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

PubMed

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

2017-12-12

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

Are Gains in Decision-Making Autonomy during Early Adolescence Beneficial for Emotional Functioning? The Case of the United States and China

ERIC Educational Resources Information Center

Qin, Lili; Pomerantz, Eva M.; Wang, Qian

2009-01-01

This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children…

Decision-Making in the Classroom and Early Adolescents' Valuing of Mathematics.

ERIC Educational Resources Information Center

Mac Iver, Douglas; Reuman, David A.

In many upper-elementary school classrooms, students are given few decision-making prerogatives. In junior high school, it becomes increasingly rare for them to receive the decision-making opportunities they believe they should have. Both person-environment fit theory and pawn theory would predict that a failure to provide students with such…

Decision making and action implementation: evidence for an early visually triggered motor activation specific to potential actions.

PubMed

Tandonnet, Christophe; Garry, Michael I; Summers, Jeffery J

2013-07-01

To make a decision may rely on accumulating evidence in favor of one alternative until a threshold is reached. Sequential-sampling models differ by the way of accumulating evidence and the link with action implementation. Here, we tested a model's prediction of an early action implementation specific to potential actions. We assessed the dynamics of action implementation in go/no-go and between-hand choice tasks by transcranial magnetic stimulation of the motor cortex (single- or paired-pulse TMS; 3-ms interstimulus interval). Prior to implementation of the selected action, the amplitude of the motor evoked potential first increased whatever the visual stimulus but only for the hand potentially involved in the to-be-produced action. These findings suggest that visual stimuli can trigger an early motor activation specific to potential actions, consistent with race-like models with continuous transmission between decision making and action implementation. Copyright © 2013 Society for Psychophysiological Research.

Decision making.

PubMed

Chambers, David W

2011-01-01

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

Taking an Evaluative Stance to Decision-Making about Professional Development Options in Early Childhood Education and Care

ERIC Educational Resources Information Center

Brownlee, Joanne Lunn; Sumsion, Jennifer; Irvine, Susan; Berthelsen, Donna; Farrell, Ann; Walsh, Kerryann; Ryan, Sharon; Mulhearn, Gerry

2015-01-01

This article builds on our ongoing work in conceptualising an "evaluative stance" framework to assist in understanding how leaders in the field of early childhood education and care (ECEC) make decisions about the selection of professional development options for themselves and their staff. It introduces the notion that evaluative…

Incorporating Family Assessment and Individualized Family Service Plans into Early Intervention Programs: A Developmental, Decision Making Process.

ERIC Educational Resources Information Center

Kochanek, Thomas T.; Friedman, Donna Haig

The monograph presents essential components of a decision making sequence used to incorporate formalized family assessment and service planning procedures into two existing early intervention programs in Massachusetts. The 1-year effort used a consultant to: (1) redefine screening and assessment processes to include both child and family centered…

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

ERIC Educational Resources Information Center

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

2015-01-01

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

Age-Related Changes in Decision Making: Comparing Informed and Noninformed Situations

ERIC Educational Resources Information Center

Van Duijvenvoorde, Anna C. K.; Jansen, Brenda R. J.; Bredman, Joren C.; Huizenga, Hilde M.

2012-01-01

Advantageous decision making progressively develops into early adulthood, most specifically in complex and motivationally salient decision situations in which direct feedback on gains and losses is provided (Figner & Weber, 2011). However, the factors that underlie this developmental improvement in decision making are still not well understood.…

Do neonatologists limit parental decision-making authority? A Canadian perspective.

PubMed

Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

2010-12-01

According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

School-Based Decision Making: Linking Decisions to Learning. Third-Year Report to the Prichard Committee.

ERIC Educational Resources Information Center

David, Jane L.

Under the Kentucky Education Reform Act (KERA), School-Based Decision Making (SBDM) is the provision that creates school councils and delegates to them the authority to make important educational decisions to improve student performance. This paper describes findings from the third year of a 5-year study of SBDM that focused on early examples of…

Cognitive influences on self-care decision making in persons with heart failure.

PubMed

Dickson, Victoria V; Tkacs, Nancy; Riegel, Barbara

2007-09-01

Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

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

A spiral model of musical decision-making.

PubMed

Bangert, Daniel; Schubert, Emery; Fabian, Dorottya

2014-01-01

This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans' (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor's (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally.

A spiral model of musical decision-making

PubMed Central

Bangert, Daniel; Schubert, Emery; Fabian, Dorottya

2014-01-01

This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans’ (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor’s (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally. PMID:24795673

Decision-making in frontotemporal dementia: clinical, theoretical and legal implications.

PubMed

Manes, Facundo; Torralva, Teresa; Ibáñez, Agustín; Roca, María; Bekinschtein, Tristán; Gleichgerrcht, Ezequiel

2011-01-01

The behavioral variant of frontotemporal dementia (bvFTD) is characterized by progressive changes in personality and social interaction, loss of empathy, disinhibition and impulsivity, most of which generally precede the onset of cognitive deficits. In this study, we investigated decision-making cognition in a group of patients with an early bvFTD diagnosis whose standard neuropsychological performance was within normal range for all variables. The Iowa Gambling Task was administered to this group of early bvFTD patients, to a group of early bvFTD patients who had shown impaired performance on the classical neuropsychological battery and to healthy controls. Decision-making was impaired in both bvFTD patient groups, whether they had shown impaired or normal performance in the classical neuropsychological evaluation. Patients with early bvFTD may perform normally on standard cognitive tests, and yet develop severe deficits in judgment and decision-making. In many current legal systems, early bvFTD patients showing preserved cognitive functioning who commit unlawful acts run the risk of not being able to plead insane or not guilty on the grounds of diminished responsibility beyond reasonable doubt. This represents a unique legal and ethical dilemma. Our findings have important implications for medicolegal decisions relating to capacity and culpability, and regarding the philosophical concept of 'free will'. 2011 S. Karger AG, Basel.

Dark Matter: The "Gravitational Pull" of Maternalist Discourses on Politicians' Decision Making for Early Childhood Policy in Australia

ERIC Educational Resources Information Center

Bown, Kathryn; Sumsion, Jennifer; Press, Frances

2011-01-01

The article reports on a study investigating influences on Australian politicians' decision making for early childhood education and care (ECEC) policy. The astronomical concept of dark matter is utilised as a metaphor for considering normalising, and therefore frequently difficult to detect and disrupt, influences implicated in politicians'…

Dissociating sensory from decision processes in human perceptual decision making.

PubMed

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

2015-12-15

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

Dissociating sensory from decision processes in human perceptual decision making

PubMed Central

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

2015-01-01

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

Composite collective decision-making.

PubMed

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

2015-06-22

Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

Categorization = Decision Making + Generalization

PubMed Central

Seger, Carol A; Peterson, Erik J.

2013-01-01

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

Contribution of economic evaluation to decision making in early phases of product development: a methodological and empirical review.

PubMed

Hartz, Susanne; John, Jürgen

2008-01-01

Economic evaluation as an integral part of health technology assessment is today mostly applied to established technologies. Evaluating healthcare innovations in their early states of development has recently attracted attention. Although it offers several benefits, it also holds methodological challenges. The aim of our study was to investigate the possible contributions of economic evaluation to industry's decision making early in product development and to confront the results with the actual use of early data in economic assessments. We conducted a literature research to detect methodological contributions as well as economic evaluations that used data from early phases of product development. Economic analysis can be beneficially used in early phases of product development for various purposes including early market assessment, R&D portfolio management, and first estimations of pricing and reimbursement scenarios. Analytical tools available for these purposes have been identified. Numerous empirical works were detected, but most do not disclose any concrete decision context and could not be directly matched with the suggested applications. Industry can benefit from starting economic evaluation early in product development in several ways. Empirical evidence suggests that there is still potential left unused.

A Methodology for Making Early Comparative Architecture Performance Evaluations

ERIC Educational Resources Information Center

Doyle, Gerald S.

2010-01-01

Complex and expensive systems' development suffers from a lack of method for making good system-architecture-selection decisions early in the development process. Failure to make a good system-architecture-selection decision increases the risk that a development effort will not meet cost, performance and schedule goals. This research provides a…

Decision Making and Binge Drinking: A Longitudinal Study

PubMed Central

Goudriaan, Anna E.; Grekin, Emily R.; Sher, Kenneth J.

2009-01-01

Background: Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity. Methods: Latent class growth analysis was used to classify college students into 4 groups (each group n = 50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included. Results: The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men. Conclusions: Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general. PMID:17403069

Stop making plans; start making decisions.

PubMed

Mankins, Michael C; Steele, Richard

2006-01-01

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

Cultural Challenges to Engaging Patients in Shared Decision Making

PubMed Central

Hawley, Sarah T.; Morris, Arden M.

2016-01-01

Objective Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. Discussion The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. Conclusion While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. PMID:27461943

Cultural challenges to engaging patients in shared decision making.

PubMed

Hawley, Sarah T; Morris, Arden M

2017-01-01

Engaging patients in their health care through shared decision-making is a priority embraced by several national and international groups. Missing from these initiatives is an understanding of the challenges involved in engaging patients from diverse backgrounds in shared decision-making. In this commentary, we summarize some of the challenges and pose points for consideration regarding how to move toward more culturally appropriate shared decision-making. The past decade has seen repeated calls for health policies, research projects and interventions that more actively include patients in decision making. Yet research has shown that patients from different racial/ethnic and cultural backgrounds appraise their decision making process less positively than do white, U.S.-born patients who are the current demographic majority. While preliminary conceptual frameworks have been proposed for considering the role of race/ethnicity and culture in healthcare utilization, we maintain that more foundational and empirical work is necessary. We offer recommendations for how to best involve patients early in treatment and how to maximize decision making in the way most meaningful to patients. Innovative and sustained efforts are needed to educate and train providers to communicate effectively in engaging patients in informed, shared decision-making and to provide culturally competent health care. Published by Elsevier Ireland Ltd.

Maternal psychological distress and child decision-making.

PubMed

Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B

2017-08-15

There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.

Making Decisions about Service Delivery in Early Childhood Programs

ERIC Educational Resources Information Center

Case-Smith, Jane; Holland, Terri

2009-01-01

Purpose: This article presents a rationale for specialized services personnel to use fluid models of service delivery and explains how specialized services personnel make decisions about the blend of service delivery methods that will best serve a child. Method: The literature on occupational therapy, physical therapy, and speech-language…

Decision Making and Cancer

PubMed Central

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

2014-01-01

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

Decision making and cancer.

PubMed

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

2015-01-01

We review decision making along the cancer continuum in the contemporary context of informed and shared decision making in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cognition, emotion, and their interaction are described, including classical psychophysical approaches, dual-process approaches that focus on conflicts between emotion versus cognition (or reason), and modern integrative approaches such as fuzzy-trace theory. In contrast to the earlier emphasis on rote use of numerical detail, modern approaches emphasize understanding the bottom-line gist of options (which encompasses emotion and other influences on meaning) and retrieving relevant social and moral values to apply to those gist representations. Finally, research on interventions to support better decision making in clinical settings is reviewed, drawing out implications for future research on decision making and cancer. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Future of Earthquake Early Warning: Quantifying Uncertainty and Making Fast Automated Decisions for Applications

NASA Astrophysics Data System (ADS)

Wu, Stephen

Earthquake early warning (EEW) systems have been rapidly developing over the past decade. Japan Meteorological Agency (JMA) has an EEW system that was operating during the 2011 M9 Tohoku earthquake in Japan, and this increased the awareness of EEW systems around the world. While longer-time earthquake prediction still faces many challenges to be practical, the availability of shorter-time EEW opens up a new door for earthquake loss mitigation. After an earthquake fault begins rupturing, an EEW system utilizes the first few seconds of recorded seismic waveform data to quickly predict the hypocenter location, magnitude, origin time and the expected shaking intensity level around the region. This early warning information is broadcast to different sites before the strong shaking arrives. The warning lead time of such a system is short, typically a few seconds to a minute or so, and the information is uncertain. These factors limit human intervention to activate mitigation actions and this must be addressed for engineering applications of EEW. This study applies a Bayesian probabilistic approach along with machine learning techniques and decision theories from economics to improve different aspects of EEW operation, including extending it to engineering applications. Existing EEW systems are often based on a deterministic approach. Often, they assume that only a single event occurs within a short period of time, which led to many false alarms after the Tohoku earthquake in Japan. This study develops a probability-based EEW algorithm based on an existing deterministic model to extend the EEW system to the case of concurrent events, which are often observed during the aftershock sequence after a large earthquake. To overcome the challenge of uncertain information and short lead time of EEW, this study also develops an earthquake probability-based automated decision-making (ePAD) framework to make robust decision for EEW mitigation applications. A cost-benefit model that

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.

The adaptive decision-making, risky decision, and decision-making style of Internet gaming disorder.

PubMed

Ko, C-H; Wang, P-W; Liu, T-L; Chen, C-S; Yen, C-F; Yen, J-Y

2017-07-01

Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews. The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively. These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making

Decision Making Under Uncertainty

DTIC Science & Technology

2010-11-01

A sound approach to rational decision making requires a decision maker to establish decision objectives, identify alternatives, and evaluate those...often violate the axioms of rationality when making decisions under uncertainty. The systematic description of such observations may lead to the...which leads to “anchoring” on the initial value. The fact that individuals have been shown to deviate from rationality when making decisions

Dissociation of emotional decision-making from cognitive decision-making in chronic schizophrenia.

PubMed

Lee, Yanghyun; Kim, Yang-Tae; Seo, Eugene; Park, Oaktae; Jeong, Sung-Hun; Kim, Sang Heon; Lee, Seung-Jae

2007-08-30

Recent studies have examined the decision-making ability of schizophrenic patients using the Iowa Gambling Task (IGT). These studies, however, were restricted to the assessment of emotional decision-making. Decision-making depends on cognitive functions as well as on emotion. The purpose of this study was to examine the performance of schizophrenic patients on the IGT and the Game of Dice Task (GDT), a decision-making task with explicit rules for gains and losses. In addition, it was intended to test whether poor performance on IGT is attributable to impairments in reversal learning within the schizophrenia group using the Simple Reversal Learning Task (SRLT), which is sensitive to measure the deficit of reversal learning following ventromedial prefrontal cortex damage. A group of 23 stable schizophrenic patients and 28 control subjects performed computerized versions of the IGT, GDT, SRLT and Wisconsin Card Sorting Test (WCST). While schizophrenic patients performed poorly on the IGT relative to normal controls, there was no significant difference between the two groups on GDT performance. The performance of the schizophrenia group on the SRLT was poorer than that of controls, but was not related to IGT performance. These data suggest that schizophrenic patients have impaired emotional decision-making but intact cognitive decision-making, suggesting that these two processes of decision-making are different. Furthermore, the impairments in reversal learning did not contribute to poor performance on the IGT in schizophrenia. Therefore, schizophrenic patients have difficulty in making decisions under ambiguous and uncertain situations whereas they make choices easily in clear and unequivocal ones. The emotional decision-making deficits in schizophrenia might be attributable more to another mechanism such as a somatic marker hypothesis than to an impairment in reversal learning.

Decision Making in Action

NASA Technical Reports Server (NTRS)

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

1994-01-01

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

[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.

Clinical decision-making of rural novice nurses.

PubMed

Seright, T J

2011-01-01

Nurses in rural settings are often the first to assess and interpret the patient's clinical presentations. Therefore, an understanding of how nurses experience decision-making is important in terms of educational preparation, resource allocation to rural areas, institutional cultures, and patient outcomes. Theory development was based on the in-depth investigation of 12 novice nurses practicing in rural critical access hospitals in a north central state. This grounded theory study consisted of face-to-face interviews with 12 registered nurses, nine of whom were observed during their work day. The participants were interviewed a second time, as a method of member checking, and during this interview they reviewed their transcripts, the emerging themes and categories. Directors of nursing from both the research sites and rural hospitals not involved in the study, experienced researchers, and nurse educators facilitated triangulation of the findings. 'Sociocentric rationalizing' emerged as the central phenomenon and referred to the sense of belonging and agency which impacted the decision-making in this small group of novice nurses in rural critical access hospitals. The observed consequences, which were conceptualized during the axial coding process and were derived from observations and interviews of the 12 novice nurses in this study include: (1) gathering information before making a decision included assessment of: the credibility of co-workers, patients' subjective and objective data, and one's own past and current experiences; (2) conferring with co-workers as a direct method of confirming/denying decisions being made was considered more realistic and expedient than policy books and decision trees; (3) rural practicum clinical experiences, along with support after orientation, provide for transition to the rural nurse role; (4) involved directors of nursing served as both models and protectors of novice nurses placed in high accountability positions early in

The Relations between Decision Making in Social Relationships and Decision Making Styles

ERIC Educational Resources Information Center

Sari, Enver

2008-01-01

The research reported in this paper aimed to examine the relationships between decisiveness in social relationships, and the decision-making styles of a group of university students and to investigate the contributions of decision-making styles in predicting decisiveness in social relationship (conflict resolution, social relationship selection…

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.

What you don't know about making decisions.

PubMed

Garvin, D A; Roberto, M A

2001-09-01

Most executives think of decision making as a singular event that occurs at a particular point in time. In reality, though, decision making is a process fraught with power plays, politics, personal nuances, and institutional history. Leaders who recognize this make far better decisions than those who persevere in the fantasy that decisions are events they alone control. That said, some decision-making processes are far more effective than others. Most often, participants use an advocacy process, possibly the least productive way to get things done. They view decision making as a contest, arguing passionately for their preferred solutions, presenting information selectively, withholding relevant conflicting data so they can make a convincing case, and standing firm against opposition. Much more powerful is an inquiry process, in which people consider a variety of options and work together to discover the best solution. Moving from advocacy to inquiry requires careful attention to three critical factors: fostering constructive, rather than personal, conflict; making sure everyone knows that their viewpoints are given serious consideration even if they are not ultimately accepted; and knowing when to bring deliberations to a close. The authors discuss in detail strategies for moving from an advocacy to an inquiry process, as well as for fostering productive conflict, true consideration, and timely closure. And they offer a framework for assessing the effectiveness of your process while you're still in the middle of it. Decision making is a job that lies at the very heart of leadership and one that requires a genius for balance: the ability to embrace the divergence that may characterize early discussions and to forge the unity needed for effective implementation.

Impaired Decision-Making in Adolescent Suicide Attempters

PubMed Central

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

2012-01-01

Objective Decision-making deficits have been linked to suicidal behavior in adults. However, it remains unclear whether impaired decision-making plays a role in the etiopathogenesis of youth suicidal behavior. The purpose of this study was to examine decision-making processes in adolescent suicide attempters and never-suicidal comparison subjects. Method Using the Iowa Gambling Task, the authors examined decision-making in 40 adolescent suicide attempters, ages 13–18, and 40 never-suicidal, demographically-matched psychiatric comparison subjects. Results Overall, suicide attempters performed significantly worse on the Iowa Gambling Task than comparison subjects. This difference in overall task performance between the groups persisted in an exact conditional logistic regression analysis that controlled for affective disorder, current psychotropic medication use, impulsivity, and hostility (adjusted odds ratio=0.96, 95% confidence interval=0.90–0.99, p<.05). A two-way repeated-measures analysis of variance revealed a significant group-by-block interaction, demonstrating that attempters failed to learn during the task, picking approximately the same proportion of disadvantageous cards in the first and final blocks of the task. In contrast, comparison subjects picked proportionately fewer cards from the disadvantageous decks as the task progressed. Within the attempter group, overall task performance did not correlate with any characteristic of the index attempt or with the personality dimensions of impulsivity, hostility, and emotional lability. Conclusions Similar to findings in adults, impaired decision-making is associated with suicidal behavior in adolescents. Longitudinal studies are needed to elucidate the temporal relationship between decision-making processes and suicidal behavior and help frame potential targets for early identification and preventive interventions to reduce youth suicide and suicidal behavior. PMID:22449645

Teacher Decision-Making.

ERIC Educational Resources Information Center

Smith, Carl B.

Since teaching is fundamentally a decision-making process, analyzing teachers' decisions can lead to a better understanding of learning and of management in the classroom. Three major features of teacher decision making are (1) that teaching is an intensely active profession; (2) that most of the work of teaching occurs in a group setting; and (3)…

[Interoception and decision-making].

PubMed

Ohira, Hideki

2015-02-01

We sometimes make decisions relying not necessarily on deliberative thoughts but on intuitive and emotional processes in uncertain situations. The somatic marker hypothesis proposed by Damasio argued that interoception, which means bodily responses such as sympathetic activity, can be represented in the insula and anterior cingulate cortex and can play critical roles in decision-making. Though this hypothesis has been criticized in its theoretical and empirical aspects, recent studies are expanding the hypothesis to elucidate multiple bodily responses including autonomic, endocrine, and immune activities that affect decision-making. In addition, cumulative findings suggest that the anterior insula where the inner model of interoception is represented can act as an interface between the brain and body in decision-making. This article aims to survey recent findings on the brain-body interplays underlying decision-making, and to propose hypotheses on the significance of the body in decision-making.

Making lineage decisions with biological noise: Lessons from the early mouse embryo.

PubMed

Simon, Claire S; Hadjantonakis, Anna-Katerina; Schröter, Christian

2018-04-30

Understanding how individual cells make fate decisions that lead to the faithful formation and homeostatic maintenance of tissues is a fundamental goal of contemporary developmental and stem cell biology. Seemingly uniform populations of stem cells and multipotent progenitors display a surprising degree of heterogeneity, primarily originating from the inherent stochastic nature of molecular processes underlying gene expression. Despite this heterogeneity, lineage decisions result in tissues of a defined size and with consistent proportions of differentiated cell types. Using the early mouse embryo as a model we review recent developments that have allowed the quantification of molecular intercellular heterogeneity during cell differentiation. We first discuss the relationship between these heterogeneities and developmental cellular potential. We then review recent theoretical approaches that formalize the mechanisms underlying fate decisions in the inner cell mass of the blastocyst stage embryo. These models build on our extensive knowledge of the genetic control of fate decisions in this system and will become essential tools for a rigorous understanding of the connection between noisy molecular processes and reproducible outcomes at the multicellular level. We conclude by suggesting that cell-to-cell communication provides a mechanism to exploit and buffer intercellular variability in a self-organized process that culminates in the reproducible formation of the mature mammalian blastocyst stage embryo that is ready for implantation into the maternal uterus. This article is categorized under: Gene Expression and Transcriptional Hierarchies > Cellular Differentiation Establishment of Spatial and Temporal Patterns > Regulation of Size, Proportion, and Timing Gene Expression and Transcriptional Hierarchies > Gene Networks and Genomics Gene Expression and Transcriptional Hierarchies > Quantitative Methods and Models. © 2018 Wiley Periodicals, Inc.

Teachers' Grading Decision Making

ERIC Educational Resources Information Center

Isnawati, Ida; Saukah, Ali

2017-01-01

This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…

Anxiety and Decision-Making

PubMed Central

Hartley, Catherine A.; Phelps, Elizabeth A.

2013-01-01

While the everyday decision-making of clinically anxious individuals is clearly influenced by their excessive fear and worry, the relationship between anxiety and decision-making remains relatively unexplored in neuroeconomic studies. In this review, we attempt to explore the role of anxiety in decision-making using a neuroeconomic approach. We first review the neural systems mediating fear and anxiety, which overlap with a network of brain regions implicated in studies of economic decision-making. We then discuss the potential influence of cognitive biases associated with anxiety upon economic choice, focusing on a set of decision-making biases involving choice in the face of potential aversive outcomes. We propose that the neural circuitry supporting fear learning and regulation may mediate the influence of anxiety upon choice, and suggest that techniques for altering fear and anxiety may also change decisions. PMID:22325982

Hospice decision making: diagnosis makes a difference.

PubMed

Waldrop, Deborah P; Meeker, Mary Ann

2012-10-01

This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36 hospice patients and 55 caregivers after 2 weeks of hospice care. The study was guided by Janis and Mann's conflict theory model (CTM) of decision making. Qualitative data analysis involved a directed content analysis using concepts from the CTM. A model of hospice enrollment decision making is presented. Concepts from the CTM (appraisal, surveying and weighing the alternatives, deliberations, adherence) were used as an organizing framework to illustrate the dynamics. Distinct differences were found by diagnosis (cancer vs. other chronic illness, e.g., heart and lung diseases) during the pre-encounter phase or before the hospice referral but no differences emerged during the post-encounter phase. Differences in decision making by diagnosis suggest the need for research about effective means for tailored communication in end-of-life decision making by type of illness. Recognition that decision making about hospice admission varies is important for clinicians who aim to provide person-centered and family-focused care.

Decision Making in Children and Adolescents: Impaired Iowa Gambling Task Performance in Early Adolescence

ERIC Educational Resources Information Center

Smith, Dana G.; Xiao, Lin; Bechara, Antoine

2012-01-01

Disadvantageous decision making is cited as one of the premier problems in childhood development, underlying risky behavior and causing adolescents to make poor choices that could prove detrimental later in life. However, there are relatively few studies looking at the development of decision making in children and adolescents, and fewer still…

Training for Aviation Decision Making: The Naturalistic Decision Making Perspective

NASA Technical Reports Server (NTRS)

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

1995-01-01

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

Dementia, Decision Making, and Capacity.

PubMed

Darby, R Ryan; Dickerson, Bradford C

After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.

Culinary Decision Making.

ERIC Educational Resources Information Center

Curtis, Rob

1987-01-01

Advises directors of ways to include day care workers in the decision-making process. Enumerates benefits of using staff to help focus and direct changes in the day care center and discusses possible pitfalls in implementation of a collective decision-making approach to management. (NH)

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

PubMed

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

2011-06-01

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

Mental disorder and legal responsibility: the relevance of stages of decision making.

PubMed

Kalis, Annemarie; Meynen, Gerben

2014-01-01

The paper discusses the relevance of decision-making models for evaluating the impact of mental disorder on legal responsibility. A three-stage model is presented that analyzes decision making in terms of behavioral control. We argue that understanding dysfunctions in each of the three stages of decision making could provide important insights in the relation between mental disorder and legal responsibility. In particular, it is argued that generating options for action constitutes an important but largely ignored stage of the decision-making process, and that dysfunctions in this early stage might undermine the whole process of making decisions (and thus behavioral control) more strongly than dysfunctions in later stages. Lastly, we show how the presented framework could be relevant to the actual psychiatric assessment of a defendant's decision making within the context of an insanity defense. Copyright © 2014 Elsevier Ltd. All rights reserved.

Participatory Decision Making.

ERIC Educational Resources Information Center

King, M. Bruce; And Others

Shifting from traditional, hierarchical bureaucracies to participatory governance and decision making is a major theme in school restructuring. This paper focuses on the involvement of teachers in key aspects of school decision making. Specifically, the paper describes how changes in power relations supported teachers' focus on improving the…

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

PubMed

Sims, Deborah; Fowler, Cathrine

2018-05-18

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

"Doing What's Best for Kids": A Narrative Study of Early Childhood Education and the Decision-Making of Superintendents

ERIC Educational Resources Information Center

Heath, Eric M.

2017-01-01

The purpose of this qualitative narrative study is to explore how superintendents perceive the importance of early childhood education in their school districts amid the State of Illinois's continued cuts to education spending. Also, this study examines the perceptions of superintendents' decision-making processes as it relates to the funding of…

Decision Making in the Airplane

NASA Technical Reports Server (NTRS)

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

1995-01-01

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

Sustainability Based Decision Making

EPA Science Inventory

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

Decision Making Styles and Progress in Occupational Decision Making.

ERIC Educational Resources Information Center

Phillips, Susan D.; And Others

1984-01-01

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

Longitudinal associations between mothers' perceptions of nonresidential fathers' investment of resources and influence in decision-making.

PubMed

Fagan, Jay; Palkovitz, Rob

2018-02-01

Nonresidential fathers are challenged to remain involved with their children across time in both direct and indirect ways, including influencing decision-making around important issues such as school attendance and medical care. An analytic sample of 1,350 families with residential mothers and nonresidential fathers was selected from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) to examine the longitudinal relationships between mothers' reports of nonresidential fathers' influence in decision-making and their provision of resources to their children. Findings indicate that fathers' voluntary contribution of tangible resources (informal child support, caregiving time) when children are 2 years old positively predict fathers' influence in decision-making regarding the care of their 4-year-old children. Fathers' early formal child support is not related to later decision-making. Fathers' communication with mother about the child at 24 months is related to later decision-making among daughters but not sons. Fathers' early decision-making is longitudinally related to later informal child support, caregiving time, and coparenting communication. The findings support the utility of a resource theory of fathering for understanding and predicting observed patterns of father involvement. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Decision-Making under Criteria Uncertainty

NASA Astrophysics Data System (ADS)

Kureychik, V. M.; Safronenkova, I. B.

2018-05-01

Uncertainty is an essential part of a decision-making procedure. The paper deals with the problem of decision-making under criteria uncertainty. In this context, decision-making under uncertainty, types and conditions of uncertainty were examined. The decision-making problem under uncertainty was formalized. A modification of the mathematical decision support method under uncertainty via ontologies was proposed. A critical distinction of the developed method is ontology usage as its base elements. The goal of this work is a development of a decision-making method under criteria uncertainty with the use of ontologies in the area of multilayer board designing. This method is oriented to improvement of technical-economic values of the examined domain.

Plasticity of Decision-Making Abilities Among Maltreated Adolescents: Evidence From a Random Controlled Trial

PubMed Central

Weller, Joshua A.; Leve, Leslie D.; Kim, Hyoun K.; Bhimji, Jabeene; Fisher, Philip A.

2014-01-01

Childhood maltreatment has lasting negative effects throughout the lifespan. Early intervention research has demonstrated that these effects can be remediated through skill-based, family-centered interventions. However, less is known about plasticity during adolescence, and whether interventions are effective many years after children experience maltreatment. This study investigated this question by examining adolescent girls’ ability to make advantageous decisions in the face of risk using a validated decision-making task; performance on this task has been associated with key neural regions involved in affective processing and executive functioning. Maltreated foster girls (n = 92), randomly assigned at age 11 to either an intervention designed to prevent risk-taking behaviors or services as usual (SAU), and non-maltreated age and SES-matched girls living with their biological parent(s) (n = 80), completed a decision-making task (at age 15–17) that assessed risk-taking and sensitivity to expected value, an index of advantageous decision-making. Girls in the SAU condition demonstrated the greatest decision-making difficulties, primarily for risks to avoid losses. In the SAU group, frequency of neglect was related to greater difficulties in this area. Girls in the intervention condition with less neglect performed similarly to non-maltreated peers. This research suggests that early maltreatment may impact decision-making abilities into adolescence and that enriched environments during early adolescence provide a window of plasticity that may ameliorate these negative effects. PMID:25997770

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

PubMed

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

2010-08-01

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

Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

PubMed

Power, Tara E; Swartzman, Leora C; Robinson, John W

2011-05-01

Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Magisterial Decision-Making: How Fifteen Stipendiary Magistrates Make Court-Room Decisions.

ERIC Educational Resources Information Center

Lawrence, Jeanette A.; Browne, Myra A.

This report describes the cognitive procedures which a group of Australian stipendiary utilize in court to make decisions. The study was based on an assumption that magistrates represent a group of professionals whose work involves making decisions of human significance, and on an assumption that the magistrates' own perceptions of their ways of…

An evaluation of learning clinical decision-making for early rehabilitation in the ICU via interactive education with audience response system.

PubMed

Toonstra, Amy L; Nelliot, Archana; Aronson Friedman, Lisa; Zanni, Jennifer M; Hodgson, Carol; Needham, Dale M

2017-06-01

Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience. An audience response system was incorporated to promote interaction and evaluate knowledge before vs. after the educational session. Up to 175 audience members, of 271 in attendance (129 (48%) physical therapists, 51 (19%) occupational therapists, 31 (11%) nursing, 14 (5%) physician, 46 (17%) other), completed both the pre- and post-test questions for each of the six unique patient cases. In four of six patient cases, there was a significant (p< 0.001) increase in identifying the correct answer regarding initiation of rehabilitation activities. This learning effect was similar irrespective of participants' years of experience and clinical discipline. An interactive, case-based, educational session may be effective for increasing short-term knowledge, and identifying knowledge gaps, regarding clinical decision-making for safe rehabilitation of patients in ICUs. Implications for Rehabilitation Lack of knowledge regarding the safety considerations for early rehabilitation of ICU patients is a barrier to implementing early rehabilitation. Interactive educational formats, such as the use of audience response systems, offer a new method of teaching and instantly assessing learning of clinically important information. In a small study, we have shown that an interactive, case-based educational format may be used to effectively teach clinical decision-making for the safe rehabilitation of ICU patients to a diverse audience of clinicians.

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

PubMed

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

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

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

PubMed

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

2015-01-01

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

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.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

PubMed

Hendrick, C Emily; Marteleto, Leticia

2017-06-01

Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras

PubMed Central

Hendrick, C. Emily; Marteleto, Leticia

2017-01-01

Maternal decision-making autonomy has been linked to positive outcomes for children’s health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children’s outcomes into adolescence and whether it impacts other domains of children’s lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents’ environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12–16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011–12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents’ school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers’ high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents’ school enrollment above and beyond other maternal, household, and regional influences. PMID:29075048

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

ERIC Educational Resources Information Center

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

2010-01-01

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

Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women.

PubMed

Obeidat, Rana F

2015-01-01

To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers' support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system.

The amygdala and decision-making.

PubMed

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

2011-03-01

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

Regret about surgical decisions among early-stage breast cancer patients: Effects of the congruence between patients' preferred and actual decision-making roles.

PubMed

Wang, Ashley Wei-Ting; Chang, Su-Mei; Chang, Cheng-Shyong; Chen, Shou-Tung; Chen, Dar-Ren; Fan, Fang; Antoni, Michael H; Hsu, Wen-Yau

2018-02-01

Early-stage breast cancer patients generally receive either a mastectomy or a lumpectomy, either by their own choice or that of their surgeon. Sometimes, there is regret about the decision afterward. To better understand regret about surgical decisions, this study examined 2 possibilities: The first is that women who take a dominant or collaborative role in decision making about the surgery express less regret afterward. The second is that congruence between preferred role and actual role predicts less regret. We also explored whether disease stage moderates the relationship between role congruence and decisional regret. In a cross-sectional design, 154 women diagnosed with breast cancer completed a survey assessing decisional role preference and actual decisional role, a measure of post-decision regret, and a measure of disturbances related to breast cancer treatment. Hierarchical regression was used to investigate prediction of decisional regret. Role congruence, not actual decisional role, was significantly associated with less decisional regret, independent of all the control variables. The interaction between disease stage and role congruence was also significant, showing that mismatch relates to regret only in women with more advanced disease. Our findings suggest that cancer patients could benefit from tailored decision support concerning their decisional role preferences in the complex scenario of medical and personal factors during the surgical decision. Copyright © 2017 John Wiley & Sons, Ltd.

The influence of gene expression profiling on decisional conflict in decision making for early-stage breast cancer chemotherapy.

PubMed

MacDonald, Karen V; Bombard, Yvonne; Deal, Ken; Trudeau, Maureen; Leighl, Natasha; Marshall, Deborah A

2016-07-01

Women with early-stage breast cancer, of whom only 15% will experience a recurrence, are often conflicted or uncertain about taking chemotherapy. Gene expression profiling (GEP) of tumours informs risk prediction, potentially affecting treatment decisions. We examined whether receiving a GEP test score reduces decisional conflict in chemotherapy treatment decision making. A general population sample of 200 women completed the decisional conflict scale (DCS) at baseline (no GEP test score scenario) and after (scenario with GEP test score added) completing a discrete choice experiment survey for early-stage breast cancer chemotherapy. We scaled the 16-item DCS total scores and subscores from 0 to 100 and calculated means, standard deviations and change in scores, with significance (p < 0.05) based on matched pairs t-tests. We identified five respondent subgroups based on preferred treatment option; almost 40% did not change their chemotherapy decision after receiving GEP testing information. Total score and all subscores (uncertainty, informed, values clarity, support, and effective decision) decreased significantly in the respondent subgroup who were unsure about taking chemotherapy initially but changed to no chemotherapy (n =33). In the subgroup of respondents (n = 25) who chose chemotherapy initially but changed to unsure, effective decision subscore increased significantly. In the overall sample, changes in total and all subscores were non-significant. GEP testing adds value for women initially unsure about chemotherapy treatment with a decrease in decisional conflict. However, for women who are confident about their treatment decisions, GEP testing may not add value. Decisions to request GEP testing should be personalised based on patient preferences. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pilot Decision-Making Training

DTIC Science & Technology

1990-05-01

Pilot Decisional Attitude Questionnaire (PDAQ). 2. Aeronautical Decision Making . a. The pilot judgment problem b. Relationship of judgment to training...lmEr OAT . REPOR TYPE ANO GATES COVEIRO May 1990 Final - June 1985 - December 1988 4 .MU AN m . .m m t 4i C ’u. SUM L FUNING MUMBRS Pilot Decision - Making ...13 AGSTRACT (Maxu’m 200 wo f -The effectiveness of a simulator-based approach to training pilot skills in risk assessment and decision making was

Strategies of Decision Making

DTIC Science & Technology

1989-05-01

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

Modelling decision-making by pilots

NASA Technical Reports Server (NTRS)

Patrick, Nicholas J. M.

1993-01-01

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

Preferred and Perceived Participation of Younger and Older Patients in Decision Making About Treatment for Early Breast Cancer: A Prospective Study.

PubMed

Hamelinck, Victoria C; Bastiaannet, Esther; Pieterse, Arwen H; van de Velde, Cornelis J H; Liefers, Gerrit-Jan; Stiggelbout, Anne M

2018-04-01

Older patients are believed to prefer a more passive role in treatment decision making, but studies reporting this relation were conducted over a decade ago or were retrospective. We prospectively compared younger (40-64 years) versus older (≥ 65 years) breast cancer patients' preferences for decision-making roles and their perceived actual roles. A prospective multicenter study was conducted in Leiden, The Hague, and Tilburg over a 2-year period. Early-stage breast cancer patients were surveyed about their preferred and perceived decision-making roles (active, shared, or passive) concerning surgery type (breast-conserving vs. mastectomy) (n = 74), adjuvant chemotherapy (aCT, n = 43), and adjuvant hormonal therapy (aHT, n = 39). For all decisions, both age groups most frequently preferred a shared role before consultation, except for decisions about aHT, for which younger patients more commonly preferred an active role. The proportion of patients favoring an active or passive role in each decision was lower for the older than the younger patients, but none of the differences was significant. Regarding perceived actual roles, both groups most frequently reported an active role in the surgical decision after consultation. In deciding about both aCT and aHT, a larger proportion of older patients perceived having had a passive role compared to younger patients, and a greater proportion of younger patients perceived having been active. Again, differences were not statistically significant. Most older patients preferred to decide together with their clinician, but preferences varied widely. Older patients more often than younger patients perceived they had not been involved in decisions about systemic therapy. Clinicians should invite all patients to participate in decision making and elicit their preferred role. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Self-Esteem in Decision Making and Decision-Making Styles of Teachers

ERIC Educational Resources Information Center

Temel, Veysel; Birol, Sefa Sahan; Nas, Kazim; Akpinar, Selahattin; Tekin, Murat

2015-01-01

The aim of the study was to examine the self-esteem in decision-making and decision-making styles of the teachers in various branches of Çat town of Erzurum Province, Turkey in terms of some variables in 2014-2015 year. A total of 153 teachers (84 females and 69 males) (age (? = 1.6536 ± 0.72837) from different departments participated in the…

Administrative decision making: a stepwise method.

PubMed

Oetjen, Reid M; Oetjen, Dawn M; Rotarius, Timothy

2008-01-01

Today's health care organizations face tremendous challenges and fierce competition. These pressures impact the decisions that managers must execute on any given day, not to mention the ever-present constraints of time, personnel, competencies, and finances. The importance of making quality and informed decisions cannot be underestimated. Traditional decision making methods are inadequate for today's larger, more complex health care organizations and the rapidly changing health care environment. As a result, today's health care managers and their teams need new approaches to making decisions for their organizations. This article examines the managerial decision making process and offers a model that can be used as a decision making template to help managers successfully navigate the choppy health care seas. The administrative decision making model will enable health care managers and other key decision makers to avoid the common pitfalls of poor decision making and guide their organizations to success.

The neural basis of belief updating and rational decision making

PubMed Central

Achtziger, Anja; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes’ rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision. PMID:22956673

The neural basis of belief updating and rational decision making.

PubMed

Achtziger, Anja; Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Steinhauser, Marco

2014-01-01

Rational decision making under uncertainty requires forming beliefs that integrate prior and new information through Bayes' rule. Human decision makers typically deviate from Bayesian updating by either overweighting the prior (conservatism) or overweighting new information (e.g. the representativeness heuristic). We investigated these deviations through measurements of electrocortical activity in the human brain during incentivized probability-updating tasks and found evidence of extremely early commitment to boundedly rational heuristics. Participants who overweight new information display a lower sensibility to conflict detection, captured by an event-related potential (the N2) observed around 260 ms after the presentation of new information. Conservative decision makers (who overweight prior probabilities) make up their mind before new information is presented, as indicated by the lateralized readiness potential in the brain. That is, they do not inhibit the processing of new information but rather immediately rely on the prior for making a decision.

Living kidney donation: considerations and decision-making.

PubMed

Agerskov, Hanne; Bistrup, Claus; Ludvigsen, Mette Spliid; Pedersen, Birthe D

2014-06-01

When possible, renal transplantation is the treatment of choice for patients with end-stage kidney disease. Technological developments in immunology have made it possible to perform kidney transplants between donors and recipients despite antibodies against the donor organ. This allows for a wider range of relationships between recipient and donor. We investigated experiences of, and reflections on, kidney donation among genetic and non-genetic living donors before first consultation at the transplant centre. The aim was to investigate early experiences in the process of becoming a living kidney donor (LKD). The study was conducted within a phenomenological-hermeneutic theoretical framework. Data were generated through semi-structured interviews with 18 potential donors. Data were interpreted and discussed in accordance with the Ricoeur's text interpretation theory on the three levels of naïve reading, structural analysis and critical interpretation and discussion. Two themes emerged: the decision-making process and dilemmas in decision-making. The study identifies that the decision about donation was made in relation to one's own life, family situation and in relation to the recipient-considerations that demonstrate that a range of dilemmas can occur during the decision-making process. The desire to help was prominent and was of significance in decision-making. The study provides insight and knowledge for the health care professionals to meet and involve donors' narratives in reflections about and modifications to clinical nursing practice. It is essential that health care professionals have an understanding and appreciation of the experiences and concerns among LKDs, and this can help in planning and providing individual nursing care and support to donors. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Incomplete and inconsistent information provided to men making decisions for treatment of early-stage prostate cancer.

PubMed

Snow, Stephanie L; Panton, Rachel L; Butler, Lorna J; Wilke, Derek R; Rutledge, Robert D H; Bell, David G; Rendon, Ricardo A

2007-05-01

To determine whether there is a gap between what patients know about early-stage prostate cancer and what they need to know to make treatment decisions, and whether the information patients receive varies depending on their treating physician. Needs assessment was performed using a questionnaire consisting of 41 statements about early-stage prostate cancer. Statements were divided into six thematic subsets. Participants used a 5-point Likert scale to rate statements in terms of knowledge of the information and importance to a treatment decision. Information gaps were defined as significant difference between the importance and knowledge of an item. Descriptive statistics were used to describe demographic subscale scores. The information gap was analyzed by a paired t test for each thematic subset. One-way analyses of variance were used to detect any differences on the basis of treating physician. Questionnaires were distributed to 270 men (135 treated by radical prostatectomy, 135 by external beam radiotherapy). The return rate was 51% (138 questionnaires). A statistically significant information gap was found among all six thematic subsets, with five of the six P values less than 0.0001. Statistically significant variation was observed in the amount of information patients received from their treating physicians among four of the thematic subsets. There is an information gap between what early-stage prostate cancer patients need to know and the information they receive. Additionally there is a difference in the amount of information provided by different physicians.

Adapting Scott and Bruce's General Decision-Making Style Inventory to Patient Decision Making in Provider Choice.

PubMed

Fischer, Sophia; Soyez, Katja; Gurtner, Sebastian

2015-05-01

Research testing the concept of decision-making styles in specific contexts such as health care-related choices is missing. Therefore, we examine the contextuality of Scott and Bruce's (1995) General Decision-Making Style Inventory with respect to patient choice situations. Scott and Bruce's scale was adapted for use as a patient decision-making style inventory. In total, 388 German patients who underwent elective joint surgery responded to a questionnaire about their provider choice. Confirmatory factor analyses within 2 independent samples assessed factorial structure, reliability, and validity of the scale. The final 4-dimensional, 13-item patient decision-making style inventory showed satisfactory psychometric properties. Data analyses supported reliability and construct validity. Besides the intuitive, dependent, and avoidant style, a new subdimension, called "comparative" decision-making style, emerged that originated from the rational dimension of the general model. This research provides evidence for the contextuality of decision-making style to specific choice situations. Using a limited set of indicators, this report proposes the patient decision-making style inventory as valid and feasible tool to assess patients' decision propensities. © The Author(s) 2015.

Medical decision-making in children and adolescents: developmental and neuroscientific aspects.

PubMed

Grootens-Wiegers, Petronella; Hein, Irma M; van den Broek, Jos M; de Vries, Martine C

2017-05-08

Various international laws and guidelines stress the importance of respecting the developing autonomy of children and involving minors in decision-making regarding treatment and research participation. However, no universal agreement exists as to at what age minors should be deemed decision-making competent. Minors of the same age may show different levels of maturity. In addition, patients deemed rational conversation-partners as a child can suddenly become noncompliant as an adolescent. Age, context and development all play a role in decision-making competence. In this article we adopt a perspective on competence that specifically focuses on the impact of brain development on the child's decision-making process. We believe that the discussion on decision-making competence of minors can greatly benefit from a multidisciplinary approach. We adopted such an approach in order to contribute to the understanding on how to deal with children in decision-making situations. Evidence emerging from neuroscience research concerning the developing brain structures in minors is combined with insights from various other fields, such as psychology, decision-making science and ethics. Four capacities have been described that are required for (medical) decision-making: (1) communicating a choice; (2) understanding; (3) reasoning; and (4) appreciation. Each capacity is related to a number of specific skills and abilities that need to be sufficiently developed to support the capacity. Based on this approach it can be concluded that at the age of 12 children can have the capacity to be decision-making competent. However, this age coincides with the onset of adolescence. Early development of the brain's reward system combined with late development of the control system diminishes decision-making competence in adolescents in specific contexts. We conclude that even adolescents possessing capacities required for decision-making, may need support of facilitating environmental factors

Role of affect in decision making.

PubMed

Bandyopadhyay, Debarati; Pammi, V S Chandrasekhar; Srinivasan, Narayanan

2013-01-01

Emotion plays a major role in influencing our everyday cognitive and behavioral functions, including decision making. We introduce different ways in which emotions are characterized in terms of the way they influence or elicited by decision making. This chapter discusses different theories that have been proposed to explain the role of emotions in judgment and decision making. We also discuss incidental emotional influences, both long-duration influences like mood and short-duration influences by emotional context present prior to or during decision making. We present and discuss results from a study with emotional pictures presented prior to decision making and how that influences both decision processes and postdecision experience as a function of uncertainty. We conclude with a summary of the work on emotions and decision making in the context of decision-making theories and our work on incidental emotions. Copyright © 2013 Elsevier B.V. All rights reserved.

Carbon Cycle Science in Support of Decision-Making

NASA Astrophysics Data System (ADS)

Brown, M. E.; West, T. O.; McGlynn, E.; Gurwick, N. P.; Duren, R. M.; Ocko, I.; Paustian, K.

2016-12-01

There has been an extensive amount of basic and applied research conducted on biogeochemical cycles, land cover change, watershed to earth system modeling, climate change, and energy efficiency. Concurrently, there continues to be interest in how to best reduce net carbon emissions, including maintaining or augmenting global carbon stocks and decreasing fossil fuel emissions. Decisions surrounding reductions in net emissions should be grounded in, and informed by, existing scientific knowledge and analyses in order to be most effective. The translation of scientific research to decision-making is rarely direct, and often requires coordination of objectives or intermediate research steps. For example, complex model output may need to be simplified to provide mean estimates for given activities; biogeochemical models used for climate change prediction may need to be altered to estimate net carbon flux associated with particular activities; or scientific analyses may need to aggregate and analyze data in a different manner to address specific questions. In the aforementioned cases, expertise and capabilities of researchers and decision-makers are both needed, and early coordination and communication is most effective. Initial analysis of existing science and current decision-making needs indicate that (a) knowledge that is co-produced by scientists and decision-makers has a higher probability of being usable for decision making, (b) scientific work in the past decade to integrate activity data into models has resulted in more usable information for decision makers, (c) attribution and accounting of carbon cycle fluxes is key to using carbon cycle science for decision-making, and (d) stronger, long-term links among research on climate and management of carbon-related sectors (e.g., energy, land use, industry, and buildings) are needed to adequately address current issues.

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

PubMed Central

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

2007-01-01

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

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

PubMed

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

2004-08-01

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

Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk

PubMed Central

Zhang, Long; Wang, Kai; Zhu, Chunyan; Yu, Fengqiong; Chen, Xingui

2015-01-01

Previous studies have reported that trait anxiety (TA) affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA), medium TA (MTA) and low TA (LTA) groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT) that measures decision making under ambiguity and the Game of Dice Task (GDT) that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT. PMID:26000629

[Shared decision making].

PubMed

Floer, B; Schnee, M; Böcken, J; Streich, W; Kunstmann, W; Isfort, J; Butzlaff, M

2004-10-29

The demand for integration of patients in medical decisions becomes more and more obvious. Little is known about whether patients are willing and ready to share therapeutic decisions. So far information is lacking, whether existing communication skills of both -- patients and physicians -- are sufficient for shared decision making (SDM). This paper presents new data on patients perspectives regarding SDM. Standardized survey of 3058 German speaking people (1565 females, 1493 males), aged 18-79 years, a population based random sample of an access panel (pool of german households available for specific surveys) regarding the following topics: medical decision making in practice, communication skills and behaviour of physicians. A majority of patients approved the model of SDM. However, some subgroups of patients, especially older patients, were less interested in the concept of SDM. Necessary communication skills which may help patients to participate in decision making were used rather scarcely. Patients who approved the model of SDM more often experienced a common and trustful exchange of information. Most patients favour the concept of SDM. The communication skills necessary for this process are to be promoted and extended. Research on patients' preferences and their participation in health care reform should be intensified. Academic and continuous medical education should focus on knowledge transfer to patients.

Risky decision-making in children with and without ADHD: A prospective study.

PubMed

Humphreys, Kathryn L; Tottenham, Nim; Lee, Steve S

2018-02-01

Learning from past decisions can enhance successful decision-making. It is unclear whether difficulties in learning from experience may contribute to risky decision-making, which may be altered among individuals with attention-deficit/hyperactivity disorder (ADHD). This study follows 192 children with and without ADHD aged 5 to 10 years for approximately 2.5 years and examines their risky decision-making using the Balloon Emotional Learning Task (BELT), a computerized assessment of sequential risky decision-making in which participants pump up a series of virtual balloons for points. The BELT contains three task conditions: one with a variable explosion point, one with a stable and early explosion point, and one with a stable and late explosion point. These conditions may be learned via experience on the task. Contrary to expectations, ADHD status was not found to be related to greater risk-taking on the BELT, and among younger children ADHD status is in fact associated with reduced risk-taking. In addition, the typically-developing children without ADHD showed significant learning-related gains on both stable task conditions. However, the children with ADHD demonstrated learning on the condition with a stable and early explosion point, but not on the condition with the stable and late explosion point, in which more pumps are required before learning when the balloon will explode. Learning during decision-making may be more difficult for children with ADHD. Because adapting to changing environmental demands requires the use of feedback to guide future behavior, negative outcomes associated with childhood ADHD may partially reflect difficulties in learning from experience.

The Effect of Decision-Making Skill Training Programs on Self-Esteem and Decision-Making Styles

ERIC Educational Resources Information Center

Colakkadioglu, Oguzhan; Celik, D. Billur

2016-01-01

Problem Statement: Decision making is a critical cognitive process in every area of human life. In this process, the individuals play an active role and obtain outputs with their functional use of decision-making skills. Therefore, the decision-making process can affect the course of life, life satisfaction, and the social relations of an…

Twelve myths about shared decision making.

PubMed

Légaré, France; Thompson-Leduc, Philippe

2014-09-01

As shared decision makes increasing headway in healthcare policy, it is under more scrutiny. We sought to identify and dispel the most prevalent myths about shared decision making. In 20 years in the shared decision making field one of the author has repeatedly heard mention of the same barriers to scaling up shared decision making across the healthcare spectrum. We conducted a selective literature review relating to shared decision making to further investigate these commonly perceived barriers and to seek evidence supporting their existence or not. Beliefs about barriers to scaling up shared decision making represent a wide range of historical, cultural, financial and scientific concerns. We found little evidence to support twelve of the most common beliefs about barriers to scaling up shared decision making, and indeed found evidence to the contrary. Our selective review of the literature suggests that twelve of the most commonly perceived barriers to scaling up shared decision making across the healthcare spectrum should be termed myths as they can be dispelled by evidence. Our review confirms that the current debate about shared decision making must not deter policy makers and clinicians from pursuing its scaling up across the healthcare continuum. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women

PubMed Central

Obeidat, Rana F.

2015-01-01

To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers’ support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system. PMID:27981122

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

Collaborative Decision Making in METOC

DTIC Science & Technology

2002-01-01

desired effect (Eagly, & Chaiken, 1993). Arguably, artificial intelligence is representative of the best of approaches in rational decision - making ...2001), The quantum of social action and the function of emotion in decision - making , Emotional and Intelligent II: The Tangled Knot of Social...Collaborative decision making in METOC W.F. Lawless Paine College, Departments of Mathematics and Psychology Augusta, GA 30901-3182 ph: 706

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…

Asymmetric life-history decision-making in butterfly larvae

PubMed Central

Aalberg Haugen, Inger M.; Dahlerus, Josefin; Gotthard, Karl; Wiklund, Christer

2010-01-01

In temperate environments, insects appearing in several generations in the growth season typically have to decide during the larval period whether to develop into adulthood, or to postpone adult emergence until next season by entering a species-specific diapause stage. This decision is typically guided by environmental cues experienced during development. An early decision makes it possible to adjust growth rate, which would allow the growing larva to respond to time stress involved in direct development, whereas a last-minute decision would instead allow the larva to use up-to-date information about which developmental pathway is the most favourable under the current circumstances. We study the timing of the larval pathway decision-making between entering pupal winter diapause and direct development in three distantly related butterflies (Pieris napi, Araschnia levana and Pararge aegeria). We pinpoint the timing of the larval diapause decision by transferring larvae from first to last instars from long daylength (inducing direct development) to short daylength conditions (inducing diapause), and vice versa. Results show that the pathway decision is typically made in the late instars in all three species, and that the ability to switch developmental pathway late in juvenile life is conditional; larvae more freely switched from diapause to direct development than in the opposite direction. We contend that this asymmetry is influenced by the additional physiological preparations needed to survive the long and cold winter period, and that the reluctance to make a late decision to enter diapause has the potential to be a general trait among temperate insects. PMID:20953962

Experiencing cancer treatment decision-making in managed care.

PubMed

Wenzel, Jennifer; Shaha, Maya

2008-09-01

This paper is a report of a study to explore women's perceptions of and experiences with breast cancer treatment decision-making in managed care organizations (MCOs). Managed care organizations are the predominant form of employer-sponsored healthcare insurance in the United States of America. These healthcare financing entities minimize cost by streamlining healthcare delivery and may impose choice restrictions. The extent of these restrictions has not previously been studied from an in-depth patient perspective. A qualitative descriptive approach was adopted using interviews with a purposive sample of 14 managed care enrollees diagnosed with breast cancer at all stages. The data were collected between 2003 and 2005. Data analysis involved a reflexive process of transcript reading, categorization, data reduction and interpretation. The findings are presented as a single theme: 'decisional conflict in managed care', with two distinct categories: decisions regarding (1) the MCOs and (2) treatment. MCO selection was perceived to be limited by employer constraints, cost issues or healthcare plan providers. For study participants, selecting a MCO was less difficult than issues surrounding treatment decision-making. Women reported that their most important treatment-related decisions surrounded diagnosis and involved selecting a treatment facility and provider. Once a satisfactory facility and provider were selected, these women preferred to defer treatment decisions to their healthcare providers. Decision interventions should be focused on assisting women with provider and treatment facility selection early in diagnosis. Our findings might also serve as a basis for policy/practice changes to address healthcare financing limitations and to expand cancer treatment-related choices while providing desired treatment decision-making support.

Critical decision-making in radiotherapy for early stage breast cancer in a neo-adjuvant treatment era.

PubMed

De Felice, Francesca; Osti, Mattia Falchetto; De Sanctis, Vitaliana; Musio, Daniela; Tombolini, Vincenzo

2017-05-01

In breast cancer management, the role of adjuvant radiation therapy (RT) has been the subject of intense controversy over the past several years, due to the improvement in neoadjuvant chemotherapy (NACT) prescription. One of the most controversial questions regarding indication for adjuvant RT is whether or not RT is essential in patients with early stage disease at diagnosis. The value of adjuvant RT remains highly debatable in those patients with clinically negative nodes at the completion of NACT. Areas covered: This review is focused on this gray area and is intended to assist with clinical decision-making. We provide a comprehensive review using PubMed and meeting proceedings of San Antonio Breast Cancer Symposium, European Society for Radiotherapy & Oncology, European Society of Medical Oncology and American Society of Clinical Oncology. Expert commentary: The identification of potential prognostic factors may lead to novel adjuvant RT indications. Phase III clinical trials are underway and their results will help guide treatment decisions.

Serotonin and decision making processes.

PubMed

Homberg, Judith R

2012-01-01

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

Strategic larval decision-making in a bivoltine butterfly.

PubMed

Friberg, Magne; Dahlerus, Josefin; Wiklund, Christer

2012-07-01

In temperate areas, insect larvae must decide between entering winter diapause or developing directly and reproducing in the same season. Long daylength and high temperature promote direct development, which is generally associated with a higher growth rate. In this work, we investigated whether the larval pathway decision precedes the adjustment of growth rate (state-independent), or whether the pathway decision is conditional on the individual's growth rate (state-dependent), in the butterfly Pieris napi. This species typically makes the pathway decision in the penultimate instar. We measured growth rate throughout larval development under two daylengths: slightly shorter and slightly longer than the critical daylength. Results indicate that the pathway decision can be both state-independent and state-dependent; under the shorter daylength condition, most larvae entered diapause, and direct development was chosen exclusively by a small subset of larvae showing the highest growth rates already in the early instars; under the longer daylength condition, most larvae developed directly, and the diapause pathway was chosen exclusively by a small subset of slow-growing individuals. Among the remainder, the choice of pathway was independent of the early growth rate; larvae entering diapause under the short daylength grew as fast as or faster than the direct developers under the longer daylength in the early instars, whereas the direct developers grew faster than the diapausers only in the ultimate instar. Hence, the pathway decision was state-dependent in a subset with a very high or very low growth rate, whereas the decision was state-independent in the majority of the larvae, which made the growth rate adjustment downstream from the pathway decision.

Quantitative light-induced fluorescence (QLF): a tool for early occlusal dental caries detection and supporting decision making in vivo.

PubMed

Alammari, M R; Smith, P W; de Josselin de Jong, E; Higham, S M

2013-02-01

This study reports the development and assessment of a novel method using quantitative light-induced fluorescence (QLF), to determine whether QLF parameters ΔF and ΔQ were appropriate for aiding diagnosis and clinical decision making of early occlusal mineral loss by comparing QLF analysis with actual restorative management. Following ethical approval, 46 subjects attending a dental teaching hospital were enrolled. White light digital (WL) and QLF images/analyses of 46 unrestored posterior teeth with suspected occlusal caries were made after a clinical decision had already been taken to explore fissures operatively. WL and QLF imaging/analysis were repeated after initial cavity preparation. The type of restorative treatment was determined by the supervising clinician independent of any imaging performed. Actual restorative management carried out was recorded as fissure sealant/preventive resin restoration (F/P) or class I occlusal restoration (Rest.) thus reflecting the extent of intervention (=gold standard). All QLF images were analysed independently. The results showed statistically significant differences between the two treatment groups ΔF (p=0.002) (mean 22.60 - F/P and 28.80 - Rest.) and ΔQ (p=0.012) (mean 230.49 - F/P and 348.30 - Rest.). ΔF and ΔQ values may be useful in aiding clinical diagnosis and decision making in relation to the management of early mineral loss and restorative intervention of occlusal caries. QLF has the potential to be a valuable tool for caries diagnosis in clinical practice. Copyright © 2012 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.

Decision making on fitness landscapes

NASA Astrophysics Data System (ADS)

Arthur, R.; Sibani, P.

2017-04-01

We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et al. that we call the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures.

Command Decision-Making: Experience Counts

DTIC Science & Technology

2005-03-18

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

The PRC Decision-Making Process

DTIC Science & Technology

2002-03-01

REPORT DATE March 2002 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE The PRC Decision - Making ...of crisis. It explores who has the authority to make decisions in China today and who will have this authority as new leaders...security and foreign policy decision - making during times of crisis. The April 2001 EP-3 incident is examined to assess high-level

Engaging Pupils in Decision-Making about Biodiversity Conservation Issues

ERIC Educational Resources Information Center

Grace, Marcus; Byrne, Jenny

2010-01-01

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

Decision Making in Adults with ADHD

ERIC Educational Resources Information Center

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

2012-01-01

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

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,…

Decision-making impairment in anorexia nervosa: New insights into the role of age and decision-making style.

PubMed

Giannunzio, Valeria; Degortes, Daniela; Tenconi, Elena; Collantoni, Enrico; Solmi, Marco; Santonastaso, Paolo; Favaro, Angela

2018-07-01

Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

When Friends' and Society's Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College.

PubMed

Bollich, Kathryn L; Hill, Patrick L; Harms, Peter D; Jackson, Joshua J

2016-01-01

Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change.

Motivations Underlying Career Decision-Making Activities: The Career Decision-Making Autonomy Scale (CDMAS)

ERIC Educational Resources Information Center

Guay, Frederic

2005-01-01

The purpose of the present research was to develop and validate a measure of motivation toward career decision-making activities, the Career Decision-Making Autonomy Scale (CDMAS). The CDMAS is designed to assess the constructs of intrinsic motivation, identified regulation, introjected regulation, and external regulation. A longitudinal study was…

Decision making: the neuroethological turn

PubMed Central

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

2014-01-01

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

Shared decision-making and patient autonomy.

PubMed

Sandman, Lars; Munthe, Christian

2009-01-01

In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

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

Navigating the Decision Space: Shared Medical Decision Making as Distributed Cognition.

PubMed

Lippa, Katherine D; Feufel, Markus A; Robinson, F Eric; Shalin, Valerie L

2017-06-01

Despite increasing prominence, little is known about the cognitive processes underlying shared decision making. To investigate these processes, we conceptualize shared decision making as a form of distributed cognition. We introduce a Decision Space Model to identify physical and social influences on decision making. Using field observations and interviews, we demonstrate that patients and physicians in both acute and chronic care consider these influences when identifying the need for a decision, searching for decision parameters, making actionable decisions Based on the distribution of access to information and actions, we then identify four related patterns: physician dominated; physician-defined, patient-made; patient-defined, physician-made; and patient-dominated decisions. Results suggests that (a) decision making is necessarily distributed between physicians and patients, (b) differential access to information and action over time requires participants to transform a distributed task into a shared decision, and (c) adverse outcomes may result from failures to integrate physician and patient reasoning. Our analysis unifies disparate findings in the medical decision-making literature and has implications for improving care and medical training.

Making the Connection between Environmental Science and Decision Making

NASA Astrophysics Data System (ADS)

Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.

2011-12-01

As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and

Measuring shared decision making in the consultation: a comparison of the OPTION and Informed Decision Making instruments.

PubMed

Weiss, Marjorie C; Peters, Tim J

2008-01-01

To investigate the applied and conceptual relationship between two measures of shared decision making using the OPTION instrument developed in Wales and the Informed Decision Making instrument developed in Seattle, USA using audio-taped consultation data from a UK general practice population. Twelve general practitioners were recruited from 6 general practices in the southwest of England. One hundred twenty-three GP-patient consultations were audio-recorded. Audiotapes were sent off to, and rated by, respective experts in the use of the OPTION and the Informed Decision Making instruments. Compared to earlier work using the Informed Decision Making tool, consultations in this sample were shorter, had fewer decisions and tended to have a greater number of elements present. Similar to previous research using the OPTION, values using the OPTION instrument were low with two items, giving the patient opportunities to ask questions and checking patient understanding, exhibiting the most variability. Using a 'key' decision in each consultation as the basis for comparison, the Informed Decision Making score was not related to the overall OPTION score (Spearman's rho=0.14, p=0.13). Both instruments also predicted different 'best' and 'worst' doctors. Using a Bland-Altman plot for assessing agreement, the mean difference between the two measures was 1.11 (CI 0.66-1.56) and the limits of agreement were -3.94 to 6.16. There were several elements between the two instruments that appeared conceptually similar and correlations for these were generally higher. These were: discussing alternatives or options (Spearman's rho=0.35, p=0.0001), discussion of the patient's role in decision making (Spearman's rho=0.23, p=0.012), discussion of the pros/cons of the alternatives (Spearman's rho=0.20, p=0.024) and assessment of the patient's understanding (Spearman's rho=0.19, p=0.03). Measures of shared decision making are helpful in identifying those shared decision making skills which may

Stress alters personal moral decision making.

PubMed

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

2012-04-01

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

Decision-making capacity should not be decisive in emergencies.

PubMed

Hubbeling, Dieneke

2014-05-01

Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients and render the process less transparent. Other solutions focus on preferences expressed when patients are not ill, but this information is often not available. The reason for such difficulties with assessing decision-making capacity is that the underlying psychological processes of normal decision-making are not well known and one cannot differentiate between unwise decisions caused by an illness or other factors. The proposed alternative, set out in this paper, is to allow compulsory treatment of patients with decision-making capacity in cases of an emergency, if the refusal is potentially life threatening, but only for a time-limited period. The argument is also made for investigating hindsight agreement, in particular after compulsory measures.

Judgment and decision making.

PubMed

Fischhoff, Baruch

2010-09-01

The study of judgment and decision making entails three interrelated forms of research: (1) normative analysis, identifying the best courses of action, given decision makers' values; (2) descriptive studies, examining actual behavior in terms comparable to the normative analyses; and (3) prescriptive interventions, helping individuals to make better choices, bridging the gap between the normative ideal and the descriptive reality. The research is grounded in analytical foundations shared by economics, psychology, philosophy, and management science. Those foundations provide a framework for accommodating affective and social factors that shape and complement the cognitive processes of decision making. The decision sciences have grown through applications requiring collaboration with subject matter experts, familiar with the substance of the choices and the opportunities for interventions. Over the past half century, the field has shifted its emphasis from predicting choices, which can be successful without theoretical insight, to understanding the processes shaping them. Those processes are often revealed through biases that suggest non-normative processes. The practical importance of these biases depends on the sensitivity of specific decisions and the support that individuals have in making them. As a result, the field offers no simple summary of individuals' competence as decision makers, but a suite of theories and methods suited to capturing these sensitivities. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

Toward a Psychology of Surrogate Decision Making.

PubMed

Tunney, Richard J; Ziegler, Fenja V

2015-11-01

In everyday life, many of the decisions that we make are made on behalf of other people. A growing body of research suggests that we often, but not always, make different decisions on behalf of other people than the other person would choose. This is problematic in the practical case of legally designated surrogate decision makers, who may not meet the substituted judgment standard. Here, we review evidence from studies of surrogate decision making and examine the extent to which surrogate decision making accurately predicts the recipient's wishes, or if it is an incomplete or distorted application of the surrogate's own decision-making processes. We find no existing domain-general model of surrogate decision making. We propose a framework by which surrogate decision making can be assessed and a novel domain-general theory as a unifying explanatory concept for surrogate decisions. © The Author(s) 2015.

Multicriteria decision analysis: Overview and implications for environmental decision making

USGS Publications Warehouse

Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene

2007-01-01

Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.

Shared decision-making, gender and new technologies.

PubMed

Zeiler, Kristin

2007-09-01

Much discussion of decision-making processes in medicine has been patient-centred. It has been assumed that there is, most often, one patient. Less attention has been given to shared decision-making processes where two or more patients are involved. This article aims to contribute to this special area. What conditions need to be met if decision-making can be said to be shared? What is a shared decision-making process and what is a shared autonomous decision-making process? Why make the distinction? Examples are drawn from the area of new reproductive medicine and clinical genetics. Possible gender-differences in shared decision-making are discussed.

Neural substrates of decision-making.

PubMed

Broche-Pérez, Y; Herrera Jiménez, L F; Omar-Martínez, E

2016-06-01

Decision-making is the process of selecting a course of action from among 2 or more alternatives by considering the potential outcomes of selecting each option and estimating its consequences in the short, medium and long term. The prefrontal cortex (PFC) has traditionally been considered the key neural structure in decision-making process. However, new studies support the hypothesis that describes a complex neural network including both cortical and subcortical structures. The aim of this review is to summarise evidence on the anatomical structures underlying the decision-making process, considering new findings that support the existence of a complex neural network that gives rise to this complex neuropsychological process. Current evidence shows that the cortical structures involved in decision-making include the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex (DLPFC). This process is assisted by subcortical structures including the amygdala, thalamus, and cerebellum. Findings to date show that both cortical and subcortical brain regions contribute to the decision-making process. The neural basis of decision-making is a complex neural network of cortico-cortical and cortico-subcortical connections which includes subareas of the PFC, limbic structures, and the cerebellum. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

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

PubMed

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

2018-04-13

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

Computational Complexity and Human Decision-Making.

PubMed

Bossaerts, Peter; Murawski, Carsten

2017-12-01

The rationality principle postulates that decision-makers always choose the best action available to them. It underlies most modern theories of decision-making. The principle does not take into account the difficulty of finding the best option. Here, we propose that computational complexity theory (CCT) provides a framework for defining and quantifying the difficulty of decisions. We review evidence showing that human decision-making is affected by computational complexity. Building on this evidence, we argue that most models of decision-making, and metacognition, are intractable from a computational perspective. To be plausible, future theories of decision-making will need to take into account both the resources required for implementing the computations implied by the theory, and the resource constraints imposed on the decision-maker by biology. Copyright © 2017 Elsevier Ltd. All rights reserved.

Changing Times, Complex Decisions: Presidential Values and Decision Making

ERIC Educational Resources Information Center

Hornak, Anne M.; Garza Mitchell, Regina L.

2016-01-01

Objective: The objective of this article is to delve more deeply into the thought processes of the key decision makers at community colleges and understand how they make decisions. Specifically, this article focuses on the role of the community college president's personal values in decision making. Method: We conducted interviews with 13…

Multi-disciplinary decision making in general practice.

PubMed

Kirby, Ann; Murphy, Aileen; Bradley, Colin

2018-04-09

Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

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

Facets of Career Decision-Making Difficulties

ERIC Educational Resources Information Center

Amir, Tami; Gati, Itamar

2006-01-01

The present research investigated the relations among the measured and the expressed career decision-making difficulties in a sample of 299 young adults who intended to apply to college or university. As hypothesised, the correlations between career decision-making difficulties, as measured by the Career Decision-Making Difficulties Questionnaire…

Age-related changes in decision making: comparing informed and noninformed situations.

PubMed

Van Duijvenvoorde, Anna C K; Jansen, Brenda R J; Bredman, Joren C; Huizenga, Hilde M

2012-01-01

Advantageous decision making progressively develops into early adulthood, most specifically in complex and motivationally salient decision situations in which direct feedback on gains and losses is provided (Figner & Weber, 2011). However, the factors that underlie this developmental improvement in decision making are still not well understood. The current study therefore investigates 2 potential factors, long-term memory and working memory, by assigning a large developmental sample (7-29 years of age) to a condition with either high or low demands on long-term and working memory. The first condition featured an age-adapted version of the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994; i.e., a noninformed situation), whereas the second condition provided an external store where explicit information on gains, losses, and probabilities per choice option was presented (i.e., an informed situation). Consistent with previous developmental IGT studies, children up to age 12 did not learn to prefer advantageous options in the noninformed condition. In contrast, all age groups learned to prefer the advantageous options in the informed conditions, although a slight developmental increase in advantageous decision making remained. These results indicate that lowering dependence on long-term and working memory improves children's advantageous decision making. The results additionally suggest that other factors, like inhibitory control processes, may play an additional role in the development of advantageous decision making.

Decision making in urological surgery.

PubMed

Abboudi, Hamid; Ahmed, Kamran; Normahani, Pasha; Abboudi, May; Kirby, Roger; Challacombe, Ben; Khan, Mohammed Shamim; Dasgupta, Prokar

2012-06-01

Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft. The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality. Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees. Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.

Understanding shared decision making in pediatric otolaryngology.

PubMed

Chorney, Jill; Haworth, Rebecca; Graham, M Elise; Ritchie, Krista; Curran, Janet A; Hong, Paul

2015-05-01

The aim of this study was to describe the level of decisional conflict experienced by parents considering surgery for their children and to determine if decisional conflict and perceptions of shared decision making are related. Prospective cohort study. Academic pediatric otolaryngology clinic. Sixty-five consecutive parents of children who underwent surgical consultation for elective otolaryngological procedures were prospectively enrolled. Participants completed the Shared Decision Making Questionnaire and the Decisional Conflict Scale. Surgeons completed the Shared Decision Making Questionnaire-Physician version. Eleven participants (16.9%) scored over 25 on the Decisional Conflict Scale, a previously defined clinical cutoff indicating significant decisional conflict. Parent years of education and parent ratings of shared decision making were significantly correlated with decisional conflict (positively and negatively correlated, respectively). A logistic regression indicated that shared decision making but not education predicted the presence of significant decisional conflict. Parent and physician ratings of shared decision making were not related, and there was no correlation between physician ratings of shared decision making and parental decisional conflict. Many parents experienced considerable decisional conflict when making decisions about their child's surgical treatment. Parents who perceived themselves as being more involved in the decision-making process reported less decisional conflict. Parents and physicians had different perceptions of shared decision making. Future research should develop and assess interventions to increase parents' involvement in decision making and explore the impact of significant decisional conflict on health outcomes. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

[Cognitive errors in diagnostic decision making].

PubMed

Gäbler, Martin

2017-10-01

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

Adaptive Strategy Selection in Decision Making.

DTIC Science & Technology

1986-07-31

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

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

PubMed

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

2015-03-31

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

Adolescent Sexual Decision-Making: An Integrative Review.

PubMed

Hulton, Linda J.

2001-10-03

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

Quantitative Decision Making.

ERIC Educational Resources Information Center

Baldwin, Grover H.

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

Considering Risk and Resilience in Decision-Making

NASA Technical Reports Server (NTRS)

Torres-Pomales, Wilfredo

2015-01-01

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

When Friends’ and Society’s Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College

PubMed Central

Bollich, Kathryn L.; Hill, Patrick L.; Harms, Peter D.; Jackson, Joshua J.

2016-01-01

Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change. PMID:26751944

24 CFR 55.20 - Decision making process.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Decision making process. 55.20... Decision making process. The decision making process for compliance with this part contains eight steps... decision making process are: (a) Step 1. Determine whether the proposed action is located in a 100-year...

Shared clinical decision making

PubMed Central

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

2015-01-01

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

Intergroup Conflict and Rational Decision Making

PubMed Central

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

2014-01-01

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

Intergroup conflict and rational decision making.

PubMed

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

2014-01-01

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

Visualization support for risk-informed decision making when planning and managing software developments

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Kiper, James D.; Menzies, Tim

2005-01-01

Key decisions are made in the early stages of planning and management of software developments. The information basis for these decisions is often a mix of analogy with past developments, and the best judgments of domain experts. Visualization of this information can support to such decision making by clarifying the status of the information and yielding insights into the ramifications of that information vis-a-vis decision alternatives.

'My kidneys, my choice, decision aid': supporting shared decision making.

PubMed

Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie

2015-06-01

For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Sterilization surgery - making a decision

MedlinePlus

... medlineplus.gov/ency/article/002138.htm Sterilization surgery - making a decision To use the sharing features on this page, ... about all the options available to you before making the decision to have a sterilization procedure. Alternative Names Deciding ...

Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology.

PubMed

Krieger, Janice L; Krok-Schoen, Jessica L; Dailey, Phokeng M; Palmer-Wackerly, Angela L; Schoenberg, Nancy; Paskett, Electra D; Dignan, Mark

2017-07-01

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients ( N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

Social Influences in Sequential Decision Making

PubMed Central

Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

2016-01-01

People often make decisions in a social environment. The present work examines social influence on people’s decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others’ authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions. PMID:26784448

Social Influences in Sequential Decision Making.

PubMed

Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

2016-01-01

People often make decisions in a social environment. The present work examines social influence on people's decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others' authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions.

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

PubMed

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

2010-06-01

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

Expectation Violation in Political Decision Making: A Psychological Case Study.

PubMed

Öllinger, Michael; Meissner, Karin; von Müller, Albrecht; Collado Seidel, Carlos

2017-01-01

Since the early Gestaltists there has been a strong interest in the question of how problem solvers get stuck in a mental impasse. A key idea is that the repeated activation of a successful strategy from the past results in a mental set ('Einstellung') which determines and constrains the option space to solve a problem. We propose that this phenomenon, which mostly was tested by fairly restricted experiments in the lab, could also be applied to more complex problem constellations and naturalistic decision making. We aim at scrutinizing and reconstructing how a mental set determines the misinterpretation of facts in the field of political decision making and leads in consequence to wrong expectations and an ill-defined problem representation. We will exemplify this psychological mechanism considering a historical example, namely the unexpected stabilization of the Franco regime at the end of World War II and its survival thereafter. A specific focus will be drawn to the significant observation that erroneous expectations were taken as the basis for decisions. This is congruent with the notion that in case of discrepancy between preconceived notions and new information, the former prevails over the new findings. Based on these findings, we suggest a theoretical model for expectation violation in political decision making and develop novel approaches for cognitive empirical research on the mechanisms of expectation violation and its maintenance in political decision making processes.

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

PubMed

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

2014-01-01

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

Neuroanatomical basis for recognition primed decision making.

PubMed

Hudson, Darren

2013-01-01

Effective decision making under time constraints is often overlooked in medical decision making. The recognition primed decision making (RPDM) model was developed by Gary Klein based on previous recognized situations to develop a satisfactory solution to the current problem. Bayes Theorem is the most popular decision making model in medicine but is limited by the need for adequate time to consider all probabilities. Unlike other decision making models, there is a potential neurobiological basis for RPDM. This model has significant implication for health informatics and medical education.

Shared Problem Models and Crew Decision Making

NASA Technical Reports Server (NTRS)

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

1994-01-01

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

Primary Breast Cancer Decision-making Among Chinese American Women: Satisfaction, Regret.

PubMed

Katie Lee, Shiu-Yu C; Knobf, M Tish

2015-01-01

Decision-making for cancer treatment is a complex, informational process. Lower satisfaction, higher decision regret, and poorer quality of life are potential adverse outcomes. The aim of the study was to describe breast cancer treatment decision outcomes and examine factors associated with decision outcomes of satisfaction and regret in Chinese American women. A cross-sectional, correlational design was used. A sample of 123 self-identified Chinese American women with early-stage breast cancer was recruited from the greater New York metropolitan area. The Breast Cancer Decision-Making Questionnaire, Decisional Conflict Scale, and Decisional Regret Scale--that were written in Chinese with equivalence from back-translation--were used to measure the factors in the decision-making process and the decisional outcome. Multiple, linear regression was used to identify predictors for decisional outcomes. The mean age of the subjects was 48.7 years (SD = 9.3 years), the majority of whom were married (80%) and not working (63%), and about half spoke Cantonese or Mandarin as their daily language. The women reported a low to moderate level of decisional conflict, postdecisional dissatisfaction, and regret with their decision. However, the women who had greater decisional conflict, who had more difficulty in communicating with their physician, who had limited English fluency, and who were financially dependent and less involved in decision-making had lower satisfaction and more regret with their treatment decision. Limited English fluency among Chinese American women negatively affected communication during the physician consultation about breast cancer treatment options, and financial barriers were also associated with lower postdecisional satisfaction and higher regret. Culturally sensitive decision support interventions are needed for Asian American women to make an informed, satisfied breast cancer treatment decision.

Do Teachers Make Decisions Like Firefighters? Applying Naturalistic Decision-Making Methods to Teachers' In-Class Decision Making in Mathematics

ERIC Educational Resources Information Center

Jazby, Dan

2014-01-01

Research into human decision making (DM) processes from outside of education paint a different picture of DM than current DM models in education. This pilot study assesses the use of critical decision method (CDM)--developed from observations of firefighters' DM -- in the context of primary mathematics teachers' in-class DM. Preliminary results…

Collective decision-making in microbes

PubMed Central

Ross-Gillespie, Adin; Kümmerli, Rolf

2014-01-01

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

Emotion, decision-making and the brain.

PubMed

Chang, Luke J; Sanfey, Alan G

2008-01-01

Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.

Analyzing Individual Decision Making Versus Group Decision Making for Alternative Selection

DTIC Science & Technology

2008-06-01

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

Automatically updating predictive modeling workflows support decision-making in drug design.

PubMed

Muegge, Ingo; Bentzien, Jörg; Mukherjee, Prasenjit; Hughes, Robert O

2016-09-01

Using predictive models for early decision-making in drug discovery has become standard practice. We suggest that model building needs to be automated with minimum input and low technical maintenance requirements. Models perform best when tailored to answering specific compound optimization related questions. If qualitative answers are required, 2-bin classification models are preferred. Integrating predictive modeling results with structural information stimulates better decision making. For in silico models supporting rapid structure-activity relationship cycles the performance deteriorates within weeks. Frequent automated updates of predictive models ensure best predictions. Consensus between multiple modeling approaches increases the prediction confidence. Combining qualified and nonqualified data optimally uses all available information. Dose predictions provide a holistic alternative to multiple individual property predictions for reaching complex decisions.

Geospatial decision support systems for societal decision making

USGS Publications Warehouse

Bernknopf, R.L.

2005-01-01

While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

Graphic Representations as Tools for Decision Making.

ERIC Educational Resources Information Center

Howard, Judith

2001-01-01

Focuses on the use of graphic representations to enable students to improve their decision making skills in the social studies. Explores three visual aids used in assisting students with decision making: (1) the force field; (2) the decision tree; and (3) the decision making grid. (CMK)

Emotion and decision making.

PubMed

Lerner, Jennifer S; Li, Ye; Valdesolo, Piercarlo; Kassam, Karim S

2015-01-03

A revolution in the science of emotion has emerged in recent decades, with the potential to create a paradigm shift in decision theories. The research reveals that emotions constitute potent, pervasive, predictable, sometimes harmful and sometimes beneficial drivers of decision making. Across different domains, important regularities appear in the mechanisms through which emotions influence judgments and choices. We organize and analyze what has been learned from the past 35 years of work on emotion and decision making. In so doing, we propose the emotion-imbued choice model, which accounts for inputs from traditional rational choice theory and from newer emotion research, synthesizing scientific models.

The Downside of Early Decision: Choosing Early Doesn't Always Mean Choosing Right

ERIC Educational Resources Information Center

Bacow, Lawrence S.

2006-01-01

The increasingly popular option of applying "early decision" (ED) requires a student to make a binding commitment that, if admitted to a particular college, she or he will enroll. Now offered by 184 U.S. colleges and universities, ED is a highly effective--and therefore highly seductive--tool for managing enrollment. This author argues,…

Decision-Making Deficits Among Maltreated Children

PubMed Central

Weller, Joshua A.; Fisher, Philip A.

2013-01-01

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

Globally optimal trial design for local decision making.

PubMed

Eckermann, Simon; Willan, Andrew R

2009-02-01

Value of information methods allows decision makers to identify efficient trial design following a principle of maximizing the expected value to decision makers of information from potential trial designs relative to their expected cost. However, in health technology assessment (HTA) the restrictive assumption has been made that, prospectively, there is only expected value of sample information from research commissioned within jurisdiction. This paper extends the framework for optimal trial design and decision making within jurisdiction to allow for optimal trial design across jurisdictions. This is illustrated in identifying an optimal trial design for decision making across the US, the UK and Australia for early versus late external cephalic version for pregnant women presenting in the breech position. The expected net gain from locally optimal trial designs of US$0.72M is shown to increase to US$1.14M with a globally optimal trial design. In general, the proposed method of globally optimal trial design improves on optimal trial design within jurisdictions by: (i) reflecting the global value of non-rival information; (ii) allowing optimal allocation of trial sample across jurisdictions; (iii) avoiding market failure associated with free-rider effects, sub-optimal spreading of fixed costs and heterogeneity of trial information with multiple trials. Copyright (c) 2008 John Wiley & Sons, Ltd.

Exogenous cortisol acutely influences motivated decision making in healthy young men.

PubMed

Putman, Peter; Antypa, Niki; Crysovergi, Panagiota; van der Does, Willem A J

2010-02-01

The glucocorticoid (GC) hormone cortisol is the end product of the hypothalamic-pituitary-adrenal axis (HPA axis). Acute psychological stress increases HPA activity and GC release. In humans, chronic disturbances in HPA activity have been observed in affective disorders and in addictive behaviour. Recent research indicates that acute effects of GCs may be anxiolytic and increase reward sensitivity. Furthermore, cortisol acutely influences early cognitive processing of emotional stimuli. In order to extend such findings to more complex emotional-cognitive behaviour, the present study tested acute effects of 40 mg cortisol on motivated decision making in 30 healthy young men. Results showed that cortisol indeed increased risky decision making, as predicted. This effect occurred for decisions where making a risky choice could potentially yield a big reward. These results are discussed with respect to currently proposed mechanisms for cortisol's potential anxiolytic effect and GCs' involvement in reward systems.

Decision-making based on emotional images.

PubMed

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

2011-01-01

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

Shared Decision Making for Better Schools.

ERIC Educational Resources Information Center

Brost, Paul

2000-01-01

Delegating decision making to those closest to implementation can result in better decisions, more support for improvement initiatives, and increased student performance. Shared decision making depends on capable school leadership, a professional community, instructional guidance mechanisms, knowledge and skills, information sharing, power, and…

Actionable knowledge and strategic decision making for bio- and agroterrorism threats: building a collaborative early warning culture.

PubMed

Mårtensson, Per-Åke; Hedström, Lars; Sundelius, Bengt; Skiby, Jeffrey E; Elbers, Armin; Knutsson, Rickard

2013-09-01

Current trends in biosecurity and cybersecurity include (1) the wide availability of technology and specialized knowledge that previously were available only to governments; (2) the global economic recession, which may increase the spread of radical non-state actors; and (3) recent US and EU commission reports that reflect concerns about non-state actors in asymmetric threats. The intersectoral and international nature of bioterrorism and agroterrorism threats requires collaboration across several sectors including intelligence, police, forensics, customs, and other law enforcement organizations who must work together with public and animal health organizations as well as environmental and social science organizations. This requires coordinated decision making among these organizations, based on actionable knowledge and information sharing. The risk of not sharing information among organizations compared to the benefit of sharing information can be considered in an "information sharing risk-benefit analysis" to prevent a terrorism incident from occurring and to build a rapid response capability. In the EU project AniBioThreat, early warning is the main topic in work package 3 (WP 3). A strategy has been generated based on an iterative approach to bring law enforcement agencies and human and animal health institutes together. Workshops and exercises have taken place during the first half of the project, and spin-off activities include new preparedness plans for institutes and the formation of a legal adviser network for decision making. In addition, a seminar on actionable knowledge was held in Stockholm, Sweden, in 2012, which identified the need to bring various agency cultures together to work on developing a resilient capability to identify early signs of bio- and agroterrorism threats. The seminar concluded that there are a number of challenges in building a collaborative culture, including developing an education program that supports collaboration and shared

Judgment and decision making.

PubMed

Mellers, B A; Schwartz, A; Cooke, A D

1998-01-01

For many decades, research in judgment and decision making has examined behavioral violations of rational choice theory. In that framework, rationality is expressed as a single correct decision shared by experimenters and subjects that satisfies internal coherence within a set of preferences and beliefs. Outside of psychology, social scientists are now debating the need to modify rational choice theory with behavioral assumptions. Within psychology, researchers are debating assumptions about errors for many different definitions of rationality. Alternative frameworks are being proposed. These frameworks view decisions as more reasonable and adaptive that previously thought. For example, "rule following." Rule following, which occurs when a rule or norm is applied to a situation, often minimizes effort and provides satisfying solutions that are "good enough," though not necessarily the best. When rules are ambiguous, people look for reasons to guide their decisions. They may also let their emotions take charge. This chapter presents recent research on judgment and decision making from traditional and alternative frameworks.

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

Analyzing Decision Logs to Understand Decision Making in Serious Crime Investigations.

PubMed

Dando, Coral J; Ormerod, Thomas C

2017-12-01

Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments. Method A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results Analyses revealed diversity in documentation of decisions that did not correlate with case type and identified significant limitations of the decision log approach to supporting investigative decision making. Differences emerged between experienced and less experienced officers' decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential inquiry opened over phase of investigation. Conclusion The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision making to avoid confirmation and satisficing, which affect less experienced detectives. Application Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them.

Nonrational processes in ethical decision making.

PubMed

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

2011-10-01

Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasilegal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior, including context, perceptions, relationships, emotions, and heuristics. For example, a large body of behavioral research has demonstrated the importance of automatic intuitive and affective processes in decision making and judgment. These processes profoundly affect human behavior and lead to systematic biases and departures from normative theories of rationality. Their influence represents an important but largely unrecognized component of ethical decision making. We selectively review this work; provide various illustrations; and make recommendations for scientists, trainers, and practitioners to aid them in integrating the understanding of nonrational processes with ethical decision making.

Decision making in midwifery: rationality and intuition.

PubMed

Steinhauer, Suyai

2015-04-01

Decision making in midwifery is a complex process that shapes and underpins clinical practice and determines, to a large extent, the quality of care. Effective decision making and professional accountability are central to clinical governance, and being able.to justify all decisions is a professional and legal requirement. At the same time, there is an emphasis in midwifery on shared decision making, and keeping women at the centre of their care, and research reveals that feelings of choice, control and autonomy are central to a positive birth experience. However the extent to which decisions are really shared and care truly woman-centred is debatable and affected by environment and culture. Using a case study of a decision made in clinical practice around amniotomy, this article explores the role of the intuitive thinking system in midwifery decision making, and highlights the importance of involving women in the decision making process.

Rodent models of adaptive decision making.

PubMed

Izquierdo, Alicia; Belcher, Annabelle M

2012-01-01

Adaptive decision making affords the animal the ability to respond quickly to changes in a dynamic environment: one in which attentional demands, cost or effort to procure the reward, and reward contingencies change frequently. The more flexible the organism is in adapting choice behavior, the more command and success the organism has in navigating its environment. Maladaptive decision making is at the heart of much neuropsychiatric disease, including addiction. Thus, a better understanding of the mechanisms that underlie normal, adaptive decision making helps achieve a better understanding of certain diseases that incorporate maladaptive decision making as a core feature. This chapter presents three general domains of methods that the experimenter can manipulate in animal decision-making tasks: attention, effort, and reward contingency. Here, we present detailed methods of rodent tasks frequently employed within these domains: the Attentional Set-Shift Task, Effortful T-maze Task, and Visual Discrimination Reversal Learning. These tasks all recruit regions within the frontal cortex and the striatum, and performance is heavily modulated by the neurotransmitter dopamine, making these assays highly valid measures in the study of psychostimulant addiction.

Parental decision making in pediatric otoplasty: The role of shared decision making in parental decisional conflict and decisional regret.

PubMed

Hong, Paul; Gorodzinsky, Ayala Y; Taylor, Benjamin A; Chorney, Jill MacLaren

2016-07-01

To date, there has been little research on shared decision making and decisional outcomes in pediatric surgery. The objectives of this study were to describe the level of decisional conflict and decisional regret experienced by parents considering otoplasty for their children, and to determine if they are related to perceptions of shared decision making. Prospective cohort clinical study. Sixty-five consecutive parents of children who underwent surgical consultation for otoplasty were prospectively enrolled. Participants completed the Demographic Form, the Decisional Conflict Scale, and the Shared Decision-Making Questionnaire after the consultation visit. The consulting surgeons completed the physician version of the Shared Decision-Making Questionnaire. Six months after surgery, parents completed the Decisional Regret Scale. The median decisional conflict was 15.63; 21 (32.8%) parents scored 25 or above, a previously defined cutoff indicating clinically significant decisional conflict. Parent ratings of shared decision making and decisional conflict were significantly negatively correlated (P < 0.001); however, there was no significant correlation between physician ratings of shared decision making and parental decisional conflict. Significant decisional regret was reported in two (3.2%) participants. Decisional regret and parent and physician ratings of shared decision making were both significantly negatively correlated (P = 0.044 and P = 0.001, respectively). Decisional regret and decisional conflict scores were significantly positively correlated (P = 0.001). Parent and physician ratings of shared decision making were correlated (intraclass correlation = 0.625, P < 0.001). Many parents experienced significant decisional conflict when making decisions about their child's elective surgical treatment. Fewer parents experienced significant decisional regret after the procedure. Parents who perceived themselves as being more involved in the decision making process

Decision making for breast cancer prevention among women at elevated risk.

PubMed

Padamsee, Tasleem J; Wills, Celia E; Yee, Lisa D; Paskett, Electra D

2017-03-24

Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women's perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.

The Longitudinal Association Between Early Childhood Obesity and Fathers' Involvement in Caregiving and Decision-Making.

PubMed

Wong, Michelle S; Jones-Smith, Jessica C; Colantuoni, Elizabeth; Thorpe, Roland J; Bleich, Sara N; Chan, Kitty S

2017-10-01

Fathers have increased their involvement in child caregiving; however, their changing role in childhood obesity is understudied. This study assessed the longitudinal association between changes in obesity among children aged 2 to 4 years and changes in fathers' involvement with raising children. Longitudinal data from the Early Childhood Longitudinal Study-Birth Cohort were used to conduct child fixed-effects linear and logistic regression analyses to assess the association between changes in childhood obesity-related outcomes (sugar-sweetened beverage consumption, screen time, BMI z score, overweight/obesity, obesity) and fathers' involvement with raising children (caregiving and influencing child-related decisions). Fixed-effects models control for all time-invariant characteristics. Analyses were controlled for time-varying confounders, including child age, maternal and paternal employment, and family poverty status. Children whose fathers increased their frequency of taking children outside and involvement with physical childcare experienced a decrease in their odds of obesity from age 2 to age 4. Obesity-related outcomes were not associated with fathers' decision-making influence. Increases in fathers' involvement with some aspects of caregiving may be associated with lower odds of childhood obesity. Encouraging fathers to increase their involvement with raising children and including fathers in childhood obesity prevention efforts may help reduce obesity risk among young children. © 2017 The Obesity Society.

Cognitive processes in anesthesiology decision making.

PubMed

Stiegler, Marjorie Podraza; Tung, Avery

2014-01-01

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

Making sense of adolescent decision-making: challenge and reality.

PubMed

Unguru, Yoram

2011-08-01

Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.

Pioneers: A Simulation of Decision-Making on a Wagon Train.

ERIC Educational Resources Information Center

Wesley, John

This simulation allows students to participate in situations and events similar to those experienced by pioneers who headed west in early wagon trains. Students face problems such as floods, droughts, blocked trails, snakes, Indians, and the lack of food. Students must make numerous individual and small-group decisions that provide them with a…

A canonical theory of dynamic decision-making.

PubMed

Fox, John; Cooper, Richard P; Glasspool, David W

2013-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering.

A Canonical Theory of Dynamic Decision-Making

PubMed Central

Fox, John; Cooper, Richard P.; Glasspool, David W.

2012-01-01

Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering. PMID:23565100

Expectation Violation in Political Decision Making: A Psychological Case Study

PubMed Central

Öllinger, Michael; Meissner, Karin; von Müller, Albrecht; Collado Seidel, Carlos

2017-01-01

Since the early Gestaltists there has been a strong interest in the question of how problem solvers get stuck in a mental impasse. A key idea is that the repeated activation of a successful strategy from the past results in a mental set (‘Einstellung’) which determines and constrains the option space to solve a problem. We propose that this phenomenon, which mostly was tested by fairly restricted experiments in the lab, could also be applied to more complex problem constellations and naturalistic decision making. We aim at scrutinizing and reconstructing how a mental set determines the misinterpretation of facts in the field of political decision making and leads in consequence to wrong expectations and an ill-defined problem representation. We will exemplify this psychological mechanism considering a historical example, namely the unexpected stabilization of the Franco regime at the end of World War II and its survival thereafter. A specific focus will be drawn to the significant observation that erroneous expectations were taken as the basis for decisions. This is congruent with the notion that in case of discrepancy between preconceived notions and new information, the former prevails over the new findings. Based on these findings, we suggest a theoretical model for expectation violation in political decision making and develop novel approaches for cognitive empirical research on the mechanisms of expectation violation and its maintenance in political decision making processes. PMID:29085316

The functional neuroanatomy of decision-making.

PubMed

Rosenbloom, Michael H; Schmahmann, Jeremy D; Price, Bruce H

2012-01-01

Decision-making is a complex executive function that draws on past experience, present goals, and anticipation of outcome, and which is influenced by prevailing and predicted emotional tone and cultural context. Functional imaging investigations and focal lesion studies identify the orbitofrontal, anterior cingulate, and dorsolateral prefrontal cortices as critical to decision-making. The authors review the connections of these prefrontal regions with the neocortex, limbic system, basal ganglia, and cerebellum, highlight current ideas regarding the cognitive processes of decision-making that these networks subserve, and present a novel integrated neuroanatomical model for decision-making. Finally, clinical relevance of this circuitry is illustrated through a discussion of frontotemporal dementia, traumatic brain injury, and sociopathy.

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.

Artificial neural networks in mammography interpretation and diagnostic decision making.

PubMed

Ayer, Turgay; Chen, Qiushi; Burnside, Elizabeth S

2013-01-01

Screening mammography is the most effective means for early detection of breast cancer. Although general rules for discriminating malignant and benign lesions exist, radiologists are unable to perfectly detect and classify all lesions as malignant and benign, for many reasons which include, but are not limited to, overlap of features that distinguish malignancy, difficulty in estimating disease risk, and variability in recommended management. When predictive variables are numerous and interact, ad hoc decision making strategies based on experience and memory may lead to systematic errors and variability in practice. The integration of computer models to help radiologists increase the accuracy of mammography examinations in diagnostic decision making has gained increasing attention in the last two decades. In this study, we provide an overview of one of the most commonly used models, artificial neural networks (ANNs), in mammography interpretation and diagnostic decision making and discuss important features in mammography interpretation. We conclude by discussing several common limitations of existing research on ANN-based detection and diagnostic models and provide possible future research directions.

Decision-Making Strategies for College Students

ERIC Educational Resources Information Center

Morey, Janis T.; Dansereau, Donald F.

2010-01-01

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

Autonomy and couples' joint decision-making in healthcare.

PubMed

Osamor, Pauline E; Grady, Christine

2018-01-11

Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making. We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples' joint decision-making, and the ethics of couples' joint decision-making. We believe that the extent to which couples' joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples' joint decision-making about a woman's own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman's autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples' joint decision-making should be viewed as consistent with the principle of respect for the woman's autonomy. At the other end of the spectrum are decisions made by the man without the woman's input, representing domination of one partner by the other. We recommend viewing the dynamics of couples' joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples' joint decision-making should not be taken at face value but should be assessed against

A communication model of shared decision making: accounting for cancer treatment decisions.

PubMed

Siminoff, Laura A; Step, Mary M

2005-07-01

The authors present a communication model of shared decision making (CMSDM) that explicitly identifies the communication process as the vehicle for decision making in cancer treatment. In this view, decision making is necessarily a sociocommunicative process whereby people enter into a relationship, exchange information, establish preferences, and choose a course of action. The model derives from contemporary notions of behavioral decision making and ethical conceptions of the doctor-patient relationship. This article briefly reviews the theoretical approaches to decision making, notes deficiencies, and embeds a more socially based process into the dynamics of the physician-patient relationship, focusing on cancer treatment decisions. In the CMSDM, decisions depend on (a) antecedent factors that have potential to influence communication, (b) jointly constructed communication climate, and (c) treatment preferences established by the physician and the patient.

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,…

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

PubMed

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

2016-07-01

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

Hospice Decision Making: Diagnosis Makes a Difference

ERIC Educational Resources Information Center

Waldrop, Deborah P.; Meeker, Mary Ann

2012-01-01

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

Understanding medical decision making in hand surgery.

PubMed

Myers, John; McCabe, Steven J

2005-10-01

The practice of medicine takes place in an environment of uncertainty. Expected value decision making, prospect theory, and regret theory are three theories of decision making under uncertainty that may be used to help us learn how patients and physicians make decisions. These theories form the underpinnings of decision analysis and provide the opportunity to introduce the broad discipline of decision science. Because decision analysis and economic analysis are underrepresented in upper extremity surgery, the authors believe these are important areas for future research.

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.

Comparing perceptual and preferential decision making.

PubMed

Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

Shared Decision Making--The First Year.

ERIC Educational Resources Information Center

Rothstein, Richard

This report summarizes an evaluation of Shared Decision Making (SDM) in Los Angeles (California) schools and also includes some comments about School Based Management (SBM). SDM is a democratization of local school decision making that delegates decisions formerly made by principals to local school leadership councils composed of teachers,…

School Counselors and Ethical Decision Making

ERIC Educational Resources Information Center

West, Dana R.

2016-01-01

Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…

Facilitating Adoption of News Tool to Develop Clinical Decision Making

ERIC Educational Resources Information Center

Brown, Robin T.

2017-01-01

This scholarly project was a non-experimental, pre/post-test design to (a) facilitate the voluntary adoption of the National Early Warning Score (NEWS), and (b) develop clinical decision making (CDM) in one cohort of junior level nursing students participating in a simulation lab. NEWS is an evidence-based predictive scoring tool developed by the…

Patients' Values in Clinical Decision-Making.

PubMed

Faggion, Clovis Mariano; Pachur, Thorsten; Giannakopoulos, Nikolaos Nikitas

2017-09-01

Shared decision-making involves the participation of patient and dental practitioner. Well-informed decision-making requires that both parties understand important concepts that may influence the decision. This fourth article in a series of 4 aims to discuss the importance of patients' values when a clinical decision is made. We report on how to incorporate important concepts for well-informed, shared decision-making. Here, we present patient values as an important issue, in addition to previously established topics such as the risk of bias of a study, cost-effectiveness of treatment approaches, and a comparison of therapeutic benefit with potential side effects. We provide 2 clinical examples and suggestions for a decision tree, based on the available evidence. The information reported in this article may improve the relationship between patient and dental practitioner, resulting in more well-informed clinical decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Styles of Career Decision-Making

ERIC Educational Resources Information Center

Bimrose, Jenny; Barnes, Sally-Anne

2007-01-01

Distinctive styles of client decision-making have emerged from case study research into the effectiveness of career guidance. This paper explores some findings from the third year of a longitudinal study currently underway in England, which relate to the ways clients approach transition points in their careers and make the decisions that move them…

Crew decision making under stress

NASA Technical Reports Server (NTRS)

Orasanu, J.

1992-01-01

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

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

PubMed

Kim, Hyejin; Song, Mi-Kyung

2018-01-01

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

Enhanced decision making through neuroscience

NASA Astrophysics Data System (ADS)

Szu, Harold; Jung, TP; Makeig, Scott

2012-06-01

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

Sex and Career Decision-Making Styles.

ERIC Educational Resources Information Center

Lunneborg, Patricia W.

1978-01-01

Tested the hypothesis of greater reliance on the intuitive style by females and on the planning style by males in making career decisions. There were no sex differences in these high school and college samples for stage or style of decision making, vocational self-concept crystallization, or self-rated vocational decisiveness. (Author/BEF)

Goal-Directed Decision Making with Spiking Neurons.

PubMed

Friedrich, Johannes; Lengyel, Máté

2016-02-03

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

Goal-Directed Decision Making with Spiking Neurons

PubMed Central

Lengyel, Máté

2016-01-01

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

The Liberation Procedure Decision-Making Experience for People With Multiple Sclerosis

PubMed Central

Murray, Cynthia L.; Ploughman, Michelle; Harris, Chelsea; Hogan, Stephen; Murdoch, Michelle; Stefanelli, Mark

2014-01-01

Despite the absence of scientific evidence demonstrating the efficacy of the “liberation procedure” in treating multiple sclerosis (MS), thousands of MS patients worldwide have undergone the procedure. The study objective was to explore the experience of liberation procedure decision making for individuals with MS. Fifteen adults in Newfoundland and Labrador, Canada, each participated in an in-depth interview. The data analysis revealed three groups of people: “waiters,” “early embracers,” and “late embracers.” Using van Manen’s hermeneutic phenomenological approach, we identified three themes each in the stories of the early and late embracers and four themes in the waiters’ stories. A characteristic of the late embracers and waiters was skepticism, whereas desperation set the embracers apart from the waiters. With a deeper understanding of the experience, nurses can be more attuned to the perspectives of MS patients while helping them make informed decisions about undergoing the liberation procedure. PMID:28462292

[Decision-making and apathy in early stage of Alzheimer's disease and in mild cognitive impairment].

PubMed

Jacus, Jean-Pierre; Bayard, Sophie; Raffard, Stéphane; Gély-Nargeot, Marie-Christine

2013-06-01

Decision-making and apathy have common neuropsychological processes and neuroanatomical substrates. However, their links in mild cognitive impairment (MCI) and Alzheimer's disease (AD) remain unclear. in order to evaluate these links, we compared 3 groups of 20 control subjects to 20 patients with MCI and 20 patients with mild AD. All participants completed the mini mental state examination (MMSE), the Lille apathy rating scale (LARS, a multidimensional scale of apathy), the game of dice task (GDT, assessing decision under risk) and the Iowa gambling task (IGT, assessing decision under ambiguity). 60% of patients in both clinical groups were apathetic versus 5% of control subjects. In both clinical groups the IGT and GDT net scores were comparable (respectively: p = 0.76 and p = 0.84), while the control group had higher scores than MCI and AD's groups (respectively, GDT p < 0.02 and p < 0.05; IGT: p < 0.05 and p < 0.05). Cognitive impairment increased the risk of disadvantageous choices in decision under risk (× 6), and under ambiguity (× 3.5). No global contribution of apathy was found for decision-making performances (all PS > 0.05), but on the LARS, the "intellectual curiosity" (cognitive dimension) was a predictor for the performances on GDT's (OR = 1.73, p = 0.05), while the "action initiation" (behavioral dimension) was a predictor of those on IGT (OR = 1.57, p = 0.05). these results highlight the behavioral and the cognitive sensitivity of the IGT and the GDT, and are analyzed according to Levy and Dubois's model of apathy, and to the three steps of the decision-making process of Gleichgerrcht et al. (2010). However, more researches are necessary to explain the causality links between action initiation and decision under ambiguity.

[Treatment Decision-Making Process of Cancer Patients].

PubMed

Lee, Shiu-Yu C Katie

2016-10-01

The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one's own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision-making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.

Stereotype threat affects financial decision making.

PubMed

Carr, Priyanka B; Steele, Claude M

2010-10-01

The research presented in this article provides the first evidence that one's decision making can be influenced by concerns about stereotypes and the devaluation of one's identity. Many studies document gender differences in decision making, and often attribute these differences to innate and stable factors, such as biological and hormonal differences. In three studies, we found that stereotype threat affected decision making and led to gender differences in loss-aversion and risk-aversion behaviors. In Study 1, women subjected to stereotype threat in academic and business settings were more loss averse than both men and women who were not facing the threat of being viewed in light of negative stereotypes. We found no gender differences in loss-aversion behavior in the absence of stereotype threat. In Studies 2a and 2b, we found the same pattern of effects for risk-aversion behavior that we had observed for loss-aversion behavior. In addition, in Study 2b, ego depletion mediated the effects of stereotype threat on women's decision making. These results suggest that individuals' decision making can be influenced by stereotype concerns.

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

Decision Making and Health Education.

ERIC Educational Resources Information Center

Duryea, Elias J.

1983-01-01

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

Heuristic decision making in medicine

PubMed Central

Marewski, Julian N.; Gigerenzer, Gerd

2012-01-01

Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care. PMID:22577307

Heuristic decision making in medicine.

PubMed

Marewski, Julian N; Gigerenzer, Gerd

2012-03-01

Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.

Learning to Make Decisions Through Constructive Controversy.

ERIC Educational Resources Information Center

Tjosvold, Dean

Students must make decisions about their lifestyle, future careers, academic pursuits, and classroom and school issues. Learning to make effective decisions for themselves and for society is an important aspect of competence. They can learn decision making through interacting and solving problems with others. A central ingredient for successful…

Impaired Decision Making in Adolescent Suicide Attempters

ERIC Educational Resources Information Center

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

2012-01-01

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

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

PubMed

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

2017-06-01

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

Assessment of Healthcare Decision-making Capacity

PubMed Central

Palmer, Barton W.; Harmell, Alexandrea L.

2016-01-01

It is often necessary for neuropsychologists, clinical psychologists, and other healthcare professionals to assess an individual's capacity to consent to treatment related to healthcare. This task can be challenging and requires a delicate balance of both respect for individuals' autonomy, as well as the protection of individuals with diminished capacity to make an autonomous decision. The purpose of the present review is to provide an overview of the conceptual model of decisional capacity as well as a brief summary of some of the currently available instruments designed to help evaluate medical decision making. In addition, current empirical literature on the relationship between neuropsychological abilities and decision-making capacity is discussed and a brief set of recommendations is provided to further aid clinicians or consultants when they are required to complete the ethically important but difficult task of making determinations about healthcare decision-making capacity. PMID:27551024

The emergency patient's participation in medical decision-making.

PubMed

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making.

PubMed

Rosen, Jan B; Brand, Matthias; Kalbe, Elke

2016-01-01

Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19-86 years, were tested with a moral decision making task comprising forced choice "everyday life" situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called "positivity effect" and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects and

Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making

PubMed Central

Rosen, Jan B.; Brand, Matthias; Kalbe, Elke

2016-01-01

Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19–86 years, were tested with a moral decision making task comprising forced choice “everyday life” situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called “positivity effect” and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects

An intelligent, knowledge-based multiple criteria decision making advisor for systems design

NASA Astrophysics Data System (ADS)

Li, Yongchang

In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection

Premarital Childbearing Decision Making.

ERIC Educational Resources Information Center

Oakley, Deborah

1985-01-01

Investigated premarital decision-making among community college students. Results concluded that premarital decisions about the number of children to have is associated with certain characteristics of the rational-comprehensive thinker, but is also associated with non-normative childbearing expectations, whether they are above or below the popular…

Goal-Proximity Decision-Making

ERIC Educational Resources Information Center

Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

2013-01-01

Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

44 CFR 9.6 - Decision-making process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making process. 9.6... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process... protection decision-making process to be followed by the Agency in applying the Orders to its actions. While...

Biotechnology and Consumer Decision-Making.

PubMed

Sax, Joanna K

Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.

Communication and Decision Making in Cancer Care: Setting Research Priorities for Decision Support/Patients’ Decision Aids

PubMed Central

Barnato, Amber E.; Llewellyn-Thomas, Hilary A.; Peters, Ellen M.; Siminoff, Laura; Collins, E. Dale; Barry, Michael J.

2013-01-01

The following is a summary report from a special symposium, entitled “Translating Research into Practice: Setting a Research Agenda for Clinical Decision Tools in Cancer Prevention, Early Detection, and Treatment”, that was held on October 23, 2005 in San Francisco at the Annual Meeting of the Society for Medical Decision Making (SMDM). The symposium was designed to answer the question: “What are the top two research priorities in the field of patients’ cancer-related decision aids?” After introductory remarks by Dr. Barry, each of four panelists–Drs. Hilary Llewellyn-Thomas, Ellen Peters, Laura Siminoff, and Dale Collins–addressed the question and provided their rationale during prepared remarks. The moderator, Dr. Michael Barry, then facilitated a discussion between the panelists, with input from the audience, to further explore and add to the various proposed research questions. Finally, Dr. Amber Barnato conducted a simple vote count (see Table 1) to prioritize the panelists’ and the audience’s recommendations. PMID:17873249

Mixed Frames and Risky Decision-Making.

PubMed

Peng, Jiaxi; Zhang, Jiaxi; Sun, Hao; Zeng, Zhicong; Mai, Yuexia; Miao, Danmin

2017-01-01

By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.

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

The hidden traps in decision making.

PubMed

Hammond, J S; Keeney, R L; Raiffa, H

1998-01-01

Bad decisions can often be traced back to the way the decisions were made--the alternatives were not clearly defined, the right information was not collected, the costs and benefits were not accurately weighted. But sometimes the fault lies not in the decision-making process but rather in the mind of the decision maker. The way the human brain works can sabotage the choices we make. John Hammond, Ralph Keeney, and Howard Raiffa examine eight psychological traps that are particularly likely to affect the way we make business decisions: The anchoring trap leads us to give disproportionate weight to the first information we receive. The statusquo trap biases us toward maintaining the current situation--even when better alternatives exist. The sunk-cost trap inclines us to perpetuate the mistakes of the past. The confirming-evidence trap leads us to seek out information supporting an existing predilection and to discount opposing information. The framing trap occurs when we misstate a problem, undermining the entire decision-making process. The overconfidence trap makes us overestimate the accuracy of our forecasts. The prudence trap leads us to be overcautious when we make estimates about uncertain events. And the recallability trap leads us to give undue weight to recent, dramatic events. The best way to avoid all the traps is awareness--forewarned is forearmed. But executives can also take other simple steps to protect themselves and their organizations from the various kinds of mental lapses. The authors show how to take action to ensure that important business decisions are sound and reliable.

A cognitive prosthesis for complex decision-making.

PubMed

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

2017-01-01

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

"Decisions, decisions, decisions": transfer and specificity of decision-making skill between sports.

PubMed

Causer, Joe; Ford, Paul R

2014-08-01

The concept of transfer of learning holds that previous practice or experience in one task or domain will enable successful performance in another related task or domain. In contrast, specificity of learning holds that previous practice or experience in one task or domain does not transfer to other related tasks or domains. The aim of the current study is to examine whether decision-making skill transfers between sports that share similar elements, or whether it is specific to a sport. Participants (n = 205) completed a video-based temporal occlusion decision-making test in which they were required to decide on which action to execute across a series of 4 versus 4 soccer game situations. A sport engagement questionnaire was used to identify 106 soccer players, 43 other invasion sport players and 58 other sport players. Positive transfer of decision-making skill occurred between soccer and other invasion sports, which are related and have similar elements, but not from volleyball, supporting the concept of transfer of learning.

Decision-making in diabetes mellitus type 1.

PubMed

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

2013-01-01

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

Improving accountability in vaccine decision-making.

PubMed

Timmis, James Kenneth; Black, Steven; Rappuoli, Rino

2017-11-01

Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically. Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.

What Learning Environments Help Improve Decision-Making?

ERIC Educational Resources Information Center

O'Connor, Donna; Larkin, Paul; Williams, A. Mark

2017-01-01

Background: Decision-making is a key component of performance in sport. However, there has been minimal investigation of how coaches may adapt practice sessions to specifically develop decision-making. Purpose: The aim in this exploratory study was to investigate the pedagogical approaches coaches use to develop decision-making in soccer. Method:…

A mechanism for value-sensitive decision-making.

PubMed

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

2013-01-01

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

Conflict and Group Decision-Making: A New Approach.

ERIC Educational Resources Information Center

Dace, Karen L.

In the opinion of decision-making scholars, conflict is a natural component of group decision-making. A new direction for conflict and group decision-making theory and research will help dispel the confusion as to the promotive or disruptive nature of disagreement in group decision-making. Conflict literature is replete with descriptions of the…

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.

Risky Decision Making in Juvenile Myoclonic Epilepsy.

PubMed

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

2018-01-01

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

Decision making within a community provider organization.

PubMed

Berggren, Ingela; Carlstrom, Eric

2010-12-01

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

Mental fatigue impairs soccer-specific decision-making skill.

PubMed

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

2016-07-01

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

Naturalistic decision making in forensic science: toward a better understanding of decision making by forensic team leaders.

PubMed

Helsloot, Ira; Groenendaal, Jelle

2011-07-01

This study uses the naturalistic decision-making (NDM) perspective to examine how Dutch forensic team leaders (i.e., the officers in charge of criminal forensic research from the crime scene until the use of laboratory assistance) make decisions in real-life settings and identifies the contextual factors that might influence those decisions. First, a focus group interview was conducted to identify four NDM mechanisms in day-to-day forensic decision making. Second, a serious game was conducted to examine the influence of three of these contextual mechanisms. The results uncovered that forensic team leaders (i) were attracted to obtain further information when more information was initially made available, (ii) were likely to devote more attention to emotionally charged cases, and (iii) used not only forensic evidence in the decision making but also tactical, unverified information of the police inquiry. Interestingly, the measured contextual influences did not deviate significantly from a control group of laypeople. © 2011 American Academy of Forensic Sciences.

How shrinks think: decision making in psychiatry.

PubMed

Bhugra, Dinesh; Malliaris, Yanni; Gupta, Susham

2010-10-01

Psychiatrists use biopsychosocial models in identifying aetiological factors in assessing their patients and similar approaches in planning management. Models in decision making will be influenced by previous experience, training, age and gender, among other factors. Critical thinking and evidence base are both important components in the process of reaching clinical decisions. Expected outcome of treatment may be another factor. The way we think influences our decision making, clinical or otherwise. With patients expecting and taking larger roles in their own management, there needs to be a shift towards patient-centred care in decision making. Further exploration in how clinical decisions are made by psychiatrists is necessary. An understanding of the manner in which therapeutic alliances are formed between the clinician and the patient is necessary to understand decision making.

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.

ED Triage Decision-Making With Mental Health Presentations: A "Think Aloud" Study.

PubMed

Clarke, Diana E; Boyce-Gaudreau, Krystal; Sanderson, Ana; Baker, John A

2015-11-01

Triage is the process whereby persons presenting to the emergency department are quickly assessed by a nurse and their need for care and service is prioritized. Research examining the care of persons presenting to emergency departments with psychiatric and mental health problems has shown that triage has often been cited as the most problematic aspect of the encounter. Three questions guided this investigation: Where do the decisions that triage nurses make fall on the intuitive versus analytic dimensions of decision making for mental health presentations in the emergency department, and does this differ according to comfort or familiarity with the type of mental health/illness presentation? How do "decision aids" (i.e., structured triage scales) help in the decision-making process? To what extent do other factors, such as attitudes, influence triage nurses' decision making? Eleven triage nurses participating in this study were asked to talk out loud about the reasoning process they would engage in while triaging patients in 5 scenarios based on mental health presentations to the emergency department. Themes emerging from the data were tweaking the results (including the use of intuition and early judgments) to arrive at the desired triage score; consideration of the current ED environment; managing uncertainty and risk (including the consideration of physical reasons for presentation); and confidence in communicating with patients in distress and managing their own emotive reactions to the scenario. Findings support the preference for using the intuitive mode of decision making with only tacit reliance on the decision aid. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

A brief history of decision making.

PubMed

Buchanan, Leigh; O'Connell, Andrew

2006-01-01

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

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

Capturing a Commander's decision making style

NASA Astrophysics Data System (ADS)

Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

2017-05-01

A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

Alterations of decision making and underlying neural correlates after resection of a mediofrontal cortical dysplasia: A single case study.

PubMed

Labudda, Kirsten; Brand, Matthias; Mertens, Markus; Ebner, Alois; Markowitsch, Hans J; Woermann, Friedrich G

2010-02-01

We investigated the impact of a congenital prefrontal lesion and its resection on decision making under risk and under ambiguity in a patient with right mediofrontal cortical dysplasia. Both kinds of decision making are normally associated with the medial prefrontal cortex. We additionally studied pre- and postsurgical fMRI activations when processing information relevant for risky decision making. Results indicate selective impairments of ambiguous decision making pre- and postsurgically. Decision making under risk was intact. In contrast to healthy subjects the patient exhibited no activation within the dysplastic anterior cingulate cortex but left-sided orbitofrontal activation on the fMRI task suggesting early reorganization processes.

DECISION-MAKING SPARK CHAMBERS,

DTIC Science & Technology

of scattering of a particle and coplanarity of two particles. Decision - making spark chambers are used to trigger an optical spark chamber of two...the position of a spark and the separation of two sparks. Many other kinds of spatial decisions can be made with these devices such as the recognition

Designing for Decision Making

ERIC Educational Resources Information Center

Jonassen, David H.

2012-01-01

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

How social cognition can inform social decision making

PubMed Central

Lee, Victoria K.; Harris, Lasana T.

2013-01-01

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

How social cognition can inform social decision making.

PubMed

Lee, Victoria K; Harris, Lasana T

2013-12-25

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

Multi-view Decision Making (MVDM) Workshop

DTIC Science & Technology

2009-02-01

reflect the realities of system-of-systems development, acquisition, fielding and support: multi-view decision making (MVDM). MVDM addresses the...including mission risk, interoperable acquisition, and operational security and survivability. Hence, a multi-view approach to decision making is

What Is Known about Parents’ Treatment Decisions? A Narrative Review of Pediatric Decision Making

PubMed Central

Lipstein, Ellen A.; Brinkman, William B.; Britto, Maria T.

2013-01-01

Background With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process. Objective To conduct a narrative review of the current research on parent decision making about pediatric treatments and identify areas in need of further investigation. Methods 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. Results 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. Conclusions 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. PMID:21969136

Development of the Supported Decision Making Inventory System.

PubMed

Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

2017-12-01

Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

Making Market Decisions in the Classroom.

ERIC Educational Resources Information Center

Rose, Stephen A.

1986-01-01

Computer software that will help intermediate and secondary social studies students learn to make rational decisions about personal and societal concerns are described. The courseware places students in the roles of business managers who make decisions about operating their firms. (RM)

Evaluating Utility in Diagnostic Decision Making.

ERIC Educational Resources Information Center

Harber, Jean R.

1981-01-01

The utility of the procedures special educators apply in making decisions about the identification of handicapped individuals has not been thoroughly studied. The paper examines the utility of diagnostic decision making from the perspective of receiver operating curve analysis. (Author)

Decision Making in Action: Applying Research to Practice

NASA Technical Reports Server (NTRS)

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

1994-01-01

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

Cognitive Continuum Theory in nursing decision-making.

PubMed

Cader, Raffik; Campbell, Steve; Watson, Don

2005-02-01

The purpose of this paper is to analyse and evaluate Cognitive Continuum Theory and to provide evidence for its relevance to nurses' decision-making. It is critical that theories used in nursing are evaluated to provide an understanding of their aims, concepts and usefulness. With the advent of evidence-based care, theories on decision-making have acquired increased significance. The criteria identified by Fawcett's framework has been used to analyse and evaluate Hammond's Cognitive Continuum Theory. Findings. There is empirical evidence to support many of the concepts and propositions of Cognitive Continuum Theory. The theory has been applied to the decision-making process of many professionals, including medical practitioners and nurses. Existing evidence suggests that Cognitive Continuum Theory can provide the framework to explain decision-making in nursing. Cognitive Continuum Theory has the potential to make major contributions towards understanding the decision-making process of nurses in the clinical environment. Knowledge of the theory in nursing practice has become crucial.

36 CFR 907.14 - Corporation decision making procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major decision making points all relevant environmental concerns are considered by the Decision Maker, the...

Integrating Trends in Decision-Making Research

DTIC Science & Technology

2016-03-01

Address correspondence to Cleotilde Gonzalez, Department of Social and Decision Sciences, Dynamic Decision Making Lab, Carnegie Mellon University...Cleotilde Gonzalez, Carnegie Mellon University, and Joachim Meyer, Tel-Aviv University Journal of Cognitive Engineering and Decision Making 201X, Volume XX...Number X, Month 2016, pp. 1 –3 DOI: 10.1177/1555343416655256 Copyright © 2016, Human Factors and Ergonomics Society. at CARNEGIE MELLON UNIV LIBRARY

Practitioners' Views on Involving Young Children in Decision Making: Challenges for the Children's Rights Agenda

ERIC Educational Resources Information Center

Hudson, Kim

2012-01-01

This article presents the key findings and discussion from a research project and subsequent report: "Involving young children in decision making: An exploration of practitioners' views". This research explored early childhood practitioners'--childcare workers, kindergarten, pre-primary and grade 1-2 teachers--views on decision making…

Making better decisions in groups

PubMed Central

Frith, Chris D.

2017-01-01

We review the literature to identify common problems of decision-making in individuals and groups. We are guided by a Bayesian framework to explain the interplay between past experience and new evidence, and the problem of exploring the space of hypotheses about all the possible states that the world could be in and all the possible actions that one could take. There are strong biases, hidden from awareness, that enter into these psychological processes. While biases increase the efficiency of information processing, they often do not lead to the most appropriate action. We highlight the advantages of group decision-making in overcoming biases and searching the hypothesis space for good models of the world and good solutions to problems. Diversity of group members can facilitate these achievements, but diverse groups also face their own problems. We discuss means of managing these pitfalls and make some recommendations on how to make better group decisions. PMID:28878973

Iowa pavement asset management decision-making framework.

DOT National Transportation Integrated Search

2015-10-01

Most local agencies in Iowa currently make their pavement treatment decisions based on their limited experience due primarily to : lack of a systematic decision-making framework and a decision-aid tool. The lack of objective condition assessment data...

Framing bioremediation decision making as negotiation: Rationale & guidelineFraming bioremediation decision making as negotiation: Rationale & guidelines

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

Bjornstad, David J.; Wolfe, Amy K.

Framing remediation decision making as negotiation: (1) social choice, not technology choice; (2) prompts decision makers to identify interested and affected parties, anticipate objections, effectively address and ameliorate objections, and avoid unacceptable decisions.

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

Competence and Quality in Real-Life Decision Making.

PubMed

Geisler, Martin; Allwood, Carl Martin

2015-01-01

What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria.

Competence and Quality in Real-Life Decision Making

PubMed Central

2015-01-01

What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria. PMID:26545239

An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

NASA Technical Reports Server (NTRS)

Elgin, Peter D.; Thomas, Rickey P.

2004-01-01

The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

Realism and Impartiality: Making Sustainability Effective in Decision-Making.

PubMed

Bastons, Miquel; Armengou, Jaume

2017-08-01

There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.

Dynamic decision making for dam-break emergency management - Part 1: Theoretical framework

NASA Astrophysics Data System (ADS)

Peng, M.; Zhang, L. M.

2013-02-01

An evacuation decision for dam breaks is a very serious issue. A late decision may lead to loss of lives and properties, but a very early evacuation will incur unnecessary expenses. This paper presents a risk-based framework of dynamic decision making for dam-break emergency management (DYDEM). The dam-break emergency management in both time scale and space scale is introduced first to define the dynamic decision problem. The probability of dam failure is taken as a stochastic process and estimated using a time-series analysis method. The flood consequences are taken as functions of warning time and evaluated with a human risk analysis model (HURAM) based on Bayesian networks. A decision criterion is suggested to decide whether to evacuate the population at risk (PAR) or to delay the decision. The optimum time for evacuating the PAR is obtained by minimizing the expected total loss, which integrates the time-related probabilities and flood consequences. When a delayed decision is chosen, the decision making can be updated with available new information. A specific dam-break case study is presented in a companion paper to illustrate the application of this framework to complex dam-breaching problems.

Jordanian Physicians' Attitudes toward Disclosure of Cancer Information and Patient Participation in Treatment Decision-making.

PubMed

Obeidat, Rana; Khrais, Huthaifah I

2016-01-01

This study aims to determine the attitude of Jordanian physicians toward disclosure of cancer information, comfort and use of different decision-making approaches, and treatment decision making. A descriptive, comparative research design was used. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons practicing mainly in oncology was recruited. A modified version of a structured questionnaire was used for data collection. The questionnaire is a valid measure of physicians' views of shared decision making. Almost 91% of all physicians indicated that the doctor should tell the patient and let him/her decide if the family should know of an early-stage cancer diagnosis. Physicians provide abundant information about the extent of the disease, the side effects and benefits of the treatment, and details of the treatment procedures. They also provided less information on the effects of treatment on the sexuality, mood, and family of the patient. Almost 48% of the participating physicians reported using shared decision making as their usual approach for treatment decision making, and 67% reported that they were comfortable with this approach. The main setting of clinical activity was the only factor associated with physicians' usual approach to medical decision making. Moreover, age, years of experience, and main setting of clinical activity were associated with physicians' comfort level with the shared approach. Although Jordanian physicians appreciate patient autonomy, self-determination, and right to information, paternalistic decision making and underuse of the shared decision-making approach persist. Strategies that target both healthcare providers and patients must be employed to promote shared decision making in the Jordanian healthcare system.

Collective Decision Making in Organizations.

ERIC Educational Resources Information Center

Svenning, Lynne L.

Based on the assumption that educators can adopt new patterns of organization and management to improve the quality of decision and change in education, this paper attempts to make decision theory and small group process theory relevant to practical decision situations confronting educational managers. Included are (1) a discussion of the…

Framing effects and risk-sensitive decision making.

PubMed

Mishra, Sandeep; Gregson, Margaux; Lalumière, Martin L

2012-02-01

Prospect theory suggests that people are risk-averse when facing gains, but risk-prone when facing losses, a pattern known as the framing effect. Although framing effects have been widely demonstrated, few studies have investigated framing effects under conditions of need. Risk-sensitivity theory predicts that decision makers should prefer high-risk options in situations of high need, when lower risk options are unlikely to meet those needs. In two experiments, we examined (1) whether framing effects occurred in behavioural tasks involving risky decision making from description and decision making from experience, (2) whether participants' risky decision making conformed to the predictions of risk-sensitivity theory, and (3) whether decision framing interacted with conditions of need to influence decision making under risk. The results suggest that under all circumstances, risky decision making conformed to the predictions of risk-sensitivity theory. Framing effects were at least partially demonstrable under all experimental conditions. Finally, negative frames interacted with situations of high need to produce particularly elevated levels of risky choice. Together, the results suggest that risk-sensitivity theory can augment prospect theory to explain choice under conditions of need. ©2011 The British Psychological Society.

Decision Making in Action: Applying Research to Practice

NASA Technical Reports Server (NTRS)

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

1994-01-01

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

Structure and Style in Career Decision Making.

ERIC Educational Resources Information Center

Kortas, Linda; And Others

1992-01-01

The Career Decision Scale, Assessment of Career Decision Making, and Cognitive Differentiation Grid were administered to 598 community college students. Results indicated a relationship between decision-making styles and vocational construct structure. Poorly developed vocational schemas predispose individuals toward dependent and intuitive…

Gender and internet consumers' decision-making.

PubMed

Yang, Chyan; Wu, Chia-Chun

2007-02-01

The purpose of this research is to provide managers of shopping websites information regarding consumer purchasing decisions based on the Consumer Styles Inventory (CSI). According to the CSI, one can capture what decision-making styles online shoppers use. Furthermore, this research also discusses the gender differences among online shoppers. Exploratory factor analysis (EFA) was used to understand the decision-making styles and discriminant analysis was used to distinguish the differences between female and male shoppers. The result shows that there are differences in purchasing decisions between online female and male Internet users.

Expert decision-making strategies

NASA Technical Reports Server (NTRS)

Mosier, Kathleen L.

1991-01-01

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

Repeated Causal Decision Making

ERIC Educational Resources Information Center

Hagmayer, York; Meder, Bjorn

2013-01-01

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

Incorporating Science into Decision-Making

USGS Publications Warehouse

Karl, Herman A.; Turner, Christine E.

2003-01-01

Alan Leshner's Editorial “Public engagement with science” (14 Feb., p. 977) highlights a conundrum: Why is science often ignored in important societal decisions, even as the call for decisions based on sound science escalates? One reason is that decision-making is often driven by a variety of nonscientific, adversarial, and stakeholder dynamics

Classifying clinical decision making: a unifying approach.

PubMed

Buckingham, C D; Adams, A

2000-10-01

This is the first of two linked papers exploring decision making in nursing which integrate research evidence from different clinical and academic disciplines. Currently there are many decision-making theories, each with their own distinctive concepts and terminology, and there is a tendency for separate disciplines to view their own decision-making processes as unique. Identifying good nursing decisions and where improvements can be made is therefore problematic, and this can undermine clinical and organizational effectiveness, as well as nurses' professional status. Within the unifying framework of psychological classification, the overall aim of the two papers is to clarify and compare terms, concepts and processes identified in a diversity of decision-making theories, and to demonstrate their underlying similarities. It is argued that the range of explanations used across disciplines can usefully be re-conceptualized as classification behaviour. This paper explores problems arising from multiple theories of decision making being applied to separate clinical disciplines. Attention is given to detrimental effects on nursing practice within the context of multidisciplinary health-care organizations and the changing role of nurses. The different theories are outlined and difficulties in applying them to nursing decisions highlighted. An alternative approach based on a general model of classification is then presented in detail to introduce its terminology and the unifying framework for interpreting all types of decisions. The classification model is used to provide the context for relating alternative philosophical approaches and to define decision-making activities common to all clinical domains. This may benefit nurses by improving multidisciplinary collaboration and weakening clinical elitism.

Risky decision making in adults with ADHD.

PubMed

Matthies, S; Philipsen, A; Svaldi, J

2012-09-01

Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD. In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT. In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction. Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression. Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research. Copyright © 2012 Elsevier Ltd. All rights reserved.

An Interactive Model of Career Decision Making.

ERIC Educational Resources Information Center

Amundson, Norman E.

1995-01-01

The decision-making model described highlights the interaction between contextual factors, decision triggers, establishing a frame of the problem, reframing, and action planning. The interactive perspective is based on process and change. Career counseling with an interactive decision-making approach requires an acknowledgment of external…

Cellular and molecular basis of decision-making

PubMed Central

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

2014-01-01

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

Shared Decision-Making for Nursing Practice: An Integrative Review

PubMed Central

Truglio-Londrigan, Marie; Slyer, Jason T.

2018-01-01

Background: 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. Objective: To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. Methods: 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. Results: 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. Conclusion: 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. PMID:29456779

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.

Making Insulation Decisions through Mathematical Modeling

ERIC Educational Resources Information Center

Yanik, H. Bahadir; Memis, Yasin

2014-01-01

Engaging students in studies about conservation and sustainability can support their understanding of making environmental conscious decisions to conserve Earth. This article aims to contribute these efforts and direct students' attention to how they can use mathematics to make environmental decisions. Contributors to iSTEM: Integrating…

Multi-Criteria Decision Making for a Spatial Decision Support System on the Analysis of Changing Risk

NASA Astrophysics Data System (ADS)

Olyazadeh, Roya; van Westen, Cees; Bakker, Wim H.; Aye, Zar Chi; Jaboyedoff, Michel; Derron, Marc-Henri

2014-05-01

this case study namely: construction of defense structures, relocation, implementation of an early warning system and spatial planning regulations. Some of the criteria are determined partly in other modules of the CHANGES SDSS, such as the costs for implementation, the risk reduction in monetary values, and societal risk. Other criteria, which could be environmental, economic, cultural, perception in nature, are defined by different stakeholders such as local authorities, expert organizations, private sector, and local public. In the next step, the stakeholders weight the importance of the criteria by pairwise comparison and visualize the decision matrix, which is a matrix based on criteria versus alternatives values. Finally alternatives are ranked by Analytic Hierarchy Process (AHP) method. We expect that this approach will help the decision makers to ease their works and reduce their costs, because the process is more transparent, more accurate and involves a group decision. In that way there will be more confidence in the overall decision making process. Keywords: MCDM, Analytic Hierarchy Process (AHP), SDSS, Natural Hazard Risk Management

Health-Related Decision-Making in HIV Disease

PubMed Central

Doyle, Katie L.; Woods, Steven Paul; Morgan, Erin E.; Iudicello, Jennifer E.; Cameron, Marizela V.; Gilbert, Paul E.; Beltran, Jessica

2016-01-01

Individuals living with HIV show moderate decision-making deficits, though no prior studies have evaluated the ability to make optimal health-related decisions across the HIV healthcare continuum. Forty-three HIV+ individuals with HIV−associated neurocognitive disorders (HAND+), 50 HIV+ individuals without HAND (HAND−), and 42 HIV− participants were administered two measures of health-related decision-making as part of a comprehensive neuropsychological battery: 1) The Decisional Conflict Scale (DCS), and 2) The Modified UCSD Brief Assessment for Capacity to Consent (UBACC-T). Multiple regression analyses revealed that HAND was an independent predictor of both the DCS and the UBACC-T, such that the HAND+ sample evidenced significantly poorer scores relative to comparison groups. Within the HIV+ sample, poorer health-related decision-making was associated with worse performance on tests of episodic memory, risky decision-making, and health literacy. Findings indicate that individuals with HAND evidence moderate deficits in effectively comprehending and evaluating various health-related choices. PMID:26946300

Trust and Decision Making: An Empirical Platform

DTIC Science & Technology

2008-06-01

13th ICCRTS “C2 for Complex Endeavors” Trust and Decision Making : An Empirical Platform Topic(s): Cognitive and Social Issues...and Decision Making : An Empirical Platform 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e...PERSON a. REPORT unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Trust and Decision Making : An Empirical Platform Dr. Joseph B

Decision Making Analysis: Critical Factors-Based Methodology

DTIC Science & Technology

2010-04-01

the pitfalls associated with current wargaming methods such as assuming a western view of rational values in decision - making regardless of the cultures...Utilization theory slightly expands the rational decision making model as it states that “actors try to maximize their expected utility by weighing the...items to categorize the decision - making behavior of political leaders which tend to demonstrate either a rational or cognitive leaning. Leaders

The Decision-Making Structure and the Dean.

ERIC Educational Resources Information Center

Johnson, Betty M.; George, Shirley A.

1987-01-01

Characteristics in the college academic setting and the external environment that affect the decision-making structure and that the dean should consider before reorganization are examined. Concepts and theories about governance, decision-making, organizational structure, and characteristics of effective decision makers are also briefly reviewed. A…

Embodied Choice: How Action Influences Perceptual Decision Making

PubMed Central

Lepora, Nathan F.; Pezzulo, Giovanni

2015-01-01

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

Embodied choice: how action influences perceptual decision making.

PubMed

Lepora, Nathan F; Pezzulo, Giovanni

2015-04-01

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

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

PubMed

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

2014-04-01

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

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

Decision Making: Rational, Nonrational, and Irrational.

ERIC Educational Resources Information Center

Simon, Herbert A.

1993-01-01

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

How well-run boards make decisions.

PubMed

Useem, Michael

2006-11-01

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

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.

[Shared decision-making in mental health care: a role model from youth mental health care].

PubMed

Westermann, G M A; Maurer, J M G

2015-01-01

In the communication and interaction between doctor and patient in Western health care there has been a paradigm shift from the paternalistic approach to shared decision-making. To summarise the background situation, recent developments and the current level of shared decision-making in (youth) mental health care. We conducted a critical review of the literature relating to the methodology development, research and the use of counselling and decision-making in mental health care. The majority of patients, professionals and other stakeholders consider shared decision-making to be desirable and important for improving the quality and efficiency of care. Up till recently most research and studies have concentrated on helping patients to develop decision-making skills and on showing patients how and where to access information. At the moment more attention is being given to the development of skills and circumstances that will increase patients' interaction with care professionals and patients' emotional involvement in shared decision-making. In mental health for children and adolescents, more often than in adult mental health care, it has been customary to give more attention to these aspects of shared decision-making, particularly during counselling sessions that mark the transition from diagnosis to treatment. This emphasis has been apparent for a long time in textbooks, daily practice, methodology development and research in youth mental health care. Currently, a number of similar developments are taking place in adult mental health care. Although most health professionals support the policy of shared decision-making, the implementation of the policy in mental health care is still at an early stage. In practice, a number of obstacles still have to be surmounted. However, the experience gained with counselling and decision-making in (youth) mental health care may serve as an example to other sections of mental health care and play an important role in the further

Neural Basis of Strategic Decision Making

PubMed Central

Lee, Daeyeol; Seo, Hyojung

2015-01-01

Human choice behaviors during social interactions often deviate from the predictions of game theory. This might arise partly from the limitations in cognitive abilities necessary for recursive reasoning about the behaviors of others. In addition, during iterative social interactions, choices might change dynamically, as knowledge about the intentions of others and estimates for choice outcomes are incrementally updated via reinforcement learning. Some of the brain circuits utilized during social decision making might be general-purpose and contribute to isomorphic individual and social decision making. By contrast, regions in the medial prefrontal cortex and temporal parietal junction might be recruited for cognitive processes unique to social decision making. PMID:26688301

Shared Decision Making with Collective Bargaining.

ERIC Educational Resources Information Center

Steimel, Eric L.

This paper examines the changing role of school leaders, in light of the current trend toward participative decision making. Executive Order 12871 mandates the formation of a partnership between unions and management, which will result in teachers playing an active role in decision making. Leaders, particularly leaders of Department of Defense…

Transformational Leadership & Decision Making in Schools

ERIC Educational Resources Information Center

Brower, Robert E.; Balch, Bradley V.

2005-01-01

It is essential for every school leader to possess the savvy to effect positive change, raise achievement levels, and foster a positive school climate. Now it seems that the struggle for school leaders to make productive decisions has become clouded with ever-growing uncertainty and skepticism. "Transformational Leadership & Decision Making in…

Instructional decision making of high school science teachers

NASA Astrophysics Data System (ADS)

Carver, Jeffrey S.

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

Multimorbidity and Decision-Making Preferences Among Older Adults.

PubMed

Chi, Winnie C; Wolff, Jennifer; Greer, Raquel; Dy, Sydney

2017-11-01

Understanding individuals' preferences for participating in health care decisions is foundational to delivering person-centered care. We aimed to (1) explore preferences for health care decision making among older adults, and (2) identify multimorbidity profiles associated with preferring less active, ie, passive, participation among older US adults. Ours was a cross-sectional, nationally representative study of 2,017 National Health and Aging Trends Study respondents. Passive decision-making preference was defined as preferring to leave decisions to physicians. Multimorbidity profiles, based on 13 prevalent chronic conditions, were examined as (1) presence of 2 or more conditions, (2) a simple conditions count, and (3) a condition clusters count. Multiple logistic regression was used with adjustment for age, sex, education, English proficiency, and mobility limitation. Most older adults preferred to participate actively in making health care decisions. Older adults with 4 or more conditions, however, and those with multiple condition clusters are relatively less likely to prefer active decision making. Primary care physicians should initiate a shared decision-making process with older adults with 4 or more conditions or multiple condition clusters. Physicians should anticipate variation in decision-making preferences among older adults and adapt a decision-making process that suits individuals' preferences for participation to ensure person-centered care delivery. © 2017 Annals of Family Medicine, Inc.

Neural basis of quasi-rational decision making.

PubMed

Lee, Daeyeol

2006-04-01

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

36 CFR 907.14 - Corporation decision making procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major... Corporation's decision making process to ensure adequate consideration of environmental factors. (b) The...

36 CFR 907.14 - Corporation decision making procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major... Corporation's decision making process to ensure adequate consideration of environmental factors. (b) The...

36 CFR 907.14 - Corporation decision making procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Corporation decision making... CORPORATION ENVIRONMENTAL QUALITY § 907.14 Corporation decision making procedures. To ensure that at major... Corporation's decision making process to ensure adequate consideration of environmental factors. (b) The...

Manipulating memory efficacy affects the behavioral and neural profiles of deterministic learning and decision-making.

PubMed

Tremel, Joshua J; Ortiz, Daniella M; Fiez, Julie A

2018-06-01

When making a decision, we have to identify, collect, and evaluate relevant bits of information to ensure an optimal outcome. How we approach a given choice can be influenced by prior experience. Contextual factors and structural elements of these past decisions can cause a shift in how information is encoded and can in turn influence later decision-making. In this two-experiment study, we sought to manipulate declarative memory efficacy and decision-making in a concurrent discrimination learning task by altering the amount of information to be learned. Subjects learned correct responses to pairs of items across several repetitions of a 50- or 100-pair set and were tested for memory retention. In one experiment, this memory test interrupted learning after an initial encoding experience in order to test for early encoding differences and associate those differences with changes in decision-making. In a second experiment, we used fMRI to probe neural differences between the two list-length groups related to decision-making across learning and assessed subsequent memory retention. We found that a striatum-based system was associated with decision-making patterns when learning a longer list of items, while a medial cortical network was associated with patterns when learning a shorter list. Additionally, the hippocampus was exclusively active for the shorter list group. Altogether, these behavioral, computational, and imaging results provide evidence that multiple types of mnemonic representations contribute to experienced-based decision-making. Moreover, contextual and structural factors of the task and of prior decisions can influence what types of evidence are drawn upon during decision-making. Copyright © 2018 Elsevier Ltd. All rights reserved.

Shared decision-making in medical encounters regarding breast cancer treatment: the contribution of methodological triangulation.

PubMed

Durif-Bruckert, C; Roux, P; Morelle, M; Mignotte, H; Faure, C; Moumjid-Ferdjaoui, N

2015-07-01

The aim of this study on shared decision-making in the doctor-patient encounter about surgical treatment for early-stage breast cancer, conducted in a regional cancer centre in France, was to further the understanding of patient perceptions on shared decision-making. The study used methodological triangulation to collect data (both quantitative and qualitative) about patient preferences in the context of a clinical consultation in which surgeons followed a shared decision-making protocol. Data were analysed from a multi-disciplinary research perspective (social psychology and health economics). The triangulated data collection methods were questionnaires (n = 132), longitudinal interviews (n = 47) and observations of consultations (n = 26). Methodological triangulation revealed levels of divergence and complementarity between qualitative and quantitative results that suggest new perspectives on the three inter-related notions of decision-making, participation and information. Patients' responses revealed important differences between shared decision-making and participation per se. The authors note that subjecting patients to a normative behavioural model of shared decision-making in an era when paradigms of medical authority are shifting may undermine the patient's quest for what he or she believes is a more important right: a guarantee of the best care available. © 2014 John Wiley & Sons Ltd.

Developmental telomere attrition predicts impulsive decision-making in adult starlings

PubMed Central

Bateson, Melissa; Brilot, Ben O.; Gillespie, Robert; Monaghan, Pat; Nettle, Daniel

2015-01-01

Animals in a poor biological state face reduced life expectancy, and as a consequence should make decisions that prioritize immediate survival and reproduction over long-term benefits. We tested the prediction that if, as has been suggested, developmental telomere attrition is a biomarker of state and future life expectancy, then individuals who have undergone greater developmental telomere attrition should display greater choice impulsivity as adults. We measured impulsive decision-making in a cohort of European starlings (Sturnus vulgaris) in which we had previously manipulated developmental telomere attrition by cross-fostering sibling chicks into broods of different sizes. We show that as predicted by state-dependent optimality models, individuals who had sustained greater developmental telomere attrition and who had shorter current telomeres made more impulsive foraging decisions as adults, valuing smaller, sooner food rewards more highly than birds with less attrition and longer telomeres. Our findings shed light on the biological embedding of early adversity and support a functional explanation for its consequences that could be applicable to other species, including humans. PMID:25473012

An introduction to behavioural decision-making theories for paediatricians.

PubMed

Haward, Marlyse F; Janvier, Annie

2015-04-01

Behavioural decision-making theories provide insights into how people make choices under conditions of uncertainty. However, few have been studied in paediatrics. This study introduces these theories, reviews current research and makes recommendations for their application within the context of shared decision-making. As parents are expected to share decision-making in paediatrics, it is critical that the fields of behavioural economics, communication and decision sciences merge with paediatric clinical ethics to optimise decision-making. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Decision Making and Confidence Given Uncertain Advice

ERIC Educational Resources Information Center

Lee, Michael D.; Dry, Matthew J.

2006-01-01

We study human decision making in a simple forced-choice task that manipulates the frequency and accuracy of available information. Empirically, we find that people make decisions consistent with the advice provided, but that their subjective confidence in their decisions shows 2 interesting properties. First, people's confidence does not depend…

Developing and Teaching Ethical Decision Making Skills.

ERIC Educational Resources Information Center

Robinson, John

1991-01-01

Student leaders and campus activities professionals can use a variety of techniques to help college students develop skill in ethical decision making, including teaching about the decision-making process, guiding students through decisions with a series of questions, playing ethics games, exploring assumptions, and best of all, role modeling. (MSE)

Decision Making: New Paradigm for Education.

ERIC Educational Resources Information Center

Wales, Charles E.; And Others

1986-01-01

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

Predicting Early Death Among Elderly Dialysis Patients: Development and Validation of a Risk Score to Assist Shared Decision Making for Dialysis Initiation.

PubMed

Thamer, Mae; Kaufman, James S; Zhang, Yi; Zhang, Qian; Cotter, Dennis J; Bang, Heejung

2015-12-01

A shared decision-making tool could help elderly patients with advanced chronic kidney disease decide about initiating dialysis therapy. Because mortality may be high in the first few months after initiating dialysis therapy, incorporating early mortality predictors in such a tool would be important for an informed decision. Our objective is to derive and validate a predictive risk score for early mortality after initiating dialysis therapy. Retrospective observational cohort, with development and validation cohorts. US Renal Data System and claims data from the Centers for Medicare & Medicaid Services for 69,441 (aged ≥67 years) patients with end-stage renal disease with a previous 2-year Medicare history who initiated dialysis therapy from January 1, 2009, to December 31, 2010. Demographics, predialysis care, laboratory data, functional limitations, and medical history. All-cause mortality in the first 3 and 6 months. Predicted mortality by logistic regression. The simple risk score (total score, 0-9) included age (0-3 points), low albumin level, assistance with daily living, nursing home residence, cancer, heart failure, and hospitalization (1 point each), and showed area under the receiver operating characteristic curve (AUROC)=0.69 in the validation sample. A comprehensive risk score with additional predictors was also developed (with AUROC=0.72, high concordance between predicted vs observed risk). Mortality probabilities were estimated from these models, with the median score of 3 indicating 12% risk in 3 months and 20% in 6 months, and the highest scores (≥8) indicating 39% risk in 3 months and 55% in 6 months. Patients who did not choose dialysis therapy and did not have a 2-year Medicare history were excluded. Routinely available information can be used by patients with chronic kidney disease, families, and their nephrologists to estimate the risk of early mortality after dialysis therapy initiation, which may facilitate informed decision making

Patient decision making among older individuals with cancer.

PubMed

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

2011-07-01

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

Health decision making: lynchpin of evidence-based practice.

PubMed

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.

Health Decision Making: Lynchpin of Evidence-Based Practice

PubMed Central

Spring, Bonnie

2008-01-01

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. Implications for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers’ intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed. PMID:19015288

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

PubMed

Hughes, K K; Dvorak, E M

1997-01-01

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

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

PubMed

Margenthaler, Julie A; Ollila, David W

2016-10-01

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

Reimbursement decisions in health policy--extending our understanding of the elements of decision-making.

PubMed

Wirtz, Veronika; Cribb, Alan; Barber, Nick

2005-09-08

Previous theoretical and empirical work on health policy decisions about reimbursement focuses on specific rationales such as effectiveness, economic considerations and equal access for equal needs. As reimbursement decisions take place in a social and political context we propose that the analysis of decision-making should incorporate factors, which go beyond those commonly discussed. As an example we chose three health technologies (sildenafil, rivastigmine and statins) to investigate how decisions about reimbursement of medicines are made in the United Kingdom National Health Service and what factors influence these decisions. From face-to-face, in-depth interviews with a purposive sample of 20 regional and national policy makers and stakeholders we identified two dimensions of decision-making, which extend beyond the rationales conventionally cited. The first dimension relates to the role of 'subjectivity' or 'the personal' in the decisions, including personal experiences of the condition and excitement about the novelty or potential benefit of the technology-these factors affect what counts as evidence, or how evidence is interpreted, in practice. The second dimension relates to the social and political function of decision-making and broadens what counts as the relevant ends of decision-making to include such things as maintaining relationships, avoiding organisational burden, generating politically and legally defensible decisions and demonstrating the willingness to care. More importantly, we will argue that these factors should not be treated as contaminants of an otherwise rational decision-making. On the contrary we suggest that they seem relevant, reasonable and also of substantial importance in considering in decision-making. Complementing the analysis of decision-making about reimbursement by incorporating these factors could increase our understanding and potentially improve decision-making.

Serial, parallel and hierarchical decision making in primates

PubMed Central

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

2017-01-01

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

Reasoning in explanation-based decision making.

PubMed

Pennington, N; Hastie, R

1993-01-01

A general theory of explanation-based decision making is outlined and the multiple roles of inference processes in the theory are indicated. A typology of formal and informal inference forms, originally proposed by Collins (1978a, 1978b), is introduced as an appropriate framework to represent inferences that occur in the overarching explanation-based process. Results from the analysis of verbal reports of decision processes are presented to demonstrate the centrality and systematic character of reasoning in a representative legal decision-making task.

Decision making about pre-medication to children.

PubMed

Proczkowska-Björklund, M; Runeson, I; Gustafsson, P A; Svedin, C G

2008-11-01

Inviting the child to participate in medical decisions regarding common medical procedures might influence the child's behaviour during the procedures. We wanted to study nurse decision-making communication regarding pre-medication before ear, nose and throat (ENT) surgery. In total, 102 children (3-6 years) signed for ENT surgery were video-filmed during the pre-medication process. The nurse decision-making communication was identified, transcribed and grouped in six main categories dependent on the level of participation (self-determination, compromise, negotiation, questioning, information, lack of communication). Associations between child factors (age, gender, verbal communication and non-verbal communication) and different nurse decision-making communication were studied. Associations between the decision-making communication and verbal hesitation and/or the child's compliance in taking pre-medication were also studied. Totally, information was the most frequently used category of decision making communication followed by negotiation and questioning. To the children showing signs of shyness, the nurse used more negotiation, questions and self-determination communication and less information. The nurse used more compromise, negotiation and gave less information to children with less compliance. No specific type of nurse decision-making communication was associated with verbal hesitation. The most important predictors for verbal hesitation were none or hesitant eye contact with nurse (OR = 4.5) and placement nearby or in parent's lap (OR = 4.7). Predictors for less compliance in taking pre-medication were verbal hesitation from the child (OR = 22.7) and children who did not give any verbal answer to nurse initial questions (OR = 5.5). Decision-making communication could not predict the child's compliance during pre-medication. Although negotiation, questioning and self-determination communication were associated with more unwillingness to take pre

Protocol-based care: the standardisation of decision-making?

PubMed

Rycroft-Malone, Jo; Fontenla, Marina; Seers, Kate; Bick, Debra

2009-05-01

To explore how protocol-based care affects clinical decision-making. In the context of evidence-based practice, protocol-based care is a mechanism for facilitating the standardisation of care and streamlining decision-making through rationalising the information with which to make judgements and ultimately decisions. However, whether protocol-based care does, in the reality of practice, standardise decision-making is unknown. This paper reports on a study that explored the impact of protocol-based care on nurses' decision-making. Theoretically informed by realistic evaluation and the promoting action on research implementation in health services framework, a case study design using ethnographic methods was used. Two sites were purposively sampled; a diabetic and endocrine unit and a cardiac medical unit. Within each site, data collection included observation, postobservation semi-structured interviews with staff and patients, field notes, feedback sessions and document review. Data were inductively and thematically analysed. Decisions made by nurses in both sites were varied according to many different and interacting factors. While several standardised care approaches were available for use, in reality, a variety of information sources informed decision-making. The primary approach to knowledge exchange and acquisition was person-to-person; decision-making was a social activity. Rarely were standardised care approaches obviously referred to; nurses described following a mental flowchart, not necessarily linked to a particular guideline or protocol. When standardised care approaches were used, it was reported that they were used flexibly and particularised. While the logic of protocol-based care is algorithmic, in the reality of clinical practice, other sources of information supported nurses' decision-making process. This has significant implications for the political goal of standardisation. The successful implementation and judicious use of tools such as

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

PubMed

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

2014-09-01

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

36 CFR 1010.13 - Trust decision-making procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01