Helping Health Care Providers and Clinical Scientists Understand Apparently Irrational Policy Decisions.

PubMed

Demeter, Sandor J

2016-12-21

Health care providers (HCP) and clinical scientists (CS) are generally most comfortable using evidence-based rational decision-making models. They become very frustrated when policymakers make decisions that, on the surface, seem irrational and unreasonable. However, such decisions usually make sense when analysed properly. The goal of this paper to provide a basic theoretical understanding of major policy models, to illustrate which models are most prevalent in publicly funded health care systems, and to propose a policy analysis framework to better understand the elements that drive policy decision-making. The proposed policy framework will also assist HCP and CS achieve greater success with their own proposals.

Development and pilot testing of a decision aid for drivers with dementia.

PubMed

Carmody, John; Potter, Jan; Lewis, Kate; Bhargava, Sanjay; Traynor, Victoria; Iverson, Don

2014-03-19

An increasing number of older adults drive automobiles. Given that the prevalence of dementia is rising, it is necessary to address the issue of driving retirement. The purpose of this study is to evaluate how a self-administered decision aid contributed to decision making about driving retirement by individuals living with dementia. The primary outcome measure in this study was decisional conflict. Knowledge, decision, satisfaction with decision, booklet use and booklet acceptability were the secondary outcome measures. A mixed methods approach was adopted. Drivers with dementia were recruited from an Aged Care clinic and a Primary Care center in NSW, Australia. Telephone surveys were conducted before and after participants read the decision aid. Twelve participants were recruited (mean age 75, SD 6.7). The primary outcome measure, decisional conflict, improved following use of the decision aid. Most participants felt that the decision aid: (i) was balanced; (ii) presented information well; and (iii) helped them decide about driving. In addition, mean knowledge scores improved after booklet use. This decision aid shows promise as an acceptable, useful and low-cost tool for drivers with dementia. A self-administered decision aid can be used to assist individuals with dementia decide about driving retirement. A randomized controlled trial is underway to evaluate the effectiveness of the tool.

Selecting the Right Data

ERIC Educational Resources Information Center

Parsley, Danette; Dean, Ceri; Miller, Kirsten

2006-01-01

Data exists in the context of a community that drives data collection and use. The effective use of data can help principals make informed decisions about their policies, practices, and procedures to improve student achievement. The more systematic and thorough principals are about bringing data to the table when making decisions, the more…

Human Decisions in Moral Dilemmas are Largely Described by Utilitarianism: Virtual Car Driving Study Provides Guidelines for Autonomous Driving Vehicles.

PubMed

Faulhaber, Anja K; Dittmer, Anke; Blind, Felix; Wächter, Maximilian A; Timm, Silja; Sütfeld, Leon R; Stephan, Achim; Pipa, Gordon; König, Peter

2018-01-22

Ethical thought experiments such as the trolley dilemma have been investigated extensively in the past, showing that humans act in utilitarian ways, trying to cause as little overall damage as possible. These trolley dilemmas have gained renewed attention over the past few years, especially due to the necessity of implementing moral decisions in autonomous driving vehicles (ADVs). We conducted a set of experiments in which participants experienced modified trolley dilemmas as drivers in virtual reality environments. Participants had to make decisions between driving in one of two lanes where different obstacles came into view. Eventually, the participants had to decide which of the objects they would crash into. Obstacles included a variety of human-like avatars of different ages and group sizes. Furthermore, the influence of sidewalks as potential safe harbors and a condition implicating self-sacrifice were tested. Results showed that participants, in general, decided in a utilitarian manner, sparing the highest number of avatars possible with a limited influence by the other variables. Derived from these findings, which are in line with the utilitarian approach in moral decision making, it will be argued for an obligatory ethics setting implemented in ADVs.

Medication adherence decision-making among adolescents and young adults with cancer.

PubMed

McGrady, Meghan E; Brown, Gabriella A; Pai, Ahna L H

2016-02-01

Nearly half of all adolescents and young adults (AYAs) with cancer struggle to adhere to oral chemotherapy or antibiotic prophylactic medication included in treatment protocols. The mechanisms that drive non-adherence remain unknown, leaving health care providers with few strategies to improve adherence among their patients. The purpose of this study was to use qualitative methods to investigate the mechanisms that drive the daily adherence decision-making process among AYAs with cancer. Twelve AYAs (ages 15-31) with cancer who had a current medication regimen that included oral chemotherapy or antibiotic prophylactic medication participated in this study. Adolescents and young adults completed a semi-structured interview and a card sorting task to elucidate the themes that impact adherence decision-making. Interviews were transcribed verbatim and coded twice by two independent raters to identify key themes and develop an overarching theoretical framework. Adolescents and young adults with cancer described adherence decision-making as a complex, multi-dimensional process influenced by personal goals and values, knowledge, skills, and environmental and social factors. Themes were generally consistent across medication regimens but differed with age, with older AYAs discussing long-term impacts and receiving physical support from their caregivers more than younger AYAs. The mechanisms that drive daily adherence decision-making among AYAs with cancer are consistent with those described in empirically-supported models of adherence among adults with other chronic medical conditions. These mechanisms offer several modifiable targets for health care providers striving to improve adherence among this vulnerable population. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medication Adherence Decision-Making Among Adolescents and Young Adults with Cancer

PubMed Central

McGrady, Meghan E.; Brown, Gabriella A.; Pai, Ahna L. H.

2015-01-01

Purpose Nearly half of all adolescents and young adults (AYAs) with cancer struggle to adhere to oral chemotherapy or antibiotic prophylactic medication included in treatment protocols. The mechanisms that drive non-adherence remain unknown, leaving health care providers with few strategies to improve adherence among their patients. The purpose of this study was to use qualitative methods to investigate the mechanisms that drive the daily adherence decision-making process among AYAs with cancer. Methods Twelve AYAs (ages 15–31) with cancer who had a current medication regimen that included oral chemotherapy or antibiotic prophylactic medication participated in this study. Adolescents and young adults completed a semi-structured interview and a card sorting task to elucidate the themes that impact adherence decision-making. Interviews were transcribed verbatim and coded twice by two independent raters to identify key themes and develop an overarching theoretical framework. Results Adolescents and young adults with cancer described adherence decision-making as a complex, multi-dimensional process influenced by personal goals and values, knowledge, skills, and environmental and social factors. Themes were generally consistent across medication regimens but differed with age, with older AYAs discussing long-term impacts and receiving physical support from their caregivers more than younger AYAs. Conclusions The mechanisms that drive daily adherence decision-making among AYAs with cancer are consistent with those described in empirically-supported models of adherence among adults with other chronic medical conditions. These mechanisms offer several modifiable targets for health care providers striving to improve adherence among this vulnerable population. PMID:26372619

Automatic Recognition and Understanding of the Driving Environment for Driver Feedback

DOT National Transportation Integrated Search

2018-01-01

A smart driving system must consider two key elements to be able to generate recommendations and make driving decisions that are effective and accurate: The environment of the car and the behavior of the driver. Our long-term goal is to develop techn...

3 CFR 8610 - Proclamation 8610 of December 1, 2010. National Impaired Driving Prevention Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... sober, drug-free, and safe on the road. Impaired driving and its consequences can seriously alter or..., but also the growing problem of drugged driving. Drugs, including those prescribed by a physician, can... to make responsible decisions when driving or riding as a passenger, especially if drug use is...

Safety evaluation of driver cognitive failures and driving errors on right-turn filtering movement at signalized road intersections based on Fuzzy Cellular Automata (FCA) model.

PubMed

Chai, Chen; Wong, Yiik Diew; Wang, Xuesong

2017-07-01

This paper proposes a simulation-based approach to estimate safety impact of driver cognitive failures and driving errors. Fuzzy Logic, which involves linguistic terms and uncertainty, is incorporated with Cellular Automata model to simulate decision-making process of right-turn filtering movement at signalized intersections. Simulation experiments are conducted to estimate the relationships between cognitive failures and driving errors with safety performance. Simulation results show Different types of cognitive failures are found to have varied relationship with driving errors and safety performance. For right-turn filtering movement, cognitive failures are more likely to result in driving errors with denser conflicting traffic stream. Moreover, different driving errors are found to have different safety impacts. The study serves to provide a novel approach to linguistically assess cognitions and replicate decision-making procedures of the individual driver. Compare to crash analysis, the proposed FCA model allows quantitative estimation of particular cognitive failures, and the impact of cognitions on driving errors and safety performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Analytic Model for DoD Investment & Divestment Decisions (Briefing Charts)

DTIC Science & Technology

2015-05-01

cost drives Strategic; Performance mixed; cost drives Invest Insurance Risk Mitigation √ “Making Trade-Offs in Corporate Portfolio Decisions...Effects (SE) + Insurance Intended externalities, unintended consequences Are SE measureable? Do they add/subtract so NPV is worthwhile? Deadweight...Sustainable Cost Effective Cost is supportable, LPO outsourced, or is income Advantageous NPV? Y Y Y Y either N N N N Secondary Effects+ Insurance

The Principle of Cognitive Consistency and Central American Policy: A Comparison of the Carter and Reagan Administrations.

ERIC Educational Resources Information Center

Holland, Lynn

The principle of cognitive consistency, formulated by Jack Snyder, explains decision-making under stressful conditions. Snyder contends that decision-making under stressful conditions creates a drive toward cognitive consistency and brings into operation tendencies: (1) toward a perception of certainty about an opponent's intention and the…

The effects of alcohol on driver performance in a decision making situation

NASA Technical Reports Server (NTRS)

Allen, R. W.; Schwartz, S. H.; Stein, A. C.; Hogge, J. R.

1978-01-01

The results are reviewed of driving simulator and in-vehicle field test experiments of alcohol effects on driver risk taking. The objective was to investigate changes in risk taking under alcoholic intoxication and relate these changes to effects on traffic safety. The experiments involved complex 15 minute driving scenarios requiring decision making and steering and speed control throughout a series of typical driving situations. Monetary rewards and penalties were employed to simulate the real-world motivations inherent in driving. A full placebo experimental design was employed, and measures related to traffic safety, driver/vehicle performance and driver behavior were obtained. Alcohol impairment was found to increase the rate of accidents and speeding tickets. Behavioral measures showed these traffic safety effects to be due to impaired psychomotor performance and perceptual distortions. Subjective estimates of risk failed to show any change in the driver's willingness to take risks when intoxicated.

DRIVE: Drive-Cycle Rapid Investigation, Visualization, and Evaluation

Science.gov Websites

specialized statistical clustering methods. The duration of these representative drive cycles, which aim to , DRIVE can benefit a variety of users. For example: Fleet managers can use the tool to make educated investment decisions by determining, in advance, the payback period for a given technology. Vehicle

Risk-taking on the road and in the mind: behavioural and neural patterns of decision making between risky and safe drivers.

PubMed

Ba, Yutao; Zhang, Wei; Peng, QiJia; Salvendy, Gavriel; Crundall, David

2016-01-01

Drivers' risk-taking is a key issue of road safety. This study explored individual differences in drivers' decision-making, linking external behaviours to internal neural activity, to reveal the cognitive mechanisms of risky driving. Twenty-four male drivers were split into two groups (risky vs. safe drivers) via the Drivier Behaviour Questionnaire-violation. The risky drivers demonstrated higher preference for the risky choices in the paradigms of Iowa Gambling Task and Balloon Analogue Risk Task. More importantly, the risky drivers showed lower amplitudes of feedback-related negativity (FRN) and loss-minus-gain FRN in both paradigms, which indicated their neural processing of error-detection. A significant difference of P300 amplitudes was also reported between groups, which indicated their neural processing of reward-evaluation and were modified by specific paradigm and feedback. These results suggested that the neural basis of risky driving was the decision patterns less revised by losses and more motivated by rewards. Risk-taking on the road is largely determined by inherent cognitive mechanisms, which can be indicated by the behavioural and neural patterns of decision-making. In this regard, it is feasible to quantize drivers’ riskiness in the cognitive stage before actual risky driving or accidents, and intervene accordingly.

Process and outcomes evaluation of older driver screening programs : the Assessment of Driving-Related Skills (ADReS) older-driver screening tool

DOT National Transportation Integrated Search

2009-05-01

Physicians are one resource for identification of older drivers who may be at risk for decreased safe driving ability. However, : physicians have not had the tools to make decisions about the safe driving ability of their patients. With this in mind,...

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

NASA Astrophysics Data System (ADS)

Flaming, Susan C.

2007-12-01

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

Do parental decision-making patterns predict compliance with use of child booster seats?

PubMed

Shimony-Kanat, Sarit; Gofin, Rosa; Kienski Woloski Wruble, Anna C; Mann, Leon

2018-03-01

Booster seat use for 4-9 year olds remains the lowest of all age groups in many countries. The objective of this study is to examine whether parents' decision-making patterns, as measured by the Melbourne Decision Making Questionnaire, relate to car booster seat use. Israeli parents of 4-7 years old children (n = 398) answered a questionnaire about car safety and decision-making habits. Ninety per cent of parents reported having a booster seat; 70.5% reported consistent booster seat use in general and on short drives during the last month (booster seat use compliance index). Greater compliance index was positively related to a vigilant decision-making pattern, passenger compliance with rear seat belts and families with fewer children. Lower booster seat use compliance index was associated with buck-passing decision-making pattern. Health professionals and policy-makers should take into account parents' habitual decision-making patterns when designing interventions for car booster seat compliance.

Demystifying Data: Designing and Implementing Data-Driven Systems and Practices for Continuous Quality Improvement

ERIC Educational Resources Information Center

Krugly, Andrew; Stein, Amanda; Centeno, Maribel G.

2014-01-01

Data-based decision making should be the driving force in any early care and education setting. Data usage compels early childhood practitioners and leaders to make decisions on the basis of more than just professional instinct. This article explores why early childhood schools should be using data for continuous quality improvement at various…

Design and Data in Balance: Using Design-Driven Decision Making to Enable Student Success

ERIC Educational Resources Information Center

Fairchild, Susan; Farrell, Timothy; Gunton, Brad; Mackinnon, Anne; McNamara, Christina; Trachtman, Roberta

2014-01-01

Data-driven approaches to school decision making have come into widespread use in the past decade, nationally and in New York City. New Visions has been at the forefront of those developments: in New Visions schools, teacher teams and school teams regularly examine student performance data to understand patterns and drive classroom- and…

Driving difficulties in Parkinson's disease

PubMed Central

Rizzo, Matthew; Uc, Ergun Y; Dawson, Jeffrey; Anderson, Steven; Rodnitzky, Robert

2011-01-01

Safe driving requires the coordination of attention, perception, memory, motor and executive functions (including decision-making) and self-awareness. PD and other disorders may impair these abilities. Because age or medical diagnosis alone is often an unreliable criterion for licensure, decisions on fitness to drive should be based on empirical observations of performance. Linkages between cognitive abilities measured by neuropsychological tasks, and driving behavior assessed using driving simulators, and natural and naturalistic observations in instrumented vehicles, can help standardize the assessment of fitness-to-drive. By understanding the patterns of driver safety errors that cause crashes, it may be possible to design interventions to reduce these errors and injuries and increase mobility. This includes driver performance monitoring devices, collision alerting and warning systems, road design, and graded licensure strategies. PMID:20187237

CD-ROM Hardware Configurations: Selection and Design.

ERIC Educational Resources Information Center

Jaffe, Lee David; Watkins, Steven G.

1992-01-01

Presents selection and design considerations to help libraries make informed decisions about hardware configurations of CD-ROM systems. Highlights include CD-ROM configurations, including single drive workstations, daisychains, and jukeboxes; network configurations, including remote access; microcomputer features; CD-ROM drive selection; and…

Holding on and letting go: the perspectives of pre-seniors and seniors on driving self-regulation in later life.

PubMed

Rudman, Deborah Laliberte; Friedland, Judith; Chipman, Mary; Sciortino, Paola

2006-01-01

Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation from the perspective of pre-senior (aged 55-64) drivers, senior (aged 65 years or over) drivers, and senior ex-drivers. Themes resulting from inductive analysis addressed the importance of driving, mechanisms of self-monitoring and self-regulation, people who influenced decision making, and opinions regarding licensing regulations. A preliminary model of the process of self-regulation that highlights intrapersonal, interpersonal, and environmental influences on why, how, and when aging drivers adapt or cease driving is presented. The model identifies areas for future research to enhance understanding of this process, including the effectiveness of self-regulation. Findings suggest that increased public awareness of issues related to driving and aging could assist aging drivers, their families, and their family physicians in optimizing driving safety for this population. Since a near accident or accident was seen as the only factor that would lead many informants to stop driving and few informants planned for driving cessation, there is a need for interventions that help aging drivers make the transition to ex-driver in a timely and personally acceptable way.

Nordic couples' decision-making processes during assisted reproduction treatments.

PubMed

Sol Olafsdottir, Helga; Wikland, Matts; Möller, Anders

2013-06-01

To study couples' perceptions of their decision-making process during the first three years of infertility treatments. This study is a part of a larger project studying the decision-making processes of 22 infertile heterosexual couples, recruited from fertility clinics in all five Nordic countries, over a three year period. A descriptive qualitative method was used. Process of decision-making during assisted reproduction treatments. Seventeen couples had succeeded in becoming parents after approximately three years. Our study suggests that the decision-making process during fertility treatments has three phases: (i) recognizing the decisions to be made, with subcategories; the driving force, mutual project, (ii) gathering knowledge and experience about the options, with subcategories; trust, patient competence, personalized support, and (iii) adapting decisions to possible options, with subcategories; strategic planning, adaption. The core category was "maintaining control in a situation of uncertainty." Two parallel processes affect couples' decision-making process, one within themselves and their relationship, and the other in their contact with the fertility clinic. Couples struggle to make decisions, trusting clinic personnel for guidance, knowledge, and understanding. Nevertheless, couples expressed disappointment with the clinics' reactions to their requests for shared decision-making. Copyright © 2013 Elsevier B.V. All rights reserved.

Determinants of Propranolol's Selective Effect on Loss Aversion.

PubMed

Sokol-Hessner, Peter; Lackovic, Sandra F; Tobe, Russell H; Camerer, Colin F; Leventhal, Bennett L; Phelps, Elizabeth A

2015-07-01

Research on emotion and decision making has suggested that arousal mediates risky decisions, but several distinct and often confounded processes drive such choices. We used econometric modeling to separate and quantify the unique contributions of loss aversion, risk attitudes, and choice consistency to risky decision making. We administered the beta-blocker propranolol in a double-blind, placebo-controlled within-subjects study, targeting the neurohormonal basis of physiological arousal. Matching our intervention's pharmacological specificity with a quantitative model delineating decision-making components allowed us to identify the causal relationships between arousal and decision making that do and do not exist. Propranolol selectively reduced loss aversion in a baseline- and dose-dependent manner (i.e., as a function of initial loss aversion and body mass index), and did not affect risk attitudes or choice consistency. These findings provide evidence for a specific, modulatory, and causal relationship between precise components of emotion and risky decision making. © The Author(s) 2015.

Data-Based Decision-Making Teams in Middle School: Observations and Implications from the Middle School Intervention Project

ERIC Educational Resources Information Center

Crone, Deanne A.; Carlson, Sarah E.; Haack, Marcia K.; Kennedy, Patrick C.; Baker, Scott K.; Fien, Hank

2016-01-01

The use of data-based decision making (DBDM) in schools to drive educational improvement and success has been strongly promoted by educational experts and policymakers, yet very little is documented about the actual DBDM practices used in schools. This study examines DBDM practices in 25 middle schools through 80 standardized observations of data…

Identification of countermeasures for unsafe driving actions. Volume 2, A review of selected literature

DOT National Transportation Integrated Search

1981-02-01

Literature on decision-making and social control was reviewed to identify key principles of human behavior that have potential for reducing the incidence of speed-too-fast and other conscious and intentional unsafe driving actions (UDAs). The review ...

A Hierarchical Approach to Target Recognition and Tracking. Summary of Results for the Period April 1, 1989-November 30, 1989

DTIC Science & Technology

1990-02-07

performance assessment, human intervention, or operator training. Algorithms on different levels are allowed to deal with the world with different degrees...have on the decisions made by the driver are a complex combination of human factors, driving experience, mission objectives, tactics, etc., and...motion. The distinction here is that the decision making program may I 12 1 I not necessarily make its decisions based on the same factors as the human

Decision making under uncertainty in a spiking neural network model of the basal ganglia.

PubMed

Héricé, Charlotte; Khalil, Radwa; Moftah, Marie; Boraud, Thomas; Guthrie, Martin; Garenne, André

2016-12-01

The mechanisms of decision-making and action selection are generally thought to be under the control of parallel cortico-subcortical loops connecting back to distinct areas of cortex through the basal ganglia and processing motor, cognitive and limbic modalities of decision-making. We have used these properties to develop and extend a connectionist model at a spiking neuron level based on a previous rate model approach. This model is demonstrated on decision-making tasks that have been studied in primates and the electrophysiology interpreted to show that the decision is made in two steps. To model this, we have used two parallel loops, each of which performs decision-making based on interactions between positive and negative feedback pathways. This model is able to perform two-level decision-making as in primates. We show here that, before learning, synaptic noise is sufficient to drive the decision-making process and that, after learning, the decision is based on the choice that has proven most likely to be rewarded. The model is then submitted to lesion tests, reversal learning and extinction protocols. We show that, under these conditions, it behaves in a consistent manner and provides predictions in accordance with observed experimental data.

The neural basis of rationalization: cognitive dissonance reduction during decision-making.

PubMed

Jarcho, Johanna M; Berkman, Elliot T; Lieberman, Matthew D

2011-09-01

People rationalize the choices they make when confronted with difficult decisions by claiming they never wanted the option they did not choose. Behavioral studies on cognitive dissonance provide evidence for decision-induced attitude change, but these studies cannot fully uncover the mechanisms driving the attitude change because only pre- and post-decision attitudes are measured, rather than the process of change itself. In the first fMRI study to examine the decision phase in a decision-based cognitive dissonance paradigm, we observed that increased activity in right-inferior frontal gyrus, medial fronto-parietal regions and ventral striatum, and decreased activity in anterior insula were associated with subsequent decision-related attitude change. These findings suggest the characteristic rationalization processes that are associated with decision-making may be engaged very quickly at the moment of the decision, without extended deliberation and may involve reappraisal-like emotion regulation processes.

The neural basis of rationalization: cognitive dissonance reduction during decision-making

PubMed Central

Jarcho, Johanna M.; Berkman, Elliot T.

2011-01-01

People rationalize the choices they make when confronted with difficult decisions by claiming they never wanted the option they did not choose. Behavioral studies on cognitive dissonance provide evidence for decision-induced attitude change, but these studies cannot fully uncover the mechanisms driving the attitude change because only pre- and post-decision attitudes are measured, rather than the process of change itself. In the first fMRI study to examine the decision phase in a decision-based cognitive dissonance paradigm, we observed that increased activity in right-inferior frontal gyrus, medial fronto-parietal regions and ventral striatum, and decreased activity in anterior insula were associated with subsequent decision-related attitude change. These findings suggest the characteristic rationalization processes that are associated with decision-making may be engaged very quickly at the moment of the decision, without extended deliberation and may involve reappraisal-like emotion regulation processes. PMID:20621961

The involvement of the striatum in decision making

PubMed Central

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

2016-01-01

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

Mental workload while driving: effects on visual search, discrimination, and decision making.

PubMed

Recarte, Miguel A; Nunes, Luis M

2003-06-01

The effects of mental workload on visual search and decision making were studied in real traffic conditions with 12 participants who drove an instrumented car. Mental workload was manipulated by having participants perform several mental tasks while driving. A simultaneous visual-detection and discrimination test was used as performance criteria. Mental tasks produced spatial gaze concentration and visual-detection impairment, although no tunnel vision occurred. According to ocular behavior analysis, this impairment was due to late detection and poor identification more than to response selection. Verbal acquisition tasks were innocuous compared with production tasks, and complex conversations, whether by phone or with a passenger, are dangerous for road safety.

Seemingly irrational driving behavior model: The effect of habit strength and anticipated affective reactions.

PubMed

Chung, Yi-Shih

2015-09-01

An increasing amount of evidence suggests that aberrant driving behaviors are not entirely rational. On the basis of the dual-process theory, this study postulates that drivers may learn to perform irrational aberrant driving behaviors, and these behaviors could be derived either from a deliberate or an intuitive decision-making approach. Accordingly, a seemingly irrational driving behavior model is proposed; in this model, the theory of planned behavior (TPB) was adopted to represent the deliberate decision-making mechanism, and habit strength was incorporated to reflect the intuitive decision process. A multiple trivariate mediation structure was designed to reflect the process through which driving behaviors are learned. Anticipated affective reactions (AARs) were further included to examine the effect of affect on aberrant driving behaviors. Considering the example of speeding behaviors, this study developed scales and conducted a two-wave survey of students in two departments at a university in Northern Taiwan. The analysis results show that habit strength consists of multiple aspects, and frequency of past behavior cannot be a complete repository for accumulating habit strength. Habit strength appeared to be a crucial mediator between intention antecedents (e.g., attitude) and the intention itself. Including habit strength in the TPB model enhanced the explained variance of speeding intention by 26.7%. In addition, AARs were different from attitudes; particularly, young drivers tended to perform speeding behaviors to reduce negative feelings such as regret. The proposed model provides an effective alternative approach for investigating aberrant driving behaviors; corresponding countermeasures are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

What counts as a decision? Predictors of perceived decision making.

PubMed

Chapman, G B; Niedermayer, L Y

2001-09-01

We examined lay perceptions of what counts as a decision. Eighty-six subjects read 10 scenarios that described clear decisions (e.g., choosing a graduate school), clear "nondecisions" (e.g., an accidental wrong turn), or ambiguous actions (e.g., eating a donut when on a diet or allowing someone else to make the decision). The subjects rated each scenario as to whether the actor had made a decision and also rated six other attributes. The scenarios were rated as clearly illustrating a decision if the actor engaged in a lot of thought and did not act reflexively. Consideration of consequences and having alternatives were moderately related to decision ratings, whereas having self-control problems and the influence of physiological drives showed little relationship with decision ratings. Thus, lay concepts of decision making differ from decision theory in that thoughtful, intentional behavior is more important in defining a decision than are decision theoretic components, such as alternatives and consequences.

Decision-making in people who relapsed to driving under the influence of alcohol.

PubMed

Kasar, Muzaffer; Gleichgerrcht, Ezequiel; Keskinkilic, Cahit; Tabo, Abdulkadir; Manes, Facundo F

2010-12-01

Alcohol use has been previously associated with neurocognitive impairments, especially in decision-making cognition. However, some studies have shown little to no decision-making deficits in relation to different characteristics of people with drinking problems. Relapsing to driving under the influence (DUI) of alcohol is an important issue with legal and psychosocial aspects. We evaluated decision-making performance in second-time DUI offenders by using the Iowa Gambling Task (IGT). Thirty-four male second-time DUI offenders who had been selected for an official psychoeducational rehabilitation program and 31 healthy controls that were matched for age, education, and alcohol use were included. Along with psychiatric assessment, we applied conventional neuropsychological testing comprising cognitive set-shifting, response inhibition, attention, and visuospatial abilities. Also, we used the Temperament and Character Inventory (TCI) to assess personality patterns. A computerized version of IGT was used. No significant differences were found between the groups in regard to sociodemographics and conventional neuropsychological testing. DUI participants had significantly higher scores only in "self-transcendence" subdomain of TCI. On the fifth block of the IGT, DUI participants had significantly lower net scores than controls (U = 380.0, p < 0.05). Also, DUI participants chose significantly more risky decks compared to controls. Our results suggest that there may be subtle decision-making deficits in DUI participants, which goes undetected on conventional neuropsychological testing and which is not correlated with TCI subdomains related with impulsivity patterns. Copyright © 2010 by the Research Society on Alcoholism.

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.

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

Determinants of propranolol’s selective effect on loss aversion

PubMed Central

Sokol-Hessner, Peter; Lackovic, Sandra F.; Tobe, Russell H.; Camerer, Colin F.; Leventhal, Bennett L.; Phelps, Elizabeth A.

2015-01-01

Research on emotion and decision-making has suggested that arousal mediates risky decisions (e.g., Bechara et al., 1997), but several distinct and often confounded processes drive such choices. Here, we used econometric modeling to separate and quantify the unique contributions of loss aversion, risk sensitivity and choice consistency to risky decision-making. We administered the beta-blocker propranolol in a double-blind, placebo-controlled within-subjects study, targeting the neurohormonal basis of physiological arousal. Matching our intervention’s pharmacological specificity with a quantitative model delineating decision-making components allowed us to identify the causal relationships between arousal and decision-making that do and do not exist. Propranolol selectively reduced loss aversion in a baseline- and dose-dependent manner (i.e. as a function of initial loss aversion and body-mass index), and did not affect risk sensitivity or choice consistency. These findings provide evidence for a specific, modulatory, and causal relationship between precise components of both emotion and risky decision-making. PMID:26063441

Using Virtual Reality to Assess Ethical Decisions in Road Traffic Scenarios: Applicability of Value-of-Life-Based Models and Influences of Time Pressure.

PubMed

Sütfeld, Leon R; Gast, Richard; König, Peter; Pipa, Gordon

2017-01-01

Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date. Models of ethics for self-driving cars should thus aim to match human decisions made in the same context. We employed immersive virtual reality to assess ethical behavior in simulated road traffic scenarios, and used the collected data to train and evaluate a range of decision models. In the study, participants controlled a virtual car and had to choose which of two given obstacles they would sacrifice in order to spare the other. We randomly sampled obstacles from a variety of inanimate objects, animals and humans. Our model comparison shows that simple models based on one-dimensional value-of-life scales are suited to describe human ethical behavior in these situations. Furthermore, we examined the influence of severe time pressure on the decision-making process. We found that it decreases consistency in the decision patterns, thus providing an argument for algorithmic decision-making in road traffic. This study demonstrates the suitability of virtual reality for the assessment of ethical behavior in humans, delivering consistent results across subjects, while closely matching the experimental settings to the real world scenarios in question.

Using Virtual Reality to Assess Ethical Decisions in Road Traffic Scenarios: Applicability of Value-of-Life-Based Models and Influences of Time Pressure

PubMed Central

Sütfeld, Leon R.; Gast, Richard; König, Peter; Pipa, Gordon

2017-01-01

Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date. Models of ethics for self-driving cars should thus aim to match human decisions made in the same context. We employed immersive virtual reality to assess ethical behavior in simulated road traffic scenarios, and used the collected data to train and evaluate a range of decision models. In the study, participants controlled a virtual car and had to choose which of two given obstacles they would sacrifice in order to spare the other. We randomly sampled obstacles from a variety of inanimate objects, animals and humans. Our model comparison shows that simple models based on one-dimensional value-of-life scales are suited to describe human ethical behavior in these situations. Furthermore, we examined the influence of severe time pressure on the decision-making process. We found that it decreases consistency in the decision patterns, thus providing an argument for algorithmic decision-making in road traffic. This study demonstrates the suitability of virtual reality for the assessment of ethical behavior in humans, delivering consistent results across subjects, while closely matching the experimental settings to the real world scenarios in question. PMID:28725188

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…

Pupil-linked arousal is driven by decision uncertainty and alters serial choice bias

NASA Astrophysics Data System (ADS)

Urai, Anne E.; Braun, Anke; Donner, Tobias H.

2017-03-01

While judging their sensory environments, decision-makers seem to use the uncertainty about their choices to guide adjustments of their subsequent behaviour. One possible source of these behavioural adjustments is arousal: decision uncertainty might drive the brain's arousal systems, which control global brain state and might thereby shape subsequent decision-making. Here, we measure pupil diameter, a proxy for central arousal state, in human observers performing a perceptual choice task of varying difficulty. Pupil dilation, after choice but before external feedback, reflects three hallmark signatures of decision uncertainty derived from a computational model. This increase in pupil-linked arousal boosts observers' tendency to alternate their choice on the subsequent trial. We conclude that decision uncertainty drives rapid changes in pupil-linked arousal state, which shape the serial correlation structure of ongoing choice behaviour.

Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations.

PubMed

Chorpita, Bruce F; Bernstein, Adam; Daleiden, Eric L

2008-03-01

This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Shared decision-making.

PubMed

Godolphin, William

2009-01-01

Shared decision-making has been called the crux of patient-centred care and identified as a key part of change for improved quality and safety in healthcare. However, it rarely happens, is hard to do and is not taught - for many reasons. Talking with patients about options is not embedded in the attitudes or communication skills training of most healthcare professionals. Information tools such as patient decision aids, personal health records and the Internet will help to shift this state, as will policy that drives patient and public involvement in healthcare delivery and training.

Risk-Taking Behavior in a Computerized Driving Task: Brain Activation Correlates of Decision-Making, Outcome, and Peer Influence in Male Adolescents.

PubMed

Vorobyev, Victor; Kwon, Myoung Soo; Moe, Dagfinn; Parkkola, Riitta; Hämäläinen, Heikki

2015-01-01

Increased propensity for risky behavior in adolescents, particularly in peer groups, is thought to reflect maturational imbalance between reward processing and cognitive control systems that affect decision-making. We used functional magnetic resonance imaging (fMRI) to investigate brain functional correlates of risk-taking behavior and effects of peer influence in 18-19-year-old male adolescents. The subjects were divided into low and high risk-taking groups using either personality tests or risk-taking rates in a simulated driving task. The fMRI data were analyzed for decision-making (whether to take a risk at intersections) and outcome (pass or crash) phases, and for the influence of peer competition. Personality test-based groups showed no difference in the amount of risk-taking (similarly increased during peer competition) and brain activation. When groups were defined by actual task performance, risk-taking activated two areas in the left medial prefrontal cortex (PFC) significantly more in low than in high risk-takers. In the entire sample, risky decision-specific activation was found in the anterior and dorsal cingulate, superior parietal cortex, basal ganglia (including the nucleus accumbens), midbrain, thalamus, and hypothalamus. Peer competition increased outcome-related activation in the right caudate head and cerebellar vermis in the entire sample. Our results suggest that the activation of the medial (rather than lateral) PFC and striatum is most specific to risk-taking behavior of male adolescents in a simulated driving situation, and reflect a stronger conflict and thus increased cognitive effort to take risks in low risk-takers, and reward anticipation for risky decisions, respectively. The activation of the caudate nucleus, particularly for the positive outcome (pass) during peer competition, further suggests enhanced reward processing of risk-taking under peer influence.

Understanding commercial truck drivers' decision-makin process concerning distracted driving.

PubMed

Swedler, David I; Pollack, Keshia M; Gielen, Andrea C

2015-05-01

A concurrent mixed methods design was used to explore personal and workplace factors, informed by the Theory of Planned Behavior, that affect truck drivers' decision-making about distracted driving on the job. Qualitative data were collected via semi-structured interviews with experts in truck safety and distracted driving, and quantitative data were collected via online survey of truck drivers in the United States. Findings from the interviews illustrated how drivers perceived distractions and the importance of supervisors enforcing organizational distracted driving policies. Survey results found that behavioral intentions were most important in regards to texting and crash and near-crash outcomes, while perceived norms from management best described the correlation between dispatch device use and negative crash-related outcomes. By using a mixed methods design, rather than two separate studies, these findings revealed nuanced differences into the influence of supervisors on distracted driving. Copyright © 2015 Elsevier Ltd. All rights reserved.

[The price-based certainty of purchase influences consumer behavior for discount].

PubMed

Arihara, Katsuhiko; Ariga, Atsunori; Furuya, Takeshi

2016-04-01

Tversky & Kahneman (1981) reported that most participants decided to drive when they could save money on a low-price good as compared to when they could save on a high-price good, even though the discount prices were same. Although this irrational decision making has been interpreted as a rate-dependent estimation of value (prospect theory), this study newly proposes that it can be explained by the certainty of purchase based on the price of goods. Experiment 1 replicated the previously reported difference in decision making, and additionally demonstrated that participants' certainty of purchase was lower for a high- than a low-price good. When it was emphasized that participants' intention to purchase high- and low-price goods were equally sure, decision making did not significantly differ (Experiment 2). Furthermore, decision making differed based only on the certainty of purchase even,when prices of goods were-same (Experiment 3). Consumers' decision making may be rather rational, depending straightforwardly on the certainty of purchase that is susceptible to price.

Examining the Direct and Indirect Effects of Fear and Anger on Criminal Decision Making Among Known Offenders.

PubMed

Bouffard, Jeff A

2015-12-01

Deterrence represents the central theoretical core of the American criminal justice system, yet relatively little attention has been paid to how emotions like fear and anger may relate to deterrence. Psychological research has debated whether negative emotions each have similar impacts on decision making (valence approaches) or if distinct emotions have unique impacts (appraisal tendency approaches). This study explores the direct and indirect influences of fear and anger on hypothetical drunk driving likelihood, including their impact on cost perceptions. Surveys were administered to 1,013 male and female incarcerated felony offenders in the Southwestern United States. Using a multivariate path model and controlling for a number of other individual factors, current fear related to increased cost perceptions and anger to decreased costs. Anger also maintained a direct influence on drunk driving, whereas fear did not. Despite their shared negative valence, fear and anger appear to have dissimilar influences on cost perceptions and criminal decision making. A better understanding of these processes may lead to improved crime prevention approaches. © The Author(s) 2014.

Older people with mild cognitive impairment -- their views about assessing driving safety.

PubMed

Johnson, David A; Frank, Oliver; Pond, Dimity; Stocks, Nigel

2013-05-01

Driving is important for older people to maintain agency, independence and social connectedness. Little research has been conducted into the views of older people with mild cognitive impairment about who decides if they are safe to drive. This qualitative study investigates the views of older people with mild cognitive impairment about decision making on driving cessation. Participants value their agency; they wanted to decide when they should stop driving themselves. However, they were also prepared to accept their general practitioner's advice when they became unfit to drive. In the interim, they self regulated the timing and distance of their driving to reduce accident risk.

Human Decision Making Based on Variations in Internal Noise: An EEG Study

PubMed Central

Amitay, Sygal; Guiraud, Jeanne; Sohoglu, Ediz; Zobay, Oliver; Edmonds, Barrie A.; Zhang, Yu-Xuan; Moore, David R.

2013-01-01

Perceptual decision making is prone to errors, especially near threshold. Physiological, behavioural and modeling studies suggest this is due to the intrinsic or ‘internal’ noise in neural systems, which derives from a mixture of bottom-up and top-down sources. We show here that internal noise can form the basis of perceptual decision making when the external signal lacks the required information for the decision. We recorded electroencephalographic (EEG) activity in listeners attempting to discriminate between identical tones. Since the acoustic signal was constant, bottom-up and top-down influences were under experimental control. We found that early cortical responses to the identical stimuli varied in global field power and topography according to the perceptual decision made, and activity preceding stimulus presentation could predict both later activity and behavioural decision. Our results suggest that activity variations induced by internal noise of both sensory and cognitive origin are sufficient to drive discrimination judgments. PMID:23840904

Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task.

PubMed

Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F

2013-01-01

An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making.

Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

PubMed Central

Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F.

2014-01-01

An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making. PMID:24478664

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

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

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

Responding to Nonwords in the Lexical Decision Task: Insights from the English Lexicon Project

ERIC Educational Resources Information Center

Yap, Melvin J.; Sibley, Daragh E.; Balota, David A.; Ratcliff, Roger; Rueckl, Jay

2015-01-01

Researchers have extensively documented how various statistical properties of words (e.g., word frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, because a better specification of the mechanisms driving nonword responses may provide…

Decision-making impairments in the context of intact reward sensitivity in schizophrenia.

PubMed

Heerey, Erin A; Bell-Warren, Kimberly R; Gold, James M

2008-07-01

Deficits in motivated behavior and decision-making figure prominently in the behavioral syndrome that characterizes schizophrenia and are difficult both to treat and to understand. One explanation for these deficits is that schizophrenia decreases sensitivity to rewards in the environment. An alternate explanation is that sensitivity to rewards is intact but that poor integration of affective with cognitive information impairs the ability to use this information to guide behavior. We tested reward sensitivity with a modified version of an existing signal detection task with asymmetric reinforcement and decision-making with a probabilistic decision-making task in 40 participants with schizophrenia and 26 healthy participants. Results showed normal sensitivity to reward in participants with schizophrenia but differences in choice patterns on the decision-making task. A logistic regression model of the decision-making data showed that participants with schizophrenia differed from healthy participants in the ability to weigh potential outcomes, specifically potential losses, when choosing between competing response options. Deficits in working memory ability accounted for group differences in ability to use potential outcomes during decision-making. These results suggest that the implicit mechanisms that drive reward-based learning are surprisingly intact in schizophrenia but that poor ability to integrate cognitive and affective information when calculating the value of possible choices might hamper the ability to use such information during explicit decision-making.

Changes of mind in an attractor network of decision-making.

PubMed

Albantakis, Larissa; Deco, Gustavo

2011-06-01

Attractor networks successfully account for psychophysical and neurophysiological data in various decision-making tasks. Especially their ability to model persistent activity, a property of many neurons involved in decision-making, distinguishes them from other approaches. Stable decision attractors are, however, counterintuitive to changes of mind. Here we demonstrate that a biophysically-realistic attractor network with spiking neurons, in its itinerant transients towards the choice attractors, can replicate changes of mind observed recently during a two-alternative random-dot motion (RDM) task. Based on the assumption that the brain continues to evaluate available evidence after the initiation of a decision, the network predicts neural activity during changes of mind and accurately simulates reaction times, performance and percentage of changes dependent on difficulty. Moreover, the model suggests a low decision threshold and high incoming activity that drives the brain region involved in the decision-making process into a dynamical regime close to a bifurcation, which up to now lacked evidence for physiological relevance. Thereby, we further affirmed the general conformance of attractor networks with higher level neural processes and offer experimental predictions to distinguish nonlinear attractor from linear diffusion models.

Data to Decisions: Creating a Culture of Model-Driven Drug Discovery.

PubMed

Brown, Frank K; Kopti, Farida; Chang, Charlie Zhenyu; Johnson, Scott A; Glick, Meir; Waller, Chris L

2017-09-01

Merck & Co., Inc., Kenilworth, NJ, USA, is undergoing a transformation in the way that it prosecutes R&D programs. Through the adoption of a "model-driven" culture, enhanced R&D productivity is anticipated, both in the form of decreased attrition at each stage of the process and by providing a rational framework for understanding and learning from the data generated along the way. This new approach focuses on the concept of a "Design Cycle" that makes use of all the data possible, internally and externally, to drive decision-making. These data can take the form of bioactivity, 3D structures, genomics, pathway, PK/PD, safety data, etc. Synthesis of high-quality data into models utilizing both well-established and cutting-edge methods has been shown to yield high confidence predictions to prioritize decision-making and efficiently reposition resources within R&D. The goal is to design an adaptive research operating plan that uses both modeled data and experiments, rather than just testing, to drive project decision-making. To support this emerging culture, an ambitious information management (IT) program has been initiated to implement a harmonized platform to facilitate the construction of cross-domain workflows to enable data-driven decision-making and the construction and validation of predictive models. These goals are achieved through depositing model-ready data, agile persona-driven access to data, a unified cross-domain predictive model lifecycle management platform, and support for flexible scientist-developed workflows that simplify data manipulation and consume model services. The end-to-end nature of the platform, in turn, not only supports but also drives the culture change by enabling scientists to apply predictive sciences throughout their work and over the lifetime of a project. This shift in mindset for both scientists and IT was driven by an early impactful demonstration of the potential benefits of the platform, in which expert-level early discovery predictive models were made available from familiar desktop tools, such as ChemDraw. This was built using a workflow-driven service-oriented architecture (SOA) on top of the rigorous registration of all underlying model entities.

Canadian psychiatrists' current attitudes, practices, and knowledge regarding fitness to drive in individuals with mental illness: a cross-Canada survey.

PubMed

Ménard, Ingrid; Korner-Bitensky, Nicol; Dobbs, Bonnie; Casacalenda, Nicola; Beck, Philip R; Dippsych, C M; Gélinas, Isabelle; Molnar, Frank J; Naglie, Gary

2006-11-01

To assess current attitudes, practices, and knowledge of Canadian psychiatrists regarding fitness to drive in individuals with mental illness and to explore variations according to provincial legislation. We carried out a national cross-sectional survey, using a random sample of psychiatrists. We used a mail survey to collect data. In total, 248 psychiatrists participated; the response rate was 54.2% on traced subjects. The majority (64.1%) reported that they strongly agreed or agreed that addressing patients' fitness to drive is an important issue. However, only 18.0% of respondents were always aware of whether their patients were active drivers. One-fourth strongly agreed or agreed that they were confident in their ability to evaluate fitness to drive. In discretionary provinces, 29.3% of psychiatrists reported not knowing their provincial legislation, as did 14.6% of psychiatrists in mandatory provinces; of those responding, 54.0% from discretionary provinces and 2.8% from mandatory provinces gave incorrect answers. Psychiatrists' responses demonstrate a broad range of attitudes, practices, and knowledge. There appears to be a large gap between what is expected of psychiatrists and their readiness and self-perceived ability to make informed clinical decisions related to driving safety. There is a clear need for education and guidelines to assist psychiatrists in decision making about driving fitness.

Beyond general behavioral theories: structural discrepancy in young motorcyclist's risky driving behavior and its policy implications.

PubMed

Chung, Yi-Shih; Wong, Jinn-Tsai

2012-11-01

While many studies examine the mean score differences of psychological determinants between heterogeneous driver groups, this study reveals a structural discrepancy in a causal behavioral framework. Using young motorcyclists (ages 18-28) as subjects, this study investigates the various roles of key influential factors in determining risky driving behavior. Multi-group analysis of structural equation modeling shows that age and gender are two factors that can effectively distinguish heterogeneous driver groups exhibiting different decision-making mechanisms in shaping their risky driving behaviors. When encountering undesirable traffic conditions, road rage can immediately increase male motorcyclists' intentions to engage in risky driving behaviors; on the other hand, young female motorcyclists further calculate their perceived risk to determine whether to engage in risky driving behaviors. This result shows that there is a significant link between risk perception and traffic condition awareness for experienced drivers (ages 25-28), but not for younger drivers (ages 18-24). This finding shows that while well-developed theories such as planned behavior and risk homeostasis provide general frameworks to explain risky driving behavior, heterogeneous driver groups may exhibit structural discrepancies that reflect their various decision-making mechanisms. This suggests that, in addition to mean differences, understanding structural discrepancies among heterogeneous groups could help researchers identify effective intervention strategies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Making DATA Work: A Process for Conducting Action Research

ERIC Educational Resources Information Center

Young, Anita; Kaffenberger, Carol

2013-01-01

This conceptual model introduces a process to help school counselors use data to drive decision making and offers examples to implement the process. A step-by-step process is offered to help school counselors and school counselor supervisors address educational issues, close achievement gaps, and demonstrate program effectiveness. To illustrate…

Counselors and Principals: Collaborating to Improve Instructional Equity

ERIC Educational Resources Information Center

Lashley, Carl A.; Stickl, Jaimie

2016-01-01

Data utilization is a key component of school improvement as data can be used to enhance student achievement both systematically and on an individual student level. Through systemically analyzing multiple sources of data, educators can make informed and knowledgeable school improvement decisions. In order to effectively make data-drive decisions…

Farmer Decision-Making for Climate Adaptation

NASA Astrophysics Data System (ADS)

Lubell, M.; Niles, M.; Salerno, J.

2015-12-01

This talk will provide an overview of several studies of how farmers make decisions about climate change adaptation and mitigation. A particular focus will be the "limiting factors hypothesis", which argues that farmers will respond to the climate variables that usually have the largest impact on their crop productivity. For example, the most limiting factor in California is usually water so how climate change affects water will be the largest drive of climate adaptation decisions. This basic idea is drawn from the broader theory of "psychological distance", which argue that human decisions are more attuned to ideas that are psychologically closer in space, time, or other factors. Empirical examples come from California, New Zealand, and Africa.

Rethinking autonomy: decision making between patient and surgeon in advanced illnesses

PubMed Central

Hinshaw, Daniel B.

2016-01-01

Patients with advanced illness such as advanced stage cancer presenting with the need for possible surgical intervention can be some of the most challenging cases for a surgeon. Often there are multiple factors influencing the decisions made. For patients they are facing not just the effects of the disease on their body, but the stark realization that the disease will also limit their life. Not only are these factors a consideration when patients are making decisions, but also the desire to make the decision that is best for themselves, the autonomous decision. Also included in this process for the patient facing the possible need for an intervention is the surgeon. While patient autonomy remains one of the main principles within medicine, guiding treatment decisions, there is also the surgeon’s autonomy to be considered. Surgeons determine if there is even a possible intervention to be offered to patients, a decision making process that respects surgeons’ autonomous choices and includes elements of paternalism as surgeons utilize their expertise to make decisions. Included in the treatment decisions that are made and the care of the patient is the impact patients’ outcomes have on the surgeon, the inherent drive to be the best for the patient and desire for good outcomes for the patient. While both the patient’s and surgeon’s autonomy are a dynamic interface influencing decision making, the main goal for the patient facing a palliative procedure is that of making treatment decisions based on the concept of shared decision making, always giving primary consideration to the patient’s goals and values. Lastly, regardless of the decision made, it is the responsibility of surgeons to their patients to be a source of support through this challenging time. PMID:27004224

A framework to investigate drivers of adaptation decisions in marine fishing: Evidence from urban, semi-urban and rural communities.

PubMed

Malakar, Krishna; Mishra, Trupti; Patwardhan, Anand

2018-05-11

Traditional fishing livelihoods need to adapt to changing fish catch/populations, led by numerous anthropogenic, environmental and climatic stressors. The decision to adapt can be influenced by a variety of socio-economic and perceptual factors. However, adaptation decision-making in fishing communities has rarely been studied. Based on previous literature and focus group discussions with community, this study identifies few prominent adaptation responses in marine fishing and proposes credible factors driving decisions to adopt them. Further, a household survey is conducted, and the association of these drivers with various adaptation strategies is examined among fisherfolk of Maharashtra (India). This statistical analysis is based on 601 responses collected across three regional fishing groups: urban, semi-urban and rural. Regional segregation is done to understand variability in decision-making among groups which might be having different socio-economic and perceptual attributes. The survey reveals that only few urban fishing households have been able to diversify into other livelihoods. While having economic capital increases the likelihood of adaptation among urban and semi-urban communities, rural fishermen are significantly driven by social capital. Perception of climate change affecting fish catch drives adoption of mechanized boats solely in urban region. But increasing number of extreme events affects decisions of semi-urban and rural fishermen. Further, rising pollution and trade competition is associated with adaptation responses in the urban and semi-urban community. Higher education might help fishermen choose convenient forms of adaptation. Also, cooperative membership and subsidies are critical in adaptation decisions. The framework and insights of the study suggest the importance of acknowledging differential decision-making of individuals and communities, for designing effective adaptation and capacity-building policies. Copyright © 2018 Elsevier B.V. All rights reserved.

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.

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

Does Simulator Sickness Impair Learning Decision Making While Driving a Police Vehicle? (Le mal du simulateur: un frein à l'apprentissage de la prise de décision en conduite d'un véhicule de police?)

ERIC Educational Resources Information Center

Paquette, Eve; Bélanger, Danielle-Claude

2015-01-01

The use of driving simulators is an innovation for police training in Quebec. There are some issues related to their impact on training objectives. This article presents the results of a study involving 71 police cadets who participated in six training sessions with a driving simulator. The training sessions were designed for developing the…

Driver fitness medical guidelines.

DOT National Transportation Integrated Search

2009-09-01

This guide provides guidance to assist licensing agencies in making decisions about an individuals fitness for driving. This is the first attempt to produce a consolidated document covering medical conditions included in the task agreement between...

Consensus statements for screening and assessment tools.

PubMed

Bédard, Michel; Dickerson, Anne E

2014-04-01

Occupational therapists, both generalists and specialists, have a critical role in providing services to senior drivers. These services include evaluating fitness-to-drive, developing interventions to support community mobility, and facilitating the transition from driving to non-driving when necessary for personal and community safety. The evaluation component and decision-making process about fitness-to-drive are highly dependent on the use of screening and assessment tools. The purpose of this paper is to briefly present the rationale and context for 12 consensus statements about the usefulness and appropriateness of screening and assessment tools to determine fitness-to-drive, within the occupational therapy clinical setting, and their implications on community mobility.

Reflections from a Professional Learning Community for Researchers Working in Research Alliances. REL 2017-262

ERIC Educational Resources Information Center

Scholz, Carrie; Ehrlich, Stacy B.; Roth, Erin

2017-01-01

There is a well-known disconnect between research and practice in education. Education practitioners and policymakers continue to make little direct use of research findings to drive state, district, school, and classroom decision-making. Conducting collaborative research is challenging--especially for researchers who have never partnered with…

Neural basis of decision making guided by emotional outcomes

PubMed Central

Matsuda, Yoshi-Taka; Fujimura, Tomomi; Ueno, Kenichi; Asamizuya, Takeshi; Suzuki, Chisato; Cheng, Kang; Okanoya, Kazuo; Okada, Masato

2015-01-01

Emotional events resulting from a choice influence an individual's subsequent decision making. Although the relationship between emotion and decision making has been widely discussed, previous studies have mainly investigated decision outcomes that can easily be mapped to reward and punishment, including monetary gain/loss, gustatory stimuli, and pain. These studies regard emotion as a modulator of decision making that can be made rationally in the absence of emotions. In our daily lives, however, we often encounter various emotional events that affect decisions by themselves, and mapping the events to a reward or punishment is often not straightforward. In this study, we investigated the neural substrates of how such emotional decision outcomes affect subsequent decision making. By using functional magnetic resonance imaging (fMRI), we measured brain activities of humans during a stochastic decision-making task in which various emotional pictures were presented as decision outcomes. We found that pleasant pictures differentially activated the midbrain, fusiform gyrus, and parahippocampal gyrus, whereas unpleasant pictures differentially activated the ventral striatum, compared with neutral pictures. We assumed that the emotional decision outcomes affect the subsequent decision by updating the value of the options, a process modeled by reinforcement learning models, and that the brain regions representing the prediction error that drives the reinforcement learning are involved in guiding subsequent decisions. We found that some regions of the striatum and the insula were separately correlated with the prediction error for either pleasant pictures or unpleasant pictures, whereas the precuneus was correlated with prediction errors for both pleasant and unpleasant pictures. PMID:25695644

Neural basis of decision making guided by emotional outcomes.

PubMed

Katahira, Kentaro; Matsuda, Yoshi-Taka; Fujimura, Tomomi; Ueno, Kenichi; Asamizuya, Takeshi; Suzuki, Chisato; Cheng, Kang; Okanoya, Kazuo; Okada, Masato

2015-05-01

Emotional events resulting from a choice influence an individual's subsequent decision making. Although the relationship between emotion and decision making has been widely discussed, previous studies have mainly investigated decision outcomes that can easily be mapped to reward and punishment, including monetary gain/loss, gustatory stimuli, and pain. These studies regard emotion as a modulator of decision making that can be made rationally in the absence of emotions. In our daily lives, however, we often encounter various emotional events that affect decisions by themselves, and mapping the events to a reward or punishment is often not straightforward. In this study, we investigated the neural substrates of how such emotional decision outcomes affect subsequent decision making. By using functional magnetic resonance imaging (fMRI), we measured brain activities of humans during a stochastic decision-making task in which various emotional pictures were presented as decision outcomes. We found that pleasant pictures differentially activated the midbrain, fusiform gyrus, and parahippocampal gyrus, whereas unpleasant pictures differentially activated the ventral striatum, compared with neutral pictures. We assumed that the emotional decision outcomes affect the subsequent decision by updating the value of the options, a process modeled by reinforcement learning models, and that the brain regions representing the prediction error that drives the reinforcement learning are involved in guiding subsequent decisions. We found that some regions of the striatum and the insula were separately correlated with the prediction error for either pleasant pictures or unpleasant pictures, whereas the precuneus was correlated with prediction errors for both pleasant and unpleasant pictures. Copyright © 2015 the American Physiological Society.

Decision tool for clients with medical issues: a framework for identifying driving risk and potential to return to driving.

PubMed

Dickerson, Anne E; Bédard, Michel

2014-04-01

This paper offers occupational therapy generalists and specialists a new framework by which to consider clinical evaluation data and an older adult's driving risk and potential to resume this previously learned skill. Based on Michon's model describing the hierarchy of driving levels, clinical questions identify the factors that may affect a client's fitness to drive. The first part is intended to support clinical judgment of whether a client needs a driving evaluation by a driver rehabilitation specialist. The second part offers a framework to organize clinical data that are already known and determine what other evaluation information is justified and necessary to make a driving recommendation. Methods and rational for use are discussed.

EGD discharge

MedlinePlus

... It is not safe to drive or handle tools or equipment. You should also avoid making important work or legal decisions for the rest of the day, even if you believe your thinking is clear. Keep an eye on the site ...

Modelling human decision-making in coupled human and natural systems

NASA Astrophysics Data System (ADS)

Feola, G.

2012-12-01

A solid understanding of human decision-making is essential to analyze the complexity of coupled human and natural systems (CHANS) and inform policies to promote resilience in the face of environmental change. Human decisions drive and/or mediate the interactions and feedbacks, and contribute to the heterogeneity and non-linearity that characterize CHANS. However, human decision-making is usually over-simplistically modeled, whereby human agents are represented deterministically either as dumb or clairvoyant decision-makers. Decision-making models fall short in the integration of both environmental and human behavioral drivers, and concerning the latter, tend to focus on only one category, e.g. economic, cultural, or psychological. Furthermore, these models render a linear decision-making process and therefore fail to account for the recursive co-evolutionary dynamics in CHANS. As a result, these models constitute only a weak basis for policy-making. There is therefore scope and an urgent need for better approaches to human decision-making, to produce the knowledge that can inform vulnerability reduction policies in the face of environmental change. This presentation synthesizes the current state-of-the-art of modelling human decision-making in CHANS, with particular reference to agricultural systems, and delineates how the above mentioned shortcomings can be overcome. Through examples from research on pesticide use and adaptation to climate change, both based on the integrative agent-centered framework (Feola and Binder, 2010), the approach for an improved understanding of human agents in CHANS are illustrated. This entails: integrative approach, focus on behavioral dynamics more than states, feedbacks between individual and system levels, and openness to heterogeneity.

Evidence-informed decision making for nutrition: African experiences and way forward.

PubMed

Aryeetey, Richmond; Holdsworth, Michelle; Taljaard, Christine; Hounkpatin, Waliou Amoussa; Colecraft, Esi; Lachat, Carl; Nago, Eunice; Hailu, Tesfaye; Kolsteren, Patrick; Verstraeten, Roos

2017-11-01

Although substantial amount of nutrition research is conducted in Africa, the research agenda is mainly donor-driven. There is a clear need for a revised research agenda in Africa which is both driven by and responding to local priorities. The present paper summarises proceedings of a symposium on how evidence can guide decision makers towards context-appropriate priorities and decisions in nutrition. The paper focuses on lessons learnt from case studies by the Evidence Informed Decision Making in Nutrition and Health Network implemented between 2015 and 2016 in Benin, Ghana and South Africa. Activities within these countries were organised around problem-oriented evidence-informed decision-making (EIDM), capacity strengthening and leadership and horizontal collaboration. Using a combination of desk-reviews, stakeholder influence-mapping, semi-structured interviews and convening platforms, these country-level studies demonstrated strong interest for partnership between researchers and decision makers, and use of research evidence for prioritisation and decision making in nutrition. Identified capacity gaps were addressed through training workshops on EIDM, systematic reviews, cost-benefit evaluations and evidence contextualisation. Investing in knowledge partnerships and development of capacity and leadership are key to drive appropriate use of evidence in nutrition policy and programming in Africa.

Prospect balancing theory: Bounded rationality of drivers' speed choice.

PubMed

Schmidt-Daffy, Martin

2014-02-01

This paper introduces a new approach to model the psychological determinants of drivers' speed choice: prospect-balancing theory. The theory transfers psychological insight into the bounded rationality of human decision-making to the field of driving behaviour. Speed choice is conceptualized as a trade-off between two options for action: the option to drive slower and the option to drive faster. Each option is weighted according to a subjective value and a subjectively weighted probability attributed to the achievement of the associated action goal; e.g. to avoid an accident by driving more slowly. The theory proposes that the subjective values and weightings of probability differ systematically from the objective conditions and thereby usually favour a cautious speed choice. A driving simulation study with 24 male participants supports this assumption. In a conflict between a monetary gain in case of fast arrival and a monetary loss in case of a collision with a deer, participants chose a velocity lower than that which would maximize their pay-out. Participants' subjective certainty of arriving in time and of avoiding a deer collision assessed at different driving speeds diverged from the respective objective probabilities in accordance with the observed bias in choice of speed. Results suggest that the bounded rationality of drivers' speed choice might be used to support attempts to improve road safety. Thus, understanding the motivational and perceptual determinants of this intuitive mode of decision-making might be a worthwhile focus of future research. Copyright © 2013 Elsevier Ltd. All rights reserved.

Predicting DUI decisions in different legal environments: investigating deterrence with a conjoint experiment.

PubMed

Yao, Jie; Johnson, Mark B; Beck, Kenneth H

2014-01-01

Driving under the influence (DUI) enforcement practices and sanctions contribute differentially to the certainty, swiftness, and severity of punishment, which are the key components of general deterrence theory. This study used a conjoint experiment to understand the decision-making process of potential DUI offenders and tested how variation in enforcement and legal punishment affects drinking and driving decisions. It sought to verify and quantify the unique deterrent effects of certainty, severity, and swiftness and to predict the rates of drinking and driving in different legal environments. One hundred twenty-one college seniors and graduate students at the University of Maryland participated in the Web-based conjoint experiment. They were randomly assigned to 4 blocks, each of which included 9 hypothetical scenarios composed of different levels of DUI enforcement and penalties. Respondents were asked to state their likelihood of drinking and driving under each scenario, as well as their estimated chance of being caught by the police for DUI. Intensified enforcement, harsh jail penalty, and immediate long license suspension were found to be the strongest deterrents to drinking and driving. Alternative ways to get home were also important in reducing people's willingness to drive. These factors accounted for most of the attribute effect on the DUI decision, whereas delayed punishment due to judicial processing, fine penalty, and legal blood alcohol concentration (BAC) limit had negligible effects. For the personal characteristics, college seniors and those who had previously driven after drinking were more likely to choose to drink and drive, whereas those who expect a jail penalty for a DUI offense were less likely to drive. Our research confirmed and quantified certainty of punishment as the greatest deterrent to DUI, but it also indicated the equally important effect of a severe jail penalty. It provides evidence on the feasibility of using a conjoint experiment in future studies to understand the general driver population and, with the help of a simulation tool, to predict DUI decisions in different legal environments. Such predictions can be used to better inform policy decisions on developing targeted general deterrence programs in different communities.

Migrant decision-making in a frontier landscape

NASA Astrophysics Data System (ADS)

Salerno, Jonathan

2016-04-01

Across the tropics, rural farmers and livestock keepers use mobility as an adaptive livelihood strategy. Continued migration to and within frontier areas is widely viewed as a driver of environmental decline and biodiversity loss. Recent scholarship advances our understanding of migration decision-making in the context of changing climate and environments, and in doing so it highlights the variation in migration responses to primarily economic and environmental factors. Building on these insights, this letter investigates past and future migration decisions in a frontier landscape of Tanzania, East Africa. Combining field observations and household data within a multilevel modeling framework, the letter analyzes the explicit importance of social factors relative to economic and environmental factors in driving decisions to migrate or remain. Results indeed suggest that local community ties and non-local social networks drive both immobility and anticipated migration, respectively. In addition, positive interactions with local protected natural resource areas promote longer-term residence. Findings shed new light on how frontier areas transition to human dominated landscapes. This highlights critical links between migration behavior and the conservation of biodiversity and management of natural resources, as well as how migrants evolve to become integrated into communities.

Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis.

PubMed

Dekkers, Tycho J; Popma, Arne; Agelink van Rentergem, Joost A; Bexkens, Anika; Huizenga, Hilde M

2016-04-01

ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Getting the Balance Right: Conceptual Considerations Concerning Legal Capacity and Supported Decision-Making.

PubMed

Parker, Malcolm

2016-09-01

The United Nations Convention on the Rights of Persons with Disabilities urges and requires changes to how signatories discharge their duties to people with intellectual disabilities, in the direction of their greater recognition as legal persons with expanded decision-making rights. Australian jurisdictions are currently undertaking inquiries and pilot projects that explore how these imperatives should be implemented. One of the important changes advocated is to move from guardianship models to supported or assisted models of decision-making. A driving force behind these developments is a strong allegiance to the social model of disability, in the formulation of the Convention, in inquiries and pilot projects, in implementation and in the related academic literature. Many of these instances suffer from confusing and misleading statements and conceptual misinterpretations of certain elements such as legal capacity, decision-making capacity, and support for decision-making. This paper analyses some of these confusions and their possible negative implications for supported decision-making instruments and those whose interests these instruments would serve, and advises a more incremental development of existing guardianship regimes. This provides a more realistic balance between neglecting the real limits of those with mental disabilities and thereby ignoring their identity and particularity, and continuing to bring them equally and fully into society.

Choice and Control Within Family Relationships: The Lived Experience of Adults With Intellectual Disability.

PubMed

Curryer, Bernadette; Stancliffe, Roger J; Dew, Angela; Wiese, Michele Y

2018-06-01

Increased choice and control is a driving force of current disability policy in Australia for people with disability and their families. Yet little is known of how adults with intellectual disability (ID) actually experience choice and control within their family relationships. We used interpretative phenomenological analysis of individual, semistructured interviews conducted with 8 Australian adults with ID to understand the meaning given to their experience of family support received around choice and decision making. Three themes were identified: (1) centrality of family, (2) experience of self-determination, and (3) limitations to choice and control. The participants identified trusted family members from whom guidance around choice and decision making was both sought and received, often involving mutual decision making and limitations to control.

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

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

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

Nissan North America: How Sub-Metering Changed the Way a Plant Does Business

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

None

2011-06-30

Case study - For Nissan, sub-metering data now drives decision-making and has empowered plant staff, helped senior leadership understand the bottom-line impact of proposed projects, and produced meaningful energy savings.

Examination of personality traits and social problem-solving skills of individuals whose driving licenses have been confiscated due to drunk driving.

PubMed

Taymur, Ibrahim; Budak, Ersin; Duyan, Veli; Kanat, Bilgen Biçer; Önen, Sinay

2017-01-02

Drunk driving is one of the major behavioral issues connected with problematic alcohol consumption. The objective of this study was to evaluate the relationship between personality traits and social problem-solving skills of individuals who drive while intoxicated. One hundred forty-four individuals apprehended twice while driving drunk and sent to a driver behavior training program (9 females and 135 males) participated in our study. The Eysenck Personality Questionnaire Revised-Abbreviated (EPQ-RA) composed of 4 subscales (Extroversion, Neuroticism, Psychoticism, and Lying) and the Social Problem Solving Inventory (SPSI) composed of 7 subscales (Cognitive, Emotion, Behavior, Problem Definition and Formulation, Creating Solution Options, Solution Implementation and Verification, and Decision Making) were used to evaluate the participants. A positive relationship was found between the Extroversion subscale of the EPQ-RA and the Cognition subscale (P <.01), Emotion subscale (P <.01), Behavior subscale (P <.01), Generation of Alternatives subscale (P <.01), Decision Making subscale (P <.05), and Solution Implementation and Verification subscale (P <.01). For individuals who repeated intoxicated driving, all subscales of the EPQ-RA (Extroversion, Lying, Neuroticism, and Psychoticism subscales) explained 12% of the scores of the Cognition subscale and 16.2% (P <.001) of the Emotion subscale of the SPSI. There was no significant relationship between the first and second incident alcohol blood levels (P >.05). Drinking and driving behaviors appear to be negative or maladaptive behaviors closely related to personality traits and may represent an effort to avoid negative emotions. Evaluation of negative emotions may have an important place in training programs intended to change drunk driving behavior.

Strategic analytics: towards fully embedding evidence in healthcare decision-making.

PubMed

Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

2015-01-01

Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

Using wind plant data to increase reliability.

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

Peters, Valerie A.; Ogilvie, Alistair B.; McKenney, Bridget L.

2011-01-01

Operators interested in improving reliability should begin with a focus on the performance of the wind plant as a whole. To then understand the factors which drive individual turbine performance, which together comprise the plant performance, it is necessary to track a number of key indicators. Analysis of these key indicators can reveal the type, frequency, and cause of failures and will also identify their contributions to overall plant performance. The ideal approach to using data to drive good decisions includes first determining which critical decisions can be based on data. When those required decisions are understood, then the analysismore » required to inform those decisions can be identified, and finally the data to be collected in support of those analyses can be determined. Once equipped with high-quality data and analysis capabilities, the key steps to data-based decision making for reliability improvements are to isolate possible improvements, select the improvements with largest return on investment (ROI), implement the selected improvements, and finally to track their impact.« less

The Factors that Influence Data Utilization in Decision-Making: The Case of HIV/AIDS Programs in Mexico

ERIC Educational Resources Information Center

Rodriguez, Daniela Cristina

2011-01-01

In Mexico, as in many other countries, HIV/AIDS strategies are developed at the federal level and implemented at the state level. Local programs are expected to use data, in particular surveillance data, to drive their decisions on programmatic activities and prioritize populations with which the program will engage. Since the early 1980s Mexico…

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

PubMed

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

2017-04-01

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

As Blood Alcohol Content (BAC) Increases, So Does Impairment | NIH MedlinePlus the Magazine

MedlinePlus

... Impairment – 0.16 - 0.30% Speech, memory, coordination, attention, reaction time, balance significantly impaired All driving-related skills dangerously impaired Judgement and decision making dangerously impaired Blackouts (amnesia) Vomiting and other signs ...

Use of reward-penalty structures in human experimentation

NASA Technical Reports Server (NTRS)

Stein, A. C.; Allen, R. W.; Schwartz, S. H.

1978-01-01

The use of motivational techniques in human performance research is reviewed and an example study employing a reward-penalty structure to simulate the motivations inherent in a real-world situation is presented. Driver behavior in a decision-making driving scenario was studied. The task involved control of an instrumented car on a cooperative test course. Subjects were penalized monetarily for tickets and accidents and rewarded for saving driving time. Two groups were assigned different ticket penalties. The group with the highest penalties tended to drive more conservatively. However, the average total payoff to each group was the same, as the conservative drivers traded off slower driving times with lower ticket penalties.

A unified framework for addiction: Vulnerabilities in the decision process

PubMed Central

Redish, A. David; Jensen, Steve; Johnson, Adam

2013-01-01

The understanding of decision-making systems has come together in recent years to form a unified theory of decision-making in the mammalian brain as arising from multiple, interacting systems (a planning system, a habit system, and a situation-recognition system). This unified decision-making system has multiple potential access points through which it can be driven to make maladaptive choices, particularly choices that entail seeking of certain drugs or behaviors. We identify 10 key vulnerabilities in the system: (1) moving away from homeostasis, (2) changing allostatic set points, (3) euphorigenic “reward-like” signals, (4) overvaluation in the planning system, (5) incorrect search of situation-action-outcome relationships, (6) misclassification of situations, (7) overvaluation in the habit system, (8) a mismatch in the balance of the two decision systems, (9) over-fast discounting processes, and (10) changed learning rates. These vulnerabilities provide a taxonomy of potential problems with decision-making systems. Although each vulnerability can drive an agent to return to the addictive choice, each vulnerability also implies a characteristic symptomology. Different drugs, different behaviors, and different individuals are likely to access different vulnerabilities. This has implications for an individual’s susceptibility to addiction and the transition to addiction, for the potential for relapse, and for the potential for treatment. PMID:18662461

Decision making in critically ill patients with hematologic malignancy.

PubMed Central

Crawford, S. W.

1991-01-01

Hematologic neoplasms that were previously considered fatal are now potentially curable with techniques such as bone marrow transplantation. Such therapies also carry significant morbidity and mortality. With the increasing application of these therapies, a growing number of physicians are using medical decision making regarding critical care for these patients. The process by which ethical decisions are reached for these critically ill patients may be baffling because of several factors: rapidly evolving treatments, uncertain probabilities of the cure of the malignant disorder, the relatively young age of many of these patients, and the poor prognosis with critical illness. I discuss a process to reach acceptable decisions, providing a case example of the application of the process. This process is derived from the ethical principles that drive decision making in general medicine and attempts to maximize patients' autonomy. It involves a consideration of accurate information regarding the disease process and the prognosis, a clear delineation of the goals of the medical care, and communication with patients. Appropriate, ethical, and consistent decisions regarding the critical care of patients with hematologic malignancy can be reached when these considerations are addressed. PMID:1815387

Building the Capacity of Principals and Teacher-Leaders to Implement Effective School and Classroom Practices.

ERIC Educational Resources Information Center

Southern Regional Education Board (SREB), 2012

2012-01-01

Great leaders make great schools. The most successful school leaders create a school climate of high achievement and continuous improvement, give teachers a voice in decision-making, use data to drive curriculum and instruction, and assure students and parents that everyone at the school is focusing on student success. They know what is going on…

The Correlation of Data-Driven Instruction to Teacher-Effectiveness, Teacher-Collaboration, and Teacher-Satisfaction

ERIC Educational Resources Information Center

Shaw, Rhonda R.

2017-01-01

Education reform is inevitable; however, the journey of reform must ensure that educators are equipped to meet the diverse needs of all children within the classrooms throughout. Data-driven decision making is going to be the driving force for making that happen. This mixed model research was designed to show how implementing data-driven…

Striatal Activity Underlies Novelty-Based Choice in Humans

PubMed Central

Wittmann, Bianca C.; Daw, Nathaniel D.; Seymour, Ben; Dolan, Raymond J.

2008-01-01

Summary The desire to seek new and unfamiliar experiences is a fundamental behavioral tendency in humans and other species. In economic decision making, novelty seeking is often rational, insofar as uncertain options may prove valuable and advantageous in the long run. Here, we show that, even when the degree of perceptual familiarity of an option is unrelated to choice outcome, novelty nevertheless drives choice behavior. Using functional magnetic resonance imaging (fMRI), we show that this behavior is specifically associated with striatal activity, in a manner consistent with computational accounts of decision making under uncertainty. Furthermore, this activity predicts interindividual differences in susceptibility to novelty. These data indicate that the brain uses perceptual novelty to approximate choice uncertainty in decision making, which in certain contexts gives rise to a newly identified and quantifiable source of human irrationality. PMID:18579085

Use of statistical and pharmacokinetic-pharmacodynamic modeling and simulation to improve decision-making: A section summary report of the trends and innovations in clinical trial statistics conference.

PubMed

Kimko, Holly; Berry, Seth; O'Kelly, Michael; Mehrotra, Nitin; Hutmacher, Matthew; Sethuraman, Venkat

2017-01-01

The application of modeling and simulation (M&S) methods to improve decision-making was discussed during the Trends & Innovations in Clinical Trial Statistics Conference held in Durham, North Carolina, USA on May 1-4, 2016. Uses of both pharmacometric and statistical M&S were presented during the conference, highlighting the diversity of the methods employed by pharmacometricians and statisticians to address a broad range of quantitative issues in drug development. Five presentations are summarized herein, which cover the development strategy of employing M&S to drive decision-making; European initiatives on best practice in M&S; case studies of pharmacokinetic/pharmacodynamics modeling in regulatory decisions; estimation of exposure-response relationships in the presence of confounding; and the utility of estimating the probability of a correct decision for dose selection when prior information is limited. While M&S has been widely used during the last few decades, it is expected to play an essential role as more quantitative assessments are employed in the decision-making process. By integrating M&S as a tool to compile the totality of evidence collected throughout the drug development program, more informed decisions will be made.

Validation of the standardized field sobriety test battery at BACs below 0.10 percent

DOT National Transportation Integrated Search

1998-08-01

This study evaluated the accuracy of the National Highway Traffic Safety Administration's (NHTSA's) Standardized Field Sobriety Test (SFST) battery to assist officers in making arrest decisions for Driving While Intoxicated (DWI) at blood alcohol con...

Power Systems of the Future: A 21st Century Power Partnership Thought Leadership Report

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

Zinaman, Owen; Miller, Mackay; Adil, Ali

This report summarizes key forces driving transformation in the power sector around the world, presents a framework for evaluating decisions regarding extent and pace of change, and defines pathways for transformation. Powerful trends in technology, policy environments, financing, and business models are driving change in power sectors globally. In light of these trends, the question is no longer whether power systems will be transformed, but rather how these transformations will occur. Three approaches to policy and technology decision-making can guide these transformations: adaptive, reconstructive, and evolutionary. Within these approaches, we explore the five pathways that have emerged as viable modelsmore » for power system transformation.« less

[The neural mechanisms of cigarette craving and self-control].

PubMed

Hayashi, Takuya

2014-01-01

A craving for cigarettes or drugs has been believed to be a fundamental psychopathological factor that drives drug-seeking behavior and relapse. Behavioral economics has revealed context-dependent changes in drug craving. Neuroimaging studies have also found craving-related signals that were altered depending on the context of the experiments. A rational decision-making theory modeled such context-dependency and uncovered a pivotal role of the prefrontal cortical circuit in both self-control and craving. Future studies should address how dopaminergic function and stress circuits can modify the function of decision-making circuits, and produce either craving or self-control.

DriveID: safety innovation through individuation.

PubMed

Sawyer, Ben; Teo, Grace; Mouloua, Mustapha

2012-01-01

The driving task is highly complex and places considerable perceptual, physical and cognitive demands on the driver. As driving is fundamentally an information processing activity, distracted or impaired drivers have diminished safety margins compared with non- distracted drivers (Hancock and Parasuraman, 1992; TRB 1998 a & b). This competition for sensory and decision making capacities can lead to failures that cost lives. Some groups, teens and elderly drivers for example, have patterns of systematically poor perceptual, physical and cognitive performance while driving. Although there are technologies developed to aid these different drivers, these systems are often misused and underutilized. The DriveID project aims to design and develop a passive, automated face identification system capable of robustly identifying the driver of the vehicle, retrieve a stored profile, and intelligently prescribing specific accident prevention systems and driving environment customizations.

Older driver self-screening based on health concerns. Volume 2, Appendices

DOT National Transportation Integrated Search

2008-10-01

The objective of this project was to create a valid and effective Web-based self-screening instrument to provide older drivers with individualized information to help them make better decisions about driving. The project was intended to improve upon ...

Conscious sedation for surgical procedures

MedlinePlus

... go home 1 to 2 hours after your procedure. When you are home: Eat a healthy meal to restore your energy. You should be able to return to your everyday activities the next day. Avoid driving, operating machinery, drinking alcohol, and making legal decisions for ...

Older driver self-screening based on health concerns. Volume 1, Technical Report

DOT National Transportation Integrated Search

2008-10-01

The objective of this project was to create a valid and effective Web-based self-screening instrument to provide older drivers with individualized information to help them make better decisions about driving. The project was intended to improve upon ...

Family Influences on College Students' Occupational Identity

ERIC Educational Resources Information Center

Berrios-Allison, Ana C.

2005-01-01

The occupational identity statuses of 232 college students were analyzed by examining their family emotional environment and the identity control processes that drive career decision making. Results of multivariate analysis showed that each family differentiation construct, family tolerance for connectedness, and separateness explained significant…

Caring for Your Percutaneous Nephrostomy Tube

MedlinePlus

... tube If the tube falls out, call your clinic immediately; do not attempt to reinsert it yourself. If you received sedation or anesthesia, you should not drive, operate machinery, drink alcohol, or make important or legal decisions for 24 hours. Discuss with your physician when ...

Decisions and desire.

PubMed

Morse, Gardiner

2006-01-01

When we make decisions, we're not always in charge. One moment we hotheadedly let our emotions get the better of us; the next, we're paralyzed by uncertainty. Then we'll pull a brilliant decision out of thin air--and wonder how we did it. Though we may have no idea how decision making happens, neuroscientists peering deep into our brains are beginning to get the picture. What they're finding may not be what you want to hear, but it's worth listening. We have dog brains, basically, with human cortexes stuck on top. By watching the brain in action as it deliberates and decides, neuroscientists are finding that not a second goes by that our animal brains aren't conferring with our modern cortexes to influence their choices. Scientists have discovered, for example, that the "reward" circuits in the brain that activate in response to cocaine, chocolate, sex, and music also find pleasure in the mere anticipation of making money--or getting revenge. And the "aversion" circuits that react to the threat of physical pain also respond with disgust when we feel cheated by a partner. In this article, HBR senior editor Gardiner Morse describes the experiments that illuminate the aggressive participation of our emotion-driven animal brains in decision making. This research also shows that our emotional brains needn't always operate beneath our radar. While our dog brains sometimes hijack our higher cognitive functions to drive bad, or at least illogical, decisions, they play an important part in rational decision making as well. The more we understand about how we make decisions, the better we can manage them.

Smart Grid as Multi-layer Interacting System for Complex Decision Makings

NASA Astrophysics Data System (ADS)

Bompard, Ettore; Han, Bei; Masera, Marcelo; Pons, Enrico

This chapter presents an approach to the analysis of Smart Grids based on a multi-layer representation of their technical, cyber, social and decision-making aspects, as well as the related environmental constraints. In the Smart Grid paradigm, self-interested active customers (prosumers), system operators and market players interact among themselves making use of an extensive cyber infrastructure. In addition, policy decision makers define regulations, incentives and constraints to drive the behavior of the competing operators and prosumers, with the objective of ensuring the global desired performance (e.g. system stability, fair prices). For these reasons, the policy decision making is more complicated than in traditional power systems, and needs proper modeling and simulation tools for assessing "in vitro" and ex-ante the possible impacts of the decisions assumed. In this chapter, we consider the smart grids as multi-layered interacting complex systems. The intricacy of the framework, characterized by several interacting layers, cannot be captured by closed-form mathematical models. Therefore, a new approach using Multi Agent Simulation is described. With case studies we provide some indications about how to develop agent-based simulation tools presenting some preliminary examples.

Fast but not intuitive, slow but not reflective: Decision conflict drives reaction times in social dilemmas.

PubMed

Evans, Anthony M; Dillon, Kyle D; Rand, David G

2015-10-01

When people have the chance to help others at a cost to themselves, are cooperative decisions driven by intuition or reflection? To answer this question, recent studies have tested the relationship between reaction times (RTs) and cooperation, reporting both positive and negative correlations. To reconcile this apparent contradiction, we argue that decision conflict (rather than the use of intuition vs. reflection) drives response times, leading to an inverted-U shaped relationship between RT and cooperation. Studies 1 through 3 show that intermediate decisions take longer than both extremely selfish and extremely cooperative decisions. Studies 4 and 5 find that the conflict between self-interested and cooperative motives explains individual differences in RTs. Manipulating conflictedness causes longer RTs and more intermediate decisions, and RTs mediate the relationship between conflict and intermediate decisions. Finally, Studies 6 and 7 demonstrate that conflict is distinct from reflection by manipulating the use of intuition (vs. reflection). Experimentally promoting reliance on intuition increases cooperation, but has no effects on decision extremity or feelings of conflictedness. In sum, we provide evidence that RTs should not be interpreted as a direct proxy for the use of intuitive or reflective processes, and dissociate the effects of conflict and reflection in social decision making. (c) 2015 APA, all rights reserved).

IBM's Health Analytics and Clinical Decision Support.

PubMed

Kohn, M S; Sun, J; Knoop, S; Shabo, A; Carmeli, B; Sow, D; Syed-Mahmood, T; Rapp, W

2014-08-15

This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation.

Development of a decision-making tool for reporting drivers with mild dementia and mild cognitive impairment to transportation administrators.

PubMed

Cameron, Duncan H; Zucchero Sarracini, Carla; Rozmovits, Linda; Naglie, Gary; Herrmann, Nathan; Molnar, Frank; Jordan, John; Byszewski, Anna; Tang-Wai, David; Dow, Jamie; Frank, Christopher; Henry, Blair; Pimlott, Nicholas; Seitz, Dallas; Vrkljan, Brenda; Taylor, Rebecca; Masellis, Mario; Rapoport, Mark J

2017-09-01

Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators. A multi-faceted, computerized decision support tool was developed, using a systematic literature and guideline review, expert opinion from an earlier Delphi study, as well as qualitative interviews and focus groups with physicians, caregivers of former drivers with dementia, and transportation administrators. The tool integrates inputs from the physician-user about the patient's clinical and driving history as well as cognitive findings, and it produces a recommendation for reporting to transportation administrators. This recommendation is translated into a customized reporting form for the transportation authority, if applicable, and additional resources are provided for the patient and caregiver. An innovative approach was needed to develop the DD-DT. The literature and guideline review confirmed the algorithm derived from the earlier Delphi study, and barriers identified in the qualitative research were incorporated into the design of the tool.

Critical Infrastructure: The National Asset Database

DTIC Science & Technology

2006-09-14

NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION...that, in its current form, it is being used inappropriately as the basis upon which federal resources, including infrastructure protection grants , are...National Asset Database has been used to support federal grant -making decisions, according to a DHS official, it does not drive those decisions. In July

Application of Bayesian and cost benefit risk analysis in water resources management

NASA Astrophysics Data System (ADS)

Varouchakis, E. A.; Palogos, I.; Karatzas, G. P.

2016-03-01

Decision making is a significant tool in water resources management applications. This technical note approaches a decision dilemma that has not yet been considered for the water resources management of a watershed. A common cost-benefit analysis approach, which is novel in the risk analysis of hydrologic/hydraulic applications, and a Bayesian decision analysis are applied to aid the decision making on whether or not to construct a water reservoir for irrigation purposes. The alternative option examined is a scaled parabolic fine variation in terms of over-pumping violations in contrast to common practices that usually consider short-term fines. The methodological steps are analytically presented associated with originally developed code. Such an application, and in such detail, represents new feedback. The results indicate that the probability uncertainty is the driving issue that determines the optimal decision with each methodology, and depending on the unknown probability handling, each methodology may lead to a different optimal decision. Thus, the proposed tool can help decision makers to examine and compare different scenarios using two different approaches before making a decision considering the cost of a hydrologic/hydraulic project and the varied economic charges that water table limit violations can cause inside an audit interval. In contrast to practices that assess the effect of each proposed action separately considering only current knowledge of the examined issue, this tool aids decision making by considering prior information and the sampling distribution of future successful audits.

Calibration of skill and judgment in driving: development of a conceptual framework and the implications for road safety.

PubMed

Horrey, William J; Lesch, Mary F; Mitsopoulos-Rubens, Eve; Lee, John D

2015-03-01

Humans often make inflated or erroneous estimates of their own ability or performance. Such errors in calibration can be due to incomplete processing, neglect of available information or due to improper weighing or integration of the information and can impact our decision-making, risk tolerance, and behaviors. In the driving context, these outcomes can have important implications for safety. The current paper discusses the notion of calibration in the context of self-appraisals and self-competence as well as in models of self-regulation in driving. We further develop a conceptual framework for calibration in the driving context borrowing from earlier models of momentary demand regulation, information processing, and lens models for information selection and utilization. Finally, using the model we describe the implications for calibration (or, more specifically, errors in calibration) for our understanding of driver distraction, in-vehicle automation and autonomous vehicles, and the training of novice and inexperienced drivers. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Simulating motivated cognition

NASA Technical Reports Server (NTRS)

Gevarter, William B.

1991-01-01

A research effort to develop a sophisticated computer model of human behavior is described. A computer framework of motivated cognition was developed. Motivated cognition focuses on the motivations or affects that provide the context and drive in human cognition and decision making. A conceptual architecture of the human decision-making approach from the perspective of information processing in the human brain is developed in diagrammatic form. A preliminary version of such a diagram is presented. This architecture is then used as a vehicle for successfully constructing a computer program simulation Dweck and Leggett's findings that relate how an individual's implicit theories orient them toward particular goals, with resultant cognitions, affects, and behavior.

Guidelines for the use of pavement marking symbols at freeway interchanges : final report.

DOT National Transportation Integrated Search

2010-03-01

Pavement marking technology has advanced to allow for the use of large multi-color symbols to be placed on : the pavement as a means of providing drivers with another source of information from which they can make : good driving decisions. This proje...

Environmental Fate and Bioaccumulation Modelling at the US Environmental Protection Agency: Application to Inform Decision-Making

EPA Science Inventory

This chapter reviews the regulatory background and policy applications driving the use of various types of environmental fate and bioaccumulation models at US EPA (air quality, surface water and watersheds, contaminated sites). Comparing current research frontiers with contempora...

Plug-In Electric Vehicle Handbook for Consumers (Spanish Version); Clean Cities, Energy Efficiency & Renewable Energy (EERE)

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

None

This is a Spanish-language handbook designed to answer a consumer's basic questions, as well as point them to additional information they need, to make the best decision about whether an electric-drive vehicle is right for them.

Modifying Evaluations and Decisions in Risky Situations.

PubMed

Maldonado, Antonio; Serra, Sara; Catena, Andrés; Cándido, Antonio; Megías, Alberto

2016-09-20

The main aim of this research was to investigate the decision making process in risky situations. We studied how different types of feedback on risky driving behaviors modulate risk evaluation and risk-taking. For a set of risky traffic situations, participants had to make evaluative judgments (judge the situation as risky or not) and urgent decisions (brake or not). In Experiment 1, participants received feedback with and without negative emotional content when they made risky behaviors. In Experiment 2 we investigated the independent effects of feedback and negative emotional stimuli. The results showed three important findings: First, urgent decisions were faster [F(1, 92) = 6.76, p = .01] and more cautious [F(1, 92) = 17.16, p < .001] than evaluative judgments. These results suggest that evaluative judgments of risk and actual risk-taking may not always coincide, and that they seem to be controlled by two different processing systems as proposed by dual process theories. Second, feedback made participants' responses even faster [F(1, 111) = 71.53, p < .001], allowing greater risk sensitivity [F(1, 111) = 22.12, p < .001] and skewing towards more cautious responses [F(1, 111) = 14.09, p < .001]. Finally, emotional stimuli had an effect only when they were presented as feedback. The results of this research increase our understanding of the processes involved in risky driving behavior and suggest efficient ways to control risk taking through the use of feedback.

Addiction, Drinking Behavior, and Driving Under the Influence

PubMed Central

Sloan, Frank A.; Chepke, Lindsey M.; Davis, Dontrell V.

2012-01-01

Using a survey of drinkers (N=1,634), we evaluated alternative explanations of heavy and binge drinking, driving under the influence (DUI), DUI arrests, speeding citations, and chargeable accidents. Explanations included socializing, short-term decision-making, unrealistic optimism, risk preferring behavior, and addiction. Most consistent relationships were between substance use and alcohol addiction and dependent variables for (1) binge drinking and (2) DUI episodes. Respondent characteristics (age, marital and employment status, race) had important roles for DUI arrests. Drinker-drivers and those arrested for DUI are partially overlapping groups with implications for treatment and policies detecting and incapacitating persons from drinking and driving. PMID:24304171

Addiction, drinking behavior, and driving under the influence.

PubMed

Sloan, Frank A; Eldred, Lindsey M; Davis, Dontrell V

2014-05-01

Using a survey of drinkers (N = 1,634), we evaluated alternative explanations of heavy and binge drinking, driving under the influence (DUI), DUI arrests, speeding citations, and chargeable accidents. Explanations included socializing, short-term decision-making, unrealistic optimism, risk preferring behavior, and addiction. Most consistent relationships were between substance use and alcohol addiction and dependent variables for (1) binge drinking and (2) DUI episodes. Respondent characteristics (age, marital and employment status, race, etc.) had important roles for DUI arrests. Drinker-drivers and those arrested for DUI are partially overlapping groups with implications for treatment and policies detecting and incapacitating persons from drinking and driving.

Emotional reactions in moral decision-making are influenced by empathy and alexithymia.

PubMed

Cecchetto, Cinzia; Korb, Sebastian; Rumiati, Raffaella Ida; Aiello, Marilena

2018-04-01

The role of emotional processes in driving moral choices remains debated. In particular, diminished emotional processing and reduced empathy have been associated with unusual high rates of utilitarian responses in moral judgments while, to date, the effects of diminished emotional processing and empathy on moral decision-making have been only partially considered. In this study, we investigated the influence of empathy and alexithymia on behavior and emotional responses while participants performed a moral decision task. Self-report (valence and arousal ratings) and physiological (skin conductance and heart rate) measures were collected during the task. Results showed that empathy and alexithymia shaped emotional reactions to moral decisions but did not bias moral choices. The more empathic the participants, the more dilemmas were perceived as unpleasant and arousing, and the greater the increase in skin conductance. Conversely, alexithymia was characterized by a reduced physiological activation during moral decisions, but normal self-report ratings. Heart rate was not modulated by empathy or alexithymia. These results add new evidence to the field of moral decision showing that empathy and alexithymia modulate emotional reactions to moral decision.

Application of risk analysis in water resourses management

NASA Astrophysics Data System (ADS)

Varouchakis, Emmanouil; Palogos, Ioannis

2017-04-01

A common cost-benefit analysis approach, which is novel in the risk analysis of hydrologic/hydraulic applications, and a Bayesian decision analysis are applied to aid the decision making on whether or not to construct a water reservoir for irrigation purposes. The alternative option examined is a scaled parabolic fine variation in terms of over-pumping violations in contrast to common practices that usually consider short-term fines. Such an application, and in such detail, represents new feedback. The results indicate that the probability uncertainty is the driving issue that determines the optimal decision with each methodology, and depending on the unknown probability handling, each methodology may lead to a different optimal decision. Thus, the proposed tool can help decision makers (stakeholders) to examine and compare different scenarios using two different approaches before making a decision considering the cost of a hydrologic/hydraulic project and the varied economic charges that water table limit violations can cause inside an audit interval. In contrast to practices that assess the effect of each proposed action separately considering only current knowledge of the examined issue, this tool aids decision making by considering prior information and the sampling distribution of future successful audits. This tool is developed in a web service for the easier stakeholders' access.

Autonomous Driver Based on an Intelligent System of Decision-Making.

PubMed

Czubenko, Michał; Kowalczuk, Zdzisław; Ordys, Andrew

The paper presents and discusses a system ( xDriver ) which uses an Intelligent System of Decision-making (ISD) for the task of car driving. The principal subject is the implementation, simulation and testing of the ISD system described earlier in our publications (Kowalczuk and Czubenko in artificial intelligence and soft computing lecture notes in computer science, lecture notes in artificial intelligence, Springer, Berlin, 2010, 2010, In Int J Appl Math Comput Sci 21(4):621-635, 2011, In Pomiary Autom Robot 2(17):60-5, 2013) for the task of autonomous driving. The design of the whole ISD system is a result of a thorough modelling of human psychology based on an extensive literature study. Concepts somehow similar to the ISD system can be found in the literature (Muhlestein in Cognit Comput 5(1):99-105, 2012; Wiggins in Cognit Comput 4(3):306-319, 2012), but there are no reports of a system which would model the human psychology for the purpose of autonomously driving a car. The paper describes assumptions for simulation, the set of needs and reactions (characterizing the ISD system), the road model and the vehicle model, as well as presents some results of simulation. It proves that the xDriver system may behave on the road as a very inexperienced driver.

Country-Level Correlates of Educational Achievement: Evidence from Large-Scale Surveys

ERIC Educational Resources Information Center

He, Jia; Van de Vijver, Fons J. R.; Kulikova, Alena

2017-01-01

Linking country-level educational achievement with other country-level indicators has the potential to drive systemic educational changes, as these correlates may reflect characteristics relevant for policy-making decisions to improve educational effectiveness. This study establishes a nomological network of educational achievement at the country…

Small-unit Training for Adaptability and Resilience in Decision Making (STAR-DM)

DTIC Science & Technology

2017-01-23

based training compared with theoretically less stressful (e.g. classroom lecture) and more Design Interactive, Inc... Design Interactive, Inc. Contract #: N00014-12-G-0427 1... Design Interactive, Inc. 3504 Lake Lynda Drive Suite 400 Orlando, FL 32825 407-706-0977, www.designinteractive.net Corporate Official: John

Crime Prevention Teaching Kit #2.

ERIC Educational Resources Information Center

Commercial Union Insurance Companies, Boston, MA.

Three lesson plans for grades seven through nine explore the social, moral, and financial impact of auto and bicycle theft and drinking and driving. Used individually or together as a complete unit, the lesson plans contain dramatic skits derived from real-life experiences of adolescents. Students simulate tough decision making in the face of…

Driving Decision Making with Data

ERIC Educational Resources Information Center

McClintock, Patricia J.; Snider, Kevin J. G.

2008-01-01

There is almost nothing more frustrating to an institutional researcher than seeing university leaders ignore data. The case study in this article examines how an institutional research office was able to put data to work in enrollment services and produce record-setting numbers of applications, admissions, and confirmations within a nine-month…

Using Key Performance Indicators to Drive Strategic Decision Making.

ERIC Educational Resources Information Center

Dolence, Michael G.; Norris, Donald M.

1994-01-01

A nine-step method for defining and pursuing key performance indicators (KPIs), derived from a strategic planning process, is outlined, and its applications at the University of Northern Colorado and Illinois Benedictine College are described and tabulated. A chart summarizes current and projected KPIs for Illinois Benedictine College for each…

Collegiate and Departmental Performance Indicators: The Measures That Matter! AIR 1997 Annual Forum Paper.

ERIC Educational Resources Information Center

Moloney, Daniel P.; Grotevant, Susan M.

In response to changing management and budgetary strategies that have been driving decision making to the lowest administrative levels, institutional researchers have been attempting to identify indicators which can be used to evaluate institutional performance and progress. This paper reviews efforts to introduce departmental operational…

Peeling Back the Wallpaper

ERIC Educational Resources Information Center

La Salle, Robin Avelar; Johnson, Ruth S.

2016-01-01

The wallpaper effect describes a phenomenon in which educators try to make data-drive decisions but rely exclusively on summary data (the outer layer of the wallpaper) for their information. These summary data may obscure reality--the layers and layers of systemic practices and policies that establish the conditions under which students learn.…

Security and Communication Improve Community Trust

ERIC Educational Resources Information Center

Schneiderman, Mark

2015-01-01

Using student information in schools is nothing new nor is the reliance on information technologies supported by external service providers. What is new is the adoption of innovations like cloud computing and data analytics that are increasing teacher and family data access, creating actionable information to drive instruction and decision making,…

Experiential Knowledge: How Literacy Practices Seek to Mediate Personal and Systemic Change

ERIC Educational Resources Information Center

Gorzelsky, Gwen

2013-01-01

By analyzing Zen guided meditations, I argue that literacy researchers can improve the field's conceptual tools by investigating experiential knowledge. Using work on procedural knowledge and the emotional bases of perception, cognition, and decision making, I show that experiential knowledge drives perceptions and action, thus shaping…

Who Should Decide How Machines Make Morally Laden Decisions?

PubMed

Martin, Dominic

2017-08-01

Who should decide how a machine will decide what to do when it is driving a car, performing a medical procedure, or, more generally, when it is facing any kind of morally laden decision? More and more, machines are making complex decisions with a considerable level of autonomy. We should be much more preoccupied by this problem than we currently are. After a series of preliminary remarks, this paper will go over four possible answers to the question raised above. First, we may claim that it is the maker of a machine that gets to decide how it will behave in morally laden scenarios. Second, we may claim that the users of a machine should decide. Third, that decision may have to be made collectively or, fourth, by other machines built for this special purpose. The paper argues that each of these approaches suffers from its own shortcomings, and it concludes by showing, among other things, which approaches should be emphasized for different types of machines, situations, and/or morally laden decisions.

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

PubMed

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

2014-10-01

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

An objective assessment of safety to drive in an upper limb cast.

PubMed

Stevenson, H L; Peterson, N; Talbot, C; Dalal, S; Watts, A C; Trail, I A

2013-03-01

Patients managed with upper limb cast immobilization often seek advice about driving. There is very little published data to assist in decision making, and advice given varies between healthcare professionals. There are no specific guidelines available from the UK Drivers and Vehicles Licensing Agency, police, or insurance companies. Evidence-based guidelines would enable clinicians to standardize the advice given to patients. Six individuals (three male, three female; mean age 36 years, range 27-43 years) were assessed by a mobility occupational therapist and driving standards agency examiner while completing a formal driving test in six different types of upper limb casts (above-elbow, below-elbow neutral, and below-elbow cast incorporating the thumb [Bennett's cast]) on both left and right sides. Of the 36 tests, participants passed 31 tests, suggesting that most people were able to safely drive with upper limb cast immobilization. However, driving in a left above-elbow cast was considered unsafe.

Current challenges in autonomous driving

NASA Astrophysics Data System (ADS)

Barabás, I.; Todoruţ, A.; Cordoş, N.; Molea, A.

2017-10-01

Nowadays the automotive industry makes a quantum shift to a future, where the driver will have smaller and smaller role in driving his or her vehicle ending up being totally excluded. In this paper, we have investigated the different levels of driving automatization, the prospective effects of these new technologies on the environment and traffic safety, the importance of regulations and their current state, the moral aspects of introducing these technologies and the possible scenarios of deploying the autonomous vehicles. We have found that the self-driving technologies are facing many challenges: a) They must make decisions faster in very diverse conditions which can include many moral dilemmas as well; b) They have an important potential in reducing the environmental pollution by optimizing their routes, driving styles by communicating with other vehicles, infrastructures and their environment; c) There is a considerable gap between the self-drive technology level and the current regulations; fortunately, this gap shows a continuously decreasing trend; d) In case of many types of imminent accidents management there are many concerns about the ability of making the right decision. Considering that this field has an extraordinary speed of development, our study is up to date at the submission deadline. Self-driving technologies become increasingly sophisticated and technically accessible, and in some cases, they can be deployed for commercial vehicles as well. According to the current stage of research and development, it is still unclear how the self-driving technologies will be able to handle extreme and unexpected events including their moral aspects. Since most of the traffic accidents are caused by human error or omission, it is expected that the emergence of the autonomous technologies will reduce these accidents in their number and gravity, but the very few currently available test results have not been able to scientifically underpin this issue yet. The increasing trend in automation of vehicles will radically change the composition of car industry players, as mechatronics will not only be a complementary part of the automobile industry but an indispensable part of it. There is a reasonable expectation that automated cars will perform the same or better in all respects than their conventional counterparts. However, it seems that the current regulations do not keep up with the development of technology and sometimes hinder the development and testing of autonomous technologies.

Social Status-Dependent Shift in Neural Circuit Activation Affects Decision Making.

PubMed

Miller, Thomas H; Clements, Katie; Ahn, Sungwoo; Park, Choongseok; Hye Ji, Eoon; Issa, Fadi A

2017-02-22

In a social group, animals make behavioral decisions that fit their social ranks. These behavioral choices are dependent on the various social cues experienced during social interactions. In vertebrates, little is known of how social status affects the underlying neural mechanisms regulating decision-making circuits that drive competing behaviors. Here, we demonstrate that social status in zebrafish ( Danio rerio ) influences behavioral decisions by shifting the balance in neural circuit activation between two competing networks (escape and swim). We show that socially dominant animals enhance activation of the swim circuit. Conversely, social subordinates display a decreased activation of the swim circuit, but an enhanced activation of the escape circuit. In an effort to understand how social status mediates these effects, we constructed a neurocomputational model of the escape and swim circuits. The model replicates our findings and suggests that social status-related shift in circuit dynamics could be mediated by changes in the relative excitability of the escape and swim networks. Together, our results reveal that changes in the excitabilities of the Mauthner command neuron for escape and the inhibitory interneurons that regulate swimming provide a cellular mechanism for the nervous system to adapt to changes in social conditions by permitting the animal to select a socially appropriate behavioral response. SIGNIFICANCE STATEMENT Understanding how social factors influence nervous system function is of great importance. Using zebrafish as a model system, we demonstrate how social experience affects decision making to enable animals to produce socially appropriate behavior. Based on experimental evidence and computational modeling, we show that behavioral decisions reflect the interplay between competing neural circuits whose activation thresholds shift in accordance with social status. We demonstrate this through analysis of the behavior and neural circuit responses that drive escape and swim behaviors in fish. We show that socially subordinate animals favor escape over swimming, while socially dominants favor swimming over escape. We propose that these differences are mediated by shifts in relative circuit excitability. Copyright © 2017 the authors 0270-6474/17/372137-12$15.00/0.

To freeze or not to freeze embryos: clarity, confusion and conflict.

PubMed

Goswami, Mohar; Murdoch, Alison P; Haimes, Erica

2015-06-01

Although embryo freezing is a routine clinical practice, there is little contemporary evidence on how couples make the decision to freeze their surplus embryos, or of their perceptions during that time. This article describes a qualitative study of 16 couples who have had in vitro fertilisation (IVF) treatment. The study question was 'What are the personal and social factors that patients consider when deciding whether to freeze embryos?' We show that while the desire for a baby is the dominant drive, couples' views revealed more nuanced and complex considerations in the decision-making process. It was clear that the desire to have a baby influenced couples' decision-making and that they saw freezing as 'part of the process'. However, there were confusions associated with the term 'freezing' related to concerns about the safety of the procedure. Despite being given written information, couples were confused about the practical aspects of embryo freezing, which suggests they were preoccupied with the immediate demands of IVF. Couples expressed ethical conflicts about freezing 'babies'. We hope the findings from this study will inform clinicians and assist them in providing support to couples confronted with this difficult decision-making.

IBM’s Health Analytics and Clinical Decision Support

PubMed Central

Sun, J.; Knoop, S.; Shabo, A.; Carmeli, B.; Sow, D.; Syed-Mahmood, T.; Rapp, W.

2014-01-01

Summary Objectives This survey explores the role of big data and health analytics developed by IBM in supporting the transformation of healthcare by augmenting evidence-based decision-making. Methods Some problems in healthcare and strategies for change are described. It is argued that change requires better decisions, which, in turn, require better use of the many kinds of healthcare information. Analytic resources that address each of the information challenges are described. Examples of the role of each of the resources are given. Results There are powerful analytic tools that utilize the various kinds of big data in healthcare to help clinicians make more personalized, evidenced-based decisions. Such resources can extract relevant information and provide insights that clinicians can use to make evidence-supported decisions. There are early suggestions that these resources have clinical value. As with all analytic tools, they are limited by the amount and quality of data. Conclusion Big data is an inevitable part of the future of healthcare. There is a compelling need to manage and use big data to make better decisions to support the transformation of healthcare to the personalized, evidence-supported model of the future. Cognitive computing resources are necessary to manage the challenges in employing big data in healthcare. Such tools have been and are being developed. The analytic resources, themselves, do not drive, but support healthcare transformation. PMID:25123736

Effects of in-vehicle warning information displays with or without spatial compatibility on driving behaviors and response performance.

PubMed

Liu, Yung-Ching; Jhuang, Jing-Wun

2012-07-01

A driving simulator study was conducted to evaluate the effects of five in-vehicle warning information displays upon drivers' emergent response and decision performance. These displays include visual display, auditory displays with and without spatial compatibility, hybrid displays in both visual and auditory format with and without spatial compatibility. Thirty volunteer drivers were recruited to perform various tasks that involved driving, stimulus-response, divided attention and stress rating. Results show that for displays of single-modality, drivers benefited more when coping with visual display of warning information than auditory display with or without spatial compatibility. However, auditory display with spatial compatibility significantly improved drivers' performance in reacting to the divided attention task and making accurate S-R task decision. Drivers' best performance results were obtained for hybrid display with spatial compatibility. Hybrid displays enabled drivers to respond the fastest and achieve the best accuracy in both S-R and divided attention tasks. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Perturbations in Effort-Related Decision-Making Driven by Acute Stress and Corticotropin-Releasing Factor.

PubMed

Bryce, Courtney A; Floresco, Stan B

2016-07-01

Acute stress activates numerous systems in a coordinated effort to promote homeostasis, and can exert differential effects on mnemonic and cognitive functions depending on a myriad of factors. Stress can alter different forms of cost/benefit decision-making, yet the mechanisms that drive these effects, remain unclear. In the present study, we probed how corticotropin-releasing factor (CRF) may contribute to stress-induced alterations in cost/benefit decision-making, using an task where well-trained rats chose between a low effort/low reward lever (LR; two pellets) and a high effort/high reward lever (HR; four pellets), with the effort requirement increasing over a session (2, 5, 10, and 20 presses). One-hour restraint stress markedly reduced preference for the HR option, but this effect was attenuated by infusions of the CRF antagonist, alpha-helical CRF. Conversely, central CRF infusion mimicked the effect of stress on decision-making, as well as increased decision latencies and reduced response vigor. CRF infusions did not alter preference for larger vs smaller rewards, but did reduce responding for food delivered on a progressive ratio, suggesting that these treatments may amplify perceived effort costs that may be required to obtain rewards. CRF infusions into the ventral tegmental area recapitulated the effect of central CRF treatment and restraint on choice behavior, suggesting that these effects may be mediated by perturbations in dopamine transmission. These findings highlight the involvement of CRF in regulating effort-related decisions and suggest that increased CRF activity may contribute to motivational impairments and abnormal decision-making associated with stress-related psychiatric disorders such as depression.

Perturbations in Effort-Related Decision-Making Driven by Acute Stress and Corticotropin-Releasing Factor

PubMed Central

Bryce, Courtney A; Floresco, Stan B

2016-01-01

Acute stress activates numerous systems in a coordinated effort to promote homeostasis, and can exert differential effects on mnemonic and cognitive functions depending on a myriad of factors. Stress can alter different forms of cost/benefit decision-making, yet the mechanisms that drive these effects, remain unclear. In the present study, we probed how corticotropin-releasing factor (CRF) may contribute to stress-induced alterations in cost/benefit decision-making, using an task where well-trained rats chose between a low effort/low reward lever (LR; two pellets) and a high effort/high reward lever (HR; four pellets), with the effort requirement increasing over a session (2, 5, 10, and 20 presses). One-hour restraint stress markedly reduced preference for the HR option, but this effect was attenuated by infusions of the CRF antagonist, alpha-helical CRF. Conversely, central CRF infusion mimicked the effect of stress on decision-making, as well as increased decision latencies and reduced response vigor. CRF infusions did not alter preference for larger vs smaller rewards, but did reduce responding for food delivered on a progressive ratio, suggesting that these treatments may amplify perceived effort costs that may be required to obtain rewards. CRF infusions into the ventral tegmental area recapitulated the effect of central CRF treatment and restraint on choice behavior, suggesting that these effects may be mediated by perturbations in dopamine transmission. These findings highlight the involvement of CRF in regulating effort-related decisions and suggest that increased CRF activity may contribute to motivational impairments and abnormal decision-making associated with stress-related psychiatric disorders such as depression. PMID:26830960

Why people drink and drive : the bases of drinking-and-driving decisions.

DOT National Transportation Integrated Search

1995-03-01

Using a Critical Incidents approach, 600 drivers were called upon to identify the bases of decisions to drink : and drive. In an unstructured interview, each driver descnbed the bases for decisions leading to specific instances : of impaired driving,...

Drivers' decision-making when attempting to cross an intersection results from choice between affordances

PubMed Central

Marti, Geoffrey; Morice, Antoine H. P.; Montagne, Gilles

2015-01-01

In theory, a safe approach to an intersection implies that drivers can simultaneously manage two scenarios: they either choose to cross or to give way to an oncoming vehicle. In this article we formalize the critical time for safe crossing (CTcross) and the critical time for safe stopping (CTstop) to represent crossing and stopping possibilities, respectively. We describe these critical times in terms of affordances and empirically test their respective contribution to the driver's decision-making process. Using a driving simulator, three groups of participants drove cars with identical acceleration capabilities and different braking capabilities. They were asked to try to cross an intersection where there was an oncoming vehicle, if they deemed the maneuver to be safe. If not, they could decide to stop or, as a last resort, make an emergency exit. The intersections were identical among groups. Results showed that although the crossing possibilities (CTcross) were the same for all groups, there were between-group differences in crossing frequency. This suggests that stopping possibilities (CTstop) play a role in the driver's decision-making process, in addition to the crossing possibilities. These results can be accounted for by a behavioral model of decision making, and provide support for the hypothesis of choice between affordances. PMID:25620922

Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: Implications for informed consent and shared decision-making.

PubMed

Blumenthal-Barby, Jennifer S; Kostick, Kristin M; Delgado, Estevan D; Volk, Robert J; Kaplan, Holland M; Wilhelms, L A; McCurdy, Sheryl A; Estep, Jerry D; Loebe, Matthias; Bruce, Courtenay R

2015-09-01

Several organizations have underscored the crucial need for patient-centered decision tools to enhance shared decision-making in advanced heart failure. The purpose of this study was to investigate the decision-making process and informational and decisional needs of patients and their caregivers regarding left ventricular assist device (LVAD) placement. In-depth, structured interviews with LVAD patients, candidates and caregivers (spouse, family members) (n = 45) were conducted. We also administered a Decisional Regret Scale. Participants reported LVAD decision-making to be quick and reflexive (n = 30), and deferred heavily to clinicians (n = 22). They did not perceive themselves as having a real choice (n = 28). The 2 most prevalent informational domains that participants identified were lifestyle issues (23 items), followed by technical (drive-line, battery) issues (14 items). Participants easily and clearly identified their values: life extension; family; and mobility. Participants reported the need to meet other patients and caregivers before device placement (n = 31), and to have an involved caregiver (n = 28) to synthesize information. Some participants demonstrated a lack of clarity regarding transplant probability: 9 of 15 patients described themselves as on a transplant trajectory, yet 7 of these were destination therapy patients. Finally, we found that decisional regret scores were low (1.307). Informed consent and shared-decision making should: (a) help patients offered highly invasive technologies for life-threatening disease get past the initial "anything to avoid thinking about death" reaction and make a more informed decision; (b) clarify transplant status; and (c) focus on lifestyle and technical issues, as patients have the most informational needs in these domains. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

A Risk-Constrained Multi-Stage Decision Making Approach to the Architectural Analysis of Mars Missions

NASA Technical Reports Server (NTRS)

Kuwata, Yoshiaki; Pavone, Marco; Balaram, J. (Bob)

2012-01-01

This paper presents a novel risk-constrained multi-stage decision making approach to the architectural analysis of planetary rover missions. In particular, focusing on a 2018 Mars rover concept, which was considered as part of a potential Mars Sample Return campaign, we model the entry, descent, and landing (EDL) phase and the rover traverse phase as four sequential decision-making stages. The problem is to find a sequence of divert and driving maneuvers so that the rover drive is minimized and the probability of a mission failure (e.g., due to a failed landing) is below a user specified bound. By solving this problem for several different values of the model parameters (e.g., divert authority), this approach enables rigorous, accurate and systematic trade-offs for the EDL system vs. the mobility system, and, more in general, cross-domain trade-offs for the different phases of a space mission. The overall optimization problem can be seen as a chance-constrained dynamic programming problem, with the additional complexity that 1) in some stages the disturbances do not have any probabilistic characterization, and 2) the state space is extremely large (i.e, hundreds of millions of states for trade-offs with high-resolution Martian maps). To this purpose, we solve the problem by performing an unconventional combination of average and minimax cost analysis and by leveraging high efficient computation tools from the image processing community. Preliminary trade-off results are presented.

Parenting and the Young Driver Problem

PubMed Central

Simons-Morton, Bruce G.; Ouimet, Marie Claude; Catalano, Richard F.

2008-01-01

Crash rates increase sharply at the age teenagers begin to drive and remain elevated relative to adult levels well into the twenties. Parents have important roles to play in managing the risk for teenage drivers before and after licensure. Parents can be involved in their teenagers’ driving, allowing them to test for permit and licensure, supervising practice driving, providing access to a vehicle, and setting and enforcing limits on driving privileges after licensure. However, the management practices of many parents may not be sufficient to provide safety effects. The literature indicates that the two most important decisions parents can make to reduce teenagers driving risk is to delay licensure and impose limits on high-risk driving conditions (such as driving at night and with teenage passengers) during the first year of licensure. Two intervention programs have been shown to increase parent limit setting as a means of reducing risky driving behaviors and improving driving performance among novice teenage drivers. This article describes the contexts of and opportunities for parent involvement in teenage driving and the efficacy of interventions to increase and improve parental management of young drivers. PMID:18702985

WILDLIFE HEALTH 2.0: BRIDGING THE KNOWLEDGE-TO-ACTION GAP.

PubMed

Stephen, Craig

2017-01-01

The unprecedented threats to the health and sustainability of wildlife populations are inspiring conversations on the need to change the way knowledge is generated, valued, and used to promote action to protect wildlife health. Wildlife Health 2.0 symbolizes the need to investigate how to improve connections between research expertise and policy or practices to protect wildlife health. Two imperatives drive this evolution: 1) growing frustrations that research is inadequately being used to inform management decisions and 2) the realization that scientific certainty is context specific for complex socioecologic issues, such as wildlife health. Failure to appreciate the unpredictability of complex systems or to incorporate ethical and cultural dimensions of decisions has limited the contribution of research to decision making. Wildlife health can draw from scholarship in other fields, such as public health and conservation, to bridge the knowledge-to-action gap. Efforts to integrate science into decisions are more likely to be effective when they enhance relevance, credibility, and legitimacy of information for people who will make or be affected by management decisions. A Wildlife Health 2.0 agenda is not a rejection of the current research paradigm but rather a call to expand our areas of inquiry to ensure that the additional contextual understanding is generated to help decision makers make good choices.

Brain pathways for cognitive-emotional decision making in the human animal.

PubMed

Levine, Daniel S

2009-04-01

As roles for different brain regions become clearer, a picture emerges of how primate prefrontal cortex executive circuitry influences subcortical decision making pathways inherited from other mammals. The human's basic needs or drives can be interpreted as residing in an on-center off-surround network in motivational regions of the hypothalamus and brain stem. Such a network has multiple attractors that, in this case, represent the amount of satisfaction of these needs, and we consider and interpret neurally a continuous-time simulated annealing algorithm for moving between attractors under the influence of noise that represents "discontent" combined with "initiative." For decision making on specific tasks, we employ a variety of rules whose neural circuitry appears to involve the amygdala and the orbital, cingulate, and dorsolateral regions of prefrontal cortex. These areas can be interpreted as connected in a three-layer adaptive resonance network. The vigilance of the network, which is influenced by the state of the hypothalamic needs network, determines the level of sophistication of the rule being utilized.

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

The Power of 2: Partnership Paves the Way for Teacher Leadership Academy

ERIC Educational Resources Information Center

Harmon, Jeanne; Herren, Kip; Luke, Rod; Emry, Terese

2012-01-01

A clear vision is the essential foundation for making decisions about precious resources for implementing professional learning: (1) people; (2) time; and (3) money. The Auburn School District in Washington state learned firsthand how a clear vision drives resource allocation to support strategic actions and how effective partnerships can be the…

Interagency Working Group on Ocean Social Science: Incorporating ecosystem services approaches into ocean and coastal decision-making and governance

EPA Science Inventory

The application of social science has been recognized as a priority for effective ocean and coastal management, driving much discussion and fostering emerging efforts in several areas. The Interagency Working Group on Ocean Social Science (IWG-OSS) is tasked with assisting the Su...

Gaming Personality and Game Dynamics in Online Discussion Instructions

ERIC Educational Resources Information Center

Tu, Chih-Hsiung; Yen, Cherng-Jyh; Sujo-Montes, Laura; Roberts, Gayle A.

2015-01-01

Gamification is the use of game mechanics to drive game-like engagements and actions. It applies game mechanics, dynamics and frameworks to promote desired learning behaviours. Positive and effective gamification could enhance learning and engage learners in more social and context-rich decision-making for problem-solving in learning tasks.…

Young Children Use Graphs to Build Mathematical Reasoning

ERIC Educational Resources Information Center

Larson, Mark J.; Whitin, David J.

2010-01-01

Mathematical, scientific, and technological knowledge is critical for people in a 21st Century world that is dependent upon a global interconnectedness and a knowledge-based economy. This is the kind of knowledge that will power innovations and drive decision making in the years ahead. Schools are therefore being called upon to devise a…

Risky Drinking and Driving/Riding Decisions: The Role of Previous Experience.

ERIC Educational Resources Information Center

Finken, Laura L.; Jacobs, Janis E.; Laguna, Kerrie D.

1998-01-01

Factors related to risky driving and drinking/driving decisions were explored by presenting vignettes to 135 older adolescents, aged 17 to 24. Analyses reveal that alcohol-related behaviors, attitudes toward the acceptability of drinking, and previous drinking and drinking/driving experiences were all significant predictors of decisions about…

[The role of information in public health decision-making].

PubMed

Cecchi, Catherine

2008-01-01

Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. Irrespective of the type of choice to be made, the need for information, knowledge, and know-how is inseparable from that of other tools or regulatory measures required for decision-making. Information is the same as competence, epidemiological and population data, health data, scientific opinion, and expert conferences--all are needed to assist in decision-making. Based on the principle of precaution, information must increasingly take into account the rejection of a society which often reasons on the basis of a presumption of zero-risk, in an idealistic manner, and which also excludes the possibility of new risks. The consumer positions himself as the regulator of decisions, specifically those with regard to the notion of acceptable level of risk. All of the actors involved in the health system are or become at one moment or another public health decision-makers. Their decision might be based either on an analytical approach, or on an intuitive approach. Although the act of decision-making is the least visible part of public health policy, it is certainly the driving force. This process should integrate the perspective of all of the relevant players, including consumers, who are currently situated more and more frequently at the heart of the health system. Public health decision-making is conducted as a function of political, strategic and environmental issues; of lobbies and their power; and of social maturation. Decision-making is a necessity. Making the right choice at the right time requires high quality information, and it is often necessary to respect a certain amount of time for reflection and ripening of an issue in order to make the best possible decision. The media and consumers play an increasingly significant role in public health decision-making and in the ensuing legislative consequences and debates which come as a result. Access to information is changing, especially thanks to the Internet which is completely modifying the global scenery of knowledge and know-how. Information supports decision-making with calculated risk, and it offers the opportunity to make choices and decisions, recognising that "to choose, is sometimes to relinquish".

Sleep. 5: Driving and automobile crashes in patients with obstructive sleep apnoea/hypopnoea syndrome.

PubMed

George, C F P

2004-09-01

Driving is a complex task involving distinct cognitive, perceptual, motor, and decision making skills. After placing the vehicle on the road, the driver must constantly survey the ever changing roadway environment to keep the vehicle in the lane and moving at an appropriate safe speed. This surveillance involves two distinct visual tasks: estimating and responding to the oncoming curvature and controlling lane position. Driving is therefore a divided attention task involving speed and lane control as well as monitoring. To do this in a safe manner requires careful attention and alertness which can be problematic for patients with obstructive sleep apnoea/hypopnoea syndrome (OSAHS) or other sleep disorders.

Developing physician consensus on the reporting of patients with mild cognitive impairment and mild dementia to transportation authorities in a region with mandatory reporting legislation.

PubMed

Rapoport, Mark J; Naglie, Gary; Herrmann, Nathan; Zucchero Sarracini, Carla; Mulsant, Benoit H; Frank, Christopher; Kiss, Alex; Seitz, Dallas; Vrkljan, Brenda; Masellis, Mario; Tang-Wai, David; Pimlott, Nicholas; Molnar, Frank

2014-12-01

To establish consensus among dementia experts about which patients with mild cognitive impairment (MCI) or mild dementia should be reported to transportation authorities. We conducted a literature review of predictors of driving safety in patients with dementia and combined these into 26 case scenarios. Using a modified Delphi technique, case scenarios were reviewed by 38 dementia experts (geriatric psychiatrists, geriatricians, cognitive neurologists and family physicians with expertise in elder care) who indicated whether or not they would report the patient in each scenario to regional transportation authorities and recommend a specialized on-road driving test. Scenarios were presented up to five times to achieve consensus, defined as 85% agreement, and discrepancies were discussed anonymously online. By the end of the fifth iteration, there was cumulative consensus on 18 scenarios (69%). The strongest predictors of decision to report were the combination of caregiver concern about the patient's driving and abnormal Clock Drawing Test, which accounted for 62% of the variance in decision to report at the same time as or without a road test (p <0.01). Based on these data, an algorithm was developed to guide physician decision-making about reporting patients with MCI or mild dementia to transportation authorities. This study supports existing international guidelines that recommend specialized on-road testing when driving safety is uncertain for patients with MCI and emphasizes the importance of assessing executive dysfunction and caregiver concern about driving. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Driving under the influence of drugs: Perceptions and attitudes of New Zealand drivers.

PubMed

Malhotra, Neha; Starkey, Nicola J; Charlton, Samuel G

2017-09-01

This study explored the patterns of drug driving in New Zealand by investigating 1) drivers' perceptions about impairment caused by legal and illegal drugs 2) countermeasures employed by drivers when under the influence of drugs (e.g., decisions not to drive) 3) drivers' attitudes about police enforcement of drug driving and 4) the factors that predict the likelihood of engaging in drug driving. Participants (n=434) were licensed drivers who completed an online questionnaire. Results of the questionnaire indicated that drivers rated hallucinogens and opiates as being the illegal drugs producing the highest level of driving impairment and cannabis the lowest. For legal drugs, sedatives were rated as having the highest driving impairment and anti-nausea and anti-depressants the lowest. Respondents' drug use history had an effect on their ratings of impairment for anti-anxiety drugs, anti-depressants, kava, sedatives, cannabis and hallucinogens such that drug users reported higher impairment ratings than Non-user. Making a decision not to drive after taking drugs was reported by users of alcohol (73.6%), cannabis (57.0%), strong painkillers (42.5%), and anti-depressants (10.0%). Respondents who reported drink driving were 3.26 times more likely to report drug driving than those reporting no drink driving. Respondents also showed greater acceptance towards driving under the influence of legal drugs (43.5%) compared to illegal drugs (10.3%). Those who did not have favourable attitudes about drug driving were less likely to report having driven under the influence of drugs. Drivers in this sample were less aware of the potential negative effects of legal drugs on driving compared to illegal drugs. More than half the respondents from this study acknowledged drug driving as a road safety issue which needs more resources dedicated to it. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Interoception drives increased rational decision-making in meditators playing the ultimatum game.

PubMed

Kirk, Ulrich; Downar, Jonathan; Montague, P Read

2011-01-01

Human decision-making is often conceptualized as a competition between cognitive and emotional processes in the brain. Deviations from rational processes are believed to derive from inclusion of emotional factors in decision-making. Here, we investigate whether experienced Buddhist meditators are better equipped to regulate emotional processes compared with controls during economic decision-making in the Ultimatum Game. We show that meditators accept unfair offers on more than half of the trials, whereas controls only accept unfair offers on one-quarter of the trials. By applying fMRI we show that controls recruit the anterior insula during unfair offers. Such responses are powerful predictors of rejecting offers in social interaction. By contrast, meditators display attenuated activity in high-level emotional representations of the anterior insula and increased activity in the low-level interoceptive representations of the posterior insula. In addition we show that a subset of control participants who play rationally (i.e., accepts >85% unfair offers) recruits the dorsolateral prefrontal cortex presumably reflecting increased cognitive demands, whereas rational meditators by contrast display elevated activity in the somatosensory cortex and posterior superior temporal cortex. In summary, when assessing unfairness in the Ultimatum Game, meditators activate a different network of brain areas compared with controls enabling them to uncouple negative emotional reactions from their behavior. These findings highlight the clinically and socially important possibility that sustained training in mindfulness meditation may impact distinct domains of human decision-making.

Quantitative imaging biomarkers: the application of advanced image processing and analysis to clinical and preclinical decision making.

PubMed

Prescott, Jeffrey William

2013-02-01

The importance of medical imaging for clinical decision making has been steadily increasing over the last four decades. Recently, there has also been an emphasis on medical imaging for preclinical decision making, i.e., for use in pharamaceutical and medical device development. There is also a drive towards quantification of imaging findings by using quantitative imaging biomarkers, which can improve sensitivity, specificity, accuracy and reproducibility of imaged characteristics used for diagnostic and therapeutic decisions. An important component of the discovery, characterization, validation and application of quantitative imaging biomarkers is the extraction of information and meaning from images through image processing and subsequent analysis. However, many advanced image processing and analysis methods are not applied directly to questions of clinical interest, i.e., for diagnostic and therapeutic decision making, which is a consideration that should be closely linked to the development of such algorithms. This article is meant to address these concerns. First, quantitative imaging biomarkers are introduced by providing definitions and concepts. Then, potential applications of advanced image processing and analysis to areas of quantitative imaging biomarker research are described; specifically, research into osteoarthritis (OA), Alzheimer's disease (AD) and cancer is presented. Then, challenges in quantitative imaging biomarker research are discussed. Finally, a conceptual framework for integrating clinical and preclinical considerations into the development of quantitative imaging biomarkers and their computer-assisted methods of extraction is presented.

Attitudes toward Infection Prophylaxis in Pediatric Oncology: A Qualitative Approach

PubMed Central

Diorio, Caroline; Tomlinson, Deborah; Boydell, Katherine M.; Regier, Dean A.; Ethier, Marie-Chantal; Alli, Amanda; Alexander, Sarah; Gassas, Adam; Taylor, Jonathan; Kellow, Charis; Mills, Denise; Sung, Lillian

2012-01-01

Background The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology. Methods The study was completed in three phases: 1) An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2) A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3) In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach. Results A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration. Conclusion Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments. PMID:23112849

Attitudes toward infection prophylaxis in pediatric oncology: a qualitative approach.

PubMed

Diorio, Caroline; Tomlinson, Deborah; Boydell, Katherine M; Regier, Dean A; Ethier, Marie-Chantal; Alli, Amanda; Alexander, Sarah; Gassas, Adam; Taylor, Jonathan; Kellow, Charis; Mills, Denise; Sung, Lillian

2012-01-01

The risks and benefits of infection prophylaxis are uncertain in children with cancer and thus, preferences should be considered in decision making. The purpose of this report was to describe the attitudes of parents, children and healthcare professionals to infection prophylaxis in pediatric oncology. THE STUDY WAS COMPLETED IN THREE PHASES: 1) An initial qualitative pilot to identify the main attributes influencing the decision to use infection prophylaxis, which were then incorporated into a discrete choice experiment; 2) A think aloud during the discrete choice experiment in which preferences for infection prophylaxis were elicited quantitatively; and 3) In-depth follow up interviews. Interviews were recorded verbatim and analyzed using an iterative, thematic analysis. Final themes were selected using a consensus approach. A total of 35 parents, 22 children and 28 healthcare professionals participated. All three groups suggested that the most important factor influencing their decision making was the effect of prophylaxis on reducing the chance of death. Themes of importance to the three groups included antimicrobial resistance, side effects of medications, the financial impact of outpatient prophylaxis and the route and schedule of administration. Effect of prophylaxis on risk of death was a key factor in decision making. Other identified factors were antimicrobial resistance, side effects of medication, financial impact and administration details. Better understanding of factors driving decision making for infection prophylaxis will help facilitate future implementation of prophylactic regiments.

Assessment, design and control strategy development of a fuel cell hybrid electric vehicle for CSU's EcoCAR

NASA Astrophysics Data System (ADS)

Fox, Matthew D.

Advanced automotive technology assessment and powertrain design are increasingly performed through modeling, simulation, and optimization. But technology assessments usually target many competing criteria making any individual optimization challenging and arbitrary. Further, independent design simulations and optimizations take considerable time to execute, and design constraints and objectives change throughout the design process. Changes in design considerations usually require re-processing of simulations and more time. In this thesis, these challenges are confronted through CSU's participation in the EcoCAR2 hybrid vehicle design competition. The complexity of the competition's design objectives leveraged development of a decision support system tool to aid in multi-criteria decision making across technologies and to perform powertrain optimization. To make the decision support system interactive, and bypass the problem of long simulation times, a new approach was taken. The result of this research is CSU's architecture selection and component sizing, which optimizes a composite objective function representing the competition score. The selected architecture is an electric vehicle with an onboard range extending hydrogen fuel cell system. The vehicle has a 145kW traction motor, 18.9kWh of lithium ion battery, a 15kW fuel cell system, and 5kg of hydrogen storage capacity. Finally, a control strategy was developed that improves the vehicles performance throughout the driving range under variable driving conditions. In conclusion, the design process used in this research is reviewed and evaluated against other common design methodologies. I conclude, through the highlighted case studies, that the approach is more comprehensive than other popular design methodologies and is likely to lead to a higher quality product. The upfront modeling work and decision support system formulation will pay off in superior and timely knowledge transfer and more informed design decisions. The hypothesis is supported by the three case studies examined in this thesis.

Decision making process and factors contributing to research participation among general practitioners: A grounded theory study.

PubMed

Tong, Seng Fah; Ng, Chirk Jenn; Lee, Verna Kar Mun; Lee, Ping Yein; Ismail, Irmi Zarina; Khoo, Ee Ming; Tahir, Noor Azizah; Idris, Iliza; Ismail, Mastura; Abdullah, Adina

2018-01-01

The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research. We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs. Purposeful sampling followed by theoretical sampling were used to attempt saturation of the core category. Data were collected using semi-structured open-ended questions. Interviews were recorded, transcribed verbatim and checked prior to analysis. Open line-by-line coding followed by focus coding were used to arrive at a substantive theory. Memoing was used to help bring concepts to higher abstract levels. The GPs' decision to participate in research was attributed to their inner drive and appreciation for primary care research and their confidence in managing their social and research environments. The drive and appreciation for research motivated the GPs to undergo research training to enhance their research knowledge, skills and confidence. However, the critical step in the GPs' decision to participate in research was their ability to align their research agenda with priorities in their social environment, which included personal life goals, clinical practice and organisational culture. Perceived support for research, such as funding and technical expertise, facilitated the GPs' participation in research. In addition, prior experiences participating in research also influenced the GPs' confidence in taking part in future research. The key to GPs deciding to participate in research is whether the research agenda aligns with the priorities in their social environment. Therefore, research training is important, but should be included in further measures and should comply with GPs' social environments and research support.

Decision making process and factors contributing to research participation among general practitioners: A grounded theory study

PubMed Central

Ng, Chirk Jenn; Lee, Verna Kar Mun; Lee, Ping Yein; Ismail, Irmi Zarina; Khoo, Ee Ming; Tahir, Noor Azizah; Idris, Iliza; Ismail, Mastura; Abdullah, Adina

2018-01-01

Introduction The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs’ decision-making process to participate in research. Methods We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs. Purposeful sampling followed by theoretical sampling were used to attempt saturation of the core category. Data were collected using semi-structured open-ended questions. Interviews were recorded, transcribed verbatim and checked prior to analysis. Open line-by-line coding followed by focus coding were used to arrive at a substantive theory. Memoing was used to help bring concepts to higher abstract levels. Results The GPs’ decision to participate in research was attributed to their inner drive and appreciation for primary care research and their confidence in managing their social and research environments. The drive and appreciation for research motivated the GPs to undergo research training to enhance their research knowledge, skills and confidence. However, the critical step in the GPs’ decision to participate in research was their ability to align their research agenda with priorities in their social environment, which included personal life goals, clinical practice and organisational culture. Perceived support for research, such as funding and technical expertise, facilitated the GPs’ participation in research. In addition, prior experiences participating in research also influenced the GPs’ confidence in taking part in future research. Conclusions The key to GPs deciding to participate in research is whether the research agenda aligns with the priorities in their social environment. Therefore, research training is important, but should be included in further measures and should comply with GPs’ social environments and research support. PMID:29694439

Prognostic categories and timing of negative prognostic communication from critical care physicians to family members at end-of-life in an intensive care unit.

PubMed

Gutierrez, Karen M

2013-09-01

Negative prognostic communication is often delayed in intensive care units, which limits time for families to prepare for end-of-life. This descriptive study, informed by ethnographic methods, was focused on exploring critical care physician communication of negative prognoses to families and identifying timing influences. Prognostic communication of critical care physicians to nurses and family members was observed and physicians and family members were interviewed. Physician perception of prognostic certainty, based on an accumulation of empirical data, and the perceived need for decision-making, drove the timing of prognostic communication, rather than family needs. Although prognoses were initially identified using intuitive knowledge for patients in one of the six identified prognostic categories, utilizing decision-making to drive prognostic communication resulted in delayed prognostic communication to families until end-of-life (EOL) decisions could be justified with empirical data. Providers will better meet the needs of families who desire earlier prognostic information by separating prognostic communication from decision-making and communicating the possibility of a poor prognosis based on intuitive knowledge, while acknowledging the uncertainty inherent in prognostication. This sets the stage for later prognostic discussions focused on EOL decisions, including limiting or withdrawing treatment, which can be timed when empirical data substantiate intuitive prognoses. This allows additional time for families to anticipate and prepare for end-of-life decision-making. © 2012 John Wiley & Sons Ltd.

The Salience Network and Its Functional Architecture in a Perceptual Decision: An Effective Connectivity Study.

PubMed

Lamichhane, Bidhan; Dhamala, Mukesh

2015-08-01

The anterior insulae (INSs) are involved in accumulating sensory evidence in perceptual decision-making independent of the motor response, whereas the dorsal anterior cingulate cortex (dACC) is known to play a role in choosing appropriate behavioral responses. Recent evidence suggests that INSs and dACC are part of the salience network (SN), a key network known to be involved in decision-making and thought to be important for the coordination of behavioral responses. However, how these nodes in the SN contribute to the decision-making process from segregation of stimuli to the generation of an appropriate behavioral response remains unknown. In this study, the authors scanned 33 participants in functional magnetic resonance imaging and asked them to decide whether the presented pairs of audio (a beep of sound) and visual (a flash of light) stimuli were synchronous or asynchronous. Participants reported their perception with a button press. Stimuli were presented in block of eight pairs with a temporal lag (ΔT) between the first (audio) and the second (visual) stimulus in each pair. They used dynamic causal modeling (DCM) and the Bayesian model evidence technique to elucidate the functional architecture between the nodes of SN. Both the synchrony and the asynchrony perception resulted in strong activation in the SN. Most importantly, the DCM analyses demonstrated that the INSs were integrating as well as driving hubs in the SN. The INSs were found to a play an important role in the integration of sensory information; input to the SN is most likely through INSs. Furthermore, significant INSs to dACC intrinsic connectivity established by these task conditions help us conclude that INSs drive the dACC to guide the behavior of choosing the appropriate response. The authors therefore argue that the dACC and INS are part of a system involved in the decision-making process from perception to planning of a motor response, and that this observed functional mechanism might be important during the performance of cognitively demanding goal-directed tasks.

GROUP DECISIONS. Shared decision-making drives collective movement in wild baboons.

PubMed

Strandburg-Peshkin, Ariana; Farine, Damien R; Couzin, Iain D; Crofoot, Margaret C

2015-06-19

Conflicts of interest about where to go and what to do are a primary challenge of group living. However, it remains unclear how consensus is achieved in stable groups with stratified social relationships. Tracking wild baboons with a high-resolution global positioning system and analyzing their movements relative to one another reveals that a process of shared decision-making governs baboon movement. Rather than preferentially following dominant individuals, baboons are more likely to follow when multiple initiators agree. When conflicts arise over the direction of movement, baboons choose one direction over the other when the angle between them is large, but they compromise if it is not. These results are consistent with models of collective motion, suggesting that democratic collective action emerging from simple rules is widespread, even in complex, socially stratified societies. Copyright © 2015, American Association for the Advancement of Science.

Personal finances for the physician: a primer on maintaining and protecting your earnings.

PubMed

Hill, Austin D; Ortega, Marc E; Williams, Anthony C

2014-07-01

Personal finance is a key component to your success as a physician. Your clinical practice does not exist in a vacuum unaffected by circumstances and decisions in your personal life. Though some events in your personal life that can negatively affect your practice are random and unavoidable, consistently making sound decisions regarding your personal life and finances will allow you to continue practicing at a high level. Most core principles of personal finance are common sense and do not involve high level math. Although the concepts are straightforward, people, including physicians, routinely fail to make good decisions at the most elementary level. The core common sense principles for financial success are: do not get divorced, manage your own money, live in a state without state income tax, and drive an old car. Follow these tenants and the path to successful and satisfactory retirement will be smooth.

The activity in the anterior insulae is modulated by perceptual decision-making difficulty.

PubMed

Lamichhane, Bidhan; Adhikari, Bhim M; Dhamala, Mukesh

2016-07-07

Previous neuroimaging studies provide evidence for the involvement of the anterior insulae (INSs) in perceptual decision-making processes. However, how the insular cortex is involved in integration of degraded sensory information to create a conscious percept of environment and to drive our behaviors still remains a mystery. In this study, using functional magnetic resonance imaging (fMRI) and four different perceptual categorization tasks in visual and audio-visual domains, we measured blood oxygen level dependent (BOLD) signals and examined the roles of INSs in easy and difficult perceptual decision-making. We created a varying degree of degraded stimuli by manipulating the task-specific stimuli in these four experiments to examine the effects of task difficulty on insular cortex response. We hypothesized that significantly higher BOLD response would be associated with the ambiguity of the sensory information and decision-making difficulty. In all of our experimental tasks, we found the INS activity consistently increased with task difficulty and participants' behavioral performance changed with the ambiguity of the presented sensory information. These findings support the hypothesis that the anterior insulae are involved in sensory-guided, goal-directed behaviors and their activities can predict perceptual load and task difficulty. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

Transport safety for older people: a study of their experiences, perceptions and management needs.

PubMed

Peel, Nancye; Westmoreland, Jacky; Steinberg, Margaret

2002-03-01

With evidence of increasing accident risk due to age-related declines in health and cognition affecting driver performance, there is a need for research promoting safe mobility of older people. The present study aimed to identify transport options and licensing issues for a group of older people in an Australian community. Ninety-five participants aged 75 and over were interviewed about their driving status and accident record and tested for cognitive ability. After stratification on cognitive level and driver status (current, ex-driver or non-driver), 30 were selected for further in-depth interviews concerning demographics, license status and impact of change, travel options available and used, and travel characteristics. Considerable reliance on the motor vehicle as the mode of transport and the decision to cease driving were major quality-of-life issues. There was little evidence of planning and support in making the decision to stop driving. Some differences in transport decisions on the basis of cognitive level were evident; however, people with severely compromised cognitive ability (and, therefore, unable to give informed consent) had been excluded. The study suggested the need for resources to assist older people/carers/health professionals to plan for the transition from driver to non-driver and to manage alternative transport options more effectively.

Influence of biases in numerical magnitude allocation on human prosocial decision making.

PubMed

Arshad, Qadeer; Nigmatullina, Yuliya; Siddiqui, Shuaib; Franka, Mustafa; Mediratta, Saniya; Ramachandaran, Sanjeev; Lobo, Rhannon; Malhotra, Paresh A; Roberts, R E; Bronstein, Adolfo M

2017-12-01

Over the past decade neuroscientific research has attempted to probe the neurobiological underpinnings of human prosocial decision making. Such research has almost ubiquitously employed tasks such as the dictator game or similar variations (i.e., ultimatum game). Considering the explicit numerical nature of such tasks, it is surprising that the influence of numerical cognition on decision making during task performance remains unknown. While performing these tasks, participants typically tend to anchor on a 50:50 split that necessitates an explicit numerical judgement (i.e., number-pair bisection). Accordingly, we hypothesize that the decision-making process during the dictator game recruits overlapping cognitive processes to those known to be engaged during number-pair bisection. We observed that biases in numerical magnitude allocation correlated with the formulation of decisions during the dictator game. That is, intrinsic biases toward smaller numerical magnitudes were associated with the formulation of less favorable decisions, whereas biases toward larger magnitudes were associated with more favorable choices. We proceeded to corroborate this relationship by subliminally and systematically inducing biases in numerical magnitude toward either higher or lower numbers using a visuo-vestibular stimulation paradigm. Such subliminal alterations in numerical magnitude allocation led to proportional and corresponding changes to an individual's decision making during the dictator game. Critically, no relationship was observed between neither intrinsic nor induced biases in numerical magnitude on decision making when assessed using a nonnumerical-based prosocial questionnaire. Our findings demonstrate numerical influences on decisions formulated during the dictator game and highlight the necessity to control for confounds associated with numerical cognition in human decision-making paradigms. NEW & NOTEWORTHY We demonstrate that intrinsic biases in numerical magnitude can directly predict the amount of money donated by an individual to an anonymous stranger during the dictator game. Furthermore, subliminally inducing perceptual biases in numerical-magnitude allocation can actively drive prosocial choices in the corresponding direction. Our findings provide evidence for numerical influences on decision making during performance of the dictator game. Accordingly, without the implementation of an adequate control for numerical influences, the dictator game and other tasks with an inherent numerical component (i.e., ultimatum game) should be employed with caution in the assessment of human behavior. Copyright © 2017 the American Physiological Society.

Fleet DNA (Presentation)

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

Walkokwicz, K.; Duran, A.

2014-06-01

The Fleet DNA project objectives include capturing and quantifying drive cycle and technology variation for the multitude of medium- and heavy-duty vocations; providing a common data storage warehouse for medium- and heavy-duty vehicle fleet data across DOE activities and laboratories; and integrating existing DOE tools, models, and analyses to provide data-driven decision making capabilities. Fleet DNA advantages include: for Government - providing in-use data for standard drive cycle development, R&D, tech targets, and rule making; for OEMs - real-world usage datasets provide concrete examples of customer use profiles; for fleets - vocational datasets help illustrate how to maximize return onmore » technology investments; for Funding Agencies - ways are revealed to optimize the impact of financial incentive offers; and for researchers -a data source is provided for modeling and simulation.« less

Educational Supervisors' Metaphorical Roots of Beliefs about Teaching and Learning

ERIC Educational Resources Information Center

Buaraphan, Khajornsak

2012-01-01

Beliefs are a complex psychological construct that have potential to drive a person to make decisions and act. A person's metaphors can serve as roots of their beliefs. In this study, the metaphor construction task (MCT) was utilized to uncover beliefs about teaching and learning held by 216 educational supervisors from 10 provinces in the central…

From Data Entry to Evidence-Based Decision-Making: How Data and Analysis Can Drive Improvements in Admissions Policies

ERIC Educational Resources Information Center

Hourigan, Clare

2011-01-01

Academic standards and performance outcomes are a major focus of the current Cycle 2 Australian Universities Quality Agency (AUQA) audits. AUQA has clearly stated that universities will need to provide "evidence of setting, maintaining, and reviewing institutional academic standards and outcomes" (2010, p. 27). To do this, universities…

Performance Based Traffic Safety Education Course. Two-Phase Program.

ERIC Educational Resources Information Center

Washington State Board of Education, Olympia.

This course for high school highway traffic safety education is intended to help students learn to make good driving decisions. It consists of twenty-one modules--ten sequenced, two not in specific sequence but intended to be completed in the earlier part of the course, and nine non-sequenced modules. Each module begins with an outline providing…

"It drives us to do it": pregnant adolescents identify drivers for sexual risk-taking.

PubMed

King Jones, Tammy C

2010-01-01

Sexual risk-taking behaviors have a negative effect on the heath and future of American adolescents. To gain insight into these behaviors and preventative efforts, this study explored the experiences and perceptions of 15 pregnant adolescents using a qualitative feminist approach and in-depth interviews. As participants discussed sex education, each identified influences on sexual decision-making that often overpowered the information received. Content analysis and constant comparison of this data led to the overarching theme "Drivers for Sexual Risk-taking." Drivers were categorized as internal and external and each demonstrated a significant influence on adolescent sexual decision-making. Results of this study can inform the development of educational efforts, reform of social policy, and the focus of future research.

Physics-based and human-derived information fusion for analysts

NASA Astrophysics Data System (ADS)

Blasch, Erik; Nagy, James; Scott, Steve; Okoth, Joshua; Hinman, Michael

2017-05-01

Recent trends in physics-based and human-derived information fusion (PHIF) have amplified the capabilities of analysts; however with the big data opportunities there is a need for open architecture designs, methods of distributed team collaboration, and visualizations. In this paper, we explore recent trends in the information fusion to support user interaction and machine analytics. Challenging scenarios requiring PHIF include combing physics-based video data with human-derived text data for enhanced simultaneous tracking and identification. A driving effort would be to provide analysts with applications, tools, and interfaces that afford effective and affordable solutions for timely decision making. Fusion at scale should be developed to allow analysts to access data, call analytics routines, enter solutions, update models, and store results for distributed decision making.

Concurrent criterion validity of the safe driving behavior measure: a predictor of on-road driving outcomes.

PubMed

Classen, Sherrilene; Wang, Yanning; Winter, Sandra M; Velozo, Craig A; Lanford, Desiree N; Bédard, Michel

2013-01-01

We determined the concurrent criterion validity of the Safe Driving Behavior Measure (SDBM) for on-road outcomes (passing or failing the on-road test as determined by a certified driving rehabilitation specialist) among older drivers and their family members-caregivers. On the basis of ratings from 168 older drivers and 168 family members-caregivers, we calculated receiver operating characteristic curves. The drivers' area under the curve (AUC) was .620 (95% confidence interval [CI] = .514-.725, p = .043). The family members-caregivers' AUC was .726 (95% CI = .622-.829, p ≤ .01). Older drivers' ratings showed statistically significant yet poor concurrent criterion validity, but family members-caregivers' ratings showed good concurrent criterion validity for the criterion on-road driving test. Continuing research with a more representative sample is being pursued to confirm the SDBM's concurrent criterion validity. This screening tool may be useful for generalist practitioners to use in making decisions regarding driving. Copyright © 2013 by the American Occupational Therapy Association, Inc.

Concurrent Criterion Validity of the Safe Driving Behavior Measure: A Predictor of On-Road Driving Outcomes

PubMed Central

Wang, Yanning; Winter, Sandra M.; Velozo, Craig A.; Lanford, Desiree N.; Bédard, Michel

2013-01-01

We determined the concurrent criterion validity of the Safe Driving Behavior Measure (SDBM) for on-road outcomes (passing or failing the on-road test as determined by a certified driving rehabilitation specialist) among older drivers and their family members–caregivers. On the basis of ratings from 168 older drivers and 168 family members–caregivers, we calculated receiver operating characteristic curves. The drivers’ area under the curve (AUC) was .620 (95% confidence interval [CI] = .514–.725, p = .043). The family members–caregivers’ AUC was .726 (95% CI = .622–.829, p ≤ .01). Older drivers’ ratings showed statistically significant yet poor concurrent criterion validity, but family members–caregivers’ ratings showed good concurrent criterion validity for the criterion on-road driving test. Continuing research with a more representative sample is being pursued to confirm the SDBM’s concurrent criterion validity. This screening tool may be useful for generalist practitioners to use in making decisions regarding driving. PMID:23245789

Performance Analysis of Hybrid Electric Vehicle over Different Driving Cycles

NASA Astrophysics Data System (ADS)

Panday, Aishwarya; Bansal, Hari Om

2017-02-01

Article aims to find the nature and response of a hybrid vehicle on various standard driving cycles. Road profile parameters play an important role in determining the fuel efficiency. Typical parameters of road profile can be reduced to a useful smaller set using principal component analysis and independent component analysis. Resultant data set obtained after size reduction may result in more appropriate and important parameter cluster. With reduced parameter set fuel economies over various driving cycles, are ranked using TOPSIS and VIKOR multi-criteria decision making methods. The ranking trend is then compared with the fuel economies achieved after driving the vehicle over respective roads. Control strategy responsible for power split is optimized using genetic algorithm. 1RC battery model and modified SOC estimation method are considered for the simulation and improved results compared with the default are obtained.

Modifications and integration of the electronic tracking board in a pediatric emergency department.

PubMed

Dexheimer, Judith W; Kennebeck, Stephanie

2013-07-01

Electronic health records (EHRs) are used for data storage; provider, laboratory, and patient communication; clinical decision support; procedure and medication orders; and decision support alerts. Clinical decision support is part of any EHR and is designed to help providers make better decisions. The emergency department (ED) poses a unique environment to the use of EHRs and clinical decision support. Used effectively, computerized tracking boards can help improve flow, communication, and the dissemination of pertinent visit information between providers and other departments in a busy ED. We discuss the unique modifications and decisions made in the implementation of an EHR and computerized tracking board in a pediatric ED. We discuss the changing views based on provider roles, customization to the user interface including the layout and colors, decision support, tracking board best practices collected from other institutions and colleagues, and a case study of using reminders on the electronic tracking board to drive pain reassessments.

How Anxiety Leads to Suboptimal Decisions Under Risky Choice Situations.

PubMed

Yang, Zhiyong; Saini, Ritesh; Freling, Traci

2015-10-01

The current research proposes that situationally activated anxiety--whether incidental or integral-impairs decision making. In particular, we theorize that anxiety drives decisionmakers to more heavily emphasize subjective anecdotal information in their decision making, at the expense of more factual statistical information--a deleterious heuristic called the anecdotal bias. Four studies provide consistent support for this assertion. Studies 1A and 1B feature field experiments that demonstrate the role of incidental anxiety in enhancing the anecdotal bias in a choice context. Study 2 builds on these findings, manipulating individuals' incidental anxiety and showing how this affects the anecdotal bias in the context of message evaluations. Study 2 also provides direct evidence that only high-arousal negative emotions such as anxiety/worry enhance the anecdotal bias, not just any negative emotion (e.g., sadness). While the first three studies examine how incidental anxiety impacts choice, the last study demonstrates the effect of integral anxiety on decision making, manipulating anxiety by intensifying participants' perceived risk. Our results show that--consistent with findings from our first three studies--the anecdotal bias is enhanced when anxiety is heightened by individuals' perception of risk. © 2015 Society for Risk Analysis.

Patient engagement with infection management in secondary care: a qualitative investigation of current experiences

PubMed Central

Rawson, Timothy M; Moore, Luke S P; Hernandez, Bernard; Castro-Sanchez, Enrique; Charani, Esmita; Georgiou, Pantelis; Ahmad, Raheelah; Holmes, Alison H

2016-01-01

Objective To understand patient engagement with decision-making for infection management in secondary care and the consequences associated with current practices. Design A qualitative investigation using in-depth focus groups. Participants Fourteen members of the public who had received antimicrobials from secondary care in the preceding 12 months in the UK were identified for recruitment. Ten agreed to participate. All participants had experience of infection management in secondary care pathways across a variety of South-East England healthcare institutes. Study findings were subsequently tested through follow-up focus groups with 20 newly recruited citizens. Results Participants reported feelings of disempowerment during episodes of infection in secondary care. Information is communicated in a unilateral manner with individuals ‘told’ that they have an infection and will receive an antimicrobial (often unnamed), leading to loss of ownership, frustration, anxiety and ultimately distancing them from engaging with decision-making. This poor communication drives individuals to seek information from alternative sources, including online, which is associated with concerns over reliability and individualisation. Failures in communication and information provision by clinicians in secondary care influence individuals’ future ideas about infections and their management. This alters their future actions towards antimicrobials and can drive prescription non-adherence and loss to follow-up. Conclusions Current infection management and antimicrobial prescribing practices in secondary care fail to engage patients with the decision-making process. Secondary care physicians must not view infection management episodes as discrete events, but as cumulative experiences which have the potential to shape future patient behaviour and understanding of antimicrobial use. PMID:27799238

Juror Decision Making in Acquaintance and Marital Rape: The Influence of Clothing, Alcohol, and Preexisting Stereotypical Attitudes.

PubMed

Osborn, Kirsty; Davis, Josh P; Button, Susan; Foster, John

2018-04-01

Stereotypical biases about women's roles in intimate relationships including their marital status and lifestyle choices such as clothing and alcohol use influence juror attributions of rape case defendant guilt, potentially reducing access to justice for victims. Across two mock-juror decision-making experiments, participants read identical fictitious sexual assault vignettes varying in intoxicated defendant-complainant relationship (married vs. acquaintance), accompanied by photographs of complainant clothing at the crime (body revealing vs. plain) and in court (smart vs. casual). Experiment 2 additionally described the defendant's alcohol consumption as either under or over the drink drive limit. Most participants delivered guilty verdicts (Experiment 1: 86.7%; Experiment 2: 75.5%), recommending mean prison sentences of 5.04 years in Experiment 1 ( n = 218 students) and 4.33 years in Experiment 2 ( n = 1,086 members of public). In Experiment 1, guilty verdict rates and sentences were significantly higher when the married-but not the acquaintance-complainant dressed smartly rather than casually in court. In Experiment 2, significantly more guilty verdicts were delivered by females (80.3%) than males (66.9%), while sentence lengths were longer in acquaintance ( M = 4.52 years) than married conditions ( M = 4.10). Significant interactions between defendant alcohol use and clothing choice of the married-but not the acquaintance complainant-at the crime also influenced sentencing decisions. Higher scores on additionally administered scales measuring rape myth acceptance and sexist attitudes, but not alcohol expectancies, predicted lenient sentencing decisions in both experiments. These findings highlight how "rape myths" concerning marriages drive juror decisions. Prosecuting lawyers should use these results to better challenge these attitudes in court. Internationally, rape is often unreported to the police, and married victims may be more willing to come forward if they believe unbiased access to justice is likely.

Preferred modes of travel among older adults: what factors affect the choice to walk instead of drive?

PubMed

Naumann, Rebecca B; Dellinger, Ann M; Anderson, Melissa L; Bonomi, Amy E; Rivara, Frederick P; Thompson, Robert S

2009-10-01

There are many factors that influence older adults' travel choices. This paper explores the associations between mode of travel choice for a short trip and older adults' personal characteristics. This study included 406 drivers over the age of 64 who were enrolled in a large integrated health plan in the United States between 1991 and 2001. Bivariate analyses and generalized linear modeling were used to examine associations between choosing to walk or drive and respondents' self-reported general health, physical and functional abilities, and confidence in walking and driving. Having more confidence in their ability to walk versus drive increased an older adult's likelihood of walking to make a short trip by about 20% (PR=1.22; 95% CI: 1.06-1.40), and walking for exercise increased the likelihood by about 50% (PR=1.53; 95% CI=1.22-1.91). Reporting fair or poor health decreased the likelihood of walking, as did cutting down on the amount of driving due to a physical problem. Factors affecting a person's decision to walk for exercise may not be the same as those that influence their decision to walk as a mode of travel. It is important to understand the barriers to walking for exercise and walking for travel to develop strategies to help older adults meet both their exercise and mobility needs. Increasing walking over driving among older adults may require programs that increase confidence in walking and encourage walking for exercise.

A multiscale forecasting method for power plant fleet management

NASA Astrophysics Data System (ADS)

Chen, Hongmei

In recent years the electric power industry has been challenged by a high level of uncertainty and volatility brought on by deregulation and globalization. A power producer must minimize the life cycle cost while meeting stringent safety and regulatory requirements and fulfilling customer demand for high reliability. Therefore, to achieve true system excellence, a more sophisticated system-level decision-making process with a more accurate forecasting support system to manage diverse and often widely dispersed generation units as a single, easily scaled and deployed fleet system in order to fully utilize the critical assets of a power producer has been created as a response. The process takes into account the time horizon for each of the major decision actions taken in a power plant and develops methods for information sharing between them. These decisions are highly interrelated and no optimal operation can be achieved without sharing information in the overall process. The process includes a forecasting system to provide information for planning for uncertainty. A new forecasting method is proposed, which utilizes a synergy of several modeling techniques properly combined at different time-scales of the forecasting objects. It can not only take advantages of the abundant historical data but also take into account the impact of pertinent driving forces from the external business environment to achieve more accurate forecasting results. Then block bootstrap is utilized to measure the bias in the estimate of the expected life cycle cost which will actually be needed to drive the business for a power plant in the long run. Finally, scenario analysis is used to provide a composite picture of future developments for decision making or strategic planning. The decision-making process is applied to a typical power producer chosen to represent challenging customer demand during high-demand periods. The process enhances system excellence by providing more accurate market information, evaluating the impact of external business environment, and considering cross-scale interactions between decision actions. Along with this process, system operation strategies, maintenance schedules, and capacity expansion plans that guide the operation of the power plant are optimally identified, and the total life cycle costs are estimated.

Perception of traffic accident risk and decision to drive under light alcohol consumption--a double-blind experimental study.

PubMed

Frick, U; Rehm, J; Knoll, A; Reifinger, M; Hasford, J

2000-01-01

Public traffic safety campaigns in Germany have focussed on the changing risk perception of young drivers. While there is some consensus that perceptions of risk affect driving, less is understood about the relationship and interaction of alcohol consumption and risk perception on the decision to drive. We examined the influence of light alcohol consumption on risk perception and decision to drive, and the interaction of alcohol consumption and cognitive feedback on the handicapping effect of alcohol on risk perception and decision to drive. In a double-blind block-randomized experimental study of 104 young drivers between 19 and 24 years of age, with two experimentally manipulated independent factors of alcohol consumption (three levels: 0% BAC, 0.015% BAC, 0.03% BAC) and feedback (positive or negative), we assessed three dependent variables: perception of traffic accident risk, subjective judgement about driving-relevant cognitive performance, decision to drive a car. Analyses of variance and covariance were used to analyze differences between levels of experimental factors. We found that persons with 0.015 BAC performed better than persons in both other alcohol conditions on the standardized risk perception task. Perceived handicap of driving was significantly more pronounced for negative feedback compared to positive feedback with no influence of the level of alcohol consumption. No significant influence on decision to drive was found of either level of alcohol consumption, feedback or sex. Decision to drive in young drivers could not be influenced by feedback or light consumption. Public health approaches have to find better determining factors.

From a Vital Sign to Vitality: Selling Exercise So Patients Want to Buy It.

PubMed

Segar, Michelle L; Guérin, Eva; Phillips, Edward; Fortier, Michelle

2016-01-01

Exercise is Medicine (EIM) and physical activity as a vital sign are based on health-focused research and reflect ideal frames and messages for clinicians. However, they are nonoptimal for patients because they do not address what drives patients' decision-making and motivation. With the growing national emphasis on patient-centered and value-based care, it is the perfect time for EIM to evolve and advance a second-level consumer-oriented exercise prescription and communication strategy. Through research on decision-making, motivation, consumer behavior, and meaningful goal pursuit, this article features six evidence-based issues to help clinicians make physical activity more relevant and compelling for patients to sustain in ways that concurrently support patient-centered care. Physical activity prescriptions and counseling can evolve to reflect affective and behavioral science and sell exercise so patients want to buy it.

Supply chain optimization for pediatric perioperative departments.

PubMed

Davis, Janice L; Doyle, Robert

2011-09-01

Economic challenges compel pediatric perioperative departments to reduce nonlabor supply costs while maintaining the quality of patient care. Optimization of the supply chain introduces a framework for decision making that drives fiscally responsible decisions. The cost-effective supply chain is driven by implementing a value analysis process for product selection, being mindful of product sourcing decisions to reduce supply expense, creating logistical efficiency that will eliminate redundant processes, and managing inventory to ensure product availability. The value analysis approach is an analytical methodology for product selection that involves product evaluation and recommendation based on consideration of clinical benefit, overall financial impact, and revenue implications. Copyright © 2011 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The role of contraceptive attributes in women's contraceptive decision making.

PubMed

Madden, Tessa; Secura, Gina M; Nease, Robert F; Politi, Mary C; Peipert, Jeffrey F

2015-07-01

Contraceptive methods have differing attributes. Women's preferences for these attributes may influence contraceptive decision making. Our objective was to identify women's contraceptive preferences among women initiating a new contraceptive method. We conducted a cross-sectional, self-administered survey of women's contraceptive preferences at the time of enrollment into the Contraceptive CHOICE Project. Participants were asked to rank the importance of 15 contraceptive attributes on a 3-point scale (1 = not at all important, 2 = somewhat important, and 3 = very important) and then to rank the 3 attributes that were the most important when choosing a contraceptive method. The survey also contained questions about prior contraceptive experience and barriers to contraceptive use. Information about demographic and reproductive characteristics was collected through the CHOICE Project baseline survey. There were 2590 women who completed the survey. Our sample was racially and socioeconomically diverse. Method attributes with the highest importance score (mean score [SD]) were effectiveness (2.97 [0.18]), safety (2.96 [0.22]), affordability (2.61 [0.61]), whether the method is long lasting (2.58 [0.61]), and whether the method is "forgettable" (2.54 [0.66]). The attributes most likely to be ranked by respondents among the top 3 attributes included effectiveness (84.2%), safety (67.8%), and side effects of the method (44.6%). Multiple contraceptive attributes influence decision making and no single attribute drives most women's decisions. Tailoring communication and helping women make complex tradeoffs between attributes can better support their contraceptive decisions and may assist them in making value-consistent choices. This process could improve continuation and satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

Developing Character and Values for Global Citizens: Analysis of Pre-Service Science Teachers' Moral Reasoning on Socioscientific Issues

ERIC Educational Resources Information Center

Lee, Hyunju; Chang, Hyunsook; Choi, Kyunghee; Kim, Sung-Won; Zeidler, Dana L.

2012-01-01

Character and values are the essential driving forces that serve as general guides or points of reference for individuals to support decision-making and to act responsibly about global socioscientific issues (SSIs). Based on this assumption, we investigated to what extent pre-service science teachers (PSTs) of South Korea possess character and…

Autonomous Science on the EO-1 Mission

NASA Technical Reports Server (NTRS)

Chien, S.; Sherwood, R.; Tran, D.; Castano, R.; Cichy, B.; Davies, A.; Rabideau, G.; Tang, N.; Burl, M.; Mandl, D.;

Acknowledging and Interrogating Multiplicities: Towards a Generous Approach in Evaluations of Early Literacy Innovation and Intervention

ERIC Educational Resources Information Center

Burnett, Cathy

2017-01-01

At a time of increasing calls from policy makers for the use of "hard evidence" in driving decision-making at national and local levels in educational contexts, this article contributes to debates about evidence-based practice in early literacy research. It proposes that a reliance on studies designed to generate 'hard' evidence limits…

Metaphorical Roots of Beliefs about Teaching and Learning Science and Their Modifications in the Standard-Based Science Teacher Preparation Programme

ERIC Educational Resources Information Center

Buaraphan, Khajornsak

2011-01-01

Beliefs are psychological constructs potentially driving a teacher to make pedagogical decisions and act. In this study, the metaphor construction task (MCT) was utilised to uncover beliefs about teaching and learning science held by 110 pre-service science teachers participating in the standard-based teacher preparation programme. Overall, the…

Capacity Enablers and Barriers for Learning Analytics: Implications for Policy and Practice

ERIC Educational Resources Information Center

Wolf, Mary Ann; Jones, Rachel; Hall, Sara; Wise, Bob

2014-01-01

The field of learning analytics is being discussed in many circles as an emerging concept in education. In many districts and states, the core philosophy behind learning analytics is not entirely new; for more than a decade, discussions of data-driven decision making and the use of data to drive instruction have been common. Still, the U.S.…

Washington State Traffic Safety Education Curriculum Guide. A Master Guide for Implementing a Performance-Based Curriculum.

ERIC Educational Resources Information Center

Washington Office of the State Superintendent of Public Instruction, Olympia. Div. of Vocational-Technical and Adult Education Services.

This guide for implementing performance-based curriculum is intended to teach students decision-making driving. Heavy emphasis is put on the tasks and concepts involving traffic flow tasks (interacting with other highway users) and the functions and factors that affect that interaction. It is a "90-hour" guide, that is, the average student needs…

Vehicles driven by teenagers in their first year of licensure.

PubMed

Williams, Allan F; Leaf, William A; Simons-Morton, Bruce G; Hartos, Jessica L

2006-03-01

to determine access to vehicles, vehicle ownership and its correlates, and types of vehicles driven by teenagers during their first year of licensure. About 3,500 Connecticut teenagers and their parents recruited at DMV offices participated in a study aimed at persuading parents to impose and maintain driving restrictions on their sons and daughters. Telephone interviews with teens and parents, which included questions on vehicles driven, were conducted upon licensure and at intervals throughout the year. The majority of both male and female teens owned vehicles immediately upon licensure. Family income and number of vehicles in the family were associated with early ownership. A year later 74% owned vehicles. Small cars, which provide inferior crash protection, were the most popular vehicle; the percent driving small cars increased from 36% to 42% over the year. About 25% were driving SUVs, pickups, or sports cars, which may increase crash risk for young beginners. One year after licensure, only 35% of teens were driving midsize or large passenger cars, the types of vehicles recommended for them, and about one-third of these vehicles were 10 or more years old. Owners were more likely than non-owners to drive older and smaller vehicles, to drive more miles, do more risky driving, and to have more traffic violations and crashes. Many teenagers in Connecticut were driving vehicles that rank low in crash protection or may increase crash risk. Attention to the young driver problem has been focused primarily on managing driving risks through graduated licensing systems. More attention needs to be given to the vehicles teens drive, and how decisions about vehicle type and ownership are made. Parents exert control over what vehicles their sons and daughters drive, and may benefit from information on how to make choices that better balance cost, safety, and other factors that go into these decisions.

The temporal derivative of expected utility: a neural mechanism for dynamic decision-making.

PubMed

Zhang, Xian; Hirsch, Joy

2013-01-15

Real world tasks involving moving targets, such as driving a vehicle, are performed based on continuous decisions thought to depend upon the temporal derivative of the expected utility (∂V/∂t), where the expected utility (V) is the effective value of a future reward. However, the neural mechanisms that underlie dynamic decision-making are not well understood. This study investigates human neural correlates of both V and ∂V/∂t using fMRI and a novel experimental paradigm based on a pursuit-evasion game optimized to isolate components of dynamic decision processes. Our behavioral data show that players of the pursuit-evasion game adopt an exponential discounting function, supporting the expected utility theory. The continuous functions of V and ∂V/∂t were derived from the behavioral data and applied as regressors in fMRI analysis, enabling temporal resolution that exceeded the sampling rate of image acquisition, hyper-temporal resolution, by taking advantage of numerous trials that provide rich and independent manipulation of those variables. V and ∂V/∂t were each associated with distinct neural activity. Specifically, ∂V/∂t was associated with anterior and posterior cingulate cortices, superior parietal lobule, and ventral pallidum, whereas V was primarily associated with supplementary motor, pre and post central gyri, cerebellum, and thalamus. The association between the ∂V/∂t and brain regions previously related to decision-making is consistent with the primary role of the temporal derivative of expected utility in dynamic decision-making. Copyright © 2012 Elsevier Inc. All rights reserved.

The Temporal Derivative of Expected Utility: A Neural Mechanism for Dynamic Decision-making

PubMed Central

Zhang, Xian; Hirsch, Joy

2012-01-01

Real world tasks involving moving targets, such as driving a vehicle, are performed based on continuous decisions thought to depend upon the temporal derivative of the expected utility (∂V/∂t), where the expected utility (V) is the effective value of a future reward. However, those neural mechanisms that underlie dynamic decision-making are not well understood. This study investigates human neural correlates of both V and ∂V/∂t using fMRI and a novel experimental paradigm based on a pursuit-evasion game optimized to isolate components of dynamic decision processes. Our behavioral data show that players of the pursuit-evasion game adopt an exponential discounting function, supporting the expected utility theory. The continuous functions of V and ∂V/∂t were derived from the behavioral data and applied as regressors in fMRI analysis, enabling temporal resolution that exceeded the sampling rate of image acquisition, hyper-temporal resolution, by taking advantage of numerous trials that provide rich and independent manipulation of those variables. V and ∂V/∂t were each associated with distinct neural activity. Specifically, ∂V/∂t was associated with anterior and posterior cingulate cortices, superior parietal lobule, and ventral pallidum, whereas V was primarily associated with supplementary motor, pre and post central gyri, cerebellum, and thalamus. The association between the ∂V/∂t and brain regions previously related to decision-making is consistent with the primary role of the temporal derivative of expected utility in dynamic decision-making. PMID:22963852

Cognitive debiasing 1: origins of bias and theory of debiasing.

PubMed

Croskerry, Pat; Singhal, Geeta; Mamede, Sílvia

2013-10-01

Numerous studies have shown that diagnostic failure depends upon a variety of factors. Psychological factors are fundamental in influencing the cognitive performance of the decision maker. In this first of two papers, we discuss the basics of reasoning and the Dual Process Theory (DPT) of decision making. The general properties of the DPT model, as it applies to diagnostic reasoning, are reviewed. A variety of cognitive and affective biases are known to compromise the decision-making process. They mostly appear to originate in the fast intuitive processes of Type 1 that dominate (or drive) decision making. Type 1 processes work well most of the time but they may open the door for biases. Removing or at least mitigating these biases would appear to be an important goal. We will also review the origins of biases. The consensus is that there are two major sources: innate, hard-wired biases that developed in our evolutionary past, and acquired biases established in the course of development and within our working environments. Both are associated with abbreviated decision making in the form of heuristics. Other work suggests that ambient and contextual factors may create high risk situations that dispose decision makers to particular biases. Fatigue, sleep deprivation and cognitive overload appear to be important determinants. The theoretical basis of several approaches towards debiasing is then discussed. All share a common feature that involves a deliberate decoupling from Type 1 intuitive processing and moving to Type 2 analytical processing so that eventually unexamined intuitive judgments can be submitted to verification. This decoupling step appears to be the critical feature of cognitive and affective debiasing.

Moving toward comprehensive acute heart failure risk assessment in the emergency department: the importance of self-care and shared decision making.

PubMed

Collins, Sean P; Storrow, Alan B

2013-08-01

Nearly 700,000 emergency department (ED) visits were due to acute heart failure (AHF) in 2009. Most visits result in a hospital admission and account for the largest proportion of a projected $70 billion to be spent on heart failure care by 2030. ED-based risk prediction tools in AHF rarely impact disposition decision making. This is a major factor contributing to the 80% admission rate for ED patients with AHF, which has remained unchanged over the last several years. Self-care behaviors such as symptom monitoring, medication taking, dietary adherence, and exercise have been associated with decreased hospital readmissions, yet self-care remains largely unaddressed in ED patients with AHF and thus represents a significant lost opportunity to improve patient care and decrease ED visits and hospitalizations. Furthermore, shared decision making encourages collaborative interaction between patients, caregivers, and providers to drive a care path based on mutual agreement. The observation that “difficult decisions now will simplify difficult decisions later” has particular relevance to the ED, given this is the venue for many such issues. We hypothesize patients as complex and heterogeneous as ED patients with AHF may need both an objective evaluation of physiologic risk as well as an evaluation of barriers to ideal self-care, along with strategies to overcome these barriers. Combining physician gestalt, physiologic risk prediction instruments, an evaluation of self-care, and an information exchange between patient and provider using shared decision making may provide the critical inertia necessary to discharge patients home after a brief ED evaluation.

Development of a requirements management system for technical decision - making processes in the geological disposal project

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

Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama

2007-07-01

NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help formore » comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on the initial stage including work analysis/modeling and the system conceptualization. (authors)« less

Is a hands-free phone safer than a handheld phone?

PubMed

Ishigami, Yoko; Klein, Raymond M

2009-01-01

Although it is becoming more and more accepted that driving while talking on a cell phone can be hazardous, most jurisdictions are making handheld phone use illegal while allowing hands-free phone use. The scientific literature exploring the effects of these two types of cell phone use on driving and driving-related performance is reviewed here. Our review shows that talking on the phone, regardless of phone type, has negative impacts on performance especially in detecting and identifying events. Performance while using a hands-free phone was rarely found to be better than when using a handheld phone. Some studies found that drivers compensate for the deleterious effects of cell phone use when using a handheld phone but neglect to do so when using a hands-free phone. Current research does not support the decision to allow hands-free phone use while driving.

Reversal of Alcohol-Induced Dysregulation in Dopamine Network Dynamics May Rescue Maladaptive Decision-making

PubMed Central

Schindler, Abigail G.; Soden, Marta E.; Zweifel, Larry S.

2016-01-01

Alcohol is the most commonly abused substance among adolescents, promoting the development of substance use disorders and compromised decision-making in adulthood. We have previously demonstrated, with a preclinical model in rodents, that adolescent alcohol use results in adult risk-taking behavior that positively correlates with phasic dopamine transmission in response to risky options, but the underlying mechanisms remain unknown. Here, we show that adolescent alcohol use may produce maladaptive decision-making through a disruption in dopamine network dynamics via increased GABAergic transmission within the ventral tegmental area (VTA). Indeed, we find that increased phasic dopamine signaling after adolescent alcohol use is attributable to a midbrain circuit, including the input from the pedunculopontine tegmentum to the VTA. Moreover, we demonstrate that VTA dopamine neurons from adult rats exhibit enhanced IPSCs after adolescent alcohol exposure corresponding to decreased basal dopamine levels in adulthood that negatively correlate with risk-taking. Building on these findings, we develop a model where increased inhibitory tone on dopamine neurons leads to a persistent decrease in tonic dopamine levels and results in a potentiation of stimulus-evoked phasic dopamine release that may drive risky choice behavior. Based on this model, we take a pharmacological approach to the reversal of risk-taking behavior through normalization of this pattern in dopamine transmission. These results isolate the underlying circuitry involved in alcohol-induced maladaptive decision-making and identify a novel therapeutic target. SIGNIFICANCE STATEMENT One of the primary problems resulting from chronic alcohol use is persistent, maladaptive decision-making that is associated with ongoing addiction vulnerability and relapse. Indeed, studies with the Iowa Gambling Task, a standard measure of risk-based decision-making, have reliably shown that alcohol-dependent individuals make riskier, more maladaptive choices than nondependent individuals, even after periods of prolonged abstinence. Using a preclinical model, in the current work, we identify a selective disruption in dopamine network dynamics that may promote maladaptive decision-making after chronic adolescent alcohol use and demonstrate its pharmacological reversal in adulthood. Together, these results highlight a novel neural mechanism underlying heightened risk-taking behavior in alcohol-dependent individuals and provide a potential therapeutic target for further investigation. PMID:27030756

[Big data analysis and evidence-based medicine: controversy or cooperation].

PubMed

Chen, Xinzu; Hu, Jiankun

2016-01-01

The development of evidence-based medicince should be an important milestone from the empirical medicine to the evidence-driving modern medicine. With the outbreak in biomedical data, the rising big data analysis can efficiently solve exploratory questions or decision-making issues in biomedicine and healthcare activities. The current problem in China is that big data analysis is still not well conducted and applied to deal with problems such as clinical decision-making, public health policy, and should not be a debate whether big data analysis can replace evidence-based medicine or not. Therefore, we should clearly understand, no matter whether evidence-based medicine or big data analysis, the most critical infrastructure must be the substantial work in the design, constructure and collection of original database in China.

An interactive driving simulation for driver control and decision-making research

NASA Technical Reports Server (NTRS)

Allen, R. W.; Hogge, J. R.; Schwartz, S. H.

1975-01-01

Display techniques and equations of motion for a relatively simple fixed base car simulation are described. The vehicle dynamics include simplified lateral (steering) and longitudinal (speed) degrees of freedom. Several simulator tasks are described which require a combination of operator control and decision making, including response to wind gust inputs, curved roads, traffic signal lights, and obstacles. Logic circuits are used to detect speeding, running red lights, and crashes. A variety of visual and auditory cues are used to give the driver appropriate performance feedback. The simulated equations of motion are reviewed and the technique for generating the line drawing CRT roadway display is discussed. On-line measurement capabilities and experimenter control features are presented, along with previous and current research results demonstrating simulation capabilities and applications.

Avoiding boredom: Caudate and insula activity reflects boredom-elicited purchase bias.

PubMed

Dal Mas, Dennis E; Wittmann, Bianca C

2017-07-01

People show a strong tendency to avoid boring situations, but the neural systems mediating this behavioural bias are yet unknown. We used functional magnetic resonance imaging (fMRI) to investigate how the anticipation of a boring task influences decisions to purchase entertainment. Participants accepted higher prices to avoid boredom compared to control tasks, and individual differences in boredom experience predicted the increase in price. This behavioural bias was associated with higher activity in the caudate nucleus during music purchases driven by boredom avoidance. Insula activation was increased during performance of the boring task and subsequently associated with individual differences in boredom-related decision making. These results identify a mechanism that drives decisions to avoid boring situations and potentially underlies consumer decisions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Keeping all options open: Parents' approaches to advance care planning.

PubMed

Beecham, Emma; Oostendorp, Linda; Crocker, Joanna; Kelly, Paula; Dinsdale, Andrew; Hemsley, June; Russell, Jessica; Jones, Louise; Bluebond-Langner, Myra

2017-08-01

Early engagement in advance care planning (ACP) is seen as fundamental for ensuring the highest standard of care for children and young people with a life-limiting condition (LLC). However, most families have little knowledge or experience of ACP. To investigate how parents of children and young people with LLCs approach and experience ACP. Open-ended, semi-structured interviews were conducted with parents of 18 children; nine children who were currently receiving palliative care services, and nine children who had received palliative care and died. Verbatim transcripts of audiotaped interviews were analysed following principles of grounded theory while acknowledging the use of deductive strategies, taking account of both the child's condition, and the timing and nature of decisions made. Parents reported having discussions and making decisions about the place of care, place of death and the limitation of treatment. Most decisions were made relatively late in the illness and by parents who wished to keep their options open. Parents reported different levels of involvement in a range of decisions; many wished to be involved in decision making but did not always feel able to do so. This study highlights that parents' approaches to decision making vary by the type of decision required. Their views may change over time, and it is important to allow them to keep their options open. We recommend that clinicians have regular discussions over the course of the illness in an effort to understand parents' approaches to particular decisions rather than to drive to closure prematurely. © 2016 The Authors Health Expectations Published by John Wiley & Sons Ltd.

SPIDER: A Framework for Understanding Driver Distraction.

PubMed

Strayer, David L; Fisher, Donald L

2016-02-01

The objective was to identify key cognitive processes that are impaired when drivers divert attention from driving. Driver distraction is increasingly recognized as a significant source of injuries and fatalities on the roadway. A "SPIDER" model is developed that identifies key cognitive processes that are impaired when drivers divert attention from driving. SPIDER is an acronym standing for scanning, predicting, identifying, decision making, and executing a response. When drivers engage in secondary activities unrelated to the task of driving, SPIDER-related processes are impaired, situation awareness is degraded, and the ability to safely operate a motor vehicle may be compromised. The pattern of interference helps to illuminate the sources of driver distraction and may help guide the integration of new technology into the automobile. © 2015, Human Factors and Ergonomics Society.

Texting while driving as impulsive choice: A behavioral economic analysis

PubMed Central

Hayashi, Yusuke; Russo, Christopher T.; Wirth, Oliver

2015-01-01

The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors. PMID:26280804

The data life cycle applied to our own data.

PubMed

Goben, Abigail; Raszewski, Rebecca

2015-01-01

Increased demand for data-driven decision making is driving the need for librarians to be facile with the data life cycle. This case study follows the migration of reference desk statistics from handwritten to digital format. This shift presented two opportunities: first, the availability of a nonsensitive data set to improve the librarians' understanding of data-management and statistical analysis skills, and second, the use of analytics to directly inform staffing decisions and departmental strategic goals. By working through each step of the data life cycle, library faculty explored data gathering, storage, sharing, and analysis questions.

Driving context influences drivers' decision to engage in visual-manual phone tasks: Evidence from a naturalistic driving study.

PubMed

Tivesten, Emma; Dozza, Marco

2015-06-01

Visual-manual (VM) phone tasks (i.e., texting, dialing, reading) are associated with an increased crash/near-crash risk. This study investigated how the driving context influences drivers' decisions to engage in VM phone tasks in naturalistic driving. Video-recordings of 1,432 car trips were viewed to identify VM phone tasks and passenger presence. Video, vehicle signals, and map data were used to classify driving context (i.e., curvature, other vehicles) before and during the VM phone tasks (N=374). Vehicle signals (i.e., speed, yaw rate, forward radar) were available for all driving. VM phone tasks were more likely to be initiated while standing still, and less likely while driving at high speeds, or when a passenger was present. Lead vehicle presence did not influence how likely it was that a VM phone task was initiated, but the drivers adjusted their task timing to situations when the lead vehicle was increasing speed, resulting in increasing time headway. The drivers adjusted task timing until after making sharp turns and lane change maneuvers. In contrast to previous driving simulator studies, there was no evidence of drivers reducing speed as a consequence of VM phone task engagement. The results show that experienced drivers use information about current and upcoming driving context to decide when to engage in VM phone tasks. However, drivers may fail to sufficiently increase safety margins to allow time to respond to possible unpredictable events (e.g., lead vehicle braking). Advanced driver assistance systems should facilitate and possibly boost drivers' self-regulating behavior. For instance, they might recognize when appropriate adaptive behavior is missing and advise or alert accordingly. The results from this study could also inspire training programs for novice drivers, or locally classify roads in terms of the risk associated with secondary task engagement while driving. Copyright © 2015. Published by Elsevier Ltd.

What the drivers do and do not tell you: using verbal protocol analysis to investigate driver behaviour in emergency situations.

PubMed

Banks, Victoria A; Stanton, Neville A; Harvey, Catherine

2014-01-01

Although task analysis of pedestrian detection can provide us with useful insights into how a driver may behave in emergency situations, the cognitive elements of driver decision-making are less well understood. To assist in the design of future Advanced Driver Assistance Systems, such as Autonomous Emergency Brake systems, it is essential that the cognitive elements of the driving task are better understood. This paper uses verbal protocol analysis in an exploratory fashion to uncover the thought processes underlying behavioural outcomes represented by hard data collected using the Southampton University Driving Simulator.

A proposal for a CT driven classification of left colon acute diverticulitis.

PubMed

Sartelli, Massimo; Moore, Frederick A; Ansaloni, Luca; Di Saverio, Salomone; Coccolini, Federico; Griffiths, Ewen A; Coimbra, Raul; Agresta, Ferdinando; Sakakushev, Boris; Ordoñez, Carlos A; Abu-Zidan, Fikri M; Karamarkovic, Aleksandar; Augustin, Goran; Costa Navarro, David; Ulrych, Jan; Demetrashvili, Zaza; Melo, Renato B; Marwah, Sanjay; Zachariah, Sanoop K; Wani, Imtiaz; Shelat, Vishal G; Kim, Jae Il; McFarlane, Michael; Pintar, Tadaja; Rems, Miran; Bala, Miklosh; Ben-Ishay, Offir; Gomes, Carlos Augusto; Faro, Mario Paulo; Pereira, Gerson Alves; Catani, Marco; Baiocchi, Gianluca; Bini, Roberto; Anania, Gabriele; Negoi, Ionut; Kecbaja, Zurabs; Omari, Abdelkarim H; Cui, Yunfeng; Kenig, Jakub; Sato, Norio; Vereczkei, Andras; Skrovina, Matej; Das, Koray; Bellanova, Giovanni; Di Carlo, Isidoro; Segovia Lohse, Helmut A; Kong, Victor; Kok, Kenneth Y; Massalou, Damien; Smirnov, Dmitry; Gachabayov, Mahir; Gkiokas, Georgios; Marinis, Athanasios; Spyropoulos, Charalampos; Nikolopoulos, Ioannis; Bouliaris, Konstantinos; Tepp, Jaan; Lohsiriwat, Varut; Çolak, Elif; Isik, Arda; Rios-Cruz, Daniel; Soto, Rodolfo; Abbas, Ashraf; Tranà, Cristian; Caproli, Emanuele; Soldatenkova, Darija; Corcione, Francesco; Piazza, Diego; Catena, Fausto

2015-01-01

Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice.

[Relevance of a driving simulator in the assessment of handicapped individuals].

PubMed

Carroz, A; Comte, P-A; Nicolo, D; Dériaz, O; Vuadens, P

2008-06-01

To evaluate the value of our driving simulator in deciding whether or not to allow patients with physical and/or cognitive deficits to resuming driving and to analyze whether or not the medical expert's final decision is based more on the results of the driving simulator than those of the neuropsychological examination. One hundred and twenty-three patients were evaluated with the driving simulator. Thirty-five of those with cognitive deficits also underwent a neuropsychological examination prior to the medical expert's decision on driving aptitude. In cases of uncertainty or disagreement, a driving assessment in real conditions was performed by a driving instructor. In cases of physical handicap, the medical expert's decision concurred with that of the occupational therapist. For brain-injured patients, there was a significant correlation between the neuropsychologist's opinion and that of the occupational therapist (kappa=0.33; P=0.01). However, the sensibility and specificity were only 55 and 80%, respectively. The correlation between an occupational therapy decision based on the driving simulator and that of the medical expert was very significant (kappa=0.81; P<0.0001) and the sensibility and specificity were 84 and 100%, respectively. In contrast, these values were lower (63 and 71%, respectively) for the correlation between the neuropsychologist's opinion and that of the medical expert. Our driving simulator enables the danger-free evaluation of driving aptitude. The results mirror an in situ assessment and are more sensitive than neuropsychological examination. In fact, the neuropsychologist's opinion often is more negative or uncertain with respect to the patient's real driving aptitude. When taking a decision on a patient's driving aptitude, the medical expert is more inclined to trust the results of the driving simulator.

Anxiety, Sedation, and Simulated Driving in Binge Drinkers

PubMed Central

Aston, Elizabeth R.; Shannon, Erin E.; Liguori, Anthony

2014-01-01

The current study evaluated the relationships among trait anxiety, subjective response to alcohol, and simulated driving following a simulated alcohol binge. Sixty drinkers with a binge history completed the State Trait Anxiety Inventory (STAI), the Alcohol Use Questionnaire, and subsequently completed a driving simulation. Participants were then administered 0.2 g/kg ethanol at 30 minute intervals (cumulative dose 0.8 g/kg). Following alcohol consumption, the Biphasic Alcohol Effects Scale (BAES) and visual analog scales of subjective impairment and driving confidence were administered, after which simulated driving was re-assessed. Due to the emphasis on simulated driving after drinking in the current study, subjective response to alcohol (i.e., self-reported sedation, stimulation, impairment, and confidence in driving ability) was assessed once following alcohol consumption, as this is the time when drinkers tend to make decisions regarding legal driving ability. Alcohol increased driving speed, speeding tickets, and collisions. Sedation following alcohol predicted increased subjective impairment and decreased driving confidence. Subjective impairment was not predicted by sensitivity to stimulation or trait anxiety. High trait anxiety predicted low driving confidence after drinking and this relationship was mediated by sedation. Increased speed after alcohol was predicted by sedation, but not by trait anxiety or stimulation. Anxiety, combined with the sedating effects of alcohol, may indicate when consumption should cease. However, once driving is initiated, sensitivity to sedation following alcohol consumption is positively related to simulated driving speed. PMID:24955664

What Does It Mean to Be a Science Librarian 2.0?

ERIC Educational Resources Information Center

Harvey, Missy

2009-01-01

Science librarians, as well as other librarians, have seen ample new technologies come and go over the years. Librarians experiment and try to find ways to employ the new tools in our libraries. A driving force in our decision making about what tools to use should always be our patrons and whether the tools can help us do a better job of…

The Impact of Involvement on Performance in Business Simulations: An Examination of Goosen's "Know Little" Decision-Making Thesis

ERIC Educational Resources Information Center

Wolfe, Joseph; Luethge, Denise J.

2003-01-01

Some game users have contended that students can be successful in games even if they "know little" about the rules and the underlying business theories driving them. Thus, if teams are uninvolved, it is possible that successful game play may not impart the learning typically found in experiential exercises nor that designed into games by their…

Serbia and the NATO Partnership for Peace Program

DTIC Science & Technology

2008-03-01

Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management ...For the first time, principles for democratic control of the military were established and clearly stated in the constitutional text and the tasks...book announced all principles driving the decision making process in Serbia related to national security and defense. The defense budget procedures

Genetic Testing and Post-Testing Decision Making among BRCA-Positive Mutation Women: A Psychosocial Approach.

PubMed

Hesse-Biber, Sharlene; An, Chen

2016-10-01

Through an analysis of an online survey of women who tested positive for the BRCA genetic mutation for breast cancer, this research uses a social constructionist and feminist standpoint lens to understand the decision-making process that leads BRCA-positive women to choose genetic testing. Additionally, this research examines how they socially construct and understand their risk for developing breast cancer, as well as which treatment options they undergo post-testing. BRCA-positive women re-frame their statistical medical risk for developing cancer and their post-testing treatment choices through a broad psychosocial context of engagement that also includes their social networks. Important psychosocial factors drive women's medical decisions, such as individual feelings of guilt and vulnerability, and the degree of perceived social support. Women who felt guilty and fearful that they might pass the BRCA gene to their children were more likely to undergo risk reducing surgery. Women with at least one daughter and women without children were more inclined toward the risk reducing surgery compared to those with only sons. These psychosocial factors and social network engagements serve as a "nexus of decision making" that does not, for the most part, mirror the medical assessments of statistical odds for hereditary cancer development, nor the specific treatment protocols outlined by the medical establishment.

Use of implicit persuasion in decision making about adjuvant cancer treatment: A potential barrier to shared decision making.

PubMed

Engelhardt, Ellen G; Pieterse, Arwen H; van der Hout, Anja; de Haes, Hanneke J C J M; Kroep, Judith R; Quarles van Ufford-Mannesse, Patricia; Portielje, Johanneke E A; Smets, Ellen M A; Stiggelbout, Anne M

2016-10-01

Shared decision making (SDM) is widely advocated, especially for preference-sensitive decisions like those on adjuvant treatment for early-stage cancer. Here, decision making involves a subjective trade-off between benefits and side-effects, and therefore, patients' informed preferences should be taken into account. If clinicians consciously or unconsciously steer patients towards the option they think is in their patients' best interest (i.e. implicit persuasion), they may be unwittingly subverting their own efforts to implement SDM. We assessed the frequency of use of implicit persuasion during consultations and whether the use of implicit persuasion was associated with expected treatment benefit and/or decision making. Observational study design in which consecutive consultations about adjuvant systemic therapy with stage I-II breast cancer patients treated at oncology outpatient clinics of general teaching hospitals and university medical centres were audiotaped, transcribed and coded by two researchers independently. In total, 105 patients (median age = 59; range: 35-87 years) were included. A median of five (range: 2-10) implicitly persuasive behaviours were employed per consultation. The number of behaviours used did not differ by disease stage (P = 0.07), but did differ by treatment option presented (P = 0.002) and nodal status (P = 0.01). About 50% of patients with stage I or node-negative disease were steered towards undergoing chemotherapy, whereas 96% of patients were steered towards undergoing endocrine therapy, irrespective of expected treatment benefit. Decisions were less often postponed if more implicit persuasion was used (P = 0.03). Oncologists frequently use implicit persuasion, steering patients towards the treatment option that they think is in their patients' best interest. Expected treatment benefit does not always seem to be the driving force behind implicit persuasion. Awareness of one's use of these steering behaviours during decision making is a first step to help overcome the performance gap between advocating and implementing SDM. Copyright © 2016 Elsevier Ltd. All rights reserved.

Endodontic decision making for asymptomatic root-filled teeth with apical periodontitis - A radiographic survey.

PubMed

Taha, Nessrin A; Albashaireh, Zakereyya S; Alfied, Rmdan G

2018-03-23

The aim of the study was to compare decision making for asymptomatic root-filled teeth among dentists with differing educational backgrounds. Case scenarios based on 14 radiographs were created and 150 participants were asked to choose from five alternative treatment decisions and to state the rationale. Demographic data of the participants were recorded. Frequency distribution and cross-tabulation were performed; chi square testing was used for comparisons and logistic regression was performed to detect significant differences. The overall response rate was 87.3%. The practitioners chose intervention predominantly with non-surgical retreatment a common choice. Poor technical quality was a driving factor, while the existing poor coronal restoration and the need for a crown were generally not taken into account by general dentists. Speciality and experience were significant factors. Practitioners were more inclined to retain rather than extract teeth. It is concluded that clear guidelines listing factors to consider for intervention are required. © 2018 Australian Society of Endodontology Inc.

Maximizing gait and balance: behaviors and decision-making processes of persons with multiple sclerosis and physical therapists.

PubMed

Held Bradford, Elissa; Finlayson, Marcia; White Gorman, Andrea; Wagner, Joanne

2018-05-01

To describe the behavioral decisions used by persons with multiple sclerosis (MS) and physical therapists to maximize gait and balance following outpatient physical therapy. A multi-method case series with seven matched pairs (persons with MS-physical therapists). Quota sampling maximized variability among persons with MS (disease steps score range 3-6). Three of the four physical therapists were MS or neurology certified. Persons with MS completed a phone survey, follow-up interview, and standardized questionnaires. Physical therapists completed an interview. Data were collected 2-8 weeks following discharge. Content and constant comparison analyses were used for thematic development and triangulation. Core themes arose exemplifying the decision-making processes and actions of persons with MS (challenging self by pushing but respecting limits) and physical therapists (finding the right fit). One overarching theme, keeping their lived world large, or participation in valued life roles, emerged integrating both perspectives driving decision-making. Participants have a shared goal of maximizing gait and balance so persons with MS can participate in valued life roles. Understanding the differences in the behavioral decisions and optimizing skill sets in shared decision-making and self-management may enhance the therapeutic partnership and engagement in gait- and balance-enhancing behaviors. Implications for Rehabilitation Persons with MS and physical therapists have a shared goal of maximizing gait and balance so persons with MS can participate in valued activities and life roles, or more poetically, keep their lived world large. Knowledge that persons with MS aim to challenge themselves by pushing but respecting limits can provide physical therapists with greater insight in helping persons with MS resolve uncertainty, set meaningful goals, and build the routines and resilience needed for engagement in gait- and balance-enhancing behaviors. Enriching skill sets in shared decision-making, behavior change and self-management may optimize the physical therapist toolbox.

Increased Reliance on Value-based Decision Processes Following Motor Cortex Disruption.

PubMed

Zénon, Alexandre; Klein, Pierre-Alexandre; Alamia, Andrea; Boursoit, François; Wilhelm, Emmanuelle; Duque, Julie

2015-01-01

During motor decision making, the neural activity in primary motor cortex (M1) encodes dynamically the competition occurring between potential action plans. A common view is that M1 represents the unfolding of the outcome of a decision process taking place upstream. Yet, M1 could also be directly involved in the decision process. Here we tested this hypothesis by assessing the effect of M1 disruption on a motor decision-making task. We applied continuous theta burst stimulation (cTBS) to inhibit either left or right M1 in different groups of subjects and included a third control group with no stimulation. Following cTBS, participants performed a task that required them to choose between two finger key-presses with the right hand according to both perceptual and value-based information. Effects were assessed by means of generalized linear mixed models and computational simulations. In all three groups, subjects relied both on perceptual (P < 0.0001) and value-based information (P = 0.003) to reach a decision. Yet, left M1 disruption led to an increased reliance on value-based information (P = 0.03). This result was confirmed by a computational model showing an increased weight of the valued-based process on the right hand finger choices following left M1 cTBS (P < 0.01). These results indicate that M1 is involved in motor decision making, possibly by weighting the final integration of multiple sources of evidence driving motor behaviors. Copyright © 2015 Elsevier Inc. All rights reserved.

Shared decision-making using personal health record technology: a scoping review at the crossroads.

PubMed

Davis, Selena; Roudsari, Abdul; Raworth, Rebecca; Courtney, Karen L; MacKay, Lee

2017-07-01

This scoping review aims to determine the size and scope of the published literature on shared decision-making (SDM) using personal health record (PHR) technology and to map the literature in terms of system design and outcomes. Literature from Medline, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Engineering Village, and Web of Science (2005-2015) using the search terms "personal health records," "shared decision making," "patient-provider communication," "decision aid," and "decision support" was included. Articles ( n  = 38) addressed the efficacy or effectiveness of PHRs for SDM in engaging patients in self-care and decision-making or ways patients can be supported in SDM via PHR. Analysis resulted in an integrated SDM-PHR conceptual framework. An increased interest in SDM via PHR is apparent, with 55% of articles published within last 3 years. Sixty percent of the literature originates from the United States. Twenty-six articles address a particular clinical condition, with 10 focused on diabetes, and one-third offer empirical evidence of patient outcomes. The tethered and standalone PHR architectural types were most studied, while the interconnected PHR type was the focus of more recently published methodological approaches and discussion articles. The study reveals a scarcity of rigorous research on SDM via PHR. Research has focused on one or a few of the SDM elements and not on the intended complete process. Just as PHR technology designed on an interconnected architecture has the potential to facilitate SDM, integrating the SDM process into PHR technology has the potential to drive PHR value. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Cognitive debiasing 1: origins of bias and theory of debiasing

PubMed Central

Croskerry, Pat; Singhal, Geeta; Mamede, Sílvia

2013-01-01

Numerous studies have shown that diagnostic failure depends upon a variety of factors. Psychological factors are fundamental in influencing the cognitive performance of the decision maker. In this first of two papers, we discuss the basics of reasoning and the Dual Process Theory (DPT) of decision making. The general properties of the DPT model, as it applies to diagnostic reasoning, are reviewed. A variety of cognitive and affective biases are known to compromise the decision-making process. They mostly appear to originate in the fast intuitive processes of Type 1 that dominate (or drive) decision making. Type 1 processes work well most of the time but they may open the door for biases. Removing or at least mitigating these biases would appear to be an important goal. We will also review the origins of biases. The consensus is that there are two major sources: innate, hard-wired biases that developed in our evolutionary past, and acquired biases established in the course of development and within our working environments. Both are associated with abbreviated decision making in the form of heuristics. Other work suggests that ambient and contextual factors may create high risk situations that dispose decision makers to particular biases. Fatigue, sleep deprivation and cognitive overload appear to be important determinants. The theoretical basis of several approaches towards debiasing is then discussed. All share a common feature that involves a deliberate decoupling from Type 1 intuitive processing and moving to Type 2 analytical processing so that eventually unexamined intuitive judgments can be submitted to verification. This decoupling step appears to be the critical feature of cognitive and affective debiasing. PMID:23882089

18 CFR 1304.6 - Appeals.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Drive, Knoxville, Tennessee 37902. Otherwise, the initial decision of the Vice President's designee... W. Summit Hill Drive, Knoxville, Tennessee 37902. Otherwise, the Vice President's decision becomes..., Tennessee Valley Authority, 400 West Summit Hill Drive, Knoxville, Tennessee 37902. If within 60 days of...

Imaging pediatric magnet ingestion with surgical-pathological correlation.

PubMed

Otjen, Jeffrey P; Rohrmann, Charles A; Iyer, Ramesh S

2013-07-01

Foreign body ingestion is a common problem in the pediatric population and a frequent cause for emergency room visits. Magnets are common household objects that when ingested can bring about severe, possibly fatal gastrointestinal complications. Radiography is an integral component of the management of these children. Pediatric and emergency radiologists alike must be aware of imaging manifestations of magnet ingestion, as their identification drives decision-making for consulting surgeons and gastroenterologists. Radiology can thus substantially augment the clinical history and physical exam, facilitating appropriate management. This manuscript sequentially presents cases of magnet ingestion featuring imaging findings coupled with surgical and pathological correlation. Each case is presented to highlight ways in which the radiologist can make impactful contributions to diagnosis and management. Clinical overview with pitfalls of magnet ingestion imaging and an imaging decision tree will also be presented.

The Role of Psychological and Physiological Factors in Decision Making under Risk and in a Dilemma

PubMed Central

Fooken, Jonas; Schaffner, Markus

2016-01-01

Different methods to elicit risk attitudes of individuals often provide differing results despite a common theory. Reasons for such inconsistencies may be the different influence of underlying factors in risk-taking decisions. In order to evaluate this conjecture, a better understanding of underlying factors across methods and decision contexts is desirable. In this paper we study the difference in result of two different risk elicitation methods by linking estimates of risk attitudes to gender, age, and personality traits, which have been shown to be related. We also investigate the role of these factors during decision-making in a dilemma situation. For these two decision contexts we also investigate the decision-maker's physiological state during the decision, measured by heart rate variability (HRV), which we use as an indicator of emotional involvement. We found that the two elicitation methods provide different individual risk attitude measures which is partly reflected in a different gender effect between the methods. Personality traits explain only relatively little in terms of driving risk attitudes and the difference between methods. We also found that risk taking and the physiological state are related for one of the methods, suggesting that more emotionally involved individuals are more risk averse in the experiment. Finally, we found evidence that personality traits are connected to whether individuals made a decision in the dilemma situation, but risk attitudes and the physiological state were not indicative for the ability to decide in this decision context. PMID:26834591

Using patient acuity data to manage patient care outcomes and patient care costs.

PubMed

Van Slyck, A; Johnson, K R

2001-01-01

This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.

Cortisol boosts risky decision-making behavior in men but not in women.

PubMed

Kluen, Lisa Marieke; Agorastos, Agorastos; Wiedemann, Klaus; Schwabe, Lars

2017-10-01

Acute stress may escalate risky decision-making in men, while there is no such effect in women. Although first evidence links these gender-specific effects of stress to stress-induced changes in cortisol, whether elevated cortisol is indeed sufficient to boost risk-taking, whether a potential cortisol effect depends on simultaneous noradrenergic activation, and whether cortisol and noradrenergic activation exert distinct effects on risk-taking in men and women is unknown. In this experiment, we therefore set out to elucidate the impact of cortisol and noradrenergic stimulation on risky decision-making in men and women. In a fully-crossed, placebo-controlled, double-blind design, male and female participants received orally either a placebo, hydrocortisone, yohimbine, an alpha-2-adrenoceptor-antagonist leading to increased noradrenergic stimulation, or both drugs before completing the balloon analogue risk task, a validated measure of risk-taking. Overall, participants' choice was risk-sensitive as reflected in reduced responding in high- compared to moderate- and low-risk conditions. Cortisol, however, led to a striking increase in risk-taking in men, whereas it had no effect on risk-taking behavior in women. Yohimbine had no such effect and the gender-specific effect of cortisol was not modulated by yohimbine. Our data show that cortisol boosts risk-taking behavior in men but not in women. This differential effect of cortisol on risk-taking may drive gender differences in risky decision-making under stress. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Development of a Search and Rescue Simulation to Study the Effects of Prolonged Isolation on Team Decision Making

NASA Technical Reports Server (NTRS)

Entin, Elliot E.; Kerrigan, Caroline; Serfaty, Daniel; Young, Philip

1998-01-01

The goals of this project were to identify and investigate aspects of team and individual decision-making and risk-taking behaviors hypothesized to be most affected by prolonged isolation. A key premise driving our research approach is that effects of stressors that impact individual and team cognitive processes in an isolated, confined, and hazardous environment will be projected onto the performance of a simulation task. To elicit and investigate these team behaviors we developed a search and rescue task concept as a scenario domain that would be relevant for isolated crews. We modified the Distributed Dynamic Decision-making (DDD) simulator, a platform that has been extensively used for empirical research in team processes and taskwork performance, to portray the features of a search and rescue scenario and present the task components incorporated into that scenario. The resulting software is called DD-Search and Rescue (Version 1.0). To support the use of the DDD-Search and Rescue simulator in isolated experiment settings, we wrote a player's manual for teaching team members to operate the simulator and play the scenario. We then developed a research design and experiment plan that would allow quantitative measures of individual and team decision making skills using the DDD-Search and Rescue simulator as the experiment platform. A description of these activities and the associated materials that were produced under this contract are contained in this report.

Dying well with reduced agency: a scoping review and thematic synthesis of the decision-making process in dementia, traumatic brain injury and frailty.

PubMed

Birchley, Giles; Jones, Kerry; Huxtable, Richard; Dixon, Jeremy; Kitzinger, Jenny; Clare, Linda

2016-07-27

In most Anglophone nations, policy and law increasingly foster an autonomy-based model, raising issues for large numbers of people who fail to fit the paradigm, and indicating problems in translating practical and theoretical understandings of 'good death' to policy. Three exemplar populations are frail older people, people with dementia and people with severe traumatic brain injury. We hypothesise that these groups face some over-lapping challenges in securing good end-of-life care linked to their limited agency. To better understand these challenges, we conducted a scoping review and thematic synthesis. To capture a range of literature, we followed established scoping review methods. We then used thematic synthesis to describe the broad themes emerging from this literature. Initial searches generated 22,375 references, and screening yielded 49, highly heterogeneous, studies that met inclusion criteria, encompassing 12 countries and a variety of settings. The thematic synthesis identified three themes: the first concerned the processes of end-of-life decision-making, highlighting the ambiguity of the dominant shared decision-making process, wherein decisions are determined by families or doctors, sometimes explicitly marginalising the antecedent decisions of patients. Despite this marginalisation, however, the patient does play a role both as a social presence and as an active agent, by whose actions the decisions of those with authority are influenced. The second theme examined the tension between predominant notions of a good death as 'natural' and the drive to medicalise death through the lens of the experiences and actions of those faced with the actuality of death. The final theme considered the concept of antecedent end-of-life decision-making (in all its forms), its influence on policy and decision-making, and some caveats that arise from the studies. Together these three themes indicate a number of directions for future research, which are likely to be applicable to other conditions that result in reduced agency. Above all, this review emphasises the need for new concepts and fresh approaches to end of life decision-making that address the needs of the growing population of frail older people, people with dementia and those with severe traumatic brain injury.

Review of fluorescence guided surgery visualization and overlay techniques

PubMed Central

Elliott, Jonathan T.; Dsouza, Alisha V.; Davis, Scott C.; Olson, Jonathan D.; Paulsen, Keith D.; Roberts, David W.; Pogue, Brian W.

2015-01-01

In fluorescence guided surgery, data visualization represents a critical step between signal capture and display needed for clinical decisions informed by that signal. The diversity of methods for displaying surgical images are reviewed, and a particular focus is placed on electronically detected and visualized signals, as required for near-infrared or low concentration tracers. Factors driving the choices such as human perception, the need for rapid decision making in a surgical environment, and biases induced by display choices are outlined. Five practical suggestions are outlined for optimal display orientation, color map, transparency/alpha function, dynamic range compression, and color perception check. PMID:26504628

Texting while driving as impulsive choice: A behavioral economic analysis.

PubMed

Hayashi, Yusuke; Russo, Christopher T; Wirth, Oliver

2015-10-01

The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors. Copyright © 2015 Elsevier Ltd. All rights reserved.

How do the EMA and FDA decide which anticancer drugs make it to the market? A comparative qualitative study on decision makers' views.

PubMed

Tafuri, G; Stolk, P; Trotta, F; Putzeist, M; Leufkens, H G; Laing, R O; De Allegri, M

2014-01-01

The process leading to a regulatory outcome is guided by factors both related and unrelated to the data package, defined in this analysis as 'formal and informal factors', respectively. The aim of this qualitative study was to analyse which formal and informal factors drive the decision-making process of the European Medicines Agency (EMA) and Food and Drug Administration (FDA) regulators with regard to anticancer drugs, using in-depth semi-structured interviews with regulators of the two agencies. In line with the theory and practice of qualitative research, no set sample size was defined a priori. Respondent enrolment continued until saturation and redundancy were reached. Data were collected through means of in-depth semi-structured interviews conducted either in a face-to-face setting or via Skype(®) with each regulator. The interviews were audio-recorded and verbatim transcribed. The analysis was manually carried out on the transcribed text. Data were independently coded and categorized by two researchers. Interpretation of the findings emerged through a process of triangulation between the two. Seven EMA and six FDA regulators, who had extensive experience with making decisions about anticancer medicines, were interviewed between April and June 2012. There is an open dialogue between the FDA and EMA, with the two moving closer and exchanging information, not opinions. Differences in decision-making between the agencies may be due to a different evaluation of end points. Different interaction modalities with industry and patients represent an additional source of divergence with a potential impact on decision-making. The key message of our respondents was that the agencies manage uncertainty in a different way: unlike the EMA, the FDA has a prevailing attitude to take risks in order to guarantee quicker access to new treatments. Although formal factors are the main drivers for regulatory decisions, the influence of informal factors plays an important role in the drug evaluation process.

Viewpoint: Availability of oestrogen receptor and HER2 status for the breast multidisciplinary meeting discussion; time to get it right.

PubMed

Francis, A; Bartlett, J; Rea, D; Pinder, S E; Stein, R C; Stobart, H; Purdie, C A; Rakha, E; Thompson, A; Shaaban, A M

2016-07-01

The efficacy and pivotal role of the multidisciplinary meeting (MDM) in informed decision making is well established. It aims to provide a forum in which clinical evidence combines with individual patient data to create a personalized treatment plan. It does not fulfil this role adequately when undertaken without the full results of the patient's investigations being available. Neither doctor nor patient can make an informed decision about treatment options without knowledge of the tumour receptor status. Both targeted therapies and the aim to treat a majority of patients within clinical trials must now drive MDM decision making to be based on accuracy and best available treatment choices. A fully informed decision on treatment delayed by 1-2 weeks is clearly preferable to rushed time target-driven decisions made without the patient being offered a fully informed choice as ratified by a multidisciplinary team. Whilst the early anxiety of waiting for all relevant information to be available may be stressful for patients, not being sure that they have been offered fully informed treatment choices is also stressful and could cause longer lasting anxiety both during and after treatment. MDMs need to develop (along with targeted therapies) to retain their role as a forum whereby patients receive a correct, but specifically a full diagnosis and allow a fully informed discussion of all treatment options, including pre-operative clinical trials. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigating risky, distracting, and protective peer passenger effects in a dual process framework.

PubMed

Ross, Veerle; Jongen, Ellen M M; Brijs, Kris; Brijs, Tom; Wets, Geert

2016-08-01

Prior studies indicated higher collision rates among young novice drivers with peer passengers. This driving simulator study provided a test for a dual process theory of risky driving by examining social rewards (peer passengers) and cognitive control (inhibitory control). The analyses included age (17-18 yrs, n=30; 21-24 yrs, n=20). Risky, distracting, and protective effects were classified by underlying driver error mechanisms. In the first drive, participants drove alone. In the second, participants drove with a peer passenger. Red-light running (violation) was more prevalent in the presence of peer passengers, which provided initial support for a dual process theory of risk driving. In a subgroup with low inhibitory control, speeding (violation) was more prevalent in the presence of peer passengers. Reduced lane-keeping variability reflected distracting effects. Nevertheless, possible protective effects for amber-light running and hazard handling (cognition and decision-making) were found in the drive with peer passengers. Avenues for further research and possible implications for targets of future driver training programs are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

A QUESTIONNAIRE TO ASSESS THE RELEVANCE AND CREDIBILITY OF OBSERVATIONAL STUDIES TO INFORM HEALTH CARE DECISION MAKING: AN ISPOR-AMCP-NPC GOOD PRACTICE TASK FORCE REPORT

PubMed Central

Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, Dan; Yang, Winnie; Mullins, C. Daniel; Kahler, Kristijan; Quon, Nicole C.; Devine, Scott; Graham, John; Cannon, Eric; Crown, William

2014-01-01

Evidence-based healthcare decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. However, widespread adoption of evidence from observational studies has been limited due to a variety of factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two Task Forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision-making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. PMID:24636373

Combining cognitive engineering and information fusion architectures to build effective joint systems

NASA Astrophysics Data System (ADS)

Sliva, Amy L.; Gorman, Joe; Voshell, Martin; Tittle, James; Bowman, Christopher

2016-05-01

The Dual Node Decision Wheels (DNDW) architecture concept was previously described as a novel approach toward integrating analytic and decision-making processes in joint human/automation systems in highly complex sociotechnical settings. In this paper, we extend the DNDW construct with a description of components in this framework, combining structures of the Dual Node Network (DNN) for Information Fusion and Resource Management with extensions on Rasmussen's Decision Ladder (DL) to provide guidance on constructing information systems that better serve decision-making support requirements. The DNN takes a component-centered approach to system design, decomposing each asset in terms of data inputs and outputs according to their roles and interactions in a fusion network. However, to ensure relevancy to and organizational fitment within command and control (C2) processes, principles from cognitive systems engineering emphasize that system design must take a human-centered systems view, integrating information needs and decision making requirements to drive the architecture design and capabilities of network assets. In the current work, we present an approach for structuring and assessing DNDW systems that uses a unique hybrid DNN top-down system design with a human-centered process design, combining DNN node decomposition with artifacts from cognitive analysis (i.e., system abstraction decomposition models, decision ladders) to provide work domain and task-level insights at different levels in an example intelligence, surveillance, and reconnaissance (ISR) system setting. This DNDW structure will ensure not only that the information fusion technologies and processes are structured effectively, but that the resulting information products will align with the requirements of human decision makers and be adaptable to different work settings .

What can Natural Language Processing do for Clinical Decision Support?

PubMed Central

Demner-Fushman, Dina; Chapman, Wendy W.; McDonald, Clement J.

2009-01-01

Computerized Clinical Decision Support (CDS) aims to aid decision making of health care providers and the public by providing easily accessible health-related information at the point and time it is needed. Natural Language Processing (NLP) is instrumental in using free-text information to drive CDS, representing clinical knowledge and CDS interventions in standardized formats, and leveraging clinical narrative. The early innovative NLP research of clinical narrative was followed by a period of stable research conducted at the major clinical centers and a shift of mainstream interest to biomedical NLP. This review primarily focuses on the recently renewed interest in development of fundamental NLP methods and advances in the NLP systems for CDS. The current solutions to challenges posed by distinct sublanguages, intended user groups, and support goals are discussed. PMID:19683066

Buying a Car: Decisions, Decisions. Book Two. Project Drive.

ERIC Educational Resources Information Center

Zook, Doris; And Others

This Project Drive booklet titled Buying a Car: Decisions, Decisions is one of eight booklets designed for intermediate level English-as-a-second-language students and low-level adult basic education/basic reading students. The goal of the booklet is to aid the student in developing the oral and sight vocabulary necessary for a basic driver…

Older driver failures of attention at intersections: using change blindness methods to assess turn decision accuracy.

PubMed

Caird, Jeff K; Edwards, Christopher J; Creaser, Janet I; Horrey, William J

2005-01-01

A modified version of the flicker technique to induce change blindness was used to examine the effects of time constraints on decision-making accuracy at intersections on a total of 62 young (18-25 years), middle-aged (26-64 years), young-old (65-73 years), and old-old (74+ years) drivers. Thirty-six intersection photographs were manipulated so that one object (i.e., pedestrian, vehicle, sign, or traffic control device) in the scene would change when the images were alternated for either 5 or 8 s using the modified flicker method. Young and middle-aged drivers made significantly more correct decisions than did young-old and old-old drivers. Logistic regression analysis of the data indicated that age and/or time were significant predictors of decision performance in 14 of the 36 intersections. Actual or potential applications of this research include driving assessment and crash investigation.

Is leadership a reliable concept in animals? An empirical study in the horse.

PubMed

Bourjade, Marie; Thierry, Bernard; Hausberger, Martine; Petit, Odile

2015-01-01

Leadership is commonly invoked when accounting for the coordination of group movements in animals, yet it remains loosely defined. In parallel, there is increased evidence of the sharing of group decisions by animals on the move. How leadership integrates within this recent framework on collective decision-making is unclear. Here, we question the occurrence of leadership in horses, a species in which this concept is of prevalent use. The relevance of the three main definitions of leadership--departing first, walking in front travel position, and eliciting the joining of mates--was tested on the collective movements of two semi-free ranging groups of Przewalski horses (Equus ferus przewalskii). We did not find any leader capable of driving most group movements or recruiting mates more quickly than others. Several group members often displayed pre-departure behaviours at the same time, and the simultaneous departure of several individuals was common. We conclude that the decision-making process was shared by several group members a group movement (i.e., partially shared consensus) and that the leadership concept did not help to depict individual departure and leading behaviour across movements in both study groups. Rather, the different proxies of leadership produced conflicting information about individual contributions to group coordination. This study discusses the implications of these findings for the field of coordination and decision-making research.

A call to insect scientists: Challenges and opportunities of managing insect communities under climate change

USGS Publications Warehouse

Hellmann, Jessica J.; Grundel, Ralph; Hoving, Chris; Schuurman, Gregor W.

2016-01-01

As climate change moves insect systems into uncharted territory, more knowledge about insect dynamics and the factors that drive them could enable us to better manage and conserve insect communities. Climate change may also require us revisit insect management goals and strategies and lead to a new kind of scientific engagement in management decision-making. Here we make five key points about the role of insect science in aiding and crafting management decisions, and we illustrate those points with the monarch butterfly and the Karner blue butterfly, two species undergoing considerable change and facing new management dilemmas. Insect biology has a strong history of engagement in applied problems, and as the impacts of climate change increase, a reimagined ethic of entomology in service of broader society may emerge. We hope to motivate insect biologists to contribute time and effort toward solving the challenges of climate change.

Cognitive impairment and dementia in Parkinson's disease: practical issues and management.

PubMed

Emre, Murat; Ford, Paul J; Bilgiç, Başar; Uç, Ergun Y

2014-04-15

Cognitive impairment and dementia pose particular challenges in the management of patients with Parkinson's disease (PD). Decision-making capacity can render patients vulnerable in a way that requires careful ethical considerations by clinicians with respect to medical decision making, research participation, and public safety. Clinicians should discuss how future decisions will be made as early in the disease course as possible. Because of cognitive, visual, and motor impairments, PD may be associated with unsafe driving, leading to early driving cessation in many. DBS of the STN and, to a lesser degree, globus pallidus interna (GPi) has consistently been associated with decreased verbal fluency, but significant global cognitive decline is usually not observed in patients who undergo rigorous selection. There are some observations suggesting lesser cognitive decline in GPi DBS than STN DBS, but further research is required. Management of PD dementia (PDD) patients involves both pharmacological and nonpharmacological measures. Patients with PDD should be offered treatment with a cholinesterase inhibitor taking into account expected benefits and potential risks. Treatment with neuroleptics may be necessary to treat psychosis; classical neuroleptics, as well as risperidone and olanzapine, should be avoided. Quetiapine might be considered first-line treatment because it does not need special monitoring, although the strongest evidence for efficacy exists for clozapine. Evidence from randomized, controlled studies in the PDD population is lacking; selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors may be used to treat depressive features. Clonazepam or melatonin may be useful in the treatment of rapid eye movement behavior disorder. © 2014 International Parkinson and Movement Disorder Society.

PRA and Conceptual Design

NASA Technical Reports Server (NTRS)

DeMott, Diana; Fuqua, Bryan; Wilson, Paul

2013-01-01

Once a project obtains approval, decision makers have to consider a variety of alternative paths for completing the project and meeting the project objectives. How decisions are made involves a variety of elements including: cost, experience, current technology, ideologies, politics, future needs and desires, capabilities, manpower, timing, available information, and for many ventures management needs to assess the elements of risk versus reward. The use of high level Probabilistic Risk Assessment (PRA) Models during conceptual design phases provides management with additional information during the decision making process regarding the risk potential for proposed operations and design prototypes. The methodology can be used as a tool to: 1) allow trade studies to compare alternatives based on risk, 2) determine which elements (equipment, process or operational parameters) drives the risk, and 3) provide information to mitigate or eliminate risks early in the conceptual design to lower costs. Creating system models using conceptual design proposals and generic key systems based on what is known today can provide an understanding of the magnitudes of proposed systems and operational risks and facilitates trade study comparisons early in the decision making process. Identifying the "best" way to achieve the desired results is difficult, and generally occurs based on limited information. PRA provides a tool for decision makers to explore how some decisions will affect risk before the project is committed to that path, which can ultimately save time and money.

Appreciating the World: A Framework for Doing Socio-Political Analysis

DTIC Science & Technology

2012-06-08

intuitively understand the structure will result in some individuals poaching elephants for personal gain and know that selfish interest can drive...ivory poaching in Africa. The group is focused on improving a condition they view negatively, thus progressing to a better state of affairs. They...The soldier provides a unique opportunity to explore the impact of interests on individual decision making. The soldier’s split identity meant he had a

Digital health care: where health care, information technology, and the Internet converge.

PubMed

Frank, S R; Williams, J R; Veiel, E L

2000-01-01

The digital health care industry applies information technologies to facilitate communications, commerce, transactions, business problem solving, and enhanced decision making for one or more groups that supply, consume, or finance health care services and products. The variation among companies is significant, but each one attempts to leverage information technology to drive sustainable evolutionary change. In an overview of the industry, a framework is provided to understand the maze of business plans.

GSA's Green Proving Ground: Identifying, Testing and Evaluating Innovative Technologies (Presentation)

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

Kandt, A.; Lowell, M.

2012-05-01

GSA's Green Proving Ground (GPG) program utilizes GSA's real estate portfolio to test and evaluate innovative and underutilized sustainable building technologies and practices. Findings are used to support the development of GSA performance specifications and inform decision making within GSA, other federal agencies, and the real estate industry. The program aims to drive innovation in environmental performance in federal buildings and help lead market transformation through deployment of new technologies.

The Interrelation Between Personnel and Training in the Soviet Armed Forces.

DTIC Science & Technology

1981-06-01

as they are planned, there is no problem; the political socialization so commonplace within the society drives into the individual the characteristics...training one receives from childhood through political socialization and collectivization tends to contradict the move towards encouraging initiative. On...military and plays a major role in the decision making process, as well as in the day to day life of the soldier. Having been raised under political

Information Center Help Desk

DTIC Science & Technology

1991-09-01

listed is made. Many factors beyond what is included in the short list of features go into making that decision. Data on optical disk drives, scanners and...support existed due to lack of hardware or software. To do this analysis the IC responses were studied in relationship to the following three issues...each based on the developed criteria. No weighting factors in terms of relative importance of each criteria can be applied in this environment. As

Non-equilibrium physics of neural networks for leaning, memory and decision making: landscape and flux perspectives

NASA Astrophysics Data System (ADS)

Wang, Jin

Cognitive behaviors are determined by underlying neural networks. Many brain functions, such as learning and memory, can be described by attractor dynamics. We developed a theoretical framework for global dynamics by quantifying the landscape associated with the steady state probability distributions and steady state curl flux, measuring the degree of non-equilibrium through detailed balance breaking. We found the dynamics and oscillations in human brains responsible for cognitive processes and physiological rhythm regulations are determined not only by the landscape gradient but also by the flux. We found that the flux is closely related to the degrees of the asymmetric connections in neural networks and is the origin of the neural oscillations. The neural oscillation landscape shows a closed-ring attractor topology. The landscape gradient attracts the network down to the ring. The flux is responsible for coherent oscillations on the ring. We suggest the flux may provide the driving force for associations among memories. Both landscape and flux determine the kinetic paths and speed of decision making. The kinetics and global stability of decision making are explored by quantifying the landscape topography through the barrier heights and the mean first passage time. The theoretical predictions are in agreement with experimental observations: more errors occur under time pressure. We quantitatively explored two mechanisms of the speed-accuracy tradeoff with speed emphasis and further uncovered the tradeoffs among speed, accuracy, and energy cost. Our results show an optimal balance among speed, accuracy, and the energy cost in decision making. We uncovered possible mechanisms of changes of mind and how mind changes improve performance in decision processes. Our landscape approach can help facilitate an understanding of the underlying physical mechanisms of cognitive processes and identify the key elements in neural networks.

What we talk about when we talk about depression: doctor-patient conversations and treatment decision outcomes

PubMed Central

Karasz, Alison; Dowrick, Christopher; Byng, Richard; Buszewicz, Marta; Ferri, Lucia; Hartman, Tim C Olde; van Dulmen, Sandra; van Weel-Baumgarten, Evelyn; Reeve, Joanne

2011-01-01

Background Efforts to address depression in primary care settings have focused on the introduction of care guidelines emphasising pharmacological treatment. To date, physician adherence remains low. Little is known of the types of information exchange or other negotiations in doctor-patient consultations about depression that influence physician decision making about treatment. Aim The study sought to understand conversational influences on physician decision making about treatment for depression. Design A secondary analysis of consultation data collected in other studies. Using a maximum variation sampling strategy, 30 transcripts of primary care consultations about distress or depression were selected from datasets collected in three countries. Transcripts were analysed to discover factors associated with prescription of medication. Method The study employed two qualitative analysis strategies: a micro-analysis approach, which examines how conversation partners shape the dialogue towards pragmatic goals; and a narrative analysis approach of the problem presentation. Results Patients communicated their conceptual representations of distress at the outset of each consultation. Concepts of depression were communicated through the narrative form of the problem presentation. Three types of narratives were identified: those emphasising symptoms, those emphasising life situations, and mixed narratives. Physician decision making regarding medication treatment was strongly associated with the form of the patient’s narrative. Physicians made few efforts to persuade patients to accept biomedical attributions or treatments. Conclusion Results of the study provide insight into why adherence to depression guidelines remains low. Data indicate that patient agendas drive the ‘action’ in consultations about depression. Physicians appear to be guided by common-sense decision-making algorithms emphasising patients’ views and preferences. PMID:22520683

A model study on the circuit mechanism underlying decision-making in Drosophila.

PubMed

Wu, Zhihua; Guo, Aike

2011-05-01

Previous elegant experiments in a flight simulator showed that conditioned Drosophila is able to make a clear-cut decision to avoid potential danger. When confronted with conflicting visual cues, the relative saliency of two competing cues is found to be a sensory ruler for flies to judge which cue should be used for decision-making. Further genetic manipulations and immunohistological analysis revealed that the dopamine system and mushroom bodies are indispensable for such a clear-cut or nonlinear decision. The neural circuit mechanism, however, is far from being clear. In this paper, we adopt a computational modeling approach to investigate how different brain areas and the dopamine system work together to drive a fly to make a decision. By developing a systems-level neural network, a two-pathway circuit is proposed. Besides a direct pathway from a feature binding area to the motor center, another connects two areas via the mushroom body, a target of dopamine release. A raised dopamine level is hypothesized to be induced by complex choice tasks and to enhance lateral inhibition and steepen the units' response gain in the mushroom body. Simulations show that training helps to assign values to formerly neutral features. For a circuit model with a blocked mushroom body, the direct pathway passes all alternatives to the motor center without changing original values, giving rise to a simple choice characterized by a linear choice curve. With respect to an intact circuit, enhanced lateral inhibition dependent on dopamine critically promotes competition between alternatives, turning the linear- into nonlinear choice behavior. Results account well for experimental data, supporting the reasonableness of model working hypotheses. Several testable predictions are made for future studies. Copyright © 2011 Elsevier Ltd. All rights reserved.

Non-Equlibrium Driven Dynamics of Continuous Attractors in Place Cell Networks

NASA Astrophysics Data System (ADS)

Zhong, Weishun; Kim, Hyun Jin; Schwab, David; Murugan, Arvind

Attractors have found much use in neuroscience as a means of information processing and decision making. Examples include associative memory with point and continuous attractors, spatial navigation and planning using place cell networks, dynamic pattern recognition among others. The functional use of such attractors requires the action of spatially and temporally varying external driving signals and yet, most theoretical work on attractors has been in the limit of small or no drive. We take steps towards understanding the non-equilibrium driven dynamics of continuous attractors in place cell networks. We establish an `equivalence principle' that relates fluctuations under a time-dependent external force to equilibrium fluctuations in a `co-moving' frame with only static forces, much like in Newtonian physics. Consequently, we analytically derive a network's capacity to encode multiple attractors as a function of the driving signal size and rate of change.

First impressions: gait cues drive reliable trait judgements.

PubMed

Thoresen, John C; Vuong, Quoc C; Atkinson, Anthony P

2012-09-01

Personality trait attribution can underpin important social decisions and yet requires little effort; even a brief exposure to a photograph can generate lasting impressions. Body movement is a channel readily available to observers and allows judgements to be made when facial and body appearances are less visible; e.g., from great distances. Across three studies, we assessed the reliability of trait judgements of point-light walkers and identified motion-related visual cues driving observers' judgements. The findings confirm that observers make reliable, albeit inaccurate, trait judgements, and these were linked to a small number of motion components derived from a Principal Component Analysis of the motion data. Parametric manipulation of the motion components linearly affected trait ratings, providing strong evidence that the visual cues captured by these components drive observers' trait judgements. Subsequent analyses suggest that reliability of trait ratings was driven by impressions of emotion, attractiveness and masculinity. Copyright © 2012 Elsevier B.V. All rights reserved.

The use of SWOT analysis to explore and prioritize conservation and development strategies for local cattle breeds.

PubMed

Martín-Collado, D; Díaz, C; Mäki-Tanila, A; Colinet, F; Duclos, D; Hiemstra, S J; Gandini, G

2013-06-01

SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis is a tool widely used to help in decision making in complex systems. It suits to exploring the issues and measures related to the conservation and development of local breeds, as it allows the integration of many driving factors influencing breed dynamics. We developed a quantified SWOT method as a decision-making tool for identification and ranking of conservation and development strategies of local breeds, and applied it to a set of 13 cattle breeds of six European countries. The method has four steps: definition of the system, identification and grouping of the driving factors, quantification of the importance of driving factors and identification and prioritization of the strategies. The factors were determined following a multi-stakeholder approach and grouped with a three-level structure. Animal genetic resources expert groups ranked the factors, and a quantification process was implemented to identify and prioritize strategies. The proposed SWOT methodology allows analyzing the dynamics of local cattle breeds in a structured and systematic way. It is a flexible tool developed to assist different stakeholders in defining the strategies and actions. The quantification process allows the comparison of the driving factors and the prioritization of the strategies for the conservation and development of local cattle breeds. We identified 99 factors across the breeds. Although the situation is very heterogeneous, the future of these breeds may be promising. The most important strengths and weaknesses were related to production systems and farmers. The most important opportunities were found in marketing new products, whereas the most relevant threats were found in selling the current products. The across-breed strategies utility decreased as they gained specificity. Therefore, the strategies at European level should focus on general aspects and be flexible enough to be adapted to the country and breed specificities.

Understanding the Influence of Climate Forecasts on Farmer Decisions as Planned Behavior

NASA Astrophysics Data System (ADS)

Artikov, Ikrom; Hoffman, Stacey J.; Lynne, Gary D.; Pytlik Zillig, Lisa M.; Hu, Qi; Tomkins, Alan J.; Hubbard, Kenneth G.; Hayes, Michael J.; Waltman, William

2006-09-01

Results of a set of four regression models applied to recent survey data of farmers in eastern Nebraska suggest the causes that drive farmer intentions of using weather and climate information and forecasts in farming decisions. The model results quantify the relative importance of attitude, social norm, perceived behavioral control, and financial capability in explaining the influence of climate-conditions information and short-term and long-term forecasts on agronomic, crop insurance, and crop marketing decisions. Attitude, serving as a proxy for the utility gained from the use of such information, had the most profound positive influence on the outcome of all the decisions, followed by norms. The norms in the community, as a proxy for the utility gained from allowing oneself to be influenced by others, played a larger role in agronomic decisions than in insurance or marketing decisions. In addition, the interaction of controllability (accuracy, availability, reliability, timeliness of weather and climate information), self-efficacy (farmer ability and understanding), and general preference for control was shown to be a substantive cause. Yet control variables also have an economic side: The farm-sales variable as a measure of financial ability and motivation intensified and clarified the role of control while also enhancing the statistical robustness of the attitude and norms variables in better clarifying how they drive the influence. Overall, the integrated model of planned behavior from social psychology and derived demand from economics, that is, the “planned demand model,” is more powerful than models based on either of these approaches alone. Taken together, these results suggest that the “human dimension” needs to be better recognized so as to improve effective use of climate and weather forecasts and information for farming decision making.

Economic evidence in intellectual disabilities: a review.

PubMed

Romeo, Renée; Molosankwe, Iris

2010-09-01

There has been a drive to meet the needs of people with intellectual disabilities in an environment of resource scarcity. It is also recognized that intervention has the potential to improve social and economic welfare. Economic analyses can be used to inform decision makers about what additional investment is needed (if any) and the impacts on a range of stakeholders of intervention. There is a paucity of economic studies in intellectual disability. The lack of economic studies is a barrier to making policy and practice decisions for people with intellectual disabilities. In the period of review, 10 economic studies were found. Information on resource and cost implications of various treatments and support for people with intellectual disabilities is needed. Economic evaluation techniques can be used to inform decision making. We conducted a systematic review of the literature from January 2006 to February 2010. There was a paucity of economic studies in the field. Analyses assessing a wide range of outcomes alongside costs were the most widely used evaluation method in the review. There is a need for more economic studies in this area.

On Elementary Affective Decisions: To Like Or Not to Like, That Is the Question

PubMed Central

Jacobs, Arthur; Hofmann, Markus J.; Kinder, Annette

2016-01-01

Perhaps the most ubiquitous and basic affective decision of daily life is deciding whether we like or dislike something/somebody, or, in terms of psychological emotion theories, whether the object/subject has positive or negative valence. Indeed, people constantly make such liking decisions within a glimpse and, importantly, often without expecting any obvious benefit or knowing the exact reasons for their judgment. In this paper, we review research on such elementary affective decisions (EADs) that entail no direct overt reward with a special focus on Neurocognitive Poetics and discuss methods and models for investigating the neuronal and cognitive-affective bases of EADs to verbal materials with differing degrees of complexity. In line with evolutionary and appraisal theories of (aesthetic) emotions and data from recent neurocognitive studies, the results of a decision tree modeling approach simulating EADs to single words suggest that a main driving force behind EADs is the extent to which such high-dimensional stimuli are associated with the “basic” emotions joy/happiness and disgust. PMID:27933013

Cortical and Hippocampal Correlates of Deliberation during Model-Based Decisions for Rewards in Humans

PubMed Central

Bornstein, Aaron M.; Daw, Nathaniel D.

2013-01-01

How do we use our memories of the past to guide decisions we've never had to make before? Although extensive work describes how the brain learns to repeat rewarded actions, decisions can also be influenced by associations between stimuli or events not directly involving reward — such as when planning routes using a cognitive map or chess moves using predicted countermoves — and these sorts of associations are critical when deciding among novel options. This process is known as model-based decision making. While the learning of environmental relations that might support model-based decisions is well studied, and separately this sort of information has been inferred to impact decisions, there is little evidence concerning the full cycle by which such associations are acquired and drive choices. Of particular interest is whether decisions are directly supported by the same mnemonic systems characterized for relational learning more generally, or instead rely on other, specialized representations. Here, building on our previous work, which isolated dual representations underlying sequential predictive learning, we directly demonstrate that one such representation, encoded by the hippocampal memory system and adjacent cortical structures, supports goal-directed decisions. Using interleaved learning and decision tasks, we monitor predictive learning directly and also trace its influence on decisions for reward. We quantitatively compare the learning processes underlying multiple behavioral and fMRI observables using computational model fits. Across both tasks, a quantitatively consistent learning process explains reaction times, choices, and both expectation- and surprise-related neural activity. The same hippocampal and ventral stream regions engaged in anticipating stimuli during learning are also engaged in proportion to the difficulty of decisions. These results support a role for predictive associations learned by the hippocampal memory system to be recalled during choice formation. PMID:24339770

National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria.

PubMed

Tesfazghi, Kemi; Hill, Jenny; Jones, Caroline; Ranson, Hilary; Worrall, Eve

2016-02-01

New vector control tools are needed to combat insecticide resistance and reduce malaria transmission. The World Health Organization (WHO) endorses larviciding as a supplementary vector control intervention using larvicides recommended by the WHO Pesticides Evaluation Scheme (WHOPES). The decision to scale-up larviciding in Nigeria provided an opportunity to investigate the factors influencing policy adoption and assess the role that actors and evidence play in the policymaking process, in order to draw lessons that help accelerate the uptake of new methods for vector control. A retrospective policy analysis was carried out using in-depth interviews with national level policy stakeholders to establish normative national vector control policy or strategy decision-making processes and compare these with the process that led to the decision to scale-up larviciding. The interviews were transcribed, then coded and analyzed using NVivo10. Data were coded according to pre-defined themes from an analytical policy framework developed a priori. Stakeholders reported that the larviciding decision-making process deviated from the normative vector control decision-making process. National malaria policy is normally strongly influenced by WHO recommendations, but the potential of larviciding to contribute to national economic development objectives through larvicide production in Nigeria was cited as a key factor shaping the decision. The larviciding decision involved a restricted range of policy actors, and notably excluded actors that usually play advisory, consultative and evidence generation roles. Powerful actors limited the access of some actors to the policy processes and content. This may have limited the influence of scientific evidence in this policy decision. This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to drive policy change and thereby accelerate access to new vector control tools. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Effects of Acute Alcohol Tolerance on Perceptions of Danger and Willingness to Drive after Drinking

PubMed Central

Amlung, Michael T.; Morris, David H.; McCarthy, Denis M.

2014-01-01

Rationale Drinking and driving is associated with elevated rates of motor vehicle accidents and fatalities. Previous research suggests that alcohol impairs judgments about the dangers of risky behaviors; however, how alcohol affects driving-related judgments is less clear. Impairments have also been shown to differ across limbs of the blood alcohol concentration (BAC) curve, which is known as acute tolerance. Objectives Examine whether perceptions about the dangerousness of driving after drinking and willingness to drive differed across ascending and descending limbs of the BAC curve. Test whether reductions in perceived danger were associated with willingness to drive on the descending limb. Methods Fifty-six participants were randomly assigned to receive either a moderate dose of alcohol (peak BAC = 0.10 g%) or placebo. We assessed perceived dangerousness and willingness to drive at matched BACs (~0.067-0.068 g%) on the ascending and descending limbs. Results Both perceived danger and willingness to drive showed acute tolerance in the alcohol group. Participants judged driving to be significantly less dangerous and were more willing to drive on the descending limb compared to the ascending limb. The magnitude of change in perceived danger significantly predicted willingness to drive on the descending limb. Conclusions Decreased impairment associated with acute tolerance may lead individuals to underestimate the dangerousness of driving after drinking and in turn make poor decisions regarding driving. This study further emphasizes the descending limb as a period of increased risk and offers support for enhancing prevention efforts by targeting drivers at declining BAC levels. PMID:24752657

Effects of acute alcohol tolerance on perceptions of danger and willingness to drive after drinking.

PubMed

Amlung, Michael T; Morris, David H; McCarthy, Denis M

2014-11-01

Drinking and driving is associated with elevated rates of motor vehicle accidents and fatalities. Previous research suggests that alcohol impairs judgments about the dangers of risky behaviors; however, how alcohol affects driving-related judgments is less clear. Impairments have also been shown to differ across limbs of the blood alcohol concentration (BAC) curve, which is known as acute tolerance. The objectives of this study were to examine whether perceptions about the dangerousness of driving after drinking and willingness to drive differed across the ascending and descending limbs of the BAC curve and to test whether reductions in perceived danger were associated with willingness to drive on the descending limb. Fifty-six participants were randomly assigned to receive either a moderate dose of alcohol (peak BAC = 0.10 g%) or placebo. We assessed perceived dangerousness and willingness to drive at matched BACs (~0.067-0.068 g%) on the ascending and descending limbs. Both perceived danger and willingness to drive showed acute tolerance in the alcohol group. Participants judged driving to be significantly less dangerous and were more willing to drive on the descending limb compared to the ascending limb. The magnitude of change in perceived danger significantly predicted willingness to drive on the descending limb. Decreased impairment associated with acute tolerance may lead individuals to underestimate the dangerousness of driving after drinking and in turn make poor decisions regarding driving. This study further emphasizes the descending limb as a period of increased risk and offers support for enhancing prevention efforts by targeting drivers at declining BAC levels.

The role of central and peripheral vision in expert decision making.

PubMed

Ryu, Donghyun; Abernethy, Bruce; Mann, David L; Poolton, Jamie M; Gorman, Adam D

2013-01-01

The purpose of this study was to investigate the role of central and peripheral vision in expert decision making. A gaze-contingent display was used to selectively present information to the central and peripheral areas of the visual field while participants performed a decision-making task. Eleven skilled and eleven less-skilled male basketball players watched video clips of basketball scenarios in three different viewing conditions: full-image control, moving window (central vision only), and moving mask (peripheral vision only). At the conclusion of each clip participants were required to decide whether it was more appropriate for the ball-carrier to pass the ball or to drive to the basket. The skilled players showed significantly higher response accuracy and faster response times compared with their lesser-skilled counterparts in all three viewing conditions, demonstrating superiority in information extraction that held irrespective of whether they were using central or peripheral vision. The gaze behaviour of the skilled players was less influenced by the gaze-contingent manipulations, suggesting they were better able to use the remaining information to sustain their normal gaze behaviour. The superior capacity of experts to interpret dynamic visual information is evident regardless of whether the visual information is presented across the whole visual field or selectively to either central or peripheral vision alone.

Siting and Routing Assessment for Solid Waste Management Under Uncertainty Using the Grey Mini-Max Regret Criterion

NASA Astrophysics Data System (ADS)

Chang, Ni-Bin; Davila, Eric

2006-10-01

Solid waste management (SWM) is at the forefront of environmental concerns in the Lower Rio Grande Valley (LRGV), South Texas. The complexity in SWM drives area decision makers to look for innovative and forward-looking solutions to address various waste management options. In decision analysis, it is not uncommon for decision makers to go by an option that may minimize the maximum regret when some determinant factors are vague, ambiguous, or unclear. This article presents an innovative optimization model using the grey mini-max regret (GMMR) integer programming algorithm to outline an optimal regional coordination of solid waste routing and possible landfill/incinerator construction under an uncertain environment. The LRGV is an ideal location to apply the GMMR model for SWM planning because of its constant urban expansion, dwindling landfill space, and insufficient data availability signifying the planning uncertainty combined with vagueness in decision-making. The results give local decision makers hedged sets of options that consider various forms of systematic and event-based uncertainty. By extending the dimension of decision-making, this may lead to identifying a variety of beneficial solutions with efficient waste routing and facility siting for the time frame of 2005 through 2010 in LRGV. The results show the ability of the GMMR model to open insightful scenario planning that can handle situational and data-driven uncertainty in a way that was previously unavailable. Research findings also indicate that the large capital investment of incineration facilities makes such an option less competitive among municipal options for landfills. It is evident that the investment from a municipal standpoint is out of the question, but possible public-private partnerships may alleviate this obstacle.

The use of syndromic surveillance for decision-making during the H1N1 pandemic: a qualitative study.

PubMed

Chu, Anna; Savage, Rachel; Willison, Don; Crowcroft, Natasha S; Rosella, Laura C; Sider, Doug; Garay, Jason; Gemmill, Ian; Winter, Anne-Luise; Davies, Richard F; Johnson, Ian

2012-10-30

Although an increasing number of studies are documenting uses of syndromic surveillance by front line public health, few detail the value added from linking syndromic data to public health decision-making. This study seeks to understand how syndromic data informed specific public health actions during the 2009 H1N1 pandemic. Semi-structured telephone interviews were conducted with participants from Ontario's public health departments, the provincial ministry of health and federal public health agency to gather information about syndromic surveillance systems used and the role of syndromic data in informing specific public health actions taken during the pandemic. Responses were compared with how the same decisions were made by non-syndromic surveillance users. Findings from 56 interviews (82% response) show that syndromic data were most used for monitoring virus activity, measuring impact on the health care system and informing the opening of influenza assessment centres in several jurisdictions, and supporting communications and messaging, rather than its intended purpose of early outbreak detection. Syndromic data had limited impact on decisions that involved the operation of immunization clinics, school closures, sending information letters home with school children or providing recommendations to health care providers. Both syndromic surveillance users and non-users reported that guidance from the provincial ministry of health, communications with stakeholders and vaccine availability were driving factors in these public health decisions. Syndromic surveillance had limited use in decision-making during the 2009 H1N1 pandemic in Ontario. This study provides insights into the reasons why this occurred. Despite this, syndromic data were valued for providing situational awareness and confidence to support public communications and recommendations. Developing an understanding of how syndromic data are utilized during public health events provides valuable evidence to support future investments in public health surveillance.

Mathematics of Ventilator-induced Lung Injury.

PubMed

Rahaman, Ubaidur

2017-08-01

Ventilator-induced lung injury (VILI) results from mechanical disruption of blood-gas barrier and consequent edema and releases of inflammatory mediators. A transpulmonary pressure (P L ) of 17 cmH 2 O increases baby lung volume to its anatomical limit, predisposing to VILI. Viscoelastic property of lung makes pulmonary mechanics time dependent so that stress (P L ) increases with respiratory rate. Alveolar inhomogeneity in acute respiratory distress syndrome acts as a stress riser, multiplying global stress at regional level experienced by baby lung. Limitation of stress (P L ) rather than strain (tidal volume [V T ]) is the safe strategy of mechanical ventilation to prevent VILI. Driving pressure is the noninvasive surrogate of lung strain, but its relations to P L is dependent on the chest wall compliance. Determinants of lung stress (V T , driving pressure, positive end-expiratory pressure, and inspiratory flow) can be quantified in terms of mechanical power, and a safe threshold can be determined, which can be used in decision-making between safe mechanical ventilation and extracorporeal lung support.

Performance in normal subjects on a novel battery of driving-related sensory-motor and cognitive tests.

PubMed

Innes, Carrie R H; Jones, Richard D; Anderson, Tim J; Hollobon, Susan G; Dalrymple-Alford, John C

2009-05-01

Currently, there is no international standard for the assessment of fitness to drive for cognitively or physically impaired persons. A computerized battery of driving-related sensory-motor and cognitive tests (SMCTests) has been developed, comprising tests of visuoperception, visuomotor ability, complex attention, visual search, decision making, impulse control, planning, and divided attention. Construct validity analysis was conducted in 60 normal, healthy subjects and showed that, overall, the novel cognitive tests assessed cognitive functions similar to a set of standard neuropsychological tests. The novel tests were found to have greater perceived face validity for predicting on-road driving ability than was found in the equivalent standard tests. Test-retest stability and reliability of SMCTests measures, as well as correlations between SMCTests and on-road driving, were determined in a subset of 12 subjects. The majority of test measures were stable and reliable across two sessions, and significant correlations were found between on-road driving scores and measures from ballistic movement, footbrake reaction, hand-control reaction, and complex attention. The substantial face validity, construct validity, stability, and reliability of SMCTests, together with the battery's level of correlation with on-road driving in normal subjects, strengthen our confidence in the ability of SMCTests to detect and identify sensory-motor and cognitive deficits related to unsafe driving and increased risk of accidents.

The 14th Annual Conference on Manual Control. [digital simulation of human operator dynamics

NASA Technical Reports Server (NTRS)

1978-01-01

Human operator dynamics during actual manual control or while monitoring the automatic control systems involved in air-to-air tracking, automobile driving, the operator of undersea vehicles, and remote handling are examined. Optimal control models and the use of mathematical theory in representing man behavior in complex man machine system tasks are discussed with emphasis on eye/head tracking and scanning; perception and attention allocation; decision making; and motion simulation and effects.

Louisiana's 2017 Master Plan for a Sustainable Coast

NASA Astrophysics Data System (ADS)

Haase, B.

2017-12-01

The Coastal Protection and Restoration Authority is charged with coordinating restoration and protection investments through the development and implementation of Louisiana's Comprehensive Master Plan for a Sustainable Coast. The first master plan was submitted to the Louisiana Legislature in 2007 and is mandated to be updated every five years. The plan's objectives are to reduce economic losses from flooding, promote sustainability by harnessing natural processes, provide habitats for commercial and recreational activities, sustain cultural heritage and promote a viable working coast. Two goals drive decision making about the appropriate suite of restoration and protection projects to include in the Plan: restore and maintain Louisiana's wetlands and provide flood protection for coastal Louisiana's citizens. As part of the decision making process, a wide range of additional metrics are used to evaluate the complex, competing needs of communities, industries, navigation and fisheries. The master plan decision making process includes the identification of individual protection and restoration projects that are evaluated with landscape, storm surge, and risk assessment models and then ranked by how well they perform over time across the set of decision drivers and metrics. High performing projects are assembled into alternatives constrained by available funding and river resources. The planning process is grounded not only on extensive scientific analysis but also on interdisciplinary collaboration between scientists, engineers, planners, community advocates, and coastal stakeholders which creates the long-term dialogue needed for complex environmental planning decisions. It is through this collaboration that recommended alternatives are reviewed and modified to develop the final Plan. Keywords:alternative formulation, comprehensive planning, ecosystem restoration, flood risk reduction and stakeholder engagement

Analysis of consumer behavior in decision making of purchasing ornamental freshwater fish (case of study at ornamental freshwater fish market at Peta Street, Bandung)

NASA Astrophysics Data System (ADS)

Gumilar, I.; Rizal, A.; Sriati; Setiawan Putra, R.

2018-04-01

This research aim was to analyzed process of decision making of purchasing ornamental freshwater fish at Peta Street, Bandung City and Analyzed what factors are driving consumers to buy freshwater fish Peta Street. The method used in this research is case study with rating scale and rank spearman analysis. The sampling technique is the accidental random sampling method consist of 30 respondents. The consumer’s decision making process consist of five stages, namely the recognition of needs, information searching, alternative evaluation, process of purchasing, and the evaluation of results. The results showed that at the stage of recognition of needs the motivation of purchasing freshwater fish because respondents are very fond of ornamental freshwater fish, at the stage of information search, the information sources are from the print media and friends or neighborhood. At the stage of alternative evaluation, the reason consumers buy ornamental freshwater fish because the quality of good products. The stage of purchasing decision process consumers bought 1-5 fish with frequency of purchase 1 time per month. The evaluation of results of post-purchasing consumers feel very satisfied with the fish products and the price is very affordable. To observe the factors that influence purchasing motivation of consumers, spearman rank test is the method. The results showed that the quality and price of the product are the factors that most influence the purchase decision of ornamental freshwater fish with the range of student-t value 3,968 and 2,107.

Cortical drive of low-frequency oscillations in the human nucleus accumbens during action selection

PubMed Central

Litvak, Vladimir; Rutledge, Robb B.; Zaehle, Tino; Schmitt, Friedhelm C.; Voges, Jürgen; Heinze, Hans-Jochen; Dolan, Raymond J.

2015-01-01

The nucleus accumbens is thought to contribute to action selection by integrating behaviorally relevant information from multiple regions, including prefrontal cortex. Studies in rodents suggest that information flow to the nucleus accumbens may be regulated via task-dependent oscillatory coupling between regions. During instrumental behavior, local field potentials (LFP) in the rat nucleus accumbens and prefrontal cortex are coupled at delta frequencies (Gruber AJ, Hussain RJ, O'Donnell P. PLoS One 4: e5062, 2009), possibly mediating suppression of afferent input from other areas and thereby supporting cortical control (Calhoon GG, O'Donnell P. Neuron 78: 181–190, 2013). In this report, we demonstrate low-frequency cortico-accumbens coupling in humans, both at rest and during a decision-making task. We recorded LFP from the nucleus accumbens in six epilepsy patients who underwent implantation of deep brain stimulation electrodes. All patients showed significant coherence and phase-synchronization between LFP and surface EEG at delta and low theta frequencies. Although the direction of this coupling as indexed by Granger causality varied between subjects in the resting-state data, all patients showed a cortical drive of the nucleus accumbens during action selection in a decision-making task. In three patients this was accompanied by a significant coherence increase over baseline. Our results suggest that low-frequency cortico-accumbens coupling represents a highly conserved regulatory mechanism for action selection. PMID:25878159

Canadian drivers' attitudes regarding preventative responses to driving while impaired by alcohol.

PubMed

Vanlaar, Ward; Nadeau, Louise; McKiernan, Anna; Hing, Marisela M; Ouimet, Marie Claude; Brown, Thomas G

2017-09-01

In many jurisdictions, a risk assessment following a first driving while impaired (DWI) offence is used to guide administrative decision making regarding driver relicensing. Decision error in this process has important consequences for public security on one hand, and the social and economic well being of drivers on the other. Decision theory posits that consideration of the costs and benefits of decision error is needed, and in the public health context, this should include community attitudes. The objective of the present study was to clarify whether Canadians prefer decision error that: i) better protects the public (i.e., false positives); or ii) better protects the offender (i.e., false negatives). A random sample of male and female adult drivers (N=1213) from the five most populated regions of Canada was surveyed on drivers' preference for a protection of the public approach versus a protection of DWI drivers approach in resolving assessment decision error, and the relative value (i.e., value ratio) they imparted to both approaches. The role of region, sex and age on drivers' value ratio were also appraised. Seventy percent of Canadian drivers preferred a protection of the public from DWI approach, with the overall relative ratio given to this preference, compared to the alternative protection of the driver approach, being 3:1. Females expressed a significantly higher value ratio (M=3.4, SD=3.5) than males (M=3.0, SD=3.4), p<0.05. Regression analysis showed that both days of alcohol use in the past 30days (CI for B: -0.07, -0.02) and frequency of driving over legal BAC limits in the past year (CI for B=-0.19, -0.01) were significantly but modestly related to lower value ratios, R 2 (adj.)=0.014, p<0.001. Regional differences were also detected. Canadian drivers strongly favour a protection of the public approach to dealing with uncertainty in assessment, even at the risk of false positives. Accounting for community attitudes concerning DWI prevention and the individual differences that influence them could contribute to more informed, coherent and effective regional policies and prevention program development. Copyright © 2017 Elsevier Ltd. All rights reserved.

Enhancing the value delivered by the statistician throughout drug discovery and development: putting statistical science into regulated pharmaceutical innovation.

PubMed

Enas, G G; Andersen, J S

With the dawn of the 21st century, the pharmaceutical industry faces a dramatically different constellation of business and scientific predictors of success than those of just a few years ago. Significant advances in science at the genetic, molecular and cellular levels, combined with progress demonstrated around the globe with drug regulations, have increased business and competitive opportunities. This has occurred in search of better and cheaper medicines that reach patients with unmet medical needs as quickly as possible. Herein lie new opportunities for those who can help business and regulatory leaders make good decisions about drug development and market authorization as quickly and efficiently as possible in the presence of uncertainty. The statistician is uniquely trained and qualified to render such value. We show how the statistician can contribute to the process of drug innovation from the very early stages of drug discovery until patients, payers and regulators are satisfied. Indeed, the very nature of regulated innovation demands that efficient and effective processes are implemented which yield the right information for good decision making. The statistician can take the lead in setting a strategy that directs such processes in the direction of greatest value. This demands skills that enable one to identify important sources of variability and uncertainty and then leverage those skills to make decisions. If such decisions call for more information, then the statistician can render experimental designs which generate the right information needed to make the decision in an efficient, timely manner. To add value to the enterprise, statisticians will have to become more intimately associated with business and regulatory decisions by building on their traditional roles (for example, numerical analyst, tactician) and unique skill sets (for example, analysis, computation, logical thought and work process, precision, accuracy). Business and regulatory savvy, coupled with excellent communication and interpersonal skills, will allow statisticians to help create the knowledge needed to drive success in the future. Copyright 2001 John Wiley & Sons, Ltd.

A questionnaire to assess the relevance and credibility of observational studies to inform health care decision making: an ISPOR-AMCP-NPC Good Practice Task Force report.

PubMed

Berger, Marc L; Martin, Bradley C; Husereau, Don; Worley, Karen; Allen, J Daniel; Yang, Winnie; Quon, Nicole C; Mullins, C Daniel; Kahler, Kristijan H; Crown, William

2014-03-01

Evidence-based health care decisions are best informed by comparisons of all relevant interventions used to treat conditions in specific patient populations. Observational studies are being performed to help fill evidence gaps. Widespread adoption of evidence from observational studies, however, has been limited because of various factors, including the lack of consensus regarding accepted principles for their evaluation and interpretation. Two task forces were formed to develop questionnaires to assist decision makers in evaluating observational studies, with one Task Force addressing retrospective research and the other Task Force addressing prospective research. The intent was to promote a structured approach to reduce the potential for subjective interpretation of evidence and drive consistency in decision making. Separately developed questionnaires were combined into a single questionnaire consisting of 33 items. These were divided into two domains: relevance and credibility. Relevance addresses the extent to which findings, if accurate, apply to the setting of interest to the decision maker. Credibility addresses the extent to which the study findings accurately answer the study question. The questionnaire provides a guide for assessing the degree of confidence that should be placed from observational studies and promotes awareness of the subtleties involved in evaluating those. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

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

Warner, R.E.

This paper seeks to provoke the thought of whether the battle manager of the future will be a human or a computer and where he/it will be located. The sensors, weapons, and problems with the missile-attack warning systems threat need to be understood before decisions can be made about the future. The author talks about technology driving the decisions and the time to make the decisions being key factors in space-battle management. He looks at when and how to kill a missile launched either from Soviet soil or space and the myriad of things that must happen before the battlemore » manager can make a decision: (1) the missile(s) must be detected; (2) then all the information about the missile(s) needs to be passed to the battle manager and all the decision makers in the chain of command, including the National Command Authority. It is emphasize the communication process must be fast and not affected by either jamming or nuclear bursts, and it also must be designed so that if a part is destroyed the system is still responsive to the battle manager. Questions such as should only the United States be protected by this system or should it include our allies; and then who are they and should an international body control the system are asked. The author finally concludes that the battle manager of the future will be located in space.« less

Intersection assistance: a safe solution for older drivers?

PubMed

Dotzauer, Mandy; Caljouw, Simone R; de Waard, Dick; Brouwer, Wiebo H

2013-10-01

Within the next few decades, the number of older drivers operating a vehicle will increase rapidly (Eurostat, 2011). As age increases so does physical vulnerability, age-related impairments, and the risk of being involved in a fatal crashes. Older drivers experience problems in driving situations that require divided attention and decision making under time pressure as reflected by their overrepresentation in at-fault crashes on intersections. Advanced Driver Assistance Systems (ADAS) especially designed to support older drivers crossing intersections might counteract these difficulties. In a longer-term driving simulator study, the effects of an intersection assistant on driving were evaluated. 18 older drivers (M=71.44 years) returned repeatedly completing a ride either with or without a support system in a driving simulator. In order to test the intersection assistance, eight intersections were depicted for further analyses. Results show that ADAS affects driving. Equipped with ADAS, drivers allocated more attention to the road center rather than the left and right, crossed intersections in shorter time, engaged in higher speeds, and crossed more often with a critical time-to-collision (TTC) value. The implications of results are discussed in terms of behavioral adaptation and safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Effects of Evidence Bounds on Decision-Making: Theoretical and Empirical Developments

PubMed Central

Zhang, Jiaxiang

2012-01-01

Converging findings from behavioral, neurophysiological, and neuroimaging studies suggest an integration-to-boundary mechanism governing decision formation and choice selection. This mechanism is supported by sequential sampling models of choice decisions, which can implement statistically optimal decision strategies for selecting between multiple alternative options on the basis of sensory evidence. This review focuses on recent developments in understanding the evidence boundary, an important component of decision-making raised by experimental findings and models. The article starts by reviewing the neurobiology of perceptual decisions and several influential sequential sampling models, in particular the drift-diffusion model, the Ornstein–Uhlenbeck model and the leaky-competing-accumulator model. In the second part, the article examines how the boundary may affect a model’s dynamics and performance and to what extent it may improve a model’s fits to experimental data. In the third part, the article examines recent findings that support the presence and site of boundaries in the brain. The article considers two questions: (1) whether the boundary is a spontaneous property of neural integrators, or is controlled by dedicated neural circuits; (2) if the boundary is variable, what could be the driving factors behind boundary changes? The review brings together studies using different experimental methods in seeking answers to these questions, highlights psychological and physiological factors that may be associated with the boundary and its changes, and further considers the evidence boundary as a generic mechanism to guide complex behavior. PMID:22870070

A behavioral economic analysis of texting while driving: Delay discounting processes

PubMed Central

Hayashi, Yusuke; Miller, Kimberly; Foreman, Anne M.; Wirth, Oliver

2016-01-01

The purpose of the present study was to examine an impulsive decision-making process underlying texting while driving from a behavioral economic perspective. A sample of 108 college students completed a novel discounting task that presented participants with a hypothetical scenario in which, after receiving a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply for a specific period of time. Participants also completed a delay discounting task in which they made repeated hypothetical choices between obtaining a larger amount of money available after a delay and an equal or lesser amount of money available immediately. The results show that the duration of the delay is a critical variable that strongly determines whether participants choose to wait to reply to a text message, and that the decrease in the likelihood of waiting as a function of delay is best described by a hyperbolic delay discounting function. The results also show that participants who self-reported higher frequency of texting while driving discounted the opportunity to reply to a text message at greater rates, whereas there was no relation between the rates of discounting of hypothetical monetary rewards and the frequency of texting while driving. The results support the conclusion that texting while driving is fundamentally an impulsive choice. PMID:27614547

Combining Hydrological Modeling and Remote Sensing Observations to Enable Data-Driven Decision Making for Devils Lake Flood Mitigation in a Changing Climate

NASA Technical Reports Server (NTRS)

Zhang, Xiaodong; Kirilenko, Andrei; Lim, Howe; Teng, Williams

2010-01-01

This slide presentation reviews work to combine the hydrological models and remote sensing observations to monitor Devils Lake in North Dakota, to assist in flood damage mitigation. This reports on the use of a distributed rainfall-runoff model, HEC-HMS, to simulate the hydro-dynamics of the lake watershed, and used NASA's remote sensing data, including the TRMM Multi-Satellite Precipitation Analysis (TMPA) and AIRS surface air temperature, to drive the model.

HIT'nDRIVE: patient-specific multidriver gene prioritization for precision oncology

PubMed Central

Hodzic, Ermin; Sauerwald, Thomas; Dao, Phuong; Wang, Kendric; Yeung, Jake; Anderson, Shawn; Vandin, Fabio; Haffari, Gholamreza; Collins, Colin C.; Sahinalp, S. Cenk

2017-01-01

Prioritizing molecular alterations that act as drivers of cancer remains a crucial bottleneck in therapeutic development. Here we introduce HIT'nDRIVE, a computational method that integrates genomic and transcriptomic data to identify a set of patient-specific, sequence-altered genes, with sufficient collective influence over dysregulated transcripts. HIT'nDRIVE aims to solve the “random walk facility location” (RWFL) problem in a gene (or protein) interaction network, which differs from the standard facility location problem by its use of an alternative distance measure: “multihitting time,” the expected length of the shortest random walk from any one of the set of sequence-altered genes to an expression-altered target gene. When applied to 2200 tumors from four major cancer types, HIT'nDRIVE revealed many potentially clinically actionable driver genes. We also demonstrated that it is possible to perform accurate phenotype prediction for tumor samples by only using HIT'nDRIVE-seeded driver gene modules from gene interaction networks. In addition, we identified a number of breast cancer subtype-specific driver modules that are associated with patients’ survival outcome. Furthermore, HIT'nDRIVE, when applied to a large panel of pan-cancer cell lines, accurately predicted drug efficacy using the driver genes and their seeded gene modules. Overall, HIT'nDRIVE may help clinicians contextualize massive multiomics data in therapeutic decision making, enabling widespread implementation of precision oncology. PMID:28768687

Obtaining Reimbursement in France and Italy for New Diabetes Products

PubMed Central

Schaefer, Elmar; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. PMID:25550411

Obtaining reimbursement in France and Italy for new diabetes products.

PubMed

Schaefer, Elmar; Schnell, Gerald; Sonsalla, Jessica

2015-01-01

Manufacturers launching next-generation or innovative medical devices in Europe face a very heterogeneous reimbursement landscape, with each country having its own pathways, timing, requirements and success factors. We selected 2 markets for a deeper look into the reimbursement landscape: France, representing a country with central decision making with defined processes, and Italy, which delegates reimbursement decisions to the regional level, resulting in a less transparent approach to reimbursement. Based on our experience in working on various new product launches and analyzing recent reimbursement decisions, we found that payers in both countries do not reward improved next-generation products with incremental reimbursement. Looking at innovations, we observe that manufacturers face a challenging and lengthy process to obtain reimbursement. In addition, requirements and key success factors differ by country: In France, comparative clinical evidence and budget impact very much drive reimbursement decisions in terms of pricing and restrictions, whereas in Italy, regional key opinion leader (KOL) support and additional local observational data are key. © 2015 Diabetes Technology Society.

Acute tolerance to alcohol impairment of behavioral and cognitive mechanisms related to driving: drinking and driving on the descending limb.

PubMed

Weafer, Jessica; Fillmore, Mark T

2012-04-01

Alcohol effects on behavioral and cognitive mechanisms influence impaired driving performance and decisions to drive after drinking (Barry 1973; Moskowitz and Robinson 1987). To date, research has focused on the ascending limb of the blood alcohol curve, and there is little understanding of how acute tolerance to impairment of these mechanisms might influence driving behavior on the descending limb. To provide an integrated examination of the degree to which alcohol impairment of motor coordination and inhibitory control contributes to driving impairment and decisions to drive on the ascending and descending limbs of the blood alcohol curve. Social-drinking adults (N = 20) performed a testing battery that measured simulated driving performance and willingness to drive, as well as mechanisms related to driving: motor coordination (grooved pegboard), inhibitory control (cued go/no-go task), and subjective intoxication. Performance was tested in response to placebo and a moderate dose of alcohol (0.65 g/kg) twice at comparable blood alcohol concentrations: once on the ascending limb and again on the descending limb. Impaired motor coordination and subjective intoxication showed acute tolerance, whereas driving performance and inhibitory control showed no recovery from impairment. Greater motor impairment was associated with poorer driving performance under alcohol, and poorer inhibitory control was associated with more willingness to drive. Findings suggest that acute tolerance to impairment of motor coordination is insufficient to promote recovery of driving performance and that the persistence of alcohol-induced disinhibition might contribute to risky decisions to drive on the descending limb.

Acute tolerance to alcohol impairment of behavioral and cognitive mechanisms related to driving: drinking and driving on the descending limb

PubMed Central

Weafer, Jessica

2015-01-01

Rationale Alcohol effects on behavioral and cognitive mechanisms influence impaired driving performance and decisions to drive after drinking (Barry 1973; Moskowitz and Robinson 1987). To date, research has focused on the ascending limb of the blood alcohol curve, and there is little understanding of how acute tolerance to impairment of these mechanisms might influence driving behavior on the descending limb. Objectives To provide an integrated examination of the degree to which alcohol impairment of motor coordination and inhibitory control contributes to driving impairment and decisions to drive on the ascending and descending limbs of the blood alcohol curve. Methods Social-drinking adults (N=20) performed a testing battery that measured simulated driving performance and willingness to drive, as well as mechanisms related to driving: motor coordination (grooved pegboard), inhibitory control (cued go/no-go task), and subjective intoxication. Performance was tested in response to placebo and a moderate dose of alcohol (0.65 g/kg) twice at comparable blood alcohol concentrations: once on the ascending limb and again on the descending limb. Results Impaired motor coordination and subjective intoxication showed acute tolerance, whereas driving performance and inhibitory control showed no recovery from impairment. Greater motor impairment was associated with poorer driving performance under alcohol, and poorer inhibitory control was associated with more willingness to drive. Conclusions Findings suggest that acute tolerance to impairment of motor coordination is insufficient to promote recovery of driving performance and that the persistence of alcohol-induced disinhibition might contribute to risky decisions to drive on the descending limb. PMID:21960182

Outsourcing decision factors in publicly owned electric utilities

NASA Astrophysics Data System (ADS)

Gonzales, James Edward

Purpose. The outsourcing of services in publicly owned electric utilities has generated some controversy. The purpose of this study was to explore this controversy by investigating the relationships between eight key independent variables and a dependent variable, "manager perceptions of overall value of outsourced services." The intent was to provide data so that utilities could make better decisions regarding outsourcing efforts. Theoretical framework. Decision theory was used as the framework for analyzing variables and alternatives used to support the outsourcing decision-making process. By reviewing these eight variables and the projected outputs and outcomes, a more predictive and potentially successful outsourcing effort can be realized. Methodology. A survey was distributed to a sample of 323 publicly owned electric utilities randomly selected from a population of 2,020 in the United States. Analysis of the data was made using statistical techniques including the Chi-Square, Lambda, Spearman's coefficient of rank correlation, as well as the Hypothesis Test, Rank Correlation, to test for relationships among the variables. Findings. Relationships among the eight key variables and perceptions of the overall value of outsourced services were generally weak. The notable exception was with the driving force (reason) for outsourcing decisions where the relationship was strongly positive. Conclusions and recommendations. The data in support of the research questions suggest that seven of the eight key variables may be weakly predictive of perceptions of the overall value of outsourced services. However, the primary driving force for outsourcing was strongly predictive. The data also suggest that many of the sampled utilities did not formally address these variables and alternatives, and therefore may not be achieving maximal results. Further studies utilizing customer perceptions rather than those of outsourcing service managers are recommended. In addition, it is recommended that a smaller sample population be analyzed after identifying one or more champions to ensure cooperation and legitimacy of data. Finally, this study supports the position that a manager's ability to identify and understand the relationships between these eight key variables and desired outcomes and outputs may contribute to more successful outsourcing operations.

Iterative near-term ecological forecasting: Needs, opportunities, and challenges

USGS Publications Warehouse

Dietze, Michael C.; Fox, Andrew; Beck-Johnson, Lindsay; Betancourt, Julio L.; Hooten, Mevin B.; Jarnevich, Catherine S.; Keitt, Timothy H.; Kenney, Melissa A.; Laney, Christine M.; Larsen, Laurel G.; Loescher, Henry W.; Lunch, Claire K.; Pijanowski, Bryan; Randerson, James T.; Read, Emily; Tredennick, Andrew T.; Vargas, Rodrigo; Weathers, Kathleen C.; White, Ethan P.

2018-01-01

Two foundational questions about sustainability are “How are ecosystems and the services they provide going to change in the future?” and “How do human decisions affect these trajectories?” Answering these questions requires an ability to forecast ecological processes. Unfortunately, most ecological forecasts focus on centennial-scale climate responses, therefore neither meeting the needs of near-term (daily to decadal) environmental decision-making nor allowing comparison of specific, quantitative predictions to new observational data, one of the strongest tests of scientific theory. Near-term forecasts provide the opportunity to iteratively cycle between performing analyses and updating predictions in light of new evidence. This iterative process of gaining feedback, building experience, and correcting models and methods is critical for improving forecasts. Iterative, near-term forecasting will accelerate ecological research, make it more relevant to society, and inform sustainable decision-making under high uncertainty and adaptive management. Here, we identify the immediate scientific and societal needs, opportunities, and challenges for iterative near-term ecological forecasting. Over the past decade, data volume, variety, and accessibility have greatly increased, but challenges remain in interoperability, latency, and uncertainty quantification. Similarly, ecologists have made considerable advances in applying computational, informatic, and statistical methods, but opportunities exist for improving forecast-specific theory, methods, and cyberinfrastructure. Effective forecasting will also require changes in scientific training, culture, and institutions. The need to start forecasting is now; the time for making ecology more predictive is here, and learning by doing is the fastest route to drive the science forward.

Iterative near-term ecological forecasting: Needs, opportunities, and challenges.

PubMed

Dietze, Michael C; Fox, Andrew; Beck-Johnson, Lindsay M; Betancourt, Julio L; Hooten, Mevin B; Jarnevich, Catherine S; Keitt, Timothy H; Kenney, Melissa A; Laney, Christine M; Larsen, Laurel G; Loescher, Henry W; Lunch, Claire K; Pijanowski, Bryan C; Randerson, James T; Read, Emily K; Tredennick, Andrew T; Vargas, Rodrigo; Weathers, Kathleen C; White, Ethan P

2018-02-13

Two foundational questions about sustainability are "How are ecosystems and the services they provide going to change in the future?" and "How do human decisions affect these trajectories?" Answering these questions requires an ability to forecast ecological processes. Unfortunately, most ecological forecasts focus on centennial-scale climate responses, therefore neither meeting the needs of near-term (daily to decadal) environmental decision-making nor allowing comparison of specific, quantitative predictions to new observational data, one of the strongest tests of scientific theory. Near-term forecasts provide the opportunity to iteratively cycle between performing analyses and updating predictions in light of new evidence. This iterative process of gaining feedback, building experience, and correcting models and methods is critical for improving forecasts. Iterative, near-term forecasting will accelerate ecological research, make it more relevant to society, and inform sustainable decision-making under high uncertainty and adaptive management. Here, we identify the immediate scientific and societal needs, opportunities, and challenges for iterative near-term ecological forecasting. Over the past decade, data volume, variety, and accessibility have greatly increased, but challenges remain in interoperability, latency, and uncertainty quantification. Similarly, ecologists have made considerable advances in applying computational, informatic, and statistical methods, but opportunities exist for improving forecast-specific theory, methods, and cyberinfrastructure. Effective forecasting will also require changes in scientific training, culture, and institutions. The need to start forecasting is now; the time for making ecology more predictive is here, and learning by doing is the fastest route to drive the science forward.

New Elements To Consider When Modeling the Hazards Associated with Botulinum Neurotoxin in Food.

PubMed

Ihekwaba, Adaoha E C; Mura, Ivan; Malakar, Pradeep K; Walshaw, John; Peck, Michael W; Barker, G C

2016-01-15

Botulinum neurotoxins (BoNTs) produced by the anaerobic bacterium Clostridium botulinum are the most potent biological substances known to mankind. BoNTs are the agents responsible for botulism, a rare condition affecting the neuromuscular junction and causing a spectrum of diseases ranging from mild cranial nerve palsies to acute respiratory failure and death. BoNTs are a potential biowarfare threat and a public health hazard, since outbreaks of foodborne botulism are caused by the ingestion of preformed BoNTs in food. Currently, mathematical models relating to the hazards associated with C. botulinum, which are largely empirical, make major contributions to botulinum risk assessment. Evaluated using statistical techniques, these models simulate the response of the bacterium to environmental conditions. Though empirical models have been successfully incorporated into risk assessments to support food safety decision making, this process includes significant uncertainties so that relevant decision making is frequently conservative and inflexible. Progression involves encoding into the models cellular processes at a molecular level, especially the details of the genetic and molecular machinery. This addition drives the connection between biological mechanisms and botulism risk assessment and hazard management strategies. This review brings together elements currently described in the literature that will be useful in building quantitative models of C. botulinum neurotoxin production. Subsequently, it outlines how the established form of modeling could be extended to include these new elements. Ultimately, this can offer further contributions to risk assessments to support food safety decision making. Copyright © 2015 Ihekwaba et al.

Funding Drives Service Decisions: A Moral Dilemma.

ERIC Educational Resources Information Center

Huebner, K. M.; Luxton, L.

1990-01-01

The 1990 Josephine L. Taylor Leadership Institute addressed the theme "Funding Drives Service Decisions: A Moral Dilemma." Institute participants identified specific dilemmas related to legislation, funding, and placement issues in education and rehabilitation of visually handicapped individuals. Participants subsequently generated solutions in…

Adapting a Driving Simulator to Study Pedestrians' Street-Crossing Decisions: A Feasibility Study.

PubMed

Jäger, M; Nyffeler, T; Müri, R; Mosimann, U P; Nef, T

2015-01-01

The decision when to cross a street safely is a challenging task that poses high demands on perception and cognition. Both can be affected by normal aging, neurodegenerative disorder, and brain injury, and there is an increasing interest in studying street-crossing decisions. In this article, we describe how driving simulators can be modified to study pedestrians' street-crossing decisions. The driving simulator's projection system and the virtual driving environment were used to present street-crossing scenarios to the participants. New sensors were added to measure when the test person starts to cross the street. Outcome measures were feasibility, usability, task performance, and visual exploration behavior, and were measured in 15 younger persons, 15 older persons, and 5 post-stroke patients. The experiments showed that the test is feasible and usable, and the selected difficulty level was appropriate. Significant differences in the number of crashes between young participants and patients (p = .001) as well as between healthy older participants and patients (p = .003) were found. When the approaching vehicle's speed is high, significant differences between younger and older participants were found as well (p = .038). Overall, the new test setup was well accepted, and we demonstrated that driving simulators can be used to study pedestrians' street-crossing decisions.

Informational and Normative Influences in Conformity from a Neurocomputational Perspective.

PubMed

Toelch, Ulf; Dolan, Raymond J

2015-10-01

We consider two distinct influences that drive conformity behaviour. Whereas informational influences facilitate adaptive and accurate responses, normative influences bias decisions to enhance social acceptance. We explore these influences from a perspective of perceptual and value-based decision-making models and apply these models to classical works on conformity. We argue that an informational account predicts a surprising tendency to conform. Moreover, we detail how normative influences fit into this framework and interact with social influences. Finally, we explore potential neuronal substrates for informational and normative influences based on a consideration of the neurobiological literature, highlighting conceptual shortcomings particularly with regard to a failure to segregate informational and normative influences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Engineering management of large scale systems

NASA Technical Reports Server (NTRS)

Sanders, Serita; Gill, Tepper L.; Paul, Arthur S.

1989-01-01

The organization of high technology and engineering problem solving, has given rise to an emerging concept. Reasoning principles for integrating traditional engineering problem solving with system theory, management sciences, behavioral decision theory, and planning and design approaches can be incorporated into a methodological approach to solving problems with a long range perspective. Long range planning has a great potential to improve productivity by using a systematic and organized approach. Thus, efficiency and cost effectiveness are the driving forces in promoting the organization of engineering problems. Aspects of systems engineering that provide an understanding of management of large scale systems are broadly covered here. Due to the focus and application of research, other significant factors (e.g., human behavior, decision making, etc.) are not emphasized but are considered.

Considerations in pharmaceutical conversion: focus on antihistamines.

PubMed

Garbus, S B; Moulton, B W; Meltzer, E O; Reich, P R; Weinreb, L F; Friedman, J A; Orland, B I

1997-04-01

The practice of pharmaceutical conversion, which encompasses three types of drug interchange (generic, brand, and therapeutic substitution), is increasing in managed care settings. Pharmaceutical conversion has numerous implications for managed care organizations, their healthcare providers, and their customers. Although drug cost may be a driving consideration in pharmaceutical conversion, a number of other considerations are of equal or greater importance in the decision-making process may affect the overall cost of patient care. Among these considerations are clinical, psychosocial, and safety issues; patient adherence; patient satisfaction; and legal implications of pharmaceutical conversion. Patient-centered care must always remain central to decisions about pharmaceutical conversion. This article discusses the issues related to, and implications of, pharmaceutical conversion utilizing the antihistamines class of drugs as the case situation.

Advanced driver assistance system: Road sign identification using VIAPIX system and a correlation technique

NASA Astrophysics Data System (ADS)

Ouerhani, Y.; Alfalou, A.; Desthieux, M.; Brosseau, C.

2017-02-01

We present a three-step approach based on the commercial VIAPIX® module for road traffic sign recognition and identification. Firstly, detection in a scene of all objects having characteristics of traffic signs is performed. This is followed by a first-level recognition based on correlation which consists in making a comparison between each detected object with a set of reference images of a database. Finally, a second level of identification allows us to confirm or correct the previous identification. In this study, we perform a correlation-based analysis by combining and adapting the Vander Lugt correlator with the nonlinear joint transformation correlator (JTC). Of particular significance, this approach permits to make a reliable decision on road traffic sign identification. We further discuss a robust scheme allowing us to track a detected road traffic sign in a video sequence for the purpose of increasing the decision performance of our system. This approach can have broad practical applications in the maintenance and rehabilitation of transportation infrastructure, or for drive assistance.

Stimulation of dopamine D₁ receptor improves learning capacity in cooperating cleaner fish.

PubMed

Messias, João P M; Santos, Teresa P; Pinto, Maria; Soares, Marta C

2016-01-27

Accurate contextual decision-making strategies are important in social environments. Specific areas in the brain are tasked to process these complex interactions and generate correct follow-up responses. The dorsolateral and dorsomedial parts of the telencephalon in the teleost fish brain are neural substrates modulated by the neurotransmitter dopamine (DA), and are part of an important neural circuitry that drives animal behaviour from the most basic actions such as learning to search for food, to properly choosing partners and managing decisions based on context. The Indo-Pacific cleaner wrasse Labroides dimidiatus is a highly social teleost fish species with a complex network of interactions with its 'client' reef fish. We asked if changes in DA signalling would affect individual learning ability by presenting cleaner fish two ecologically different tasks that simulated a natural situation requiring accurate decision-making. We demonstrate that there is an involvement of the DA system and D1 receptor pathways on cleaners' natural abilities to learn both tasks. Our results add significantly to the growing literature on the physiological mechanisms that underlie and facilitate the expression of cooperative abilities. © 2016 The Author(s).

Exploring key factors in online shopping with a hybrid model.

PubMed

Chen, Hsiao-Ming; Wu, Chia-Huei; Tsai, Sang-Bing; Yu, Jian; Wang, Jiangtao; Zheng, Yuxiang

2016-01-01

Nowadays, the web increasingly influences retail sales. An in-depth analysis of consumer decision-making in the context of e-business has become an important issue for internet vendors. However, factors affecting e-business are complicated and intertwined. To stimulate online sales, understanding key influential factors and causal relationships among the factors is important. To gain more insights into this issue, this paper introduces a hybrid method, which combines the Decision Making Trial and Evaluation Laboratory (DEMATEL) with the analytic network process, called DANP method, to find out the driving factors that influence the online business mostly. By DEMATEL approach the causal graph showed that "online service" dimension has the highest degree of direct impact on other dimensions; thus, the internet vendor is suggested to made strong efforts on service quality throughout the online shopping process. In addition, the study adopted DANP to measure the importance of key factors, among which "transaction security" proves to be the most important criterion. Hence, transaction security should be treated with top priority to boost the online businesses. From our study with DANP approach, the comprehensive information can be visually detected so that the decision makers can spotlight on the root causes to develop effectual actions.

Information Foraging for Perceptual Decisions

PubMed Central

2016-01-01

We tested an information foraging framework to characterize the mechanisms that drive active (visual) sampling behavior in decision problems that involve multiple sources of information. Experiments 1 through 3 involved participants making an absolute judgment about the direction of motion of a single random dot motion pattern. In Experiment 4, participants made a relative comparison between 2 motion patterns that could only be sampled sequentially. Our results show that: (a) Information (about noisy motion information) grows to an asymptotic level that depends on the quality of the information source; (b) The limited growth is attributable to unequal weighting of the incoming sensory evidence, with early samples being weighted more heavily; (c) Little information is lost once a new source of information is being sampled; and (d) The point at which the observer switches from 1 source to another is governed by online monitoring of his or her degree of (un)certainty about the sampled source. These findings demonstrate that the sampling strategy in perceptual decision-making is under some direct control by ongoing cognitive processing. More specifically, participants are able to track a measure of (un)certainty and use this information to guide their sampling behavior. PMID:27819455

Ising model for collective decision making during group motion

NASA Astrophysics Data System (ADS)

Pinkoviezky, Itai; Gov, Nir; Couzin, Iain

Collective decision making is a key feature during natural motion of animal groups and is also crucial for human groups. This phenomenon can be exemplified by the scenario of two subgroups that hold conflicting preferred directions of motion. The constraint of group cohesion drives the motion either towards a compromise or towards one of the preferred targets. The transition between compromise and decision has been found in simulations of flock models, but the nature of this transition is not well understood. We present a minimal spin model for this system where we interpret the spin-spin interaction as a social force. This model exhibits both first and second order transitions. The group motion changes from size-dependent diffusion at high temperatures to run-and-tumble motion below the critical temperature. In the presence of minority and majority subgroups, we find that there is a trade-off between the speed of reaching a target and the accuracy. We then compare the results of the spin model to detailed simulations of a flock model, and find overall very similar dynamics, with the role of the temperature taken by the inverse of the number of uninformed individuals.

Invited review: Helping dairy farmers to improve economic performance utilizing data-driving decision support tools.

PubMed

Cabrera, V E

2018-01-01

The objective of this review paper is to describe the development and application of a suite of more than 40 computerized dairy farm decision support tools contained at the University of Wisconsin-Madison (UW) Dairy Management website http://DairyMGT.info. These data-driven decision support tools are aimed to help dairy farmers improve their decision-making, environmental stewardship and economic performance. Dairy farm systems are highly dynamic in which changing market conditions and prices, evolving policies and environmental restrictions together with every time more variable climate conditions determine performance. Dairy farm systems are also highly integrated with heavily interrelated components such as the dairy herd, soils, crops, weather and management. Under these premises, it is critical to evaluate a dairy farm following a dynamic integrated system approach. For this approach, it is crucial to use meaningful data records, which are every time more available. These data records should be used within decision support tools for optimal decision-making and economic performance. Decision support tools in the UW-Dairy Management website (http://DairyMGT.info) had been developed using combination and adaptation of multiple methods together with empirical techniques always with the primary goal for these tools to be: (1) highly user-friendly, (2) using the latest software and computer technologies, (3) farm and user specific, (4) grounded on the best scientific information available, (5) remaining relevant throughout time and (6) providing fast, concrete and simple answers to complex farmers' questions. DairyMGT.info is a translational innovative research website in various areas of dairy farm management that include nutrition, reproduction, calf and heifer management, replacement, price risk and environment. This paper discusses the development and application of 20 selected (http://DairyMGT.info) decision support tools.

Academic medical centers as innovation ecosystems to address population -omics challenges in precision medicine.

PubMed

Silva, Patrick J; Schaibley, Valerie M; Ramos, Kenneth S

2018-02-15

While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations. Until recently, these data have primarily been consumed in clinical research, but now increasingly being considered in clinical decision- making. Such advances are disrupting common diagnostic business models around which academic medical centers (AMCs) and molecular diagnostic companies have collaborated over the last decade. Proprietary biomarkers and patents on proprietary diagnostic content are no longer driving biomarker collaborations between industry and AMCs. Increasingly the scope of the data commons and biorepositories that AMCs can assemble through a nexus of academic and pharma collaborations is driving a virtuous cycle of precision medicine capabilities that make an AMC relevant and highly competitive. A rebalancing of proprietary strategies and open innovation strategies is warranted to enable institutional precision medicine asset portfolios. The scope of the AMC's clinical trial and research collaboration portfolios with industry are increasingly dependent on the currency of data, and less on patents. Intrapeneurial support of internal service offerings, clinical trials and clinical laboratory services for example, will be important new points of emphasis at the academic-industry interface. Streamlining these new models of industry collaboration for AMCs are a new area for technology transfer offices to offer partnerships and to add value beyond the traditional intellectual property offering.

[Driving and health at work].

PubMed

Giorgio, Marie-Thérèse

2015-09-01

The role of the occupational physician is to prevent occupational accidents and diseases. Therefore, he is the one to decide if a worker is fit to drive in the context of his professional activity, including in cases where no specific driving license is required (e.g. forklift truck, mobile crane). This decision is an important one, as two thirds of fatal occupational accidents occur on the road. The decision is made on the basis of both a medical examination and the regulation, which indicates all contraindications to driving. The physician's responsibility is involved, as is the employer's, as he must ensure that his employee is fit to drive and possesses a valid driving license at all times. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Cortical drive of low-frequency oscillations in the human nucleus accumbens during action selection.

PubMed

Stenner, Max-Philipp; Litvak, Vladimir; Rutledge, Robb B; Zaehle, Tino; Schmitt, Friedhelm C; Voges, Jürgen; Heinze, Hans-Jochen; Dolan, Raymond J

2015-07-01

The nucleus accumbens is thought to contribute to action selection by integrating behaviorally relevant information from multiple regions, including prefrontal cortex. Studies in rodents suggest that information flow to the nucleus accumbens may be regulated via task-dependent oscillatory coupling between regions. During instrumental behavior, local field potentials (LFP) in the rat nucleus accumbens and prefrontal cortex are coupled at delta frequencies (Gruber AJ, Hussain RJ, O'Donnell P. PLoS One 4: e5062, 2009), possibly mediating suppression of afferent input from other areas and thereby supporting cortical control (Calhoon GG, O'Donnell P. Neuron 78: 181-190, 2013). In this report, we demonstrate low-frequency cortico-accumbens coupling in humans, both at rest and during a decision-making task. We recorded LFP from the nucleus accumbens in six epilepsy patients who underwent implantation of deep brain stimulation electrodes. All patients showed significant coherence and phase-synchronization between LFP and surface EEG at delta and low theta frequencies. Although the direction of this coupling as indexed by Granger causality varied between subjects in the resting-state data, all patients showed a cortical drive of the nucleus accumbens during action selection in a decision-making task. In three patients this was accompanied by a significant coherence increase over baseline. Our results suggest that low-frequency cortico-accumbens coupling represents a highly conserved regulatory mechanism for action selection. Copyright © 2015 the American Physiological Society.

Older adult opinions of "advance driving directives".

PubMed

Betz, Marian E; Lowenstein, Steven R; Schwartz, Robert

2013-01-01

Discussions about driving cessation are difficult. "Advance driving directives" (ADDs), like advance directives for end-of-life care, would allow drivers to designate someone to help make driving decisions for them in the future. It is not known if older drivers support the concept of ADDs. Cross-sectional study of a convenience sample of English-speaking drivers (55+ years) at 2 independent living facilities and 2 community centers who completed anonymous surveys. Of 168 participants, 80% were female; the median age was 76.5 years (range = 56-93 years). Most (74%) drove daily or almost daily, and 7% reported a crash in the past year. Few had spoken with someone about driving safety (5%) or their wishes when driving skills decline (21%). Of the few who had discussed this topic, 83% had spoken with a family member; only 17% had spoken with a health care provider. However, participants were open to driving discussions, and 54% said they would be willing to complete an ADD if recommended. Of these, 79% said it was "likely" or "very likely" they would comply with the directive in the future. Most (73%) supported mandatory, age-based retesting; the median recommended testing age suggested was 80 years. More participants thought the driver (71%), a family member (61%), or a physician (59%) should determine license revocation for an unsafe driver, rather than the department of motor vehicles (32%). Many older drivers may be open to discussing their driving plans with physicians and family members. ADDs may facilitate these discussions in the present and help define driving-related wishes in the future.

Decisions Made with Less Evidence Involve Higher Levels of Corticosubthalamic Nucleus Theta Band Synchrony.

PubMed

Zavala, Baltazar; Tan, Huiling; Little, Simon; Ashkan, Keyoumars; Green, Alexander L; Aziz, Tipu; Foltynie, Thomas; Zrinzo, Ludvic; Zaghloul, Kareem; Brown, Peter

2016-06-01

The switch between automatic action selection and more controlled forms of decision-making is a dynamic process thought to involve both cortical and subcortical structures. During sensory conflict, medial pFC oscillations in the theta band (<8 Hz) drive those of the subthalamic nucleus (STN), and this is thought to increase the threshold of evidence needed for one competing response to be selected over another. Here, we were interested in testing whether STN activity is also altered by the rate at which evidence is presented during a congruent dot motion task absent of any explicit sensory conflict. By having a series of randomly moving dots gradually transform to congruent motion at three different rates (slow, medium, fast), we were able to show that a slower rate increased the time it took participants to make a response but did not alter the total amount of evidence that was integrated before the response. Notably, this resulted in a decision being made with a lower amount of instantaneous evidence during the slow and medium trials. Consistent with the idea that medial pFC-STN activity is involved in executing cognitive control, the higher levels of ambiguity during these trials were associated with increased theta band synchrony between the cortex and the STN, with the cortical oscillations Granger-causal to those of the STN. These results further confirm the involvement of the STN in decision-making and suggest that the disruption of this network may underlie some of the unwanted cognitive deficits associated with STN deep brain stimulation.

Pathological gambling in Parkinson's disease: subthalamic oscillations during economics decisions.

PubMed

Rosa, Manuela; Fumagalli, Manuela; Giannicola, Gaia; Marceglia, Sara; Lucchiari, Claudio; Servello, Domenico; Franzini, Angelo; Pacchetti, Claudio; Romito, Luigi; Albanese, Alberto; Porta, Mauro; Pravettoni, Gabriella; Priori, Alberto

2013-10-01

Pathological gambling develops in up to 8% of patients with Parkinson's disease. Although the pathophysiology of gambling remains unclear, several findings argue for a dysfunction in the basal ganglia circuits. To clarify the role of the subthalamic nucleus in pathological gambling, we studied its activity during economics decisions. We analyzed local field potentials recorded from deep brain stimulation electrodes in the subthalamic nucleus while parkinsonian patients with (n = 8) and without (n = 9) pathological gambling engaged in an economics decision-making task comprising conflictual trials (involving possible risk-taking) and non conflictual trials. In all parkinsonian patients, subthalamic low frequencies (2-12 Hz) increased during economics decisions. Whereas, in patients without gambling, low-frequency oscillations exhibited a similar pattern during conflictual and non conflictual stimuli, in those with gambling, low-frequency activity increased significantly more during conflictual than during non conflictual stimuli. The specific low-frequency oscillatory pattern recorded in patients with Parkinson's disease who gamble could reflect a subthalamic dysfunction that makes their decisional threshold highly sensitive to risky options. When parkinsonian patients process stimuli related to an economics task, low-frequency subthalamic activity increases. This task-related change suggests that the cognitive-affective system that drives economics decisional processes includes the subthalamic nucleus. The specific subthalamic neuronal activity during conflictual decisions in patients with pathological gambling supports the idea that the subthalamic nucleus is involved in behavioral strategies and in the pathophysiology of gambling. Copyright © 2013 Movement Disorder Society.

Neural Signatures of Value Comparison in Human Cingulate Cortex during Decisions Requiring an Effort-Reward Trade-off

PubMed Central

Kennerley, Steven W.; Friston, Karl; Bestmann, Sven

2016-01-01

Integrating costs and benefits is crucial for optimal decision-making. Although much is known about decisions that involve outcome-related costs (e.g., delay, risk), many of our choices are attached to actions and require an evaluation of the associated motor costs. Yet how the brain incorporates motor costs into choices remains largely unclear. We used human fMRI during choices involving monetary reward and physical effort to identify brain regions that serve as a choice comparator for effort-reward trade-offs. By independently varying both options' effort and reward levels, we were able to identify the neural signature of a comparator mechanism. A network involving supplementary motor area and the caudal portion of dorsal anterior cingulate cortex encoded the difference in reward (positively) and effort levels (negatively) between chosen and unchosen choice options. We next modeled effort-discounted subjective values using a novel behavioral model. This revealed that the same network of regions involving dorsal anterior cingulate cortex and supplementary motor area encoded the difference between the chosen and unchosen options' subjective values, and that activity was best described using a concave model of effort-discounting. In addition, this signal reflected how precisely value determined participants' choices. By contrast, separate signals in supplementary motor area and ventromedial prefrontal cortex correlated with participants' tendency to avoid effort and seek reward, respectively. This suggests that the critical neural signature of decision-making for choices involving motor costs is found in human cingulate cortex and not ventromedial prefrontal cortex as typically reported for outcome-based choice. Furthermore, distinct frontal circuits seem to drive behavior toward reward maximization and effort minimization. SIGNIFICANCE STATEMENT The neural processes that govern the trade-off between expected benefits and motor costs remain largely unknown. This is striking because energetic requirements play an integral role in our day-to-day choices and instrumental behavior, and a diminished willingness to exert effort is a characteristic feature of a range of neurological disorders. We use a new behavioral characterization of how humans trade off reward maximization with effort minimization to examine the neural signatures that underpin such choices, using BOLD MRI neuroimaging data. We find the critical neural signature of decision-making, a signal that reflects the comparison of value between choice options, in human cingulate cortex, whereas two distinct brain circuits drive behavior toward reward maximization or effort minimization. PMID:27683898

Neural Signatures of Value Comparison in Human Cingulate Cortex during Decisions Requiring an Effort-Reward Trade-off.

PubMed

Klein-Flügge, Miriam C; Kennerley, Steven W; Friston, Karl; Bestmann, Sven

2016-09-28

Integrating costs and benefits is crucial for optimal decision-making. Although much is known about decisions that involve outcome-related costs (e.g., delay, risk), many of our choices are attached to actions and require an evaluation of the associated motor costs. Yet how the brain incorporates motor costs into choices remains largely unclear. We used human fMRI during choices involving monetary reward and physical effort to identify brain regions that serve as a choice comparator for effort-reward trade-offs. By independently varying both options' effort and reward levels, we were able to identify the neural signature of a comparator mechanism. A network involving supplementary motor area and the caudal portion of dorsal anterior cingulate cortex encoded the difference in reward (positively) and effort levels (negatively) between chosen and unchosen choice options. We next modeled effort-discounted subjective values using a novel behavioral model. This revealed that the same network of regions involving dorsal anterior cingulate cortex and supplementary motor area encoded the difference between the chosen and unchosen options' subjective values, and that activity was best described using a concave model of effort-discounting. In addition, this signal reflected how precisely value determined participants' choices. By contrast, separate signals in supplementary motor area and ventromedial prefrontal cortex correlated with participants' tendency to avoid effort and seek reward, respectively. This suggests that the critical neural signature of decision-making for choices involving motor costs is found in human cingulate cortex and not ventromedial prefrontal cortex as typically reported for outcome-based choice. Furthermore, distinct frontal circuits seem to drive behavior toward reward maximization and effort minimization. The neural processes that govern the trade-off between expected benefits and motor costs remain largely unknown. This is striking because energetic requirements play an integral role in our day-to-day choices and instrumental behavior, and a diminished willingness to exert effort is a characteristic feature of a range of neurological disorders. We use a new behavioral characterization of how humans trade off reward maximization with effort minimization to examine the neural signatures that underpin such choices, using BOLD MRI neuroimaging data. We find the critical neural signature of decision-making, a signal that reflects the comparison of value between choice options, in human cingulate cortex, whereas two distinct brain circuits drive behavior toward reward maximization or effort minimization. Copyright © 2016 Klein-Flügge et al.

Speech-based E-mail and driver behavior: effects of an in-vehicle message system interface.

PubMed

Jamson, A Hamish; Westerman, Stephen J; Hockey, G Robert J; Carsten, Oliver M J

2004-01-01

As mobile office technology becomes more advanced, drivers have increased opportunity to process information "on the move." Although speech-based interfaces can minimize direct interference with driving, the cognitive demands associated with such systems may still cause distraction. We studied the effects on driving performance of an in-vehicle simulated "E-mail" message system; E-mails were either system controlled or driver controlled. A high-fidelity, fixed-base driving simulator was used to test 19 participants on a car-following task. Virtual traffic scenarios varying in driving demand. Drivers compensated for the secondary task by adopting longer headways but showed reduced anticipation of braking requirements and shorter time to collision. Drivers were also less reactive when processing E-mails, demonstrated by a reduction in steering wheel inputs. In most circumstances, there were advantages in providing drivers with control over when E-mails were opened. However, during periods without E-mail interaction in demanding traffic scenarios, drivers showed reduced braking anticipation. This may be a result of increased cognitive costs associated with the decision making process when using a driver-controlled interface when the task of scheduling E-mail acceptance is added to those of driving and E-mail response. Actual or potential applications of this research include the design of speech-based in-vehicle messaging systems.

Is it really good to talk? Testing the impact of providing concurrent verbal protocols on driving performance.

PubMed

Salmon, Paul Matthew; Goode, Natassia; Spiertz, Antje; Thomas, Miles; Grant, Eryn; Clacy, Amanda

2017-06-01

Questions have been raised regarding the impact that providing concurrent verbal protocols has on task performance in various settings; however, there has been little empirical testing of this in road transport. The aim of this study was to examine the impact of providing concurrent verbal protocols on driving performance. Participants drove an instrumented vehicle around a set route, twice whilst providing a concurrent verbal protocol, and twice without. A comparison revealed no differences in behaviour related to speed, braking and steering wheel angle when driving mid-block, but a significant difference in aspects of braking and acceleration at roundabouts. When not providing a verbal protocol, participants were found to brake harder on approach to a roundabout and accelerate more heavily coming out of roundabouts. It is concluded that providing verbal protocols may have a positive effect on braking and accelerating. Practical implications related to driver training and future research are discussed. Practitioner Summary: Verbal protocol analysis is used by ergonomists to understand aspects of cognition and decision-making during complex tasks such as driving and control room operation. This study examines the impact that it has on driving performance, providing evidence to support its continued use in ergonomics applications.

Modeling of driver's collision avoidance maneuver based on controller switching model.

PubMed

Kim, Jong-Hae; Hayakawa, Soichiro; Suzuki, Tatsuya; Hayashi, Koji; Okuma, Shigeru; Tsuchida, Nuio; Shimizu, Masayuki; Kido, Shigeyuki

2005-12-01

This paper presents a modeling strategy of human driving behavior based on the controller switching model focusing on the driver's collision avoidance maneuver. The driving data are collected by using the three-dimensional (3-D) driving simulator based on the CAVE Automatic Virtual Environment (CAVE), which provides stereoscopic immersive virtual environment. In our modeling, the control scenario of the human driver, that is, the mapping from the driver's sensory information to the operation of the driver such as acceleration, braking, and steering, is expressed by Piecewise Polynomial (PWP) model. Since the PWP model includes both continuous behaviors given by polynomials and discrete logical conditions, it can be regarded as a class of Hybrid Dynamical System (HDS). The identification problem for the PWP model is formulated as the Mixed Integer Linear Programming (MILP) by transforming the switching conditions into binary variables. From the obtained results, it is found that the driver appropriately switches the "control law" according to the sensory information. In addition, the driving characteristics of the beginner driver and the expert driver are compared and discussed. These results enable us to capture not only the physical meaning of the driving skill but the decision-making aspect (switching conditions) in the driver's collision avoidance maneuver as well.

A behavioral economic analysis of texting while driving: Delay discounting processes.

PubMed

Hayashi, Yusuke; Miller, Kimberly; Foreman, Anne M; Wirth, Oliver

2016-12-01

The purpose of the present study was to examine an impulsive decision-making process underlying texting while driving from a behavioral economic perspective. A sample of 108 college students completed a novel discounting task that presented participants with a hypothetical scenario in which, after receiving a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply for a specific period of time. Participants also completed a delay discounting task in which they made repeated hypothetical choices between obtaining a larger amount of money available after a delay and an equal or lesser amount of money available immediately. The results show that the duration of the delay is a critical variable that strongly determines whether participants choose to wait to reply to a text message, and that the decrease in the likelihood of waiting as a function of delay is best described by a hyperbolic delay discounting function. The results also show that participants who self-reported higher frequency of texting while driving discounted the opportunity to reply to a text message at greater rates, whereas there was no relation between the rates of discounting of hypothetical monetary rewards and the frequency of texting while driving. The results support the conclusion that texting while driving is fundamentally an impulsive choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of driving after stroke--a pluridisciplinary task.

PubMed

Ponsford, A-S; Viitanen, M; Lundberg, C; Johansson, K

2008-03-01

The aim of the study was to analyze the assessment procedure and identify predictors for the team decision when assessing fitness to drive a car after stroke. The material used was a retrospective data set with 200 stroke clients from Queen Elisabeth's Foundation Mobility Centre at Banstead UK. Fifty-four percent of clients were considered fit to continue driving where 9% could resume driving after car adaptation and training. Important factors for the outcome were vision (acuity and field), neuropsychological functions (divided attention), and track and/or on road test (reaction time, anticipation, speed, and positioning). Cognitive impairment was the main problem in those who failed the driving test and judged not fit for continued driving. Car adaptation, mainly comprising infrared transmitted secondary controls together with automatic transmission was recommended in 35% of the cases. The contribution of different specialist groups appears to be necessary for an effective evaluation, but the assessment procedure can be done more cost-effectively by dividing it into two separate parts and removing certain subtests. The in-car track test is an important part of the assessment procedure with a high face validity and could in many cases make it unnecessary to perform in-traffic tests with unsafe drivers. Car adaptation is often necessary for a client with pronounced hemi-paresis and a full road test can for those only be performed after training the use of car controls.

Context-dependent decision-making: a simple Bayesian model

PubMed Central

Lloyd, Kevin; Leslie, David S.

2013-01-01

Many phenomena in animal learning can be explained by a context-learning process whereby an animal learns about different patterns of relationship between environmental variables. Differentiating between such environmental regimes or ‘contexts’ allows an animal to rapidly adapt its behaviour when context changes occur. The current work views animals as making sequential inferences about current context identity in a world assumed to be relatively stable but also capable of rapid switches to previously observed or entirely new contexts. We describe a novel decision-making model in which contexts are assumed to follow a Chinese restaurant process with inertia and full Bayesian inference is approximated by a sequential-sampling scheme in which only a single hypothesis about current context is maintained. Actions are selected via Thompson sampling, allowing uncertainty in parameters to drive exploration in a straightforward manner. The model is tested on simple two-alternative choice problems with switching reinforcement schedules and the results compared with rat behavioural data from a number of T-maze studies. The model successfully replicates a number of important behavioural effects: spontaneous recovery, the effect of partial reinforcement on extinction and reversal, the overtraining reversal effect, and serial reversal-learning effects. PMID:23427101

Context-dependent decision-making: a simple Bayesian model.

PubMed

Lloyd, Kevin; Leslie, David S

2013-05-06

Many phenomena in animal learning can be explained by a context-learning process whereby an animal learns about different patterns of relationship between environmental variables. Differentiating between such environmental regimes or 'contexts' allows an animal to rapidly adapt its behaviour when context changes occur. The current work views animals as making sequential inferences about current context identity in a world assumed to be relatively stable but also capable of rapid switches to previously observed or entirely new contexts. We describe a novel decision-making model in which contexts are assumed to follow a Chinese restaurant process with inertia and full Bayesian inference is approximated by a sequential-sampling scheme in which only a single hypothesis about current context is maintained. Actions are selected via Thompson sampling, allowing uncertainty in parameters to drive exploration in a straightforward manner. The model is tested on simple two-alternative choice problems with switching reinforcement schedules and the results compared with rat behavioural data from a number of T-maze studies. The model successfully replicates a number of important behavioural effects: spontaneous recovery, the effect of partial reinforcement on extinction and reversal, the overtraining reversal effect, and serial reversal-learning effects.

Opting out of dialysis – Exploring patients' decisions to forego dialysis in favour of conservative non-dialytic management for end-stage renal disease.

PubMed

Seah, Angeline S T; Tan, Fiona; Srinivas, Subramaniam; Wu, Huei Yei; Griva, Konstadina

2015-10-01

Dialysis prolongs the life of people with end-stage renal disease (ESRD), but for patients who are elderly and suffer multiple comorbid illnesses the benefits of dialysis may be outweighed by its negative consequences. Non-dialytic conservative management has therefore become an alternative treatment route, yet little is known on patients' experience with choosing end-of-life treatment. To gain insight into the decision-making process leading to opting out of dialysis and the experience with conservative non-dialytic management from the patients' perspective. Qualitative study using semi-structured interviews. Interpretative phenomenological analysis was undertaken as the framework for data analysis. N = 9 ESRD participants who have taken the decision to forego dialysis were recruited from the advanced care programme under the National Healthcare Group, Singapore. Participants discussed life since ESRD diagnosis, and the personal and contextual factors that led them to choose conservative management. The perceived physical and financial burden of dialysis both for the individual but most importantly for their family, uncertainty over likely gains over risks which were fuelled by communication of negative dialysis stories of others, coupled with sense of life completion and achievement led them to refuse dialysis. All participants took ownership of their decision despite contrary advice by doctors and were content with their decision and current management. Study highlights the factors driving patients' decisions for conservative non-dialytic management over dialysis to allow medical professionals to offer appropriate support to patients through their decision-making process and in caring them for the rest of their lives. © 2013 John Wiley & Sons Ltd.

No Pass, No Drive?

ERIC Educational Resources Information Center

Zirkel, Perry A.

2001-01-01

Discusses basis for Kentucky appellate court decision that state's no-pass, no-drive statute did not violate due-process and equal-protection clauses of the Kentucky and federal constitutions, but did violate the federal Family Education Rights and Privacy Act, but nevertheless did not invalidate the statute. Explains why the decision is…

Naturalistic drive cycle synthesis for pickup trucks.

PubMed

Liu, Zifan; Ivanco, Andrej; Filipi, Zoran

2015-09-01

Future pick-up trucks are meeting much stricter fuel economy and exhaust emission standards. Design tradeoffs will have to be carefully evaluated to satisfy consumer expectations within the regulatory and cost constraints. Boundary conditions will obviously be critical for decision making: thus, the understanding of how customers are driving in naturalistic settings is indispensable. Federal driving schedules, while critical for certification, do not capture the richness of naturalistic cycles, particularly the aggressive maneuvers that often shape consumer perception of performance. While there are databases with large number of drive cycles, applying all of them directly in the design process is impractical. Therefore, representative drive cycles that capture the essence of the naturalistic driving should be synthesized from naturalistic driving data. Naturalistic drive cycles are firstly categorized by investigating their micro-trip components, defined as driving activities between successive stops. Micro-trips are expected to characterize underlying local traffic conditions, and separate different driving patterns. Next, the transitions from one vehicle state to another vehicle state in each cycle category are captured with Transition Probability Matrix (TPM). Candidate drive cycles can subsequently be synthesized using Markov Chain based on TPMs for each category. Finally, representative synthetic drive cycles are selected through assessment of significant cycle metrics to identify the ones with smallest errors. This paper provides a framework for synthesis of representative drive cycles from naturalistic driving data, which can subsequently be used for efficient optimization of design or control of pick-up truck powertrains. Manufacturers will benefit from representative drive cycles in several aspects, including quick assessments of vehicle performance and energy consumption in simulations, component sizing and design, optimization of control strategies, and vehicle testing under real-world conditions. This is in contrast to using federal certification test cycles, which were never intended to capture pickup truck segment. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

Biological, developmental, and neurobehavioral factors relevant to adolescent driving risks.

PubMed

Dahl, Ronald E

2008-09-01

This article reviews emerging knowledge about key aspects of neurobehavioral development, with an emphasis on the development of self-regulation over behavior and emotions and its relevance to driving risks among youth. It begins with a brief overview of recent advances in understanding adolescent brain maturation and presents a heuristic model focusing on brain-behavior-social-context interactions during adolescent development. The article considers the relatively slow neurobehavioral maturation of cognitive control and emphasizes the importance of affective influences on decision making. It points to several questions about programs and policies that may help to protect high-risk youth during this important maturational period. The heuristic model is then used to examine a specific neuroregulatory system during adolescence--the regulation of sleep and arousal. This focus on sleep illustrates key points about brain-behavior-social-context interactions by looking at both biological and social influences on sleep in teens. Moreover, sleep has direct relevance to understanding a specific dimension of driving risk in youth. Sleep deprivation is rampant among adolescents, and the consequences of insufficient sleep (sleepiness, lapses in attention, susceptibility to aggression, and negative synergy with alcohol) appear to contribute significantly to driving risks in teens.

Representativity and univocity of traffic signs and their effect on trajectory movement in a driving simulation task: Warning signs.

PubMed

Vilchez, Jose Luis

2017-07-04

The effect of traffic signs on the behavior of drivers is not completely understood. Knowing about how humans process the meaning of signs (not just by learning but instinctively) will improve reaction time and decision making when traveling. The economic, social, and psychological consequences of car accidents are well known. This study sounds out which traffic signs are more ergonomic for participants, from a cognitive point of view, and determines, at the same time, their effect in participants' movement trajectories in a driving simulation task. Results point out that the signs least representative of their meaning produce a greater deviation from the center of the road than the most representative ones. This study encourages both an in-depth analysis of the effect on movement of roadside signs and the study of how this effect can be modified by the context in which these signs are presented (with the aim to move the research closer to and analyze the data in real contexts). The goal is to achieve clarity of meaning and lack of counterproductive effects on the trajectory of representative signs (those that provoke fewer mistakes in the decision task).

Looking for the Right Balance between Dentist as Manager and Dentist as Care Provider.

PubMed

Reddy, Akhil

2015-01-01

In the quest to understand the implications of separating management and treatment, we must first examine the forces driving management decisions. By defining ownership and equity interest, we are able to isolate a critical factor in the decision-making process. Evaluating the spectrum of the different models of dentistry gives us insight into potential advantages as well as disadvantages that can arise. In private practice, an owner typically wants to see the business grow over a lifetime, while, on the other end of the spectrum, corporate dental companies may be prioritizing dividends, investment returns through speedy packaged sales, or other means of reporting progress to investors. Interestingly, each model of dentistry has shown strength and growth, but there is no clear path to what is deemed ideal.

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

Pardo-Bosch, Francesc, E-mail: francesc.pardo@upc.edu; Political Science Department, University of California - Berkeley; Aguado, Antonio, E-mail: antonio.aguado@upc.edu

Infrastructure construction, one of the biggest driving forces of the economy nowadays, requires a huge analysis and clear transparency to decide what projects have to be executed with the few resources available. With the aim to provide the public administrations a tool with which they can make their decisions easier, the Sustainability Index of Infrastructure Projects (SIIP) has been defined, with a multi-criteria decision system called MIVES, in order to classify non-uniform investments. This index evaluates, in two inseparable stages, the contribution to the sustainable development of each infrastructure project, analyzing its social, environmental and economic impact. The result ofmore » the SIIP allows to decide the order with which projects will be prioritized. The case of study developed proves the adaptability and utility of this tool for the ordinary budget management.« less

Consumer-driven health plans: latest challenge to practices' cash flow.

PubMed

Hajny, Tom

2007-01-01

CDHPs are here to stay. Employers welcome CDHPs because they drive costs away from themselves and into the hands of both consumers and provides. The consumer will make medical purchase decisions tempered by personal economic considerations. The providers are left to figure it all out with the hope their cash flow, cost budgets, and customer service will not be negatively impacted. It will not be easy. Practices must become educated on how CDHPs work, become knowledgeable about specific HSA scenarios in their market, develop optimum processes and procedures, and train staff.

The Lived Experience of Anemia Without a Cause.

PubMed

O'Malley, Patricia

2017-09-01

This article explores anemia without an obvious cause from two perspectives: a patient and the evidence. Although evidence is required to drive favorable patient outcomes, the focus on evidence often hides the patient experience during diagnosis and treatment. Knowledge of experience with evidence can provide a deeper perspective for clinical decision making and meet nursing's ethical mandate to relieve suffering. Although one patient experience does not reflect every patient experience, this patient's experience demonstrates how difficult and dark anemia can be. Copyright © 2017 Elsevier Inc. All rights reserved.

Independence, loss, and social identity: Perspectives on driving cessation and dementia.

PubMed

Sanford, Sarah; Rapoport, Mark J; Tuokko, Holly; Crizzle, Alexander; Hatzifilalithis, Stephanie; Laberge, Sarah; Naglie, Gary

2018-01-01

The purpose of this study on driving cessation was to explore the process of coping, decision-making and adaptation through this major life transition. We sought to examine understandings of the emotional responses of drivers and ex-drivers with dementia from the perspective of healthcare providers and family caregivers of persons with dementia. Interviews and focus groups were conducted with several key informant groups: healthcare providers who work with patients with dementia and their families ( N = 10), representatives from organizations that provide services and support for persons with dementia ( N = 6), and family caregivers of drivers and former drivers with dementia ( N = 13). Data analysis involved inductive analytic techniques to generate descriptive and analytic themes from the data. The main themes from the analysis involve the: (1) Loss of independence and disruption to identity connected to emotional responses to driving cessation; (2) Experience of driving cessation as one loss within a series of losses related to dementia; (3) Importance of addressing emotional and identity-related effects in supportive responses to driving cessation; and (4) Support for maintained and adapted roles as a strategy to provide meaning and purpose in the context of driving cessation. Driving cessation can represent a significant disruption to identity, and is closely linked to losses, such as independence, within people's broader experiences of grief and loss associated with dementia. The findings suggest the need for supportive responses that address unique emotion and identity-related aspects of driving cessation for people with dementia and their family caregivers.

Revealed access to haemodialysis facilities in northeastern Iran: Factors that matter in rural and urban areas.

PubMed

Kiani, Behzad; Bagheri, Nasser; Tara, Ahmad; Hoseini, Benyamin; Tabesh, Hamed; Tara, Mahmood

2017-11-07

Poor access to haemodialysis facilities is associated with high mortality and morbidity rates. This study investigated factors affecting revealed access to the haemodialysis facilities considering patients living in rural and urban areas without any haemodialysis facility (Group A) and those living urban areas with haemodialysis facilities (Group B). This study is based on selfreported Actual Access Time (AAT) to referred haemodialysis facilities and other information regarding travel to haemodialysis facilities from patients. All significant variables on univariate analysis were entered into a univariate general linear model in order to identify factors associated with AAT. Both spatial (driving time and distance) and non-spatial factors (sex, income level, caregivers, transportation mode, education level, ethnicity and personal vehicle ownership) influenced the revealed access identified in Group A. The non-spatial factors for Group B patients were the same as for Group A, but no spatial factor was identified in Group B. It was found that accessibility is strongly underestimated when driving time is chosen as accessibility measure to haemodialysis facilities. Analysis of revealed access determinants provides policymakers with an appropriate decision base for making appropriate decisions and finding solutions to decrease the access time for patients under haemodialysis therapy. Driving time alone is not a good proxy for measuring access to haemodialysis facilities as there are many other potential obstacles, such as women's special travel problems, poor other transportation possibilities, ethnicity disparities, low education levels, low caregiver status and low-income.

Data-driven decision support for radiologists: re-using the National Lung Screening Trial dataset for pulmonary nodule management.

PubMed

Morrison, James J; Hostetter, Jason; Wang, Kenneth; Siegel, Eliot L

2015-02-01

Real-time mining of large research trial datasets enables development of case-based clinical decision support tools. Several applicable research datasets exist including the National Lung Screening Trial (NLST), a dataset unparalleled in size and scope for studying population-based lung cancer screening. Using these data, a clinical decision support tool was developed which matches patient demographics and lung nodule characteristics to a cohort of similar patients. The NLST dataset was converted into Structured Query Language (SQL) tables hosted on a web server, and a web-based JavaScript application was developed which performs real-time queries. JavaScript is used for both the server-side and client-side language, allowing for rapid development of a robust client interface and server-side data layer. Real-time data mining of user-specified patient cohorts achieved a rapid return of cohort cancer statistics and lung nodule distribution information. This system demonstrates the potential of individualized real-time data mining using large high-quality clinical trial datasets to drive evidence-based clinical decision-making.

Driver education: Enhancing knowledge of sleep, fatigue and risky behaviour to improve decision making in young drivers.

PubMed

Alvaro, Pasquale K; Burnett, Nicole M; Kennedy, Gerard A; Min, William Yu Xun; McMahon, Marcus; Barnes, Maree; Jackson, Melinda; Howard, Mark E

2018-03-01

This study assessed the impact of an education program on knowledge of sleepiness and driving behaviour in young adult drivers and their performance and behaviour during simulated night driving. Thirty-four participants (18-26 years old) were randomized to receive either a four-week education program about sleep and driving or a control condition. A series of questionnaires were administered to assess knowledge of factors affecting sleep and driving before and after the four-week education program. Participants also completed a two hour driving simulator task at 1am after 17 h of extended wakefulness to assess the impact on driving behaviour. There was an increase in circadian rhythm knowledge in the intervention group following the education program. Self-reported risky behaviour increased in the control group with no changes in other aspects of sleep knowledge. There were no significant differences in proportion of intervention and control participants who had microsleeps (p ≤ .096), stopped driving due to sleepiness (p = .107), recorded objective episodes of drowsiness (p = .455), and crashed (p = .761), although there was a trend towards more control participants having microsleeps and stopping driving. Those in the intervention group reported higher subjective sleepiness at the end of the drive [M = 6.25, SD = 3.83, t(31) = 2.15, p = .05] and were more likely to indicate that they would stop driving [M = 3.08, SD = 1.16, t(31) = 2.24, p = .04]. The education program improved some aspects of driver knowledge about sleep and safety. The results also suggested that the education program lead to an increased awareness of sleepiness. Education about sleep and driving could reduce the risk of drowsy driving and associated road trauma in young drivers, but requires evaluation in a broader sample with assessment of real world driving outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Electrophysiological brain indices of risk behavior modification induced by contingent feedback.

PubMed

Megías, Alberto; Torres, Miguel Angel; Catena, Andrés; Cándido, Antonio; Maldonado, Antonio

2018-02-01

The main aim of this research was to study the effects of response feedback on risk behavior and the neural and cognitive mechanisms involved, as a function of the feedback contingency. Sixty drivers were randomly assigned to one of three feedback groups: contingent, non-contingent and no feedback. The participants' task consisted of braking or not when confronted with a set of risky driving situations, while their electroencephalographic activity was continuously recorded. We observed that contingent feedback, as opposed to non-contingent feedback, promoted changes in the response bias towards safer decisions. This behavioral modification implied a higher demand on cognitive control, reflected in a larger amplitude of the N400 component. Moreover, the contingent feedback, being predictable and entailing more informative value, gave rise to smaller SPN and larger FRN scores when compared with non-contingent feedback. Taken together, these findings provide a new and complex insight into the neurophysiological basis of the influence of feedback contingency on the processing of decision-making under risk. We suggest that response feedback, when contingent upon the risky behavior, appears to improve the functionality of the brain mechanisms involved in decision-making and can be a powerful tool for reducing the tendency to choose risky options in risk-prone individuals. Copyright © 2018 Elsevier B.V. All rights reserved.

Susceptibility to social pressure following ventromedial prefrontal cortex damage

PubMed Central

Rusch, Michelle L.; Dawson, Jeffrey D.; Rizzo, Matthew; Anderson, Steven W.

2015-01-01

Social pressure influences human behavior including risk taking, but the psychological and neural underpinnings of this process are not well understood. We used the human lesion method to probe the role of ventromedial prefrontal cortex (vmPFC) in resisting adverse social pressure in the presence of risk. Thirty-seven participants (11 with vmPFC damage, 12 with brain damage outside the vmPFC and 14 without brain damage) were tested in driving simulator scenarios requiring left-turn decisions across oncoming traffic with varying time gaps between the oncoming vehicles. Social pressure was applied by a virtual driver who honked aggressively from behind. Participants with vmPFC damage were more likely to select smaller and potentially unsafe gaps under social pressure, while gap selection by the comparison groups did not change under social pressure. Participants with vmPFC damage also showed prolonged elevated skin conductance responses (SCR) under social pressure. Comparison groups showed similar initial elevated SCR, which then declined prior to making left-turn decisions. The findings suggest that the vmPFC plays an important role in resisting explicit and immediately present social pressure with potentially negative consequences. The vmPFC appears to contribute to the regulation of emotional responses and the modulation of decision making to optimize long-term outcomes. PMID:25816815

Mindfulness training increases cooperative decision making in economic exchanges: Evidence from fMRI.

PubMed

Kirk, Ulrich; Gu, Xiaosi; Sharp, Carla; Hula, Andreas; Fonagy, Peter; Montague, P Read

2016-09-01

Emotions have been shown to exert influences on decision making during economic exchanges. Here we investigate the underlying neural mechanisms of a training regimen which is hypothesized to promote emotional awareness, specifically mindfulness training (MT). We test the hypothesis that MT increases cooperative economic decision making using fMRI in a randomized longitudinal design involving 8weeks of either MT or active control training (CT). We find that MT results in an increased willingness to cooperate indexed by higher acceptance rates to unfair monetary offers in the Ultimatum Game. While controlling for acceptance rates of monetary offers between intervention groups, subjects in the MT and CT groups show differential brain activation patterns. Specifically, a subset of more cooperative MT subjects displays increased activation in the septal region, an area linked to social attachment, which may drive the increased willingness to express cooperative behavior in the MT cohort. Furthermore, MT resulted in attenuated activity in anterior insula compared with the CT group in response to unfair monetary offers post-training, which may suggest that MT enables greater ability to effectively regulate the anterior insula and thereby promotes social cooperation. Finally, functional connectivity analyses show a coupling between the septal region and posterior insula in the MT group, suggesting an integration of interoceptive inputs. Together, these results highlight that MT may be employed in contexts where emotional regulation is required to promote social cooperation. Copyright © 2016 Elsevier Inc. All rights reserved.

The hidden challenge of cross-border negotiations.

PubMed

Sebenius, James K

2002-03-01

Cultural differences can influence business negotiations in unexpected ways, as many a hapless deal maker has learned. But the differences extend well beyond surface behaviors, such as proper table manners and the exchange of business cards--and even beyond deeper cultural characteristics, such as attitudes about relationships and deadlines. Indeed, there's another, equally treacherous aspect to cross-border negotiation: the ways that people from different regions come to agreement, or the processes involved in negotiations. Decision-making and governance processes can vary widely from culture to culture, not only in terms of legal technicalities but also in terms of the behaviors and core beliefs that drive them. Numerous promising deals have failed because people ignored or underestimated the powerful differences in process across cultures. In this article, James Sebenius offers ways in which negotiators can prepare for such cultural differences. A useful approach, he says, is to map out the decision-making process--including who's involved, what formal and informal roles people play, and how a resolution is actually reached. With that knowledge, you can design a strategy that anticipates obstacles before they arise. Governance and decision-making processes can take devilishly unexpected forms as you cross borders. But by designing your strategy and tactics so that you're reaching all the right people, you increase your chances of striking a sustainable deal. Those negotiations that might otherwise have failed because people ignored or underestimated powerful disparities in process will, in the end, yield a meaningful yes.

Human Decision Processes: Implications for SSA Support Tools

NASA Astrophysics Data System (ADS)

Picciano, P.

2013-09-01

Despite significant advances in computing power and artificial intelligence (AI), few critical decisions are made without a human decision maker in the loop. Space Situational Awareness (SSA) missions are both critical and complex, typically adhering to the human-in-the-loop (HITL) model. The collection of human operators injects a needed diversity of expert knowledge, experience, and authority required to successfully fulfill SSA tasking. A wealth of literature on human decision making exists citing myriad empirical studies and offering a varied set of prescriptive and descriptive models of judgment and decision making (Hastie & Dawes, 2001; Baron, 2000). Many findings have been proven sufficiently robust to allow information architects or system/interface designers to take action to improve decision processes. For the purpose of discussion, these concepts are bifurcated in two groups: 1) vulnerabilities to mitigate, and 2) capabilities to augment. These vulnerabilities and capabilities refer specifically to the decision process and should not be confused with a shortcoming or skill of a specific human operator. Thus the framing of questions and orders, the automated tools with which to collaborate, priming and contextual data, and the delivery of information all play a critical role in human judgment and choice. Evaluating the merits of any decision can be elusive; in order to constrain this discussion, ‘rational choice' will tend toward the economic model characteristics such as maximizing utility and selection consistency (e.g., if A preferred to B, and B preferred to C, than A should be preferred to C). Simple decision models often encourage one to list the pros and cons of a decision, perhaps use a weighting schema, but one way or another weigh the future benefit (or harm) of making a selection. The result (sought by the rationalist models) should drive toward higher utility. Despite notable differences in researchers' theses (to be discussed in the full paper), one opinion shared is that the rational, economic, deliberate listing/evaluation of all options is NOT representative of how many decision are made. A framework gaining interest lately describes two systems predominantly at work: intuition and reasoning (Kahneman, 2003). Intuition is fast, automatic, and parallel contrasted with the more effortful, deliberative, and sequential reasoning. One of the issues of contention is that considerable research is stacked supporting both sides claiming that intuition is: • A hallmark of expertise responsible for rapid, optimal decisions in the face of adversity • A vulnerability where biases serve as decision traps leading to wrong choices Using seminal studies from a range of domains and tasking, potential solutions for SSA decision support will be offered. Important issues such as managing uncertainty, framing inquiries, and information architecture, and contextual cues will be discussed. The purpose is to provide awareness of the human limitations and capabilities in complex decision making so engineers and designers can consider such factors in their development of SSA tools.

The passive-aggressive organization.

PubMed

Kaplan, Robert S; Norton, David P

2005-10-01

Passive-aggressive organizations are friendly places to work: People are congenial, conflict is rare, and consensus is easy to reach. But, at the end of the day, even the best proposals fail to gain traction, and a company can go nowhere so imperturbably that it's easy to pretend everything is fine. Such companies are not necessarily saddled with mulishly passive-aggressive employees. Rather, they are filled with mostly well-intentioned people who are the victirms of flawed processes and policies. Commonly, a growing company's halfhearted or poorly thought-out attempts to decentralize give rise to multiple layers of managers, whose authority for making decisions becomes increasingly unclear. Some managers, as a result, hang back, while others won't own up to the calls they've made, inviting colleagues to second-guess or overturn the decisions. In such organizations, information does not circulate freely, and that makes it difficult for workers to understand the impact of their actions on company performance and for managers to correctly appraise employees' value to the organization. A failure to accurately match incentives to performance stifles initiative, and people do just enough to get by. Breaking free from this pattern is hard; a long history of seeing corporate initiatives ignored and then fade away tends to make people cynical. Often it's best to bring in an outsider to signal that this time things will be different. He or she will need to address every obstacle all at once: clarify decision rights; see to it that decisions stick; and reward people for sharing information and adding value, not for successfully negotiating corporate politics. If those steps are not taken, it's only a matter of time before the diseased elements of a passive-aggressive organization overwhelm the remaining healthy ones and drive the company into financial distress.

Dynamic Interplay of Value and Sensory Information in High-Speed Decision Making.

PubMed

Afacan-Seref, Kivilcim; Steinemann, Natalie A; Blangero, Annabelle; Kelly, Simon P

2018-03-05

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively [1-6], but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases are affected by starting the integrator closer to the more valuable bound. Here, we show significant departures from this account for humans making rapid sensory-instructed action choices. Behavior was best explained by a simple model in which the evidence representation-and hence, rate of accumulation-is itself biased by value and is non-stationary, increasing over the short decision time frame. Because the value bias initially dominates, the model uniquely predicts a dynamic "turn-around" effect on low-value cues, where the accumulator first launches toward the incorrect action but is then re-routed to the correct one. This was clearly exhibited in electrophysiological signals reflecting motor preparation and evidence accumulation. Finally, we construct an extended model that implements this dynamic effect through plausible sensory neural response modulations and demonstrate the correspondence between decision signal dynamics simulated from a behavioral fit of that model and the empirical decision signals. Our findings suggest that value and sensory information can exert simultaneous and dynamically countervailing influences on the trajectory of the accumulation-to-bound process, driving rapid, sensory-guided actions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Theory of choice in bandit, information sampling and foraging tasks.

PubMed

Averbeck, Bruno B

2015-03-01

Decision making has been studied with a wide array of tasks. Here we examine the theoretical structure of bandit, information sampling and foraging tasks. These tasks move beyond tasks where the choice in the current trial does not affect future expected rewards. We have modeled these tasks using Markov decision processes (MDPs). MDPs provide a general framework for modeling tasks in which decisions affect the information on which future choices will be made. Under the assumption that agents are maximizing expected rewards, MDPs provide normative solutions. We find that all three classes of tasks pose choices among actions which trade-off immediate and future expected rewards. The tasks drive these trade-offs in unique ways, however. For bandit and information sampling tasks, increasing uncertainty or the time horizon shifts value to actions that pay-off in the future. Correspondingly, decreasing uncertainty increases the relative value of actions that pay-off immediately. For foraging tasks the time-horizon plays the dominant role, as choices do not affect future uncertainty in these tasks.

Computational substrates of social value in interpersonal collaboration.

PubMed

Fareri, Dominic S; Chang, Luke J; Delgado, Mauricio R

2015-05-27

Decisions to engage in collaborative interactions require enduring considerable risk, yet provide the foundation for building and maintaining relationships. Here, we investigate the mechanisms underlying this process and test a computational model of social value to predict collaborative decision making. Twenty-six participants played an iterated trust game and chose to invest more frequently with their friends compared with a confederate or computer despite equal reinforcement rates. This behavior was predicted by our model, which posits that people receive a social value reward signal from reciprocation of collaborative decisions conditional on the closeness of the relationship. This social value signal was associated with increased activity in the ventral striatum and medial prefrontal cortex, which significantly predicted the reward parameters from the social value model. Therefore, we demonstrate that the computation of social value drives collaborative behavior in repeated interactions and provide a mechanistic account of reward circuit function instantiating this process. Copyright © 2015 the authors 0270-6474/15/358170-11$15.00/0.

Internal States and Behavioral Decision-Making: Toward an Integration of Emotion and Cognition.

PubMed

Kennedy, Ann; Asahina, Kenta; Hoopfer, Eric; Inagaki, Hidehiko; Jung, Yonil; Lee, Hyosang; Remedios, Ryan; Anderson, David J

2014-01-01

Social interactions, such as an aggressive encounter between two conspecific males or a mating encounter between a male and a female, typically progress from an initial appetitive or motivational phase, to a final consummatory phase. This progression involves both changes in the intensity of the animals' internal state of arousal or motivation and sequential changes in their behavior. How are these internal states, and their escalating intensity, encoded in the brain? Does this escalation drive the progression from the appetitive/motivational to the consummatory phase of a social interaction and, if so, how are appropriate behaviors chosen during this progression? Recent work on social behaviors in flies and mice suggests possible ways in which changes in internal state intensity during a social encounter may be encoded and coupled to appropriate behavioral decisions at appropriate phases of the interaction. These studies may have relevance to understanding how emotion states influence cognitive behavioral decisions at higher levels of brain function. Copyright © 2014 Cold Spring Harbor Laboratory Press; all rights reserved.

Artificial Intelligence based technique for BTS placement

NASA Astrophysics Data System (ADS)

Alenoghena, C. O.; Emagbetere, J. O.; Aibinu, A. M.

2013-12-01

The increase of the base transceiver station (BTS) in most urban areas can be traced to the drive by network providers to meet demand for coverage and capacity. In traditional network planning, the final decision of BTS placement is taken by a team of radio planners, this decision is not fool proof against regulatory requirements. In this paper, an intelligent based algorithm for optimal BTS site placement has been proposed. The proposed technique takes into consideration neighbour and regulation considerations objectively while determining cell site. The application will lead to a quantitatively unbiased evaluated decision making process in BTS placement. An experimental data of a 2km by 3km territory was simulated for testing the new algorithm, results obtained show a 100% performance of the neighbour constrained algorithm in BTS placement optimization. Results on the application of GA with neighbourhood constraint indicate that the choices of location can be unbiased and optimization of facility placement for network design can be carried out.

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology.

PubMed

Bhargava, Rohit; Madabhushi, Anant

2016-07-11

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area.

Emerging Themes in Image Informatics and Molecular Analysis for Digital Pathology

PubMed Central

Bhargava, Rohit; Madabhushi, Anant

2017-01-01

Pathology is essential for research in disease and development, as well as for clinical decision making. For more than 100 years, pathology practice has involved analyzing images of stained, thin tissue sections by a trained human using an optical microscope. Technological advances are now driving major changes in this paradigm toward digital pathology (DP). The digital transformation of pathology goes beyond recording, archiving, and retrieving images, providing new computational tools to inform better decision making for precision medicine. First, we discuss some emerging innovations in both computational image analytics and imaging instrumentation in DP. Second, we discuss molecular contrast in pathology. Molecular DP has traditionally been an extension of pathology with molecularly specific dyes. Label-free, spectroscopic images are rapidly emerging as another important information source, and we describe the benefits and potential of this evolution. Third, we describe multimodal DP, which is enabled by computational algorithms and combines the best characteristics of structural and molecular pathology. Finally, we provide examples of application areas in telepathology, education, and precision medicine. We conclude by discussing challenges and emerging opportunities in this area. PMID:27420575

Probiotics drive gut microbiome triggering emotional brain signatures.

PubMed

Bagga, Deepika; Reichert, Johanna Louise; Koschutnig, Karl; Aigner, Christoph Stefan; Holzer, Peter; Koskinen, Kaisa; Eichinger, Christine Moissl; Schöpf, Veronika

2018-05-03

Experimental manipulation of the gut microbiome was found to modify emotional and cognitive behavior, neurotransmitter expression and brain function in rodents, but corresponding human data remain scarce. The present double-blind, placebo-controlled randomised study aimed at investigating the effects of 4 weeks' probiotic administration on behavior, brain function and gut microbial composition in healthy volunteers. Forty-five healthy participants divided equally into three groups (probiotic, placebo and no intervention) underwent functional MRI (emotional decision-making and emotional recognition memory tasks). In addition, stool samples were collected to investigate the gut microbial composition. Probiotic administration for 4 weeks was associated with changes in brain activation patterns in response to emotional memory and emotional decision-making tasks, which were also accompanied by subtle shifts in gut microbiome profile. Microbiome composition mirrored self-reported behavioral measures and memory performance. This is the first study reporting a distinct influence of probiotic administration at behavioral, neural, and microbiome levels at the same time in healthy volunteers. The findings provide a basis for future investigations into the role of the gut microbiota and potential therapeutic application of probiotics.

'Known unknowns - examining the burden of neurocognitive impairment in the end-stage renal failure population'.

PubMed

Wilson, Scott; Dhar, Arup; Tregaskis, Peter; Lambert, Gavin; Barton, David; Walker, Rowan

2018-01-18

The burden of neurocognitive impairment (NCI) in patients receiving maintenance dialysis represents a spectrum of deficits across multiple cognitive domains which are associated with hospitalisation, reduced quality-of-life, mortality and forced decision-making around dialysis withdrawal. Point prevalence data suggests that dialysis patients manifest NCI at rates 3-5 fold higher than the general population with executive function the most commonly affected cognitive domain. The unique physiology of the renal failure state and maintenance dialysis appears to drive an excess of vascular dementia subtype compared to the general population where classical Alzheimer's disease predominates. Despite the absence of evidence based cost-effective therapies for NCI, detecting it in this population creates opportunity to proactively personalise care through education, supported decision making and targeted communication strategies to cover specific areas of deficit and help define goals of care. This review discusses NCI in the dialysis setting, including developments in the definition of neurocognitive impairment, dialysis-specific epidemiology across modalities, screening strategies and opportunities for dialysis providers in this space. This article is protected by copyright. All rights reserved.

Harm aversion explains utilitarian choices in moral decision-making in males but not in females.

PubMed

Rota, G; Palumbo, S; Lattanzi, N; Manfrinati, A; Sarlo, M; Lotto, L; Pietrini, P; Rumiati, R; Pellegrini, S

2016-06-01

In recent years, a great deal of research has relied on hypothetical sacrificial dilemmas to investigate decision-making processes involved in pro-social utilitarian choices. Recent evidence, however, has suggested that moral sacrificial choices may actually reflect reduced harm aversion and antisocial dispositions rather than an utilitarian inclination. Here, we used moral dilemmas to confront healthy volunteers with controversial action choices. We measured impulsiveness and venturesomeness personality traits, which have been shown to influence harm aversion, to test their role in utilitarian action and evaluation of moral acceptability. The results of the present study show that, in males, venturesomeness drives engagement in actions and increases moral acceptability. In contrast, in females no effects of venturesomeness were observed on moral action and evaluation. Rather, in females empathetic concern and personal distress, elicited by the vicarious experience of the other's emotional states, exerted an inhibitory effect on action. Taken together, these findings indicate that the "harm aversion hypothesis" may contribute to explain utilitarian choices in males but not in females. In both genders, no association was observed between impulsiveness and moral action.

Concept of operations for knowledge discovery from Big Data across enterprise data warehouses

NASA Astrophysics Data System (ADS)

Sukumar, Sreenivas R.; Olama, Mohammed M.; McNair, Allen W.; Nutaro, James J.

2013-05-01

The success of data-driven business in government, science, and private industry is driving the need for seamless integration of intra and inter-enterprise data sources to extract knowledge nuggets in the form of correlations, trends, patterns and behaviors previously not discovered due to physical and logical separation of datasets. Today, as volume, velocity, variety and complexity of enterprise data keeps increasing, the next generation analysts are facing several challenges in the knowledge extraction process. Towards addressing these challenges, data-driven organizations that rely on the success of their analysts have to make investment decisions for sustainable data/information systems and knowledge discovery. Options that organizations are considering are newer storage/analysis architectures, better analysis machines, redesigned analysis algorithms, collaborative knowledge management tools, and query builders amongst many others. In this paper, we present a concept of operations for enabling knowledge discovery that data-driven organizations can leverage towards making their investment decisions. We base our recommendations on the experience gained from integrating multi-agency enterprise data warehouses at the Oak Ridge National Laboratory to design the foundation of future knowledge nurturing data-system architectures.

Navigating Monogamy: Nonapeptide Sensitivity in a Memory Neural Circuit May Shape Social Behavior and Mating Decisions.

PubMed

Ophir, Alexander G

2017-01-01

The role of memory in mating systems is often neglected despite the fact that most mating systems are defined in part by how animals use space. Monogamy, for example, is usually characterized by affiliative (e.g., pairbonding) and defensive (e.g., mate guarding) behaviors, but a high degree of spatial overlap in home range use is the easiest defining feature of monogamous animals in the wild. The nonapeptides vasopressin and oxytocin have been the focus of much attention for their importance in modulating social behavior, however this work has largely overshadowed their roles in learning and memory. To date, the understanding of memory systems and mechanisms governing social behavior have progressed relatively independently. Bridging these two areas will provide a deeper appreciation for understanding behavior, and in particular the mechanisms that mediate reproductive decision-making. Here, I argue that the ability to mate effectively as monogamous individuals is linked to the ability to track conspecifics in space. I discuss the connectivity across some well-known social and spatial memory nuclei, and propose that the nonapeptide receptors within these structures form a putative "socio-spatial memory neural circuit." This purported circuit may function to integrate social and spatial information to shape mating decisions in a context-dependent fashion. The lateral septum and/or the nucleus accumbens, and neuromodulation therein, may act as an intermediary to relate socio-spatial information with social behavior. Identifying mechanisms responsible for relating information about the social world with mechanisms mediating mating tactics is crucial to fully appreciate the suite of factors driving reproductive decisions and social decision-making.

77 FR 24264 - Notice of Receipt of Petition for Decision That Nonconforming Left-Hand Drive 2006 Land Rover...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

..., and Roof Panel Systems, 119 New Pneumatic Tires for Vehicles other than passenger Cars, 124...-0040, Notice 1] Notice of Receipt of Petition for Decision That Nonconforming Left-Hand Drive 2006 Land Rover Range Rover Multi-Purpose Passenger Vehicles Manufactured Prior to September 1, 2006 Are Eligible...

Perceptions, intentions and behavioral norms that affect pre-license driving among Arab youth in Israel.

PubMed

Gesser-Edelsburg, Anat; Zemach, Mina; Lotan, Tsippy; Elias, Wafa; Grimberg, Einat

2018-02-01

The present study examines reported pre-license driving among youth from the population of Arab citizens of Israel. The purpose of the present study is to examine which sociodemographic variables, attitudes and perceptions about safe driving and individual and societal behavioral norms are associated with pre-license driving. The research distinguished between the factors that actually contribute to pre-license driving (reported behavior, peer norms, gender and parents' messages) and the factors that explain the intention (parental authority, social norms, parents' messages and fear of road crashes). Even though there was a significant partial overlap (84%) between those who intend to drive without a license and those who reported driving without a license, the main factors that distinguish pre-license driving groups are different from the factors that distinguish the intention to drive before receiving a license. What is unique about the findings is the identification of the context in which social norms are influential and that in which parental authority is influential. The study indicated that in the case of pre-license driving, the main motivating factor is subjective norms, whereas in the case of expecting to drive without a license, the main motivating factor is the interaction between parental authority and the messages that parents convey. While actual behavior pertains to the behavioral level, we argue that intended behavior pertains to the cognitive level. At this level, rational considerations arise, such as fear of parental punishment and fear of accidents. These considerations compete with the influence of friends and their norms, and may outweigh them. The findings suggest that it is important to safeguard youth against the influence of peer pressure as early as the stage of behavioral intentions. Follow-up studies can simulate situations of pre-license driving due to social pressure and identify the factors that might affect young people's decision-making. Moreover, providing parents with training before the accompaniment period is highly recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Complexity and Competition in Appetitive and Aversive Neural Circuits

PubMed Central

Barberini, Crista L.; Morrison, Sara E.; Saez, Alex; Lau, Brian; Salzman, C. Daniel

2012-01-01

Decision-making often involves using sensory cues to predict possible rewarding or punishing reinforcement outcomes before selecting a course of action. Recent work has revealed complexity in how the brain learns to predict rewards and punishments. Analysis of neural signaling during and after learning in the amygdala and orbitofrontal cortex, two brain areas that process appetitive and aversive stimuli, reveals a dynamic relationship between appetitive and aversive circuits. Specifically, the relationship between signaling in appetitive and aversive circuits in these areas shifts as a function of learning. Furthermore, although appetitive and aversive circuits may often drive opposite behaviors – approaching or avoiding reinforcement depending upon its valence – these circuits can also drive similar behaviors, such as enhanced arousal or attention; these processes also may influence choice behavior. These data highlight the formidable challenges ahead in dissecting how appetitive and aversive neural circuits interact to produce a complex and nuanced range of behaviors. PMID:23189037

Pyrrhic victories: the need for social status drives costly competitive behavior.

PubMed

van den Bos, Wouter; Golka, Philipp J M; Effelsberg, David; McClure, Samuel M

2013-01-01

Competitive behavior is commonly defined as the decision to maximize one's payoffs relative to others. We argue instead that competitive drive derives from a desire for social status. We make use of a multi-player auction task in which subjects knowingly incur financial losses for the sake of winning auctions. First, we show that overbidding is increased when the task includes members of a rival out-group, suggesting that social identity is an important mediator of competitiveness. In addition, we show that the extent that individuals are willing to incur losses is related to affective responses to social comparisons but not to monetary outcomes. Second, we show that basal levels of testosterone predict overbidding, and that this effect of testosterone is mediated by affective responses to social comparisons. Based on these findings, we argue that competitive behavior should be conceptualized in terms of social motivations as opposed to just relative monetary payoffs.

Physics and Hard Disk Drives-A Career in Industry

NASA Astrophysics Data System (ADS)

Lambert, Steven

2014-03-01

I will participate in a panel discussion about ``Career Opportunities for Physicists.'' I enjoyed 27 years doing technology development and product support in the hard disk drive business. My PhD in low temperature physics was excellent training for this career since I learned how to work in a lab, analyze data, write and present technical information, and define experiments that got to the heart of a problem. An academic position did not appeal to me because I had no passion to pursue a particular topic in basic physics. My work in industry provided an unending stream of challenging problems to solve, and it was a rich and rewarding experience. I'm now employed by the APS to focus on our interactions with physicists in industry. I welcome the chance to share my industrial experience with students, post-docs, and others who are making decisions about their career path. Industrial Physics Fellow, APS Headquarters.

Optimal Control of Connected and Automated Vehicles at Roundabouts

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

Zhao, Liuhui; Malikopoulos, Andreas; Rios-Torres, Jackeline

Connectivity and automation in vehicles provide the most intriguing opportunity for enabling users to better monitor transportation network conditions and make better operating decisions to improve safety and reduce pollution, energy consumption, and travel delays. This study investigates the implications of optimally coordinating vehicles that are wirelessly connected to each other and to an infrastructure in roundabouts to achieve a smooth traffic flow without stop-and-go driving. We apply an optimization framework and an analytical solution that allows optimal coordination of vehicles for merging in such traffic scenario. The effectiveness of the efficiency of the proposed approach is validated through simulationmore » and it is shown that coordination of vehicles can reduce total travel time by 3~49% and fuel consumption by 2~27% with respect to different traffic levels. In addition, network throughput is improved by up to 25% due to elimination of stop-and-go driving behavior.« less

Pyrrhic victories: the need for social status drives costly competitive behavior

PubMed Central

van den Bos, Wouter; Golka, Philipp J. M.; Effelsberg, David; McClure, Samuel M.

2013-01-01

Competitive behavior is commonly defined as the decision to maximize one's payoffs relative to others. We argue instead that competitive drive derives from a desire for social status. We make use of a multi-player auction task in which subjects knowingly incur financial losses for the sake of winning auctions. First, we show that overbidding is increased when the task includes members of a rival out-group, suggesting that social identity is an important mediator of competitiveness. In addition, we show that the extent that individuals are willing to incur losses is related to affective responses to social comparisons but not to monetary outcomes. Second, we show that basal levels of testosterone predict overbidding, and that this effect of testosterone is mediated by affective responses to social comparisons. Based on these findings, we argue that competitive behavior should be conceptualized in terms of social motivations as opposed to just relative monetary payoffs. PMID:24167468

Psychology, psychologists, and public policy.

PubMed

McKnight, Katherine M; Sechrest, Lee; McKnight, Patrick E

2005-01-01

Evidence-based policy is being encouraged in all areas of public service ( Black 2001 ). Unprecedented federal legislation reflects a faith in science "as a force for improved public policy" ( Feuer et al. 2002 ). The objective of evidence-based policy is to use scientific research to drive decision making. Thus, the link between social science research and public policy seems to be a natural one. The purpose of this chapter is to address how psychological science in general, and clinical psychology in particular, can be of use to public policy makers. We discuss how psychological science can be relevant and applicable to informing policy, and we describe the role clinical scientists might play in generating, disseminating, and implementing that information. We also note distinct limitations on the usefulness of psychological research in driving public policy. We discuss some pitfalls and recommend areas where clinical psychology might best serve public policy.

Within-Day Recharge of Plug-In Hybrid Electric Vehicles: Energy Impact of Public Charging Infrastructure

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

Dong, Jing; Lin, Zhenhong

2012-01-01

This paper studies the role of public charging infrastructure in increasing PHEV s share of driving on electricity and the resulting petroleum use reduction. Using vehicle activity data obtained from the GPS-tracking household travel survey in Austin, Texas, gasoline and electricity consumptions of PHEVs in real world driving context are estimated. Driver s within-day recharging behavior, constrained by travel activities and public charger network, is modeled as a boundedly rational decision and incorporated in the energy use estimation. The key findings from the Austin dataset include: (1) public charging infrastructure makes PHEV a competitive vehicle choice for consumers without amore » home charger; (2) providing sufficient public charging service is expected to significantly reduce petroleum consumption of PHEVs; and (3) public charging opportunities offer greater benefits for PHEVs with a smaller battery pack, as within-day recharges compensate battery capacity.« less

A Car-Steering Model Based on an Adaptive Neuro-Fuzzy Controller

NASA Astrophysics Data System (ADS)

Amor, Mohamed Anis Ben; Oda, Takeshi; Watanabe, Shigeyoshi

This paper is concerned with the development of a car-steering model for traffic simulation. Our focus in this paper is to propose a model of the steering behavior of a human driver for different driving scenarios. These scenarios are modeled in a unified framework using the idea of target position. The proposed approach deals with the driver’s approximation and decision-making mechanisms in tracking a target position by means of fuzzy set theory. The main novelty in this paper lies in the development of a learning algorithm that has the intention to imitate the driver’s self-learning from his driving experience and to mimic his maneuvers on the steering wheel, using linear networks as local approximators in the corresponding fuzzy areas. Results obtained from the simulation of an obstacle avoidance scenario show the capability of the model to carry out a human-like behavior with emphasis on learned skills.

Effects of Non-Driving Related Task Modalities on Takeover Performance in Highly Automated Driving.

PubMed

Wandtner, Bernhard; Schömig, Nadja; Schmidt, Gerald

2018-04-01

Aim of the study was to evaluate the impact of different non-driving related tasks (NDR tasks) on takeover performance in highly automated driving. During highly automated driving, it is allowed to engage in NDR tasks temporarily. However, drivers must be able to take over control when reaching a system limit. There is evidence that the type of NDR task has an impact on takeover performance, but little is known about the specific task characteristics that account for performance decrements. Thirty participants drove in a simulator using a highly automated driving system. Each participant faced five critical takeover situations. Based on assumptions of Wickens's multiple resource theory, stimulus and response modalities of a prototypical NDR task were systematically manipulated. Additionally, in one experimental group, the task was locked out simultaneously with the takeover request. Task modalities had significant effects on several measures of takeover performance. A visual-manual texting task degraded performance the most, particularly when performed handheld. In contrast, takeover performance with an auditory-vocal task was comparable to a baseline without any task. Task lockout was associated with faster hands-on-wheel times but not altered brake response times. Results showed that NDR task modalities are relevant factors for takeover performance. An NDR task lockout was highly accepted by the drivers and showed moderate benefits for the first takeover reaction. Knowledge about the impact of NDR task characteristics is an enabler for adaptive takeover concepts. In addition, it might help regulators to make decisions on allowed NDR tasks during automated driving.

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain.

PubMed

Dominkovics, Pau; Granell, Carlos; Pérez-Navarro, Antoni; Casals, Martí; Orcau, Angels; Caylà, Joan A

2011-11-29

Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios.

Development of spatial density maps based on geoprocessing web services: application to tuberculosis incidence in Barcelona, Spain

PubMed Central

2011-01-01

Background Health professionals and authorities strive to cope with heterogeneous data, services, and statistical models to support decision making on public health. Sophisticated analysis and distributed processing capabilities over geocoded epidemiological data are seen as driving factors to speed up control and decision making in these health risk situations. In this context, recent Web technologies and standards-based web services deployed on geospatial information infrastructures have rapidly become an efficient way to access, share, process, and visualize geocoded health-related information. Methods Data used on this study is based on Tuberculosis (TB) cases registered in Barcelona city during 2009. Residential addresses are geocoded and loaded into a spatial database that acts as a backend database. The web-based application architecture and geoprocessing web services are designed according to the Representational State Transfer (REST) principles. These web processing services produce spatial density maps against the backend database. Results The results are focused on the use of the proposed web-based application to the analysis of TB cases in Barcelona. The application produces spatial density maps to ease the monitoring and decision making process by health professionals. We also include a discussion of how spatial density maps may be useful for health practitioners in such contexts. Conclusions In this paper, we developed web-based client application and a set of geoprocessing web services to support specific health-spatial requirements. Spatial density maps of TB incidence were generated to help health professionals in analysis and decision-making tasks. The combined use of geographic information tools, map viewers, and geoprocessing services leads to interesting possibilities in handling health data in a spatial manner. In particular, the use of spatial density maps has been effective to identify the most affected areas and its spatial impact. This study is an attempt to demonstrate how web processing services together with web-based mapping capabilities suit the needs of health practitioners in epidemiological analysis scenarios. PMID:22126392

The patient-centered outcomes research institute should focus on high-impact problems that can be solved quickly.

PubMed

Sox, Harold

2012-10-01

The Affordable Care Act created the Patient-Centered Outcomes Research Institute (PCORI) to help patients, clinicians, and policy makers make well-informed decisions about health care. Because its funding expires in 2019, the institute has little time in which to produce timely, practice-changing results that will build public support for comparative effectiveness research. PCORI should plan its research agenda strategically, so that it addresses research questions that comparative effectiveness research could answer quickly and decisively. To date, the institute has not chosen this path. In January 2012 PCORI's first research agenda described broad research priorities rather than specific clinical questions. The institute must drive the burgeoning discipline of comparative effectiveness research forward, starting with a research project agenda that conveys a sense of urgency and strategic direction.

New technology continues to invade healthcare. What are the strategic implications/outcomes?

PubMed

Smith, Coy

2004-01-01

Healthcare technology continues to advance and be implemented in healthcare organizations. Nurse executives must strategically evaluate the effectiveness of each proposed system or device using a strategic planning process. Clinical information systems, computer-chip-based clinical monitoring devices, advanced Web-based applications with remote, wireless communication devices, clinical decision support software--all compete for capital and registered nurse salary dollars. The concept of clinical transformation is developed with new models of care delivery being supported by technology rather than driving care delivery. Senior nursing leadership's role in clinical transformation and healthcare technology implementation is developed. Proposed standards, expert group action, business and consumer groups, and legislation are reviewed as strategic drivers in the development of an electronic health record and healthcare technology. A matrix of advancing technology and strategic decision-making parameters are outlined.

Automation bias: a systematic review of frequency, effect mediators, and mitigators

PubMed Central

Roudsari, Abdul; Wyatt, Jeremy C

2011-01-01

Automation bias (AB)—the tendency to over-rely on automation—has been studied in various academic fields. Clinical decision support systems (CDSS) aim to benefit the clinical decision-making process. Although most research shows overall improved performance with use, there is often a failure to recognize the new errors that CDSS can introduce. With a focus on healthcare, a systematic review of the literature from a variety of research fields has been carried out, assessing the frequency and severity of AB, the effect mediators, and interventions potentially mitigating this effect. This is discussed alongside automation-induced complacency, or insufficient monitoring of automation output. A mix of subject specific and freetext terms around the themes of automation, human–automation interaction, and task performance and error were used to search article databases. Of 13 821 retrieved papers, 74 met the inclusion criteria. User factors such as cognitive style, decision support systems (DSS), and task specific experience mediated AB, as did attitudinal driving factors such as trust and confidence. Environmental mediators included workload, task complexity, and time constraint, which pressurized cognitive resources. Mitigators of AB included implementation factors such as training and emphasizing user accountability, and DSS design factors such as the position of advice on the screen, updated confidence levels attached to DSS output, and the provision of information versus recommendation. By uncovering the mechanisms by which AB operates, this review aims to help optimize the clinical decision-making process for CDSS developers and healthcare practitioners. PMID:21685142

Crimson Spotted Rainbowfish (Melanotaenia duboulayi) Change Their Spatial Position according to Nutritional Requirement.

PubMed

Hansen, M J; Schaerf, T M; Krause, J; Ward, A J W

2016-01-01

Decision making in moving animal groups has been shown to be disproportionately influenced by individuals at the front of groups. Therefore, an explanation of state-dependent positioning of individuals within animal groups may provide a mechanism for group movement decisions. Nutritional state is dynamic and can differ between members of the same group. It is also known to drive animal movement decisions. Therefore, we assayed 6 groups of 8 rainbowfish foraging in a flow tank. Half of the fish had been starved for 24h and half had been fed 1h prior to experimental start. Groups were assayed again one week later but individuals were allocated to the opposite nutritional treatment. During the assay the positions of individually identified fish were recorded as were the number of food items they each ate and the position within the group they acquired them from. Food-deprived fish were more often found towards the front of the shoal; the mean weighted positional score of food-deprived fish was significantly larger than that of well-fed fish. Individuals were not consistent in their position within a shoal between treatments. There was a significant positive correlation between mean weighted positional score and number of food items acquired which displays an obvious benefit to front positions. These results suggest that positional preferences are based on nutritional state and provide a mechanism for state-dependent influence on group decision-making as well as increasing our understanding of what factors are important for group functioning.

Automation bias: a systematic review of frequency, effect mediators, and mitigators.

PubMed

Goddard, Kate; Roudsari, Abdul; Wyatt, Jeremy C

2012-01-01

Automation bias (AB)--the tendency to over-rely on automation--has been studied in various academic fields. Clinical decision support systems (CDSS) aim to benefit the clinical decision-making process. Although most research shows overall improved performance with use, there is often a failure to recognize the new errors that CDSS can introduce. With a focus on healthcare, a systematic review of the literature from a variety of research fields has been carried out, assessing the frequency and severity of AB, the effect mediators, and interventions potentially mitigating this effect. This is discussed alongside automation-induced complacency, or insufficient monitoring of automation output. A mix of subject specific and freetext terms around the themes of automation, human-automation interaction, and task performance and error were used to search article databases. Of 13 821 retrieved papers, 74 met the inclusion criteria. User factors such as cognitive style, decision support systems (DSS), and task specific experience mediated AB, as did attitudinal driving factors such as trust and confidence. Environmental mediators included workload, task complexity, and time constraint, which pressurized cognitive resources. Mitigators of AB included implementation factors such as training and emphasizing user accountability, and DSS design factors such as the position of advice on the screen, updated confidence levels attached to DSS output, and the provision of information versus recommendation. By uncovering the mechanisms by which AB operates, this review aims to help optimize the clinical decision-making process for CDSS developers and healthcare practitioners.

Bayesian methods to estimate urban growth potential

USGS Publications Warehouse

Smith, Jordan W.; Smart, Lindsey S.; Dorning, Monica; Dupéy, Lauren Nicole; Méley, Andréanne; Meentemeyer, Ross K.

2017-01-01

Urban growth often influences the production of ecosystem services. The impacts of urbanization on landscapes can subsequently affect landowners’ perceptions, values and decisions regarding their land. Within land-use and land-change research, very few models of dynamic landscape-scale processes like urbanization incorporate empirically-grounded landowner decision-making processes. Very little attention has focused on the heterogeneous decision-making processes that aggregate to influence broader-scale patterns of urbanization. We examine the land-use tradeoffs faced by individual landowners in one of the United States’ most rapidly urbanizing regions − the urban area surrounding Charlotte, North Carolina. We focus on the land-use decisions of non-industrial private forest owners located across the region’s development gradient. A discrete choice experiment is used to determine the critical factors influencing individual forest owners’ intent to sell their undeveloped properties across a series of experimentally varied scenarios of urban growth. Data are analyzed using a hierarchical Bayesian approach. The estimates derived from the survey data are used to modify a spatially-explicit trend-based urban development potential model, derived from remotely-sensed imagery and observed changes in the region’s socioeconomic and infrastructural characteristics between 2000 and 2011. This modeling approach combines the theoretical underpinnings of behavioral economics with spatiotemporal data describing a region’s historical development patterns. By integrating empirical social preference data into spatially-explicit urban growth models, we begin to more realistically capture processes as well as patterns that drive the location, magnitude and rates of urban growth.

At the Intersection of Faith, Culture, and Family Dynamics: A Complex Case of Refusal of Treatment for Childhood Cancer.

PubMed

Brown, Amy E Caruso

2017-01-01

Refusing treatment for potentially curable childhood cancers engenders much discussion and debate. I present a case in which the competent parents of a young Amish child with acute myeloid leukemia deferred authority for decision making to the child's maternal grandfather, who was vocal in his opposition to treatment. I analyze three related concerns that distinguish this case from other accounts of refused treatment. First, I place deference to grandparents as decision makers in the context of surrogate decision making more generally. Second, the maternal grandfather's ardent refusal of treatment and his rationale appeared to be inconsistent with the beliefs expressed by other family members and by members of the same Amish community, leading members of the medical team to question whether refusal of treatment should be treated differently when it appears to be based on the idiosyncratic beliefs of an individual rather than on community-wide values. Third, the medical team perceived tension and dissension between the nonverbal behavior of some family members and the verbal statements made by the maternal grandfather, leading the team to question the parents' true wishes and debate how to weigh nonverbal and indirect forms of communication. Finally, building upon the conclusions of these queries, I explore whether, if the child's prognosis was less favorable or if he were to relapse later, the maternal grandfather should have been permitted to drive a decision to refuse further treatment. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

Crimson Spotted Rainbowfish (Melanotaenia duboulayi) Change Their Spatial Position according to Nutritional Requirement

PubMed Central

Hansen, M. J.; Schaerf, T. M.; Krause, J.; Ward, A. J. W.

2016-01-01

Decision making in moving animal groups has been shown to be disproportionately influenced by individuals at the front of groups. Therefore, an explanation of state-dependent positioning of individuals within animal groups may provide a mechanism for group movement decisions. Nutritional state is dynamic and can differ between members of the same group. It is also known to drive animal movement decisions. Therefore, we assayed 6 groups of 8 rainbowfish foraging in a flow tank. Half of the fish had been starved for 24h and half had been fed 1h prior to experimental start. Groups were assayed again one week later but individuals were allocated to the opposite nutritional treatment. During the assay the positions of individually identified fish were recorded as were the number of food items they each ate and the position within the group they acquired them from. Food-deprived fish were more often found towards the front of the shoal; the mean weighted positional score of food-deprived fish was significantly larger than that of well-fed fish. Individuals were not consistent in their position within a shoal between treatments. There was a significant positive correlation between mean weighted positional score and number of food items acquired which displays an obvious benefit to front positions. These results suggest that positional preferences are based on nutritional state and provide a mechanism for state-dependent influence on group decision-making as well as increasing our understanding of what factors are important for group functioning. PMID:26849566

Holding On and Letting Go: The Perspectives of Pre-Seniors and Seniors on Driving Self-Regulation in Later Life

ERIC Educational Resources Information Center

Rudman, Deborah Laliberte; Friedland, Judith; Chipman, Mary; Sciortino, Paola

2006-01-01

Although decisions related to driving are vital to well-being in later life, little is known about how aging drivers who do not experience a medical condition that requires driving cessation regulate their driving. This exploratory, qualitative study used focus groups with 79 such community-dwelling individuals to examine driving self-regulation…

Association between unsafe driving performance and cognitive-perceptual dysfunction in older drivers.

PubMed

Park, Si-Woon; Choi, Eun Seok; Lim, Mun Hee; Kim, Eun Joo; Hwang, Sung Il; Choi, Kyung-In; Yoo, Hyun-Chul; Lee, Kuem Ju; Jung, Hi-Eun

2011-03-01

To find an association between cognitive-perceptual problems of older drivers and unsafe driving performance during simulated automobile driving in a virtual environment. Cross-sectional study. A driver evaluation clinic in a rehabilitation hospital. Fifty-five drivers aged 65 years or older and 48 drivers in their late twenties to early forties. All participants underwent evaluation of cognitive-perceptual function and driving performance, and the results were compared between older and younger drivers. The association between cognitive-perceptual function and driving performance was analyzed. Cognitive-perceptual function was evaluated with the Cognitive Perceptual Assessment for Driving (CPAD), a computer-based assessment tool consisting of depth perception, sustained attention, divided attention, the Stroop test, the digit span test, field dependency, and trail-making test A and B. Driving performance was evaluated with use of a virtual reality-based driving simulator. During simulated driving, car crashes were recorded, and an occupational therapist observed unsafe performances in controlling speed, braking, steering, vehicle positioning, making lane changes, and making turns. Thirty-five older drivers did not pass the CPAD test, whereas all of the younger drivers passed the test. When using the driving simulator, a significantly greater number of older drivers experienced car crashes and demonstrated unsafe performance in controlling speed, steering, and making lane changes. CPAD results were associated with car crashes, steering, vehicle positioning, and making lane changes. Older drivers who did not pass the CPAD test are 4 times more likely to experience a car crash, 3.5 times more likely to make errors in steering, 2.8 times more likely to make errors in vehicle positioning, and 6.5 times more likely to make errors in lane changes than are drivers who passed the CPAD test. Unsafe driving performance and car crashes during simulated driving were more prevalent in older drivers than in younger drivers. Unsafe performance in steering, vehicle positioning, making lane changes, and car crashes were associated with cognitive-perceptual dysfunction. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Dynamics of Metabolism and Decision Making During Alcohol Consumption: Modeling and Analysis.

PubMed

Giraldo, Luis Felipe; Passino, Kevin M; Clapp, John D; Ruderman, Danielle

2017-11-01

Heavy alcohol consumption is considered an important public health issue in the United States as over 88 000 people die every year from alcohol-related causes. Research is being conducted to understand the etiology of alcohol consumption and to develop strategies to decrease high-risk consumption and its consequences, but there are still important gaps in determining the main factors that influence the consumption behaviors throughout the drinking event. There is a need for methodologies that allow us not only to identify such factors but also to have a comprehensive understanding of how they are connected and how they affect the dynamical evolution of a drinking event. In this paper, we use previous empirical findings from laboratory and field studies to build a mathematical model of the blood alcohol concentration dynamics in individuals that are in drinking events. We characterize these dynamics as the result of the interaction between a decision-making system and the metabolic process for alcohol. We provide a model of the metabolic process for arbitrary alcohol intake patterns and a characterization of the mechanisms that drive the decision-making process of a drinker during the drinking event. We use computational simulations and Lyapunov stability theory to analyze the effects of the parameters of the model on the blood alcohol concentration dynamics that are characterized. Also, we propose a methodology to inform the model using data collected in situ and to make estimations that provide additional information to the analysis. We show how this model allows us to analyze and predict previously observed behaviors, to design new approaches for the collection of data that improves the construction of the model, and help with the design of interventions.

The impact of sleep disorders on driving safety-findings from the Second Strategic Highway Research Program naturalistic driving study.

PubMed

Liu, Shu-Yuan; Perez, Miguel A; Lau, Nathan

2018-04-01

This study investigated the association between driving safety and seven sleep disorders amongst 3541 participants of the Second Strategic Highway Research Program (SHRP 2) naturalistic driving study. SHRP 2 collected naturalistic driving data from participants between 16 and 98 years old by instrumenting participants' vehicles. The analyses used logistic regression to determine the likelihood of crash or near-crash involvement, Poisson log-linear regression to assess crash or near-crash rate, and ordinal logistic regression to assess driver maneuver appropriateness and crash or near-crash severity. These analyses did not account for any medical treatments for the sleep disorders. Females with restless legs syndrome/Willis-Ekbom disease (RLS/WED), drivers with insomnia or narcolepsy, are associated with significantly higher risk of crash or near-crash. Drivers with shift work sleep disorder (SWSD) are associated with significantly increased crash or near-crash rate. Females with RLS/WED or sleep apnea and drivers with SWSD are associated with less safe driver maneuver and drivers with periodic limb movement disorder are associated with more severe events. The four analyses provide no evidence of safety decrements associated with migraine. This study is the first examination on the association between seven sleep disorders and different measures of driving risk using large-scale naturalistic driving study data. The results corroborate much of the existing simulator and epidemiological research related to sleep-disorder patients and their driving safety, but add ecological validity to those findings. These results contribute to the empirical basis for medical professionals, policy makers, and employers in making decisions to aid individuals with sleep disorders in balancing safety and personal mobility.

Driving with indirect viewing sensors: understanding the visual perception issues

NASA Astrophysics Data System (ADS)

O'Kane, Barbara L.

1996-05-01

Visual perception is one of the most important elements of driving in that it enables the driver to understand and react appropriately to the situation along the path of the vehicle. The visual perception of the driver is enabled to the greatest extent while driving during the day. Noticeable decrements in visual acuity, range of vision, depth of field and color perception occur at night and under certain weather conditions. Indirect viewing sensors, utilizing various technologies and spectral bands, may assist the driver's normal mode of driving. Critical applications in the military as well as other official activities may require driving at night without headlights. In these latter cases, it is critical that the device, being the only source of scene information, provide the required scene cues needed for driving on, and often-times, off road. One can speculate about the scene information that a driver needs, such as road edges, terrain orientation, people and object detection in or near the path of the vehicle, and so on. But the perceptual qualities of the scene that give rise to these perceptions are little known and thus not quantified for evaluation of indirect viewing devices. This paper discusses driving with headlights and compares the scene content with that provided by a thermal system in the 8 - 12 micrometers micron spectral band, which may be used for driving at some time. The benefits and advantages of each are discussed as well as their limitations in providing information useful for the driver who must make rapid and critical decisions based upon the scene content available. General recommendations are made for potential avenues of development to overcome some of these limitations.

Defense Acquisitions: Future Aerostat and Airship Investment Decisions Drive Oversight and Coordination Needs

DTIC Science & Technology

2012-10-01

earlier, LEMV experienced schedule delays of at least 10 months, largely rooted in technical, design, and engineering problems in scaling up the airship ...had informal coordination with the Blue Devil Block 2 effort in the past. For example, originally both airships had several diesel engine ...DEFENSE ACQUISITIONS Future Aerostat and Airship Investment Decisions Drive Oversight and Coordination Needs

Survey of Argentine Health Researchers on the Use of Evidence in Policymaking

PubMed Central

Corluka, Adrijana; Hyder, Adnan A.; Segura, Elsa; Winch, Peter; McLean, Robert K. D.

2015-01-01

Objective In this study, Argentine health researchers were surveyed regarding their perceptions of facilitators and barriers to evidence-based policymaking in Argentina, as well as their publication activities, and research environment satisfaction. Methods A self-administered online survey was sent to health researchers in Argentina. The survey questions were based on a preceding qualitative study of Argentine health researchers, as well as the scientific literature. Results Of the 647 researchers that were reached, 226 accessed the survey, for a response rate of 34.9%. Over 80% of researchers surveyed had never been involved in or contributed to decision-making, while over 90% of researchers indicated they would like to be involved in the decision-making process. Decision-maker self-interest was perceived to be the driving factor in the development of health and healthcare policies. Research conducted by a research leader was seen to be the most influential factor in influencing health policy, followed by policy relevance of the research. With respect to their occupational environment, researchers rated highest and most favourably the opportunities available to present, discuss and publish research results and their ability to further their education and training. Argentine researchers surveyed demonstrated a strong interest and willingness to contribute their work and expertise to inform Argentine health policy development. Conclusion Despite Argentina’s long scientific tradition, there are relatively few institutionalized linkages between health research results and health policymaking. Based on the results of this study, the disconnect between political decision-making and the health research system, coupled with fewer opportunities for formalized or informal researcher/decision-maker interaction, contribute to the challenges in evidence informing health policymaking in Argentina. Improving personal contact and the building of relationships between researchers and policymakers in Argentina will require taking into account researcher perceptions of policymakers, as highlighted in this study. PMID:25928292

Simulation modelling as a tool for knowledge mobilisation in health policy settings: a case study protocol.

PubMed

Freebairn, L; Atkinson, J; Kelly, P; McDonnell, G; Rychetnik, L

2016-09-21

Evidence-informed decision-making is essential to ensure that health programs and services are effective and offer value for money; however, barriers to the use of evidence persist. Emerging systems science approaches and advances in technology are providing new methods and tools to facilitate evidence-based decision-making. Simulation modelling offers a unique tool for synthesising and leveraging existing evidence, data and expert local knowledge to examine, in a robust, low risk and low cost way, the likely impact of alternative policy and service provision scenarios. This case study will evaluate participatory simulation modelling to inform the prevention and management of gestational diabetes mellitus (GDM). The risks associated with GDM are well recognised; however, debate remains regarding diagnostic thresholds and whether screening and treatment to reduce maternal glucose levels reduce the associated risks. A diagnosis of GDM may provide a leverage point for multidisciplinary lifestyle modification interventions. This research will apply and evaluate a simulation modelling approach to understand the complex interrelation of factors that drive GDM rates, test options for screening and interventions, and optimise the use of evidence to inform policy and program decision-making. The study design will use mixed methods to achieve the objectives. Policy, clinical practice and research experts will work collaboratively to develop, test and validate a simulation model of GDM in the Australian Capital Territory (ACT). The model will be applied to support evidence-informed policy dialogues with diverse stakeholders for the management of GDM in the ACT. Qualitative methods will be used to evaluate simulation modelling as an evidence synthesis tool to support evidence-based decision-making. Interviews and analysis of workshop recordings will focus on the participants' engagement in the modelling process; perceived value of the participatory process, perceived commitment, influence and confidence of stakeholders in implementing policy and program decisions identified in the modelling process; and the impact of the process in terms of policy and program change. The study will generate empirical evidence on the feasibility and potential value of simulation modelling to support knowledge mobilisation and consensus building in health settings.

Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting.

PubMed

Harris, Claire; Allen, Kelly; King, Richard; Ramsey, Wayne; Kelly, Cate; Thiagarajan, Malar

2017-05-05

This is the second in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. Rising healthcare costs, continuing advances in health technologies and recognition of ineffective practices and systematic waste are driving disinvestment of health technologies and clinical practices that offer little or no benefit in order to maximise outcomes from existing resources. However there is little information to guide regional health services or individual facilities in how they might approach disinvestment locally. This paper outlines the investigation of potential settings and methods for decision-making about disinvestment in the context of an Australian health service. Methods include a literature review on the concepts and terminology relating to disinvestment, a survey of national and international researchers, and interviews and workshops with local informants. A conceptual framework was drafted and refined with stakeholder feedback. There is a lack of common terminology regarding definitions and concepts related to disinvestment and no guidance for an organisation-wide systematic approach to disinvestment in a local healthcare service. A summary of issues from the literature and respondents highlight the lack of theoretical knowledge and practical experience and provide a guide to the information required to develop future models or methods for disinvestment in the local context. A conceptual framework was developed. Three mechanisms that provide opportunities to introduce disinvestment decisions into health service systems and processes were identified. Presented in order of complexity, time to achieve outcomes and resources required they include 1) Explicit consideration of potential disinvestment in routine decision-making, 2) Proactive decision-making about disinvestment driven by available evidence from published research and local data, and 3) Specific exercises in priority setting and system redesign. This framework identifies potential opportunities to initiate disinvestment activities in a systematic integrated approach that can be applied across a whole organisation using transparent, evidence-based methods. Incorporating considerations for disinvestment into existing decision-making systems and processes might be achieved quickly with minimal cost; however establishment of new systems requires research into appropriate methods and provision of appropriate skills and resources to deliver them.

Development of deep drawn aluminum piston tanks

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

Whitehead, J.C.; Bronder, R.L.; Kilgard, L.W.

1990-06-08

An aluminum piston tank has been developed for applications requiring lightweight, low cost, low pressure, positive-expulsion liquid storage. The 3 liter (183 in{sup 3}) vessel is made primarily from aluminum sheet, using production forming and joining operations. The development process relied mainly on pressurizing prototype parts and assemblies to failure, as the primary source of decision making information for driving the tank design toward its optimum minimum-mass configuration. Critical issues addressed by development testing included piston operation, strength of thin-walled formed shells, alloy choice, and joining the end cap to the seamless deep drawn can. 9 refs., 8 figs.

Consumer Health Informatics--integrating patients, providers, and professionals online.

PubMed

Klein-Fedyshin, Michele S

2002-01-01

Consumer Health Informatics (CHI) means different things to patients, health professionals, and health care systems. A broader perspective on this new and rapidly developing field will enable us to understand and better apply its advances. This article provides an overview of CHI discussing its evolution and driving forces, along with advanced applications such as Personal Health Records, Internet transmission of personal health data, clinical e-mail, online pharmacies, and shared decision-making tools. Consumer Health Informatics will become integrated with medical care, electronic medical records, and patient education to impact the whole process and business of health care.

Driving Decisions and Vehicle Crashes Among Older Drivers

DOT National Transportation Integrated Search

1995-07-01

American society is undergoing a major demographic transformation. A larger proportion of the population is becoming older and an increasing number of older individuals are licensed to drive and they drive more than their age cohorts a decade ago. Th...

Driving and Dementia of the Alzheimer Type: Beliefs and Cessation Strategies among Stakeholders

ERIC Educational Resources Information Center

Perkinson, Margaret A.; Berg-Weger, Marla L.; Carr, David B.; Meuser, Thomas M.; Palmer, Janice L.; Buckles, Virginia D.; Powlishta, Kimberly K.; Foley, Daniel J.; Morris, John C.

2005-01-01

Purpose: Although driving by persons with Alzheimer's disease (AD) is an important public health concern, we know little about the attitudes and perceptions of key stakeholders regarding driving safety in these individuals or the factors that precipitate and influence driving assessment and cessation decisions. Design and Methods: We convened 10…

Driving and off-road impairments underlying failure on road testing in Parkinson's disease.

PubMed

Devos, Hannes; Vandenberghe, Wim; Tant, Mark; Akinwuntan, Abiodun E; De Weerdt, Willy; Nieuwboer, Alice; Uc, Ergun Y

2013-12-01

Parkinson's disease (PD) affects driving ability. We aimed to determine the most critical impairments in specific road skills and in clinical characteristics leading to failure on a road test in PD. In this cross-sectional study, certified driving assessment experts evaluated specific driving skills in 104 active, licensed drivers with PD using a standardized, on-road checklist and issued a global decision of pass/fail. Participants also completed an off-road evaluation assessing demographic features, disease characteristics, motor function, vision, and cognition. The most important driving skills and off-road predictors of the pass/fail outcome were identified using multivariate stepwise regression analyses. Eighty-six (65%) passed and 36 (35%) failed the on-road driving evaluation. Persons who failed performed worse on all on-road items. When adjusted for age and gender, poor performances on lateral positioning at low speed, speed adaptations at high speed, and left turning maneuvers yielded the best model that determined the pass/fail decision (R(2) = 0.56). The fail group performed poorer on all motor, visual, and cognitive tests. Measures of visual scanning, motor severity, PD subtype, visual acuity, executive functions, and divided attention were independent predictors of pass/fail decisions in the multivariate model (R(2) = 0.60). Our study demonstrated that failure on a road test in PD is determined by impairments in specific driving skills and associated with deficits in motor, visual, executive, and visuospatial functions. These findings point to specific driving and off-road impairments that can be targeted in multimodal rehabilitation programs for drivers with PD. © 2013 Movement Disorder Society.

Improving decision making in crisis.

PubMed

Higgins, Guy; Freedman, Jennifer

2013-01-01

The most critical activity during emergencies or crises is making decisions about what to do next. This paper provides insights into the challenges that people face in making decisions at any time, but particularly during emergencies and crises. It also introduces the reader to the concept of different sense-making/decision-making domains, the human behaviours that can adversely affect decision making - decision derailers - and ways in which emergency responders can leverage this knowledge to make better decisions. While the literature on decision making is extensive, this paper is focused on those aspects that apply particularly to decision making in emergencies or times of crisis.

High-Resolution Climate Data Visualization through GIS- and Web-based Data Portals

NASA Astrophysics Data System (ADS)

WANG, X.; Huang, G.

2017-12-01

Sound decisions on climate change adaptation rely on an in-depth assessment of potential climate change impacts at regional and local scales, which usually requires finer resolution climate projections at both spatial and temporal scales. However, effective downscaling of global climate projections is practically difficult due to the lack of computational resources and/or long-term reference data. Although a large volume of downscaled climate data has been make available to the public, how to understand and interpret the large-volume climate data and how to make use of the data to drive impact assessment and adaptation studies are still challenging for both impact researchers and decision makers. Such difficulties have become major barriers preventing informed climate change adaptation planning at regional scales. Therefore, this research will explore new GIS- and web-based technologies to help visualize the large-volume regional climate data with high spatiotemporal resolutions. A user-friendly public data portal, named Climate Change Data Portal (CCDP, http://ccdp.network), will be established to allow intuitive and open access to high-resolution regional climate projections at local scales. The CCDP offers functions of visual representation through geospatial maps and data downloading for a variety of climate variables (e.g., temperature, precipitation, relative humidity, solar radiation, and wind) at multiple spatial resolutions (i.e., 25 - 50 km) and temporal resolutions (i.e., annual, seasonal, monthly, daily, and hourly). The vast amount of information the CCDP encompasses can provide a crucial basis for assessing impacts of climate change on local communities and ecosystems and for supporting better decision making under a changing climate.

Patient-Centered Imaging: Shared Decision Making for Cardiac Imaging Procedures with Exposure to Ionizing Radiation

PubMed Central

Einstein, Andrew J.; Berman, Daniel S.; Min, James K.; Hendel, Robert C.; Gerber, Thomas C.; Carr, J. Jeffrey; Cerqueira, Manuel D.; Cullom, S. James; DeKemp, Robert; Dickert, Neal; Dorbala, Sharmila; Garcia, Ernest V.; Gibbons, Raymond J.; Halliburton, Sandra S.; Hausleiter, Jörg; Heller, Gary V.; Jerome, Scott; Lesser, John R.; Fazel, Reza; Raff, Gilbert L.; Tilkemeier, Peter; Williams, Kim A.; Shaw, Leslee J.

2014-01-01

Objective To identify key components of a radiation accountability framework fostering patient-centered imaging and shared decision-making in cardiac imaging. Background An NIH-NHLBI/NCI-sponsored symposium was held in November 2012 to address these issues. Methods Symposium participants, working in three tracks, identified key components of a framework to target critical radiation safety issues for the patient, the laboratory, and the larger population of patients with known or suspected cardiovascular disease. Results Use of ionizing radiation during an imaging procedure should be disclosed to all patients by the ordering provider at the time of ordering, and reinforced by the performing provider team. An imaging protocol with effective dose ≤3mSv is considered very low risk, not warranting extensive discussion or written consent. However, a protocol effective dose <20mSv was proposed as a level requiring particular attention in terms of shared decision-making and either formal discussion or written informed consent. Laboratory reporting of radiation dosimetry is a critical component of creating a quality laboratory fostering a patient-centered environment with transparent procedural methodology. Efforts should be directed to avoiding testing involving radiation, in patients with inappropriate indications. Standardized reporting and diagnostic reference levels for computed tomography and nuclear cardiology are important for the goal of public reporting of laboratory radiation dose levels in conjunction with diagnostic performance. Conclusions The development of cardiac imaging technologies revolutionized cardiology practice by allowing routine, noninvasive assessment of myocardial perfusion and anatomy. It is now incumbent upon the imaging community to create an accountability framework to safely drive appropriate imaging utilization. PMID:24530677

Neuropsychological sex differences associated with age of initiated use among young adult cannabis users.

PubMed

Crane, Natania A; Schuster, Randi Melissa; Mermelstein, Robin J; Gonzalez, Raul

2015-01-01

Earlier initiation of cannabis use is associated with poorer neuropsychological functioning across several domains. Given well-documented sex differences in neuromaturation during adolescence, initiation of cannabis use during this time may affect neuropsychological functioning differently for males and females. In the current study, we examined sex differences in the relationship between age of initiated cannabis use and neuropsychological performance after controlling for amount of lifetime cannabis use in 44 male and 25 female young adult cannabis users. We found that an earlier age of initiated use was related to poorer episodic memory, especially immediate recall, in females, but not in males. On the other hand, we found that, surprisingly, an earlier age of initiated use was associated with better decision making overall. However, exploratory analyses found sex-specific factors associated with decision making and age of initiated use, specifically that attention-deficit/hyperactivity disorder (ADHD) symptoms in females may drive the relationship between an earlier age of initiated use and better decision making. Further, an earlier age of initiated use was associated with less education, a lower IQ, and fewer years of mother's education for females, but more lifetime cannabis use for males. Taken together, our findings suggest there are sex differences in the associations between age of initiated cannabis use and neuropsychological functioning. The current study provides preliminary evidence that males and females may have different neuropsychological vulnerabilities that place them at risk for initiating cannabis use and continued cannabis use, highlighting the importance of examining the impact of cannabis on neuropsychological functioning separately for males and females.

The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

PubMed

Bern-Klug, Mercedes

2008-01-01

Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

Water Resource Planning Under Future Climate and Socioeconomic Uncertainty in the Cauvery River Basin in Karnataka, India.

PubMed

Bhave, Ajay Gajanan; Conway, Declan; Dessai, Suraje; Stainforth, David A

2018-02-01

Decision-Making Under Uncertainty (DMUU) approaches have been less utilized in developing countries than developed countries for water resources contexts. High climate vulnerability and rapid socioeconomic change often characterize developing country contexts, making DMUU approaches relevant. We develop an iterative multi-method DMUU approach, including scenario generation, coproduction with stakeholders and water resources modeling. We apply this approach to explore the robustness of adaptation options and pathways against future climate and socioeconomic uncertainties in the Cauvery River Basin in Karnataka, India. A water resources model is calibrated and validated satisfactorily using observed streamflow. Plausible future changes in Indian Summer Monsoon (ISM) precipitation and water demand are used to drive simulations of water resources from 2021 to 2055. Two stakeholder-identified decision-critical metrics are examined: a basin-wide metric comprising legal instream flow requirements for the downstream state of Tamil Nadu, and a local metric comprising water supply reliability to Bangalore city. In model simulations, the ability to satisfy these performance metrics without adaptation is reduced under almost all scenarios. Implementing adaptation options can partially offset the negative impacts of change. Sequencing of options according to stakeholder priorities into Adaptation Pathways affects metric satisfaction. Early focus on agricultural demand management improves the robustness of pathways but trade-offs emerge between intrabasin and basin-wide water availability. We demonstrate that the fine balance between water availability and demand is vulnerable to future changes and uncertainty. Despite current and long-term planning challenges, stakeholders in developing countries may engage meaningfully in coproduction approaches for adaptation decision-making under deep uncertainty.

Considerations for Reporting Finite Element Analysis Studies in Biomechanics

PubMed Central

Erdemir, Ahmet; Guess, Trent M.; Halloran, Jason; Tadepalli, Srinivas C.; Morrison, Tina M.

2012-01-01

Simulation-based medicine and the development of complex computer models of biological structures is becoming ubiquitous for advancing biomedical engineering and clinical research. Finite element analysis (FEA) has been widely used in the last few decades to understand and predict biomechanical phenomena. Modeling and simulation approaches in biomechanics are highly interdisciplinary, involving novice and skilled developers in all areas of biomedical engineering and biology. While recent advances in model development and simulation platforms offer a wide range of tools to investigators, the decision making process during modeling and simulation has become more opaque. Hence, reliability of such models used for medical decision making and for driving multiscale analysis comes into question. Establishing guidelines for model development and dissemination is a daunting task, particularly with the complex and convoluted models used in FEA. Nonetheless, if better reporting can be established, researchers will have a better understanding of a model’s value and the potential for reusability through sharing will be bolstered. Thus, the goal of this document is to identify resources and considerate reporting parameters for FEA studies in biomechanics. These entail various levels of reporting parameters for model identification, model structure, simulation structure, verification, validation, and availability. While we recognize that it may not be possible to provide and detail all of the reporting considerations presented, it is possible to establish a level of confidence with selective use of these parameters. More detailed reporting, however, can establish an explicit outline of the decision-making process in simulation-based analysis for enhanced reproducibility, reusability, and sharing. PMID:22236526

Strategies for promoting equity: experience with community financing in three African countries.

PubMed

Gilson, L; Kalyalya, D; Kuchler, F; Lake, S; Oranga, H; Ouendo, M

2001-10-01

Although the need for a pro-poor health reform agenda in low and middle income countries is increasingly clear, implementing such policy change is always difficult. This paper seeks to contribute to thinking about how to take forward such an agenda by reflection on the community financing activities of the UNICEF/WHO Bamako Initiative. It presents findings from a three-country study, undertaken in Benin, Kenya and Zambia in 1994/95, which was initiated in order to better understand the nature of the equity impact of community financing activities as well as the factors underlying this impact. The sustained relative affordability gains achieved in Benin emphasise the importance of ensuring that financing change is used as a policy lever for strengthening health service management in support of quality of care improvements. All countries, however, failed in protecting the most poor from the burden of payment, benefiting this group preferentially and ensuring that their views were heard in decision-making. Tackling these problems requires, amongst other things, an appropriate balance between central and local-level decision-making as well as the creation of local decision-making structures which have representation from civil society groups that can voice the needs of the most poor. Leadership, strategy and tactics are also always important in securing any kind of equity gain-such as establishing equity goals to drive implementation. In the experiences examined, the dominance of the goal of financial sustainability contributed to their equity failures. Further research is required to understand what equity goals communities themselves would prefer to guide financing policy.

The ventral hippocampus, but not the dorsal hippocampus is critical for learned approach-avoidance decision making.

PubMed

Schumacher, Anett; Vlassov, Ekaterina; Ito, Rutsuko

2016-04-01

The resolution of an approach-avoidance conflict induced by ambivalent information involves the appraisal of the incentive value of the outcomes and associated stimuli to orchestrate an appropriate behavioral response. Much research has been directed at delineating the neural circuitry underlying approach motivation and avoidance motivation separately. Very little research, however, has examined the neural substrates engaged at the point of decision making when opposing incentive motivations are experienced simultaneously. We hereby examine the role of the dorsal and ventral hippocampus (HPC) in a novel approach-avoidance decision making paradigm, revisiting a once popular theory of HPC function, which posited the HPC to be the driving force of a behavioral inhibition system that is activated in situations of imminent threat. Rats received pre-training excitotoxic lesions of the dorsal or ventral HPC, and were trained to associate different non-spatial cues with appetitive, aversive and neutral outcomes in three separate arms of the radial maze. On the final day of testing, a state of approach-avoidance conflict was induced by simultaneously presenting two cues of opposite valences, and comparing the time the rats spent interacting with the superimposed 'conflict' cue, and the neutral cue. The ventral HPC-lesioned group showed significant preference for the conflict cue over the neutral cue, compared to the dorsal HPC-lesioned, and control groups. Thus, we provide evidence that the ventral, but not dorsal HPC, is a crucial component of the neural circuitry concerned with exerting inhibitory control over approach tendencies under circumstances in which motivational conflict is experienced. © 2015 Wiley Periodicals, Inc.

Water Resource Planning Under Future Climate and Socioeconomic Uncertainty in the Cauvery River Basin in Karnataka, India

NASA Astrophysics Data System (ADS)

Bhave, Ajay Gajanan; Conway, Declan; Dessai, Suraje; Stainforth, David A.

2018-02-01

Decision-Making Under Uncertainty (DMUU) approaches have been less utilized in developing countries than developed countries for water resources contexts. High climate vulnerability and rapid socioeconomic change often characterize developing country contexts, making DMUU approaches relevant. We develop an iterative multi-method DMUU approach, including scenario generation, coproduction with stakeholders and water resources modeling. We apply this approach to explore the robustness of adaptation options and pathways against future climate and socioeconomic uncertainties in the Cauvery River Basin in Karnataka, India. A water resources model is calibrated and validated satisfactorily using observed streamflow. Plausible future changes in Indian Summer Monsoon (ISM) precipitation and water demand are used to drive simulations of water resources from 2021 to 2055. Two stakeholder-identified decision-critical metrics are examined: a basin-wide metric comprising legal instream flow requirements for the downstream state of Tamil Nadu, and a local metric comprising water supply reliability to Bangalore city. In model simulations, the ability to satisfy these performance metrics without adaptation is reduced under almost all scenarios. Implementing adaptation options can partially offset the negative impacts of change. Sequencing of options according to stakeholder priorities into Adaptation Pathways affects metric satisfaction. Early focus on agricultural demand management improves the robustness of pathways but trade-offs emerge between intrabasin and basin-wide water availability. We demonstrate that the fine balance between water availability and demand is vulnerable to future changes and uncertainty. Despite current and long-term planning challenges, stakeholders in developing countries may engage meaningfully in coproduction approaches for adaptation decision-making under deep uncertainty.

Prefrontal Dopamine D1 and D2 Receptors Regulate Dissociable Aspects of Decision Making via Distinct Ventral Striatal and Amygdalar Circuits.

PubMed

Jenni, Nicole L; Larkin, Joshua D; Floresco, Stan B

2017-06-28

Mesocortical dopamine (DA) regulates a variety of cognitive functions via actions on D 1 and/or D 2 receptors. For example, risk/reward decision making is modulated differentially by these two receptors within the prefrontal cortex (PFC), with D 2 receptors enabling flexible decision making and D 1 receptors promoting persistence in choice biases. However, it is unclear how DA mediates opposing patterns of behavior by acting on different receptors within the same terminal region. We explored the possibility that DA may act on separate networks of PFC neurons that are modulated by D 1 or D 2 receptors and in turn interface with divergent downstream structures such as the basolateral amygdala (BLA) or nucleus accumbens (NAc). Decision making was assessed using a probabilistic discounting task in which well trained male rats chose between small/certain or large/risky rewards, with the odds of obtaining the larger reward changing systematically within a session. Selective disruption of D 1 or D 2 modulation of separate PFC output pathways was achieved using unilateral intra-PFC infusions of DA antagonists combined with contralateral inactivation of the BLA or NAc. Disrupting D 2 (but not D 1 ) modulation of PFC→BLA circuitry impaired adjustments in decision biases in response to changes in reward probabilities. In contrast, disrupting D 1 modulation of PFC→NAc networks reduced risky choice, attenuating reward sensitivity and increasing sensitivity to reward omissions. These findings reveal that mesocortical DA can facilitate dissociable components of reward seeking and action selection by acting on different functional networks of PFC neurons that can be distinguished by the subcortical projection targets with which they interface. SIGNIFICANCE STATEMENT Prefrontal cortical dopamine regulates a variety of executive functions governed by the frontal lobes via actions on D 1 and D 2 receptors. These receptors can in some instances mediate different patterns of behavior, but the mechanisms underlying these dissociable actions are unclear. Using a selective disconnection approach, we reveal that D 1 and D 2 receptors can facilitate diverse aspects of decision making by acting on separate networks of prefrontal neurons that interface with distinct striatal or amygdalar targets. These findings reveal an additional level of complexity in how mesocortical DA regulates different forms of cognition via actions on different receptors, highlighting how it may act upon distinct cortical microcircuits to drive different patterns of behavior. Copyright © 2017 the authors 0270-6474/17/376200-14$15.00/0.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

Navigating Monogamy: Nonapeptide Sensitivity in a Memory Neural Circuit May Shape Social Behavior and Mating Decisions

PubMed Central

Ophir, Alexander G.

2017-01-01

The role of memory in mating systems is often neglected despite the fact that most mating systems are defined in part by how animals use space. Monogamy, for example, is usually characterized by affiliative (e.g., pairbonding) and defensive (e.g., mate guarding) behaviors, but a high degree of spatial overlap in home range use is the easiest defining feature of monogamous animals in the wild. The nonapeptides vasopressin and oxytocin have been the focus of much attention for their importance in modulating social behavior, however this work has largely overshadowed their roles in learning and memory. To date, the understanding of memory systems and mechanisms governing social behavior have progressed relatively independently. Bridging these two areas will provide a deeper appreciation for understanding behavior, and in particular the mechanisms that mediate reproductive decision-making. Here, I argue that the ability to mate effectively as monogamous individuals is linked to the ability to track conspecifics in space. I discuss the connectivity across some well-known social and spatial memory nuclei, and propose that the nonapeptide receptors within these structures form a putative “socio-spatial memory neural circuit.” This purported circuit may function to integrate social and spatial information to shape mating decisions in a context-dependent fashion. The lateral septum and/or the nucleus accumbens, and neuromodulation therein, may act as an intermediary to relate socio-spatial information with social behavior. Identifying mechanisms responsible for relating information about the social world with mechanisms mediating mating tactics is crucial to fully appreciate the suite of factors driving reproductive decisions and social decision-making. PMID:28744194

Factors influencing older people's experiences of participation in autonomous decisions concerning their daily care in their own homes: a review of the literature.

PubMed

Fjordside, Solveig; Morville, Annette

2016-12-01

To review the literature on how older people perceive opportunities and limitations with regard to participation in autonomous decisions concerning their daily care in their own homes. The perception of personal control plays a critical role in an older person's health and well-being. Little is known about factors that facilitate or hinder older people's autonomous decision-making in their own homes. The study has been carried out as a literature review. The following databases were used: CINAHL, PubMed, PsykInfo, Cochrane, SweMed, Embase. Research studies range from 2009 to 2014. The review includes 12 publications. Four core themes are generated: older person's autonomy in their own home; autonomy and relationship; the balance between autonomy and dependency; older people's autonomy and the organisation of home care. Older people have a strong inner drive to maintain autonomy in their own home. The autonomy is challenged when the person becomes increasingly dependent on help. The relationship with carers is of vital importance with regard to the person's ability to make autonomous decisions. The organisation of home care restricts older people' scope for autonomy. Older people's own perspectives on autonomous decisions can contribute to the ongoing debate about how nursing care can be developed with respect to their autonomy. Nursing care demands attention to an older person's desire for autonomy despite dependency. A framework for systematic ethical discussions among carers may improve awareness about factors that facilitate or hinder good personalised care. The organisation of nursing care needs to be shaped in line with best practice for older people. © 2016 John Wiley & Sons Ltd.

Effects of major-road vehicle speed and driver age and gender on left-turn gap acceptance.

PubMed

Yan, Xuedong; Radwan, Essam; Guo, Dahai

2007-07-01

Because the driver's gap-acceptance maneuver is a complex and risky driving behavior, it is a highly concerned topic for traffic safety and operation. Previous studies have mainly focused on the driver's gap acceptance decision itself but did not pay attention to the maneuver process and driving behaviors. Using a driving simulator experiment for left-turn gap acceptance at a stop-controlled intersection, this study evaluated the effects of major traffic speed and driver age and gender on gap acceptance behaviors. The experiment results illustrate relationships among drivers' left-turn gap decision, driver's acceleration rate, steering action, and the influence of the gap-acceptance maneuver on the vehicles in the major traffic stream. The experiment results identified an association between high crash risk and high traffic speed at stop-controlled intersections. The older drivers, especially older female drivers, displayed a conservative driving attitude as a compensation for reduced driving ability, but also showed to be the most vulnerable group for the relatively complex driving maneuvers.

Shared Decision-Making in the Management of Congenital Vascular Malformations.

PubMed

Horbach, Sophie E R; Ubbink, Dirk T; Stubenrouch, Fabienne E; Koelemay, Mark J W; van der Vleuten, Carine J M; Verhoeven, Bas H; Reekers, Jim A; Schultze Kool, Leo J; van der Horst, Chantal M A M

2017-03-01

In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters. In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making). Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores. Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.

Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.

PubMed

Gregory, Megan E; Sonesh, Shirley C; Feitosa, Jennifer; Benishek, Lauren E; Hughes, Ashley M; Salas, Eduardo

2017-09-01

Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.

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.

Responding to Nonwords in the Lexical Decision Task: Insights from the English Lexicon Project

PubMed Central

Yap, Melvin J.; Sibley, Daragh E.; Balota, David A.; Ratcliff, Roger; Rueckl, Jay

2014-01-01

Researchers have extensively documented how various statistical properties of words (e.g., word-frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, since a better specification of the mechanisms driving nonword responses may provide valuable insights into early lexical processes. In the present study, item-level and participant-level analyses were conducted on the trial-level lexical decision data for almost 37,000 nonwords in the English Lexicon Project in order to identify the influence of different psycholinguistic variables on nonword lexical decision performance, and to explore individual differences in how participants respond to nonwords. Item-level regression analyses reveal that nonword response time was positively correlated with number of letters, number of orthographic neighbors, number of affixes, and baseword number of syllables, and negatively correlated with Levenshtein orthographic distance and baseword frequency. Participant-level analyses also point to within- and between-session stability in nonword responses across distinct sets of items, and intriguingly reveal that higher vocabulary knowledge is associated with less sensitivity to some dimensions (e.g., number of letters) but more sensitivity to others (e.g., baseword frequency). The present findings provide well-specified and interesting new constraints for informing models of word recognition and lexical decision. PMID:25329078

The Impact of Menstrual Cycle Phase on Economic Choice and Rationality.

PubMed

Lazzaro, Stephanie C; Rutledge, Robb B; Burghart, Daniel R; Glimcher, Paul W

2016-01-01

It is well known that hormones affect both brain and behavior, but less is known about the extent to which hormones affect economic decision-making. Numerous studies demonstrate gender differences in attitudes to risk and loss in financial decision-making, often finding that women are more loss and risk averse than men. It is unclear what drives these effects and whether cyclically varying hormonal differences between men and women contribute to differences in economic preferences. We focus here on how economic rationality and preferences change as a function of menstrual cycle phase in women. We tested adherence to the Generalized Axiom of Revealed Preference (GARP), the standard test of economic rationality. If choices satisfy GARP then there exists a well-behaved utility function that the subject's decisions maximize. We also examined whether risk attitudes and loss aversion change as a function of cycle phase. We found that, despite large fluctuations in hormone levels, women are as technically rational in their choice behavior as their male counterparts at all phases of the menstrual cycle. However, women are more likely to choose risky options that can lead to potential losses while ovulating; during ovulation women are less loss averse than men and therefore more economically rational than men in this regard. These findings may have market-level implications: ovulating women more effectively maximize expected value than do other groups.

Susceptibility to social pressure following ventromedial prefrontal cortex damage.

PubMed

Chen, Kuan-Hua; Rusch, Michelle L; Dawson, Jeffrey D; Rizzo, Matthew; Anderson, Steven W

2015-11-01

Social pressure influences human behavior including risk taking, but the psychological and neural underpinnings of this process are not well understood. We used the human lesion method to probe the role of ventromedial prefrontal cortex (vmPFC) in resisting adverse social pressure in the presence of risk. Thirty-seven participants (11 with vmPFC damage, 12 with brain damage outside the vmPFC and 14 without brain damage) were tested in driving simulator scenarios requiring left-turn decisions across oncoming traffic with varying time gaps between the oncoming vehicles. Social pressure was applied by a virtual driver who honked aggressively from behind. Participants with vmPFC damage were more likely to select smaller and potentially unsafe gaps under social pressure, while gap selection by the comparison groups did not change under social pressure. Participants with vmPFC damage also showed prolonged elevated skin conductance responses (SCR) under social pressure. Comparison groups showed similar initial elevated SCR, which then declined prior to making left-turn decisions. The findings suggest that the vmPFC plays an important role in resisting explicit and immediately present social pressure with potentially negative consequences. The vmPFC appears to contribute to the regulation of emotional responses and the modulation of decision making to optimize long-term outcomes. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

The Impact of Menstrual Cycle Phase on Economic Choice and Rationality

PubMed Central

Lazzaro, Stephanie C.; Rutledge, Robb B.; Burghart, Daniel R.; Glimcher, Paul W.

2016-01-01

It is well known that hormones affect both brain and behavior, but less is known about the extent to which hormones affect economic decision-making. Numerous studies demonstrate gender differences in attitudes to risk and loss in financial decision-making, often finding that women are more loss and risk averse than men. It is unclear what drives these effects and whether cyclically varying hormonal differences between men and women contribute to differences in economic preferences. We focus here on how economic rationality and preferences change as a function of menstrual cycle phase in women. We tested adherence to the Generalized Axiom of Revealed Preference (GARP), the standard test of economic rationality. If choices satisfy GARP then there exists a well-behaved utility function that the subject’s decisions maximize. We also examined whether risk attitudes and loss aversion change as a function of cycle phase. We found that, despite large fluctuations in hormone levels, women are as technically rational in their choice behavior as their male counterparts at all phases of the menstrual cycle. However, women are more likely to choose risky options that can lead to potential losses while ovulating; during ovulation women are less loss averse than men and therefore more economically rational than men in this regard. These findings may have market-level implications: ovulating women more effectively maximize expected value than do other groups. PMID:26824245

Decision-making on shared sanitation in the informal settlements of Kisumu, Kenya.

PubMed

Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy

2017-10-01

Unlike most quantitative studies that investigate decision-making on investing in sanitation, this study adopted a qualitative approach to investigate decision-making on shared sanitation in the informal settlements of Kisumu city, in Kenya. Using a grounded theory approach, landlords and tenants were interviewed to identify sanitation decisions, individuals involved in decision-making and factors influencing decision-making. The results indicate that the main sanitation decisions are on investment, emptying, repair and cleaning. Landlords make investment, emptying and repair decisions, while tenants make cleaning decisions. Absentee landlords are less involved in most decision-making compared to live-in landlords, who rarely consult tenants in decision-making. Tenants make decisions after consultations with a third party and often collectively with other tenants. Sanitation interventions in informal settlements should thus, target landlords and tenants, with investment efforts being directed at landlords and maintenance efforts at tenants.

The money blind: how to stop industry bias in biomedical science, without violating the First Amendment.

PubMed

Robertson, Christopher T

2011-01-01

The pharmaceutical and medical device industries use billions of dollars to support the biomedical science that physicians, regulators, and patients use to make healthcare decisions--the decisions that drive an increasingly large portion of the American economy. Compelling evidence suggests that this industry money buys favorable results, biasing the outcomes of scientific research. Current efforts to manage the problem, including disclosure mandates and peer reviews, are ineffective. A blinding mechanism, operating through an intermediary such as the National Institutes of Health, could instead be developed to allow industry support of science without allowing undue influence. If the editors of biomedical journals fail to mandate that industry funders utilize such a solution, the federal government has several regulatory levers available, including conditioning federal funding and direct regulation, both of which could be done without violating the First Amendment.

The Future of Health Care Reform: What Is Driving Enrollment?

PubMed

Callaghan, Timothy H; Jacobs, Lawrence R

2017-04-01

Against a backdrop of ongoing operational challenges, insurance market turbulence, and the ever present pull of partisanship, enrollment in the ACA's programs has soared and significant variations have developed across states in terms of their pace of coverage expansion. Our article explores why ACA enrollment has varied so dramatically across states. We explore the potential influence of party control, presidential cueing, administrative capacity, the reverberating effects of ACA policy decisions, affluence, and unemployment on enrollment. Our multivariate analysis finds that party control dominated early state decision making, but that relative enrollment in insurance exchanges and the Medicaid expansion are driven by a changing mix of political and administrative factors. Health politics is entering a new era as Republicans replace the ACA and devolve significant discretion to states to administer Medicaid and other programs. Our findings offer insights into future directions in health reform and in learning and diffusion. Copyright © 2017 by Duke University Press.

The Impact of Alternative Payment Models on Oncology Innovation and Patient Care.

PubMed

Miller, Amy M; Omenn, Gilbert S; Kean, Marcia A

2016-05-15

Oncology care is in a time of major transformation. Scientific discovery is driving breakthroughs in prevention, diagnostics, and treatment, resulting in tremendous gains for patients as the number of cancer survivors continues to grow on an annual basis. At the same time, there is mounting pressure across the healthcare system to contain costs while improving the quality of cancer care. In response to this pressure, private and government payers are increasingly turning to tools such as alternative payment models (APM) and clinical pathways to improve the efficiency of care, inform coverage decisions, and support shared decision-making. As APMs, clinical pathways and other tools are utilized more broadly, it will be critical that these models support the evidence-based use of innovative biomedical advances, including personalized medicine, and deliver patient-centered, high-value care. Clin Cancer Res; 22(10); 2335-41. ©2016 AACR. ©2016 American Association for Cancer Research.

Virtually ‘in the heat of the moment’: insula activation in safe sex negotiation among risky men

PubMed Central

Xue, Feng; Droutman, Vita; Barkley-Levenson, Emily; Melrose, A James; Miller, Lynn C; Monterosso, John R; Bechara, Antoine; Appleby, Paul R; Christensen, John L; Godoy, Carlos G; Read, Stephen J

2018-01-01

Abstract HIV is most prevalent among men who have sex with men (MSM), and although most MSM use condoms consistently during casual sex, some take risks. To better understand the psychology of those risky decisions, we examined neural correlates of playing a virtual sexual ‘hook up’ game in an functional magnetic resonance imaging scanner in MSM who had, in the past 90 days, been sexually risky (N = 76) or safe (N = 31). We found that during potentially risky sexual choices, previously risky MSM had more right insula activity than previously safe MSM. Real-life sexual risk was related to trait positive and negative urgency. Insula activity that differentiated risky and safe MSM was related to trait positive and negative urgency. Future work should further examine if, and to what extent, insula activation during safe sex negotiation drives MSM’s rash risky sexual decision-making. PMID:29149326

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

Mundaca, Luis; Neij, Lena; Worrell, Ernst

The growing complexities of energy systems, environmental problems and technology markets are driving and testing most energy-economy models to their limits. To further advance bottom-up models from a multidisciplinary energy efficiency policy evaluation perspective, we review and critically analyse bottom-up energy-economy models and corresponding evaluation studies on energy efficiency policies to induce technological change. We use the household sector as a case study. Our analysis focuses on decision frameworks for technology choice, type of evaluation being carried out, treatment of market and behavioural failures, evaluated policy instruments, and key determinants used to mimic policy instruments. Although the review confirms criticismmore » related to energy-economy models (e.g. unrealistic representation of decision-making by consumers when choosing technologies), they provide valuable guidance for policy evaluation related to energy efficiency. Different areas to further advance models remain open, particularly related to modelling issues, techno-economic and environmental aspects, behavioural determinants, and policy considerations.« less

Effects of Alcohol on Performance on a Distraction Task During Simulated Driving

PubMed Central

Allen, Allyssa J.; Meda, Shashwath A.; Skudlarski, Pawel; Calhoun, Vince; Astur, Robert; Ruopp, Kathryn C.; Pearlson, Godfrey D.

2009-01-01

Background Prior studies report that accidents involving intoxicated drivers are more likely to occur during performance of secondary tasks. We studied this phenomenon, using a dual-task paradigm, involving performance of a visual oddball (VO) task while driving in an alcohol challenge paradigm. Previous functional MRI (fMRI) studies of the VO task have shown activation in the anterior cingulate, hippocampus, and prefrontal cortex. Thus, we predicted dose-dependent decreases in activation of these areas during VO performance. Methods Forty healthy social drinkers were administered 3 different doses of alcohol, individually tailored to their gender and weight. Participants performed a VO task while operating a virtual reality driving simulator in a 3T fMRI scanner. Results Analysis showed a dose-dependent linear decrease in Blood Oxygen Level Dependent activation during task performance, primarily in hippocampus, anterior cingulate, and dorsolateral prefrontal areas, with the least activation occurring during the high dose. Behavioral analysis showed a dose-dependent linear increase in reaction time, with no effects associated with either correct hits or false alarms. In all dose conditions, driving speed decreased significantly after a VO stimulus. However, at the high dose this decrease was significantly less. Passenger-side line crossings significantly increased at the high dose. Conclusions These results suggest that driving impairment during secondary task performance may be associated with alcohol-related effects on the above brain regions, which are involved with attentional processing/decision-making. Drivers with high blood alcohol concentrations may be less able to orient or detect novel or sudden stimuli during driving. PMID:19183133

Systematic review of the quality and generalizability of studies on the effects of opioids on driving and cognitive/psychomotor performance.

PubMed

Mailis-Gagnon, Angela; Lakha, Shehnaz Fatima; Furlan, Andrea; Nicholson, Keith; Yegneswaran, Balaji; Sabatowski, Rainer

2012-07-01

The effect of opioids on driving performance has been much debated. Driving is a complex task requiring integration of psychomotor, cognitive, motor and decision-making skills, visual-spatial abilities, divided attention, and behavioral and emotional control. The objective of this systematic review was to assess the quality of studies and to revisit the concept that patients on stable opioids are safe to drive as it applies to everyday practice. We searched MEDLINE, EMBASE, PSYCinfo, CENTRAL, TRANSPORT, CINAHL, reference lists of retrieved articles and narrative reviews, for studies on chronic cancer and noncancer pain patients on opioids, tested by driving, driving simulator, or cognitive/psychomotor tests. Methodological quality was assessed with Methodological Index for Nonrandomized Studies, cognitive/psychomotor tests were appraised regarding their sensitivity and validation, and whether confounding variables potentially affecting the study conclusions were recorded. The results were analyzed both quantitatively and qualitatively. We included 35 studies (2044 patients, 1994 controls), 9% of the studies were of poor, 54% of fair, and 37% of high quality; 3 quarters of the studies used high sensitivity cognitive tests. Amount and dose of opioids varied largely in many studies. Mean number of possible but unreported confounders was 2.2 (range, 0 to 4), relating to failure of the studies to mention co-prescriptions with psychotropic effects, pain severity, sleep disorder or daytime somnolence, and/or significant depressive or anxiety-related problems. The commonly held concept that "chronic pain patients on stable opioids are safe to drive" cannot be generalized to all such patients in everyday practice, but may be applicable only to a subset who meet certain criteria.

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.

[Decision Making and Electrodermal Activity].

PubMed

Kobayakawa, Mutsutaka

2016-08-01

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

Does Travel Time to a Radiation Facility Impact Patient Decision-Making Regarding Treatment for Prostate Cancer? A Study of the New Hampshire State Cancer Registry.

PubMed

Ghali, Fady; Celaya, Maria; Laviolette, Michael; Ingimarsson, Johann; Carlos, Heather; Rees, Judy; Hyams, Elias

2018-02-01

We sought to determine whether further distance from a radiation center is associated with lower utilization of external beam radiation therapy (XRT). We retrospectively identified patients with a new diagnosis of localized prostate cancer (CaP) within the New Hampshire State Cancer Registry from 2004 to 2011. Patients were categorized by age, D'Amico risk category, year of treatment, marital status, season of diagnosis, urban/rural residence, and driving time to the nearest radiation facility. Treatment decisions were stratified into those requiring multiple trips (XRT) or a single trip (surgery or brachytherapy). Multivariable regression analysis was performed. A total of 4,731 patients underwent treatment for newly diagnosed CaP during the study period, including 1,575 multitrip (XRT) and 3,156 single-trip treatments. Of these, 87.6% lived within a 30-minute drive to a radiation facility. In multivariable analysis, time to the nearest radiation facility was not associated with treatment decisions (P = .26). However, higher risk category, older age, married status, and winter diagnosis were associated with XRT (P < .05). More recent year of diagnosis and urban residence were associated with single-trip therapy (primarily surgery) (P < .05). There was a significant interaction between travel time and season of diagnosis (P = .03), as well as a marginally significant interaction with urban/rural status (P = .07). Overall, further travel time to a radiation facility was not associated with lower utilization of XRT. These data are encouraging regarding access to care for CaP in New Hampshire. © 2016 National Rural Health Association.

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

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.

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

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

One Way of Thinking About Decision Making.

ERIC Educational Resources Information Center

Dalis, Gus T.; Strasser, Ben B.

The authors present the DALSTRA model of decision making, a descriptive statement of ways individuals or groups respond to different kinds of decision-making problems they encounter. Decision making is viewed in two phases: the decision-making antecedents (whether to decide, how to decide) and the modes of decision making (Chance/Impulse,…

Effect of audio in-vehicle red light-running warning message on driving behavior based on a driving simulator experiment.

PubMed

Yan, Xuedong; Liu, Yang; Xu, Yongcun

2015-01-01

Drivers' incorrect decisions of crossing signalized intersections at the onset of the yellow change may lead to red light running (RLR), and RLR crashes result in substantial numbers of severe injuries and property damage. In recent years, some Intelligent Transport System (ITS) concepts have focused on reducing RLR by alerting drivers that they are about to violate the signal. The objective of this study is to conduct an experimental investigation on the effectiveness of the red light violation warning system using a voice message. In this study, the prototype concept of the RLR audio warning system was modeled and tested in a high-fidelity driving simulator. According to the concept, when a vehicle is approaching an intersection at the onset of yellow and the time to the intersection is longer than the yellow interval, the in-vehicle warning system can activate the following audio message "The red light is impending. Please decelerate!" The intent of the warning design is to encourage drivers who cannot clear an intersection during the yellow change interval to stop at the intersection. The experimental results showed that the warning message could decrease red light running violations by 84.3 percent. Based on the logistic regression analyses, drivers without a warning were about 86 times more likely to make go decisions at the onset of yellow and about 15 times more likely to run red lights than those with a warning. Additionally, it was found that the audio warning message could significantly reduce RLR severity because the RLR drivers' red-entry times without a warning were longer than those with a warning. This driving simulator study showed a promising effect of the audio in-vehicle warning message on reducing RLR violations and crashes. It is worthwhile to further develop the proposed technology in field applications.

Integrating Water Quality and River Rehabilitation Management - A Decision-Analytical Perspective

NASA Astrophysics Data System (ADS)

Reichert, P.; Langhans, S.; Lienert, J.; Schuwirth, N.

2009-04-01

Integrative river management involves difficult decisions about alternative measures to improve their ecological state. For this reason, it seems useful to apply knowledge from the decision sciences to support river management. We discuss how decision-analytical elements can be employed for designing an integrated river management procedure. An important aspect of this procedure is to clearly separate scientific predictions of the consequences of alternatives from objectives to be achieved by river management. The key elements of the suggested procedure are (i) the quantitative elicitation of the objectives from different stakeholder groups, (ii) the compilation of the current scientific knowledge about the consequences of the effects resulting from suggested measures in the form of a probabilistic mathematical model, and (iii) the use of these predictions and valuations to prioritize alternatives, to uncover conflicting objectives, to support the design of better alternatives, and to improve the transparency of communication about the chosen management strategy. The development of this procedure led to insights regarding necessary steps to be taken for rational decision-making in river management, to guidelines about the use of decision-analytical techniques for performing these steps, but also to new insights about the application of decision-analytical techniques in general. In particular, the consideration of the spatial distribution of the effects of measures and the potential added value of connected rehabilitated river reaches leads to favoring measures that have a positive effect beyond a single river reach. As these effects only propagate within the river network, this results in a river basin oriented management concept as a consequence of a rational decision support procedure, rather than as an a priori management paradigm. There are also limitations to the support that can be expected from the decision-analytical perspective. It will not provide the societal values that are driving prioritization in river management, it will only support their elicitation and rational use. This is particularly important for the assessment of micro-pollutants because of severe limitations in scientific knowledge of their effects on river ecosystems. This makes the influence of pollution by micro-pollutants on prioritization of measures strongly dependent on the weight of the precautionary principle relative to other societal objectives of river management.

Strategic Decision Making Paradigms: A Primer for Senior Leaders

DTIC Science & Technology

2009-07-01

decision making . STRATEGIC DECISION MAKING Strategic Change: There are several strategic...influenced by stakeholders outside of the organization. The Ontology of Strategic Decision Making . Strategic decisions are non-routine and involve...Coates USAWC, July 2009 5 The Complexity of Strategic Decision Making Strategic decisions entail “ill-structured,”6 “messy” or

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.

Advancing Aeronautics: A Decision Framework for Selecting Research Agendas

NASA Technical Reports Server (NTRS)

Anton, Philip S.; Ecola, Liisa; Kallimani, James G.; Light, Thomas; Ohlandt, Chad J. R.; Osburg, Jan; Raman, Raj; Grammich, Clifford A.

2011-01-01

Publicly funded research has long played a role in the development of aeronautics, ranging from foundational research on airfoils to development of the air-traffic control system. Yet more than a century after the research and development of successful controlled, sustained, heavier-than-air flight vehicles, there are questions over the future of aeronautics research. The field of aeronautics is relatively mature, technological developments within it have become more evolutionary, and funding decisions are sometimes motivated by the continued pursuit of these evolutionary research tracks rather than by larger factors. These developments raise questions over whether public funding of aeronautics research continues to be appropriate or necessary and at what levels. Tightened federal budgets and increasing calls to address other public demands make these questions sharper still. To help it address the questions of appropriate directions for publicly funded aeronautics research, the National Aeronautics and Space Administration's (NASA's) Aeronautics Research Mission Directorate (ARMD) asked the RAND Corporation to assess the elements required to develop a strategic view of aeronautics research opportunities; identify candidate aeronautic grand challenges, paradigms, and concepts; outline a framework for evaluating them; and exercise the framework as an example of how to use it. Accordingly, this research seeks to address these questions: What aeronautics research should be supported by the U.S. government? What compelling and desirable benefits drive government-supported research? How should the government--especially NASA--make decisions about which research to support? Advancing aeronautics involves broad policy and decisionmaking challenges. Decisions involve tradeoffs among competing perspectives, uncertainties, and informed judgment.

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.

Challenges in Diabetes Care: Can Digital Health Help Address Them?

PubMed Central

Close, Kelly

2016-01-01

In Brief There is great enthusiasm for the potential of digital health solutions in medicine and diabetes to address key care challenges: patient and provider burden, lack of data to inform therapeutic decision-making, poor access to care, and costs. However, the field is still in its nascent days; many patients and providers do not currently engage with digital health tools, and for those who do, the burden is still often high. Over time, digital health has excellent potential to collect data more seamlessly, make collected data more useful, and drive better outcomes at lower costs in less time. But there is still much to prove. This review offers key background information on the current state of digital health in diabetes, six of the most promising digital health technologies and services, and the challenges that remain. PMID:27621530

[Impact of diabetes mellitus on driving safety].

PubMed

Ekoé, J M; Laberge-Nadeau, C; Ghadirian, P; Hamet, P

1991-01-01

Driving ability is controlled by specific regulations. Therefore disabled individuals or those with certain chronic diseases may be affected by these regulations. These latter are based on assumption that the existence and the nature of certain diseases may cause particular hazard; and this could be prevented by introducing certain driving regulations. This hypothesis has not been tested properly, considering the proposed and suspected risk factors. Diabetes mellitus is a good example of the interested medical condition in this field. Review of the literature do not provide adequate information to allow us to conclude whether the insulin treated diabetic person is at higher risk to develop traffic accident, compared with non diabetic individual; and there is no definite explanation whether hypoglycaemia play a causative role in the etiology of traffic accident among insulin treated diabetics. Perhaps the lack of knowledge in this field is due to use of non-standardized methodologies and small sample size studies which make the comparisons difficult. The existing regulations in different countries are based on empirical knowledge and common sense. This often leads to conflictual situations and apparently discriminatory decisions regarding diabetics. Further comparative and prospective studies are needed.

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.

Conflicts of interest: research and clinical care.

PubMed

Morris, John C

1994-01-01

Conflicts of interest and other ethical dilemmas occur in Alzheimer disease (AD) patient care and research but often are underrecognized by physicians. One or more bioethical principles of autonomy, confidentiality, truth telling, beneficence, and justice, which apply to demented individuals as they do to other patients, may conflict in everyday clinical situations. For example, when demented patients wish to continue driving, autonomy (the patient's right to self-determination) conflicts with beneficence (the duty to promote the patient's welfare). Cognitively impaired patients depend on others for ethical decision making in the resolution of these dilemmas. It is essential that clinicians and investigators involved in the decision-making process do so without bias or conflict of interest. Full disclosure of financial interests increasingly is an accepted requirement in the conduct of biomedical research. In AD, less obvious potential conflicts of interest arise when physicians recruit their patients for antidementia drug trials sponsored by a pharmaceutical company (that provides the physician with research funding) or when investigators fail to acknowledge the patient's withdrawal of assent when attempting to complete a research protocol. The recognition of both financial and nonfinancial conflicts should lead to measures to reduce bias, which in turn will improve the integrity of research findings and promote patient welfare.

Can composite digital monitoring biomarkers come of age? A framework for utilization.

PubMed

Kovalchick, Christopher; Sirkar, Rhea; Regele, Oliver B; Kourtis, Lampros C; Schiller, Marie; Wolpert, Howard; Alden, Rhett G; Jones, Graham B; Wright, Justin M

2017-12-01

The application of digital monitoring biomarkers in health, wellness and disease management is reviewed. Harnessing the near limitless capacity of these approaches in the managed healthcare continuum will benefit from a systems-based architecture which presents data quality, quantity, and ease of capture within a decision-making dashboard. A framework was developed which stratifies key components and advances the concept of contextualized biomarkers. The framework codifies how direct, indirect, composite, and contextualized composite data can drive innovation for the application of digital biomarkers in healthcare. The de novo framework implies consideration of physiological, behavioral, and environmental factors in the context of biomarker capture and analysis. Application in disease and wellness is highlighted, and incorporation in clinical feedback loops and closed-loop systems is illustrated. The study of contextualized biomarkers has the potential to offer rich and insightful data for clinical decision making. Moreover, advancement of the field will benefit from innovation at the intersection of medicine, engineering, and science. Technological developments in this dynamic field will thus fuel its logical evolution guided by inputs from patients, physicians, healthcare providers, end-payors, actuarists, medical device manufacturers, and drug companies.

Concept of Operations for Collaboration and Discovery from Big Data Across Enterprise Data Warehouses

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

Olama, Mohammed M; Nutaro, James J; Sukumar, Sreenivas R

2013-01-01

The success of data-driven business in government, science, and private industry is driving the need for seamless integration of intra and inter-enterprise data sources to extract knowledge nuggets in the form of correlations, trends, patterns and behaviors previously not discovered due to physical and logical separation of datasets. Today, as volume, velocity, variety and complexity of enterprise data keeps increasing, the next generation analysts are facing several challenges in the knowledge extraction process. Towards addressing these challenges, data-driven organizations that rely on the success of their analysts have to make investment decisions for sustainable data/information systems and knowledge discovery. Optionsmore » that organizations are considering are newer storage/analysis architectures, better analysis machines, redesigned analysis algorithms, collaborative knowledge management tools, and query builders amongst many others. In this paper, we present a concept of operations for enabling knowledge discovery that data-driven organizations can leverage towards making their investment decisions. We base our recommendations on the experience gained from integrating multi-agency enterprise data warehouses at the Oak Ridge National Laboratory to design the foundation of future knowledge nurturing data-system architectures.« less

The experiential health information processing model: supporting collaborative web-based patient education

PubMed Central

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-01-01

Background First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. Results In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. Conclusion An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided. PMID:19087353

The role of cognitive versus emotional intelligence in Iowa Gambling Task performance: What's emotion got to do with it?

PubMed

Webb, Christian A; DelDonno, Sophie; Killgore, William D S

2014-01-01

Debate persists regarding the relative role of cognitive versus emotional processes in driving successful performance on the widely used Iowa Gambling Task (IGT). From the time of its initial development, patterns of IGT performance were commonly interpreted as primarily reflecting implicit, emotion-based processes. Surprisingly, little research has tried to directly compare the extent to which measures tapping relevant cognitive versus emotional competencies predict IGT performance in the same study. The current investigation attempts to address this question by comparing patterns of associations between IGT performance, cognitive intelligence (Wechsler Abbreviated Scale of Intelligence; WASI) and three commonly employed measures of emotional intelligence (EI; Mayer-Salovey-Caruso Emotional Intelligence Test, MSCEIT; Bar-On Emotional Quotient Inventory, EQ-i; Self-Rated Emotional Intelligence Scale, SREIS). Results indicated that IGT performance was more strongly associated with cognitive, than emotional, intelligence. To the extent that the IGT indeed mimics "real-world" decision-making, our findings, coupled with the results of existing research, may highlight the role of deliberate, cognitive capacities over implicit, emotional processes in contributing to at least some domains of decision-making relevant to everyday life.

Perceptual Biases in Relation to Paranormal and Conspiracy Beliefs

PubMed Central

van Elk, Michiel

2015-01-01

Previous studies have shown that one’s prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional biases. Two field studies were conducted in which visitors of a paranormal conducted a perceptual decision making task (i.e. the face / house categorization task; Experiment 1) or a visual attention task (i.e. the global / local processing task; Experiment 2). In the first experiment it was found that skeptics compared to believers more often incorrectly categorized ambiguous face stimuli as representing a house, indicating that disbelief rather than belief in the paranormal is driving the bias observed for the categorization of ambiguous stimuli. In the second experiment, it was found that skeptics showed a classical ‘global-to-local’ interference effect, whereas believers in conspiracy theories were characterized by a stronger ‘local-to-global interference effect’. The present study shows that individual differences in paranormal and conspiracy beliefs are associated with perceptual and attentional biases, thereby extending the growing body of work in this field indicating effects of cultural learning on basic perceptual processes. PMID:26114604

Perceptual Biases in Relation to Paranormal and Conspiracy Beliefs.

PubMed

van Elk, Michiel

2015-01-01

Previous studies have shown that one's prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional biases. Two field studies were conducted in which visitors of a paranormal conducted a perceptual decision making task (i.e. the face/house categorization task; Experiment 1) or a visual attention task (i.e. the global/local processing task; Experiment 2). In the first experiment it was found that skeptics compared to believers more often incorrectly categorized ambiguous face stimuli as representing a house, indicating that disbelief rather than belief in the paranormal is driving the bias observed for the categorization of ambiguous stimuli. In the second experiment, it was found that skeptics showed a classical 'global-to-local' interference effect, whereas believers in conspiracy theories were characterized by a stronger 'local-to-global interference effect'. The present study shows that individual differences in paranormal and conspiracy beliefs are associated with perceptual and attentional biases, thereby extending the growing body of work in this field indicating effects of cultural learning on basic perceptual processes.

The role of cognitive versus emotional intelligence in Iowa Gambling Task performance: What’s emotion got to do with it?

PubMed Central

Webb, Christian A.; DelDonno, Sophie; Killgore, William D.S.

2014-01-01

Debate persists regarding the relative role of cognitive versus emotional processes in driving successful performance on the widely used Iowa Gambling Task (IGT). From the time of its initial development, patterns of IGT performance were commonly interpreted as primarily reflecting implicit, emotion-based processes. Surprisingly, little research has tried to directly compare the extent to which measures tapping relevant cognitive versus emotional competencies predict IGT performance in the same study. The current investigation attempts to address this question by comparing patterns of associations between IGT performance, cognitive intelligence (Wechsler Abbreviated Scale of Intelligence; WASI) and three commonly employed measures of emotional intelligence (EI; Mayer–Salovey–Caruso Emotional Intelligence Test, MSCEIT; Bar-On Emotional Quotient Inventory, EQ-i; Self-Rated Emotional Intelligence Scale, SREIS). Results indicated that IGT performance was more strongly associated with cognitive, than emotional, intelligence. To the extent that the IGT indeed mimics “real-world” decision-making, our findings, coupled with the results of existing research, may highlight the role of deliberate, cognitive capacities over implicit, emotional processes in contributing to at least some domains of decision-making relevant to everyday life. PMID:25635149

The experiential health information processing model: supporting collaborative web-based patient education.

PubMed

O'Grady, Laura A; Witteman, Holly; Wathen, C Nadine

2008-12-16

First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed. In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context. An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.

Drivers who self-estimate lower blood alcohol concentrations are riskier drivers after drinking.

PubMed

Laude, Jennifer R; Fillmore, Mark T

2016-04-01

Alcohol increases the tendency for risky driving in some individuals but not others. Little is known about the factors underlying this individual difference. Studies find that those who underestimate their blood alcohol concentration (BAC) following a dose of alcohol tend to be more impulsive and report greater willingness to drive after drinking than those who estimate their BACs to be greater than their actual BAC. BAC underestimation could contribute to risky driving behavior following alcohol as such drivers might perceive little impairment in their driving ability and thus no need for caution. This study was designed to test the relationship between drivers' BAC estimations following a dose of alcohol or a placebo and the degree of risky driving they displayed during a simulated driving test. Forty adult drivers performed a simulated driving test and estimated their blood alcohol concentration after receiving a dose of alcohol (0.65 g/kg for men and 0.56 g/kg for women) or a placebo. Alcohol increased risk-taking and impaired driving skill. Those who estimated their BAC to be lower were the riskiest drivers following both alcohol and placebo. The tendency to estimate lower BACs could support a series of high-risk decisions, regardless of one's actual BAC. This could include the decision to drive after drinking.

A regret-induced status-quo bias

PubMed Central

Nicolle, A.; Fleming, S.M.; Bach, D.R.; Driver, J.; Dolan, R. J.

2011-01-01

A suboptimal bias towards accepting the ‘status-quo’ option in decision-making is well established behaviorally, but the underlying neural mechanisms are less clear. Behavioral evidence suggests the emotion of regret is higher when errors arise from rejection rather than acceptance of a status-quo option. Such asymmetry in the genesis of regret might drive the status-quo bias on subsequent decisions, if indeed erroneous status-quo rejections have a greater neuronal impact than erroneous status-quo acceptances. To test this, we acquired human fMRI data during a difficult perceptual decision task that incorporated a trial-to-trial intrinsic status-quo option, with explicit signaling of outcomes (error or correct). Behaviorally, experienced regret was higher after an erroneous status-quo rejection compared to acceptance. Anterior insula and medial prefrontal cortex showed increased BOLD signal after such status-quo rejection errors. In line with our hypothesis, a similar pattern of signal change predicted acceptance of the status-quo on a subsequent trial. Thus, our data link a regret-induced status-quo bias to error-related activity on the preceding trial. PMID:21368043

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.

Shared decision-making - Rhetoric and reality: Women's experiences and perceptions of adjuvant treatment decision-making for breast cancer.

PubMed

Mahmoodi, Neda; Sargeant, Sally

2017-01-01

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.

Local navigation and fuzzy control realization for autonomous guided vehicle

NASA Astrophysics Data System (ADS)

El-Konyaly, El-Sayed H.; Saraya, Sabry F.; Shehata, Raef S.

1996-10-01

This paper addresses the problem of local navigation for an autonomous guided vehicle (AGV) in a structured environment that contains static and dynamic obstacles. Information about the environment is obtained via a CCD camera. The problem is formulated as a dynamic feedback control problem in which speed and steering decisions are made on the fly while the AGV is moving. A decision element (DE) that uses local information is proposed. The DE guides the vehicle in the environment by producing appropriate navigation decisions. Dynamic models of a three-wheeled vehicle for driving and steering mechanisms are derived. The interaction between them is performed via the local feedback DE. A controller, based on fuzzy logic, is designed to drive the vehicle safely in an intelligent and human-like manner. The effectiveness of the navigation and control strategies in driving the AGV is illustrated and evaluated.

Measuring Shared Decision Making in Psychiatric Care

PubMed Central

Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.

2014-01-01

Objective Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. Methods A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. Results Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. Conclusions The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. PMID:22854725

Linking decision-making research and cancer prevention and control: important themes.

PubMed

McCaul, Kevin D; Peters, Ellen; Nelson, Wendy; Stefanek, Michael

2005-07-01

This article describes 6 themes underlying the multiple presentations from the Basic and Applied Decision Making in Cancer Control meeting, held February 19-20, 2004. The following themes have important implications for research and practice linking basic decision-making research to cancer prevention and control: (a) Traditional decision-making theories fail to capture real-world decision making, (b) decision makers are often unable to predict future preferences, (c) preferences are often constructed on the spot and thus are influenced by situational cues, (d) decision makers often rely on feelings rather than beliefs when making a decision, (e) the perspective of the decision maker is critical in determining preferences, and (f) informed decision making may--or may not--yield the best decisions.

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

PubMed Central

Story, William T.; Burgard, Sarah A.

2012-01-01

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

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

PubMed

Story, William T; Burgard, Sarah A

2012-12-01

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

Deep space telecommunications, navigation, and information management - Support of the Space Exploration Initiative

NASA Technical Reports Server (NTRS)

Hall, Justin R.; Hastrup, Rolf C.

1990-01-01

The principal challenges in providing effective deep space navigation, telecommunications, and information management architectures and designs for Mars exploration support are presented. The fundamental objectives are to provide the mission with the means to monitor and control mission elements, obtain science, navigation, and engineering data, compute state vectors and navigate, and to move these data efficiently and automatically between mission nodes for timely analysis and decision making. New requirements are summarized, and related issues and challenges including the robust connectivity for manned and robotic links, are identified. Enabling strategies are discussed, and candidate architectures and driving technologies are described.

Twelfth Annual Conference on Manual Control

NASA Technical Reports Server (NTRS)

Wempe, T. E.

1976-01-01

Main topics discussed cover multi-task decision making, attention allocation and workload measurement, displays and controls, nonvisual displays, tracking and other psychomotor tasks, automobile driving, handling qualities and pilot ratings, remote manipulation, system identification, control models, and motion and visual cues. Sixty-five papers are included with presentations on results of analytical studies to develop and evaluate human operator models for a range of control task, vehicle dynamics and display situations; results of tests of physiological control systems and applications to medical problems; and on results of simulator and flight tests to determine display, control and dynamics effects on operator performance and workload for aircraft, automobile, and remote control systems.

Bedside to Bench: Integrating Quantitative Clinical Pharmacology and Reverse Translation to Optimize Drug Development.

PubMed

Gibbs, John P; Menon, Rajeev; Kasichayanula, Sreeneeranj

2018-02-01

With so much emphasis on reducing attrition and becoming more efficient in the delivery of healthcare, there are many opportunities to leverage existing clinical data in drug development and to foster the practice of reverse translation. The application of quantitative approaches to convert clinical trial and real-world data to knowledge will continue to drive innovation. Herein we discuss recent examples of reverse translation and consider future opportunities to capture critical clinical knowledge to inform decision-making in drug development. © 2017 The Authors. Clinical Pharmacology & Therapeutics published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Deep space telecommunications, navigation, and information management - Support of the Space Exploration Initiative

NASA Astrophysics Data System (ADS)

Hall, Justin R.; Hastrup, Rolf C.

1990-10-01

The principal challenges in providing effective deep space navigation, telecommunications, and information management architectures and designs for Mars exploration support are presented. The fundamental objectives are to provide the mission with the means to monitor and control mission elements, obtain science, navigation, and engineering data, compute state vectors and navigate, and to move these data efficiently and automatically between mission nodes for timely analysis and decision making. New requirements are summarized, and related issues and challenges including the robust connectivity for manned and robotic links, are identified. Enabling strategies are discussed, and candidate architectures and driving technologies are described.

Shared decision-making in epilepsy management.

PubMed

Pickrell, W O; Elwyn, G; Smith, P E M

2015-06-01

Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

[Shared decision-making in medical practice--patient-centred communication skills].

PubMed

van Staveren, Remke

2011-01-01

Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

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…

A Self-Adaptive Dynamic Recognition Model for Fatigue Driving Based on Multi-Source Information and Two Levels of Fusion

PubMed Central

Sun, Wei; Zhang, Xiaorui; Peeta, Srinivas; He, Xiaozheng; Li, Yongfu; Zhu, Senlai

2015-01-01

To improve the effectiveness and robustness of fatigue driving recognition, a self-adaptive dynamic recognition model is proposed that incorporates information from multiple sources and involves two sequential levels of fusion, constructed at the feature level and the decision level. Compared with existing models, the proposed model introduces a dynamic basic probability assignment (BPA) to the decision-level fusion such that the weight of each feature source can change dynamically with the real-time fatigue feature measurements. Further, the proposed model can combine the fatigue state at the previous time step in the decision-level fusion to improve the robustness of the fatigue driving recognition. An improved correction strategy of the BPA is also proposed to accommodate the decision conflict caused by external disturbances. Results from field experiments demonstrate that the effectiveness and robustness of the proposed model are better than those of models based on a single fatigue feature and/or single-source information fusion, especially when the most effective fatigue features are used in the proposed model. PMID:26393615

Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision

PubMed Central

Edwards, Adrian; Elwyn, Glyn

2006-01-01

Abstract Background  Shared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice. Aims  We undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely. Method  The study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi‐structured telephone interviews were conducted and analysed using the constant comparative method of content analysis. Results  All patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as ‘patient‐led’. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions. Conclusions  Practitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non‐alignment of patient preferences with the actual model of decision making if this occurs. PMID:17083558

Toward an Expanded Definition of Adaptive Decision Making.

ERIC Educational Resources Information Center

Phillips, Susan D.

1997-01-01

Uses the lifespan, life-space model to examine the definition of adaptive decision making. Reviews the existing definition of adaptive decision making as "rational" decision making and offers alternate perspectives on decision making with an emphasis on the implications of using the model. Makes suggestions for future theory, research,…

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

PubMed

Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

2015-06-11

Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

Registered nurses' decision-making regarding documentation in patients' progress notes.

PubMed

Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne

2012-10-01

To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive continuum theory as a decision-making framework, provides a powerful means of guiding nurses' decision-making. © 2012 Blackwell Publishing Ltd.

Stereo and photometric image sequence interpretation for detecting negative obstacles using active gaze control and performing an autonomous jink

NASA Astrophysics Data System (ADS)

Hofmann, Ulrich; Siedersberger, Karl-Heinz

2003-09-01

Driving cross-country, the detection and state estimation relative to negative obstacles like ditches and creeks is mandatory for safe operation. Very often, ditches can be detected both by different photometric properties (soil vs. vegetation) and by range (disparity) discontinuities. Therefore, algorithms should make use of both the photometric and geometric properties to reliably detect obstacles. This has been achieved in UBM's EMS-Vision System (Expectation-based, Multifocal, Saccadic) for autonomous vehicles. The perception system uses Sarnoff's image processing hardware for real-time stereo vision. This sensor provides both gray value and disparity information for each pixel at high resolution and framerates. In order to perform an autonomous jink, the boundaries of an obstacle have to be measured accurately for calculating a safe driving trajectory. Especially, ditches are often very extended, so due to the restricted field of vision of the cameras, active gaze control is necessary to explore the boundaries of an obstacle. For successful measurements of image features the system has to satisfy conditions defined by the perception expert. It has to deal with the time constraints of the active camera platform while performing saccades and to keep the geometric conditions defined by the locomotion expert for performing a jink. Therefore, the experts have to cooperate. This cooperation is controlled by a central decision unit (CD), which has knowledge about the mission and the capabilities available in the system and of their limitations. The central decision unit reacts dependent on the result of situation assessment by starting, parameterizing or stopping actions (instances of capabilities). The approach has been tested with the 5-ton van VaMoRs. Experimental results will be shown for driving in a typical off-road scenario.

A timely account of the role of duration in decision making.

PubMed

Ariely, D; Zakay, D

2001-09-01

The current work takes a general perspective on the role of time in decision making. There are many different relationships and interactions between time and decision making, and no single summary can do justice to this topic. In this paper we will describe a few of the aspects in which time and decision making are interleaved: (a) temporal perspectives of decisions--the various temporal orientations that decision-makers may adopt while making decisions, and the impact of such temporal orientations on the decision process and its outcomes; (b) time as a medium within which decisions take place--the nature of decision processes that occur along time; (c) time as a resource and as a contextual factor--the implications of shortage in time resources and the impact of time limits on decision making processes and performance; (d) time as a commodity--time as the subject matter of decision making. The paper ends with a few general questions on the role of duration in decision making.

What is known about parents' treatment decisions? A narrative review of pediatric decision making.

PubMed

Lipstein, Ellen A; Brinkman, William B; Britto, Maria T

2012-01-01

With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process. To conduct a narrative review of the current research on parent decision making about pediatric treatments and identify areas in need of further investigation. Articles presenting original research on parent decision making were identified from MEDLINE (1966-6/2011), using the terms "decision making," "parent," and "child." We included papers focused on treatment decisions but excluded those focused on information disclosure to children, vaccination, and research participation decisions. We found 55 papers describing 52 distinct studies, the majority being descriptive, qualitative studies of the decision-making process, with very limited assessment of decision outcomes. Although parents' preferences for degree of participation in pediatric decision making vary, most are interested in sharing the decision with the provider. In addition to the provider, parents are influenced in their decision making by changes in their child's health status, other community members, prior knowledge, and personal factors, such as emotions and faith. Parents struggle to balance these influences as well as to know when to include their child in decision making. Current research demonstrates a diversity of influences on parent decision making and parent decision preferences; however, little is known about decision outcomes or interventions to improve outcomes. Further investigation, using prospective methods, is needed in order to understand how to support parents through the difficult treatment decisions.

Management of complex knowledge in planning for sustainable development: The use of multi-criteria decision aids

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

Kain, Jaan-Henrik; Soederberg, Henriette

2008-01-15

The vision of sustainable development entails new and complex planning situations, confronting local policy makers with changing political conditions, different content in decision making and planning and new working methods. Moreover, the call for sustainable development has been a major driving force towards an increasingly multi-stakeholder planning system. This situation requires competence in working in, and managing, groups of actors, including not only experts and project owners but also other categories of stakeholders. Among other qualities, such competence requires a working strategy aimed at integrating various, and sometimes incommensurable, forms of knowledge to construct a relevant and valid knowledge basemore » prior to decision making. Consequently, there lies great potential in methods that facilitate the evaluation of strategies for infrastructural development across multiple knowledge areas, so-called multi-criteria decision aids (MCDAs). In the present article, observations from six case studies are discussed, where the common denominators are infrastructural planning, multi-stakeholder participation and the use of MCDAs as interactive decision support. Three MCDAs are discussed - NAIADE, SCA and STRAD - with an emphasis on how they function in their procedural context. Accordingly, this is not an analysis of MCDA algorithms, of software programming aspects or of MCDAs as context-independent 'decision machines'-the focus is on MCDAs as actor systems, not as expert systems. The analysis is carried out across four main themes: (a) symmetrical management of different forms of knowledge; (b) management of heterogeneity, pluralism and conflict; (c) functionality and ease of use; and (d) transparency and trust. It shows that STRAD, by far, seems to be the most useful MCDA in interactive settings. NAIADE and SCA are roughly equivalent but have their strengths and weaknesses in different areas. Moreover, it was found that some MCDA issues require further attention, i.e., regarding transparency and understandability; qualitative/quantitative knowledge input; switching between different modes of weighting; software flexibility; as well as graphic and user interfaces.« less

Pit bearing capacity effect on status of soil plug during pile driving in ocean engineering

NASA Astrophysics Data System (ADS)

Yan, Shu-Wang; Zhou, Qun-Hua; Liu, Run; Dong, Wei

2011-06-01

Foundation piles of the offshore oil platforms in the Bohai Bay are usually longer than 100 m with a diameter larger than 2 m. Driving such long and large-sized piles into the ground is a difficult task. It needs a comprehensive consider ation of the pile dimensions, soil properties and the hammer energy. Thoughtful drivability analysis has to be performed in the design stage. It has been shown that judging whether the soil column inside the pile is fully plugged, which makes the pile behave as close-ended, strongly influences the accuracy of drivability analysis. Engineering practice repeatedly indicates that the current methods widely used for soil plug judgment often give incorrect results, leading the designers to make a wrong decision. It has been found that this problem is caused by the ignorance of the bearing capacity provided by the soil surrounding the pile. Based on the Terzaghi's bearing capacity calculation method for deep foundation, a new approach for judging soil plug status is put forward, in which the surcharge effect has been considered and the dynamic effect coefficient is included. This approach has been applied to some practical engineering projects successfully, which may give more reasonable results than the currently used method does.

Coding and traceability: cells and tissues in North America.

PubMed

Brubaker, Scott A; Wilson, Diane

2010-11-01

Cell and tissue banking professionals in North America have long understood the value of labeling their allografts with descriptive names that make them easily recognized. They have also understood that advantages exist in possessing the capability to track them internally and externally to better understand tissue handling from donation through distribution. An added insight that can assist with strategic planning is to know who uses them, how many, and for what purpose or application. Uniquely coding allografts naturally aids tracking in event of recall or the rare need to link them if implicated in an adverse outcome report. These values relate to an ability or inability to sufficiently track specific cell/tissue types throughout the allograft's lifetime. These concepts easily fit into the functions of a Quality Program and promote recipient safety. It is management oversight that drives the direction taken and either optimizes this knowledge or limits it. How concepts related to coding and tracing human cells and tissues for transplantation have evolved in North America, and where they may be headed, are described in this manuscript. Many protocols are in place but they exist in numerous operational silos. Quality Management System concepts should drive decision-making and include considerations for future planning beyond our own professional lifetimes.

Composite collective decision-making

PubMed Central

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

2015-01-01

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

Modeling Individual Differences in Response Time and Accuracy in Numeracy

PubMed Central

Ratcliff, Roger; Thompson, Clarissa A.; McKoon, Gail

2015-01-01

In the study of numeracy, some hypotheses have been based on response time (RT) as a dependent variable and some on accuracy, and considerable controversy has arisen about the presence or absence of correlations between RT and accuracy, between RT or accuracy and individual differences like IQ and math ability, and between various numeracy tasks. In this article, we show that an integration of the two dependent variables is required, which we accomplish with a theory-based model of decision making. We report data from four tasks: numerosity discrimination, number discrimination, memory for two-digit numbers, and memory for three-digit numbers. Accuracy correlated across tasks, as did RTs. However, the negative correlations that might be expected between RT and accuracy were not obtained; if a subject was accurate, it did not mean that they were fast (and vice versa). When the diffusion decision-making model was applied to the data (Ratcliff, 1978), we found significant correlations across the tasks between the quality of the numeracy information (drift rate) driving the decision process and between the speed/ accuracy criterion settings, suggesting that similar numeracy skills and similar speed-accuracy settings are involved in the four tasks. In the model, accuracy is related to drift rate and RT is related to speed-accuracy criteria, but drift rate and criteria are not related to each other across subjects. This provides a theoretical basis for understanding why negative correlations were not obtained between accuracy and RT. We also manipulated criteria by instructing subjects to maximize either speed or accuracy, but still found correlations between the criteria settings between and within tasks, suggesting that the settings may represent an individual trait that can be modulated but not equated across subjects. Our results demonstrate that a decision-making model may provide a way to reconcile inconsistent and sometimes contradictory results in numeracy research. PMID:25637690

Analysis of the decision-making process of nurse managers: a collective reflection.

PubMed

Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

2015-01-01

to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

Shared Decision-Making for Nursing Practice: An Integrative Review.

PubMed

Truglio-Londrigan, Marie; Slyer, Jason T

2018-01-01

Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.

Does future-oriented thinking predict adolescent decision making?

PubMed

Eskritt, Michelle; Doucette, Jesslyn; Robitaille, Lori

2014-01-01

A number of theorists, as well as plain common sense, suggest that future-oriented thinking (FOT) should be involved in decision making; therefore, the development of FOT should be related to better quality decision making. FOT and quality of the decision making were measured in adolescents as well as adults in 2 different experiments. Though the results of the first experiment revealed an increase in quality of decision making across adolescence into adulthood, there was no relationship between FOT and decision making. In the second experiment, FOT predicted performance on a more deliberative decision-making task independent of age, but not performance on the Iowa Gambling Task (IGT). Performance on the IGT was instead related to emotion regulation. The study's findings suggest that FOT can be related to reflective decision making but not necessarily decision making that is more intuitive.

Mothers' process of decision making for gastrostomy placement.

PubMed

Brotherton, Ailsa; Abbott, Janice

2012-05-01

In this article we present the findings of an exploration of mothers' discourses on decision making for gastrostomy placement for their child. Exploring in-depth interviews of a purposive sample, we analyzed the mothers' discourses of the decision-making process to understand how their experiences of the process influenced their subsequent constructions of decision making. Mothers negotiated decision making by reflecting on their personal experiences of feeding their child, either orally or via a tube, and interwove their background experiences with the communications from members of the health care team until a decision was reached. Decision making was often fraught with difficulty, resulting in anxiety and guilt. Experiences of decision making ranged from perceived coercion to true choice, which encompasses a truly child-centered decision. The resulting impact of the decision-making process on the mothers was profound. We conclude with an exploration of the implications for clinical practice and describe how health care professionals can support mothers to ensure that decision-making processes for gastrostomy placement in children are significantly improved.

Path Analysis Examining Self-Efficacy and Decision-Making Performance on a Simulated Baseball Task

ERIC Educational Resources Information Center

Hepler, Teri J.; Feltz, Deborah L.

2012-01-01

The purpose of this study was to examine the relationship between decision-making self-efficacy and decision-making performance in sport. Undergraduate students (N = 78) performed 10 trials of a decision-making task in baseball. Self-efficacy was measured before performing each trial. Decision-making performance was assessed by decision speed and…

Decision Styles and Rationality: An Analysis of the Predictive Validity of the General Decision-Making Style Inventory

ERIC Educational Resources Information Center

Curseu, Petru Lucian; Schruijer, Sandra G. L.

2012-01-01

This study investigates the relationship between the five decision-making styles evaluated by the General Decision-Making Style Inventory, indecisiveness, and rationality in decision making. Using a sample of 102 middle-level managers, the results show that the rational style positively predicts rationality in decision making and negatively…

Effect of simulator training on fitness-to-drive after stroke: a 5-year follow-up of a randomized controlled trial.

PubMed

Devos, Hannes; Akinwuntan, Abiodun Emmanuel; Nieuwboer, Alice; Ringoot, Isabelle; Van Berghen, Karen; Tant, Mark; Kiekens, Carlotte; De Weerdt, Willy

2010-01-01

No long-term studies have been reported on the effect of training programs on driving after stroke. The authors' primary aim was to determine the effect of simulator versus cognitive rehabilitation therapy on fitness-to-drive at 5 years poststroke. A second aim was to investigate differences in clinical characteristics between stroke survivors who resumed and stopped driving. In a previously reported randomized controlled trial, 83 stroke survivors received 15 hours of simulator training (n = 42) or cognitive therapy (n = 41). In this 5-year follow-up study, 61 participants were reassessed. Fitness-to-drive decisions were obtained from medical, visual, neuropsychological, and on-road tests; 44 participants (simulator group, n = 21; cognitive group, n = 23) completed all assessments. The primary outcome measures were fitness-to-drive decision and current driving status. The authors found that 5 years after stroke, 18 of 30 participants (60%) in the simulator group were considered fit to drive, compared with 15 of 31 (48%) in the cognitive group (P = .36); 34 of 61 (56%) participants were driving. Current drivers were younger (P = .04), had higher Barthel scores (P = .008), had less comorbidity (P = .01), and were less severely depressed (P = .02) than those who gave up driving. The advantage of simulator-based driving training over cognitive rehabilitation therapy, evident at 6 months poststroke, had faded 5 years later. Poststroke drivers were younger and less severely affected and depressed than nondrivers.