulation strategies in risky choice using the "cold" deliberative version of the Columbia Card Task (CCT; Figner et al., 2009). Fifty-three participants completed the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) and--one month later--the CCT and the PANAS. Greater habitual cognitive reappraisal use was related to increased risk taking, accompanied by decreased sensitivity to changes in probability and loss amount. Greater habitual expressive suppression use was related to decreased risk taking. The results show that habitual use of reappraisal and suppression strategies predict risk taking when decisions involve predominantly cognitive-deliberative processes.

  6. Impact of stakeholders influence, geographic level and risk perception on strategic decisions in simulated foot and mouth disease epizootics in France.

    PubMed

    Marsot, Maud; Rautureau, Séverine; Dufour, Barbara; Durand, Benoit

    2014-01-01

    Comparison of control strategies against animal infectious diseases allows determining optimal strategies according to their epidemiological and/or economic impacts. However, in real life, the choice of a control strategy does not always obey a pure economic or epidemiological rationality. The objective of this study was to analyze the choice of a foot and mouth disease (FMD) control strategy as a decision-making process in which the decision-maker is influenced by several stakeholders (government, agro-food industries, public opinion). For each of these, an indicator of epizootic impact was quantified to compare seven control strategies. We then determined how, in France, the optimal control strategy varied according to the relative weights of stakeholders and to the perception of risk by the decision-maker (risk-neutral/risk-averse). When the scope of decision was national, whatever their perception of risk and the stakeholders' weights, decision-makers chose a strategy based on vaccination. This consensus concealed marked differences between regions, which were connected with the regional breeding characteristics. Vaccination-based strategies were predominant in regions with dense cattle and swine populations, and in regions with a dense population of small ruminants, combined with a medium density of cattle and swine. These differences between regions suggested that control strategies could be usefully adapted to local breeding conditions. We then analyzed the feasibility of adaptive decision-making processes depending on the date and place where the epizootic starts, or on the evolution of the epizootic over time. The initial conditions always explained at least half of the variance of impacts, the remaining variance being attributed to the variability of epizootics evolution. However, the first weeks of this evolution explained a large part of the impacts variability. Although the predictive value of the initial conditions for determining the optimal strategy was weak, adaptive strategies changing dynamically according to the evolution of the epizootic appeared feasible.

  7. The left inferior frontal gyrus is involved in adjusting response bias during a perceptual decision-making task.

    PubMed

    Reckless, Greg E; Ousdal, Olga T; Server, Andres; Walter, Henrik; Andreassen, Ole A; Jensen, Jimmy

    2014-05-01

    Changing the way we make decisions from one environment to another allows us to maintain optimal decision-making. One way decision-making may change is how biased one is toward one option or another. Identifying the regions of the brain that underlie the change in bias will allow for a better understanding of flexible decision-making. An event-related, perceptual decision-making task where participants had to detect a picture of an animal amongst distractors was used during functional magnetic resonance imaging. Positive and negative financial motivation were used to affect a change in response bias, and changes in decision-making behavior were quantified using signal detection theory. Response bias became relatively more liberal during both positive and negative motivated trials compared to neutral trials. For both motivational conditions, the larger the liberal shift in bias, the greater the left inferior frontal gyrus (IFG) activity. There was no relationship between individuals' belief that they used a different strategy and their actual change in response bias. The present findings suggest that the left IFG plays a role in adjusting response bias across different decision environments. This suggests a potential role for the left IFG in flexible decision-making.

  8. Overcoming Innocents' Naiveté: Pre-interrogation Decision-making Among Innocent Suspects.

    PubMed

    Scherr, Kyle C; Alberts, Kimberly M; Franks, Andrew S; Hawkins, Ian

    2016-07-01

    Suspects, especially innocent ones, are highly susceptible to waiving their interrogation rights. This research tested the ability of two strategies to overcome innocent suspects' willingness to waive their rights. One strategy was based on the social influence of scarcity (i.e., not constraining the pre-interrogation time limit). The other strategy focused on disrupting individuals' cognitive fluency during the decision-making process (i.e., violating their induced expectation of offering a waiver). Disrupting innocent individuals' cognitive fluency increased their willingness to invoke their rights and, notably, was not qualified by interactions with any other factors. However, scarcity did not influence individuals' pre-interrogation decision-making. Results also further established the association between innocent individuals' naïve mindset and their willingness to waive their rights - specifically, innocents' willingness to waive their rights increased with the strength of their just world beliefs. The theoretical and applied implications of these findings are discussed. The importance and benefit of reforming pre-interrogation protocols using fair and feasible strategies that would disrupt suspects' cognitive fluency are emphasized. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  9. Learning Strategy Preferences, Decision-Making Styles, Ways of Knowing, and Cultural Awareness of Members of the National Academic Advising Association

    ERIC Educational Resources Information Center

    Trout, Donna K.

    2009-01-01

    Academic advisors help students with the process of decision making, of making sense of their world, of understanding how they go about learning, and of understanding how to appreciate diversity in their world. If advisors are to help students in these areas, academic advisors should be aware of the cognitive processes of how they make sense of…

  10. Schools and Data: The Educator's Guide for Using Data to Improve Decision Making

    ERIC Educational Resources Information Center

    Creighton, Theodore B.

    2006-01-01

    Since the first edition of "Schools and Data", the No Child Left Behind Act has swept the country, and data-based decision making is no longer an option for educators. Today's educational climate makes it imperative for all schools to collect data and use statistical analysis to help create clear goals and recognize strategies for…

  11. Shared Decision Making in ICUs: An American College of Critical Care Medicine and American Thoracic Society Policy Statement.

    PubMed

    Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B

    2016-01-01

    Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Patient and surrogate preferences for decision-making roles regarding value-laden choices range from preferring to exercise significant authority to ceding such authority to providers. Clinicians should adapt the decision-making model to the needs and preferences of the patient or surrogate.

  12. Economic Evaluation Enhances Public Health Decision Making

    PubMed Central

    Rabarison, Kristina M.; Bish, Connie L.; Massoudi, Mehran S.; Giles, Wayne H.

    2015-01-01

    Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking “how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?” is important when making decisions about resource allocation and scaling of interventions. PMID:26157792

  13. Decision Theory and the Governance of Technology.

    ERIC Educational Resources Information Center

    Woodhouse, Edward J.

    1987-01-01

    Provides an overview of the decision making process for science and technology. Finds that government agencies and officials are not the major decision makers. Examines obstacles to achieving intelligent decisions when policy makers are scientists, business executives, and consumers. Concludes with five strategies for improving technological…

  14. 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.

  15. Planning the Transition to End-of-Life Care in Advanced Cancer (PDQ®)—Health Professional Version

    Cancer.gov

    Planning the transition to end-of-life care in advanced cancer involves making decisions that can be challenging and emotionally distressing. Get information about likely topics and strategies to improve patient-oncologist communication and decision making in this clinician summary.

  16. 77 FR 40634 - Solicitation for a Cooperative Agreement: Pretrial Technical Assistance for Evidence-Based...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-10

    ...: Pretrial Technical Assistance for Evidence-Based Decision Making in Local Criminal Justice Systems AGENCY... NIC initiative, Evidence-Based Decision Making (EBDM) in Local Criminal Justice Systems. Work under... individual system planning activities. These change strategies are critical to meeting their system's harm...

  17. IT Strategy and Decision-Making: A Comparison of Four Universities

    ERIC Educational Resources Information Center

    Wilmore, Andrew

    2014-01-01

    Universities are increasingly dependent on information technology (IT) to support delivery of their objectives. It is crucial, therefore, that the IT investments made lead to successful outcomes. This study analyses the governance structures and decision-making processes used to approve and prioritise IT projects. Factors influencing an…

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

    ERIC Educational Resources Information Center

    Clark, William F.; Pelham, Anabel O.

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

  19. Ventral Striatum and the Evaluation of Memory Retrieval Strategies

    PubMed Central

    Badre, David; Lebrecht, Sophie; Pagliaccio, David; Long, Nicole M.; Scimeca, Jason M.

    2015-01-01

    Adaptive memory retrieval requires mechanisms of cognitive control that facilitate the recovery of goal-relevant information. Frontoparietal systems are known to support control of memory retrieval. However, the mechanisms by which the brain acquires, evaluates, and adapts retrieval strategies remain unknown. Here, we provide evidence that ventral striatal activation tracks the success of a retrieval strategy and correlates with subsequent reliance on that strategy. Human participants were scanned with fMRI while performing a lexical decision task. A rule was provided that indicated the likely semantic category of a target word given the category of a preceding prime. Reliance on the rule improved decision-making, as estimated within a drift diffusion framework. Ventral striatal activation tracked the benefit that relying on the rule had on decision-making. Moreover, activation in ventral striatum correlated with a participant’s subsequent reliance on the rule. Taken together, these results support a role for ventral striatum in learning and evaluating declarative retrieval strategies. PMID:24564466

  20. Sleep-related car crashes: risk perception and decision-making processes in young drivers.

    PubMed

    Lucidi, Fabio; Russo, Paolo Maria; Mallia, Luca; Devoto, Alessandra; Lauriola, Marco; Violani, Cristiano

    2006-03-01

    The aim of the present study is to analyse factors affecting worries, coping strategies and decisions of young drivers regarding the risk of sleep-related car crashes. Furthermore, the study also analyses whether framing the same information about sleepiness in two different linguistic forms influences: (1) the evaluation of the level of risk associated to a specific level of drowsiness (Attribute Framing problem); (2) the willingness to enact strategies to "prevent" sleepiness before night-time driving (Goal Framing problem); (3) the choice between two different ways, both of equal expected efficacy, of lowering drowsiness (Risky decision-making Framing problem). Six hundred and ninety-five young drivers [(57.6% females, 42.4% males); mean age 20.85 years (S.D.=1.2)] answered questions on drive risk perception and sleepiness, on nocturnal driving experience and on the strategies to deal with driver sleepiness, responding to one of the two different versions of the framed problems. A sub-sample of 130 participants completed the framed problems in both versions. The results show that experiences of sleep attacks and nocturnal driving frequency in the past 6 months affect both risk perception and the preventive strategies adopted. Furthermore, the manipulation on two out of the three problems (attribute and risky decision-making frames) significantly affected the respondents' evaluation.

  1. The Rational Patient and Beyond: Implications for Treatment Adherence in People with Psychiatric Disabilities

    PubMed Central

    Corrigan, Patrick W.; Rüsch, Nicolas; Ben-Zeev, Dror; Sher, Tamara

    2014-01-01

    Purpose/Objective Many people with psychiatric disabilities do not benefit from evidence-based practices because they often do not seek out or fully adhere to them. One way psychologists have made sense of this rehabilitation and health decision process and subsequent behaviors (of which adherence might be viewed as one) is by proposing a “rational patient;” namely, that decisions are made deliberatively by weighing perceived costs and benefits of intervention options. Social psychological research, however, suggests limitations to a rational patient theory that impact models of health decision making. Design The research literature was reviewed for studies of rational patient models and alternative theories with empirical support. Special focus was on models specifically related to decisions about rehabilitation strategies for psychiatric disability. Results Notions of the rational patient evolved out of several psychological models including the health belief model, protection motivation theory, and theory of planned behavior. A variety of practice strategies evolved to promote rational decision making. However, research also suggests limitations to rational deliberations of health. (1) Rather than carefully and consciously considered, many health decisions are implicit, potentially occurring outside awareness. (2) Decisions are not always planful; often it is the immediate exigencies of a context rather than an earlier balance of costs and benefits that has the greatest effects. (3) Cool cognitions often do not dictate the process; emotional factors have an important role in health decisions. Each of these limitations suggests additional practice strategies that facilitate a person’s health decisions. Conclusions/Implications Old models of rational decision making need to be supplanted by multi-process models that explain supra-deliberative factors in health decisions and behaviors. PMID:24446671

  2. The rational patient and beyond: implications for treatment adherence in people with psychiatric disabilities.

    PubMed

    Corrigan, Patrick W; Rüsch, Nicolas; Ben-Zeev, Dror; Sher, Tamara

    2014-02-01

    Many people with psychiatric disabilities do not benefit from evidence-based practices because they often do not seek out or fully adhere to them. One way psychologists have made sense of this rehabilitation and health decision process and subsequent behaviors (of which adherence might be viewed as one) is by proposing a "rational patient"; namely, that decisions are made deliberatively by weighing perceived costs and benefits of intervention options. Social psychological research, however, suggests limitations to a rational patient theory that impact models of health decision making. The research literature was reviewed for studies of rational patient models and alternative theories with empirical support. Special focus was on models specifically related to decisions about rehabilitation strategies for psychiatric disability. Notions of the rational patient evolved out of several psychological models including the health belief model, protection motivation theory, and theory of planned behavior. A variety of practice strategies evolved to promote rational decision making. However, research also suggests limitations to rational deliberations of health. (1) Rather than carefully and consciously considered, many health decisions are implicit, potentially occurring outside awareness. (2) Decisions are not always planful; often it is the immediate exigencies of a context rather than an earlier balance of costs and benefits that has the greatest effects. (3) Cool cognitions often do not dictate the process; emotional factors have an important role in health decisions. Each of these limitations suggests additional practice strategies that facilitate a person's health decisions. Old models of rational decision making need to be supplanted by multiprocess models that explain supradeliberative factors in health decisions and behaviors. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  3. Stress and Aeronautical Team Decision Making: Strengthening the Weak Links

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    A model that characterizes pilots'decision making in flight will be presented. Elements of the model that appear most vulnerable to stress will be examined in light of accidents and incidents. The model includes two major components: Situation assessment and choice of a course of action. While based on Klein's Recognition-Primed Decision Making, it is tailored to the aviation environment which includes certain features that may be common to other domains: Primarily, aviation is highly proceduralized and options are generally well known. What appears to make decisions difficult are ambiguity, time pressure, and risk. In addition, decisions must often be made while carrying out the standard procedures of flight, including checklists, review of approach plates, standard briefings, and communication with air traffic controllers or cabin crew. The effects of stressors on decision making by pilots with varying levels of expertise will be explored, along with strategies for strengthening the weak links.

  4. 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.

  5. Considerations of informed consent and decision-making competence in older adults with cognitive impairment.

    PubMed

    Mayo, Ann M; Wallhagen, Margaret I

    2009-04-01

    Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research. Copyright 2009, SLACK Incorporated.

  6. A response-time approach to comparing generalized rational and take-the-best models of decision making.

    PubMed

    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) approach. TTB predicts that RT is determined solely by the expected time required to locate the 1st discriminating attribute, whereas RAT predicts that RT is determined by the difference in summed evidence between the 2 alternatives. Critical test pairs are used that partially decouple these 2 factors. Under conditions in which ideal observer TTB and RAT strategies yield equivalent decisions, both the RT results and the estimated attribute weights suggest that the vast majority of subjects adopted the generalized TTB strategy. The RT approach is also validated in an experimental condition in which use of a RAT strategy is essentially forced upon subjects. (c) 2007 APA, all rights reserved.

  7. 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.

  8. Biased and unbiased perceptual decision-making on vocal emotions.

    PubMed

    Dricu, Mihai; Ceravolo, Leonardo; Grandjean, Didier; Frühholz, Sascha

    2017-11-24

    Perceptual decision-making on emotions involves gathering sensory information about the affective state of another person and forming a decision on the likelihood of a particular state. These perceptual decisions can be of varying complexity as determined by different contexts. We used functional magnetic resonance imaging and a region of interest approach to investigate the brain activation and functional connectivity behind two forms of perceptual decision-making. More complex unbiased decisions on affective voices recruited an extended bilateral network consisting of the posterior inferior frontal cortex, the orbitofrontal cortex, the amygdala, and voice-sensitive areas in the auditory cortex. Less complex biased decisions on affective voices distinctly recruited the right mid inferior frontal cortex, pointing to a functional distinction in this region following decisional requirements. Furthermore, task-induced neural connectivity revealed stronger connections between these frontal, auditory, and limbic regions during unbiased relative to biased decision-making on affective voices. Together, the data shows that different types of perceptual decision-making on auditory emotions have distinct patterns of activations and functional coupling that follow the decisional strategies and cognitive mechanisms involved during these perceptual decisions.

  9. Optimal strategies for electric energy contract decision making

    NASA Astrophysics Data System (ADS)

    Song, Haili

    2000-10-01

    The power industry restructuring in various countries in recent years has created an environment where trading of electric energy is conducted in a market environment. In such an environment, electric power companies compete for the market share through spot and bilateral markets. Being profit driven, electric power companies need to make decisions on spot market bidding, contract evaluation, and risk management. New methods and software tools are required to meet these upcoming needs. In this research, bidding strategy and contract pricing are studied from a market participant's viewpoint; new methods are developed to guide a market participant in spot and bilateral market operation. A supplier's spot market bidding decision is studied. Stochastic optimization is formulated to calculate a supplier's optimal bids in a single time period. This decision making problem is also formulated as a Markov Decision Process. All the competitors are represented by their bidding parameters with corresponding probabilities. A systematic method is developed to calculate transition probabilities and rewards. The optimal strategy is calculated to maximize the expected reward over a planning horizon. Besides the spot market, a power producer can also trade in the bilateral markets. Bidding strategies in a bilateral market are studied with game theory techniques. Necessary and sufficient conditions of Nash Equilibrium (NE) bidding strategy are derived based on the generators' cost and the loads' willingness to pay. The study shows that in any NE, market efficiency is achieved. Furthermore, all Nash equilibria are revenue equivalent for the generators. The pricing of "Flexible" contracts, which allow delivery flexibility over a period of time with a fixed total amount of electricity to be delivered, is analyzed based on the no-arbitrage pricing principle. The proposed algorithm calculates the price based on the optimality condition of the stochastic optimization formulation. Simulation examples illustrate the tradeoffs between prices and scheduling flexibility. Spot bidding and contract pricing are not independent decision processes. The interaction between spot bidding and contract evaluation is demonstrated with game theory equilibrium model and market simulation results. It leads to the conclusion that a market participant's contract decision making needs to be further investigated as an integrated optimization formulation.

  10. Swarm intelligence: when uncertainty meets conflict.

    PubMed

    Conradt, Larissa; List, Christian; Roper, Timothy J

    2013-11-01

    Good decision making is important for the survival and fitness of stakeholders, but decisions usually involve uncertainty and conflict. We know surprisingly little about profitable decision-making strategies in conflict situations. On the one hand, sharing decisions with others can pool information and decrease uncertainty (swarm intelligence). On the other hand, sharing decisions can hand influence to individuals whose goals conflict. Thus, when should an animal share decisions with others? Using a theoretical model, we show that, contrary to intuition, decision sharing by animals with conflicting goals often increases individual gains as well as decision accuracy. Thus, conflict-far from hampering effective decision making-can improve decision outcomes for all stakeholders, as long as they share large-scale goals. In contrast, decisions shared by animals without conflict were often surprisingly poor. The underlying mechanism is that animals with conflicting goals are less correlated in individual choice errors. These results provide a strong argument in the interest of all stakeholders for not excluding other (e.g., minority) factions from collective decisions. The observed benefits of including diverse factions among the decision makers could also be relevant to human collective decision making.

  11. [Factors influencing nurses' clinical decision making--focusing on critical thinking disposition].

    PubMed

    Park, Seungmi; Kwon, In Gak

    2007-10-01

    The purpose of this study was to investigate the factors influencing nurses' clinical decision making focusing on critical thinking disposition. The subjects of this study consisted of 505 nurses working at one of the general hospitals located in Seoul. Data was collected by a self-administered questionnaire between December 2006 and January 2007. Data was analyzed by one way ANOVA, Pearson correlation coefficients, and stepwise multiple regression using SPSS Win 14.0. The mean scores of critical thinking disposition and clinical decision making were 99.10 and 134.32 respectively. Clinical decision making scores were significantly higher in groups under continuing education, with a master or higher degree, with clinical experience more than 5 years, or with experts. Critical thinking disposition and its subscales have a significant correlation with clinical decision making. Intellectual eagerness/curiosity, prudence, clinical experience, intellectual honesty, self-confidence, and healthy skepticism were important factors influencing clinical decision making(adjusted R(2)=33%). Results of this study suggest that various strategies such as retaining experienced nurses, encouraging them to continue with education and enhancing critical thinking disposition are warranted for development of clinical decision making.

  12. A taxonomy of decision problems on the flight deck

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith M.; Fischer, Ute; Tarrel, Richard J.

    1993-01-01

    Examining cases of real crews making decisions in full-mission simulators or through Aviation Safety Reporting System (ASRS) reports shows that there are many different types of decisions that crews must make. Features of the situation determine the type of decision that must be made. The paper identifies six types of decisions that require different types of cognitive work and are also subject to different types of error or failure. These different requirements, along with descriptions of effective crew strategies, can serve as a basis for developing training practices and for evaluating crews.

  13. Cost effectiveness of molecular profiling for adjuvant decision making in patients with node-negative breast cancer.

    PubMed

    Bonastre, Julia; Marguet, Sophie; Lueza, Beranger; Michiels, Stefan; Delaloge, Suzette; Saghatchian, Mahasti

    2014-11-01

    To conduct an economic evaluation of the 70-gene signature used to guide adjuvant chemotherapy decision making both in patients with node-negative breast cancer (NNBC) and in the subgroup of estrogen receptor (ER) -positive patients. We used a mixed approach combining patient-level data from a multicenter validation study of the 70-gene signature (untreated patients) and secondary sources for chemotherapy efficacy, unit costs, and utility values. Three strategies on which to base the decision to administer adjuvant chemotherapy were compared: the 70-gene signature, Adjuvant! Online, and chemotherapy in all patients. In the base-case analysis, costs from the French National Insurance Scheme, life-years (LYs), and quality-adjusted life-years (QALYs) were computed for the three strategies over a 10-year period. Cost-effectiveness acceptability curves using the net monetary benefit were computed, combining bootstrap and probabilistic sensitivity analyses. The mean differences in LYs and QALYs were similar between the three strategies. The 70-gene signature strategy was associated with a higher cost, with a mean difference of €2,037 (range, €1,472 to €2,515) compared with Adjuvant! Online and of €657 (95% CI, -€642 to €3,130) compared with systematic chemotherapy. For a €50,000 per QALY willingness-to-pay threshold, the probability of being the most cost-effective strategy was 92% (76% in ER-positive patients) for the Adjuvant! Online strategy, 6% (4% in ER-positive patients) for the systematic chemotherapy strategy, and 2% (20% in ER-positive patients) for the 70-gene strategy. Optimizing adjuvant chemotherapy decision making based on the 70-gene signature is unlikely to be cost effective in patients with NNBC. © 2014 by American Society of Clinical Oncology.

  14. 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

  15. Age differences in experiential and deliberative processes in unambiguous and ambiguous decision making.

    PubMed

    Huang, Yumi H; Wood, Stacey; Berger, Dale E; Hanoch, Yaniv

    2015-09-01

    Older adults experience declines in deliberative decisional capacities, while their affective or experiential abilities tend to remain intact (Peters & Bruine de Bruin, 2012). The current study used this framework to investigate age differences in description-based and experience-based decision-making tasks. Description-based tasks emphasize deliberative processing by allowing decision makers to analyze explicit descriptions of choice-reward information. Experience-based tasks emphasize affective or experiential processing because they lack the explicit choice-reward information, forcing decision makers to rely on feelings and information derived from past experiences. This study used the Columbia Card Task (CCT) as a description-based task where probability information is provided and the Iowa Gambling Task (IGT) as an experience-based task, where it is not. As predicted, compared to younger adults (N = 65), older adults (N = 65) performed more poorly on the CCT but performed similarly on the IGT. Deliberative capacities (i.e., executive control and numeracy abilities) explained the relationship between age and performance on the CCT, suggesting that age-related differences in description-based decision-making tasks are related to declines in deliberative capacities. However, deliberative capacities were not associated with performance on the IGT for either older or younger adults. Nevertheless, on the IGT, older adults reported more use of affect-based strategies versus deliberative strategies, whereas younger adults reported similar use of these strategies. This finding offers partial support for the idea that decision-making tasks that rely on deliberate processing are more likely to demonstrate age effects than those that are more experiential. (c) 2015 APA, all rights reserved).

  16. Stasis Theory as a Strategy for Workplace Teaming and Decision Making

    ERIC Educational Resources Information Center

    Brizee, H. Allen

    2008-01-01

    Current scholarship tells us that skills in teaming are essential for students and practitioners of professional communication. Writers must be able to cooperate with subject-matter experts and team members to make effective decisions and complete projects. Scholarship also suggests that rapid changes in technology and changes in teaming processes…

  17. Assessing Students' Performances in Decision-Making: Coping Strategies of Biology Teachers

    ERIC Educational Resources Information Center

    Steffen, Benjamin; Hößle, Corinna

    2017-01-01

    Decision-making in socioscientific issues (SSI) constitutes a real challenge for both biology teachers and learners. The assessment of students' performances in SSIs constitutes a problem, especially for biology teachers. The study at hand was conducted in Germany and uses a qualitative approach following the research procedures of grounded theory…

  18. Regulatory Fit and Systematic Exploration in a Dynamic Decision-Making Environment

    ERIC Educational Resources Information Center

    Otto, A. Ross; Markman, Arthur B.; Gureckis, Todd M.; Love, Bradley C.

    2010-01-01

    This work explores the influence of motivation on choice behavior in a dynamic decision-making environment, where the payoffs from each choice depend on one's recent choice history. Previous research reveals that participants in a regulatory fit exhibit increased levels of exploratory choice and flexible use of multiple strategies over the course…

  19. The neural correlates of risky decision making across short and long runs

    PubMed Central

    Rao, Li-Lin; Dunn, John C.; Zhou, Yuan; Li, Shu

    2015-01-01

    People frequently change their preferences for options of gambles which they play once compared to those they play multiple times. In general, preferences for repeated play gambles are more consistent with the expected values of the options. According to the one-process view, the change in preference is due to a change in the structure of the gamble that is relevant to decision making. According to the two-process view, the change is attributable to a shift in the decision making strategy that is used. To adjudicate between these two theories, we asked participants to choose between gambles played once or 100 times, and to choose between them based on their expected value. Consistent with the two-process theory, we found a set of brain regions that were sensitive to the extent of behavioral change between single and aggregated play and also showed significant (de)activation in the expected value choice task. These results support the view that people change their decision making strategies for risky choice considered once or multiple times. PMID:26516095

  20. Patient Decision Control and the Use of Cardiac Catheterization

    PubMed Central

    Paasche-Orlow, Michael K.; Orner, Michelle B.; Stewart, Sabrina K.; Kressin, Nancy R.

    2015-01-01

    Background: Shared decision-making is a key determinant of patient-centered care. A lack of patient involvement in treatment decisions may explain persistent racial disparities in rates of cardiac catheterization (CCATH). To date, limited evidence exists to demonstrate whether patients who engage in shared decision-makingare more or less likely to undergo non-emergency CCATH. Objective: To assess the relationship between participation in the decision to undergo a CCATH and the use of CCATH. We also examined whether preference for or actual engagement in decision-making varied by patient race. Methods: We analyzed data from 826 male Veterans Administration patients for whom CCATH was indicated and who participated in the Cardiac Decision Making Study. Results: After controlling for confounders, patients reporting any degree of decision control were more likely to receive CCATH compared with those reporting no control (doctor made decision without patient input) (54% vs 39%, P<.0001). Across racial groups, patients were equally likely to report a preference for control over decision-making (P=.53) as well as to experience discordance between their preference for control and their perception of the actual decision-making process (P=.59). Therefore, these factors did not mediate racial disparities in rates of CCATH use. Conclusion: Shared decision-making is an essential feature of whole-person care. While participation in decision-making may not explain disparities in CCATH rates, further work is required to identify strategies to improve congruence between patients' desire for and actual control over decision-making to actualize patient-centered care. PMID:26331101

  1. The left inferior frontal gyrus is involved in adjusting response bias during a perceptual decision-making task

    PubMed Central

    Reckless, Greg E; Ousdal, Olga T; Server, Andres; Walter, Henrik; Andreassen, Ole A; Jensen, Jimmy

    2014-01-01

    Introduction Changing the way we make decisions from one environment to another allows us to maintain optimal decision-making. One way decision-making may change is how biased one is toward one option or another. Identifying the regions of the brain that underlie the change in bias will allow for a better understanding of flexible decision-making. Methods An event-related, perceptual decision-making task where participants had to detect a picture of an animal amongst distractors was used during functional magnetic resonance imaging. Positive and negative financial motivation were used to affect a change in response bias, and changes in decision-making behavior were quantified using signal detection theory. Results Response bias became relatively more liberal during both positive and negative motivated trials compared to neutral trials. For both motivational conditions, the larger the liberal shift in bias, the greater the left inferior frontal gyrus (IFG) activity. There was no relationship between individuals' belief that they used a different strategy and their actual change in response bias. Conclusions The present findings suggest that the left IFG plays a role in adjusting response bias across different decision environments. This suggests a potential role for the left IFG in flexible decision-making. PMID:24944869

  2. Changing hospitals, choosing chemotherapy and deciding you've made the right choice: Understanding the role of online support groups in different health decision-making activities.

    PubMed

    Sillence, Elizabeth; Bussey, Lauren

    2017-05-01

    To investigate the ways in which people use online support groups (OSGs) in relation to their health decision-making and to identify the key features of the resource that support those activities. Eighteen participants who used OSGs for a range of health conditions participated in qualitative study in which they were interviewed about their experiences of using OSGs in relation to decision-making. Exploration of their experiences was supported by discussion of illustrative quotes. Across the health conditions OSGs supported two main decision-making activities: (i) prompting decision making and (ii) evaluating and confirming decisions already made. Depending on the activity, participants valued information about the process, the experience and the outcome of patient narratives. The importance of forum interactivity was highlighted in relation to advice-seeking and the selection of relevant personal experiences. People use OSGs in different ways to support their health related decision-making valuing the different content types of the narratives and the interactivity provided by the resource. Engaging with OSGs helps people in a number of different ways in relation to decision-making. However, it only forms one part of people's decision-making strategies and appropriate resources should be signposted where possible. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Algorithms for optimizing the treatment of depression: making the right decision at the right time.

    PubMed

    Adli, M; Rush, A J; Möller, H-J; Bauer, M

    2003-11-01

    Medication algorithms for the treatment of depression are designed to optimize both treatment implementation and the appropriateness of treatment strategies. Thus, they are essential tools for treating and avoiding refractory depression. Treatment algorithms are explicit treatment protocols that provide specific therapeutic pathways and decision-making tools at critical decision points throughout the treatment process. The present article provides an overview of major projects of algorithm research in the field of antidepressant therapy. The Berlin Algorithm Project and the Texas Medication Algorithm Project (TMAP) compare algorithm-guided treatments with treatment as usual. The Sequenced Treatment Alternatives to Relieve Depression Project (STAR*D) compares different treatment strategies in treatment-resistant patients.

  4. A mechanism for value-sensitive decision-making.

    PubMed

    Pais, Darren; Hogan, Patrick M; Schlegel, Thomas; Franks, Nigel R; Leonard, Naomi E; Marshall, James A R

    2013-01-01

    We present a dynamical systems analysis of a decision-making mechanism inspired by collective choice in house-hunting honeybee swarms, revealing the crucial role of cross-inhibitory 'stop-signalling' in improving the decision-making capabilities. We show that strength of cross-inhibition is a decision-parameter influencing how decisions depend both on the difference in value and on the mean value of the alternatives; this is in contrast to many previous mechanistic models of decision-making, which are typically sensitive to decision accuracy rather than the value of the option chosen. The strength of cross-inhibition determines when deadlock over similarly valued alternatives is maintained or broken, as a function of the mean value; thus, changes in cross-inhibition strength allow adaptive time-dependent decision-making strategies. Cross-inhibition also tunes the minimum difference between alternatives required for reliable discrimination, in a manner similar to Weber's law of just-noticeable difference. Finally, cross-inhibition tunes the speed-accuracy trade-off realised when differences in the values of the alternatives are sufficiently large to matter. We propose that the model, and the significant role of the values of the alternatives, may describe other decision-making systems, including intracellular regulatory circuits, and simple neural circuits, and may provide guidance in the design of decision-making algorithms for artificial systems, particularly those functioning without centralised control.

  5. 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.

  6. Case Method Strategies for Teaching Sexual Ethics to Relativists and Skeptics

    ERIC Educational Resources Information Center

    Vacek, Edward

    2017-01-01

    Many undergraduates are culturally shaped to avoid making ethical judgments. They spontaneously adopt relativist and skeptical strategies such as "It all depends," or "Whose morality?" or "Who's to say?" as ways of fending off the challenge of making moral decisions. The current tsunami that is washing away…

  7. From policy to patients and back: surgical treatment decision making for patients with breast cancer.

    PubMed

    Katz, Steven J; Hawley, Sarah T

    2007-01-01

    Persistent use of mastectomy for breast cancer has motivated concerns about overtreatment by surgeons and lack of patient involvement in decisions. However, recent studies suggest that patients perceive substantial involvement and that some patients prefer more invasive surgery, while other research suggests that surgical treatment choices might be poorly informed. Decision-making quality can be improved by increasing patients' knowledge about treatments' risks and benefits and by optimizing their involvement. The mastectomy story underscores the limitations of utilization measures as quality indicators. Strategies to improve patient outcomes should focus on tools to improve the quality of decision making and innovations in multispecialty practice.

  8. 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

  9. Helping patients make better decisions: how to apply behavioral economics in clinical practice

    PubMed Central

    Courtney, Maureen Reni; Spivey, Christy; Daniel, Kathy M

    2014-01-01

    Clinicians are committed to effectively educating patients and helping them to make sound decisions concerning their own health care. However, how do clinicians determine what is effective education? How do they present information clearly and in a manner that patients understand and can use to make informed decisions? Behavioral economics (BE) is a subfield of economics that can assist clinicians to better understand how individuals actually make decisions. BE research can help guide interactions with patients so that information is presented and discussed in a more deliberate and impactful way. We can be more effective providers of care when we understand the factors that influence how our patients make decisions, factors of which we may have been largely unaware. BE research that focuses on health care and medical decision making is becoming more widely known, and what has been reported suggests that BE interventions can be effective in the medical realm. The purpose of this article is to provide clinicians with an overview of BE decision science and derived practice strategies to promote more effective behavior change in patients. PMID:25378915

  10. The Implementation and Evaluation of the Patient Admission Prediction Tool: Assessing Its Impact on Decision-Making Strategies and Patient Flow Outcomes in 2 Australian Hospitals.

    PubMed

    Crilly, Julia L; Boyle, Justin; Jessup, Melanie; Wallis, Marianne; Lind, James; Green, David; FitzGerald, Gerry

    2015-01-01

    To evaluate the implementation of a Patient Admission Prediction Tool (PAPT) in terms of patient flow outcomes and decision-making strategies. The PAPT was implemented in 2 Australian public teaching hospitals during October-December 2010 (hospital A) and October-December 2011 (hospital B). A multisite prospective, comparative (before and after) design was used. Patient flow outcomes measured included access block and hospital occupancy. Daily and weekly data were collected from patient flow reports and routinely collected emergency department information by the site champion and researchers. Daily decision-making strategies ranged from business as usual to use of overcensus beds. Weekly strategies included advanced approval to use of overcensus beds and prebooking nursing staff. These strategies resulted in improved weekend discharges to manage incoming demand for the following week. Following the introduction of the PAPT and workflow guidelines, patient access and hospital occupancy levels could be maintained despite increases in patient presentations (hospital A). The use of a PAPT, embedded in patient flow management processes and championed by a manager, can benefit bed and staff management. Further research that incorporates wider evaluation of the use of the tool at other sites is warranted.

  11. The science of medical decision making: neurosurgery, errors, and personal cognitive strategies for improving quality of care.

    PubMed

    Fargen, Kyle M; Friedman, William A

    2014-01-01

    During the last 2 decades, there has been a shift in the U.S. health care system towards improving the quality of health care provided by enhancing patient safety and reducing medical errors. Unfortunately, surgical complications, patient harm events, and malpractice claims remain common in the field of neurosurgery. Many of these events are potentially avoidable. There are an increasing number of publications in the medical literature in which authors address cognitive errors in diagnosis and treatment and strategies for reducing such errors, but these are for the most part absent in the neurosurgical literature. The purpose of this article is to highlight the complexities of medical decision making to a neurosurgical audience, with the hope of providing insight into the biases that lead us towards error and strategies to overcome our innate cognitive deficiencies. To accomplish this goal, we review the current literature on medical errors and just culture, explain the dual process theory of cognition, identify common cognitive errors affecting neurosurgeons in practice, review cognitive debiasing strategies, and finally provide simple methods that can be easily assimilated into neurosurgical practice to improve clinical decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning.

    PubMed

    Williams, Charlene R; McLaughlin, Jacqueline E; Cox, Wendy C; Shepherd, Greene

    2016-09-25

    Objective. To determine if student pharmacists' preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection.

  13. Who Chokes Under Pressure? The Big Five Personality Traits and Decision-Making under Pressure.

    PubMed

    Byrne, Kaileigh A; Silasi-Mansat, Crina D; Worthy, Darrell A

    2015-02-01

    The purpose of the present study was to examine whether the Big Five personality factors could predict who thrives or chokes under pressure during decision-making. The effects of the Big Five personality factors on decision-making ability and performance under social (Experiment 1) and combined social and time pressure (Experiment 2) were examined using the Big Five Personality Inventory and a dynamic decision-making task that required participants to learn an optimal strategy. In Experiment 1, a hierarchical multiple regression analysis showed an interaction between neuroticism and pressure condition. Neuroticism negatively predicted performance under social pressure, but did not affect decision-making under low pressure. Additionally, the negative effect of neuroticism under pressure was replicated using a combined social and time pressure manipulation in Experiment 2. These results support distraction theory whereby pressure taxes highly neurotic individuals' cognitive resources, leading to sub-optimal performance. Agreeableness also negatively predicted performance in both experiments.

  14. Relationship between Student Pharmacist Decision Making Preferences and Experiential Learning

    PubMed Central

    McLaughlin, Jacqueline E.; Cox, Wendy C.; Shepherd, Greene

    2016-01-01

    Objective. To determine if student pharmacists’ preferences towards experiential and rational thinking are associated with performance on advanced pharmacy practice experiences (APPEs) and whether thinking style preference changes following APPEs. Methods. The Rational Experiential Inventory (REI), a validated survey of thinking style, was administered to student pharmacists before starting APPEs and re-administered after completing APPEs. APPE grades were compared to initial REI scores. Results. Rational Experiential Inventory scores remained consistent before and after APPEs. Overall, APPE grades were independent of REI scores. In a regression model, the REI experiential score was a significant negative predictor of hospital APPE grades. Conclusion. These findings suggest that overall APPE performance is independent of decision-making preference, and decision-making style does not change following immersion into APPEs. Instead of targeting teaching strategies towards a specific decision-making style, preceptors may use pedagogical approaches that promote sound clinical decision-making skills through critical thinking and reflection. PMID:27756927

  15. Primary care professional's perspectives on treatment decision making for depression with African Americans and Latinos in primary care practice.

    PubMed

    Patel, Sapana R; Schnall, Rebecca; Little, Virna; Lewis-Fernández, Roberto; Pincus, Harold Alan

    2014-12-01

    Increasing interest has been shown in shared decision making (SDM) to improve mental health care communication between underserved immigrant minorities and their providers. Nonetheless, very little is known about this process. The following is a qualitative study of fifteen primary care providers at two Federally Qualified Health Centers in New York and their experience during depression treatment decision making. Respondents described a process characterized in between shared and paternalistic models of treatment decision making. Barriers to SDM included discordant models of illness, stigma, varying role expectations and decision readiness. Respondents reported strategies used to overcome barriers including understanding illness perceptions and the role of the community in the treatment process, dispelling stigma using cultural terms, orienting patients to treatment and remaining available regarding the treatment decision. Findings from this study have implications for planning SDM interventions to guide primary care providers through treatment engagement for depression.

  16. Acting Irrationally to Improve Performance in Stochastic Worlds

    NASA Astrophysics Data System (ADS)

    Belavkin, Roman V.

    Despite many theories and algorithms for decision-making, after estimating the utility function the choice is usually made by maximising its expected value (the max EU principle). This traditional and 'rational' conclusion of the decision-making process is compared in this paper with several 'irrational' techniques that make choice in Monte-Carlo fashion. The comparison is made by evaluating the performance of simple decision-theoretic agents in stochastic environments. It is shown that not only the random choice strategies can achieve performance comparable to the max EU method, but under certain conditions the Monte-Carlo choice methods perform almost two times better than the max EU. The paper concludes by quoting evidence from recent cognitive modelling works as well as the famous decision-making paradoxes.

  17. Neural Signatures of Rational and Heuristic Choice Strategies: A Single Trial ERP Analysis.

    PubMed

    Wichary, Szymon; Magnuski, Mikołaj; Oleksy, Tomasz; Brzezicka, Aneta

    2017-01-01

    In multi-attribute choice, people use heuristics to simplify decision problems. We studied the use of heuristic and rational strategies and their electrophysiological correlates. Since previous work linked the P3 ERP component to attention and decision making, we were interested whether the amplitude of this component is associated with decision strategy use. To this end, we recorded EEG when participants performed a two-alternative choice task, where they could acquire decision cues in a sequential manner and use them to make choices. We classified participants' choices as consistent with a rational Weighted Additive rule (WADD) or a simple heuristic Take The Best (TTB). Participants differed in their preference for WADD and TTB. Using a permutation-based single trial approach, we analyzed EEG responses to consecutive decision cues and their relation to the individual strategy preference. The preference for WADD over TTB was associated with overall higher signal amplitudes to decision cues in the P3 time window. Moreover, the preference for WADD was associated with similar P3 amplitudes to consecutive cues, whereas the preference for TTB was associated with substantial decreases in P3 amplitudes to consecutive cues. We also found that the preference for TTB was associated with enhanced N1 component to cues that discriminated decision alternatives, suggesting very early attention allocation to such cues by TTB users. Our results suggest that preference for either WADD or TTB has an early neural signature reflecting differences in attentional weighting of decision cues. In light of recent findings and hypotheses regarding P3, we interpret these results as indicating the involvement of catecholamine arousal systems in shaping predecisional information processing and strategy selection.

  18. Neural Signatures of Rational and Heuristic Choice Strategies: A Single Trial ERP Analysis

    PubMed Central

    Wichary, Szymon; Magnuski, Mikołaj; Oleksy, Tomasz; Brzezicka, Aneta

    2017-01-01

    In multi-attribute choice, people use heuristics to simplify decision problems. We studied the use of heuristic and rational strategies and their electrophysiological correlates. Since previous work linked the P3 ERP component to attention and decision making, we were interested whether the amplitude of this component is associated with decision strategy use. To this end, we recorded EEG when participants performed a two-alternative choice task, where they could acquire decision cues in a sequential manner and use them to make choices. We classified participants’ choices as consistent with a rational Weighted Additive rule (WADD) or a simple heuristic Take The Best (TTB). Participants differed in their preference for WADD and TTB. Using a permutation-based single trial approach, we analyzed EEG responses to consecutive decision cues and their relation to the individual strategy preference. The preference for WADD over TTB was associated with overall higher signal amplitudes to decision cues in the P3 time window. Moreover, the preference for WADD was associated with similar P3 amplitudes to consecutive cues, whereas the preference for TTB was associated with substantial decreases in P3 amplitudes to consecutive cues. We also found that the preference for TTB was associated with enhanced N1 component to cues that discriminated decision alternatives, suggesting very early attention allocation to such cues by TTB users. Our results suggest that preference for either WADD or TTB has an early neural signature reflecting differences in attentional weighting of decision cues. In light of recent findings and hypotheses regarding P3, we interpret these results as indicating the involvement of catecholamine arousal systems in shaping predecisional information processing and strategy selection. PMID:28867996

  19. The effect of subjective awareness measures on performance in artificial grammar learning task.

    PubMed

    Ivanchei, Ivan I; Moroshkina, Nadezhda V

    2018-01-01

    Systematic research into implicit learning requires well-developed awareness-measurement techniques. Recently, trial-by-trial measures have been widely used. However, they can increase complexity of a study because they are an additional experimental variable. We tested the effects of these measures on performance in artificial grammar learning study. Four groups of participants were assigned to different awareness measures conditions: confidence ratings, post-decision wagering, decision strategy attribution or none. Decision-strategy-attribution participants demonstrated better grammar learning and longer response times compared to controls. They also exhibited a conservative bias. Grammaticality by itself was a stronger predictor of strings endorsement in decision-strategy-attribution group compared to other groups. Confidence ratings and post-decision wagering only affected the response times. These results were supported by an additional experiment that used a balanced chunk strength design. We conclude that a decision-strategy-attribution procedure may force participants to adopt an analytical decision-making strategy and rely mostly on conscious knowledge of artificial grammar. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science.

    PubMed

    Kim, Hyejin; Song, Mi-Kyung

    2018-01-01

    Adults who lack decision-making capacity and a surrogate ("unbefriended" adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Six electronic databases were searched using 4 keywords: "unbefriended," "unrepresented patients," "adult orphans," and "incapacitated patients without surrogates." After screening, the final sample included 10 data-based articles for synthesis. Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.

  1. Simply criminal: predicting burglars' occupancy decisions with a simple heuristic.

    PubMed

    Snook, Brent; Dhami, Mandeep K; Kavanagh, Jennifer M

    2011-08-01

    Rational choice theories of criminal decision making assume that offenders weight and integrate multiple cues when making decisions (i.e., are compensatory). We tested this assumption by comparing how well a compensatory strategy called Franklin's Rule captured burglars' decision policies regarding residence occupancy compared to a non-compensatory strategy (i.e., Matching Heuristic). Forty burglars each decided on the occupancy of 20 randomly selected photographs of residences (for which actual occupancy was known when the photo was taken). Participants also provided open-ended reports on the cues that influenced their decisions in each case, and then rated the importance of eight cues (e.g., deadbolt visible) over all decisions. Burglars predicted occupancy beyond chance levels. The Matching Heuristic was a significantly better predictor of burglars' decisions than Franklin's Rule, and cue use in the Matching Heuristic better corresponded to the cue ecological validities in the environment than cue use in Franklin's Rule. The most important cue in burglars' models was also the most ecologically valid or predictive of actual occupancy (i.e., vehicle present). The majority of burglars correctly identified the most important cue in their models, and the open-ended technique showed greater correspondence between self-reported and captured cue use than the rating over decision technique. Our findings support a limited rationality perspective to understanding criminal decision making, and have implications for crime prevention.

  2. Decision-making in diabetes mellitus type 1.

    PubMed

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

    2013-01-01

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

  3. Factors influencing women's perceptions of shared decision making during labor and delivery: Results from a large-scale cohort study of first childbirth.

    PubMed

    Attanasio, Laura B; Kozhimannil, Katy B; Kjerulff, Kristen H

    2018-06-01

    To examine correlates of shared decision making during labor and delivery. Data were from a cohort of women who gave birth to their first baby in Pennsylvania, 2009-2011 (N = 3006). We used logistic regression models to examine the association between labor induction and mode of delivery in relation to women's perceptions of shared decision making, and to investigate race/ethnicity and SES as potential moderators. Women who were Black and who did not have a college degree or private insurance were less likely to report high shared decision making, as well as women who underwent labor induction, instrumental vaginal or cesarean delivery. Models with interaction terms showed that the reduction in odds of shared decision making associated with cesarean delivery was greater for Black women than for White women. Women in marginalized social groups were less likely to report shared decision making during birth and Black women who delivered by cesarean had particularly low odds of shared decision making. Strategies designed to improve the quality of patient-provider communication, information sharing, and shared decision making must be attentive to the needs of vulnerable groups to ensure that such interventions reduce rather than widen disparities. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. THE FUTURE OF SUSTAINABLE MANAGEMENT APPROACHES AND REVITALIZATION TOOLS-ELECTRONIC (SMARTE): 2006-2010

    EPA Science Inventory

    SMARTe is being developed to give stakeholders information resources, analytical tools, communication strategies, and a decision analysis approach to be able to make better decisions regarding future uses of property. The development of the communication tools and decision analys...

  5. 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

  6. 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.

  7. Students' Use of Decision-Making Strategies with Regard to Socioscientific Issues: An Application of the Rasch Partial Credit Model

    ERIC Educational Resources Information Center

    Eggert, Sabina; Bogeholz, Susanne

    2010-01-01

    Decision making about socioscientific issues is an important aspect of modern science education worldwide. Among the many topics that represent socioscientific issues, issues relating to the sustainable development of our environment are one crucial topic. However, difficulties exist with respect to the assessment of teaching outcomes related to…

  8. An Examination of the Decision-Making Processes Used by Superintendents in Reducing School District Budgets

    ERIC Educational Resources Information Center

    Slaven, Lori A.

    2014-01-01

    Purpose: The purpose of this study was to determine the degree of importance of Harvey et al.'s (1997) 13 problem-solving strategies for making retrenchment decisions on school district budgets as perceived by California superintendents of medium-sized school districts. Methodology: The subjects in the present study were 86 superintendents of…

  9. Enhancing Students' Aeronautical Decision-Making through Scaffolding Strategies for Higher Order Thinking

    ERIC Educational Resources Information Center

    Murray, Rita Marie

    2012-01-01

    Over the last few decades, classroom training in aviation education has continued mostly unchanged. It remains a highly structured presentation of information in a lecture format. The purpose of this study was to determine the effect of a method of teaching aeronautical decision making in aviation education based on integrated and scaffolded…

  10. Public Marketing: An Alternative Policy Decision-Making Idea for Small Cities. Community Development Research Series.

    ERIC Educational Resources Information Center

    Meyers, James; And Others

    The concept of public marketing presents a strategy for the systems approach to community development that would facilitate the community decision making process via improved communication. Basic aspects of the social marketing process include: (1) product policy; (2) channels of distribution; (3) pricing (perceived price vs quality and quantity…

  11. Risky Business: An Integrated Institutional Theory for Understanding High-Risk Decision Making in Higher Education

    ERIC Educational Resources Information Center

    Turner, Lauren A.; Angulo, A. J.

    2018-01-01

    Lauren A. Turner and A. J. Angulo explore how institutional theory can be applied to explain variance in higher education organizational strategies. Given strong regulatory, normative, and cultural-cognitive pressures to conform, they ask, why do some colleges engage in high-risk decision making? To answer this, they bring together classic and…

  12. Development of risk-based air quality management strategies under impacts of climate change.

    PubMed

    Liao, Kuo-Jen; Amar, Praveen; Tagaris, Efthimios; Russell, Armistead G

    2012-05-01

    Climate change is forecast to adversely affect air quality through perturbations in meteorological conditions, photochemical reactions, and precursor emissions. To protect the environment and human health from air pollution, there is an increasing recognition of the necessity of developing effective air quality management strategies under the impacts of climate change. This paper presents a framework for developing risk-based air quality management strategies that can help policy makers improve their decision-making processes in response to current and future climate change about 30-50 years from now. Development of air quality management strategies under the impacts of climate change is fundamentally a risk assessment and risk management process involving four steps: (1) assessment of the impacts of climate change and associated uncertainties; (2) determination of air quality targets; (3) selections of potential air quality management options; and (4) identification of preferred air quality management strategies that minimize control costs, maximize benefits, or limit the adverse effects of climate change on air quality when considering the scarcity of resources. The main challenge relates to the level of uncertainties associated with climate change forecasts and advancements in future control measures, since they will significantly affect the risk assessment results and development of effective air quality management plans. The concept presented in this paper can help decision makers make appropriate responses to climate change, since it provides an integrated approach for climate risk assessment and management when developing air quality management strategies. Development of climate-responsive air quality management strategies is fundamentally a risk assessment and risk management process. The risk assessment process includes quantification of climate change impacts on air quality and associated uncertainties. Risk management for air quality under the impacts of climate change includes determination of air quality targets, selections of potential management options, and identification of effective air quality management strategies through decision-making models. The risk-based decision-making framework can also be applied to develop climate-responsive management strategies for the other environmental dimensions and assess costs and benefits of future environmental management policies.

  13. Physician Approaches to Conflict with Families Surrounding End-of-Life Decision-making in the Intensive Care Unit. A Qualitative Study.

    PubMed

    Mehter, Hashim M; McCannon, Jessica B; Clark, Jack A; Wiener, Renda Soylemez

    2018-02-01

    Families of critically ill patients are often asked to make difficult decisions to pursue, withhold, or withdraw aggressive care or resuscitative measures, exercising "substituted judgment" from the imagined standpoint of the patient. Conflict may arise between intensive care unit (ICU) physicians and family members regarding the optimal course of care. To characterize how ICU physicians approach and manage conflict with surrogates regarding end-of-life decision-making. Semistructured interviews were conducted with 18 critical care physicians from four academically affiliated hospitals. Interview transcripts were analyzed using methods of grounded theory. Physicians described strategies for engaging families to resolve conflict about end-of-life decision-making and tending to families' emotional health. Physicians commonly began by gauging family receptiveness to recommendations from the healthcare team. When faced with resistance to recommendations for less aggressive care, approaches ranged from deference to family wishes to various persuasive strategies designed to change families' minds, and some of those strategies may be counterproductive or harmful. The likelihood of deferring to family in the event of conflict was associated with the perceived sincerity of the family's "substituted judgment" and the ability to control patient pain and suffering. Physicians reported concern for the family's emotional needs and made efforts to alleviate the burden on families by assuming decision-making responsibility and expressing nonabandonment and commitment to the patient. Physicians were attentive to repairing damage to their relationship with the family in the aftermath of conflict. Finally, physicians described their own emotional responses to conflict, ranging from frustration and anxiety to satisfaction with successful resolution of conflict. Critical care physicians described a complex and multilayered approach to physician-family conflict. The reported strategies offer insight into pragmatic approaches to achieving resolution of conflict while attending to both family and physician emotional impact, and they also highlight some potentially unhelpful or harmful behaviors that should be avoided. Further research is needed to evaluate how these strategies are perceived by families and other ICU clinicians and how they affect patient, family, and clinician outcomes.

  14. Fostering Synergies Among Organizations to put Climate in Context for Use in Decision Making

    NASA Astrophysics Data System (ADS)

    Garfin, G. M.; Parris, A.; Dow, K.; Meyer, R.; Close, S.

    2016-12-01

    Making science usable for decision making requires a knowledge of the social and institutional contexts of decision making, an ability to develop or tap into networks for sharing information and developing knowledge, a capacity for innovating or providing services, and a program for social learning to inform decisions and improve the processes of engagement and collaboration (i.e., mechanisms for feedback, evaluation, and changes in policy or practices). Active participation by and partnerships between researchers, practitioners, and decision-makers provides a foundation for making progress in each of the aforementioned areas of endeavor. In twenty years of incubating experimental climate services, the NOAA Regional Integrated Sciences and Assessments program offers not a few ideas and examples of practices to foster synergies among organizations, that result in tangible benefits to decision-makers. Strategies include (a) designing explicit mutual learning through temporary institutions, such as workshop series, in order to develop social capital and knowledge networks (e.g., to co-develop and disseminate experimental forecasts); (b) articulating ground rules, roles, and responsibilities in managing the boundary between scientists and practitioners (e.g., in multi-partner climate adaptation planning processes); and (c) cross-training between scientists and practitioners, by embedding team members in other organizations or recruiting members from those organizations (e.g., Cooperative Extension). A promising strategy is boundary chaining, pioneered by the Great Lakes Integrated Sciences and Assessments, in which science information and service providers partner with other boundary organizations, to leverage networks, expertise, resources, and to reduce transaction costs. Partners with complementary strengths and roles can then, work iteratively and synergize to mediate the co-production of a combination of services for decision making, such as data and information, facilitation, and evaluation.

  15. Smart strategies for doctors and doctors-in-training: heuristics in medicine.

    PubMed

    Wegwarth, Odette; Gaissmaier, Wolfgang; Gigerenzer, Gerd

    2009-08-01

    How do doctors make sound decisions when confronted with probabilistic data, time pressures and a heavy workload? One theory that has been embraced by many researchers is based on optimisation, which emphasises the need to integrate all information in order to arrive at sound decisions. This notion makes heuristics, which use less than complete information, appear as second-best strategies. In this article, we challenge this pessimistic view of heuristics. We introduce two medical problems that involve decision making to the reader: one concerns coronary care issues and the other macrolide prescriptions. In both settings, decision-making tools grounded in the principles of optimisation and heuristics, respectively, have been developed to assist doctors in making decisions. We explain the structure of each of these tools and compare their performance in terms of their facilitation of correct predictions. For decisions concerning both the coronary care unit and the prescribing of macrolides, we demonstrate that sacrificing information does not necessarily imply a forfeiting of predictive accuracy, but can sometimes even lead to better decisions. Subsequently, we discuss common misconceptions about heuristics and explain when and why ignoring parts of the available information can lead to the making of more robust predictions. Heuristics are neither good nor bad per se, but, if applied in situations to which they have been adapted, can be helpful companions for doctors and doctors-in-training. This, however, requires that heuristics in medicine be openly discussed, criticised, refined and then taught to doctors-in-training rather than being simply dismissed as harmful or irrelevant. A more uniform use of explicit and accepted heuristics has the potential to reduce variations in diagnoses and to improve medical care for patients.

  16. Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making.

    PubMed

    Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O

    2016-10-07

    Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs. Copyright © 2016 by the American Society of Nephrology.

  17. Reappraising the ultimatum: an fMRI study of emotion regulation and decision making.

    PubMed

    Grecucci, Alessandro; Giorgetta, Cinzia; Van't Wout, Mascha; Bonini, Nicolao; Sanfey, Alan G

    2013-02-01

    Emotion regulation strategies provide a means by which to modulate our social behavior. In this study, we investigated the effect of using reappraisal to both up- and downregulate social decision making. After being instructed on how to use reappraisal, participants played the Ultimatum Game while undergoing functional magnetic resonance imaging and applied the strategies of upregulation (reappraising the proposer's intentions as more negative), down-regulation (reappraising the proposer's intentions as less negative), as well as a baseline "look" condition. As hypothesized, when reappraising, decision acceptance rates were altered, with a greater number of unfair offers accepted while down-regulating and a greater number of unfair offers rejected while upregulating, both relative to the baseline condition. At the neural level, during reappraisal, significant activations were observed in the inferior and middle frontal gyrus (MFG), in addition to the medial prefrontal cortex and cingulate gyrus for unfair offers only. Regulated decisions involved left inferior frontal gyrus for upregulation and MFG for down-regulation strategies, respectively. Importantly, the effects of emotion modulation were evident in posterior insula, with less activation for down-regulation and more activation for upregulation in these areas. Notably, we show for the first time that top-down strategies such as reappraisal strongly affect our socioeconomic decisions.

  18. Stop wasting valuable time.

    PubMed

    Mankins, Michael C

    2004-09-01

    Companies routinely squander their most precious resource--the time of their top executives. In the typical company, senior executives meet to discuss strategy for only three hours a month. And that time is poorly spent in diffuse discussions never even meant to result in any decision. The price of misused executive time is high. Delayed strategic decisions lead to overlooked waste and high costs, harmful cost reductions, missed new product and business development opportunities, and poor long-term investments. But a few deceptively simple changes in the way top management teams set agendas and structure team meetings can make an enormous difference in their effectiveness. Efficient companies use seven techniques to make the most of the time their top executives spend together. They keep strategy meetings separate from meetings focused on operations. They explore issues through written communications before they meet, so that meeting time is used solely for reaching decisions. In setting agendas, they rank the importance of each item according to its potential to create value for the company. They seek to get issues not only on, but also off, the agenda quickly, keeping to a clear implementation timetable. They make sure they have considered all viable alternatives before deciding a course of action. They use a common language and methodology for reaching decisions. And they insist that, once a decision is made, they stick to it--that there be no more debate or mere grudging compliance. Once leadership teams get the basics right, they can make more fundamental changes in the way they work together. Strategy making can be transformed from a series of fragmented and unproductive events into a streamlined, effective, and continuing management dialogue. In companies that have done this, management meetings aren't a necessary evil; they're a source of real competitive advantage.

  19. People adopt optimal policies in simple decision-making, after practice and guidance.

    PubMed

    Evans, Nathan J; Brown, Scott D

    2017-04-01

    Organisms making repeated simple decisions are faced with a tradeoff between urgent and cautious strategies. While animals can adopt a statistically optimal policy for this tradeoff, findings about human decision-makers have been mixed. Some studies have shown that people can optimize this "speed-accuracy tradeoff", while others have identified a systematic bias towards excessive caution. These issues have driven theoretical development and spurred debate about the nature of human decision-making. We investigated a potential resolution to the debate, based on two factors that routinely differ between human and animal studies of decision-making: the effects of practice, and of longer-term feedback. Our study replicated the finding that most people, by default, are overly cautious. When given both practice and detailed feedback, people moved rapidly towards the optimal policy, with many participants reaching optimality with less than 1 h of practice. Our findings have theoretical implications for cognitive and neural models of simple decision-making, as well as methodological implications.

  20. The Role of Intuition in Risk/Benefit Decision-Making in Human Subjects Research

    PubMed Central

    Resnik, David B.

    2016-01-01

    One of the key principles of ethical research involving human subjects is that the risks of research to should be acceptable in relation to expected benefits. Institutional review board (IRB) members often rely on intuition to make risk/benefit decisions concerning proposed human studies. Some have objected to using intuition to make these decisions because intuition is unreliable and biased and lacks transparency. In this paper, I examine the role of intuition in IRB risk/benefit decision-making and argue that there are practical and philosophical limits to our ability to reduce our reliance on intuition in this process. The fact that IRB risk/benefit decision-making involves intuition need not imply that it is hopelessly subjective or biased, however, since there are strategies that IRBs can employ to improve their decisions, such as using empirical data to estimate the probability of potential harms and benefits, developing classification systems to guide the evaluation of harms and benefits, and engaging in moral reasoning concerning the acceptability of risks. PMID:27294429

  1. The rational choice model in family decision making at the end of life.

    PubMed

    Karasz, Alison; Sacajiu, Galit; Kogan, Misha; Watkins, Liza

    2010-01-01

    Most end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient's wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families. Researchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques. For both staff and families, consideration of a patient's best interests generally took priority over the patient's wishes. Staff generally introduced discussion of the patient's wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients' autonomy and "right to choose," played a role in family decision making. The priority given to the patients' wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care.

  2. The Role of Intuition in Risk/Benefit Decision-Making in Human Subjects Research.

    PubMed

    Resnik, David B

    2017-01-01

    One of the key principles of ethical research involving human subjects is that the risks of research to should be acceptable in relation to expected benefits. Institutional review board (IRB) members often rely on intuition to make risk/benefit decisions concerning proposed human studies. Some have objected to using intuition to make these decisions because intuition is unreliable and biased and lacks transparency. In this article, I examine the role of intuition in IRB risk/benefit decision-making and argue that there are practical and philosophical limits to our ability to reduce our reliance on intuition in this process. The fact that IRB risk/benefit decision-making involves intuition need not imply that it is hopelessly subjective or biased, however, since there are strategies that IRBs can employ to improve their decisions, such as using empirical data to estimate the probability of potential harms and benefits, developing classification systems to guide the evaluation of harms and benefits, and engaging in moral reasoning concerning the acceptability of risks.

  3. Affective influences on partner choice: role of mood in social decisions.

    PubMed

    Forgas, J P

    1991-11-01

    Does mood influence our information search and decision strategies when choosing a partner? In Experiment 1 (N = 60), sad Ss preferred rewarding to competent partners and remembered information supporting that choice better. In Experiment 2 (N = 96), mood effects on information selectivity, decision speed, and processing strategy in partner choices were found. In Experiment 3 (N = 42), a computerized stimulus presentation revealed mood-induced differences in the latency, self-exposure, and eventual recall of interpersonal information. These results are interpreted as evidence for mood-induced selectivity in information search and decision strategies when making realistic partner choices. The implications of the findings for research on interpersonal relations and for contemporary affect-cognition theories are considered.

  4. Breast Conservation Therapy Versus Mastectomy: Shared Decision-Making Strategies and Overcoming Decisional Conflicts in Your Patients.

    PubMed

    Margenthaler, Julie A; Ollila, David W

    2016-10-01

    Although breast-conserving therapy is considered the preferred treatment for the majority of women with early-stage breast cancer, mastectomy rates in this group remain high. The patient, physician, and systems factors contributing to a decision for mastectomy are complicated. Understanding the individual patient's values and goals when making this decision is paramount to providing a shared decision-making process that will yield the desired outcome. The cornerstones of this discussion include education of the patient, access to decision-aid tools, and time to make an informed decision. However, it is also paramount for the physician to understand that a significant majority of women with an informed and complete understanding of their surgical choices will still prefer mastectomy. The rates of breast conservation versus mastectomy should not be considered a quality measure alone. Rather, the extent by which patients are informed, involved in decision-making, and undergoing treatments that reflect their goals is the true test of quality. Here we explore some of the factors that impact the patient preference for breast conservation versus mastectomy and how shared decision-making can be maximized for patient satisfaction.

  5. Real estate strategies for 2005.

    PubMed

    Dunbar, Donald R

    2005-05-01

    Today's healthcare real estate strategies involve: assessing and prioritizing capital availability for building projects, carefully planning and implementing the process for the project Making beneficial decisions regarding facility management and maintenance.

  6. Multiple stakeholders in multi-criteria decision-making in the context of Municipal Solid Waste Management: A review

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

    Soltani, Atousa; Hewage, Kasun; Reza, Bahareh

    2015-01-15

    Highlights: • We review Municipal Solid Waste Management studies with focus on multiple stakeholders. • We focus on studies with multi-criteria decision analysis methods and discover their trends. • Most studies do not offer solutions for situations where stakeholders compete for more benefits or have unequal voting powers. • Governments and experts are the most participated stakeholders and AHP is the most dominant method. - Abstract: Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, andmore » finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies.« less

  7. Modeling Search Behaviors during the Acquisition of Expertise in a Sequential Decision-Making Task.

    PubMed

    Moënne-Loccoz, Cristóbal; Vergara, Rodrigo C; López, Vladimir; Mery, Domingo; Cosmelli, Diego

    2017-01-01

    Our daily interaction with the world is plagued of situations in which we develop expertise through self-motivated repetition of the same task. In many of these interactions, and especially when dealing with computer and machine interfaces, we must deal with sequences of decisions and actions. For instance, when drawing cash from an ATM machine, choices are presented in a step-by-step fashion and a specific sequence of choices must be performed in order to produce the expected outcome. But, as we become experts in the use of such interfaces, is it possible to identify specific search and learning strategies? And if so, can we use this information to predict future actions? In addition to better understanding the cognitive processes underlying sequential decision making, this could allow building adaptive interfaces that can facilitate interaction at different moments of the learning curve. Here we tackle the question of modeling sequential decision-making behavior in a simple human-computer interface that instantiates a 4-level binary decision tree (BDT) task. We record behavioral data from voluntary participants while they attempt to solve the task. Using a Hidden Markov Model-based approach that capitalizes on the hierarchical structure of behavior, we then model their performance during the interaction. Our results show that partitioning the problem space into a small set of hierarchically related stereotyped strategies can potentially capture a host of individual decision making policies. This allows us to follow how participants learn and develop expertise in the use of the interface. Moreover, using a Mixture of Experts based on these stereotyped strategies, the model is able to predict the behavior of participants that master the task.

  8. 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.

  9. How Qualitative Research Informs Clinical and Policy Decision Making in Transplantation: A Review.

    PubMed

    Tong, Allison; Morton, Rachael L; Webster, Angela C

    2016-09-01

    Patient-centered care is no longer just a buzzword. It is now widely touted as a cornerstone in delivering quality care across all fields of medicine. However, patient-centered strategies and interventions necessitate evidence about patients' decision-making processes, values, priorities, and needs. Qualitative research is particularly well suited to understanding the experience and perspective of patients, donors, clinicians, and policy makers on a wide range of transplantation-related topics including organ donation and allocation, adherence to prescribed therapy, pretransplant and posttransplant care, implementation of clinical guidelines, and doctor-patient communication. In transplantation, evidence derived from qualitative research has been integrated into strategies for shared decision-making, patient educational resources, process evaluations of trials, clinical guidelines, and policies. The aim of this article is to outline key concepts and methods used in qualitative research, guide the appraisal of qualitative studies, and assist clinicians to understand how qualitative research may inform their practice and policy.

  10. The influence of emotion regulation on social interactive decision-making.

    PubMed

    van't Wout, Mascha; Chang, Luke J; Sanfey, Alan G

    2010-12-01

    Although adequate emotion regulation is considered to be essential in every day life, it is especially important in social interactions. However, the question as to what extent two different regulation strategies are effective in changing decision-making in a consequential socially interactive context remains unanswered. We investigated the effect of expressive suppression and emotional reappraisal on strategic decision-making in a social interactive task, that is, the Ultimatum Game. As hypothesized, participants in the emotional reappraisal condition accepted unfair offers more often than participants in the suppression and no-regulation condition. Additionally, the effect of emotional reappraisal influenced the amount of money participants proposed during a second interaction with partners that had treated them unfairly in a previous interaction. These results support and extend previous findings that emotional reappraisal as compared to expressive suppression, is a powerful regulation strategy that influences and changes how we interact with others even in the face of inequity.

  11. The influence of emotion regulation on social interactive decision-making

    PubMed Central

    van ’t Wout, Mascha; Chang, Luke J.; Sanfey, Alan G.

    2010-01-01

    Although adequate emotion regulation is considered to be essential in every day life, it is especially important in social interactions. However, the question as to what extent two different regulation strategies are effective in changing decision-making in a consequential socially interactive context remains unanswered. We investigated the effect of expressive suppression and emotional reappraisal on strategic decision-making in a social interactive task, i.e. the Ultimatum Game. As hypothesized, participants in the emotional reappraisal condition accepted unfair offers more often than participants in the suppression and no-regulation condition. Additionally, the effect of emotional reappraisal influenced the amount of money participants proposed during a second interaction with partners that had treated them unfairly in a previous interaction. These results support and extend previous findings that emotional reappraisal as compared to expressive suppression, is a powerful regulation strategy that influences and changes how we interact with others even in the face of inequity. PMID:21171756

  12. Lived Religion as Reproductive Decision-Making Resource Among Romanian Women Who Use Abortion as Contraception.

    PubMed

    Pop, Cristina A

    2017-05-30

    This article draws upon qualitative ethnographic data collected between 2005 and 2013 in southern Romania among women who have been consistently using abortion as a contraceptive method. It particularly considers the role that lived religion might have played in some individuals' strategies to render abortion a justifiable practice. Over the last seven decades, Romanian women's experiences of abortion have often been at odds with both secular and religious regulations. This study shifts the perspective from the biopolitics and the bioethics of abortion toward women's own reproductive decision-making strategies in a context of enduring traditional patriarchy. It explores the fluid and pragmatic ways in which some Romanians use the notions of "God's will," "sin," "redemption," "afterlife," and "Godparenting" to redefine abortion as a partially disembodied reproductive event. As a reproductive decision-making resource, lived religion empowers women to navigate the lived complexities of conception and contraception.

  13. 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

  14. 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.

  15. Intelligent support of e-management for consumer-focused virtual enterprises

    NASA Astrophysics Data System (ADS)

    Chandra, Charu; Smirnov, Alexander V.

    2000-10-01

    The interest in consumer-focused virtual enterprises (VE) decision-making problem is growing fast. The purpose of this type of enterprise is to transform incomplete information about customer orders and available resources into-co-ordinated plans for production and replenishment of goods and services in the temporal network formed by collaborating units. This implies that information in the consumer-focused VE can be shared via Internet, Intranet, and Extranet for business-to-consumer (B2C), business-to-business service (B2B-S), and business-to-business goods (B2B-G) transactions. One of the goals of Internet-Based Management (e-management) is to facilitate transfer and sharing of data and knowledge in the context of enterprise collaboration. This paper discusses a generic framework of e-management that integrates intelligent information support group-decision making, and agreement modeling for a VE network. It offers the platform for design and modeling of diverse implementation strategies related to the type of agreement, optimization policies, decision-making strategies, organization structures, and information sharing strategies and mechanisms, and business policies for the VE.

  16. 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.

  17. 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.

  18. Ecological models supporting environmental decision making: a strategy for the future

    USGS Publications Warehouse

    Schmolke, Amelie; Thorbek, Pernille; DeAngelis, Donald L.; Grimm, Volker

    2010-01-01

    Ecological models are important for environmental decision support because they allow the consequences of alternative policies and management scenarios to be explored. However, current modeling practice is unsatisfactory. A literature review shows that the elements of good modeling practice have long been identified but are widely ignored. The reasons for this might include lack of involvement of decision makers, lack of incentives for modelers to follow good practice, and the use of inconsistent terminologies. As a strategy for the future, we propose a standard format for documenting models and their analyses: transparent and comprehensive ecological modeling (TRACE) documentation. This standard format will disclose all parts of the modeling process to scrutiny and make modeling itself more efficient and coherent.

  19. Age and self-relevance effects on information search during decision making.

    PubMed

    Hess, Thomas M; Queen, Tara L; Ennis, Gilda E

    2013-09-01

    We investigated how information search strategies used to support decision making were influenced by self-related implications of the task to the individual. Consistent with the notion of selective engagement, we hypothesized that increased self-relevance would result in more adaptive search behaviors and that this effect would be stronger in older adults than in younger adults. We examined search behaviors in 79 younger and 81 older adults using a process-tracing procedure with 2 different decision tasks. The impact of motivation (i.e., self-related task implications) was examined by manipulating social accountability and the age-related relevance of the task. Although age differences in search strategies were not great, older adults were more likely than younger adults to use simpler strategies in contexts with minimal self-implications. Contrary to expectations, young and old alike were more likely to use noncompensatory than compensatory strategies, even when engaged in systematic search, with education being the most important determinant of search behavior. The results support the notion that older adults are adaptive decision makers and that factors other than age may be more important determinants of performance in situations where knowledge can be used to support performance.

  20. Evaluative methodology for prioritizing transportation energy conservation strategies

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

    Pang, L.M.G.

    An analytical methodology was developed for the purpose of prioritizing a set of transportation energy conservation (TEC) strategies within an urban environment. Steps involved in applying the methodology consist of 1) defining the goals, objectives and constraints of the given urban community, 2) identifying potential TEC strategies, 3) assessing the impact of the strategies, 4) applying the TEC evaluation model, and 5) utilizing a selection process to determine the optimal set of strategies for implementation. This research provides an overview of 21 TEC strategies, a quick-response technique for estimating energy savings, a multiattribute utility theory approach for assessing subjective impacts,more » and a computer program for making the strategy evaluations, all of which assist in expediting the execution of the entire methodology procedure. The critical element of the methodology is the strategy evaluation model which incorporates a number of desirable concepts including 1) a comprehensive accounting of all relevant impacts, 2) the application of multiobjective decision-making techniques, 3) an approach to assure compatibilty among quantitative and qualitative impact measures, 4) the inclusion of the decision maker's preferences in the evaluation procedure, and 5) the cost-effectiveness concept. Application of the methodolgy to Salt Lake City, Utah demonstrated its utility, ease of use and favorability by decision makers.« less

  1. Decision-making in product portfolios of pharmaceutical research and development – managing streams of innovation in highly regulated markets

    PubMed Central

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success. PMID:25364229

  2. Decision-making in product portfolios of pharmaceutical research and development--managing streams of innovation in highly regulated markets.

    PubMed

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success.

  3. The School Psychologist as a Facilitator of Parent Involvement in Decisions Concerning Their Children. An Overview.

    ERIC Educational Resources Information Center

    Lapides, Joseph

    Factors influencing decision making are reviewed, and strategies which a school psychologist can use to increase parent involvement in decisions about their handicapped children are delineated. It is explained that four types of interventions are effective in promoting parental involvement: decision counseling, the balance sheet schema to help…

  4. Discovering Decision Knowledge from Web Log Portfolio for Managing Classroom Processes by Applying Decision Tree and Data Cube Technology.

    ERIC Educational Resources Information Center

    Chen, Gwo-Dong; Liu, Chen-Chung; Ou, Kuo-Liang; Liu, Baw-Jhiune

    2000-01-01

    Discusses the use of Web logs to record student behavior that can assist teachers in assessing performance and making curriculum decisions for distance learning students who are using Web-based learning systems. Adopts decision tree and data cube information processing methodologies for developing more effective pedagogical strategies. (LRW)

  5. Cognitive Processes in Decisions Under Risk are not the Same as in Decisions Under Uncertainty

    PubMed Central

    Volz, Kirsten G.; Gigerenzer, Gerd

    2012-01-01

    We deal with risk versus uncertainty, a distinction that is of fundamental importance for cognitive neuroscience yet largely neglected. In a world of risk (“small world”), all alternatives, consequences, and probabilities are known. In uncertain (“large”) worlds, some of this information is unknown or unknowable. Most of cognitive neuroscience studies exclusively study the neural correlates for decisions under risk (e.g., lotteries), with the tacit implication that understanding these would lead to an understanding of decision making in general. First, we show that normative strategies for decisions under risk do not generalize to uncertain worlds, where simple heuristics are often the more accurate strategies. Second, we argue that the cognitive processes for making decisions in a world of risk are not the same as those for dealing with uncertainty. Because situations with known risks are the exception rather than the rule in human evolution, it is unlikely that our brains are adapted to them. We therefore suggest a paradigm shift toward studying decision processes in uncertain worlds and provide first examples. PMID:22807893

  6. Modelling risk aversion to support decision-making for controlling zoonotic livestock diseases.

    PubMed

    van Asseldonk, M A P M; Bergevoet, R H M; Ge, L

    2013-12-01

    Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the non-monetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decision-making. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey.

  7. Systematic behavior research for understanding consumer decision making.

    PubMed

    Lin, Chin-Feng

    2009-05-01

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

  8. 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.

  9. Dynamics of Sequential Decision Making

    NASA Astrophysics Data System (ADS)

    Rabinovich, Mikhail I.; Huerta, Ramón; Afraimovich, Valentin

    2006-11-01

    We suggest a new paradigm for intelligent decision-making suitable for dynamical sequential activity of animals or artificial autonomous devices that depends on the characteristics of the internal and external world. To do it we introduce a new class of dynamical models that are described by ordinary differential equations with a finite number of possibilities at the decision points, and also include rules solving this uncertainty. Our approach is based on the competition between possible cognitive states using their stable transient dynamics. The model controls the order of choosing successive steps of a sequential activity according to the environment and decision-making criteria. Two strategies (high-risk and risk-aversion conditions) that move the system out of an erratic environment are analyzed.

  10. From information processing to decisions: Formalizing and comparing psychologically plausible choice models.

    PubMed

    Heck, Daniel W; Hilbig, Benjamin E; Moshagen, Morten

    2017-08-01

    Decision strategies explain how people integrate multiple sources of information to make probabilistic inferences. In the past decade, increasingly sophisticated methods have been developed to determine which strategy explains decision behavior best. We extend these efforts to test psychologically more plausible models (i.e., strategies), including a new, probabilistic version of the take-the-best (TTB) heuristic that implements a rank order of error probabilities based on sequential processing. Within a coherent statistical framework, deterministic and probabilistic versions of TTB and other strategies can directly be compared using model selection by minimum description length or the Bayes factor. In an experiment with inferences from given information, only three of 104 participants were best described by the psychologically plausible, probabilistic version of TTB. Similar as in previous studies, most participants were classified as users of weighted-additive, a strategy that integrates all available information and approximates rational decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

    PubMed Central

    Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

    2017-01-01

    Background: Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods: The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results: The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion: This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care) perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability. PMID:29179292

  12. Do Not Fear Your Opponent: Suboptimal Changes of a Prevention Strategy when Facing Stronger Opponents

    ERIC Educational Resources Information Center

    Slezak, Diego Fernandez; Sigman, Mariano

    2012-01-01

    The time spent making a decision and its quality define a widely studied trade-off. Some models suggest that the time spent is set to optimize reward, as verified empirically in simple-decision making experiments. However, in a more complex perspective compromising components of regulation focus, ambitions, fear, risk and social variables,…

  13. The Values of College Students in Business Simulation Game: A Means-End Chain Approach

    ERIC Educational Resources Information Center

    Lin, Yu-Ling; Tu, Yu-Zu

    2012-01-01

    Business simulation games (BSGs) enable students to practice making decisions in a virtual environment, accumulate experience in application of strategies, and train themselves in modes of decision-making. This study examines the value sought by players of BSG. In this study, a means-end chain (MEC) model was adopted as the basis, and ladder…

  14. The Impact of Cooperative Learning on Developing the Sixth Grade Students Decision-Making Skill and Academic Achievement

    ERIC Educational Resources Information Center

    Asha, Intisar K.; Al Hawi, Asma M.

    2016-01-01

    This study aimed at investigating the effect of cooperative learning on developing the sixth graders' decision making skill and their academic achievement. The study sample, which was selected randomly, consisted of (46) students and divided into two groups: the experimental group that taught using the cooperative learning strategy and the control…

  15. How Will I Know What My Students Need? Preparing Preservice Teachers to Use Running Records to Make Instructional Decisions

    ERIC Educational Resources Information Center

    Gillett, Erin; Ellingson, Susan Pierson

    2017-01-01

    Effective teachers use assessment data to make instructional decisions. One of the most informative techniques to assess young learners' reading progress in the primary grades is the running record. Running records provide concrete evidence of students' skills, reading levels, strategies, and progress as readers. The data gathered help teachers…

  16. Evaluating a Teaching Module on Ethically Responsible Evidence-Based Practice Decision Making in an Advanced Micro Practice Course

    ERIC Educational Resources Information Center

    Wong, Rose

    2017-01-01

    This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and…

  17. Creating a System for Data-Driven Decision-Making: Applying the Principal-Agent Framework

    ERIC Educational Resources Information Center

    Wohlstetter, Priscilla; Datnow, Amanda; Park, Vicki

    2008-01-01

    The purpose of this article is to improve our understanding of data-driven decision-making strategies that are initiated at the district or system level. We apply principal-agent theory to the analysis of qualitative data gathered in a case study of 4 urban school systems. Our findings suggest educators at the school level need not only systemic…

  18. Negative outcomes evoke cyclic irrational decisions in Rock, Paper, Scissors.

    PubMed

    Dyson, Benjamin James; Wilbiks, Jonathan Michael Paul; Sandhu, Raj; Papanicolaou, Georgios; Lintag, Jaimie

    2016-02-04

    Rock, Paper, Scissors (RPS) represents a unique gaming space in which the predictions of human rational decision-making can be compared with actual performance. Playing a computerized opponent adopting a mixed-strategy equilibrium, participants revealed a non-significant tendency to over-select Rock. Further violations of rational decision-making were observed using an inter-trial analysis where participants were more likely to switch their item selection at trial n + 1 following a loss or draw at trial n, revealing the strategic vulnerability of individuals following the experience of negative rather than positive outcome. Unique switch strategies related to each of these trial n outcomes were also identified: after losing participants were more likely to 'downgrade' their item (e.g., Rock followed by Scissors) but after drawing participants were more likely to 'upgrade' their item (e.g., Rock followed by Paper). Further repetition analysis revealed that participants were more likely to continue their specific cyclic item change strategy into trial n + 2. The data reveal the strategic vulnerability of individuals following the experience of negative rather than positive outcome, the tensions between behavioural and cognitive influences on decision making, and underline the dangers of increased behavioural predictability in other recursive, non-cooperative environments such as economics and politics.

  19. Decision making under ambiguity and under risk in mesial temporal lobe epilepsy.

    PubMed

    Delazer, Margarete; Zamarian, Laura; Bonatti, Elisabeth; Kuchukhidze, Giorgi; Koppelstätter, Florian; Bodner, Thomas; Benke, Thomas; Trinka, Eugen

    2010-01-01

    Decision making is essential in everyday life. Though the importance of the mesial temporal lobe in emotional processing and feedback learning is generally recognized, decision making in mesial temporal lobe epilepsy (mTLE) is almost unexplored so far. Twenty-eight consecutive epilepsy patients with drug resistant mTLE and fifty healthy controls performed decision tasks under initial ambiguity (participants have to learn by feedback to make advantageous decisions) and under risk (advantageous choices may be made by estimating risks and by rational strategies). A subgroup analysis compared the performance of patients affected by MRI-verified abnormalities of the hippocampus or amygdala. The effect of lesion side was also assessed. In decision under ambiguity, mTLE patients showed marked deficits and did not improve over the task. Patients with hippocampus abnormality and patients with amygdala abnormality showed comparable deficits. No difference was found between right and left TLE groups. In decision under risk, mTLE patients performed at the same level as controls. Results suggest that mTLE patients have difficulties in learning from feedback and in making decisions in uncertain, ambiguous situations. By contrast, they are able to make advantageous decisions when full information is given and risks, possible gains and losses are exactly defined.

  20. 'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making.

    PubMed

    Cleary, Michelle; Raeburn, Toby; Escott, Phil; West, Sancia; Lopez, Violeta

    2018-05-09

    In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care. © 2018 Australian College of Mental Health Nurses Inc.

  1. Distance-Based and Distributed Learning: A Decision Tool for Education Leaders.

    ERIC Educational Resources Information Center

    McGraw, Tammy M.; Ross, John D.

    This decision tool presents a progression of data collection and decision-making strategies that can increase the effectiveness of distance-based or distributed learning instruction. A narrative and flow chart cover the following steps: (1) basic assumptions, including purpose of instruction, market scan, and financial resources; (2) needs…

  2. The effect of four user interface concepts on visual scan pattern similarity and information foraging in a complex decision making task.

    PubMed

    Starke, Sandra D; Baber, Chris

    2018-07-01

    User interface (UI) design can affect the quality of decision making, where decisions based on digitally presented content are commonly informed by visually sampling information through eye movements. Analysis of the resulting scan patterns - the order in which people visually attend to different regions of interest (ROIs) - gives an insight into information foraging strategies. In this study, we quantified scan pattern characteristics for participants engaging with conceptually different user interface designs. Four interfaces were modified along two dimensions relating to effort in accessing information: data presentation (either alpha-numerical data or colour blocks), and information access time (all information sources readily available or sequential revealing of information required). The aim of the study was to investigate whether a) people develop repeatable scan patterns and b) different UI concepts affect information foraging and task performance. Thirty-two participants (eight for each UI concept) were given the task to correctly classify 100 credit card transactions as normal or fraudulent based on nine transaction attributes. Attributes varied in their usefulness of predicting the correct outcome. Conventional and more recent (network analysis- and bioinformatics-based) eye tracking metrics were used to quantify visual search. Empirical findings were evaluated in context of random data and possible accuracy for theoretical decision making strategies. Results showed short repeating sequence fragments within longer scan patterns across participants and conditions, comprising a systematic and a random search component. The UI design concept showing alpha-numerical data in full view resulted in most complete data foraging, while the design concept showing colour blocks in full view resulted in the fastest task completion time. Decision accuracy was not significantly affected by UI design. Theoretical calculations showed that the difference in achievable accuracy between very complex and simple decision making strategies was small. We conclude that goal-directed search of familiar information results in repeatable scan pattern fragments (often corresponding to information sources considered particularly important), but no repeatable complete scan pattern. The underlying concept of the UI affects how visual search is performed, and a decision making strategy develops. This should be taken in consideration when designing for applied domains. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Individual responsibility as ground for priority setting in shared decision-making.

    PubMed

    Sandman, Lars; Gustavsson, Erik; Munthe, Christian

    2016-10-01

    Given healthcare resource constraints, voices are being raised to hold patients responsible for their health choices. In parallel, there is a growing trend towards shared decision-making, aiming to empower patients and give them more control over healthcare decisions. More power and control over decisions is usually taken to mean more responsibility for them. The trend of shared decision-making would therefore seem to strengthen the case for invoking individual responsibility in the healthcare priority setting. To analyse whether the implementation of shared decision-making would strengthen the argument for invoking individual responsibility in the healthcare priority setting using normative analysis. Shared decision-making does not constitute an independent argument in favour of employing individual responsibility since these notions rest on different underlying values. However, if a health system employs shared decision-making, individual responsibility may be used to limit resource implications of accommodating patient preferences outside professional standards and goals. If a healthcare system employs individual responsibility, high level dynamic shared decision-making implying a joint deliberation resulting in a decision where both parties are willing to revise initial standpoints may disarm common objections to the applicability of individual responsibility by virtue of making patients more likely to exercise adequate control of their own actions. However, if communication strategies applied in the shared decision-making are misaligned to the patient's initial capacities, arguments against individual responsibility might, on the other hand, gain strength. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. The evolutionary roots of human decision making.

    PubMed

    Santos, Laurie R; Rosati, Alexandra G

    2015-01-03

    Humans exhibit a suite of biases when making economic decisions. We review recent research on the origins of human decision making by examining whether similar choice biases are seen in nonhuman primates, our closest phylogenetic relatives. We propose that comparative studies can provide insight into four major questions about the nature of human choice biases that cannot be addressed by studies of our species alone. First, research with other primates can address the evolution of human choice biases and identify shared versus human-unique tendencies in decision making. Second, primate studies can constrain hypotheses about the psychological mechanisms underlying such biases. Third, comparisons of closely related species can identify when distinct mechanisms underlie related biases by examining evolutionary dissociations in choice strategies. Finally, comparative work can provide insight into the biological rationality of economically irrational preferences.

  5. Jordanian Physicians' Attitudes toward Disclosure of Cancer Information and Patient Participation in Treatment Decision-making.

    PubMed

    Obeidat, Rana; Khrais, Huthaifah I

    2016-01-01

    This study aims to determine the attitude of Jordanian physicians toward disclosure of cancer information, comfort and use of different decision-making approaches, and treatment decision making. A descriptive, comparative research design was used. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons practicing mainly in oncology was recruited. A modified version of a structured questionnaire was used for data collection. The questionnaire is a valid measure of physicians' views of shared decision making. Almost 91% of all physicians indicated that the doctor should tell the patient and let him/her decide if the family should know of an early-stage cancer diagnosis. Physicians provide abundant information about the extent of the disease, the side effects and benefits of the treatment, and details of the treatment procedures. They also provided less information on the effects of treatment on the sexuality, mood, and family of the patient. Almost 48% of the participating physicians reported using shared decision making as their usual approach for treatment decision making, and 67% reported that they were comfortable with this approach. The main setting of clinical activity was the only factor associated with physicians' usual approach to medical decision making. Moreover, age, years of experience, and main setting of clinical activity were associated with physicians' comfort level with the shared approach. Although Jordanian physicians appreciate patient autonomy, self-determination, and right to information, paternalistic decision making and underuse of the shared decision-making approach persist. Strategies that target both healthcare providers and patients must be employed to promote shared decision making in the Jordanian healthcare system.

  6. Perceived Benefits and Drawbacks of Disclosure Practices: An Analysis of PLWHAs' Strategies for Disclosing HIV Status.

    PubMed

    Catona, Danielle; Greene, Kathryn; Magsamen-Conrad, Kate

    2015-01-01

    People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

  7. Shared Decision Making in Intensive Care Units: An American College of Critical Care Medicine and American Thoracic Society Policy Statement

    PubMed Central

    Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.

    2015-01-01

    Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value-laden choices range from preferring to exercise significant authority to ceding such authority to providers. Clinicians should adapt the decision-making model to the needs and preferences of the patient or surrogate. PMID:26509317

  8. Neurocognitive Development of Risk Aversion from Early Childhood to Adulthood

    PubMed Central

    Paulsen, David J.; Carter, R. McKell; Platt, Michael L.; Huettel, Scott A.; Brannon, Elizabeth M.

    2012-01-01

    Human adults tend to avoid risk. In behavioral economic studies, risk aversion is manifest as a preference for sure gains over uncertain gains. However, children tend to be less averse to risk than adults. Given that many of the brain regions supporting decision-making under risk do not reach maturity until late adolescence or beyond it is possible that mature risk-averse behavior may emerge from the development of decision-making circuitry. To explore this hypothesis, we tested 5- to 8-year-old children, 14- to 16-year-old adolescents, and young adults in a risky-decision task during functional magnetic resonance imaging (fMRI) data acquisition. To our knowledge, this is the youngest sample of children in an fMRI decision-making task. We found a number of decision-related brain regions to increase in activation with age during decision-making, including areas associated with contextual memory retrieval and the incorporation of prior outcomes into the current decision-making strategy, e.g., insula, hippocampus, and amygdala. Further, children who were more risk-averse showed increased activation during decision-making in ventromedial prefrontal cortex and ventral striatum. Our findings indicate that the emergence of adult levels of risk aversion co-occurs with the recruitment of regions supporting decision-making under risk, including the integration of prior outcomes into current decision-making behavior. This pattern of results suggests that individual differences in the development of risk aversion may reflect differences in the maturation of these neural processes. PMID:22291627

  9. Neurocognitive development of risk aversion from early childhood to adulthood.

    PubMed

    Paulsen, David J; Carter, R McKell; Platt, Michael L; Huettel, Scott A; Brannon, Elizabeth M

    2011-01-01

    Human adults tend to avoid risk. In behavioral economic studies, risk aversion is manifest as a preference for sure gains over uncertain gains. However, children tend to be less averse to risk than adults. Given that many of the brain regions supporting decision-making under risk do not reach maturity until late adolescence or beyond it is possible that mature risk-averse behavior may emerge from the development of decision-making circuitry. To explore this hypothesis, we tested 5- to 8-year-old children, 14- to 16-year-old adolescents, and young adults in a risky-decision task during functional magnetic resonance imaging (fMRI) data acquisition. To our knowledge, this is the youngest sample of children in an fMRI decision-making task. We found a number of decision-related brain regions to increase in activation with age during decision-making, including areas associated with contextual memory retrieval and the incorporation of prior outcomes into the current decision-making strategy, e.g., insula, hippocampus, and amygdala. Further, children who were more risk-averse showed increased activation during decision-making in ventromedial prefrontal cortex and ventral striatum. Our findings indicate that the emergence of adult levels of risk aversion co-occurs with the recruitment of regions supporting decision-making under risk, including the integration of prior outcomes into current decision-making behavior. This pattern of results suggests that individual differences in the development of risk aversion may reflect differences in the maturation of these neural processes.

  10. Decision curve analysis for assessing the usefulness of tests for making decisions to treat: an application to tests for prodromal psychosis.

    PubMed

    Pulleyblank, Ryan; Chuma, Jefter; Gilbody, Simon M; Thompson, Carl

    2013-09-01

    For a test to be considered useful for making treatment decisions, it is necessary that making treatment decisions based on the results of the test be a preferable strategy to making treatment decisions without the test. Decision curve analysis is a framework for assessing when a test would be expected to be useful, which integrates evidence of a test's performance characteristics (sensitivity and specificity), condition prevalence among at-risk patients, and patient preferences for treatment. We describe decision curve analysis generally and illustrate its potential through an application to tests for prodromal psychosis. Clinical psychosis is often preceded by a prodromal phase, but not all those with prodromal symptoms proceed to develop full psychosis. Patients identified as at risk for developing psychosis may be considered for proactive treatment to mitigate development of clinically defined psychosis. Tests exist to help identify those at-risk patients most likely to develop psychosis, but it is uncertain when these tests would be considered useful for making proactive treatment decisions. We apply decision curve analysis to results from a systematic review of studies investigating clinical tests for predicting the development of psychosis in at-risk populations, and present resulting decision curves that illustrate when the tests may be expected to be useful for making proactive treatment decisions.

  11. 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.

  12. An innovative approach to addressing childhood obesity: a knowledge-based infrastructure for supporting multi-stakeholder partnership decision-making in Quebec, Canada.

    PubMed

    Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L; Dubé, Laurette

    2015-01-23

    Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a "portrait", which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity.

  13. An Innovative Approach to Addressing Childhood Obesity: A Knowledge-Based Infrastructure for Supporting Multi-Stakeholder Partnership Decision-Making in Quebec, Canada

    PubMed Central

    Addy, Nii Antiaye; Shaban-Nejad, Arash; Buckeridge, David L.; Dubé, Laurette

    2015-01-01

    Multi-stakeholder partnerships (MSPs) have become a widespread means for deploying policies in a whole of society strategy to address the complex problem of childhood obesity. However, decision-making in MSPs is fraught with challenges, as decision-makers are faced with complexity, and have to reconcile disparate conceptualizations of knowledge across multiple sectors with diverse sets of indicators and data. These challenges can be addressed by supporting MSPs with innovative tools for obtaining, organizing and using data to inform decision-making. The purpose of this paper is to describe and analyze the development of a knowledge-based infrastructure to support MSP decision-making processes. The paper emerged from a study to define specifications for a knowledge-based infrastructure to provide decision support for community-level MSPs in the Canadian province of Quebec. As part of the study, a process assessment was conducted to understand the needs of communities as they collect, organize, and analyze data to make decisions about their priorities. The result of this process is a “portrait”, which is an epidemiological profile of health and nutrition in their community. Portraits inform strategic planning and development of interventions, and are used to assess the impact of interventions. Our key findings indicate ambiguities and disagreement among MSP decision-makers regarding causal relationships between actions and outcomes, and the relevant data needed for making decisions. MSP decision-makers expressed a desire for easy-to-use tools that facilitate the collection, organization, synthesis, and analysis of data, to enable decision-making in a timely manner. Findings inform conceptual modeling and ontological analysis to capture the domain knowledge and specify relationships between actions and outcomes. This modeling and analysis provide the foundation for an ontology, encoded using OWL 2 Web Ontology Language. The ontology is developed to provide semantic support for the MSP process, defining objectives, strategies, actions, indicators, and data sources. In the future, software interacting with the ontology can facilitate interactive browsing by decision-makers in the MSP in the form of concepts, instances, relationships, and axioms. Our ontology also facilitates the integration and interpretation of community data, and can help in managing semantic interoperability between different knowledge sources. Future work will focus on defining specifications for the development of a database of indicators and an information system to help decision-makers to view, analyze and organize indicators for their community. This work should improve MSP decision-making in the development of interventions to address childhood obesity. PMID:25625409

  14. Environmental Economics Research Strategy (2005)

    EPA Pesticide Factsheets

    This 2005 Environmental Economics Research Strategy outlines EPA’s research effort to provide the necessary behavioral science foundation for making decisions and designing environmental policies at the least cost to American businesses and consumers.

  15. Deep Rationality: The Evolutionary Economics of Decision Making.

    PubMed

    Kenrick, Douglas T; Griskevicius, Vladas; Sundie, Jill M; Li, Norman P; Li, Yexin Jessica; Neuberg, Steven L

    2009-10-01

    What is a "rational" decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research.

  16. Deep Rationality: The Evolutionary Economics of Decision Making

    PubMed Central

    Kenrick, Douglas T.; Griskevicius, Vladas; Sundie, Jill M.; Li, Norman P.; Li, Yexin Jessica; Neuberg, Steven L.

    2009-01-01

    What is a “rational” decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research. PMID:20686634

  17. Heuristic decision making in medicine

    PubMed Central

    Marewski, Julian N.; Gigerenzer, Gerd

    2012-01-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care. PMID:22577307

  18. Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice.

    PubMed

    Hajjaj, F M; Salek, M S; Basra, M K A; Finlay, A Y

    2010-05-01

    This article reviews an aspect of daily clinical practice which is of critical importance in virtually every clinical consultation, but which is seldom formally considered. Non-clinical influences on clinical decision-making profoundly affect medical decisions. These influences include patient-related factors such as socioeconomic status, quality of life and patient's expectations and wishes, physician-related factors such as personal characteristics and interaction with their professional community, and features of clinical practice such as private versus public practice as well as local management policies. This review brings together the different strands of knowledge concerning non-clinical influences on clinical decision-making. This aspect of decision-making may be the biggest obstacle to the reality of practising evidence-based medicine. It needs to be understood in order to develop clinical strategies that will facilitate the practice of evidence-based medicine.

  19. Heuristic decision making in medicine.

    PubMed

    Marewski, Julian N; Gigerenzer, Gerd

    2012-03-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.

  20. Women's autonomy in household decision-making: a demographic study in Nepal.

    PubMed

    Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R

    2010-07-15

    How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between women's household position and their autonomy in decision making. We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making. Women's autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in women's autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Women's increased education is positively associated with autonomy in own health care decision making (p < 0.01), however their more schooling (SLC and above) shows non-significance with other outcome measures. Interestingly, rich women are less likely to have autonomy to make decision in own healthcare. Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.

  1. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy.

  2. Essential dimensions of a marketing strategy in the hospital industry.

    PubMed

    McIlwain, T F; McCracken, M J

    1997-01-01

    This paper reviews existing literature and defines essential dimensions of a hospital's marketing strategy for each of two business strategies; using the results of a national survey, this study confirms that hospitals make different marketing decisions based on the type of business strategy adopted by the hospital.

  3. Economic considerations for social distancing and behavioral based policies during an epidemic

    PubMed Central

    Fenichel, Eli P.

    2013-01-01

    Public policies intended to induce behavioral change, specifically incentives to reduce interpersonal contacts or to “social distance,” increasingly play a prominent role in public disease response strategies as governments plan for and respond to major epidemics. I compare social distancing incentives and outcomes under decentralized, full control social planner, and constrained social planner, without health class specific control, decision making scenarios. Constrained social planner decision making, based on non-health class specific controls, can in some instances make society worse off than decentralized decision making (i.e. no intervention). The oft neglected behavior of recovered and immune individuals is important for welfare and health outcomes. PMID:23419635

  4. Development the conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation

    NASA Astrophysics Data System (ADS)

    Milana; Khan, M. K.; Munive, J. E.

    2014-07-01

    The importance of maintenance has escalated significantly by the increasing of automation in manufacturing process. This condition switches traditional maintenance perspective of inevitable cost into the business competitive driver. Consequently, maintenance strategy and operation decision needs to be synchronized to business and manufacturing concerns. This paper shows the development of conceptual design of Knowledge Based System for Integrated Maintenance Strategy and Operation (KBIMSO). The framework of KBIMSO is elaborated to show the process of how the KBIMSO works to reach the maintenance decision. By considering the multi-criteria of maintenance decision making, the KB system embedded with GAP and AHP to support integrated maintenance strategy and operation which is novel in this area. The KBIMSO is useful to review the existing maintenance system and give reasonable recommendation of maintenance decisions in respect to business and manufacturing perspective.

  5. 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.

  6. Improving decision speed, accuracy and group cohesion through early information gathering in house-hunting ants.

    PubMed

    Stroeymeyt, Nathalie; Giurfa, Martin; Franks, Nigel R

    2010-09-29

    Successful collective decision-making depends on groups of animals being able to make accurate choices while maintaining group cohesion. However, increasing accuracy and/or cohesion usually decreases decision speed and vice-versa. Such trade-offs are widespread in animal decision-making and result in various decision-making strategies that emphasize either speed or accuracy, depending on the context. Speed-accuracy trade-offs have been the object of many theoretical investigations, but these studies did not consider the possible effects of previous experience and/or knowledge of individuals on such trade-offs. In this study, we investigated how previous knowledge of their environment may affect emigration speed, nest choice and colony cohesion in emigrations of the house-hunting ant Temnothorax albipennis, a collective decision-making process subject to a classical speed-accuracy trade-off. Colonies allowed to explore a high quality nest site for one week before they were forced to emigrate found that nest and accepted it faster than emigrating naïve colonies. This resulted in increased speed in single choice emigrations and higher colony cohesion in binary choice emigrations. Additionally, colonies allowed to explore both high and low quality nest sites for one week prior to emigration remained more cohesive, made more accurate decisions and emigrated faster than emigrating naïve colonies. These results show that colonies gather and store information about available nest sites while their nest is still intact, and later retrieve and use this information when they need to emigrate. This improves colony performance. Early gathering of information for later use is therefore an effective strategy allowing T. albipennis colonies to improve simultaneously all aspects of the decision-making process--i.e. speed, accuracy and cohesion--and partly circumvent the speed-accuracy trade-off classically observed during emigrations. These findings should be taken into account in future studies on speed-accuracy trade-offs.

  7. There Are at Least Two Kinds of Probability Matching: Evidence from a Secondary Task

    ERIC Educational Resources Information Center

    Otto, A. Ross; Taylor, Eric G.; Markman, Arthur B.

    2011-01-01

    Probability matching is a suboptimal behavior that often plagues human decision-making in simple repeated choice tasks. Despite decades of research, recent studies cannot find agreement on what choice strategies lead to probability matching. We propose a solution, showing that two distinct local choice strategies--which make different demands on…

  8. Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

    PubMed Central

    Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

    2013-01-01

    Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

  9. Effectiveness of a theoretically-based judgment and decision making intervention for adolescents.

    PubMed

    Knight, Danica K; Dansereau, Donald F; Becan, Jennifer E; Rowan, Grace A; Flynn, Patrick M

    2015-05-01

    Although adolescents demonstrate capacity for rational decision making, their tendency to be impulsive, place emphasis on peers, and ignore potential consequences of their actions often translates into higher risk-taking including drug use, illegal activity, and physical harm. Problems with judgment and decision making contribute to risky behavior and are core issues for youth in treatment. Based on theoretical and empirical advances in cognitive science, the Treatment Readiness and Induction Program (TRIP) represents a curriculum-based decision making intervention that can be easily inserted into a variety of content-oriented modalities as well as administered as a separate therapeutic course. The current study examined the effectiveness of TRIP for promoting better judgment among 519 adolescents (37 % female; primarily Hispanic and Caucasian) in residential substance abuse treatment. Change over time in decision making and premeditation (i.e., thinking before acting) was compared among youth receiving standard operating practice (n = 281) versus those receiving standard practice plus TRIP (n = 238). Change in TRIP-specific content knowledge was examined among clients receiving TRIP. Premeditation improved among youth in both groups; TRIP clients showed greater improvement in decision making. TRIP clients also reported significant increases over time in self-awareness, positive-focused thinking (e.g., positive self-talk, goal setting), and recognition of the negative effects of drug use. While both genders showed significant improvement, males showed greater gains in metacognitive strategies (i.e., awareness of one's own cognitive process) and recognition of the negative effects of drug use. These results suggest that efforts to teach core thinking strategies and apply/practice them through independent intervention modules may benefit adolescents when used in conjunction with content-based programs designed to change problematic behaviors.

  10. Effectiveness of a Theoretically-Based Judgment and Decision Making Intervention for Adolescents

    PubMed Central

    Knight, Danica K.; Dansereau, Donald F.; Becan, Jennifer E.; Rowan, Grace A.; Flynn, Patrick M.

    2014-01-01

    Although adolescents demonstrate capacity for rational decision making, their tendency to be impulsive, place emphasis on peers, and ignore potential consequences of their actions often translates into higher risk-taking including drug use, illegal activity, and physical harm. Problems with judgment and decision making contribute to risky behavior and are core issues for youth in treatment. Based on theoretical and empirical advances in cognitive science, the Treatment Readiness and Induction Program (TRIP) represents a curriculum-based decision making intervention that can be easily inserted into a variety of content-oriented modalities as well as administered as a separate therapeutic course. The current study examined the effectiveness of TRIP for promoting better judgment among 519 adolescents (37% female; primarily Hispanic and Caucasian) in residential substance abuse treatment. Change over time in decision making and premeditation (i.e., thinking before acting) was compared among youth receiving standard operating practice (n = 281) versus those receiving standard practice plus TRIP (n = 238). Change in TRIP-specific content knowledge was examined among clients receiving TRIP. Premeditation improved among youth in both groups; TRIP clients showed greater improvement in decision making. TRIP clients also reported significant increases over time in self-awareness, positive-focused thinking (e.g., positive self-talk, goal setting), and recognition of the negative effects of drug use. While both genders showed significant improvement, males showed greater gains in metacognitive strategies (i.e., awareness of one’s own cognitive process) and recognition of the negative effects of drug use. These results suggest that efforts to teach core thinking strategies and apply/practice them through independent intervention modules may benefit adolescents when used in conjunction with content-based programs designed to change problematic behaviors. PMID:24760288

  11. Adult-Onset Type 1 Diabetes: A Qualitative Study of Decision-Making Needs.

    PubMed

    Jull, Janet; Witteman, Holly O; Ferne, Judi; Yoganathan, Manosila; Stacey, Dawn

    2016-04-01

    Type 1 diabetes is an autoimmune disease resulting from insulin deficiency and must be carefully managed to prevent serious health complications. Diabetes education and management strategies usually focus on meeting the decision-making needs of children and their families, but little is known about the decisional needs of people with adult-onset type 1 diabetes. The aim of this study was to explore the diabetes-related decision-making needs of people diagnosed with adult-onset type 1 diabetes. An interpretive descriptive qualitative study was conducted. Participants who self-identified as having adult-onset type 1 diabetes were interviewed using a semistructured interview guide. Transcripts were coded to identify needs, supports and barriers using thematic analysis. Participating in the study were 8 adults (2 men, 6 women), ages 33 to 57, with type 1 diabetes for durations of 1 to 20 or more years. Their decision-making needs are summarized in 6 broad themes: 1) people diagnosed with type 1 diabetes are launched into a process of decision-making; 2) being diagnosed with type 1 diabetes means you will always have to make decisions; 3) knowledge is crucial; 4) personal preferences matter; 5) support is critical for decisions about self-care in type 1 diabetes; 6) living with type 1 diabetes means making very individualized decisions about daily life. The findings describe the sudden and ubiquitous nature of type 1 diabetes decision-making and the need to tailor approaches for making care decisions in type 1 diabetes. People diagnosed with adult-onset type 1 diabetes require access to reliable information, support and opportunities for participation in decision-making. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  12. “Trying to Be a Good Parent” As Defined By Interviews With Parents Who Made Phase I, Terminal Care, and Resuscitation Decisions for Their Children

    PubMed Central

    Hinds, Pamela S.; Oakes, Linda L.; Hicks, Judy; Powell, Brent; Srivastava, Deo Kumar; Spunt, Sheri L.; Harper, JoAnn; Baker, Justin N.; West, Nancy K.; Furman, Wayne L.

    2009-01-01

    Purpose When a child's cancer progresses beyond current treatment capability, the parents are likely to participate in noncurative treatment decision making. One factor that helps parents to make these decisions and remain satisfied with them afterward is deciding as they believe a good parent would decide. Because being a good parent to a child with incurable cancer has not been formally defined, we conducted a descriptive study to develop such a definition. Methods In face-to-face interviews, 62 parents who had made one of three decisions (enrollment on a phase I study, do not resuscitate status, or terminal care) for 58 patients responded to two open-ended questions about the definition of a good parent and about how clinicians could help them fulfill this role. For semantic content analysis of the interviews, a rater panel trained in this method independently coded all responses. Inter-rater reliability was excellent. Results Among the aspects of the definition qualitatively identified were making informed, unselfish decisions in the child's best interest, remaining at the child's side, showing the child that he is cherished, teaching the child to make good decisions, advocating for the child with the staff, and promoting the child's health. We also identified 15 clinician strategies that help parents be a part of making these decisions on behalf of a child with advanced cancer. Conclusion The definition and the strategies may be used to guide clinicians in helping parents fulfill the good parent role and take comfort afterward in having acted as a good parent. PMID:19805693

  13. Mental models: an alternative evaluation of a sensemaking approach to ethics instruction.

    PubMed

    Brock, Meagan E; Vert, Andrew; Kligyte, Vykinta; Waples, Ethan P; Sevier, Sydney T; Mumford, Michael D

    2008-09-01

    In spite of the wide variety of approaches to ethics training it is still debatable which approach has the highest potential to enhance professionals' integrity. The current effort assesses a novel curriculum that focuses on metacognitive reasoning strategies researchers use when making sense of day-to-day professional practices that have ethical implications. The evaluated trainings effectiveness was assessed by examining five key sensemaking processes, such as framing, emotion regulation, forecasting, self-reflection, and information integration that experts and novices apply in ethical decision-making. Mental models of trained and untrained graduate students, as well as faculty, working in the field of physical sciences were compared using a think-aloud protocol 6 months following the ethics training. Evaluation and comparison of the mental models of participants provided further validation evidence for sensemaking training. Specifically, it was found that trained students applied metacognitive reasoning strategies learned during training in their ethical decision-making that resulted in complex mental models focused on the objective assessment of the situation. Mental models of faculty and untrained students were externally-driven with a heavy focus on autobiographical processes. The study shows that sensemaking training has a potential to induce shifts in researchers' mental models by making them more cognitively complex via the use of metacognitive reasoning strategies. Furthermore, field experts may benefit from sensemaking training to improve their ethical decision-making framework in highly complex, novel, and ambiguous situations.

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

    PubMed Central

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

    2016-01-01

    Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these “experts” were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid should function as a teaching tool, which engages the user with each choice-point in the decision making process, rather than simply providing an “answer.” Based on these findings, we offer suggestions for tools and strategies that could be deployed in the research methods classroom to facilitate and strengthen students' statistical decision making abilities. PMID:26909064

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

    PubMed

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

    2016-01-01

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

  16. A strategy for monitoring and managing declines in an amphibian community.

    PubMed

    Grant, Evan H Campbell; Zipkin, Elise F; Nichols, James D; Campbell, J Patrick

    2013-12-01

    Although many taxa have declined globally, conservation actions are inherently local. Ecosystems degrade even in protected areas, and maintaining natural systems in a desired condition may require active management. Implementing management decisions under uncertainty requires a logical and transparent process to identify objectives, develop management actions, formulate system models to link actions with objectives, monitor to reduce uncertainty and identify system state (i.e., resource condition), and determine an optimal management strategy. We applied one such structured decision-making approach that incorporates these critical elements to inform management of amphibian populations in a protected area managed by the U.S. National Park Service. Climate change is expected to affect amphibian occupancy of wetlands and to increase uncertainty in management decision making. We used the tools of structured decision making to identify short-term management solutions that incorporate our current understanding of the effect of climate change on amphibians, emphasizing how management can be undertaken even with incomplete information. Estrategia para Monitorear y Manejar Disminuciones en una Comunidad de Anfibios. © 2013 Society for Conservation Biology.

  17. Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

    PubMed

    Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

    2002-02-01

    Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

  18. 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.

  19. Physician Perspectives on Decision Making for Treatment of Pediatric Sleep-Disordered Breathing.

    PubMed

    Boss, Emily F; Links, Anne R; Saxton, Ron; Cheng, Tina L; Beach, Mary Catherine

    2017-10-01

    Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis. Physicians provided a variety of perspectives on decision making for treatment that fell into 3 overarching themes: approach to surgery and alternatives, communication and decision making with families, and sociocultural factors/barriers to care. Perspectives were moderately heterogeneous, suggesting that individual social and relational elements may significantly influence how physicians refer patients and recommend treatment, and how parents choose surgery for this prevalent condition. These findings will inform development of culturally competent communication strategies and support tools to enhance shared decision making for physicians treating children with SDB.

  20. Involvement of Family Members and Professionals in Older Women's Post-Fall Decision Making.

    PubMed

    Bergeron, Caroline D; Hilfinger Messias, DeAnne K; Friedman, Daniela B; Spencer, S Melinda; Miller, Susan C

    2018-03-01

    This exploratory, descriptive study examined involvement of family members and professionals in older women's post-fall decision making. We conducted semistructured interviews with 17 older women who had recently fallen and 11 individuals these women identified as being engaged in their post-fall decision-making processes. Qualitative data analysis involved open and axial coding and development of themes. After experiencing a fall, these older women's openness to others' opinions and advice; their assessments of types and credibility of potential information sources; and the communication practices they established with these sources influenced how they accessed, accepted, or rejected information from family members and professionals. Increased awareness of the involvement of others in post-fall decision making could enhance communication with older women who fall. Developing and implementing practical strategies to help family members and professionals initiate and engage in conversations about falls and their consequences could lead to more open decision making and improved post-fall quality of life among older women.

  1. Cancer care decision making in multidisciplinary meetings.

    PubMed

    Dew, Kevin; Stubbe, Maria; Signal, Louise; Stairmand, Jeannine; Dennett, Elizabeth; Koea, Jonathan; Simpson, Andrew; Sarfati, Diana; Cunningham, Chris; Batten, Lesley; Ellison-Loschmann, Lis; Barton, Josh; Holdaway, Maureen

    2015-03-01

    Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes. © The Author(s) 2014.

  2. Dairy cow culling strategies: making economical culling decisions.

    PubMed

    Lehenbauer, T W; Oltjen, J W

    1998-01-01

    The purpose of this report was to examine important economic elements of culling decisions, to review progress in development of culling decision support systems, and to discern some of the potentially rewarding areas for future research on culling models. Culling decisions have an important influence on the economic performance of the dairy but are often made in a nonprogrammed fashion and based partly on the intuition of the decision maker. The computer technology that is available for dairy herd management has made feasible the use of economic models to support culling decisions. Financial components--including profit, cash flow, and risk--are major economic factors affecting culling decisions. Culling strategies are further influenced by short-term fluctuations in cow numbers as well as by planned herd expansion. Changes in herd size affect the opportunity cost for postponed replacement and may alter the relevance of optimization strategies that assume a fixed herd size. Improvements in model components related to biological factors affecting future cow performance, including milk production, reproductive status, and mastitis, appear to offer the greatest economic potential for enhancing culling decision support systems. The ultimate value of any culling decision support system for developing economic culling strategies will be determined by its results under field conditions.

  3. 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.

  4. Midwives׳ decision making about transfers for 'slow' labour in rural New Zealand.

    PubMed

    Patterson, Jean; Skinner, Joan; Foureur, Maralyn

    2015-06-01

    Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour. Ethics approval was obtained from the NZ National Ethics Committee. to explore midwives׳ decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. New Zealand. 15 midwives who provided LMC services to women in their rural areas. 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman׳s preferences and the distance and time involved in the transfer. the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Health preferences and decision-making needs of disadvantaged women.

    PubMed

    Bunn, Helen; Lange, Ilta; Urrutia, Mila; Campos, Maria Sylvia; Campos, Solange; Jaimovich, Sonia; Campos, Cecilia; Jacobsen, Mary Jane; Gaboury, Isabelle

    2006-11-01

    This paper reports the results of a survey of disadvantaged women in La Pintana, a municipality of Santiago, Chile, to determine their health decision-making needs. Research is needed as there is no published community-based study focusing specifically on health decision-making needs of disadvantaged women. From April to November 1999, we conducted a cross-sectional interview survey of women registered at primary healthcare centres in La Pintana, an impoverished municipality of Santiago, Chile. The survey participants were 554 adult women over 15 years of age. Seventy-five percent reported making current health-related decisions. Types of decisions were primarily about navigation: where, when and from whom to seek care. The most common role in decision-making was sharing the decision with others, specifically husbands and other family members. Fifty-four percent experienced decisional conflict or uncertainty about options. Those reporting more manifestations of decisional conflict were more likely to lack information on available options, pros and cons of the options, and chances of benefits and harms associated with the options; they were also more likely to be unclear about what was important to them, to feel pressure from others, lack skill or ability in decision-making and be older. The most common strategies used when making all types of decisions were obtaining information on options and recommendations, and getting support from others. Participants preferred to receive information about options through counselling from their physicians, rather than nurses, from printed materials and from discussion groups of people facing the same decision. The majority of disadvantaged women were actively involved in decision-making and needed decision support to navigate the healthcare system. Nurses should play a more pivotal role in providing health decision support. This study needs to be replicated in other countries and cultural contexts.

  6. The Migration toward Ethical Decision Making as a Core Course into the B-School: Instructional Strategies and Approaches for Consideration

    ERIC Educational Resources Information Center

    Nelson, Johnathan; Smith, Lola B.; Hunt, Clifford Steven

    2014-01-01

    Many academicians are asking the following question: "Are we ill-preparing our business students if we fail to offer future business professionals the opportunity to engage in a greater understanding of the ethical decision making process?" The authors provide a current review of the literature on the state of ethics education in…

  7. Social Science and the Courts: Challenges and Strategies for Bridging Gaps between Law and Research

    ERIC Educational Resources Information Center

    Morgan, Julie Margetta; Pullin, Diana

    2010-01-01

    Social scientists collect vital information that bears on issues of education policy. When the courts are faced with an opportunity to make a decision that shapes education, judges need access to high-quality research, but they must also be convinced that it can be useful in their decision making. This article approaches the question of how social…

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

    PubMed

    Lin, Chin-Feng; Wang, Hui-Fang

    2008-12-01

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

  9. Predicting species distributions for conservation decisions

    PubMed Central

    Guisan, Antoine; Tingley, Reid; Baumgartner, John B; Naujokaitis-Lewis, Ilona; Sutcliffe, Patricia R; Tulloch, Ayesha I T; Regan, Tracey J; Brotons, Lluis; McDonald-Madden, Eve; Mantyka-Pringle, Chrystal; Martin, Tara G; Rhodes, Jonathan R; Maggini, Ramona; Setterfield, Samantha A; Elith, Jane; Schwartz, Mark W; Wintle, Brendan A; Broennimann, Olivier; Austin, Mike; Ferrier, Simon; Kearney, Michael R; Possingham, Hugh P; Buckley, Yvonne M

    2013-01-01

    Species distribution models (SDMs) are increasingly proposed to support conservation decision making. However, evidence of SDMs supporting solutions for on-ground conservation problems is still scarce in the scientific literature. Here, we show that successful examples exist but are still largely hidden in the grey literature, and thus less accessible for analysis and learning. Furthermore, the decision framework within which SDMs are used is rarely made explicit. Using case studies from biological invasions, identification of critical habitats, reserve selection and translocation of endangered species, we propose that SDMs may be tailored to suit a range of decision-making contexts when used within a structured and transparent decision-making process. To construct appropriate SDMs to more effectively guide conservation actions, modellers need to better understand the decision process, and decision makers need to provide feedback to modellers regarding the actual use of SDMs to support conservation decisions. This could be facilitated by individuals or institutions playing the role of ‘translators’ between modellers and decision makers. We encourage species distribution modellers to get involved in real decision-making processes that will benefit from their technical input; this strategy has the potential to better bridge theory and practice, and contribute to improve both scientific knowledge and conservation outcomes. PMID:24134332

  10. Knowledge Co-production Strategies for Water Resources Modeling and Decision Making

    NASA Astrophysics Data System (ADS)

    Gober, P.

    2016-12-01

    The limited impact of scientific information on policy making and climate adaptation in North America has raised awareness of the need for new modeling strategies and knowledge transfer processes. This paper outlines the rationale for a new paradigm in water resources modeling and management, using examples from the USA and Canada. Principles include anticipatory modeling, complex system dynamics, decision making under uncertainty, visualization, capacity to represent and manipulate critical trade-offs, stakeholder engagement, local knowledge, context-specific activities, social learning, vulnerability analysis, iterative and collaborative modeling, and the concept of a boundary organization. In this framework, scientists and stakeholders are partners in the production and dissemination of knowledge for decision making, and local knowledge is fused with scientific observation and methodology. Discussion draws from experience in building long-term collaborative boundary organizations in Phoenix, Arizona in the USA and the Saskatchewan River Basin (SRB) in Canada. Examples of boundary spanning activities include the use of visualization, the concept of a decision theater, infrastructure to support social learning, social networks, and reciprocity, simulation modeling to explore "what if" scenarios of the future, surveys to elicit how water problems are framed by scientists and stakeholders, and humanistic activities (theatrical performances, art exhibitions, etc.) to draw attention to local water issues. The social processes surrounding model development and dissemination are at least as important as modeling assumptions, procedures, and results in determining whether scientific knowledge will be used effectively for water resources decision making.

  11. Strategic self-regulation, decision-making and emotion processing in poly-substance abusers in their first year of abstinence.

    PubMed

    Verdejo-García, Antonio; Rivas-Pérez, Cristina; Vilar-López, Raquel; Pérez-García, Miguel

    2007-01-12

    Individuals with substance dependence (ISD) frequently show signs of impaired emotion processing, self-regulation and decision-making, even after prolonged abstinence from drug use and partial recovery of other neuropsychological functions. These impairments have been associated with alterations in the orbitofrontal cortex (OFC) in lesion and imaging studies. The aim of this study was to examine the performance of a group of ISD, who had been abstinent for at least 4 months, on a series of emotional perception, self-regulation and decision-making tests sensitive to OFC dysfunction. Thirty ISD (poly-substance abusers in their first year of abstinence) and 35 healthy comparison (HC) participants were in the study. We administered the Ekman Faces Test (EFT), the Revised Strategy Application Test (R-SAT) and the Iowa Gambling Task (IGT) to both ISD and HC. Results showed that the ISD presented significant deficits in the recognition of facial emotional expressions and decision-making as measured by the EFT and the IGT. The ISD also showed poorer strategy awareness, impaired self-regulation and higher impulsivity on the R-SAT. We found significant correlations between the different measures linked to OFC functioning. We did not find significant correlations between length of abstinence and performance on these tests. These results suggest that the evaluation of emotion, self-regulation and decision-making contributes greatly to the characterization of the persistent deficits exhibited by ISD during prolonged abstinence.

  12. Contextual influences on animal decision-making: Significance for behavior-based wildlife conservation and management.

    PubMed

    Owen, Megan A; Swaisgood, Ronald R; Blumstein, Daniel T

    2017-01-01

    Survival and successful reproduction require animals to make critical decisions amidst a naturally dynamic environmental and social background (i.e. "context"). However, human activities have pervasively, and rapidly, extended contextual variation into evolutionarily novel territory, potentially rendering evolved animal decision-making mechanisms and strategies maladaptive. We suggest that explicitly focusing on animal decision-making (ADM), by integrating and applying findings from studies of sensory ecology, cognitive psychology, behavioral economics and eco-evolutionary strategies, may enhance our understanding of, and our ability to predict how, human-driven changes in the environment and population demography will influence animal populations. Fundamentally, the decisions animals make involve evolved mechanisms, and behaviors emerge from the combined action of sensory integration, cognitive mechanisms and strategic rules of thumb, and any of these processes may have a disproportionate influence on behavior. Although there is extensive literature exploring ADM, it generally reflects a canalized, discipline-specific approach that lacks a unified conceptual framework. As a result, there has been limited application of ADM theory and research findings into predictive models that can enhance management outcomes, even though it is likely that the relative resilience of species to rapid environmental change is fundamentally a result of how ADM is linked to contextual variation. Here, we focus on how context influences ADM, and highlight ideas and results that may be most applicable to conservation biology. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

  13. My Lived Experiences Are More Important Than Your Probabilities: The Role of Individualized Risk Estimates for Decision Making about Participation in the Study of Tamoxifen and Raloxifene (STAR).

    PubMed

    Holmberg, Christine; Waters, Erika A; Whitehouse, Katie; Daly, Mary; McCaskill-Stevens, Worta

    2015-11-01

    Decision-making experts emphasize that understanding and using probabilistic information are important for making informed decisions about medical treatments involving complex risk-benefit tradeoffs. Yet empirical research demonstrates that individuals may not use probabilities when making decisions. To explore decision making and the use of probabilities for decision making from the perspective of women who were risk-eligible to enroll in the Study of Tamoxifen and Raloxifene (STAR). We conducted narrative interviews with 20 women who agreed to participate in STAR and 20 women who declined. The project was based on a narrative approach. Analysis included the development of summaries of each narrative, and thematic analysis with developing a coding scheme inductively to code all transcripts to identify emerging themes. Interviewees explained and embedded their STAR decisions within experiences encountered throughout their lives. Such lived experiences included but were not limited to breast cancer family history, a personal history of breast biopsies, and experiences or assumptions about taking tamoxifen or medicines more generally. Women's explanations of their decisions about participating in a breast cancer chemoprevention trial were more complex than decision strategies that rely solely on a quantitative risk-benefit analysis of probabilities derived from populations In addition to precise risk information, clinicians and risk communicators should recognize the importance and legitimacy of lived experience in individual decision making. © The Author(s) 2015.

  14. Convergence to consensus in heterogeneous groups and the emergence of informal leadership.

    PubMed

    Gavrilets, Sergey; Auerbach, Jeremy; van Vugt, Mark

    2016-07-14

    When group cohesion is essential, groups must have efficient strategies in place for consensus decision-making. Recent theoretical work suggests that shared decision-making is often the most efficient way for dealing with both information uncertainty and individual variation in preferences. However, some animal and most human groups make collective decisions through particular individuals, leaders, that have a disproportionate influence on group decision-making. To address this discrepancy between theory and data, we study a simple, but general, model that explicitly focuses on the dynamics of consensus building in groups composed by individuals who are heterogeneous in preferences, certain personality traits (agreeability and persuasiveness), reputation, and social networks. We show that within-group heterogeneity can significantly delay democratic consensus building as well as give rise to the emergence of informal leaders, i.e. individuals with a disproportionately large impact on group decisions. Our results thus imply strong benefits of leadership particularly when groups experience time pressure and significant conflict of interest between members (due to various between-individual differences). Overall, our models shed light on why leadership and decision-making hierarchies are widespread, especially in human groups.

  15. Decision-making under surprise and uncertainty: Arsenic contamination of water supplies

    NASA Astrophysics Data System (ADS)

    Randhir, Timothy O.; Mozumder, Pallab; Halim, Nafisa

    2018-05-01

    With ignorance and potential surprise dominating decision making in water resources, a framework for dealing with such uncertainty is a critical need in hydrology. We operationalize the 'potential surprise' criterion proposed by Shackle, Vickers, and Katzner (SVK) to derive decision rules to manage water resources under uncertainty and ignorance. We apply this framework to managing water supply systems in Bangladesh that face severe, naturally occurring arsenic contamination. The uncertainty involved with arsenic in water supplies makes the application of conventional analysis of decision-making ineffective. Given the uncertainty and surprise involved in such cases, we find that optimal decisions tend to favor actions that avoid irreversible outcomes instead of conventional cost-effective actions. We observe that a diversification of the water supply system also emerges as a robust strategy to avert unintended outcomes of water contamination. Shallow wells had a slight higher optimal level (36%) compare to deep wells and surface treatment which had allocation levels of roughly 32% under each. The approach can be applied in a variety of other cases that involve decision making under uncertainty and surprise, a frequent situation in natural resources management.

  16. Research on the influence of parking charging strategy based on multi-level extension theory of group decision making

    NASA Astrophysics Data System (ADS)

    Cheng, Fen; Hu, Wanxin

    2017-05-01

    Based on analysis of the impact of the experience of parking policy at home and abroad, design the impact analysis process of parking strategy. First, using group decision theory to create a parking strategy index system and calculate its weight. Index system includes government, parking operators and travelers. Then, use a multi-level extension theory to analyze the CBD parking strategy. Assess the parking strategy by calculating the correlation of each indicator. Finally, assess the strategy of parking charges through a case. Provide a scientific and reasonable basis for assessing parking strategy. The results showed that the model can effectively analyze multi-target, multi-property parking policy evaluation.

  17. 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

  18. Reflections in the clinical practice.

    PubMed

    Borrell-Carrió, F; Hernández-Clemente, J C

    2014-03-01

    The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria). We have added the importance of emotions in decision making within highly complex situations, such as those occurring within the clinical practice. The quality of the reflective act depends, among other factors, on the ability of metacognition (thinking about what we think). Finally, we propose an educational strategy based on having a task supervisor and rectification scenarios to improve the quality of medical decision making. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  19. A new decision sciences for complex systems.

    PubMed

    Lempert, Robert J

    2002-05-14

    Models of complex systems can capture much useful information but can be difficult to apply to real-world decision-making because the type of information they contain is often inconsistent with that required for traditional decision analysis. New approaches, which use inductive reasoning over large ensembles of computational experiments, now make possible systematic comparison of alternative policy options using models of complex systems. This article describes Computer-Assisted Reasoning, an approach to decision-making under conditions of deep uncertainty that is ideally suited to applying complex systems to policy analysis. The article demonstrates the approach on the policy problem of global climate change, with a particular focus on the role of technology policies in a robust, adaptive strategy for greenhouse gas abatement.

  20. The Evolutionary Roots of Human Decision Making

    PubMed Central

    Santos, Laurie R.; Rosati, Alexandra G.

    2015-01-01

    Humans exhibit a suite of biases when making economic decisions. We review recent research on the origins of human decision making by examining whether similar choice biases are seen in nonhuman primates, our closest phylogenetic relatives. We propose that comparative studies can provide insight into four major questions about the nature of human choice biases that cannot be addressed by studies of our species alone. First, research with other primates can address the evolution of human choice biases and identify shared versus human-unique tendencies in decision making. Second, primate studies can constrain hypotheses about the psychological mechanisms underlying such biases. Third, comparisons of closely related species can identify when distinct mechanisms underlie related biases by examining evolutionary dissociations in choice strategies. Finally, comparative work can provide insight into the biological rationality of economically irrational preferences. PMID:25559115

  1. The future in clinical genetics: affective forecasting biases in patient and clinician decision making.

    PubMed

    Peters, S A; Laham, S M; Pachter, N; Winship, I M

    2014-04-01

    When clinicians facilitate and patients make decisions about predictive genetic testing, they often base their choices on the predicted emotional consequences of positive and negative test results. Research from psychology and decision making suggests that such predictions may often be biased. Work on affective forecasting-predicting one's future emotional states-shows that people tend to overestimate the impact of (especially negative) emotional events on their well-being; a phenomenon termed the impact bias. In this article, we review the causes and consequences of the impact bias in medical decision making, with a focus on applying such findings to predictive testing in clinical genetics. We also recommend strategies for reducing the impact bias and consider the ethical and practical implications of doing so. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Teaching metacognition in clinical decision-making using a novel mnemonic checklist: an exploratory study

    PubMed Central

    Chew, Keng Sheng; Durning, Steven J; van Merriënboer, Jeroen JG

    2016-01-01

    INTRODUCTION Metacognition is a cognitive debiasing strategy that clinicians can use to deliberately detach themselves from the immediate context of a clinical decision, which allows them to reflect upon the thinking process. However, cognitive debiasing strategies are often most needed when the clinician cannot afford the time to use them. A mnemonic checklist known as TWED (T = threat, W = what else, E = evidence and D = dispositional factors) was recently created to facilitate metacognition. This study explores the hypothesis that the TWED checklist improves the ability of medical students to make better clinical decisions. METHODS Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios. RESULTS The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group. CONCLUSION The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making. PMID:26778635

  3. Decision making under explicit risk is impaired in individuals with human immunodeficiency virus (HIV).

    PubMed

    Fujiwara, Esther; Tomlinson, Sara E; Purdon, Scot E; Gill, M John; Power, Christopher

    2015-01-01

    Human immunodeficiency virus (HIV) can affect the frontal-striatal brain regions, which are known to subserve decision-making functions. Previous studies have reported impaired decision making among HIV+ individuals using the Iowa Gambling Task, a task that assesses decision making under ambiguity. Previous study populations often had significant comorbidities such as past or present substance use disorders and/or hepatitis C virus coinfection, complicating conclusions about the unique contributions of HIV-infection to decision making. Decision making under explicit risk has very rarely been examined in HIV+ individuals and was tested here using the Game of Dice Task (GDT). We examined decision making under explicit risk in the GDT in 20 HIV+ individuals without substance use disorder or HCV coinfection, including a demographically matched healthy control group (n = 20). Groups were characterized on a standard neuropsychological test battery. For the HIV+ group, several disease-related parameters (viral load, current and nadir CD4 T-cell count) were included. Analyses focused on the GDT and spanned between-group (t-tests; analysis of covariance, ANCOVA) as well as within-group comparisons (Pearson/Spearman correlations). HIV+ individuals were impaired in the GDT, compared to healthy controls (p = .02). Their decision-making impairments were characterized by less advantageous choices and more random choice strategies, especially towards the end of the task. Deficits in the GDT in the HIV+ group were related to executive dysfunctions, slowed processing/motor speed, and current immune system status (CD4+ T-cell levels, ps < .05). Decision making under explicit risk in the GDT can occur in HIV-infected individuals without comorbidities. The correlational patterns may point to underlying fronto-subcortical dysfunctions in HIV+ individuals. The GDT provides a useful measure to assess risky decision making in this population and should be tested in larger studies.

  4. 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.

  5. 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

  6. Perspectives on counseling patients about menopausal hormone therapy: strategies in a complex data environment.

    PubMed

    Parish, Sharon J; Nappi, Rossella E; Kingsberg, Sheryl

    2018-03-05

    This narrative review strives to give healthcare providers (HCPs) who care for menopausal women better tools and skills to initiate discussions with women about menopause and hormone therapy (HT), communicate complex concepts and data, and promote shared decision-making. We review relevant studies on HT, barriers to treatment of menopausal symptoms, and effective communication strategies. We also provide recommendations for communicating with patients about HT based on the medical literature and our own professional experience. Both patient and HCP-related barriers can prevent women from accessing treatment for bothersome symptoms of menopause. Many women and HCPs have a poor understanding of the complex, nuanced data regarding HT. The benefits and risks vary with patient age and time since menopause, duration of use, inclusion of a progestin, and patient medical history. Women may also have fears about potential side effects of HT and feel unable to make informed choices. Strategies for effective patient communication and shared decision-making include use of open-ended questions to elicit patient's concerns and preferences, reflecting back to the patient what the HCP heard, presenting evidence about benefits and risks in language the patient can understand, keeping risks in perspective (eg, provide absolute, and also relative risks) without minimizing them, and making conscious efforts to minimize potential bias. Necessary components for achieving high-quality, shared decisions about HT involve a combination of medical evidence, communication skills, and recognition of patient goals and concerns. Use of such strategies can enhance women's satisfaction with care.

  7. 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.

  8. 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.

  9. A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

    PubMed

    Fowler, G E; Baker, D M; Lee, M J; Brown, S R

    2017-11-01

    The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

  10. Climate change/variability science and adaptive strategies for state and regional transportation decision making.

    DOT National Transportation Integrated Search

    2010-04-01

    The objective of this study was to generate a baseline understanding of current policy responses to climate : change/variability at the state and regional transportation-planning and -decision levels. Specifically, : researchers were interested in th...

  11. Is short-term memory involved in decision making? Evidence from a short-term memory patient.

    PubMed

    Gozzi, Marta; Papagno, Costanza

    2007-03-01

    It is reasonable to suggest that working memory (WM; Baddeley & Hitch, 1974) is involved in decision making, as decision making is dependent on the ability to remember and update past choices and outcomes. However, contradictory results have been reported in the literature concerning the role of two of its components, namely the central executive and the phonological loop. In order to investigate the role of these components in the decision-making process, we tested a patient with intact central executive but impaired phonological loop on a laboratory decision-making task involving hypothetical gambles (gambling task, GT). When tested in a no-load condition (simple keypress task), her performance was not significantly different from that of matched controls. We also verified whether her performance would be affected differently by memory-load when compared with control subjects. The memory task (holding a string of letters in memory) loaded WM without incurring number-number interference. When the memory-load was imposed during the GT, both the patient and the controls showed a decline in performance, but the strategy they adopted differed. Possible explanations are discussed. In conclusion, our results suggest that the phonological loop is not directly involved in decision making.

  12. Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses.

    PubMed

    Gutiérrez-Roig, Mario; Segura, Carlota; Duch, Jordi; Perelló, Josep

    2016-01-01

    Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go "up" or "down" in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops.

  13. Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses

    PubMed Central

    Segura, Carlota; Duch, Jordi; Perelló, Josep

    2016-01-01

    Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go “up” or “down” in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops. PMID:27532219

  14. Modeling the Mental Health Practice Change Preferences of Educators: A Discrete-Choice Conjoint Experiment.

    PubMed

    Cunningham, Charles E; Barwick, Melanie; Short, Kathy; Chen, Yvonne; Rimas, Heather; Ratcliffe, Jenna; Mielko, Stephanie

    2014-01-01

    Schools are sometimes slow to adopt evidence-based strategies for improving the mental health outcomes of students. This study used a discrete-choice conjoint experiment to model factors influencing the decision of educators to adopt strategies for improving children's mental health outcomes. A sample of 1,010 educators made choices between hypothetical mental health practice change strategies composed by systematically varying the four levels of 16 practice change attributes. Latent class analysis yielded two segments with different practice change preferences. Both segments preferred small-group workshops, conducted by engaging experts, teaching skills applicable to all students. Participants expressed little interest in Internet options. The support of colleagues, administrators, and unions exerted a strong influence on the practice change choices of both segments. The Change Ready segment, 77.1 % of the sample, was more intent on adopting new strategies to improve the mental health of students. They preferred that schools, rather than the provincial ministry of education, make practice change decisions, coaching was provided to all participants, and participants received post-training follow-up sessions. The Demand Sensitive segment (22.9 %) was less intent on practice change. They preferred that individual teachers make practice change decisions, recommended discretionary coaching, and chose no post-training follow-up support. This study emphasizes the complex social, organizational, and policy context within which educators make practice change decisions. Efforts to disseminate strategies to improve the mental health outcomes of students need to be informed by the preferences of segments of educators who are sensitive to different dimensions of the practice change process. In the absence of a broad consensus of educators, administrators, and unions, potentially successful practice changes are unlikely to be adopted.

  15. Constructing food choice decisions.

    PubMed

    Sobal, Jeffery; Bisogni, Carole A

    2009-12-01

    Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

  16. Value for money in changing clinical practice: should decisions about guidelines and implementation strategies be made sequentially or simultaneously?

    PubMed

    Hoomans, Ties; Severens, Johan L; Evers, Silvia M A A; Ament, Andre J H A

    2009-01-01

    Decisions about clinical practice change, that is, which guidelines to adopt and how to implement them, can be made sequentially or simultaneously. Decision makers adopting a sequential approach first compare the costs and effects of alternative guidelines to select the best set of guideline recommendations for patient management and subsequently examine the implementation costs and effects to choose the best strategy to implement the selected guideline. In an integral approach, decision makers simultaneously decide about the guideline and the implementation strategy on the basis of the overall value for money in changing clinical practice. This article demonstrates that the decision to use a sequential v. an integral approach affects the need for detailed information and the complexity of the decision analytic process. More importantly, it may lead to different choices of guidelines and implementation strategies for clinical practice change. The differences in decision making and decision analysis between the alternative approaches are comprehensively illustrated using 2 hypothetical examples. We argue that, in most cases, an integral approach to deciding about change in clinical practice is preferred, as this provides more efficient use of scarce health-care resources.

  17. Voice in Political Decision-Making: The Effect of Group Voice on Perceived Trustworthiness of Decision Makers and Subsequent Acceptance of Decisions

    ERIC Educational Resources Information Center

    Terwel, Bart W.; Harinck, Fieke; Ellemers, Naomi; Daamen, Dancker D. L.

    2010-01-01

    The implementation of carbon dioxide capture and storage technology (CCS) is considered an important climate change mitigation strategy, but the viability of this technology will depend on public acceptance of CCS policy decisions. The results of three experiments with students as participants show that whether or not interest groups receive an…

  18. Choosing an Advanced Therapy in Parkinson's Disease; is it an Evidence-Based Decision in Current Practice?

    PubMed

    Nijhuis, Frouke A P; van Heek, Jolien; Bloem, Bastiaan R; Post, Bart; Faber, Marjan J

    2016-07-25

    In advanced Parkinson's disease (PD), neurologists and patients face a complex decision for an advanced therapy. When choosing a treatment, the best available evidence should be combined with the professional's expertise and the patient's preferences. The objective of this study was to explore current decision-making in advanced PD. We conducted focus group discussions and individual interviews with patients (N = 20) who had received deep brain stimulation, Levodopa-Carbidopa intestinal gel, or subcutaneous apomorphine infusion, and with their caregivers (N = 16). Furthermore, we conducted semi-structured interviews with neurologists (N = 7) and PD nurse specialists (N = 3) to include the perspectives of all key players in this decision-making process. Data were analyzed by two researchers using a qualitative thematic analysis approach. Four themes representing current experiences with the decision-making process were identified: 1) information and information needs, 2) factors influencing treatment choice and individual decision strategies, 3) decision-making roles, and 4) barriers and facilitators to shared decision-making (SDM). Patient preferences were taken into account, however patients were not always provided with adequate information. The professional's expertise influenced the decision-making process in both positive and negative ways. Although professionals and patients considered SDM essential for the decision of an advanced treatment, they mentioned several barriers for the implementation in current practice. In this study we found several factors explaining why in current practice, evidence-based decision-making in advanced PD is not optimal. An important first step would be to develop objective information on all treatment options.

  19. The Public Health Service guidelines. Governing research involving human subjects: An analysis of the policy-making process

    NASA Technical Reports Server (NTRS)

    Frankel, M. S.

    1972-01-01

    The policy making process which led to development of the Public Health Service Guidelines governing research involving human subjects is outlined. Part 1 examines the evolution of PHS Guidelines, tracing (1) evolution of thought and legal interpretation regarding research using human subjects; (2) initial involvement of the Federal government; (3) development of the government's research program; (4) the social-political environment in which formal government policy was developed; and (5) various policy statements issued by the government. Part 2 analyzes the process by which PHS Guidelines were developed and examines the values and other underlying factors which contributed to their development. It was concluded that the evolution of the Guidelines is best understood within the context of a mixed-scanning strategy. In such a strategy, policy makers make fundamental decisions regarding the basic direction of policy and subsequent decisions are made incrementally and within the contexts set by the original fundamental decisions.

  20. Contemporary evidence-based practice in Canadian emergency medical services: a vision for integrating evidence into clinical and policy decision-making.

    PubMed

    Jensen, Jan L; Travers, Andrew H

    2017-05-01

    Nationally, emphasis on the importance of evidence-based practice (EBP) in emergency medicine and emergency medical services (EMS) has continuously increased. However, meaningful incorporation of effective and sustainable EBP into clinical and administrative decision-making remains a challenge. We propose a vision for EBP in EMS: Canadian EMS clinicians and leaders will understand and use the best available evidence for clinical and administrative decision-making, to improve patient health outcomes, the capability and quality of EMS systems of care, and safety of patients and EMS professionals. This vision can be implemented with the use of a structure, process, system, and outcome taxonomy to identify current barriers to true EBP, to recognize the opportunities that exist, and propose corresponding recommended strategies for local EMS agencies and at the national level. Framing local and national discussions with this approach will be useful for developing a cohesive and collaborative Canadian EBP strategy.

  1. 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.

  2. 2010 Comprehensive Economic Development Strategy "Vision Hampton Roads"

    DOT National Transportation Integrated Search

    2010-02-19

    The strategy is an economic development planning tool intended to aid : local governments in decision-making. The document provides an analysis : of regional and local economic conditions within the Hampton Roads : region, defined as including the te...

  3. TACtic- A Multi Behavioral Agent for Trading Agent Competition

    NASA Astrophysics Data System (ADS)

    Khosravi, Hassan; Shiri, Mohammad E.; Khosravi, Hamid; Iranmanesh, Ehsan; Davoodi, Alireza

    Software agents are increasingly being used to represent humans in online auctions. Such agents have the advantages of being able to systematically monitor a wide variety of auctions and then make rapid decisions about what bids to place in what auctions. They can do this continuously and repetitively without losing concentration. To provide a means of evaluating and comparing (benchmarking) research methods in this area the trading agent competition (TAC) was established. This paper describes the design, of TACtic. Our agent uses multi behavioral techniques at the heart of its decision making to make bidding decisions in the face of uncertainty, to make predictions about the likely outcomes of auctions, and to alter the agent's bidding strategy in response to the prevailing market conditions.

  4. Opportunities and barriers for smaller portions in food service: lessons from marketing and behavioral economics

    PubMed Central

    Riis, J

    2014-01-01

    This paper uses the frameworks and evidence from marketing and behavioral economics to highlight the opportunities and barriers for portion control in food service environments. Applying Kahneman's ‘thinking fast and slow' concepts, it describes 10 strategies that can be effective in ‘tricking' the consumer's fast cognitive system to make better decisions and in triggering the slow cognitive system to help prevent the fast system from making bad decisions. These strategies include shrinking defaults, elongating packages, increasing the visibility of small portions, offering more mixed virtue options, adding more small sizes, offering ‘right-sized' standard portions, using meaningful size labels, adopting linear pricing, using temporal landmarks to push smaller portions and facilitating pre-commitment. For each of these strategies, I discuss the specific cost and revenue barriers that a food service operator would face if the strategy were adopted. PMID:25033960

  5. Opportunities and barriers for smaller portions in food service: lessons from marketing and behavioral economics.

    PubMed

    Riis, J

    2014-07-01

    This paper uses the frameworks and evidence from marketing and behavioral economics to highlight the opportunities and barriers for portion control in food service environments. Applying Kahneman's 'thinking fast and slow' concepts, it describes 10 strategies that can be effective in 'tricking' the consumer's fast cognitive system to make better decisions and in triggering the slow cognitive system to help prevent the fast system from making bad decisions. These strategies include shrinking defaults, elongating packages, increasing the visibility of small portions, offering more mixed virtue options, adding more small sizes, offering 'right-sized' standard portions, using meaningful size labels, adopting linear pricing, using temporal landmarks to push smaller portions and facilitating pre-commitment. For each of these strategies, I discuss the specific cost and revenue barriers that a food service operator would face if the strategy were adopted.

  6. Multi-criteria decision making to support waste management: A critical review of current practices and methods.

    PubMed

    Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

    2017-01-01

    Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

  7. What would my avatar do? Gaming, pathology, and risky decision making

    PubMed Central

    Bailey, Kira; West, Robert; Kuffel, Judson

    2013-01-01

    Recent work has revealed a relationship between pathological video game use and increased impulsivity among children and adolescents. A few studies have also demonstrated increased risk-taking outside of the video game environment following game play, but this work has largely focused on one genre of video games (i.e., racing). Motivated by these findings, the aim of the current study was to examine the relationship between pathological and non-pathological video game use, impulsivity, and risky decision making. The current study also investigated the relationship between experience with two of the most popular genres of video games [i.e., first-person shooter (FPS) and strategy] and risky decision making. Consistent with previous work, ~7% of the current sample of college-aged adults met criteria for pathological video game use. The number of hours spent gaming per week was associated with increased impulsivity on a self-report measure and on the temporal discounting (TD) task. This relationship was sensitive to the genre of video game; specifically, experience with FPS games was positively correlated with impulsivity, while experience with strategy games was negatively correlated with impulsivity. Hours per week and pathological symptoms predicted greater risk-taking in the risk task and the Iowa Gambling task, accompanied by worse overall performance, indicating that even when risky choices did not pay off, individuals who spent more time gaming and endorsed more symptoms of pathological gaming continued to make these choices. Based on these data, we suggest that the presence of pathological symptoms and the genre of video game (e.g., FPS, strategy) may be important factors in determining how the amount of game experience relates to impulsivity and risky-decision making. PMID:24058356

  8. What would my avatar do? Gaming, pathology, and risky decision making.

    PubMed

    Bailey, Kira; West, Robert; Kuffel, Judson

    2013-01-01

    Recent work has revealed a relationship between pathological video game use and increased impulsivity among children and adolescents. A few studies have also demonstrated increased risk-taking outside of the video game environment following game play, but this work has largely focused on one genre of video games (i.e., racing). Motivated by these findings, the aim of the current study was to examine the relationship between pathological and non-pathological video game use, impulsivity, and risky decision making. The current study also investigated the relationship between experience with two of the most popular genres of video games [i.e., first-person shooter (FPS) and strategy] and risky decision making. Consistent with previous work, ~7% of the current sample of college-aged adults met criteria for pathological video game use. The number of hours spent gaming per week was associated with increased impulsivity on a self-report measure and on the temporal discounting (TD) task. This relationship was sensitive to the genre of video game; specifically, experience with FPS games was positively correlated with impulsivity, while experience with strategy games was negatively correlated with impulsivity. Hours per week and pathological symptoms predicted greater risk-taking in the risk task and the Iowa Gambling task, accompanied by worse overall performance, indicating that even when risky choices did not pay off, individuals who spent more time gaming and endorsed more symptoms of pathological gaming continued to make these choices. Based on these data, we suggest that the presence of pathological symptoms and the genre of video game (e.g., FPS, strategy) may be important factors in determining how the amount of game experience relates to impulsivity and risky-decision making.

  9. 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.

  10. Effect of Implicit Perceptual-Motor Training on Decision-Making Skills and Underpinning Gaze Behavior in Combat Athletes.

    PubMed

    Milazzo, Nicolas; Farrow, Damian; Fournier, Jean F

    2016-08-01

    This study investigated the effect of a 12-session, implicit perceptual-motor training program on decision-making skills and visual search behavior of highly skilled junior female karate fighters (M age = 15.7 years, SD = 1.2). Eighteen participants were required to make (physical or verbal) reaction decisions to various attacks within different fighting scenarios. Fighters' performance and eye movements were assessed before and after the intervention, and during acquisition through the use of video-based and on-mat decision-making tests. The video-based test revealed that following training, only the implicit perceptual-motor group (n = 6) improved their decision-making accuracy significantly compared to a matched motor training (placebo, n = 6) group and a control group (n = 6). Further, the implicit training group significantly changed their visual search behavior by focusing on fewer locations for longer durations. In addition, the session-by-session analysis showed no significant improvement in decision accuracy between training session 1 and all the other sessions, except the last one. Coaches should devote more practice time to implicit learning approaches during perceptual-motor training program to achieve significant decision-making improvements and more efficient visual search strategy with elite athletes. © The Author(s) 2016.

  11. The application of the heuristic-systematic processing model to treatment decision making about prostate cancer.

    PubMed

    Steginga, Suzanne K; Occhipinti, Stefano

    2004-01-01

    The study investigated the utility of the Heuristic-Systematic Processing Model as a framework for the investigation of patient decision making. A total of 111 men recently diagnosed with localized prostate cancer were assessed using Verbal Protocol Analysis and self-report measures. Study variables included men's use of nonsystematic and systematic information processing, desire for involvement in decision making, and the individual differences of health locus of control, tolerance of ambiguity, and decision-related uncertainty. Most men (68%) preferred that decision making be shared equally between them and their doctor. Men's use of the expert opinion heuristic was related to men's verbal reports of decisional uncertainty and having a positive orientation to their doctor and medical care; a desire for greater involvement in decision making was predicted by a high internal locus of health control. Trends were observed for systematic information processing to increase when the heuristic strategy used was negatively affect laden and when men were uncertain about the probabilities for cure and side effects. There was a trend for decreased systematic processing when the expert opinion heuristic was used. Findings were consistent with the Heuristic-Systematic Processing Model and suggest that this model has utility for future research in applied decision making about health.

  12. Cohesion in Military and Aviation Psychology: An Annotated Bibliography and Suggestions for US Army Aviation

    DTIC Science & Technology

    2005-06-01

    serve a significant influence upon perceptions. Strategies for mitigating the detrimental effects of racism and sexism are suggested. Leaders need to...Hedlund, J. (1998). Extending the multilevel theory of team decision making: Effects of feedback and experience in hierarchical teams. Academy of...Colquitt, J.A., & Hedlund, J. (1998). Extending the multilevel theory of team decision making: Effects of feedback and experience in hierarchical

  13. Practical example of game theory application for production route selection

    NASA Astrophysics Data System (ADS)

    Olender, M.; Krenczyk, D.

    2017-08-01

    The opportunity which opens before manufacturers on the dynamic market, especially before those from the sector of the small and medium-sized enterprises, is associated with the use of the virtual organizations concept. The planning stage of such organizations could be based on supporting decision-making tasks using the tools and formalisms taken from the game theory. In the paper the model of the virtual manufacturing network, along with the practical example of decision-making situation as two person game and the decision strategies with an analysis of calculation results are presented.

  14. Shared Decision Making at the Limit of Viability: A Blueprint for Physician Action

    PubMed Central

    2016-01-01

    Objective To document interactions during the antenatal consultation between parents and neonatologist that parents linked to their satisfaction with their participation in shared decision making for their infant at risk of being born at the limit of viability. Methods This multiple-case ethnomethodological qualitative research study, included mothers admitted for a threatened premature delivery between 200/7 and 266/7 weeks gestation, the father, and the staff neonatologist conducting the clinical antenatal consultation. Content analysis of an audiotaped post-antenatal consultation interview with parents obtained their satisfaction scores as well as their comments on physician actions that facilitated their desired participation. Results Five cases, each called a “system—infant at risk”, included 10 parents and 6 neonatologists. From the interviews emerged a blueprint for action by physicians, including communication strategies that parents say facilitated their participation in decision making; such as building trustworthy physician-parent relationships, providing "balanced" information, offering choices, and allowing time to think. Conclusion Parent descriptions indicate that the opportunity to participate to their satisfaction in the clinical antenatal consultation depends on how the physician interacts with them. Practice implications The parent-identified communication strategies facilitate shared decision making regarding treatment in the best interest of the infant at risk to be born at the limit of viability. PMID:27893823

  15. “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

  16. A Cognitive Modeling Approach to Strategy Formation in Dynamic Decision Making.

    PubMed

    Prezenski, Sabine; Brechmann, André; Wolff, Susann; Russwinkel, Nele

    2017-01-01

    Decision-making is a high-level cognitive process based on cognitive processes like perception, attention, and memory. Real-life situations require series of decisions to be made, with each decision depending on previous feedback from a potentially changing environment. To gain a better understanding of the underlying processes of dynamic decision-making, we applied the method of cognitive modeling on a complex rule-based category learning task. Here, participants first needed to identify the conjunction of two rules that defined a target category and later adapt to a reversal of feedback contingencies. We developed an ACT-R model for the core aspects of this dynamic decision-making task. An important aim of our model was that it provides a general account of how such tasks are solved and, with minor changes, is applicable to other stimulus materials. The model was implemented as a mixture of an exemplar-based and a rule-based approach which incorporates perceptual-motor and metacognitive aspects as well. The model solves the categorization task by first trying out one-feature strategies and then, as a result of repeated negative feedback, switching to two-feature strategies. Overall, this model solves the task in a similar way as participants do, including generally successful initial learning as well as reversal learning after the change of feedback contingencies. Moreover, the fact that not all participants were successful in the two learning phases is also reflected in the modeling data. However, we found a larger variance and a lower overall performance of the modeling data as compared to the human data which may relate to perceptual preferences or additional knowledge and rules applied by the participants. In a next step, these aspects could be implemented in the model for a better overall fit. In view of the large interindividual differences in decision performance between participants, additional information about the underlying cognitive processes from behavioral, psychobiological and neurophysiological data may help to optimize future applications of this model such that it can be transferred to other domains of comparable dynamic decision tasks.

  17. A Cognitive Modeling Approach to Strategy Formation in Dynamic Decision Making

    PubMed Central

    Prezenski, Sabine; Brechmann, André; Wolff, Susann; Russwinkel, Nele

    2017-01-01

    Decision-making is a high-level cognitive process based on cognitive processes like perception, attention, and memory. Real-life situations require series of decisions to be made, with each decision depending on previous feedback from a potentially changing environment. To gain a better understanding of the underlying processes of dynamic decision-making, we applied the method of cognitive modeling on a complex rule-based category learning task. Here, participants first needed to identify the conjunction of two rules that defined a target category and later adapt to a reversal of feedback contingencies. We developed an ACT-R model for the core aspects of this dynamic decision-making task. An important aim of our model was that it provides a general account of how such tasks are solved and, with minor changes, is applicable to other stimulus materials. The model was implemented as a mixture of an exemplar-based and a rule-based approach which incorporates perceptual-motor and metacognitive aspects as well. The model solves the categorization task by first trying out one-feature strategies and then, as a result of repeated negative feedback, switching to two-feature strategies. Overall, this model solves the task in a similar way as participants do, including generally successful initial learning as well as reversal learning after the change of feedback contingencies. Moreover, the fact that not all participants were successful in the two learning phases is also reflected in the modeling data. However, we found a larger variance and a lower overall performance of the modeling data as compared to the human data which may relate to perceptual preferences or additional knowledge and rules applied by the participants. In a next step, these aspects could be implemented in the model for a better overall fit. In view of the large interindividual differences in decision performance between participants, additional information about the underlying cognitive processes from behavioral, psychobiological and neurophysiological data may help to optimize future applications of this model such that it can be transferred to other domains of comparable dynamic decision tasks. PMID:28824512

  18. On Goal-Oriented, Hydrogeological Site Investigation: A Holistic Approach (Henry Darcy Medal Lecture)

    NASA Astrophysics Data System (ADS)

    Rubin, Yoram

    2016-04-01

    UQ (for Uncertainty Quantification) is a critical element of groundwater management and by extension, of hydrological site investigation. While it is clear that UQ is an important goal, there is ambiguity as to what the target of the UQ should be, and how to make UQ relevant in the context of public policy. Planning for UQ (meaning what measurements to take, where, how many, what frequency, etc.), one could consider environmental performance parameters (EPMs, such as concentrations or travel time) as the targets of site investigation. But there is a need to go beyond EPMs, and to consider the uncertainty related to impacts such as enhanced cancer-risk due to groundwater contamination or, more generally, to decisions facing regulators. In any case, UQ requires site investigation, and decision-makers, who end up paying for it, are not really interested in EPMs: they care about making operational decisions that are defensible legally and justified from the perspective of public good. The key to UQ, whether considering EPMS or operational decisions concerning the public good, is defining a suitable strategy for site investigation. There is a body of published works on relating site investigations with EPMs, but much less is known on how to support operational decisions with strategies for site characterization. In this lecture, I will address this issue and I will outline a comprehensive approach for addressing it using a statistical formalism that couples hypothesis testing with Bayesian statistics. I refer to this approach as goal-oriented site investigation. I will show how site investigation strategies, with specifics such as which measurements to take and where, could be related to goals lined with operational decisions. This includes (1) defining the relevant goals; (2) formulating hypotheses; (3) defining alternative strategies for site investigation and (4) evaluating them in terms of probabilities for making errors in accepting or rejecting the hypotheses.

  19. Impact of ambiguity and risk on decision making in mild Alzheimer's disease.

    PubMed

    Sinz, H; Zamarian, L; Benke, T; Wenning, G K; Delazer, M

    2008-01-01

    Decisions under ambiguity and decisions under risk are crucial types of decision making in daily living at any age. This is the first study assessing these two types of decisions in patients with mild dementia of Alzheimer's type (DAT) by means of the Iowa Gambling Task (IGT) and a newly developed, Probability-Associated Gambling (PAG) task. While rules for gains and losses are implicit in the IGT, in the PAG task rules are explicit and winning probabilities, which change from trial to trial, can be estimated. Results of the IGT indicated that DAT patients made more disadvantageous decisions than healthy controls. Patients also shifted more frequently among decks, i.e. under ambiguity decisions were taken randomly and no advantageous strategy was established over time by DAT patients. Thus, not only actual choices but also development of advantageous strategies may be revealing about decision making in the IGT. Compared to controls, patients demonstrated less advantageous choices in the PAG task as well. They gambled more often in the low winning probabilities and less frequently in the high probabilities than healthy participants. Patients' performance on both tasks correlated with measures of executive functions. Findings of the present investigation are consistent with the early pathological cerebral changes and related (cognitive, emotional) deficits reported for DAT. As suggested by our study, decisions under ambiguity as well as decisions under risk are impaired in mild DAT. It may thus be expected that patients with mild DAT have difficulties in taking decisions in every-day life situations, both in cases of ambiguity (information on probability is missing or conflicting, and the expected utility of the different options is incalculable) and in cases of risk (outcomes can be predicted by well-defined or estimable probabilities).

  20. Social network and decision-making in primates: a report on Franco-Japanese research collaborations.

    PubMed

    Sueur, Cédric; Pelé, Marie

    2016-07-01

    Sociality is suggested to evolve as a strategy for animals to cope with challenges in their environment. Within a population, each individual can be seen as part of a network of social interactions that vary in strength, type and dynamics (Sueur et al. 2011a). The structure of this social network can strongly impact upon not only on the fitness of individuals and their decision-making, but also on the ecology of populations and the evolution of a species. Our Franco-Japanese collaboration allowed us to study social networks in several species (Japanese macaques, chimpanzees, colobines, etc.) and on different topics (social epidemiology, social evolution, information transmission). Individual attributes such as stress, rank or age can affect how individuals take decisions and the structure of the social network. This heterogeneity is linked to the assortativity of individuals and to the efficiency of the flow within a network. It is important, therefore, that this heterogeneity is integrated in the process or pattern under study in order to provide a better resolution of investigation and, ultimately, a better understanding of behavioural strategies, social dynamics and social evolution. How social information affects decision-making could be important to understand how social groups make collective decisions and how information may spread throughout the social group. In human beings, road-crossing behaviours in the presence of other individuals is a good way to study the influence of social information on individual behaviour and decision-making, for instance. Culture directly affects which information - personal vs social - individuals prefer to follow. Our collaboration contributed to the understanding of the relative influence of different factors, cultural and ecological, on primate, including human, sociality.

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