Autonomy and dependence: a discussion paper on decision-making in teenagers and young adults undergoing cancer treatment.

PubMed

Davies, Jane; Kelly, Daniel; Hannigan, Ben

2015-09-01

A discussion which aims to explore the diversity of decision-making during teenage and young adult cancer treatment. The discussion will be related to the concepts of autonomy, dependence and decision-making in this age group. The experience of cancer involves a significant series of treatment decisions. However, other non-treatment decisions also have to be made which can relate to any aspect of everyday life. These decisions occur against the backdrop of young people's disease experience. Discussion paper. A literature search for the period 1990-2013 was undertaken. This included searching the following databases: Cumulative Index for Nursing and Allied Health Literature (CINAHL), SCOPUS, Medline, DARE, Applied Social Sciences Index and Abstracts (ASSIA), (Psych Info) and The Cochrane Library. There is a lack of evidence into the experience of everyday decisions made by young people during cancer treatment. This may affect them in the form of unmet needs that nurses, or other professionals, fail to appreciate. Further exploration of how teenagers and young adults experience the range and process of decision-making during cancer treatment could be useful in helping to provide effective supportive care for this age group. © 2015 John Wiley & Sons Ltd.

‘To do or not to do’? The neurobiology of decision-making in daily life: I. Getting the basics

PubMed Central

Palmini, André; Haase, Victor Geraldi

2007-01-01

The constant conflict between decisions leading to immediate pleasurable consequences versus behaviors aiming at long-term social advantages is reviewed here in the framework of the evolutionary systems regulating behavior. The inescapable temporal perspective in decision-making in everyday life is highlighted and integrated with the role of the executive functions in the modulation of subcortical systems. In particular, the representations of the ‘non-existent’ future in the prefrontal cortical regions and how these representations can bridge theory and practice in everyday life are addressed. Relevant discussions regarding the battle between emotions and reasons in the determination of more complex decisions in the realm of neuroeconomics and in moral issues have been reserved for a second essay. PMID:29213362

[Clinical everyday ethics-support in handling moral distress? : Evaluation of an ethical decision-making model for interprofessional clinical teams].

PubMed

Tanner, S; Albisser Schleger, H; Meyer-Zehnder, B; Schnurrer, V; Reiter-Theil, S; Pargger, H

2014-06-01

High-tech medicine and cost rationing provoke moral distress up to burnout syndromes. The consequences are severe, not only for those directly involved but also for the quality of patient care and the institutions. The multimodal model METAP (Modular, Ethical, Treatment, Allocation, Process) was developed as clinical everyday ethics to support the interprofessional ethical decision-making process. The distinctive feature of the model lays in education concerning ethics competence in dealing with difficult treatment decisions. METAP has been evaluated for quality testing. The research question of interest was whether METAP supports the handling of moral distress. The evaluation included 3 intensive care units and 3 geriatric units. In all, 33 single and 9 group interviews were held with 24 physicians, 44 nurses, and 9 persons from other disciplines. An additional questionnaire was completed by 122 persons (return rate 57%). Two-thirds of the interview answers and 55% of the questionnaire findings show that clinical everyday ethics supports the handling of moral distress, especially for interdisciplinary communication and collaboration and for the explanation and evaluation of treatment goals. METAP does not provide support for persons who are rarely confronted with ethical problems or have not applied the model long enough yet. To a certain degree, moral distress is unavoidable and must be addressed as an interprofessional problem. Herein, clinical everyday ethics may provide targeted support for ethical decision-making competence.

Justice in and through Education? Students' Participation in Decision-Making

ERIC Educational Resources Information Center

Rönnlund, Maria

2014-01-01

Drawing on one year of ethnographic work in three Swedish lower secondary schools, this article problematizes students' participation in decision-making in everyday school life in the perspective of social justice. In order to extend the traditional liberal understanding of justice and include also relational, procedurial, social and cultural…

Shared decision-making for people living with dementia in extended care settings: a systematic review

PubMed Central

Bunn, Frances; Goodman, Claire

2018-01-01

Background Shared decision-making is recognised as an important element of person-centred dementia care. Objectives The aim of this review was to explore how people living with dementia and cognitive impairment can be included in day-to-day decisions about their health and care in extended care settings. Design A systematic review including primary research relating to shared decision-making, with cognitively impaired adults in (or transferrable to) extended care settings. Databases searched were: CINAHL, PubMed, the Cochrane Library, NICE Evidence, OpenGrey, Autism Data, Google Scholar, Scopus and Medicines Complete (June to October 2016 and updated 2018) for studies published in the last 20 years. Results Of the 19 included studies 15 involved people with living dementia, seven in extended care settings. People living with cognitive impairment often have the desire and ability to participate in decision-making about their everyday care, although this is regularly underestimated by their staff and family care partners. Shared decision-making has the potential to improve quality of life for both the person living with dementia and those who support them. How resources to support shared decision-making are implemented in extended care settings is less well understood. Conclusions Evidence suggests that people living with cognitive impairment value opportunities to be involved in everyday decision-making about their care. How these opportunities are created, understood, supported and sustained in extended care settings remains to be determined. Trial registration number CRD42016035919 PMID:29886439

If times change, should we throw away the hearthstone? Exploring (Dis) continuities in autonomy and decision-making in the lives of Ghanaian women

PubMed Central

Dzokoto, Vivian A. A.; Darkwah, Akosua K.

2014-01-01

This paper attempts to investigate continuities and discontinuities between traditional and modern representations of womanhood and female gender roles focusing primarily on family and work settings. Using approaches informed by Sociology, Cultural Psychology, and African Studies, the paper explores traditional views of womanhood encapsulated in (and also transmitted intergenerationally) through proverbs. This customary perspective is contrasted with the results of the Everyday Lives Survey from the Pathways of Women's Empowerment Ghana project. The survey investigated the nature of everyday life– education, work, decision making, access to institutions, and autonomy in relationships—in six hundred (600) adult women in both rural and urban communities in three regions of Ghana. We argue that although the times are changing, there have only been modest disruptions in the lives of Ghanaian women as far as issues of autonomy and decision-making in are concerned. PMID:25506334

"May I Please Tell You a Little Anecdote?" Inter-Professional Decision-Making about Inclusion in the Borderland between General and Special Schooling

ERIC Educational Resources Information Center

Røn Larsen, Maja

2016-01-01

This article addresses inter-professional work and decision-making around inclusion in school, using an approach inspired by social practice theory. Based on a case analysis, the article presents analytical examples of the ways in which knowledge from children's everyday life tends to be considered anecdotal and disregarded in the decision-making…

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.

Ecosystem Services in Environmental Science Literacy

ERIC Educational Resources Information Center

Ruppert, John Robert

2015-01-01

Human beings depend on a set of benefits that emerge from functioning ecosystems, termed Ecosystem Services (ES), and make decisions in everyday life that affect these ES. Recent advancements in science have led to an increasingly sophisticated understanding of ES and how they can be used to inform environmental decision-making. Following suit, US…

The Forms and Functions of Real-Life Moral Decision-Making.

ERIC Educational Resources Information Center

Krebs, Dennis L.; Denton, Kathy; Wark, Gillian

1997-01-01

Observes that the Kohlbergian model of morality does not give a good account of the ways in which people make moral decisions in their everyday lives. Argues that a functional model of moral judgment and moral behavior derived from evolutionary theory may supply a better account of real-life morality. (DSK)

Phronesis: Beyond the Research Ethics Committee-A Crucial Decision-Making Skill for Health Researchers During Community Research.

PubMed

Greeff, Minrie; Rennie, Stuart

2016-04-01

Health researchers conducting research in the community are often faced with unanticipated ethical issues that arise in the course of their research and that go beyond the scope of ethical approval by the research ethics committee. Eight expert researchers were selected through extreme intensity purposive sampling, because they are representative of unusual manifestations of the phenomenon related to their research in the community. They were selected to take part in a semi-structured focus group discussion on whether practical wisdom (phronesis) is used as a decision-making skill to solve unanticipated ethical issues during research in the community. Although the researchers were not familiar with the concept phronesis, it became obvious that it formed an integral part of their everyday existence and decision making during intervention research. They could balance research ethics with practical considerations. The capacity of practical wisdom as a crucial decision-making skill should be assimilated into a researcher's everyday reality, and also into the process of mentoring young researchers to become phronimos. Researchers should be taught this skill to handle unanticipated ethical issues. © The Author(s) 2016.

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.

Shared decision-making for people living with dementia in extended care settings: a systematic review.

PubMed

Daly, Rachel Louise; Bunn, Frances; Goodman, Claire

2018-06-09

Shared decision-making is recognised as an important element of person-centred dementia care. The aim of this review was to explore how people living with dementia and cognitive impairment can be included in day-to-day decisions about their health and care in extended care settings. A systematic review including primary research relating to shared decision-making, with cognitively impaired adults in (or transferrable to) extended care settings. Databases searched were: CINAHL, PubMed, the Cochrane Library, NICE Evidence, OpenGrey, Autism Data, Google Scholar, Scopus and Medicines Complete (June to October 2016 and updated 2018) for studies published in the last 20 years. Of the 19 included studies 15 involved people with living dementia, seven in extended care settings. People living with cognitive impairment often have the desire and ability to participate in decision-making about their everyday care, although this is regularly underestimated by their staff and family care partners. Shared decision-making has the potential to improve quality of life for both the person living with dementia and those who support them. How resources to support shared decision-making are implemented in extended care settings is less well understood. Evidence suggests that people living with cognitive impairment value opportunities to be involved in everyday decision-making about their care. How these opportunities are created, understood, supported and sustained in extended care settings remains to be determined. CRD42016035919. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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

Casuistry as bioethical method: an empirical perspective.

PubMed

Braunack-Mayer, A

2001-07-01

This paper examines the role that casuistry, a model of bioethical reasoning revived by Jonsen and Toulmin, plays in ordinary moral reasoning. I address the question: 'What is the evidence for contemporary casuistry's claim that everyday moral reasoning is casuistic in nature?' The paper begins with a description of the casuistic method, and then reviews the empirical arguments Jonsen and Toulmin offer to show that every-day moral decision-making is casuistic. Finally, I present the results of qualitative research conducted with 15 general practitioners (GPs) in South Australia, focusing on the ways in which these GP participants used stories and anecdotes in their own moral reasoning. This research found that the GPs interviewed did use a form of casuistry when talking about ethical dilemmas. However, the GPs' homespun casuistry often lacked one central element of casuistic reasoning--clear paradigm cases on which to base comparisons. I conclude that casuistic reasoning does appear to play a role in every-day moral decision-making, but that it is a more subdued role than perhaps casuists would like.

Affecting others: social appraisal and emotion contagion in everyday decision making.

PubMed

Parkinson, Brian; Simons, Gwenda

2009-08-01

In a diary study of interpersonal affect transfer, 41 participants reported on decisions involving other people over 3 weeks. Reported anxiety and excitement were reliably related to the perceived anxiety and excitement of another person who was present during decision making. Risk and importance appraisals partially mediated effects of other's anxiety on own anxiety as predicted by social appraisal theory. However, other's emotion remained a significant independent predictor of own emotion after controlling for appraisals, supporting the additional impact of more direct forms of affect transfer such as emotion contagion. Significant affect-transfer effects remained even after controlling for participants' perceptions of the other's emotion in addition to all measured appraisals, confirming that affect transfer does not require explicit registration of someone else's feelings. This research provides some of the clearest evidence for the operation of both social appraisal and automatic affect transfer in everyday social life.

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

PubMed Central

2017-01-01

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

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

PubMed

Nantha, Yogarabindranath Swarna

2017-11-01

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

Why we should talk about option generation in decision-making research

PubMed Central

Kalis, Annemarie; Kaiser, Stefan; Mojzisch, Andreas

2013-01-01

Most empirical studies on decision-making start from a set of given options for action. However, in everyday life there is usually no one asking you to choose between A, B, and C. Recently, the question how people come up with options has been receiving growing attention. However, so far there has been neither a systematic attempt to define the construct of “option” nor an attempt to show why decision-making research really needs this construct. This paper aims to fill that void by developing definitions of “option” and “option generation” that can be used as a basis for decision-making research in a wide variety of decision-making settings, while clarifying how these notions relate to familiar psychological constructs. We conclude our analysis by arguing that there are indeed reasons to believe that option generation is an important and distinct aspect of human decision-making. PMID:23986737

Why we should talk about option generation in decision-making research.

PubMed

Kalis, Annemarie; Kaiser, Stefan; Mojzisch, Andreas

2013-01-01

Most empirical studies on decision-making start from a set of given options for action. However, in everyday life there is usually no one asking you to choose between A, B, and C. Recently, the question how people come up with options has been receiving growing attention. However, so far there has been neither a systematic attempt to define the construct of "option" nor an attempt to show why decision-making research really needs this construct. This paper aims to fill that void by developing definitions of "option" and "option generation" that can be used as a basis for decision-making research in a wide variety of decision-making settings, while clarifying how these notions relate to familiar psychological constructs. We conclude our analysis by arguing that there are indeed reasons to believe that option generation is an important and distinct aspect of human decision-making.

Everyday ethics and help-seeking in early rheumatoid arthritis

PubMed Central

Townsend, A.; Adam, P.; Cox, S.M.; Li, L.C.

2018-01-01

Background Sociological understandings of chronic illness have revealed tensions and complexities around help-seeking. Although ethics underpins healthcare, its application in the area of chronic illness is limited. Here we apply an ethical framework to interview accounts and identify ethical challenges in the early rheumatoid arthritis (RA) experience. Methods In-depth interviews were conducted with eight participants who had been diagnosed with RA in the 12 months prior to recruitment. Applying the concepts of autonomous decision-making and procedural justice highlighted ethical concerns which arose throughout the help-seeking process. Analysis was based on the constant-comparison approach. Results Individuals described decision-making, illness actions and the medical encounter. The process was complicated by inadequate knowledge about symptoms, common-sense understandings about the GP appointment, difficulties concerning access to specialists, and patient–practitioner interactions. Autonomous decision-making and procedural justice were compromised. The accounts revealed contradictions between the policy ideals of active self-management, patient-centred care and shared decision-making, and the everyday experiences of individuals. Conclusions For ethical healthcare there is a need for: public knowledge about early RA symptoms; more effective patient–practitioner communication; and increased support during the wait between primary and secondary care. Healthcare facilities and the government may consider different models to deliver services to people requiring rheumatology consults. PMID:20610465

Medical decision and patient's preference: 'much ethics' and more trust always needed.

PubMed

Anyfantakis, Dimitrios; Symvoulakis, Emmanouil K

2011-01-01

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice.

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

PubMed

Noon, Amy J

2014-01-01

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

Me or you? Neural correlates of moral reasoning in everyday conflict situations in adolescents and adults.

PubMed

Sommer, Monika; Meinhardt, Jörg; Rothmayr, Christoph; Döhnel, Katrin; Hajak, Göran; Rupprecht, Rainer; Sodian, Beate

2014-01-01

Throughout adolescence, progress in the understanding of the moral domain as well as changes in moral behavior is observable. We tested 16 adolescents (14-16 years of age) and 16 healthy adults (22-31 years of age) on the developmental changes in everyday moral decision making using functional magnetic resonance imaging (fMRI). Using verbal stories describing everyday moral conflict situations, subjects had to decide between a moral standard or a personal desire. In the moral conflict situations, adolescents not only chose significantly more often the hedonistic alternative than adults, but they also reported higher certainty ratings. Contrasted with everyday social conflict situations that required a decision between a social-oriented behavior and a personal need, moral conflict situations induced an activity increase in frontal areas, the middle temporal gyrus, the thalamus, and the parahippocampal gyrus in adolescents compared to adults. Moreover, a closer look at the moral conflict situations revealed that adolescents showed more activity than adults in brain areas that are also centrally involved in theory of mind (ToM) during morally oriented decisions in contrast to personal-oriented decisions. This indicated that the development of moral reasoning may be strongly correlated with the development of ToM reasoning.

Spillover Effects of Loss of Control on Risky Decision-Making

PubMed Central

Beisswingert, Birgit M.; Zhang, Keshun; Goetz, Thomas; Fischbacher, Urs

2016-01-01

Decision making in risky situations is frequently required in our everyday lives and has been shown to be influenced by various factors, some of which are independent of the risk context. Based on previous findings and theories about the central role of perceptions of control and their impact on subsequent settings, spillover effects of subjective loss of control on risky decision-making are assumed. After developing an innovative experimental paradigm for inducing loss of control, its hypothesized effects on risky decision-making are investigated. Partially supporting the hypotheses, results demonstrated no increased levels of risk perceptions but decreased risk-taking behavior following experiences of loss of control. Thus, this study makes a methodological contribution by proposing a newly developed experimental paradigm facilitating further research on the effects of subjective loss of control, and additionally provides partial evidence for the spillover effects of loss of control experiences on risky decision-making. PMID:26930066

Risk approximation in decision making: approximative numeric abilities predict advantageous decisions under objective risk.

PubMed

Mueller, Silke M; Schiebener, Johannes; Delazer, Margarete; Brand, Matthias

2018-01-22

Many decision situations in everyday life involve mathematical considerations. In decisions under objective risk, i.e., when explicit numeric information is available, executive functions and abilities to handle exact numbers and ratios are predictors of objectively advantageous choices. Although still debated, exact numeric abilities, e.g., normative calculation skills, are assumed to be related to approximate number processing skills. The current study investigates the effects of approximative numeric abilities on decision making under objective risk. Participants (N = 153) performed a paradigm measuring number-comparison, quantity-estimation, risk-estimation, and decision-making skills on the basis of rapid dot comparisons. Additionally, a risky decision-making task with exact numeric information was administered, as well as tasks measuring executive functions and exact numeric abilities, e.g., mental calculation and ratio processing skills, were conducted. Approximative numeric abilities significantly predicted advantageous decision making, even beyond the effects of executive functions and exact numeric skills. Especially being able to make accurate risk estimations seemed to contribute to superior choices. We recommend approximation skills and approximate number processing to be subject of future investigations on decision making under risk.

The EU Dimension to Soil Science in Schools

ERIC Educational Resources Information Center

Johnson, Sue

2012-01-01

The EU as a context for science lessons may be given scant attention but EU decision-making is a vital factor in everyday life. Lessons on the emergence of soil science with Charles Darwin's simple scientific experiments can be linked with competence through action, inclusion and argumentations in science lessons. Decisions about an EU Soil…

Medical Decision and Patient's Preference: 'Much Ethics' and More Trust Always Needed

PubMed Central

Anyfantakis, Dimitrios; Symvoulakis, Emmanouil K

2011-01-01

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice. PMID:21647328

Understanding Risky Behavior: The Influence of Cognitive, Emotional and Hormonal Factors on Decision-Making under Risk.

PubMed

Kusev, Petko; Purser, Harry; Heilman, Renata; Cooke, Alex J; Van Schaik, Paul; Baranova, Victoria; Martin, Rose; Ayton, Peter

2017-01-01

Financial risky decisions and evaluations pervade many human everyday activities. Scientific research in such decision-making typically explores the influence of socio-economic and cognitive factors on financial behavior. However, very little research has explored the holistic influence of contextual, emotional, and hormonal factors on preferences for risk in insurance and investment behaviors. Accordingly, the goal of this review article is to address the complexity of individual risky behavior and its underlying psychological factors, as well as to critically examine current regulations on financial behavior.

Understanding Risky Behavior: The Influence of Cognitive, Emotional and Hormonal Factors on Decision-Making under Risk

PubMed Central

Kusev, Petko; Purser, Harry; Heilman, Renata; Cooke, Alex J.; Van Schaik, Paul; Baranova, Victoria; Martin, Rose; Ayton, Peter

2017-01-01

Financial risky decisions and evaluations pervade many human everyday activities. Scientific research in such decision-making typically explores the influence of socio-economic and cognitive factors on financial behavior. However, very little research has explored the holistic influence of contextual, emotional, and hormonal factors on preferences for risk in insurance and investment behaviors. Accordingly, the goal of this review article is to address the complexity of individual risky behavior and its underlying psychological factors, as well as to critically examine current regulations on financial behavior. PMID:28203215

Fast and Accurate Learning When Making Discrete Numerical Estimates.

PubMed

Sanborn, Adam N; Beierholm, Ulrik R

2016-04-01

Many everyday estimation tasks have an inherently discrete nature, whether the task is counting objects (e.g., a number of paint buckets) or estimating discretized continuous variables (e.g., the number of paint buckets needed to paint a room). While Bayesian inference is often used for modeling estimates made along continuous scales, discrete numerical estimates have not received as much attention, despite their common everyday occurrence. Using two tasks, a numerosity task and an area estimation task, we invoke Bayesian decision theory to characterize how people learn discrete numerical distributions and make numerical estimates. Across three experiments with novel stimulus distributions we found that participants fell between two common decision functions for converting their uncertain representation into a response: drawing a sample from their posterior distribution and taking the maximum of their posterior distribution. While this was consistent with the decision function found in previous work using continuous estimation tasks, surprisingly the prior distributions learned by participants in our experiments were much more adaptive: When making continuous estimates, participants have required thousands of trials to learn bimodal priors, but in our tasks participants learned discrete bimodal and even discrete quadrimodal priors within a few hundred trials. This makes discrete numerical estimation tasks good testbeds for investigating how people learn and make estimates.

Fast and Accurate Learning When Making Discrete Numerical Estimates

PubMed Central

Sanborn, Adam N.; Beierholm, Ulrik R.

2016-01-01

Many everyday estimation tasks have an inherently discrete nature, whether the task is counting objects (e.g., a number of paint buckets) or estimating discretized continuous variables (e.g., the number of paint buckets needed to paint a room). While Bayesian inference is often used for modeling estimates made along continuous scales, discrete numerical estimates have not received as much attention, despite their common everyday occurrence. Using two tasks, a numerosity task and an area estimation task, we invoke Bayesian decision theory to characterize how people learn discrete numerical distributions and make numerical estimates. Across three experiments with novel stimulus distributions we found that participants fell between two common decision functions for converting their uncertain representation into a response: drawing a sample from their posterior distribution and taking the maximum of their posterior distribution. While this was consistent with the decision function found in previous work using continuous estimation tasks, surprisingly the prior distributions learned by participants in our experiments were much more adaptive: When making continuous estimates, participants have required thousands of trials to learn bimodal priors, but in our tasks participants learned discrete bimodal and even discrete quadrimodal priors within a few hundred trials. This makes discrete numerical estimation tasks good testbeds for investigating how people learn and make estimates. PMID:27070155

Substitute decision-making for adults with intellectual disabilities living in residential care: learning through experience.

PubMed

Dunn, Michael C; Clare, Isabel C H; Holland, Anthony J

2008-03-01

In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, 'strategic substitute decision-making', paralleled the MCA's legal and ethical framework, whilst the second process, 'relational substitute decision-making', was markedly different from these statutory procedures. In this setting, 'relational substitute decision-making' underpinned everyday personal and social interventions connected with residents' daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed.

Cells, circuits, and choices: social influences on perceptual decision making.

PubMed

Mojzisch, Andreas; Krug, Kristine

2008-12-01

Making decisions is an integral part of everyday life. Social psychologists have demonstrated in many studies that humans' decisions are frequently and strongly influenced by the opinions of others--even in simple perceptual decisions, where, for example, participants have to judge what an image looks like. However, because the effect of other people's opinions on decision making has remained largely unaddressed by the neuroimaging and neurophysiology literature, we are only beginning to understand how social influence is integrated into the decision-making process. We put forward the thesis that by probing the neurophysiology of social influence with perceptual decision-making tasks similar to those used in the seminal work of Asch (1952, 1956), this gap could be remedied. Perceptual paradigms are already widely used to probe neuronal mechanisms of decision making in nonhuman primates. There is also increasing evidence about how nonhuman primates' behavior is influenced by observing conspecifics. The high spatial and temporal resolution of neurophysiological recordings in awake monkeys could provide insight into where and how social influence modulates decision making, and thus should enable us to develop detailed functional models of the neural mechanisms that support the integration of social influence into the decision-making process.

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

PubMed Central

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

2016-01-01

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

Attitudes towards Science Learning among 10th-Grade Students: A Qualitative Look

ERIC Educational Resources Information Center

Raved, Lena; Assaraf, Orit Ben Zvi

2011-01-01

The twenty-first century is characterized by multiple, frequent and remarkable scientific advancements, which have a major effect on the decisions that govern everyday life. It is therefore vital to give proper comprehensive scientific education to the population and provide it with the right tools for decision-making. This in turn requires that…

Eye Movements in Reading as Rational Behavior

ERIC Educational Resources Information Center

Bicknell, Klinton

2011-01-01

Moving one's eyes while reading is one of the most complex everyday tasks humans face. To perform efficiently, readers must make decisions about when and where to move their eyes every 200-300ms. Over the past decades, it has been demonstrated that these fine-grained decisions are influenced by a range of linguistic properties of the text, and…

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

PubMed

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

2016-10-01

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

Decision-Making in Multiple Sclerosis Patients: A Systematic Review.

PubMed

Neuhaus, Mireille; Calabrese, Pasquale; Annoni, Jean-Marie

2018-01-01

Multiple sclerosis (MS) is frequently associated with cognitive and behavioural deficits. A growing number of studies suggest an impact of MS on decision-making abilities. The aim of this systematic review was to assess if (1) performance of MS patients in decision-making tasks was consistently different from controls and (2) whether this modification was associated with cognitive dysfunction and emotional alterations. The search was conducted on Pubmed/Medline database. 12 studies evaluating the difference between MS patients and healthy controls using validated decision-making tasks were included. Outcomes considered were quantitative (net scores) and qualitative measurements (deliberation time and learning from feedback). Quantitative and qualitative decision-making impairment in MS was present in 64.7% of measurements. Patients were equally impaired in tasks for decision-making under risk and ambiguity. A correlation to other cognitive functions was present in 50% of cases, with the highest associations in the domains of processing speed and attentional capacity. In MS patients, qualitative and quantitative modifications may be present in any kind of decision-making task and can appear independently of other cognitive measures. Since decision-making abilities have a significant impact on everyday life, this cognitive aspect has an influential importance in various MS-related treatment settings.

Numeracy, Ratio Bias, and Denominator Neglect in Judgments of Risk and Probability

ERIC Educational Resources Information Center

Reyna, Valerie F.; Brainerd, Charles J.

2008-01-01

"Numeracy," so-called on analogy with literacy, is essential for making health and other social judgments in everyday life [Reyna, V. F., & Brainerd, C. J. (in press). The importance of mathematics in health and human judgment: Numeracy, risk communication, and medical decision making. "Learning and Individual Differences."]. Recent research on…

The Power of Art to Develop Artists and Activists

ERIC Educational Resources Information Center

Prettyman, Sandra Spickard; Gargarella, Elisa

2013-01-01

Many teens today feel as though they have limited opportunities to prove to society that they can make positive and meaningful contributions to their communities. They are presented with few opportunities to make important choices and decisions regarding their lives and communities and often have no mechanisms in their everyday lives to help them…

Technology and Transition in the 21st Century

ERIC Educational Resources Information Center

Kellems, Ryan O.; Grigal, Meg; Unger, Darlene D.; Simmons, Thomas J.; Bauder, Debra; Williams, Caroline

2015-01-01

Devices like smartphones, tablets, and MP3 players are becoming everyday tools for the majority of the population. Technology can assist students with disabilities in many self-determination activities, such as choice making, decision making, and self-management. In addition, technology tools can support them in a wide range of transition-related…

Decision-making of older patients in context of the doctor-patient relationship: a typology ranging from "self-determined" to "doctor-trusting" patients.

PubMed

Wrede-Sach, Jennifer; Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike

2013-01-01

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences.

Privilege as Privileging: Making the Dynamic and Complex Nature of Privilege and Marginalization Accessible

ERIC Educational Resources Information Center

Minarik, Joseph D.

2017-01-01

Privilege is one of the central constructs social work educators reference to increase self-awareness and concern about inequality, but it is often oversimplified. This article argues how the concept of privilege can be made more credible to learners by anchoring it to everyday business-as-usual decision making, stereotyping, and various…

Improving Sexual Health for Young People: Making Sexuality Education a Priority

ERIC Educational Resources Information Center

Helmer, Janet; Senior, Kate; Davison, Belinda; Vodic, Andrew

2015-01-01

How well do young people understand their developing sexuality and what this means? This paper reports on findings from the Our Lives: Culture, Context and Risk project, which investigated sexual behaviour and decision-making in the context of the everyday life experience and aspirations of Indigenous and non-Indigenous young people (16-25 years)…

Effect of experience on clinical decision making by cardiorespiratory physiotherapists in acute care settings.

PubMed

Smith, Megan; Higgs, Joy; Ellis, Elizabeth

2010-02-01

This article investigates clinical decision making in acute care hospitals by cardiorespiratory physiotherapists with differing degrees of clinical experience. Participants were observed as they engaged in their everyday practice and were interviewed about their decision making. Texts of the data were interpreted by using a hermeneutic approach that involved repeated reading and analysis of fieldnotes and interview transcripts to develop an understanding of the effect of experience on clinical decision making. Participants were classified into categories of cardiorespiratory physiotherapy experience: less experienced (<2 years), intermediate experience (2.5-4 years), and more experienced (>7 years). Four dimensions characteristic of increasing experience in cardiorespiratory physiotherapy clinical decision making were identified: 1) an individual practice model, 2) refined approaches to clinical decision making, 3) working in context, and 4) social and emotional capability. Underpinning these dimensions was evidence of reflection on practice, motivation to achieve best practice, critique of new knowledge, increasing confidence, and relationships with knowledgeable colleagues. These findings reflect characteristics of physiotherapy expertise that have been described in the literature. This study adds knowledge about the field of cardiorespiratory physiotherapy to the existing body of research on clinical decision making and broadens the existing understanding of characteristics of physiotherapy expertise.

Inside the black box of shared decision making: distinguishing between the process of involvement and who makes the decision

PubMed Central

Edwards, Adrian; Elwyn, Glyn

2006-01-01

Abstract Background  Shared decision making has practical implications for everyday health care. However, it stems from largely theoretical frameworks and is not widely implemented in routine practice. Aims  We undertook an empirical study to inform understanding of shared decision making and how it can be operationalized more widely. Method  The study involved patients visiting UK general practitioners already well experienced in shared decision making. After these consultations, semi‐structured telephone interviews were conducted and analysed using the constant comparative method of content analysis. Results  All patients described at least some components of shared decision making but half appeared to perceive the decision as shared and half as ‘patient‐led’. However, patients exhibited some uncertainty about who had made the decision, reflecting different meanings of decision making from those described in the literature. A distinction is indicated between the process of involvement (option portrayal, exchange of information and exploring preferences for who makes the decision) and the actual decisional responsibility (who makes the decision). The process of involvement appeared to deliver benefits for patients, not the action of making the decision. Preferences for decisional responsibility varied during some consultations, generating unsatisfactory interactions when actual decisional responsibility did not align with patient preferences at that stage of a consultation. However, when conducted well, shared decision making enhanced reported satisfaction, understanding and confidence in the decisions. Conclusions  Practitioners can focus more on the process of involving patients in decision making rather than attaching importance to who actually makes the decision. They also need to be aware of the potential for changing patient preferences for decisional responsibility during a consultation and address non‐alignment of patient preferences with the actual model of decision making if this occurs. PMID:17083558

Decision-Making of Older Patients in Context of the Doctor-Patient Relationship: A Typology Ranging from “Self-Determined” to “Doctor-Trusting” Patients

PubMed Central

Voigt, Isabel; Diederichs-Egidi, Heike; Hummers-Pradier, Eva; Dierks, Marie-Luise; Junius-Walker, Ulrike

2013-01-01

Background. This qualitative study aims to gain insight into the perceptions and experiences of older patients with regard to sharing health care decisions with their general practitioners. Patients and Methods. Thirty-four general practice patients (≥70 years) were asked about their preferences and experiences concerning shared decision making with their doctors using qualitative semistructured interviews. All interviews were analysed according to principles of content analysis. The resulting categories were then arranged into a classification grid to develop a typology of preferences for participating in decision-making processes. Results. Older patients generally preferred to make decisions concerning everyday life rather than medical decisions, which they preferred to leave to their doctors. We characterised eight different patient types based on four interdependent positions (self-determination, adherence, information seeking, and trust). Experiences of a good doctor-patient relationship were associated with trust, reliance on the doctor for information and decision making, and adherence. Conclusion. Owing to the varied patient decision-making types, it is not easy for doctors to anticipate the desired level of patient involvement. However, the decision matter and the self-determination of patients provide good starting points in preparing the ground for shared decision making. A good relationship with the doctor facilitates satisfying decision-making experiences. PMID:23691317

Changes in Cognition and Decision Making Capacity Following Brain Tumour Resection: Illustrated with Two Cases.

PubMed

Veretennikoff, Katie; Walker, David; Biggs, Vivien; Robinson, Gail

2017-09-24

Changes in cognition, behaviour and emotion frequently occur in patients with primary and secondary brain tumours. This impacts the ability to make considered decisions, especially following surgical resection, which is often overlooked in the management of patients. Moreover, the impact of cognitive deficits on decision making ability affects activities of daily living and functional independence. The assessment process to ascertain decision making capacity remains a matter of debate. One avenue for evaluating a patient's ability to make informed decisions in the context of brain tumour resection is neuropsychological assessment. This involves the assessment of a wide range of cognitive abilities on standard measurement tools, providing a robust approach to ascertaining capacity. Evidence has shown that a comprehensive and tailored neuropsychological assessment has greater sensitivity than brief cognitive screening tools to detect subtle and/or specific cognitive deficits in brain tumours. It is the precise nature and severity of any cognitive deficits that determines any implications for decision making capacity. This paper focuses on cognitive deficits and decision making capacity following surgical resection of both benign and malignant, and primary and secondary brain tumours in adult patients, and the implications for patients' ability to consent to future medical treatment and make decisions related to everyday activities.

Decision-Making in Multiple Sclerosis Patients: A Systematic Review

PubMed Central

2018-01-01

Background Multiple sclerosis (MS) is frequently associated with cognitive and behavioural deficits. A growing number of studies suggest an impact of MS on decision-making abilities. The aim of this systematic review was to assess if (1) performance of MS patients in decision-making tasks was consistently different from controls and (2) whether this modification was associated with cognitive dysfunction and emotional alterations. Methods The search was conducted on Pubmed/Medline database. 12 studies evaluating the difference between MS patients and healthy controls using validated decision-making tasks were included. Outcomes considered were quantitative (net scores) and qualitative measurements (deliberation time and learning from feedback). Results Quantitative and qualitative decision-making impairment in MS was present in 64.7% of measurements. Patients were equally impaired in tasks for decision-making under risk and ambiguity. A correlation to other cognitive functions was present in 50% of cases, with the highest associations in the domains of processing speed and attentional capacity. Conclusions In MS patients, qualitative and quantitative modifications may be present in any kind of decision-making task and can appear independently of other cognitive measures. Since decision-making abilities have a significant impact on everyday life, this cognitive aspect has an influential importance in various MS-related treatment settings. PMID:29721338

Changes in Cognition and Decision Making Capacity Following Brain Tumour Resection: Illustrated with Two Cases

PubMed Central

Veretennikoff, Katie; Walker, David; Biggs, Vivien; Robinson, Gail

2017-01-01

Changes in cognition, behaviour and emotion frequently occur in patients with primary and secondary brain tumours. This impacts the ability to make considered decisions, especially following surgical resection, which is often overlooked in the management of patients. Moreover, the impact of cognitive deficits on decision making ability affects activities of daily living and functional independence. The assessment process to ascertain decision making capacity remains a matter of debate. One avenue for evaluating a patient’s ability to make informed decisions in the context of brain tumour resection is neuropsychological assessment. This involves the assessment of a wide range of cognitive abilities on standard measurement tools, providing a robust approach to ascertaining capacity. Evidence has shown that a comprehensive and tailored neuropsychological assessment has greater sensitivity than brief cognitive screening tools to detect subtle and/or specific cognitive deficits in brain tumours. It is the precise nature and severity of any cognitive deficits that determines any implications for decision making capacity. This paper focuses on cognitive deficits and decision making capacity following surgical resection of both benign and malignant, and primary and secondary brain tumours in adult patients, and the implications for patients’ ability to consent to future medical treatment and make decisions related to everyday activities. PMID:28946652

Economic Decisions for Others: An Exception to Loss Aversion Law

PubMed Central

Mengarelli, Flavia; Moretti, Laura; Faralla, Valeria; Vindras, Philippe; Sirigu, Angela

2014-01-01

In everyday life, people often make decisions on behalf of others. The current study investigates whether risk preferences of decision-makers differ when the reference point is no longer their own money but somebody else money. Thirty four healthy participants performed three different monetary risky choices tasks by making decisions for oneself and for another unknown person. Results showed that loss aversion bias was significantly reduced when participants were choosing on behalf of another person compared to when choosing for themselves. The influence of emotions like regret on decision-making may explain these results. We discuss the importance of the sense of responsibility embodied in the emotion of regret in modulating economic decisions for self but not for others. Moreover, our findings are consistent with the Risk-as-feelings hypothesis, suggesting that self-other asymmetrical behavior is due to the extent the decision-maker is affected by the real and emotional consequences of his/her decision. PMID:24454788

Visual Communication and Cognition in Everyday Decision-Making.

PubMed

Jaenichen, Claudine

2017-01-01

Understanding cognition and the context of decision-making should be prioritized in the design process in order to accurately anticipate the outcome for intended audiences. A thorough understanding of cognition has been excluded from being a part of foundational design principals in visual communication. By defining leisure, direct, urgent, and emergency scenarios and providing examples of work that deeply considers the viewer's relationship to the design solution in context of these scenarios allows us to affirm the relevancy of cognition as a design variable and the importance of projects that advocate public utility.

Deep Rationality: The Evolutionary Economics of Decision Making.

PubMed

Kenrick, Douglas T; Griskevicius, Vladas; Sundie, Jill M; Li, Norman P; Li, Yexin Jessica; Neuberg, Steven L

2009-10-01

What is a "rational" decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research.

Deep Rationality: The Evolutionary Economics of Decision Making

PubMed Central

Kenrick, Douglas T.; Griskevicius, Vladas; Sundie, Jill M.; Li, Norman P.; Li, Yexin Jessica; Neuberg, Steven L.

2009-01-01

What is a “rational” decision? Economists traditionally viewed rationality as maximizing expected satisfaction. This view has been useful in modeling basic microeconomic concepts, but falls short in accounting for many everyday human decisions. It leaves unanswered why some things reliably make people more satisfied than others, and why people frequently act to make others happy at a cost to themselves. Drawing on an evolutionary perspective, we propose that people make decisions according to a set of principles that may not appear to make sense at the superficial level, but that demonstrate rationality at a deeper evolutionary level. By this, we mean that people use adaptive domain-specific decision-rules that, on average, would have resulted in fitness benefits. Using this framework, we re-examine several economic principles. We suggest that traditional psychological functions governing risk aversion, discounting of future benefits, and budget allocations to multiple goods, for example, vary in predictable ways as a function of the underlying motive of the decision-maker and individual differences linked to evolved life-history strategies. A deep rationality framework not only helps explain why people make the decisions they do, but also inspires multiple directions for future research. PMID:20686634

From moral to legal judgment: the influence of normative context in lawyers and other academics

PubMed Central

Spranger, Tade M.; Erk, Susanne; Walter, Henrik

2011-01-01

Various kinds of normative judgments are an integral part of everyday life. We extended the scrutiny of social cognitive neuroscience into the domain of legal decisions, investigating two groups, lawyers and other academics, during moral and legal decision-making. While we found activation of brain areas comprising the so-called ‘moral brain’ in both conditions, there was stronger activation in the left dorsolateral prefrontal cortex and middle temporal gyrus particularly when subjects made legal decisions, suggesting that these were made in respect to more explicit rules and demanded more complex semantic processing. Comparing both groups, our data show that behaviorally lawyers conceived themselves as emotionally less involved during normative decision-making in general. A group × condition interaction in the dorsal anterior cingulate cortex suggests a modulation of normative decision-making by attention based on subjects’ normative expertise. PMID:20194515

From moral to legal judgment: the influence of normative context in lawyers and other academics.

PubMed

Schleim, Stephan; Spranger, Tade M; Erk, Susanne; Walter, Henrik

2011-01-01

Various kinds of normative judgments are an integral part of everyday life. We extended the scrutiny of social cognitive neuroscience into the domain of legal decisions, investigating two groups, lawyers and other academics, during moral and legal decision-making. While we found activation of brain areas comprising the so-called 'moral brain' in both conditions, there was stronger activation in the left dorsolateral prefrontal cortex and middle temporal gyrus particularly when subjects made legal decisions, suggesting that these were made in respect to more explicit rules and demanded more complex semantic processing. Comparing both groups, our data show that behaviorally lawyers conceived themselves as emotionally less involved during normative decision-making in general. A group × condition interaction in the dorsal anterior cingulate cortex suggests a modulation of normative decision-making by attention based on subjects' normative expertise.

Choice-making among Medicaid HCBS and ICF/MR recipients in six states.

PubMed

Lakin, K Charlie; Doljanac, Robert; Byun, Soo-Yong; Stancliffe, Roger; Taub, Sarah; Chiri, Giuseppina

2008-09-01

Choice in everyday decisions and in support-related decisions was addressed among 2,398 adults with intellectual and developmental disabilities receiving Medicaid Home and Community Based Services (HCBS) and Intermediate Care Facility (ICF/MR) services and living in non family settings in six states. Everyday choice in daily life and in support-related choice was considerably higher on average for HCBS than for ICF/MR recipients, but after controlling for level of intellectual disability, medical care needs, mobility, behavioral and psychiatric conditions, and self-reporting, we found that choice was more strongly associated with living in a congregate setting than whether that setting was HCBS- or ICF/MR-financed. Marked differences in choice were also evident between states.

Conscious sedation for surgical procedures

MedlinePlus

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

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.

The meaning of technology in an intensive care unit--an interview study.

PubMed

Wikström, Ann-Charlott; Cederborg, Ann-Christin; Johanson, Marita

2007-08-01

Previous research has suggested technology may dehumanise patient care and also that technology may restrict nurses' freedom of action. This raises questions about the relationship between technology, care and medicine in units where the patient's need for treatment is often an emergency. The aim of the study was to explore how staff members in an intensive care unit (ICU) make sense of technology in their everyday practice. Twelve staff members from one ICU were interviewed about their understanding of technology in their everyday practice. Three main findings emerged from the analysis: Technology seems to be considered decisive as it directs and controls medical treatment and results in the patients' well being; technology is seen as facilitating everyday practice because it makes treatment more secure and decreases workload; however technology can complicate the staff members' everyday practice as it is not completely trustworthy, is not easy to handle and can cause ethical dilemmas. Contrary to previous findings this study shows that technology seems to be embedded in care and medical treatment. Furthermore, the meaning of technology appears to be dependent on the different staff members' accounting practices.

Decision making under ambiguity and under risk in mesial temporal lobe epilepsy.

PubMed

Delazer, Margarete; Zamarian, Laura; Bonatti, Elisabeth; Kuchukhidze, Giorgi; Koppelstätter, Florian; Bodner, Thomas; Benke, Thomas; Trinka, Eugen

2010-01-01

Decision making is essential in everyday life. Though the importance of the mesial temporal lobe in emotional processing and feedback learning is generally recognized, decision making in mesial temporal lobe epilepsy (mTLE) is almost unexplored so far. Twenty-eight consecutive epilepsy patients with drug resistant mTLE and fifty healthy controls performed decision tasks under initial ambiguity (participants have to learn by feedback to make advantageous decisions) and under risk (advantageous choices may be made by estimating risks and by rational strategies). A subgroup analysis compared the performance of patients affected by MRI-verified abnormalities of the hippocampus or amygdala. The effect of lesion side was also assessed. In decision under ambiguity, mTLE patients showed marked deficits and did not improve over the task. Patients with hippocampus abnormality and patients with amygdala abnormality showed comparable deficits. No difference was found between right and left TLE groups. In decision under risk, mTLE patients performed at the same level as controls. Results suggest that mTLE patients have difficulties in learning from feedback and in making decisions in uncertain, ambiguous situations. By contrast, they are able to make advantageous decisions when full information is given and risks, possible gains and losses are exactly defined.

Programme characteristics and everyday occupations in day centres and clubhouses in Sweden.

PubMed

Hultqvist, Jenny; Markström, Urban; Tjörnstrand, Carina; Eklund, Mona

2017-05-01

Meaningful everyday occupations are important for mental health and recovery and are provided by both community-based day centres (DCs) and clubhouses. It is unknown, however, if any of the two has more recovery-promoting features. This nine-month longitudinal study compared DC and clubhouses, concerning the users' perceptions of unit and programme characteristics, and aspects of everyday occupations in terms of engagement and satisfaction. Stability over time in these respects, as well as motivation for participation and relationships with occupational engagement and satisfaction, were explored. Participants from 10 DCs (n = 128) and 5 clubhouses (n = 57) completed self-report instruments. DC attendees rated lower levels on two organizational factors; choice and ability to influence decisions, and the unit's social network. Motivation showed to be an important factor for perceived occupational engagement, which did not differ between the two groups. DC attendees were more satisfied with their everyday occupations at baseline, but that factor increased more in the clubhouse group and there was no group difference at follow-up. The unit and programme characteristics and occupational engagement showed stability over time. Clubhouses seemed more advantageous and DC services may consider developing users' opportunities for choice and decision-making, and peer support.

Information Skills for an Information Age?

ERIC Educational Resources Information Center

Gawith, Gwen

1986-01-01

Although information skills are the most basic of skills, the tendency is to teach strategies related to educational projects, erroneously assuming that these "information skills" are applicable to everyday decision-making. Educated imaginations are needed for today's variety of lifelong creative information situations. (17 references)…

Exploring the role of religiosity and spirituality in amniocentesis decision-making among Latinas.

PubMed

Seth, Sarah Guerra; Goka, Thomas; Harbison, Andrea; Hollier, Lisa; Peterson, Susan; Ramondetta, Lois; Noblin, Sarah Jane

2011-12-01

Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas' spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas' daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God's will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.

Rodent Versions of the Iowa Gambling Task: Opportunities and Challenges for the Understanding of Decision-Making

PubMed Central

de Visser, Leonie; Homberg, Judith R.; Mitsogiannis, Manuela; Zeeb, Fiona D.; Rivalan, Marion; Fitoussi, Aurélie; Galhardo, Vasco; van den Bos, Ruud; Winstanley, Catherine A.; Dellu-Hagedorn, Françoise

2011-01-01

Impaired decision-making is a core problem in several psychiatric disorders including attention-deficit/hyperactivity disorder, schizophrenia, obsessive–compulsive disorder, mania, drug addiction, eating disorders, and substance abuse as well as in chronic pain. To ensure progress in the understanding of the neuropathophysiology of these disorders, animal models with good construct and predictive validity are indispensable. Many human studies aimed at measuring decision-making capacities use the Iowa gambling task (IGT), a task designed to model everyday life choices through a conflict between immediate gratification and long-term outcomes. Recently, new rodent models based on the same principle have been developed to investigate the neurobiological mechanisms underlying IGT-like decision-making on behavioral, neural, and pharmacological levels. The comparative strengths, as well as the similarities and differences between these paradigms are discussed. The contribution of these models to elucidate the neurobehavioral factors that lead to poor decision-making and to the development of better treatments for psychiatric illness is considered, along with important future directions and potential limitations. PMID:22013406

Beyond decision making: class, community organizations, and the healthwork of people living with HIV/AIDS. Contributions from institutional ethnographic research.

PubMed

Mykhalovskiy, Eric

2008-01-01

The consolidation of antiretroviral therapy as the primary biomedical response to HIV infection in the global North has occasioned a growing interest in the health decision making of people living with HIV (PHAs). This interest is burdened by the weight of a behaviorist theoretical orientation that limits decision making to individual acts of rational choice. This article offers an alternative way to understand how PHAs come to take (or not take) biomedical treatments. Drawing on institutional ethnographic research conducted in Toronto, Canada, it explores how the "healthwork" of coming to take (or not take) treatments is organized by extended relations of biomedical knowledge. The article focuses on two aspects of the knowledge relations of coming to take pharmaceutical medications that transcend the conceptual and relational terrain of rational decision-making perspectives. First, it explores disjunctures between the everyday healthwork of poor, socially marginalized PHAs and the terms of biomedical decision making. Second, it investigates the knowledge-mediating activities of community-based organizations that help mitigate those disjunctures.

Student Achievement Effects of Technology-Supported Remediation of Understanding of Fractions

ERIC Educational Resources Information Center

Ross, John A.; Bruce, Catherine D.

2009-01-01

Students have difficulty learning fractions, and problems in understanding fractions persist into adulthood, with moderate to severe consequences for everyday and occupational decision-making. Remediation of student misconceptions is hampered by deficiencies in teachers' knowledge of the discipline and pedagogical content knowledge. We theorized…

Science for All. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2008-01-01

Students need to be competent in science because of its impact on everyday decision-making, the rapid pace of change and the increasing interdependent global economy (Lawton, 2007; U.S. Department of Education, 2000; Lederman, 1998). According to the National Research Council, "Teachers of science should develop communities of science learners…

What Financial Dilemmas Reveal about Students' Social and Mathematical Understanding

ERIC Educational Resources Information Center

Sawatzki, Carly

2013-01-01

Everyday financial dilemmas require us to draw on social, interdisciplinary, and mathematical understandings simultaneously and in synergy if we are to make informed financial decisions. Financial literacy is enjoying an elevated status across the "Australian Curriculum." This paper reviews some of the literature on financial literacy,…

Staying in Science: Can Understanding of the Disciplinary Connectedness of Science Help?

ERIC Educational Resources Information Center

Mooed, Azra; Kaiser, Susan

2018-01-01

Most international curricula require students to develop conceptual and procedural understandings along with developing an understanding about the nature of science. Moreover, science education endeavours to produce scientifically literate citizens capable of making informed decisions about the social-scientific issues in their everyday lives;…

Authenticity of Mathematical Modeling

ERIC Educational Resources Information Center

Tran, Dung; Dougherty, Barbara J.

2014-01-01

Some students leave high school never quite sure of the relevancy of the mathematics they have learned. They fail to see links between school mathematics and the mathematics of everyday life that requires thoughtful decision making and often complex problem solving. Is it possible to bridge the gap between school mathematics and the mathematics in…

Establishing the Environment: Setting a Supportive Climate.

ERIC Educational Resources Information Center

Phillips, Kristina M.

Supportive classroom environments can enhance students' learning about their own diversity as well as that of others. Discussing basic diversity variables such as gender, age, and race can raise awareness and conscious decision making about how students use and view communication in their everyday lives. A graduate student instructor enhances her…

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.

Towards a differentiated understanding of active travel behaviour: Using social theory to explore everyday commuting

PubMed Central

Guell, C.; Panter, J.; Jones, N.R.; Ogilvie, D.

2012-01-01

Fostering physical activity is an established public health priority for the primary prevention of a variety of chronic diseases. One promising population approach is to seek to embed physical activity in everyday lives by promoting walking and cycling to and from work (‘active commuting’) as an alternative to driving. Predominantly quantitative epidemiological studies have investigated travel behaviours, their determinants and how they may be changed towards more active choices. This study aimed to depart from narrow behavioural approaches to travel and investigate the social context of commuting with qualitative social research methods. Within a social practice theory framework, we explored how people describe their commuting experiences and make commuting decisions, and how travel behaviour is embedded in and shaped by commuters' complex social worlds. Forty-nine semi-structured interviews and eighteen photo-elicitation interviews with accompanying field notes were conducted with a subset of the Commuting and Health in Cambridge study cohort, based in the UK. The findings are discussed in terms of three particularly pertinent facets of the commuting experience. Firstly, choice and decisions are shaped by the constantly changing and fluid nature of commuters' social worlds. Secondly, participants express ambiguities in relation to their reasoning, ambitions and identities as commuters. Finally, commuting needs to be understood as an embodied and emotional practice. With this in mind, we suggest that everyday decision-making in commuting requires the tactical negotiation of these complexities. This study can help to explain the limitations of more quantitative and static models and frameworks in predicting travel behaviour and identify future research directions. PMID:22486840

Ambiguity aversion in schizophrenia: An fMRI study of decision-making under risk and ambiguity.

PubMed

Fujino, Junya; Hirose, Kimito; Tei, Shisei; Kawada, Ryosaku; Tsurumi, Kosuke; Matsukawa, Noriko; Miyata, Jun; Sugihara, Genichi; Yoshihara, Yujiro; Ideno, Takashi; Aso, Toshihiko; Takemura, Kazuhisa; Fukuyama, Hidenao; Murai, Toshiya; Takahashi, Hidehiko

2016-12-01

When making decisions in everyday life, we often have to choose between uncertain outcomes. Economic studies have demonstrated that healthy people tend to prefer options with known probabilities (risk) than those with unknown probabilities (ambiguity), which is referred to as "ambiguity aversion." However, it remains unclear how patients with schizophrenia behave under ambiguity, despite growing evidence of their altered decision-making under uncertainty. In this study, combining economic tools and functional magnetic resonance imaging (fMRI), we assessed the attitudes toward risk/ambiguity and investigated the neural correlates during decision-making under risk/ambiguity in schizophrenia. Although no significant difference in attitudes under risk was observed, patients with schizophrenia chose ambiguity significantly more often than the healthy controls. Attitudes under risk and ambiguity did not correlate across patients with schizophrenia. Furthermore, unlike in the healthy controls, activation of the left lateral orbitofrontal cortex was not increased during decision-making under ambiguity compared to under risk in schizophrenia. These results suggest that ambiguity aversion, a well-established subjective bias, is attenuated in patients with schizophrenia, highlighting the need to distinguish between risk and ambiguity when assessing decision-making under these situations. Our findings, comprising important clinical implications, contribute to improved understanding of the mechanisms underlying altered decision-making in patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

It's immoral, but I'd do it! Psychopathy traits affect decision-making in sacrificial dilemmas and in everyday moral situations.

PubMed

Pletti, Carolina; Lotto, Lorella; Buodo, Giulia; Sarlo, Michela

2017-05-01

This research investigated whether emotional hyporeactivity affects moral judgements and choices of action in sacrificial moral dilemmas and in everyday moral conflict situations in which harm to other's welfare is differentially involved. Twenty-six participants with high trait psychopathy (HP) and 25 with low trait psychopathy (LP) were selected based on the primary psychopathy scale of the Levenson Self-Report Psychopathy Scale. HP participants were more likely to sacrifice one person to save others in sacrificial dilemmas and to pursue a personal advantage in everyday moral situations entailing harm to another's good. While deciding in these situations, HP participants experienced lower unpleasantness as compared to LP participants. Conversely, no group differences emerged in choice of action and unpleasantness ratings for everyday moral situations that did not entail harm to others. Importantly, moral judgements did not differ in the two groups. These results suggest that high psychopathy trait affects choices of action in sacrificial dilemmas because of reduced emotional reactivity to harmful acts. The dissociation between choice of action and moral judgement suggests that the former is more closely related to emotional experience. Also, emotion seems to play a critical role in discriminating harmful from harmless acts and in driving decisions accordingly. © 2016 The British Psychological Society.

Everyday Ethics: Ethical Issues and Stress in Nursing Practice

PubMed Central

Ulrich, Connie M.; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-01-01

Aim This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Background Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. Methods A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analyzed using descriptive statistics, cross-tabulations and Pearson correlations. Results A total of 422 questionnaires were used in the analysis. The five most frequently-occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Conclusion Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. PMID:20735502

Everyday ethics: ethical issues and stress in nursing practice.

PubMed

Ulrich, Connie M; Taylor, Carol; Soeken, Karen; O'Donnell, Patricia; Farrar, Adrienne; Danis, Marion; Grady, Christine

2010-11-01

This paper is a report of a study of the type, frequency, and level of stress of ethical issues encountered by nurses in their everyday practice. Everyday ethical issues in nursing practice attract little attention but can create stress for nurses. Nurses often feel uncomfortable in addressing the ethical issues they encounter in patient care. A self-administered survey was sent in 2004 to 1000 nurses in four states in four different census regions of the United States of America. The adjusted response rate was 52%. Data were analysed using descriptive statistics, cross-tabulations and Pearson correlations. A total of 422 questionnaires were used in the analysis. The five most frequently occurring and most stressful ethical and patient care issues were protecting patients' rights; autonomy and informed consent to treatment; staffing patterns; advanced care planning; and surrogate decision-making. Other common occurrences were unethical practices of healthcare professionals; breaches of patient confidentiality or right to privacy; and end-of-life decision-making. Younger nurses and those with fewer years of experience encountered ethical issues more frequently and reported higher levels of stress. Nurses from different regions also experienced specific types of ethical problems more commonly. Nurses face daily ethical challenges in the provision of quality care. To retain nurses, targeted ethics-related interventions that address caring for an increasingly complex patient population are needed. © 2010 Blackwell Publishing Ltd.

Practicing governance towards equity in health systems: LMIC perspectives and experience.

PubMed

Gilson, Lucy; Lehmann, Uta; Schneider, Helen

2017-09-15

The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in low- and middle-income country (LMIC) health systems. Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice - and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts - in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multi-disciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems.

Rhetorical Use of Inscriptions in Students' Written Arguments About Socioscientific Issues

NASA Astrophysics Data System (ADS)

Xiao, Sihan

2018-05-01

Educators expect that students be able to make informed decisions about science-related problems in their everyday lives. Engaging science in such problems often entails evaluating available evidence for given arguments. This study explores how students use inscriptions as evidence to argue about socioscientific issues. Fifth- and sixth-grade students (N = 102) in two intact classrooms completed written argument tasks in which they were asked to cite given inscriptions to support their decisions about energy use or genetically modified organisms. Qualitative content analyses of these written arguments, which focused on the coordination between inscriptions and claims, show three patterns of rhetorical use of inscriptions: seeing is believing, believing is seeing, and asserting is inferring. What counts as evidence was not the inscriptions per se, but the rhetorical functions they performed in particular arguments. These findings suggest that justifying socioscientific decisions is functionally different from explaining scientific phenomena. Linking these two activities in school may help students more productively engage with science in their everyday lives.

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

PubMed

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

2013-09-01

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

Fostering Scientific Reasoning in Education--Meta-Analytic Evidence from Intervention Studies

ERIC Educational Resources Information Center

Engelmann, Katharina; Neuhaus, Birgit J.; Fischer, Frank

2016-01-01

Scientific reasoning skills are not just for researchers, they are also increasingly relevant for making informed decisions in our everyday lives. How can these skills be facilitated? The current state of research on supporting scientific reasoning includes intervention studies but lacks an integrated analysis of the approaches to foster…

Virtual Teamwork: Students Studying about Ethics in an Online Environment

ERIC Educational Resources Information Center

Ng, Wan

2008-01-01

The fundamental concepts of ethics: value, obligation and responsibility are what many of us use in our everyday decision-making on issues that affect our lives. Students in the coursework unit "Science and technology in contemporary society" learn about these concepts in relation to science and technological research and development. The learning…

Preservice Elementary Teachers' Ideas about Scientific Practices

ERIC Educational Resources Information Center

Ricketts, Amy

2014-01-01

With the goal of producing scientifically literate citizens who are able to make informed decisions and reason critically when science intersects with their everyday lives, the National Research Council (NRC) has produced two recent documents that call for a new approach to K-12 science education that is based on scientific practices, crosscutting…

From Understanding to Deference: Laypersons' and Medical Students' Views on Conflicts within Medicine

ERIC Educational Resources Information Center

Bromme, Rainer; Thomm, Eva; Wolf, Veronika

2015-01-01

When making personally relevant decisions (e.g. on health-related issues), laypersons have to deal increasingly with science-based knowledge claims that are frequently not only inconsistent if not contradictory but also beyond their own everyday understanding. Nevertheless, they need to reason about these issues. The present interview study…

Progressing to University: Hidden Messages at Two State Schools

ERIC Educational Resources Information Center

Donnelly, Michael

2015-01-01

This paper considers some of the ways that schools play a role in shaping higher education (HE) decision-making. Through their everyday practices and processes, schools can carry hidden messages about progression to HE, including choice of university. The sorts of routine aspects of school life dealt with here include events and activities,…

A Pragmatic Approach to Ethical Decision-Making in Engineering Practice: Characteristics, Evaluation Criteria, and Implications for Instruction and Assessment.

PubMed

Zhu, Qin; Jesiek, Brent K

2017-06-01

This paper begins by reviewing dominant themes in current teaching of professional ethics in engineering education. In contrast to more traditional approaches that simulate ethical practice by using ethical theories to reason through micro-level ethical dilemmas, this paper proposes a pragmatic approach to ethics that places more emphasis on the practical plausibility of ethical decision-making. In addition to the quality of ethical justification, the value of a moral action also depends on its effectiveness in solving an ethical dilemma, cultivating healthy working relationships, negotiating existing organizational cultures, and achieving contextual plausibility in everyday professional practice. This paper uses a cross-cultural ethics scenario to further elaborate how a pragmatic approach can help us rethink ethical reasoning, as well as ethics instruction and assessment. This paper is expected to be of interest to educators eager to improve the ability of engineers and other professional students to effectively and appropriately deal with the kinds of everyday ethical issues they will likely face in their careers.

Elucidating Poor Decision-Making in a Rat Gambling Task

PubMed Central

Seriès, Peggy; Marchand, Alain R.; Dellu-Hagedorn, Françoise

2013-01-01

Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task – the Rat Gambling Task (RGT), we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms. PMID:24339988

Elucidating poor decision-making in a rat gambling task.

PubMed

Rivalan, Marion; Valton, Vincent; Seriès, Peggy; Marchand, Alain R; Dellu-Hagedorn, Françoise

2013-01-01

Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task--the Rat Gambling Task (RGT), we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms.

Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations

PubMed Central

Schweizer, T. Sophie; Schmalenberger, Katja M.; Eisenlohr-Moul, Tory A.; Mojzisch, Andreas; Kaiser, Stefan; Funke, Joachim

2016-01-01

Which factors influence a human being’s ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand, researchers working on the cognitive and clinical aspects of creativity. PMID:27536258

Cognitive and Affective Aspects of Creative Option Generation in Everyday Life Situations.

PubMed

Schweizer, T Sophie; Schmalenberger, Katja M; Eisenlohr-Moul, Tory A; Mojzisch, Andreas; Kaiser, Stefan; Funke, Joachim

2016-01-01

Which factors influence a human being's ability to develop new perspectives and be creative? This ability is pivotal for any context in which new cognitions are required, such as innovative endeavors in science and art, or psychotherapeutic settings. In this article, we seek to bring together two research programs investigating the generation of creative options: On the one hand, research on option generation in the decision-making literature and, on the other hand, cognitive and clinical creativity research. Previous decision-making research has largely neglected the topic of generating creative options. Experiments typically provided participants with a clear set of options to choose from, but everyday life situations are less structured and allow countless ways to react. Before choosing an option, agents have to self-generate a set of options to choose from. Such option generation processes have only recently moved to the center of attention. The present study examines the creative quality of self-generated options in daily life situations. A student sample (N = 48) generated options for action in 70 briefly described everyday life scenarios. We rated the quality of the options on three dimensions of creativity- originality, feasibility, and divergence -and linked these qualities to option generation fluency (speed and number of generated options), situational features like the familiarity and the affective valence of the situation in which the options were generated, and trait measures of cognitive performance. We found that when situations were familiar to the participant, greater negative affective valence of the situation was associated with more originality and divergence of generated options. We also found that a higher option generation fluency was associated with a greater maximal originality of options. We complete our article with a joint research agenda for researchers in the decision-making field focusing on option generation and, on the other hand, researchers working on the cognitive and clinical aspects of creativity.

Interactions between risky decisions, impulsiveness and smoking in young tattooed women

PubMed Central

2013-01-01

Background According to previous studies, one of the common problems of everyday life of persons with tattoos is risky behavior. However, direct examination of the decision making process, as well as factors which determine women’s risk-taking decisions to get tattoos, have not been conducted. This study investigates whether risk taking decision-making is associated with the self-assessment impulsiveness in tattooed women. Methods Young women (aged 18–35 years) with (N = 60) and without (N = 60) tattoos, performed the Iowa Gambling Task (IGT), as a measure of decision-making processes, as well as completing the Barratt Impulsivity Scale (BIS-11). Results Tattooed women showed significantly higher scores in the BIS-11 and preference for disadvantageous decks on the IGT compared to non-tattooed women. There was no significant correlation between risky decision-making in the IGT and BIS-11 impulsivity measures. A significantly higher rate of smoking was observed in the tattooed women. However, the analysis did not reveal a group effect after adjustment for smoking in the IGT and the BIS-11 measures. Conclusions The present study was specifically designed to resolve questions regarding associations between impulsiveness and risky decision-making in tattooed women. It shows that in tattooed women, risky decisions are not a direct result of their self-reported impulsiveness. Smoking does not explain the psychometric differences between tattooed women and controls. PMID:24180254

Towards a differentiated understanding of active travel behaviour: using social theory to explore everyday commuting.

PubMed

Guell, C; Panter, J; Jones, N R; Ogilvie, D

2012-07-01

Fostering physical activity is an established public health priority for the primary prevention of a variety of chronic diseases. One promising population approach is to seek to embed physical activity in everyday lives by promoting walking and cycling to and from work ('active commuting') as an alternative to driving. Predominantly quantitative epidemiological studies have investigated travel behaviours, their determinants and how they may be changed towards more active choices. This study aimed to depart from narrow behavioural approaches to travel and investigate the social context of commuting with qualitative social research methods. Within a social practice theory framework, we explored how people describe their commuting experiences and make commuting decisions, and how travel behaviour is embedded in and shaped by commuters' complex social worlds. Forty-nine semi-structured interviews and eighteen photo-elicitation interviews with accompanying field notes were conducted with a subset of the Commuting and Health in Cambridge study cohort, based in the UK. The findings are discussed in terms of three particularly pertinent facets of the commuting experience. Firstly, choice and decisions are shaped by the constantly changing and fluid nature of commuters' social worlds. Secondly, participants express ambiguities in relation to their reasoning, ambitions and identities as commuters. Finally, commuting needs to be understood as an embodied and emotional practice. With this in mind, we suggest that everyday decision-making in commuting requires the tactical negotiation of these complexities. This study can help to explain the limitations of more quantitative and static models and frameworks in predicting travel behaviour and identify future research directions. Copyright © 2012 Elsevier Ltd. All rights reserved.

The principles of Catholic social teaching: A guide for decision making from daily clinical encounters to national policy-making.

PubMed

Wright, Karen Shields

2017-02-01

Catholic social teaching (CST), a branch of moral theology, addresses contemporary issues within the political, economic, and cultural structures of society. The threefold cornerstone of CST contains the principles of human dignity, solidarity, and subsidiarity. It is the foundation on which to form our conscience in order to evaluate the framework of society and is the Catholic criteria for prudential judgment and direction in developing current policy-making. With knowledge of these social principles, in combination with our faith, we will be more armed and informed as to articulate the Catholic vision of reality, the truthful nature of the human person and society, to apply and integrate the social teachings in our everyday administrative and clinical encounters, and through the virtue of charity take action within the social, political, and economic spheres in which we have influence. Summary: The Church's social encyclicals are a reflection upon the issues of the day using the light of faith and reason. They offer commentary on the ways to evaluate and address particular social problems-also using natural law principles-in the areas of politics, economics, and culture. Quotes were selected from the encyclicals that define and expand upon the primary principles for the purpose of representing them for study, reflection, and use in everyday personal and business encounters and decision making for healthcare professionals.

The principles of Catholic social teaching: A guide for decision making from daily clinical encounters to national policy-making

PubMed Central

2017-01-01

Catholic social teaching (CST), a branch of moral theology, addresses contemporary issues within the political, economic, and cultural structures of society. The threefold cornerstone of CST contains the principles of human dignity, solidarity, and subsidiarity. It is the foundation on which to form our conscience in order to evaluate the framework of society and is the Catholic criteria for prudential judgment and direction in developing current policy-making. With knowledge of these social principles, in combination with our faith, we will be more armed and informed as to articulate the Catholic vision of reality, the truthful nature of the human person and society, to apply and integrate the social teachings in our everyday administrative and clinical encounters, and through the virtue of charity take action within the social, political, and economic spheres in which we have influence. Summary: The Church's social encyclicals are a reflection upon the issues of the day using the light of faith and reason. They offer commentary on the ways to evaluate and address particular social problems—also using natural law principles—in the areas of politics, economics, and culture. Quotes were selected from the encyclicals that define and expand upon the primary principles for the purpose of representing them for study, reflection, and use in everyday personal and business encounters and decision making for healthcare professionals. PMID:28392595

Rent or Buy

ERIC Educational Resources Information Center

Van Hecke, Tanja

2009-01-01

When one looks around in everyday life, one sees mathematics everywhere: i.e., when making the right decisions whether to rent or buy a bicycle depending on the circumstances. Mathematics can determine (in case of renting a bicycle) the maximum rental cost to ensure that you will be able to pay the rental cost every month. The period you need the…

Influence of Culture on Secondary School Students' Understanding of Statistics: A Fijian Perspective

ERIC Educational Resources Information Center

Sharma, Sashi

2014-01-01

Although we use statistical notions daily in making decisions, research in statistics education has focused mostly on formal statistics. Further, everyday culture may influence informal ideas of statistics. Yet, there appears to be minimal literature that deals with the educational implications of the role of culture. This paper will discuss the…

Investigating the Preservice Primary School, Mathematics and Science Teachers' STEM Awareness

ERIC Educational Resources Information Center

Bakirci, Hasan; Karisan, Dilek

2018-01-01

Today's life requires individuals to be prepared for complex world environment, to make complex decisions, and to have critical thinking skills related to everyday life issues at hand. STEM education is thought to be the glorious solution to thrive in a global knowledge driven world. Teachers are key elements for successful STEM education. Present…

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 socialized sex roles for higher emotional empathy leading to more altruistic decisions.

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 and socialized sex roles for higher emotional empathy leading to more altruistic decisions. PMID:27147990

Integrating visible light 3D scanning into the everyday world

NASA Astrophysics Data System (ADS)

Straub, Jeremy

2015-05-01

Visible light 3D scanning offers the potential to non-invasively and nearly non-perceptibly incorporate 3D imaging into the everyday world. This paper considers the various possible uses of visible light 3D scanning technology. It discusses multiple possible usage scenarios including in hospitals, security perimeter settings and retail environments. The paper presents a framework for assessing the efficacy of visible light 3D scanning for a given application (and compares this to other scanning approaches such as those using blue light or lasers). It also discusses ethical and legal considerations relevant to real-world use and concludes by presenting a decision making framework.

Extending decision making competence to special populations: a pilot study of persons on the autism spectrum

PubMed Central

Levin, Irwin P.; Gaeth, Gary J.; Foley-Nicpon, Megan; Yegorova, Vitaliya; Cederberg, Charles; Yan, Haoyang

2015-01-01

The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from “theory of mind” to predict key components of decision making in high-functioning young adults on the autism spectrum. A battery of tests was administered to 15 high-functioning college students with autism spectrum disorder (ASD), focusing on decision making competence (DMC) and other aspects of decision making related to known deficits associated with autism. Data from this group were compared to data from unselected college students receiving the same measures. First, as a test of a key social deficit associated with autism, the target group scored much lower on the Empathy Quotient scale. Traditional elements of decision making competency such as Numeracy and application of decision rules were comparable across groups. However, there were differences in thinking style, with the ASD group showing lesser ability and engagement in intuitive thinking, and they showed lower levels of risk taking. For comparisons within the ASD group, autobiographical reports concerning individual lifestyles and outcomes were used to derive a scale of Social Functioning. The lowest scoring individuals showed the lowest levels of intuitive thinking, the lowest perceived levels of others’ endorsement of socially undesirable behaviors, and the lowest ability to discriminate between “good” and “bad” risks. Results are discussed in terms of interventions that might aid high-functioning young adults with ASD in their everyday decision making. PMID:25972831

Extending decision making competence to special populations: a pilot study of persons on the autism spectrum.

PubMed

Levin, Irwin P; Gaeth, Gary J; Foley-Nicpon, Megan; Yegorova, Vitaliya; Cederberg, Charles; Yan, Haoyang

2015-01-01

The area of decision making has much to offer in our effort to understand special populations. This pilot study is an example of just such a project, where we illustrate how traditional decision making tools and tasks can be used to uncover strengths and weaknesses within a growing population of young adults with autism. In this pilot project we extended accounts of autistic behavior such as those derived from "theory of mind" to predict key components of decision making in high-functioning young adults on the autism spectrum. A battery of tests was administered to 15 high-functioning college students with autism spectrum disorder (ASD), focusing on decision making competence (DMC) and other aspects of decision making related to known deficits associated with autism. Data from this group were compared to data from unselected college students receiving the same measures. First, as a test of a key social deficit associated with autism, the target group scored much lower on the Empathy Quotient scale. Traditional elements of decision making competency such as Numeracy and application of decision rules were comparable across groups. However, there were differences in thinking style, with the ASD group showing lesser ability and engagement in intuitive thinking, and they showed lower levels of risk taking. For comparisons within the ASD group, autobiographical reports concerning individual lifestyles and outcomes were used to derive a scale of Social Functioning. The lowest scoring individuals showed the lowest levels of intuitive thinking, the lowest perceived levels of others' endorsement of socially undesirable behaviors, and the lowest ability to discriminate between "good" and "bad" risks. Results are discussed in terms of interventions that might aid high-functioning young adults with ASD in their everyday decision making.

Study protocol for 'we DECide': implementation of advance care planning for nursing home residents with dementia.

PubMed

Ampe, Sophie; Sevenants, Aline; Coppens, Evelien; Spruytte, Nele; Smets, Tinne; Declercq, Anja; van Audenhove, Chantal

2015-05-01

To evaluate the effects of 'we DECide', an educational intervention for nursing home staff on shared decision-making in the context of advance care planning for residents with dementia. Advance care planning (preparing care choices for when persons no longer have decision-making capacity) is of utmost importance for nursing home residents with dementia, but is mostly not realized for this group. Advance care planning consists of discussing care choices and making decisions and corresponds to shared decision-making (the involvement of persons and their families in care and treatment decisions). This quasi-experimental pre-test-post-test study is conducted in 19 nursing homes (Belgium). Participants are nursing home staff. 'We DECide' focuses on three crucial moments for discussing advance care planning: the time of admission, crisis situations and everyday conversations. The 'ACP-audit' assesses participants' views on the organization of advance care planning (organizational level), the 'OPTION scale' evaluates the degree of shared decision-making in individual conversations (clinical level) and the 'IFC-SDM Questionnaire' assesses participants' views on Importance, Frequency and Competence of realizing shared decision-making (clinical level). (Project funded: July 2010). The study hypothesis is that 'we DECide' results in a higher realization of shared decision-making in individual conversations on advance care planning. A better implementation of advance care planning will lead to a higher quality of end-of-life care and more person-centred care. We believe our study will be of interest to researchers and to professional nursing home caregivers and policy-makers. © 2014 John Wiley & Sons Ltd.

Rapid Decisions From Experience

PubMed Central

Zeigenfuse, Matthew D.; Pleskac, Timothy J.; Liu, Taosheng

2014-01-01

In many everyday decisions, people quickly integrate noisy samples of information to form a preference among alternatives that offer uncertain rewards. Here, we investigated this decision process using the Flash Gambling Task (FGT), in which participants made a series of choices between a certain payoff and an uncertain alternative that produced a normal distribution of payoffs. For each choice, participants experienced the distribution of payoffs via rapid samples updated every 50 ms. We show that people can make these rapid decisions from experience and that the decision process is consistent with a sequential sampling process. Results also reveal a dissociation between these preferential decisions and equivalent perceptual decisions where participants had to determine which alternatives contained more dots on average. To account for this dissociation, we developed a sequential sampling rank-dependent utility model, which showed that participants in the FGT attended more to larger potential payoffs than participants in the perceptual task despite being given equivalent information. We discuss the implications of these findings in terms of computational models of preferential choice and a more complete understanding of experience-based decision making. PMID:24549141

Institutionalizing Telemedicine Applications: The Challenge of Legitimizing Decision-Making

PubMed Central

Lettieri, Emanuele

2011-01-01

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements— rationality, fairness, and efficiency—that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications—benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators’ perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed. PMID:21955510

Neuropsychological correlates of decision making in patients with bulimia nervosa.

PubMed

Brand, Matthias; Franke-Sievert, Christiane; Jacoby, Georg E; Markowitsch, Hans J; Tuschen-Caffier, Brunna

2007-11-01

In addition to the core psychopathology of bulimia nervosa (BN), patients with BN often show impulsive behavior that has been related to decision making deficits in other patient groups, such as individuals with anorexia nervosa and pathological gamblers. However, it remains unclear whether BN patients also show difficulties in decision making. In this study, 14 patients with BN and 14 healthy comparison subjects, matched for age, gender, education, body mass index, and intelligence, were examined with the Game of Dice Task (M. Brand, E. Fujiwara, et al., 2005), a gambling task that has fixed winning probabilities and explicit rules for gains and losses, as well as with a neuropsychological test battery and personality questionnaires. On the task, the patients with BN chose the disadvantageous alternatives more frequently than did the comparison subjects. Performance on the Game of Dice Task was related to executive functioning but not to other neuropsychological functions, personality, or disease-specific variables in the BN group. Thus, in patients with BN, decision making abnormalities and executive reductions can be demonstrated and might be neuropsychological correlates of the patients' dysfunctional everyday-life decision making behavior. Neurocognitive functions should be considered in the treatment of BN. PsycINFO Database Record (c) 2007 APA, all rights reserved.

Institutionalizing telemedicine applications: the challenge of legitimizing decision-making.

PubMed

Zanaboni, Paolo; Lettieri, Emanuele

2011-09-28

During the last decades a variety of telemedicine applications have been trialed worldwide. However, telemedicine is still an example of major potential benefits that have not been fully attained. Health care regulators are still debating why institutionalizing telemedicine applications on a large scale has been so difficult and why health care professionals are often averse or indifferent to telemedicine applications, thus preventing them from becoming part of everyday clinical routines. We believe that the lack of consolidated procedures for supporting decision making by health care regulators is a major weakness. We aim to further the current debate on how to legitimize decision making about the institutionalization of telemedicine applications on a large scale. We discuss (1) three main requirements--rationality, fairness, and efficiency--that should underpin decision making so that the relevant stakeholders perceive them as being legitimate, and (2) the domains and criteria for comparing and assessing telemedicine applications--benefits and sustainability. According to these requirements and criteria, we illustrate a possible reference process for legitimate decision making about which telemedicine applications to implement on a large scale. This process adopts the health care regulators' perspective and is made up of 2 subsequent stages, in which a preliminary proposal and then a full proposal are reviewed.

Science at the supermarket: multiplication, personalization and consumption of science in everyday life.

PubMed

Tateo, Luca

2014-06-01

Which is the kind science's psychological guidance upon everyday life? I will try to discuss some issues about the role that techno-scientific knowledge plays in sense-making and decision making about practical questions of life. This relation of both love and hate, antagonism and connivance is inscribable in a wider debate between a trend of science to intervene in fields that are traditionally prerogative of political, religious or ethical choices, and, on the other side, the position of those who aim at stemming "technocracy" and governing these processes. I argue that multiplication, personalization and consumption are the characteristics of the relationship between science, technology and society in the age of "multiculturalism" and "multi-scientism". This makes more difficult but intriguing the study and understanding of the processes through which scientific knowledge is socialized. Science topics, like biotech, climate change, etc. are today an unavoidable reference frame. It is not possible to not know them and to attach them to the most disparate questions. Like in the case of Moscovici's "Freud for all seasons", the fact itself that the members of a group or a society believe in science as a reference point for others, roots its social representation and the belief that it can solve everyday life problems.

Our Legal Heritage: A Case Approach. Bulletin No. 14.

ERIC Educational Resources Information Center

Alabama State Dept. of Education, Montgomery. Div. of Instructional Services.

This booklet, intended for use with junior high school students, contains background readings on specific areas of the legal system and case studies of authentic court decisions relevant to each area. The purpose of the booklet is to introduce students to the influence of law on everyday life and to make them aware of the legal heritage and legal…

Save Our Planet--750 Everyday Ways You Can Help Clean Up the Earth.

ERIC Educational Resources Information Center

MacEachern, Diane

People, corporations and government are all responsible for the state of the environment and for their contributions to its care. By making small but substantial decisions about the things that are done, the goods that are bought, and the laws that are passed everyone can help to ensure a world that's fit for the future. If government and…

Promoting Societal-Oriented Communication and Decision Making Skills by Learning about Advertising in Science Education

ERIC Educational Resources Information Center

Belova, Nadja; Eilks, Ingo

2014-01-01

In our everyday lives we are surrounded by advertising in its various forms. Thus in the school context it is not surprising that the issue of advertising is addressed by different subjects, with the main foci being advertising-specific language, images and illustrations, use of stereotypes, strategies of persuasion, etc. But advertising also…

Managing United States public lands in response to climate change: a view from the ground up.

PubMed

Ellenwood, Mikaela S; Dilling, Lisa; Milford, Jana B

2012-05-01

Federal land managers are faced with the task of balancing multiple uses and goals when making decisions about land use and the activities that occur on public lands. Though climate change is now well recognized by federal agencies and their local land and resource managers, it is not yet clear how issues related to climate change will be incorporated into on-the-ground decision making within the framework of multiple use objectives. We conducted a case study of a federal land management agency field office, the San Juan Public Lands Center in Durango, CO, U.S.A., to understand from their perspective how decisions are currently made, and how climate change and carbon management are being factored into decision making. We evaluated three major management sectors in which climate change or carbon management may intersect other use goals: forests, biofuels, and grazing. While land managers are aware of climate change and eager to understand more about how it might affect land resources, the incorporation of climate change considerations into everyday decision making is currently quite limited. Climate change is therefore on the radar screen, but remains a lower priority than other issues. To assist the office in making decisions that are based on sound scientific information, further research is needed into how management activities influence carbon storage and resilience of the landscape under climate change.

The decision-making capacity of elderly hospitalized patients: validation of a test on their choice of return home.

PubMed

Romdhani, Mouna; Abbas, Rachid; Peyneau, Cécile; Koskas, Pierre; Houenou Quenum, Nadège; Galleron, Sandrine; Drunat, Olivier

2018-03-01

Elderly hospitalized patients have uncertain or questionable capacity to make decisions about their care. Determining whether an elderly patient possesses decision-making capacity to return at home is a major concern for geriatricians in everyday practice. To construct and internally validate a new tool, the dream of home test (DROM-test), as support for decision making hospitalization discharge destination for the elderly in the acute or sub-acute care setting. The DROM-test consists of 10 questions and 4 vignettes based upon the 4 relevant criteria for decision-making: capacity to understand information, to appreciate and reason about medical risks and to communicate a choice. A prospective observational study was conducted during 6 months in 2 geriatric care units in Bretonneau Hospital (Assistance publique, Hôpitaux de Paris). We compared the patient decision of DROM-test regarding discharge recommendations with those of an Expert committee and of the team in charge of the patient. 102 were included: mean age 83.1 + 6.7 [70; 97], 66.67% females. Principal components analysis revealed four dimensions: choice, understanding, reasoning and understanding. The area under the ROC curve was 0.64 for the choice dimension, 0.59 for the understanding, 0.53 for the reasoning and 0.52 for the apprehension. Only the choice dimension was statistically associated with the decision of the committee of experts (p=0.017). Even though Drom-test has limitations, it provides an objective way to ascertain decision-making capacity for hospitalised elderly patients.

Stressing The Person: Legal and Everyday Person Attributions Under Stress

PubMed Central

Kubota, Jennifer T.; Mojdehbakhsh, Rachel; Raio, Candace; Brosch, Tobias; Uleman, Jim S.; Phelps, Elizabeth A.

2014-01-01

When determining the cause of a person’s behavior, perceivers often overweigh dispositional explanations and underweigh situational explanations, an error known as the Fundamental Attribution Error (FAE). The FAE occurs in part because dispositional explanations are relatively automatic, whereas considering the situation requires additional cognitive effort. Stress is known to impair the prefrontal cortex and executive functions important for the attribution process. We investigated if stress increases dispositional attributions in common place and legal situations. Experiencing a physiological stressor increased participants’ cortisol, dispositional attributions of common everyday behaviors, and negative evaluations. When determining whether a crime was due to the defendant’s disposition or the mitigating situation, self-reported stress correlated with increased dispositional judgments of defendant’s behavior. These findings indicate that stress may makes people more likely to commit the FAE and less favorable in their evaluations of others both in daily life and when making socially consequential judicial decisions. PMID:25175000

Individual differences in cognition, affect, and performance: Behavioral, neuroimaging, and molecular genetic approaches

PubMed Central

Parasuraman, Raja; Jiang, Yang

2012-01-01

We describe the use of behavioral, neuroimaging, and genetic methods to examine individual differences in cognition and affect, guided by three criteria: (1) relevance to human performance in work and everyday settings; (2) interactions between working memory, decision-making, and affective processing; and (3) examination of individual differences. The results of behavioral, functional MRI (fMRI), event-related potential (ERP), and molecular genetic studies show that analyses at the group level often mask important findings associated with sub-groups of individuals. Dopaminergic/noradrenergic genes influencing prefrontal cortex activity contribute to inter-individual variation in working memory and decision behavior, including performance in complex simulations of military decision-making. The interactive influences of individual differences in anxiety, sensation seeking, and boredom susceptibility on evaluative decision-making can be systematically described using ERP and fMRI methods. We conclude that a multi-modal neuroergonomic approach to examining brain function (using both neuroimaging and molecular genetics) can be usefully applied to understanding individual differences in cognition and affect and has implications for human performance at work. PMID:21569853

Daily decision-making about food during pregnancy: a New Zealand study.

PubMed

Pullon, Susan; Ballantyne, Angela; Macdonald, Lindsay; Barthow, Christine; Wickens, Kristin; Crane, Julian

2018-01-12

Pregnancy has always been a life-changing event for women and their families, but societal concern about pregnancy and motherhood has become intense in the digital age. The role of health promotion agencies and others supplying health-related resources about lifestyle behaviours is both important and in need of scrutiny. Ever increasing advice for pregnant women, their families and health professionals, abounds. This study of decision making during pregnancy investigated how women made everyday decisions during pregnancy about food and drink, as well as dietary supplements and medications, alcohol and recreational drugs. This qualitative interview study was a side-arm to a double-blind randomized, placebo-controlled trial conducted with pregnant women in Wellington New Zealand, 2013-2016. Data from interviews with 20 women were analysed using inductive thematic analysis. In relation to decision-making about lifestyle behaviours, five themes emerged-Information about food; Wanted and unwanted advice; Worry, anxiety and indecision; Making daily decisions about food; Changes in decision making over time. Participating women talked more about food selection and restriction advice than any other lifestyle topic. Analysis demonstrated concern about information accuracy and overload from multiple, diverse sources. Women described learning how to assess resource credibility, how to develop decision-making skills, and who to trust. The study raises important questions about how the health information environment, despite best intentions, can be confusing or potentially harmful. The study underlines the continued importance of the role health professionals have in not only interpreting information to discuss individualized advice, but also in empowering pregnant women to develop lifestyle-related decision-making skills. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Influences of Transportation on Health Decision-Making and Self-Management Behaviors among Older Adults with Chronic Conditions.

PubMed

Ruggiano, Nicole; Shtompel, Natalia; Whiteman, Karen; Sias, Kathy

2017-01-01

Although transportation has been established as a facilitator/barrier to health self-management, little is known about how the context of transportation shapes health self-management behaviors and decision-making among older adults with chronic conditions. This study interviewed 37 older adults with chronic conditions in Florida to examine their perspectives about how transportation influences their chronic care self-management. The data were systematically analyzed for themes. The thematic findings revealed how transportation intersected with participants' everyday experiences with chronic health self-management, how they evaluated transportation as part of the process of making decisions about health, and how creative problem-solving about transportation became an additional health self-management activity for addressing their complex needs. These findings suggest that the context of transportation goes beyond a basic facilitator/barrier for health and enhance our understanding about how transportation services and policies may be changed to better address the needs of older adults with chronic conditions.

The embodied spaces of children with complex care needs: Effects on the social realities and power negotiations of families.

PubMed

Woodgate, Roberta L; Zurba, Melanie; Edwards, Marie; Ripat, Jacquie D; Rempel, Gina

2017-07-01

This paper presents research findings that advance knowledge around the power and agency families with children with complex care needs (CCN). Our conceptual framework uses concepts from geography towards situating the experiences and social realities of family carers within the 'embodied space of care'. The data originate from a longitudinal qualitative study of Canadian families with children with CCN. Findings reveal that interactions and decision-making processes relating to health and everyday life were complex and socially interconnected, and emphasize the need for provisions for family-based decision-making and enhanced social inclusion of families and the importance of the renegotiation of power. Copyright © 2017 Elsevier Ltd. All rights reserved.

The role of testosterone and estrogen in consumer behavior and social & economic decision making: A review.

PubMed

Stanton, Steven J

2017-06-01

A contribution to a special issue on Hormones and Human Competition.This manuscript reviews the current literature on the actions of the steroid hormones testosterone and estradiol in shaping humans' behavior within two applied contexts, specifically consumer behavior and decision making (both social and economic). The theoretical argument put forth is that steroids shape these everyday behaviors and choices in service to being more competitive in achieving long-term goals related to resource acquisition, mating success, and social dominance. In addition, a discussion of the increased research focus on the role of steroids in other applied business domains will highlight the relevant applications of basic science discoveries in behavioral endocrinology. Copyright © 2016 Elsevier Inc. All rights reserved.

Biocultural Ecology: Exploring the Social Construction of the Southern Appalachain Ecosystem

Treesearch

David P. Robertson; R. Bruce Hull

2003-01-01

The idea of a Southern Appalachian Ecosystem is now so much a part of our everyday language that many of the people who talk, write, and make decisions about thc place are unaware of the long and complicated history behind the idea. One primary purpose of this case study was to demonstrate how the Southern Appalachian Ecosystem has been socially constructed and reified...

Raising a Thinking Preteen: The "I Can Problem Solve" Program for 8- to 12-Year-Olds.

ERIC Educational Resources Information Center

Shure, Myrna B.

Aimed at parents of early adolescents, this book helps parents provide the skills teens need to cope with life's everyday frustrations and to make informed decisions about problems such as the stresses of homework, friendship, contending with peer pressure, and dealing with bullies. The foundation of the book is the "I Can Problem Solve" (ICPS)…

What Does Research Say about the Ideal Condition for Students Learning Mathematics?--A "Baker's Dozen" Articles to Inform Secondary Teaching

ERIC Educational Resources Information Center

Jones, Karrie A.; Vermette, Paul J.; Jones, Jennifer L.

2012-01-01

In seeking to align the everyday decision-making and lesson delivery of secondary teachers to current research in mathematics education, this piece provides an application of theory into classroom practice. By focusing on a sample of 13 quantitative and qualitative research studies of pedagogical best practice published since 2000, a set of…

Teaching science for public understanding: Developing decision-making abilities

NASA Astrophysics Data System (ADS)

Siegel, Marcelle A.

One of the most important challenges educators have is teaching students how to make decisions about complex issues. In this study, methods designed to enhance students' decision-making skills and attitudes were investigated. An issue-oriented science curriculum was partly replaced with activities designed by the experimenter. The first objective of the study was to examine the effects of an instructional method to increase students' use of relevant scientific evidence in their decisions. The second goal of the research was to test whether the instructional activities could promote students' beliefs that science is relevant to them, because attitudes have been shown to affect students' performance and persistence (Schommer, 1994). Third, the study was designed to determine whether the instructional activities would affect students' beliefs that their intelligence is not fixed but can grow; this question is based on Dweck and Leggett's (1988) definition of two orientations toward intelligence---entity theorists and incremental theorists (Dweck & Leggett, 1988; Dweck & Henderson, 1989). Two urban high-school classrooms participated in this study. Tenth graders examined scientific materials about current issues involving technology and society. Instructional materials on decision making were prepared for one class of students to enhance their regular issue-oriented course, Science and Sustainability. A computer program, called Convince Me (Schank, Ranney & Hoadley, 1996), provided scaffolding for making an evidence-based decision. The experimental group's activities also included pen-and-paper lessons on decision making and the effect of experience on the structure of the brain. The control class continued to engage in Science and Sustainability decision-making activities during the time the experimental class completed the treatment. The control group did not show significant improvement on decision-making tasks, and the experimental group showed marginally significant gains (p = .06) according to the Rasch analysis. A measure of students' understanding of coherent argumentation was correlated with higher decision posttest scores. Over time, both classes significantly regarded science as being more relevant to everyday life. Students' attitudes about ability showed insignificant changes.

Participation in communication and decision-making: children and young people's experiences in a hospital setting.

PubMed

Coyne, Imelda; Gallagher, Pamela

2011-08-01

To explore hospitalised children and young people's experiences of participation in communication and decision-making. There is a growing recognition internationally that children and young people have a right to participate in matters that affect their lives. Although this has led to more support for children's participation in communication exchanges and decision-making in health care, there remains a lack of studies in this area. Qualitative. Data were obtained through a combination of focus groups and single interviews with participants aged 7-18 (n = 55), from three hospitals in Ireland. Children wanted to be included in communication exchanges but appeared to occupy a marginal role with discussions largely carried out between parents and health professionals. They wanted to participate in 'small' everyday decisions about their care and treatment but were constrained mainly by adults' actions. Although children want to be included in the decision-making process, some prefer to leave the more 'serious' decisions to parents and health professionals, whilst others prefer to share the decision. Children's preferences can vary; therefore, decision-making should be seen as being on a continuum rather than an 'all or nothing' basis. Health care professionals and parents appear to play a significant role on whether children's efforts to participate are facilitated and supported in the hospital setting. Clearly, some may have reservations/concerns about children's participation, which suggests the need for clear guidelines/policies that reflect all stakeholder views. Children should be supported in having their voices heard in matters that directly affect their lives. © 2011 Blackwell Publishing Ltd.

The role of decision-making ability in HIV/AIDS: impact on prospective memory.

PubMed

Coulehan, Kelly; Byrd, Desiree; Arentoft, Alyssa; Monzones, Jennifer; Fuentes, Armando; Fraser, Felicia; Rosario, Ana; Morgello, Susan; Mindt, Monica Rivera

2014-01-01

Prospective memory (ProM), a form of episodic memory related to execution of future intentions, is important for everyday functioning. Among persons living with HIV (PLWH), executive dysfunction is implicated in ProM impairments. However, specific subcomponents of executive functioning involved in ProM deficits remain poorly understood. Unlike more "traditional" neurocognitive (NC) measures of executive functioning associated with dorsolateral prefrontal cortex (i.e., conceptual reasoning, abstraction), those associated with medial orbitofrontal/ventromedial prefrontal (mOF/vmP) cortex (i.e., decision making, inhibitory control, goal-oriented behavior) have yet to be examined in ProM. This study characterized ProM ability in a sample of 89 HIV-seropositive adults and examined the unique role of decision-making ability in ProM. Participants completed a standard NC battery, the Iowa Gambling Task (IGT; a decision-making measure), and the Memory for Intentions Screening Test (MIST; a ProM measure). Correlational analyses revealed that both traditional executive functioning measures and the IGT were associated with ProM. Regression analyses revealed that the IGT significantly predicted ProM, even after accounting for NC measures. Among all NC measures, only executive functioning significantly contributed to ProM. Further examination of mOF/vmP-sensitive executive dysfunction within this population is needed as PLWH may require more tailored treatment recommendations due to specific decision-making difficulties that can impact medication management.

Evidence for top-down control of eye movements during visual decision making.

PubMed

Glaholt, Mackenzie G; Wu, Mei-Chun; Reingold, Eyal M

2010-05-01

Participants' eye movements were monitored while they viewed displays containing 6 exemplars from one of several categories of everyday items (belts, sunglasses, shirts, shoes), with a column of 3 items presented on the left and another column of 3 items presented on the right side of the display. Participants were either required to choose which of the two sets of 3 items was the most expensive (2-AFC) or which of the 6 items was the most expensive (6-AFC). Importantly, the stimulus display, and the relevant stimulus dimension, were held constant across conditions. Consistent with the hypothesis of top-down control of eye movements during visual decision making, we documented greater selectivity in the processing of stimulus information in the 6-AFC than the 2-AFC decision. In addition, strong spatial biases in looking behavior were demonstrated, but these biases were largely insensitive to the instructional manipulation, and did not substantially influence participants' choices.

Daytime REM sleep affects emotional experience but not decision choices in moral dilemmas.

PubMed

Cellini, Nicola; Lotto, Lorella; Pletti, Carolina; Sarlo, Michela

2017-09-11

Moral decision-making depends on the interaction between automatic emotional responses and rational cognitive control. A natural emotional regulator state seems to be sleep, in particular rapid eye movement (REM) sleep. We tested the impact of daytime sleep, either with or without REM, on moral decision. Sixty participants were presented with 12 sacrificial (6 Footbridge- and 6 Trolley-type) and 8 everyday-type moral dilemmas at 9 AM and at 5 PM. In sacrificial dilemmas, participants had to decide whether or not to kill one person to save more people (utilitarian choice), and to judge how morally acceptable the proposed choice was. In everyday-type dilemmas, participants had to decide whether to endorse moral violations involving dishonest behavior. At 12 PM, 40 participants took a 120-min nap (17 with REM and 23 with NREM only) while 20 participants remained awake. Mixed-model analysis revealed that participants judged the utilitarian choice as less morally acceptable in the afternoon, irrespective of sleep. We also observed a negative association between theta activity during REM and increased self-rated unpleasantness during moral decisions. Nevertheless, moral decision did not change across the day and between groups. These results suggest that although both time and REM sleep may affect the evaluation of a moral situation, these factors did not ultimately impact the individual moral choices.

Perceived influence, decision-making and access to information in family services as factors of parental empowerment: a cross-sectional study of parents with young children.

PubMed

Vuorenmaa, Maaret; Halme, Nina; Perälä, Marja-Leena; Kaunonen, Marja; Åstedt-Kurki, Päivi

2016-06-01

Parental empowerment is known to increase parents' resources and to reduce stress, and therefore to improve family well-being. Professionals working in family services (child health clinics, school health care, day care, preschool and primary school) encounter families in various everyday settings and can significantly support parental empowerment. This study aimed (i) to identify associations between parental empowerment and demographic and family service characteristics (i.e. parents' participation and perceived influence, decision-making and access to information) and (ii) to identify predictors of maternal and paternal empowerment. Study design was cross-sectional. Participants were mothers (n = 571) and fathers (n = 384) of children aged 0-9 who were selected by stratified random sampling in 2009. Associations were analysed by t-test, one-way analysis of variance and multiple linear regression analysis. Sufficient perceived influence and joint decision-making by family and professionals on family service appointments emerged as significant variables of increased parental empowerment. Access to adequate information about municipal services was also associated with high empowerment. These family service characteristics were associated with parents' sense that they were able to manage in everyday life and had influence on specific service situations and family services in general. Mothers with a child aged under 3 or a child in home care or primary school, and fathers with a lower education feel less empowered in family services than other parents. Knowledge about the factors associated with parental empowerment can contribute to further reinforce parental empowerment, help identify parents who need special attention and contribute to the development of family services. © 2015 Nordic College of Caring Science.

Prediction Error Representation in Individuals With Generalized Anxiety Disorder During Passive Avoidance.

PubMed

White, Stuart F; Geraci, Marilla; Lewis, Elizabeth; Leshin, Joseph; Teng, Cindy; Averbeck, Bruno; Meffert, Harma; Ernst, Monique; Blair, James R; Grillon, Christian; Blair, Karina S

2017-02-01

Deficits in reinforcement-based decision making have been reported in generalized anxiety disorder. However, the pathophysiology of these deficits is largely unknown; published studies have mainly examined adolescents, and the integrity of core functional processes underpinning decision making remains undetermined. In particular, it is unclear whether the representation of reinforcement prediction error (PE) (the difference between received and expected reinforcement) is disrupted in generalized anxiety disorder. This study addresses these issues in adults with the disorder. Forty-six unmedicated individuals with generalized anxiety disorder and 32 healthy comparison subjects group-matched on IQ, gender, and age performed a passive avoidance task while undergoing functional MRI. Data analyses were performed using a computational modeling approach. Behaviorally, individuals with generalized anxiety disorder showed impaired reinforcement-based decision making. Imaging results revealed that during feedback, individuals with generalized anxiety disorder relative to healthy subjects showed a reduced correlation between PE and activity within the ventromedial prefrontal cortex, ventral striatum, and other structures implicated in decision making. In addition, individuals with generalized anxiety disorder relative to healthy participants showed a reduced correlation between punishment PEs, but not reward PEs, and activity within the left and right lentiform nucleus/putamen. This is the first study to identify computational impairments during decision making in generalized anxiety disorder. PE signaling is significantly disrupted in individuals with the disorder and may lead to their decision-making deficits and excessive worry about everyday problems by disrupting the online updating ("reality check") of the current relationship between the expected values of current response options and the actual received rewards and punishments.

JPRS Report, Soviet Union, Kommunist, No. 3, February 1987.

DTIC Science & Technology

1987-06-05

everyday realities and that of ostentatious well-being. The ideology and mentality of stagnation were also reflected on the state of culture, literature...society and in the behavior of some party members and make the decisions urgently required by reality . Despite their tremendous possibilities and...although they existed in virtually - all labor collective, many primary party organizations were unable to hold principled positions. Few of them mounted a

Physical Attractiveness, Opportunity, and Success in Everyday Exchange.

ERIC Educational Resources Information Center

Mulford, Matthew; Orbell, John; Shatto, Catherine; Stockard, Jean

1998-01-01

Addresses the role of perceived physical attractiveness in everyday exchange. Indicates that decisions to enter into play and to cooperate with others is directly related to individuals' perceptions of others' attractiveness, but that individuals' perceptions of their own attractiveness affects men's and women's decisions differently. Suggests…

The Quantitative Science of Evaluating Imaging Evidence.

PubMed

Genders, Tessa S S; Ferket, Bart S; Hunink, M G Myriam

2017-03-01

Cardiovascular diagnostic imaging tests are increasingly used in everyday clinical practice, but are often imperfect, just like any other diagnostic test. The performance of a cardiovascular diagnostic imaging test is usually expressed in terms of sensitivity and specificity compared with the reference standard (gold standard) for diagnosing the disease. However, evidence-based application of a diagnostic test also requires knowledge about the pre-test probability of disease, the benefit of making a correct diagnosis, the harm caused by false-positive imaging test results, and potential adverse effects of performing the test itself. To assist in clinical decision making regarding appropriate use of cardiovascular diagnostic imaging tests, we reviewed quantitative concepts related to diagnostic performance (e.g., sensitivity, specificity, predictive values, likelihood ratios), as well as possible biases and solutions in diagnostic performance studies, Bayesian principles, and the threshold approach to decision making. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

What do we know about the application of the Mental Capacity Act (2005) in healthcare practice regarding decision-making for frail and older people? A systematic literature review.

PubMed

Hinsliff-Smith, Kathryn; Feakes, Ruth; Whitworth, Gillian; Seymour, Jane; Moghaddam, Nima; Dening, Tom; Cox, Karen

2017-03-01

In England and Wales, decision-making in cases of uncertain mental capacity is regulated by the Mental Capacity Act 2005. The Act provides a legal framework for decision-making for adults (16 and over) who are shown to lack capacity and where best interest decisions need to be made on their behalf. Frail older people with cognitive impairments represent a growing demographic sector across England and Wales for whom the protective principles of the Act have great relevance, as they become increasingly dependent on the care of others. However, while the Act articulates core principles, applying the Act in everyday healthcare contexts raises challenges for care providers in terms of interpretation and application. This paper presents a review of the published evidence documenting the use of the Act in healthcare practice, with particular reference to frail older people. Our aim was to identify, review and critically evaluate published empirical studies concerned with the implementation and application of the Act in healthcare settings. A systematic approach was undertaken with pre-determined exclusion and inclusion criteria applied across five electronic bibliographic databases combined with a manual search of specific journals. This review reports on 38 empirical sources which met the inclusion criteria published between 2005 and 2013. From the 38 sources, three descriptive themes were identified: knowledge and understanding, implementation and tensions in applying the Act, and alternative perspectives of the Act. There is a need for improved knowledge and conceptualisation to enable successful incorporation of the Act into everyday care provision. Inconsistencies in the application of the Act are apparent across a variety of care settings. This review suggest staff need more opportunities to engage, learn and implement the Act, in order for it to have greater resonance to their individual practice and ultimately benefit patient care. © 2015 John Wiley & Sons Ltd.

Development of a novel task for investigating decision making in a social context following traumatic brain injury.

PubMed

Kelly, Michelle; McDonald, Skye; Kellett, David

2014-01-01

Examination of social cognition as a target for assessment and intervention is beginning to gain momentum in a number of illnesses and acquired disorders. One facet of social cognition is decision making within interpersonal situations. This skill forms an important part of our everyday lives and is commonly impaired in those with neurological and mental health conditions. A novel task was developed to allow the assessment of decision making specifically within a social context and was examined within a group known to experience this difficulty. Participants with severe traumatic brain injury (TBI) were compared to healthy control participants on the Social Decision Making Task (SDMT), which required the participant to learn who the "friendly" players were in a game of toss. Participants also completed a nonsocial decision-making task, the Iowa Gambling Task (IGT) as well as a battery of neuropsychological tests and social cognition tasks. Current social functioning was also examined. Consistent with predictions, the TBI group made poorer decisions on the SDMT than the control group; however, group differences were not evident on the IGT. No significant relationships were observed between the SDMT and either measures of executive functioning (including working memory and reversal learning) or social cognition (including emotion recognition and theory of mind). Performance on the SDMT and the IGT were not associated, suggesting that the two tasks measure different constructs. The SDMT offers a novel way of examining decision making within a social context following TBI and may also be useful in other populations known to have specific social cognition impairment. Future research should aim to provide further clarification of the mechanisms of action and neuroanatomical correlates of poor performance on this task.

Investigating the role of the ventromedial prefrontal cortex in the assessment of brands.

PubMed

Santos, José Paulo; Seixas, Daniela; Brandão, Sofia; Moutinho, Luiz

2011-01-01

The ventromedial prefrontal cortex (vmPFC) is believed to be important in everyday preference judgments, processing emotions during decision-making. However, there is still controversy in the literature regarding the participation of the vmPFC. To further elucidate the contribution of the vmPFC in brand preference, we designed a functional magnetic resonance imaging (fMRI) study where 18 subjects assessed positive, indifferent, and fictitious brands. Also, both the period during and after the decision process were analyzed, hoping to unravel temporally the role of the vmPFC, using modeled and model-free fMRI analysis. Considering together the period before and after decision-making, there was activation of the vmPFC when comparing positive with indifferent or fictitious brands. However, when the decision-making period was separated from the moment after the response, and especially for positive brands, the vmPFC was more active after the choice than during the decision process itself, challenging some of the existing literature. The results of the present study support the notion that the vmPFC may be unimportant in the decision stage of brand preference, questioning theories that postulate that the vmPFC is in the origin of such a choice. Further studies are needed to investigate in detail why the vmPFC seems to be involved in brand preference only after the decision process.

Investigating the Role of the Ventromedial Prefrontal Cortex in the Assessment of Brands

PubMed Central

Santos, José Paulo; Seixas, Daniela; Brandão, Sofia; Moutinho, Luiz

2011-01-01

The ventromedial prefrontal cortex (vmPFC) is believed to be important in everyday preference judgments, processing emotions during decision-making. However, there is still controversy in the literature regarding the participation of the vmPFC. To further elucidate the contribution of the vmPFC in brand preference, we designed a functional magnetic resonance imaging (fMRI) study where 18 subjects assessed positive, indifferent, and fictitious brands. Also, both the period during and after the decision process were analyzed, hoping to unravel temporally the role of the vmPFC, using modeled and model-free fMRI analysis. Considering together the period before and after decision-making, there was activation of the vmPFC when comparing positive with indifferent or fictitious brands. However, when the decision-making period was separated from the moment after the response, and especially for positive brands, the vmPFC was more active after the choice than during the decision process itself, challenging some of the existing literature. The results of the present study support the notion that the vmPFC may be unimportant in the decision stage of brand preference, questioning theories that postulate that the vmPFC is in the origin of such a choice. Further studies are needed to investigate in detail why the vmPFC seems to be involved in brand preference only after the decision process. PMID:21687799

[Factors behind action, emotion, and decision making].

PubMed

Watanabe, Katsumi

2009-12-01

Human actions, emotions, and decision making are products of complex interactions between explicit and implicit processes at various levels of spatial and temporal scales. Although it may not be possible to obtain to experimental data for all the complexity of human behavioral and emotional processes in our everyday life, recent studies have investigated the effects of social contexts on actions, emotions, and decision making; these studies include those in the fields of experimental psychology, cognitive science, and neuroscience. In this paper, we review several empirical studies that exemplify how our actions, social emotions, and decision making are influenced by the presence of implicit external, rather than internal factors, particularly by presence of other individuals. The following are the main principles identified. (1) Unconscious behavioral contagion: Individuals tend to mimic others' actions. This tendency occurs unconsciously even when the observed and the to-be-executed movements are unrelated at various levels and aspects of behaviors (e. g., behavioral tempo and speed). (2) Neural substrates of social emotions: Various social emotions, including admiration, compassion, envy, and schadenfreude, are represented in neuronal networks that are similar to those of basic emotional processes. (3) Evasive nature of human decision making: Individuals tend to overrate their own subjective impression of and emotional reaction in forecasting affective reaction to events in the future, even though the predictive power of information from peer group is much larger in this regard. Individuals are seldom aware of the dissociation between their intended choice and excuted actions and are willing to give elaborate explanations for the choices they, in fact, did not make. Using these empirical examples, I will illustrate the considerable influences of implicit, unconscious processes on human actions, emotions, and decision making.

User participation is a family matter: A multiple case study of the experiences of older, hospitalised people and their relatives.

PubMed

Nyborg, Ingrid; Danbolt, Lars J; Kirkevold, Marit

2017-12-01

The purpose of this multiple case study was to compare and contrast older people's and their relatives' experiences of participation in decision-making processes regarding the planning of everyday life after discharge from hospital. Internationally, patient involvement in health services is established to benefit patient health and to improve quality of the services. The literature shows that at hospital discharge, older people would benefit from better communication and more active participation of relatives in the discharge planning. Little research has been carried out on the experiences of patients and relatives as a family in this context, and even less has investigated their participation. This study used a qualitative design with a comparative multicase approach. Participants were recruited from two hospitals in Norway using a purposive sampling strategy. Semi-structured interviews were conducted with five patients and with six of their relatives. Three patterns of experiences were identified: contradicting experiences; consistent experiences of nonpreferred participation; similar, but separate experiences of user participation. User participation in the planning of everyday life following discharge appeared to be random and limited for both patients and their relatives, and conflicting for the families as a whole. The decision-making processes seemed to be limited to the hospital context and did not include the broader context of everyday life following discharge. The results underscore the importance of taking a family perspective when caring for older people. Family meetings might be a useful tool to ensure systematic assessment and integration of the perspectives of both older people and their family in the planning of follow-up care. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Attitudes toward risk and ambiguity in patients with autism spectrum disorder.

PubMed

Fujino, Junya; Tei, Shisei; Hashimoto, Ryu-Ichiro; Itahashi, Takashi; Ohta, Haruhisa; Kanai, Chieko; Okada, Rieko; Kubota, Manabu; Nakamura, Motoaki; Kato, Nobumasa; Takahashi, Hidehiko

2017-01-01

Although the ability to make optimal decisions under uncertainty is an integral part of everyday life, individuals with autism spectrum disorder (ASD) frequently report that they experience difficulties with this skill. In behavioral economics, researchers distinguish two types of uncertainty to understand decision-making in this setting: risk (known probabilities) and ambiguity (unknown probabilities). However, it remains unclear how individuals with ASD behave under risk and ambiguity, despite growing evidence of their altered decision-making under uncertainty. We therefore extended previous research by studying the attitudes of those with ASD toward risk and ambiguity in both positive and negative contexts (i.e., gain and loss). In gain contexts, no significant difference was observed between the groups in risk attitudes, but ambiguity aversion was attenuated in ASD. In loss contexts, ambiguity attitudes did not significantly differ between the groups, but the ASD participants were less risk-seeking compared with the controls. In addition, insensitivity to the context change under risk and ambiguity in ASD was both significantly associated with poor social skills. These results improve our understanding of altered decision-making under uncertainty by disentangling the attitudes toward risk and ambiguity in ASD individuals. Applying behavioral economic tools may provide insights into the mechanisms underlying behavioral disturbances in ASD.

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

PubMed

Collins, Anne; Koechlin, Etienne

2012-01-01

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

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

PubMed Central

Collins, Anne; Koechlin, Etienne

2012-01-01

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

The role of decision-making ability in HIV/AIDS: Impact on prospective memory

PubMed Central

Coulehan, Kelly; Byrd, Desiree; Arentoft, Alyssa; Monzones, Jennifer; Fuentes, Armando; Fraser, Felicia; Rosario, Ana; Morgello, Susan; Rivera Mindt, Monica

2017-01-01

Background Prospective memory (ProM), a form of episodic memory related to execution of future intentions, is important for everyday functioning. Among persons living with HIV (PLWH), executive dysfunction is implicated in ProM impairments. However, specific subcomponents of executive functioning involved in ProM deficits remain poorly understood. Unlike more “traditional” neurocognitive (NC) measures of executive functioning associated with dorsolateral prefrontal cortex (i.e., conceptual reasoning, abstraction), those associated with medial orbitofrontal/ventromedial prefrontal (mOF/vmP) cortex (i.e., decision making, inhibitory control, goal-oriented behavior) have yet to be examined in ProM. Method This study characterized ProM ability in a sample of 89 HIV-seropositive adults and examined the unique role of decision-making ability in ProM. Participants completed a standard NC battery, the Iowa Gambling Task (IGT; a decision-making measure), and the Memory for Intentions Screening Test (MIST; a ProM measure). Results Correlational analyses revealed that both traditional executive functioning measures and the IGT were associated with ProM. Regression analyses revealed that the IGT significantly predicted ProM, even after accounting for NC measures. Among all NC measures, only executive functioning significantly contributed to ProM. Discussion Further examination of mOF/vmP-sensitive executive dysfunction within this population is needed as PLWH may require more tailored treatment recommendations due to specific decision-making difficulties that can impact medication management. PMID:25089330

Decision-making heuristics and biases across the life span.

PubMed

Strough, Jonell; Karns, Tara E; Schlosnagle, Leo

2011-10-01

We outline a contextual and motivational model of judgment and decision-making (JDM) biases across the life span. Our model focuses on abilities and skills that correspond to deliberative, experiential, and affective decision-making processes. We review research that addresses links between JDM biases and these processes as represented by individual differences in specific abilities and skills (e.g., fluid and crystallized intelligence, executive functioning, emotion regulation, personality traits). We focus on two JDM biases-the sunk-cost fallacy (SCF) and the framing effect. We trace the developmental trajectory of each bias from preschool through middle childhood, adolescence, early adulthood, and later adulthood. We conclude that life-span developmental trajectories differ depending on the bias investigated. Existing research suggests relative stability in the framing effect across the life span and decreases in the SCF with age, including in later life. We highlight directions for future research on JDM biases across the life span, emphasizing the need for process-oriented research and research that increases our understanding of JDM biases in people's everyday lives. © 2011 New York Academy of Sciences.

Decision-making heuristics and biases across the life span

PubMed Central

Strough, JoNell; Karns, Tara E.; Schlosnagle, Leo

2013-01-01

We outline a contextual and motivational model of judgment and decision-making (JDM) biases across the life span. Our model focuses on abilities and skills that correspond to deliberative, experiential, and affective decision-making processes. We review research that addresses links between JDM biases and these processes as represented by individual differences in specific abilities and skills (e.g., fluid and crystallized intelligence, executive functioning, emotion regulation, personality traits). We focus on two JDM biases—the sunk-cost fallacy (SCF) and the framing effect. We trace the developmental trajectory of each bias from preschool through middle childhood, adolescence, early adulthood, and later adulthood. We conclude that life-span developmental trajectories differ depending on the bias investigated. Existing research suggests relative stability in the framing effect across the life span and decreases in the SCF with age, including in later life. We highlight directions for future research on JDM biases across the life span, emphasizing the need for process-oriented research and research that increases our understanding of JDM biases in people’s everyday lives. PMID:22023568

Does the U.S. Supreme Court's Recent Activism in Reviewing Educational Disputes Make the Attempt To Implement a Code of Professional Ethics for Educators a Vain Effort?

ERIC Educational Resources Information Center

Petronicolos, Loucas

This paper explores whether or not the recent increase of interest by the U.S. Supreme Court in educational disputes results in a gradual reduction in the role that professional ethics plays in educators' everyday decisions. It is argued that there are links between an educator's professional ethics and constitutional justice. The increase in…

The art of negotiation. An everyday experience.

PubMed

Smeltzer, C H

1991-01-01

The art of negotiation permeates every aspect of one's professional and personal life. Nurse administrators who use a scientific method of negotiation to augment professional judgment and decision making can create a climate conductive to success. The author reviews the definition and purpose of negotiation, examines concepts associated with negotiation and communication, analyzes the steps in the negotiation process, relates the negotiation process to the change process, and describes strategies for conducting effective negotiation.

ERP Correlates of Simulated Purchase Decisions

PubMed Central

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

2016-01-01

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

ERP Correlates of Simulated Purchase Decisions.

PubMed

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

2016-01-01

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

'She's usually quicker than the calculator': financial management and decision-making in couples living with dementia.

PubMed

Boyle, Geraldine

2013-09-01

This article explores how married couples managed their finances and made financial decisions when one spouse had dementia, drawing comparisons with the approaches used prior to the illness. More specifically, the article examines the role of social factors in influencing the involvement of people with dementia in financial management and decision-making, particularly whether a gender dynamic adopted earlier in a marriage similarly influenced a gendered approach following dementia. The research formed part of a larger study of everyday decision-making by couples living with dementia which explored the role of non-cognitive factors in influencing whether people with dementia were involved in decision-making processes. Twenty-one married couples living at home took part; the recently-diagnosed were excluded. Qualitative methods -including participant observation and interviews - were used to examine the couples' fiscal management and decision-making-processes, the perceptions of people with dementia and their spouses about their current financial abilities and whether any support provided by spouse-carers influenced their partners' financial capacity. The fieldwork was undertaken in the North of England between June 2010 and May 2011. Thematic analysis of the data showed that social factors influenced the perceived capacity of people with dementia and the financial practices adopted by the couples. In particular, gender influenced whether people with dementia were involved in financial decisions. The research demonstrated that non-cognitive factors need to be taken into account when assessing and facilitating the capacity of people with dementia. In addition, as people with dementia were somewhat marginalised in decisions about designating financial authority (Lasting Power of Attorney), spouse-carers may need guidance on how to undertake advance care planning and how to support their relatives with dementia in major decision-making, particularly when there are communication difficulties. © 2013 John Wiley & Sons Ltd.

Viewing sexual images is associated with reduced physiological arousal response to gambling loss.

PubMed

Lui, Ming; Hsu, Ming

2018-01-01

Erotic imagery is one highly salient emotional signal that exists everywhere in daily life. The impact of sexual stimuli on human decision-making, however, has rarely been investigated. This study examines the impact of sexual stimuli on financial decision-making under risk. In each trial, either a sexual or neutral image was presented in a picture categorization task before a gambling task. Thirty-four men made gambling decisions while their physiological arousal, measured by skin conductance responses (SCRs), was recorded. Behaviorally, the proportion of gambling decisions did not differ between the sexual and neutral image trials. Physiologically, participants had smaller arousal differences, measured in micro-siemen per dollar, between losses and gains in the sexual rather than in the neutral image trials. Moreover, participants' SCRs to losses relative to gains predicted the proportion of gambling decisions in the neutral image trials but not in the sexual image trials. The results were consistent with the hypothesis that the presence of emotionally salient sexual images reduces attentional and arousal-related responses to gambling losses. Our results are consistent with the theory of loss attention involving increased cognitive investment in losses compared to gains. The findings also have potential practical implications for our understanding of the specific roles of sexual images in human financial decision making in everyday life, such as gambling behaviors in the casino.

Viewing sexual images is associated with reduced physiological arousal response to gambling loss

PubMed Central

Hsu, Ming

2018-01-01

Erotic imagery is one highly salient emotional signal that exists everywhere in daily life. The impact of sexual stimuli on human decision-making, however, has rarely been investigated. This study examines the impact of sexual stimuli on financial decision-making under risk. In each trial, either a sexual or neutral image was presented in a picture categorization task before a gambling task. Thirty-four men made gambling decisions while their physiological arousal, measured by skin conductance responses (SCRs), was recorded. Behaviorally, the proportion of gambling decisions did not differ between the sexual and neutral image trials. Physiologically, participants had smaller arousal differences, measured in micro-siemen per dollar, between losses and gains in the sexual rather than in the neutral image trials. Moreover, participants’ SCRs to losses relative to gains predicted the proportion of gambling decisions in the neutral image trials but not in the sexual image trials. The results were consistent with the hypothesis that the presence of emotionally salient sexual images reduces attentional and arousal-related responses to gambling losses. Our results are consistent with the theory of loss attention involving increased cognitive investment in losses compared to gains. The findings also have potential practical implications for our understanding of the specific roles of sexual images in human financial decision making in everyday life, such as gambling behaviors in the casino. PMID:29649287

Probabilistic inference under time pressure leads to a cortical-to-subcortical shift in decision evidence integration.

PubMed

Oh-Descher, Hanna; Beck, Jeffrey M; Ferrari, Silvia; Sommer, Marc A; Egner, Tobias

2017-11-15

Real-life decision-making often involves combining multiple probabilistic sources of information under finite time and cognitive resources. To mitigate these pressures, people "satisfice", foregoing a full evaluation of all available evidence to focus on a subset of cues that allow for fast and "good-enough" decisions. Although this form of decision-making likely mediates many of our everyday choices, very little is known about the way in which the neural encoding of cue information changes when we satisfice under time pressure. Here, we combined human functional magnetic resonance imaging (fMRI) with a probabilistic classification task to characterize neural substrates of multi-cue decision-making under low (1500 ms) and high (500 ms) time pressure. Using variational Bayesian inference, we analyzed participants' choices to track and quantify cue usage under each experimental condition, which was then applied to model the fMRI data. Under low time pressure, participants performed near-optimally, appropriately integrating all available cues to guide choices. Both cortical (prefrontal and parietal cortex) and subcortical (hippocampal and striatal) regions encoded individual cue weights, and activity linearly tracked trial-by-trial variations in the amount of evidence and decision uncertainty. Under increased time pressure, participants adaptively shifted to using a satisficing strategy by discounting the least informative cue in their decision process. This strategic change in decision-making was associated with an increased involvement of the dopaminergic midbrain, striatum, thalamus, and cerebellum in representing and integrating cue values. We conclude that satisficing the probabilistic inference process under time pressure leads to a cortical-to-subcortical shift in the neural drivers of decisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of context on risk taking and decision times in obsessive-compulsive disorder.

PubMed

Sip, Kamila E; Muratore, Alexandra F; Stern, Emily R

2016-04-01

Despite the fact that OCD patients show altered decision making in everyday life, few studies have investigated how patients make risky decisions and what contextual factors impact choices. We investigated cognitive context with the use of the "framing effect" task, which investigates decision making based on whether monetarily equivalent choice options are framed in terms of a potential to either lose (lose $20 out of $50) or gain (gain $30 out of $50) money. In addition, we manipulated social context by providing positive or neutral feedback on subjects' choices. Overall, participants were risk taking for options framed in terms of potential loss and risk averse for options framed in terms of potential gain (the classic framing effect). Although OCD patients were generally more risk averse, the effect of the frame on choices did not differ significantly from healthy participants and choices were not impacted by social context. Within OCD patients, greater self-reported indecisiveness was associated with a larger effect of the frame on choices. OCD patients were also significantly slower to make choices in the loss compared to gain frame, an effect that was not observed among healthy participants. Overall, our results suggest that the framing of choice options has a differential effect on decision times but not the actual choices made by OCD patients, and that patients are not sensitive to social feedback when making choices. The correlation between indecisiveness and the framing effect in OCD suggests that further work interrogating the relationship between specific symptoms and decision making among patients may yield new insights into the disorder. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effects of episodic future thinking on discounting: Personalized age-progressed pictures improve risky long-term health decisions.

PubMed

Kaplan, Brent A; Reed, Derek D; Jarmolowicz, David P

2016-03-01

Many everyday choices are associated with both delayed and probabilistic outcomes. The temporal attention hypothesis suggests that individuals' decision making can be improved by focusing attention on temporally distal events and implies that environmental manipulations that bring temporally distal outcomes into focus may alter an individual's degree of discounting. One such manipulation, episodic future thinking, has shown to lower discount rates; however, several questions remain about the applicability of episodic future thinking to domains other than delay discounting. The present experiments examine the effects of a modified episodic-future-thinking procedure in which participants viewed age-progressed computer-generated images of themselves and answered questions related to their future, on probability discounting in the context of both a delayed health gain and loss. Results indicate that modified episodic future thinking effectively altered individuals' degree of discounting in the predicted directions and demonstrate the applicability of episodic future thinking to decision making of socially significant outcomes. © 2015 Society for the Experimental Analysis of Behavior.

Going All In: Unfavorable Sex Ratios Attenuate Choice Diversification.

PubMed

Ackerman, Joshua M; Maner, Jon K; Carpenter, Stephanie M

2016-06-01

When faced with risky decisions, people typically choose to diversify their choices by allocating resources across a variety of options and thus avoid putting "all their eggs in one basket." The current research revealed that this tendency is reversed when people face an important cue to mating-related risk: skew in the operational sex ratio, or the ratio of men to women in the local environment. Counter to the typical strategy of choice diversification, findings from four studies demonstrated that the presence of romantically unfavorable sex ratios (those featuring more same-sex than opposite-sex individuals) led heterosexual people to diversify financial resources less and instead concentrate investment in high-risk/high-return options when making lottery, stock-pool, retirement-account, and research-funding decisions. These studies shed light on a key process by which people manage risks to mating success implied by unfavorable interpersonal environments. These choice patterns have important implications for mating behavior as well as other everyday forms of decision making. © The Author(s) 2016.

Do the right thing: the assumption of optimality in lay decision theory and causal judgment.

PubMed

Johnson, Samuel G B; Rips, Lance J

2015-03-01

Human decision-making is often characterized as irrational and suboptimal. Here we ask whether people nonetheless assume optimal choices from other decision-makers: Are people intuitive classical economists? In seven experiments, we show that an agent's perceived optimality in choice affects attributions of responsibility and causation for the outcomes of their actions. We use this paradigm to examine several issues in lay decision theory, including how responsibility judgments depend on the efficacy of the agent's actual and counterfactual choices (Experiments 1-3), individual differences in responsibility assignment strategies (Experiment 4), and how people conceptualize decisions involving trade-offs among multiple goals (Experiments 5-6). We also find similar results using everyday decision problems (Experiment 7). Taken together, these experiments show that attributions of responsibility depend not only on what decision-makers do, but also on the quality of the options they choose not to take. Copyright © 2015 Elsevier Inc. All rights reserved.

Neural mechanisms underlying urgent and evaluative behaviors: An fMRI study on the interaction of automatic and controlled processes.

PubMed

Megías, Alberto; Navas, Juan Francisco; Petrova, Dafina; Cándido, Antonio; Maldonado, Antonio; Garcia-Retamero, Rocio; Catena, Andrés

2015-08-01

Dual-process theories have dominated the study of risk perception and risk-taking over the last two decades. However, there is a lack of objective brain-level evidence supporting the two systems of processing in every-day risky behavior. To address this issue, we propose the dissociation between evaluative and urgent behaviors as evidence of dual processing in risky driving situations. Our findings show a dissociation of evaluative and urgent behavior both at the behavioral and neural level. fMRI data showed an increase of activation in areas implicated in motor programming, emotional processing, and visuomotor integration in urgent behavior compared to evaluative behavior. These results support a more automatic processing of risk in urgent tasks, relying mainly on heuristics and experiential appraisal. The urgent task, which is characterized by strong time pressure and the possibility for negative consequences among others factors, creates a suitable context for the experiential-affective system to guide the decision-making process. Moreover, we observed greater frontal activation in the urgent task, suggesting the participation of cognitive control in safe behaviors. The findings of this research are relevant for the study of the neural mechanisms underlying dual process models in risky perception and decision-making, especially because of their proximity to everyday activities. © 2015 Wiley Periodicals, Inc.

Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety.

PubMed

Sonuga-Barke, Edmund J S; Cortese, Samuele; Fairchild, Graeme; Stringaris, Argyris

2016-03-01

Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review. We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes. Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research. © 2015 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes.

PubMed

Clarinval, Caroline; Biller-Andorno, Nikola

2014-06-23

This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context.

Brain responses to social norms: Meta-analyses of fMRI studies.

PubMed

Zinchenko, Oksana; Arsalidou, Marie

2018-02-01

Social norms have a critical role in everyday decision-making, as frequent interaction with others regulates our behavior. Neuroimaging studies show that social-based and fairness-related decision-making activates an inconsistent set of areas, which sometimes includes the anterior insula, anterior cingulate cortex, and others lateral prefrontal cortices. Social-based decision-making is complex and variability in findings may be driven by socio-cognitive activities related to social norms. To distinguish among social-cognitive activities related to social norms, we identified 36 eligible articles in the functional magnetic resonance imaging (fMRI) literature, which we separate into two categories (a) social norm representation and (b) norm violations. The majority of original articles (>60%) used tasks associated with fairness norms and decision-making, such as ultimatum game, dictator game, or prisoner's dilemma; the rest used tasks associated to violation of moral norms, such as scenarios and sentences of moral depravity ratings. Using quantitative meta-analyses, we report common and distinct brain areas that show concordance as a function of category. Specifically, concordance in ventromedial prefrontal regions is distinct to social norm representation processing, whereas concordance in right insula, dorsolateral prefrontal, and dorsal cingulate cortices is distinct to norm violation processing. We propose a neurocognitive model of social norms for healthy adults, which could help guide future research in social norm compliance and mechanisms of its enforcement. © 2017 Wiley Periodicals, Inc.

[Shared decision-making as a new quality indicator in nephrology: a nationwide survey in Germany].

PubMed

Scheibler, Fülöp; Stoffel, Markus P; Barth, Claudia; Kuch, Christine; Steffen, Petra; Baldamus, Conrad A; Pfaff, Holger

2005-04-15

Shared decision-making (SDM) as a model in physician-patient interaction is gaining relevance in the German health system. By applying this model, mid- and long-term improvements are expected especially in the outcomes of chronic diseases. Up to now, there has hardly been any empirical data available in German health services research regarding the state and development of SDM. This study establishes a baseline and provides actual data on this subject based on a German-wide survey of end-stage renal disease (ESRD) patients. Standardized German-wide survey of 6,614 patients with ESRD. The questionnaire included an instrument to measure the patients' perceived involvement in care (PICS) which had been translated and validated before. 82% of the questioned patients feel their physicians facilitated involvement in decision making. 81% of the patients actively inform themselves concerning their disease and treatment options. 69% state that SDM has taken place. Age, years on dialysis and gender correlate with perceived involvement. This paper provides a valid baseline for the prospective research of SDM in ESRD. The results indicate that dialysis patients are willing to participate in the process of medical decision-making. Characteristics and preferences of the patients should be taken into account not only in everyday clinical interactions. They could be monitored systematically within the framework of quality management and used as potential for quality improvement.

Feasibility and acceptability of shared decision-making to promote alcohol behavior change among women Veterans: Results from focus groups.

PubMed

Abraham, Traci H; Wright, Patricia; White, Penny; Booth, Brenda M; Cucciare, Michael A

2017-01-01

Although rates of unhealthy drinking are high among women Veterans with mental health comorbidities, most women Veterans with mental comorbidities who present to primary care with unhealthy drinking do not receive alcohol-related care. Barriers to alcohol-related treatment could be reduced through patient-centered approaches to care, such as shared decision-making. We assessed the feasibility and acceptability of a telephone-delivered shared decision-making intervention for promoting alcohol behavior change in women Veterans with unhealthy drinking and co-morbid depression and/or probable post-traumatic stress disorder. We used 3, 2-hour focus group discussions with 19 women Veterans to identify barriers and solicit recommendations for using the intervention with women Veterans who present to primary care with unhealthy drinking and mental health comorbidities. Transcripts from the focus groups were qualitatively analyzed using template analysis. Although participants perceived that the intervention was feasible and acceptable for the targeted patient population, they identified the treatment delivery modality, length of telephone sessions, and some of the option grid content as potential barriers. Facilitators included strategies for enhancing the telephone-delivered shared decision-making sessions and diversifying the treatment options contained in the option grids. Focus group feedback resulted in preliminary adaptations to the intervention that are mindful of women Veterans' individual preferences for care and realistic in the everyday context of their busy lives.

Executive function and decision-making in women with fibromyalgia.

PubMed

Verdejo-García, Antonio; López-Torrecillas, Francisca; Calandre, Elena Pita; Delgado-Rodríguez, Antonia; Bechara, Antoine

2009-02-01

Patients with fibromyalgia (FM) typically report cognitive problems, and they state that these deficits are disturbing in everyday life. Despite these substantial subjective complaints by FM patients, very few studies have addressed objectively the effect of such aversive states on neuropsychological performance. In this study we aimed to examine possible impairment of executive function and decision-making in a sample of 36 women diagnosed with FM and 36 healthy women matched in age, education, and socio-economic status. We contrasted performance of both groups on two measures of executive functioning: the Wisconsin Card Sorting Test (WCST), which assesses cognitive flexibility skills, and the Iowa Gambling Tasks (IGT; original and variant versions), which assess emotion-based decision-making. We also examined the relationship between executive function performance and pain experience, and between executive function and personality traits of novelty-seeking, harm avoidance, reward dependence, and persistence (measured by the Temperament and Character Inventory-Revised). Results showed that on the WCST, FM women showed poorer performance than healthy comparison women on the number of categories and non-perseverative errors, but not on perseverative errors. FM patients also showed altered learning curve in the original IGT (where reward is immediate and punishment is delayed), suggesting compromised emotion-based decision-making; but not in the variant IGT (where punishment is immediate but reward is delayed), suggesting hypersensitivity to reward. Personality variables were very mildly associated with cognitive performance in FM women.

Impact of ambiguity and risk on decision making in mild Alzheimer's disease.

PubMed

Sinz, H; Zamarian, L; Benke, T; Wenning, G K; Delazer, M

2008-01-01

Decisions under ambiguity and decisions under risk are crucial types of decision making in daily living at any age. This is the first study assessing these two types of decisions in patients with mild dementia of Alzheimer's type (DAT) by means of the Iowa Gambling Task (IGT) and a newly developed, Probability-Associated Gambling (PAG) task. While rules for gains and losses are implicit in the IGT, in the PAG task rules are explicit and winning probabilities, which change from trial to trial, can be estimated. Results of the IGT indicated that DAT patients made more disadvantageous decisions than healthy controls. Patients also shifted more frequently among decks, i.e. under ambiguity decisions were taken randomly and no advantageous strategy was established over time by DAT patients. Thus, not only actual choices but also development of advantageous strategies may be revealing about decision making in the IGT. Compared to controls, patients demonstrated less advantageous choices in the PAG task as well. They gambled more often in the low winning probabilities and less frequently in the high probabilities than healthy participants. Patients' performance on both tasks correlated with measures of executive functions. Findings of the present investigation are consistent with the early pathological cerebral changes and related (cognitive, emotional) deficits reported for DAT. As suggested by our study, decisions under ambiguity as well as decisions under risk are impaired in mild DAT. It may thus be expected that patients with mild DAT have difficulties in taking decisions in every-day life situations, both in cases of ambiguity (information on probability is missing or conflicting, and the expected utility of the different options is incalculable) and in cases of risk (outcomes can be predicted by well-defined or estimable probabilities).

Exploring morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones.

PubMed

Gammon, D; Christiansen, E K; Wynn, R

2009-07-01

Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.

Reading the medical record. I. Analysis of physicians' ways of reading the medical record.

PubMed

Nygren, E; Henriksson, P

1992-01-01

Physicians were interviewed about their routines in everyday use of the medical record. From the interviews, we conclude that the medical record is a well functioning working instrument for the experienced physician. Using the medical record as a basis for decision making involves interpretation of format, layout and other textural features of the type-written data. Interpretation of these features provides effective guidance in the process of searching, reading and assessing the relevance of different items of information in the record. It seems that this is a skill which is an integrated part of diagnostic expertise. This skill plays an important role in decision making based on the large amount of information about a patient, which is exhibited to the reader in the medical record. This finding has implications for the design of user interfaces for reading computerized medical records.

Advance directives outside the USA: are they the best solution everywhere?

PubMed

Sanchez-Gonzalez, M A

1997-09-01

This article evaluates the potential role of advance directives outside of their original North American context. In order to do this, the article first analyses the historical process which has promoted advance directives in recent years. Next, it brings to light certain presuppositions which have given them force: atomistic individualism, contractualism, consumerism and entrepreneurialism, pluralism, proceduralism, and "American moralism." The article next studies certain European cultural peculiarities which could affect advance directives: the importance of virtue versus rights, stoicism versus consumerist utilitarianism, rationalism verus empiricism, statism versus citizens' initiative, and justice versus autonomy. The article concludes by recognising that autonomy has a transcultural value, although it must be balanced with other principles. Advance Directives can have a function in certain cases. But it does not seem adequate to delegate to advance directives more and more medical decisions, and to make them more binding everyday. It is indispensable to develop other decision-making criteria.

Knowing Loved Ones’ End-of-Life Health Care Wishes: Attachment Security Predicts Caregivers’ Accuracy

PubMed Central

Turan, Bulent; Goldstein, Mary K.; Garber, Alan M.; Carstensen, Laura L.

2011-01-01

Objective At times caregivers make life-and-death decisions for loved ones. Yet very little is known about the factors that make caregivers more or less accurate as surrogate decision makers for their loved ones. Previous research suggests that in low stress situations, individuals with high attachment-related anxiety are attentive to their relationship partners’ wishes and concerns, but get overwhelmed by stressful situations. Individuals with high attachment-related avoidance are likely to avoid intimacy and stressful situations altogether. We hypothesized that both of these insecure attachment patterns limit surrogates’ ability to process distressing information and should therefore be associated with lower accuracy in the stressful task of predicting their loved ones’ end-of-life health care wishes. Methods Older patients visiting a medical clinic stated their preferences toward end-of-life health care in different health contexts and surrogate decision makers independently predicted those preferences. For comparison purposes, surrogates also predicted patients’ perceptions of everyday living conditions so that surrogates’ accuracy of their loved ones’ perceptions in non-stressful situations could be assessed. Results Surrogates high on either type of insecure attachment dimension were less accurate in predicting their loved ones’ end-of-life health care wishes. Interestingly, even though surrogates’ attachment-related anxiety was associated with lower accuracy of end-of-life health care wishes of patients, it was associated with higher accuracy in the non-stressful task of predicting their everyday living conditions. Conclusions Attachment orientation plays an important role in accuracy about loved ones’ end-of-life health care wishes. Interventions may target emotion regulation strategies associated with insecure attachment orientations. PMID:22081941

Spinal fusion surgery: From relief to insecurity.

PubMed

Damsgaard, Janne B; Jørgensen, Lene B; Norlyk, Annelise; Birkelund, Regner

2017-02-01

During their decision-making process patients perceive surgery as a voluntary yet necessary choice. Surgery initiates hope for a life with less pain but also creates a feeling of existential insecurity in terms of fear, isolation and uncertainty. The aim of this study was to explore how patients experience their situation from the point of making the decision to undergo spinal fusion surgery to living their everyday life after surgery. A phenomenological-hermeneutic study design was applied based on the French philosopher Paul Ricoeur's theory of interpretation. Data were collected through observations and semi-structured interviews. The recommendation and decision to undergo spinal fusion surgery felt like a turning point for the patients and brought hope of regaining their normal lives, of being a more resourceful parent, partner, friend and colleague with no or less pain. Thus, deciding to undergo surgery created a brief feeling of relief. However, life with back pain had changed the patients' understanding of themselves. Consequently, some patients postoperatively experienced insecurity and a weakened self-image with difficulties creating meaning in their lives. Being recommended and undergoing spinal fusion surgery initiates hope for a life with less pain and altered life conditions. At the same time, paradoxically, this creates a feeling of existential insecurity in terms of facing the surgery and the future to come. It is, therefore, important to recognise and include the patients' everyday life experiences concerning how they give (or may not give) meaning to their illness, i.e. their understanding of how it is affecting them. These aspects are essential for the patients' definition and re-definition of themselves and thus crucial to draw upon in the relationship and communication between patient and healthcare professional. Copyright © 2016 Elsevier Ltd. All rights reserved.

Everyday ethics in internal medicine resident clinic: an opportunity to teach.

PubMed

Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Catherine Beach, Mary; Hughes, Mark T

2011-07-01

Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor-resident interactions. This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor-Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor-System Interaction (financial issues; doctor-system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. © Blackwell Publishing Ltd 2011.

Everyday ethics in internal medicine resident clinic: an opportunity to teach

PubMed Central

Carrese, Joseph A; McDonald, Erin L; Moon, Margaret; Taylor, Holly A; Khaira, Kiran; Beach, Mary Catherine; Hughes, Mark T

2011-01-01

OBJECTIVES Being a good doctor requires competency in ethics. Accordingly, ethics education during residency training is important. We studied the everyday ethics-related issues (i.e. ordinary ethics issues commonly faced) that internal medical residents encounter in their out-patient clinic and determined whether teaching about these issues occurred during faculty preceptor–resident interactions. METHODS This study involved a multi-method qualitative research design combining observation of preceptor-resident discussions with preceptor interviews. The study was conducted in two different internal medicine training programme clinics over a 2-week period in June 2007. Fifty-three residents and 19 preceptors were observed, and 10 preceptors were interviewed. Transcripts of observer field notes and faculty interviews were carefully analysed. The analysis identified several themes of everyday ethics issues and determined whether preceptors identified and taught about these issues. RESULTS Everyday ethics content was considered present in 109 (81%) of the 135 observed case presentations. Three major thematic domains and associated sub-themes related to everyday ethics issues were identified, concerning: (i) the Doctor–Patient Interaction (relationships; communication; shared decision making); (ii) the Resident as Learner (developmental issues; challenges and conflicts associated with training; relationships with colleagues and mentors; interactions with the preceptor), and; (iii) the Doctor–System Interaction (financial issues; doctor–system issues; external influences; doctor frustration related to system issues). Everyday ethics issues were explicitly identified by preceptors (without teaching) in 18 of 109 cases (17%); explicit identification and teaching occurred in only 13 cases (12%). CONCLUSIONS In this study a variety of everyday ethics issues were frequently encountered as residents cared for patients. Yet, faculty preceptors infrequently explicitly identified or taught these issues during their interactions with residents. Ethics education is important and residents may regard teaching about the ethics-related issues they actually encounter to be highly relevant. A better understanding of the barriers to teaching is needed in order to promote education about everyday ethics in the out-patient setting. PMID:21649704

How should I decide? The neural correlates of everyday moral reasoning.

PubMed

Sommer, Monika; Rothmayr, Christoph; Döhnel, Katrin; Meinhardt, Jörg; Schwerdtner, Johannes; Sodian, Beate; Hajak, Göran

2010-06-01

The present fMRI study is the first that investigates everyday moral conflict situations in which a moral standard clashes with a personal desire. In such situations people have to decide between a morally guided and a hedonistic behaviour. Twelve healthy subjects were presented with verbal stories describing conflicts with either moral or neutral content. The moral stories described conflicts requiring a decision between a personal desire and a conflicting moral standard, whereas the neutral conflicts required a decision between two conflicting personal desires. When compared to neutral conflicts, moral conflicts elicited higher activity in a wide spread neural network including the medial frontal cortex, the temporal cortex and the temporo-parietal junction and the posterior cingulate cortex. Further analyses of the moral conflicts revealed that hedonistic decisions in contrast to morally guided decisions were associated with significantly higher rankings of uncertainty and unpleasant emotions and induced significant more activation in the amygdala/parahippocampal region. The present results generalise findings on the neuroscience of moral understanding by extending it to everyday moral decisions. Furthermore, the results show that the amydala region plays a central role in the processing of negative emotional consequences associated with immoral decisions. Copyright 2010 Elsevier Ltd. All rights reserved.

Activity classification using realistic data from wearable sensors.

PubMed

Pärkkä, Juha; Ermes, Miikka; Korpipää, Panu; Mäntyjärvi, Jani; Peltola, Johannes; Korhonen, Ilkka

2006-01-01

Automatic classification of everyday activities can be used for promotion of health-enhancing physical activities and a healthier lifestyle. In this paper, methods used for classification of everyday activities like walking, running, and cycling are described. The aim of the study was to find out how to recognize activities, which sensors are useful and what kind of signal processing and classification is required. A large and realistic data library of sensor data was collected. Sixteen test persons took part in the data collection, resulting in approximately 31 h of annotated, 35-channel data recorded in an everyday environment. The test persons carried a set of wearable sensors while performing several activities during the 2-h measurement session. Classification results of three classifiers are shown: custom decision tree, automatically generated decision tree, and artificial neural network. The classification accuracies using leave-one-subject-out cross validation range from 58 to 97% for custom decision tree classifier, from 56 to 97% for automatically generated decision tree, and from 22 to 96% for artificial neural network. Total classification accuracy is 82 % for custom decision tree classifier, 86% for automatically generated decision tree, and 82% for artificial neural network.

Challenging Operations: An Ethical Framework to Assist Humanitarian Aid Workers in their Decision-making Processes

PubMed Central

Clarinval, Caroline; Biller-Andorno, Nikola

2014-01-01

Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575

"It can be challenging, it can be scary, it can be gratifying": Obstetricians' narratives of negotiating patient choice, clinical experience, and standards of care in decision-making.

PubMed

Diamond-Brown, Lauren

2018-05-01

This paper examines obstetricians' perceptions of standards of care and patient-centered care in clinical decision-making in childbirth. Patient-centered care and standardization of medicine are two social movements that seek to change how physicians make clinical decisions. Sociologists question if these limit physician discretion and weaken their social power; the degree to which this occurs in everyday practice is up for debate. Of additional concern is how physicians deal with observed tensions between these ideals. These questions are answered through in-depth interviews with 50 self-selected obstetricians from Massachusetts, Louisiana, and Vermont collected between 2013 and 2015. Interview data was analyzed using a grounded theory and template approach. The author problematizes obstetricians' attitudes about standards of care and shared decision-making, mechanisms that encourage or discourage these approaches to decision-making, and how obstetricians negotiate tensions between patient choice, clinical experience, and standards. The key findings are that most obstetricians feel they have the authority to interpret the appropriateness of standards and patient choice on a case-by-case basis. They feel empowered and/or constrained by pressures to practice patient-centered care and standards depending upon their style of practice and the organizational context. Following standards of care is encouraged through organizational mechanisms such as pressure from colleagues, malpractice threat, hospital policy, and payer restrictions. Practicing shared decision-making is challenged when the patient wants something that violates the physician's clinical experience and/or standards of care. When obstetricians prioritize patient choice over experience and/or standards this is done for moral reasons, less so because of organizational pressures. These findings have implications for theorizing the social status of medical professionals, understanding how physicians deal with tensions between standardized and individualized ideals in medicine, and illuminating the way obstetricians interpret power in the physician-patient relationship. Copyright © 2018 Elsevier Ltd. All rights reserved.

Learning Science through the PDEODE Teaching Strategy: Helping Students Make Sense of Everyday Situations

ERIC Educational Resources Information Center

Costu, Bayram

2008-01-01

The aim of this study was to investigate effectiveness of PDEODE (Predict-Discuss-Explain-Observe-Discuss-Explain) teaching strategy in helping students make sense of everyday situations. For this, condensation concept was chosen among many science concepts since it is related to many everyday-life events. Forty-eight eleventh graders students…

Exercise prescription for patients with non-specific chronic low back pain: a qualitative exploration of decision making in physiotherapy practice.

PubMed

Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

2016-12-01

Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. A qualitative study using a philosophical hermeneutic approach. Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists' assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) which exercise? - the tension between evidence and everyday practice and (3) compliance-orientated more than concordance based. This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Flexing dual-systems models: How variable cognitive control in children informs our understanding of risk-taking across development.

PubMed

Li, Rosa

2017-10-01

Prevailing models of the development of decision-making propose that peak risk-taking occurs in adolescence due to a neural imbalance between two processes: gradual, linearly developing cognitive control and rapid, non-linearly developing reward-processing. Though many studies have found neural evidence supporting this dual-systems imbalance model, its behavioral predictions have been surprisingly difficult to document. Most laboratory studies have not found adolescents to exhibit greater risk-taking than children, and public health data show everyday risk-taking to peak in late adolescence/early adulthood. Moreover, when adolescents are provided detailed information about decision options and consequences, they evince similar behavior to adults. Such findings point to a critical feature of the development of decision-making that is missed by imbalance models. Specifically, the engagement of cognitive control is context dependent, such that cognitive control and therefore advantageous decision-making increases when available information is high and decreases when available information is low. Furthermore, the context dependence of cognitive control varies across development, such that increased information availability benefits children more than adolescents, who benefit more than adults. This review advances a flexible dual-systems model that is only imbalanced under certain conditions; explains disparities between neural, behavioral, and public health findings; and provides testable hypotheses for future research. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

[Cognitive traps and clinical decisions].

PubMed

Motterlini, Matteo

2017-12-01

We are fallible, we have limited computational capabilities, limited access to information, little memory. Moreover, in everyday life, we feel joy, fear, anger, and other emotions that influence our decisions in a little, "calculated" way. Not everyone, however, is also aware that the mistakes we make are often systematic and therefore, in particular circumstances, are foreseeable. Doctors and patients are constantly called upon to make decisions. They need to identify relevant information (for example, the symptoms or outcome of an examination), formulate a judgment (for example a diagnosis), choose an action course among the various possible ones based on one's own preferences (e.g. medication or surgery), so act. The exact size of the medical error is unknown, but probably huge. In fact, the more we investigate and the more we find. Often these mistakes depend on the cognitive process. Any (rational) decision requires, in particular, an assessment of the possible effects of the action it implements; for example how much pleasure or pain it will cause us. In the medical field, too, the principle of informed consent provides that the patient's preferences and values are to guide clinical choices. Yet, not always the preferences that people express before making an experience match with their preferences after living that experience. Some ingenious experiments suggest (in a seemingly paradoxical way) that before a direct experience, people prefer less pain; after that experience they prefer more, but with a better memory.

Organizational Culture and Safety

NASA Technical Reports Server (NTRS)

Adams, Catherine A.

2003-01-01

'..only a fool perseveres in error.' Cicero. Humans will break the most advanced technological devices and override safety and security systems if they are given the latitude. Within the workplace, the operator may be just one of several factors in causing accidents or making risky decisions. Other variables considered for their involvement in the negative and often catastrophic outcomes include the organizational context and culture. Many organizations have constructed and implemented safety programs to be assimilated into their culture to assure employee commitment and understanding of the importance of everyday safety. The purpose of this paper is to examine literature on organizational safety cultures and programs that attempt to combat vulnerability, risk taking behavior and decisions and identify the role of training in attempting to mitigate unsafe acts.

The neural bases of acquisitiveness: decisions to acquire and discard everyday goods differ across frames, items, and individuals.

PubMed

Wang, John M; Seidler, Rachael D; Hall, Julie L; Preston, Stephanie D

2012-04-01

The human tendency to acquire and keep large quantities of goods has become a serious concern, but has yet to be examined from a neuroscientific perspective. The mesolimbocortical system, particularly the orbitofrontal cortex (OFC) and nucleus accumbens (NAcc), is implicated when humans and animals acquire rewards. However, this may not extend to acquisitiveness per se, which involves fairly mundane items and is interconnected with a failure to discard. Moreover, the NAcc has not been implicated in neuroimaging studies of the extreme acquisitiveness of compulsive hoarders. In a study of the neural bases of normal acquisitiveness, subjects made decisions during functional neuroimaging to acquire or remove everyday items from a hypothetical collection, while maximizing personal preference or monetary profit. All decisions engaged the OFC, but the OFC and all regions of interest shifted in their relative involvement across the four decision contexts. The NAcc was only engaged during personal acquisition to the extent of problematic hoarding, suggesting that even common items can acquire an incentive salience that makes them hard to resist for acquisitive individuals. The types of items preferred also shifted with condition, with subjects only being biased toward expensive items when instructed to maximize profit. Item preferences even differed depending on whether participants were acquiring versus removing items, even though the task only differed superficially in the two conditions. Acquisitiveness reflects a complex mix of affective, cognitive, and personality factors that extend well beyond the drive to acquire valuable resources, with important implications for basic decision science, sustainability, and pathologies associated with compulsive acquisition. Copyright © 2012 Elsevier Ltd. All rights reserved.

Natural capital and ecosystem services informing decisions: From promise to practice

PubMed Central

Guerry, Anne D.; Polasky, Stephen; Lubchenco, Jane; Chaplin-Kramer, Rebecca; Daily, Gretchen C.; Griffin, Robert; Ruckelshaus, Mary; Bateman, Ian J.; Duraiappah, Anantha; Elmqvist, Thomas; Feldman, Marcus W.; Folke, Carl; Hoekstra, Jon; Kareiva, Peter M.; Keeler, Bonnie L.; Li, Shuzhuo; McKenzie, Emily; Ouyang, Zhiyun; Reyers, Belinda; Ricketts, Taylor H.; Rockström, Johan; Tallis, Heather; Vira, Bhaskar

2015-01-01

The central challenge of the 21st century is to develop economic, social, and governance systems capable of ending poverty and achieving sustainable levels of population and consumption while securing the life-support systems underpinning current and future human well-being. Essential to meeting this challenge is the incorporation of natural capital and the ecosystem services it provides into decision-making. We explore progress and crucial gaps at this frontier, reflecting upon the 10 y since the Millennium Ecosystem Assessment. We focus on three key dimensions of progress and ongoing challenges: raising awareness of the interdependence of ecosystems and human well-being, advancing the fundamental interdisciplinary science of ecosystem services, and implementing this science in decisions to restore natural capital and use it sustainably. Awareness of human dependence on nature is at an all-time high, the science of ecosystem services is rapidly advancing, and talk of natural capital is now common from governments to corporate boardrooms. However, successful implementation is still in early stages. We explore why ecosystem service information has yet to fundamentally change decision-making and suggest a path forward that emphasizes: (i) developing solid evidence linking decisions to impacts on natural capital and ecosystem services, and then to human well-being; (ii) working closely with leaders in government, business, and civil society to develop the knowledge, tools, and practices necessary to integrate natural capital and ecosystem services into everyday decision-making; and (iii) reforming institutions to change policy and practices to better align private short-term goals with societal long-term goals. PMID:26082539

Natural capital and ecosystem services informing decisions: From promise to practice.

PubMed

Guerry, Anne D; Polasky, Stephen; Lubchenco, Jane; Chaplin-Kramer, Rebecca; Daily, Gretchen C; Griffin, Robert; Ruckelshaus, Mary; Bateman, Ian J; Duraiappah, Anantha; Elmqvist, Thomas; Feldman, Marcus W; Folke, Carl; Hoekstra, Jon; Kareiva, Peter M; Keeler, Bonnie L; Li, Shuzhuo; McKenzie, Emily; Ouyang, Zhiyun; Reyers, Belinda; Ricketts, Taylor H; Rockström, Johan; Tallis, Heather; Vira, Bhaskar

2015-06-16

The central challenge of the 21st century is to develop economic, social, and governance systems capable of ending poverty and achieving sustainable levels of population and consumption while securing the life-support systems underpinning current and future human well-being. Essential to meeting this challenge is the incorporation of natural capital and the ecosystem services it provides into decision-making. We explore progress and crucial gaps at this frontier, reflecting upon the 10 y since the Millennium Ecosystem Assessment. We focus on three key dimensions of progress and ongoing challenges: raising awareness of the interdependence of ecosystems and human well-being, advancing the fundamental interdisciplinary science of ecosystem services, and implementing this science in decisions to restore natural capital and use it sustainably. Awareness of human dependence on nature is at an all-time high, the science of ecosystem services is rapidly advancing, and talk of natural capital is now common from governments to corporate boardrooms. However, successful implementation is still in early stages. We explore why ecosystem service information has yet to fundamentally change decision-making and suggest a path forward that emphasizes: (i) developing solid evidence linking decisions to impacts on natural capital and ecosystem services, and then to human well-being; (ii) working closely with leaders in government, business, and civil society to develop the knowledge, tools, and practices necessary to integrate natural capital and ecosystem services into everyday decision-making; and (iii) reforming institutions to change policy and practices to better align private short-term goals with societal long-term goals.

Making sense of effective partnerships among senior leaders in the National Health Service.

PubMed

Mitra, Mahima; Hoff, Timothy; Brankin, Paul; Dopson, Sue

2017-05-22

Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions. We conducted 24 in-depth interviews with physician and nonphysician leaders in job titles including Chief Operating Officer, Managing Director, Medical Director, and Clinical Director. Ideas from the social psychological perspectives of sensemaking, organizational role theory, and organizational citizenship behavior helped frame the study. We identified four areas of ongoing tension between senior leaders. Each of these was linked to a set of underlying drivers, with the strongest support for drivers with interpersonal roots. Effective strategies for resolving tensions involved significant effort by leaders at improving the interpersonal dynamics associated with everyday interaction and forging relational connections through enhanced trust within the leadership team. This study outlines the organizational and individual characteristics that lend to effective collaboration among senior health care leadership and the types of collaborative tensions likely to be experienced by senior health care leaders. Organizations should provide greater role clarity for senior leadership roles, promote "soft" interpersonal competencies within them, and better assess potential leaders for success in senior roles. Organizational support in the form of facilitation, time, and spaces to learn together can provide a better context for collaborative decision-making.

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

PubMed

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients' attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind.

Evaluating automatic attentional capture by self-relevant information.

PubMed

Ocampo, Brenda; Kahan, Todd A

2016-01-01

Our everyday decisions and memories are inadvertently influenced by self-relevant information. For example, we are faster and more accurate at making perceptual judgments about stimuli associated with ourselves, such as our own face or name, as compared with familiar non-self-relevant stimuli. Humphreys and Sui propose a "self-attention network" to account for these effects, wherein self-relevant stimuli automatically capture our attention and subsequently enhance the perceptual processing of self-relevant information. We propose that the masked priming paradigm and continuous flash suppression represent two ways to experimentally examine these controversial claims.

Which medical and social decision topics are important after early diagnosis of Alzheimer's Disease from the perspectives of people with Alzheimer's Disease, spouses and professionals?

PubMed

Bronner, Katharina; Perneczky, Robert; McCabe, Rose; Kurz, Alexander; Hamann, Johannes

2016-03-08

The relevance of early decision making will rise with increasing availability of early detection of Alzheimer's disease (AD) using brain imaging or biomarkers. Five people with mild AD, six relatives and 13 healthcare professionals with experience in the management of AD were interviewed in a qualitative study regarding medical and social decision topics that emerge after early diagnosis of Alzheimer's disease. Medical treatment, assistance in everyday life and legal issues emerged as the main decision topics after an early diagnosis of AD. People with AD mostly got in contact with the health and social care system through the initiative of their spouses. They were usually aware of their illness and most received antidementia drugs and/or behavioural interventions. Following diagnosis people with AD received support by their spouses. Healthcare professionals were aware of the risk of excessive demand on relatives due to supporting their family member with AD. In the opinion of healthcare professionals legal issues should be arranged in time before patients lose their decisional capacity. In addition, people with AD and spouses reported various coping strategies, in particular "carry on as normal" after diagnosis but mostly are reluctant to actively plan for future stages of the disease. Due to the common desire to "carry on as usual" after a diagnosis of AD, many people with AD and spouses may miss the opportunity to discuss and decide on important medical and social topics. A structured approach e.g. a decision aid might support people with AD and spouses in their decision making process and thereby preserve persons' with AD autonomy before they lose the capacity in decision-making.

Stimulus-reinforcement Based Decision-making and Anxiety: Impairment in Generalized Anxiety Disorder (GAD), but not in Generalized Social Phobia (GSP)

PubMed Central

DeVido, Jeffrey; Jones, Matthew; Geraci, Marilla; Hollon, Nick; Blair, R. J. R.; Pine, Daniel S.; Blair, Karina

2010-01-01

Background Generalized Social Phobia (GSP) involves the fear/avoidance of social situations while Generalized Anxiety Disorder (GAD) involves an intrusive worry about everyday life circumstances. It remains unclear whether these, highly comorbid, conditions represent distinct disorders or alternative presentations of a single underlying pathology. In this study, we examined stimulus-reinforcement based decision-making in GSP and GAD. Methods Twenty unmedicated patients with GSP, sixteen unmedicated patients with GAD and nineteen age, IQ, and gender matched healthy comparison individuals completed the Differential Reward/ Punishment Learning Task (DRPLT). In this task, the subject chooses between two objects associated with different levels of reward or punishment. Thus, response choice indexes not only reward/ punishment sensitivity but also sensitivity to reward/ punishment level according to between-object reinforcement distance. Results We found that patients with GAD committed a significantly greater number of errors compared to both the patients with GSP and the healthy comparison individuals. In contrast, the patients with GSP and the healthy comparison individuals did not differ in performance on this task. Conclusions These results link GAD with an anomalous non-affective based decision-making. Further, they are indicative that GSP and GAD are associated with distinct pathophysiologies. PMID:19102795

Predicting functional ability in mild cognitive impairment with the Dementia Rating Scale-2.

PubMed

Greenaway, Melanie C; Duncan, Noah L; Hanna, Sherrie; Smith, Glenn E

2012-06-01

We examined the utility of cognitive evaluation to predict instrumental activities of daily living (IADLs) and decisional ability in Mild Cognitive Impairment (MCI). Sixty-seven individuals with single-domain amnestic MCI were administered the Dementia Rating Scale-2 (DRS-2) as well as the Everyday Cognition assessment form to assess functional ability. The DRS-2 Total Scores and Initiation/Perseveration and Memory subscales were found to be predictive of IADLs, with Total Scores accounting for 19% of the variance in IADL performance on average. In addition, the DRS-2 Initiation/Perseveration and Total Scores were predictive of ability to understand information, and the DRS-2 Conceptualization helped predict ability to communicate with others, both key variables in decision-making ability. These findings suggest that performance on the DRS-2, and specific subscales related to executive function and memory, is significantly related to IADLs in individuals with MCI. These cognitive measures are also associated with decision-making-related abilities in MCI.

Disentangling the effects of serotonin on risk perception: S-carriers of 5-HTTLPR are primarily concerned with the magnitude of the outcomes, not the uncertainty.

PubMed

Millroth, Philip; Juslin, Peter; Eriksson, Elias; Agren, Thomas

2017-10-01

Serotonin signaling is vital for reward processing, and hence, also for decision-making. The serotonin transporter gene linked polymorphic region (5-HTTLPR) has been connected to decision making, suggesting that short-allele carriers (s) are more risk averse than long-allele homozygotes (ll). However, previous research has not identified if this occurs because s-carriers (i) are more sensitive to the uncertainty of the outcomes or (ii) are more sensitive to the magnitude of the outcomes. This issue was disentangled using a willingness-to-pay task, where the participants evaluated prospects involving certain gains, uncertain gains, and ambiguous gains. The results clearly favored the hypothesis that s-carriers react more to the magnitude of the outcomes. Self-reported measures of everyday risk-taking behavior also favored this hypothesis. We discuss how these results are in line with recent research on the serotonergic impact on reward processing. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Experience as knowledge: Disability, distillation and (reprogenetic) decision-making.

PubMed

Boardman, Felicity K

2017-10-01

'Experiential knowledge' is increasingly recognised as an important influence on reproductive decision-making. 'Experiential knowledge of disability' in particular is a significant resource within prenatal testing/screening contexts, enabling prospective parents to imagine and appraise future lives affected by disability. However, the concept of 'experiential knowledge' has been widely critiqued for its idiosyncrasy, its impermanence and consequently its perceived inferiority to (medical) knowledge. This paper explores some of these key critiques of experiential knowledge through an analysis of its constitution and uses in the context of reproductive decision-making. Seventeen UK-resident women with Spinal Muscular Atrophy (SMA), or with SMA in their family, took part in two in-depth interviews: one in 2007-9 and the other in 2013-4. By comparing and contrasting these women's accounts at two time points, this paper demonstrates the stark contrast between 'lived experience' of SMA (the visceral everyday realities of life with the condition) and the various way(s) this experience was transformed into, and presented as, 'knowledge' through the processes of making, and accounting, for reproductive decisions. The analysis highlights that multiple, distinct and sometimes competing experiential frameworks are used to conceptualise SMA across time and context. However, rather than evidence of its fallibility, this finding highlights that 'knowledge' is an inappropriate vessel with which to capture and transfer 'experiential knowledge'. Rather, we need to consider how to value such insight in ways that harnesses its inherent strength without leaving it vulnerable to the epistemological critiques attracted by labelling it 'knowledge'. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

[Rationing, prioritisation, rationalizing: Significance in everyday intensive care].

PubMed

Gretenkort, P

2015-11-01

Rationing, even in the treatment of critically ill patients, is the reality on intensive care units. Severity of illnesses and urgency of care are posing high ethical barriers for explicit cost-saving orders. Nevertheless, implicit rationing decisions are a daily ethical minefield, which is not always appreciated by healthcare providers. In this article, typical decision-making situations are described, where limitation of resources plays a role. The idea of saving resources by rationalising rather than rationing results from the fact that not every patient benefits from the full scope of services available in the intensive care unit, and not every patient desires the full scope of care to be supplied to them. Thus, the irrational use of resources can sometimes be avoided to save them for cases where they are necessary.

A qualitative study on the ethics of transforming care: examining the development and implementation of Canada's first mental health strategy.

PubMed

Park, Melissa M; Lencucha, Raphael; Mattingly, Cheryl; Zafran, Hiba; Kirmayer, Laurence J

2015-08-19

The Mental Health Commission of Canada worked collaboratively with stakeholders to create a new framework for a federal mental health strategy, which is now mandated for implementation by 2017. The proposed strategies have been written into provincial health plans, hospital accreditation standards, and the annual objectives of psychiatric departments and community organizations. This project will explore the decision-making process among those who contributed to Canada's first federal mental health policy and those implementing this policy in the clinical setting. Despite the centrality of ethical reasoning to the successful uptake of the recent national guidelines for recovery-oriented care, to date, there are no studies focused exclusively on the ethical tensions that emerged and continue to emerge during the creation and implementation of the new standards for recovery-oriented practice. This two-year Canadian Institute of Health Research Catalyst Grant in Ethics (2015-2017) consists of three components. C-I, a retrospective, qualitative study consisting of document analysis and interviews with key policy-makers of the ethical tensions that arose during the development of Canada's Mental Health Strategy will be conducted in parallel to C-II, a theory-based, focused ethnography of how mental health practitioners in a psychiatric setting reason about and act upon new standards in everyday practice. Case-based scenarios of ethical tensions will be developed from C-I/II and fed-forward to C-III: participatory forums with policy-makers, mental health practitioners, and other stakeholders in recovery-oriented services to collectively identify and prioritize key ethical concerns and generate action steps to close the gap between the policy-making process and its implementation at the local level. Policy-makers and clinicians make important everyday decisions that effect the creation and implementation of new practice standards. Particularly, there is a need to understand how ethical dilemmas that arise during this decision-making process and the reasoning and resources they use to resolve these tensions impact on the implementation process. This catalyst grant in ethics will (1) introduce a novel line of inquiry focusing on the ethical tensions that arose in the development of Canada's first mental health strategy, while (2) intensifying our focus on the ethical aspects of moving policy into action.

Nurse ethical awareness: Understanding the nature of everyday practice.

PubMed

Milliken, Aimee; Grace, Pamela

2017-08-01

Much attention has been paid to the role of the nurse in recognizing and addressing ethical dilemmas. There has been less emphasis, however, on the issue of whether or not nurses understand the ethical nature of everyday practice. Awareness of the inherently ethical nature of practice is a component of nurse ethical sensitivity, which has been identified as a component of ethical decision-making. Ethical sensitivity is generally accepted as a necessary precursor to moral agency, in that recognition of the ethical content of practice is necessary before consistent action on behalf of patient interests can take place. This awareness is also compulsory in ensuring patient good by recognizing the unique interests and wishes of individuals, in line with an ethic of care. Scholarly and research literature are used to argue that bolstering ethical awareness and ensuring that nurses understand the ethical nature of the role are an obligation of the profession. Based on this line of reasoning, recommendations for education and practice, along with directions for future research, are suggested.

Biographical Narratives of Encounter: The Significance of Mobility and Emplacement in Shaping Attitudes towards Difference

PubMed Central

Sadgrove, Joanna

2014-01-01

This paper is located within work in urban studies about the significance of contact with difference as a means for reducing prejudice and achieving social change. Recent approaches, influenced by theories of affect, have emphasised non-conscious everyday negotiations of difference in the city. In this paper it is argued that such approaches lose sight of the significance of the subject: of the reflective judgements of ‘others’ made by individuals; of our ability to make decisions around the control of our feelings and identifications; and of the significance of personal pasts and collective histories in shaping the ways we perceive and react to encounters. Rather, this paper uses a biographical approach focusing on interviewees’ narratives of encounter. Through its attention to processes of mobility and emplacement, it contributes to debates about when contact with difference matters by highlighting the importance of everyday social normativities in the production of moral dispositions. PMID:26300566

[Error prevention through management of complications in urology: standard operating procedures from commercial aviation as a model].

PubMed

Kranz, J; Sommer, K-J; Steffens, J

2014-05-01

Patient safety and risk/complication management rank among the current megatrends in modern medicine, which has undoubtedly become more complex. In time-critical, error-prone and difficult situations, which often occur repeatedly in everyday clinical practice, guidelines are inappropriate for acting rapidly and intelligently. With the establishment and consistent use of standard operating procedures like in commercial aviation, a possible strategic approach is available. These medical aids to decision-making - quick reference cards - are short, optimized instructions that enable a standardized procedure in case of medical claims.

Simple heuristics in over-the-counter drug choices: a new hint for medical education and practice.

PubMed

Riva, Silvia; Monti, Marco; Antonietti, Alessandro

2011-01-01

Over-the-counter (OTC) drugs are widely available and often purchased by consumers without advice from a health care provider. Many people rely on self-management of medications to treat common medical conditions. Although OTC medications are regulated by the National and the International Health and Drug Administration, many people are unaware of proper dosing, side effects, adverse drug reactions, and possible medication interactions. This study examined how subjects make their decisions to select an OTC drug, evaluating the role of cognitive heuristics which are simple and adaptive rules that help the decision-making process of people in everyday contexts. By analyzing 70 subjects' information-search and decision-making behavior when selecting OTC drugs, we examined the heuristics they applied in order to assess whether simple decision-making processes were also accurate and relevant. Subjects were tested with a sequence of two experimental tests based on a computerized Java system devised to analyze participants' choices in a virtual environment. We found that subjects' information-search behavior reflected the use of fast and frugal heuristics. In addition, although the heuristics which correctly predicted subjects' decisions implied significantly fewer cues on average than the subjects did in the information-search task, they were accurate in describing order of information search. A simple combination of a fast and frugal tree and a tallying rule predicted more than 78% of subjects' decisions. The current emphasis in health care is to shift some responsibility onto the consumer through expansion of self medication. To know which cognitive mechanisms are behind the choice of OTC drugs is becoming a relevant purpose of current medical education. These findings have implications both for the validity of simple heuristics describing information searches in the field of OTC drug choices and for current medical education, which has to prepare competent health specialists to orientate and support the choices of their patients.

Simple heuristics in over-the-counter drug choices: a new hint for medical education and practice

PubMed Central

Riva, Silvia; Monti, Marco; Antonietti, Alessandro

2011-01-01

Introduction Over-the-counter (OTC) drugs are widely available and often purchased by consumers without advice from a health care provider. Many people rely on self-management of medications to treat common medical conditions. Although OTC medications are regulated by the National and the International Health and Drug Administration, many people are unaware of proper dosing, side effects, adverse drug reactions, and possible medication interactions. Purpose This study examined how subjects make their decisions to select an OTC drug, evaluating the role of cognitive heuristics which are simple and adaptive rules that help the decision-making process of people in everyday contexts. Subjects and methods By analyzing 70 subjects’ information-search and decision-making behavior when selecting OTC drugs, we examined the heuristics they applied in order to assess whether simple decision-making processes were also accurate and relevant. Subjects were tested with a sequence of two experimental tests based on a computerized Java system devised to analyze participants’ choices in a virtual environment. Results We found that subjects’ information-search behavior reflected the use of fast and frugal heuristics. In addition, although the heuristics which correctly predicted subjects’ decisions implied significantly fewer cues on average than the subjects did in the information-search task, they were accurate in describing order of information search. A simple combination of a fast and frugal tree and a tallying rule predicted more than 78% of subjects’ decisions. Conclusion The current emphasis in health care is to shift some responsibility onto the consumer through expansion of self medication. To know which cognitive mechanisms are behind the choice of OTC drugs is becoming a relevant purpose of current medical education. These findings have implications both for the validity of simple heuristics describing information searches in the field of OTC drug choices and for current medical education, which has to prepare competent health specialists to orientate and support the choices of their patients. PMID:23745077

Six Challenges for Ethical Conduct in Science.

PubMed

Niemi, Petteri

2016-08-01

The realities of human agency and decision making pose serious challenges for research ethics. This article explores six major challenges that require more attention in the ethics education of students and scientists and in the research on ethical conduct in science. The first of them is the routinization of action, which makes the detection of ethical issues difficult. The social governance of action creates ethical problems related to power. The heuristic nature of human decision making implies the risk of ethical bias. The moral disengagement mechanisms represent a human tendency to evade personal responsibility. The greatest challenge of all might be the situational variation in people's ethical behaviour. Even minor situational factors have a surprisingly strong influence on our actions. Furthermore, finally, the nature of ethics itself also causes problems: instead of clear answers, we receive a multitude of theories and intuitions that may sometimes be contradictory. All these features of action and ethics represent significant risks for ethical conduct in science. I claim that they have to be managed within the everyday practices of science and addressed explicitly in research ethics education. I analyse them and suggest some ways in which their risks can be alleviated.

Patients’ Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings

PubMed Central

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

Background The contribution of patients’ non-medical characteristics to individual physicians’ decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients’ non-medical characteristics are presented at MDT meetings and how this information may affect the team’s final medical decisions. Design Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians’ verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. Results In the final sample of patients’ records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient’s age and his/her “likeability” were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients’ non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. Limitations The design of the study made it difficult to draw definite cause-and-effect conclusions. Conclusion The Social Representations approach suggests that patients’ non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians’ everyday professional practice. The links observed between patients’ attributes and the medical decisions made at these meetings show that these attributes should be taken into account in order to understand how medical decisions are reached in difficult situations of this kind. PMID:27167521

Dual-stream modulation failure: a novel hypothesis for the formation and maintenance of delusions in schizophrenia.

PubMed

Speechley, William J; Ngan, Elton T C

2008-01-01

Delusions, a cardinal feature of schizophrenia, are characterized by the development and preservation of false beliefs despite reason and evidence to the contrary. A number of cognitive models have made important contributions to our understanding of delusions, though it remains unclear which core cognitive processes are malfunctioning to enable individuals with delusions to form and maintain erroneous beliefs. We propose a modified dual-stream processing model that provides a viable and testable mechanism that can account for this debilitating symptom. Dual-stream models divide decision-making into two streams: a fast, intuitive and automatic form of processing (Stream 1); and a slower, conscious and deliberative process (Stream 2). Our novel model proposes two key influences on the way these streams interact in everyday decision-making: conflict and emotion. Conflict: in most decision-making scenarios one obvious answer presents itself and the two streams converge onto the same conclusion. However, in instances where there are competing alternative possibilities, an individual often experiences dissonance, or a sense of conflict. The detection of this conflict biases processing towards the more deliberative Stream 2. Emotion: highly emotional states can result in behavior that is reflexive and action-oriented. This may be due to the power of emotionally valenced stimuli to bias reasoning towards Stream 1. We propose that in schizophrenia, an abnormal response to these two influences results in a pathological schism between Stream 1 and Stream 2, enabling erroneous intuitive explanations to coexist with contrary logical explanations of the same event. Specifically, we suggest that delusions are the result of a failure to reconcile the two streams due to both a failure of conflict to bias decision-making towards Stream 2 and an accentuated emotional bias towards Stream 1.

Carbon innumeracy.

PubMed

Grinstein, Amir; Kodra, Evan; Chen, Stone; Sheldon, Seth; Zik, Ory

2018-01-01

Individuals must have a quantitative understanding of the carbon footprint tied to their everyday decisions to make efficient sustainable decisions. We report research of the innumeracy of individuals as it relates to their carbon footprint. In three studies that varied in terms of scale and sample, respondents estimate the quantity of CO2 released when combusting a gallon of gasoline in comparison to several well-known metrics including food calories and travel distance. Consistently, respondents estimated the quantity of CO2 from gasoline compared to other metrics with significantly less accuracy while exhibiting a tendency to underestimate CO2. Such relative absence of carbon numeracy of even a basic consumption habit may limit the effectiveness of environmental policies and campaigns aimed at changing individual behavior. We discuss several caveats as well as opportunities for policy design that could aid the improvement of people's quantitative understanding of their carbon footprint.

California Earthquake Clearinghouse Crisis Information-Sharing Strategy in Support of Situational Awareness, Understanding Interdependencies of Critical Infrastructure, Regional Resilience, Preparedness, Risk Assessment/mitigation, Decision-Making and Everyday Operational Needs

NASA Astrophysics Data System (ADS)

Rosinski, A.; Morentz, J.; Beilin, P.

2017-12-01

The principal function of the California Earthquake Clearinghouse is to provide State and Federal disaster response managers, and the scientific and engineering communities, with prompt information on ground failure, structural damage, and other consequences from significant seismic events such as earthquakes and tsunamis. The overarching problem highlighted in discussions with Clearinghouse partners is the confusion and frustration of many of the Operational Area representatives, and some regional utilities throughout the state on what software applications they should be using and maintaining to meet State, Federal, and Local, requirements, and for what purposes, and how to deal with the limitations of these applications. This problem is getting in the way of making meaningful progress on developing multi-application interoperability and the necessary supporting cross-sector information-sharing procedures and dialogue on essential common operational information that entities need to share for different all hazards missions and related operational activities associated with continuity, security, and resilience. The XchangeCore based system the Clearinghouse is evolving helps deal with this problem, and does not compound it by introducing yet another end-user application; there is no end-user interface with which one views XchangeCore, all viewing of data provided through XchangeCore occurs in and on existing, third-party operational applications. The Clearinghouse efforts with XchangeCore are compatible with FEMA, which is currently using XchangeCore-provided data for regional and National Business Emergency Operations Center (source of business information sharing during emergencies) response. Also important, and should be emphasized, is that information-sharing is not just for response, but for preparedness, risk assessment/mitigation decision-making, and everyday operational needs for situational awareness. In other words, the benefits of the Clearinghouse information sharing efforts transcend emergency response. The Clearinghouse is in the process of developing an Information-Sharing System Guide and CONOPS/ templates, that should be aimed a multi-stakeholder, non-technical audience.

Collective enumeration.

PubMed

Bahrami, Bahador; Didino, Daniele; Frith, Chris; Butterworth, Brian; Rees, Geraint

2013-04-01

Many joint decisions in everyday life (e.g., Which bar is less crowded?) depend on approximate enumeration, but very little is known about the psychological characteristics of counting together. Here we systematically investigated collective approximate enumeration. Pairs of participants made individual and collective enumeration judgments in a 2-alternative forced-choice task and when in disagreement, they negotiated joint decisions via verbal communication and received feedback about accuracy at the end of each trial. The results showed that two people could collectively count better than either one alone, but not as well as expected by previous models of collective sensory decision making in more basic perceptual domains (e.g., luminance contrast). Moreover, such collective enumeration benefited from prior, noninteractive practice showing that social learning of how to combine shared information about enumeration required substantial individual experience. Finally, the collective context had a positive but transient impact on an individual's enumeration sensitivity. This transient social influence may be explained as a motivational factor arising from the fact that members of a collective must take responsibility for their individual decisions and face the consequences of their judgments.

Incidental fear cues increase monetary loss aversion.

PubMed

Schulreich, Stefan; Gerhardt, Holger; Heekeren, Hauke R

2016-04-01

In many everyday decisions, people exhibit loss aversion-a greater sensitivity to losses relative to gains of equal size. Loss aversion is thought to be (at least partly) mediated by emotional--in particular, fear-related--processes. Decision research has shown that even incidental emotions, which are unrelated to the decision at hand, can influence decision making. The effect of incidental fear on loss aversion, however, is thus far unclear. In two studies, we experimentally investigated how incidental fear cues, presented during (Study 1) or before (Study 2) choices to accept or reject mixed gambles over real monetary stakes, influence monetary loss aversion. We find that the presentation of fearful faces, relative to the presentation of neutral faces, increased risk aversion-an effect that could be attributed to increased loss aversion. The size of this effect was moderated by psychopathic personality: Fearless dominance, in particular its interpersonal facet, but not self-centered impulsivity, attenuated the effect of incidental fear cues on loss aversion, consistent with reduced fear reactivity. Together, these results highlight the sensitivity of loss aversion to the affective context. (c) 2016 APA, all rights reserved).

Understanding consumer decisions using behavioral economics.

PubMed

Zandstra, Elizabeth H; Miyapuram, Krishna P; Tobler, Philippe N

2013-01-01

Consumers make many decisions in everyday life involving finances, food, and health. It is known from behavioral economics research that people are often driven by short-term gratification, that is, people tend to choose the immediate, albeit smaller reward. But choosing the delayed reward, that is, delaying the gratification, can actually be beneficial. How can we motivate consumers to resist the "now" and invest in their future, leading to sustainable or healthy habits? We review recent developments from behavioral and neuroimaging studies that are relevant for understanding consumer decisions. Further, we present results from our field research that examined whether we can increase the perceived value of a (delayed) environmental benefit using tailored communication, that is, change the way it is framed. More specifically, we investigated whether we can boost the value of an abstract, long-term "green" claim of a product by expressing it as a concrete, short-term benefit. This is a new application area for behavioral economics. Copyright © 2013 Elsevier B.V. All rights reserved.

If you want to save, focus on the forest rather than on trees. The effects of shifts in levels of construal on saving decisions.

PubMed

Rudzinska-Wojciechowska, Joanna

2017-01-01

Although financial decisions are expected to be rational, there is a growing body of experimental research indicating that small psychological changes in one's mind-set in the actual decision-making moment might affect saving ratios. In this article, another type of change in one's mind-set, which can influence saving decisions, is explored, namely the level of construal. Construal level is a key descriptor of people's cognitive representations of targets, and is a way of characterising the mental mind-sets people use. Building on recent advances in the link between construal levels and intertemporal choices, the present research evaluates the effect of shifts in levels of construal in the very moment of decision making on people's propensity to save money. It is suggested that triggering a high-level construal mind-set would influence individuals' financial decisions and result in greater willingness to save than triggering a low-level construal mind-set. This assumption is supported by the findings: across three experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The first experiment demonstrated that people in an abstract mind-set are more willing to delay financial gratification than those in a concrete mind-set. In the second and third experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The research provides further evidence that mental states, which can be evoked by previous, unrelated tasks, such as level of cognitive abstraction, can influence everyday financial decisions. It, thus, highlights the role of situational factors that consumers may be not aware of, which still affect their savings decisions.

Using quantitative risk information in decisions about statins: a qualitative study in a community setting.

PubMed

Polak, Louisa; Green, Judith

2015-04-01

A large literature informs guidance for GPs about communicating quantitative risk information so as to facilitate shared decision making. However, relatively little has been written about how patients utilise such information in practice. To understand the role of quantitative risk information in patients' accounts of decisions about taking statins. This was a qualitative study, with participants recruited and interviewed in community settings. Semi-structured interviews were conducted with 34 participants aged >50 years, all of whom had been offered statins. Data were analysed thematically, using elements of the constant comparative method. Interviewees drew frequently on numerical test results to explain their decisions about preventive medication. In contrast, they seldom mentioned quantitative risk information, and never offered it as a rationale for action. Test results were spoken of as objects of concern despite an often-explicit absence of understanding, so lack of understanding seems unlikely to explain the non-use of risk estimates. Preventive medication was seen as 'necessary' either to treat test results, or because of personalised, unequivocal advice from a doctor. This study's findings call into question the assumption that people will heed and use numerical risk information once they understand it; these data highlight the need to consider the ways in which different kinds of knowledge are used in practice in everyday contexts. There was little evidence from this study that understanding probabilistic risk information was a necessary or valued condition for making decisions about statin use. © British Journal of General Practice 2015.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting.

PubMed

Carpenter, Stephanie M; Yates, J Frank; Preston, Stephanie D; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional "coherence shifting," the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed.

Regulating Emotions during Difficult Multiattribute Decision Making: The Role of Pre-Decisional Coherence Shifting

PubMed Central

Carpenter, Stephanie M.; Yates, J. Frank; Preston, Stephanie D.; Chen, Lydia

2016-01-01

Almost all real-life decisions entail attribute conflict; every serious choice alternative is better than its competitors on some attribute dimensions but worse on others. In pre-decisional “coherence shifting,” the decision maker gradually softens that conflict psychologically to the point where one alternative is seen as dominant over its competitors, or nearly so. Specifically, weaknesses of the eventually chosen alternative come to be perceived as less severe and less important while its strengths seem more desirable and significant. The research described here demonstrates that difficult multiattribute decision problems are aversive and that pre-decisional coherence shifting aids individuals in regulating that emotional discomfort. Across three studies, attribute conflict was confirmed to be aversive (Study 1), and skin conductance responses and ratings of decision difficulty both decreased in participants who coherence shifted (Study 2). Coherence shifting was also diminished among decision makers who were depleted of regulatory resources, known to be required for common emotion regulation mechanisms. Further, coherence shifting was shown to be relatively common among people who reported strong suppression tendencies in everyday emotion regulation (Study 3). Overall, the data suggest that, at least in part, coherence shifting serves as a tool that helps decision makers manage the pre-decisional discomfort generated by attribute conflict. Theoretical and practical implications are discussed. PMID:26986752

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

PubMed Central

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z.; Levin, Frances R.

2014-01-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions. PMID:25505817

Exploring laypeople’s epistemic beliefs about medicine – a factor-analytic survey study

PubMed Central

2012-01-01

Background The aim of this study was to develop an instrument to measure laypeople’s beliefs about the nature of medical knowledge and knowing (the EBAM). Such beliefs should be a target of increased research interest because they influence how people handle medical information, for example in shared decision making. Methods An online survey was completed by 284 participants. Items assessed different aspects of laypeople’s epistemic beliefs about medicine and explicitly focused on the appearance of medical knowledge in everyday life and the evaluation of different sources as a way to justify knowledge. Results Factor analysis yielded a five-factor solution for the instrument. Dimensions covered by the instrument are certainty of medical knowledge, credibility of medical textbooks, credibility of medical information on the Internet, justification of medical knowledge, and preliminarity of medical knowledge. Conclusions Results indicate that laypeople have meaningful beliefs about the nature of medical knowledge and the trustworthiness of different sources. The instrument developed seems promising for measuring laypeople’s epistemic beliefs about medicine, which may help to increase patients’ compliance in medical decision making. PMID:22963643

Bridging the Gap between Human Judgment and Automated Reasoning in Predictive Analytics

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

Sanfilippo, Antonio P.; Riensche, Roderick M.; Unwin, Stephen D.

2010-06-07

Events occur daily that impact the health, security and sustainable growth of our society. If we are to address the challenges that emerge from these events, anticipatory reasoning has to become an everyday activity. Strong advances have been made in using integrated modeling for analysis and decision making. However, a wider impact of predictive analytics is currently hindered by the lack of systematic methods for integrating predictive inferences from computer models with human judgment. In this paper, we present a predictive analytics approach that supports anticipatory analysis and decision-making through a concerted reasoning effort that interleaves human judgment and automatedmore » inferences. We describe a systematic methodology for integrating modeling algorithms within a serious gaming environment in which role-playing by human agents provides updates to model nodes and the ensuing model outcomes in turn influence the behavior of the human players. The approach ensures a strong functional partnership between human players and computer models while maintaining a high degree of independence and greatly facilitating the connection between model and game structures.« less

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol.

PubMed

Hogue, Aaron; Bobek, Molly; Tau, Gregory Z; Levin, Frances R

2014-10-01

Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

Reward: commentary. Temporal discounting in conduct disorder: toward an experience-adaptation hypothesis of the role of psychosocial insecurity.

PubMed

Sonuga-Barke, Edmund J S

2014-02-01

Young people with conduct disorder often experience histories of psychosocial adversity and socioeconomic insecurity. For these individuals, real-world future outcomes are not only delayed in their delivery but also highly uncertain. Under such circumstances, accentuated time preference (extreme favoring of the present over the future) is a rational response to the everyday reality of social and economic transactions. Building on this observation, the author sets out the hypothesis that the exaggerated temporal discounting displayed by individuals with conduct disorder reported by White et al. (2014) is an adaptation to chronic exposure to psychosocial insecurity during development. The author postulates that this adaptation leads to (a) a decision-making bias whereby delay and uncertainty are coded as inseparable characteristics of choice outcomes and/or (b) reprogramming of the brain networks regulating intertemporal decision making. Future research could explore the putative role of environmental exposures to adversity in the development of exaggerated temporal discounting in conduct disorder as well as the mediating role of putative cognitive and neurobiological adaptations.

Preserved complex emotion-based learning in amnesia.

PubMed

Turnbull, Oliver H; Evans, Cathryn E Y

2006-01-01

An important role for emotion in decision-making has recently been highlighted by disruptions in problem solving abilities after lesion to the frontal lobes. Such complex decision-making skills appear to be based on a class of memory ability (emotion-based learning) that may be anatomically independent of hippocampally mediated episodic memory systems. There have long been reports of intact emotion-based learning in amnesia, arguably dating back to the classic report of Claparede. However, all such accounts relate to relatively simple patterns of emotional valence learning, rather than the more complex contingency patterns of emotional experience, which characterise everyday life. A patient, SL, who had a profound anterograde amnesia following posterior cerebral artery infarction, performed a measure of complex emotion-based learning (the Iowa Gambling Task) on three separate occasions. Despite his severe episodic memory impairment, he showed normal levels of performance on the Gambling Task, at levels comparable or better than controls-including learning that persisted across substantial periods of time (weeks). Thus, emotion-based learning systems appear able to encode, and sustain, more sophisticated patterns of valence learning than have previously been reported.

Respect for patient autonomy as a medical virtue.

PubMed

Cook, Thomas; Mavroudis, Constantine D; Jacobs, Jeffrey P; Mavroudis, Constantine

2015-12-01

Respect for patient autonomy is an important and indispensable principle in the ethical practice of clinical medicine. Legal tenets recognise the centrality of this principle and the inherent right of patients of sound mind - properly informed - to make their own personal medical decisions. In the course of everyday medical practice, however, challenging cases may result in ethical dilemmas for the patient, the physician, and society. Resolution of these dilemmas requires a thorough understanding of the underlying principles that allow the clinician to make informed decisions and to offer considered therapeutic options to the patient. We argue in this paper that there is also need for a transition of moral competency from understanding principles to attaining virtue in the classic Aristotelian tradition. Achieving moral virtue is based on a lifetime of learning, practising, and watching how others, who have achieved virtue, act and perform their duties. We further claim that learning moral virtue in medical practice is best realised by incorporating the lessons learnt during daily rounds where frank discussions and considered resolutions can occur under the leadership of senior practitioners who have achieved a semblance of moral excellence.

Institutional Violence in the Everyday Practices of School: The Narrative of a Young Lesbian.

ERIC Educational Resources Information Center

Herr, Kathryn

1999-01-01

Explores the role of institutionalized violence in one young lesbian's decision to drop out of high school. Casting this young woman as a school failure masks the school's unwillingness to interrupt everyday practices (errors of alienation, omission, and repression) that diminished her sense of self and learning capacity. (29 references) (MLH)

Teaching about Energy: From Everyday to Scientific Understandings

ERIC Educational Resources Information Center

Millar, Robin

2014-01-01

A key challenge in designing a teaching programme on energy is in deciding how best to deal with the differences in how the word "energy" is used and understood in everyday discourse and in science. Many of the most important decisions and choices about energy matters, both for individuals and society, can be adequately understood from…

Making a difference: ethical consumption and the everyday.

PubMed

Adams, Matthew; Raisborough, Jayne

2010-06-01

Our everyday shopping practices are increasingly marketed as opportunities to 'make a difference' via our ethical consumption choices. In response to a growing body of work detailing the ways in which specific alignments of 'ethics' and 'consumption' are mediated, we explore how 'ethical' opportunities such as the consumption of Fairtrade products are recognized, experienced and taken-up in the everyday. The 'everyday' is approached here via a specially commissioned Mass Observation directive, a volunteer panel of correspondents in the UK. Our on-going thematic analysis of their autobiographical accounts aims to explore a complex unevenness in the ways 'ordinary' people experience and negotiate calls to enact their ethical agency through consumption. Situating ethical consumption, moral obligation and choice in the everyday is, we argue, important if we are to avoid both over-exaggerating the reflexive and self-conscious sensibilities involved in ethical consumption, and, adhering to a reductive understanding of ethical self-expression.

Final Conversations, Phase 2: Children and Everyday Communication

ERIC Educational Resources Information Center

Keeley, Maureen; Baldwin, Paula

2012-01-01

This qualitative study examined messages of everyday communication (small talk and routine interactions). The importance of these messages was highlighted in light of their role in creating structure, safety, and meaning making in the family at the end of life. In addition, family rituals that developed from children's everyday communication were…

An investigation of the role of some person and situation variables in multiple cue probability learning.

PubMed

Bayindir, Mustafa; Bolger, Fergus; Say, Bilge

2016-07-19

Making decisions using judgements of multiple non-deterministic indicators is an important task, both in everyday and professional life. Learning of such decision making has often been studied as the mapping of stimuli (cues) to an environmental variable (criterion); however, little attention has been paid to the effects of situation-by-person interactions on this learning. Accordingly, we manipulated cue and feedback presentation mode (graphic or numeric) and task difficulty, and measured individual differences in working memory capacity (WMC). We predicted that graphic presentation, fewer cues, and elevated WMC would facilitate learning, and that person and task characteristics would interact such that presentation mode compatible with the decision maker's cognitive capability (enhanced visual or verbal WMC) would assist learning, particularly for more difficult tasks. We found our predicted main effects, but no significant interactions, except that those with greater WMC benefited to a larger extent with graphic than with numeric presentation, regardless of which type of working memory was enhanced or number of cues. Our findings suggest that the conclusions of past research based predominantly on tasks using numeric presentation need to be reevaluated and cast light on how working memory helps us learn multiple cue-criterion relationships, with implications for dual-process theories of cognition.

Hypothetical decision making in schizophrenia: The role of expected value computation and “irrational” biases

PubMed Central

Brown, Jaime K.; Waltz, James A.; Strauss, Gregory P.; McMahon, Robert P.; Frank, Michael J.; Gold, James M.

2013-01-01

The aim of the present study was to examine the contributions to decision making (DM) deficits in schizophrenia (SZ) patients, of expected value (EV) estimation and loss aversion. Patients diagnosed with SZ (n=46) and healthy controls (n=34) completed two gambling tasks. In one task, participants chose between two options with the same EV across two conditions: Loss frames and Keep frames. A second task involved accepting or rejecting gambles, in which gain and loss amounts varied, determining the EV of each trial. SZ patients showed a reduced “framing effect” relative to controls, as they did not show an increased tendency to gamble when faced with a certain loss. SZ patients also showed a reduced tendency to modify behavior as a function of EV. The degree to which choices tracked EV correlated significantly with several cognitive measures in both patients and controls. SZ patients show distinct deviations from normal behavior under risk when their decisions are based on prospective outcomes. These deviations are two-fold: cognitive deficits prevent value-based DM in more-impaired patients, and in less-impaired patients there is a lack of influence from well-established subjective biases found in healthy people. These abnormalities likely affect every-day DM strategies in schizophrenia patients. PMID:23664664

Modafinil alters decision making based on feedback history - a randomized placebo-controlled double blind study in humans.

PubMed

Bellebaum, Christian; Kuchinke, Lars; Roser, Patrik

2017-02-01

Modafinil is becoming increasingly popular as a cognitive enhancer. Research on the effects of modafinil on cognitive function have yielded mixed results, with negative findings for simple memory and attention tasks and enhancing effects for more complex tasks. In the present study we examined whether modafinil, due to its known effect on the dopamine level in the striatum, alters feedback-related choice behaviour. We applied a task that separately tests the choice of previously rewarded behaviours (approach) and avoidance of previously punished behaviours. 18 participants received a single dose of 200 mg modafinil. Their performance was compared to a group of 22 participants who received placebo in a double-blind design. Modafinil but not placebo induced a significant bias towards approach behaviour as compared to the frequency of avoidance behaviour. General attention, overall feedback-based acquisition of choice behaviour and reaction times in high vs low conflict choices were not significantly affected by modafinil. This finding suggests that modafinil has a specific effect on dopamine-mediated choice behaviour based on the history of feedback, while a contribution of noradrenaline is also conceivable. The described change in decision making cannot be considered as cognitive enhancement, but might rather have detrimental effects on decisions in everyday life.

Hypothetical decision making in schizophrenia: the role of expected value computation and "irrational" biases.

PubMed

Brown, Jaime K; Waltz, James A; Strauss, Gregory P; McMahon, Robert P; Frank, Michael J; Gold, James M

2013-09-30

The aim of the present study was to examine the contributions to decision making (DM) deficits in schizophrenia (SZ) patients of expected value (EV) estimation and loss aversion. Patients diagnosed with SZ (n=46) and healthy controls (n=34) completed two gambling tasks. In one task, participants chose between two options with the same EV across two conditions: Loss frames and Keep frames. A second task involved accepting or rejecting gambles, in which gain and loss amounts varied, determining the EV of each trial. SZ patients showed a reduced "framing effect" relative to controls, as they did not show an increased tendency to gamble when faced with a certain loss. SZ patients also showed a reduced tendency to modify behavior as a function of EV. The degree to which choices tracked EV correlated significantly with several cognitive measures in both patients and controls. SZ patients show distinct deviations from normal behavior under risk when their decisions are based on prospective outcomes. These deviations are two-fold: cognitive deficits prevent value-based DM in more-impaired patients, and in less-impaired patients there is a lack of influence from well-established subjective biases found in healthy people. These abnormalities likely affect everyday DM strategies in schizophrenia patients. © 2013 Elsevier Ireland Ltd. All rights reserved.

The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making.

PubMed

Laidsaar-Powell, Rebekah; Butow, Phyllis; Charles, Cathy; Gafni, Amiram; Entwistle, Vikki; Epstein, Ronald; Juraskova, Ilona

2017-11-01

Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM. Copyright © 2017 Elsevier B.V. All rights reserved.

Risk attitudes and birth order.

PubMed

Krause, Philipp; Heindl, Johannes; Jung, Andreas; Langguth, Berthold; Hajak, Göran; Sand, Philipp G

2014-07-01

Risk attitudes play important roles in health behavior and everyday decision making. It is unclear, however, whether these attitudes can be predicted from birth order. We investigated 200 mostly male volunteers from two distinct settings. After correcting for multiple comparisons, for the number of siblings and for confounding by gender, ordinal position predicted perception of health-related risks among participants in extreme sports (p < .01). However, the direction of the effect contradicted Adlerian theory. Except for alcohol consumption, these findings extended to self-reported risk behavior. Together, the data call for a cautious stand on the impact of birth order on risk attitudes. © The Author(s) 2013.

Informed consent in posthumous sperm procurement.

PubMed

Hostiuc, Sorin; Curca, Cristian George

2010-10-01

Assisted reproductive technologies are increasingly more present in our everyday life: from classical sperm/egg donation or in vitro fertilization to newer, more controversial methods such as surrogate motherhood, male pregnancies or posthumous sperm procurement. Every year, new concepts are emerging in this field and the medical world is not always prepared to deal with them. The greatest problem of using posthumous sperm procurement as an assisted reproductive method resides in analyzing consent related. An extensive research of the scientific literature revealed eight possible situations which we will present and analyze in this article. By analyzing consent related issues we present a decision making algorithm for posthumous sperm procurement.

Does the PFC model of analogy account for decision making, problem solving, reasoning, flexibility, adaptability, and even creativity?

PubMed

Barutta, Joaquin; Guex, Raphael; Ibáñez, Agustín

2010-06-01

Abstract From everyday cognition to scientific discovery, analogical processes play an important role: bringing connection, integration, and interrelation of information. Recently, a PFC model of analogy has been proposed to explain many cognitive processes and integrate general functional properties of PFC. We argue here that analogical processes do not suffice to explain the cognitive processes and functions of PFC. Moreover the model does not satisfactorily integrate specific explanatory mechanisms required for the different processes involved. Its relevance would be improved if fewer cognitive phenomena were considered and more specific predictions and explanations about those processes were stated.

Genomic data into everyday work of a medical practitioner - digital tools for decision-making.

PubMed

Jokiranta, Sakari; Hotakainen, Kristina; Salonen, Iiris; Pöllänen, Pasi; Hänninen, Kai-Petri; Forsström, Jari; Kunnamo, Ilkka

Recent technological development has enabled fast and cost-effective simultaneous analyses of several gene variants or sequence of even the whole genome. For medical practitioners this has created challenges although genomic information may be clinically useful in new applications such as finding out individual risk for diseases influenced by as many as 50,000 variable DNA regions or in detecting pharmacogenetic risks prior to prescribing a medicine. New digital tools have paved the way for utilization of genomic data via easy access and clear clinical interpretation for both doctor and patient. In this review we describe some of these tools and applications for clinical use.

Everyday Matters in Science and Mathematics: Studies of Complex Classroom Events

ERIC Educational Resources Information Center

Nemirovsky, Ricardo, Ed.; Rosebery, Ann S., Ed.; Solomon, Jesse, Ed.; Warren, Beth, Ed.

2005-01-01

This book re-examines the dichotomy between the everyday and the disciplinary in mathematics and science education, and explores alternatives to this opposition from points of view grounded in the close examination of complex classroom events. It makes the case that students' everyday experience and knowledge in their entire manifold forms matter…

Carbon innumeracy

PubMed Central

Kodra, Evan; Chen, Stone; Sheldon, Seth; Zik, Ory

2018-01-01

Individuals must have a quantitative understanding of the carbon footprint tied to their everyday decisions to make efficient sustainable decisions. We report research of the innumeracy of individuals as it relates to their carbon footprint. In three studies that varied in terms of scale and sample, respondents estimate the quantity of CO2 released when combusting a gallon of gasoline in comparison to several well-known metrics including food calories and travel distance. Consistently, respondents estimated the quantity of CO2 from gasoline compared to other metrics with significantly less accuracy while exhibiting a tendency to underestimate CO2. Such relative absence of carbon numeracy of even a basic consumption habit may limit the effectiveness of environmental policies and campaigns aimed at changing individual behavior. We discuss several caveats as well as opportunities for policy design that could aid the improvement of people’s quantitative understanding of their carbon footprint. PMID:29723206

Wisdom in clinical reasoning and medical practice.

PubMed

Edmondson, Ricca; Pearce, Jane; Woerner, Markus H

2009-01-01

Exploring informal components of clinical reasoning, we argue that they need to be understood via the analysis of professional wisdom. Wise decisions are needed where action or insight is vital, but neither everyday nor expert knowledge provides solutions. Wisdom combines experiential, intellectual, ethical, emotional and practical capacities; we contend that it is also more strongly social than is usually appreciated. But many accounts of reasoning specifically rule out such features as irrational. Seeking to illuminate how wisdom operates, we therefore build on Aristotle's work on informal reasoning. His account of rhetorical communication shows how non-formal components can play active parts in reasoning, retaining, or even enhancing its reasonableness. We extend this account, applying it to forms of healthcare-related reasoning which are characterised by the need for wise decision-making. We then go on to explore some of what clinical wise reasoning may mean, concluding with a case taken from psychotherapeutic practice.

End of life care: The experiences of advance care planning amongst family caregivers of people with advanced dementia - A qualitative study.

PubMed

Ashton, Susan Elizabeth; Roe, Brenda; Jack, Barbara; McClelland, Bob

2016-09-01

End of life decisions for people with advanced dementia are reported as often being difficult for families as they attempt to make appropriate and justified decisions. To explore the experiences of advance care planning amongst family caregivers of people with advanced dementia. Qualitative research including a series of single cases (close family relatives). A purposive sample of 12 family caregivers within a specialist dementia unit was interviewed about their experiences of advance care planning between August 2009 and February 2010. Family caregivers need encouragement to ask the right questions during advance care planning to discuss the appropriateness of nursing and medical interventions at the end of life. Advance care planning can be facilitated with the family caregiver in the context of everyday practice within the nursing home environment for older people with dementia. © The Author(s) 2014.

Improving the assessment of everyday cognitive functioning in patients with epilepsy by means of proxy reports.

PubMed

Karkoska, Anne; Hallmeyer-Elgner, Susanne; Berth, Hendrik; Reichmann, Heinz; Schmitz-Peiffer, Henning

2015-03-01

The self-report of cognitive deficits by of patients with epilepsy is often poorly correlated with objective test performances but highly related to mood and personality. The aim of this study was to evaluate whether information obtained by close relatives of the patient shows higher correlations with the patients' objective test scores and thereby can be a complementary measure for ensuring a reliable basis for diagnostic decision-making. Thirty-four patients and 29 relatives were asked to fill in a questionnaire about everyday cognitive deficits of the patient. All patients completed a neuropsychological test battery comprising measures of memory, attention, and executive functioning and questionnaires on anxiety, depression, and the personality trait neuroticism. Correlations between relatives' reports and patients' test performances were highly significant across all examined domains. By contrast, self-reports of the patients significantly correlated with none of the neuropsychological measures of memory and with only a subset of the objective measures of attention and executive functioning. Regression analyses additionally revealed a strong dependency of the patients' self-assessment on depression, anxiety, and neuroticism (R(2)=0.42). These results point out the risk of self-reports distorting reality and additionally recommend consulting a close relative of the patient to ensure reliable information about the patient's everyday cognitive functioning. Copyright © 2014 Elsevier Inc. All rights reserved.

Perspectives of German and US Students as They Make Meaning of Science in Their Everyday Lives

ERIC Educational Resources Information Center

Preczewski, Paul J.; Mittler, Alexandra; Tillotson, John W.

2009-01-01

Scientific literacy is a major educational and political goal worldwide, yet the development and enhancement of scientific literacy is not well understood. In order to better understand scientific literacy at the level of everyday science meaning making and a person's ability to address scientific questions and issues, this study reports on…

Geospatial Data Fusion and Multigroup Decision Support for Surface Water Quality Management

NASA Astrophysics Data System (ADS)

Sun, A. Y.; Osidele, O.; Green, R. T.; Xie, H.

2010-12-01

Social networking and social media have gained significant popularity and brought fundamental changes to many facets of our everyday life. With the ever-increasing adoption of GPS-enabled gadgets and technology, location-based content is likely to play a central role in social networking sites. While location-based content is not new to the geoscience community, where geographic information systems (GIS) are extensively used, the delivery of useful geospatial data to targeted user groups for decision support is new. Decision makers and modelers ought to make more effective use of the new web-based tools to expand the scope of environmental awareness education, public outreach, and stakeholder interaction. Environmental decision processes are often rife with uncertainty and controversy, requiring integration of multiple sources of information and compromises between diverse interests. Fusing of multisource, multiscale environmental data for multigroup decision support is a challenging task. Toward this goal, a multigroup decision support platform should strive to achieve transparency, impartiality, and timely synthesis of information. The latter criterion often constitutes a major technical bottleneck to traditional GIS-based media, featuring large file or image sizes and requiring special processing before web deployment. Many tools and design patterns have appeared in recent years to ease the situation somewhat. In this project, we explore the use of Web 2.0 technologies for “pushing” location-based content to multigroups involved in surface water quality management and decision making. In particular, our granular bottom-up approach facilitates effective delivery of information to most relevant user groups. Our location-based content includes in-situ and remotely sensed data disseminated by NASA and other national and local agencies. Our project is demonstrated for managing the total maximum daily load (TMDL) program in the Arroyo Colorado coastal river basin in Texas. The overall design focuses on assigning spatial information to decision support elements and on efficiently using Web 2.0 technologies to relay scientific information to the nonscientific community. We conclude that (i) social networking, if appropriately used, has great potential for mitigating difficulty associated with multigroup decision making; (ii) all potential stakeholder groups should be involved in creating a useful decision support system; and (iii) environmental decision support systems should be considered a must-have, instead of an optional component of TMDL decision support projects. Acknowledgment: This project was supported by NASA grant NNX09AR63G.

Can verbal instruction enhance the recall of an everyday task and promote error-monitoring in people with dementia of the Alzheimer-type?

PubMed

Balouch, Sara; Rusted, Jennifer M

2017-03-01

People with dementia of the Alzheimer-type (DAT) have difficulties with performing everyday tasks, and error awareness is poor. Here we investigate whether recall of actions and error monitoring in everyday task performance improved when they instructed another person on how to make tea. In this situation, both visual and motor cues are present, and attention is sustained by the requirement to keep instructing. The data were drawn from a longitudinal study recording performance in four participants with DAT, filmed regularly for five years in their own homes, completing three tea-making conditions: performed-recall (they made tea themselves); instructed-recall (they instructed the experimenter on how to make tea); and verbal-recall (they described how to make tea). Accomplishment scores (percentage of task they correctly recalled), errors and error-monitoring were coded. Task accomplishment was comparable in the performed-recall and instructed-recall conditions, but both were significantly better than task accomplishment in the verbal-recall condition. Third person instruction did not improve error-monitoring. This study has implications for everyday task rehabilitation for people with DAT.

The way adults with orientation to mathematics teaching cope with the solution of everyday real-world problems

NASA Astrophysics Data System (ADS)

Gazit, Avikam; Patkin, Dorit

2012-03-01

The article aims to check the way adults, some who are practicing mathematics teachers at elementary school, some who are academicians making a career change to mathematics teachers at junior high school and the rest who are pre-service mathematics teachers at elementary school, cope with the solution of everyday real-world problems of buying and selling. The findings show that even adults with mathematical background tend to make mistakes in solving everyday real-world problems. Only about 70% of the adults who have an orientation to mathematics solved the sample problem correctly. The lowest percentage of success was demonstrated by the academicians making a career change to junior high school mathematics teachers whereas the highest percentage of success was manifested by pre-service elementary school mathematics teachers. Moreover, the findings illustrate that life experience of the practicing mathematics teachers and, mainly, of the academicians making a career change, who were older than the pre-service teachers, did not facilitate the solution of such a real-world problem. Perhaps the reason resides in the process of mathematics teaching at school, which does not put an emphasis on the solution of everyday real-world problems.

The Model of Children's Active Travel (M-CAT): a conceptual framework for examining factors influencing children's active travel.

PubMed

Pont, Karina; Ziviani, Jenny; Wadley, David; Abbott, Rebecca

2011-06-01

The current decline in children's participation in physical activity has attracted the attention of those concerned with children's health and wellbeing. A sustainable approach to ensuring children engage in adequate amounts of physical activity is to support their involvement in incidental activity such as active travel (AT), which includes walking or riding a bicycle to or from local destinations, such as school or a park. Understanding how we can embed physical activity into children's everyday occupational roles is a way in which occupational therapists can contribute to this important health promotion agenda. To present a simple, coherent and comprehensive framework as a means of examining factors influencing children's AT. Based on current literature, this conceptual framework incorporates the observable environment, parents' perceptions and decisions regarding their children's AT, as well as children's own perceptions and decisions regarding AT within their family contexts across time. The Model of Children's Active Travel (M-CAT) highlights the complex and dynamic nature of factors impacting the decision-making process of parents and children in relation to children's AT. The M-CAT offers a way forward for researchers to examine variables influencing active travel in a systematic manner. Future testing of the M-CAT will consolidate understanding of the factors underlying the decision-making process which occurs within families in the context of their communities. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Organizational values in the provision of access to care for the uninsured

PubMed Central

Harrison, Krista Lyn; Taylor, Holly A.

2017-01-01

Background For the last 20 years, health provider organizations have made efforts to align mission, values, and everyday practices to ensure high-quality, high-value, and ethical care. However, little attention has been paid to the organizational values and practices of community-based programs that organize and facilitate access to care for uninsured populations. This study aimed to identify and describe organizational values relevant to resource allocation and policy decisions that affect the services offered to members, using the case of community access programs: county-based programs that provide access to care for the uninsured working poor. Methods Comparative and qualitative case study methodology was used, including document review, observations, and key informant interviews, at two geographically diverse programs. Results Nine values were identified as relevant to decision making: stewardship, quality care, access to care, service to others, community well-being, member independence, organizational excellence, decency, and fairness. The way these values were deployed in resource allocation decisions that affected services offered to the uninsured are illustrated in one example per site. Conclusions This study addresses the previous dearth in the literature regarding an empirical description of organizational values employed in decision making of community organizations. To assess the transferability of the values identified, we compared our empirical results to prior empirical and conceptual work in the United States and internationally and found substantial alignment. Future studies can examine whether the identified organizational values are reflective of those at other health care organizations. PMID:28781981

Caring in nursing homes to promote autonomy and participation.

PubMed

Hedman, Maria; Häggström, Elisabeth; Mamhidir, Anna-Greta; Pöder, Ulrika

2017-01-01

Autonomy and participation are threatened within the group of older people living in nursing homes. Evidence suggests that healthcare personnel act on behalf of older people but are still excluding them from decision-making in everyday care. The purpose was to describe registered nurses' experience of caring for older people in nursing homes to promote autonomy and participation. A descriptive design with a phenomenological approach was used. Data were collected by semi-structured individual interviews. Analysis was inspired by Giorgi's method. Participants and research context: A total of 13 registered nurses from 10 nursing homes participated. Ethical considerations: Ethical approval was obtained from the Regional Research Ethics Committee. Informed consent was achieved and confidentiality guaranteed. The essence of caring for older people in nursing homes to promote autonomy and participation consisted of registered nurses' awareness of older people's frailty and the impact of illness to support health and well-being, and awareness of acknowledgement in everyday life and trusting relationships. Paying attention to older people by being open to the persons' wishes were aspects that relied on registered nurses' trusting relationships with older people, their relatives and surrounding healthcare personnel. The awareness reflected challenges in caring to promote older people's right to autonomy and participation in nursing homes. Registered nurses' strategies, hopes for and/or concerns about development of everyday life in nursing homes were revealed and mirrored their engagement in caring for older people. Awareness of older people's frailty in nursing homes and the importance of maintained health and well-being were described as the main source for promoting autonomy and participation. Everyday life and care in nursing homes needs to be addressed from both older people's and healthcare personnel's perspectives, to promote autonomy and participation for residents in nursing homes.

Using Mobile & Personal Sensing Technologies to Support Health Behavior Change in Everyday Life: Lessons Learned

PubMed Central

Klasnja, Predrag; Consolvo, Sunny; McDonald, David W.; Landay, James A.; Pratt, Wanda

2009-01-01

Lifestyle modification is a key facet of the prevention and management of chronic diseases. Mobile devices that people already carry provide a promising platform for facilitating these lifestyle changes. This paper describes key lessons learned from the development and evaluation of two mobile systems for encouraging physical activity. We argue that by supporting persistent cognitive activation of health goals, encouraging an extensive range of relevant healthy behaviors, focusing on long-term patterns of activity, and facilitating social support as an optional but not primary motivator, systems can be developed that effectively motivate behavior change and provide support when and where people make decisions that affect their health. PMID:20351876

Class transformation and work-life balance in urban Britain: the case of Manchester.

PubMed

Ward, Kevin; Fagan, Colette; McDowell, Linda; Perrons, Diane; Ray, Kathryn

2010-01-01

Recent years have seen an expansion in the work on the attitudes, beliefs and preferences of those middle-class groups that have accompanied the return of capital to many North American and western European city centres and their surrounding urban suburbs. Yet despite this, it is argued that there is little research linking gentrification to wider processes of social transformation, particularly debates over housing market decision-making, the balancing of work and life, and the gender division of labour within the household. It is to examining the interaction of these aspects of everyday life in a gentrifying area that this paper turns, using the example of Chorlton, a southern urban suburb of Manchester.

An exploration of citizen science for population health research in retail food environments.

PubMed

Pomeroy, Stephanie J; Minaker, Leia M; Mah, Catherine L

2018-01-22

Public engagement is an essential component of public health research, practice, knowledge exchange processes, and decision making. Citizen science was first documented in the early 1900s as an approach to public engagement and there is growing interest in how it can be used in health research. This commentary describes how citizen science approaches were incorporated into a public engagement activity as part of a population health intervention research project on the retail food environment, a workshop we hosted called The Food In This Place in St. John's, Newfoundland and Labrador. We used citizen science methods and approaches to train and support participants to critically analyze a sample of everyday local retail food environments.

Prediction of disease course in inflammatory bowel diseases.

PubMed

Lakatos, Peter Laszlo

2010-06-07

Clinical presentation at diagnosis and disease course of both Crohn's disease (CD) and ulcerative colitis are heterogeneous and variable over time. Since most patients have a relapsing course and most CD patients develop complications (e.g. stricture and/or perforation), much emphasis has been placed in the recent years on the determination of important predictive factors. The identification of these factors may eventually lead to a more personalized, tailored therapy. In this TOPIC HIGHLIGHT series, we provide an update on the available literature regarding important clinical, endoscopic, fecal, serological/routine laboratory and genetic factors. Our aim is to assist clinicians in the everyday practical decision-making when choosing the treatment strategy for their patients suffering from inflammatory bowel diseases.

Current Legal I-O Issues.

ERIC Educational Resources Information Center

Ofsanko, Frank

This report focuses on a myriad of national, state, and local laws, regulations and court decisions which govern the everyday work of industrial and organizational psychologists. Legislation already in effect and legislation still pending are discussed. Citing relevant legislation and court decisions throughout the text, the paper addresses such…

Assessing the progress of rehabilitation in patients with ACL reconstruction using the International Knee Documentation Committee Subjective Knee Form

NASA Astrophysics Data System (ADS)

Leguizamon, J. H.; Braidot, A.; Catalfamo Formento, P.

2011-12-01

There are numerous assessment tools designed to provide information on the results of reconstructive surgery of anterior cruciate ligament (ACL). They are also used for monitoring progress and facilitating clinical decision-making during the rehabilitation process. A brief summary of some existing tools specifically designed to evaluate knee ligament injuries is presented in this article. Then, one of those outcome measures, the International Knee Documentation Committee Subjective Knee Form (IKDC) was applied to a group of patients (N = 10) who had undergone surgery for ACL reconstruction. The patients attended the same physiotherapy service and followed a unified rehabilitation protocol. The assessment was performed twice: four and six months after surgery. The results showed an improvement in the rehabilitation of most patients tested (verified by a difference equal to or greater than 9 points on the IKDC outcome between measurements 1 and 2). The IKDC probed to be an instrument of quick and easy application. It provided quantitative data about the progress of rehabilitation and could be applied in everyday clinical physiotherapy practice. However, the results suggested considering the IKDC as one component of an evaluation kit to make decisions regarding the progress of the rehabilitation treatment.

Conflicts of interest: research and clinical care.

PubMed

Morris, John C

1994-01-01

Conflicts of interest and other ethical dilemmas occur in Alzheimer disease (AD) patient care and research but often are underrecognized by physicians. One or more bioethical principles of autonomy, confidentiality, truth telling, beneficence, and justice, which apply to demented individuals as they do to other patients, may conflict in everyday clinical situations. For example, when demented patients wish to continue driving, autonomy (the patient's right to self-determination) conflicts with beneficence (the duty to promote the patient's welfare). Cognitively impaired patients depend on others for ethical decision making in the resolution of these dilemmas. It is essential that clinicians and investigators involved in the decision-making process do so without bias or conflict of interest. Full disclosure of financial interests increasingly is an accepted requirement in the conduct of biomedical research. In AD, less obvious potential conflicts of interest arise when physicians recruit their patients for antidementia drug trials sponsored by a pharmaceutical company (that provides the physician with research funding) or when investigators fail to acknowledge the patient's withdrawal of assent when attempting to complete a research protocol. The recognition of both financial and nonfinancial conflicts should lead to measures to reduce bias, which in turn will improve the integrity of research findings and promote patient welfare.

The role of cognitive versus emotional intelligence in Iowa Gambling Task performance: What's emotion got to do with it?

PubMed

Webb, Christian A; DelDonno, Sophie; Killgore, William D S

2014-01-01

Debate persists regarding the relative role of cognitive versus emotional processes in driving successful performance on the widely used Iowa Gambling Task (IGT). From the time of its initial development, patterns of IGT performance were commonly interpreted as primarily reflecting implicit, emotion-based processes. Surprisingly, little research has tried to directly compare the extent to which measures tapping relevant cognitive versus emotional competencies predict IGT performance in the same study. The current investigation attempts to address this question by comparing patterns of associations between IGT performance, cognitive intelligence (Wechsler Abbreviated Scale of Intelligence; WASI) and three commonly employed measures of emotional intelligence (EI; Mayer-Salovey-Caruso Emotional Intelligence Test, MSCEIT; Bar-On Emotional Quotient Inventory, EQ-i; Self-Rated Emotional Intelligence Scale, SREIS). Results indicated that IGT performance was more strongly associated with cognitive, than emotional, intelligence. To the extent that the IGT indeed mimics "real-world" decision-making, our findings, coupled with the results of existing research, may highlight the role of deliberate, cognitive capacities over implicit, emotional processes in contributing to at least some domains of decision-making relevant to everyday life.

Computation of emotions in man and machines.

PubMed

Robinson, Peter; el Kaliouby, Rana

2009-12-12

The importance of emotional expression as part of human communication has been understood since Aristotle, and the subject has been explored scientifically since Charles Darwin and others in the nineteenth century. Advances in computer technology now allow machines to recognize and express emotions, paving the way for improved human-computer and human-human communications. Recent advances in psychology have greatly improved our understanding of the role of affect in communication, perception, decision-making, attention and memory. At the same time, advances in technology mean that it is becoming possible for machines to sense, analyse and express emotions. We can now consider how these advances relate to each other and how they can be brought together to influence future research in perception, attention, learning, memory, communication, decision-making and other applications. The computation of emotions includes both recognition and synthesis, using channels such as facial expressions, non-verbal aspects of speech, posture, gestures, physiology, brain imaging and general behaviour. The combination of new results in psychology with new techniques of computation is leading to new technologies with applications in commerce, education, entertainment, security, therapy and everyday life. However, there are important issues of privacy and personal expression that must also be considered.

The role of cognitive versus emotional intelligence in Iowa Gambling Task performance: What’s emotion got to do with it?

PubMed Central

Webb, Christian A.; DelDonno, Sophie; Killgore, William D.S.

2014-01-01

Debate persists regarding the relative role of cognitive versus emotional processes in driving successful performance on the widely used Iowa Gambling Task (IGT). From the time of its initial development, patterns of IGT performance were commonly interpreted as primarily reflecting implicit, emotion-based processes. Surprisingly, little research has tried to directly compare the extent to which measures tapping relevant cognitive versus emotional competencies predict IGT performance in the same study. The current investigation attempts to address this question by comparing patterns of associations between IGT performance, cognitive intelligence (Wechsler Abbreviated Scale of Intelligence; WASI) and three commonly employed measures of emotional intelligence (EI; Mayer–Salovey–Caruso Emotional Intelligence Test, MSCEIT; Bar-On Emotional Quotient Inventory, EQ-i; Self-Rated Emotional Intelligence Scale, SREIS). Results indicated that IGT performance was more strongly associated with cognitive, than emotional, intelligence. To the extent that the IGT indeed mimics “real-world” decision-making, our findings, coupled with the results of existing research, may highlight the role of deliberate, cognitive capacities over implicit, emotional processes in contributing to at least some domains of decision-making relevant to everyday life. PMID:25635149

Sidetracked by trolleys: Why sacrificial moral dilemmas tell us little (or nothing) about utilitarian judgment.

PubMed

Kahane, Guy

2015-01-01

Research into moral decision-making has been dominated by sacrificial dilemmas where, in order to save several lives, it is necessary to sacrifice the life of another person. It is widely assumed that these dilemmas draw a sharp contrast between utilitarian and deontological approaches to morality, and thereby enable us to study the psychological and neural basis of utilitarian judgment. However, it has been previously shown that some sacrificial dilemmas fail to present a genuine contrast between utilitarian and deontological options. Here, I raise deeper problems for this research paradigm. Even when sacrificial dilemmas present a contrast between utilitarian and deontological options at a philosophical level, it is misleading to interpret the responses of ordinary folk in these terms. What is currently classified as "utilitarian judgment" does not in fact share essential features of a genuine utilitarian outlook, and is better explained in terms of commonsensical moral notions. When subjects deliberate about such dilemmas, they are not deciding between opposing utilitarian and deontological solutions, but engaging in a richer process of weighing opposing moral reasons. Sacrificial dilemmas therefore tell us little about utilitarian decision-making. An alternative approach to studying proto-utilitarian tendencies in everyday moral thinking is proposed.

Computation of emotions in man and machines

PubMed Central

Robinson, Peter; el Kaliouby, Rana

2009-01-01

The importance of emotional expression as part of human communication has been understood since Aristotle, and the subject has been explored scientifically since Charles Darwin and others in the nineteenth century. Advances in computer technology now allow machines to recognize and express emotions, paving the way for improved human–computer and human–human communications. Recent advances in psychology have greatly improved our understanding of the role of affect in communication, perception, decision-making, attention and memory. At the same time, advances in technology mean that it is becoming possible for machines to sense, analyse and express emotions. We can now consider how these advances relate to each other and how they can be brought together to influence future research in perception, attention, learning, memory, communication, decision-making and other applications. The computation of emotions includes both recognition and synthesis, using channels such as facial expressions, non-verbal aspects of speech, posture, gestures, physiology, brain imaging and general behaviour. The combination of new results in psychology with new techniques of computation is leading to new technologies with applications in commerce, education, entertainment, security, therapy and everyday life. However, there are important issues of privacy and personal expression that must also be considered. PMID:19884138

Bad is freer than good: Positive-negative asymmetry in attributions of free will.

PubMed

Feldman, Gilad; Wong, Kin Fai Ellick; Baumeister, Roy F

2016-05-01

Recent findings support the idea that the belief in free will serves as the basis for moral responsibility, thus promoting the punishment of immoral agents. We theorized that free will extends beyond morality to serve as the basis for accountability and the capacity for change more broadly, not only for others but also for the self. Five experiments showed that people attributed higher freedom of will to negative than to positive valence, regardless of morality or intent, for both self and others. In recalling everyday life situations and in classical decision making paradigms, negative actions, negatives outcomes, and negative framing were attributed higher free will than positive ones. Free will attributions were mainly driven by action or outcome valence, but not intent. These findings show consistent support for the idea that free will underlies laypersons' sense-making for accountability and change under negative circumstances. Copyright © 2016 Elsevier Inc. All rights reserved.

Everyday Learning about Sleep. Everyday Learning Series. Volume 5, Number 1

ERIC Educational Resources Information Center

Linke, Pam

2007-01-01

The Everyday Learning Series has been developed to focus attention on the every day life experiences of early childhood and to offer insight about how parents and carers can make the most of these experiences. Having a new baby is wonderful and exciting and one of the most trying times in a parent's life. So it is no wonder that anyone caring for…

If you want to save, focus on the forest rather than on trees. The effects of shifts in levels of construal on saving decisions

PubMed Central

2017-01-01

Although financial decisions are expected to be rational, there is a growing body of experimental research indicating that small psychological changes in one’s mind-set in the actual decision-making moment might affect saving ratios. In this article, another type of change in one’s mind-set, which can influence saving decisions, is explored, namely the level of construal. Construal level is a key descriptor of people’s cognitive representations of targets, and is a way of characterising the mental mind-sets people use. Building on recent advances in the link between construal levels and intertemporal choices, the present research evaluates the effect of shifts in levels of construal in the very moment of decision making on people’s propensity to save money. It is suggested that triggering a high-level construal mind-set would influence individuals’ financial decisions and result in greater willingness to save than triggering a low-level construal mind-set. This assumption is supported by the findings: across three experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The first experiment demonstrated that people in an abstract mind-set are more willing to delay financial gratification than those in a concrete mind-set. In the second and third experiments, those with an abstract mind-set showed an increased willingness to save when compared to those with a concrete mind-set. The research provides further evidence that mental states, which can be evoked by previous, unrelated tasks, such as level of cognitive abstraction, can influence everyday financial decisions. It, thus, highlights the role of situational factors that consumers may be not aware of, which still affect their savings decisions. PMID:28552943

‘It’s my home and your work’: the views of a filmed vignette describing a challenging everyday situation from the perspective of people with intellectual disabilities

PubMed Central

Hellzen, Ove; Haugenes, Marit; Østby, May

2018-01-01

ABSTRACT Purpose: Examining everyday challenges in the interactions between people with intellectual disabilities and their staff, as seen from the user’s perspective, is an important perspective in health care research. Involving people with intellectual disabilities as so-called co-researchers is a relatively unexplored research strategy. In this paper, co-researchers participated in all the steps of the research process, from planning to reporting, in addition to the written reporting of the findings. The aim of this study was to explore how people with intellectual disabilities experienced a filmed vignette of an everyday situation. Method: Based on audio-recorded and transcribed individual and focus-group interviews with people with intellectual disabilities, performed by co-researchers with intellectual disabilities together with researchers, qualitative content analysis was used. Results: The analysis reveals three themes: “being emotionally touched”, “being aware of the other”, and “being unclear”. Conclusions: The results are discussed in light of normalization and participation in society with independence and one’s own decision-making. Regarding the care of people with intellectual disabilities, the main finding is the need to focus not only on greater involvement of this population in their own daily lives, but also to teach self-determination skills. Another finding is the importance of involving people with intellectual impairment as co-researchers. PMID:29733261

Moral experience: a framework for bioethics research.

PubMed

Hunt, Matthew R; Carnevale, Franco A

2011-11-01

Theoretical and empirical research in bioethics frequently focuses on ethical dilemmas or problems. This paper draws on anthropological and phenomenological sources to develop an alternative framework for bioethical enquiry that allows examination of a broader range of how the moral is experienced in the everyday lives of individuals and groups. Our account of moral experience is subjective and hermeneutic. We define moral experience as "Encompassing a person's sense that values that he or she deem important are being realised or thwarted in everyday life. This includes a person's interpretations of a lived encounter, or a set of lived encounters, that fall on spectrums of right-wrong, good-bad or just-unjust". In our conceptualisation, moral experience is not limited to situations that are heavily freighted with ethically-troubling ramifications or are sources of debate and disagreement. Important aspects of moral experience are played out in mundane and everyday settings. Moral experience provides a research framework, the scope of which extends beyond the evaluation of ethical dilemmas, processes of moral justification and decision-making, and moral distress. This broad research focus is consistent with views expressed by commentators within and beyond bioethics who have called for deeper and more sustained attention in bioethics scholarship to a wider set of concerns, experiences and issues that better captures what is ethically at stake for individuals and communities. In this paper we present our conceptualisation of moral experience, articulate its epistemological and ontological foundations and discuss opportunities for empirical bioethics research using this framework.

Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial.

PubMed

Fitzpatrick, Stephanie L; Golden, Sherita Hill; Stewart, Kerry; Sutherland, June; DeGross, Sharie; Brown, Tina; Wang, Nae-Yuh; Allen, Jerilyn; Cooper, Lisa A; Hill-Briggs, Felicia

2016-12-01

To compare the effectiveness of three delivery modalities of Decision-making Education for Choices In Diabetes Everyday (DECIDE), a nine-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training, compared with an enhanced usual care (UC), on clinical and behavioral outcomes among urban African Americans with type 2 diabetes. Eligible participants (n = 182) had a suboptimal CVD risk factor profile (A1C, blood pressure, and/or lipids). Participants were randomized to DECIDE Self-Study (n = 46), DECIDE Individual (n = 45), DECIDE Group (n = 46), or Enhanced UC (n = 45). Intervention duration was 18-20 weeks. Outcomes were A1C, blood pressure, lipids, problem-solving, disease knowledge, and self-care activities, all measured at baseline, 1 week, and 6 months after completion of the intervention. DECIDE modalities and Enhanced UC did not significantly differ in clinical outcomes at 6 months postintervention. In participants with A1C ≥7.5% (58 mmol/mol) at baseline, A1C declined in each DECIDE modality at 1 week postintervention (P < 0.05) and only in Self-Study at 6 months postintervention (b = -0.24, P < 0.05). There was significant reduction in systolic blood pressure in Self-Study (b = -4.04) and Group (b = -3.59) at 6 months postintervention. Self-Study, Individual, and Enhanced UC had significant declines in LDL and Self-Study had an increase in HDL (b = 1.76, P < 0.05) at 6 months postintervention. Self-Study and Individual had a higher increase in knowledge than Enhanced UC (P < 0.05), and all arms improved in problem-solving (P < 0.01) at 6 months postintervention. DECIDE modalities showed benefits after intervention. Self-Study demonstrated robust improvements across clinical and behavioral outcomes, suggesting program suitability for broader dissemination to populations with similar educational and literacy levels. © 2016 by the American Diabetes Association.

Counterfactual Thinking Deficit in Huntington's Disease.

PubMed

Solca, Federica; Poletti, Barbara; Zago, Stefano; Crespi, Chiara; Sassone, Francesca; Lafronza, Annalisa; Maraschi, Anna Maria; Sassone, Jenny; Silani, Vincenzo; Ciammola, Andrea

2015-01-01

Counterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving - all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington's Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment. Tests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects. Our results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test - Part A, Phonemic Verbal Fluency Test and FAB. Spontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients' daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients' ability to analyse current behaviors and future actions.

Informing health? Negotiating the logics of choice and care in everyday practices of 'healthy living'.

PubMed

Henwood, Flis; Harris, Roma; Spoel, Philippa

2011-06-01

This paper reports on a qualitative study examining everyday practices of healthy living (HL). Forty-four semi-structured interviews were undertaken with Canadian and UK citizens, aged 45 - 70, in April-May 2010. The research sits within the now substantial literature concerned with how health information is mediated, both by people and technologies, and employed in the context of 'good' health citizenship. Throughout this work, notions of 'choice' and 'empowerment' have been interrogated, theoretically and empirically, to reveal both the knowledge/power relationships integral to 'informing' processes and the shifting relationship between information and care in contemporary health encounters. In this paper, we analyse how people make sense of what it means to live healthily and how they know if they are doing so by focussing on three ways in which study participants become informed about healthy living: through their engagement with universal HL messages, through their own information searches, and through their attempts to measure their 'healthiness'. Following Mol's (2008) critique of the "logic of choice" in contemporary healthcare, we understand healthy living as a "situation of choice" where complex problems are framed as simple matters of choice and where information and technologies are understood as neutral aids to decision-making in support of 'correct' choices. Our analysis builds on and extends Mol's work by exploring how participants negotiate between this "logic of choice" and her alternative "logic of care" in their accounts of everyday HL informing practices and how the two logics "interfere" with one another. These accounts show resistance to the logic of choice through 'calls for care' but they also show clearly how the disciplining logic of choice works to (re)present such calls for care as failed attempts at healthy living, undermining the very practices the logic of choice seeks to encourage. Copyright © 2011 Elsevier Ltd. All rights reserved.

Temporal and visual source memory deficits among ecstasy/polydrug users.

PubMed

Fisk, John E; Gallagher, Denis T; Hadjiefthyvoulou, Florentia; Montgomery, Catharine

2014-03-01

We wished to investigate whether source memory judgements are adversely affected by recreational illicit drug use. Sixty-two ecstasy/polydrug users and 75 non ecstasy users completed a source memory task, in which they tried to determine whether or not a word had been previously presented and if so, attempted to recall the format, location and temporal position in which the word had occurred. While not differing in terms of the number of hits and false positive responses, ecstasy/polydrug users adopted a more liberal decision criterion when judging if a word had been presented previously. With regard to source memory, users were less able to determine the format in which words had been presented (upper versus lower case). Female users did worse than female nonusers in determining which list (first or second) a word was from. Unexpectedly, the current frequency of cocaine use was negative associated with list and case source memory performance. Given the role that source memory plays in everyday cognition, those who use cocaine more frequently might have more difficulty in everyday tasks such as recalling the sources of crucial information or making use of contextual information as an aid to learning.

Social heuristics shape intuitive cooperation.

PubMed

Rand, David G; Peysakhovich, Alexander; Kraft-Todd, Gordon T; Newman, George E; Wurzbacher, Owen; Nowak, Martin A; Greene, Joshua D

2014-04-22

Cooperation is central to human societies. Yet relatively little is known about the cognitive underpinnings of cooperative decision making. Does cooperation require deliberate self-restraint? Or is spontaneous prosociality reined in by calculating self-interest? Here we present a theory of why (and for whom) intuition favors cooperation: cooperation is typically advantageous in everyday life, leading to the formation of generalized cooperative intuitions. Deliberation, by contrast, adjusts behaviour towards the optimum for a given situation. Thus, in one-shot anonymous interactions where selfishness is optimal, intuitive responses tend to be more cooperative than deliberative responses. We test this 'social heuristics hypothesis' by aggregating across every cooperation experiment using time pressure that we conducted over a 2-year period (15 studies and 6,910 decisions), as well as performing a novel time pressure experiment. Doing so demonstrates a positive average effect of time pressure on cooperation. We also find substantial variation in this effect, and show that this variation is partly explained by previous experience with one-shot lab experiments.

Catholicism and Everyday Morality: Filipino women's narratives on reproductive health.

PubMed

Natividad, Maria Dulce F

2018-05-07

This study examines the relationship between state policies, religion, reproductive politics, and competing understandings of embodied sexual and reproductive morality. Using ethnographic and life history interviews, this study looks at the lives of Filipino urban poor women and how they interpret, follow and resist Catholic Church doctrines and practices as these relate to sexuality and reproduction. Taking everyday morality as embedded in social practice, this paper argues that women's subjective reinterpretations of Catholic teachings regarding contraception and abortion render religion pliant in a way that restores moral equilibrium in women's lives. It is in this process of adjusting and re-adjusting this moral order that women are able to construct their moral worlds. Further, this article investigates how social class, gender and religion work in tension with one another in women's everyday decisions and how the constraints and opportunities that poor women encounter in their everyday lives are enabled by the state and its institutions.

Why evidence-based medicine is a good approach in physical and rehabilitation medicine. Thesis.

PubMed

Negrini, S

2014-10-01

According to a good definition, evidence-based medicine (EBM) is: "The explicit, conscientious, and judicious use of the current best evidence in making decisions about the care of individual patients (and populations)". More appropriate in a clinical context like that of physical and rehabilitation medicine (PRM) is looking at evidence based clinical practice (EBCP), whose definition is: "The integration of best research evidence with clinical expertise and patient values". In the past the term evidence-based physical and rehabilitation medicine (EBPRM) was also proposed. In this thesis, after some historical notes on EBM and on PRM, we will discuss why in our view EBPRM must be the real foundation of our everyday PRM clinical practice.

Prediction of disease course in inflammatory bowel diseases

PubMed Central

Lakatos, Peter Laszlo

2010-01-01

Clinical presentation at diagnosis and disease course of both Crohn’s disease (CD) and ulcerative colitis are heterogeneous and variable over time. Since most patients have a relapsing course and most CD patients develop complications (e.g. stricture and/or perforation), much emphasis has been placed in the recent years on the determination of important predictive factors. The identification of these factors may eventually lead to a more personalized, tailored therapy. In this TOPIC HIGHLIGHT series, we provide an update on the available literature regarding important clinical, endoscopic, fecal, serological/routine laboratory and genetic factors. Our aim is to assist clinicians in the everyday practical decision-making when choosing the treatment strategy for their patients suffering from inflammatory bowel diseases. PMID:20518078

The Reality of Myoelectric Prostheses: Understanding What Makes These Devices Difficult for Some Users to Control

PubMed Central

Chadwell, Alix; Kenney, Laurence; Thies, Sibylle; Galpin, Adam; Head, John

2016-01-01

Users of myoelectric prostheses can often find them difficult to control. This can lead to passive-use of the device or total rejection, which can have detrimental effects on the contralateral limb due to overuse. Current clinically available prostheses are “open loop” systems, and although considerable effort has been focused on developing biofeedback to “close the loop,” there is evidence from laboratory-based studies that other factors, notably improving predictability of response, may be as, if not more, important. Interestingly, despite a large volume of research aimed at improving myoelectric prostheses, it is not currently known which aspect of clinically available systems has the greatest impact on overall functionality and everyday usage. A protocol has, therefore, been designed to assess electromyographic (EMG) skill of the user and predictability of the prosthesis response as significant parts of the control chain, and to relate these to functionality and everyday usage. Here, we present the protocol and results from early pilot work. A set of experiments has been developed. First, to characterize user skill in generating the required level of EMG signal, as well as the speed with which users are able to make the decision to activate the appropriate muscles. Second, to measure unpredictability introduced at the skin–electrode interface, in order to understand the effects of the socket-mounted electrode fit under different loads on the variability of time taken for the prosthetic hand to respond. To evaluate prosthesis user functionality, four different outcome measures are assessed. Using a simple upper limb functional task prosthesis users are assessed for (1) success of task completion, (2) task duration, (3) quality of movement, and (4) gaze behavior. To evaluate everyday usage away from the clinic, the symmetricity of their real-world arm use is assessed using activity monitoring. These methods will later be used to assess a prosthesis user cohort to establish the relative contribution of each control factor to the individual measures of functionality and everyday usage (using multiple regression models). The results will support future researchers, designers, and clinicians in concentrating their efforts on the area that will have the greatest impact on improving prosthesis use. PMID:27597823

Quality of Life for Dementia Caregiving Dyads: Effects of Incongruent Perceptions of Everyday Care and Values.

PubMed

Moon, Heehyul; Townsend, Aloen L; Whitlatch, Carol J; Dilworth-Anderson, Peggye

2017-08-01

This dyadic study investigated incongruence in care recipients' (CRs') and caregivers' (CGs') perceptions of (a) CRs' involvement in decision making and (b) how much CRs value social relations as predictors of subjective quality of life (QOL) of CRs with mild-to-moderate dementia and their primary family CGs. A secondary analysis of cross-sectional, dyadic data from in-person interviews with 205 CRs with mild-to-moderate dementia and their primary family CGs Incongruence was operationalized in two ways: absolute difference and direction of difference. Paired t tests and multilevel modeling were used to analyze differences. CGs reported CRs were significantly less involved in decision making and valued social relations significantly less than CRs. Greater incongruence on CRs' values significantly predicted lower QOL of CG and CR. When CGs reported that CRs valued social relationships less than the CR himself/herself reported, CGs' and CRs' QOL was significantly lower compared with QOL for dyads where there was no incongruence on CRs' values. Incongruent perceptions of CRs' involvement in decisions were not a significant predictor of QOL. This study provides evidence for the importance of assessing both CRs' and CGs' QOL, as well as incongruence in their perceptions in domains that may affect both of their QOL. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Situation-Specific Theory of Heart Failure Self-Care: Revised and Updated.

PubMed

Riegel, Barbara; Dickson, Victoria Vaughan; Faulkner, Kenneth M

2016-01-01

Since the situation-specific theory of heart failure (HF) self-care was published in 2008, we have learned much about how and why patients with HF take care of themselves. This knowledge was used to revise and update the theory. The purpose of this article was to describe the revised, updated situation-specific theory of HF self-care. Three major revisions were made to the existing theory: (1) a new theoretical concept reflecting the process of symptom perception was added; (2) each self-care process now involves both autonomous and consultative elements; and (3) a closer link between the self-care processes and the naturalistic decision-making process is described. In the revised theory, HF self-care is defined as a naturalistic decision-making process with person, problem, and environmental factors that influence the everyday decisions made by patients and the self-care actions taken. The first self-care process, maintenance, captures those behaviors typically referred to as treatment adherence. The second self-care process, symptom perception, involves body listening, monitoring signs, as well as recognition, interpretation, and labeling of symptoms. The third self-care process, management, is the response to symptoms when they occur. A total of 5 assumptions and 8 testable propositions are specified in this revised theory. Prior research illustrates that all 3 self-care processes (ie, maintenance, symptom perception, and management) are integral to self-care. Further research is greatly needed to identify how best to help patients become experts in HF self-care.

'Everyone has an agenda': Professionals' understanding and negotiation of risk within the Guardianship system of Victoria, Australia.

PubMed

Wyllie, Aaron; Saunders, Bernadette J

2018-02-19

It is frequently asserted that pressures to assess and manage risk have eroded the therapeutic, rights-based foundation of the human services profession. Some argue that human service workers operate in a culture of fear in which self-protection and blame avoidance, rather than clients' needs, primarily drive decision-making. In the field of Adult Guardianship, it has been suggested that organisational risk avoidance may be motivating applications for substitute decision-makers, unnecessarily curtailing clients' rights and freedoms. However, the absence of research examining the operation of risk within Guardianship decision-making inhibits verifying and responding to this very serious suggestion. This article draws on semi-structured interviews conducted with 10 professionals involved in the Victorian Guardianship system, which explored how issues of risk are perceived and negotiated in everyday practice. Risk was found to be a complex and subjective construct which can present both dangers and opportunities for Guardianship practitioners and their clients. While a number of participants reported that Guardianship might sometimes operate as an avenue for mitigating the fear and uncertainty of risk, most participants also valued positive risk-taking and were willing, in their clients' interests, to challenge conservative logics of risk. These findings highlight the need for further research which examines how service providers and policy makers can create spaces that support open discussions around issues of risk and address practitioners' sense of fear and vulnerability. © 2018 John Wiley & Sons Ltd.

How incidental values from the environment affect decisions about money, risk, and delay.

PubMed

Ungemach, Christoph; Stewart, Neil; Reimers, Stian

2011-02-01

How different are £0.50 and £1.50, "a small chance" and "a good chance," or "three months" and "nine months"? Our studies show that people behave as if the differences between these values are altered by incidental everyday experiences. Preference for a £1.50 lottery rather than a £0.50 lottery was stronger among individuals exposed to intermediate supermarket prices than among those exposed to lower or higher prices. Preference for "a good chance" rather than "a small chance" of winning a lottery was stronger among participants who predicted intermediate probabilities of rain than among those who predicted lower or higher chances of rain. Preference for consumption in "three months" rather than "nine months" was stronger among participants who planned for an intermediate birthday than among participants who planned for a sooner or later birthday. These fluctuations directly challenge economic accounts that translate monies, risks, and delays into subjective equivalents with stable functions. The decision-by-sampling model-in which subjective values are rank positions constructed from comparisons with samples-predicts these effects and indicates a primary role for sampling in decision making.

Modeling the Evolution of Beliefs Using an Attentional Focus Mechanism

PubMed Central

Marković, Dimitrije; Gläscher, Jan; Bossaerts, Peter; O’Doherty, John; Kiebel, Stefan J.

2015-01-01

For making decisions in everyday life we often have first to infer the set of environmental features that are relevant for the current task. Here we investigated the computational mechanisms underlying the evolution of beliefs about the relevance of environmental features in a dynamical and noisy environment. For this purpose we designed a probabilistic Wisconsin card sorting task (WCST) with belief solicitation, in which subjects were presented with stimuli composed of multiple visual features. At each moment in time a particular feature was relevant for obtaining reward, and participants had to infer which feature was relevant and report their beliefs accordingly. To test the hypothesis that attentional focus modulates the belief update process, we derived and fitted several probabilistic and non-probabilistic behavioral models, which either incorporate a dynamical model of attentional focus, in the form of a hierarchical winner-take-all neuronal network, or a diffusive model, without attention-like features. We used Bayesian model selection to identify the most likely generative model of subjects’ behavior and found that attention-like features in the behavioral model are essential for explaining subjects’ responses. Furthermore, we demonstrate a method for integrating both connectionist and Bayesian models of decision making within a single framework that allowed us to infer hidden belief processes of human subjects. PMID:26495984

Supporting decision-making by a health promotion programme: experiences of persons ageing in the context of migration

PubMed Central

Barenfeld, Emmelie; Gustafsson, Susanne; Wallin, Lars; Dahlin-Ivanoff, Synneve

2017-01-01

ABSTRACT This study is part of the Promoting Aging Migrants’ Capabilities programme that applied person-centred group meetings and one individual home visit to prolong independence in daily activities among people ≥70 years who had migrated to Sweden from Finland or the Western Balkan region. With the purpose to understand programme outcomes, the study aimed to explore the participants’ everyday experiences of using health-promoting messages exchanged during the programme. Using a grounded theory approach, 12 persons aged 70–83 years were interviewed six months to one year after their participation in the programme. The participants experienced how using health-promoting messages was a dynamic process of how to make decisions on taking action to satisfy health-related needs of oneself or others immediately or deferring action. Five sub-processes were also identified: gaining inner strength, meeting challenges in available resources, being attentive to what is worth knowing, approaching health risks, and identifying opportunities to advocate for others. The results suggest that the programme could develop personal skills to support older people who have migrated to overcome health-related challenges. They further demonstrate the importance of supporting their health literacy before personal resources hinder action, and call for research on programmes to overcome environmental barriers to health. PMID:28639481

Role-playing simulation as an educational tool for health care personnel: developing an embedded assessment framework.

PubMed

Libin, Alexander; Lauderdale, Manon; Millo, Yuri; Shamloo, Christine; Spencer, Rachel; Green, Brad; Donnellan, Joyce; Wellesley, Christine; Groah, Suzanne

2010-04-01

Simulation- and video game-based role-playing techniques have been proven effective in changing behavior and enhancing positive decision making in a variety of professional settings, including education, the military, and health care. Although the need for developing assessment frameworks for learning outcomes has been clearly defined, there is a significant gap between the variety of existing multimedia-based instruction and technology-mediated learning systems and the number of reliable assessment algorithms. This study, based on a mixed methodology research design, aims to develop an embedded assessment algorithm, a Knowledge Assessment Module (NOTE), to capture both user interaction with the educational tool and knowledge gained from the training. The study is regarded as the first step in developing an assessment framework for a multimedia educational tool for health care professionals, Anatomy of Care (AOC), that utilizes Virtual Experience Immersive Learning Simulation (VEILS) technology. Ninety health care personnel of various backgrounds took part in online AOC training, choosing from five possible scenarios presenting difficult situations of everyday care. The results suggest that although the simulation-based training tool demonstrated partial effectiveness in improving learners' decision-making capacity, a differential learner-oriented approach might be more effective and capable of synchronizing educational efforts with identifiable relevant individual factors such as sociobehavioral profile and professional background.

Sidetracked by trolleys: Why sacrificial moral dilemmas tell us little (or nothing) about utilitarian judgment

PubMed Central

Kahane, Guy

2015-01-01

Research into moral decision-making has been dominated by sacrificial dilemmas where, in order to save several lives, it is necessary to sacrifice the life of another person. It is widely assumed that these dilemmas draw a sharp contrast between utilitarian and deontological approaches to morality, and thereby enable us to study the psychological and neural basis of utilitarian judgment. However, it has been previously shown that some sacrificial dilemmas fail to present a genuine contrast between utilitarian and deontological options. Here, I raise deeper problems for this research paradigm. Even when sacrificial dilemmas present a contrast between utilitarian and deontological options at a philosophical level, it is misleading to interpret the responses of ordinary folk in these terms. What is currently classified as “utilitarian judgment” does not in fact share essential features of a genuine utilitarian outlook, and is better explained in terms of commonsensical moral notions. When subjects deliberate about such dilemmas, they are not deciding between opposing utilitarian and deontological solutions, but engaging in a richer process of weighing opposing moral reasons. Sacrificial dilemmas therefore tell us little about utilitarian decision-making. An alternative approach to studying proto-utilitarian tendencies in everyday moral thinking is proposed. PMID:25791902

Yielding to desire: the durability of affective preferences.

PubMed

Rapp, David N; Jacovina, Matthew E; Slaten, Daniel G; Krause, Elise

2014-09-01

People's expectations about the future are guided not just by the contingencies of situations but also by what they hope or wish will happen next. These preferences can inform predictions that run counter to what should or must occur based on the logic of unfolding events. Effects of this type have been regularly identified in studies of judgment and decision making, with individuals' choices often reflecting emotional rather than rational influences. Encouraging individuals to rely less on their emotional considerations has proven a challenge as affective responses are generated quickly and are seemingly informative for decisions. In 6 experiments we examined whether individuals could be encouraged to rely less on their affective preferences when making judgments about future events. Participants read stories in which contexts informed the likelihood of events in ways that might run counter to their preferential investments in particular outcomes. While being less than relevant given the logic of events, participants' affective considerations remained influential despite time allotted for predictive reflection. In contrast, instructional warnings helped attenuate the influence of affective considerations, even under conditions previously shown to encourage preferential biases. The findings are discussed with respect to factors that mediate preference effects, and highlight challenges for overcoming people's reliance on affective contributors to everyday judgments and comprehension.

Perceived genetic knowledge, attitudes towards genetic testing, and the relationship between these among patients with a chronic disease.

PubMed

Morren, Mattijn; Rijken, Mieke; Baanders, Arianne N; Bensing, Jozien

2007-02-01

Genetics increasingly permeate everyday medicine. When patients want to make informed decisions about genetic testing, they require genetic knowledge. This study examined the genetic knowledge and attitudes of patients with chronic diseases, and the relationship between both. In addition, patients were asked about their preferred source of genetic information. Questionnaires were mailed to participants of a nationwide representative sample of patients with chronic diseases in the Netherlands (n = 1916). The response rate was 82% (n = 1496). Perceived genetic knowledge was low, particularly among older and lower educated patients. Attitudes towards genetics were rather positive, especially among younger and higher educated patients. Some concerns were also documented, mainly about the consequences of genetic testing for employment and taking insurance. Patients who perceived to have little knowledge found it difficult to formulate an opinion about genetic testing. Higher levels of genetic knowledge were associated with a more favourable attitude towards genetics. Chronic patients prefer to receive genetic information from their GP. Chronic patients are ill prepared when they require genetic knowledge to make decisions regarding the treatment of their disease. This seems to result from a knowledge deficiency rather than from disagreement with the genetic developments. When chronic patients are in need of information about genetics or genetic testing, their general practitioner should provide this.

Self-determination and older people--a concept analysis.

PubMed

Ekelund, Christina; Dahlin-Ivanoff, Synneve; Eklund, Kajsa

2014-03-01

Self-determination has emerged as an important concept within health care, used to emphasize clients' control and independence as they participate in rehabilitation. To strengthen clients' self-determination is a central aim in occupational therapy. However, there is a lack of a clear definition of self-determination concerning community-dwelling older people. The definition should be flexible in different contexts, such as cultural. To define and clarify the concept of self-determination in relation to community-dwelling frail older people. Walker & Avant's analysis procedure was carried out to identify textual attributes to the concept of self-determination, supplemented by a content analysis of 21 articles that were used to define and further justify the textual attributes. Self-determination was used in diverse contexts for community-dwelling older people, concerning: decision-making in everyday life, professionals' views, health, and legal/ethical rights. Different textual attributes were identified, to propose a conceptual definition of self-determination in relation to community-dwelling frail older people: A process in which a person has control and legal/ethical rights, and has the knowledge and ability to make a decision of his/her own free choice. This concept analysis has contributed to clarifying the concept for the convenience of research with community-dwelling frail older people.

Determining if an older adult can make and execute decisions to live safely at home: a capacity assessment and intervention model

PubMed Central

Skelton, Felicia; Kunik, Mark E.; Regev, Tziona; Naik, Aanand D.

2009-01-01

Determining an older adult’s capacity to live safely and independently in the community presents a serious and complicated challenge to the health care system. Evaluating one’s ability to make and execute decisions regarding safe and independent living incorporates clinical assessments, bioethical considerations, and often legal declarations of capacity. Capacity assessments usually result in life changes for patients and their families, including a caregiver managing some everyday tasks, placement outside of the home, and even legal guardianship. The process of determining capacity and recommending intervention is often inefficient and highly variable in most cases. Physicians are rarely trained to conduct capacity assessments and assessment methods are heterogeneous. An interdisciplinary team of clinicians developed the capacity assessment and intervention (CAI) model at a community outpatient geriatrics clinic to address these critical gaps. This report follows one patient through the entire CAI model, describing processes for a typical case. It then examines two additional case reports that highlight common challenges in capacity assessment. The CAI model uses assessment methods common to geriatrics clinical practice and conducts assessments and interventions in a standardized fashion. Reliance on common, validated measures increases generalizability of the model across geriatrics practice settings and patient populations. PMID:19481271

Fuzzy Decision-Making Fuser (FDMF) for Integrating Human-Machine Autonomous (HMA) Systems with Adaptive Evidence Sources.

PubMed

Liu, Yu-Ting; Pal, Nikhil R; Marathe, Amar R; Wang, Yu-Kai; Lin, Chin-Teng

2017-01-01

A brain-computer interface (BCI) creates a direct communication pathway between the human brain and an external device or system. In contrast to patient-oriented BCIs, which are intended to restore inoperative or malfunctioning aspects of the nervous system, a growing number of BCI studies focus on designing auxiliary systems that are intended for everyday use. The goal of building these BCIs is to provide capabilities that augment existing intact physical and mental capabilities. However, a key challenge to BCI research is human variability; factors such as fatigue, inattention, and stress vary both across different individuals and for the same individual over time. If these issues are addressed, autonomous systems may provide additional benefits that enhance system performance and prevent problems introduced by individual human variability. This study proposes a human-machine autonomous (HMA) system that simultaneously aggregates human and machine knowledge to recognize targets in a rapid serial visual presentation (RSVP) task. The HMA focuses on integrating an RSVP BCI with computer vision techniques in an image-labeling domain. A fuzzy decision-making fuser (FDMF) is then applied in the HMA system to provide a natural adaptive framework for evidence-based inference by incorporating an integrated summary of the available evidence (i.e., human and machine decisions) and associated uncertainty. Consequently, the HMA system dynamically aggregates decisions involving uncertainties from both human and autonomous agents. The collaborative decisions made by an HMA system can achieve and maintain superior performance more efficiently than either the human or autonomous agents can achieve independently. The experimental results shown in this study suggest that the proposed HMA system with the FDMF can effectively fuse decisions from human brain activities and the computer vision techniques to improve overall performance on the RSVP recognition task. This conclusion demonstrates the potential benefits of integrating autonomous systems with BCI systems.

Fuzzy Decision-Making Fuser (FDMF) for Integrating Human-Machine Autonomous (HMA) Systems with Adaptive Evidence Sources

PubMed Central

Liu, Yu-Ting; Pal, Nikhil R.; Marathe, Amar R.; Wang, Yu-Kai; Lin, Chin-Teng

2017-01-01

A brain-computer interface (BCI) creates a direct communication pathway between the human brain and an external device or system. In contrast to patient-oriented BCIs, which are intended to restore inoperative or malfunctioning aspects of the nervous system, a growing number of BCI studies focus on designing auxiliary systems that are intended for everyday use. The goal of building these BCIs is to provide capabilities that augment existing intact physical and mental capabilities. However, a key challenge to BCI research is human variability; factors such as fatigue, inattention, and stress vary both across different individuals and for the same individual over time. If these issues are addressed, autonomous systems may provide additional benefits that enhance system performance and prevent problems introduced by individual human variability. This study proposes a human-machine autonomous (HMA) system that simultaneously aggregates human and machine knowledge to recognize targets in a rapid serial visual presentation (RSVP) task. The HMA focuses on integrating an RSVP BCI with computer vision techniques in an image-labeling domain. A fuzzy decision-making fuser (FDMF) is then applied in the HMA system to provide a natural adaptive framework for evidence-based inference by incorporating an integrated summary of the available evidence (i.e., human and machine decisions) and associated uncertainty. Consequently, the HMA system dynamically aggregates decisions involving uncertainties from both human and autonomous agents. The collaborative decisions made by an HMA system can achieve and maintain superior performance more efficiently than either the human or autonomous agents can achieve independently. The experimental results shown in this study suggest that the proposed HMA system with the FDMF can effectively fuse decisions from human brain activities and the computer vision techniques to improve overall performance on the RSVP recognition task. This conclusion demonstrates the potential benefits of integrating autonomous systems with BCI systems. PMID:28676734

Pregnant women's navigation of information on everyday household chemicals: phthalates as a case study.

PubMed

Ashley, Justin M; Hodgson, Alexandra; Sharma, Sapna; Nisker, Jeff

2015-11-25

Current developments in science and the media have now placed pregnant women in a precarious situation as they are charged with the responsibility to navigate through information sources to make the best decisions for her pregnancy. Yet little is known regarding how pregnant women want to receive and use health information in general, let alone information regarding the uncertain risks to pregnancy in everyday household products such as phthalates found in cosmetics and canned food liners. Using phthalates as an example, this study investigated how pregnant women obtain, evaluate, and act on information regarding their pregnancy. Pregnant women were recruited using pamphlets and posters distributed in prenatal clinics, prenatal fairs and physician offices in Southwestern Ontario Canada. Research participants were engaged in 20 to 40 min semi-structured interviews regarding their use of information sources in pregnancy, particularly regarding phthalates in cosmetics and canned food liners. Interviews were transcribed verbatim and analyzed using constructivist grounded theory techniques supported by NVivo 9™ software. Theoretical sufficiency was reached after 23 pregnant women were interviewed and their transcripts analyzed. Three overlapping themes resulted from the co-constructed analysis: I-Strength of Information Sources; II-Value Modifiers; and III-Deciding to Control Exposure. The research participants reported receiving information from a wide range of sources that they perceived varying in strength or believability. They then described the strategies employed to increase the validity of the message in order to avoid risk exposure. Pregnant women preferred a strong source of information such as physician, government but frequently used weak sources such as the internet or the opinions of friends. A model was developed from the relationship between themes that describes how pregnant women navigate the multiple sources of information available to them. Our study provides insight into how pregnant women receive, appraise, and act on information regarding everyday household chemicals. Clinicians and their professional organizations should produce specific educational materials to assist women in understanding exposure to everyday products in pregnancy.

Optimal Predictions in Everyday Cognition: The Wisdom of Individuals or Crowds?

ERIC Educational Resources Information Center

Mozer, Michael C.; Pashler, Harold; Homaei, Hadjar

2008-01-01

Griffiths and Tenenbaum (2006) asked individuals to make predictions about the duration or extent of everyday events (e.g., cake baking times), and reported that predictions were optimal, employing Bayesian inference based on veridical prior distributions. Although the predictions conformed strikingly to statistics of the world, they reflect…

Making Their Way: Four Books on Youth, Culture, and Identity.

ERIC Educational Resources Information Center

Mickelson, Roslyn Arlin

2000-01-01

Reviews four books that contextually examine definitions of childhood and adolescence: "Peer Power: Preadolescent Culture and Identity" (Patricia A. Adler and Peter Adler); "Angels' Town: Chero Ways, Gang Life, and Rhetorics of the Everyday" (Ralph Cintron); "Everyday Courage: The Lives and Stories of Urban Teenagers"…

3D printing and IoT for personalized everyday objects in nursing and healthcare

NASA Astrophysics Data System (ADS)

Asano, Yoshihiro; Tanaka, Hiroya; Miyagawa, Shoko; Yoshioka, Junki

2017-04-01

Today, application of 3D printing technology for medical use is getting popular. It strongly helps to make complicated shape of body parts with functional materials. We can complement injured, weakened or lacked parts, and recover original shape and functions. However, these cases are mainly focusing on the symptom itself, not on everyday lives of patients. With life span extending, many of us will live a life with chronic disease for long time. Then, we should think about our living environment more carefully. For example, we can make personalized everyday objects and support their body and mind. Therefore, we use 3D printing for making everyday objects from nursing / healthcare perspective. In this project, we have 2 main research questions. The first one is how to make objects which patients really require. We invited many kinds of people such as engineer, nurses and patients to our research activity. Nurses can find patient's real demands firstly, and engineers support them with rapid prototyping. Finally, we found the best collaboration methodologies among nurses, engineers and patients. The second question is how to trace and evaluate usages of created objects. Apparently, it's difficult to monitor user's activity for a long time. So we're developing the IoT sensing system, which monitor activities remotely. We enclose a data logger which can lasts about one month with 3D printed objects. After one month, we can pick up the data from objects and understand how it has been used.

Cognitive impairment in patients clinically recovered from central nervous system depressant drug overdose.

PubMed

Dassanayake, Tharaka L; Michie, Patricia T; Jones, Alison; Carter, Gregory; Mallard, Trevor; Whyte, Ian

2012-08-01

Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), working memory (Letter-Number Sequencing), and impulsivity and decision making (Cambridge Neuropsychological Test Automated Battery Information Sampling) in 107 patients with CNS-D overdose (benzodiazepines, opioids, or antipsychotics) with a control group of 68 with non-CNS-D overdose (acetaminophen, selective serotonin reuptake inhibitors, and serotonin noradrenaline reuptake inhibitors) on discharge from hospital. Outcome measures were adjusted for demographic and clinical covariates in multivariate regression models. Compared with the controls, patients in the CNS-D group were significantly impaired in all domains: they had prolonged Trail-Making completion times and reaction times, poorer working memory and planning and were more impulsive in decision making. Their Stockings of Cambridge Task performance was comparable to that of the control group for simple problems but worsened with increasing task complexity. The results show that patients with CNS-D overdose could be impaired in multiple cognitive domains underlying everyday functioning even at the time they are deemed medically fit to be discharged. Such impairments could adversely affect social and professional lives of this relatively young population during the immediate postdischarge period.

Functional compensation in the ventromedial prefrontal cortex improves memory-dependent decisions in older adults.

PubMed

Lighthall, Nichole R; Huettel, Scott A; Cabeza, Roberto

2014-11-19

Everyday consumer choices frequently involve memory, as when we retrieve information about consumer products when making purchasing decisions. In this context, poor memory may affect decision quality, particularly in individuals with memory decline, such as older adults. However, age differences in choice behavior may be reduced if older adults can recruit additional neural resources that support task performance. Although such functional compensation is well documented in other cognitive domains, it is presently unclear whether it can support memory-guided decision making and, if so, which brain regions play a role in compensation. The current study engaged younger and older humans in a memory-dependent choice task in which pairs of consumer products from a popular online-shopping site were evaluated with different delays between the first and second product. Using functional imaging (fMRI), we found that the ventromedial prefrontal cortex (vmPFC) supports compensation as defined by three a priori criteria: (1) increased vmPFC activation was observed in older versus younger adults; (2) age-related increases in vmPFC activity were associated with increased retrieval demands; and (3) increased vmPFC activity was positively associated with performance in older adults-evidence of successful compensation. Extending these results, we observed evidence for compensation in connectivity between vmPFC and the dorsolateral PFC during memory-dependent choice. In contrast, we found no evidence for age differences in value-related processing or age-related compensation for choices without delayed retrieval. Together, these results converge on the conclusion that age-related decline in memory-dependent choice performance can be minimized via functional compensation in vmPFC. Copyright © 2014 the authors 0270-6474/14/3415648-10$15.00/0.

Functional Compensation in the Ventromedial Prefrontal Cortex Improves Memory-Dependent Decisions in Older Adults

PubMed Central

Huettel, Scott A.; Cabeza, Roberto

2014-01-01

Everyday consumer choices frequently involve memory, as when we retrieve information about consumer products when making purchasing decisions. In this context, poor memory may affect decision quality, particularly in individuals with memory decline, such as older adults. However, age differences in choice behavior may be reduced if older adults can recruit additional neural resources that support task performance. Although such functional compensation is well documented in other cognitive domains, it is presently unclear whether it can support memory-guided decision making and, if so, which brain regions play a role in compensation. The current study engaged younger and older humans in a memory-dependent choice task in which pairs of consumer products from a popular online-shopping site were evaluated with different delays between the first and second product. Using functional imaging (fMRI), we found that the ventromedial prefrontal cortex (vmPFC) supports compensation as defined by three a priori criteria: (1) increased vmPFC activation was observed in older versus younger adults; (2) age-related increases in vmPFC activity were associated with increased retrieval demands; and (3) increased vmPFC activity was positively associated with performance in older adults—evidence of successful compensation. Extending these results, we observed evidence for compensation in connectivity between vmPFC and the dorsolateral PFC during memory-dependent choice. In contrast, we found no evidence for age differences in value-related processing or age-related compensation for choices without delayed retrieval. Together, these results converge on the conclusion that age-related decline in memory-dependent choice performance can be minimized via functional compensation in vmPFC. PMID:25411493

Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses.

PubMed

Gutiérrez-Roig, Mario; Segura, Carlota; Duch, Jordi; Perelló, Josep

2016-01-01

Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go "up" or "down" in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops.

Market Imitation and Win-Stay Lose-Shift Strategies Emerge as Unintended Patterns in Market Direction Guesses

PubMed Central

Segura, Carlota; Duch, Jordi; Perelló, Josep

2016-01-01

Decisions made in our everyday lives are based on a wide variety of information so it is generally very difficult to assess what are the strategies that guide us. Stock market provides a rich environment to study how people make decisions since responding to market uncertainty needs a constant update of these strategies. For this purpose, we run a lab-in-the-field experiment where volunteers are given a controlled set of financial information -based on real data from worldwide financial indices- and they are required to guess whether the market price would go “up” or “down” in each situation. From the data collected we explore basic statistical traits, behavioural biases and emerging strategies. In particular, we detect unintended patterns of behavior through consistent actions, which can be interpreted as Market Imitation and Win-Stay Lose-Shift emerging strategies, with Market Imitation being the most dominant. We also observe that these strategies are affected by external factors: the expert advice, the lack of information or an information overload reinforce the use of these intuitive strategies, while the probability to follow them significantly decreases when subjects spends more time to make a decision. The cohort analysis shows that women and children are more prone to use such strategies although their performance is not undermined. Our results are of interest for better handling clients expectations of trading companies, to avoid behavioural anomalies in financial analysts decisions and to improve not only the design of markets but also the trading digital interfaces where information is set down. Strategies and behavioural biases observed can also be translated into new agent based modelling or stochastic price dynamics to better understand financial bubbles or the effects of asymmetric risk perception to price drops. PMID:27532219

Children's Use of Inscriptions in Argumentation about Socioscientific Issues

NASA Astrophysics Data System (ADS)

Xiao, Sihan

Engaging science in everyday life often means not advancing knowledge or making new claims, but evaluating given claims with available evidence. In everyday situations, evidence is usually presented in some type of inscription (e.g. tables, diagrams, and other images). This study explores elementary students' use of inscriptions as evidence in written arguments about socioscientific issues and how a school year of science instruction may play a role in that use. Three science teachers and their 102 students in 5th and 6th grades at a progressive urban K-6 school participated in this study. I administered a written argument task at the beginning and the end of the 2013--2014 school year, in which students were asked to justify their personal decisions about either alternative energy use or genetically modified organisms. Throughout the year, I worked closely with the teachers to organize classroom instruction towards promoting argumentation and coordination between claims and evidence, and videotaped their science lessons. Content analysis on students' written arguments reveals that photos were cited the most in students' written arguments, while tables were cited the least. Students tended to merely point to an inscription without articulate its relation to a particular claim, or to assert that an inscription "shows" a claim without saying how. They were also likely to credit inscriptions that aligned with their own position rather than discount those that supported counterclaims. From pre to post, these patterns did not change significantly. Analysis on science instruction further shows that the contestability of the claims students encountered in the classroom was low, meaning that they were not framed in arguable ways. The resources available to students for resolving these claims were also limited. The classroom discourse was not open enough for productive argumentation. These patterns may potentially account for the lack of change in students' use of inscriptions in their written arguments. This study extends previous research on what children think counts as evidence in arguing about everyday science. Findings suggest that while students learn to evaluate scientific explanations in school, they are put in a different position of having to justify their decisions when facing everyday science. School science should explicitly link the two tasks. Further, we need to frame the learning of science as stabilizing legitimately contestable claims, and provide relevant resources for students to argue with. Classroom discourse, lastly, should be open to argumentation and integrative with disciplinary and epistemic aspects of scientific practices.

The affect heuristic, mortality salience, and risk: domain-specific effects of a natural disaster on risk-benefit perception.

PubMed

Västfjäll, Daniel; Peters, Ellen; Slovic, Paul

2014-12-01

We examine how affect and accessible thoughts following a major natural disaster influence everyday risk perception. A survey was conducted in the months following the 2004 south Asian Tsunami in a representative sample of the Swedish population (N = 733). Respondents rated their experienced affect as well as the perceived risk and benefits of various everyday decision domains. Affect influenced risk and benefit perception in a way that could be predicted from both the affect-congruency and affect heuristic literatures (increased risk perception and stronger risk-benefit correlations). However, in some decision domains, self-regulation goals primed by the natural disaster predicted risk and benefit ratings. Together, these results show that affect, accessible thoughts and motivational states influence perceptions of risks and benefits. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Counterfactual Thinking Deficit in Huntington’s Disease

PubMed Central

Solca, Federica; Poletti, Barbara; Zago, Stefano; Crespi, Chiara; Sassone, Francesca; Lafronza, Annalisa; Maraschi, Anna Maria; Sassone, Jenny; Silani, Vincenzo; Ciammola, Andrea

2015-01-01

Background and Objective Counterfactual thinking (CFT) refers to the generation of mental simulations of alternatives to past events, actions and outcomes. CFT is a pervasive cognitive feature in every-day life and is closely related to decision-making, planning and problem-solving – all of which are cognitive processes linked to unimpaired frontal lobe functioning. Huntington’s Disease (HD) is a neurodegenerative disorder characterised by motor, behavioral and cognitive dysfunctions. Because an impairment in frontal and executive functions has been described in HD, we hypothesised that HD patients may have a CFT impairment. Methods Tests of spontaneous counterfactual thoughts and counterfactual-derived inferences were administered to 24 symptomatic HD patients and 24 age- and sex-matched healthy subjects. Results Our results show a significant impairment in the spontaneous generation of CFT and low performance on the Counterfactual Inference Test (CIT) in HD patients. Low performance on the spontaneous CFT test significantly correlates with impaired attention abilities, verbal fluency and frontal lobe efficiency, as measured by Trail Making Test – Part A, Phonemic Verbal Fluency Test and FAB. Conclusions Spontaneous CFT and the use of this type of reasoning are impaired in HD patients. This deficit may be related to frontal lobe dysfunction, which is a hallmark of HD. Because CFT has a pervasive role in patients’ daily lives regarding their planning, decision making and problem solving skills, cognitive rehabilitation may improve HD patients’ ability to analyse current behaviors and future actions. PMID:26070155

[Bioethics in medical institutions--new custom or help? The example of clinical ethics consultation at a University Medical Center].

PubMed

Richter, G

2014-08-01

Although ethics committees are well established in the medical sciences for human clinical trials, animal research and scientific integrity, the development of clinical ethics in German hospitals started much later during the first decade of the twenty-first century. Clinical ethics consultation should be pragmatic and problem-centered and can be defined as an ethically qualified and informed conflict management within a given legal framework to deal with and resolve value-driven, normative problems in the care of patients. Clinical ethics consultations enable shared clinical decision-making of all parties (e.g. clinicians, patients, family and surrogates) involved in a particular patient's care. The clinical ethicist does not act as an ethics expert by making independent recommendations or decisions; therefore, the focus is different from other medical consultants. Ethics consultation was first established by healthcare ethics committees (HEC) or clinical ethics consultation (CEC) groups which were called in to respond to an ethically problematic situation. To avoid ethical dilemmas or crises and to act preventively with regard to ethical issues in individual patients, an ethics liaison service is an additional option to ethics case consultations which take place on a regular basis by scheduled ethics rounds during the normal ward rounds. The presence of the ethicist offers some unique advantages: it allows early recognition of even minor ethical problems and accommodates the dynamics of ethical and clinical goal-setting in the course of patient care. Most importantly, regular and non-authoritative participation of the ethicist in normal ward rounds allows continuous ethical education of the staff within the everyday clinical routine. By facilitating clinical ethical decision-making, the ethicist seeks to empower physicians and medical staff to deal appropriately with ethical problems by themselves. Because of this proactive approach, the ethics liaison service can make a significant contribution to preventative ethics in reducing the number of emerging ethical problems to the satisfaction of all parties involved.

Rural science education as social justice

NASA Astrophysics Data System (ADS)

Eppley, Karen

2017-03-01

What part can science education play in the dismantling of obstacles to social justice in rural places? In this Forum contribution, I use "Learning in and about Rural Places: Connections and Tensions Between Students' Everyday Experiences and Environmental Quality Issues in their Community"(Zimmerman and Weible 2016) to explicitly position rural education as a project of social justice that seeks full participatory parity for rural citizens. Fraser's (2009) conceptualization of social justice in rural education requires attention to the just distribution of resources, the recognition of the inherent capacities of rural people, and the right to equal participation in democratic processes that lead to opportunities to make decisions affecting local, regional, and global lives. This Forum piece considers the potential of place-based science education to contribute to this project.

Individuals with episodic amnesia are not stuck in time.

PubMed

Craver, Carl F; Kwan, Donna; Steindam, Chloe; Rosenbaum, R Shayna

2014-05-01

The metaphor that individuals with episodic amnesia due to hippocampal damage are "stuck in time" persists in science, philosophy, and everyday life despite mounting evidence that episodic amnesia can spare many central aspects of temporal consciousness. Here we describe some of this evidence, focusing specifically on KC, one of the most thoroughly documented and severe cases of episodic amnesia on record. KC understands the concept of time, knows that it passes, and can orient himself with respect to his personal past and future. He expresses typical attitudes toward his past and future, and he is able to make future-regarding decisions. Theories claiming that the hippocampus plays an essential role in temporal consciousness need to be revised in light of these findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cognition and Emotions in Recurrent Depressive Disorders - The Role of Inflammation and the Kynurenine Pathway.

PubMed

Talarowska, Monika; Galecki, Piotr

2016-01-01

Separating emotions from cognition seems impossible in everyday experiences of a human being. Emotional processes have an impact on the ability of planning and solving problems, or decision-making skills. They are a valuable source of information about ourselves, our partners in interactions and the surrounding world. Recent years have shown that axial symptoms of depression are caused by emotion regulation disorders, dysfunctions in the reward system and deficits of cognitive processes. There is a few studies concerning a link between emotional and inflammatory processes in depression. The aim of this article is to present results of contemporary research studies over mutual connections between social cognition, cognitive processes and inflammatory factors significant for the aetiology of recurrent depressive disorders, with particular reference to the role of kynurenine pathways.

Research integrity and everyday practice of science.

PubMed

Grinnell, Frederick

2013-09-01

Science traditionally is taught as a linear process based on logic and carried out by objective researchers following the scientific method. Practice of science is a far more nuanced enterprise, one in which intuition and passion become just as important as objectivity and logic. Whether the activity is committing to study a particular research problem, drawing conclusions about a hypothesis under investigation, choosing whether to count results as data or experimental noise, or deciding what information to present in a research paper, ethical challenges inevitably will arise because of the ambiguities inherent in practice. Unless these ambiguities are acknowledged and their sources understood explicitly, responsible conduct of science education will not adequately prepare the individuals receiving the training for the kinds of decisions essential to research integrity that they will have to make as scientists.

Unpacking Ideologies of Linguistic Purism: How Dual Language Teachers Make Sense of Everyday Translanguaging

ERIC Educational Resources Information Center

Martínez, Ramón Antonio; Hikida, Michiko; Durán, Leah

2015-01-01

This article draws on qualitative data from two Spanish-English dual language elementary classrooms to explore how teachers in these classrooms made sense of the everyday practice of bilingualism. Methodologically, this study relied on participant observation, video recording, and semi-structured interviews. Conceptually, this article draws on the…

Incorporating the Aesthetic Dimension into Pedagogy

ERIC Educational Resources Information Center

Webster, R. Scott; Wolfe, Melissa

2013-01-01

This paper reports on a case study that was undertaken to discover not only the belief and intent behind the everyday opportunities that four exemplary teachers offered their high performing students but what activities they incorporated into their everyday lessons in an attempt to make sense of how aesthetic experiences may enhance learning. The…

Making a Big Deal about Everyday Objects

ERIC Educational Resources Information Center

Masse, Don

2010-01-01

Claes Oldenburg and Coosje van Bruggen, who have been married over 30 years, take items from popular culture and transform them into giant sculptures that are on display all over the world. Their installations include clothespins, baseball bats, garden shovels and ice cream cones, to name a few. This transformation of everyday things is a great…

Making Sense of an Information World: The Everyday-Life Information Behavior of Preteens

ERIC Educational Resources Information Center

Meyers, Eric M.; Fisher, Karen E.; Marcoux, Elizabeth

2009-01-01

This article presents an empirically-grounded framework for mediating the everyday-life information worlds of youth aged 9-13. "Tweens" are a sandwiched population with behaviors, circumstances, and needs distinct from children and young adults. Little research has addressed their information-seeking, especially regarding nonschool contexts. Thus,…

Mapping the brain's metaphor circuitry: metaphorical thought in everyday reason

PubMed Central

Lakoff, George

2014-01-01

An overview of the basics of metaphorical thought and language from the perspective of Neurocognition, the integrated interdisciplinary study of how conceptual thought and language work in the brain. The paper outlines a theory of metaphor circuitry and discusses how everyday reason makes use of embodied metaphor circuitry. PMID:25566012

Everyday Engineering: What Makes a Bic Click?

ERIC Educational Resources Information Center

Moyer, Richard; Everett, Susan

2009-01-01

The ballpoint pen is an ideal example of simple engineering that we use everyday. But is it really so simple? The ballpoint pen is a remarkable combination of technology and science. Its operation uses several scientific principles related to chemistry and physics, such as properties of liquids and simple machines. They represent significant…

Outcomes research in pediatric settings: recent trends and future directions.

PubMed

Forrest, Christopher B; Shipman, Scott A; Dougherty, Denise; Miller, Marlene R

2003-01-01

Pediatric outcomes research examines the effects of health care delivered in everyday medical settings on the health of children and adolescents. It is an area of inquiry in its nascent stages of development. We conducted a systematic literature review that covered articles published during the 6-year interval 1994-1999 and in 39 peer-reviewed journals chosen for their likelihood of containing child health services research. This article summarizes the article abstraction, reviews the literature, describes recent trends, and makes recommendations for future work. In the sample of journals that we examined, the number of pediatric outcomes research articles doubled between 1994 and 1999. Hospitals and primary care practices were the most common service sectors, accounting for more than half of the articles. Common clinical categories included neonatal conditions, asthma, psychosocial problems, and injuries. Approximately 1 in 5 studies included multistate or national samples; 1 in 10 used a randomized controlled trial study design. Remarkably few studies examined the health effects of preventive, diagnostic, long-term management, or curative services delivered to children and adolescents. Outcomes research in pediatric settings is a rapidly growing area of inquiry that is acquiring breadth but has achieved little depth in any single content area. Much work needs to be done to inform decision making regarding the optimal ways to finance, organize, and deliver child health care services. To improve the evidence base of pediatric health care, more effectiveness research is needed to evaluate the overall and relative effects of services delivered to children and adolescents in everyday settings.

Ethics and gender issues in palliative care in nursing homes: an Austrian participatory research project.

PubMed

Reitinger, Elisabeth; Heimerl, Katharina

2014-06-01

The development of palliative care in nursing homes in German-speaking countries has gained in importance within the past 15-20 years. Ethical and gender issues are core aspects of a palliative care culture and should therefore be better understood. The aim of this study was to highlight insights regarding ethical and gender issues, based on the experiences of professionals in nursing homes. A 2-year participatory action research study was performed in collaboration with three nursing homes in Austria. The article focusses on 10 group discussions with interdisciplinary professional teams that were conducted to generate ethical narratives. Thematic and narrative analysis was undertaken both individually and within the interdisciplinary research team. Findings and interpretations were validated with practitioners and researchers. A total of 36 narratives were collected and summarised within eight themes concerning the theoretical journey of a nursing home resident with relatives from entry into the house until death. The most burdensome ethical dilemmas are not the ones around death and dying but rather those relating to small-scale everyday work/life issues. Sharing experiences and feelings in ethical discussions provides relief. Emotions are important facilitators of insight into ethical dilemmas. Gender issues can be observed in care situations as well as in the organisational structure of nursing homes. Opportunities to share experiences and perspectives around ethical questions in interdisciplinary group discussions help professionals to better understand difficult issues and find appropriate ways of managing them. There is a need for communication structures such as facilitated ethical discussions that enable nursing home staff to reflect their everyday decisions. Expression of emotions should be encouraged in ethical decision-making processes in nursing homes. Gender-sensitive reflection supports the development of palliative care as organisational culture. © 2014 John Wiley & Sons Ltd.

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing.

PubMed

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-06-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals' everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients' space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants' everyday lives. We found that participants' everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants' everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off 'ripple effects' within participants' space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de-centre everyday human behaviour. Opportunities to support renal patients in managing illness and experiencing wellbeing outside the clinical setting lie in a space-time re-design of chronic care services. Copyright © 2017 Elsevier Ltd. All rights reserved.

Difficulties in everyday life: young persons with attention-deficit/hyperactivity disorder and autism spectrum disorders perspectives. A chat-log analysis.

PubMed

Ahlström, Britt H; Wentz, Elisabet

2014-01-01

This study focuses on the everyday life of young persons with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). There are follow-up studies describing ADHD, and ASD in adults, and residual impairments that affect life. Few qualitative studies have been conducted on the subject of their experiences of everyday life, and even fewer are from young persons' perspectives. This study's aim was to describe how young persons with ADHD and ASD function and how they manage their everyday life based on analyses of Internet-based chat logs. Twelve young persons (7 males and 5 females aged 15-26) diagnosed with ADHD and ASD were included consecutively and offered 8 weeks of Internet-based Support and Coaching (IBSC). Data were collected from 12 chat logs (445 pages of text) produced interactively by the participants and the coaches. Qualitative content analysis was applied. The text was coded and sorted into subthemes and further interpreted into themes. The findings revealed two themes: "fighting against an everyday life lived in vulnerability" with the following subthemes: "difficult things," "stress and rest," and "when feelings and thoughts are a concern"; and the theme "struggling to find a life of one's own" with the following subthemes: "decide and carry out," "making life choices," and "taking care of oneself." Dealing with the problematic situations that everyday encompasses requires personal strength and a desire to find adequate solutions, as well as to discover a role in society. This study, into the provision of support and coaching over the Internet, led to more in-depth knowledge about these young persons' everyday lives and revealed their ability to use IBSC to express the complexity of everyday life for young persons with ADHD and ASD. The implications of the findings are that using online coaching makes available new opportunities for healthcare professionals to acknowledge these young persons' problems.

Contextualising renal patient routines: Everyday space-time contexts, health service access, and wellbeing

PubMed Central

McQuoid, Julia; Jowsey, Tanisha; Talaulikar, Girish

2017-01-01

Stable routines are key to successful illness self-management for the growing number of people living with chronic illness around the world. Yet, the influence of chronically ill individuals’ everyday contexts in supporting routines is poorly understood. This paper takes a space-time geographical approach to explore the everyday space-time contexts and routines of individuals with chronic kidney disease (CKD). We ask: what is the relationship between renal patients’ space-time contexts and their ability to establish and maintain stable routines, and, what role does health service access play in this regard? We draw from a qualitative case study of 26 individuals with CKD in Australia. Data comprised self-reported two day participant diaries and semi-structured interviews. Thematic analysis of interview transcripts was guided by an inductive-deductive approach. We examined the embeddedness of routines within the space-time contexts of participants’ everyday lives. We found that participants’ everyday space-time contexts were highly complex, especially for those receiving dialysis and/or employed, making routines difficult to establish and vulnerable to disruption. Health service access helped shape participants’ everyday space-time contexts, meaning that incidences of unpredictability in accessing health services set-off ‘ripple effects’ within participants’ space-time contexts, disrupting routines and making everyday life negotiation more difficult. The ability to absorb ripple effects from unpredictable health services without disrupting routines varied by space-time context. Implications of these findings for the deployment of the concept of routine in health research, the framing of patient success in self-managing illness, and health services design are discussed. In conclusion, efforts to understand and support individuals in establishing and maintaining routines that support health and wellbeing can benefit from approaches that contextualise and de-centre everyday human behaviour. Opportunities to support renal patients in managing illness and experiencing wellbeing outside the clinical setting lie in a space-time re-design of chronic care services. PMID:28482275

Behavioral contagion during learning about another agent’s risk-preferences acts on the neural representation of decision-risk

PubMed Central

Suzuki, Shinsuke; Jensen, Emily L. S.; Bossaerts, Peter; O’Doherty, John P.

2016-01-01

Our attitude toward risk plays a crucial role in influencing our everyday decision-making. Despite its importance, little is known about how human risk-preference can be modulated by observing risky behavior in other agents at either the behavioral or the neural level. Using fMRI combined with computational modeling of behavioral data, we show that human risk-preference can be systematically altered by the act of observing and learning from others’ risk-related decisions. The contagion is driven specifically by brain regions involved in the assessment of risk: the behavioral shift is implemented via a neural representation of risk in the caudate nucleus, whereas the representations of other decision-related variables such as expected value are not affected. Furthermore, we uncover neural computations underlying learning about others’ risk-preferences and describe how these signals interact with the neural representation of risk in the caudate. Updating of the belief about others’ preferences is associated with neural activity in the dorsolateral prefrontal cortex (dlPFC). Functional coupling between the dlPFC and the caudate correlates with the degree of susceptibility to the contagion effect, suggesting that a frontal–subcortical loop, the so-called dorsolateral prefrontal–striatal circuit, underlies the modulation of risk-preference. Taken together, these findings provide a mechanistic account for how observation of others’ risky behavior can modulate an individual’s own risk-preference. PMID:27001826

Improving the Quality of Informed Consent in Clinical Research with Information Technology.

PubMed

Taber, Celia; Warren, Jim; Day, Karen

2016-01-01

The clinical research industry has yet to fully embrace information technology (IT) for informed consent purposes, even though it is used indispensably in our everyday lives and in other areas of clinical research and healthcare. This paper presents findings of a meta-narrative literature review to discuss the potential for IT to improve the quality of clinical research informed consent. The review reveals three main rationales for including IT in research consent. First, in the current context consent documents frequently fail to be effective decision aids for patients, and the lack of patient centricity in the process. Second, social media provides opportunities for patients to consult with a broader community during research consent to seek broader support, and potential to participate in creating a more patient centric process. Third, multimedia tools provide opportunities for improved patient education, engagement and decision making during research consent. IT offers opportunities to achieve more meaningful research consent, but more research is needed to create an evidence base, policies and economic analyses on the return on investment of using IT in the process.

Everyday Leadership: Attitudes and Actions for Respect and Success. Guidebook for Teens

ERIC Educational Resources Information Center

MacGregor, Mariam G.

2006-01-01

Written and experiential activities help teens discover their own leadership potential and develop skills that guide them to act responsibly and make a difference in the world around them. Teens gain a greater understanding of who they are, what matters to them, how that translates into leadership, and how leadership relates to everyday life.…

Enhanced subgenual cingulate response to altruistic decisions in remitted major depressive disorder

PubMed Central

Pulcu, Erdem; Zahn, Roland; Moll, Jorge; Trotter, Paula D.; Thomas, Emma J.; Juhasz, Gabriella; Deakin, J.F.William; Anderson, Ian M.; Sahakian, Barbara J.; Elliott, Rebecca

2014-01-01

Background Major depressive disorder (MDD) is associated with functional abnormalities in fronto-meso-limbic networks contributing to decision-making, affective and reward processing impairments. Such functional disturbances may underlie a tendency for enhanced altruism driven by empathy-based guilt observed in some patients. However, despite the relevance of altruistic decisions to understanding vulnerability, as well as everyday psychosocial functioning, in MDD, their functional neuroanatomy is unknown. Methods Using a charitable donations experiment with fMRI, we compared 14 medication-free participants with fully remitted MDD and 15 demographically-matched control participants without MDD. Results Compared with the control group, the remitted MDD group exhibited enhanced BOLD response in a septal/subgenual cingulate cortex (sgACC) region for charitable donation relative to receiving simple rewards and higher striatum activation for both charitable donation and simple reward relative to a low level baseline. The groups did not differ in demographics, frequency of donations or response times, demonstrating only a difference in neural architecture. Conclusions We showed that altruistic decisions probe residual sgACC hypersensitivity in MDD even after symptoms are fully remitted. The sgACC has previously been shown to be associated with guilt which promotes altruistic decisions. In contrast, the striatum showed common activation to both simple and altruistic rewards and could be involved in the so-called “warm glow” of donation. Enhanced neural response in the depression group, in areas previously linked to altruistic decisions, supports the hypothesis of a possible association between hyper-altruism and depression vulnerability, as shown by recent epidemiological studies. PMID:24936421

Reproductive strategies and Islamic discourse: Malian migrants negotiate everyday life in Paris, France.

PubMed

Sargent, Carolyn F

2006-03-01

Approximately 37 thousand Malians currently reside in France as part of the West African diaspora. Primarily Muslim, both women and men confront challenges to their understandings of Islamic prohibitions and expectations, especially those addressing conjugal relations and reproduction. Biomedical policies generate marital conflicts and pose health dilemmas for women who face family and community pressures to reproduce but biomedical encouragement to limit childbearing. For many women, contraception represents a reprieve from repeated pregnancies and fatigue in spite of resistance from those who contest women's reproductive decisions as antithetical to Islam. French social workers play a particularly controversial role by introducing women to a discourse of women's rights that questions the authority of husbands and of religious doctrine. Women and men frame decisions and debate in diverse interpretations of Islam as they seek to manage the contradictions of everyday life and assert individual agency in the context of immigration and health politics.

Machine Learning in Medical Imaging.

PubMed

Giger, Maryellen L

2018-03-01

Advances in both imaging and computers have synergistically led to a rapid rise in the potential use of artificial intelligence in various radiological imaging tasks, such as risk assessment, detection, diagnosis, prognosis, and therapy response, as well as in multi-omics disease discovery. A brief overview of the field is given here, allowing the reader to recognize the terminology, the various subfields, and components of machine learning, as well as the clinical potential. Radiomics, an expansion of computer-aided diagnosis, has been defined as the conversion of images to minable data. The ultimate benefit of quantitative radiomics is to (1) yield predictive image-based phenotypes of disease for precision medicine or (2) yield quantitative image-based phenotypes for data mining with other -omics for discovery (ie, imaging genomics). For deep learning in radiology to succeed, note that well-annotated large data sets are needed since deep networks are complex, computer software and hardware are evolving constantly, and subtle differences in disease states are more difficult to perceive than differences in everyday objects. In the future, machine learning in radiology is expected to have a substantial clinical impact with imaging examinations being routinely obtained in clinical practice, providing an opportunity to improve decision support in medical image interpretation. The term of note is decision support, indicating that computers will augment human decision making, making it more effective and efficient. The clinical impact of having computers in the routine clinical practice may allow radiologists to further integrate their knowledge with their clinical colleagues in other medical specialties and allow for precision medicine. Copyright © 2018. Published by Elsevier Inc.

Ethics, intimacy and sexuality in aged care.

PubMed

Cook, Catherine; Schouten, Vanessa; Henrickson, Mark; McDonald, Sandra

2017-12-01

To analyse the accounts of staff, family and residents to advance ethical insights into intimacy and sexuality in residential care. Discourses of ageing readily construct people in residential aged care as postsexual, vulnerable and at risk of sexual exploitation, and therefore, expressions of intimacy and sexuality may be responded to as deviant and inherently risky. Staff may manage decision-making tacitly, without recourse to policies and education. The proof-of-concept study used a discursive methodology, identifying discourses that shape diverse meanings of intimacy, sexuality and ageing. Data analysis involved thematic analysis. Semi-structured interviews were conducted with four participants in 2015 as part of a mixed-methods study. This article reports on the qualitative data. Four themes were identified in the data analysis: mediated intimate relationships and everyday ethics; self-referential morality; knowing the person then and now; and juggling ethical priorities. Data indicated that participants used their personal moral compass to inform their decision-making, without any related policies and applied ethics and communication education. As a result, staff described moral uncertainty and moral distress. Staff indicated that there were tensions in terms of the role of proxy decision-makers, as there were situations where staff believed they were more aware of residents' current wishes and cognitive capabilities than family members. Staff, families and residents routinely address intimacy and sexuality in aged care. Ethically informed education and policies may enhance the role of staff as advocates, ensuring older people living in RAC are as at home and autonomous as possible. © 2017 John Wiley & Sons Ltd.

Small Talk: Children's Everyday `Molecule' Ideas

NASA Astrophysics Data System (ADS)

Jakab, Cheryl

2013-08-01

This paper reports on 6-11-year-old children's `sayings and doings' (Harré 2002) as they explore molecule artefacts in dialectical-interactive teaching interviews (Fleer, Cultural Studies of Science Education 3:781-786, 2008; Hedegaard et al. 2008). This sociocultural study was designed to explore children's everyday awareness of and meaning-making with cultural molecular artefacts. Our everyday world is populated with an ever increasing range of molecular or nanoworld words, symbols, images, and games. What do children today say about these artefacts that are used to represent molecular world entities? What are the material and social resources that can influence a child's everyday and developing scientific ideas about `molecules'? How do children interact with these cognitive tools when given expert assistance? What meaning-making is afforded when children are socially and materially assisted in using molecular tools in early chemical and nanoworld thinking? Tool-dependent discursive studies show that provision of cultural artefacts can assist and direct developmental thinking across many domains of science (Schoultz et al., Human Development 44:103-118, 2001; Siegal 2008). Young children's use of molecular artefacts as cognitive tools has not received much attention to date (Jakab 2009a, b). This study shows 6-11-year-old children expressing everyday ideas of molecular artefacts and raising their own questions about the artefacts. They are seen beginning to domesticate (Erneling 2010) the words, symbols, and images to their own purposes when given the opportunity to interact with such artefacts in supported activity. Discursive analysis supports the notion that using `molecules' as cultural tools can help young children to begin `putting on molecular spectacles' (Kind 2004). Playing with an interactive game (ICT) is shown to be particularly helpful in assisting children's early meaning-making with representations of molecules, atoms, and their chemical symbols.

Effect of DECIDE (Decision-making Education for Choices In Diabetes Everyday) Program Delivery Modalities on Clinical and Behavioral Outcomes in Urban African Americans With Type 2 Diabetes: A Randomized Trial

PubMed Central

Fitzpatrick, Stephanie L.; Golden, Sherita Hill; Stewart, Kerry; Sutherland, June; DeGross, Sharie; Brown, Tina; Wang, Nae-Yuh; Allen, Jerilyn; Cooper, Lisa A.

2016-01-01

OBJECTIVE To compare the effectiveness of three delivery modalities of Decision-making Education for Choices In Diabetes Everyday (DECIDE), a nine-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training, compared with an enhanced usual care (UC), on clinical and behavioral outcomes among urban African Americans with type 2 diabetes. RESEARCH DESIGN AND METHODS Eligible participants (n = 182) had a suboptimal CVD risk factor profile (A1C, blood pressure, and/or lipids). Participants were randomized to DECIDE Self-Study (n = 46), DECIDE Individual (n = 45), DECIDE Group (n = 46), or Enhanced UC (n = 45). Intervention duration was 18–20 weeks. Outcomes were A1C, blood pressure, lipids, problem-solving, disease knowledge, and self-care activities, all measured at baseline, 1 week, and 6 months after completion of the intervention. RESULTS DECIDE modalities and Enhanced UC did not significantly differ in clinical outcomes at 6 months postintervention. In participants with A1C ≥7.5% (58 mmol/mol) at baseline, A1C declined in each DECIDE modality at 1 week postintervention (P < 0.05) and only in Self-Study at 6 months postintervention (b = −0.24, P < 0.05). There was significant reduction in systolic blood pressure in Self-Study (b = −4.04) and Group (b = −3.59) at 6 months postintervention. Self-Study, Individual, and Enhanced UC had significant declines in LDL and Self-Study had an increase in HDL (b = 1.76, P < 0.05) at 6 months postintervention. Self-Study and Individual had a higher increase in knowledge than Enhanced UC (P < 0.05), and all arms improved in problem-solving (P < 0.01) at 6 months postintervention. CONCLUSIONS DECIDE modalities showed benefits after intervention. Self-Study demonstrated robust improvements across clinical and behavioral outcomes, suggesting program suitability for broader dissemination to populations with similar educational and literacy levels. PMID:27879359

Neurobiology of Everyday Communication: What Have We Learned From Music?

PubMed

Kraus, Nina; White-Schwoch, Travis

2016-06-09

Sound is an invisible but powerful force that is central to everyday life. Studies in the neurobiology of everyday communication seek to elucidate the neural mechanisms underlying sound processing, their stability, their plasticity, and their links to language abilities and disabilities. This sound processing lies at the nexus of cognitive, sensorimotor, and reward networks. Music provides a powerful experimental model to understand these biological foundations of communication, especially with regard to auditory learning. We review studies of music training that employ a biological approach to reveal the integrity of sound processing in the brain, the bearing these mechanisms have on everyday communication, and how these processes are shaped by experience. Together, these experiments illustrate that music works in synergistic partnerships with language skills and the ability to make sense of speech in complex, everyday listening environments. The active, repeated engagement with sound demanded by music making augments the neural processing of speech, eventually cascading to listening and language. This generalization from music to everyday communications illustrates both that these auditory brain mechanisms have a profound potential for plasticity and that sound processing is biologically intertwined with listening and language skills. A new wave of studies has pushed neuroscience beyond the traditional laboratory by revealing the effects of community music training in underserved populations. These community-based studies reinforce laboratory work highlight how the auditory system achieves a remarkable balance between stability and flexibility in processing speech. Moreover, these community studies have the potential to inform health care, education, and social policy by lending a neurobiological perspective to their efficacy. © The Author(s) 2016.

Teaching Science Through the Language of Students in Technology-Enhanced Instruction

NASA Astrophysics Data System (ADS)

Ryoo, Kihyun

2015-02-01

This study examines whether and how tapping into students' everyday language in a web-based learning environment can improve all students' science learning in linguistically heterogeneous classrooms. A total of 220 fifth-grade English Language Learners (ELLs) and their non-ELL peers were assigned to either an everyday English approach condition or a textbook approach condition, and completed technology-enhanced instruction focusing on respiration and photosynthesis. Students in the everyday English approach condition were taught the concepts in everyday, conversational English before content-specific scientific terms were introduced, while students in the textbook approach condition were taught the same concepts and vocabulary simultaneously. The results show that the everyday English approach was significantly more effective in helping both ELLs and non-ELL students develop a coherent understanding of abstract concepts related to photosynthesis and respiration. Students in the everyday English approach condition were also better able to link content-specific terms to their understanding of the concepts. These findings show the potential advantage of using students' everyday English as a resource to make science more accessible to linguistically diverse students in mainstream classrooms. By integrating students' everyday language in science instruction, it is possible for all students including ELLs to acquire both the content and language of science.

The Dark Side of Malleability: Incremental Theory Promotes Immoral Behaviors

PubMed Central

Huang, Niwen; Zuo, Shijiang; Wang, Fang; Cai, Pan; Wang, Fengxiang

2017-01-01

Implicit theories drastically affect an individual’s processing of social information, decision making, and action. The present research focuses on whether individuals who hold the implicit belief that people’s moral character is fixed (entity theorists) and individuals who hold the implicit belief that people’s moral character is malleable (incremental theorists) make different choices when facing a moral decision. Incremental theorists are less likely to make the fundamental attribution error (FAE), rarely make moral judgment based on traits and show more tolerance to immorality, relative to entity theorists, which might decrease the possibility of undermining the self-image when they engage in immoral behaviors, and thus we posit that incremental beliefs facilitate immorality. Four studies were conducted to explore the effect of these two types of implicit theories on immoral intention or practice. The association between implicit theories and immoral behavior was preliminarily examined from the observer perspective in Study 1, and the results showed that people tended to associate immoral behaviors (including everyday immoral intention and environmental destruction) with an incremental theorist rather than an entity theorist. Then, the relationship was further replicated from the actor perspective in Studies 2–4. In Study 2, implicit theories, which were measured, positively predicted the degree of discrimination against carriers of the hepatitis B virus. In Study 3, implicit theories were primed through reading articles, and the participants in the incremental condition showed more cheating than those in the entity condition. In Study 4, implicit theories were primed through a new manipulation, and the participants in the unstable condition (primed incremental theory) showed more discrimination than those in the other three conditions. Taken together, the results of our four studies were consistent with our hypotheses. PMID:28824517

The Dark Side of Malleability: Incremental Theory Promotes Immoral Behaviors.

PubMed

Huang, Niwen; Zuo, Shijiang; Wang, Fang; Cai, Pan; Wang, Fengxiang

2017-01-01

Implicit theories drastically affect an individual's processing of social information, decision making, and action. The present research focuses on whether individuals who hold the implicit belief that people's moral character is fixed (entity theorists) and individuals who hold the implicit belief that people's moral character is malleable (incremental theorists) make different choices when facing a moral decision. Incremental theorists are less likely to make the fundamental attribution error (FAE), rarely make moral judgment based on traits and show more tolerance to immorality, relative to entity theorists, which might decrease the possibility of undermining the self-image when they engage in immoral behaviors, and thus we posit that incremental beliefs facilitate immorality. Four studies were conducted to explore the effect of these two types of implicit theories on immoral intention or practice. The association between implicit theories and immoral behavior was preliminarily examined from the observer perspective in Study 1, and the results showed that people tended to associate immoral behaviors (including everyday immoral intention and environmental destruction) with an incremental theorist rather than an entity theorist. Then, the relationship was further replicated from the actor perspective in Studies 2-4. In Study 2, implicit theories, which were measured, positively predicted the degree of discrimination against carriers of the hepatitis B virus. In Study 3, implicit theories were primed through reading articles, and the participants in the incremental condition showed more cheating than those in the entity condition. In Study 4, implicit theories were primed through a new manipulation, and the participants in the unstable condition (primed incremental theory) showed more discrimination than those in the other three conditions. Taken together, the results of our four studies were consistent with our hypotheses.

Privacy-Preserving Patient-Centric Clinical Decision Support System on Naïve Bayesian Classification.

PubMed

Liu, Ximeng; Lu, Rongxing; Ma, Jianfeng; Chen, Le; Qin, Baodong

2016-03-01

Clinical decision support system, which uses advanced data mining techniques to help clinician make proper decisions, has received considerable attention recently. The advantages of clinical decision support system include not only improving diagnosis accuracy but also reducing diagnosis time. Specifically, with large amounts of clinical data generated everyday, naïve Bayesian classification can be utilized to excavate valuable information to improve a clinical decision support system. Although the clinical decision support system is quite promising, the flourish of the system still faces many challenges including information security and privacy concerns. In this paper, we propose a new privacy-preserving patient-centric clinical decision support system, which helps clinician complementary to diagnose the risk of patients' disease in a privacy-preserving way. In the proposed system, the past patients' historical data are stored in cloud and can be used to train the naïve Bayesian classifier without leaking any individual patient medical data, and then the trained classifier can be applied to compute the disease risk for new coming patients and also allow these patients to retrieve the top- k disease names according to their own preferences. Specifically, to protect the privacy of past patients' historical data, a new cryptographic tool called additive homomorphic proxy aggregation scheme is designed. Moreover, to leverage the leakage of naïve Bayesian classifier, we introduce a privacy-preserving top- k disease names retrieval protocol in our system. Detailed privacy analysis ensures that patient's information is private and will not be leaked out during the disease diagnosis phase. In addition, performance evaluation via extensive simulations also demonstrates that our system can efficiently calculate patient's disease risk with high accuracy in a privacy-preserving way.

Beyond a code of ethics: phenomenological ethics for everyday practice.

PubMed

Greenfield, Bruce; Jensen, Gail M

2010-06-01

Physical therapy, like all health-care professions, governs itself through a code of ethics that defines its obligations of professional behaviours. The code of ethics provides professions with a consistent and common moral language and principled guidelines for ethical actions. Yet, and as argued in this paper, professional codes of ethics have limits applied to ethical decision-making in the presence of ethical dilemmas. Part of the limitations of the codes of ethics is that there is no particular hierarchy of principles that govern in all situations. Instead, the exigencies of clinical practice, the particularities of individual patient's illness experiences and the transformative nature of chronic illnesses and disabilities often obscure the ethical concerns and issues embedded in concrete situations. Consistent with models of expert practice, and with contemporary models of patient-centred care, we advocate and describe in this paper a type of interpretative and narrative approach to moral practice and ethical decision-making based on phenomenology. The tools of phenomenology that are well defined in research are applied and examined in a case that illustrates their use in uncovering the values and ethical concerns of a patient. Based on the deconstruction of this case on a phenomenologist approach, we illustrate how such approaches for ethical understanding can help assist clinicians and educators in applying principles within the context and needs of each patient. (c) 2010 John Wiley & Sons, Ltd.

Mechanisms underlying selecting objects for action

PubMed Central

Wulff, Melanie; Laverick, Rosanna; Humphreys, Glyn W.; Wing, Alan M.; Rotshtein, Pia

2015-01-01

We assessed the factors which affect the selection of objects for action, focusing on the role of action knowledge and its modulation by distracters. Fourteen neuropsychological patients and 10 healthy aged-matched controls selected pairs of objects commonly used together among distracters in two contexts: with real objects and with pictures of the same objects presented sequentially on a computer screen. Across both tasks, semantically related distracters led to slower responses and more errors than unrelated distracters and the object actively used for action was selected prior to the object that would be passively held during the action. We identified a sub-group of patients (N = 6) whose accuracy was 2SDs below the controls performances in the real object task. Interestingly, these impaired patients were more affected by the presence of unrelated distracters during both tasks than intact patients and healthy controls. Note that the impaired patients had lesions to left parietal, right anterior temporal and bilateral pre-motor regions. We conclude that: (1) motor procedures guide object selection for action, (2) semantic knowledge affects action-based selection, (3) impaired action decision making is associated with the inability to ignore distracting information and (4) lesions to either the dorsal or ventral visual stream can lead to deficits in making action decisions. Overall, the data indicate that impairments in everyday tasks can be evaluated using a simulated computer task. The implications for rehabilitation are discussed. PMID:25954177

Opting in and opting out: a grounded theory of nursing's contribution to inpatient rehabilitation.

PubMed

Pryor, Julie; Walker, Annette; O'Connell, Beverly; Worrall-Carter, Linda

2009-12-01

To develop a grounded theory of nursing's contribution to patient rehabilitation from the perspective of nurses working in inpatient rehabilitation. Grounded theory method, informed by the theoretical perspective of symbolic interactionism, was used to guide data collection and analysis, and the development of a grounded theory. Five inpatient rehabilitation units in Australia. Thirty-five registered and 18 enrolled nurses participated in audio-taped interviews and/or were observed during periods of their everyday practice. The analysis revealed a situation whereby nurses made decisions about when to 'opt in' and when to 'opt out' of inpatient rehabilitation. This occurred on two levels: with their interaction with patients and allied health professionals, and when faced with negative system issues that impacted on their ability to contribute to patient rehabilitation. The primary contribution nurses made to inpatient rehabilitation was working directly with patients, enabling them to self-care. Nurses coached patients when their decisions about 'opting in' and 'opting out' were based on assessment of the person in their particular context. In contrast, the nurses mostly distanced themselves from system-based problems, 'opting out' of addressing them. They did this not to make their working lives easier, but more manageable. System-based problems impacted negatively on the nurses' ability to deliver comprehensive rehabilitation care. As a consequence, some nurses felt unable to influence the care and they withdrew professionally to make their work lives more manageable.

The Three I's for Ethics as an Everyday Activity: Integration, Intrinsic Valuing, and Intersubjectivity

ERIC Educational Resources Information Center

Bai, Heesoon

2004-01-01

In addressing the theme of ethics as an everyday activity, this essay makes a case for the primacy of preventive ethics over interventional ethics. Preventive ethics aims at creating a condition of viability and wellbeing for all members of the earth community, an ethical ideal that follows from the thesis that all life-phenomena are…

Investigating the Integration of Everyday Phenomena and Practical Work in Physics Teaching in Vietnamese High Schools

ERIC Educational Resources Information Center

Ng, Wan; Nguyen, Van Thanh

2006-01-01

Making science relevant in students' learning is an important aspect of science education. This involves the ability to draw in examples from daily contexts to begin with the learning or to apply concepts learnt into familiar everyday phenomena that students observe and experience around them. Another important aspect of science education is the…

Inference to the Best Explanation (IBE) versus Explaining for the Best Inference (EBI)

ERIC Educational Resources Information Center

Wilkenfeld, Daniel A.; Lombrozo, Tania

2015-01-01

In pedagogical contexts and in everyday life, we often come to believe something because it would best explain the data. What is it about the explanatory endeavor that makes it essential to everyday learning and to scientific progress? There are at least two plausible answers. On one view, there is something special about having true…

Knowledge and Beliefs about National Development and Developmental Hierarchies: the Viewpoints of Ordinary People in Thirteen Countries

PubMed Central

Thornton, Arland; Binstock, Georgina; Abbasi-Shavazi, Mohammad Jalal; Ghimire, Dirgha; Gjonca, Arjan; Melegh, Attila; Mitchell, Colter; Moaddel, Mansoor; Xie, Yu; Yang, Li-shou; Young-DeMarco, Linda; Yount, Kathryn M.

2012-01-01

Scholars and policy makers have for centuries constructed and used developmental hierarchies to characterize different countries. The hypotheses motivating this paper are that such social constructions have been circulated internationally, are constructed similarly in various countries, and follow the social constructions of elite international organizations, such as the United Nations. This paper uses data from fifteen surveys in thirteen diverse countries to study how developmental hierarchies are understood in everyday life. Our research shows that most people have constructions of developmental hierarchies that are similar across countries and are similar to the developmental hierarchies constructed by the United Nations. These findings suggest that developmental hierarchies are widely understood around the world and are widely available to ordinary people as they make decisions about many aspects of life. PMID:23017917

What is the problem with breast-feeding? A qualitative analysis of infant feeding perceptions.

PubMed

Stewart-Knox, B; Gardiner, K; Wright, M

2003-08-01

Breast-feeding rates are low in Northern Ireland (NI) compared with other regions of Europe. The aim of this study has therefore been to define and explore factors determining infant feeding decisions with a view to the planning of future research and intervention needs. Participants were approached at convenience from the throughput of women attending a large teaching hospital antenatal clinic to take part in focus group discussion. Dominant themes indicated that the main barriers to breast-feeding are restricted freedom and independence associated with family issues, return to work, societal embarrassment and perceived social isolation. The dialogue suggested that breast-feeding leads to inability to carry out everyday activities and social exclusion. Incompatible social norms make it difficult for mothers to breast-feed successfully. This implies that future promotional efforts should take a societal approach.

The Japanese value of harmony and nursing ethics.

PubMed

Konishi, Emiko; Yahiro, Michiko; Nakajima, Naoko; Ono, Miki

2009-09-01

Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses' perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses' harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for all. Because of the unique link between harmony and the location of interaction, the ideal 'workplace harmony' threatened some nurses' professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged.

Everyday memory and working memory in adolescents with mild intellectual disability.

PubMed

Van der Molen, M J; Van Luit, J E H; Van der Molen, Maurits W; Jongmans, Marian J

2010-05-01

Everyday memory and its relationship to working memory was investigated in adolescents with mild intellectual disability and compared to typically developing adolescents of the same age (CA) and younger children matched on mental age (MA). Results showed a delay on almost all memory measures for the adolescents with mild intellectual disability compared to the CA control adolescents. Compared to the MA control children, the adolescents with mild intellectual disability performed less well on a general everyday memory index. Only some significant associations were found between everyday memory and working memory for the mild intellectual disability group. These findings were interpreted to suggest that adolescents with mild intellectual disability have difficulty in making optimal use of their working memory when new or complex situations tax their abilities.

Do people really know what makes a family history of cancer?

PubMed

Lim, Jennifer N W; Hewison, Jenny

2014-12-01

Family history is often referred to as a family tree in casual everyday conservations, but it carries a different connotation in medicine. This study is the first to investigate people's understanding of 'family medical history' and the concept of 'family' in the context of inherited cancer. Three hundred and nine staff at the Faculty of Medicine and Health, University of Leeds completed an online web survey. Not all respondents understood or knew what makes a family history of cancer. Only 54% knew exactly the type of information required to make a family history. Apart from blood relatives, adopted and step-siblings, step parents, in-laws, spouses, friends and colleagues were also named as 'family' for family history taking. Personal experience of living with cancer and academic qualification were not significant in influencing knowledge of family history. There is misunderstanding and poor knowledge of family history of cancer and the type of information required to make a family history even in a sample of people teaching and researching medicine and health issues. Public understanding of the value of family medical history in cancer prevention and management is important if informed clinical decisions and appropriate health care are to be delivered. © 2012 John Wiley & Sons Ltd.

Healthcare needs of displaced women: Osire refugee camp, Namibia.

PubMed

Pinehas, Lusia N; van Wyk, Neltjie C; Leech, Ronell

2016-03-01

The aim of this study was to explore and describe the experiences of healthcare needs of displaced women in the Osire refugee camp in Namibia. Namibia is a country where displaced people from other African countries seek refuge as a result of their own country's political instability. All displaced people are hosted in the Osire camp, which is a highly protected area. There are more women than men in the camp and their health is often compromised. In this descriptive phenomenological study, the natural dimension of the experiences of the participants of their healthcare needs were explored through in-depth interviews and reflected upon through transcendental processes to formulate the phenomenological dimension thereof. The essence of displaced women's healthcare needs was "the need for the restoration of hope and human dignity". Their needs refer to measures to enhance their autonomy and freedom; skills training; certainty about their future; security with aid distribution; protection against stigmatization due to human immunodeficiency virus (HIV) infection; protection against abuse; and participation in reproductive health care. When displaced women are admitted in a camp they lose their freedom to make decisions about everyday functioning and future. They thus develop feelings of insecurity and vulnerability. The participants referred to several factors that were detrimental for their well-being. The essence of their needs was "the need for the restoration of hope and human dignity" that could only be achieved when their needs are addressed. As nurses are in close contact with displaced women in refugee camps they should negotiate opportunities for the women to discuss their concerns with the camp officials. Policies should make provision for the involvement of displaced people in all aspects that relate to their everyday and future living arrangements. © 2016 International Council of Nurses.

'Gonna make yer gorgeous': Everyday transformation, resistance and belonging in the care-based hair salon.

PubMed

Ward, Richard; Campbell, Sarah; Keady, John

2016-05-01

This paper makes a contribution to an emerging debate on dementia and citizenship through a focus on the everyday experiences of women living with dementia and in receipt of care. In particular, a link is drawn between hairdressing and citizenship in the context of dementia care. Informed by a wider debate over the importance of an emplaced, embodied and performative approach to citizenship, the authors highlight the way that intersecting forms of resistance unfold in the salon. The Hair and Care project, as the name implies, focused upon hair care and styling in the context of a wider consideration of appearance and how it is managed and what it means for people living with dementia. With a focus upon the routine, mundane and thereby often unproblematised aspects of everyday life in/with care, the discussion draws together two key ideas concerned with the interplay of power and resistance: Essed's (1991) theory of 'everyday discrimination' and Scott's (1985) notion of 'everyday resistance'. The findings illuminate the creative and collective forms of agency exercised by older women living with dementia, in the context of their relationships with one another and with the hairdressers whose services and support inspire their loyalty and patronage. Findings from the study point to the link between (inter-)personal practices of appearance management and a wider set of social conditions that are manifest in the on-going struggle over time, space and bodies in dementia care. © The Author(s) 2016.

Microcantilevers track single-cell mass

USDA-ARS?s Scientific Manuscript database

Determining the mass of objects by weighing them has been an everyday practice that informs all manner of decisions. However, direct measurement of the mass of sub-microgram objects, especially in fluid, is still a technological grand challenge. Recent advances in microscale cantilever sensors have ...

STATISTICS-BASED APPROACH TO WASTEWATER TREATMENT PLANT OPERATIONS

EPA Science Inventory

This paper describes work toward development of a convenient decision support system to improve everyday operation and control of the wastewater treatment process. The goal is to help the operator detect problems in the process and select appropriate control actions. The system...

[Ethical case discussions in the intensive care unit : from testing to routine].

PubMed

Meyer-Zehnder, B; Barandun Schäfer, U; Albisser Schleger, H; Reiter-Theil, S; Pargger, H

2014-06-01

The daily work of many healthcare professionals has become more complex and demanding in recent years. Apart from purely medical issues, ethical questions and problems arise quite often. Managing these problems requires ethical knowledge. Questions about the usefulness of a therapy and treatment occur especially at the end of life. So-called medical futility, a useless futile therapy, is often perceived by nurses and physicians in intensive care units who themselves often develop symptoms of depression or burnout. The clinical ethical model METAP (acronym from module, ethics, therapy decision, allocation and process) provides methods and criteria that allow the clinical team to treat and solve ethical issues according to a solution-oriented approach. The ethical decision-making of this model addresses these issues according to a series of sequential stages in the form of a so-called escalation model. When it is not possible to tackle and solve an ethical problem or dilemma in one stage, one moves to the next. The implementation of this approach in everyday practice requires the commitment of all team members in addition to certain basic conditions. In a surgical intensive care unit a fixed date in the schedule is reserved for ethical case discussions (level 3 of the escalation model). At this level a team member who has been specified according to a quarterly plan is responsible for the organization and performance of the discussion. All protocols of the 44 ethical case discussions in 41 patients between January 2011 and July 2012 were collected and summarized. A short questionnaire to all participants recorded their assessment of the benefits for the patient and the team as well as their perception of personal stress reduction. Also queried was the impact of this method on the collaboration between nurses and physicians and the ethical competence. Ethical case discussions among the care team took place regularly (44 case discussions between January 2011 and June 2012). The duration of these discussions ranged from 30 to 60 min. On average 6.2 persons took part, including 2.7 nurses and 3.2 physicians. Of the 41 patients (16 female, 25 male) for whom a discussion was carried out, 23 died during the continued hospital stay. The respondents (response rate 52 %) assessed the benefit for patients and team as high (slightly higher benefit for physicians than nurses) and 55 % of physicians and 71 % of nurses perceived a reduction in the burden of decision-making in difficult cases due to the case discussions. All physicians and 66 % of the nurses reported an improvement in the cooperation between the professional groups and 80 % of the nurses and more than half of the physicians noticed an increase in their own ethical competence. A methodically structured ethical decision-making process can and should be integrated into the clinical routine. This process requires a fixed place in everyday practice and the defined responsibility for the actual organization and performance. Support by medical and nursing management personnel is also essential for the implementation. The regular occurrence of ethical case discussions among the care team relieves the participants and improves collaboration between nurses and physicians.

Inside 'bed management': ethnographic insights from the vantage point of UK hospital nurses.

PubMed

Allen, Davina

2015-03-01

In the face of unprecedented financial and demographic challenges, optimising acute bed utilisation by the proactive management of patient flows is a pressing policy concern in high-income countries. Despite the growing literature on this topic, bed management has received scant sociological attention. Drawing on practice-based approaches, this article deploys ethnographic data to examine bed management from the perspective of UK hospital nurses. While the nursing contribution to bed management is recognised formally in their widespread employment in patient access and discharge liaison roles, nurses at all levels in the study site were enrolled in this organisational priority. Rather than the rational, centrally controlled processes promulgated by policymakers, bed management emerges as a predominantly distributed activity, described here as match-making. An example of micro-level rationing, for the most part, match-making was not informed by explicit criteria nor did it hinge on clearly identifiable decisions to grant or deny access. Rather it was embedded in the everyday practices and situated rationalities through which nurses accomplished the accommodations necessary to balance demand with resources. © 2014 Foundation for the Sociology of Health & Illness.

Don't Push Your Luck! Educational Family Board (Not Bored) Game for School-Age Children Living with Chronic Conditions.

PubMed

Kennedy, Andrea; Semple, Lisa; Alderson, Kerri; Bouskill, Vanessa; Karasevich, Janice; Riske, Brenda; van Gunst, Sheri

Children who are living with chronic conditions may be supported in self-care through enjoyable active learning and family social processes. This research focused on development and evaluation of "Don't Push Your Luck!", an educational board game designed to inspire family discussion about chronic conditions, and help affected children learn about self-care choices and consequences. Mixed-method research was conducted with families from one outpatient Cystic Fibrosis Clinic and four Hemophilia Treatment Centres in Canada and United States (N=72). In phase I, board game prototype and questionnaires were refined with affected boys, siblings, and parents living with hemophilia (n=11), compared with families living with cystic fibrosis (n=11). In phase II, final board game was evaluated with families living with hemophilia (n=50). Data collection included pre-post-game questionnaires on decision-making and Haemo-QoL Index©, and post-game enjoyment. Analysis included descriptive statistics, inferential statistics (non-parametric), and qualitative themes. Findings revealed this game was an enjoyable and effective resource to engage families in self-care discussions. Key themes included communication, being involved, knowing, decisions and consequences, and being connected. Qualitative and quantitative findings aligned. Statistical significance suggests the game enhanced family engagement to support decision-making skills, as parents identified that the game helped them talk about important topics, and children gained insight regarding family supports and self-care responsibility. This board game was an effective, developmentally appropriate family resource to facilitate engagement and conversation about everyday life experiences in preparation for self-care. There is promising potential to extend this educational family board game intervention with a greater range of school-age children and families living with chronic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

PubMed

Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

2015-01-01

Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD. Copyright © 2015 Elsevier Inc. All rights reserved.

78 FR 64289 - General Motors, LLC, Receipt of Petition for Decision of Inconsequential Noncompliance

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-28

... everyday use of the vehicle. 5. Paragraph S4.2.6 of FMVSS No. 202a allows 13 mm of permanent displacement... subject head restraints is 19 mm. Thus, the potential head restraint displacement due to the improperly...

Family food practices: relationships, materiality and the everyday at the end of life.

PubMed

Ellis, Julie

2018-02-01

This article draws on data from a research project that combined participant observation with in-depth interviews to explore family relationships and experiences of everyday life during life-threatening illness. In it I suggest that death has often been theorised in ways that make its 'mundane' practices less discernible. As a means to foreground the everyday, and to demonstrate its importance to the study of dying, this article explores the (re)negotiation of food and eating in families facing the end of life. Three themes that emerged from the study's broader focus on family life are discussed: 'food talk' and making sense of illness; food, family and identity; and food 'fights'. Together the findings illustrate the material, social and symbolic ways in which food acts relationally in the context of dying, extending conceptual work on materiality in death studies in novel directions. The article also contributes new empirical insights to a limited sociological literature on food, families and terminal illness, building on work that theorises the entanglements of materiality, food, bodies and care. The article concludes by highlighting the analytical value of everyday materialities such as food practices for future research on dying as a relational experience. © 2018 The Author. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.

Guide to Good Posture

MedlinePlus

... Affect how well your joints move Affect your balance and increase your risk of falling Make it harder to digest your food Make it harder to breathe How can I improve my posture in general? Be mindful of your posture during everyday activities, ...

[Health literacy, a way to reduce social health inequalities].

PubMed

Bragard, I; Coucke, Ph A; Pétré, B; Etienne, A-M; Guillaume, M

2017-01-01

Health Literacy (HL) is defined as «the knowledge, motivation, and competences to access, understand, appraise and apply health information in order to make judgments and take decisions in everyday life concerning health care, disease prevention and health promotion to maintain or improve quality of life». This concept begins to be recognized as a priority area for action at political level in Belgium. Indeed, a limited HL may affect health by leading, for example, with poorer management of chronic diseases, more hospital admissions and premature deaths. This paper addresses the question of HL evaluation, improvement interventions as well as the many challenges that remain in this area. HL seems fundamental to the development of better health management. It would allow patients to play a more active role in health care, to involve all health stakeholders, and to contribute to a more sustainable health system. Improving HL could allow better equal access to health care.e.

Sleep deprivation: Impact on cognitive performance

PubMed Central

Alhola, Paula; Polo-Kantola, Päivi

2007-01-01

Today, prolonged wakefulness is a widespread phenomenon. Nevertheless, in the field of sleep and wakefulness, several unanswered questions remain. Prolonged wakefulness can be due to acute total sleep deprivation (SD) or to chronic partial sleep restriction. Although the latter is more common in everyday life, the effects of total SD have been examined more thoroughly. Both total and partial SD induce adverse changes in cognitive performance. First and foremost, total SD impairs attention and working memory, but it also affects other functions, such as long-term memory and decision-making. Partial SD is found to influence attention, especially vigilance. Studies on its effects on more demanding cognitive functions are lacking. Coping with SD depends on several factors, especially aging and gender. Also interindividual differences in responses are substantial. In addition to coping with SD, recovering from it also deserves attention. Cognitive recovery processes, although insufficiently studied, seem to be more demanding in partial sleep restriction than in total SD. PMID:19300585

Learning clinical reasoning.

PubMed

Pinnock, Ralph; Welch, Paul

2014-04-01

Errors in clinical reasoning continue to account for significant morbidity and mortality, despite evidence-based guidelines and improved technology. Experts in clinical reasoning often use unconscious cognitive processes that they are not aware of unless they explain how they are thinking. Understanding the intuitive and analytical thinking processes provides a guide for instruction. How knowledge is stored is critical to expertise in clinical reasoning. Curricula should be designed so that trainees store knowledge in a way that is clinically relevant. Competence in clinical reasoning is acquired by supervised practice with effective feedback. Clinicians must recognise the common errors in clinical reasoning and how to avoid them. Trainees can learn clinical reasoning effectively in everyday practice if teachers provide guidance on the cognitive processes involved in making diagnostic decisions. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

A clinician's understanding of ethics in palliative care: an American perspective.

PubMed

Cimino, James E

2003-04-01

I believe the standard for making ethical decisions should be the same for all patients: appropriate medical interventions, carefully weighing their benefits and burdens, and trying to honor the wishes of the patients. When cure is not possible, the balance between benefits and burdens should shift to greater consideration of the burden side of the equation. The ascendancy of autonomy over other medical ethical principles is the center for most of the ethical dilemmas encountered in palliative care. This paper discusses the issues of autonomy, informed consent, patient capacity, advance directives, futility, "do-not-resuscitate" orders, withholding or withdrawing interventions, euthanasia, and sedation therapy. After 41 years of my personally caring for over 4000 terminally ill patients, primarily at Calvary Hospital, the most practical approach has been to establish trust with patients and families, determining their goals, and diligently applying the principles of beneficence (benefits) and nonmaleficence (burdens) in everyday practice.

Reliability of Travel Time: Challenges Posed by a Multimodal Transport Participation

NASA Astrophysics Data System (ADS)

Wanjek, Monika; Hauger, Georg

2017-10-01

Travel time reliability represents an essential component in individual decision making processes for transport participants, particularly regarding mode choices. As criteria that describe the quality of both transportation systems and transportation modes, travel time reliability is already frequently compiled, analysed and quoted as an argument. Currently, travel time reliability is solely mentioned on monomodal trips, while it has remained unconsidered on multimodal transport participation. Given the fact that multimodality gained significantly in importance, it is crucial to discuss how travel time reliability could be determined on multimodal trips. This paper points out the challenges that occur for applying travel time reliability on multimodal transport participation. Therefore, examples will be given within this paper. In order to illustrate theoretical ideas, trips and influencing factors that could be expected within the everyday transport behaviour of commuters in a (sub)urban area will be described.

A Neural Mechanism of Preference Shifting Under Zero Price Condition

PubMed Central

Votinov, Mikhail; Aso, Toshihiko; Fukuyama, Hidenao; Mima, Tatsuya

2016-01-01

In everyday life, free products have a strong appeal to us, even if we do not need them. Behavioral studies demonstrated that people have a tendency to switch their preference from preferred more expensive products to less preferable, cheaper alternatives, when the cheaper option becomes free. However, the neural representation of this behavioral anomaly called “Zero price” is still unclear. Using fMRI, we studied subjects while they performed binary preference choice task for items with different prices. We found that zero-related change of preference was associated with activation of the choice network, which includes inferior parietal lobule (IPL), posterior cingulate cortex and medial prefrontal cortex. Moreover, the amount of activation in medial prefrontal cortex was positively correlated with the subjective happiness score of getting free products. Our findings suggest that the Zero-price effect is driven by affective evaluations during decision-making. PMID:27148024

Exploring high school students' use of theory and evidence in an everyday context: the role of scientific thinking in environmental science decision-making

NASA Astrophysics Data System (ADS)

Yang, Fang-Ying

2004-11-01

This study examined 10th-grade students' use of theory and evidence in evaluating a socio-scientific issue: the use of underground water, after students had received a Science, Technology and Society-oriented instruction. Forty-five male and 45 female students from two intact, single-sex, classes participated in this study. A flow-map method was used to assess the participants' conceptual knowledge. The reasoning mode was assessed using a questionnaire with open-ended questions. Results showed that, although some weak to moderate associations were found between conceptual organization in memory and reasoning modes, the students' ability to incorporate theory and evidence was in general inadequate. It was also found that students' reasoning modes were consistent with their epistemological perspectives. Moreover, male and female students appear to have different reasoning approaches.

Law in everyday life and death: a socio-legal study of chronic disorders of consciousness

PubMed Central

Halliday, Simon; Kitzinger, Celia; Kitzinger, Jenny

2015-01-01

This paper addresses, from a socio-legal perspective, the question of the significance of law for the treatment, care and the end-of-life decision making for patients with chronic disorders of consciousness. We use the phrase ‘chronic disorders of consciousness’ as an umbrella term to refer to severely brain-injured patients in prolonged comas, vegetative or minimally conscious states. Based on an analysis of interviews with family members of patients with chronic disorders of consciousness, we explore the images of law that were drawn upon and invoked by these family members when negotiating the situation of their relatives, including, in some cases, the ending of their lives. By examining ‘legal consciousness’ in this way (an admittedly confusing term in the context of this study,) we offer a distinctly sociological contribution to the question of how law matters in this particular domain of social life. PMID:26041944

Internet of Things in Marketing: Opportunities and Security Issues

NASA Astrophysics Data System (ADS)

Abashidze, Irakli; Dąbrowski, Marcin

2016-12-01

Internet of Things (IoT) affects different areas of human activities: everyday life of ordinary citizens, work style of marketing teams, factories and even entire cities. Large companies try to implement the technology in their marketing strategy that reshapes not only communication style and product promotion but consumers' expectations, perceptions and requirements towards companies. IoT is expected to become a huge network that will encompass not only smart devices but significantly influence humans' behavior, in this particular case - decision making style in different phases of purchase process. Therefore, the need for comprehensive scientific research is necessary. The issue needs to be reviewed from various points of view, such as opportunities, advantages, disadvantages, legal and technical considerations. The paper is an attempt to review different aspects of using Internet of Things for marketing purposes, identify some of the major problems and present possible ways of solution.

Effect of professional expertise and exposure to everyday life decision-making on moral choices.

PubMed

Boccia, Maddalena; Verde, Paola; Angelino, Gregorio; Carrozzo, Paolo; Vecchi, Diego; Piccardi, Laura; Colangeli, Stefano; Cordellieri, Pierluigi; Ferlazzo, Fabio; Giannini, Anna Maria

2017-07-27

Moral sense is defined as a feeling of fairness or unfairness of an action that knowingly causes harm to people other than the subject. It is crucial in determining human behavior and becomes pivotal in operational environments. Here we assessed whether professional daily life experience in an operational environment affects moral judgment by asking 41 military pilots of the Italian Air Force (P) and 69 controls (C) to solve 40 moral dilemmas. We found that P gave more morally acceptable utilitarian responses to moral dilemmas. Interestingly, men and women in P equally accepted utilitarian resolutions of moral dilemmas, whereas in C women were less prone than men to accept utilitarian responses. We conclude that professional daily life experience of P, in an operational environment, affects moral judgment and mitigates gender predisposition towards moral dilemmas. Copyright © 2017 Elsevier B.V. All rights reserved.

Pediatric Non-alcoholic Fatty Liver Disease: Current Thinking.

PubMed

Nobili, Valerio; Socha, Piotr

2017-10-31

Non-alcoholic fatty liver disease (NAFLD), an increasingly prevalent paediatric disorder is diagnosed and managed by both paediatric gastroenterologists / hepatologists but also frequently by the general paediatrician. This paper updates recent advances in diagnostic and therapeutic approach which may be applied to everyday practice. Diagnosis of NAFLD takes into account the risk factor profile and is a diagnosis of exclusion. Techniques such as transient elastography and specific biomarkers aimed at improving diagnosis and monitoring of NAFLD need further validation in the paediatric population. Defining the risk to develop cirrhosis seems to be of primary importance already in childhood and a combination of genetic, clinical and environmental factors can help in monitoring and making decisions on therapy. Weight reduction therapy should be the aim of treatment approach but the compliance is poor and pharmacological treatment would be helpful- DHA, some probiotics, vitamin E are to be considered but evidence is not sufficient to recommend widespread use.

Machine learning of network metrics in ATLAS Distributed Data Management

NASA Astrophysics Data System (ADS)

Lassnig, Mario; Toler, Wesley; Vamosi, Ralf; Bogado, Joaquin; ATLAS Collaboration

2017-10-01

The increasing volume of physics data poses a critical challenge to the ATLAS experiment. In anticipation of high luminosity physics, automation of everyday data management tasks has become necessary. Previously many of these tasks required human decision-making and operation. Recent advances in hardware and software have made it possible to entrust more complicated duties to automated systems using models trained by machine learning algorithms. In this contribution we show results from one of our ongoing automation efforts that focuses on network metrics. First, we describe our machine learning framework built atop the ATLAS Analytics Platform. This framework can automatically extract and aggregate data, train models with various machine learning algorithms, and eventually score the resulting models and parameters. Second, we use these models to forecast metrics relevant for networkaware job scheduling and data brokering. We show the characteristics of the data and evaluate the forecasting accuracy of our models.

Strategies for Sustained Weight Management: Perspectives From African American Patients With Type 2 Diabetes.

PubMed

Fitzpatrick, Stephanie L; Hill-Briggs, Felicia

2017-06-01

Purpose The purpose of this study was to identify effective strategies for sustained weight management used by African American patients with obesity and type 2 diabetes. Methods In this study, nominal group technique was used to identify effective strategies for weight management used by 12 African Americans with overweight/obesity and type 2 diabetes who successfully lost or maintained their weight after completing DECIDE (Decision-making Education for Choices In Diabetes Everyday), a 9-module, literacy-adapted diabetes and cardiovascular disease (CVD) education and problem-solving training program. Results Participants generated a list of 101 strategies that covered 4 domains: nutrition, physical activity, cognitive-behavioral strategies, and other. Self-monitoring and relying on social support were the top 2 strategies for weight maintenance. Conclusion Future obesity studies should consider including friends/family as well as electronic tools to facilitate self-monitoring and regular practice of behavioral strategies for long-term success.

"Saying no is no easy matter" A qualitative study of competing concerns in rationing decisions in general practice

PubMed Central

Carlsen, Benedicte; Norheim, Ole Frithjof

2005-01-01

Background The general practitioner in Norway is expected to ensure equity and effectiveness through fair rationing. At the same time, due to recent reforms of the Norwegian health care sector, both the role of economic incentives and patient autonomy have been strengthened. Studies indicate that modern general practitioners, both in Norway and in other countries are uncomfortable with the gatekeeper role, but there is little knowledge about how general practitioners experience rationing in practice. Methods Through focus group interviews with Norwegian general practitioners, we explore physicians' attitudes toward factors of influence on medical decision making and how rationing dilemmas are experienced in everyday practice. Results Four major concerns appeared in the group discussions: The obligation to ration health care, professional autonomy, patient autonomy, and competition. A central finding was that the physicians find rationing difficult because saying no in face to face relations often is felt uncomfortable and in conflict with other important objectives for the general practitioner. Conclusion It is important to understand the association between using economic incentives in the management of health care, increasing patient autonomy, and the willingness among physicians to contribute to efficient, fair and legitimate resource allocation. PMID:16281967

Impacting Society through Astronomy Undergraduate Courses

NASA Astrophysics Data System (ADS)

Schleigh, Sharon

2015-04-01

A high percentage of non-science majors enroll in undergraduate, introductory astronomy courses across the country. The perception of the astronomy course as being easier than the ``hard sciences'' and the idea that the course will focus on ``pretty pictures'', influences the interests of the non-science majors. Often the students that enroll in these courses will not take other science courses, resulting in the only opportunity to teach college students about basic scientific concepts that impact their lives. Vast misconceptions about the nature of science, the role of science and scientists in society, and social issues embedded in scientific information, impact the decisions that individuals make about every day events. In turn, these decisions influence the policies that construct our society. This talk will provide an overview of the common misconceptions and discuss how they impact our society as a whole. The research presented provides evidence of the impact that introductory college astronomy courses have on changing these everyday misconceptions and influencing non-science majors' ideas about science in society. The research suggests that introductory courses designed for non-science majors are extremely important in impacting our society, and begs for a stronger understanding and implementation of best practices for teaching and learning in the college classroom environment.

Management of everyday work in Emergency Departments - an exploratory study with Swedish Managers.

PubMed

Andersson, Henrik; Wireklint Sundström, Birgitta; Nilsson, Kerstin; Jakobsson Ung, Eva

2014-10-01

Through their formal mandate, position and authority, managers are responsible for managing everyday work in Emergency Departments (EDs) as well as striving for excellence and dealing with the individual needs of practitioners and patients. The aim of the present study is to explore managers' experiences of managing everyday work in Swedish EDs. A qualitative and exploratory design has been used in this study. Seven managers were interviewed at two EDs. Data was analysed using qualitative content analysis with focus on latent content. Managers experience everyday work in the ED as lifesaving work. One of the characteristics of their approach to everyday work is their capability for rapidly identifying patients with life-threatening conditions and for treating them accordingly. The practitioners are on stand-by in order to deal with unexpected situations. This implies having to spend time waiting for the physicians' decisions. Management is characterised by a command and control approach. The managers experience difficulties in meeting the expectations of their staff. They strive to be proactive but instead they become reactive since the prevailing medical, bureaucratic and production-orientated systems constrain them. The managers demonstrate full compliance with the organisational systems. This threatens to reduce their freedom of action and influences the way they perform their managerial duties within and outside the EDs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Navigating spatial and temporal complexity in developing a long-term land use database for an agricultural watershed

USDA-ARS?s Scientific Manuscript database

No comprehensive protocols exist for the collection, standardization, and storage of agronomic management information into a database that preserves privacy, maintains data uncertainty, and translates everyday decisions into quantitative values. This manuscript describes the development of a databas...

Nonverbal Communication across Eastern-Western Cultures: Facial Expressions during Interviews of Japanese Students

ERIC Educational Resources Information Center

Khoo, Keiko

2007-01-01

Background: Effective educational evaluations involve interviews, observations and nonverbal cue interpretations. Educators carry out these evaluative activities everyday as instructors, advisors or administrators, often relying on nothing but their intuition. These evaluations inform the future decisions. One must determine if students really…

How can everyday practical knowledge be understood with inspiration from philosophy?

PubMed

Lykkeslet, Else; Gjengedal, Eva

2006-04-01

Many nursing scholars are inspired by philosophy when investigating phenomena within nursing. This paper focuses on the everyday practical knowledge of nurses. Based on an empirical project carried out in a surgical ward the authors make an attempt, with help from philosophy, at identifying and conceptualizing elements of knowledge in everyday practice. With reference to texts by Heidegger and Wittgenstein the authors investigate two dimensions of nursing knowledge: a dimension of doing and a dimension of being. These dimensions are further developed and concretized in the paper. The doing dimension is emphasized through the concepts of adapting and exploring. The being dimension has its basis in being understanding and being connected. These two dimensions constitute a form of knowledge which is mobile and flexible. This knowledge is in place in everyday situations and it works where it is supposed to work.

Geo-portal as a planning instrument: supporting decision making and fostering market potential of Energy efficiency in buildings

NASA Astrophysics Data System (ADS)

Cuca, Branka; Brumana, Raffaella; Oreni, Daniela; Iannaccone, Giuliana; Sesana, Marta Maria

2014-03-01

Steady technological progress has led to a noticeable advancement in disciplines associated with Earth observation. This has enabled information transition regarding changing scenarios, both natural and urban, to occur in (almost) real time. In particular, the need for integration on a local scale with the wider territorial framework has occurred in analysis and monitoring of built environments over the last few decades. The progress of Geographic Information (GI) science has provided significant advancements when it comes to spatial analysis, while the almost free availability of the internet has ensured a fast and constant exchange of geo-information, even for everyday users' requirements. Due to its descriptive and semantic nature, geo-spatial information is capable of providing a complete overview of a certain phenomenon and of predicting the implications within the natural, social and economic context. However, in order to integrate geospatial data into decision making processes, it is necessary to provide a specific context, which is well supported by verified data. This paper investigates the potentials of geo-portals as planning instruments developed to share multi-temporal/multi-scale spatial data, responding to specific end-users' demands in the case of Energy efficiency in Buildings (EeB) across European countries. The case study regards the GeoCluster geo-portal and mapping tool (Project GE2O, FP7), built upon a GeoClustering methodology for mapping of indicators relevant for energy efficiency technologies in the construction sector.

Neural time course of visually enhanced echo suppression.

PubMed

Bishop, Christopher W; London, Sam; Miller, Lee M

2012-10-01

Auditory spatial perception plays a critical role in day-to-day communication. For instance, listeners utilize acoustic spatial information to segregate individual talkers into distinct auditory "streams" to improve speech intelligibility. However, spatial localization is an exceedingly difficult task in everyday listening environments with numerous distracting echoes from nearby surfaces, such as walls. Listeners' brains overcome this unique challenge by relying on acoustic timing and, quite surprisingly, visual spatial information to suppress short-latency (1-10 ms) echoes through a process known as "the precedence effect" or "echo suppression." In the present study, we employed electroencephalography (EEG) to investigate the neural time course of echo suppression both with and without the aid of coincident visual stimulation in human listeners. We find that echo suppression is a multistage process initialized during the auditory N1 (70-100 ms) and followed by space-specific suppression mechanisms from 150 to 250 ms. Additionally, we find a robust correlate of listeners' spatial perception (i.e., suppressing or not suppressing the echo) over central electrode sites from 300 to 500 ms. Contrary to our hypothesis, vision's powerful contribution to echo suppression occurs late in processing (250-400 ms), suggesting that vision contributes primarily during late sensory or decision making processes. Together, our findings support growing evidence that echo suppression is a slow, progressive mechanism modifiable by visual influences during late sensory and decision making stages. Furthermore, our findings suggest that audiovisual interactions are not limited to early, sensory-level modulations but extend well into late stages of cortical processing.

Reasoning Strategies in the Context of Engineering Design with Everyday Materials

ERIC Educational Resources Information Center

Worsley, Marcelo; Blikstein, Paulo

2016-01-01

"Making" represents an increasingly popular label for describing a form of engineering design. While making is growing in popularity, there are still open questions about the strategies that students are using in these activities. Assessing and improving learning in making/ engineering design contexts require that we have a better…

How Concrete Is Concrete?

ERIC Educational Resources Information Center

Gravemeijer, Koeno

2011-01-01

If we want to make something concrete in mathematics education, we are inclined introduce, what we call, "manipulatives", in the form of tactile objects or visual representations. If we want to make something concrete in a everyday-life conversation, we look for an example. In the former, we try to make a concrete model of our own,…

Story as World Making

ERIC Educational Resources Information Center

Short, Kathy G.

2012-01-01

Stories are woven so tightly into the fabric of our everyday lives that it's easy to overlook their significance in framing how we think about ourselves and the world. Stories are meaning making, providing a means of structuring and reflecting on our experiences in order to understand their significance. Story is also life making, a way of…

Prefrontal Control and Internet Addiction: A Theoretical Model and Review of Neuropsychological and Neuroimaging Findings

PubMed Central

Brand, Matthias; Young, Kimberly S.; Laier, Christian

2014-01-01

Most people use the Internet as a functional tool to perform their personal goals in everyday-life such as making airline or hotel reservations. However, some individuals suffer from a loss of control over their Internet use resulting in personal distress, symptoms of psychological dependence, and diverse negative consequences. This phenomenon is often referred to as Internet addiction. Only Internet Gaming Disorder has been included in the appendix of the DSM-5, but it has already been argued that Internet addiction could also comprise problematic use of other applications with cybersex, online relations, shopping, and information search being Internet facets at risk for developing an addictive behavior. Neuropsychological investigations have pointed out that certain prefrontal functions in particular executive control functions are related to symptoms of Internet addiction, which is in line with recent theoretical models on the development and maintenance of the addictive use of the Internet. Control processes are particularly reduced when individuals with Internet addiction are confronted with Internet-related cues representing their first choice use. For example, processing Internet-related cues interferes with working memory performance and decision making. Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency. The neuropsychological and neuroimaging results have important clinical impact, as one therapy goal should enhance control over the Internet use by modifying specific cognitions and Internet use expectancies. PMID:24904393

Prefrontal control and internet addiction: a theoretical model and review of neuropsychological and neuroimaging findings.

PubMed

Brand, Matthias; Young, Kimberly S; Laier, Christian

2014-01-01

Most people use the Internet as a functional tool to perform their personal goals in everyday-life such as making airline or hotel reservations. However, some individuals suffer from a loss of control over their Internet use resulting in personal distress, symptoms of psychological dependence, and diverse negative consequences. This phenomenon is often referred to as Internet addiction. Only Internet Gaming Disorder has been included in the appendix of the DSM-5, but it has already been argued that Internet addiction could also comprise problematic use of other applications with cybersex, online relations, shopping, and information search being Internet facets at risk for developing an addictive behavior. Neuropsychological investigations have pointed out that certain prefrontal functions in particular executive control functions are related to symptoms of Internet addiction, which is in line with recent theoretical models on the development and maintenance of the addictive use of the Internet. Control processes are particularly reduced when individuals with Internet addiction are confronted with Internet-related cues representing their first choice use. For example, processing Internet-related cues interferes with working memory performance and decision making. Consistent with this, results from functional neuroimaging and other neuropsychological studies demonstrate that cue-reactivity, craving, and decision making are important concepts for understanding Internet addiction. The findings on reductions in executive control are consistent with other behavioral addictions, such as pathological gambling. They also emphasize the classification of the phenomenon as an addiction, because there are also several similarities with findings in substance dependency. The neuropsychological and neuroimaging results have important clinical impact, as one therapy goal should enhance control over the Internet use by modifying specific cognitions and Internet use expectancies.

Make the healthy choice the easy choice: using behavioral economics to advance a culture of health.

PubMed

Volpp, K G; Asch, D A

2017-05-01

Despite great advances in the science and technology of health care, a large gap separates theoretically achievable advances in health from what individuals and populations actually achieve. Human behavior sits on the final common pathway to so many of our health and health care goals, including the prevention and management of illness and the fostering of wellness. Behavioral economics is a relatively new field offering approaches to supplement many of the conventional approaches to improving health behaviors that rely on education or standard economic theory. While those conventional approaches presume that an educated public will naturally make decisions that optimize personal welfare, approaches derived from behavioral economics harness existing and predictable patterns of behavior that often lead people to make choices against their best interests. By keeping these predictable patterns of behavior in mind when designing health insurance, health care programs or the health-related aspects of everyday life, behavioral economists aim to meet people half-way: no longer asking them to reshape their behavior to something more health promoting, but helping the behavioral patterns they already follow lead them to better health. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Decision-making in rectal surgery.

PubMed

MacDermid, E; Young, C J; Young, J; Solomon, M

2014-03-01

The decision to create a stoma after anterior resection has significant consequences. Decisions under uncertainty are made with a variety of cognitive tools, or heuristics. Past experience has been shown to be a powerful heuristic in other domains. Our aim was to identify whether the misfortune of recent anastomotic leakage or surgeon propensity to take everyday risks would affect their decision to defunction a range of anastomoses. Questionnaires were sent to members of the Colorectal Surgical Society of Australia and New Zealand. Participants were asked for demographic information, questions regarding risk-taking propensity, when their last anastomotic leakage occurred and whether they would defunction a range of hypothetical rectal anastomoses grouped according to height, American Society of Anesthesiologists grade and use of preoperative radiotherapy. Scores were derived for hypothetical patient likelihood of having a stoma created and individual surgeon propensity for stoma formation. Hazard regression analysis was used to assess demographic predictors of stoma formation. In total, 110 (75.3%) of 146 surveyed surgeons replied; 72 (65.5%) reported anastomotic leakage within the last 12 months. Surgeons' propensity for risk-taking was comparable (24.6 vs 27.53, 95% confidence interval, Mann-Whitney-U) to previously studied participants in economic models. Surgeon age (< 50 years) and lower propensity for risk-taking were demonstrated to be independent predictors of stoma formation on regression analysis. Although the decision to create a stoma after anterior resection may be made in the belief that its foundation derives from rational thought, it appears that other unrecognized operator factors such as age and risk-taking exert an effect. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

A cross-cultural convergent parallel mixed methods study of what makes a cancer-related symptom or functional health problem clinically important.

PubMed

Giesinger, Johannes M; Aaronson, Neil K; Arraras, Juan I; Efficace, Fabio; Groenvold, Mogens; Kieffer, Jacobien M; Loth, Fanny L; Petersen, Morten Aa; Ramage, John; Tomaszewski, Krzysztof A; Young, Teresa; Holzner, Bernhard

2018-02-01

In this study, we investigated what makes a symptom or functional impairment clinically important, that is, relevant for a patient to discuss with a health care professional (HCP). This is the first part of a European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group project focusing on the development of thresholds for clinical importance for the EORTC QLQ-C30 questionnaire and its corresponding computer-adaptive version. We conducted interviews with cancer patients and HCPs in 6 European countries. Participants were asked to name aspects of a symptom or problem that make it clinically important and to provide importance ratings for a predefined set of aspects (eg, need for help and limitations of daily functioning). We conducted interviews with 83 cancer patients (mean age, 60.3 y; 50.6% men) and 67 HCPs. Participants related clinical importance to limitations of everyday life (patients, 65.1%; HCPs, 77.6%), the emotional impact of a symptom/problem (patients, 53.0%; HCPs, 64.2%), and duration/frequency (patients, 51.8%; HCPs, 49.3%). In the patient sample, importance ratings were highest for worries by partner or family, limitations in everyday life, and need for help from the medical staff. Health care professionals rated limitations in everyday life and need for help from the medical staff to be most important. Limitations in everyday life, need for (medical) help, and emotional impact on the patient or family/partner were found to be relevant aspects of clinical importance. Based on these findings, we will define anchor items for the development of thresholds for clinical importance for the EORTC measures in a Europe-wide field study. Copyright © 2017 John Wiley & Sons, Ltd.

The real deal: Willingness-to-pay and satiety expectations are greater for real foods versus their images.

PubMed

Romero, Carissa A; Compton, Michael T; Yang, Yueran; Snow, Jacqueline C

2017-11-23

Laboratory studies of human dietary choice have relied on computerized two-dimensional (2D) images as stimuli, whereas in everyday life, consumers make decisions in the context of real foods that have actual caloric content and afford grasping and consumption. Surprisingly, few studies have compared whether real foods are valued more than 2D images of foods, and in the studies that have, differences in the stimuli and testing conditions could have resulted in inflated bids for the real foods. Moreover, although the caloric content of food images has been shown to influence valuation, no studies to date have investigated whether 'real food exposure effects' on valuation reflect greater sensitivity to the caloric content of real foods versus images. Here, we compared willingness-to-pay (WTP) for, and expectations about satiety after consuming, everyday snack foods that were displayed as real foods versus 2D images. Critically, our 2D images were matched closely to the real foods for size, background, illumination, and apparent distance, and trial presentation and stimulus timing were identical across conditions. We used linear mixed effects modeling to determine whether effects of display format were modulated by food preference and the caloric content of the foods. Compared to food images, observers were willing to pay 6.62% more for (Experiment 1) and believed that they would feel more satiated after consuming (Experiment 2), foods displayed as real objects. Moreover, these effects appeared to be consistent across food preference, caloric content, as well as observers' estimates of the caloric content of the foods. Together, our results confirm that consumers' perception and valuation of everyday foods is influenced by the format in which they are displayed. Our findings raise important new insights into the factors that shape dietary choice in real-world contexts and highlight potential avenues for improving public health approaches to diet and obesity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Aesthetic engagements: "being" in everyday life with advanced cancer.

PubMed

la Cour, Karen; Hansen, Helle Ploug

2012-03-01

Living with advanced cancer can present an overwhelming challenge. It may impact the everyday life of the individual with respect to an array of psychological, physical, social, and existential issues. We focus on ways in which people with advanced cancer experience and use their engagement in daily activities when confronting nearing death. Through a phenomenological analysis based on Heidegger's thinking, we illuminate the complexities of "being toward death" and the human striving for authentic being through engagement in daily living. The main findings demonstrate how sensory experiences support being through an appreciation of everyday aesthetics. Furthermore, the making of material things was identified as a means to express the value of self and others in relation to the involved individual's past, present, and future.

The convergence between self-reports and observer ratings of financial skills and direct assessment of financial capabilities in patients with schizophrenia: more detail is not always better.

PubMed

Harvey, Philip D; Stone, Laura; Lowenstein, David; Czaja, Sara J; Heaton, Robert K; Twamley, Elizabeth W; Patterson, Thomas L

2013-06-01

Despite multiple lines of evidence suggesting that people with schizophrenia tend to overestimate their ability to perform everyday tasks such as money management, self-report methods are still widely used to assess functioning. In today's technology driven financial world patients are faced with increasingly complex financial management tasks. To meet these challenges adequate financial skills are required. Thus, accurate assessments of these abilities are critical to decisions regarding a patient's need for support such as a financial trustee. As part of the larger VALERO study, 195 patients with schizophrenia were asked to self-report their everyday financial skills (five common financial tasks) with the Independent Living Skills Survey (ILSS). They were also assessed with performance-based measures of neuro-cognition and functional capacity with a focus on financial skills. In addition, a friend, relative, or clinician informant was interviewed with the ILSS and a best estimate rating of functioning was generated. Scores on the performance-based measures of financial skills and neuropsychological tests were uncorrelated with self-reported financial activities. Interviewer and all informant judgments of financial abilities were also minimally correlated with performance on functional skill tests. Discrete financial skills appear to be challenging for clinicians to rate with accuracy without the use of direct assessments. Direct assessment of financial skills seems prudent when making determinations about the need for guardianship or other financial supervision. Copyright © 2013 Elsevier B.V. All rights reserved.

The Convergence between Self-reports and Observer Ratings of Financial Skills and Direct Assessment of Financial Capabilities in Patients with Schizophrenia: More Detail is Not Always Better

PubMed Central

Harvey, Philip D.; Stone, Laura; Lowenstein, David; Czaja, Sara J.; Heaton, Robert K.; Patterson, Thomas L

2013-01-01

Despite multiple lines of evidence suggesting that people with schizophrenia tend to overestimate their ability to perform everyday tasks such as money management, self-report methods are still widely used to assess functioning. In today’s technology driven financial world patients are faced with increasingly complex financial management tasks. To meet these challenges adequate financial skills are required. Thus, accurate assessments of these abilities are critical to decisions regarding a patient’s need for support such as a financial trustee. As part of the larger VALERO study, 195 patients with schizophrenia were asked to self-report their everyday financial skills (five common financial tasks) with the Independent Living Skills Survey (ILSS). They were also assessed with performance-based measures of neuro-cognition and functional capacity with a focus on financial skills. In addition, a friend, relative, or clinician informant was interviewed with the ILSS and a best estimate rating of functioning was generated. Scores on the performance-based measures of financial skills and neuropsychological tests were uncorrelated with self-reported financial activities. Interviewer and all informant judgments of financial abilities were also minimally correlated with performance on functional skills tests. Discrete financial skills appear to be challenging for clinicians to rate with accuracy without the use of direct assessments. Direct assessment of financial skills seems prudent when making determinations about the need for guardianship or other financial supervision. PMID:23537475

Cyclone Tracy and the Darwin Educators: A Case in Crisis Management.

ERIC Educational Resources Information Center

Beare, Hedley

The story of successful crisis management teaches some lessons applicable not only to surmounting crises but to everyday management decisions as well. On Christmas eve, 1974, a cyclone demolished 90 percent of the city of Darwin in Australia's Northern Territory. As thousands gathered in neighborhood schools, a team of educational administrators…

Dilemmatic Aspects of Language Policies in a Trilingual Preschool Group

ERIC Educational Resources Information Center

Puskás, Tünde; Björk-Willén, Polly

2017-01-01

This article explores dilemmatic aspects of language policies in a preschool group in which three languages (Swedish, Romani and Arabic) are spoken on an everyday basis. The article highlights the interplay between policy decisions on the societal level, the teachers' interpretations of these policies, as well as language practices on the micro…

Ethical Issues in Paediatric Practice - Part I: General Principles

PubMed Central

Attard-Montalto, S

2001-01-01

Clinical problems with ethical implications pose an ever increasing dilemma in everyday medical practice, and this is particularly the case with ethical issues involving children and those unable to take their own decisions. In this editorial we shall review some of the general principles that guide medical ethical problems. PMID:22368603

Rethinking the Politics of "Fit" and Educational Leadership

ERIC Educational Resources Information Center

Tooms, Autumn K.; Lugg, Catherine A.; Bogotch, Ira

2010-01-01

This theoretical analysis employs a poststructuralist lens to reveal the constructs behind the word "fit", an oft used descriptor integral to the discourse of school hiring practices, personnel decisions, and politics. Although the term is a part of the everyday culture of school politics, it is rarely considered with any depth. Using the metaphor…

Impact of the telephone assistive device (TAD) on stuttering severity while speaking on the telephone.

PubMed

Chambers, Nola

2009-01-01

There is extensive experimental evidence that altered auditory feedback (AAF) can have a clinically significant effect on the severity of speech symptoms in people who stutter. However, there is less evidence regarding whether these experimental effects can be observed in naturalistic everyday settings particularly when using the telephone. This study aimed to investigate the effectiveness of the Telephone Assistive Device (TAD), which is designed to provide AAF on the telephone to people who stutter, on reducing stuttering severity. Nine adults participated in a quasi-experimental study. Stuttering severity was measured first without and then with the device in participants' naturalistic settings while making and receiving telephone calls (immediate benefit). Participants were then allowed a week of repeated use of the device following which all measurements were repeated (delayed benefit). Overall, results revealed significant immediate benefits from the TAD in all call conditions. Delayed benefits in received and total calls were also significant. There was substantial individual variability in response to the TAD but none of the demographic or speech-related factors measured in the study were found to significantly impact the benefit (immediate or delayed) derived from the TAD. Results have implications for clinical decision making for adults who stutter.

Making Biology Learning Relevant to Students: Integrating People, History, and Context into College Biology Teaching

ERIC Educational Resources Information Center

Chamany, Katayoun; Allen, Deborah; Tanner, Kimberly

2008-01-01

Teaching students to make connections between what they learn in the classroom and what they see in everyday life is imperative. As biology instructors, they may choose to teach biology devoid of social context, believing that students can make these connections on their own. However, students model their instructors' behaviors, and follow their…

How Can You Make the Most of Those "WOW Moments"?

ERIC Educational Resources Information Center

Hardman, Sally; Luke, Sue

2016-01-01

Children are naturally curious about the world around them and are often intrigued by everyday objects and experiences. Primary school teachers frequently make use of "WOW moments" to generate children's interest in science (Feasey, 2005). These moments capitalise on the children's fascination with objects and experiences in their…

How We Get Our Daily Bread, or the History of Domestic Technology Revealed.

ERIC Educational Resources Information Center

Cowan, Ruth Schwartz

1998-01-01

Presents the process of making, baking, and delivering bread as an interesting example of how the development and application of technology can make a difference in people's lives. Traces the development of this everyday food item from the earliest cultures to the modern-day kitchen. (MJP)

On the Value of Make-Believe

ERIC Educational Resources Information Center

Silcox, Mark

2012-01-01

The practice of make-believe has traditionally been viewed as valuable by psychologists and philosophers more or less exclusively as a mechanism for social initiation, a tool for everyday problem solving, or a method for children to learn about adult responsibilities. This instrumentalist approach has influenced the development of a wide variety…

Impact of Cognitive Load on Family Decision Makers' Recall and Understanding of Donation Requests for the Genotype-Tissue Expression (GTEx) Project.

PubMed

Siminoff, Laura A; Wilson-Genderson, Maureen; Mosavel, Maghboeba; Barker, Laura; Trgina, Jennifer; Traino, Heather M; Nathan, Howard M; Hasz, Richard D; Walters, Gary

2018-01-01

Genomic research projects that collect tissues from deceased organ and tissue donors must obtain the authorization of family decision makers under difficult circumstances that may affect the authorization process. Using a quasi-experimental design, the Ethical, Legal, and Social Issues (ELSI) substudy of the Genotype-Tissue Expression (GTEx) project compared the recall and understanding of the donation authorization process of two groups: family members who had authorized donation of tissues to the GTEx project (the comparison group) and family members who had authorized organ and tissue donations in years previous, who subsequently participated in two different mock-authorization processes that mimicked the GTEx authorization process (the intervention groups). Participants in the comparison and intervention groups were matched on key demographic characteristics. We found that participants in the intervention groups who experienced a mock-authorization process demonstrated better recall of the tissue donation request than members of the comparison group. Our data indicate that the stress associated with the loss of a loved one limited the ability of family members to recall details about the GTEx project. However, we found a similar lack of knowledge in both the comparison and the intervention group participants, suggesting lack of knowledge may be due to the complexity and unfamiliarity of the information presented to them during the authorization process. We discuss these findings in the context of everyday clinical decision making in cognitively challenging conditions. Copyright 2018 The Journal of Clinical Ethics. All rights reserved.

New tools for an old trade: a socio-technical appraisal of how electronic decision support is used by primary care practitioners.

PubMed

Peiris, David; Usherwood, Tim; Weeramanthri, Tarun; Cass, Alan; Patel, Anushka

2011-11-01

This article explores Australian general practitioners' (GPs) views on a novel electronic decision support (EDS) tool being developed for cardiovascular disease management. We use Timmermans and Berg's technology-in-practice approach to examine how technologies influence and are influenced by the social networks in which they are placed. In all, 21 general practitioners who piloted the tool were interviewed. The tool occupied an ill-defined middle ground in a dialectical relationship between GPs' routine care and factors promoting best practice. Drawing on Lipsky's concept of 'street-level bureaucrats', the tool's ability to process workloads expeditiously was of greatest appeal to GPs. This feature of the tool gave it the potential to alter the structure, process and content of healthcare encounters. The credibility of EDS tools appears to be mediated by fluid notions of best practice, based on an expert scrutiny of the evidence, synthesis via authoritative guidelines and dissemination through trusted and often informal networks. Balanced against this is the importance of 'soft' forms of knowledge such as intuition and timing in everyday decision-making. This resonates with Aristotle's theory of phronesis (practical wisdom) and may render EDS tools inconsequential if they merely process biomedical data. While EDS tools show promise in improving health practitioner performance, the socio-technical dimensions of their implementation warrant careful consideration. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Evaluating medico-legal decisional competency criteria.

PubMed

Whiting, Demian

2015-06-01

In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria-where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the "Decisional Competency in Medico-Legal Contexts" section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idealized view of competent decision-making, according to which decisional competency is a matter of possessing those abilities or attributes that are needed to engage in good or effective or, perhaps, substantially autonomous or rational decision-making. The view has some plausibility-it accords with the way decisional competency is understood in a number of everyday contexts-but fails as an interpretation of the question regarding the abilities that should be needed for decisional competence in medico-legal contexts. Nevertheless, consideration of why it is mistaken suggests a more accurate interpretation and points the way in which the question regarding the evaluation of medico-legal competency criteria is to be answered. Building on other scholarly work in the area, I outline in the "Primary and Secondary Requirements" section several requirements that decisional competence criteria ought to satisfy. Then, in the "Applying the Framework" section, I say something about the extent to which medico-legal competency criteria, as well as some models of decisional competency proposed in the academic literature, fulfil those requirements.

Rescheduling nursing shifts: scoping the challenge and examining the potential of mathematical model based tools.

PubMed

Clark, Alistair; Moule, Pam; Topping, Annie; Serpell, Martin

2015-05-01

To review research in the literature on nursing shift scheduling / rescheduling, and to report key issues identified in a consultation exercise with managers in four English National Health Service trusts to inform the development of mathematical tools for rescheduling decision-making. Shift rescheduling is unrecognised as an everyday time-consuming management task with different imperatives from scheduling. Poor rescheduling decisions can have quality, cost and morale implications. A systematic critical literature review identified rescheduling issues and existing mathematic modelling tools. A consultation exercise with nursing managers examined the complex challenges associated with rescheduling. Minimal research exists on rescheduling compared with scheduling. Poor rescheduling can result in greater disruption to planned nursing shifts and may impact negatively on the quality and cost of patient care, and nurse morale and retention. Very little research examines management challenges or mathematical modelling for rescheduling. Shift rescheduling is a complex and frequent management activity that is more challenging than scheduling. Mathematical modelling may have potential as a tool to support managers to minimise rescheduling disruption. The lack of specific methodological support for rescheduling that takes into account its complexity, increases the likelihood of harm for patients and stress for nursing staff and managers. © 2013 John Wiley & Sons Ltd.

Bruno de Finetti: the mathematician, the statistician, the economist, the forerunner.

PubMed

Rossi, C

2001-12-30

Bruno de Finetti is possibly the best known Italian applied mathematician of the 20th century, but was he really just a mathematician? Looking at his papers it is always possible to find original and pioneering contributions to the various fields he was interested in, where he always put his mathematical "formamentis" and skills at the service of the applications, often extending standard theories and models in order to achieve more general results. Many contributions are also devoted to educational issues, in mathematics in general and in probability and statistics in particular.He really thought that mathematics and, in particular, those topics related to uncertainty, should enter in everyday life as a useful support to everyone's decision making. He always imagined and lived mathematics as a basic tool both for better understanding and describing complex phenomena and for helping decision makers in assuming coherent and feasible actions. His many important contributions to the theory of probability and to mathematical statistics are well known all over the world, thus, in the following, minor, but still pioneering, aspects of his work, related both to theory and to applications of mathematical tools, and to his work in the field of education and training of teachers, are presented. Copyright 2001 John Wiley & Sons, Ltd.

Effect of Reinforcement History on Hand Choice in an Unconstrained Reaching Task

PubMed Central

Stoloff, Rebecca H.; Taylor, Jordan A.; Xu, Jing; Ridderikhoff, Arne; Ivry, Richard B.

2011-01-01

Choosing which hand to use for an action is one of the most frequent decisions people make in everyday behavior. We developed a simple reaching task in which we vary the lateral position of a target and the participant is free to reach to it with either the right or left hand. While people exhibit a strong preference to use the hand ipsilateral to the target, there is a region of uncertainty within which hand choice varies across trials. We manipulated the reinforcement rates for the two hands, either by increasing the likelihood that a reach with the non-dominant hand would successfully intersect the target or decreasing the likelihood that a reach with the dominant hand would be successful. While participants had minimal awareness of these manipulations, we observed an increase in the use of the non-dominant hand for targets presented in the region of uncertainty. We modeled the shift in hand use using a Q-learning model of reinforcement learning. The results provided a good fit of the data and indicate that the effects of increasing and decreasing the rate of positive reinforcement are additive. These experiments emphasize the role of decision processes for effector selection, and may point to a novel approach for physical rehabilitation based on intrinsic reinforcement. PMID:21472031

Contextual and social influences on valuation and choice.

PubMed

Engelmann, Jan B; Hein, Grit

2013-01-01

To survive in our complex environment, we have to adapt to changing contexts. Prior research that investigated how contextual changes are processed in the human brain has demonstrated important modulatory influences on multiple cognitive processes underlying decision-making, including perceptual judgments, working memory, as well as cognitive and attentional control. However, in everyday life, the importance of context is even more obvious during economic and social interactions, which often have implicit rule sets that need to be recognized by a decision-maker. Here, we review recent evidence from an increasing number of studies in the fields of Neuroeconomics and Social Neuroscience that investigate the neurobiological basis of contextual effects on valuation and social choice. Contrary to the assumptions of rational choice theory, multiple contextual factors, such as the availability of alternative choice options, shifts in reference point, and social context, have been shown to modulate behavior, as well as signals in task-relevant neural networks. A consistent picture that emerges from neurobiological results is that valuation-related activity in striatum and ventromedial prefrontal cortex is highly context dependent during both social and nonsocial choice. Alternative approaches to model and explain choice behavior, such as comparison-based choice models, as well as implications for future research are discussed. Copyright © 2013 Elsevier B.V. All rights reserved.

Reinventing the academic health center.

PubMed

Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

2005-11-01

Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

Between demarcation and discretion: The medical-administrative boundary as a locus of safety in high-volume organisational routines.

PubMed

Grant, Suzanne; Guthrie, Bruce

2018-04-01

Patient safety is an increasing concern for health systems internationally. The majority of administrative work in UK general practice takes place in the context of organisational routines such as repeat prescribing and test results handling, where high workloads and increased clinician dependency on administrative staff have been identified as an emerging safety issue. Despite this trend, most research to date has focused on the redistribution of the clinical workload between doctors, nurses and allied health professionals within individual care settings. Drawing on Strauss's negotiated order perspective, we examine ethnographically the achievement of safety across the medical-administrative boundary in key high-volume routines in UK general practice. We focus on two main issues. First, GPs engaged in strategies of demarcation by defining receptionist work as routine, unspecialised and dependent upon GP clinical knowledge and oversight as the safety net to deal with complexity and risk. Receptionists consented to this 'social closure' when describing their role, thus reinforcing the underlying inter-occupational relationship of medical domination. Second, in everyday practice, GPs and receptionists engaged in informal boundary-blurring to safely accommodate the complexity of everyday high-volume routine work. This comprised additional informal discretionary spaces for receptionist decision-making and action that went beyond the routine safety work formally assigned to them. New restratified intra-occupational hierarchies were also being created between receptionists based on the complexity of the safety work that they were authorised to do at practice level, with specialised roles constituting a new form of administrative 'professional project'. The article advances negotiated order theory by providing an in-depth examination of the ways in which medical-administrative boundary-making and boundary-blurring constitute distinct modes of safety in high-volume routines. It also provides the basis for further research and safety improvement to maximise team-level understandings of the pivotal role of medical-administrative negotiations in achieving safety and mitigating risk. Copyright © 2018 Elsevier Ltd. All rights reserved.

Using Sound Knowledge to Teach about Noise-Induced Hearing Loss

ERIC Educational Resources Information Center

McDonnough, Jacqueline T.; Matkins, Juanita Jo

2007-01-01

Throughout our lives we are surrounded by sounds in our environment. Our ability to hear plays an essential part in our everyday existence. Students should develop an understanding of the role technology plays in personal and social decisions. If we are to meet these goals we need to integrate aspects of responsible behavior toward hearing health…

Comprehension of Indirect Requests Is Influenced by Their Degree of Imposition

ERIC Educational Resources Information Center

Stewart, Andrew J.; Le-luan, Elizabeth; Wood, Jeffrey S.; Yao, Bo; Haigh, Matthew

2018-01-01

In everyday conversation much communication is achieved using indirect language. This is particularly true when we utter requests. The decision to use indirect language is influenced by a number of factors, including deniability, politeness, and the degree of imposition on the receiver of a request. In this article we report the results of an…

Air and Space Expeditionary Force Crisis Action Leadership for Commanders

DTIC Science & Technology

2004-04-01

2002), 337. 2 Mark, Friedman, M.D., Everyday Crisis Management (Naperville, IL: First Decision Press, 2002), 5. 3 Stephen R. Covey, The 7 Habits of Highly Effective People (New...Berkley Publishing Group, 2002), 9. 12 Lt Col Bryan Gallagher, USAF, interviewed by author, February 2004. 13 Stephen R. Covey, The 7 Habits of Highly Effective People (New

Everyday Ethics in Research: Translating Authorship Guidelines into Practice in the Bench Sciences

ERIC Educational Resources Information Center

Louis, Karen Seashore; Holdsworth, Janet M.; Anderson, Melissa S.; Campbell, Eric G.

2008-01-01

Peer-reviewed papers are the major currency in the realm of science. Without an appropriate number of publications in high-quality journals, scientists do not get university positions, are not promoted, and fail to get grants to fund their research. Decisions made about authorship are not always straightforward, as accepted practice sometimes…

Teaching through a Crisis: September 11 and Beyond. Occasional Paper Series 11

ERIC Educational Resources Information Center

McKersie, Alison; Lent, Patricia; Rose, Megan; Stuart-Hunt, Rella; Edstrom, Lisa; Rothschild, Cynthia R.; Weisman, Alexandra; Delacorte, Kate; Vascellaro, Sal; Abell, Kate

2003-01-01

The days following September 11, 2001, were characterized for many by a startling clarity, as if someone had applied a magnified lens to life's everyday routines and every moment, every gesture, every word exchanged with friends, colleagues and family was more nuanced and precious than before. The decision to publish this volume of essays was…

Reasoning about Make-Believe and Hypothetical Suppositions: Towards a Theory of Belief-Contravening Reasoning

ERIC Educational Resources Information Center

Amsel, Eric; Trionfi, Gabriel; Campbell, Richard

2005-01-01

The present study explores how suppositions which conflict with accepted beliefs are represented and reasoned about. Two studies test the predictions regarding the nature and developmental changes in children's ability to represent and reason about hypothetical or make-believe suppositions which violate their everyday knowledge and beliefs. In…

Complex negotiations: the lived experience of enacting agency after a stroke.

PubMed

Bergström, Aileen L; Eriksson, Gunilla; Asaba, Eric; Erikson, Anette; Tham, Kerstin

2015-01-01

This qualitative, longitudinal, descriptive study aimed to understand the lived experience of enacting agency, and to describe the phenomenon of agency and the meaning structure of the phenomenon during the year after a stroke. Agency is defined as making things happen in everyday life through one's actions. This study followed six persons (three men and three women, ages 63 to 89), interviewed on four separate occasions. Interview data were analysed using the Empirical Phenomenological Psychological method. The main findings showed that the participants experienced enacting agency in their everyday lives after stroke as negotiating different characteristics over a span of time, a range of difficulty, and in a number of activities, making these negotiations complex. The four characteristics described how the participants made things happen in their everyday lives through managing their disrupted bodies, taking into account their past and envisioning their futures, dealing with the world outside themselves, and negotiating through internal dialogues. This empirical evidence regarding negotiations challenges traditional definitions of agency and a new definition of agency is proposed. Understanding clients' complex negotiations and offering innovative solutions to train in real-life situations may help in the process of enabling occupations after a stroke.

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.

Persistent barriers and strategic practices: why (asking about) the everyday matters in diabetes care.

PubMed

Rendle, Katharine A S; May, Suepattra G; Uy, Visith; Tietbohl, Caroline K; Mangione, Carol M; Frosch, Dominick L

2013-01-01

The purpose of this study was to explore the everyday barriers to and practices of low-income patients managing their diabetes. The study team conducted semistructured qualitative interviews with 20 patients with type 2 diabetes who were receiving care at safety-net clinics in Southern California. Transcripts were analyzed using grounded theory to identify emergent themes across participants. Participants described managing diabetes with limited financial resources as often a game of balance and negotiation, whereby purchasing healthy foods is abandoned because of a more pressing concern in their life. Although participants described strategic attempts at incorporating healthy dietary practices for diabetes management into their daily decisions, these efforts were significantly impeded by the existence of persistent and seemingly insurmountable barriers. Although the challenges that low-income patients face in managing their diabetes may seem insurmountable at times, there are several ways that health care providers can help reduce the burden of these challenges, including tailoring their recommendations to incorporate the everyday socioeconomic environment of patients and engaging in clear, open communication with patients.

Everyday moral reasoning in the governmentality of HIV risk.

PubMed

Cristian Rangel, J; Adam, Barry D

2014-01-01

Drawing on the sociology of morality, this article analyses the social contexts, discourses and ethno-methods of everyday life that shape real-world decisions of gay men around HIV prevention. Through an analysis of the predominant narratives in an online public forum created for an HIV prevention campaign, this article explores the ways in which homosexually active men engage in everyday moral reasoning and challenge a neoliberal moral order of risk and responsibility. The article concludes that gay and bisexual men engage in forms of practical morality with their sexual partners and imagine larger communities of interest, love, companionship and pleasure. At the same time, they draw heavily from discourses on individual and rational responsibility, as well as narratives of romance and community, that shape forms of moral selfhood. Risk management techniques that are grounded in notions of rational choice and that are insensitive to the emotional worlds that these men inhabit create situations of risk avoidance but also inadvertently open them to new forms of vulnerability. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Decision-making in nursing practice: An integrative literature review.

PubMed

Nibbelink, Christine W; Brewer, Barbara B

2018-03-01

To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. © 2017 John Wiley & Sons Ltd.

The changing landscape of care: does ethics education have a new role to play in health practice?

PubMed

Wintrup, Julie

2015-05-08

In the UK, higher education and health care providers share responsibility for educating the workforce. The challenges facing health practice also face health education and as educators we are implicated, by the way we design curricula and through students' experiences and their stories. This paper asks whether ethics education has a new role to play, in a context of major organisational change, a global and national austerity agenda and the ramifications of disturbing reports of failures in care. It asks: how would it be different if equal amounts of attention were given to the conditions in which health decisions are made, if the ethics of organisational and policy decisions were examined, and if guiding collaborations with patients and others who use services informed ethics education and its processes? This is in three parts. In part one an example from an inspection report is used to question the ways in which clinical events are decontextualised and constructed for different purposes. Ramifications of a decision are reflected upon and a case made for different kinds of allegiances to be developed. In part two I go on to broaden the scope of ethics education and make a case for beginning with the messy realities of practice rather than with overarching moral theories. The importance of power in ethical practice is introduced, and in part three the need for greater political and personal awareness is proposed as a condition of moral agency. This paper proposes that ethics education has a new contribution to make, in supporting and promoting ethical practice - as it is defined in and by the everyday actions and decisions of practitioners and people who need health services. Ethics education that promotes moral agency, rather than problem solving approaches, would explore not only clinical problems, but also the difficult and contested arenas in which they occur. It would seek multiple perspectives and would begin with places and people, and their priorities. It would support students to locate their practice in imperfect global contexts, and to understand how individual and collective forms of power can influence healthcare quality.

Use of Mobile Clinical Decision Support Software by Junior Doctors at a UK Teaching Hospital: Identification and Evaluation of Barriers to Engagement.

PubMed

Patel, Rakesh; Green, William; Shahzad, Muhammad Waseem; Larkin, Chris

2015-08-13

Clinical decision support (CDS) tools improve clinical diagnostic decision making and patient safety. The availability of CDS to health care professionals has grown in line with the increased prevalence of apps and smart mobile devices. Despite these benefits, patients may have safety concerns about the use of mobile devices around medical equipment. This research explored the engagement of junior doctors (JDs) with CDS and the perceptions of patients about their use. There were three objectives for this research: (1) to measure the actual usage of CDS tools on mobile devices (mCDS) by JDs, (2) to explore the perceptions of JDs about the drivers and barriers to using mCDS, and (3) to explore the perceptions of patients about the use of mCDS. This study used a mixed-methods approach to study the engagement of JDs with CDS accessed through mobile devices. Usage data were collected on the number of interactions by JDs with mCDS. The perceived drivers and barriers for JDs to using CDS were then explored by interviews. Finally, these findings were contrasted with the perception of patients about the use of mCDS by JDs. Nine of the 16 JDs made a total of 142 recorded interactions with the mCDS over a 4-month period. Only 27 of the 114 interactions (24%) that could be categorized as on-shift or off-shift occurred on-shift. Eight individual, institutional, and cultural barriers to engagement emerged from interviews with the user group. In contrast to reported cautions and concerns about the impact of clinicians' use of mobile phone on patient health and safety, patients had positive perceptions about the use of mCDS. Patients reported positive perceptions toward mCDS. The usage of mCDS to support clinical decision making was considered to be positive as part of everyday clinical practice. The degree of engagement was found to be limited due to a number of individual, institutional, and cultural barriers. The majority of mCDS engagement occurred outside of the workplace. Further research is required to verify these findings and assess their implications for future policy and practice.

"...because I am something special" or "I think I will be something like a guinea pig": information and assent of legal minors in clinical trials – assessment of understanding, appreciation and reasoning

PubMed Central

Koelch, Michael; Singer, Hanneke; Prestel, Anja; Burkert, Jessica; Schulze, Ulrike; Fegert, Jörg M

2009-01-01

Background The aim of this study is to assess and evaluate the capacities for understanding, appreciation and reasoning of legal minors with psychiatric disorders and their parents and their competence to consent or assent to participation in clinical trials. The beliefs, fears, motivation and influencing factors for decision-making of legal minors and parents were also examined. Methods Using the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), an instrument developed for adults whose capacities to consent are unclear, we provided information about clinical trials and assessed understanding, appreciation and reasoning. We adapted this tool for legal minors and examined 19 children and adolescents between the ages of 7 and 15 with attention deficit/hyperactivity disorder (ADHD) or ADHD combined with oppositional defiant disorder (DSM-IV 314.00/314.01/312.8) enrolled in clinical trials. Parents were also examined using the MacCAT-CR. Results Facts such as the procedures involved in trials or their duration were well understood by legal minors, but more abstract issues like the primary purpose of the trial were not understood by children and adolescents or by many parents. Legal minors also had difficulties understanding the nature of placebo and the probability of receiving placebo. Children's and adolescents' decisions were influenced by fears about their disorder worsening and by problems in their relationship with their parents. Parents wanted the best therapy for their children in order to minimize problems in school. Conclusion Legal minors and parents need to be informed more precisely about specific issues like placebo and the primary purpose of trials. In general, the reasoning of children and adolescents was influenced by their experience with their disorder and decision making was based on reasonable arguments. Their fears were based on everyday experiences such as school performance or family relationships. PMID:19175905

Ethics and/or Aesthetics? Reflections on Cosmetic Surgery for Adolescents.

PubMed

Vergallo, Gianluca Montanari; Marinelli, Enrico; Napoletano, Simona; Di Luca, Natale Mario; Zaami, Simona

2018-01-01

Cosmetic surgery entails various ethical issues, even more so in cases involving adolescent patients. Cosmetic surgeons need to take into account how modern societies consider physical appearance an essential component of everyday life, as well as the vulnerability of youths and adolescents. For that reason, it is imperative to thoroughly assess the psychological and emotional states, in addition to the motivations, of minor patients. That goal can be achieved through the use of the DAS-59, (the Derriford Appearance Scale)1 , an effective and dependable tool devised to evaluate the psychological difficulties and distress experienced by people living with problems of appearance. Prior to undergoing cosmetic surgery procedures, adolescents should be required to go through adequate counseling, over multiple sessions and extended to their family members as well, on account of the complex issues inherent in evaluating the risk-benefit ratio and a prospective patient's decision-making capability. A concerted effort on the part of surgeons, psychiatrists or psychologists is key in determining the real motivations behind a minor's decision to opt for cosmetic surgery in the first place. Possible psychiatric conditions may in fact prevent a minor from making a free, informed decision. From an ethical standpoint, cosmetic surgery procedures should be geared to serve the best interest of the minor patient, who may experience distress over his or her body image, from a health and psychological balance perspective and improve his or her social, affective and working life. Besides, cosmetic surgery should not be overly invasive compared to its potential benefits. Those procedures aimed at achieving ″ideal beauty″ are not desirable and ought to be banned. By virtue of such criteria, the authors have set out to evaluate the ethical admissibility of some aesthetic treatments. Thus, doctors should not consent to any request coming from their patients, but rather, intervene only in presence of an objective physical flaw or deformity, e.g. protruding ears, which have a potential to negatively affect social life and interactions.

Allowing Brief Delays in Responding Improves Event-Based Prospective Memory for Young Adults Living with HIV Disease

PubMed Central

Loft, Shayne; Doyle, Katie L.; Naar-King, Sylvie; Outlaw, Angulique Y.; Nichols, Sharon L.; Weber, Erica; Blackstone, Kaitlin; Woods, Steven Paul

2014-01-01

Event-based prospective memory (PM) tasks require individuals to remember to perform an action when they encounter a specific cue in the environment, and have clear relevance for daily functioning for individuals with HIV. In many everyday tasks, the individual must not only maintain the intent to perform the PM task, but the PM task response also competes with the alternative and more habitual task response. The current study examined whether event-based PM can be improved by slowing down the pace of the task environment. Fifty-seven young adults living with HIV performed an ongoing lexical decision task while simultaneously performing a PM task of monitoring for a specific word (which was focal to the ongoing task of making lexical decisions) or syllable contained in a word (which was nonfocal). Participants were instructed to refrain from making task responses until after a tone was presented, which occurred at varying onsets (0–1600ms) after each stimulus appeared. Improvements in focal and non-focal PM accuracy were observed with response delays of 600ms. Furthermore, the difference in PM accuracy between the low demand focal PM task and the resource demanding non-focal PM task was reduced by half across increasingly longer delays, falling from 31% at 0ms delay to only 14% at 1600ms delay. The degree of ongoing task response slowing for the PM conditions, relative to a control condition that did not have a PM task and made lexical decisions only, also decreased with increased delay. Overall, the evidence indicates that delaying the task responses of younger HIV-infected adults increased the probability that the PM relevant features of task stimuli were adequately assessed prior to the ongoing task response, and by implication that younger HIV infected adults can more adequately achieve PM goals when the pace of the task environment is slowed down. PMID:25116075

[Psychiatry with open doors. Part 1: Rational for an open door for acute psychiatry].

PubMed

Sollberger, D; Lang, U E

2014-03-01

Despite the reform efforts of the last decades modern acute psychiatry still stands between conflicting priorities in everyday practice. The protection of patient autonomy might conflict with a regulatory mandate of psychiatry in societal contexts and the necessity of coercive measures and involuntary treatment might become problematic with respect to presumed but contentious interests of the patient. The conflicts particularly concern questions of involuntary commitment, door closing, coercive and isolation measures. Research on the topic of therapeutic effectiveness of these practices is rare. Accordingly, the practice depends on the federal state, hospital and ward and is very heterogeneous. Epidemiological prognosis predicts an increase of psychiatric disorders; however, simultaneously in terms of medical ethics the warranty of patient autonomy, shared decision-making and informed consent in psychiatry become increasingly more important. This challenges structural and practical changes in psychiatry, particularly in situations of self and third party endangerment which are outlined and a rationale for an opening of the doors in acute psychiatric wards is provided.

A quantum theory account of order effects and conjunction fallacies in political judgments.

PubMed

Yearsley, James M; Trueblood, Jennifer S

2017-09-06

Are our everyday judgments about the world around us normative? Decades of research in the judgment and decision-making literature suggest the answer is no. If people's judgments do not follow normative rules, then what rules if any do they follow? Quantum probability theory is a promising new approach to modeling human behavior that is at odds with normative, classical rules. One key advantage of using quantum theory is that it explains multiple types of judgment errors using the same basic machinery, unifying what have previously been thought of as disparate phenomena. In this article, we test predictions from quantum theory related to the co-occurrence of two classic judgment phenomena, order effects and conjunction fallacies, using judgments about real-world events (related to the U.S. presidential primaries). We also show that our data obeys two a priori and parameter free constraints derived from quantum theory. Further, we examine two factors that moderate the effects, cognitive thinking style (as measured by the Cognitive Reflection Test) and political ideology.

The unique experience of home for parents and carers of children with disabilities.

PubMed

Aplin, Tammy; Thornton, Heloise; Gustafsson, Louise

2017-01-24

The aim of this paper was to investigate the experience of home for parents and carers of children with disabilities in Australia. Data for this qualitative study were gathered using semi-structured interviews with four families living in their own homes. An inductive thematic analysis revealed two main themes. The first was titled 'Aspects making everyday life easier' explored the aspects of the home environment that facilitated home life for the child, including access to transport, services, family and home modifications. The second theme 'Decisions and efforts to create opportunities for the child' emphasized the efforts made by parents and carers to promote their child's independence and participation including a strong consideration for their children's future needs. The study indicated that the location of home, appropriate home modifications and planning for the future defined the experience of home for parents and carers. These findings identify some important considerations for occupational therapists when providing services in the homes of families with children who have a disability.

Food Insecurity in Singapore: The Communicative (Dis)Value of the Lived Experiences of the Poor.

PubMed

Tan, Naomi; Kaur-Gill, Satveer; Dutta, Mohan J; Venkataraman, Nina

2017-08-01

Food insecurity is a form of health disparity that results in adverse health outcomes, particularly among disenfranchised and vulnerable populations. Using the culture-centered approach, this article engages with issues of food insecurity, health, and poverty among the low-income community in Singapore. Through 30 in-depth interviews, the narratives of the food insecure are privileged in articulating their lived experiences of food insecurity and in co-constructing meanings of health informed by their sociocultural context, in a space that typically renders them invisible. Arguing that poverty is communicatively sustained through the erasure of subaltern voices from mainstream discourses and policy platforms, we ask the research question: What are the meanings of food insecurity in the everyday experiences of health among the poor in Singapore? Our findings demonstrate that the meanings of health among the food insecure are constituted in culture and materiality, structurally constrained, and ultimately complexify their negotiations of health and health decision making.

Perceived Relevance of Educative Information on Public (Skin) Health: Results of a Representative, Population-Based Telephone Survey.

PubMed

Haluza, Daniela; Schwab, Markus; Simic, Stana; Cervinka, Renate; Moshammer, Hanns

2015-11-09

Individual skin health attitudes are influenced by various factors, including public education campaigns, mass media, family, and friends. Evidence-based, educative information materials assist communication and decision-making in doctor-patient interactions. The present study aims at assessing the prevailing use of skin health information material and sources and their impact on skin health knowledge, motives to tan, and sun protection. We conducted a questionnaire survey among a representative sample of Austrian residents. Print media and television were perceived as the two most relevant sources for skin health information, whereas the source physician was ranked third. Picking the information source physician increased participants' skin health knowledge (p = 0.025) and sun-protective behavior (p < 0.001). The study results highlight the demand for targeted health messages to attain lifestyle changes towards photo-protective habits. Providing resources that encourage pro-active counseling in every-day doctor-patient communication could increase skin health knowledge and sun-protective behavior, and thus, curb the rise in skin cancer incidence rates.

Health literacy revisited: what do we mean and why does it matter?

PubMed

Peerson, Anita; Saunders, Margo

2009-09-01

'Health literacy' refers to accessing, understanding and using information to make health decisions. However, despite its introduction into the World Health Organization's Health Promotion Glossary, the term remains a confusing concept. We consider various definitions and measurements of health literacy in the international and Australian literature, and discuss the distinction between the broader concept of 'health literacy' (applicable to everyday life) and 'medical literacy' (related to individuals as patients within health care settings). We highlight the importance of health literacy in relation to the health promotion and preventive health agenda. Because health literacy involves knowledge, motivation and activation, it is a complex thing to measure and to influence. The development of health literacy policies will be facilitated by better evidence on the extent, patterns and impact of low health literacy, and what might be involved in improving it. However, the current lack of consensus of definitions and measurement of health literacy will first need to be overcome.

Shared Decision-Making in the Management of Congenital Vascular Malformations.

PubMed

Horbach, Sophie E R; Ubbink, Dirk T; Stubenrouch, Fabienne E; Koelemay, Mark J W; van der Vleuten, Carine J M; Verhoeven, Bas H; Reekers, Jim A; Schultze Kool, Leo J; van der Horst, Chantal M A M

2017-03-01

In shared decision-making, clinicians and patients arrive at a joint treatment decision, by incorporating best available evidence and the patients' personal values and preferences. Little is known about the role of shared decision-making in managing patients with congenital vascular malformations, for which preference-sensitive decision-making seems obvious. The authors investigated preferences regarding decision-making and current shared decision-making behavior during physician-patient encounters. In two Dutch university hospitals, adults and children with congenital vascular malformations facing a treatment-related decision were enrolled. Before the consultation, patients (or parents of children) expressed their preference regarding decision-making (Control Preferences Scale). Afterward, participants completed shared decision-making-specific questionnaires (nine-item Shared Decision-Making Questionnaire, CollaboRATE, and satisfaction), and physicians completed the Shared Decision-Making Questionnaire-Physician questionnaire. Consultations were audiotaped and patient involvement was scored by two independent researchers using the five-item Observing Patient Involvement instrument. All questionnaire results were expressed on a scale of 0 to 100 (optimum shared decision-making). Fifty-five participants (24 parents and 31 adult patients) were included. Two-thirds preferred the shared decision-making approach (Control Preferences Scale). Objective five-item Observing Patient Involvement scores were low (mean ± SD, 31 ± 15), whereas patient and physician Shared Decision-Making Questionnaire scores were high, with means of 68 ± 18 and 68 ± 19, respectively. The median CollaboRATE score was 93. There was no clear relationship between shared decision-making and satisfaction scores. Although adults and parents of children with vascular malformations express a strong desire for shared decision-making, objective shared decision-making behavior is still lacking, most likely because of poor awareness of the shared decision-making concept among patients, parents, and physicians. To improve shared decision-making practice, targeted interventions (e.g., decision aids, staff training) are essential.

Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.

PubMed

Gregory, Megan E; Sonesh, Shirley C; Feitosa, Jennifer; Benishek, Lauren E; Hughes, Ashley M; Salas, Eduardo

2017-09-01

Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.

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

PubMed

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

2016-04-01

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

Decision-making on shared sanitation in the informal settlements of Kisumu, Kenya.

PubMed

Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy

2017-10-01

Unlike most quantitative studies that investigate decision-making on investing in sanitation, this study adopted a qualitative approach to investigate decision-making on shared sanitation in the informal settlements of Kisumu city, in Kenya. Using a grounded theory approach, landlords and tenants were interviewed to identify sanitation decisions, individuals involved in decision-making and factors influencing decision-making. The results indicate that the main sanitation decisions are on investment, emptying, repair and cleaning. Landlords make investment, emptying and repair decisions, while tenants make cleaning decisions. Absentee landlords are less involved in most decision-making compared to live-in landlords, who rarely consult tenants in decision-making. Tenants make decisions after consultations with a third party and often collectively with other tenants. Sanitation interventions in informal settlements should thus, target landlords and tenants, with investment efforts being directed at landlords and maintenance efforts at tenants.

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

PubMed

Gillespie, Mary

2010-11-01

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

[Decision Making and Electrodermal Activity].

PubMed

Kobayakawa, Mutsutaka

2016-08-01

Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process.

Making DNA Fingerprints.

ERIC Educational Resources Information Center

Nunley, Kathie F.

1996-01-01

Presents an activity to simulate electrophoresis using everyday items. Uses adding machine paper to construct a set of DNA fingerprints that can be used to solve crime cases designed by students in any biology class. (JRH)

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

PubMed Central

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

2016-01-01

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

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

PubMed

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

2016-08-01

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

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

PubMed Central

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

2016-01-01

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

Distinction between Externally vs. Internally Guided Decision-Making: Operational Differences, Meta-Analytical Comparisons and Their Theoretical Implications

PubMed Central

Nakao, Takashi; Ohira, Hideki; Northoff, Georg

2012-01-01

Most experimental studies of decision-making have specifically examined situations in which a single less-predictable correct answer exists (externally guided decision-making under uncertainty). Along with such externally guided decision-making, there are instances of decision-making in which no correct answer based on external circumstances is available for the subject (internally guided decision-making). Such decisions are usually made in the context of moral decision-making as well as in preference judgment, where the answer depends on the subject’s own, i.e., internal, preferences rather than on external, i.e., circumstantial, criteria. The neuronal and psychological mechanisms that allow guidance of decisions based on more internally oriented criteria in the absence of external ones remain unclear. This study was undertaken to compare decision-making of these two kinds empirically and theoretically. First, we reviewed studies of decision-making to clarify experimental–operational differences between externally guided and internally guided decision-making. Second, using multi-level kernel density analysis, a whole-brain-based quantitative meta-analysis of neuroimaging studies was performed. Our meta-analysis revealed that the neural network used predominantly for internally guided decision-making differs from that for externally guided decision-making under uncertainty. This result suggests that studying only externally guided decision-making under uncertainty is insufficient to account for decision-making processes in the brain. Finally, based on the review and results of the meta-analysis, we discuss the differences and relations between decision-making of these two types in terms of their operational, neuronal, and theoretical characteristics. PMID:22403525

Making everyday tasks easier - arthritis

MedlinePlus

... GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly and Firestein's Textbook of Rheumatology . ... GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly and Firestein's Textbook of Rheumatology . ...

Online Safety: Fraud, Security, Phishing, Vishing

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... Theft Online Safety Privacy Report Scams and Frauds Online Safety Be aware of these scams when you' ... Security and Safety Internet Fraud Phishing and Vishing Online Security and Safety The internet makes many everyday ...

Making Choices about Everyday Care (for Families)

MedlinePlus

... and assists caregivers of brain-impaired adults through education, research, services and advocacy. FCA’s information Clearinghouse covers current medical, social, public policy and caregiving issues related to brain impairments. For residents of the ...

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,…

Self psychology and the modern dance choreographer.

PubMed

Press, Carol M

2009-04-01

Theory and research methodology of self psychology are integrated with the experiences of modern dance choreographers to investigate the importance of creativity, art making, and aesthetics in mental health and our everyday lives. Empathy, as aesthetically based, is explored to understand the capacity of the arts to unite us in our humanity. Connections between aesthetic development, creativity, and infant patterns of learning are drawn. The influence of sensual and exploration/assertion motivational systems upon the contemporary choreographer are highlighted, leading to an understanding of the selfobject function of sensation and movement for the dance artist. Through an examination of the moment to moment ritualized experiences of studio work, the creative process in making dances is discussed. Ultimately understanding creativity and aesthetically based empathy inform our delineation of mental health and the need for aesthetic experience in everyday life.

Becoming Heritage: A Place-Making Study of Old Neighbourhood Marketplace in Bandung

NASA Astrophysics Data System (ADS)

Ekomadyo, A. S.; Nurfadillah, A.; Kartamihardja, A.; Cungwin, A. J.

2018-05-01

The urban architectural heritages of Bandung represents the city’s historical layers. A unique urban architectural element found in Bandung is the heritage neighborhood marketplace. In the style of European post-renaissance urban design, a heritage neighborhood marketplace is initially designed as housing clusters with open spaces as neighborhood centre to create community privacy. But along the time, the neighborhood centre open their enclosed spaces and landmark buildings, transforming itself into small marketplaces with intensively daily activities. Through everyday place-making methods, this article investigates the history and meaning of neighborhood marketplace as everyday urban artefacts through observation, historical study, and interview. The study reveals are three main forces assembling the current form of neighborhood marketplaces in Bandung: Dutch-Indies colonialization, Chinese society trading network, and local traders’ tradition. Dutch-Indies colonialization in Bandung brought European architectural knowledge into neighborhood morphological design that contributed well-defined urban spaces. The Chinese trading network has been at place since the diaspora era and is still continued until now, bridging past and present life through economic activities. Local traders, who came after Dutch-Indies colonialization, fill the empty spaces of neighborhood centres with intensive formal and informal economic activities. Bandung heritage neighborhood marketplaces represent the city’s urban constellation, where global and local political-economic and socio-cultural forces meet in an urban process. Here, the urban heritage is redefined as living artefacts experienced in everyday urban life. Keywords: urban heritage, place making, neighborhood marketplace, Bandung, urban assemblage, living artefacts.

Addressing Challenges to Public Understanding of Science: Epistemic Cognition, Motivated Reasoning, and Conceptual Change

ERIC Educational Resources Information Center

Sinatra, Gale M.; Kienhues, Dorothe; Hofer, Barbara K.

2014-01-01

Science is of critical importance to daily life in a knowledge society and has a significant influence on many everyday decisions. As scientific problems increase in their number and complexity, so do the challenges facing the public in understanding these issues. Our objective is to focus on 3 of those challenges: the challenge of reasoning about…

Mobile Fatwa (M-Fatwa): The Integration of Islamic Fatwa through Mobile Technology

ERIC Educational Resources Information Center

Nawi, Mohd Aliff Mohd; Hamzah, Mohd Isa

2014-01-01

Fatwa institutions play an important role to disseminate information about the fatwa decision that has been discussed. Fatwa is decided will be a guide and reference to the Muslims for dismantling all the problems related to religious law in everyday life. The purpose of this paper to discuss the integration method fatwa information using a mobile…

Beyond an Assumed Mother-Child Symbiosis in Nutritional Guidelines: The Everyday Reasoning behind Complementary Feeding Decisions

ERIC Educational Resources Information Center

Nielsen, Annemette; Michaelsen, Kim F.; Holm, Lotte

2014-01-01

Researchers question the implications of the way in which "motherhood" is constructed in public health discourse. Current nutritional guidelines for Danish parents of young children are part of this discourse. They are shaped by an assumed symbiotic relationship between the nutritional needs of the child and the interest and focus of the…

Strategic Decision Making Paradigms: A Primer for Senior Leaders

DTIC Science & Technology

2009-07-01

decision making . STRATEGIC DECISION MAKING Strategic Change: There are several strategic...influenced by stakeholders outside of the organization. The Ontology of Strategic Decision Making . Strategic decisions are non-routine and involve...Coates USAWC, July 2009 5 The Complexity of Strategic Decision Making Strategic decisions entail “ill-structured,”6 “messy” or

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

NASA Astrophysics Data System (ADS)

Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

2013-10-01

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

Making the Familiar Strange: Creative Cultural Storytelling within the Communication Classroom

ERIC Educational Resources Information Center

Blinne, Kristen C.

2012-01-01

In this activity, students employ mock campfire storytelling to "make the familiar strange" in the same spirit as Horace Miner's (1956) classic tale of the "Nacirema." Students work individually, in pairs, or as small groups (around three) to create a whimsical story that deconstructs a mundane, everyday ritual (event, activity, practice) into a…

Making Connections: Promoting Music Making in the Home through a Preschool Music Program

ERIC Educational Resources Information Center

Cooper, Shelly; Cardany, Audrey Berger

2008-01-01

The Musical Play program is designed to assist children ages 2 to 5 and their parents. The program creators sought to help families build a repertoire of songs and activities for everyday living and to encourage musical play at home. The program includes developmentally appropriate songs, materials, and activities and incorporates a wide variety…

Everyday Engagement: Making Students and Parents Your Partners in Learning

ERIC Educational Resources Information Center

Ridnouer, Katy

2011-01-01

While there are lots of books about how to engage students more effectively in the classroom, here at last is a book that also makes engaging parents part of a solution to higher student achievement. Top-selling ASCD (Association for Supervision and Curriculum Development) author and classroom teacher Katy Ridnouer explains what you need to do to…

Educating Teachers of "Chinese as a Local/Global Language": Teaching "Chinese with Australian Characteristics"

ERIC Educational Resources Information Center

Singh, Michael; Han, Jinghe

2014-01-01

How can the education of teacher-researchers from China be framed in ways so that they might make Chinese learnable for primary and secondary school learners for whom English is their everyday language of instruction and communication. The concept "making Chinese learnable" and the characters of the language learners are explained in the…

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

PubMed

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

2016-01-01

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

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

PubMed

Dhukaram, Anandhi Vivekanandan; Baber, Chris

2015-06-01

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

The use of assistive technology in the everyday lives of young people living with dementia and their caregivers. Can a simple remote control make a difference?

PubMed

Jentoft, Rita; Holthe, Torhild; Arntzen, Cathrine

2014-12-01

This study was a part of a larger study exploring the impact of assistive technology on the lives of young people living with dementia (YPD). This paper focuses on one of the most useful devices, the simple remote control (SRC). The objective was to explore the reason why the SRC is significant and beneficial in the everyday lives of YPD and their caregivers. This qualitative longitudinal study had a participatory design. Eight participants received an SRC. The range for using it was 0-15 months. In-depth interviews and observations were conducted at baseline and repeated every third month up to 18 months. A situated learning approach was used in the analysis to provide a deeper understanding of the significance and use of SRC. Young people having dementia spend a substantial amount of time alone. Watching television was reported to be important, but handling remote controls was challenging and created a variety of problems. YPD learned to use SRC, which made important differences in the everyday lives of all family members. Comprehensive support from caregivers and professionals was important for YPD in the learning process. The SRC was deemed a success because it solved challenges regarding the use of television in everyday lives of families. The design was recognizable and user-friendly, thus allowing YPD to learn its operation. Access to professional support and advice regarding assistive technology is vital for establishing a system for follow-up and continued collaboration to make future adaptations and adjustments.

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

PubMed

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

2017-12-01

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

Shared decision-making - Rhetoric and reality: Women's experiences and perceptions of adjuvant treatment decision-making for breast cancer.

PubMed

Mahmoodi, Neda; Sargeant, Sally

2017-01-01

This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.

Measuring Shared Decision Making in Psychiatric Care

PubMed Central

Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.

2014-01-01

Objective Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. Methods A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. Results Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. Conclusions The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. PMID:22854725

Linking decision-making research and cancer prevention and control: important themes.

PubMed

McCaul, Kevin D; Peters, Ellen; Nelson, Wendy; Stefanek, Michael

2005-07-01

This article describes 6 themes underlying the multiple presentations from the Basic and Applied Decision Making in Cancer Control meeting, held February 19-20, 2004. The following themes have important implications for research and practice linking basic decision-making research to cancer prevention and control: (a) Traditional decision-making theories fail to capture real-world decision making, (b) decision makers are often unable to predict future preferences, (c) preferences are often constructed on the spot and thus are influenced by situational cues, (d) decision makers often rely on feelings rather than beliefs when making a decision, (e) the perspective of the decision maker is critical in determining preferences, and (f) informed decision making may--or may not--yield the best decisions.

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

PubMed Central

Story, William T.; Burgard, Sarah A.

2012-01-01

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

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

PubMed

Story, William T; Burgard, Sarah A

2012-12-01

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

Shared decision-making in epilepsy management.

PubMed

Pickrell, W O; Elwyn, G; Smith, P E M

2015-06-01

Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

[Shared decision-making in medical practice--patient-centred communication skills].

PubMed

van Staveren, Remke

2011-01-01

Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

Language Development: 2 Year Olds

MedlinePlus

... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... enrich his vocabulary and language skills by making reading a part of your everyday routine. At this ...

Catalytic Chemistry.

ERIC Educational Resources Information Center

Borer, Londa; And Others

1996-01-01

Describes an approach for making chemistry relevant to everyday life. Involves the study of kinetics using the decomposition of hydrogen peroxide by vegetable juices. Allows students to design and carry out experiments and then draw conclusions from their results. (JRH)

Exercise and age

MedlinePlus

... down the stairs STRETCHING Stretching can help your body stay flexible. To stay limber: Learn shoulder, upper arm, and calf stretches Take yoga classes Do everyday activities, such as making your bed or bending over to tie your shoes

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…

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,…

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology.

PubMed

Hansen, Dominique; Dendale, Paul; Coninx, Karin; Vanhees, Luc; Piepoli, Massimo F; Niebauer, Josef; Cornelissen, Veronique; Pedretti, Roberto; Geurts, Eva; Ruiz, Gustavo R; Corrà, Ugo; Schmid, Jean-Paul; Greco, Eugenio; Davos, Constantinos H; Edelmann, Frank; Abreu, Ana; Rauch, Bernhard; Ambrosetti, Marco; Braga, Simona S; Barna, Olga; Beckers, Paul; Bussotti, Maurizio; Fagard, Robert; Faggiano, Pompilio; Garcia-Porrero, Esteban; Kouidi, Evangelia; Lamotte, Michel; Neunhäuserer, Daniel; Reibis, Rona; Spruit, Martijn A; Stettler, Christoph; Takken, Tim; Tonoli, Cajsa; Vigorito, Carlo; Völler, Heinz; Doherty, Patrick

2017-07-01

Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases.

Eating and drinking interventions for people at risk of lacking decision-making capacity: who decides and how?

PubMed

Clarke, Gemma; Galbraith, Sarah; Woodward, Jeremy; Holland, Anthony; Barclay, Stephen

2015-06-11

Some people with progressive neurological diseases find they need additional support with eating and drinking at mealtimes, and may require artificial nutrition and hydration. Decisions concerning artificial nutrition and hydration at the end of life are ethically complex, particularly if the individual lacks decision-making capacity. Decisions may concern issues of life and death: weighing the potential for increasing morbidity and prolonging suffering, with potentially shortening life. When individuals lack decision-making capacity, the standard processes of obtaining informed consent for medical interventions are disrupted. Increasingly multi-professional groups are being utilised to make difficult ethical decisions within healthcare. This paper reports upon a service evaluation which examined decision-making within a UK hospital Feeding Issues Multi-Professional Team. A three month observation of a hospital-based multi-professional team concerning feeding issues, and a one year examination of their records. The key research questions are: a) How are decisions made concerning artificial nutrition for individuals at risk of lacking decision-making capacity? b) What are the key decision-making factors that are balanced? c) Who is involved in the decision-making process? Decision-making was not a singular decision, but rather involved many different steps. Discussions involving relatives and other clinicians, often took place outside of meetings. Topics of discussion varied but the outcome relied upon balancing the information along four interdependent axes: (1) Risks, burdens and benefits; (2) Treatment goals; (3) Normative ethical values; (4) Interested parties. Decision-making was a dynamic ongoing process with many people involved. The multiple points of decision-making, and the number of people involved with the decision-making process, mean the question of 'who decides' cannot be fully answered. There is a potential for anonymity of multiple decision-makers to arise. Decisions in real world clinical practice may not fit precisely into a model of decision-making. The findings from this service evaluation illustrate that within multi-professional team decision-making; decisions may contain elements of both substituted and supported decision-making, and may be better represented as existing upon a continuum.

Registered nurses' decision-making regarding documentation in patients' progress notes.

PubMed

Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne

2012-10-01

To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive continuum theory as a decision-making framework, provides a powerful means of guiding nurses' decision-making. © 2012 Blackwell Publishing Ltd.

A timely account of the role of duration in decision making.

PubMed

Ariely, D; Zakay, D

2001-09-01

The current work takes a general perspective on the role of time in decision making. There are many different relationships and interactions between time and decision making, and no single summary can do justice to this topic. In this paper we will describe a few of the aspects in which time and decision making are interleaved: (a) temporal perspectives of decisions--the various temporal orientations that decision-makers may adopt while making decisions, and the impact of such temporal orientations on the decision process and its outcomes; (b) time as a medium within which decisions take place--the nature of decision processes that occur along time; (c) time as a resource and as a contextual factor--the implications of shortage in time resources and the impact of time limits on decision making processes and performance; (d) time as a commodity--time as the subject matter of decision making. The paper ends with a few general questions on the role of duration in decision making.

Representation of People's Decisions in Health Information Systems. A Complementary Approach for Understanding Health Care Systems and Population Health.

PubMed

Gonzalez Bernaldo de Quiros, Fernan; Dawidowski, Adriana R; Figar, Silvana

2017-02-01

In this study, we aimed: 1) to conceptualize the theoretical challenges facing health information systems (HIS) to represent patients' decisions about health and medical treatments in everyday life; 2) to suggest approaches for modeling these processes. The conceptualization of the theoretical and methodological challenges was discussed in 2015 during a series of interdisciplinary meetings attended by health informatics staff, epidemiologists and health professionals working in quality management and primary and secondary prevention of chronic diseases of the Hospital Italiano de Buenos Aires, together with sociologists, anthropologists and e-health stakeholders. HIS are facing the need and challenge to represent social human processes based on constructivist and complexity theories, which are the current frameworks of human sciences for understanding human learning and socio-cultural changes. Computer systems based on these theories can model processes of social construction of concrete and subjective entities and the interrelationships between them. These theories could be implemented, among other ways, through the mapping of health assets, analysis of social impact through community trials and modeling of complexity with system simulation tools. This analysis suggested the need to complement the traditional linear causal explanations of disease onset (and treatments) that are the bases for models of analysis of HIS with constructivist and complexity frameworks. Both may enlighten the complex interrelationships among patients, health services and the health system. The aim of this strategy is to clarify people's decision making processes to improve the efficiency, quality and equity of the health services and the health system.

‘Rhyme or reason?’ Saying no to mass vaccination: subjective re-interpretation in the context of the A(H1N1) influenza pandemic in Sweden 2009–2010

PubMed Central

Lundgren, Britta

2015-01-01

During the swine flu pandemic of 2009–2010, all Swedish citizens were recommended to be vaccinated with the influenza vaccine Pandemrix. However, a very serious and unexpected side effect emerged during the summer of 2010: more than 200 children and young adults were diagnosed with narcolepsy after vaccination. Besides the tragic outcome for these children and their families, this adverse side effect suggests future difficulties in obtaining trust in vaccination in cases of emerging pandemics, and thus there is a growing need to find ways to understand the complexities of vaccination decision processes. This article explores written responses to a questionnaire from a Swedish folk life archive as an unconventional source for analysing vaccine decisions. The aim is to investigate how laypersons responded to and re-interpreted the message about the recommended vaccination in their answers. The answers show the confusion and complex circumstances and influences in everyday life that people reflect on when making such important decisions. The issue of confusion is traced back to the initial communications about the vaccination intervention in which both autonomy and solidarity were expected from the population. Common narratives and stories about the media or ‘big pharma capitalism’ are entangled with private memories, accidental coincidences and serendipitous associations. It is obvious that vaccination interventions that require compliance from large groups of people need to take into account the kind of personal experience narratives that are produced by the complex interplay of the factors described by the informants. PMID:26077985

My, your and our needs for safety and security: relatives' reflections on using information and communication technology in dementia care.

PubMed

Olsson, Annakarin; Engström, Maria; Skovdahl, Kirsti; Lampic, Claudia

2012-03-01

The present paper reports on a study aimed at describing relatives' reflections on different kinds of information and communication technology (ICT) devices that are used or can be used in the daily care of persons with dementia. Many persons with dementia continue living in their own homes, which requires the support of their relatives. One way to meet the needs of relatives and persons with dementia is to use ICT. An interview study was conducted in Sweden (2007-2008) with a purposive sample of 14 spouses of a person with dementia. Qualitative content analysis was used to identify categories and themes in the data. Relatives' reflections on the use of ICT were described as ICT - a support in daily life, ICT - internal and external conditions and ICT - the decision to use or not use. Based on these categories, a theme was revealed: shifting between different perspectives: my, your and our needs for safety and security. Relatives struggle to create a situation of safety and security in daily life for themselves and the persons with dementia. ICT devices with the right functionality and used at the right time are regarded as useful in solving everyday problems. In the decision to use or not use ICT, the opportunity to create a safe and secure environment overshadows potential ethical problems. Providing early information about ICT to persons with dementia and their relatives could facilitate joint decision-making regarding use of ICT. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

Dating, Marriage, and Parenthood for HIV-Positive Heterosexual Puerto Rican Men: Normalizing Perspectives on Everyday Life With HIV

PubMed Central

Sastre, Francisco; Sheehan, Diana M.; Gonzalez, Arnaldo

2014-01-01

HIV-positive men are living long and healthier lives while managing HIV as a chronic illness. Although research has extensively documented the experiences of illness of people living with HIV, dating, marriage, and fatherhood among heterosexual Latino men has not been examined. To address this gap, this study used a qualitative study design to examine patterns and strategies for dating, marriage, and parenthood among 24 HIV-positive heterosexual Puerto Rican men living in Boston. The findings in our study indicate that an HIV diagnosis does not necessarily deter men from having an active sexual life, marrying, or having children. In fact, for some of the men, engaging in these social and life-changing events is part of moving on and normalizing life with HIV; these men planned for, achieved, and interpreted these events in the context of establishing normalcy with HIV. Although the HIV diagnosis discouraged some men from engaging in sexual relations, getting married, or having children, others fulfilled these desires with strategies aimed to reconciling their HIV status in their personal life, including dating or marrying HIV-positive women only. Additional important themes identified in this study include the decision to disclose HIV status to new sexual partners as well as the decision to accept the risk of HIV transmission to a child or partner in order to fulfill desires of fatherhood. Understanding the personal struggles, decision-making patterns, and needs of HIV-positive heterosexual men can aid in designing interventions that support healthy living with HIV. PMID:24794822

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.

'Treats', 'sometimes foods', 'junk': a qualitative study exploring 'extra foods' with parents of young children.

PubMed

Petrunoff, Nicholas A; Wilkenfeld, Rachel L; King, Lesley A; Flood, Victoria M

2014-05-01

The present study investigated parents' understanding and approaches to providing energy-dense and nutrient-poor 'extra foods' to pre-school children and explored variation between parents of low and high socio-economic status in relation to these issues. We conducted thirteen focus groups. Data were subject to framework analysis. Child-care centres in distinctly socially disadvantaged and socially advantaged areas. Eighty-eight parents of children aged 3-5 years. The three most common terms parents identified to describe foods that are not 'everyday foods' were 'treats', 'sometimes foods' and 'junk'. Parents' perceptions regarding what influences them in providing food to their children included seven sub-themes: (i) the influence of the child; (ii) food-related parenting practices; (iii) health considerations; (iv) food costs and convenience; (v) external factors perceived as influencing their child; (vi) factors related to child care; and (vii) social influences and occasions. Parents' decision-making processes regarding provision of 'extra foods' related to moderation and balance. Parents generally expressed the position that as long as a child is eating healthy foods, then treats are appropriate; and for many parents, this might apply frequently. All groups described the health of their child as an influence, but parents in low socio-economic groups were more likely to describe immediate concerns (dental health, behaviour) in relation to avoiding sugar-dense food or drink. The belief that provision of 'extra foods' can be frequent as long as children are eating a healthy balance of foods is factored into parents' decision making. Challenging this belief may be important for reducing the consumption of 'extra foods' by young children.

A decision-making tool to prescribe knee orthoses in daily practice for patients with osteoarthritis.

PubMed

Coudeyre, Emmanuel; Nguyen, Christelle; Chabaud, Aurore; Pereira, Bruno; Beaudreuil, Johann; Coudreuse, Jean-Marie; Deat, Philippe; Sailhan, Frédéric; Lorenzo, Alain; Rannou, François

2018-03-01

To develop a decision-making tool (DMT) to facilitate the prescription of knee orthoses for patients with osteoarthritis (OA) in daily practice. A steering committee gathered a multidisciplinary task force experienced in OA management/clinical research. Two members performed a literature review with qualitative analysis of the highest-quality randomized controlled trials and practice guidelines to confirm evidence concerning knee orthosis for OA. A first DMT draft was presented to the task force in a 1-day meeting in January 2016. The first version of the DMT was criticized and discussed regarding everyday practice issues. Every step was discussed and amended until consensus agreement was achieved within the task force. Then 4 successive consultation rounds occurred by electronic communication, first with primary- and secondary-care physicians, then with international experts. All corrections and suggestions by each member were shared with the rest of the task force and included to reach final consensus. The final version was validated by the steering committee. The definition and indication of several types of knee orthoses (sleeve, patello-femoral, hinged or unicompartmental offloading braces) were detailed. Orthoses may be proposed in addition to first-line non-pharmacological treatment if patient acceptance is considered good. At every step, a specific clinical assessment is needed. Based on the latest high-level evidence, practice guidelines, and an expert panel, a DMT to facilitate daily practice prescription of knee orthoses for OA patients was designed. An evaluation of DMT implementation in a wide range of health professionals is still needed. Copyright © 2018 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.

Orphan/vulnerable child caregiving moderates the association between women's autonomy and their BMI in three African countries.

PubMed

Kanamori, Mariano; Carter-Pokras, Olivia; Madhavan, Sangeetha; Feldman, Robert; He, Xin; Lee, Sunmin

2014-01-01

Enhancement of women's autonomy is a key factor for improving women's health and nutrition. With nearly 12 million orphan and vulnerable children (OVC) in Africa due to HIV/AIDS, the study of OVC primary caregivers' nutrition is fundamental. We investigated the association between married women's autonomy and their nutritional status; explored whether this relationship was modified by OVC primary caregiving; and analyzed whether decision-making autonomy mediated the association between household wealth and body mass index (BMI). This cross-sectional study used the data from Demographic Health Surveys collected during 2006-2007 from 20- to 49-year-old women in Namibia (n = 2633), Swaziland (n = 1395), and Zambia (n = 2920). Analyses included logistic regression, Sobel, and Goodman tests. Our results indicated that women's educational attainment increased the odds for being overweight (Swaziland and Zambia) and decreased the odds for being underweight (Namibia). In Zambia, having at least primary education increased the odds for being overweight only among child primary caregivers regardless of the OVC status of the child, and having autonomy for buying everyday household items increased the odds for being overweight only among OVC primary caregivers. Decision-making autonomy mediated the association between household wealth and OVC primary caregivers' BMI in Zambia (Z = 2.13, p value = 0.03). We concluded that depending on each country's contextual characteristics, having education can decrease the odds for being an underweight woman or increase the odds for being an overweight woman. Further studies should explore why in Namibia education has an effect on women's overweight status only among women who are caring for a child.

Role of Spontaneous Brain Activity in Explicit and Implicit Aspects of Cognitive Flexibility under Socially Conflicting Situations: A Resting-state fMRI Study using Fractional Amplitude of Low-frequency Fluctuations.

PubMed

Fujino, Junya; Tei, Shisei; Jankowski, Kathryn F; Kawada, Ryosaku; Murai, Toshiya; Takahashi, Hidehiko

2017-12-26

We are constantly exposed to socially conflicting situations in everyday life, and cognitive flexibility is essential for adaptively coping with such difficulties. Flexible goal choice and pursuit are not exclusively conscious, and therefore cognitive flexibility involves both explicit and implicit forms of processing. However, it is unclear how individual differences in explicit and implicit aspects of flexibility are associated with neural activity in a resting state. Here, we measured intrinsic fractional amplitude of low-frequency fluctuations (fALFF) by resting-state functional magnetic resonance imaging (RS-fMRI) as an indicator of regional brain spontaneous activity, together with explicit and implicit aspects of cognitive flexibility using the Cognitive Flexibility Scale (CFS) and Implicit Association Test (IAT). Consistent with the dual processing theory, there was a strong association between explicit aspects of flexibility (CFS score) and "rationalism" thinking style and between implicit aspects (IAT effect) and "experientialism." The level of explicit flexibility was also correlated with fALFF values in the left lateral prefrontal cortex, whereas the level of implicit flexibility was correlated with fALFF values in the right cerebellum. Furthermore, the fALFF values in both regions predicted individual preference for flexible decision-making strategy in a vignettes simulation task. These results add to our understanding of the neural mechanisms underlying flexible decision-making for solving social conflicts. More generally, our findings highlight the utility of RS-fMRI combined with both explicit and implicit psychometric measures for better understanding individual differences in social cognition. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Orphan/vulnerable child caregiving moderates the association between women’s autonomy and their BMI in three African countries

PubMed Central

Carter-Pokras, Olivia; Madhavan, Sangeetha; Feldman, Robert; He, Xin; Lee, Sunmin

2014-01-01

Enhancement of women’s autonomy is a key factor for improving women’s health and nutrition. With nearly 12 million orphan and vulnerable children (OVC) in Africa due to HIV/AIDS, the study of OVC primary caregivers’ nutrition is fundamental. We investigated the association between married women’s autonomy and their nutritional status; explored whether this relationship was modified by OVC primary caregiving; and, analyzed whether decision-making autonomy mediated the association between household wealth and body mass index (BMI). This cross-sectional study used data from Demographic Health Surveys collected during 2006–2007 from 20–49 year old women in Namibia (n=2,633), Swaziland (n=1,395), and Zambia (n=2,920). Analyses included logistic regression, Sobel and Goodman tests. Our results indicated that women’s educational attainment increased the odds for being overweight (Swaziland and Zambia) and decreased the odds for being underweight (Namibia). In Zambia, having at least primary education increased the odds for being overweight only among child primary caregivers regardless of the OVC status of the child, and having autonomy for buying everyday household items increased the odds for being overweight only among OVC primary caregivers. Decision-making autonomy mediated the association between household wealth and OVC primary caregivers’ BMI in Zambia (Z=2.13, p-value0.03). We concluded that depending on each country’s contextual characteristics, having education can decrease the odds for being an underweight woman or increase the odds for being an overweight woman. Further studies should explore why in Namibia, education has an effect on women’s overweight status only among women who are caring for a child. PMID:24888977

Making Technological Timelines: Anticipatory Repair and Testing in High Performance Scientific Computing

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

Sims, Benjamin

Think of some examples of repair in everyday life. Maybe you had a car accident and took your car to the body shop. Maybe the head came off your child’s doll and you had to glue it back on. Maybe the handle of your shovel cracked and you wrapped the cracked area with duct tape to hold it together. These are examples of what could be called reactive repair, where an unexpected accident initiates a sequence of action and decision-making that ends in repair. In these cases, most of the thinking and planning surrounding repair takes place after a breakdownmore » has been identified. This type of repair is often taken to be distinct from deliberate design, as it occurs within the context of technology that is already in operation, often has an improvisational character, and may be performed by end users or technicians rather than credentialed experts. But does repair always have to be reactive? And if not, what does this tell us about the distinction between design and repair, and their respective roles in shaping technological change? The short answer is that repair, like design, can play a dynamic and forward-looking role in shaping technological trajectories – not only stabilizing existing systems, but anticipating change and generating new technological futures.« less

Making Technological Timelines: Anticipatory Repair and Testing in High Performance Scientific Computing

DOE PAGES

Sims, Benjamin

2017-05-23

Think of some examples of repair in everyday life. Maybe you had a car accident and took your car to the body shop. Maybe the head came off your child’s doll and you had to glue it back on. Maybe the handle of your shovel cracked and you wrapped the cracked area with duct tape to hold it together. These are examples of what could be called reactive repair, where an unexpected accident initiates a sequence of action and decision-making that ends in repair. In these cases, most of the thinking and planning surrounding repair takes place after a breakdownmore » has been identified. This type of repair is often taken to be distinct from deliberate design, as it occurs within the context of technology that is already in operation, often has an improvisational character, and may be performed by end users or technicians rather than credentialed experts. But does repair always have to be reactive? And if not, what does this tell us about the distinction between design and repair, and their respective roles in shaping technological change? The short answer is that repair, like design, can play a dynamic and forward-looking role in shaping technological trajectories – not only stabilizing existing systems, but anticipating change and generating new technological futures.« less

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