Relationship Power, Sexual Decision Making, and HIV Risk Among Midlife and Older Women.

PubMed

Altschuler, Joanne; Rhee, Siyon

2015-01-01

The number of midlife and older women with HIV/AIDS is high and increasing, especially among women of color. This article addresses these demographic realities by reporting on findings about self-esteem, relationship power, and HIV risk from a pilot study of midlife and older women. A purposive sample (N = 110) of ethnically, economically, and educationally diverse women 40 years and older from the Greater Los Angeles Area was surveyed to determine their levels of self-esteem, general relationship power, sexual decision-making power, safer sex behaviors, and HIV knowledge. Women with higher levels of self-esteem exercised greater power in their relationships with their partner. Women with higher levels of general relationship power and self-esteem tend to exercise greater power in sexual decision making, such as having sex and choosing sexual acts. Income and sexual decision-making power were statistically significant in predicting the use of condoms. Implications and recommendations for future HIV/AIDS research and intervention targeting midlife and older women are presented.

Ethical Decisions in Palliative Care: Interprofessional Relations as a Burnout Protective Factor? Results From a Mixed-Methods Multicenter Study in Portugal.

PubMed

Hernández-Marrero, Pablo; Pereira, Sandra Martins; Carvalho, Ana Sofia

2016-09-01

Ethical decisions are part of contemporary practices in palliative care. The need of making such decisions is associated to higher burnout levels and other work related problems among healthcare professionals. As part of the project entitled "Decisions in End-of-Life Care in Spain and Portugal" (DELiCaSP), this study aims to (i) identify the most common ethical decisions made by Portuguese palliative care teams and (ii) understand how the making of such decisions relates to burnout. A mixed methods study was conducted with 9 palliative care teams, using (i) questionnaires of socio-demographic and professional variables, work-related experiences, (ii) the Maslach Burnout Inventory, (iii) interviews and (iv) observations. These teams were geographically dispersed across the country, covering the North, Centrum and South regions, and heterogeneous: Five palliative care units for inpatients; three home care teams; and one hospital support team. A total of 20 interviews and 240 hours of observations were completed until reaching saturation. The most common ethical decisions were related to communication issues (information disclosure of the diagnosis and prognosis), forgoing treatment and sedation. Although perceived as stressful, emotionally demanding and challenging, ethical decisions were not significantly associated with burnout. Making ethical decisions is not associated with higher burnout levels among professionals working in Portuguese palliative care teams. This can be explained by the interprofessional decision-making process followed by these teams, which promotes a sense of shared-decision and team-based empowerment; and by the advanced level of interdisciplinary education in palliative care that these professionals have. © The Author(s) 2015.

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

PubMed

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

2017-01-01

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

Is fear perception special? Evidence at the level of decision-making and subjective confidence.

PubMed

Koizumi, Ai; Mobbs, Dean; Lau, Hakwan

2016-11-01

Fearful faces are believed to be prioritized in visual perception. However, it is unclear whether the processing of low-level facial features alone can facilitate such prioritization or whether higher-level mechanisms also contribute. We examined potential biases for fearful face perception at the levels of perceptual decision-making and perceptual confidence. We controlled for lower-level visual processing capacity by titrating luminance contrasts of backward masks, and the emotional intensity of fearful, angry and happy faces. Under these conditions, participants showed liberal biases in perceiving a fearful face, in both detection and discrimination tasks. This effect was stronger among individuals with reduced density in dorsolateral prefrontal cortex, a region linked to perceptual decision-making. Moreover, participants reported higher confidence when they accurately perceived a fearful face, suggesting that fearful faces may have privileged access to consciousness. Together, the results suggest that mechanisms in the prefrontal cortex contribute to making fearful face perception special. © The Author (2016). Published by Oxford University Press.

Good decision-making is associated with an adaptive cardiovascular response to social competitive stress.

PubMed

Alacreu-Crespo, Adrián; Costa, Raquel; Abad-Tortosa, Diana; Salvador, Alicia; Serrano, Miguel Ángel

2018-06-22

Competition elicits different psychological and cardiovascular responses depending on a person's skills. Decision-making has been considered a distal factor that influences competition, but there are no studies analyzing this relationship. Our objective was to analyze whether decision-making affects the response to competition. Specifically, we aimed to test whether good performers on a decision-making test, the Iowa Gambling Task (IGT), showed an adaptive cardiovascular response to competition. In all, 116 participants (44 women) performed the IGT and were classified into Good or Poor decision-makers. Subsequently, they were exposed to a stress task in two different conditions: a face-to-face competition (winners/losers) or a control condition, while an electrocardiogram was recorded. In the competition group, good decision-makers increased their high-frequency respect to the total heart rate variability (HF/HRV) levels during the task, compared to Poor decision-makers. Again, competition group good decision-makers, showed lower LF and higher HF/HRV reactivity than the control group, which represents lower HRV stress pattern. Moreover, in the group of losers, good decision-makers had a decline in low frequency (LF) during the task and faster recovery than poor decision-makers. In conclusion, good decision-makers have a more adaptive stress response and higher levels of mental effort, based on total HRV interpretation. Decision-making skills could be a factor in a more adaptive cardiovascular response to competition.

Utilising Benchmarking to Inform Decision-Making at the Institutional Level: A Research-Informed Process

ERIC Educational Resources Information Center

Booth, Sara

2013-01-01

Benchmarking has traditionally been viewed as a way to compare data only; however, its utilisation as a more investigative, research-informed process to add rigor to decision-making processes at the institutional level is gaining momentum in the higher education sector. Indeed, with recent changes in the Australian quality environment from the…

Educational Status of the Married Women and Their Participation at Household Decision Making in Rural Bangladesh

NASA Astrophysics Data System (ADS)

Chanda, Sanjoy Kumar; Howlader, Hasan; Nahar, Nasrin

2012-11-01

The key focus of this study is to explain the level of education of married women and their participation in decision making process at different arena of rural household. To find out the nature of the reality, survey research design was used for this study. The study was conducted at Maharajpur, one of the unions of Jhenidah district in Bangladesh in 2011. The respondents of the study consisted of 120 married women who were purposively selected from the study area. Data were collected through direct interview method using an interview schedule. Data were shown on univariate, as well as bivariate statistical tables and then analyzed. The study reveals that a significant percent (93.3) of higher level of education completed women had their consent of getting married whereas no consent was made by illiterate women. In the same way 46.7 percent higher level of education completed women had high level of purchasing power in compare to illiterate (.0%) and primary (14.6%) level completed women for the same level of purchasing. In the political decision making 86.7 percent higher level of education completed women had own consent to vote for election in contrast to 77.8 percent illiterate and 70.7 percent primary level completed women were influenced by their husband to decide voting.

Give blood today or save lives tomorrow: Matching decision and message construal level to maximize blood donation intentions.

PubMed

Czeizler, Amalia; Garbarino, Ellen

2017-01-01

The research extends construal theory by testing if a match between the temporal construal framing of a blood donation decision and a blood donation request leads to higher donation intentions than a mismatch. Results show participants considering future donation who read an abstract donation request have significantly higher donation intentions than those who read a concrete request. Conversely, participants considering donating today who read a concrete donation request have significantly higher donation intentions than those who read an abstract request. This study confirms the importance of matching the construal framing of the communication to the temporal framing of the decision.

Higher Trait Psychopathy Is Associated with Increased Risky Decision-Making and Less Coincident Insula and Striatal Activity

PubMed Central

Sutherland, Matthew T.; Fishbein, Diana H.

2017-01-01

Higher trait levels of psychopathy have been associated with both a tendency to maintain disadvantageous decision-making strategies and aberrant cortico-limbic neural activity. To explore the neural mechanisms associated with the psychopathy-related propensity to continue selecting risky choices, a non-forensic sample of participants completed a self-report psychopathy questionnaire and two runs of a risky decision-making task during H215O positron emission tomography (PET) scanning. In this secondary data analysis study, we leveraged data previously collected to examine the impact of previous drug use on risky decision-making to explore the relations between self-reported psychopathy and behavioral and brain metrics during performance of the Cambridge Decision-Making Task (CDMT), in which volunteers chose between small/likely or large/unlikely potential reward outcomes. Behaviorally, we observed that psychopathy scores were differentially correlated with the percent of risky decisions made in run 1 vs. run 2 of the task. Specifically, higher levels of psychopathy, above and beyond that attributable to drug use or sex, were associated with greater tendencies to make risky selections only in the second half (run 2) of the task. In parallel, psychopathy scores negatively correlated with regional cerebral blood flow (rCBF) in the right insula and right ventral striatum during run 2 of the CDMT. These exploratory outcomes suggest that greater levels of psychopathy may be associated with an inability to translate experience with negative outcomes into behavioral adaptations possibly due to decreased neural efficiency in regions related to somatic and/or reward feedback processes. PMID:29311863

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

PubMed

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

2013-12-01

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

The Role of Patient Activation in Preferences for Shared Decision Making: Results From a National Survey of U.S. Adults.

PubMed

Smith, Samuel G; Pandit, Anjali; Rush, Steven R; Wolf, Michael S; Simon, Carol J

2016-01-01

Studies investigating preferences for shared decision making (SDM) have focused on associations with sociodemographic variables, with few investigations exploring patient factors. We aimed to investigate the relationship between patient activation and preferences for SDM in 6 common medical decisions among a nationally representative cross-sectional survey of American adults. Adults older than 18 were recruited online (n = 2,700) and by telephone (n = 700). Respondents completed sociodemographic assessments and the Patient Activation Measure. They were also asked whether they perceived benefit (yes/no) in SDM in 6 common medical decisions. Nearly half of the sample (45.9%) reached the highest level of activation (Level 4). Activation was associated with age (p < .001), higher income (p = .001), higher education (p = .010), better self-rated health (p < .001), and fewer chronic conditions (p = .050). The proportion of people who agreed that SDM was beneficial varied from 53.1% (deciding the necessity of a diagnostic test) to 71.8% (decisions associated with making lifestyle changes). After we controlled for participant characteristics, higher activation was associated with greater perceived benefit in SDM across 4 of the 6 decisions. Preferences for SDM varied among 6 common medical scenarios. Low patient activation is an important barrier to SDM that could be ameliorated through the development of behavioral interventions.

40 CFR Appendix Ix to Part 261 - Wastes Excluded Under §§ 260.20 and 260.22

Code of Federal Regulations, 2010 CFR

2010-07-01

... delisting level established in Condition (1), or is at a level in the ground water or soil higher than the... violation of the delisting petition and a possible revocation of the decision. American Steel Cord... established in Condition (1), or is at a level in the ground water or soil higher than the health based level...

The Relationship between Spirituality, Religiousness, and Career Adaptability

ERIC Educational Resources Information Center

Duffy, Ryan D.; Blustein, David L.

2005-01-01

The present study examined the relationship between spirituality, religiousness, and career adaptability using a sample of undergraduate students (N=144). We proposed that higher levels of religiousness and spirituality would predict higher levels of career adaptability, defined in this study by career decision self-efficacy and career choice…

Salivary cortisol and alpha-amylase levels during an assessment procedure correlate differently with risk-taking measures in male and female police recruits

PubMed Central

van den Bos, Ruud; Taris, Ruben; Scheppink, Bianca; de Haan, Lydia; Verster, Joris C.

2013-01-01

Recent laboratory studies have shown that men display more risk-taking behavior in decision-making tasks following stress, whilst women are more risk-aversive or become more task-focused. In addition, these studies have shown that sex differences are related to levels of the stress hormone cortisol (indicative of activation of the hypothalamus-pituitary-adrenocortical-axis): the higher the levels of cortisol the more risk-taking behavior is shown by men, whereas women generally display more risk-aversive or task-focused behavior following higher levels of cortisol. Here, we assessed whether such relationships hold outside the laboratory, correlating levels of cortisol obtained during a job-related assessment procedure with decision-making parameters in the Cambridge Gambling Task (CGT) in male and female police recruits. The CGT allows for discriminating different aspects of reward-based decision-making. In addition, we correlated levels of alpha-amylase [indicative of activation of the sympatho-adrenomedullary-axis (SAM)] and decision-making parameters. In line with earlier studies men and women only differed in risk-adjustment in the CGT. Salivary cortisol levels correlated positively and strongly with risk-taking measures in men, which was significantly different from the weak negative correlation in women. In contrast, and less strongly so, salivary alpha-amylase levels correlated positively with risk-taking in women, which was significantly different from the weak negative correlation with risk-taking in men. Collectively, these data support and extend data of earlier studies indicating that risky decision-making in men and women is differently affected by stress hormones. The data are briefly discussed in relation to the effects of stress on gambling. PMID:24474909

The risk of disabling, surgery and reoperation in Crohn's disease - A decision tree-based approach to prognosis.

PubMed

Dias, Cláudia Camila; Pereira Rodrigues, Pedro; Fernandes, Samuel; Portela, Francisco; Ministro, Paula; Martins, Diana; Sousa, Paula; Lago, Paula; Rosa, Isadora; Correia, Luis; Moura Santos, Paula; Magro, Fernando

2017-01-01

Crohn's disease (CD) is a chronic inflammatory bowel disease known to carry a high risk of disabling and many times requiring surgical interventions. This article describes a decision-tree based approach that defines the CD patients' risk or undergoing disabling events, surgical interventions and reoperations, based on clinical and demographic variables. This multicentric study involved 1547 CD patients retrospectively enrolled and divided into two cohorts: a derivation one (80%) and a validation one (20%). Decision trees were built upon applying the CHAIRT algorithm for the selection of variables. Three-level decision trees were built for the risk of disabling and reoperation, whereas the risk of surgery was described in a two-level one. A receiver operating characteristic (ROC) analysis was performed, and the area under the curves (AUC) Was higher than 70% for all outcomes. The defined risk cut-off values show usefulness for the assessed outcomes: risk levels above 75% for disabling had an odds test positivity of 4.06 [3.50-4.71], whereas risk levels below 34% and 19% excluded surgery and reoperation with an odds test negativity of 0.15 [0.09-0.25] and 0.50 [0.24-1.01], respectively. Overall, patients with B2 or B3 phenotype had a higher proportion of disabling disease and surgery, while patients with later introduction of pharmacological therapeutic (1 months after initial surgery) had a higher proportion of reoperation. The decision-tree based approach used in this study, with demographic and clinical variables, has shown to be a valid and useful approach to depict such risks of disabling, surgery and reoperation.

The impact of threat of shock on the framing effect and temporal discounting: executive functions unperturbed by acute stress?

PubMed

Robinson, Oliver J; Bond, Rebecca L; Roiser, Jonathan P

2015-01-01

Anxiety and stress-related disorders constitute a large global health burden, but are still poorly understood. Prior work has demonstrated clear impacts of stress upon basic cognitive function: biasing attention toward unexpected and potentially threatening information and instantiating a negative affective bias. However, the impact that these changes have on higher-order, executive, decision-making processes is unclear. In this study, we examined the impact of a translational within-subjects stress induction (threat of unpredictable shock) on two well-established executive decision-making biases: the framing effect (N = 83), and temporal discounting (N = 36). In both studies, we demonstrate (a) clear subjective effects of stress, and (b) clear executive decision-making biases but (c) no impact of stress on these decision-making biases. Indeed, Bayes factor analyses confirmed substantial preference for decision-making models that did not include stress. We posit that while stress may induce subjective mood change and alter low-level perceptual and action processes (Robinson et al., 2013c), some higher-level executive processes remain unperturbed by these impacts. As such, although stress can induce a transient affective biases and altered mood, these need not result in poor financial 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.

Different effects of dopaminergic medication on perceptual decision-making in Parkinson's disease as a function of task difficulty and speed-accuracy instructions.

PubMed

Huang, Yu-Ting; Georgiev, Dejan; Foltynie, Tom; Limousin, Patricia; Speekenbrink, Maarten; Jahanshahi, Marjan

2015-08-01

When choosing between two options, sufficient accumulation of information is required to favor one of the options over the other, before a decision is finally reached. To establish the effect of dopaminergic medication on the rate of accumulation of information, decision thresholds and speed-accuracy trade-offs, we tested 14 patients with Parkinson's disease (PD) on and off dopaminergic medication and 14 age-matched healthy controls on two versions of the moving-dots task. One version manipulated the level of task difficulty and hence effort required for decision-making and the other the urgency, requiring decision-making under speed vs. accuracy instructions. The drift diffusion model was fitted to the behavioral data. As expected, the reaction time data revealed an effect of task difficulty, such that the easier the perceptual decision-making task was, the faster the participants responded. PD patients not only made significantly more errors compared to healthy controls, but interestingly they also made significantly more errors ON than OFF medication. The drift diffusion model indicated that PD patients had lower drift rates when tested ON compared to OFF medication, indicating that dopamine levels influenced the quality of information derived from sensory information. On the speed-accuracy task, dopaminergic medication did not directly influence reaction times or error rates. PD patients OFF medication had slower RTs and made more errors with speed than accuracy instructions compared to the controls, whereas such differences were not observed ON medication. PD patients had lower drift rates and higher response thresholds than the healthy controls both with speed and accuracy instructions and ON and OFF medication. For the patients, only non-decision time was higher OFF than ON medication and higher with accuracy than speed instructions. The present results demonstrate that when task difficulty is manipulated, dopaminergic medication impairs perceptual decision-making and renders it more errorful in PD relative to when patients are tested OFF medication. In contrast, for the speed/accuracy task, being ON medication improved performance by eliminating the significantly higher errors and slower RTs observed for patients OFF medication compared to the HC group. There was no evidence of dopaminergic medication inducing impulsive decisions when patients were acting under speed pressure. For the speed-accuracy instructions, the sole effect of dopaminergic medication was on non-decision time, which suggests that medication primarily affected processes tightly coupled with the motor symptoms of PD. Interestingly, the current results suggest opposite effects of dopaminergic medication on the levels of difficulty and speed-accuracy versions of the moving dots task, possibly reflecting the differential effect of dopamine on modulating drift rate (levels of difficulty task) and non-decision time (speed-accuracy task) in the process of perceptual decision making. Copyright © 2015 Elsevier Ltd. All rights reserved.

Impact of different training strategies on the accuracy of a Bayesian network for predicting hospital admission.

PubMed

Leegon, Jeffrey; Aronsky, Dominik

2006-01-01

The healthcare environment is constantly changing. Probabilistic clinical decision support systems need to recognize and incorporate the changing patterns and adjust the decision model to maintain high levels of accuracy. Using data from >75,000 ED patients during a 19-month study period we examined the impact of various static and dynamic training strategies on a decision support system designed to predict hospital admission status for ED patients. Training durations ranged from 1 to 12 weeks. During the study period major institutional changes occurred that affected the system's performance level. The average area under the receiver operating characteristic curve was higher and more stable when longer training periods were used. The system showed higher accuracy when retrained an updated with more recent data as compared to static training period. To adjust for temporal trends the accuracy of decision support systems can benefit from longer training periods and retraining with more recent data.

Antibiotic and shared decision-making preferences among adolescents in Malaysia

PubMed Central

Ngadimon, Irma Wati; Islahudin, Farida; Hatah, Ernieda; Mohamed Shah, Noraida; Makmor-Bakry, Mohd

2015-01-01

Background The purpose of this study was to establish baseline information on the current level of knowledge about, attitude toward, and experience with antibiotic usage, and preferences for shared decision making among adolescents in Malaysia. Methods A cross-sectional survey, involving 1,105 respondents who were aged between 13 and 17 years and who lived in Malaysia, was conducted using a validated questionnaire. The survey assessed knowledge, attitude, and experience with regard to antibiotic usage, and adolescents’ preferences for the style of shared decision-making process. Results The majority (n=786 [71.13%]) of the respondents had a low level of knowledge, 296 (26.79%) had a moderate level of knowledge, and 23 (2.08%) had a high level of knowledge. Further, they demonstrated a slightly negative attitude mean score of 3.30±0.05 (range: 0–8 points) but a positive experience mean score of 2.90±0.029 (range: 0–4 points). There was a positive correlation between knowledge and attitude scores, with a higher knowledge level associated with a more positive attitude toward antibiotic usage (r=0.257, P<0.001). Higher knowledge scores were associated with a more negative experience with antibiotic usage (r=−0.83, P=0.006). When assessing preference in shared decision making, more adolescents preferred an active role (n=408 [37%]) compared with collaborative (n=360 [32.6%]) or passive (n=337 [30.5%]) (P=0.028) roles. Conclusion Current health care settings should involve adolescents in the decision-making process. Education packages can be introduced to improve adolescents’ knowledge of and practice of taking antibiotics, as well as to encourage their participation in decision making, in an attempt to reduce misuse of antibiotics. PMID:25999702

Which Tier? Effects of Linear Assessment and Student Characteristics on GCSE Entry Decisions

ERIC Educational Resources Information Center

Vitello, Sylvia; Crawford, Cara

2018-01-01

In England, students obtain General Certificate of Secondary Education (GCSE) qualifications, typically at age 16. Certain GCSEs are tiered; students take either higher-level (higher tier) or lower-level (foundation tier) exams, which may have different educational, career and psychological consequences. In particular, foundation tier entry, if…

Executive function, approach sensitivity, and emotional decision making as influences on risk behaviors in young adults.

PubMed

Patrick, Megan E; Blair, Clancy; Maggs, Jennifer L

2008-05-01

Relations among executive function, behavioral approach sensitivity, emotional decision making, and risk behaviors (alcohol use, drug use, and delinquent behavior) were examined in single female college students (N = 72). Hierarchical multiple regressions indicated a significant Approach Sensitivity x Working Memory interaction in which higher levels of alcohol use were associated with the combination of greater approach tendency and better working memory. This Approach Sensitivity x Working Memory interaction was also marginally significant for drug use and delinquency. Poor emotional decision making, as measured by a gambling task, was also associated with higher levels of alcohol use, but only for individuals low in inhibitory control. Findings point to the complexity of relations among aspects of self-regulation and personality and provide much needed data on neuropsychological correlates of risk behaviors in a nonclinical population.

Trends in Developmental Education.

ERIC Educational Resources Information Center

Arendale, David

This paper contains an overview of policy decisions being made at the state and national levels about learning assistance activities in higher education and developmental education. The principles driving those decisions are also outlined. Some policymakers want to fine the high schools from which under prepared students have graduated; others…

[Knowledge, trust, and the decision to donate organs : A comparison of medical students and students of other disciplines in Germany].

PubMed

Terbonssen, T; Settmacher, U; Dirsch, O; Dahmen, U

2018-02-01

Following the organ transplant scandal in Germany in 2011, the willingness to donate organs postmortem decreased dramatically. This was explained by a loss of confidence in the German organ donation system. The aim of this study was to evaluate the relationship between knowledge, trust, and fear in respect to organ donation and the explicit willingness to potentially act as an organ donor by comparing medical students to students of other disciplines. We conducted a Facebook-based online survey (June-July 2013). The participating students were divided into two groups according to their discipline: medical students and other students. Based on questions covering different aspects of organ donation, a knowledge, trust, and fear score was established and calculated. The answers were related to an explicitly expressed decision to donate organs as expressed in a signed organ donor card. In total, 2484 participants took part in our survey. Of these, 1637 were students, 83.7% (N = 1370) of which were medical students and 16.3% (N = 267) other students. As expected, medical students reached a higher knowledge score regarding organ donation compared with other students (knowledge score 4.13 vs. 3.38; p < 0.001). They also demonstrated more confidence in organ donation, resulting in a higher confidence score (3.94 vs. 3.33; p < 0.001) and expressed less fear towards organ donation as indicated by the lower fear score (1.76 vs. 2.04; p < 0.01). Medical students declared their written willingness to donate organs more often than did other students (78.2% vs. 55.2%; p < 0.001). Entries on organ donation cards did not differ significantly between medical students and other students. Medical students possessing an organ donor card showed a higher knowledge and a higher trust score than did medical students without an organ donor card. In contrast, other students possessing an organ donor card showed a higher trust score but did not show a higher knowledge score. The higher level of knowledge and trust demonstrated by the medical students was associated with a higher rate of written decisions to donate organs. In contrast, the lower level of knowledge and trust observed in the non-medical students was associated with a lower rate of organ donor cards. Interestingly, in the group of non-medical students, the decision regarding organ donation was associated with a higher level of trust, but not with a higher level of knowledge. It would appear that knowledge, trust, and the decision to donate organs are closely related. In cases of a low level of knowledge, confidence is even more important. Therefore, organ donation campaigns should focus on increasing knowledge and fostering trust.

Factors affecting the decision to be treated with continuous positive airway pressure for obstructive sleep apnea syndrome.

PubMed

Tzischinsky, Orna; Shahrabani, Shosh; Peled, Ron

2011-07-01

Obstructive sleep apnea syndrome (OSAS) is a sleep-related breathing disorder characterized by excessive daytime sleepiness, accidents and high medical expenses. The first line of treatment for OSAS is continuous positive airway pressure (CPAP). To examine attitudes and beliefs as well as physiological and sociodemographic factors affecting OSA patients' decision whether or not to purchase a CPAP device. The study was divided into two stages; in the first, 83 subjects completed self-administered questionnaires prior to sleep examination (polysomnography, PSG). The questionnaires related to sleep habits, sleep disorders, questions organized around health belief model (HBM) concepts, sociodemographic information, health status and PSG examination. In the second stage, 3 months later, 50 OSAS patients were interviewed by telephone, which included questions about their reasons for purchasing/not purchasing the CPAP device. Only 48% of the OSAS patients purchased the CPAP device. The significant factors positively affecting the decision included higher levels of physiological factors such as body mass index (coefficient 0.36, P < 0.05) and respiratory disturbance index (coefficient 0.16, P < 0.05), higher income levels (coefficient 3.26, P < 0.05), and higher levels of knowledge about OSAS (coefficient -2.98, P < 0.1). Individuals who are more aware of their own health condition, are better informed about OSAS and have higher incomes are more likely to purchase the device. We suggest reducing the level of co-payment and providing patients with more information about the severe effects of OSAS.

Higher-level fusion for military operations based on abductive inference: proof of principle

NASA Astrophysics Data System (ADS)

Pantaleev, Aleksandar V.; Josephson, John

2006-04-01

The ability of contemporary military commanders to estimate and understand complicated situations already suffers from information overload, and the situation can only grow worse. We describe a prototype application that uses abductive inferencing to fuse information from multiple sensors to evaluate the evidence for higher-level hypotheses that are close to the levels of abstraction needed for decision making (approximately JDL levels 2 and 3). Abductive inference (abduction, inference to the best explanation) is a pattern of reasoning that occurs naturally in diverse settings such as medical diagnosis, criminal investigations, scientific theory formation, and military intelligence analysis. Because abduction is part of common-sense reasoning, implementations of it can produce reasoning traces that are very human understandable. Automated abductive inferencing can be deployed to augment human reasoning, taking advantage of computation to process large amounts of information, and to bypass limits to human attention and short-term memory. We illustrate the workings of the prototype system by describing an example of its use for small-unit military operations in an urban setting. Knowledge was encoded as it might be captured prior to engagement from a standard military decision making process (MDMP) and analysis of commander's priority intelligence requirements (PIR). The system is able to reasonably estimate the evidence for higher-level hypotheses based on information from multiple sensors. Its inference processes can be examined closely to verify correctness. Decision makers can override conclusions at any level and changes will propagate appropriately.

Information support for decision making on dispatching control of water distribution in irrigation

NASA Astrophysics Data System (ADS)

Yurchenko, I. F.

2018-05-01

The research has been carried out on developing the technique of supporting decision making for on-line control, operational management of water allocation for the interfarm irrigation projects basing on the analytical patterns of dispatcher control. This technique provides an increase of labour productivity as well as higher management quality due to the improved level of automation, as well as decision making optimization taking into account diagnostics of the issues, solutions classification, information being required to the decision makers.

Health literacy, numeracy, and other characteristics associated with hospitalized patients' preferences for involvement in decision making.

PubMed

Goggins, Kathryn M; Wallston, Kenneth A; Nwosu, Samuel; Schildcrout, Jonathan S; Castel, Liana; Kripalani, Sunil

2014-01-01

Little research has examined the association of health literacy and numeracy with patients' preferred involvement in the problem-solving and decision-making process in the hospital. Using a sample of 1,249 patients hospitalized with cardiovascular disease from the Vanderbilt Inpatient Cohort Study (VICS), we assessed patients' preferred level of involvement using responses to two scenarios of differing symptom severity from the Problem-Solving Decision-Making Scale. Using multivariable modeling, we determined the relationship of health literacy, subjective numeracy, and other patient characteristics with preferences for involvement in decisions, and how this differed by scenario. The authors found that patients with higher levels of health literacy desired more participation in the problem-solving and decision-making process, as did patients with higher subjective numeracy skills, greater educational attainment, female gender, less perceived social support, or greater health care system distrust (p<.05 for each predictor in multivariable models). Patients also preferred to participate more in the decision-making process when the hypothetical symptom they were experiencing was less severe (i.e., they deferred more to their physician when the hypothetical symptom was more severe). These findings underscore the role that patient characteristics, especially health literacy and numeracy, play in decisional preferences among hospitalized patients.

Bounded Rationality and Voting Decisions over 160 Years: Voter Behavior and Increasing Complexity in Decision-Making

PubMed Central

Stadelmann, David; Torgler, Benno

2013-01-01

Using a quasi-natural voting experiment encompassing a 160-year period (1848–2009) in Switzerland, we investigate whether a higher level of complexity leads to increased reliance on trusted parliamentary representatives. We find that when more referenda are held on the same day, constituents are more likely to refer to parliamentary recommendations when making their decisions. This finding holds true even when we narrow our focus to referenda with a relatively lower voter turnout on days on which more than one referendum is held. We also demonstrate that when constituents face a higher level of complexity, they follow the parliamentary recommendations rather than those of interest groups. “Viewed as a geometric figure, the ant’s path is irregular, complex, hard to describe. But its complexity is really a complexity in the surface of the beach, not a complexity in the ant.” ( [1] p. 51) PMID:24391888

Bounded rationality and voting decisions over 160 years: voter behavior and increasing complexity in decision-making.

PubMed

Stadelmann, David; Torgler, Benno

2013-01-01

Using a quasi-natural voting experiment encompassing a 160-year period (1848-2009) in Switzerland, we investigate whether a higher level of complexity leads to increased reliance on trusted parliamentary representatives. We find that when more referenda are held on the same day, constituents are more likely to refer to parliamentary recommendations when making their decisions. This finding holds true even when we narrow our focus to referenda with a relatively lower voter turnout on days on which more than one referendum is held. We also demonstrate that when constituents face a higher level of complexity, they follow the parliamentary recommendations rather than those of interest groups. "Viewed as a geometric figure, the ant's path is irregular, complex, hard to describe. But its complexity is really a complexity in the surface of the beach, not a complexity in the ant." ( [1] p. 51).

Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist-patient consultations.

PubMed

Ng, Yew Keong; Shah, Noraida Mohamed; Loong, Ly Sia; Pee, Lay Ting; Hidzir, Sarina Anim M; Chong, Wei Wen

2018-01-01

This study investigated patients' and pharmacists' attitudes toward concordance in a pharmacist-patient consultation and how patients' attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use. A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t -test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients' self-efficacy in decision making. A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p <0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients' perceived level of involvement, and attitudes toward concordance are significant predictors of patients' self-efficacy in decision making ( p <0.05). Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients' involvement in medication-related decision making.

Assessing the predictive power of psychological empowerment and health literacy for older patients' participation in health care: a cross-sectional population-based study.

PubMed

Sak, Gabriele; Rothenfluh, Fabia; Schulz, Peter J

2017-02-20

Research has confirmed a positive link between patient involvement in decision-making and improvements in health outcomes. The objective of this study was to examine the roles of psychological empowerment and health literacy on the elderly's willingness to engage in treatment decisions. A self-administered questionnaire was completed by a randomly selected sample of Swiss adults aged 65-80 years old (N = 826). Multivariate logistic regression was applied to determine the contribution of health literacy, psychological empowerment, and trust in physician on participants' preference to be active, collaborative or passive in decision-making. Most of the survey respondents preferred some participation in dealing with health related decisions (collaborative: 51%, and active: 35.6%). More than two-thirds of the sample was satisfied with their current involvement in medical decision-making (72.7%). Roughly one-fifth (18.8%) wished to attain a more active engagement than currently experienced, and the remainder of the sample preferred the opposite (8.5%). Due to higher reported levels of psychological empowerment and health literacy, Swiss-German seniors significantly preferred and assumed higher participation in medical decisions than Swiss-Italians. Psychological empowerment correlated with older adults' preferred and perceived involvement in medical decision-making. However, health literacy only predicted actual involvement in the last treatment decision that had to be made, differentiating only the active from the passive involvement group. Additionally, this research showed that health literacy mediated the relationship between psychological empowerment and the actual involvement in the last treatment decision that had to be made by the participant. Trust in physician and age appeared to be barriers to involvement, whereas education served as a facilitator. As older adults' health literacy plays a role in individuals' willingness to attain an active role in health care decision-making, public health efforts should aim at developing programs and appropriate information that facilitate this process, especially for individuals with moderate or lower levels of health literacy. The current investigation showed that adequate health literacy levels are essential (but not sufficient) in order to reach higher rates of participation in the healthcare context. This research complements past evidence by adding knowledge on the psychosocial antecedents, and their combined effects on patients' involvement in healthcare.

Patients' preferences for involvement in the decision-making process for treating diabetic retinopathy.

PubMed

Marahrens, Lydia; Kern, Raimar; Ziemssen, Tjalf; Fritsche, Andreas; Martus, Peter; Ziemssen, Focke; Roeck, Daniel

2017-08-09

To assess factors associated with the preferred role of the attending ophthalmologist in the decision-making processes before treating diabetic retinopathy (DR). Cross-sectional study of 810 adults attending secondary diabetes care centers (NCT02311504). Diabetes patients were classified using a validated questionnaire in an ophthalmologist-dominant decision-making (ODM), shared decision-making (SDM) and patient-dominant decision-making (PDM) style. Multivariate logistic regression was performed to determine factors associated with the decision-making process. A majority of 74.3% patients preferred SDM between ophthalmologist and patient, 17.4% patients wanted ODM, delegating the decision-making process to the ophthalmologist, 8.3% preferred the autonomous style of PDM. Patients wanting ODM were older (OR = 1.2 per decade, p = 0.013), had a lower level of education (OR = 1.4, p = 0.001) and had a higher frequency of consultations per year (OR = 1.3, p = 0.022). Patients with better basic knowledge in DR and memorizing their HbA 1 c level showed a higher propensity for SDM (OR = 1.1, p = 0.037). Patients wanting PDM had a significantly higher education (OR = 1.3, p = 0.036) and a greater desire for receiving information from self-help groups (OR = 1.3, p = 0.015). The first evaluation of the general patient wishes for the treatment of DR confirmed the concept of SDM, which was favored by three quarters. In particular, older patients with low educational attainment wanted to delegate the decision-making process to the ophthalmologist. Amelioration of ophthalmologic education in diabetic programs might take up patients' propensity for SDM. Regardless of the decision-making group, nearly all patients wanted the medical and scientific information to be transferred by and shared with the ophthalmologist. The study was registered on www.clinicaltrials.gov (identifier: NCT02311504) on December 4th 2014.

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

PubMed

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

2017-07-01

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

Women's participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana.

PubMed

Amugsi, Dickson A; Lartey, Anna; Kimani, Elizabeth; Mberu, Blessing U

2016-05-31

Low-quality monotonous diet is a major problem confronting resource-constrained settings across the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between women's decision-making autonomy and women's achievement of higher dietary diversity (DD) and determine the socio-demographic factors that can independently predict women's attainment of higher DD. The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised of 2262 women aged 15-49 years and who have complete dietary data. The DD score was derived from a 24-h recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD ≤4) and higher (DD ≥5). Logistic regression was used to assess the association between women decision-making autonomy (final say on how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for covariates at the individual and household levels. The analysis showed that women participation in decision-making regarding household purchases was significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of achieving higher DD were higher among women who had a say in deciding household purchases, compared to women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20). Compared to women who lived in polygamous households, those who lived in monogamous households had higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93). Net other covariates, women who have a say in making household purchases are more likely to achieve higher DD compare to those who do not have a say. This may indicate autonomy to buy nutritious foods, suggesting that improving women decision-making autonomy could have a positive impact on women dietary intake.

California Policy Options to Accelerate Latino Student Success in Higher Education

ERIC Educational Resources Information Center

Santiago, Deborah A.

2006-01-01

California policy makers and institutional leaders are making critical policy, programmatic, and budgetary decisions affecting segments of the state's population that lack sufficient levels of formal training and education. These decisions are occurring at a time when five critical trends are converging in the state. These trends are: (1)…

Decision Making and Communications Process Assessment of NASA Using Three Change Requests from the Space Launch System Program

NASA Technical Reports Server (NTRS)

Hicks, Karen Campbell

2015-01-01

This thesis investigated the communication and decision making process as part of the Systems Engineering practices at the NASA/Marshall Center to determine its level of effectiveness. Data was collected across three change requests to assess how decisions were made, how the decisions were communicated, and whether a process mattered in the formulation and dissemination of those decisions. Data results revealed the comprehensive decision making process for the technical change requests to be effective. Evidence revealed that the process was sufficiently tailored to accommodate the need of each individual technical change which promoted effective communication amongst the stakeholders in the formulation of the strategic decision recommendations elevated to upper management. However, data results also revealed the dissemination of the final decision and approval of the change requests from the higher organizational level down to all stakeholders was less effective. An establishment of a culmination meeting at the end of the change request decision process in which to close the communication loop with all entities would be beneficial.

Surrogate End-of-Life Care Decision Makers' Postbereavement Grief and Guilt Responses.

PubMed

Lovell, Geoff P; Smith, Trish; Kannis-Dymand, Lee

2015-01-01

This article examined differences in familial/friend surrogate decision makers' (N = 93) postbereavement grief and guilt associated with decisions to either prioritize comfort or longevity in determining end-of-life care for decisionally incapacitated adult palliative loved ones. Results demonstrated that participants prioritizing the longevity of loved ones experienced significantly and meaningfully higher levels of grief, complicated grief, and trauma related guilt than those who prioritized comfort.

Comparing perceptual and preferential decision making.

PubMed

Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

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

Evidence-based librarianship: an overview.

PubMed

Eldredge, J D

2000-10-01

To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors.

Evidence-based librarianship: an overview

PubMed Central

Eldredge, Jonathan D.

2000-01-01

Objective: To demonstrate how the core characteristics of both evidence-based medicine (EBM) and evidence-based health care (EBHC) can be adapted to health sciences librarianship. Method: Narrative review essay involving development of a conceptual framework. The author describes the central features of EBM and EBHC. Following each description of a central feature, the author then suggests ways that this feature applies to health sciences librarianship. Results: First, the decision-making processes of EBM and EBHC are compatible with health sciences librarianship. Second, the EBM and EBHC values of favoring rigorously produced scientific evidence in decision making are congruent with the core values of librarianship. Third, the hierarchical levels of evidence can be applied to librarianship with some modifications. Library researchers currently favor descriptive-survey and case-study methods over systematic reviews, randomized controlled trials, or other higher levels of evidence. The library literature nevertheless contains diverse examples of randomized controlled trials, controlled-comparison studies, and cohort studies conducted by health sciences librarians. Conclusions: Health sciences librarians are confronted with making many practical decisions. Evidence-based librarianship offers a decision-making framework, which integrates the best available research evidence. By employing this framework and the higher levels of research evidence it promotes, health sciences librarians can lay the foundation for more collaborative and scientific endeavors. PMID:11055296

The Relationship among Family Interaction Patterns and Career Indecision and Career Decision-Making Self-Efficacy.

ERIC Educational Resources Information Center

Whiston, Susan C.

1996-01-01

Undergraduate women with higher levels of organization and control in their families experienced less career indecision but not higher career self-efficacy. Males and females whose families had intellectual/cultural orientation had higher self-efficacy in using occupational information. An inverse relationship appeared between this type of…

Predicting explorative motor learning using decision-making and motor noise.

PubMed

Chen, Xiuli; Mohr, Kieran; Galea, Joseph M

2017-04-01

A fundamental problem faced by humans is learning to select motor actions based on noisy sensory information and incomplete knowledge of the world. Recently, a number of authors have asked whether this type of motor learning problem might be very similar to a range of higher-level decision-making problems. If so, participant behaviour on a high-level decision-making task could be predictive of their performance during a motor learning task. To investigate this question, we studied performance during an explorative motor learning task and a decision-making task which had a similar underlying structure with the exception that it was not subject to motor (execution) noise. We also collected an independent measurement of each participant's level of motor noise. Our analysis showed that explorative motor learning and decision-making could be modelled as the (approximately) optimal solution to a Partially Observable Markov Decision Process bounded by noisy neural information processing. The model was able to predict participant performance in motor learning by using parameters estimated from the decision-making task and the separate motor noise measurement. This suggests that explorative motor learning can be formalised as a sequential decision-making process that is adjusted for motor noise, and raises interesting questions regarding the neural origin of explorative motor learning.

Predicting explorative motor learning using decision-making and motor noise

PubMed Central

Galea, Joseph M.

2017-01-01

A fundamental problem faced by humans is learning to select motor actions based on noisy sensory information and incomplete knowledge of the world. Recently, a number of authors have asked whether this type of motor learning problem might be very similar to a range of higher-level decision-making problems. If so, participant behaviour on a high-level decision-making task could be predictive of their performance during a motor learning task. To investigate this question, we studied performance during an explorative motor learning task and a decision-making task which had a similar underlying structure with the exception that it was not subject to motor (execution) noise. We also collected an independent measurement of each participant’s level of motor noise. Our analysis showed that explorative motor learning and decision-making could be modelled as the (approximately) optimal solution to a Partially Observable Markov Decision Process bounded by noisy neural information processing. The model was able to predict participant performance in motor learning by using parameters estimated from the decision-making task and the separate motor noise measurement. This suggests that explorative motor learning can be formalised as a sequential decision-making process that is adjusted for motor noise, and raises interesting questions regarding the neural origin of explorative motor learning. PMID:28437451

Cycles of shame: menstrual shame, body shame, and sexual decision-making.

PubMed

Schooler, Deborah; Ward, L Monique; Merriwether, Ann; Caruthers, Allison S

2005-11-01

Although numerous factors have been implicated in women's sexual decision-making, less attention has been focused on how their feelings about their bodies and reproductive functions affect these processes. Recent findings link menstrual shame to lower levels of sexual activity and higher levels of sexual risk; however the mechanisms behind these relations remain unexplored. Accordingly, this study investigates the contributions of menstrual shame and global body shame to sexual decision-making among 199 undergraduate women. Using structural equation modeling, we evaluated a mediated model, whereby menstrual shame is indirectly associated with sexual decision-making via body shame. As expected, women who reported feeling more comfort about menstruation also reported more body comfort and, in turn, more sexual assertiveness, more sexual experience, and less sexual risk.

Factors that Influence STEM-Promising Females' Decision to Attend a Non Research-Intensive Undergraduate Institution

ERIC Educational Resources Information Center

Miller, Roxanne Greitz; Hurlock, Ashley J.

2017-01-01

Non research-intensive institutions of higher education are effective at narrowing STEM gender gaps in major selection and persistence to degree completion, yet the decision to attend such a setting is likely seen as counterintuitive when such institutions typically have lower levels of research, financial resources, and total student enrollments…

Trustworthiness and Negative Affect Predict Economic Decision-Making.

PubMed

Nguyen, Christopher M; Koenigs, Michael; Yamada, Torricia H; Teo, Shu Hao; Cavanaugh, Joseph E; Tranel, Daniel; Denburg, Natalie L

2011-09-01

The Ultimatum Game (UG) is a widely used and well-studied laboratory model of economic decision-making. Here, we studied 129 healthy adults and compared demographic (i.e., age, gender, education), cognitive (i.e., intelligence, attention/working memory, speed, language, visuospatial, memory, executive functions), and personality (i.e., "Big Five", positive affect, negative affect) variables between those with a "rational" versus an "irrational" response pattern on the UG. Our data indicated that participants with "rational" UG performance (accepting any offer, no matter the fairness) endorsed higher levels of trust, or the belief in the sincerity and good intentions of others, while participants with "irrational" UG performance (rejecting unfair offers) endorsed higher levels of negative affect, such as anger and contempt. These personality variables were the only ones that differentiated the two response patterns-demographic and cognitive factors did not differ between rational and irrational players. The results indicate that the examination of personality and affect is crucial to our understanding of the individual differences that underlie decision-making.

Trustworthiness and Negative Affect Predict Economic Decision-Making

PubMed Central

Nguyen, Christopher M.; Koenigs, Michael; Yamada, Torricia H.; Teo, Shu Hao; Cavanaugh, Joseph E.; Tranel, Daniel; Denburg, Natalie L.

2012-01-01

The Ultimatum Game (UG) is a widely used and well-studied laboratory model of economic decision-making. Here, we studied 129 healthy adults and compared demographic (i.e., age, gender, education), cognitive (i.e., intelligence, attention/working memory, speed, language, visuospatial, memory, executive functions), and personality (i.e., “Big Five”, positive affect, negative affect) variables between those with a “rational” versus an “irrational” response pattern on the UG. Our data indicated that participants with “rational” UG performance (accepting any offer, no matter the fairness) endorsed higher levels of trust, or the belief in the sincerity and good intentions of others, while participants with “irrational” UG performance (rejecting unfair offers) endorsed higher levels of negative affect, such as anger and contempt. These personality variables were the only ones that differentiated the two response patterns—demographic and cognitive factors did not differ between rational and irrational players. The results indicate that the examination of personality and affect is crucial to our understanding of the individual differences that underlie decision-making. PMID:23493494

Effectiveness of UK and International A-Level Assessment in Predicting Performance in Engineering

ERIC Educational Resources Information Center

Birch, David M.; Rienties, Bart

2014-01-01

In many universities, admissions decisions are made based upon the advanced-level (A-Level) results. The purpose of this study was to assess the value of A-level and international equivalents as a predictor of early achievement in higher education. About 135 UK and 92 international undergraduate engineering students from 35 countries were assessed…

Thinking about Thinking.

ERIC Educational Resources Information Center

Parker, Sarah J.

The teaching of decision-making, problem-solving, and higher-order thinking skills is necessary to ensure adaptability to our world of accelerated change. Living skills in the technology and information age will include the understanding and application of higher level thinking skills, which will be the educational "basics" of tomorrow.…

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

PubMed Central

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

2014-01-01

Researchers have extensively documented how various statistical properties of words (e.g., word-frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, since a better specification of the mechanisms driving nonword responses may provide valuable insights into early lexical processes. In the present study, item-level and participant-level analyses were conducted on the trial-level lexical decision data for almost 37,000 nonwords in the English Lexicon Project in order to identify the influence of different psycholinguistic variables on nonword lexical decision performance, and to explore individual differences in how participants respond to nonwords. Item-level regression analyses reveal that nonword response time was positively correlated with number of letters, number of orthographic neighbors, number of affixes, and baseword number of syllables, and negatively correlated with Levenshtein orthographic distance and baseword frequency. Participant-level analyses also point to within- and between-session stability in nonword responses across distinct sets of items, and intriguingly reveal that higher vocabulary knowledge is associated with less sensitivity to some dimensions (e.g., number of letters) but more sensitivity to others (e.g., baseword frequency). The present findings provide well-specified and interesting new constraints for informing models of word recognition and lexical decision. PMID:25329078

Attitudes toward concordance and self-efficacy in decision making: a cross-sectional study on pharmacist–patient consultations

PubMed Central

Ng, Yew Keong; Shah, Noraida Mohamed; Loong, Ly Sia; Pee, Lay Ting; Hidzir, Sarina Anim M; Chong, Wei Wen

2018-01-01

Purpose This study investigated patients’ and pharmacists’ attitudes toward concordance in a pharmacist–patient consultation and how patients’ attitudes toward concordance relate to their involvement and self-efficacy in decision making associated with medication use. Subjects and methods A cross-sectional study was conducted among patients with chronic diseases and pharmacists from three public hospitals in Malaysia. The Revised United States Leeds Attitudes toward Concordance (RUS-LATCon) was used to measure attitudes toward concordance in both patients and pharmacists. Patients also rated their perceived level of involvement in decision making and completed the Decision Self-Efficacy scale. One-way analysis of variance (ANOVA) and independent t-test were used to determine significant differences between different subgroups on attitudes toward concordance, and multiple linear regression was performed to find the predictors of patients’ self-efficacy in decision making. Results A total of 389 patients and 93 pharmacists participated in the study. Pharmacists and patients scored M=3.92 (SD=0.37) and M=3.84 (SD=0.46) on the RUS-LATCon scale, respectively. Seven items were found to be significantly different between pharmacists and patients on the subscale level. Patients who felt fully involved in decision making (M=3.94, SD=0.462) scored significantly higher on attitudes toward concordance than those who felt partially involved (M=3.82, SD=0.478) and not involved at all (M=3.68, SD=0.471; p<0.001). Patients had an average score of 76.7% (SD=14.73%) on the Decision Self-Efficacy scale. In multiple linear regression analysis, ethnicity, number of medications taken by patients, patients’ perceived level of involvement, and attitudes toward concordance are significant predictors of patients’ self-efficacy in decision making (p<0.05). Conclusion Patients who felt involved in their consultations had more positive attitudes toward concordance and higher confidence in making an informed decision. Further study is recommended on interventions involving pharmacists in supporting patients’ involvement in medication-related decision making. PMID:29731609

Acute Exposure to Low-to-Moderate Carbon Dioxide Levels and Submariner Decision Making.

PubMed

Rodeheffer, Christopher D; Chabal, Sarah; Clarke, John M; Fothergill, David M

2018-06-01

Submarines routinely operate with higher levels of ambient carbon dioxide (CO2) (i.e., 2000 - 5000 ppm) than what is typically considered normal (i.e., 400 - 600 ppm). Although significant cognitive impairments are rarely reported at these elevated CO2 levels, recent studies using the Strategic Management Simulation (SMS) test have found impairments in decision-making performance during acute CO2 exposure at levels as low as 1000 ppm. This is a potential concern for submarine operations, as personnel regularly make mission-critical decisions that affect the safety and efficiency of the vessel and its crew while exposed to similar levels of CO2. The objective of this study was to determine if submariner decision-making performance is impacted by acute exposure to levels of CO2 routinely present in the submarine atmosphere during sea patrols. Using a subject-blinded balanced design, 36 submarine-qualified sailors were randomly assigned to receive 1 of 3 CO2 exposure conditions (600, 2500, or 15,000 ppm). After a 45-min atmospheric acclimation period, participants completed an 80-min computer-administered SMS test as a measure of decision making. There were no significant differences for any of the nine SMS measures of decision making between the CO2 exposure conditions. In contrast to recent research demonstrating cognitive deficits on the SMS test in students and professional-grade office workers, we were unable to replicate this effect in a submariner population-even with acute CO2 exposures more than an order of magnitude greater than those used in previous studies that demonstrated such effects.Rodeheffer CD, Chabal S, Clarke JM, Fothergill DM. Acute exposure to low-to-moderate carbon dioxide levels and submariner decision making. Aerosp Med Hum Perform. 2018; 89(6):520-525.

Individual moral philosophies and ethical decision making of undergraduate athletic training students and educators.

PubMed

Caswell, Shane V; Gould, Trenton E

2008-01-01

Ethics research in athletic training is lacking. Teaching students technical skills is important, but teaching them how to reason and to behave in a manner that befits responsible health care professionals is equally important. To expand ethics research in athletic training by (1) describing undergraduate athletic training students' and educators' individual moral philosophies and ethical decision-making abilities and (2) investigating the effects of sex and level of education on mean composite individual moral philosophies and ethical decision-making scores. Stratified, multistage, cluster-sample correlational study. Mailed survey instruments were distributed in classroom settings at 30 institutions having Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training programs. Undergraduate students and educators (n = 598: 373 women, 225 men; mean age = 23.5 +/- 6.3 years) from 25 CAAHEP-accredited athletic training programs. We used the Ethics Position Questionnaire and the Dilemmas in Athletic Training Questionnaire to compute participants' mean composite individual moral philosophies (idealism and relativism) and ethical decision-making scores, respectively. Three separate 2 (sex: male, female) x 3 (education level: underclass, upper class, educator) between-subjects factorial analyses of variance using idealism, relativism, and ethical decision-making scores as dependent measures were performed. Respondents reported higher idealism scores (37.57 +/- 4.91) than relativism scores (31.70 +/- 4.80) (response rate = 83%). The mean ethical decision-making score for all respondents was 80.76 +/- 7.88. No significant interactions were revealed. The main effect for sex illustrated that men reported significantly higher relativism scores ( P = .0014, eta (2) = .015) than did women. The main effect for education level revealed significant differences between students' and educators' idealism ( P = .0190, eta (2) = .013), relativism ( P < .001, eta (2) = .050), and ethical decision-making scores ( P < .001, eta (2) = .027). Tukey honestly significant difference post hoc analysis indicated that educators possessed lower idealism scores (36.90 +/- 5.70) and relativism scores (29.92 +/- 4.86) and higher ethical decision-making scores (82.98 +/- 7.62) than did students. Our findings do not support changes in athletic training ethics education practices to address sex-specific needs. However, when opportunities occur for students to reason using different ethical perspectives, educators should be aware of their students' and their own moral philosophies in order to optimally facilitate professional growth.

Effects of automation of information-processing functions on teamwork.

PubMed

Wright, Melanie C; Kaber, David B

2005-01-01

We investigated the effects of automation as applied to different stages of information processing on team performance in a complex decision-making task. Forty teams of 2 individuals performed a simulated Theater Defense Task. Four automation conditions were simulated with computer assistance applied to realistic combinations of information acquisition, information analysis, and decision selection functions across two levels of task difficulty. Multiple measures of team effectiveness and team coordination were used. Results indicated different forms of automation have different effects on teamwork. Compared with a baseline condition, an increase in automation of information acquisition led to an increase in the ratio of information transferred to information requested; an increase in automation of information analysis resulted in higher team coordination ratings; and automation of decision selection led to better team effectiveness under low levels of task difficulty but at the cost of higher workload. The results support the use of early and intermediate forms of automation related to acquisition and analysis of information in the design of team tasks. Decision-making automation may provide benefits in more limited contexts. Applications of this research include the design and evaluation of automation in team environments.

Shared clinical decision making

PubMed Central

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

2015-01-01

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

Readability Levels of Health-Based Websites: From Content to Comprehension

ERIC Educational Resources Information Center

Schutten, Mary; McFarland, Allison

2009-01-01

Three of the national health education standards include decision-making, accessing information and analyzing influences. WebQuests are a popular inquiry-oriented method used by secondary teachers to help students achieve these content standards. While WebQuests support higher level thinking skills, the readability level of the information on the…

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed

Martinez, Kathryn A; Resnicow, Ken; Williams, Geoffrey C; Silva, Marlene; Abrahamse, Paul; Shumway, Dean A; Wallner, Lauren P; Katz, Steven J; Hawley, Sarah T

2016-12-01

Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Among the 1690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Autonomy-supportive communication by cancer doctors can improve patients' perceived decision quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does physician communication style impact patient report of decision quality for breast cancer treatment?

PubMed Central

Resnicow, Ken; Williams, Geoffrey C.; Silva, Marlene; Abrahamse, Paul; Shumway, Dean; Wallner, Lauren; Katz, Steven; Hawley, Sarah

2016-01-01

Objective Provider communication that supports patient autonomy has been associated with numerous positive patient outcomes. However, to date, no research has examined the relationship between perceived provider communication style and patient-assessed decision quality in breast cancer. Methods Using a population-based sample of women with localized breast cancer, we assessed patient perceptions of autonomy-supportive communication from their surgeons and medical oncologists, as well as patient-reported decision quality. We used multivariable linear regression to examine the association between autonomy-supportive communication and subjective decision quality for surgery and chemotherapy decisions, controlling for sociodemographic and clinical factors, as well as patient-reported communication preference (non-directive or directive). Results Among the 1,690 women included in the overall sample, patient-reported decision quality scores were positively associated with higher levels of perceived autonomy-supportive communication from surgeons (β=0.30; p<0.001) and medical oncologists (β=0.26; p<0.001). Patient communication style preference moderated the association between physician communication style received and perceived decision quality. Conclusion Autonomy-supportive communication by physicians was associated with higher subjective decision quality among women with localized breast cancer. These results support future efforts to design interventions that enhance autonomy-supportive communication. Practice Implications Autonomy-supportive communication by cancer doctors can improve patients’ perceived decision quality. PMID:27395750

Blunted Ambiguity Aversion During Cost-Benefit Decisions in Antisocial Individuals.

PubMed

Buckholtz, Joshua W; Karmarkar, Uma; Ye, Shengxuan; Brennan, Grace M; Baskin-Sommers, Arielle

2017-05-17

Antisocial behavior is often assumed to reflect aberrant risk processing. However, many of the most significant forms of antisocial behavior, including crime, reflect the outcomes of decisions made under conditions of ambiguity rather than risk. While risk and ambiguity are formally distinct and experimentally dissociable, little is known about ambiguity sensitivity in individuals who engage in chronic antisocial behavior. We used a financial decision-making task in a high-risk community-based sample to test for associations between sensitivity to ambiguity, antisocial behavior, and arrest history. Sensitivity to ambiguity was lower in individuals who met diagnostic criteria for Antisocial Personality Disorder. Lower ambiguity sensitivity was also associated with higher externalizing (but not psychopathy) scores, and with higher levels of aggression (but not rule-breaking). Finally, blunted sensitivity to ambiguity also predicted a greater frequency of arrests. Together, these data suggest that alterations in cost-benefit decision-making under conditions of ambiguity may promote antisocial behavior.

Individual relocation decisions after tornadoes: a multi-level analysis.

PubMed

Cong, Zhen; Nejat, Ali; Liang, Daan; Pei, Yaolin; Javid, Roxana J

2018-04-01

This study examines how multi-level factors affected individuals' relocation decisions after EF4 and EF5 (Enhanced Fujita Tornado Intensity Scale) tornadoes struck the United States in 2013. A telephone survey was conducted with 536 respondents, including oversampled older adults, one year after these two disaster events. Respondents' addresses were used to associate individual information with block group-level variables recorded by the American Community Survey. Logistic regression revealed that residential damage and homeownership are important predictors of relocation. There was also significant interaction between these two variables, indicating less difference between homeowners and renters at higher damage levels. Homeownership diminished the likelihood of relocation among younger respondents. Random effects logistic regression found that the percentage of homeownership and of higher income households in the community buffered the effect of damage on relocation; the percentage of older adults reduced the likelihood of this group relocating. The findings are assessed from the standpoint of age difference, policy implications, and social capital and vulnerability. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Factors Influencing Pharmacy Students' Choice of Major and Its Relationship to Anticipatory Socialization

PubMed Central

2010-01-01

Objectives To determine factors that influenced students' choice of pharmacy as a major and assess relationships between these factors and anticipatory socialization. Methods Two hundred fifteen freshman and sophomore students enrolled in a 0-6 doctor of pharmacy program completed a survey instrument on which they rated 6 motivational factors in their decision to major in pharmacy and answered questions related to anticipatory socialization. Bivariate and multivariate analyses were used to answer the research questions posed. Results Female students ranked desire to help others as a stronger motivating factor in their decision to pursue a career in pharmacy than did male students. Caucasian students rated providing more career opportunities and providing an entry-level doctorate as stronger motivating factors for pursuing pharmacy than did Asian students. Asian students had lower levels of anticipatory socialization than other students. Students with higher levels of motivation had higher levels of anticipatory socialization. Conclusion Results of this study provide further insight into effective recruiting strategies and recommendations for improved pharmacy education. PMID:20585437

Career Experiences of Women Academicians in Kenyan Institutions of Higher Learning

ERIC Educational Resources Information Center

Nanyama, Evalyne

2012-01-01

Currently, women academicians in Kenya are underrepresented at all levels in Kenyan IHL, leading to less participation and integration into the administration and governance of higher institutions. As a result women academicians have little chance of making meaningful contributions to important policies and decisions that affect the institutions…

Attitudes Affecting Online Learning Implementation in Higher Education Institutions

ERIC Educational Resources Information Center

Mitchell, Betty; Geva-May, Iris

2009-01-01

This study explores attitudes towards and affecting online learning implementation (OLI). In recent years there has been greater acceptance of online learning (OL) by institutional decision-makers, as evidenced by higher levels of institutional involvement; nevertheless, the increase in faculty acceptance lags behind. This gap affects the…

Decision-making, financial risk aversion, and behavioral biases: The role of testosterone and stress.

PubMed

Nofsinger, John R; Patterson, Fernando M; Shank, Corey A

2018-05-01

We examine the relation between testosterone, cortisol, and financial decisions in a sample of naïve investors. We find that testosterone level is positively related to excess risk-taking, whereas cortisol level is negatively related to excess risk-taking (correlation coefficient [r]: 0.75 and -0.21, respectively). Additionally, we find support for the dual-hormone hypothesis in a financial context. Specifically, the testosterone-to-cortisol ratio is significantly related to loss aversion. Individuals with a higher ratio are 3.4 times more likely to sell losing stocks (standard error [SE]: 1.63). Furthermore, we find a positive feedback loop between financial success, testosterone, and cortisol. Specifically, financial success is significantly related to higher post-trial testosterone and cortisol by a factor of 0.53 (SE: 0.14). Finally, we find that in a competitive environment, testosterone level increases significantly, leading to greater risk-taking than in noncompetitive environment. Overall, this study underscores the importance of the endocrine system on financial decision-making. The results of this study are relevant to a broad audience, including investors looking to optimize financial performance, industry human resources, market regulators, and researchers. Copyright © 2018 Elsevier B.V. All rights reserved.

Domestic decision-making power, social support, and postpartum depression symptoms among immigrant and native women in Taiwan.

PubMed

Chien, Li-Yin; Tai, Chen-Jei; Yeh, Mei-Chiang

2012-01-01

Domestic decision-making power is an integral part of women's empowerment. No study has linked domestic decision-making power and social support concurrently to postpartum depression and compared these between immigrant and native populations. The aim of this study was to examine domestic decision-making power and social support and their relationship to postpartum depressive symptoms among immigrant and native women in Taiwan. This cross-sectional survey included 190 immigrant and 190 native women who had delivered healthy babies during the past year in Taipei City. Depression was measured using the Edinburgh Postnatal Depression Scale, with a cutoff score of 10. Logistic regression was used to determine the factors associated with postpartum depression symptoms. Immigrant mothers had significantly higher prevalence of postpartum depression symptoms (41.1% vs. 8.4%) and had significantly lower levels of domestic decision-making power and social support than native mothers did. Logistic regression showed that insufficient family income was associated with an increased risk of postpartum depression symptoms, whereas social support and domestic decision-making power levels were associated negatively with postpartum depression symptoms. After accounting for these factors, immigrant women remained at higher risk of postpartum depression symptoms than native women did, odds ratio = 2.59, 95% CI [1.27, 5.28]. Domestic decision-making power and social support are independent protective factors for postpartum depression symptoms among immigrant and native women in Taiwan. Social support and empowerment interventions should be tested to discover whether they are able to prevent or alleviate postpartum depression symptoms, with special emphasis on immigrant mothers.

Insights into the concept and measurement of health literacy from a study of shared decision-making in a low literacy population.

PubMed

Smith, Sian K; Nutbeam, Don; McCaffery, Kirsten J

2013-08-01

This article explores the concept and measurement of health literacy in the context of shared health decision-making. It draws upon a series of qualitative and quantitative studies undertaken in the development and evaluation of a bowel cancer screening decision aid for low literacy populations. The findings indicate that different types of health literacy (functional, interactive and critical) are required in decision-making and present a set of instruments to assess and discriminate between higher level health literacy skills required for engagement in decision-making. It concludes that greater sophistication in both the definition and measurement of health literacy in research is needed.

A mathematical framework for combining decisions of multiple experts toward accurate and remote diagnosis of malaria using tele-microscopy.

PubMed

Mavandadi, Sam; Feng, Steve; Yu, Frank; Dimitrov, Stoyan; Nielsen-Saines, Karin; Prescott, William R; Ozcan, Aydogan

2012-01-01

We propose a methodology for digitally fusing diagnostic decisions made by multiple medical experts in order to improve accuracy of diagnosis. Toward this goal, we report an experimental study involving nine experts, where each one was given more than 8,000 digital microscopic images of individual human red blood cells and asked to identify malaria infected cells. The results of this experiment reveal that even highly trained medical experts are not always self-consistent in their diagnostic decisions and that there exists a fair level of disagreement among experts, even for binary decisions (i.e., infected vs. uninfected). To tackle this general medical diagnosis problem, we propose a probabilistic algorithm to fuse the decisions made by trained medical experts to robustly achieve higher levels of accuracy when compared to individual experts making such decisions. By modelling the decisions of experts as a three component mixture model and solving for the underlying parameters using the Expectation Maximisation algorithm, we demonstrate the efficacy of our approach which significantly improves the overall diagnostic accuracy of malaria infected cells. Additionally, we present a mathematical framework for performing 'slide-level' diagnosis by using individual 'cell-level' diagnosis data, shedding more light on the statistical rules that should govern the routine practice in examination of e.g., thin blood smear samples. This framework could be generalized for various other tele-pathology needs, and can be used by trained experts within an efficient tele-medicine platform.

Nurses’ Use of Race in Clinical Decision Making

PubMed Central

Sellers, Sherrill L.; Moss, Melissa E.; Calzone, Kathleen; Abdallah, Khadijah E.; Jenkins, Jean F.; Bonham, Vence L.

2017-01-01

Purpose To examine nurses’ self-reported use of race in clinical evaluation. Design This cross-sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States. Methods Multivariate regression analysis was used to examine associations between RACE score and individual-level characteristics and beliefs in 5,733 registered nurses. Findings Analysis revealed significant relationships between RACE score and nurses’ race and ethnicity, educational level, and views on the clinical importance of patient demographic characteristics. Asian nurses reported RACE scores 1.41 points higher than White nurses (p < .001), and Black nurses reported RACE scores 0.55 points higher than White nurses (p < .05). Compared to diploma-level nurses, the baccalaureate-level nurses reported 0.69 points higher RACE scores (p < .05), master’s-level nurses reported 1.63 points higher RACE scores (p < .001), and doctorate-level nurses reported 1.77 points higher RACE scores (p < .01). In terms of clinical importance of patient characteristics, patient race and ethnicity corresponded to a 0.54-point increase in RACE score (p < .001), patient genes to a 0.21-point increase in RACE score (p < .001), patient family history to a 0.15-point increase in RACE score (p < .01), and patient age to a 0.19-point increase in RACE score (p < .001). Conclusions Higher reported use of race among minority nurses may be due, in part, to differential levels of racial self-awareness. A relatively linear positive relationship between level of nursing degree nursing education and use of race suggests that a stronger foundation of knowledge about genetic ancestry, population genetics and the concept “race” and genetic ancestry may increase in clinical decision making could allow nurses to more appropriately use of race in clinical care. Integrating patient demographic characteristics into clinical decisions is an important component of nursing practice. Clinical Relevance Registered nurses provide care for diverse racial and ethnic patient populations and stand on the front line of clinical care, making them essential for reducing racial and ethnic disparities in healthcare delivery. Exploring registered nurses’ individual-level characteristics and clinical use of race may provide a more comprehensive understanding of specific training needs and inform nursing education and practice. PMID:27676232

Nurses' Use of Race in Clinical Decision Making.

PubMed

Sellers, Sherrill L; Moss, Melissa E; Calzone, Kathleen; Abdallah, Khadijah E; Jenkins, Jean F; Bonham, Vence L

2016-11-01

To examine nurses' self-reported use of race in clinical evaluation. This cross-sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States. Multivariate regression analysis was used to examine associations between RACE score and individual-level characteristics and beliefs in 5,733 registered nurses. Analysis revealed significant relationships between RACE score and nurses' race and ethnicity, educational level, and views on the clinical importance of patient demographic characteristics. Asian nurses reported RACE scores 1.41 points higher than White nurses (p < .001), and Black nurses reported RACE scores 0.55 points higher than White nurses (p < .05). Compared to diploma-level nurses, the baccalaureate-level nurses reported 0.69 points higher RACE scores (p < .05), master's-level nurses reported 1.63 points higher RACE scores (p < .001), and doctorate-level nurses reported 1.77 points higher RACE scores (p < .01). In terms of clinical importance of patient characteristics, patient race and ethnicity corresponded to a 0.54-point increase in RACE score (p < .001), patient genes to a 0.21-point increase in RACE score (p < .001), patient family history to a 0.15-point increase in RACE score (p < .01), and patient age to a 0.19-point increase in RACE score (p < .001). Higher reported use of race among minority nurses may be due, in part, to differential levels of racial self-awareness. A relatively linear positive relationship between level of nursing degree nursing education and use of race suggests that a stronger foundation of knowledge about genetic ancestry, population genetics and the concept "race" and genetic ancestry may increase in clinical decision making could allow nurses to more appropriately use of race in clinical care. Integrating patient demographic characteristics into clinical decisions is an important component of nursing practice. Registered nurses provide care for diverse racial and ethnic patient populations and stand on the front line of clinical care, making them essential for reducing racial and ethnic disparities in healthcare delivery. Exploring registered nurses' individual-level characteristics and clinical use of race may provide a more comprehensive understanding of specific training needs and inform nursing education and practice. © 2016 Sigma Theta Tau International.

Culture and medical decision making: Healthcare consumer perspectives in Japan and the United States.

PubMed

Alden, Dana L; Friend, John M; Lee, Angela Y; de Vries, Marieke; Osawa, Ryosuke; Chen, Qimei

2015-12-01

Two studies identified core value influences on medical decision-making processes across and within cultures. In Study 1, Japanese and American adults reported desired levels of medical decision-making influence across conditions that varied in seriousness. Cultural antecedents (interdependence, independence, and power distance) were also measured. In Study 2, American adults reviewed a colorectal cancer screening decision aid. Decision preparedness was measured along with interdependence, independence, and desire for medical information. In Study 1, higher interdependence predicted stronger desire for decision-making information in both countries, but was significantly stronger in Japan. The path from information desire to decision-making influence desire was significant only in Japan. The independence path to desire for decision-making influence was significant only in the United States. Power distance effects negatively predicted desire for decision-making influence only in the United States. For Study 2, high (low) interdependents and women (men) in the United States felt that a colorectal cancer screening decision aid helped prepare them more (less) for a medical consultation. Low interdependent men were at significantly higher risk for low decision preparedness. Study 1 suggests that Japanese participants may tend to view medical decision-making influence as an interdependent, information sharing exchange, whereas American respondents may be more interested in power sharing that emphasizes greater independence. Study 2 demonstrates the need to assess value influences on medical decision-making processes within and across cultures and suggests that individually tailored versions of decision aids may optimize decision preparedness. (c) 2015 APA, all rights reserved).

Effects of Gain/Loss Framing in Cyber Defense Decision-Making

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

Bos, Nathan; Paul, Celeste; Gersh, John

Cyber defense requires decision making under uncertainty. Yet this critical area has not been a strong focus of research in judgment and decision-making. Future defense systems, which will rely on software-defined networks and may employ ‘moving target’ defenses, will increasingly automate lower level detection and analysis, but will still require humans in the loop for higher level judgment. We studied the decision making process and outcomes of 17 experienced network defense professionals who worked through a set of realistic network defense scenarios. We manipulated gain versus loss framing in a cyber defense scenario, and found significant effects in one ofmore » two focal problems. Defenders that began with a network already in quarantine (gain framing) used a quarantine system more than those that did not (loss framing). We also found some difference in perceived workload and efficacy. Alternate explanations of these findings and implications for network defense are discussed.« less

Decision-making under surprise and uncertainty: Arsenic contamination of water supplies

NASA Astrophysics Data System (ADS)

Randhir, Timothy O.; Mozumder, Pallab; Halim, Nafisa

2018-05-01

With ignorance and potential surprise dominating decision making in water resources, a framework for dealing with such uncertainty is a critical need in hydrology. We operationalize the 'potential surprise' criterion proposed by Shackle, Vickers, and Katzner (SVK) to derive decision rules to manage water resources under uncertainty and ignorance. We apply this framework to managing water supply systems in Bangladesh that face severe, naturally occurring arsenic contamination. The uncertainty involved with arsenic in water supplies makes the application of conventional analysis of decision-making ineffective. Given the uncertainty and surprise involved in such cases, we find that optimal decisions tend to favor actions that avoid irreversible outcomes instead of conventional cost-effective actions. We observe that a diversification of the water supply system also emerges as a robust strategy to avert unintended outcomes of water contamination. Shallow wells had a slight higher optimal level (36%) compare to deep wells and surface treatment which had allocation levels of roughly 32% under each. The approach can be applied in a variety of other cases that involve decision making under uncertainty and surprise, a frequent situation in natural resources management.

Learning Programmes for Environmental Sustainability: A Different Approach to Curriculum Design

ERIC Educational Resources Information Center

Zietsman, S.; Pretorius, R. W.

2006-01-01

Environmental management in South Africa is constrained by a lack of capacity for effective stakeholder engagement and environmental decision-making. The country's excellent environmental legislation demands that environmental professionals be appropriately trained at the higher education level. To this end, a Bachelors level learning programme in…

Issues for a Model of Language Planning.

ERIC Educational Resources Information Center

Bamgbose, Ayo

1989-01-01

Examines the following issues as they relate to a model of language planning: (1) types of decisions (policy or implemental, higher- or lower-level, rational or arbitrary); (2) the planning mechanism; (3) the role of fact finding (prepolicy, preimplementation, and intraimplementation); (4) levels of planning; and (5) the nature of status versus…

Bourdieu and Higher Education Research: A Bricolage Approach

ERIC Educational Resources Information Center

Morrison, Andrew

2017-01-01

I argue for the continuing relevance of the Bourdieusian theoretical schema to research related to higher education. The paper discusses my use of Bourdieu in two research projects: an examination of the educational and occupational decision-making of final-year vocational A-level students; an analysis of the perceptions of final-year…

Responding to nonwords in the lexical decision task: Insights from the English Lexicon Project.

PubMed

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

2015-05-01

Researchers have extensively documented how various statistical properties of words (e.g., word frequency) influence lexical processing. However, the impact of lexical variables on nonword decision-making performance is less clear. This gap is surprising, because a better specification of the mechanisms driving nonword responses may provide valuable insights into early lexical processes. In the present study, item-level and participant-level analyses were conducted on the trial-level lexical decision data for almost 37,000 nonwords in the English Lexicon Project in order to identify the influence of different psycholinguistic variables on nonword lexical decision performance and to explore individual differences in how participants respond to nonwords. Item-level regression analyses reveal that nonword response time was positively correlated with number of letters, number of orthographic neighbors, number of affixes, and base-word number of syllables, and negatively correlated with Levenshtein orthographic distance and base-word frequency. Participant-level analyses also point to within- and between-session stability in nonword responses across distinct sets of items, and intriguingly reveal that higher vocabulary knowledge is associated with less sensitivity to some dimensions (e.g., number of letters) but more sensitivity to others (e.g., base-word frequency). The present findings provide well-specified and interesting new constraints for informing models of word recognition and lexical decision. (c) 2015 APA, all rights reserved).

Pitting intuitive and analytical thinking against each other: the case of transitivity.

PubMed

Rusou, Zohar; Zakay, Dan; Usher, Marius

2013-06-01

Identifying which thinking mode, intuitive or analytical, yields better decisions has been a major subject of inquiry by decision-making researchers. Yet studies show contradictory results. One possibility is that the ambiguity is due to the variability in experimental conditions across studies. Our hypothesis is that decision quality depends critically on the level of compatibility between the thinking mode employed in the decision and the nature of the decision-making task. In two experiments, we pitted intuition and analytical thinking against each other on tasks that were either mainly intuitive or mainly analytical. Thinking modes, as well as task characteristics, were manipulated in a factorial design, with choice transitivity as the dependent measure. Results showed higher choice consistency (transitivity) when thinking mode and the characteristics of the decision task were compatible.

Dopamine and Stress System Modulation of Sex Differences in Decision Making.

PubMed

Georgiou, Polymnia; Zanos, Panos; Bhat, Shambhu; Tracy, J Kathleen; Merchenthaler, Istvan J; McCarthy, Margaret M; Gould, Todd D

2018-01-01

Maladaptive decision making is associated with several neuropsychiatric disorders, including problem gambling and suicidal behavior. The prevalence of these disorders is higher in men vs women, suggesting gender-dependent regulation of their pathophysiology underpinnings. We assessed sex differences in decision making using the rat version of the Iowa gambling task. Female rats identified the most optimal choice from session 1, whereas male rats from session 5. Male, but not female rats, progressively improved their advantageous option responding and surpassed females. Estrus cycle phase did not affect decision making. To test whether pharmacological manipulations targeting the dopaminergic and stress systems affect decision making in a sex-dependent manner, male and female rats received injections of a dopamine D 2 receptor (D 2 R) antagonist (eticlopride), D 2 R agonist (quinpirole), corticotropin-releasing factor 1 (CRF 1 ) antagonist (antalarmin), and α 2 -adrenergic receptor antagonist (yohimbine; used as a pharmacological stressor). Alterations in mRNA levels of D 2 R and CRF 1 were also assessed. Eticlopride decreased advantageous responding in male, but not female rats, whereas quinpirole decreased advantageous responding specifically in females. Yohimbine dose-dependently decreased advantageous responding in female rats, whereas decreased advantageous responding was only observed at higher doses in males. Antalarmin increased optimal choice responding only in female rats. Higher Drd2 and Crhr1 expression in the amygdala were observed in female vs male rats. Higher amygdalar Crhr1 expression was negatively correlated with advantageous responding specifically in females. This study demonstrates the relevance of dopaminergic- and stress-dependent sex differences to maladaptive decision making.

Effects of Clinical Decision Topic on Patients' Involvement in and Satisfaction With Decisions and Their Subsequent Implementation.

PubMed

Freidl, Marion; Pesola, Francesca; Konrad, Jana; Puschner, Bernd; Kovacs, Attila Istvan; De Rosa, Corrado; Fiorillo, Andrea; Krogsgaard Bording, Malene; Kawohl, Wolfram; Rössler, Wulf; Nagy, Marietta; Munk-Jørgensen, Povl; Slade, Mike

2016-06-01

Clinical decision making is an important aspect of mental health care. Predictors of how patients experience decision making and whether decisions are implemented are underresearched. This study investigated the relationship between decision topic and involvement in the decision, satisfaction with it, and its subsequent implementation from both staff and patient perspectives. As part of the Clinical Decision Making and Outcome in Routine Care for People With Severe Mental Illness study, patients (N=588) and their providers (N=213) were recruited from community-based mental health services in six European countries. Both completed bimonthly assessments for one year using the Clinical Decision Making in Routine Care Scale to assess the decision topic and implementation; both also completed the Clinical Decision Making Involvement and Satisfaction Scale. Three categories of decision topics were determined: treatment (most frequently cited), social, and financial. The topic identified as most important remained stable over the follow-up. Patients were more likely to rate their involvement as active rather than passive for social decisions (odds ratio [OR]=5.7, p<.001) and financial decisions (OR=9.5, p<.001). They were more likely to report higher levels of satisfaction rather than lower levels for social decisions (OR=1.5, p=.01) and financial decisions (OR=1.7, p=.01). Social decisions were more likely to be partly implemented (OR=3.0, p<.001) or fully implemented (OR=1.7, p=.03) than not implemented. Patients reported poorer involvement, satisfaction, and implementation in regard to treatment-related decisions, compared with social and financial decisions. Clinicians may need to employ different interactional styles for different types of decisions to maximize satisfaction and decision implementation.

Decision-level fusion of SAR and IR sensor information for automatic target detection

NASA Astrophysics Data System (ADS)

Cho, Young-Rae; Yim, Sung-Hyuk; Cho, Hyun-Woong; Won, Jin-Ju; Song, Woo-Jin; Kim, So-Hyeon

2017-05-01

We propose a decision-level architecture that combines synthetic aperture radar (SAR) and an infrared (IR) sensor for automatic target detection. We present a new size-based feature, called target-silhouette to reduce the number of false alarms produced by the conventional target-detection algorithm. Boolean Map Visual Theory is used to combine a pair of SAR and IR images to generate the target-enhanced map. Then basic belief assignment is used to transform this map into a belief map. The detection results of sensors are combined to build the target-silhouette map. We integrate the fusion mass and the target-silhouette map on the decision level to exclude false alarms. The proposed algorithm is evaluated using a SAR and IR synthetic database generated by SE-WORKBENCH simulator, and compared with conventional algorithms. The proposed fusion scheme achieves higher detection rate and lower false alarm rate than the conventional algorithms.

Association between Work Related Stress and Health Related Quality of Life: The Impact of Socio-Demographic Variables. A Cross Sectional Study in a Region of Central Italy.

PubMed

La Torre, Giuseppe; Sestili, Cristina; Mannocci, Alice; Sinopoli, Alessandra; De Paolis, Massimiliano; De Francesco, Sara; Rapaccini, Laura; Barone, Marco; Iodice, Valentina; Lojodice, Bruno; Sernia, Sabina; De Sio, Simone; Del Cimmuto, Angela; De Giusti, Maria

2018-01-19

The aim of this work is investigate relationship between health-related quality of life and work-related stress and the impact of gender, education level, and age on this relationship. A cross-sectional study was conducted among workers of various setting in Rome and Frosinone. Work-related stress was measured with a demand-control questionnaire and health-related functioning by SF (short form)-12 health survey. There were 611 participants. Men reported high mental composite summary (MCS) and physical composite summary (PCS). In multivariate analysis age, gender ( p < 0.001) and job demand (0.045) predicted low PCS. Low MCS predicted poor PCS. Job demand and educational level resulted negatively associated with MCS. In an analysis stratified for age, gender, and educational level, gender and age resulted effect modifier for MCS, gender and education level for PCS. In women increase of decision latitude predict ( p = 0.001) an increase in MCS; a low job demand predict high MCS in male ( p ≤ 0.001). In younger workers, a lower level of job demand predicted high MCS (<0.001). For PCS, gender and education level resulted effect modifier. In women, high decision latitude predicted higher PCS ( p = 0.001) and lower level of job demand results in higher PCS ( p ≤ 0.001). Higher educational level resulted predictor of low PCS. Management of risk about work-related stress should consider socio-demographic factors.

The relationship between child- and parent-reported shared decision making and child-, parent-, and clinician-reported treatment outcome in routinely collected child mental health services data.

PubMed

Edbrooke-Childs, Julian; Jacob, Jenna; Argent, Rachel; Patalay, Praveetha; Deighton, Jessica; Wolpert, Miranda

2016-04-01

Shared decision making (SDM) between service users and providers is increasingly being suggested as a key component of good healthcare. The aim of this research was to explore whether child- and parent-reported experience of SDM was associated with child- and parent-reported improvement in psychosocial difficulties and clinician-reported functioning at the end of treatment in child and adolescent mental health services (CAMHS). The sample comprised N = 177 children (62% female; 31% aged 6-12 and 69% aged 13-18) with a variety of mental health problems from 17 services where routinely collected data consisted of presenting problems at outset, child- and parent-reported change in symptoms between Time 1 and Time 2 (Strengths and Difficulties Questionnaire; SDQ), clinician-reported change in functioning between Time 1 and Time 2 (Children's Global Assessment Scale; CGAS), and experience of SDM at Time 2 (as measured by responses to the Experience of Service Questionnaire; ESQ). Analysis revealed that both child- and parent-reported experience of SDM were associated with higher levels of child- and parent-reported improvement in psychosocial difficulties. However, child-reported experience of SDM was only associated with higher levels of child-reported improvement when their parents also reported higher levels of SDM. In CAMHS, involving both children and parents in decision making may contribute to enhanced treatment outcomes. © The Author(s) 2015.

Countering the negative effects of job insecurity through participative decision making: lessons from the demand-control model.

PubMed

Probst, Tahira M

2005-10-01

This study examined the effectiveness of increased organizational participative decision making in attenuating the negative consequences of job insecurity. Data were collected from 807 employees in 6 different companies. Analyses suggest that job insecurity is related to lower coworker, work, and supervisor satisfaction and higher turnover intentions and work withdrawal behaviors. However, employees with greater participative decision-making opportunities reported fewer negative consequences of job insecurity compared with employees with fewer participative decision-making opportunities. Results are interpreted using the demand-control model and suggest that organizations that allow greater employee participative decision making may experience fewer negative side effects from today's rising levels of employee job insecurity. Copyright (c) 2005 APA, all rights reserved.

Factors associated with health-related decision-making in older adults from Southern Brazil.

PubMed

Morsch, Patricia; Mirandola, Andrea Ribeiro; Caberlon, Iride Cristofoli; Bós, Ângelo José Gonçalves

2017-05-01

To analyze older adults' health-related decision-making profile. Secondary analysis of a population-based study with 6945 older-adults (aged ≥60 years) in Southern Brazil. Multiple logistic regressions were calculated to describe the odds of deciding alone or asking for advice, compared with the chance of letting someone else decide about health-related issues. Associated variables were age, sex, marital status, education level, number of chronic morbidities, having children and quality of life. The odds of asking for advice instead of letting others decide were significantly higher in the younger group and those with better levels of quality of life, independent of other variables. The chance of asking for advice was lower for unmarried (62%), widowed (76%) and those with children (50%). The chance of men deciding for themselves about their health instead of letting others decide was 47% higher compared with women (P = 0.0002), but 45% lower in the older group (P < 0.0001). Participants who where unmarried and childless, and individuals with better levels of quality of life were more likely to decide alone instead of letting others decide (P < 0.05). Decision-making is fundamental for older adults' good quality of life. Aging makes older adults more vulnerable to dependence; however, it does not necessarily mean that they lose or decrease their ability to make decisions regarding their own health and desires. Geriatr Gerontol Int 2017; 17: 798-803. © 2016 Japan Geriatrics Society.

Opt Out: Women with Children Leaving Mid-Level Student Affairs Positions

ERIC Educational Resources Information Center

Hebreard, Dana

2010-01-01

This phenomenological study is about the decision-making process of women with young children at the mid-level student affairs position who decide to opt out of their career for a minimum of one year, and for some, return to higher education. The study is based on interviews with 17 mid-level college administrators and mothers of young children,…

Effect of risk aversion on prioritizing conservation projects.

PubMed

Tulloch, Ayesha I T; Maloney, Richard F; Joseph, Liana N; Bennett, Joseph R; Di Fonzo, Martina M I; Probert, William J M; O'Connor, Shaun M; Densem, Jodie P; Possingham, Hugh P

2015-04-01

Conservation outcomes are uncertain. Agencies making decisions about what threat mitigation actions to take to save which species frequently face the dilemma of whether to invest in actions with high probability of success and guaranteed benefits or to choose projects with a greater risk of failure that might provide higher benefits if they succeed. The answer to this dilemma lies in the decision maker's aversion to risk--their unwillingness to accept uncertain outcomes. Little guidance exists on how risk preferences affect conservation investment priorities. Using a prioritization approach based on cost effectiveness, we compared 2 approaches: a conservative probability threshold approach that excludes investment in projects with a risk of management failure greater than a fixed level, and a variance-discounting heuristic used in economics that explicitly accounts for risk tolerance and the probabilities of management success and failure. We applied both approaches to prioritizing projects for 700 of New Zealand's threatened species across 8303 management actions. Both decision makers' risk tolerance and our choice of approach to dealing with risk preferences drove the prioritization solution (i.e., the species selected for management). Use of a probability threshold minimized uncertainty, but more expensive projects were selected than with variance discounting, which maximized expected benefits by selecting the management of species with higher extinction risk and higher conservation value. Explicitly incorporating risk preferences within the decision making process reduced the number of species expected to be safe from extinction because lower risk tolerance resulted in more species being excluded from management, but the approach allowed decision makers to choose a level of acceptable risk that fit with their ability to accommodate failure. We argue for transparency in risk tolerance and recommend that decision makers accept risk in an adaptive management framework to maximize benefits and avoid potential extinctions due to inefficient allocation of limited resources. © 2014 Society for Conservation Biology.

Individual Moral Philosophies and Ethical Decision Making of Undergraduate Athletic Training Students and Educators

PubMed Central

Caswell, Shane V; Gould, Trenton E

2008-01-01

Context: Ethics research in athletic training is lacking. Teaching students technical skills is important, but teaching them how to reason and to behave in a manner that befits responsible health care professionals is equally important. Objective: To expand ethics research in athletic training by (1) describing undergraduate athletic training students' and educators' individual moral philosophies and ethical decision-making abilities and (2) investigating the effects of sex and level of education on mean composite individual moral philosophies and ethical decision-making scores. Design: Stratified, multistage, cluster-sample correlational study. Setting: Mailed survey instruments were distributed in classroom settings at 30 institutions having Commission on Accreditation of Allied Health Education Programs (CAAHEP)–accredited athletic training programs. Patients or Other Participants: Undergraduate students and educators (n = 598: 373 women, 225 men; mean age = 23.5 ± 6.3 years) from 25 CAAHEP-accredited athletic training programs. Main Outcome Measure(s): We used the Ethics Position Questionnaire and the Dilemmas in Athletic Training Questionnaire to compute participants' mean composite individual moral philosophies (idealism and relativism) and ethical decision-making scores, respectively. Three separate 2 (sex: male, female) × 3 (education level: underclass, upper class, educator) between-subjects factorial analyses of variance using idealism, relativism, and ethical decision-making scores as dependent measures were performed. Results: Respondents reported higher idealism scores (37.57 ± 4.91) than relativism scores (31.70 ± 4.80) (response rate = 83%). The mean ethical decision-making score for all respondents was 80.76 ± 7.88. No significant interactions were revealed. The main effect for sex illustrated that men reported significantly higher relativism scores ( P = .0014, η 2 = .015) than did women. The main effect for education level revealed significant differences between students' and educators' idealism ( P = .0190, η 2 = .013), relativism ( P < .001, η 2 = .050), and ethical decision-making scores ( P < .001, η 2 = .027). Tukey honestly significant difference post hoc analysis indicated that educators possessed lower idealism scores (36.90 ± 5.70) and relativism scores (29.92 ± 4.86) and higher ethical decision-making scores (82.98 ± 7.62) than did students. Conclusions: Our findings do not support changes in athletic training ethics education practices to address sex-specific needs. However, when opportunities occur for students to reason using different ethical perspectives, educators should be aware of their students' and their own moral philosophies in order to optimally facilitate professional growth. PMID:18345347

Perceived involvement and preferences in shared decision-making among patients with hypertension.

PubMed

Mah, Hui Chin; Muthupalaniappen, Leelavathi; Chong, Wei Wen

2016-06-01

Shared decision-making (SDM) is an important component of patient-centred care. However, there is limited information on its implementation in Malaysia, particularly in chronic diseases such as hypertension. The objective of this study was to examine perceived involvement and role preferences of patients with hypertension in treatment decision-making. A cross-sectional survey was conducted among 210 patients with hypertension in a teaching hospital in Malaysia. The majority of respondents agreed that their doctor recognized that a decision needs to be made (89.5%) and informed them that different options are available (77.1%). However, respondents' perceived level of involvement in other aspects of treatment decision-making process was low, including in the selection of treatment and in reaching an agreement with their doctor on how to proceed with treatment. In terms of preferred decision-making roles, 51.4% of respondents preferred a collaborative role with their physicians, 44.8% preferred a passive role while only 1.9% preferred an active role. Age and educational level were found to be significantly related to patient preferences for involvement in SDM. Younger patients (<60 years) and those with higher educational level preferred SDM over passive decision-making (ρ < 0.01). Encouragement from health care providers was perceived as a major motivating factor for SDM among patients with hypertension, with 91% of respondents agreeing that this would motivate their participation in SDM. Preferences for involvement in decision-making among patients with hypertension are varied, and influenced by age and educational level. Physicians have a key role in encouraging patients to participate in SDM. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Effects of imperfect automation on decision making in a simulated command and control task.

PubMed

Rovira, Ericka; McGarry, Kathleen; Parasuraman, Raja

2007-02-01

Effects of four types of automation support and two levels of automation reliability were examined. The objective was to examine the differential impact of information and decision automation and to investigate the costs of automation unreliability. Research has shown that imperfect automation can lead to differential effects of stages and levels of automation on human performance. Eighteen participants performed a "sensor to shooter" targeting simulation of command and control. Dependent variables included accuracy and response time of target engagement decisions, secondary task performance, and subjective ratings of mental work-load, trust, and self-confidence. Compared with manual performance, reliable automation significantly reduced decision times. Unreliable automation led to greater cost in decision-making accuracy under the higher automation reliability condition for three different forms of decision automation relative to information automation. At low automation reliability, however, there was a cost in performance for both information and decision automation. The results are consistent with a model of human-automation interaction that requires evaluation of the different stages of information processing to which automation support can be applied. If fully reliable decision automation cannot be guaranteed, designers should provide users with information automation support or other tools that allow for inspection and analysis of raw data.

Adaptive Multi-scale Prognostics and Health Management for Smart Manufacturing Systems

PubMed Central

Choo, Benjamin Y.; Adams, Stephen C.; Weiss, Brian A.; Marvel, Jeremy A.; Beling, Peter A.

2017-01-01

The Adaptive Multi-scale Prognostics and Health Management (AM-PHM) is a methodology designed to enable PHM in smart manufacturing systems. In application, PHM information is not yet fully utilized in higher-level decision-making in manufacturing systems. AM-PHM leverages and integrates lower-level PHM information such as from a machine or component with hierarchical relationships across the component, machine, work cell, and assembly line levels in a manufacturing system. The AM-PHM methodology enables the creation of actionable prognostic and diagnostic intelligence up and down the manufacturing process hierarchy. Decisions are then made with the knowledge of the current and projected health state of the system at decision points along the nodes of the hierarchical structure. To overcome the issue of exponential explosion of complexity associated with describing a large manufacturing system, the AM-PHM methodology takes a hierarchical Markov Decision Process (MDP) approach into describing the system and solving for an optimized policy. A description of the AM-PHM methodology is followed by a simulated industry-inspired example to demonstrate the effectiveness of AM-PHM. PMID:28736651

Context retrieval and description benefits for recognition of unfamiliar faces.

PubMed

Jones, Todd C; Robinson, Kealagh; Steel, Brenna C

2018-04-19

Describing unfamiliar faces during or immediately after their presentation in a study phase can produce better recognition memory performance compared with a view-only control condition. We treated descriptions as elaborative information that is part of the study context and investigated how context retrieval influences recognition memory. Following general dual-process theories, we hypothesized that recollection would be used to recall descriptions and that description recall would influence recognition decisions, including the level of recognition confidence. In four experiments description conditions produced higher hit rates and higher levels of recognition confidence than control conditions. Participants recalled descriptive content on some trials, and this context retrieval was linked to an increase in the recognition confidence level. Repeating study faces in description conditions increased recognition scores, recognition confidence level, and context retrieval. Estimates of recollection from Yonelinas' (1994) dual-process signal detection ROCs were, on average, very close to the measures of context recall. Description conditions also produced higher estimates of familiarity. Finally, we found evidence that participants engaged in description activity in some ostensibly view-only trials. An emphasis on the information participants use in making their recognition decisions can advance understanding on description effects when descriptions are part of the study trial context. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

PubMed Central

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

2009-01-01

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

The influence of campus experiences on the level of outness among trans-spectrum and queer-spectrum students.

PubMed

Garvey, Jason C; Rankin, Susan R

2015-01-01

This study utilized MANOVA and hierarchical multiple regression to examine the relationships between campus experiences and coming-out decisions among trans- and queer-spectrum undergraduates. Findings revealed higher levels of outness/disclosure for cisgender LGBQ women, and more negative perceptions of campus climate, classroom climate, and curriculum inclusivity and higher use of campus resources for trans-spectrum students. Results also revealed that higher levels of outness significantly related to poorer perceptions of campus responses and campus resources. Implications address the need to foster an encouraging and supportive campus and classroom climate and to improve the relationships with LGBTQ resource centers for trans- and queer-spectrum students.

Coordination of Individual and Organizational Planning for Natural Hazards (Invited)

NASA Astrophysics Data System (ADS)

Krantz, D. H.

2013-12-01

Decision making consists of constructing or selecting a plan. This is true at many levels of decision making: individuals or households, small groups, larger organizations, and governments. In each case, plans are constructed or selected taking account of the decision maker's prioritized set of active goals and the decision maker's beliefs about the probability or the extent to which each goal will be attained through a given plan. Planning for mitigation of or response to natural hazards can be improved if the plans of the many decision makers at multiple levels are coordinated. Government planning should ideally be informed by knowledge about the plans of businesses and non-profit organizations as well as knowledge about individual, household, and neighborhood plans. Similarly, plans at the individual and organizational levels should be informed by knowledge of others' plans at the same and at higher and lower levels of aggregation. Coordination can be impaired by differences in goals, differences in beliefs about the instrumentality of plans toward given goals, and also by ignorance of others' goals and plans. Good coordination requires incentives that promote sharing of plans, horizontally and vertically, and that alleviate conflicts in goals and conflicts in beliefs that will inevitably surface once plans are shared. Thus, four different kinds of decision aids are needed to improve natural hazard planning: mechanisms that support horizontal dissemination of plans, mechanisms that support vertical dissemination, mechanisms for examining goal conflicts and reducing these through plans that take others' goals into account, and mechanisms for examining belief conflicts.

An interval logic for higher-level temporal reasoning

NASA Technical Reports Server (NTRS)

Schwartz, R. L.; Melliar-Smith, P. M.; Vogt, F. H.; Plaisted, D. A.

1983-01-01

Prior work explored temporal logics, based on classical modal logics, as a framework for specifying and reasoning about concurrent programs, distributed systems, and communications protocols, and reported on efforts using temporal reasoning primitives to express very high level abstract requirements that a program or system is to satisfy. Based on experience with those primitives, this report describes an Interval Logic that is more suitable for expressing such higher level temporal properties. The report provides a formal semantics for the Interval Logic, and several examples of its use. A description of decision procedures for the logic is also included.

Effortful semantic decision-making boosts memory performance in older adults.

PubMed

Fu, Li; Maes, Joseph H R; Varma, Samarth; Kessels, Roy P C; Daselaar, Sander M

2017-04-01

A major concern in age-related cognitive decline is episodic memory (EM). Previous studies indicate that both resource and binding deficits contribute to EM decline. Environmental support by task manipulations encouraging stronger cognitive effort and deeper levels of processing may facilitate compensation for these two deficits. To clarify factors that can counteract age-related EM decline, we assessed effects of cognitive effort (four levels) and level of processing (LoP, shallow/deep) during encoding on subsequent retrieval. Young (YAs, N = 23) and older (OAs, N = 23) adults performed two incidental encoding tasks, deep/semantic and shallow/perceptual. Cognitive effort was manipulated by varying decision-making demands. EM performance, indexed by d-prime, was later tested using a recognition task. Results showed that regardless of LoP, increased cognitive effort caused higher d-primes in both age groups. Compared to YAs, OAs showed a lower d-prime after shallow encoding across all cognitive effort levels, and after deep encoding with low cognitive effort. Deep encoding with higher levels of cognitive effort completely eliminated these age differences. Our findings support an environmental-compensatory account of cognitive ageing and can have important therapeutic implications.

The decision to have an abortion from both partners' perspectives: a dyadic analysis.

PubMed

Vandamme, Joke; Buysse, Ann; Loeys, Tom; Vrancken, Carine; T'Sjoen, Guy

2017-02-01

Male partners are often involved in induced abortion although they have no legal rights. It is, however, unknown how women's thoughts and feelings regarding the decision for abortion are associated with the decisional experiences of the involved male partners and vice versa. Flemish women and their involved male partners (IMP) filled out a questionnaire on abortion motives and feelings of decisiveness in the abortion centre waiting room (N = 106 couples). Actor Partner Interdependence Models investigated whether the decisiveness of one partner was associated with a subjective feeling of autonomy (high internal, low external abortion motivation) and decisiveness of the other partner, above and beyond the own feeling of autonomy and personal vulnerabilities for being uncertain. Partner congruence in motivation and decisiveness was substantial (r= 0.23 to 0.42), especially for cohabiting partners. The IMPs were less internally motivated for the abortion than the women but both partners reported more internal than external motives, and they both tended to feel certain. In contrast to the women, a higher subjective feeling of autonomy in the IMPs was not associated with feeling more certain. When accounting for partners' living situation, levels of uncertainty were not only associated with personal vulnerabilities for being uncertain, but were also related to the degree of uncertainty and subjective level of autonomy of the other partner. Partners' thoughts and feelings regarding the decision for abortion partially have an interpersonal basis and mostly run parallel despite an inherent gender difference in level and importance of decision autonomy.

Exploring alternate specifications to explain agency-level effects in placement decisions regarding Aboriginal children: Further analysis of the Canadian Incidence Study of Reported Child Abuse and Neglect Part C.

PubMed

Fallon, Barbara; Chabot, Martin; Fluke, John; Blackstock, Cindy; Sinha, Vandna; Allan, Kate; MacLaurin, Bruce

2015-11-01

A series of papers using data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS) explored the influence of clinical and organizational characteristics on the decision to place Aboriginal children in out-of-home placements at the conclusion of child maltreatment investigations. The purpose of this paper is to further explore a consistent finding of the previous analyses: the proportion of investigations involving Aboriginal children at a child welfare agency is associated with placement for all children in that agency. CIS-2008 data were used in the analysis, which allowed for inclusion of previously unavailable organizational and contextual variables. Multi-level statistical models were developed to analyze the influence of clinical and organizational variables on the placement decision. Final models revealed that the proportion of investigations conducted by the child welfare agency involving Aboriginal children was again a key agency-level predictor of the placement decision for any child served by the agency. Specifically, the higher the proportion of investigations of Aboriginal children, the more likely placement was to occur for any child. Further, this analysis demonstrated that structure of governance, an organizational-level variable not available in previous cycles of the CIS, is an important agency-level predictor of out-of-home placement. Further analysis is needed to fully understand individual and organizational level variables that may influence decisions regarding placement of Aboriginal children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Factors that influence parental decisions to participate in clinical research: consenters vs nonconsenters.

PubMed

Hoberman, Alejandro; Shaikh, Nader; Bhatnagar, Sonika; Haralam, Mary Ann; Kearney, Diana H; Colborn, D Kathleen; Kienholz, Michelle L; Wang, Li; Bunker, Clareann H; Keren, Ron; Carpenter, Myra A; Greenfield, Saul P; Pohl, Hans G; Mathews, Ranjiv; Moxey-Mims, Marva; Chesney, Russell W

2013-06-01

A child's health, positive perceptions of the research team and consent process, and altruistic motives play significant roles in the decision-making process for parents who consent for their child to enroll in clinical research. This study identified that nonconsenting parents were better educated, had private insurance, showed lower levels of altruism, and less understanding of study design. To determine the factors associated with parental consent for their child's participation in a randomized, placebo-controlled trial. Cross-sectional survey conducted from July 2008 to May 2011. The survey was an ancillary study to the Randomized Intervention for Children with VesicoUreteral Reflux Study. Seven children's hospitals participating in a randomized trial evaluating management of children with vesicoureteral reflux. Parents asked to provide consent for their child's participation in the randomized trial were invited to complete an anonymous online survey about factors influencing their decision. A total of 120 of the 271 (44%) invited completed the survey; 58 of 125 (46%) who had provided consent and 62 of 144 (43%) who had declined consent completed the survey. A 60-question survey examining child, parent, and study characteristics; parental perception of the study; understanding of the design; external influences; and decision-making process. RESULTS Having graduated from college and private health insurance were associated with a lower likelihood of providing consent. Parents who perceived the trial as having a low degree of risk, resulting in greater benefit to their child and other children, causing little interference with standard care, or exhibiting potential for enhanced care, or who perceived the researcher as professional were significantly more likely to consent to participate. Higher levels of understanding of the randomization process, blinding, and right to withdraw were significantly positively associated with consent to participate. CONCLUSIONS AND RELEVANCE Parents who declined consent had a relatively higher socioeconomic status, had more anxiety about their decision, and found it harder to make their decision compared with consenting parents, who had higher levels of trust and altruism, perceived the potential for enhanced care, reflected better understanding of randomization, and exhibited low decisional uncertainty. Consideration of the factors included in the conceptual model should enhance the quality of the informed consent process and improve participation in pediatric clinical trials.

Considering the Marketing of Higher Education: The Role of Student Learning Gain as a Potential Indicator of Teaching Quality

ERIC Educational Resources Information Center

Polkinghorne, Martyn; Roushan, Gelareh; Taylor, Julia

2017-01-01

The marketization of higher education has ensured that students have become consumers. As a result, students are demanding increased levels of information regarding potential university courses so that they can make informed decisions regarding how best to invest their money, time and opportunity. A comparison of the teaching quality delivered on…

Oxygen desaturation during night sleep affects decision-making in patients with obstructive sleep apnea.

PubMed

Delazer, Margarete; Zamarian, Laura; Frauscher, Birgit; Mitterling, Thomas; Stefani, Ambra; Heidbreder, Anna; Högl, Birgit

2016-08-01

This study assessed decision-making and its associations with executive functions and sleep-related factors in patients with obstructive sleep apnea. Thirty patients with untreated obstructive sleep apnea and 20 healthy age- and education-matched controls performed the Iowa Gambling Task, a decision-making task under initial ambiguity, as well as an extensive neuropsychological test battery. Patients, but not controls, also underwent a detailed polysomnographic assessment. Results of group analyses showed that patients performed at the same level of controls on the Iowa Gambling Task. However, the proportion of risky performers was significantly higher in the patient group than in the control group. Decision-making did not correlate with executive functions and subjective ratings of sleepiness, whereas there was a significant positive correlation between advantageous performance on the Iowa Gambling Task and percentage of N2 sleep, minimal oxygen saturation, average oxygen saturation and time spent below 90% oxygen saturation level. Also, the minimal oxygen saturation accounted for 27% of variance in decision-making. In conclusion, this study shows that a subgroup of patients with obstructive sleep apnea may be at risk of disadvantageous decision-making under ambiguity. Among the sleep-related factors, oxygen saturation is a significant predictor of advantageous decision-making. © 2016 European Sleep Research Society.

Parents Matter: The Role of Parents in Teens' Decisions about Sex. Research Brief. Publication #2009-45

ERIC Educational Resources Information Center

Ikramullah, Erum; Manlove, Jennifer; Cui, Carol; Moore, Kristin A.

2009-01-01

Adolescents are influenced by a variety of social factors and institutions. Prior research confirms what many of us know instinctively: that parents can be one of the strongest influences in adolescents' lives. For example, higher levels of parental involvement in their adolescents' lives are linked with lower levels of delinquency, violent…

Differences in Simulated Doctor and Patient Medical Decision Making: A Construal Level Perspective

PubMed Central

Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

2013-01-01

Background Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. Objective This study investigated the characteristics of and differences in doctor–patient medical decision making on the basis of construal level theory. Methods A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Results Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, p<.001). The effect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, p<.001). The effect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Conclusion Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation. PMID:24244445

Differences in simulated doctor and patient medical decision making: a construal level perspective.

PubMed

Peng, Jiaxi; He, Fei; Zhang, Yan; Liu, Quanhui; Miao, Danmin; Xiao, Wei

2013-01-01

Patients are often confronted with diverse medical decisions. Often lacking relevant medical knowledge, patients fail to independently make medical decisions and instead generally rely on the advice of doctors. This study investigated the characteristics of and differences in doctor-patient medical decision making on the basis of construal level theory. A total of 420 undergraduates majoring in clinical medicine were randomly assigned to six groups. Their decisions to opt for radiotherapy and surgery were investigated, with the choices described in a positive/neutral/negative frame × decision making for self/others. Compared with participants giving medical advice to patients, participants deciding for themselves were more likely to select radiotherapy (F1, 404 = 13.92, p = 011). Participants from positive or neutral frames exhibited a higher tendency to choose surgery than did those from negative frames (F2, 404 = 22.53, p<.001). The effect of framing on independent decision making was nonsignificant (F2, 404 = 1.07, p = 35); however the effect of framing on the provision of advice to patients was significant (F2, 404 = 12.95, p<.001). The effect of construal level was significant in the positive frame (F1, 404 = 8.06, p = 005) and marginally significant in the neutral frame (F2, 404 = 3.31, p = 07) but nonsignificant in the negative frame (F2, 404 = .29, p = 59). Both social distance and framing depiction significantly affected medical decision making and exhibited a significant interaction. Differences in medical decision making between doctors and patients need further investigation.

Complementary Cognitive Capabilities, Economic Decision-Making, and Aging

PubMed Central

Li, Ye; Baldassi, Martine; Johnson, Eric J.; Weber, Elke U.

2014-01-01

Fluid intelligence decreases with age, yet evidence about age declines in decision-making quality is mixed: Depending on the study, older adults make worse, equally good, or even better decisions than younger adults. We propose a potential explanation for this puzzle, namely that age differences in decision performance result from the interplay between two sets of cognitive capabilities that impact decision making, one in which older adults fare worse (i.e., fluid intelligence) and one in which they fare better (i.e., crystallized intelligence). Specifically, we hypothesized that older adults’ higher levels of crystallized intelligence can provide an alternate pathway to good decisions when the fluid intelligence pathway declines. The performance of older adults relative to younger adults therefore depends on the relative importance of each type of intelligence for the decision at hand. We tested this complementary capabilities hypothesis in a broad sample of younger and older adults, collecting a battery of standard cognitive measures and measures of economically important decision-making “traits”—including temporal discounting, loss aversion, financial literacy, and debt literacy. We found that older participants performed as well as or better than younger participants on these four decision-making measures. Structural equation modeling verified our hypothesis: Older participants’ greater crystallized intelligence offset their lower levels of fluid intelligence for temporal discounting, financial literacy, and debt literacy, but not for loss aversion. These results have important implications for public policy and for the design of effective decision environments for older adults. PMID:24040999

Complementary cognitive capabilities, economic decision making, and aging.

PubMed

Li, Ye; Baldassi, Martine; Johnson, Eric J; Weber, Elke U

2013-09-01

Fluid intelligence decreases with age, yet evidence about age declines in decision-making quality is mixed: Depending on the study, older adults make worse, equally good, or even better decisions than younger adults. We propose a potential explanation for this puzzle, namely that age differences in decision performance result from the interplay between two sets of cognitive capabilities that impact decision making, one in which older adults fare worse (i.e., fluid intelligence) and one in which they fare better (i.e., crystallized intelligence). Specifically, we hypothesized that older adults' higher levels of crystallized intelligence can provide an alternate pathway to good decisions when the fluid intelligence pathway declines. The performance of older adults relative to younger adults therefore depends on the relative importance of each type of intelligence for the decision at hand. We tested this complementary capabilities hypothesis in a broad sample of younger and older adults, collecting a battery of standard cognitive measures and measures of economically important decision-making "traits"--including temporal discounting, loss aversion, financial literacy, and debt literacy. We found that older participants performed as well as or better than younger participants on these four decision-making measures. Structural equation modeling verified our hypothesis: Older participants' greater crystallized intelligence offset their lower levels of fluid intelligence for temporal discounting, financial literacy, and debt literacy, but not for loss aversion. These results have important implications for public policy and for the design of effective decision environments for older adults.

The Somatic Marker Hypothesis and Sexual Decision Making: Understanding the Role of Iowa Gambling Task Performance and Daily Sexual Arousal on the Sexual Behavior of Gay and Bisexual Men.

PubMed

Rendina, H Jonathon; Millar, Brett M; Dash, Genevieve; Feldstein Ewing, Sarah W; Parsons, Jeffrey T

2018-04-19

The sexual decision-making literature suggests that sexual arousal and behavior are associated. The somatic marker hypothesis suggests that individual neuropsychological differences in decision making, as measured by the Iowa Gambling Task (IGT), may moderate these associations; however, this hypothesis has yet to be tested with event-level sexual behavior data. We hypothesized that (a) daily sexual arousal would be positively associated with likelihood of engaging in sex and condomless anal sex (CAS) and (b) IGT scores would moderate these associations such that the associations would be stronger among those with higher IGT scores. We used daily diary data from 334 highly sexually active gay and bisexual men to examine the main and interaction effects of sexual arousal and IGT scores on sexual engagement and CAS. As hypothesized, daily sexual arousal was positively associated with greater odds of both sexual engagement and CAS with casual male partners. Individual-level IGT performance significantly moderated the day-level association between arousal and sexual engagement, which was stronger for men with higher IGT scores. There was no main effect of IGT scores on either sexual behavior outcome, nor did it moderate the association between arousal and CAS. These findings highlight the influence of sexual arousal on sexual engagement, which differed by IGT scores; the effect of arousal on CAS was much less variable and may not be moderated by neurocognitive factors. This study supports the importance of exploring integrated behavioral/biomedical interventions to improve individual decision making to prevent HIV infection.

Effects of noise on the performance of a memory decision response task

NASA Technical Reports Server (NTRS)

Lawton, B. W.

1972-01-01

An investigation has been made to determine the effects of noise on human performance. Fourteen subjects performed a memory-decision-response task in relative quiet and while listening to tape recorded noises. Analysis of the data obtained indicates that performance was degraded in the presence of noise. Significant increases in problem solution times were found for impulsive noise conditions as compared with times found for the no-noise condition. Performance accuracy was also degraded. Significantly more error responses occurred at higher noise levels; a direct or positive relation was found between error responses and noise level experienced by the subjects.

An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

PubMed

Grant, Aileen; Sullivan, Frank; Dowell, Jon

2013-06-21

Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary).Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. General practitioners in the higher prescribing quality practices made two different 'types' of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence.

An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?

PubMed Central

2013-01-01

Background Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence. There has been substantial investment in technologies and interventions to address this issue, but effect sizes so far have been small to moderate. This suggests that prescribing is a decision-making process that is not sufficiently understood. By understanding more about prescribing processes and the implementation of research evidence, variation may more easily be understood and more effective interventions proposed. Methods An ethnographic study in three Scottish general practices with diverse organizational characteristics. Practices were ranked by their performance against Audit Scotland prescribing quality indicators, incorporating established best research evidence. Two practices of high prescribing quality and one practice of low prescribing quality were recruited. Participant observation, formal and informal interviews, and a review of practice documentation were employed. Results Practices ranked as high prescribing quality consistently made and applied macro and micro prescribing decisions, whereas the low-ranking practice only made micro prescribing decisions. Macro prescribing decisions were collective, policy decisions made considering research evidence in light of the average patient, one disease, condition, or drug. Micro prescribing decisions were made in consultation with the patient considering their views, preferences, circumstances and other conditions (if necessary). Although micro prescribing can operate independently, the implementation of evidence-based, quality prescribing was attributable to an interdependent relationship. Macro prescribing policy enabled prescribing decisions to be based on scientific evidence and applied consistently where possible. Ultimately, this influenced prescribing decisions that occur at the micro level in consultation with patients. Conclusion General practitioners in the higher prescribing quality practices made two different ‘types’ of prescribing decision; macro and micro. Macro prescribing informs micro prescribing and without a macro basis to draw upon the low-ranked practice had no effective mechanism to engage with, reflect on and implement relevant evidence. Practices that recognize these two levels of decision making about prescribing are more likely to be able to implement higher quality evidence. PMID:23799906

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

PubMed

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

2015-01-01

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

Chinese Culture, Homosexuality Stigma, Social Support and Condom Use: A Path Analytic Model.

PubMed

Liu, Hongjie; Feng, Tiejian; Ha, Toan; Liu, Hui; Cai, Yumao; Liu, Xiaoli; Li, Jian

2011-01-01

PURPOSE: The objective of this study was to examine the interrelationships among individualism, collectivism, homosexuality-related stigma, social support, and condom use among Chinese homosexual men. METHODS: A cross-sectional study using the respondent-driven sampling approach was conducted among 351 participants in Shenzhen, China. Path analytic modeling was used to analyze the interrelationships. RESULTS: The results of path analytic modeling document the following statistically significant associations with regard to homosexuality: (1) higher levels of vertical collectivism were associated with higher levels of public stigma [β (standardized coefficient) = 0.12] and self stigma (β = 0.12); (2) higher levels of vertical individualism were associated with higher levels self stigma (β = 0.18); (3) higher levels of horizontal individualism were associated with higher levels of public stigma (β = 0.12); (4) higher levels of self stigma were associated with higher levels of social support from sexual partners (β = 0.12); and (5) lower levels of public stigma were associated with consistent condom use (β = -0.19). CONCLUSIONS: The findings enhance our understanding of how individualist and collectivist cultures influence the development of homosexuality-related stigma, which in turn may affect individuals' decisions to engage in HIV-protective practices and seek social support. Accordingly, the development of HIV interventions for homosexual men in China should take the characteristics of Chinese culture into consideration.

Chinese Culture, Homosexuality Stigma, Social Support and Condom Use: A Path Analytic Model

PubMed Central

Liu, Hongjie; Feng, Tiejian; Ha, Toan; Liu, Hui; Cai, Yumao; Liu, Xiaoli; Li, Jian

2011-01-01

Purpose The objective of this study was to examine the interrelationships among individualism, collectivism, homosexuality-related stigma, social support, and condom use among Chinese homosexual men. Methods A cross-sectional study using the respondent-driven sampling approach was conducted among 351 participants in Shenzhen, China. Path analytic modeling was used to analyze the interrelationships. Results The results of path analytic modeling document the following statistically significant associations with regard to homosexuality: (1) higher levels of vertical collectivism were associated with higher levels of public stigma [β (standardized coefficient) = 0.12] and self stigma (β = 0.12); (2) higher levels of vertical individualism were associated with higher levels self stigma (β = 0.18); (3) higher levels of horizontal individualism were associated with higher levels of public stigma (β = 0.12); (4) higher levels of self stigma were associated with higher levels of social support from sexual partners (β = 0.12); and (5) lower levels of public stigma were associated with consistent condom use (β = −0.19). Conclusions The findings enhance our understanding of how individualist and collectivist cultures influence the development of homosexuality-related stigma, which in turn may affect individuals’ decisions to engage in HIV-protective practices and seek social support. Accordingly, the development of HIV interventions for homosexual men in China should take the characteristics of Chinese culture into consideration. PMID:21731850

Effect of feedback mode and task difficulty on quality of timing decisions in a zero-sum game.

PubMed

Tikuisis, Peter; Vartanian, Oshin; Mandel, David R

2014-09-01

The objective was to investigate the interaction between the mode of performance outcome feedback and task difficulty on timing decisions (i.e., when to act). Feedback is widely acknowledged to affect task performance. However, the extent to which feedback display mode and its impact on timing decisions is moderated by task difficulty remains largely unknown. Participants repeatedly engaged a zero-sum game involving silent duels with a computerized opponent and were given visual performance feedback after each engagement. They were sequentially tested on three different levels of task difficulty (low, intermediate, and high) in counterbalanced order. Half received relatively simple "inside view" binary outcome feedback, and the other half received complex "outside view" hit rate probability feedback. The key dependent variables were response time (i.e., time taken to make a decision) and survival outcome. When task difficulty was low to moderate, participants were more likely to learn and perform better from hit rate probability feedback than binary outcome feedback. However, better performance with hit rate feedback exacted a higher cognitive cost manifested by higher decision response time. The beneficial effect of hit rate probability feedback on timing decisions is partially moderated by task difficulty. Performance feedback mode should be judiciously chosen in relation to task difficulty for optimal performance in tasks involving timing decisions.

Decision-making for risky gains and losses among college students with Internet gaming disorder.

PubMed

Yao, Yuan-Wei; Chen, Pin-Ru; Li, Song; Wang, Ling-Jiao; Zhang, Jin-Tao; Yip, Sarah W; Chen, Gang; Deng, Lin-Yuan; Liu, Qin-Xue; Fang, Xiao-Yi

2015-01-01

Individuals with Internet gaming disorder (IGD) tend to exhibit disadvantageous risky decision-making not only in their real life but also in laboratory tasks. Decision-making is a complex multifaceted function and different cognitive processes are involved in decision-making for gains and losses. However, the relationship between impaired decision-making and gain versus loss processing in the context of IGD is poorly understood. The main aim of the present study was to separately evaluate decision-making for risky gains and losses among college students with IGD using the Cups task. Additionally, we further examined the effects of outcome magnitude and probability level on decision-making related to risky gains and losses respectively. Sixty college students with IGD and 42 matched healthy controls (HCs) participated. Results indicated that IGD subjects exhibited generally greater risk taking tendencies than HCs. In comparison to HCs, IGD subjects made more disadvantageous risky choices in the loss domain (but not in the gain domain). Follow-up analyses indicated that the impairment was associated to insensitivity to changes in outcome magnitude and probability level for risky losses among IGD subjects. In addition, higher Internet addiction severity scores were associated with percentage of disadvantageous risky options in the loss domain. These findings emphasize the effect of insensitivity to losses on disadvantageous decisions under risk in the context of IGD, which has implications for future intervention studies.

Tenure Track Policy Increases Representation of Women in Senior Academic Positions, but Is Insufficient to Achieve Gender Balance

PubMed Central

Bakker, Martha M.; Jacobs, Maarten H.

2016-01-01

Underrepresentation of women in senior positions is a persistent problem in universities worldwide, and a wide range of strategies to combat this situation is currently being contemplated. One such strategy is the introduction of a tenure track system, in which decisions to promote scientific staff to higher ranks are guided by a set of explicit and transparent criteria, as opposed to earlier situations in which decisions were based on presumably more subjective impressions by superiors. We examined the effect of the introduction of a tenure track system at Wageningen University (The Netherlands) on male and female promotion rates. We found that chances on being promoted to higher levels were already fairly equal between men and women before the tenure track system was introduced, and improved–more for women than for men–after the introduction of the tenure track system. These results may partly be explained by affirmative actions, but also by the fact that legacy effects of historical discrimination have led to a more competitive female population of scientists. In spite of these outcomes, extrapolations of current promotion rates up to 2025 demonstrate that the equal or even higher female promotion rates do not lead to substantial improvement of the gender balance at higher levels (i.e., associate professor and higher). Since promotion rates are small compared to the total amount of staff, the current distribution of men and women will, especially at higher levels, exhibit a considerable degree of inertia—unless additional affirmative action is taken. PMID:27684072

The relationship between shared decision-making and health-related quality of life among patients in Hong Kong SAR, China.

PubMed

Xu, Richard H; Cheung, Annie W L; Wong, Eliza L Y

2017-08-01

To elucidate the association between health-related quality of life and shared decision-making among patients in Hong Kong after adjustment for potential confounding variables. A telephone survey was conducted with patients attending all public specialist outpatient clinics in Hong Kong between July and December 2014. The Specialist Outpatient Patient Experience Questionnaire and EQ-5D questionnaire were used to evaluate shared decision-making and quality of life, respectively. We performed a Tobit regression analysis to examine the associations between shared decision-making and quality of life after adjustment for known social, economic and health-related factors. Twenty-six of the Hospital Authority's specialist outpatient clinics. Patients aged 18 years or older who attended one of the Hospital Authority's specialist outpatient clinics between July and November 2014. Shared decision-making and quality of life score. Overall, 13 966 patients completed the study. The group reporting partial involvement in decision-making had slightly higher EQ-5D scores than the 'not involved' group and the 'fully involved' group. EQ-5D scores were higher among subjects who were younger, male, and had a higher level of education. Respondents living alone and living in institutions scored lower on the EQ-5D than patients living with families. Important differences in the relationship between the attitudes towards shared decision-making and quality of life were identified among patients. These associations should be taken into consideration when promoting patient-centred care and improving health professional-patient communication. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[Profesionalismo en médicos de un hospital de segundo nivel].

PubMed

Prieto-Miranda, Sergio Emilio; Jiménez-Bernardino, Carlos Alberto; Monjaraz-Guzmán, Elizabeth Guadalupe; Esparza-Pérez, Ramiro Israel

2017-01-01

It takes many years to acquire abilities and technical skills necessary to do a good work as a doctor and even more years, for being "good professionals". Much of this training is based on old teaching schemes, but medicine has changed. So far no studies in our medium addressing the problem are known. The aim of this paper was to determine the level of professionalism in physicians that work in a second-level hospital. Descriptive cross-sectional study. We apply a survey to physicians, residents and medical interns in a second-level hospital. We developed and implemented a questionnaire on professionalism, which contained 18 items, 3 demographic questions and 15 questions with a Likert scale, which identified four dimensions: specialized knowledge, autonomy in decision-making, self-regulation and social commitment. Descriptive and inferential statistics were used, considering significant a p-value <0.05. We surveyed 228 physicians, 57.5% demonstrated competence in professionalism. 93.3% of the participants were competent in specialized knowledge and 60.5% in social commitment. The physicians and residents got the higher scores, and these differences were significant between autonomy in decision-making and specialized knowledge (p < 0.001). The medical interns obtained lower scores in all dimensions compared with residents and physicians. More than a half of physicians surveyed had a competent level of professionalism but only in some dimensions. We observed higher scores with a higher academic grade.

Decision Guidance for Sustainable Manufacturing

ERIC Educational Resources Information Center

Shao, Guodong

2013-01-01

Sustainable manufacturing has significant impacts on a company's business performance and competitiveness in today's world. A growing number of manufacturing industries are initiating efforts to address sustainability issues; however, to achieve a higher level of sustainability, manufacturers need methodologies for formally describing, analyzing,…

Recent Developments in the Law.

ERIC Educational Resources Information Center

Journal of Law and Education, 1983

1983-01-01

An overview of recent court decisions on prayer in public schools is followed by brief synopses of cases in nine areas concerning primary and secondary levels and four areas concerning higher education. Finally, law review articles on federal and state issues are summarized. (MD)

Systems Analysis and Design for Decision Support Systems on Economic Feasibility of Projects

NASA Astrophysics Data System (ADS)

Balaji, S. Arun

2010-11-01

This paper discuss about need for development of the Decision Support System (DSS) software for economic feasibility of projects in Rwanda, Africa. The various economic theories needed and the corresponding formulae to compute payback period, internal rate of return and benefit cost ratio of projects are clearly given in this paper. This paper is also deals with the systems flow chart to fabricate the system in any higher level computing language. The various input requirements from the projects and the output needed for the decision makers are also included in this paper. The data dictionary used for input and output data structure is also explained.

[Correlation of resistance to peer pressure and risky decision-making with adolescent health risk behaviors].

PubMed

An, Jing; Sun, Ying; Wang, Xi; Zu, Ping; Mai, Jin-cheng; Liang, Jian-ping; Xu, Zhi-yong; Man, Xue-jun; Mao, Yan; Tao, Fang-biao

2013-03-01

To explore possible interrelationships among resistance to peer pressure, risky decision-making and health risk behaviors among young adolescents. Based on the cluster sampling method, the participants who were recruited from 5 junior middle schools in Guangzhou and 3 junior middle schools in Shenyang city on October, 2010, were administered to complete the questionnaire concerned with their experiences with drinking and smoking during the past 30 days preceding the survey, and the hours using computer daily both in weekdays and in weekend. The level of resistance to peer influence and risky decision-making were assessed by Resistance to peer influence scale (RPIS) and Youth decision-making questionnaire (YDMQ). Logistic regression was used to explore possible interrelationships among resistance to peer influence, risky decision-making and health risk behaviors among young adolescents. A total of 1985 questionnaires were valid, including 1001(50.4%) boys and 984 (49.6%) girls. About 27.1% (537/1985) junior middle school students reported having health risk behaviors, boys' (30.7%, 307/1001) was higher than girls' (23.4%, 230/984) with significant gender difference (P < 0.05). The prevalence of smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend were 5.1% (102/1985), 14.3% (284/1985), 3.5% (70/1985) and 13.7% (272/1985), respectively. The rate of drinking, using computer over 3 hours daily in weekdays and in weekend were higher in males (16.4% (164/1001), 4.5% (45/1001), 16.2% (162/1001)) than those in females (12.2% (120/984), 2.5% (25/984), 11.2% (110/984)) (P < 0.05). The scores of RPIS and YDMQ of the two cities adolescents were 2.82 ± 0.39 and 1.68 ± 0.62. The students reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekend gained lower RPIS scores (2.43 ± 0.40, 2.61 ± 0.41, 2.77 ± 0.40) than their counterparts who didn't report these kind of health risk behaviors (2.84 ± 0.38, 2.85 ± 0.38, 2.82 ± 0.39)(P < 0.05). And those reported smoking, drinking during the past 30 days before the survey and using computer over 3 hours daily in weekdays and in weekend gained higher YDMQ scores (2.38 ± 0.66, 2.06 ± 0.66, 1.97 ± 0.72, 1.84 ± 0.64, respectively) than their counterparts who didn't report these kind of health risk behaviors (1.64 ± 0.38, 1.61 ± 0.58, 1.67 ± 0.61, 1.65 ± 0.61, respectively) (P < 0.05). After adjusting gender, area, parental education degree, self-reported family economic condition, multi-variant logistic regression analysis indicated that the low and middle level of resistance to peer influence (low and middle level vs high level, had odds ratios of 2.97 (1.96 - 4.50) and 1.51 (1.05 - 2.16)), and also the middle and high level of risky decision-making (middle and high level vs low level, had odds ratios of 1.62 (1.19 - 2.22) and 3.43 (2.39 - 4.90)) were all the risk factors of adolescent health risk behaviors. Adolescents with poor ability of resistance to peer pressure and high risky decision-making were both the risk factors of adolescent health risk behaviors.

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

PubMed

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

2009-10-07

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

40 CFR Appendix Ix to Part 261 - Wastes Excluded Under §§ 260.20 and 260.22

Code of Federal Regulations, 2011 CFR

2011-07-01

... delisting level established in Condition (1), or is at a level in the ground water or soil higher than the... violation of the delisting petition and a possible revocation of the decision. Ampex Recording Media... using distilled water. (B) Organics: Benzene, 0.87 ppm; Benzo(a)anthracene, 0.10 ppm; Benzo(a)pyrene, 0...

Understanding enrolment in community health insurance in sub-Saharan Africa: a population-based case-control study in rural Burkina Faso.

PubMed Central

De Allegri, Manuela; Kouyaté, Bocar; Becher, Heiko; Gbangou, Adjima; Pokhrel, Subhash; Sanon, Mamadou; Sauerborn, Rainer

2006-01-01

OBJECTIVE: To identify factors associated with decision to enrol in a community health insurance (CHI) scheme. METHODS: We conducted a population-based case-control study among 15 communities offered insurance in 2004 in rural Burkina Faso. For inclusion in the study, we selected all 154 enrolled (cases) and a random sample of 393 non-enrolled (controls) households. We used unconditional logistic regression (applying Huber-White correction to account for clustering at the community level) to explore the association between enrolment status and a set of household head, household and community characteristics. FINDINGS: Multivariate analysis revealed that enrolment in CHI was associated with Bwaba ethnicity, higher education, higher socioeconomic status, a negative perception of the adequacy of traditional care, a higher proportion of children living within the household, greater distance from the health facility, and a lower level of socioeconomic inequality within the community, but not with household health status or previous household health service utilization. CONCLUSION: Our study provides evidence that the decision to enrol in CHI is shaped by a combination of household head, household, and community factors. Policies aimed at enhancing enrolment ought to act at all three levels. On the basis of our findings, we discuss specific policy recommendations and highlight areas for further research. PMID:17143458

Algorithm for decision support as the tool for control system of industries with variable assortment of products

NASA Astrophysics Data System (ADS)

Ladaniuk, Anatolii; Ivashchuk, Viacheslav; Kisała, Piotr; Askarova, Nursanat; Sagymbekova, Azhar

2015-12-01

Conditions of diversification of enterprise products are involving for changes of higher levels of management hierarchy, so it's leading by tasks correcting and changing schedule for operating of production plans. Ordinary solve by combination of enterprise resource are planning and management execution system often has exclusively statistical content. So, the development of decision support system, that helps to use knowledge about subject for capabilities estimating and order of operation of production object is relevant in this time.

The time-course of lexical activation in Japanese morphographic word recognition: evidence for a character-driven processing model.

PubMed

Miwa, Koji; Libben, Gary; Dijkstra, Ton; Baayen, Harald

2014-01-01

This lexical decision study with eye tracking of Japanese two-kanji-character words investigated the order in which a whole two-character word and its morphographic constituents are activated in the course of lexical access, the relative contributions of the left and the right characters in lexical decision, the depth to which semantic radicals are processed, and how nonlinguistic factors affect lexical processes. Mixed-effects regression analyses of response times and subgaze durations (i.e., first-pass fixation time spent on each of the two characters) revealed joint contributions of morphographic units at all levels of the linguistic structure with the magnitude and the direction of the lexical effects modulated by readers' locus of attention in a left-to-right preferred processing path. During the early time frame, character effects were larger in magnitude and more robust than radical and whole-word effects, regardless of the font size and the type of nonwords. Extending previous radical-based and character-based models, we propose a task/decision-sensitive character-driven processing model with a level-skipping assumption: Connections from the feature level bypass the lower radical level and link up directly to the higher character level.

How Awareness Changes the Relative Weights of Evidence During Human Decision-Making

PubMed Central

Lamme, Victor A. F.; Dehaene, Stanislas

2011-01-01

Human decisions are based on accumulating evidence over time for different options. Here we ask a simple question: How is the accumulation of evidence affected by the level of awareness of the information? We examined the influence of awareness on decision-making using combined behavioral methods and magneto-encephalography (MEG). Participants were required to make decisions by accumulating evidence over a series of visually presented arrow stimuli whose visibility was modulated by masking. Behavioral results showed that participants could accumulate evidence under both high and low visibility. However, a top-down strategic modulation of the flow of incoming evidence was only present for stimuli with high visibility: once enough evidence had been accrued, participants strategically reduced the impact of new incoming stimuli. Also, decision-making speed and confidence were strongly modulated by the strength of the evidence for high-visible but not low-visible evidence, even though direct priming effects were identical for both types of stimuli. Neural recordings revealed that, while initial perceptual processing was independent of visibility, there was stronger top-down amplification for stimuli with high visibility than low visibility. Furthermore, neural markers of evidence accumulation over occipito-parietal cortex showed a strategic bias only for highly visible sensory information, speeding up processing and reducing neural computations related to the decision process. Our results indicate that the level of awareness of information changes decision-making: while accumulation of evidence already exists under low visibility conditions, high visibility allows evidence to be accumulated up to a higher level, leading to important strategical top-down changes in decision-making. Our results therefore suggest a potential role of awareness in deploying flexible strategies for biasing information acquisition in line with one's expectations and goals. PMID:22131904

How awareness changes the relative weights of evidence during human decision-making.

PubMed

de Lange, Floris P; van Gaal, Simon; Lamme, Victor A F; Dehaene, Stanislas

2011-11-01

Human decisions are based on accumulating evidence over time for different options. Here we ask a simple question: How is the accumulation of evidence affected by the level of awareness of the information? We examined the influence of awareness on decision-making using combined behavioral methods and magneto-encephalography (MEG). Participants were required to make decisions by accumulating evidence over a series of visually presented arrow stimuli whose visibility was modulated by masking. Behavioral results showed that participants could accumulate evidence under both high and low visibility. However, a top-down strategic modulation of the flow of incoming evidence was only present for stimuli with high visibility: once enough evidence had been accrued, participants strategically reduced the impact of new incoming stimuli. Also, decision-making speed and confidence were strongly modulated by the strength of the evidence for high-visible but not low-visible evidence, even though direct priming effects were identical for both types of stimuli. Neural recordings revealed that, while initial perceptual processing was independent of visibility, there was stronger top-down amplification for stimuli with high visibility than low visibility. Furthermore, neural markers of evidence accumulation over occipito-parietal cortex showed a strategic bias only for highly visible sensory information, speeding up processing and reducing neural computations related to the decision process. Our results indicate that the level of awareness of information changes decision-making: while accumulation of evidence already exists under low visibility conditions, high visibility allows evidence to be accumulated up to a higher level, leading to important strategical top-down changes in decision-making. Our results therefore suggest a potential role of awareness in deploying flexible strategies for biasing information acquisition in line with one's expectations and goals.

Effects of reflection on clinical decision-making of intensive care unit nurses.

PubMed

Razieh, Shahrokhi; Somayeh, Ghafari; Fariba, Haghani

2018-07-01

Nurses are one of the most influential factors in overcoming the main challenges faced by health systems throughout the world. Every health system should, hence, empower nurses in clinical judgment and decision-making skills. This study evaluated the effects of implementing Tanner's reflection method on clinical decision-making of nurses working in an intensive care unit (ICU). This study used an experimental, pretest, posttest design. The setting was the intensive care unit of Amin Hospital Isfahan, Iran. The convenience sample included 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). This clinical trial was performed on 60 nurses working in the ICU of Amin Hospital (Isfahan, Iran). The nurses were selected by census sampling and randomly allocated to either the case or the control group. Data were collected using a questionnaire containing demographic characteristics and the clinical decision-making scale developed by Laurie and Salantera (NDMI-14). The questionnaire was completed before and one week after the intervention. The data were analyzed using SPSS 21.0. The two groups were not significantly different in terms of the level and mean scores of clinical decision-making before the intervention (P = 0.786). Based on the results of independent t-test, the mean score of clinical decision-making one week after the intervention was significantly higher in the case group than in the control group (P = 0.009; t = -2.69). The results of Mann Whitney test showed that one week after the intervention, the nurses' level of clinical decision-making in the case group rose to the next level (P = 0.001). Reflection could improve the clinical decision-making of ICU nurses. It is, thus, recommended to incorporate this method into the nursing curriculum and care practices. Copyright © 2018. Published by Elsevier Ltd.

Defining the Pathways of Parental Decision-making and Satisfaction Levels About Newborn Circumcision in a Setting Where Traditional Male Circumcision is Prevalent: An Online Survey Study.

PubMed

Özveren, Bora

2016-04-01

To investigate the decision-making attitudes, course of informed consent, and satisfaction levels of parents who opted for newborn circumcision (NC) in a societal setting where the timing of circumcision is generally determined by tradition. Online questionnaire was sent to 1235 parents of boys who had NC. The response rate was 50.4%. The final decision of newborn circumcision depended on the mother in 51.47%. Nearly 75% of circumcisions were performed before hospital discharge. The most common (70.65%) reported reason for parents' choice was medical/hygienic. When evaluating their decision, 93.05% refused any feelings of regret and 96.26% stated they would decide the same if they had another son. The source of information on newborn circumcision was mostly physicians (39.27%), followed by friends and family (31.2%). Parental preference, having nonreligious motives, and being previously informed about the procedure by experienced peers appeared as significant factors on the decision regarding timing of NC. In total, 79.90% ranked their satisfaction level as "very satisfied" on a Likert scale. The mean rate of satisfaction was significantly higher in parents who acquired previous information from healthcare providers and who acknowledged sufficient preprocedural counseling before giving consent. In a society where the timing of circumcision is usually determined by faiths and traditions, parental decision-making on newborn circumcision is greatly influenced by personal choices of parents, based on timely, accurate, and adequate information received from peers and healthcare providers. Medical providers play an important role on the informed decision of parents and impact on satisfaction with prior decision and outcomes of newborn circumcision. Copyright © 2016 Elsevier Inc. All rights reserved.

Informed decision making before prostate-specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men.

PubMed

Gökce, Mehmet I; Wang, Xuemei; Frost, Jacqueline; Roberson, Pamela; Volk, Robert J; Brooks, Durado; Canfield, Steven E; Pettaway, Curtis A

2017-02-15

The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM). A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014. The ACS-DA was presented in a group format. Levels of knowledge on PCa were evaluated before and after the presentation. Participants' decisional conflict and thoughts about the presentation also were evaluated. Logistic regression analyses were performed to determine factors associated with having an adequate level of knowledge. Before receiving the ACS-DA, 33.1% of participants had adequate knowledge on PCa, and this increased to 77% after the DA (P < .0001). On multivariate analysis, higher education level (odds ratio, 11.19; P = .001) and history of another cancer (odds ratio, 7.45; P = .03) were associated with having adequate knowledge after receiving the DA. Levels of decisional conflict were low and were correlated with levels of knowledge after receiving the DA. The majority of men also rated the presentation as favorable and would recommend the ACS-DA to others. Use of the ACS-DA was feasible among MUM and led to increased PCa knowledge. This also correlated with low levels of decisional conflict. The ACS-DA presented to groups of men may serve as a feasible tool for informed decision making in a MUM population. Cancer 2017;123:583-591. © 2016 American Cancer Society. © 2016 American Cancer Society.

[Emigration of Quebec physicians: motivation for departure and return].

PubMed

Leduc, N; Bilodeau, H; Contandriopoulos, A P; Sainte-Marie, G; Fournier, M A; Dandavino, A

2001-01-01

Since the 80's, outmigration of physicians from Quebec is steadily increasing. About 46 percent of outmigrating doctors explain their move by factors related to their occupational life (higher income, greater opportunity in the academic career, larger amount of resources devoted to the health care system). Nearly 40 percent relate their decision to personal factors (greater job opportunity for their wife/husband, quality of family life...). The factors linked to the context of the receiving place (political climate, linguistic regulations, income tax level...) play a minor role on the migration decision. As concerns the returning physicians, 80 percent explain their decision by personal factors. The factors linked to the occupational life have a lower role. It appears therefore that doctor outmigration from Quebec is not directly determined by manpower policies adopted by the Province during the last two decades, except the policies directly linked to the income level of professionals.

Stress in telephone helpline nurses is associated with failures of concentration, attention and memory, and with more conservative referral decisions.

PubMed

Allan, Julia L; Farquharson, Barbara; Johnston, Derek W; Jones, Martyn C; Choudhary, Carolyn J; Johnston, Marie

2014-05-01

Nurses working for telephone-based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information-processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress-reduction interventions could improve the quality and safety of care that callers to medical helplines receive. © 2013 The British Psychological Society.

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

PubMed

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

2015-03-13

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

Women's decision-making autonomy and children's schooling in rural Mozambique.

PubMed

Luz, Luciana; Agadjanian, Victor

2015-03-24

Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.

The impact of the Rasouli decision: a Survey of Canadian intensivists.

PubMed

Cape, David; Fox-Robichaud, Alison; Turgeon, Alexis F; Seely, Andrew; Hall, Richard; Burns, Karen; Singal, Rohit K; Dodek, Peter; Bagshaw, Sean; Sibbald, Robert; Downar, James

2016-03-01

In a landmark 2013 decision, the Supreme Court of Canada (SCC) ruled that the withdrawal of life support in certain circumstances is a treatment requiring patient or substitute decision maker (SDM) consent. How intensive care unit (ICU) physicians perceive this ruling is unknown. To determine physician knowledge of and attitudes towards the SCC decision, as well as the self-reported changes in practice attributed to the decision. We surveyed intensivists at university hospitals across Canada. We used a knowledge test and Likert-scale questions to measure respondent knowledge of and attitudes towards the ruling. We used vignettes to assess decision making in cases of intractable physician-SDM conflict over the management of patients with very poor prognoses. We compared management choices pre-SCC decision versus post-SCC decision versus the subjective, respondent-defined most appropriate choice. Responses were compared across predefined subgroups. We performed qualitative analysis on free-text responses. We received 82 responses (response rate=42%). Respondents reported providing high levels of self-defined inappropriate treatment. Although most respondents reported no change in practice, there was a significant overall shift towards higher intensity and less subjectively appropriate management after the SCC decision. Attitudes to the SCC decision and approaches to disputes over end-of-life (EoL) care in the ICU were highly variable. There were no significant differences among predefined subgroups. Many Canadian ICU physicians report providing a higher intensity of treatment, and less subjectively appropriate treatment, in situations of dispute over EoL care after the Supreme Court of Canada's ruling in Cuthbertson versus Rasouli. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Workplace Vaccination and Other Factors Impacting Influenza Vaccination Decision among Employees in Israel

PubMed Central

Shahrabani, Shosh; Benzion, Uri

2010-01-01

The study examined the factors affecting the decision to be vaccinated against influenza among employees in Israel. The research, conducted in 2007/2008, included 616 employees aged 18−65 at various workplaces in Israel, among them companies that offered their employees influenza vaccination. The research questionnaire included socio-demographic characteristics, and the Health Belief Model principles. The results show that the significant factors affecting vaccination compliance include a vaccination program at workplaces, vaccinations in the past, higher levels of vaccine’s perceived benefits, and lower levels of barriers to getting the vaccine. We conclude that vaccine compliance is larger at companies with workplace vaccination programs providing easier accessibility to vaccination. PMID:20617008

The effect of education debt on dentists' career decisions.

PubMed

Nicholson, Sean; Vujicic, Marko; Wanchek, Tanya; Ziebert, Anthony; Menezes, Adriana

2015-11-01

The purpose of the study was to determine whether there is an association between the amount of education debt on completing dental school (initial debt) and certain career decisions. The authors surveyed 1,842 practicing dentists who completed dental school between 1996 and 2011 to ascertain their initial education debt, the balance on their debt in 2013, and a variety of specialization and practice decisions made during their careers. Data also included demographic characteristics and parental income and education levels. Dentists with higher initial debt were less likely to specialize and more likely to enter private practice, accept high-paying jobs on graduation, and work longer hours. Choice of employment setting, practice ownership, and whether to provide Medicaid and charity care were associated with dentists' sexes and races but not debt. High debt levels influenced some career decisions, but the magnitude of these effects was small compared with the effects of demographic characteristics, including race and sex, on career choices. Policy makers concerned about the influence of student debt on the professional decisions of dental school graduates should recognize that students' demographic characteristics may be more powerful in driving career choices. Copyright © 2015 American Dental Association. Published by Elsevier Inc. All rights reserved.

A multichannel decision-level fusion method for T wave alternans detection

NASA Astrophysics Data System (ADS)

Ye, Changrong; Zeng, Xiaoping; Li, Guojun; Shi, Chenyuan; Jian, Xin; Zhou, Xichuan

2017-09-01

Sudden cardiac death (SCD) is one of the most prominent causes of death among patients with cardiac diseases. Since ventricular arrhythmia is the main cause of SCD and it can be predicted by T wave alternans (TWA), the detection of TWA in the body-surface electrocardiograph (ECG) plays an important role in the prevention of SCD. But due to the multi-source nature of TWA, the nonlinear propagation through thorax, and the effects of the strong noises, the information from different channels is uncertain and competitive with each other. As a result, the single-channel decision is one-sided while the multichannel decision is difficult to reach a consensus on. In this paper, a novel multichannel decision-level fusion method based on the Dezert-Smarandache Theory is proposed to address this issue. Due to the redistribution mechanism for highly competitive information, higher detection accuracy and robustness are achieved. It also shows promise to low-cost instruments and portable applications by reducing demands for the synchronous sampling. Experiments on the real records from the Physikalisch-Technische Bundesanstalt diagnostic ECG database indicate that the performance of the proposed method improves by 12%-20% compared with the one-dimensional decision method based on the periodic component analysis.

Improving the cost-effectiveness of IRS with climate informed health surveillance systems

PubMed Central

Worrall, Eve; Connor, Stephen J; Thomson, Madeleine C

2008-01-01

Background This paper examines how the cost-effectiveness of IRS varies depending on the severity of transmission and level of programme coverage and how efficiency could be improved by incorporating climate information into decision making for malaria control programmes as part of an integrated Malaria Early Warning and Response System (MEWS). Methods A climate driven model of malaria transmission was used to simulate cost-effectiveness of alternative IRS coverage levels over six epidemic and non-epidemic years. Decision rules for a potential MEWS system that triggers different IRS coverage are described. The average and marginal cost per case averted with baseline IRS coverage (24%) and under varying IRS coverage levels (50%, 75% and 100%) were calculated. Results Average cost-effectiveness of 24% coverage varies dramatically between years, from US$108 per case prevented in low transmission to US$0.42 in epidemic years. Similarly for higher coverage (24–100%) cost per case prevented is far higher in low than high transmission years ($108–$267 to $0.88–$2.26). Discussion Efficiency and health benefit gains could be achieved by implementing MEWS that provides timely, accurate information. Evidence from southern Africa, (especially Botswana) supports this. Conclusion Advance knowledge of transmission severity can help managers make coverage decisions which optimise resource use and exploit efficiency gains if a fully integrated MEWS is in place alongside a health system with sufficient flexibility to modify control plans in response to information. More countries and programmes should be supported to use the best available evidence and science to integrate climate informed MEWS into decision making within malaria control programmes. PMID:19108723

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

PubMed

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

2006-12-01

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

Affective decision-making and externalizing behaviors: the role of autonomic activity.

PubMed

Bubier, Jennifer L; Drabick, Deborah A G

2008-08-01

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.

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

PubMed

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

2018-07-01

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

Behavioral Ethics and Teaching Ethical Decision Making

ERIC Educational Resources Information Center

Drumwright, Minette; Prentice, Robert; Biasucci, Cara

2015-01-01

Business education often renders students less likely to act ethically. An infusion of liberal learning in the form of behavioral ethics could improve this situation by prompting students to develop higher levels of professionalism that encompass ethics, social responsibility, self-critical reflection, and personal accountability. More…

Adolescent neural response to reward is related to participant sex and task motivation

PubMed Central

Alarcón, Gabriela; Cservenka, Anita; Nagel, Bonnie J.

2017-01-01

Risky decision making is prominent during adolescence, perhaps contributed to by heightened sensation seeking and ongoing maturation of reward and dopamine systems in the brain, which are, in part, modulated by sex hormones. In this study, we examined sex differences in the neural substrates of reward sensitivity during a risky decision-making task and hypothesized that compared with girls, boys would show heightened brain activation in reward-relevant regions, particularly the nucleus accumbens, during reward receipt. Further, we hypothesized that testosterone and estradiol levels would mediate this sex difference. Moreover, we predicted boys would make more risky choices on the task. While boys showed increased nucleus accumbens blood oxygen level-dependent (BOLD) response relative to girls, sex hormones did not mediate this effect. As predicted, boys made a higher percentage of risky decisions during the task. Interestingly, boys also self-reported more motivation to perform well and earn money on the task, while girls self-reported higher state anxiety prior to the scan session. Motivation to earn money partially mediated the effect of sex on nucleus accumbens activity during reward. Previous research shows that increased motivation and salience of reinforcers is linked with more robust striatal BOLD response, therefore psychosocial factors, in addition to sex, may play an important role in reward sensitivity. Elucidating neurobiological mechanisms that support adolescent sex differences in risky decision making has important implications for understanding individual differences that lead to advantageous and adverse behaviors that affect health outcomes. PMID:27816780

Contextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.

PubMed

McRobert, Allistair Paul; Causer, Joe; Vassiliadis, John; Watterson, Leonie; Kwan, James; Williams, Mark A

2013-06-01

It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. Skilled (n=9) and less skilled (n=9) emergency medicine physicians responded to high-fidelity simulated scenarios under high- and low-context information conditions. Skilled physicians demonstrated higher diagnostic accuracy irrespective of condition, and were less affected by the removal of context-specific information compared with less skilled physicians. The skilled physicians generated more options, and selected better quality options during diagnostic reasoning compared with less skilled counterparts. These cognitive processes were active irrespective of the level of context-specific information presented, although high-context information enhanced understanding of the patients' symptoms resulting in higher diagnostic accuracy. Our findings have implications for scenario design and the manipulation of contextual information during simulation training.

Perceived need for information among patients with a haematological malignancy: associations with information satisfaction and treatment decision-making preferences.

PubMed

Rood, Janneke A J; van Zuuren, Florence J; Stam, Frank; van der Ploeg, Tjeerd; Eeltink, Corien; Verdonck-de Leeuw, Irma M; Huijgens, Peter C

2015-06-01

For patients with haematological malignancies, information on disease, prognosis, treatment and impact on quality of life is of the utmost importance. To gain insight into the perceived need for information in relation to sociodemographic and clinical parameters, comorbidity, quality of life (QoL) and information satisfaction, we compiled a questionnaire based on existing validated questionnaires. A total of 458 patients diagnosed with a haematological malignancy participated. The perceived need for information was moderate to high (40-70%). Multivariate regression analyses showed that a higher need for information was related to younger age, worse QoL, being member of a patient society and moderate comorbidity. The need for disease and treatment-related information was higher than the need for psychosocial information. A higher need for disease and treatment-related information was associated to being diagnosed with multiple myeloma. A higher need for psychosocial information was related to a lower educational level. The information provision could be improved according to 41% of the patients. Higher satisfaction with provided information was associated with better QoL. Most patients (62%) reported that they wanted to be fully informed about their illness and actively involved in treatment decision-making. The results contribute to improving patient-tailored information provision and shared decision-making in clinical practice. Copyright © 2014 John Wiley & Sons, Ltd.

Risk of predation makes foragers less choosy about their food.

PubMed

Charalabidis, Alice; Dechaume-Moncharmont, François-Xavier; Petit, Sandrine; Bohan, David A

2017-01-01

Animals foraging in the wild have to balance speed of decision making and accuracy of assessment of a food item's quality. If resource quality is important for maximizing fitness, then the duration of decision making may be in conflict with other crucial and time consuming tasks, such as anti-predator behaviours or competition monitoring. Individuals facing the risk of predation and/or competition should adjust the duration of decision making and, as a consequence, their level of choosiness for resources. When exposed to predation, the forager could either maintain its level of choosiness for food items but accept a reduction in the amount of food items consumed or it could reduce its level of choosiness and accept all prey items encountered. Under competition risk, individuals are expected to reduce their level of choosiness as slow decision making exposes individuals to a higher risk of opportunity costs. To test these predictions, the level of choosiness of a seed-eating carabid beetle, Harpalus affinis, was examined under 4 different experimental conditions of risk: i) predation risk; ii) intraspecific competition; iii) interspecific competition; and, iv) control. All the risks were simulated using chemical cues from individual conspecifics or beetles of different species that are predatory or granivorous. Our results show that when foraging under the risk of predation, H. affinis individuals significantly reduce their level of choosiness for seeds. Reductions in level of choosiness for food items might serve as a sensible strategy to reduce both the total duration of a foraging task and the cognitive load of the food quality assessment. No significant differences were observed when individuals were exposed to competition cues. Competition, (i.e opportunity cost) may not be perceived as risk high enough to induce changes in the level of choosiness. Our results suggest that considering the amount of items consumed, alone, would be a misleading metric when assessing individual response to a risk of predation. Foraging studies should therefore also take in account the decision making process.

Human perceptual decision making: disentangling task onset and stimulus onset.

PubMed

Cardoso-Leite, Pedro; Waszak, Florian; Lepsien, Jöran

2014-07-01

The left dorsolateral prefrontal cortex (ldlPFC) has been highlighted as a key actor in human perceptual decision-making (PDM): It is theorized to support decision-formation independently of stimulus type or motor response. PDM studies however generally confound stimulus onset and task onset: when the to-be-recognized stimulus is presented, subjects know that a stimulus is shown and can set up processing resources-even when they do not know which stimulus is shown. We hypothesized that the ldlPFC might be involved in task preparation rather than decision-formation. To test this, we asked participants to report whether sequences of noisy images contained a face or a house within an experimental design that decorrelates stimulus and task onset. Decision-related processes should yield a sustained response during the task, whereas preparation-related areas should yield transient responses at its beginning. The results show that the brain activation pattern at task onset is strikingly similar to that observed in previous PDM studies. In particular, they contradict the idea that ldlPFC forms an abstract decision and suggest instead that its activation reflects preparation for the upcoming task. We further investigated the role of the fusiform face areas and parahippocampal place areas which are thought to be face and house detectors, respectively, that feed their signals to higher level decision areas. The response patterns within these areas suggest that this interpretation is unlikely and that the decisions about the presence of a face or a house in a noisy image might instead already be computed within these areas without requiring higher-order areas. Copyright © 2013 Wiley Periodicals, Inc.

Collective decision-making in microbes

PubMed Central

Ross-Gillespie, Adin; Kümmerli, Rolf

2014-01-01

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

The Impact of Telemedicine on Pediatric Critical Care Triage.

PubMed

Harvey, Jillian B; Yeager, Brooke E; Cramer, Christina; Wheeler, David; McSwain, S David

2017-11-01

To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. Retrospective evaluation of consultations occurring between April 2012 and March 2016. Pediatric critical care telemedicine and telephone consultations in 52 rural healthcare settings in South Carolina. Pediatric patients receiving critical care telemedicine or telephone consultations. Telemedicine consultations. Data were collected from the consulting provider for 484 total consultations by telephone or telemedicine. We examined the providers' self-reported assessments about the consultation, decision-making, and triage outcomes. We estimate a logit model to predict triage location as a function of telemedicine consult age and sex. For telemedicine patients, the odds of triage to a non-ICU level of care are 2.55 times larger than the odds for patients receiving telephone consultations (p = 0.0005). Providers rated the accuracy of their assessments higher when consultations were provided via telemedicine. When patients were transferred to a non-ICU location following a telemedicine consultation, providers indicated that the use of telemedicine influenced the triage decision in 95.7% of cases (p < 0.001). For patients transferred to a non-ICU location, an increase in transfers to a higher level of care within 24 hours was not observed. Pediatric critical care telemedicine consultation to community hospitals is feasible and results in a reduction in PICU admissions. This study demonstrates an improvement in provider-reported accuracy of patient assessment via telemedicine compared with telephone, which may produce a higher comfort level with transporting patients to a lower level of care. Pediatric critical care telemedicine consultations represent a promising means of improving care and reducing costs for critically ill children in rural areas.

Affective decision-making deficits, linked to a dysfunctional ventromedial prefrontal cortex, revealed in 10th-grade Chinese adolescent smokers

PubMed Central

Xiao, Lin; Bechara, Antoine; Cen, Steven; Grenard, Jerry L.; Stacy, Alan W.; Gallaher, Peggy; Wei, Yonglan; Jia, Yong; Johnson, C. Anderson

2008-01-01

This study addressed the question of whether poor decision making would be associated with adolescent past 7-day smoking. We conducted a cross-sectional study of 208 10th-grade adolescents in Chengdu City, China. We used the Iowa Gambling Task (IGT) to assess decision-making, and the Self-ordered Pointing Task (SOPT) to assess working memory capacity. Paper and pencil questionnaires assessed the school academic performance (SAP) and smoking variables. The results showed that a significantly higher proportion of past 7-day smokers (91.7%) were susceptible to future smoking and cigarette offers from best friends compared to other levels of smokers (never, ever and past 30-day smokers). Consistent with these behavioral data, the neuropsychological assessments revealed that relative to never smokers, past 7-day adolescent smokers (but not ever smokers or past 30-day smokers) demonstrated significantly lower scores on the IGT. Moreover, a higher proportion of past 7-day smokers (91.7%) performed poorly (no more than an overall net score of 10) on the IGT than nonsmokers and irregular (ever or past 30-day) smokers (about 65.3%). There were no differences on working memory performance for smokers (at any level) compared to never smokers after adjusting for school-type. In addition, logistic regression showed that the IGT significantly predicted past 7-day smoking after controlling for the working memory, school academic performance and demographic variables. These results suggest that poor affective decision making might predispose some adolescents to smoking in the future or in the social situations where their peers are smoking. Intervention targeting affective decision making might hold promise for reducing adolescents’ risks for substance use. PMID:18584472

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

PubMed

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

2012-12-01

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

Rewards boost sustained attention through higher effort: A value-based decision making approach.

PubMed

Massar, Stijn A A; Lim, Julian; Sasmita, Karen; Chee, Michael W L

2016-10-01

Maintaining sustained attention over time is an effortful process limited by finite cognitive resources. Recent theories describe the role of motivation in the allocation of such resources as a decision process: the costs of effortful performance are weighed against its gains. We examined this hypothesis by combining methods from attention research and decision neuroscience. Participants first performed a sustained attention task at different levels of reward. They then performed a reward-discounting task, measuring the subjective costs of performance. Results demonstrated that higher rewards led to improved performance (Exp 1-3), and enhanced attentional effort (i.e. pupil diameter; Exp 2 & 3). Moreover, discounting curves constructed from the choice task indicated that subjects devalued rewards that came at the cost of staying vigilant for a longer duration (Exp 1 & 2). Motivation can thus boost sustained attention through increased effort, while sustained performance is regarded as a cost against which rewards are discounted. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Internet use and decision making in community-based older adults

PubMed Central

James, Bryan D.; Boyle, Patricia A.; Yu, Lei; Bennett, David A.

2013-01-01

Use of the internet may provide tools and resources for better decision making, yet little is known about the association of internet use with decision making in older persons. We examined this relationship in 661 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Participants were asked to report if they had access to the internet and how frequently they used the internet and email. A 12-item instrument was used to assess financial and healthcare decision making using materials designed to approximate those used in real world settings. Items were summed to yield a total decision making score. Associations were tested via linear regression models adjusted for age, sex, race, education, and a measure of global cognitive function. Secondary models further adjusted for income, depression, loneliness, social networks, social support, chronic medical conditions, instrumental activities of daily living (IADLs), life space size, and health and financial literacy. Interaction terms were used to test for effect modification. Almost 70% of participants had access to the internet, and of those with access, 55% used the internet at least several times a week. Higher frequency of internet use was associated with better financial and healthcare decision making (β = 0.11, p = 0.002). The association persisted in a fully adjusted model (β = 0.08, p = 0.024). Interaction models indicated that higher frequency of internet use attenuated the relationships of older age, poorer cognitive function, and lower levels of health and financial literacy with poorer healthcare and financial decision making. These findings indicate that internet use is associated with better health and financial decision making in older persons. Future research is required to understand whether promoting the use of the internet can produce improvements in healthcare and financial decision making. PMID:24578696

Impulsivity in abstinent early- and late-onset alcoholics: differences in self-report measures and a discounting task.

PubMed

Dom, G; D'haene, P; Hulstijn, W; Sabbe, B

2006-01-01

To test the hypothesis that early-onset alcoholics (EOAs) can be differentiated from late-onset alcoholics (LOAs) by more severe substance-related problems and higher levels of impulsivity and aggression. A cross-sectional patient survey with a community comparison group. The European Addiction Severity Index was used to assess substance-related problems and the Barratt Impulsiveness Scale, the Dutch version of the Zuckermann Sensation Seeking Scale and the Buss-Durkee Hostility Inventory were used to assess impulsive and aggressive traits. Impulsive decision making was assessed using a delay discounting task (DDT) with hypothetical monetary rewards. Participants were EOAs (n = 42) and LOAs (n = 46) recruited from an addiction treatment centre and an unmatched, non-substance-abusing comparison group (n = 54). Findings The EOAs had higher levels of impulsive decision making than both the LOAs and the comparison group. The EOAs had higher scores than the LOAs on measures of impulsiveness, aggressiveness and the severity of substance-related problems. This study provides evidence that EOAs are more impulsive and aggressive than LOAs. Further identification of alcoholism subtypes based on dimensions of impulsivity should be considered in the light of their relationship with pharmacological and behavioural treatment interventions.

High deductible health plans: does cost sharing stimulate increased consumer sophistication?

PubMed

Gupta, Neal; Polsky, Daniel

2015-06-01

To determine whether increased cost sharing in health insurance plans induces higher levels of consumer sophistication in a non-elderly population. This analysis is based on the collection of survey and demographic data collected from enrollees in the RAND health insurance experiment (HIE). During the RAND HIE, enrollees were randomly assigned to different levels of cost sharing (0, 25, 50 and 95%). The study population compromises about 2000 people enrolled in the RAND HIE, between the years 1974 and 1982. Effects on health-care decision making were measured using the results of a standardized questionnaire, administered at the beginning and end of the experiment. Points of enquiry included whether or not enrollees' (i) recognized the need for second opinions (ii) questioned the effectiveness of certain therapies and (iii) researched the background/skill of their medical providers. Consumer sophistication was also measured for regular health-care consumers, as indicated by the presence of a chronic disease. We found no statically significant changes (P < 0.05) in the health-care decision-making strategies between individuals randomized to high cost sharing plans and low cost sharing plans. Furthermore, we did not find a stronger effect for patients with a chronic disease. The evidence from the RAND HIE does not support the hypothesis that a higher level of cost sharing incentivizes the development of consumer sophistication. As a result, cost sharing alone will not promote individuals to become more selective in their health-care decision-making. © 2012 Blackwell Publishing Ltd.

A Preliminary Experimental Examination of Worldview Verification, Perceived Racism, and Stress Reactivity in African Americans

PubMed Central

Lucas, Todd; Lumley, Mark A.; Flack, John M.; Wegner, Rhiana; Pierce, Jennifer; Goetz, Stefan

2016-01-01

Objective According to worldview verification theory, inconsistencies between lived experiences and worldviews are psychologically threatening. These inconsistencies may be key determinants of stress processes that influence cardiovascular health disparities. This preliminary examination considers how experiencing injustice can affect perceived racism and biological stress reactivity among African Americans. Guided by worldview verification theory, it was hypothesized that responses to receiving an unfair outcome would be moderated by fairness of the accompanying decision process, and that this effect would further depend on the consistency of the decision process with preexisting justice beliefs. Method A sample of 118 healthy African American adults completed baseline measures of justice beliefs, followed by a laboratory-based social-evaluative stressor task. Two randomized fairness manipulations were implemented during the task: participants were given either high or low levels of distributive (outcome) and procedural (decision process) justice. Glucocorticoid (cortisol) and inflammatory (C-reactive protein) biological responses were measured in oral fluids, and attributions of racism were also measured. Results The hypothesized 3-way interaction was generally obtained. Among African Americans with a strong belief in justice, perceived racism, cortisol and C-reactive protein responses to low distributive justice were higher when procedural justice was low. Among African Americans with a weak belief in justice however, these responses were higher when a low level of distributive justice was coupled with high procedural justice. Conclusions Biological and psychological processes that contribute to cardiovascular health disparities are affected by consistency between individual-level and contextual justice factors. PMID:27018728

Decision-making of Chinese caregivers for adult out-of-home placement.

PubMed

Marcus, Y L Chiu; Rommel, C H Hung

2006-09-01

In the light of the existence of lengthy waiting lists for out-of-home placements, this study examines the factors affecting the decision to apply or not to apply for this facility in a city traditionally characterized by a cultural and policy emphasis on family responsibility and by relatively low levels of welfare commitment to residential services. A sample of 321 people responsible for providing care for adults with moderate to severe intellectual disability (ID) from 22 service units of seven non-governmental organizations in Hong Kong was surveyed by means of a structured questionnaire. The non-application group reported better emotional ties with the people with ID and greater confidence in their caregiving skills, but also tended to be caring for more challenging people with poorer health and higher or more frequent levels of self-harm behaviour than the application group who exhibited higher levels of worry and fear. Discriminant analysis successfully predicted 80% of non-application cases, while logistic regression revealed that decline in perceived competence to care, absence of other health problems and at least one parent of the client having long-term illness were better predictors of the decision to apply than handicap-specific characteristics of the people with ID themselves. The implications of this finding are discussed, and consideration given to the possibility of developing policies designed to strengthen and treasure family values while not detracting from the importance of providing proper community support.

Integrating Strategic Marketing on an Institutional Level.

ERIC Educational Resources Information Center

Liu, Sandra S.

1998-01-01

Higher education differs from other service enterprises in its social responsibility and the context for decision making. An integrated marketing strategy based on the identified positioning of the institution plays a crucial role in successful enrollment and long-term institutional development. Marketing can make a significant contribution to…

Active vision and image/video understanding with decision structures based on the network-symbolic models

NASA Astrophysics Data System (ADS)

Kuvich, Gary

2003-08-01

Vision is a part of a larger information system that converts visual information into knowledge structures. These structures drive vision process, resolve ambiguity and uncertainty via feedback projections, and provide image understanding that is an interpretation of visual information in terms of such knowledge models. The ability of human brain to emulate knowledge structures in the form of networks-symbolic models is found. And that means an important shift of paradigm in our knowledge about brain from neural networks to "cortical software". Symbols, predicates and grammars naturally emerge in such active multilevel hierarchical networks, and logic is simply a way of restructuring such models. Brain analyzes an image as a graph-type decision structure created via multilevel hierarchical compression of visual information. Mid-level vision processes like clustering, perceptual grouping, separation of figure from ground, are special kinds of graph/network transformations. They convert low-level image structure into the set of more abstract ones, which represent objects and visual scene, making them easy for analysis by higher-level knowledge structures. Higher-level vision phenomena are results of such analysis. Composition of network-symbolic models works similar to frames and agents, combines learning, classification, analogy together with higher-level model-based reasoning into a single framework. Such models do not require supercomputers. Based on such principles, and using methods of Computational intelligence, an Image Understanding system can convert images into the network-symbolic knowledge models, and effectively resolve uncertainty and ambiguity, providing unifying representation for perception and cognition. That allows creating new intelligent computer vision systems for robotic and defense industries.

Information giving and decision-making in patients with advanced cancer: a systematic review.

PubMed

Gaston, Christine M; Mitchell, Geoffrey

2005-11-01

Patients with advanced, non-curable cancer face difficult decisions on further treatment, where a small increase in survival time must be balanced against the toxicity of the treatment. If patients want to be involved in these decisions, in keeping with current notions of autonomy and empowerment, they also require to be adequately informed both on the treatments proposed and on their own disease status and prognosis. A systematic review was performed on decision-making and information provision in patients with advanced cancer. Studies of interventions to improve information giving and encourage participation in decision-making were reviewed, including both randomised controlled trials and uncontrolled studies. Almost all patients expressed a desire for full information, but only about two-thirds wished to participate actively in decision-making. Higher educational level, younger age and female sex were predictive of a desire to participate in decision-making. Active decision-making was more common in patients with certain cancers (e.g. breast) than others (e.g. prostate). A number of simple interventions including question prompt sheets, audio-taping of consultations and patient decision aids have been shown to facilitate such involvement.

Direction of an initial saccade depends on radiological expertise

NASA Astrophysics Data System (ADS)

Pietrzyk, Mariusz W.; McEntee, Mark F.; Evanoff, Michael E.; Brennan, Patrick C.; Mello-Thoms, Claudia R.

2014-03-01

Purpose: To evaluate the role of radiographic details in global impression of chest x-ray images viewed by experts in thoracic and non-thoracic domains. Materials and Methods: The study was approved by IRB. Five thoracic and five non-thoracic radiologists participated in two tachistoscopic (one low pass and one with the entire frequency spectrum, each lasting 270 ms) each containing 50 PA chest radiographs with 50% prevalence of pulmonary nodule. Eye movements were monitored in order to evaluate a pre-saccade shift of visual attention, saccade latency, decision time and the time to first fixation on a pulmonary nodule. Results: Thoracic radiologists showed significantly higher pre-saccadic shift of visual attention towards pulmonary nodules once using the full frequency spectrum (p < 0.05). An initial saccade orientation made by these radiologists on full resolution images correlated at significant level with their confidence ranking of pulmonary nodules (ρ = -0.387, p < 0.001). Conclusions: Thoracic radiologists benefited from high spatial frequency appearance during a rapid presentation of chest radiograph by allocating pre-saccade attention towards pulmonary nodules. This behavior correlated with a higher number of correct decisions, followed by higher confidence in the decisions made, and briefer reaction times.

Military Enlistment and Attrition. An Analysis of Decision Reversal

DTIC Science & Technology

1987-06-01

instability, defined as being unemployed at the time of enlistment or having had a spell of jobless- ness within the past 12 months. For graduates, attrition...opportunities. The level of education an individual obtains is related to the value of higher education to the individual (both monetary and psychic ...value, does suggest that unemployed graduates are more likely to enlist, all other things equal, the higher their previous wage rate. The previous

Affective decision-making moderates the effects of automatic associations on alcohol use among drug offenders.

PubMed

Cappelli, Christopher; Ames, Susan; Shono, Yusuke; Dust, Mark; Stacy, Alan

2017-09-01

This study used a dual-process model of cognition in order to investigate the possible influence of automatic and deliberative processes on lifetime alcohol use in a sample of drug offenders. The objective was to determine if automatic/implicit associations in memory can exert an influence over an individual's alcohol use and if decision-making ability could potentially modify the influence of these associations. 168 participants completed a battery of cognitive tests measuring implicit alcohol associations in memory (verb generation) as well as their affective decision-making ability (Iowa Gambling Task). Structural equation modeling procedures were used to test the relationship between implicit associations, decision-making, and lifetime alcohol use. Results revealed that among participants with lower levels of decision-making, implicit alcohol associations more strongly predicted higher lifetime alcohol use. These findings provide further support for the interaction between a specific decision function and its influence over automatic processes in regulating alcohol use behavior in a risky population. Understanding the interaction between automatic associations and decision processes may aid in developing more effective intervention components.

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

PubMed

Albantakis, Larissa; Deco, Gustavo

2011-06-01

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

Decision conflict and regret among surrogate decision makers in the medical intensive care unit.

PubMed

Miller, Jesse J; Morris, Peter; Files, D Clark; Gower, Emily; Young, Michael

2016-04-01

Family members of critically ill patients in the intensive care unit face significant morbidity. It may be the decision-making process that plays a significant role in the psychological morbidity associated with being a surrogate in the ICU. We hypothesize that family members facing end-of-life decisions will have more decisional conflict and decisional regret than those facing non-end-of-life decisions. We enrolled a sample of adult patients and their surrogates in a tertiary care, academic medical intensive care unit. We queried the surrogates regarding decisions they had made on behalf of the patient and assessed decision conflict. We then contacted the family member again to assess decision regret. Forty (95%) of 42 surrogates were able to identify at least 1 decision they had made on behalf of the patient. End-of-life decisions (defined as do not resuscitate [DNR]/do not intubate [DNI] or continuation of life support) accounted for 19 of 40 decisions (47.5%). Overall, the average Decision Conflict Scale (DCS) score was 21.9 of 100 (range 0-100, with 0 being little decisional conflict and 100 being great decisional conflict). The average DCS score for families facing end-of-life decisions was 25.5 compared with 18.7 for all other decisions. Those facing end-of-life decisions scored higher on the uncertainty subscale (subset of DCS questions that indicates level of certainty regarding decision) with a mean score of 43.4 compared with all other decisions with a mean score of 27.0. Overall, very few surrogates experienced decisional regret with an average DRS score of 13.4 of 100. Nearly all surrogates enrolled were faced with decision-making responsibilities on behalf of his or her critically ill family member. In our small pilot study, we found more decisional conflict in those surrogates facing end-of-life decisions, specifically on the subset of questions dealing with uncertainty. Surrogates report low levels of decisional regret. Copyright © 2015 Elsevier Inc. All rights reserved.

Information acquisition for women facing surgical treatment for breast cancer: influencing factors and selected outcomes.

PubMed

O'Leary, Katherine A; Estabrooks, Carole A; Olson, Kärin; Cumming, Ceinwen

2007-12-01

To examine, summarize, and critically assess the literature focusing on information use by early-stage breast cancer patients. Empirical articles reporting the information needs, sources used/preferred, and intervention-related outcomes experienced by patients in the context of making a treatment choice were chosen. Several healthcare databases were searched. Articles were limited to those published in English between January 1, 1986 and March 31, 2006. A total of 25 articles met the inclusion criteria. Information needs were consistent, and highest rankings were for (in order): information about chances for a cure, stage of disease, and treatment options. Results were equivocal regarding the factors found to influence information need: age, time since diagnosis, and preferred role in decision-making. The highest ranked information sources accessed and preferred were physicians. Age, education, and type of treatment chosen influenced source choice. Patients using consumer decision aids (CDAs) had less decisional conflict, higher satisfaction with the decision made and the decision process, and higher knowledge levels. Information needs and source use were influenced by several personal and contextual factors. A better understanding of source use could provide more effective ways of disseminating information to patients.

Measuring decisional certainty among women seeking abortion.

PubMed

Ralph, Lauren J; Foster, Diana Greene; Kimport, Katrina; Turok, David; Roberts, Sarah C M

2017-03-01

Evaluating decisional certainty is an important component of medical care, including preabortion care. However, minimal research has examined how to measure certainty with reliability and validity among women seeking abortion. We examine whether the Decisional Conflict Scale (DCS), a measure widely used in other health specialties and considered the gold standard for measuring this construct, and the Taft-Baker Scale (TBS), a measure developed by abortion counselors, are valid and reliable for use with women seeking abortion and predict the decision to continue the pregnancy. Eligible women at four family planning facilities in Utah completed baseline demographic surveys and scales before their abortion information visit and follow-up interviews 3 weeks later. For each scale, we calculated mean scores and explored factors associated with high uncertainty. We evaluated internal reliability using Cronbach's alpha and assessed predictive validity by examining whether higher scale scores, indicative of decisional uncertainty or conflict, were associated with still being pregnant at follow-up. Five hundred women completed baseline surveys; two-thirds (63%) completed follow-up, at which time 11% were still pregnant. Mean scores on the DCS (15.5/100) and TBS (12.4/100) indicated low uncertainty, with acceptable reliability (α=.93 and .72, respectively). Higher scores on each scale were significantly and positively associated with still being pregnant at follow-up in both unadjusted and adjusted analyses. The DCS and TBS demonstrate acceptable reliability and validity among women seeking abortion care. Comparing scores on the DCS in this population to other studies of decision making suggests that the level of uncertainty in abortion decision making is comparable to or lower than other health decisions. The high levels of decisional certainty found in this study challenge the narrative that abortion decision making is exceptional compared to other healthcare decisions and requires additional protection such as laws mandating waiting periods, counseling and ultrasound viewing. Copyright © 2016. Published by Elsevier Inc.

Prosthetic Cost Projections for Servicemembers with Major Limb Loss from Vietnam and OIF/OEF

DTIC Science & Technology

2010-01-01

death rates ), DOD = Department of Defense, DSS = Decision Support Sys- tem, MFCL = Medicare Functional Classification Level, OEF = Operation...age-sex-race-adjusted death rates . Figure 3. Markov model for unilateral upper limb and bilateral upper limbs for Operation Iraqi Freedom...Operation Enduring Freedom (OIF/OEF) group. ASR = age-sex-race-adjusted death rates . 394 JRRD, Volume 47, Number 4, 2010 higher, one level lower, or

Army Reserve Components Research Roadmap Volume 2: Research Agenda

DTIC Science & Technology

1997-09-01

over a 150-mile radius. This obviously makes training above the company level difficult for any time other than annual training (AT). In addition...at a higher level of decision- making , fluidity in the assignments of force structures to units creates wide spread change which affects whole units...can increasingly make TADSS and other enhancements practical solutions to persistent training needs. It should also be noted that the questions

Maximizing Intellectual Potential in Today's Learner: Can We Really Improve Students' Thinking?

ERIC Educational Resources Information Center

Martin, David S.

1992-01-01

Ties together the educational threads of teaching thinking skills and improving the intellectual performance in deaf learners. Identifies six criteria for curriculum or research decisions related to teaching for higher-level problem solving. Applications of these ideas to mathematics are left to the reader. (MDH)

Redesigning State Financial Aid: Principles to Guide State Aid Policymaking

ERIC Educational Resources Information Center

Pingel, Sarah; Sponsler, Brian A.

2015-01-01

Several factors create a challenging environment for individuals seeking financial support to complete a postsecondary degree program. In recognition of the challenges of paying for higher education, decision-makers at the federal and state levels support college-going with public policy. Through direct institutional allocations, need and…

Aging: Sensitivity versus Criterion in Taste Perception.

ERIC Educational Resources Information Center

Kushnir, T.; Shapira, N.

1983-01-01

Employed the signal-detection paradigm as a model for investigating age-related biological versus cognitive effects on perceptual behavior. Old and young subjects reported the presence or absence of sugar in threshold level solutions and tap water. Older subjects displayed a higher detection threshold and obtained a stricter criterion of decision.…

Taxing Times: An Educational Intervention to Enhance Moral Reasoning in Tax

ERIC Educational Resources Information Center

Doyle, Elaine

2015-01-01

This paper outlines the development and implementation of an online educational intervention designed to enhance moral reasoning in higher level tax students. Before decisions are made about how to behave ethically, cognitive moral reasoning takes place. The importance of education in developing morally sensitive individuals who use principled…

Strategic by Design: Iterative Approaches to Educational Planning

ERIC Educational Resources Information Center

Chance, Shannon

2010-01-01

Linear planning and decision-making models assume a level of predictability that is uncommon today. Such models inadequately address the complex variables found in higher education. When academic organizations adopt paired-down business strategies, they restrict their own vision. They fail to harness emerging opportunities or learn from their own…

Women’s decision-making autonomy and children’s schooling in rural Mozambique

PubMed Central

Luz, Luciana; Agadjanian, Victor

2015-01-01

BACKGROUND Women’s decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women’s autonomy and children’s schooling. OBJECTIVE To examine the relationship between rural women’s decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child’s gender. METHODS The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. RESULTS The results show a positive association of women’s decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women’s autonomy is net of other women’s characteristics typically associated with enrollment and does not mediate the effects of those characteristics. CONCLUSIONS Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters’ schooling and may have a greater say in making and implementing decisions regarding daughters’ education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women’s status on children’s educational outcomes. PMID:26491400

The provision of information and informed decision-making on prenatal screening for Down syndrome: a questionnaire- and register-based survey in a non-selected population.

PubMed

Schoonen, Marleen; Wildschut, Hajo; Essink-Bot, Marie-Louise; Peters, Ingrid; Steegers, Eric; de Koning, Harry

2012-06-01

Evaluating the information provision procedure about prenatal screening for Down syndrome, using informed decision-making as a quality-indicator. Questionnaire- and register-based surveys. Midwives associated with 59 midwifery practices completed process data for 6435 pregnancies. Pregnant women (n=510) completed questionnaires on informed decision-making. Midwives offered information to 98.5% of women; 62.6% of them wished to receive information, of these, 81.9% actually received information. Decision-relevant knowledge was adequate in 89.0% of responding women. Knowledge about Down syndrome was less adequate than knowledge about the screening program. Participants in the screening program had higher knowledge scores on Down syndrome and on the screening program than non-participants. Of the women who intended to participate (35.8%), 3.1% had inadequate knowledge. A total of 75.5% of women made an informed decision; 94.3% of women participating in the screening program, and 64.9% of women not participating. This quality assurance study showed high levels of informed decision-making and a relatively low participation rate in the national screening program for Down syndrome in the Netherlands. Knowledge of the Down syndrome condition needs to be improved. This evaluation may serve as a pilot study for quality monitoring studies at a national level. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Results from a randomized trial of a web-based, tailored decision aid for women at high risk for breast cancer

PubMed Central

Banegas, Matthew P.; McClure, Jennifer B.; Barlow, William E.; Ubel, Peter A.; Smith, Dylan M.; Zikmund-Fisher, Brian J.; Greene, Sarah M.; Fagerlin, Angela

2013-01-01

Objective To assess the impact of Guide to Decide (GtD), a web-based, personally-tailored decision aid designed to inform women’s decisions about prophylactic tamoxifen and raloxifene use. Methods Postmenopausal women, age 46–74, with BCRAT 5-year risk ≥1.66% and no prior history of breast cancer were randomized to one of three study arms: intervention (n = 690), Time 1 control (n = 160), or 3-month control (n = 162). Intervention participants viewed GtD prior to completing a post-test and 3 month follow-up assessment. Controls did not. We assessed the impact of GtD on women’s decisional conflict levels and treatment decision behavior at post-test and at 3 months, respectively. Results Intervention participants had significantly lower decisional conflict levels at post-test (p < 0.001) and significantly higher odds of making a decision about whether or not to take prophylactic tamoxifen or raloxifene at 3-month follow-up (p < 0.001) compared to control participants. Conclusion GtD lowered decisional conflict and helped women at high risk of breast cancer decide whether to take prophylactic tamoxifen or raloxifene to reduce their cancer risk. Practice implications Web-based, tailored decision aids should be used more routinely to facilitate informed medical decisions, reduce patients’ decisional conflict, and empower patients to choose the treatment strategy that best reflects their own values. PMID:23395006

Intergenerational equity and environmental restoration cleanup levels.

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

Hocking, E. K.; Environmental Assessment

2001-01-01

The United States Department of Energy environmental restoration program faces difficult decisions about the levels of cleanup to be achieved at its many contaminated sites and has acknowledged the need for considering intergenerational equity in its decision making. Intergenerational equity refers to the fairness of access to resources across generations. Environmental restoration cleanup levels can have unintended and unfair consequences for future generations access to resources. The potentially higher costs associated with using low, non-risk-based cleanup levels for remediation may divert funding from other activities that could have a greater beneficial impact on future generations. Low, non-risk-based cleanup levels couldmore » also result in more damage to the nation's resources than would occur if a higher cleanup level were used. The loss or impairment of these resources could have an inequitable effect on future generations. However, intergenerational inequity could arise if sites are not completely restored and if access to and use of natural and cultural resources are unfairly limited as a result of residual contamination. In addition to concerns about creating possible intergenerational inequities related to selected cleanup levels, the tremendous uncertainties associated with sites and their restoration can lead site planners to rely on stewardship by default. An ill-conceived stewardship program can contribute to intergenerational inequity by limiting access to resources while passing on risks to future generations and not preparing them for those risks. This paper presents a basic model and process for designing stewardship programs that can achieve equity among generations.« less

Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation.

PubMed

Kennedy, David P; Brown, Ryan A; Morrison, Penelope; Vie, Loryana; Ryan, Gery W; Tucker, Joan S

2015-01-31

Homeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect. To explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis. We identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances. Interventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.

Individual differences in competent consumer choice: the role of cognitive reflection and numeracy skills.

PubMed

Graffeo, Michele; Polonio, Luca; Bonini, Nicolao

2015-01-01

In this paper, we investigate whether cognitive reflection and numeracy skills affect the quality of the consumers' decision-making process in a purchase decision context. In a first (field) experiment, an identical product was on sale in two shops with different initial prices and discounts. One of the two deals was better than the other and the consumers were asked to choose the best one and to describe which arithmetic operations they used to solve the problem; then they were asked to complete the numeracy scale (Lipkus et al., 2001). The choice procedures used by the consumers were classified as "complete decision approach" when all the arithmetic operations needed to solve the problem were computed, and as "partial decision approach" when only some operations were computed. A mediation model shows that higher numeracy is associated with use of the complete decision approach. In turn, this approach is positively associated with the quality of the purchase decision. Given that these findings highlight the importance of the decision processes, in a second (laboratory) experiment we used a supplementary method to study the type of information search used by the participants: eye-tracking. In this experiment the participants were presented with decision problems similar to those used in Experiment 1 and they completed the Lipkus numeracy scale and the Cognitive Reflection Test (CRT; Frederick, 2005). Participants with a high CRT score chose the best deal more frequently, and showed a more profound and detailed information search pattern compared to participants with a low CRT score. Overall, results indicate that higher levels of cognitive reflection and numeracy skills predict the use of a more thorough decision process (measured with two different techniques: retrospective verbal reports and eye movements). In both experiments the decision process is a crucial factor which greatly affects the quality of the purchase decision.

Individual differences in competent consumer choice: the role of cognitive reflection and numeracy skills

PubMed Central

Graffeo, Michele; Polonio, Luca; Bonini, Nicolao

2015-01-01

In this paper, we investigate whether cognitive reflection and numeracy skills affect the quality of the consumers’ decision-making process in a purchase decision context. In a first (field) experiment, an identical product was on sale in two shops with different initial prices and discounts. One of the two deals was better than the other and the consumers were asked to choose the best one and to describe which arithmetic operations they used to solve the problem; then they were asked to complete the numeracy scale (Lipkus et al., 2001). The choice procedures used by the consumers were classified as “complete decision approach” when all the arithmetic operations needed to solve the problem were computed, and as “partial decision approach” when only some operations were computed. A mediation model shows that higher numeracy is associated with use of the complete decision approach. In turn, this approach is positively associated with the quality of the purchase decision. Given that these findings highlight the importance of the decision processes, in a second (laboratory) experiment we used a supplementary method to study the type of information search used by the participants: eye-tracking. In this experiment the participants were presented with decision problems similar to those used in Experiment 1 and they completed the Lipkus numeracy scale and the Cognitive Reflection Test (CRT; Frederick, 2005). Participants with a high CRT score chose the best deal more frequently, and showed a more profound and detailed information search pattern compared to participants with a low CRT score. Overall, results indicate that higher levels of cognitive reflection and numeracy skills predict the use of a more thorough decision process (measured with two different techniques: retrospective verbal reports and eye movements). In both experiments the decision process is a crucial factor which greatly affects the quality of the purchase decision. PMID:26136721

The Roles of Cost and Quality Information in Medicare Advantage Plan Enrollment Decisions: an Observational Study.

PubMed

Reid, Rachel O; Deb, Partha; Howell, Benjamin L; Conway, Patrick H; Shrank, William H

2016-02-01

To facilitate informed decision-making in the Medicare Advantage marketplace, the Centers for Medicare & Medicaid Services publishes plan information on the Medicare Plan Finder website, including costs, benefits, and star ratings reflecting quality. Little is known about how beneficiaries weigh costs versus quality in enrollment decisions. We aimed to assess associations between publicly reported Medicare Advantage plan attributes (i.e., costs, quality, and benefits) and brand market share and beneficiaries' enrollment decisions. We performed a nationwide, beneficiary-level cross-sectional analysis of 847,069 beneficiaries enrolling in Medicare Advantage for the first time in 2011. Matching beneficiaries with their plan choice sets, we used conditional logistic regression to estimate associations between plan attributes and enrollment to assess the proportion of enrollment variation explained by plan attributes and willingness to pay for quality. Relative to the total variation explained by the model, the variation in plan choice explained by premiums (25.7 %) and out-of-pocket costs (11.6 %) together explained nearly three times as much as quality ratings (13.6 %), but brand market share explained the most variation (35.3 %). Further, while beneficiaries were willing to pay more in total annual combined premiums and out-of-pocket costs for higher-rated plans (from $4,154.93 for 2.5-star plans to $5,698.66 for 5-star plans), increases in willingness to pay diminished at higher ratings, from $549.27 (95 %CI: $541.10, $557.44) for a rating increase from 2.5 to 3 stars to $68.22 (95 %CI: $61.44, $75.01) for an increase from 4.5 to 5 stars. Willingness to pay varied among subgroups: beneficiaries aged 64-65 years were more willing to pay for higher-rated plans, while black and rural beneficiaries were less willing to pay for higher-rated plans. While beneficiaries prefer higher-quality and lower-cost Medicare Advantage plans, marginal utility for quality diminishes at higher star ratings, and their decisions are strongly associated with plans' brand market share.

Speed accuracy trade-off under response deadlines

PubMed Central

Karşılar, Hakan; Simen, Patrick; Papadakis, Samantha; Balcı, Fuat

2014-01-01

Perceptual decision making has been successfully modeled as a process of evidence accumulation up to a threshold. In order to maximize the rewards earned for correct responses in tasks with response deadlines, participants should collapse decision thresholds dynamically during each trial so that a decision is reached before the deadline. This strategy ensures on-time responding, though at the cost of reduced accuracy, since slower decisions are based on lower thresholds and less net evidence later in a trial (compared to a constant threshold). Frazier and Yu (2008) showed that the normative rate of threshold reduction depends on deadline delays and on participants' uncertainty about these delays. Participants should start collapsing decision thresholds earlier when making decisions under shorter deadlines (for a given level of timing uncertainty) or when timing uncertainty is higher (for a given deadline). We tested these predictions using human participants in a random dot motion discrimination task. Each participant was tested in free-response, short deadline (800 ms), and long deadline conditions (1000 ms). Contrary to optimal-performance predictions, the resulting empirical function relating accuracy to response time (RT) in deadline conditions did not decline to chance level near the deadline; nor did the slight decline we typically observed relate to measures of endogenous timing uncertainty. Further, although this function did decline slightly with increasing RT, the decline was explainable by the best-fitting parameterization of Ratcliff's diffusion model (Ratcliff, 1978), whose parameters are constant within trials. Our findings suggest that at the very least, typical decision durations are too short for participants to adapt decision parameters within trials. PMID:25177265

Development and evaluation of learning module on clinical decision-making in Prosthodontics.

PubMed

Deshpande, Saee; Lambade, Dipti; Chahande, Jayashree

2015-01-01

Best practice strategies for helping students learn the reasoning skills of problem solving and critical thinking (CT) remain a source of conjecture, particularly with regard to CT. The dental education literature is fundamentally devoid of research on the cognitive components of clinical decision-making. This study was aimed to develop and evaluate the impact of blended learning module on clinical decision-making skills of dental graduates for planning prosthodontics rehabilitation. An interactive teaching module consisting of didactic lectures on clinical decision-making and a computer-assisted case-based treatment planning software was developed Its impact on cognitive knowledge gain in clinical decision-making was evaluated using an assessment involving problem-based multiple choice questions and paper-based case scenarios. Mean test scores were: Pretest (17 ± 1), posttest 1 (21 ± 2) and posttest 2 (43 ± 3). Comparison of mean scores was done with one-way ANOVA test. There was overall significant difference in between mean scores at all the three points (P < 0.001). A pair-wise comparison of mean scores was done with Bonferroni test. The mean difference is significant at the 0.05 level. The pair-wise comparison shows that posttest 2 score is significantly higher than posttest 1 and posttest 1 is significantly higher than pretest that is, pretest 2 > posttest 1 > pretest. Blended teaching methods employing didactic lectures on the clinical decision-making as well as computer assisted case-based learning can be used to improve quality of clinical decision-making in prosthodontic rehabilitation for dental graduates.

Diffusion of an economic development policy innovation: explaining the international spread of casino gambling.

PubMed

Richard, Brian

2010-06-01

This study uses an event history analysis to examine the factors that lead to the adoption of casino gambling among 13 nations around the world. Specifically, measures of fiscal stress, economic development, tourism, religiosity, and income levels are tested for their relationship to national decisions to legalize casino gambling. This study found that economic development needs, as measured by general unemployment rates, were associated with the casino legalization decisions of national governments. Higher unemployment rates were more likely in the years that nations legalized casino gambling. Religiosity, measured by frequency of church attendance, was also found to be a significant barrier in legalization decisions. Measures of fiscal stress, tourism, and income levels were not found to have significant relationships with the legalization decisions. This is interesting because these factors are often cited in case studies, media reports, and the statements of politicians during legalization processes. This study points to the need for further research in several areas. Further exploration of potential explanatory variables and more appropriate measures of currently theorized factors is warranted. Another area for further research is the seeming contradictory findings of multiple statistical analyses and multiple anecdotal findings of the impacts of fiscal stress on the casino legalization decision.

On the use of Bayesian decision theory for issuing natural hazard warnings

NASA Astrophysics Data System (ADS)

Economou, T.; Stephenson, D. B.; Rougier, J. C.; Neal, R. A.; Mylne, K. R.

2016-10-01

Warnings for natural hazards improve societal resilience and are a good example of decision-making under uncertainty. A warning system is only useful if well defined and thus understood by stakeholders. However, most operational warning systems are heuristic: not formally or transparently defined. Bayesian decision theory provides a framework for issuing warnings under uncertainty but has not been fully exploited. Here, a decision theoretic framework is proposed for hazard warnings. The framework allows any number of warning levels and future states of nature, and a mathematical model for constructing the necessary loss functions for both generic and specific end-users is described. The approach is illustrated using one-day ahead warnings of daily severe precipitation over the UK, and compared to the current decision tool used by the UK Met Office. A probability model is proposed to predict precipitation, given ensemble forecast information, and loss functions are constructed for two generic stakeholders: an end-user and a forecaster. Results show that the Met Office tool issues fewer high-level warnings compared with our system for the generic end-user, suggesting the former may not be suitable for risk averse end-users. In addition, raw ensemble forecasts are shown to be unreliable and result in higher losses from warnings.

On the use of Bayesian decision theory for issuing natural hazard warnings.

PubMed

Economou, T; Stephenson, D B; Rougier, J C; Neal, R A; Mylne, K R

2016-10-01

Warnings for natural hazards improve societal resilience and are a good example of decision-making under uncertainty. A warning system is only useful if well defined and thus understood by stakeholders. However, most operational warning systems are heuristic: not formally or transparently defined. Bayesian decision theory provides a framework for issuing warnings under uncertainty but has not been fully exploited. Here, a decision theoretic framework is proposed for hazard warnings. The framework allows any number of warning levels and future states of nature, and a mathematical model for constructing the necessary loss functions for both generic and specific end-users is described. The approach is illustrated using one-day ahead warnings of daily severe precipitation over the UK, and compared to the current decision tool used by the UK Met Office. A probability model is proposed to predict precipitation, given ensemble forecast information, and loss functions are constructed for two generic stakeholders: an end-user and a forecaster. Results show that the Met Office tool issues fewer high-level warnings compared with our system for the generic end-user, suggesting the former may not be suitable for risk averse end-users. In addition, raw ensemble forecasts are shown to be unreliable and result in higher losses from warnings.

On the use of Bayesian decision theory for issuing natural hazard warnings

PubMed Central

Stephenson, D. B.; Rougier, J. C.; Neal, R. A.; Mylne, K. R.

2016-01-01

Warnings for natural hazards improve societal resilience and are a good example of decision-making under uncertainty. A warning system is only useful if well defined and thus understood by stakeholders. However, most operational warning systems are heuristic: not formally or transparently defined. Bayesian decision theory provides a framework for issuing warnings under uncertainty but has not been fully exploited. Here, a decision theoretic framework is proposed for hazard warnings. The framework allows any number of warning levels and future states of nature, and a mathematical model for constructing the necessary loss functions for both generic and specific end-users is described. The approach is illustrated using one-day ahead warnings of daily severe precipitation over the UK, and compared to the current decision tool used by the UK Met Office. A probability model is proposed to predict precipitation, given ensemble forecast information, and loss functions are constructed for two generic stakeholders: an end-user and a forecaster. Results show that the Met Office tool issues fewer high-level warnings compared with our system for the generic end-user, suggesting the former may not be suitable for risk averse end-users. In addition, raw ensemble forecasts are shown to be unreliable and result in higher losses from warnings. PMID:27843399

Supporting shared decision making using an Option Grid for osteoarthritis of the knee in an interface musculoskeletal clinic: A stepped wedge trial.

PubMed

Elwyn, Glyn; Pickles, Tim; Edwards, Adrian; Kinsey, Katharine; Brain, Kate; Newcombe, Robert G; Firth, Jill; Marrin, Katy; Nye, Alan; Wood, Fiona

2016-04-01

To evaluate whether introducing tools, specifically designed for use in clinical encounters, namely Option Grids, into a clinical practice setting leads to higher levels of shared decision making. A stepped wedge trial design where 6 physiotherapists at an interface clinic in Oldham, UK, were sequentially instructed in how to use an Option Grid for osteoarthritis of the knee. Patients with suspected or confirmed osteoarthritis of the knee were recruited, six per clinician prior to instruction, and six per clinician afterwards. We measured shared decision making, patient knowledge, and readiness to decide. A total of 72 patients were recruited; 36 were allocated to the intervention group. There was an 8.4 point (95% CI 4.4 to 12.2) increase in the Observer OPTION score (range 0-100) in the intervention group. The mean gain in knowledge was 0.9 points (score range 0-5, 95% CI, 0.3 to 1.5). There was no increase in encounter duration. Shared decision making increased when clinicians used the knee osteoarthritis Option Grid. Tools designed to support collaboration and deliberation about treatment options lead to increased levels of shared decision making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Sexual Communication and Knowledge among Mexican Parents and their Adolescent Children

PubMed Central

Gallegos, Esther C.; Villarruel, Antonia M.; Gómez, Marco Vinicio; Onofre, Dora Julia; Zhou, Yan

2009-01-01

This study describes the sexual knowledge and communication of Mexican parents and adolescents. Pre-intervention data was analyzed from 829 high school students (ages 14-17) and one of their parents. Differences were found between parents and adolescents in sexual knowledge (M = 16.16 vs. M = 14.92; t = 7.20; p < 0.001); specifically parents had higher knowledge related to STD’s, HIV/AIDs, and condom use. Parents perceived more general communication (t (787) = 6.33 p < .001), and less discomfort talking about sex (t (785) = 4.69, p < .001) than adolescents. Parents with higher education levels scored higher in HIV knowledge and general communication. Fathers had higher total sexual knowledge while mothers perceived higher sexual communication than fathers. There were no differences in knowledge and communication by parental socioeconomic level. Results suggest health care providers need to assist parents in developing specific knowledge and skills to support their adolescents’ sexual decision making. PMID:17403494

The effect of fight cost structure on fighting behaviour involving simultaneous decisions and variable investment levels.

PubMed

Broom, Mark; Johanis, Michal; Rychtář, Jan

2018-01-01

In the "producer-scrounger" model, a producer discovers a resource and is in turn discovered by a second individual, the scrounger, who attempts to steal it. This resource can be food or a territory, and in some situations, potentially divisible. In a previous paper we considered a producer and scrounger competing for an indivisible resource, where each individual could choose the level of energy that they would invest in the contest. The higher the investment, the higher the probability of success, but also the higher the costs incurred in the contest. In that paper decisions were sequential with the scrounger choosing their strategy before the producer. In this paper we consider a version of the game where decisions are made simultaneously. For the same cost functions as before, we analyse this case in detail, and then make comparisons between the two cases. Finally we discuss some real examples with potentially variable and asymmetric energetic investments, including intraspecific contests amongst spiders and amongst parasitoid wasps. In the case of the spiders, detailed estimates of energetic expenditure are available which demonstrate the asymmetric values assumed in our models. For the wasps the value of the resource can affect the probabilities of success of the defender and attacker, and differential energetic investment can be inferred. In general for real populations energy usage varies markedly depending upon crucial parameters extrinsic to the individual such as resource value and intrinsic ones such as age, and is thus an important factor to consider when modelling.

Telomere length and procedural justice predict stress reactivity responses to unfair outcomes in African Americans.

PubMed

Lucas, Todd; Pierce, Jennifer; Lumley, Mark A; Granger, Douglas A; Lin, Jue; Epel, Elissa S

2017-12-01

This experiment demonstrates that chromosomal telomere length (TL) moderates response to injustice among African Americans. Based on worldview verification theory - an emerging psychosocial framework for understanding stress - we predicted that acute stress responses would be most pronounced when individual-level expectancies for justice were discordant with justice experiences. Healthy African Americans (N=118; 30% male; M age=31.63years) provided dried blood spot samples that were assayed for TL, and completed a social-evaluative stressor task during which high versus low levels of distributive (outcome) and procedural (decision process) justice were simultaneously manipulated. African Americans with longer telomeres appeared more resilient (in emotional and neuroendocrine response-higher DHEAs:cortisol) to receiving an unfair outcome when a fair decision process was used, whereas African Americans with shorter telomeres appeared more resilient when an unfair decision process was used. TL may indicate personal histories of adversity and associated stress-related expectancies that influence responses to injustice. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occupational stress, job insecurity and perception of the health status in Italian teachers with stable or temporary employment.

PubMed

Forcella, L; Di Donato, A; Reversi, S; Fattorini, E; Boscolo, P

2009-01-01

The object of this study is to analyse job stress and insecurity and the perception of symptoms (health status) of 374 teachers (30 women and 74 men) with stable or temporary employment in schools in Pescara, a town in Central Italy. Job strain and job insecurity were analysed by an Italian version of the Karasek?s questionnaire, the perception of the health status by a 12 item test, and state and trait anxiety by STAI I and STAI II. There were no significant differences depending on the type of school. The young women with temporary contracts showed only higher levels of job insecurity than the women with stable employment, while those over 50 years old also showed more elevated values of job strain. Men with temporary contracts showed higher levels of both job insecurity and state and trait anxiety. The following highly significant correlations were observed: a) in women, job strain and perception of symptoms vs STAI I and STAI II (p<0.001); b) in men, job strain, job insecurity and perception of symptoms vs STAI II; job strain vs perception of symptoms as well as a negative correlation of decision latitude vs job insecurity, STAI I and STAI II (p<0.01). These results highlight differences in the perception of job insecurity between men and women. In particular, the decision latitude (skill decision + decision authority) plays an important role in men; temporary employment is mainly related to anxiety in men, while anxiety enhances the perception of poor health status mainly in women.

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

PubMed

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

2016-06-01

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

Adolescent neural response to reward is related to participant sex and task motivation.

PubMed

Alarcón, Gabriela; Cservenka, Anita; Nagel, Bonnie J

2017-02-01

Risky decision making is prominent during adolescence, perhaps contributed to by heightened sensation seeking and ongoing maturation of reward and dopamine systems in the brain, which are, in part, modulated by sex hormones. In this study, we examined sex differences in the neural substrates of reward sensitivity during a risky decision-making task and hypothesized that compared with girls, boys would show heightened brain activation in reward-relevant regions, particularly the nucleus accumbens, during reward receipt. Further, we hypothesized that testosterone and estradiol levels would mediate this sex difference. Moreover, we predicted boys would make more risky choices on the task. While boys showed increased nucleus accumbens blood oxygen level-dependent (BOLD) response relative to girls, sex hormones did not mediate this effect. As predicted, boys made a higher percentage of risky decisions during the task. Interestingly, boys also self-reported more motivation to perform well and earn money on the task, while girls self-reported higher state anxiety prior to the scan session. Motivation to earn money partially mediated the effect of sex on nucleus accumbens activity during reward. Previous research shows that increased motivation and salience of reinforcers is linked with more robust striatal BOLD response, therefore psychosocial factors, in addition to sex, may play an important role in reward sensitivity. Elucidating neurobiological mechanisms that support adolescent sex differences in risky decision making has important implications for understanding individual differences that lead to advantageous and adverse behaviors that affect health outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Adaptation by Stealth: Understanding climate information use across scales and decision spaces in water management in the United States

NASA Astrophysics Data System (ADS)

Kirchhoff, C.; Vang Rasmussen, L.; Lemos, M. C.

2016-12-01

While there has been considerable focus on understanding how factors related to the creation of climate knowledge affect its uptake and use, less attention has been paid to the actors, decisions, and processes through which climate information supports, or fails to support, action. This is particularly the case concerning how different scales of decision-making influence information uptake. In this study, we seek to understand how water and resource managers' decision space influences climate information use in two Great Lakes watersheds. We find that despite the availability of tailored climate information, actual use of information in decision making remains low. Reasons include: a) lack of willingness to place climate on agendas because local managers perceive climate change as politically risky and a difficult and intangible problem; b) lack of formal mandate or authority at the city and county scale to translate climate information into on-the-ground action, c) problems with the information itself, and d) perceived lack of demand for climate information by those managers who have the mandate and authority (e.g. at the state level) to use (or help others use) climate information. Our findings suggest that 1) climate scientists and information brokers should produce information that meets a range of decision needs and reserve intensive tailoring efforts for decision makers who have authority and willingness to employ climate information, 2) without support from higher levels of decision-making (e.g. state) it is unlikely that climate information use for adaptation decisions will accelerate significantly in the next few years, and 3) the trend towards adopting more sustainability and resilience practices over climate-specific actions should be supported as an important component of the climate adaptation repertoire.

Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer

PubMed

Yamauchi, Keiko; Nakao, Motoyuki; Nakashima, Mitsuyo; Ishihara, Yoko

2017-04-01

Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process. Creative Commons Attribution License

Congruence between Preferred and Actual Participation Roles Increases Satisfaction with Treatment Decision Making among Japanese Women with Breast Cancer

PubMed Central

Yamauchi, Keiko; Nakao, Motoyuki; Nakashima, Mitsuyo; Ishihara, Yoko

2017-01-01

Objective: This study investigated the correlation between participation in the treatment decision-making process and satisfaction with the process among Japanese women with breast cancer. The influence of sociodemographic and clinical characteristics on satisfaction with the treatment decision-making process was also examined. Methods: We conducted a cross-sectional, self-administered internet survey of 650 Japanese women with breast cancer in March 2016. Decisional role (active, collaborative, passive) in the treatment decision-making was elicited using the Japanese version of the Control Preference Scale. Satisfaction with the decision-making process was assessed. Result: About half of the participants preferred to play a collaborative role, while half of the participants perceived that they played an active role. Satisfaction among the participants who made their treatment choice collaboratively with their physicians was significantly higher than that of participants who made the choice by themselves or entrusted their physicians to make the decision. However, two-way ANOVA demonstrated that satisfaction level was associated with the congruence between the participants’ preferred and actual decisional roles, but not with the actual decisional roles that they played. This association had no interaction with sociodemographic and clinical status, except for education level. A majority of the participants who participated in the roles they preferred in choosing their treatment option indicated that they would participate in the same role if they were to face a similar decision-making situation in the future. Conclusion: Regardless of their role played in the cancer treatment decision-making process, and irrespective of their sociodemographic and clinical status, Japanese women with breast cancer are more satisfied with the treatment decision-making process when their participation in the process matches their preferred role in the process. PMID:28545197

Correlates of quality of life among African American and white cancer survivors.

PubMed

Matthews, Alicia K; Tejeda, Silvia; Johnson, Timothy P; Berbaum, Michael L; Manfredi, Clara

2012-01-01

African Americans continue to suffer disproportionately from cancer morbidity and mortality, with emerging evidence suggesting potential quality of life (QOL) disparities in the survivorship period. The objective of the study was to assess sociodemographic, clinical, and psychosocial factors associated with physical and mental health QOL (PHQOL and MHQOL) among African American and white cancer survivors. Patients were recruited from tumor registries. Telephone interviews were conducted with 248 African American and 244 white respondents with a history of breast, prostate, or colorectal cancers. Multivariate regression models were used to assess what factors were associated with PHQOL and MHQOL. Key racial differences in adjusted analyses included poorer MHQOL scores among African Americans compared with white survivors. Furthermore, race moderated the relationship between perceived social support and MHQOL, where higher social support levels were associated with increased MHQOL among African Americans. Other correlates of QOL impacted racial groups similarly. For example, factors associated with PHQOL scores included being unemployed, being uninsured, the presence of medical comorbidities, a longer time since diagnosis, and higher levels of cancer-related stress appraisals. Factors associated with MHQOL scores included being unemployed, higher levels of daily stress, higher levels of stress associated with the diagnosis, higher levels of education, higher levels of perceived social support, and higher levels of spirituality. Interventions aimed at increasing social support may have important implications for improving QOL outcomes among African Americans. Measuring and understanding factors associated with QOL have important implications for patient adjustment and clinical decision making.

Correlates of Quality of Life among African American and White Cancer Survivors

PubMed Central

Matthews, Alicia K.; Tejeda, Silvia; Johnson, Timothy P.; Berbaum, Michael L.; Manfredi, Clara

2013-01-01

Background African Americans continue to suffer disproportionately from cancer morbidity and mortality with emerging evidence suggesting potential quality of life (QOL) disparities in the survivorship period. Objective To assess sociodemographic, clinical, and psychosocial factors associated with physical and mental health QOL (PHQOL and MHQOL) among African American and white cancer survivors. Methods Patients were recruited from tumor registries. Telephone interviews were conducted with 248 African American and 244 white respondents with a history of breast, prostate, or colorectal cancers. Multivariate regression models were used to assess what factors were associated with PHQOL and MHQOL. Results Key racial differences in adjusted analyses included poorer MHQOL scores among African Americans compared to white survivors. Furthermore, race moderated the relationship between perceived social support and MHQOL, where higher social support levels were associated with increased MHQOL among African Americans. Other correlates of QOL impacted racial groups similarly. For example, factors associated with PHQOL scores included being unemployed, uninsured, the presence of medical comorbidities, a longer time since diagnosis and higher levels of cancer related stress appraisals. Factors associated with MHQOL scores included being unemployed, higher levels of daily stress, higher levels of stress associated with the diagnosis, higher levels of education, higher levels of perceived social support, and higher levels of spirituality. Conclusion Interventions aimed at increasing social support may have important implications for improving QOL outcomes among African Americans. Implications for Practice Measuring and understanding factors associated with QOL have important implications for patient adjustment and clinical decision-making. PMID:22495496

Specific Barriers and Drivers in Different Stages of Decision-Making about Energy Efficiency Upgrades in Private Homes

PubMed Central

Klöckner, Christian A.; Nayum, Alim

2016-01-01

Energy efficiency upgrades of privately owned homes like adding to the insulation layers in the walls, roof or floor, or replacing windows with more efficiently insulated versions can contribute significantly to reducing the energy impact of the building sector and thus also the CO2 footprint of a household. However, even in countries like Norway that have a rather high rate of renovation, energy upgrades are not always integrated into such a refurbishment project. This study tests which structural and internal psychological barriers hinder and which drivers foster decision-making to implement such measures, once a renovation project is planned. With a theoretical background in stage-based models of decision-making 24 barriers and drivers were tested for their specific effect in the stages of decision-making. The four stages of decision-making assumed in this study were (1) “not being in a decision mode,” (2) “deciding what to do,” (3) “deciding how to do it,” and (4) “planning implementation.” Based on an online survey of 3787 Norwegian households, it was found that the most important barriers toward deciding to implement energy efficiency upgrades were not owning the dwelling and feeling the right time had not come yet. The most important drivers of starting to decide were higher expected comfort levels, better expected living conditions, and an expected reduction of energy costs. For the transition from deciding what to do to how to do it, not managing to make a decision and feeling the right point in time has not come yet were the strongest barriers, easily accessible information and an expected reduction of energy costs were the most important drivers. The final transition from deciding how to do the upgrades to planning implementation was driven by expecting a payoff within a reasonable time frame and higher expected comfort levels; the most important barriers were time demands for supervising contractors and—again—a feeling that the right point in time has not come yet. Implications for policy-making and marketing are discussed. PMID:27660618

Specific Barriers and Drivers in Different Stages of Decision-Making about Energy Efficiency Upgrades in Private Homes.

PubMed

Klöckner, Christian A; Nayum, Alim

2016-01-01

Energy efficiency upgrades of privately owned homes like adding to the insulation layers in the walls, roof or floor, or replacing windows with more efficiently insulated versions can contribute significantly to reducing the energy impact of the building sector and thus also the CO2 footprint of a household. However, even in countries like Norway that have a rather high rate of renovation, energy upgrades are not always integrated into such a refurbishment project. This study tests which structural and internal psychological barriers hinder and which drivers foster decision-making to implement such measures, once a renovation project is planned. With a theoretical background in stage-based models of decision-making 24 barriers and drivers were tested for their specific effect in the stages of decision-making. The four stages of decision-making assumed in this study were (1) "not being in a decision mode," (2) "deciding what to do," (3) "deciding how to do it," and (4) "planning implementation." Based on an online survey of 3787 Norwegian households, it was found that the most important barriers toward deciding to implement energy efficiency upgrades were not owning the dwelling and feeling the right time had not come yet. The most important drivers of starting to decide were higher expected comfort levels, better expected living conditions, and an expected reduction of energy costs. For the transition from deciding what to do to how to do it, not managing to make a decision and feeling the right point in time has not come yet were the strongest barriers, easily accessible information and an expected reduction of energy costs were the most important drivers. The final transition from deciding how to do the upgrades to planning implementation was driven by expecting a payoff within a reasonable time frame and higher expected comfort levels; the most important barriers were time demands for supervising contractors and-again-a feeling that the right point in time has not come yet. Implications for policy-making and marketing are discussed.

Drug related webpages classification using images and text information based on multi-kernel learning

NASA Astrophysics Data System (ADS)

Hu, Ruiguang; Xiao, Liping; Zheng, Wenjuan

2015-12-01

In this paper, multi-kernel learning(MKL) is used for drug-related webpages classification. First, body text and image-label text are extracted through HTML parsing, and valid images are chosen by the FOCARSS algorithm. Second, text based BOW model is used to generate text representation, and image-based BOW model is used to generate images representation. Last, text and images representation are fused with a few methods. Experimental results demonstrate that the classification accuracy of MKL is higher than those of all other fusion methods in decision level and feature level, and much higher than the accuracy of single-modal classification.

Enhancing students' critical thinking in science: A two-year design based exploration in a large undergraduate science course

NASA Astrophysics Data System (ADS)

Yoo, Suhyun

The purpose of this study was to explore how to enhance students' critical thinking in an introductory undergraduate science course. As a design experiment, this study aimed to design, develop, implement, and refine learning activities, and investigate how the learning activities worked in fostering students' critical thinking in a large size classroom context. In this study, critical thinking in science was framed with six categories, 1) identifying decisions, 2) evaluating decisions, 3) providing own decision, 4) argument and justification for own decision, 5) presenting supporting data/evidence, and 6) integrating other perspectives, as the result of literature review. To enhance critical thinking, three design principles, 1) authentic task, 2) question prompts, and 3) peer interaction, were associated with the learning activities for two consecutive years. The research context was within a large general science course and the learning activities for a module were designed, implemented and refined for two years. Specially, changes in design strategies were made in the two design principles, question prompts and peer interaction, after the 1st implementation. With regard to the use of question prompts, the students of the 2nd year were provided with procedural and elaborative question prompts, while those of the 1st year only received procedural question prompts embedded in the Group and Community Discussion Charts. Second, instead of being engaged six times in two types of discussions, group and community discussions, the students of the 2nd year were required to take part in a community discussion twice and to prepare for the discussion by learning about and understanding important aspects of dealing with the hurricane situation. For individual preparation, elaborative question prompts were embedded in the Individual Worksheet. Quantitative and qualitative research methods were taken to investigate how the two different designs of the 1st and 2nd years worked for enhancing critical thinking in a large-size classroom. Data came from the students' written documents during and after the learning activities. The result from the descriptive and comparative analysis on the written documents for two years indicated that there were changes in patterns of reasoning between the two years. It was evident that the groups engaged in decision-making for communities of the 2nd year showed more concrete and shaped reasoning than those of the 1st year. The result of the t-test indicated that there was a significant difference in critical thinking demonstrated in individual reports between the students of the 1st and the 2nd years. The students of the 2nd year demonstrated better levels of critical thinking than those of the 1st year. Specially, among the six categories of critical thinking, the students of the 2nd year demonstrated better levels in three categories, 1) providing one's own decision, 2) argumentation and justification for one's own decision, and 3) integrating other perspectives, than those of the 1st year. By the multiple-case study method, four themes were found to explain what made students demonstrated higher levels of critical thinking: 1) understanding of one's assigned role, 2) linking roles to make decisions, 3) answers to the question prompts, and 4) use of data and source, were raised in explaining the different pattern between the students with higher and lower levels of critical thinking. Also, a trend was visible across artifacts for higher performing students in both years.

Impact of ethics and economics on end-of-life decisions in an Indian neonatal unit.

PubMed

Miljeteig, Ingrid; Sayeed, Sadath Ali; Jesani, Amar; Johansson, Kjell Arne; Norheim, Ole Frithjof

2009-08-01

The aim of this article was to describe how providers in an Indian NICU reach life-or-death treatment decisions. Qualitative in-depth interviews, field observations, and document analysis were conducted at an Indian nonprofit private tertiary institution that provided advanced neonatal care under conditions of resource scarcity. Compared with American and European units with similar technical capabilities, the unit studied maintained a much higher threshold for treatment initiation and continuation (range: 28-32 completed gestational weeks). We observed that complex, interrelated socioeconomic reasons influenced specific treatment decisions. Providers desired to protect families and avoid a broad range of perceived harms: they were reluctant to risk outcomes with chronic disability; they openly factored scarcity of institutional resources; they were sensitive to local, culturally entrenched intrafamilial dynamics; they placed higher regard for "precious" infants; and they felt relatively powerless to prevent gender discrimination. Formal or regulatory guidelines were either lacking or not controlling. In a tertiary-level academic Indian NICU, multiple factors external to predicted clinical survival of a preterm newborn influence treatment decisions. Providers adjust their decisions about withdrawing or withholding treatment on the basis of pragmatic considerations. Numerous issues related to resource scarcity are relevant, and providers prioritize outcomes that affect stakeholders other than the newborn. These findings may have implications for initiatives that seek to improve global neonatal health.

The Impact of STOV (Standort Verwaltung) on Unit Time Utilization

DTIC Science & Technology

1981-05-01

units will be presented. In addition to reviewing the basic agreement which describes general STOV responsibilities, representatives from all...which cannot be resolved at the local level will be raised to the next higher level in the respective chain of command for review and decision. 2. Apart...available the above-mentioned materials for review and reproduction. The described records shall be retained for a period of at least three years as of

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies

PubMed Central

Curşeu, Petru L.; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J. M.

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies. PMID:26441750

Cognitive synergy in groups and group-to-individual transfer of decision-making competencies.

PubMed

Curşeu, Petru L; Meslec, Nicoleta; Pluut, Helen; Lucas, Gerardus J M

2015-01-01

In a field study (148 participants organized in 38 groups) we tested the effect of group synergy and one's position in relation to the collaborative zone of proximal development (CZPD) on the change of individual decision-making competencies. We used two parallel sets of decision tasks reported in previous research to test rationality and we evaluated individual decision-making competencies in the pre-group and post-group conditions as well as group rationality (as an emergent group level phenomenon). We used multilevel modeling to analyze the data and the results showed that members of synergetic groups had a higher cognitive gain as compared to members of non-synergetic groups, while highly rational members (members above the CZPD) had lower cognitive gains compared to less rational group members (members situated below the CZPD). These insights extend the literature on group-to-individual transfer of learning and have important practical implications as they show that group dynamics influence the development of individual decision-making competencies.

Workflow management in large distributed systems

NASA Astrophysics Data System (ADS)

Legrand, I.; Newman, H.; Voicu, R.; Dobre, C.; Grigoras, C.

2011-12-01

The MonALISA (Monitoring Agents using a Large Integrated Services Architecture) framework provides a distributed service system capable of controlling and optimizing large-scale, data-intensive applications. An essential part of managing large-scale, distributed data-processing facilities is a monitoring system for computing facilities, storage, networks, and the very large number of applications running on these systems in near realtime. All this monitoring information gathered for all the subsystems is essential for developing the required higher-level services—the components that provide decision support and some degree of automated decisions—and for maintaining and optimizing workflow in large-scale distributed systems. These management and global optimization functions are performed by higher-level agent-based services. We present several applications of MonALISA's higher-level services including optimized dynamic routing, control, data-transfer scheduling, distributed job scheduling, dynamic allocation of storage resource to running jobs and automated management of remote services among a large set of grid facilities.

Forecasting the effects of land-use and climate change on wildlife communities and habitats in the lower Mississippi Valley

USGS Publications Warehouse

Faulkner, Stephen P.

2010-01-01

Landscape patterns and processes reflect both natural ecosystem attributes and the policy and management decisions of individual Federal, State, county, and private organizations. Land-use regulation, water management, and habitat conservation and restoration efforts increasingly rely on landscape-level approaches that incorporate scientific information into the decision-making process. Since management actions are implemented to affect future conditions, decision-support models are necessary to forecast potential future conditions resulting from these decisions. Spatially explicit modeling approaches enable testing of different scenarios and help evaluate potential outcomes of management actions in conjunction with natural processes such as climate change. The ability to forecast the effects of changing land use and climate is critically important to land and resource managers since their work is inherently site specific, yet conservation strategies and practices are expressed at higher spatial and temporal scales that must be considered in the decisionmaking process.

Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

PubMed

Torke, Alexia M; Callahan, Christopher M; Sachs, Greg A; Wocial, Lucia D; Helft, Paul R; Monahan, Patrick O; Slaven, James E; Montz, Kianna; Burke, Emily S; Inger, Lev

2018-03-01

Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6 weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR] = 0.65, 95% CI 0.50, 0.85) and depression (AOR = 0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β = -0.30, p = 0.003) and higher decision quality (β = -0.44, p < 0.0001). Information was associated with higher post-traumatic stress (β = 0.23, p = 0.022) but also higher satisfaction (β = 0.61, p < 0.001). Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.

Interrater Agreement on the Visual Analysis of Individual Tiers and Functional Relations in Multiple Baseline Designs.

PubMed

Wolfe, Katie; Seaman, Michael A; Drasgow, Erik

2016-11-01

Previous research on visual analysis has reported low levels of interrater agreement. However, many of these studies have methodological limitations (e.g., use of AB designs, undefined judgment task) that may have negatively influenced agreement. Our primary purpose was to evaluate whether agreement would be higher than previously reported if we addressed these weaknesses. Our secondary purposes were to investigate agreement at the tier level (i.e., the AB comparison) and at the functional relation level in multiple baseline designs and to examine the relationship between raters' decisions at each of these levels. We asked experts (N = 52) to make judgments about changes in the dependent variable in individual tiers and about the presence of an overall functional relation in 31 multiple baseline graphs. Our results indicate that interrater agreement was just at or just below minimally adequate levels for both types of decisions and that agreement at the individual tier level often resulted in agreement about the overall functional relation. We report additional findings and discuss implications for practice and future research. © The Author(s) 2016.

Police officer response to the injured officer: a survey-based analysis of medical care decisions.

PubMed

Sztajnkrycer, Matthew D; Callaway, David W; Baez, Amado Alejandro

2007-01-01

No widely accepted, specialized medical training exists for police officers confronted with medical emergencies while under conditions of active threat. The purpose of this study was to assess medical decision-making capabilities of law enforcement personnel under these circumstances. Web-based surveys were administered to all sworn officers within the county jurisdiction. Thirty-eight key actions were predetermined for nine injured officer scenarios, with each correct action worth one point. Descriptive statistics and t-tests were used to analyze results. Ninety-seven officers (65.1% response rate) responded to the survey. The majority of officers (68.0%) were trained to the first-responder level. Overall mean score for the scenarios was 15.5 +/- 3.6 (range 7-25). A higher level of medical training (EMT-B/P versus first responder) was associated with a higher mean score (16.6 +/- 3.4, p = 0.05 vs. 15.0 +/- 3.6, p = 0.05). Tactical unit assignment was associated with a lower score compared with non-assigned officers (13.5 +/- 2.9 vs. 16.0 +/- 3.6, p = 0.0085). No difference was noted based upon previous military experience. Ninety-two percent of respondents expressed interest in a law enforcement-oriented advanced first-aid course. Tactical medical decision-making capability, as assessed through the nine scenarios, was sub-optimal. In this post 9/11 era, development of law enforcement-specific medical training appears appropriate.

Gendered Pathways to Burnout: Results from the SALVEO Study.

PubMed

Beauregard, Nancy; Marchand, Alain; Bilodeau, Jaunathan; Durand, Pierre; Demers, Andrée; Haines, Victor Y

2018-04-18

Burnout is a pervasive mental health problem in the workforce, with mounting evidence suggesting ties with occupational and safety outcomes such as work injuries, critical events and musculoskeletal disorders. While environmental [work and non-work, work-to-family conflict (WFC)] and individual (personality) pathways to burnout are well documented, little is known about how gender comes to influence such associative patterns. The aim of the study consisted in examining gendered pathways to burnout. Data were derived from the SALVEO study, a cross-sectional study of 2026 workers from 63 workplaces from the province of Québec (Canada). Data were analyzed using multilevel path analysis. Direct effects of gendered pathways were evidenced for work (e.g. decision latitude) and non-work (e.g. child-related strains) environmental pathways, as well as for individual pathways (i.e. internal locus of control). Indirect effects of gendered pathways were also evidenced, with women reporting higher levels of burnout compared to men due to lower levels of decision latitude and of self-esteem, as well as higher levels of WFC. Women also reported lower burnout levels through investing more time into domestic tasks, which could represent a recovery strategy to highly demanding work. WFC further mediated the associations between working hours and burnout, as well as the between irregular work schedules and burnout. These result suggest than men distinctively reported higher levels of burnout due to the specific nature of their work contract negatively impacting on WFC, and incidentally, on their mental health. Study results supported our hypotheses positing that gender distinctively shapes environmental and individual pathways to burnout. OHS prevention efforts striving for better mental health outcomes in the workforce could relevantly be informed by a gendered approach to burnout.

Nurse-physician collaboration and associations with perceived autonomy in Cypriot critical care nurses.

PubMed

Georgiou, Evanthia; Papathanassoglou, Elizabeth DE; Pavlakis, Andreas

2017-01-01

Increased nurse-physician collaboration is a factor in improved patient outcomes. Limited autonomy of nurses has been proposed as a barrier to collaboration. This study aims to explore nurse-physician collaboration and potential associations with nurses' autonomy and pertinent nurses' characteristics in adult intensive care units (ICUs) in Cyprus. Descriptive correlational study with sampling of the entire adult ICU nurses' population in Cyprus (five ICUs in four public hospitals, n = 163, response rate 88·58%). Nurse-physician collaboration was assessed by the Collaboration and Satisfaction About Care Decisions Scale (CSACD), and autonomy by the Varjus et al. scale. The average CSACD score was 36·36 ± 13·30 (range: 7-70), implying low levels of collaboration and satisfaction with care decisions. Male participants reported significantly lower CSACD scores (t = 2·056, p = 0·04). CSACD correlated positively with years of ICU nursing experience (r = 0·332, p < 0·0001) and professional satisfaction (r = 0·455, p < 0·0001). The mean autonomy score was 76·15 ± 16·84 (range: 18-108). Higher degree of perceived collaboration (CSACD scores) associated with higher autonomy scores (r = 0·508, p <0·0001). Our findings imply low levels of nurse-physician collaboration and satisfaction with care decisions and moderate levels of autonomy in ICU nurses in Cyprus. The results provide insight into the association between nurse-physician collaboration and nurses' autonomy and the correlating factors. © 2015 British Association of Critical Care Nurses.

A preliminary experimental examination of worldview verification, perceived racism, and stress reactivity in African Americans.

PubMed

Lucas, Todd; Lumley, Mark A; Flack, John M; Wegner, Rhiana; Pierce, Jennifer; Goetz, Stefan

2016-04-01

According to worldview verification theory, inconsistencies between lived experiences and worldviews are psychologically threatening. These inconsistencies may be key determinants of stress processes that influence cardiovascular health disparities. This preliminary examination considers how experiencing injustice can affect perceived racism and biological stress reactivity among African Americans. Guided by worldview verification theory, it was hypothesized that responses to receiving an unfair outcome would be moderated by fairness of the accompanying decision process, and that this effect would further depend on the consistency of the decision process with preexisting justice beliefs. A sample of 118 healthy African American adults completed baseline measures of justice beliefs, followed by a laboratory-based social-evaluative stressor task. Two randomized fairness manipulations were implemented during the task: participants were given either high or low levels of distributive (outcome) and procedural (decision process) justice. Glucocorticoid (cortisol) and inflammatory (C-reactive protein) biological responses were measured in oral fluids, and attributions of racism were also measured. The hypothesized 3-way interaction was generally obtained. Among African Americans with a strong belief in justice, perceived racism, cortisol, and C-reactive protein responses to low distributive justice were higher when procedural justice was low. Among African Americans with a weak belief in justice however, these responses were higher when a low level of distributive justice was coupled with high procedural justice. Biological and psychological processes that contribute to cardiovascular health disparities are affected by consistency between individual-level and contextual justice factors. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Beliefs and Values among Rural Citizens: Shared Expectations for Educational Attainment?

ERIC Educational Resources Information Center

Deggs, David M.; Miller, Michael T.

2011-01-01

Discussions at the local, state, and national level have been focused on the importance of providing access and opportunity for college attendance. While these discussions are important to raising public interest in higher education attainment, they often negate how community values influence the college attendance decision process. This study…

Activity-Based Costing for Agile Manufacturing Control

DTIC Science & Technology

1998-08-01

INVESTMENT FOR A PROPOSED CAPITAL EQUIPMENT .... PURCHASE...to maintain a complex accounting system to meet your decision-making needs and the requirements of GAAP (Generally Accepted Accounting Principles). An...to be used primarily for job quotation, then some of the secondary activities can be consolidated into "higher" level activities that would shorten the

Affirmative Action's Fate: Are 20 More Years Enough?

ERIC Educational Resources Information Center

Moses, Michele S.; Yun, John T.; Marin, Patricia

2009-01-01

In this article we examine the current status of affirmative action in postsecondary admissions through a concurrent review of recent court rulings, state legislation, and higher education enrollment data. Analyzing each of these factors in the context of the others is important because the court decisions and state-level legislation interact to…

Characteristics of the Social Demand for Two-Level Professional Training

ERIC Educational Resources Information Center

Tuzikov, A.; Zinurova, R.

2009-01-01

The political decision to convert to the system of multilevel professional training in the higher educational institutions of Russia has already been made and formalized in law. The system, a combination of the "bachelor's and master's" pattern and the "specialist" pattern is being adopted starting in 2009. However, in spite of…

Coach or Counselor - What's the Difference? Learning Times. Volume 8, Number 1, Winter 2010

ERIC Educational Resources Information Center

LDA Minnesota, 2010

2010-01-01

This issue of "Learning Times" discusses how individuals with ADHD (Attention-Deficit/Hyperactivity Disorder) can benefit from coaches and counselors. This issue also includes the following features: (1) Healthy Legacy: Anxiety, Inattention, Poor Decisions Increase in Kids with Higher Lead Levels; (2) Parent Corner: New Book for Kids…

Minimum Wages and Teenagers' Enrollment--Employment Outcomes: A Multinominal Logit Model.

ERIC Educational Resources Information Center

Ehrenberg, Ronald G.; Marcus, Alan J.

1982-01-01

This paper tests the hypothesis that the effect of minimum wage legislation on teenagers' education decisions is asymmetrical across family income classes, with the legislation inducing children from low-income families to reduce their levels of schooling and children from higher-income families to increase their educational attainment. (Author)

Physicians' anxiety due to uncertainty and use of race in medical decision making.

PubMed

Cunningham, Brooke A; Bonham, Vence L; Sellers, Sherrill L; Yeh, Hsin-Chieh; Cooper, Lisa A

2014-08-01

The explicit use of race in medical decision making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain. The aim of this study was to investigate whether physician anxiety due to uncertainty (ADU) is associated with a higher propensity to use race in medical decision making. This study included a national cross-sectional survey of general internists. A national sample of 1738 clinically active general internists drawn from the SK&A physician database were included in the study. ADU is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision making. We used bivariate regression to test for associations between physician characteristics, ADU, and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders. The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, P=0.04, for each 1-point increase in ADU), as did physicians who understood "race" to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients scored lower on RACE. This study demonstrates positive associations between physicians' ADU, meanings attributed to race, and self-reported use of race in medical decision making. Future research should examine the potential impact of these associations on patient outcomes and health care disparities.

Physicians’ Anxiety Due to Uncertainty and Use of Race in Medical Decision-Making

PubMed Central

Cunningham, Brooke A.; Bonham, Vence L.; Sellers, Sherrill L.; Yeh, Hsin-Chieh; Cooper, Lisa A.

2014-01-01

Background The explicit use of race in medical decision-making is contested. Researchers have hypothesized that physicians use race in care when they are uncertain. Objectives To investigate whether physician anxiety due to uncertainty is associated with a higher propensity to use race in medical decision-making. Research Design A national cross-sectional survey of general internists Subjects A national sample of 1738 clinically active general internists drawn from the SK&A physician database Measures Anxiety Due to Uncertainty (ADU) is a 5-item measure of emotional reactions to clinical uncertainty. Bonham and Sellers Racial Attributes in Clinical Evaluation (RACE) scale includes 7 items that measure self-reported use of race in medical decision-making. We used bivariate regression to test for associations between physician characteristics, ADU and RACE. Multivariate linear regression was performed to test for associations between ADU and RACE while adjusting for potential confounders. Results The mean score on ADU was 19.9 (SD=5.6). Mean score on RACE was 13.5 (SD=5.6). After adjusting for physician demographics, physicians with higher levels of ADU scored higher on RACE (+β=0.08 in RACE, p=0.04, for each 1-point increase in ADU), as did physicians who understand “race” to mean biological or genetic ancestral, rather than sociocultural, group. Physicians who graduated from a US medical school, completed fellowship, and had more white patients, scored lower on RACE. Conclusions This study demonstrates positive associations between physicians’ anxiety due to uncertainty, meanings attributed to race, and self-reported use of race in medical decision-making. Future research should examine the potential impact of these associations on patient outcomes and healthcare disparities. PMID:25025871

Small firm self-insurance under the Affordable Care Act.

PubMed

Buettgens, Matthew; Blumberg, Linda J

2012-11-01

The Affordable Care Act changes the small-group insurance market substan­tially beginning in 2014, but most changes do not apply to self-insured plans. This exemp­tion provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employ­ers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stabil­ity in small-group insurance coverage.

Job strain and ambulatory work blood pressure in healthy young men and women.

PubMed

Light, K C; Turner, J R; Hinderliter, A L

1992-08-01

The effect of high job strain (defined as high psychological demands plus low decision latitude at work) on blood pressure was determined in 129 healthy, nonhypertensive men (n = 65) and women (n = 64). Blood pressure measures included mean screening levels obtained in a clinical environment, mean ambulatory levels from one 8-hour workday, and the change in levels from screening to mean work levels. In male workers, men with high and low job strain showed similar blood pressures at screening, but men with high job strain showed greater increases from screening to work, resulting in higher mean work blood pressure. Occupational status was unrelated to job strain or blood pressure in men. In female workers, women with high and low job strain did not differ in any measure of blood pressure; however, there were trends for higher occupational status and greater skill discretion to be associated with higher blood pressure responses at work in women.

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

PubMed

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

2009-12-01

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

Prescription medicines: decision-making preferences of patients who receive different levels of public subsidy.

PubMed

Robertson, Jane; Doran, Evan; Henry, David A; Salkeld, Glenn

2014-02-01

To compare the relative importance of medicine attributes and decision-making preferences of patients with higher or lower levels of insurance coverage in a publicly funded health care system. Cross-sectional telephone survey of randomly selected regular medicine users aged ≥18 years in the Hunter Valley, NSW, Australia. Questions about 27 medicine attributes and active involvement in decisions to start a new medicine. After adjustment, there were few differences between the 408 concession card holders (high insurance) and 410 general beneficiaries (low insurance) in their assessment of the importance of medicine attributes. For both groups, the explanation of treatment options, establishing the need for the medicine, and medicine efficacy and safety were the most important considerations. Medicine costs, the treatment burden and medicine familiarity were less important; the views of family and friends ranked lowest. There was a statistically significantly greater influence of the regular doctor for the concession card holders than general beneficiaries (93.6 vs. 84%, adjusted OR 2.80, 95% CI 1.31, 5.99). Concession card holders were more likely to favour doctors having more say in the decision-making process (crude OR 1.69, 95% CI 1.28, 2.24), and more likely to report the most recent treatment decision being made by the doctor alone, compared with general beneficiaries (61.2 vs. 40.3%). Medicine need, efficacy and safety are viewed as paramount for most patients, irrespective of insurance status. While patients report the importance of participation in treatment decisions, delegation of decision making to the doctor was common in practice. © 2011 John Wiley & Sons Ltd.

The relationship between risk factors and aeronautical decision making in the flight training environment

NASA Astrophysics Data System (ADS)

Wetmore, Michael J.

The purpose of this applied dissertation was to investigate the relationship between risk factors and aeronautical decision making in the flight training environment using a quantitative, non-experimental, ex post facto research design. All 75 of the flight training accidents that involved a fatality from the years 2001-2003 were selected for study from the National Transportation Safety Board (NTSB) aviation accident database. Objective evidence from the Factual Reports was used to construct accident chains and to code and quantify total risk factors and total poor aeronautical decisions. The data were processed using correlational statistical tests at the 1% significance level. There was a statistically significant relationship between total risk factors per flight and poor decisions per flight. Liveware risks were the most prevalent risk factor category. More poor decisions were made during preflight than any other phase of flight. Pilots who made multiple poor decisions per flight had significantly higher risk factors per flight. A risk factor threat to decision making chart is presented for use by flight instructors and/or flight training organizations. The main threat to validity of this study was the NTSB accident investigation team investigative equality assumption.

Hierarchical effects on target detection and conflict monitoring

PubMed Central

Cao, Bihua; Gao, Feng; Ren, Maofang; Li, Fuhong

2016-01-01

Previous neuroimaging studies have demonstrated a hierarchical functional structure of the frontal cortices of the human brain, but the temporal course and the electrophysiological signature of the hierarchical representation remains unaddressed. In the present study, twenty-one volunteers were asked to perform a nested cue-target task, while their scalp potentials were recorded. The results showed that: (1) in comparison with the lower-level hierarchical targets, the higher-level targets elicited a larger N2 component (220–350 ms) at the frontal sites, and a smaller P3 component (350–500 ms) across the frontal and parietal sites; (2) conflict-related negativity (non-target minus target) was greater for the lower-level hierarchy than the higher-level, reflecting a more intensive process of conflict monitoring at the final step of target detection. These results imply that decision making, context updating, and conflict monitoring differ among different hierarchical levels of abstraction. PMID:27561989

Evolutions in clinical reasoning assessment: The Evolving Script Concordance Test.

PubMed

Cooke, Suzette; Lemay, Jean-François; Beran, Tanya

2017-08-01

Script concordance testing (SCT) is a method of assessment of clinical reasoning. We developed a new type of SCT case design, the evolving SCT (E-SCT), whereby the patient's clinical story is "evolving" and with thoughtful integration of new information at each stage, decisions related to clinical decision-making become increasingly clear. We aimed to: (1) determine whether an E-SCT could differentiate clinical reasoning ability among junior residents (JR), senior residents (SR), and pediatricians, (2) evaluate the reliability of an E-SCT, and (3) obtain qualitative feedback from participants to help inform the potential acceptability of the E-SCT. A 12-case E-SCT, embedded within a 24-case pediatric SCT (PaedSCT), was administered to 91 pediatric residents (JR: n = 50; SR: n = 41). A total of 21 pediatricians served on the panel of experts (POE). A one-way analysis of variance (ANOVA) was conducted across the levels of experience. Participants' feedback on the E-SCT was obtained with a post-test survey and analyzed using two methods: percentage preference and thematic analysis. Statistical differences existed across levels of training: F = 19.31 (df = 2); p < 0.001. The POE scored higher than SR (mean difference = 10.34; p < 0.001) and JR (mean difference = 16.00; p < 0.001). SR scored higher than JR (mean difference = 5.66; p < 0.001). Reliability (Cronbach's α) was 0.83. Participants found the E-SCT engaging, easy to follow and true to the daily clinical decision-making process. The E-SCT demonstrated very good reliability and was effective in distinguishing clinical reasoning ability across three levels of experience. Participants found the E-SCT engaging and representative of real-life clinical reasoning and decision-making processes. We suggest that further refinement and utilization of the evolving style case will enhance SCT as a robust, engaging, and relevant method for the assessment of clinical reasoning.

Clinical decision making for a tooth with apical periodontitis: the patients' preferred level of participation.

PubMed

Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Chaudry, Faiza; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

2014-06-01

To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP. Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05). Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025). The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

eHealth Literacy and Partner Involvement in Treatment Decision Making for Men With Newly Diagnosed Localized Prostate Cancer.

PubMed

Song, Lixin; Tatum, Kimberly; Greene, Giselle; Chen, Ronald C

2017-03-01

To examine how the eHealth literacy of partners of patients with newly diagnosed prostate cancer affects their involvement in decision making, and to identify the factors that influence their eHealth literacy.
. Cross-sectional exploratory study.
. North Carolina.
. 142 partners of men with newly diagnosed localized prostate cancer. 
. A telephone survey and descriptive and multiple linear regression analyses were used.
. The partners' eHealth literacy, involvement in treatment decision making, and demographics, and the health statuses of the patients and their partners. 
. Higher levels of eHealth literacy among partners were significantly associated with their involvement in getting a second opinion, their awareness of treatment options, and the size of the social network they relied on for additional information and support for treatment decision making for prostate cancer. The factor influencing eHealth literacy was the partners' access to the Internet for personal use, which explained some of the variance in eHealth literacy.
. This study described how partners' eHealth literacy influenced their involvement in treatment decision making for prostate cancer and highlighted the influencing factors (i.e., partners' access to the Internet for personal use).
. When helping men with prostate cancer and their partners with treatment decision making, nurses need to assess eHealth literacy levels to determine whether nonelectronically based education materials are needed and to provide clear instructions on how to use eHealth resources.

Decision-making, sensitivity to reward, and attrition in weight-management

PubMed Central

Koritzky, Gilly; Dieterle, Camille; Rice, Chantelle; Jordan, Katie; Bechara, Antoine

2014-01-01

Objective Attrition is a common problem in weight-management. Understanding the risk factors for attrition should enhance professionals’ ability to increase completion rates and improve health outcomes for more individuals. We propose a model that draws upon neuropsychological knowledge on reward-sensitivity in obesity and overeating to predict attrition. Design & Methods 52 participants in a weight-management program completed a complex decision-making task.Decision-making characteristics – including sensitivity to reward – were further estimated using a quantitative model. Impulsivity and risk-taking measures were also administered. Results Consistent with the hypothesis that sensitivity to reward predicted attrition, program dropouts had higher sensitivity to reward than completers (p < 0.03). No differences were observed between completers and dropouts in initial BMI, age, employment status, or the number of prior weight-loss attempts (p ≥ 0.07). Completers had a slightly higher education level than dropouts, but its inclusion in the model did not increase predictive power. Impulsivity, delay of gratification, and risk-taking did not predict attrition, either. Conclusions Findings link attrition in weight-management to the neural mechanisms associated with reward-seeking and related influences on decision-making. Individual differences in the magnitude of response elicited by rewards may account for the relative difficulty experienced by dieters in adhering to treatment. PMID:24771588

Dynamic Selective Exposure during Decision-Making.

PubMed

Phillips, James G; Hoon, Teressa; Landon, Jason

2016-01-01

To understand dynamic changes in the likelihood that people would access and selectively expose themselves to information online, the present study examined the checking of account balances during simulated gambling. Sixteen participants played 120 hands of computer Blackjack for points, at higher or lower levels of risk (different point multipliers), and after each win or loss the computer recorded if participants checked their account balances. There were individual differences in checking rates. Participants who were more likely to check balances exhibited a selectivity of exposure to decision consonant information after a win at low risk. Although it was expected that people would seek to maintain positive mood, data were better explained in terms of Cognitive Dissonance. The effects of Cognitive Dissonance are liable to extend beyond single static decisions into dynamic online environments.

A simulator study of the interaction of pilot workload with errors, vigilance, and decisions

NASA Technical Reports Server (NTRS)

Smith, H. P. R.

1979-01-01

A full mission simulation of a civil air transport scenario that had two levels of workload was used to observe the actions of the crews and the basic aircraft parameters and to record heart rates. The results showed that the number of errors was very variable among crews but the mean increased in the higher workload case. The increase in errors was not related to rise in heart rate but was associated with vigilance times as well as the days since the last flight. The recorded data also made it possible to investigate decision time and decision order. These also varied among crews and seemed related to the ability of captains to manage the resources available to them on the flight deck.

Dual processing model of medical decision-making.

PubMed

Djulbegovic, Benjamin; Hozo, Iztok; Beckstead, Jason; Tsalatsanis, Athanasios; Pauker, Stephen G

2012-09-03

Dual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administered to the patient who may or may not have a disease. We developed a mathematical model in which we linked a recently proposed descriptive psychological model of cognition with the threshold model of medical decision-making and show how this approach can be used to better understand decision-making at the bedside and explain the widespread variation in treatments observed in clinical practice. We show that physician's beliefs about whether to treat at higher (lower) probability levels compared to the prescriptive therapeutic thresholds obtained via system II processing is moderated by system I and the ratio of benefit and harms as evaluated by both system I and II. Under some conditions, the system I decision maker's threshold may dramatically drop below the expected utility threshold derived by system II. This can explain the overtreatment often seen in the contemporary practice. The opposite can also occur as in the situations where empirical evidence is considered unreliable, or when cognitive processes of decision-makers are biased through recent experience: the threshold will increase relative to the normative threshold value derived via system II using expected utility threshold. This inclination for the higher diagnostic certainty may, in turn, explain undertreatment that is also documented in the current medical practice. We have developed the first dual processing model of medical decision-making that has potential to enrich the current medical decision-making field, which is still to the large extent dominated by expected utility theory. The model also provides a platform for reconciling two groups of competing dual processing theories (parallel competitive with default-interventionalist theories).

Memory bias in health anxiety is related to the emotional valence of health-related words.

PubMed

Ferguson, Eamonn; Moghaddam, Nima G; Bibby, Peter A

2007-03-01

A model based on the associative strength of object evaluations is tested to explain why those who score higher on health anxiety have a better memory for health-related words. Sixty participants observed health and nonhealth words. A recognition memory task followed a free recall task and finally subjects provided evaluations (emotionality, imageability, and frequency) for all the words. Hit rates for health words, d', c, and psychological response times (PRTs) for evaluations were examined using multi-level modelling (MLM) and regression. Health words had a higher hit rate, which was greater for those with higher levels of health anxiety. The higher hit rate for health words is partly mediated by the extent to which health words are evaluated as emotionally unpleasant, and this was stronger for (moderated by) those with higher levels of health anxiety. Consistent with the associative strength model, those with higher levels of health anxiety demonstrated faster PRTs when making emotional evaluations of health words compared to nonhealth words, while those lower in health anxiety were slower to evaluate health words. Emotional evaluations speed the recognition of health words for high health anxious individuals. These findings are discussed with respect to the wider literature on cognitive processes in health anxiety, automatic processing, implicit attitudes, and emotions in decision making.

Body Weight Can Change How Your Emotions Are Perceived

PubMed Central

2016-01-01

Accurately interpreting other’s emotions through facial expressions has important adaptive values for social interactions. However, due to the stereotypical social perception of overweight individuals as carefree, humorous, and light-hearted, the body weight of those with whom we interact may have a systematic influence on our emotion judgment even though it has no relevance to the expressed emotion itself. In this experimental study, we examined the role of body weight in faces on the affective perception of facial expressions. We hypothesized that the weight perceived in a face would bias the assessment of an emotional expression, with overweight faces generally more likely to be perceived as having more positive and less negative expressions than healthy weight faces. Using two-alternative forced-choice perceptual decision tasks, participants were asked to sort the emotional expressions of overweight and healthy weight facial stimuli that had been gradually morphed across six emotional intensity levels into one of two categories—“neutral vs. happy” (Experiment 1) and “neutral vs. sad” (Experiment 2). As predicted, our results demonstrated that overweight faces were more likely to be categorized as happy (i.e., lower happy decision threshold) and less likely to be categorized as sad (i.e., higher sad decision threshold) compared to healthy weight faces that had the same levels of emotional intensity. The neutral-sad decision threshold shift was negatively correlated with participant’s own fear of becoming fat, that is, those without a fear of becoming fat more strongly perceived overweight faces as sad relative to those with a higher fear. These findings demonstrate that the weight of the face systematically influences how its emotional expression is interpreted, suggesting that being overweight may make emotional expressions appear more happy and less sad than they really are. PMID:27870892

Body Weight Can Change How Your Emotions Are Perceived.

PubMed

Oh, Yujung; Hass, Norah C; Lim, Seung-Lark

2016-01-01

Accurately interpreting other's emotions through facial expressions has important adaptive values for social interactions. However, due to the stereotypical social perception of overweight individuals as carefree, humorous, and light-hearted, the body weight of those with whom we interact may have a systematic influence on our emotion judgment even though it has no relevance to the expressed emotion itself. In this experimental study, we examined the role of body weight in faces on the affective perception of facial expressions. We hypothesized that the weight perceived in a face would bias the assessment of an emotional expression, with overweight faces generally more likely to be perceived as having more positive and less negative expressions than healthy weight faces. Using two-alternative forced-choice perceptual decision tasks, participants were asked to sort the emotional expressions of overweight and healthy weight facial stimuli that had been gradually morphed across six emotional intensity levels into one of two categories-"neutral vs. happy" (Experiment 1) and "neutral vs. sad" (Experiment 2). As predicted, our results demonstrated that overweight faces were more likely to be categorized as happy (i.e., lower happy decision threshold) and less likely to be categorized as sad (i.e., higher sad decision threshold) compared to healthy weight faces that had the same levels of emotional intensity. The neutral-sad decision threshold shift was negatively correlated with participant's own fear of becoming fat, that is, those without a fear of becoming fat more strongly perceived overweight faces as sad relative to those with a higher fear. These findings demonstrate that the weight of the face systematically influences how its emotional expression is interpreted, suggesting that being overweight may make emotional expressions appear more happy and less sad than they really are.

Cancer drug funding decisions in Scotland: impact of new end-of-life, orphan and ultra-orphan processes.

PubMed

Morrell, Liz; Wordsworth, Sarah; Fu, Howell; Rees, Sian; Barker, Richard

2017-08-30

The Scottish Medicines Consortium evaluates new drugs for use in the National Health Service in Scotland. Reforms in 2014 to their evaluation process aimed to increase patient access to new drugs for end-of-life or rare conditions; the changes include additional steps in the process to gain further information from patients and clinicians, and for revised commercial agreements. This study examines the extent of any impact of the reforms on funding decisions. Data on the Scottish Medicines Consortium's funding decisions during 24 months post-reform were extracted from published Advice, for descriptive statistics and thematic analysis. Comparison data were extracted for the 24 months pre-reform. Data on decisions for England by the National Institute for Clinical and Health Excellence for the same drugs were extracted from published Technology Appraisals. The new process was used by 90% (53/59) of cancer submissions. It is triggered if the initial advice is not to recommend, and this risk-of-rejection level is higher than in the pre-period. Thirty-eight cancer drugs obtained some level of funding through the new process, but there was no significant difference in the distribution of decision types compared to the pre-reform period. Thematic analysis of patient and clinician input showed no clear relationship between issues raised and funding decision. Differences between SMC's and NICE's definitions of End-of-Life did not fully explain differences in funding decisions. The Scottish Medicines Consortium's reforms have allowed funding of up to 38 cancer drugs that might previously have been rejected. However, the contribution of specific elements of the reforms to the final decision is unclear. The process could be improved by increased transparency in how the non-quantitative inputs influence decisions. Some disparities in funding decisions between England and Scotland are likely to remain despite recent process convergence.

Knocking at the College Door: Projections of High School Graduates, 9th Edition. Revised

ERIC Educational Resources Information Center

Bransberger, Peace; Michelau, Demarée K.

2017-01-01

For nearly 40 years, the Western Interstate Commission for Higher Education (WICHE) has produced projections of high school graduates. The purpose of "Knocking at the College Door: Projections of High School Graduates" is to equip decision-makers at all levels with information about how the numbers of high school graduates are likely to…

Financial Literacy. Snapshots. Volume 6, Issue 6, Article 1

ERIC Educational Resources Information Center

Thomson, Sue

2015-01-01

Young people face financial issues at an earlier age than their parents. Decisions about higher education, the need to be able to manage online payment facilities or even mobile phone plans require a level of financial literacy. PISA 2012 offered an opportunity to collect information about the financial literacy of Australian 15-year-old students,…

78 FR 48769 - Mercedes-Benz USA, LLC and Daimler AG, Receipt of Petition for Decision of Inconsequential...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-09

... subject vehicles contain parking lamps that exceed the maximum designated candlepower output level... for parking lamps). Due to a programming issue in the electronic control unit, the voltage in the parking lamp circuit is 12.8 volts which is higher than the design voltage specification of 7 volts in the...

Effect of Personal Financial Knowledge on College Students' Credit Card Behavior

ERIC Educational Resources Information Center

Robb, Cliff A.; Sharpe, Deanna L.

2009-01-01

Analysis of survey data collected from 6,520 students at a large Midwestern University affirmed that financial knowledge is a significant factor in the credit card decisions of college students but not entirely in expected ways. Results of a double hurdle analysis indicated that students with relatively higher levels of financial knowledge were…

Institutional Transfer and the Management of Risk in Higher Education. WISCAPE Working Paper

ERIC Educational Resources Information Center

Deil-Amen, Regina; Goldrick-Rab, Sara

2009-01-01

By probing the micro-level interactions and experiences shaping students' thoughts, behaviors, and decisions during college the authors hope to generate a better picture of how individuals enact the intersection of their own agency with their given social context. Such insights may enable a more accurate and meaningful interpretation of the…

ADHD Symptomatology and Adjustment to College in China and the United States

ERIC Educational Resources Information Center

Norvilitis, Jill M.; Sun, Ling; Zhang, Jie

2010-01-01

This study examined ADHD symptomatology and college adjustment in 420 participants--147 from the United States and 273 from China. It was hypothesized that higher levels of ADHD symptoms in general and the inattentive symptom group in particular would be related to decreased academic and social adjustment, career decision-making self-efficacy, and…

How Does University Decision Making Shape the Faculty?

ERIC Educational Resources Information Center

Cross, John G.; Goldenberg, Edie N.

2003-01-01

Even a cursory reading of the higher education literature reveals a growing concern with the changing mix of tenure-track and non-tenure-track faculty. The focus a few years ago was on the apparent withdrawal of tenure-track faculty from commitment to instruction, especially at the first- and second-year levels. The focus now is on the rapidly…

Validating College Course Placement Decisions Based on CLEP Exam Scores: CLEP Placement Validity Study Results. Statistical Report

ERIC Educational Resources Information Center

Godfrey, Kelly E.; Jagesic, Sanja

2016-01-01

The College-Level Examination Program® (CLEP®) is a computer-based prior-learning assessment that allows examinees the opportunity to demonstrate mastery of knowledge and skills necessary to earn postsecondary course credit in higher education. Currently, there are 33 exams in five subject areas: composition and literature, world languages,…

Exploring Sense of Community and Persistence in the Community College

ERIC Educational Resources Information Center

Bengfort, Randall R.

2012-01-01

As concern grows about the level of college completion in the U.S., higher education leaders are seeking ways to help more students attain their educational objectives. This study sought to aid that effort by determining if a theoretical framework of sense of community developed by McMillan and Chavis (1986) influences students' decisions to…

Impact of School Autonomy on Student Achievement: Cases from Australia

ERIC Educational Resources Information Center

Caldwell, Brian John

2016-01-01

Purpose: The purpose of this paper is to report four case studies in Australia that respond to the question: "How have schools with a relatively high degree of autonomy used their increased authority and responsibility to make decisions that have led in explicit cause-and-effect fashion to higher levels of student achievement"?…

The role of conservation programs in drought risk adaptation

Treesearch

Steven Wallander; Marcel Aillery; Daniel Hellerstein; Michael Hand

2013-01-01

This report evaluates the extent to which farms facing higher levels of drought risk are more likely to participate in conservation programs, and fi nds a strong link between drought risk and program participation. Prior research has shown that climate-related risk exposure infl uences production decisions such as crop choice; our research shows that adaptation also...

A Data Warehouse Model for Micro-Level Decision Making in Higher Education

ERIC Educational Resources Information Center

van Dyk, Liezl

2008-01-01

An abundance of research, by educational researchers and scholars of teaching and learning alike, can be found on the use of ICT to plan design and deliver learning activities and assessment activities. The first steps of the instructional design process are covered quite thoroughly by this. However, the use of ICT and quantitative methods to…

Intelligence moderates neural responses to monetary reward and punishment.

PubMed

Hawes, Daniel R; DeYoung, Colin G; Gray, Jeremy R; Rustichini, Aldo

2014-05-01

The relations between intelligence (IQ) and neural responses to monetary gains and losses were investigated in a simple decision task. In 94 healthy adults, typical responses of striatal blood oxygen level-dependent (BOLD) signal after monetary reward and punishment were weaker for subjects with higher IQ. IQ-moderated differential responses to gains and losses were also found for regions in the medial prefrontal cortex, posterior cingulate cortex, and left inferior frontal cortex. These regions have previously been identified with the subjective utility of monetary outcomes. Analysis of subjects' behavior revealed a correlation between IQ and the extent to which choices were related to experienced decision outcomes in preceding trials. Specifically, higher IQ predicted behavior to be more strongly correlated with an extended period of previously experienced decision outcomes, whereas lower IQ predicted behavior to be correlated exclusively to the most recent decision outcomes. We link these behavioral and imaging findings to a theoretical model capable of describing a role for intelligence during the evaluation of rewards generated by unknown probabilistic processes. Our results demonstrate neural differences in how people of different intelligence respond to experienced monetary rewards and punishments. Our theoretical discussion offers a functional description for how these individual differences may be linked to choice behavior. Together, our results and model support the hypothesis that observed correlations between intelligence and preferences may be rooted in the way decision outcomes are experienced ex post, rather than deriving exclusively from how choices are evaluated ex ante.

Strategic Decision Making Cycle in Higher Education: Case Study of E-Learning

ERIC Educational Resources Information Center

Divjak, Blaženka; Redep, Nina Begicevic

2015-01-01

This paper presents the methodology for strategic decision making in higher education (HE). The methodology is structured as a cycle of strategic decision making with four phases, and it is focused on institutional and national perspective, i.e. on decision making that takes place at institutions of HE and relevant national authorities, in case…

Learning in Insect Pollinators and Herbivores.

PubMed

Jones, Patricia L; Agrawal, Anurag A

2017-01-31

The relationship between plants and insects is influenced by insects' behavioral decisions during foraging and oviposition. In mutualistic pollinators and antagonistic herbivores, past experience (learning) affects such decisions, which ultimately can impact plant fitness. The higher levels of dietary generalism in pollinators than in herbivores may be an explanation for the differences in learning seen between these two groups. Generalist pollinators experience a high level of environmental variation, which we suggest favors associative learning. Larval herbivores employ habituation and sensitization-strategies useful in their less variable environments. Exceptions to these patterns based on habitats, mobility, and life history provide critical tests of current theory. Relevant plant traits should be under selection to be easily learned and remembered in pollinators and difficult to learn in herbivores. Insect learning thereby has the potential to have an important, yet largely unexplored, role in plant-insect coevolution.

Research brief: sexual communication and knowledge among Mexican parents and their adolescent children.

PubMed

Gallegos, Esther C; Villarruel, Antonia M; Gómez, Marco Vinicio; Onofre, Dora Julia; Zhou, Yan

2007-01-01

This study describes the sexual knowledge and communication of Mexican parents and adolescents. Preintervention data were analyzed from 829 high school students (ages 14-17) and one of the parents of each. Differences were found between parents and adolescents in sexual knowledge (M = 16.16 vs. M = 14.92; t = 7.20, p < .001); specifically, parents had higher knowledge related to sexually transmitted diseases, HIV/AIDS, and condom use. Parents perceived more general communication (t [787] = 6.33, p < .001), and less discomfort talking about sex (t [785] = 4.69, p < .001) than adolescents. Parents with higher education levels scored higher in HIV knowledge and general communication. Fathers had higher total sexual knowledge, whereas mothers perceived higher sexual communication than fathers. There were no differences in knowledge and communication by parental socioeconomic level. Results suggest health care providers need to assist parents in developing specific knowledge and skills to support their adolescents' sexual decision-making.

Contract management survey 2002.

PubMed

Hoppszallern, Suzanna

2002-10-01

Spending on clinical contracts continues to outpace spending on business services, but may be leveling off. The 12th annual Contract Management Survey shows that the performance of clinical vendors is now comparable to business service vendors in meeting savings targets. Both business and clinical vendors are receiving higher marks from hospital leaders, but execs quickly respond to low marks by bringing the service back in-house of changing vendors. This report examines trends in outsourcing, satisfaction levels, the decision-making process, contract features and performance, and spending.

An Integrated Tool Suite for En Route Radar Controllers in NextGen

NASA Technical Reports Server (NTRS)

Mercer, Joey; Prevot, Thomas; Brasil, Connie; Mainini, Matthew; Kupfer, Michael; Smtih, Nancy

2010-01-01

This paper describes recent human-in-the-loop research in the Airspace Operations Laboratory at the NASA Ames Research Center focusing on en route air traffic management with advanced trajectory planning tools and increased levels of human-automation cooperation. The decision support tools were exercised in a simulation of seven contiguous high-altitude sectors. Preliminary data suggests the controllers were able to manage higher amounts of traffic as compared to today, while maintaining acceptable levels of workload.

Medical Decision-Making Incapacity among Newly Diagnosed Older Patients with Hematological Malignancy Receiving First Line Chemotherapy: A Cross-Sectional Study of Patients and Physicians

PubMed Central

Sugano, Koji; Okuyama, Toru; Iida, Shinsuke; Komatsu, Hirokazu; Ishida, Takashi; Kusumoto, Shigeru; Uchida, Megumi; Nakaguchi, Tomohiro; Kubota, Yosuke; Ito, Yoshinori; Takahashi, Kazuhisa; Akechi, Tatsuo

2015-01-01

Background Decision-making capacity to provide informed consent regarding treatment is essential among cancer patients. The purpose of this study was to identify the frequency of decision-making incapacity among newly diagnosed older patients with hematological malignancy receiving first-line chemotherapy, to examine factors associated with incapacity and assess physicians’ perceptions of patients’ decision-making incapacity. Methods Consecutive patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Decision-making capacity was assessed using the Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory-Revised (SICIATRI-R). Cognitive impairment, depressive condition and other possible associated factors were also evaluated. Results Among 139 eligible patients registered for this study, 114 completed the survey. Of these, 28 (25%, 95% confidence interval [CI]: 17%-32%) were judged as having some extent of decision-making incompetency according to SICIATRI-R. Higher levels of cognitive impairment and increasing age were significantly associated with decision-making incapacity. Physicians experienced difficulty performing competency assessment (Cohen’s kappa -0.54). Conclusions Decision-making incapacity was found to be a common and under-recognized problem in older patients with cancer. Age and assessment of cognitive impairment may provide the opportunity to find patients that are at a high risk of showing decision-making incapacity. PMID:26296202

Consensus or controversy? The classification and treatment decision-making by 491 maxillofacial surgeons from around the world in three cases of a unilateral mandibular condyle fracture.

PubMed

Kommers, Sofie C; Boffano, Paolo; Forouzanfar, Tymour

2015-12-01

Many studies are available in the literature on both classification and treatment of unilateral mandibular condyle fractures. To date however, controversy regarding the best treatment for unilateral mandibular condyle fractures remains. In this study, an attempt was made to quantify the level of agreement between a sample of maxillofacial surgeons worldwide, on the classification and treatment decisions in three different unilateral mandibular condyle fracture cases. In total, 491 of 3044 participants responded. In all three mandibular condyle fracture cases, a fairly high level of disagreement was found. Only in the case of a subcondylar fracture, assuming dysocclusion was present, more than 81% of surgeons agreed that the best treatment would be open reduction and internal fixation. Based on the study results, there is considerable variation among surgeons worldwide with regard to treatment of unilateral mandibular condyle fracture. 3D imaging in higher fractures tends to lead to more invasive treatment decisions. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Vocational identity, positive affect, and career thoughts in a group of young adult central nervous system cancer survivors.

PubMed

Lange, Dustin D; Wong, Alex W K; Strauser, David R; Wagner, Stacia

2014-12-01

The aims of this study were as follows: (a) to compare levels of career thoughts and vocational identity between young adult childhood central nervous system (CNS) cancer survivors and noncancer peers and (b) to investigate the contribution of vocational identity and affect on career thoughts among cancer survivors. Participants included 45 young adult CNS cancer survivors and a comparison sample of 60 college students. Participants completed Career Thoughts Inventory, My Vocational Situation, and the Positive and Negative Affect Schedule. Multivariate analysis of variance and multiple regression analysis were used to analyze the data in this study. CNS cancer survivors had a higher level of decision-making confusion than the college students. Multiple regression analysis indicated that vocational identity and positive affect significantly predicted the career thoughts of CNS survivors. The differences in decision-making confusion suggest that young adult CNS survivors would benefit from interventions that focus on providing knowledge of how to make decisions, while increasing vocational identity and positive affect for this specific population could also be beneficial.

Plan Execution Interchange Language (PLEXIL)

NASA Technical Reports Server (NTRS)

Estlin, Tara; Jonsson, Ari; Pasareanu, Corina; Simmons, Reid; Tso, Kam; Verma, Vandi

2006-01-01

Plan execution is a cornerstone of spacecraft operations, irrespective of whether the plans to be executed are generated on board the spacecraft or on the ground. Plan execution frameworks vary greatly, due to both different capabilities of the execution systems, and relations to associated decision-making frameworks. The latter dependency has made the reuse of execution and planning frameworks more difficult, and has all but precluded information sharing between different execution and decision-making systems. As a step in the direction of addressing some of these issues, a general plan execution language, called the Plan Execution Interchange Language (PLEXIL), is being developed. PLEXIL is capable of expressing concepts used by many high-level automated planners and hence provides an interface to multiple planners. PLEXIL includes a domain description that specifies command types, expansions, constraints, etc., as well as feedback to the higher-level decision-making capabilities. This document describes the grammar and semantics of PLEXIL. It includes a graphical depiction of this grammar and illustrative rover scenarios. It also outlines ongoing work on implementing a universal execution system, based on PLEXIL, using state-of-the-art rover functional interfaces and planners as test cases.

Dissociable Neural Processes Underlying Risky Decisions for Self Versus Other

PubMed Central

Jung, Daehyun; Sul, Sunhae; Kim, Hackjin

2013-01-01

Previous neuroimaging studies on decision making have mainly focused on decisions on behalf of oneself. Considering that people often make decisions on behalf of others, it is intriguing that there is little neurobiological evidence on how decisions for others differ from those for oneself. The present study directly compared risky decisions for self with those for another person using functional magnetic resonance imaging (fMRI). Participants were asked to perform a gambling task on behalf of themselves (decision-for-self condition) or another person (decision-for-other condition) while in the scanner. Their task was to choose between a low-risk option (i.e., win or lose 10 points) and a high-risk option (i.e., win or lose 90 points) with variable levels of winning probability. Compared with choices regarding others, those regarding oneself were more risk-averse at lower winning probabilities and more risk-seeking at higher winning probabilities, perhaps due to stronger affective process during risky decisions for oneself compared with those for other. The brain-activation pattern changed according to the target, such that reward-related regions were more active in the decision-for-self condition than in the decision-for-other condition, whereas brain regions related to the theory of mind (ToM) showed greater activation in the decision-for-other condition than in the decision-for-self condition. Parametric modulation analysis using individual decision models revealed that activation of the amygdala and the dorsomedial prefrontal cortex (DMPFC) were associated with value computations for oneself and for another, respectively, during risky financial decisions. The results of the present study suggest that decisions for oneself and for other may recruit fundamentally distinct neural processes, which can be mainly characterized as dominant affective/impulsive and cognitive/regulatory processes, respectively. PMID:23519016

Evolutionary Perspective on Collective Decision Making

NASA Astrophysics Data System (ADS)

Farrell, Dene; Sayama, Hiroki; Dionne, Shelley D.; Yammarino, Francis J.; Wilson, David Sloan

Team decision making dynamics are investigated from a novel perspective by shifting agency from decision makers to representations of potential solutions. We provide a new way to navigate social dynamics of collective decision making by interpreting decision makers as constituents of an evolutionary environment of an ecology of evolving solutions. We demonstrate distinct patterns of evolution with respect to three forms of variation: (1) Results with random variations in utility functions of individuals indicate that groups demonstrating minimal internal variation produce higher true utility values of group solutions and display better convergence; (2) analysis of variations in behavioral patterns within a group shows that a proper balance between selective and creative evolutionary forces is crucial to producing adaptive solutions; and (3) biased variations of the utility functions diminish the range of variation for potential solution utility, leaving only the differential of convergence performance static. We generally find that group cohesion (low random variation within a group) and composition (appropriate variation of behavioral patterns within a group) are necessary for a successful navigation of the solution space, but performance in both cases is susceptible to group level biases.

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

Radojcic, Riko; Nowak, Matt; Nakamoto, Mark

The status of the development of a Design-for-Stress simulation flow that captures the stress effects in packaged 3D-stacked Si products like integrated circuits (ICs) using advanced via-middle Through Si Via technology is outlined. The next set of challenges required to proliferate the methodology and to deploy it for making and dispositioning real Si product decisions are described here. These include the adoption and support of a Process Design Kit (PDK) that includes the relevant material properties, the development of stress simulation methodologies that operate at higher levels of abstraction in a design flow, and the development and adoption of suitablemore » models required to make real product reliability decisions.« less

On the costs of self-interested economic behavior: how does stinginess get under the skin?

PubMed

Dunn, Elizabeth W; Ashton-James, Claire E; Hanson, Margaret D; Aknin, Lara B

2010-05-01

The present study examined how financial decisions 'get under the skin'. Participants played an economic game in which they could donate some of their payment to another student. Affect was measured afterward and salivary cortisol was measured before and afterward. Participants who kept more money for themselves reported less positive affect, more negative affect, and more shame. Shame predicted higher levels of post-game cortisol, controlling for pre-game cortisol; stingy economic behavior therefore produced a significant indirect effect on cortisol via shame. Thus, shame and cortisol represent plausible emotional and biological pathways linking everyday decisions with downstream consequences for health.

Tick-Tock Goes the Croc: A High-Density EEG Study of Risk-Reactivity and Binge-Drinking.

PubMed

Kiat, John E; Cheadle, Jacob E

2018-05-31

Links between individual differences in risk processing and high-risk behaviors such as binge drinking have long been the focus of active research. However, investigations in this area almost exclusively utilize decision-making focused paradigms. This emphasis makes it difficult to assess links between risk behaviors and raw risk reactivity independent of decision and feedback processes. A deeper understanding of this association has the potential to shed light on the role of risk reactivity in high-risk behavior susceptibility. To contribute towards this aim, this study utilizes a popular risk-taking game, the crocodile dentist, to assess links between individual differences in decision-free risk-reactivity and reported binge drinking frequency levels. In this task, participants engage in a series of decision-free escalating risk responses. Risk-reactivity was assessed by measuring Late Positive Potential responses towards risk-taking action initiation cues using high-density 256-Channel EEG. The results indicate that, after controlling for overall alcohol consumption frequency, higher rates of reported binge drinking are associated with both increased general risk-taking responsivity and increased risk-reactivity escalation as a function of risk level. These findings highlight intriguing links between risk reactivity and binge drinking frequency, making key contributions in the areas of risk-taking and affective science.

Health Management Information System utilization in Pakistan: challenges, pitfalls and the way forward.

PubMed

Qazi, Muhammad Suleman; Ali, Moazzam

2011-12-01

Use of data generated through the Health Management Information System (HMIS) in decision making has been facing various challenges ever since its inception in Pakistan. This descriptive qualitative study attempts to explore the perceptions of health managers to identify the status and issues in use of HMIS. Overall 26 managers (all men, ages ranging from 26 to 49 years; selected from federal level (2), provincial (4) and seven selected districts (20) from all four provinces) were interviewed face to face. The respondents identified a number of hurdles resulting in non-use, misuse and disuse of data. These included limited scope of HMIS, dubious data quality, political motives behind demand of data and an element of corruption in data reporting etc. A great deal of political and administrative will is required to institutionalize transparency in decision making in health management and HMIS is an important tool for doing so. Appropriate legislation and regulations are needed to create a conducive policy environment that would help in changing the existing decision making culture. The effective use of information requires that besides capacity development of district health managers in understanding and use of data, the higher level decision makers are provided with relevant data timely and in an easily understandable form along with the recommended actions pertinent to this data.

Cognitive Fatigue Destabilizes Economic Decision Making Preferences and Strategies.

PubMed

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

2015-01-01

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

Cognitive Fatigue Destabilizes Economic Decision Making Preferences and Strategies

PubMed Central

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

2015-01-01

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

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

PubMed

De Las Cuevas, Carlos; Peñate, Wenceslao; de Rivera, Luis

2014-01-01

Nonadherence to prescribed medications is a significant barrier to the successful treatment of psychiatric disorders in clinical practice. It has been argued that patient participation in shared decision making improves adherence to treatment plans. To assess to what extent treatment adherence of psychiatric patients is influenced by the concordance between their preferred participation and their actual participation in decision making. A total of 967 consecutive psychiatric outpatients completed the Control Preference Scale twice consecutively before consultation, one for their preferences of participation, and the other for the style they had usually experienced until then, and the eight-item self-report Morisky Medication Adherence Scale 8. Most psychiatric outpatients preferred a collaborative role in decision making. Congruence was achieved in only 50% of the patients, with most mismatch cases preferring more involvement than had been experienced. Self-reported adherence was significantly higher in those patients in whom there was concordance between their preferences and their experiences of participation in decision making, regardless of the type of participation preferred. Congruence between patients' preferences and actual experiences for level of participation in shared decision making is relevant for their adherence to treatment.

The Role of Visual Area V4 in the Discrimination of Partially Occluded Shapes

PubMed Central

Kosai, Yoshito; El-Shamayleh, Yasmine; Fyall, Amber M.

2014-01-01

The primate brain successfully recognizes objects, even when they are partially occluded. To begin to elucidate the neural substrates of this perceptual capacity, we measured the responses of shape-selective neurons in visual area V4 while monkeys discriminated pairs of shapes under varying degrees of occlusion. We found that neuronal shape selectivity always decreased with increasing occlusion level, with some neurons being notably more robust to occlusion than others. The responses of neurons that maintained their selectivity across a wider range of occlusion levels were often sufficiently sensitive to support behavioral performance. Many of these same neurons were distinctively selective for the curvature of local boundary features and their shape tuning was well fit by a model of boundary curvature (curvature-tuned neurons). A significant subset of V4 neurons also signaled the animal's upcoming behavioral choices; these decision signals had short onset latencies that emerged progressively later for higher occlusion levels. The time course of the decision signals in V4 paralleled that of shape selectivity in curvature-tuned neurons: shape selectivity in curvature-tuned neurons, but not others, emerged earlier than the decision signals. These findings provide evidence for the involvement of contour-based mechanisms in the segmentation and recognition of partially occluded objects, consistent with psychophysical theory. Furthermore, they suggest that area V4 participates in the representation of the relevant sensory signals and the generation of decision signals underlying discrimination. PMID:24948811

Retirement Savings Behavior of Higher Education Employees

ERIC Educational Resources Information Center

Dulebohn, James H.; Murray, Brian

2007-01-01

Higher education employees often participate in university-sponsored defined contribution pension plans that place the investment decision responsibility upon them. In order to examine investment decision-making behavior with retirement savings plans we investigated attitude-mediated, individual difference determinants of risky decision-making…

Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

PubMed

Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra

2013-01-01

To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health decisions, need to be improved.

Mood stability versus mood instability in bipolar disorder: A possible role for emotional mental imagery

PubMed Central

Holmes, Emily A.; Deeprose, Catherine; Fairburn, Christopher G.; Wallace-Hadrill, Sophie M.A.; Bonsall, Michael B.; Geddes, John R.; Goodwin, Guy M.

2011-01-01

A cognitive model of bipolar disorder suggests that mental imagery acts as an emotional amplifier of mood and may be heightened in bipolar disorder. First, we tested whether patients with bipolar disorder would score higher on mental imagery measures than a matched healthy control group. Second, we examined differences in imagery between patients divided into groups according to their level of mood stability. Mood ratings over approximately 6-months, made using a mobile phone messaging system, were used to divide patients into stable or unstable groups. Clinician decisions of mood stability were corroborated with statistical analysis. Results showed (I) compared to healthy controls, patients with bipolar disorder had significantly higher scores for general mental imagery use, more vivid imagery of future events, higher levels of intrusive prospective imagery, and more extreme imagery-based interpretation bias; (II) compared to patients with stable mood, patients with unstable mood had higher levels of intrusive prospective imagery, and this correlated highly with their current levels of anxiety and depression. The findings were consistent with predictions. Further investigation of imagery in bipolar disorder appears warranted as it may highlight processes that contribute to mood instability with relevance for cognitive behaviour therapy. PMID:21798515

Age and expertise effects in aviation decision making and flight control in a flight simulator.

PubMed

Kennedy, Quinn; Taylor, Joy L; Reade, Gordon; Yesavage, Jerome A

2010-05-01

Age (due to declines in cognitive abilities necessary for navigation) and level of aviation expertise are two factors that may affect aviation performance and decision making under adverse weather conditions. We examined the roles of age, expertise, and their relationship on aviation decision making and flight control performance during a flight simulator task. Seventy-two IFR-rated general aviators, aged 19-79 yr, made multiple approach, holding pattern entry, and landing decisions while navigating under Instrument Flight Rules weather conditions. Over three trials in which the fog level varied, subjects decided whether or not to land the aircraft. They also completed two holding pattern entries. Subjects' flight control during approaches and holding patterns was measured. Older pilots (41+ yr) were more likely than younger pilots to land when visibility was inadequate (older pilots' mean false alarm rate: 0.44 vs 0.25). They also showed less precise flight control for components of the approach, performing 0.16 SD below mean approach scores. Expertise attenuated an age-related decline in flight control during holding patterns: older IFR/CFI performed 0.73 SD below mean score; younger IFR/CFI, younger CFII/ATP, older CFII/ATP: 0.32, 0.26, 0.03 SD above mean score. Additionally, pilots with faster processing speed (by median split) had a higher mean landing decision false alarm rate (0.42 vs 0.28), yet performed 0.14 SD above the mean approach control score. Results have implications regarding specialized training for older pilots and for understanding processes involved in older adults' real world decision making and performance.

How to achieve benefit from mission-oriented research: lessons from the U.S. Department of Agriculture and the Naval Research Laboratory

NASA Astrophysics Data System (ADS)

Logar, N. J.

2006-12-01

Does the research performed by government mission agencies contribute to improved decision-making? Climate research within the U.S. Department of Agriculture (USDA) has the stated goal of providing "optimal benefit" to decision makers on all levels, and the meteorology division of Department of Defense's Naval Research Laboratory promises research directed towards application. Assuming that research can lead to benefit for decision makers with minimal guidance can lead to irrelevance, wasted effort, and missed opportunities. Moving beyond the assumption leads to critical consideration of processes creating climate and meteorological science. I report the results of contextual mapping, of research on decision processes, and of interviews with agency scientists and users of science to evaluate their science regimes. In the case of the USDA scientists do target stakeholders through formal and informal mechanisms, but much of the science does not find use due to institutional constraints, political considerations, and disciplinary inertia. The research results will provide options for closing these policy gaps, such as higher-level stakeholder interaction and better representation of diverse interests. I apply the economic concept of supply and demand to describe where supply of science provides decision support that matches user demand, and where science policies might miss opportunities or mischaracterize research as useful to a specific user. This analysis leads to increased understanding of how factors such as the definition of scientific problems, hierarchies in science decision-making structures, quality control mechanisms beyond peer review, distribution of participants in the knowledge production enterprise, and social accountability guide the process of producing useful information.

Study on relationship of performance shaping factor in human error probability with prevalent stress of PUSPATI TRIGA reactor operators

NASA Astrophysics Data System (ADS)

Rahim, Ahmad Nabil Bin Ab; Mohamed, Faizal; Farid, Mohd Fairus Abdul; Fazli Zakaria, Mohd; Sangau Ligam, Alfred; Ramli, Nurhayati Binti

2018-01-01

Human factor can be affected by prevalence stress measured using Depression, Anxiety and Stress Scale (DASS). From the respondents feedback can be summarized that the main factor causes the highest prevalence stress is due to the working conditions that require operators to handle critical situation and make a prompt critical decisions. The relationship between the prevalence stress and performance shaping factors found that PSFFitness and PSFWork Process showed positive Pearson’s Correlation with the score of .763 and .826 while the level of significance, p = .028 and p = .012. These positive correlations with good significant values between prevalence stress and human performance shaping factor (PSF) related to fitness, work processes and procedures. The higher the stress level of the respondents, the higher the score of selected for the PSFs. This is due to the higher levels of stress lead to deteriorating physical health and cognitive also worsened. In addition, the lack of understanding in the work procedures can also be a factor that causes a growing stress. The higher these values will lead to the higher the probabilities of human error occur. Thus, monitoring the level of stress among operators RTP is important to ensure the safety of RTP.

Sliding versus Deciding in Relationships: Associations with Relationship Quality, Commitment, and Infidelity

PubMed Central

Owen, Jesse; Rhoades, Galena K.; Stanley, Scott M.

2013-01-01

From choosing a partner to date to deciding to cohabit or marry, individuals are faced with many relationship choices. Given the costs of failed relationships (e.g., personal distress, problems with work, lower well-being for children, lost opportunities to meet other partners), it is important consider how individuals are approaching these decisions. The current study tested if more thoughtful and clear relationship decision-making processes would relate to individuals’ levels of satisfaction with and dedication to their partners as well as their extra-dyadic involvements. In a sample of 252 men and women, the results showed that regardless of relationship status (i.e., dating, cohabiting, or married), those who reported more thoughtful decision-making processes also reported more dedication to their partners, higher satisfaction with the relationship, and fewer extra-dyadic involvements. PMID:23690736

State- and trait-greed, its impact on risky decision-making and underlying neural mechanisms.

PubMed

Mussel, Patrick; Reiter, Andrea M F; Osinsky, Roman; Hewig, Johannes

2015-04-01

We investigated whether greed would predict risky decision-making and recorded neural responses during a monetary gambling task using the electroencephalogram. We found that individuals high in trait-greed took higher risks to maximize monetary outcome. Furthermore, this relation was moderated by state-greed; specifically, trait-greed had a stronger impact on risky decision-making when activated by situational characteristics. On the neural level, greedy individuals showed a specific response to favorable and unfavorable outcomes. Specifically, they had a reduced feedback-related negativity-difference score to these events, indicating that they might have difficulty in learning from experience, especially from mistakes and negative feedback. It is concluded that greed may explain risky and reckless behavior in diverse settings, such as investment banking, and may account for phenomena such as stock market bubbles.

The contribution of perceived parental support to the career self-efficacy of deaf, hard-of-hearing, and hearing adolescents.

PubMed

Michael, Rinat; Most, Tova; Cinamon, Rachel Gali

2013-01-01

The current study examined the contribution of different types of parental support to career self-efficacy among 11th and 12th grade students (N = 160): 66 students with hearing loss (23 hard of hearing and 43 deaf) and 94 hearing students. Participants completed the Career-Related Parent Support Scale, the Career Decision-Making Self-Efficacy Scale, and the Self-Efficacy for the Management of Work-Family Conflict questionnaire. Different aspects of parental support predicted different types of career self-efficacies across the 3 groups. Differences among groups were also found when levels of parental support were compared. The deaf group perceived lower levels of parental career-related modeling and verbal encouragement in comparison with the hard-of-hearing students and higher levels of parental emotional support compared with the hearing participants. No significant differences were found among the research groups in career decision-making self-efficacy and self-efficacy in managing work-family conflict. Implications for theory and practice are discussed.

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

PubMed

Jung, Sandy

2015-01-01

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

Impaired decision-making as a young adult outcome of girls diagnosed with attention-deficit/hyperactivity disorder in childhood.

PubMed

Miller, Meghan; Sheridan, Margaret; Cardoos, Stephanie L; Hinshaw, Stephen P

2013-01-01

We examined decision-making in young adulthood in a follow-up study of females diagnosed with attention-deficit/hyperactivity disorder (ADHD) between 6 and 12 years. Participants with childhood ADHD (n = 114) and matched comparison females (n = 77), followed prospectively for 10 years, performed the Iowa Gambling Task (IGT) at ages 17-25 years. This task assesses preference for high-reward/high-risk chances that result in lower overall gains (disadvantageous decks of cards) compared to low-reward/low-risk chances that result in higher overall gains (advantageous decks of cards). Relative to comparison participants, young adult females with a history of ADHD did not increase their preference for advantageous decks across time blocks, suggesting difficulties in learning to change behavior over the course of the IGT. Overall, childhood diagnoses of ADHD were associated with disadvantageous decision-making in young adulthood. These results extend findings on decision-making in males with ADHD by demonstrating comparable levels of impairment in an all-female sample.

Apathy and emotion-based decision-making in amnesic mild cognitive impairment and Alzheimer's disease.

PubMed

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

2014-01-01

Apathy and reduced emotion-based decision-making are two behavioral modifications independently described in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). The aims of this study were to investigate decision-making based on emotional feedback processing in AD and aMCI and to study the impact of reduced decision-making performances on apathy. We recruited 20 patients with AD, 20 participants with aMCI, and 20 healthy controls. All participants completed the Lille apathy rating scale (LARS) and the Iowa gambling task (IGT). Both aMCI and AD participants had reduced performances on the IGT and were more apathetic compared to controls without any difference between aMCI and AD groups. For the entire sample, LARS initiation dimension was related to IGT disadvantageous decision-making profile. We provide the first study showing that both aMCI and AD individuals make less profitable decisions than controls, whereas aMCI and AD did not differ. Disadvantageous decision-making profile on the IGT was associated with higher level of apathy on the action initiation dimension. The role of an abnormal IGT performance as a risk factor for the development of apathy needs to be investigated in other clinical populations and in normal aging.

Dissociating neural variability related to stimulus quality and response times in perceptual decision-making.

PubMed

Bode, Stefan; Bennett, Daniel; Sewell, David K; Paton, Bryan; Egan, Gary F; Smith, Philip L; Murawski, Carsten

2018-03-01

According to sequential sampling models, perceptual decision-making is based on accumulation of noisy evidence towards a decision threshold. The speed with which a decision is reached is determined by both the quality of incoming sensory information and random trial-by-trial variability in the encoded stimulus representations. To investigate those decision dynamics at the neural level, participants made perceptual decisions while functional magnetic resonance imaging (fMRI) was conducted. On each trial, participants judged whether an image presented under conditions of high, medium, or low visual noise showed a piano or a chair. Higher stimulus quality (lower visual noise) was associated with increased activation in bilateral medial occipito-temporal cortex and ventral striatum. Lower stimulus quality was related to stronger activation in posterior parietal cortex (PPC) and dorsolateral prefrontal cortex (DLPFC). When stimulus quality was fixed, faster response times were associated with a positive parametric modulation of activation in medial prefrontal and orbitofrontal cortex, while slower response times were again related to more activation in PPC, DLPFC and insula. Our results suggest that distinct neural networks were sensitive to the quality of stimulus information, and to trial-to-trial variability in the encoded stimulus representations, but that reaching a decision was a consequence of their joint activity. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

ERIC Educational Resources Information Center

Dressel, Paul L.

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

Measurements of background radiation levels around Indian station Bharati, during 33rd Indian Scientific Expedition to Antarctica.

PubMed

Bakshi, A K; Prajith, Rama; Chinnaesakki, S; Pal, Rupali; Sathian, Deepa; Dhar, Ajay; Selvam, T Palani; Sapra, B K; Datta, D

2017-02-01

A comprehensive measurement of radioactivity concentrations of the primordial radionuclides 238 U, 232 Th and 40 K and their decay products in the soil samples collected from the sites of Indian research stations, Bharati and Maitri, at Antarctica was carried out using gamma spectrometric method. The activity concentrations in the soil samples of Bharati site were observed to be few times higher than of Maitri site. The major contributor to radioactivity content in the soil at Bharati site is 232 Th radionuclide in higher concentration. The gamma radiation levels based on the measured radioactivity of soil samples were calculated using the equation given in UNSCEAR 2000. The calculated radiation levels were compared with the measured values and found to correlate reasonably well. The study could be useful for the scientists working at Antarctica especially those at Indian station to take decision to avoid areas with higher radioactivity before erecting any facility for long term experiment or use. Copyright © 2016 Elsevier Ltd. All rights reserved.

Orientation Transfer in Vernier and Stereoacuity Training

PubMed Central

Snell, Nathaniel; Kattner, Florian; Rokers, Bas; Green, C. Shawn

2015-01-01

Human performance on various visual tasks can be improved substantially via training. However, the enhancements are frequently specific to relatively low-level stimulus dimensions. While such specificity has often been thought to be indicative of a low-level neural locus of learning, recent research suggests that these same effects can be accounted for by changes in higher-level areas–in particular in the way higher-level areas read out information from lower-level areas in the service of highly practiced decisions. Here we contrast the degree of orientation transfer seen after training on two different tasks—vernier acuity and stereoacuity. Importantly, while the decision rule that could improve vernier acuity (i.e. a discriminant in the image plane) would not be transferable across orientations, the simplest rule that could be learned to solve the stereoacuity task (i.e. a discriminant in the depth plane) would be insensitive to changes in orientation. Thus, given a read-out hypothesis, more substantial transfer would be expected as a result of stereoacuity than vernier acuity training. To test this prediction, participants were trained (7500 total trials) on either a stereoacuity (N = 9) or vernier acuity (N = 7) task with the stimuli in either a vertical or horizontal configuration (balanced across participants). Following training, transfer to the untrained orientation was assessed. As predicted, evidence for relatively orientation specific learning was observed in vernier trained participants, while no evidence of specificity was observed in stereo trained participants. These results build upon the emerging view that perceptual learning (even very specific learning effects) may reflect changes in inferences made by high-level areas, rather than necessarily fully reflecting changes in the receptive field properties of low-level areas. PMID:26700311

A Qualitative Readiness-Requirements Assessment Model for Enterprise Big-Data Infrastructure Investment

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

Olama, Mohammed M; McNair, Wade; Sukumar, Sreenivas R

2014-01-01

In the last three decades, there has been an exponential growth in the area of information technology providing the information processing needs of data-driven businesses in government, science, and private industry in the form of capturing, staging, integrating, conveying, analyzing, and transferring data that will help knowledge workers and decision makers make sound business decisions. Data integration across enterprise warehouses is one of the most challenging steps in the big data analytics strategy. Several levels of data integration have been identified across enterprise warehouses: data accessibility, common data platform, and consolidated data model. Each level of integration has its ownmore » set of complexities that requires a certain amount of time, budget, and resources to implement. Such levels of integration are designed to address the technical challenges inherent in consolidating the disparate data sources. In this paper, we present a methodology based on industry best practices to measure the readiness of an organization and its data sets against the different levels of data integration. We introduce a new Integration Level Model (ILM) tool, which is used for quantifying an organization and data system s readiness to share data at a certain level of data integration. It is based largely on the established and accepted framework provided in the Data Management Association (DAMA-DMBOK). It comprises several key data management functions and supporting activities, together with several environmental elements that describe and apply to each function. The proposed model scores the maturity of a system s data governance processes and provides a pragmatic methodology for evaluating integration risks. The higher the computed scores, the better managed the source data system and the greater the likelihood that the data system can be brought in at a higher level of integration.« less

Orientation Transfer in Vernier and Stereoacuity Training.

PubMed

Snell, Nathaniel; Kattner, Florian; Rokers, Bas; Green, C Shawn

2015-01-01

Human performance on various visual tasks can be improved substantially via training. However, the enhancements are frequently specific to relatively low-level stimulus dimensions. While such specificity has often been thought to be indicative of a low-level neural locus of learning, recent research suggests that these same effects can be accounted for by changes in higher-level areas--in particular in the way higher-level areas read out information from lower-level areas in the service of highly practiced decisions. Here we contrast the degree of orientation transfer seen after training on two different tasks--vernier acuity and stereoacuity. Importantly, while the decision rule that could improve vernier acuity (i.e. a discriminant in the image plane) would not be transferable across orientations, the simplest rule that could be learned to solve the stereoacuity task (i.e. a discriminant in the depth plane) would be insensitive to changes in orientation. Thus, given a read-out hypothesis, more substantial transfer would be expected as a result of stereoacuity than vernier acuity training. To test this prediction, participants were trained (7500 total trials) on either a stereoacuity (N = 9) or vernier acuity (N = 7) task with the stimuli in either a vertical or horizontal configuration (balanced across participants). Following training, transfer to the untrained orientation was assessed. As predicted, evidence for relatively orientation specific learning was observed in vernier trained participants, while no evidence of specificity was observed in stereo trained participants. These results build upon the emerging view that perceptual learning (even very specific learning effects) may reflect changes in inferences made by high-level areas, rather than necessarily fully reflecting changes in the receptive field properties of low-level areas.

A qualitative readiness-requirements assessment model for enterprise big-data infrastructure investment

NASA Astrophysics Data System (ADS)

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

2014-05-01

In the last three decades, there has been an exponential growth in the area of information technology providing the information processing needs of data-driven businesses in government, science, and private industry in the form of capturing, staging, integrating, conveying, analyzing, and transferring data that will help knowledge workers and decision makers make sound business decisions. Data integration across enterprise warehouses is one of the most challenging steps in the big data analytics strategy. Several levels of data integration have been identified across enterprise warehouses: data accessibility, common data platform, and consolidated data model. Each level of integration has its own set of complexities that requires a certain amount of time, budget, and resources to implement. Such levels of integration are designed to address the technical challenges inherent in consolidating the disparate data sources. In this paper, we present a methodology based on industry best practices to measure the readiness of an organization and its data sets against the different levels of data integration. We introduce a new Integration Level Model (ILM) tool, which is used for quantifying an organization and data system's readiness to share data at a certain level of data integration. It is based largely on the established and accepted framework provided in the Data Management Association (DAMADMBOK). It comprises several key data management functions and supporting activities, together with several environmental elements that describe and apply to each function. The proposed model scores the maturity of a system's data governance processes and provides a pragmatic methodology for evaluating integration risks. The higher the computed scores, the better managed the source data system and the greater the likelihood that the data system can be brought in at a higher level of integration.

A Delphi-Based Approach for Detecting Key E-Learning Trends in Postgraduate Education: The Spanish Case

ERIC Educational Resources Information Center

Lopez-Catalan, Blanca; Bañuls, Victor A.

2017-01-01

Purpose: The purpose of this paper is to present the results of national level Delphi study carried out in Spain aimed at providing inputs for higher education administrators and decision makers about key e-learning trends for supporting postgraduate courses. Design/methodology/approach: The ranking of the e-learning trends is based on a…

Impulsivity and related neuropsychological features in regular and addictive first person shooter gaming.

PubMed

Metcalf, Olivia; Pammer, Kristen

2014-03-01

Putative cyber addictions are of significant interest. There remains little experimental research into excessive use of first person shooter (FPS) games, despite their global popularity. Moreover, the role between excessive gaming and impulsivity remains unclear, with previous research showing conflicting findings. The current study investigated performances on a number of neuropsychological tasks (go/no-go, continuous performance task, Iowa gambling task) and a trait measure of impulsivity for a group of regular FPS gamers (n=25), addicted FPS gamers (n=22), and controls (n=22). Gamers were classified using the Addiction-Engagement Questionnaire. Addicted FPS gamers had significantly higher levels of trait impulsivity on the Barratt Impulsiveness Scale compared to controls. Addicted FPS gamers also had significantly higher levels of disinhibition in a go/no-go task and inattention in a continuous performance task compared to controls, whereas the regular FPS gamers had better decision making on the Iowa gambling task compared to controls. The results indicate impulsivity is associated with FPS gaming addiction, comparable to pathological gambling. The relationship between impulsivity and excessive gaming may be unique to the FPS genre. Furthermore, regular FPS gaming may improve decision making ability.

Interaction among general practitioners age and patient load in the prediction of job strain, decision latitude and perception of job demands. A cross-sectional study.

PubMed

Vanagas, Giedrius; Bihari-Axelsson, Susanna

2004-12-07

It is widely recognized and accepted that job strain adversely impacts the workforce. Individual responses to stressful situations can vary greatly and it has been shown that certain people are more likely to experience high levels of stress in their job than others. Studies highlighted that there can be age differences in job strain perception. Cross-sectional postal survey of 300 Lithuanian general practitioners. Psychosocial stress was investigated with a questionnaire based on the Reeder scale. Job demands were investigated with the Karasek scale. The analysis included descriptive statistics; logistic regression beta coefficients to find out predictors and interactions between characteristics and predictors. Response rate was 66% (N = 197). Logistic regression as significant predictors for job strain assigned - duration of work in primary care; for job demands- age and duration of working in primary care; for decision latitude- age and patient load.The interactions with regard to job strain showed that GP's age and job strain are negatively associated to a low patient load. Lower decision latitude for older GP age is strongly related to higher patient load. Job demands and GP age are slightly positively related at low patient load. Lithuanian GP's have high patient load and are at risk of stress, they have high job demands and low decision latitude. Older GP's perceive less strain, lower job demands and higher decision latitude in case of low patient load. Young GP's decision latitude has week association to patient load. Regarding to the changes in patient load younger GP's perceive it more sensitively as changes in job demands.

PTSD, Acute Stress, Performance and Decision-Making in Emergency Service Workers.

PubMed

Regehr, Cheryl; LeBlanc, Vicki R

2017-06-01

Despite research identifying high levels of stress and traumatic stress symptoms among those in the emergency services, the impact of these symptoms on performance and hence public safety remains uncertain. This review paper discusses a program of research that has examined the effects of prior critical incident exposure, acute stress, and current post-traumatic symptoms on the performance and decision-making during an acutely stressful event among police officers, police communicators, paramedics and child protection workers. Four studies, using simulation methods involving video simulators, human-patient simulators, and/or standardized patients, examined the performance of emergency workers in typical workplace situations related to their individual profession. Results varied according to level of acuity of stress and the nature of performance and decision-making. There was no evidence that PTSD had a direct impact on global performance on tasks for which emergency responders are highly trained. However, PTSD was associated with assessment of risk in situations that required professional judgement. Further, individuals experiencing PTSD symptoms reported higher levels of acute stress when faced with high acuity situations. Acute stress in these studies was associated with performance deficits on complex cognitive tasks, verbal memory impairment and heightened assessment of risk. © 2017 American Academy of Psychiatry and the Law.

Risk-taking and social exclusion in adolescence: Neural mechanisms underlying peer influences on decision-making

PubMed Central

Peake, Shannon J.; Dishion, Thomas J.; Stormshak, Elizabeth A.; Moore, William E.; Pfeifer, Jennifer H.

2013-01-01

Social exclusion and risk-taking are both common experiences of concern in adolescence, yet little is known about how the two may be related at behavioral or neural levels. In this fMRI study, adolescents (N=27, 14 male, 14–17 years-old) completed a series of tasks in the scanner assessing risky decision-making before and after an episode of social exclusion. In this particular context, exclusion was associated with greater behavioral risk-taking among adolescents with low self-reported resistance to peer influence (RPI). When making risky decisions after social exclusion, adolescents who had lower RPI exhibited higher levels of activity in right temporoparietal junction (rTPJ), and this response in rTPJ was a significant mediator of the relationship between RPI and greater risk-taking after social exclusion. Lower RPI was also associated with lower levels of activity in lPFC during crashes following social exclusion, but unlike rTPJ this response in lPFC was not a significant mediator of the relationship between RPI and greater risk-taking after social exclusion. The results suggest that mentalizing and/or attentional mechanisms have a unique direct effect on adolescents’ vulnerability to peer influence on risk-taking. PMID:23707590

Extending the Reach of Evidence-Based Medicine: A Proposed Categorization of Lower-Level Evidence.

PubMed

Detterbeck, Frank C; Gould, Michael K; Lewis, Sandra Zelman; Patel, Sheena

2018-02-01

Clinical practice involves making many treatment decisions for which only limited formal evidence exists. While the methodology of evidence-based medicine (EBM) has evolved tremendously, there is a need to better characterize lower-level evidence. This should enhance the ability to appropriately weigh the evidence against other considerations, and counter the temptation to think it is more robust than it actually is. A framework to categorize lower-level evidence is proposed, consisting of nonrandomized comparisons, extrapolation using indirect evidence, rationale, and clinical experience (ie, an accumulated general impression). Subtypes are recognized within these categories, based on the degree of confounding in nonrandomized comparisons, the uncertainty involved in extrapolation from indirect evidence, and the plausibility of a rationale. Categorizing the available evidence in this way can promote a better understanding of the strengths and limitations of using such evidence as the basis for treatment decisions in clinically relevant areas that are devoid of higher-level evidence. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

A generic testbed for the design of plasma spectrometer control software with application to the THOR-CSW solar wind instrument

NASA Astrophysics Data System (ADS)

De Keyser, Johan; Lavraud, Benoit; Neefs, Eddy; Berkenbosch, Sophie; Beeckman, Bram; Maggiolo, Romain; Gamby, Emmanuel; Fedorov, Andrei; Baruah, Rituparna; Wong, King-Wah; Amoros, Carine; Mathon, Romain; Génot, Vincent; Marcucci, Federica; Brienza, Daniele

2017-04-01

Modern plasma spectrometers require intelligent software that is able to exploit their capabilities to the fullest. While the low-level control of the instrument and basic tasks such as performing the basic measurement, temperature control, and production of housekeeping data are to be done by software that is executed on an FPGA and/or processor inside the instrument, higher level tasks such as control of measurement sequences, on-board moment calculation, beam tracking decisions, and data compression, may be performed by the instrument or in the payload data processing unit. Such design decisions, as well as an assessment of the workload on the different processing components, require early prototyping. We have developed a generic simulation testbed for the design of plasma spectrometer control software that allows an early evaluation of the level of resources that is needed at each level. Early prototyping can pinpoint bottlenecks in the design allowing timely remediation. We have applied this tool to the THOR Cold Solar Wind (CSW) plasma spectrometer. Some examples illustrating the usefulness of the tool are given.

Theoretical life history responses of juvenile Oncorhynchus mykiss to changes in food availability using a dynamic state-dependent approach

USGS Publications Warehouse

Romine, Jason G.; Benjamin, Joseph R.; Perry, Russell W.; Casal, Lynne; Connolly, Patrick J.; Sauter, Sally S.

2013-01-01

Marine subsidies can play an important role in the growth, survival, and migratory behavior of rearing juvenile salmonids. Availability of high-energy, marine-derived food sources during critical decision windows may influence the timing of emigration or the decision to forego emigration completely and remain in the freshwater environment. Increasing growth and growth rate during these decision windows may result in an altered juvenile population structure, which will ultimately affect the adult population age-structure. We used a state dependent model to understand how the juvenile Oncorhynchus mykiss population structure may respond to increased availability of salmon eggs in their diet during critical decision windows. Our models predicted an increase in smolt production until coho salmon eggs comprised more than 50 percent of juvenile O. mykiss diet at the peak of the spawning run. At higher-than intermediate levels of egg consumption, smolt production decreased owing to increasing numbers of fish adopting a resident life-history strategy. Additionally, greater growth rates decreased the number of age-3 smolts and increased the number of age-2 smolts. Increased growth rates with higher egg consumption also decreased the age at which fish adopted the resident pathway. Our models suggest that the introduction of a high-energy food source during critical periods of the year could be sufficient to increase smolt production.

Patient-centred assessment of social support, health status and quality of life in patients with acute coronary syndrome.

PubMed

de Jong-Watt, Wynne; Sherifi, Ines

2011-01-01

Measurement of health status (HS) and social support are becoming increasingly accepted as tools to guide clinical decision-making and patient-centred practice. To assess self-reported HS, cardiac-health related quality of life and social support in subjects with a diagnosis of acute coronary syndrome (ACS). The study used a quantitative descriptive design. 36 subjects with a diagnosis of ACS were selected from patients admitted to medical units at a teaching hospital in Toronto, Ontario. One-time, semi-structured interviews were conducted using valid and reliable cardiac-specific HS and social support measures. Analysis indicated that subjects with higher perceived social support and patients with higher income reported greater treatment satisfaction and C-HROL. Subjects with severe angina reported a higher perceived level of social support than those with more moderate physical limitation due to angina. Patients' social environment and HS significantly impact their satisfaction with treatment. Patient-centred measures assist in clinical decision-making, patient-centred care planning and patient involvement in their care.

Risk factors for interpersonal conflicts at work.

PubMed

De Raeve, Lore; Jansen, Nicole Wh; van den Brandt, Piet A; Vasse, Rineke M; Kant, Ijmert

2008-04-01

The main goal of this study was to identify work-related risk factors for the onset of interpersonal conflicts at work. Longitudinal data from the Maastricht Cohort Study on "fatigue at work" (N=9241) were used. After the respondents who reported an interpersonal conflict at baseline were excluded, logistic regression analyses were used to determine the role of several work-related risk factors at baseline in the onset of a conflict with coworkers or supervisors after 1 year of follow-up. Higher psychological job demands, higher levels of role ambiguity, the presence of physical demands, higher musculoskeletal demands, a poorer physical work environment, shift work, overtime, and higher levels of job insecurity significantly predicted the onset of both a coworker conflict and a supervisor conflict. Higher levels of coworker and supervisor social support, more autonomy concerning the terms of employment, good overall job satisfaction, monetary gratification, and esteem reward significantly protected against the onset of both a coworker conflict and a supervisor conflict. Higher levels of decision latitude and more career opportunities also significantly protected against the onset of a supervisor conflict. Several factors in the work environment were related to the onset of interpersonal conflicts at work. Given the rather serious consequences of interpersonal conflicts at work with respect to health and well-being, the observed risk factors can serve as a starting point for effective prevention and intervention strategies in the workplace.

[Acceptance or refusal of abortion for maternal reasons. Survey of 3021 employees of the Federal Government].

PubMed

García Romero, H; González González, A; García Barrios, C; Galicia, J

2000-05-01

A survey was conducted among 3021 employees from the Mexican Federal Government regarding their acceptance or rejection of abortion in five different circumstances. Socioeconomic information was obtained from the interviewed and the result was that 23% totally rejected abortion, and 6% accepted abortion in any situation. Abortion was accepted by 61% in case of pregnancy threatens the mother's life; 63% in case a single woman has been raped; 41% if there are so many children and such situation implies economic problems for the family; 13% if the couple prefers to wait for an economic improvement; and 18% if the couple has decided to have no more than two kids. Also from the interviewed, 16% pointed out that abortion must be an exclusive decision from the woman and 29% thought it must be a shared decision with the partner. Abortion is better accepted by young people, by couples with few children or living in free union and by people with higher education level and higher income. It is also better accepted by people with no religion, or people who do not attend religious services or by whom religion does not affect their decisions in life.

Economic Value Biases Uncertain Perceptual Choices in the Parietal and Prefrontal Cortices

PubMed Central

Summerfield, Christopher; Koechlin, Etienne

2010-01-01

An observer detecting a noisy sensory signal is biased by the costs and benefits associated with its presence or absence. When these costs and benefits are asymmetric, sensory, and economic information must be integrated to inform the final choice. However, it remains unknown how this information is combined at the neural or computational levels. To address this question, we asked healthy human observers to judge the presence or absence of a noisy sensory signal under economic conditions that favored yes responses (liberal blocks), no responses (conservative blocks), or neither response (neutral blocks). Economic information biased fast choices more than slow choices, suggesting that value and sensory information are integrated early in the decision epoch. More formal simulation analyses using an Ornstein–Uhlenbeck process demonstrated that the influence of economic information was best captured by shifting the origin of evidence accumulation toward the more valuable bound. We then used the computational model to generate trial-by-trial estimates of decision-related evidence that were based on combined sensory and economic information (the decision variable or DV), and regressed these against fMRI activity recorded whilst participants performed the task. Extrastriate visual regions responded to the level of sensory input (momentary evidence), but fMRI signals in the parietal and prefrontal cortices responded to the decision variable. These findings support recent single-neuron data suggesting that economic information biases decision-related signals in higher cortical regions. PMID:21267421

The interrelationship of organizational characteristics of magnet hospitals, nursing leadership, and nursing job satisfaction.

PubMed

Upenieks, Valda V

2003-01-01

This study examined whether magnet hospitals continue to provide higher levels of job satisfaction and empowerment among nurses when compared with non-magnet hospitals. Also studied at both types of hospitals was whether job satisfaction discrepancy was interlinked with leadership effectiveness and support of professional nursing practice. Nurses employed at magnet hospitals experienced higher levels of empowerment and job satisfaction due to greater access to work empowerment structures. The elements accounting for differences in empowerment and job satisfaction scores included: (1) greater accessibility of magnet nurse leaders, (2) better support of clinical nurse autonomous decision making by magnet nurse leaders, and (3) greater access to work empowerment structures such as opportunity, information, and resources at magnet hospitals.

A boost of confidence: The role of the ventromedial prefrontal cortex in memory, decision-making, and schemas.

PubMed

Hebscher, Melissa; Gilboa, Asaf

2016-09-01

The ventromedial prefrontal cortex (vmPFC) has been implicated in a wide array of functions across multiple domains. In this review, we focus on the vmPFC's involvement in mediating strategic aspects of memory retrieval, memory-related schema functions, and decision-making. We suggest that vmPFC generates a confidence signal that informs decisions and memory-guided behaviour. Confidence is central to these seemingly diverse functions: (1) Strategic retrieval: lesions to the vmPFC impair an early, automatic, and intuitive monitoring process ("feeling of rightness"; FOR) often associated with confabulation (spontaneous reporting of erroneous memories). Critically, confabulators typically demonstrate high levels of confidence in their false memories, suggesting that faulty monitoring following vmPFC damage may lead to indiscriminate confidence signals. (2) Memory schemas: the vmPFC is critically involved in instantiating and maintaining contextually relevant schemas, broadly defined as higher level knowledge structures that encapsulate lower level representational elements. The correspondence between memory retrieval cues and these activated schemas leads to FOR monitoring. Stronger, more elaborate schemas produce stronger FOR and influence confidence in the veracity of memory candidates. (3) Finally, we review evidence on the vmPFC's role in decision-making, extending this role to decision-making during memory retrieval. During non-mnemonic and mnemonic decision-making the vmPFC automatically encodes confidence. Confidence signal in the vmPFC is revealed as a non-linear relationship between a first-order monitoring assessment and second-order action or choice. Attempting to integrate the multiple functions of the vmPFC, we propose a posterior-anterior organizational principle for this region. More posterior vmPFC regions are involved in earlier, automatic, subjective, and contextually sensitive functions, while more anterior regions are involved in controlled actions based on these earlier functions. Confidence signals reflect the non-linear relationship between first-order, posterior-mediated and second-order, anterior-mediated processes and are represented along the entire axis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Increased Mortality Exposure within the Family Rather than Individual Mortality Experiences Triggers Faster Life-History Strategies in Historic Human Populations

PubMed Central

Störmer, Charlotte; Lummaa, Virpi

2014-01-01

Life History Theory predicts that extrinsic mortality risk is one of the most important factors shaping (human) life histories. Evidence from contemporary populations suggests that individuals confronted with high mortality environments show characteristic traits of fast life-history strategies: they marry and reproduce earlier, have shorter birth intervals and invest less in their offspring. However, little is known of the impact of mortality experiences on the speed of life histories in historical human populations with generally higher mortality risk, and on male life histories in particular. Furthermore, it remains unknown whether individual-level mortality experiences within the family have a greater effect on life-history decisions or family membership explains life-history variation. In a comparative approach using event history analyses, we study the impact of family versus individual-level effects of mortality exposure on two central life-history parameters, ages at first marriage and first birth, in three historical human populations (Germany, Finland, Canada). Mortality experience is measured as the confrontation with sibling deaths within the natal family up to an individual's age of 15. Results show that the speed of life histories is not adjusted according to individual-level mortality experiences but is due to family-level effects. The general finding of lower ages at marriage/reproduction after exposure to higher mortality in the family holds for both females and males. This study provides evidence for the importance of the family environment for reproductive timing while individual-level mortality experiences seem to play only a minor role in reproductive life history decisions in humans. PMID:24421897

Increased mortality exposure within the family rather than individual mortality experiences triggers faster life-history strategies in historic human populations.

PubMed

Störmer, Charlotte; Lummaa, Virpi

2014-01-01

Life History Theory predicts that extrinsic mortality risk is one of the most important factors shaping (human) life histories. Evidence from contemporary populations suggests that individuals confronted with high mortality environments show characteristic traits of fast life-history strategies: they marry and reproduce earlier, have shorter birth intervals and invest less in their offspring. However, little is known of the impact of mortality experiences on the speed of life histories in historical human populations with generally higher mortality risk, and on male life histories in particular. Furthermore, it remains unknown whether individual-level mortality experiences within the family have a greater effect on life-history decisions or family membership explains life-history variation. In a comparative approach using event history analyses, we study the impact of family versus individual-level effects of mortality exposure on two central life-history parameters, ages at first marriage and first birth, in three historical human populations (Germany, Finland, Canada). Mortality experience is measured as the confrontation with sibling deaths within the natal family up to an individual's age of 15. Results show that the speed of life histories is not adjusted according to individual-level mortality experiences but is due to family-level effects. The general finding of lower ages at marriage/reproduction after exposure to higher mortality in the family holds for both females and males. This study provides evidence for the importance of the family environment for reproductive timing while individual-level mortality experiences seem to play only a minor role in reproductive life history decisions in humans.

BEING EMOTIONAL DURING DECISION MAKING—GOOD OR BAD? AN EMPIRICAL INVESTIGATION

PubMed Central

SEO, MYEONG-GU; BARRETT, LISA FELDMAN

2008-01-01

This paper examines the link between affective experience and decision-making performance. In a stock investment simulation, 101 stock investors rated their feelings on an Internet Web site while making investment decisions each day for 20 consecutive business days. Contrary to the popular belief that feelings are generally bad for decision making, we found that individuals who experienced more intense feelings achieved higher decision-making performance. Moreover, individuals who were better able to identify and distinguish among their current feelings achieved higher decision-making performance via their enhanced ability to control the possible biases induced by those feelings. PMID:18449361

Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

PubMed

Convey, Helen; Holt, Janet; Summers, Barbara

2018-07-01

This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

Do different perceptual task sets modulate electrophysiological correlates of masked visuomotor priming? Attention to shape and color put to the test.

PubMed

Zovko, Monika; Kiefer, Markus

2013-02-01

According to classical theories, automatic processes operate independently of attention. Recent evidence, however, shows that masked visuomotor priming, an example of an automatic process, depends on attention to visual form versus semantics. In a continuation of this approach, we probed feature-specific attention within the perceptual domain and tested in two event-related potential (ERP) studies whether masked visuomotor priming in a shape decision task specifically depends on attentional sensitization of visual pathways for shape in contrast to color. Prior to the masked priming procedure, a shape or a color decision task served to induce corresponding task sets. ERP analyses revealed visuomotor priming effects over the occipitoparietal scalp only after the shape, but not after the color induction task. Thus, top-down control coordinates automatic processing streams in congruency with higher-level goals even at a fine-grained level. Copyright © 2012 Society for Psychophysiological Research.

Attention Alters Perceived Attractiveness.

PubMed

Störmer, Viola S; Alvarez, George A

2016-04-01

Can attention alter the impression of a face? Previous studies showed that attention modulates the appearance of lower-level visual features. For instance, attention can make a simple stimulus appear to have higher contrast than it actually does. We tested whether attention can also alter the perception of a higher-order property-namely, facial attractiveness. We asked participants to judge the relative attractiveness of two faces after summoning their attention to one of the faces using a briefly presented visual cue. Across trials, participants judged the attended face to be more attractive than the same face when it was unattended. This effect was not due to decision or response biases, but rather was due to changes in perceptual processing of the faces. These results show that attention alters perceived facial attractiveness, and broadly demonstrate that attention can influence higher-level perception and may affect people's initial impressions of one another. © The Author(s) 2016.

Workers' perceptions of how jobs affect health: a social ecological perspective.

PubMed

Ettner, S L; Grzywacz, J G

2001-04-01

A national sample of 2,048 workers was asked to rate the impact of their job on their physical and mental health. Ordered logistic regression analyses based on social ecology theory showed that the workers' responses were significantly correlated with objective and subjective features of their jobs, in addition to personality characteristics. Workers who had higher levels of perceived constraints and neuroticism, worked nights or overtime, or reported serious ongoing stress at work or higher job pressure reported more negative effects. Respondents who had a higher level of extraversion, were self-employed, or worked part time or reported greater decision latitude or use of skills on the job reported more positive effects. These findings suggest that malleable features of the work environment are associated with perceived effects of work on health, even after controlling for personality traits and other sources of reporting bias.

Organizational restructuring, government control and loss of legitimacy following an organizational crisis: the case of Israel's nonprofit human services.

PubMed

Mano, Rita; Rosenberg, Dennis

2014-01-01

The study explores organizational restructuring following the occurrence of a crisis. Restructuring activities following an intervention are considered here to be indicators of an organization's loss of legitimacy because they have lost their independent status, a basic characteristic of nonprofit human settings. The study shows that according to the Resource Based View of organization restructuring--experienced as downsizing, neglecting and abandoning of projects--organizations are affected by (a) government intervention in decision making; (b) higher demands for accountability; and (c) higher evaluations of performance gaps. On the basis of the study of a sample of 138 Nonprofit Human Services in Israel, the results show that the higher the level of restructuring, the higher the level of legitimacy. However, organization location in metropolitan areas moderates the link between restructuring and legitimacy loss. We conclude that Israel's nonprofit human services being overly dependent on goverhment funding are more prone to restructuring and losing legitimacy following organizational crisis.

Clinical decision-making among new graduate nurses attending residency programs in Saudi Arabia.

PubMed

Al-Dossary, Reem Nassar; Kitsantas, Panagiota; Maddox, P J

2016-02-01

This study examined the impact of residency programs on clinical decision-making of new Saudi graduate nurses who completed a residency program compared to new Saudi graduate nurses who did not participate in residency programs. This descriptive study employed a convenience sample (N=98) of new graduate nurses from three hospitals in Saudi Arabia. A self-administered questionnaire was used to collect data. Clinical decision-making skills were measured using the Clinical Decision Making in Nursing Scale. Descriptive statistics, independent t-tests, and multiple linear regression analysis were utilized to examine the effect of residency programs on new graduate nurses' clinical decision-making skills. On average, resident nurses had significantly higher levels of clinical decision-making skills than non-residents (t=23.25, p=0.000). Enrollment in a residency program explained 86.9% of the variance in total clinical decision making controlling for age and overall grade point average. The findings of this study support evidence in the nursing literature conducted primarily in the US and Europe that residency programs have a positive influence on new graduate nurses' clinical decision-making skills. This is the first study to examine the impact of residency programs on clinical decision-making among new Saudi graduate nurses who completed a residency program. The findings of this study underscore the need for the development and implementation of residency programs for all new nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

Productivity and turnover in PCPs: the role of staff participation in decision-making.

PubMed

Hung, Dorothy Y; Rundall, Thomas G; Cohen, Deborah J; Tallia, Alfred F; Crabtree, Benjamin F

2006-10-01

Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

Call-handlers' working conditions and their subjective experience of work: a transversal study.

PubMed

Croidieu, Sophie; Charbotel, Barbara; Vohito, Michel; Renaud, Liliane; Jaussaud, Joelle; Bourboul, Christian; Ardiet, Dominique; Imbard, Isabelle; Guerin, Anne Céline; Bergeret, Alain

2008-10-01

The present study sought to describe call-center working conditions and call-handlers' subjective experience of their work. A transversal study was performed in companies followed by the 47 occupational physicians taking part. A dedicated questionnaire included one part on working conditions (work-station organization, task types, work schedules, and controls) and another on the perception of working conditions. Psychosocial risk factors were explored by three dimensions of the Karasek questionnaire, decision latitude, psychological demands and social support. A descriptive stage characterized the population and quantified the frequency of the various types of work organization, working conditions and perception. Certain working conditions data were crossed with perception data. The total sample comprised 2,130 call-handlers from around 100 different companies. The population was 71.9% female, with a mean age of 32.4 years. The general educational level was high, with 1,443 (68.2%) of call-handlers having at least 2 years' higher education; 1,937 of the workers (91.2%) had permanent work contracts. Some working situations were found to be associated with low decision latitude and high psychological demands: i.e., where the schedule (full-time or part-time) was imposed, where the call-handlers had not chosen to work in a call-center, or where they received prior warning of controls. Moreover, the rate of low decision latitude and high psychological demands increased with seniority in the job. The rate of low decision latitude increased with the size of the company and was higher when call duration was imposed and when the call-handlers handled only incoming calls. The rate of high psychological demands was higher when call-handlers handled both incoming and outgoing calls. This study confirmed the high rate of psychosocial constraints for call-handlers and identified work situations at risk.

Fostering change within organizational participants of multisectoral health care alliances.

PubMed

Hearld, Larry R; Alexander, Jeffrey A; Mittler, Jessica N

2012-01-01

A touted advantage of multisectoral health care alliances is their ability to coordinate diverse constituencies and pursue community health goals in ways that allow them to make greater progress than each constituency could independently. However, participating organizations may have goals that do not entirely overlap or necessarily align with the alliance's goals, which can weaken or undermine an alliance's efforts. Fostering changes within participating organizations in ways that are consistent with the alliance's goals (i.e., alliance-oriented change) may be one mechanism by which alliances can coordinate diverse activities and improve care in their local communities. We examined whether alliance-oriented change within participating organizations is associated with alliance decision-making and conflict management style, level of participation, perceptions of alliance participation benefits and costs, and awareness of alliance activities within participating organizations. The study used two rounds of survey data collected from organizational participants of 14 alliances participating in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. Alliance participants generally reported low levels of alliance-oriented change within their organizations as a result of the alliance and its activities. However, participants reporting higher levels of internal change in response to alliance activities had more positive perceptions of alliance decision-making style, higher levels of participation in alliance activities, more positive perceptions of alliance participation benefits relative to costs, and greater awareness of alliance activities across multiple levels of their respective organizations. Despite relatively low levels of alliance-oriented change within participating organizations, alliances may still have the means to align the goal orientations of a diverse membership and foster change that may extend the reach of the alliance in the community.

Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders.

PubMed

Cleemput, Irina; Christiaens, Wendy; Kohn, Laurence; Léonard, Christian; Daue, François; Denis, Alain

2015-06-01

In systems with public health insurance, coverage decisions should reflect social values. Deliberation among stakeholders could achieve this goal, but rarely involves patients and citizens directly. This study aimed at evaluating the acceptability, and the perceived benefits and risks, of public and patient involvement (PPI) in coverage decision making to Belgian stakeholders. A two-round Delphi survey was conducted among all stakeholder groups. The survey was constructed on the basis of interviews with 10 key stakeholders and a review of the literature on participation models. Consensus was defined as 65% or more of the respondents agreeing with a statement and less than 15% disagreeing. Eighty stakeholders participated in both rounds. They were defined as the Delphi panel. Belgian stakeholders are open toward PPI in coverage decision processes. Benefits are expected to exceed risks. The preferred model for involvement is to consult citizens or patients, within the existing decision-making structures and at specific milestones in the process. Consulting citizens and patients is a higher level of involvement than merely informing them and a lower level than letting them participate actively. Consultation involves asking nonbinding advice on (parts of) the decision problem. According to the Delphi panel, the benefits of PPI could be increasing awareness among members of the general public and patients about the challenges and costs of health care, and enriched decision processes with expertise by experience from patients. Potential risks include subjectivity, insufficient resources to participate and weigh on the process, difficulties in finding effective ways to express a collective opinion, the risk of manipulation, and lobbying or power games of other stakeholders. PPI in coverage decision-making processes is acceptable to Belgian stakeholders, be it in different ways for different types of decisions. Benefits are expected to outweigh risks. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Dual processing model of medical decision-making

PubMed Central

2012-01-01

Background Dual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administered to the patient who may or may not have a disease. Methods We developed a mathematical model in which we linked a recently proposed descriptive psychological model of cognition with the threshold model of medical decision-making and show how this approach can be used to better understand decision-making at the bedside and explain the widespread variation in treatments observed in clinical practice. Results We show that physician’s beliefs about whether to treat at higher (lower) probability levels compared to the prescriptive therapeutic thresholds obtained via system II processing is moderated by system I and the ratio of benefit and harms as evaluated by both system I and II. Under some conditions, the system I decision maker’s threshold may dramatically drop below the expected utility threshold derived by system II. This can explain the overtreatment often seen in the contemporary practice. The opposite can also occur as in the situations where empirical evidence is considered unreliable, or when cognitive processes of decision-makers are biased through recent experience: the threshold will increase relative to the normative threshold value derived via system II using expected utility threshold. This inclination for the higher diagnostic certainty may, in turn, explain undertreatment that is also documented in the current medical practice. Conclusions We have developed the first dual processing model of medical decision-making that has potential to enrich the current medical decision-making field, which is still to the large extent dominated by expected utility theory. The model also provides a platform for reconciling two groups of competing dual processing theories (parallel competitive with default-interventionalist theories). PMID:22943520

Evidence use in decision-making on introducing innovations: a systematic scoping review with stakeholder feedback.

PubMed

Turner, Simon; D'Lima, Danielle; Hudson, Emma; Morris, Stephen; Sheringham, Jessica; Swart, Nick; Fulop, Naomi J

2017-12-04

A range of evidence informs decision-making on innovation in health care, including formal research findings, local data and professional opinion. However, cultural and organisational factors often prevent the translation of evidence for innovations into practice. In addition to the characteristics of evidence, it is known that processes at the individual level influence its impact on decision-making. Less is known about the ways in which processes at the professional, organisational and local system level shape evidence use and its role in decisions to adopt innovations. A systematic scoping review was used to review the health literature on innovations within acute and primary care and map processes at the professional, organisational and local system levels which influence how evidence informs decision-making on innovation. Stakeholder feedback on the themes identified was collected via focus groups to test and develop the findings. Following database and manual searches, 31 studies reporting primary qualitative data met the inclusion criteria: 24 were of sufficient methodological quality to be included in the thematic analysis. Evidence use in decision-making on innovation is influenced by multi-level processes (professional, organisational, local system) and interactions across these levels. Preferences for evidence vary by professional group and health service setting. Organisations can shape professional behaviour by requiring particular forms of evidence to inform decision-making. Pan-regional organisations shape innovation decision-making at lower levels. Political processes at all levels shape the selection and use of evidence in decision-making. The synthesis of results from primary qualitative studies found that evidence use in decision-making on innovation is influenced by processes at multiple levels. Interactions between different levels shape evidence use in decision-making (e.g. professional groups and organisations can use local systems to validate evidence and legitimise innovations, while local systems can tailor or frame evidence to influence activity at lower levels). Organisational leaders need to consider whether the environment in which decisions are made values diverse evidence and stakeholder perspectives. Further qualitative research on decision-making practices that highlights how and why different types of evidence come to count during decisions, and tracks the political aspects of decisions about innovation, is needed.

Disagreeing on Whether Agreement Is Persuasive: Perceptions of Expert Group Decisions

PubMed Central

Votruba, Ashley M.; Kwan, Virginia S. Y.

2015-01-01

While expert groups often make recommendations on a range of non-controversial as well as controversial issues, little is known about how the level of expert consensus—the level of expert agreement—influences perceptions of the recommendations. This research illustrates that for non-controversial issues expert groups that exhibit high levels of agreement are more persuasive than expert groups that exhibit low levels of agreement. This effect is mediated by the perceived entitativity—the perceived cohesiveness or unification of the group—of the expert group. But for controversial issues, this effect is moderated by the perceivers’ implicit assumptions about the group composition. When perceivers are provided no information about a group supporting the Affordable Care Act—a highly controversial piece of U.S. legislation that is divided by political party throughout the country—higher levels of agreement are less persuasive than lower levels of agreement because participants assume there were more democrats and fewer republicans in the group. But when explicitly told that the group was half republicans and half democrats, higher levels of agreement are more persuasive. PMID:25811384

Disagreeing on whether agreement is persuasive: perceptions of expert group decisions.

PubMed

Votruba, Ashley M; Kwan, Virginia S Y

2015-01-01

While expert groups often make recommendations on a range of non-controversial as well as controversial issues, little is known about how the level of expert consensus-the level of expert agreement-influences perceptions of the recommendations. This research illustrates that for non-controversial issues expert groups that exhibit high levels of agreement are more persuasive than expert groups that exhibit low levels of agreement. This effect is mediated by the perceived entitativity-the perceived cohesiveness or unification of the group-of the expert group. But for controversial issues, this effect is moderated by the perceivers' implicit assumptions about the group composition. When perceivers are provided no information about a group supporting the Affordable Care Act-a highly controversial piece of U.S. legislation that is divided by political party throughout the country-higher levels of agreement are less persuasive than lower levels of agreement because participants assume there were more democrats and fewer republicans in the group. But when explicitly told that the group was half republicans and half democrats, higher levels of agreement are more persuasive.

Space and Power in the Ivory Tower: Decision Making in Public Higher Education

ERIC Educational Resources Information Center

Blanchette, Sandra McCoskrie

2011-01-01

The challenges of managing physical space in higher education are often left unspoken and under researched. In this multiple case study of three urban universities, decision-making processes are examined with particular attention to who has institutional decision-making authority. Effective and efficient space management is important because the…

Space and Power in the Ivory Tower: Decision Making in Public Higher Education

ERIC Educational Resources Information Center

Blanchette, Sandra McCoskrie

2010-01-01

The challenges of managing physical space in public higher education are often left unspoken and under researched. In this multiple case study of three urban universities, decision-making processes are examined with particular attention to who has institutional decision-making authority. Effective and efficient space management is important…

Teacher Participation in the Decision-Making Process: Reality and Repercussions in Indian Higher Education

ERIC Educational Resources Information Center

Mehta, Deepa; Gardia, Alok; Rathore, H. C. S.

2010-01-01

The study reported here focused on comparing teachers' actual and desired participation in different decision-making situations and examined how participation in decision making differs in Indian higher educational institutions. The paper provides a comparison of findings with similar studies conducted in Western settings regarding the…

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

DOE PAGES

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

2016-09-03

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Energy-Water Nexus: Balancing the Tradeoffs between Two-Level Decision Makers

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

Zhang, Xiaodong; Vesselinov, Velimir Valentinov

Energy-water nexus has substantially increased importance in the recent years. Synergistic approaches based on systems-analysis and mathematical models are critical for helping decision makers better understand the interrelationships and tradeoffs between energy and water. In energywater nexus management, various decision makers with different goals and preferences, which are often conflicting, are involved. These decision makers may have different controlling power over the management objectives and the decisions. They make decisions sequentially from the upper level to the lower level, challenging decision making in energy-water nexus. In order to address such planning issues, a bi-level decision model is developed, which improvesmore » upon the existing studies by integration of bi-level programming into energy-water nexus management. The developed model represents a methodological contribution to the challenge of sequential decisionmaking in energy-water nexus through provision of an integrated modeling framework/tool. An interactive fuzzy optimization methodology is introduced to seek a satisfactory solution to meet the overall satisfaction of the two-level decision makers. The tradeoffs between the two-level decision makers in energy-water nexus management are effectively addressed and quantified. Application of the proposed model to a synthetic example problem has demonstrated its applicability in practical energy-water nexus management. Optimal solutions for electricity generation, fuel supply, water supply including groundwater, surface water and recycled water, capacity expansion of the power plants, and GHG emission control are generated. In conclusion, these analyses are capable of helping decision makers or stakeholders adjust their tolerances to make informed decisions to achieve the overall satisfaction of energy-water nexus management where bi-level sequential decision making process is involved.« less

Assessing the Degree of Integrated Learner-Centered Instruction on Student Outcomes in a Large Non-Major Environmental Science Course

ERIC Educational Resources Information Center

Thompson, Ruthanne; Bolin, Greta; Coe, Alice

2012-01-01

The decision to employ learner-centered teaching methods, teacher-centered teaching methods, or whether to integrate the two within large lecture halls in higher education continues to be heavily researched and hotly debated. All, in one form or another, have been shown effective at varying levels, throughout a myriad of disciplines and across…

Determinants of Household Water Conservation Retrofit Activity: A Discrete Choice Model Using Survey Data

NASA Astrophysics Data System (ADS)

Cameron, T. A.; Wright, M. B.

1990-02-01

Economic analyses of residential water demand have typically concentrated on price and income elasticities. In the short run a substantial change in water prices might induce only small changes in consumption levels. As time passes, however, households will have the opportunity to "retrofit" existing water-using equipment to make it less water-intensive. This produces medium- to long-run demand elasticities that are higher than short-run studies suggest. We examine responses to water conservation questions appearing on the Los Angeles Department of Water and Power's 1983 residential energy survey. We find that households' decisions to install shower retrofit devices are influenced by the potential to save money on water heating bills. We attribute toilet retrofit decisions more to noneconomic factors which might be characterized as "general conservation mindedness." The endogeneity of these retrofit decisions casts some doubt on the results of studies of individual households that treat voluntary retrofits as exogenous.

Home advantage in soccer--A matter of expectations, goal setting and tactical decisions of coaches?

PubMed

Staufenbiel, Kathrin; Lobinger, Babett; Strauss, Bernd

2015-01-01

In soccer, home teams win about 67% of decided games. The causes for this home advantage are still unresolved. There is a shortage of research on the psychological states of actors involved. In this study, we examined soccer coaches' expectations, goal setting and tactical decisions in relation to game location. Soccer coaches (N = 297) with different expertise levels participated in an experimental, online management game and were randomly assigned to one of two groups, "home game (HG)" or "away game." Participants received information on the game for which they were asked to make decisions in multiple points. The only differing information between groups was game location. Regardless of expertise, HG coaches had higher expectations to win, set more challenging goals and decided for more offensive and courageous playing tactics. Possible consequences of these findings concerning home advantage in soccer are discussed.

Dual process interaction model of HIV-risk behaviors among drug offenders.

PubMed

Ames, Susan L; Grenard, Jerry L; Stacy, Alan W

2013-03-01

This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected.

Complementary treatment of psychotic and epileptic patients in malaysia.

PubMed

Razali, Salleh Mohd; Yassin, Azhar Mohd

2008-09-01

The objective of this article is to describe and compare the use of traditional/complementary medicine (T/CM) among psychotic (schizophrenia and schizophreniform disorder) and epileptic Malay patients in peninsular Malaysia. There were 60 patients in each group. T/CM consultation was uniformly spread across all levels of education and social status. We could not find a single over-riding factor that influenced the decision to seek T/CM treatment because the decision to seek such treatment was complex and the majority of decisions were made by others. Fifty-three patients (44.2%), consisting of 37 (61.7%) psychotic and 16 (26.7%) epileptic patients had consulted Malay traditional healers (bomoh) and/or homeopathic practitioners in addition to modern treatment; of these, only three had consulted bomoh and homeopathic practitioners at the same time. The use of T/CM was significantly higher in psychotic than in epileptic Malay patients.

Dual Process Interaction Model of HIV-Risk Behaviors Among Drug Offenders

PubMed Central

Grenard, Jerry L.; Stacy, Alan W.

2012-01-01

This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive functions may dampen or block effects of spontaneously activated associations. Consistent with this model, latent variable interaction analyses revealed that drug offenders scoring higher in affective decision making were relatively protected from predictive effects of spontaneous sex associations promoting risky sex. Among drug offenders with lower levels of affective decision making ability, spontaneous sexually-related associations more strongly predicted risky sex (lack of condom use and greater number of sex partners). These findings help elucidate associative and control process effects on appetitive behaviors and are important for explaining why some individuals engage in risky sex, while others are relatively protected. PMID:22331391

A simple two-stage model predicts response time distributions.

PubMed

Carpenter, R H S; Reddi, B A J; Anderson, A J

2009-08-15

The neural mechanisms underlying reaction times have previously been modelled in two distinct ways. When stimuli are hard to detect, response time tends to follow a random-walk model that integrates noisy sensory signals. But studies investigating the influence of higher-level factors such as prior probability and response urgency typically use highly detectable targets, and response times then usually correspond to a linear rise-to-threshold mechanism. Here we show that a model incorporating both types of element in series - a detector integrating noisy afferent signals, followed by a linear rise-to-threshold performing decision - successfully predicts not only mean response times but, much more stringently, the observed distribution of these times and the rate of decision errors over a wide range of stimulus detectability. By reconciling what previously may have seemed to be conflicting theories, we are now closer to having a complete description of reaction time and the decision processes that underlie it.

Acceptability and preliminary feasibility of an internet/CD-ROM-based education and decision program for early-stage prostate cancer patients: randomized pilot study.

PubMed

Diefenbach, Michael A; Mohamed, Nihal E; Butz, Brian P; Bar-Chama, Natan; Stock, Richard; Cesaretti, Jamie; Hassan, Waleed; Samadi, David; Hall, Simon J

2012-01-13

Prostate cancer is the most common cancer affecting men in the United States. Management options for localized disease exist, yet an evidence-based criterion standard for treatment still has to emerge. Although 5-year survival rates approach 98%, all treatment options carry the possibility for significant side effects, such as erectile dysfunction and urinary incontinence. It is therefore recommended that patients be actively involved in the treatment decision process. We have developed an Internet/CD-ROM-based multimedia Prostate Interactive Educational System (PIES) to enhance patients' treatment decision making. PIES virtually mirrors a health center to provide patients with information about prostate cancer and its treatment through an intuitive interface, using videos, animations, graphics, and texts. (1) To examine the acceptability and feasibility of the PIES intervention and to report preliminary outcomes of the program in a pilot trial among patients with a new prostate cancer diagnosis, and (2) to explore the potential impact of tailoring PIES treatment information to participants' information-seeking styles on study outcomes. Participants (n = 72) were patients with newly diagnosed localized prostate cancer who had not made a treatment decision. Patients were randomly assigned to 3 experimental conditions: (1) control condition (providing information through standard National Cancer Institute brochures; 26%), and PIES (2) with tailoring (43%) and (3) without tailoring to a patient's information-seeking style (31%). Questionnaires were administrated before (t1) and immediately after the intervention (t2). Measurements include evaluation and acceptability of the PIES intervention, monitoring/blunting information-seeking style, psychological distress, and decision-related variables (eg, decisional confidence, feeling informed about prostate cancer and treatment, and treatment preference). The PIES program was well accepted by patients and did not interfere with the clinical routine. About 79% of eligible patients (72/91) completed the pre- and post-PIES intervention assessments. Patients in the PIES groups compared with those in the control condition were significantly more likely to report higher levels of confidence in their treatment choices, higher levels of helpfulness of the information they received in making a treatment decision, and that the information they received was emotionally reassuring. Patients in the PIES groups compared with those in the control condition were significantly less likely to need more information about treatment options, were less anxious about their treatment choices, and thought the information they received was clear (P < .05). Tailoring PIES information to information-seeking style was not related to decision-making variables. This pilot study confirms that the implementation of PIES within a clinical practice is feasible and acceptable to patients with a recent diagnosis of prostate cancer. PIES improved key decision-making process variables and reduced the emotional impact of a difficult medical decision.

Age and Expertise Effects in Aviation Decision Making and Flight Control in a Flight Simulator

PubMed Central

Kennedy, Quinn; Taylor, Joy L.; Reade, Gordon; Yesavage, Jerome A.

2010-01-01

Introduction Age (due to declines in cognitive abilities necessary for navigation) and level of aviation expertise are two factors that may affect aviation performance and decision making under adverse weather conditions. We examined the roles of age, expertise, and their relationship on aviation decision making and flight control performance during a flight simulator task. Methods Seventy-two IFR-rated general aviators, aged 19–79 yr, made multiple approach, holding pattern entry, and landing decisions while navigating under Instrument Flight Rules weather conditions. Over three trials in which the fog level varied, subjects decided whether or not to land the aircraft. They also completed two holding pattern entries. Subjects’ flight control during approaches and holding patterns was measured. Results Older pilots (41+ yr) were more likely than younger pilots to land when visibility was inadequate (older pilots’ mean false alarm rate: 0.44 vs 0.25). They also showed less precise flight control for components of the approach, performing 0.16 SD below mean approach scores. Expertise attenuated an age-related decline in flight control during holding patterns: older IFR/CFI performed 0.73 SD below mean score; younger IFR/CFI, younger CFII/ATP, older CFII/ATP: 0.32, 0.26, 0.03 SD above mean score. Additionally, pilots with faster processing speed (by median split) had a higher mean landing decision false alarm rate (0.42 vs 0.28), yet performed 0.14 SD above the mean approach control score. Conclusions Results have implications regarding specialized training for older pilots and for understanding processes involved in older adults’ real world decision making and performance. PMID:20464816

Incentives for Optimal Multi-level Allocation of HIV Prevention Resources

PubMed Central

Malvankar, Monali M.; Zaric, Gregory S.

2013-01-01

HIV/AIDS prevention funds are often allocated at multiple levels of decision-making. Optimal allocation of HIV prevention funds maximizes the number of HIV infections averted. However, decision makers often allocate using simple heuristics such as proportional allocation. We evaluate the impact of using incentives to encourage optimal allocation in a two-level decision-making process. We model an incentive based decision-making process consisting of an upper-level decision maker allocating funds to a single lower-level decision maker who then distributes funds to local programs. We assume that the lower-level utility function is linear in the amount of the budget received from the upper-level, the fraction of funds reserved for proportional allocation, and the number of infections averted. We assume that the upper level objective is to maximize the number of infections averted. We illustrate with an example using data from California, U.S. PMID:23766551

The role of the striatum in effort-based decision-making in the absence of reward.

PubMed

Schouppe, Nathalie; Demanet, Jelle; Boehler, Carsten N; Ridderinkhof, K Richard; Notebaert, Wim

2014-02-05

Decision-making involves weighing costs against benefits, for instance, in terms of the effort it takes to obtain a reward of a given magnitude. This evaluation process has been linked to the dorsal anterior cingulate cortex (dACC) and the striatum, with activation in these brain structures reflecting the discounting effect of effort on reward. Here, we investigate how cognitive effort influences neural choice processes in the absence of an extrinsic reward. Using functional magnetic resonance imaging in humans, we used an effort-based decision-making task in which participants were required to choose between two options for a subsequent flanker task that differed in the amount of cognitive effort. Cognitive effort was manipulated by varying the proportion of incongruent trials associated with each choice option. Choice-locked activation in the striatum was higher when participants chose voluntarily for the more effortful alternative but displayed the opposite trend on forced-choice trials. The dACC revealed a similar, yet only trend-level significant, activation pattern. Our results imply that activation levels in the striatum reflect a cost-benefit analysis, in which a balance is made between effort discounting and the intrinsic motivation to choose a cognitively challenging task. Moreover, our findings indicate that it matters whether this challenge is voluntarily chosen or externally imposed. As such, the present findings contrast with classical findings on effort discounting that found reductions in striatum activation for higher effort by finding enhancements of the same neural circuits when a cognitively challenging task is voluntarily selected and does not entail the danger of losing reward.

The influence of dispositional optimism on decision regret to undergo major breast reconstructive surgery.

PubMed

Zhong, Toni; Bagher, Shaghayegh; Jindal, Kunaal; Zeng, Delong; O'Neill, Anne C; MacAdam, Sheina; Butler, Kate; Hofer, Stefan O P; Pusic, Andrea; Metcalfe, Kelly A

2013-12-01

It is not known if optimism influences regret following major reconstructive breast surgery. We examined the relationship between dispositional optimism, major complications and decision regret in patients undergoing microsurgical breast reconstruction. A consecutive series of 290 patients were surveyed. Independent variables were: (1) dispositional optimism and (2) major complications. The primary outcome was Decision Regret. A multivariate regression analysis determined the relationship between the independent variables, confounders and decision regret. Of the 181 respondents, 63% reported no regret after breast reconstruction, 26% had mild regret, and 11% moderate to severe regret. Major complications did not have a significant effect on decision regret, and the impact of dispositional optimism was not significant in Caucasian women. There was a significant effect in non-Caucasian women with less optimism who had significantly higher levels of mild regret 1.36 (CI 1.02-1.97) and moderate to severe regret 1.64 (CI 1.0-93.87). This is the first paper to identify a subgroup of non-Caucasian patients with low dispositional optimism who may be at risk for developing regret after microsurgical breast reconstruction. Possible strategies to ameliorate regret may involve addressing cultural and language barriers, setting realistic expectations, and providing more support during the pre-operative decision-making phase. © 2013 Wiley Periodicals, Inc.

Patients' perception of their involvement in shared treatment decision making: Key factors in the treatment of inflammatory bowel disease.

PubMed

Veilleux, Sophie; Noiseux, Isabelle; Lachapelle, Nathalie; Kohen, Rita; Vachon, Luc; Guay, Brian White; Bitton, Alain; Rioux, John D

2018-02-01

This study aims to characterize the relationships between the quality of the information given by the physician, the involvement of the patient in shared decision making (SDM), and outcomes in terms of satisfaction and anxiety pertaining to the treatment of inflammatory bowel disease (IBD). A Web survey was conducted among 200 Canadian patients affected with IBD. The theoretical model of SDM was adjusted using path analysis. SAS software was used for all statistical analyses. The quality of the knowledge transfer between the physician and the patient is significantly associated with the components of SDM: information comprehension, patient involvement and decision certainty about the chosen treatment. In return, patient involvement in SDM is significantly associated with higher satisfaction and, as a result, lower anxiety as regards treatment selection. This study demonstrates the importance of involving patients in shared treatment decision making in the context of IBD. Understanding shared decision making may motivate patients to be more active in understanding the relevant information for treatment selection, as it is related to their level of satisfaction, anxiety and adherence to treatment. This relationship should encourage physicians to promote shared decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

Impaired decision-making and impulse control in Internet gaming addicts: evidence from the comparison with recreational Internet game users.

PubMed

Wang, Yifan; Wu, Lingdan; Wang, Lingxiao; Zhang, Yifen; Du, Xiaoxia; Dong, Guangheng

2017-11-01

Although Internet games have been proven to be addictive, only a few game players develop online gaming addiction. A large number of players play online games recreationally without being addicted to it. These individuals are defined as recreational Internet gaming users (RGU). So far, no research has investigated decision-making and impulse control in RGU. In the current study, we used delay discounting (DD) task and probabilistic discounting (PD) task to examine decision-making and impulse control in 20 healthy controls, 20 subjects with Internet gaming disorder (IGD) and 23 RGU during fMRI scanning. At the behavioral level, RGU showed lower DD rate and higher PD rate than subjects with IGD and there was no significant difference between RGU and healthy controls on the DD and PD rates. At the neural level, RGU showed increased neural response in the parahippocampal gyrus, the anterior cingulate cortex, the medial frontal gyrus and the inferior frontal gyrus as compared with subjects with IGD. These brain regions may play an important role in preventing RGU from developing addiction. The results suggest that the RGU are capable of inhibiting impulse due to additional cognitive endeavor and the subjects with IGD have deficit in decision-making and impulsive control, which are associated with brain dysfunction. © 2016 Society for the Study of Addiction.

Factors influencing the decision to attend screening for cancer in the UK: a meta-ethnography of qualitative research.

PubMed

Young, B; Bedford, L; Kendrick, D; Vedhara, K; Robertson, J F R; das Nair, R

2017-05-09

This review aimed to better understand experiences of being invited to cancer screening and associated decision-making. Qualitative evidence explaining UK cancer screening attendance decisions was systematically identified. Data were extracted and meta-ethnography used to identify shared themes, synthesize findings and generate higher level interpretations. Thirty-four studies met inclusion criteria. They related to uptake of breast, cervical, colorectal, prostate, ovarian and lung cancer screening. Three primary themes emerged from the synthesis. 'Relationships with the health service' shaped decisions, influenced by trust, compliance with power, resistance to control or surveillance and perceived failures to meet cultural, religious and language needs. 'Fear of cancer screening' was both a motivator and barrier in different ways and to varying degrees. Strategies to negotiate moderate fear levels were evident. 'Experiences of risk' included the creation of alternative personal risk discourses and the use of screening as a coping strategy, influenced by disease beliefs and feelings of health and wellness. The findings highlight the importance of the provider-patient relationship in screening uptake and enrich our understanding of how fear and risk are experienced and negotiated. This knowledge can help promote uptake and improve the effectiveness of cancer screening. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Mental fatigue impairs soccer-specific decision-making skill.

PubMed

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

2016-07-01

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

Does self-stigma reduce the probability of seeking mental health information?

PubMed

Lannin, Daniel G; Vogel, David L; Brenner, Rachel E; Abraham, W Todd; Heath, Patrick J

2016-04-01

An important first step in seeking counseling may involve obtaining information about mental health concerns and treatment options. Researchers have suggested that some people may avoid such information because it is too threatening due to self-stigma and negative attitudes, but the link to actual help-seeking decisions has not been tested. Therefore, the purpose of the present study was to examine whether self-stigma and attitudes negatively impact decisions to seek information about mental health concerns and counseling. Probit regression models with 370 undergraduates showed that self-stigma negatively predicted decisions to seek both mental health and counseling information, with attitudes toward counseling mediating self-stigma's influence on these decisions. Among individuals experiencing higher levels of distress, the predicted probabilities of seeking mental health information (8.5%) and counseling information (8.4%) for those with high self-stigma were nearly half of those with low self-stigma (17.1% and 15.0%, respectively). This suggests that self-stigma may hinder initial decisions to seek mental health and counseling information, and implies the need for the development of early interventions designed to reduce help-seeking barriers. (c) 2016 APA, all rights reserved).

When is diagnostic testing inappropriate or irrational? Acceptable regret approach.

PubMed

Hozo, Iztok; Djulbegovic, Benjamin

2008-01-01

The authors provide a new model within the framework of theories of bounded rationality for the observed physicians' behavior that their ordering of diagnostic tests may not be rational. Contrary to the prevailing thinking, the authors find that physicians do not act irrationally or inappropriately when they order diagnostic tests in usual clinical practice. When acceptable regret (i.e., regret that a decision maker finds tolerable upon making a wrong decision) is taken into account, the authors show that physicians tend to order diagnostic tests at a higher level of pretest probability of disease than predicted by expected utility theory. They also show why physicians tend to overtest when regret about erroneous decisions is extremely small. Finally, they explain variations in the practice of medicine. They demonstrate that in the same clinical situation, different decision makers might have different acceptable regret thresholds for withholding treatment, for ordering a diagnostic test, or for administering treatment. This in turn means that for some decision makers, the most rational strategy is to do nothing, whereas for others, it may be to order a diagnostic test, and still for others, choosing treatment may be the most rational course of action.

Relationship between impulsivity and decision-making in cocaine dependence

PubMed Central

Kjome, Kimberly L.; Lane, Scott D.; Schmitz, Joy M.; Green, Charles; Ma, Liangsuo; Prasla, Irshad; Swann, Alan C.; Moeller, F. Gerard

2010-01-01

Impulsivity and decision-making are associated on a theoretical level in that impaired planning is a component of both. However, few studies have examined the relationship between measures of decision-making and impulsivity in clinical populations. The purpose of this study was to compare cocaine-dependent subjects to controls on a measure of decision-making (the Iowa Gambling Task or IGT), a questionnaire measure of impulsivity (the Barratt Impulsiveness Scale or BIS-11), and a measure of behavioral inhibition (the immediate memory task or IMT), and to examine the interrelationship among these measures. Results of the study showed that cocaine-dependent subjects made more disadvantageous choices on the IGT, had higher scores on the BIS, and more commission errors on the IMT. Cognitive model analysis showed that choice consistency factors on the IGT differed between cocaine-dependent subjects and controls. However, there was no significant correlation between IGT performance and the BIS total score or subscales or IMT commission errors. These results suggest that in cocaine dependent subjects there is little overlap between decision-making as measured by the IGT and impulsivity/behavioral inhibition as measured by the BIS and IMT. PMID:20478631

Evidence of Adverse Selection in Iranian Supplementary Health Insurance Market

PubMed Central

Mahdavi, Gh; Izadi, Z

2012-01-01

Background: Existence or non-existence of adverse selection in insurance market is one of the important cases that have always been considered by insurers. Adverse selection is one of the consequences of asymmetric information. Theory of adverse selection states that high-risk individuals demand the insurance service more than low risk individuals do. Methods: The presence of adverse selection in Iran’s supplementary health insurance market is tested in this paper. The study group consists of 420 practitioner individuals aged 20 to 59. We estimate two logistic regression models in order to determine the effect of individual’s characteristics on decision to purchase health insurance coverage and loss occurrence. Using the correlation between claim occurrence and decision to purchase health insurance, the adverse selection problem in Iranian supplementary health insurance market is examined. Results: Individuals with higher level of education and income level purchase less supplementary health insurance and make fewer claims than others make and there is positive correlation between claim occurrence and decision to purchase supplementary health insurance. Conclusion: Our findings prove the evidence of the presence of adverse selection in Iranian supplementary health insurance market. PMID:23113209

Exploring Audiologists' Language and Hearing Aid Uptake in Initial Rehabilitation Appointments.

PubMed

Sciacca, Anna; Meyer, Carly; Ekberg, Katie; Barr, Caitlin; Hickson, Louise

2017-06-13

The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon. A binomial, multivariate logistic regression analysis was conducted to investigate the associations between these language measures and hearing aid uptake. The logistic regression model revealed that the Flesch-Kincaid reading grade level of audiologists' language was significantly associated with hearing aid uptake. Patients were less likely to obtain hearing aids when audiologists' language was at a higher reading grade level. No associations were found between audiologists' use of jargon and hearing aid uptake. Audiologists' use of complex language may present a barrier for patients to understand hearing rehabilitation recommendations. Reduced understanding may limit patient participation in the decision-making process and result in patients being less willing to trial hearing aids. Clear, concise language is recommended to facilitate shared decision making.

The effect of methylphenidate on decision making in patients with borderline personality disorder and attention-deficit/hyperactivity disorder.

PubMed

Gvirts, Hila Z; Lewis, Yael D; Dvora, Shira; Feffer, Kfir; Nitzan, Uriel; Carmel, Ziv; Levkovitz, Yechiel; Maoz, Hagai

2018-07-01

Impaired decision making in patients with borderline personality disorder (BPD) has been reported in several studies. Although methylphenidate (MPH) is known to ameliorate impaired decision making in patients with attention-deficit/hyperactivity disorder (ADHD), it has not yet been examined in patients with BPD. We therefore assessed the efficacy of a single dose of MPH on cognitive functions and decision making in patients with BPD. Twenty-two patients diagnosed with BPD participated in the study. The study was a randomized, double-blind placebo-controlled, random block order cross-over trial. Patients participated in two sessions and performed the Test of Variables of Attention, a digit-span test, and the computerized Iowa Gambling Task, after they had been administered either the MPH or a placebo. ADHD symptoms were assessed using the Adult ADHD Self-Report Scale-18. Lower scores on the inattention symptoms scale were associated with a greater improvement in decision making following the administration of MPH when compared with improvements in patients with higher ADHD scores [F(1,17)=5.63, P=0.030]. We conclude that MPH may improve decision making in patients with BPD, although this effect is mediated by the level of ADHD symptoms. Further studies are needed to assess whether a prolonged beneficial effect of MPH on decision making in patients with BPD might also be present in 'real life'.

Land use and management in PR China: problems and strategies.

PubMed

Cai, Y

1990-10-01

The conflict between population and land in China results from high population density, declining availability of arable land, decrease in cropland, overgrazing, inability to afford imported grain, and expansion of land use for urbanization. Unwise decisions have been made. These decisions have resulted in land degradation, soil erosion, deforestation, degradation of grasslands, waste of land for freight storage or waste disposal due to low grain prices, and nonagricultural constructions on croplands. Ineffective land management problems are identified as: 1) the lack of an economic means of guiding land use and land is not valued; the lack of any mechanism to ensure economic land use including public lands which are not accounted for with rent; 2) the lack of integration of departments into the decision making structure and too many departments making decisions about the same land; 3) the lack of choice in land use which results in higher government departments being unaware of local conditions, and the lack of appropriate investment which results in short-term exploitation; and 4) surveys are inadequate for decision making. The strategies suggested for improvement in land use management include low resources expenditure in production and appropriate goods consumption. The goal is to sustain subsistence with gradual improvement through development. Land resources must be conserved and the environment protected. The solutions to depend on food imports or reduce the nutritional level deny the equally plausible solution to generate a higher level of input. The profit motive and scientific agricultural practices could accomplish this end. Reclamation for cropland is possible for 8 million hectares of wasteland in wide areas in Sanjiang Plain and 3.4 million hectares in small pockets in Eastern Monsoon China. Traditional agriculture must be transformed and an optimum scale of land operation established. Land tenure reform is necessary. Regional conditions must prevail as the guiding principles. Several implementation strategies are suggested: controlling population growth and establishing a balance between expenditure and land productivity, expanding and conserving forest areas, increasing agricultural investment, reforming land tenure, adjusting land product prices, strengthening land administration, developing other industries, and reforming economic and political systems.

A Multi Criteria Group Decision-Making Model for Teacher Evaluation in Higher Education Based on Cloud Model and Decision Tree

ERIC Educational Resources Information Center

Chang, Ting-Cheng; Wang, Hui

2016-01-01

This paper proposes a cloud multi-criteria group decision-making model for teacher evaluation in higher education which is involving subjectivity, imprecision and fuzziness. First, selecting the appropriate evaluation index depending on the evaluation objectives, indicating a clear structural relationship between the evaluation index and…

Due Process and Higher Education: A Systemic Approach to Fair Decision Making. ERIC Digest.

ERIC Educational Resources Information Center

Stevens, Ed

University officials and faculty are frequently required to make decisions based on interpretations of disputed facts. By applying the concept of due process within the context of higher education, they can meet legal challenges of contract and constitutional law and the pedagogical demand for justice. To guide their efforts, decision makers can…

Decision Making for Chinese Students to Receive Their Higher Education in the U.S.

ERIC Educational Resources Information Center

Chao, Chiangnan

2016-01-01

This study examines Chinese students' decision making considerations for coming to the U.S. for their higher education. Due to the large number of Chinese students in the U.S, it is an interesting topic for educators and researchers to explore the decision making considerations Chinese students choose for studying abroad. International student…

Moral Judgments of Chief Academic Officers at Institutions of Higher Education

ERIC Educational Resources Information Center

Weaver, Megan D.

2012-01-01

Chief Academic Officers (CAO) are leaders in institutions of higher education and have wide decision-making scope. Previous research has clearly demonstrated the need for leaders to engage in ethical decision-making. Moral judgments are an aspect of ethical decision-making, so it is important for CAOs to make moral judgments. This study examined…

Identifying family members who may struggle in the role of surrogate decision maker.

PubMed

Majesko, Alyssa; Hong, Seo Yeon; Weissfeld, Lisa; White, Douglas B

2012-08-01

Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties. To identify: 1) factors associated with lower levels of confidence among family members to function as surrogates and 2) whether the quality of clinician-family communication is associated with the timing of decisions to forego life support. We conducted a prospective study of 230 surrogate decision makers for incapacitated, mechanically ventilated patients at high risk of death in four intensive care units at University of California San Francisco Medical Center from 2006 to 2007. Surrogates completed a questionnaire addressing their perceived ability to act as a surrogate and the quality of their communication with physicians. We used clustered multivariate logistic regression to identify predictors of low levels of perceived ability to act as a surrogate and a Cox proportional hazard model to determine whether quality of communication was associated with the timing of decisions to withdraw life support. There was substantial variability in family members' confidence to act as surrogate decision makers, with 27% rating their perceived ability as 7 or lower on a 10-point scale. Independent predictors of lower role confidence were the lack of prior experience as a surrogate (odds ratio 2.2, 95% confidence interval [1.04-4.46], p=.04), no prior discussions with the patient about treatment preferences (odds ratio 3.7, 95% confidence interval [1.79-7.76], p<.001), and poor quality of communication with the ICU physician (odds ratio 1.2, 95% confidence interval [1.09-1.35] p<.001). Higher quality physician-family communication was associated with a significantly shorter duration of life-sustaining treatment among patients who died (β=0.11, p=.001). Family members without prior experience as a surrogate and those who had not engaged in advanced discussions with the patient about treatment preferences were at higher risk to report less confidence in carrying out the surrogate role. Better-quality clinician-family communication was associated with both more confidence among family members to act as surrogates and a shorter duration of use of life support among patients who died.

Pretreatment tables predicting pathologic stage of locally advanced prostate cancer.

PubMed

Joniau, Steven; Spahn, Martin; Briganti, Alberto; Gandaglia, Giorgio; Tombal, Bertrand; Tosco, Lorenzo; Marchioro, Giansilvio; Hsu, Chao-Yu; Walz, Jochen; Kneitz, Burkhard; Bader, Pia; Frohneberg, Detlef; Tizzani, Alessandro; Graefen, Markus; van Cangh, Paul; Karnes, R Jeffrey; Montorsi, Francesco; van Poppel, Hein; Gontero, Paolo

2015-02-01

Pretreatment tables for the prediction of pathologic stage have been published and validated for localized prostate cancer (PCa). No such tables are available for locally advanced (cT3a) PCa. To construct tables predicting pathologic outcome after radical prostatectomy (RP) for patients with cT3a PCa with the aim to help guide treatment decisions in clinical practice. This was a multicenter retrospective cohort study including 759 consecutive patients with cT3a PCa treated with RP between 1987 and 2010. Retropubic RP and pelvic lymphadenectomy. Patients were divided into pretreatment prostate-specific antigen (PSA) and biopsy Gleason score (GS) subgroups. These parameters were used to construct tables predicting pathologic outcome and the presence of positive lymph nodes (LNs) after RP for cT3a PCa using ordinal logistic regression. In the model predicting pathologic outcome, the main effects of biopsy GS and pretreatment PSA were significant. A higher GS and/or higher PSA level was associated with a more unfavorable pathologic outcome. The validation procedure, using a repeated split-sample method, showed good predictive ability. Regression analysis also showed an increasing probability of positive LNs with increasing PSA levels and/or higher GS. Limitations of the study are the retrospective design and the long study period. These novel tables predict pathologic stage after RP for patients with cT3a PCa based on pretreatment PSA level and biopsy GS. They can be used to guide decision making in men with locally advanced PCa. Our study might provide physicians with a useful tool to predict pathologic stage in locally advanced prostate cancer that might help select patients who may need multimodal treatment. Copyright © 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Work-group characteristics and performance in collectivistic and individualistic cultures.

PubMed

Sosik, John J; Jung, Dong I

2002-02-01

The authors conducted a cross-cultural longitudinal investigation of the effects of culture (individualism-collectivism dichotomy) on group characteristics (functional heterogeneity, preference for teamwork, group potency, outcome expectation) and on performance of 83 work groups performing 2 decision-making tasks over a 15-week period. The individualists (U.S. students) reported higher levels of functional heterogeneity and group potency and attained higher levels of group performance than did the collectivists (Korean students). In addition, culture and time interacted to influence ratings of group potency and outcome expectation. The difference in ratings of group potency between individualists and collectivists increased over time. Outcome expectation was greater among the collectivists in Time 1 and among the individualists in Time 2. The authors discuss implications for future cross-cultural group research and international management.

Reproductive health concerns in six conflict-affected areas of Sri Lanka.

PubMed

Kottegoda, Sepali; Samuel, Kumudini; Emmanuel, Sarala

2008-05-01

This article draws on a study conducted by the Women and Media Collective between 2004 and 2005 to highlight some of the reproductive health concerns of women from Sinhalese, Tamil and Muslim ethnic groups, living in situations of conflict in Sri Lanka. The study focussed on women from six conflict-affected areas in the north and east of the country: Jaffna (Northern Province), Mannar and Puttalam (North-Western Province), Polonnaruwa (North-Central Province), Batticaloa and Ampara (Eastern Province). Higher levels of poverty, higher rates of school drop-out, low pay and precarious access to work, mainly in the informal sector, higher rates of early marriage, pregnancy and home births, higher levels of maternal mortality and lower levels of contraceptive use were found. Economic, social and physical insecurity were key to these phenomena. Physically and psychologically, women were at high risk of sexual and physical violence, mainly from their partners/spouses but also from family members, often related to dowry. The article brings out the voices of women whose lives have been overshadowed by conflict and displacement, and the nature of structural barriers that impede their right to health care services, to make informed decisions about their lives and to live free of familial violence.

Emotional decisions in structured populations for the evolution of public cooperation

NASA Astrophysics Data System (ADS)

Wang, Yongjie; Chen, Tong; Chen, Qiao; Si, Guangrun

2017-02-01

The behaviors of humans are not always profit-driven in public goods games (PGG). In addition, social preference and decision-making might be influenced, even changed by heuristics and conformity in the real life. Motivated by the facts, we would like to investigate the role of emotional system in cooperative behaviors of structured population in PGG. Meantime, the effects of diffusion of influence are studied in structured population. Numerical simulation results are indicated that emotions play very significant role indeed in emergence and maintenance of cooperation in structured populations in PGG. However, the influences of emotions on others are limited due to diminishing of influence diffusion and the existence of pure defectors. What is more, conformity, to some extent, could drive potentially more people to accept cooperative strategy with higher probability. Higher-level cooperation could be promoted as increasing values of synergy factors, but while the effects might diminish gradually as increasing number of positive heuristic players and conformist. Our work may be beneficial to address the social dilemmas in PGG.

Enrollment in prescription drug insurance: the interaction of numeracy and choice set size.

PubMed

Szrek, Helena; Bundorf, M Kate

2014-04-01

To determine how choice set size affects decision quality among individuals of different levels of numeracy choosing prescription drug plans. Members of an Internet-enabled panel age 65 and over were randomly assigned to sets of prescription drug plans varying in size from 2 to 16 plans from which they made a hypothetical choice. They answered questions about enrollment likelihood and the costs and benefits of their choice. The measure of decision quality was enrollment likelihood among those for whom enrollment was beneficial. Enrollment likelihood by numeracy and choice set size was calculated. A model of moderated mediation was analyzed to understand the role of numeracy as a moderator of the relationship between the number of plans and the quality of the enrollment decision and the roles of the costs and benefits in mediating that relationship. More numerate adults made better decisions than less numerate adults when choosing among a small number of alternatives but not when choice sets were larger. Choice set size had little effect on decision making of less numerate adults. Differences in decision making costs between more and less numerate adults helped explain the effect of choice set size on decision quality. Interventions to improve decision making in the context of Medicare Part D may differentially affect lower and higher numeracy adults. The conflicting results on choice overload in the psychology literature may be explained in part by differences amongst individuals in how they respond to choice set size.

Configural frequency analysis as a method of determining patients' preferred decision-making roles in dialysis.

PubMed

Loeffert, Sabine; Ommen, Oliver; Kuch, Christine; Scheibler, Fueloep; Woehrmann, Andrej; Baldamus, Conrad; Pfaff, Holger

2010-09-11

Numerous studies examined factors in promoting a patient preference for active participation in treatment decision making with only modest success. The purpose of this study was to identify types of patients wishing to participate in treatment decisions as well as those wishing to play a completely active or passive role based on a Germany-wide survey of dialysis patients; using a prediction typal analysis method that defines types as configurations of categories belonging to different attributes and takes particularly higher order interactions between variables into account. After randomly splitting the original patient sample into two halves, an exploratory prediction configural frequency analysis (CFA) was performed on one-half of the sample (n = 1969) and the identified types were considered as hypotheses for an inferential prediction CFA for the second half (n = 1914). 144 possible prediction types were tested by using five predictor variables and control preferences as criterion. An α-adjustment (0.05) for multiple testing was performed by the Holm procedure. 21 possible prediction types were identified as hypotheses in the exploratory prediction CFA; four patient types were confirmed in the confirmatory prediction CFA: patients preferring a passive role show low information seeking preference, above average trust in their physician, perceive their physician's participatory decision-making (PDM)-style positive, have a lower educational level, and are 56-75 years old (Type 1; p < 0.001) or > 76 years old (Type 2; p < 0.001). Patients preferring an active role show high information seeking preference, a higher educational level, and are < 55 years old. They have either below average trust, perceive the PDM-style negative (Type 3; p < 0.001) or above average trust and perceive the PDM-style positive (Type 4; p < 0.001). The method prediction configural frequency analysis was newly introduced to the research field of patient participation and could demonstrate how a particular control preference role is determined by an association of five variables.

Psychosocial working conditions and self-reported long-term illness: a population-based study of Swedish-born and foreign-born employed persons.

PubMed

Sundquist, Jan; Ostergren, Per-Olof; Sundquist, Kristina; Johansson, Sven-Erik

2003-11-01

Knowledge pertaining to the relationship between migration status and psychosocial job characteristics and long-term illness is not readily available in the international literature. The aim of this study is to analyse the cross-sectional associations between high psychological job demands and low decision latitude (high job strain), work-related social support and long-term illness among foreign-born and Swedish-born people. The present study combines four annual simple random samples covering 1994-97 from the Swedish Annual Level of Living Survey (SALLS). A sub-sample, including only employed persons and consisting of 10,072 Swedish-born persons, 710 labour migrants and 333 refugees aged 25-64 years, was analysed using logistic regression. Refugees had a higher risk (OR=1.33; 95% CI: 1.05-1.69) of long-term illness than Swedes. Moreover, those experiencing both high job demands and a low decision latitude ran an increased risk (OR=1.74; 95% CI: 1.42-2.13) of long-term illness. About 63% of the refugees among the unskilled/skilled manual workers had low decision latitudes in comparison with 17% of the intermediate and senior salaried employees. There were only small differences in job demands between labour immigrants, refugees and Swedes. There was no interaction between migration status and high job strain. However, refugees with low social support had nearly twice as high a risk of long-term illness as Swedes with high-level work-related social support. Refugees ran a higher risk of long-term illness than Swedes. Although there were no differences in risk between labour immigrants, refugees and Swedes under job strain, refugees with low work-related social support had a high risk of long-term illness. Unskilled/skilled refugee workers had lower decision latitudes than Swedes.

Crucial Decisions in American Higher Education.

ERIC Educational Resources Information Center

Cowley, W. H.

In an informal address, this David Jacks Professor of Higher Education offers a historical review of decision-making in American higher education. This discussion centers around these milestones: the founding of Harvard in 1636; the first alumni gift in 1648; faculty organization in 1725; annual subventions for state universities in 1805; the…

Implicit Theoretical Leadership Frameworks of Higher Education Administrators.

ERIC Educational Resources Information Center

Lees, Kimberly; And Others

Colleges and universities have a unique organizational culture that influences the decision-making processes used by leaders of higher education. This paper presents findings of a study that attempted to identify the theoretical frameworks that administrators of higher education use to guide their decision-making processes. The following…

Characterizing uncertain sea-level rise projections to support investment decisions.

PubMed

Sriver, Ryan L; Lempert, Robert J; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions.

Characterizing uncertain sea-level rise projections to support investment decisions

PubMed Central

Lempert, Robert J.; Wikman-Svahn, Per; Keller, Klaus

2018-01-01

Many institutions worldwide are considering how to include uncertainty about future changes in sea-levels and storm surges into their investment decisions regarding large capital infrastructures. Here we examine how to characterize deeply uncertain climate change projections to support such decisions using Robust Decision Making analysis. We address questions regarding how to confront the potential for future changes in low probability but large impact flooding events due to changes in sea-levels and storm surges. Such extreme events can affect investments in infrastructure but have proved difficult to consider in such decisions because of the deep uncertainty surrounding them. This study utilizes Robust Decision Making methods to address two questions applied to investment decisions at the Port of Los Angeles: (1) Under what future conditions would a Port of Los Angeles decision to harden its facilities against extreme flood scenarios at the next upgrade pass a cost-benefit test, and (2) Do sea-level rise projections and other information suggest such conditions are sufficiently likely to justify such an investment? We also compare and contrast the Robust Decision Making methods with a full probabilistic analysis. These two analysis frameworks result in similar investment recommendations for different idealized future sea-level projections, but provide different information to decision makers and envision different types of engagement with stakeholders. In particular, the full probabilistic analysis begins by aggregating the best scientific information into a single set of joint probability distributions, while the Robust Decision Making analysis identifies scenarios where a decision to invest in near-term response to extreme sea-level rise passes a cost-benefit test, and then assembles scientific information of differing levels of confidence to help decision makers judge whether or not these scenarios are sufficiently likely to justify making such investments. Results highlight the highly-localized and context dependent nature of applying Robust Decision Making methods to inform investment decisions. PMID:29414978

Making the Connection between Environmental Science and Decision Making

NASA Astrophysics Data System (ADS)

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

2011-12-01

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

Team performance in networked supervisory control of unmanned air vehicles: effects of automation, working memory, and communication content.

PubMed

McKendrick, Ryan; Shaw, Tyler; de Visser, Ewart; Saqer, Haneen; Kidwell, Brian; Parasuraman, Raja

2014-05-01

Assess team performance within a net-worked supervisory control setting while manipulating automated decision aids and monitoring team communication and working memory ability. Networked systems such as multi-unmanned air vehicle (UAV) supervision have complex properties that make prediction of human-system performance difficult. Automated decision aid can provide valuable information to operators, individual abilities can limit or facilitate team performance, and team communication patterns can alter how effectively individuals work together. We hypothesized that reliable automation, higher working memory capacity, and increased communication rates of task-relevant information would offset performance decrements attributed to high task load. Two-person teams performed a simulated air defense task with two levels of task load and three levels of automated aid reliability. Teams communicated and received decision aid messages via chat window text messages. Task Load x Automation effects were significant across all performance measures. Reliable automation limited the decline in team performance with increasing task load. Average team spatial working memory was a stronger predictor than other measures of team working memory. Frequency of team rapport and enemy location communications positively related to team performance, and word count was negatively related to team performance. Reliable decision aiding mitigated team performance decline during increased task load during multi-UAV supervisory control. Team spatial working memory, communication of spatial information, and team rapport predicted team success. An automated decision aid can improve team performance under high task load. Assessment of spatial working memory and the communication of task-relevant information can help in operator and team selection in supervisory control systems.

[Gender analysis on prenatal care in rural areas of Xinjiang and Anhui province].

PubMed

Yang, Li; Lv, Meng-Tao; Cui, Ying; Deng, Li-na; Tian, Xiao-bo

2009-10-01

To introduce the gender-specific view to the prenatal care and analysing the health behavior and its influencing factors. Random sampling in cluster was used to select those study population and face to face interview was carried out at their residence in Xinjiang and Anhui province. The overall socioeconomic status of women in rural areas of Xinjiang and Anhui province was low and 93.2% of the women had education level on junior middle school or below. Politically women were less interested in these issues with only 63.1% of them ever participated in the election program or voting. In household daily life, women's status was almost equal to or even higher than men, but men always called the shots when something important in family happened. Men still held the power of decision making. In 47.3% of the families, the husband played a decisive role on decision making. In 37.7% of the families, husbands controlled the money. When getting into expensive expenditure, 35.2% of the families having men made the final approval. When there were different opinions between the couples, husband usually made the final decision in 44.2% of all the families compared to 6.3% of the families that wives made the final decision. 73.9% of women under survey had undergone prenatal examination and the rate on household deliveries reached 30.3%. Both gender consciousness and educational level had influenced the effect on prenatal care. It is important to better prenatal health service in rural areas and to improve socioeconomic status on gender consciousness of women.

Executive functions, information sampling, and decision making in narcolepsy with cataplexy.

PubMed

Delazer, Margarete; Högl, Birgit; Zamarian, Laura; Wenter, Johanna; Gschliesser, Viola; Ehrmann, Laura; Brandauer, Elisabeth; Cevikkol, Zehra; Frauscher, Birgit

2011-07-01

Narcolepsy with cataplexy (NC) affects neurotransmitter systems regulating emotions and cognitive functions. This study aimed to assess executive functions, information sampling, reward processing, and decision making in NC. Twenty-one NC patients and 58 healthy participants performed an extensive neuropsychological test battery. NC patients scored as controls in executive function tasks assessing set shifting, reversal learning, working memory, and planning. Group differences appeared in a task measuring information sampling and reward sensitivity. NC patients gathered less information, tolerated a higher level of uncertainty, and were less influenced by reward contingencies than controls. NC patients also showed reduced learning in decision making and had significantly lower scores than controls in the fifth block of the IOWA gambling task. No correlations were found with measures of sleepiness. NC patients may achieve high performance in several neuropsychological domains, including executive functions. Specific differences between NC patients and controls highlight the importance of the hypocretin system in reward processing and decision making and are in line with previous neuroimaging and neurophysiological studies. PsycINFO Database Record (c) 2011 APA, all rights reserved.

Mother–Adolescent Agreement Regarding Decision-Making Autonomy: A Longitudinal Comparison of Families of Adolescents with and without Spina Bifida

PubMed Central

Devine, Katie A.; Wasserman, Rachel M.; Gershenson, Lily S.; Essner, Bonnie S.

2011-01-01

Objective Longitudinal comparison of mother and adolescent agreement regarding decision-making autonomy for adolescents with and without spina bifida (SB). Methods Forty-two mother–adolescent dyads of adolescents with SB and 55 comparison dyads reported on who was responsible for decision-making across five waves of data collection, beginning at age 8 or 9 years through age 16 or 17 years. Results The proportion of tasks that dyads agreed were decided by adolescents increased over time for both samples beginning at age 12 or 13 years, but appeared to be delayed by roughly two years for youth with SB and was lower for youth with SB from lower socioeconomic (SES) backgrounds. Mothers and adolescents with low SES demonstrated higher proportions of tasks that dyads agreed were decided by mothers. Conclusions SB and low SES are risk factors for lower levels of agreed-upon decision-making autonomy. Future studies should examine how parent–adolescent agreement regarding autonomy relates to psychosocial outcomes. PMID:20943730

Motivational Reasons for Biased Decisions: The Sunk-Cost Effect's Instrumental Rationality.

PubMed

Domeier, Markus; Sachse, Pierre; Schäfer, Bernd

2018-01-01

The present study describes the mechanism of need regulation, which accompanies the so-called "biased" decisions. We hypothesized an unconscious urge for psychological need satisfaction as the trigger for cognitive biases. In an experimental study ( N = 106), participants had the opportunity to win money in a functionality test. In the test, they could either use the solution they had developed (sunk cost) or an alternative solution that offered a higher probability of winning. The selection of the sunk-cost option (SCO) was the most chosen option, supporting the hypothesis of this study. The reason behind the majority of participants choosing the SCO seemed to be the satisfaction of psychological needs, despite a reduced chance of winning money. An intervention, which aimed at triggering self-reflection, had no impact on the decision. The findings of this study contribute to the discussion on the reasons for cognitive biases and their formation in the human mind. Moreover, it discusses the application of the label "irrational" for biased decisions and proposes reasons for instrumental rationality, which exist at an unconscious, need-regulative level.

Supply chain network design problem for a new market opportunity in an agile manufacturing system

NASA Astrophysics Data System (ADS)

Babazadeh, Reza; Razmi, Jafar; Ghodsi, Reza

2012-08-01

The characteristics of today's competitive environment, such as the speed with which products are designed, manufactured, and distributed, and the need for higher responsiveness and lower operational cost, are forcing companies to search for innovative ways to do business. The concept of agile manufacturing has been proposed in response to these challenges for companies. This paper copes with the strategic and tactical level decisions in agile supply chain network design. An efficient mixed-integer linear programming model that is able to consider the key characteristics of agile supply chain such as direct shipments, outsourcing, different transportation modes, discount, alliance (process and information integration) between opened facilities, and maximum waiting time of customers for deliveries is developed. In addition, in the proposed model, the capacity of facilities is determined as decision variables, which are often assumed to be fixed. Computational results illustrate that the proposed model can be applied as a power tool in agile supply chain network design as well as in the integration of strategic decisions with tactical decisions.

The color of juvenile justice: racial disparities in dispositional decisions.

PubMed

Fader, Jamie J; Kurlychek, Megan C; Morgan, Kirstin A

2014-03-01

Existing research on dispositional decisions typically models the outcome as merely placed or not placed. However, this does not accurately reflect the wide variation in residential options available to juvenile court actors. In this research, we combine data from ProDES, which tracks adjudicated youth in Philadelphia, with data from the Program Design Inventory, which describes over 100 intervention programs, to further examine the factors that influence court actors' decision making in selecting an appropriate program for a juvenile offender. We find that even after controlling for legal and needs-based factors, race continues to exert a significant influence, with decision makers being significantly more likely to commit minority youth to facilities using physical regimen as their primary modality and reserving smaller, therapeutic facilities for their white counterparts. Using focal concerns theory as an explanatory lens, we suggest that court actors in this jurisdiction employ a racialized perceptual shorthand of youthful offenders that attributes both higher levels of blame and lower evaluations of reformability to minority youth. Copyright © 2013 Elsevier Inc. All rights reserved.

Motivational Reasons for Biased Decisions: The Sunk-Cost Effect’s Instrumental Rationality

PubMed Central

Domeier, Markus; Sachse, Pierre; Schäfer, Bernd

2018-01-01

The present study describes the mechanism of need regulation, which accompanies the so-called “biased” decisions. We hypothesized an unconscious urge for psychological need satisfaction as the trigger for cognitive biases. In an experimental study (N = 106), participants had the opportunity to win money in a functionality test. In the test, they could either use the solution they had developed (sunk cost) or an alternative solution that offered a higher probability of winning. The selection of the sunk-cost option (SCO) was the most chosen option, supporting the hypothesis of this study. The reason behind the majority of participants choosing the SCO seemed to be the satisfaction of psychological needs, despite a reduced chance of winning money. An intervention, which aimed at triggering self-reflection, had no impact on the decision. The findings of this study contribute to the discussion on the reasons for cognitive biases and their formation in the human mind. Moreover, it discusses the application of the label “irrational” for biased decisions and proposes reasons for instrumental rationality, which exist at an unconscious, need-regulative level. PMID:29881366

Effect of Interactions between Harvester Ants on Forager Decisions

PubMed Central

Davidson, Jacob D.; Arauco-Aliaga, Roxana P.; Crow, Sam; Gordon, Deborah M.; Goldman, Mark S.

2017-01-01

Harvester ant colonies adjust their foraging activity to day-to-day changes in food availability and hour-to-hour changes in environmental conditions. This collective behavior is regulated through interactions, in the form of brief antennal contacts, between outgoing foragers and returning foragers with food. Here we consider how an ant, waiting in the entrance chamber just inside the nest entrance, uses its accumulated experience of interactions to decide whether to leave the nest to forage. Using videos of field observations, we tracked the interactions and foraging decisions of ants in the entrance chamber. Outgoing foragers tended to interact with returning foragers at higher rates than ants that returned to the deeper nest and did not forage. To provide a mechanistic framework for interpreting these results, we develop a decision model in which ants make decisions based upon a noisy accumulation of individual contacts with returning foragers. The model can reproduce core trends and realistic distributions for individual ant interaction statistics, and suggests possible mechanisms by which foraging activity may be regulated at an individual ant level. PMID:28758093

Using CART to Identify Thresholds and Hierarchies in the Determinants of Funding Decisions.

PubMed

Schilling, Chris; Mortimer, Duncan; Dalziel, Kim

2017-02-01

There is much interest in understanding decision-making processes that determine funding outcomes for health interventions. We use classification and regression trees (CART) to identify cost-effectiveness thresholds and hierarchies in the determinants of funding decisions. The hierarchical structure of CART is suited to analyzing complex conditional and nonlinear relationships. Our analysis uncovered hierarchies where interventions were grouped according to their type and objective. Cost-effectiveness thresholds varied markedly depending on which group the intervention belonged to: lifestyle-type interventions with a prevention objective had an incremental cost-effectiveness threshold of $2356, suggesting that such interventions need to be close to cost saving or dominant to be funded. For lifestyle-type interventions with a treatment objective, the threshold was much higher at $37,024. Lower down the tree, intervention attributes such as the level of patient contribution and the eligibility for government reimbursement influenced the likelihood of funding within groups of similar interventions. Comparison between our CART models and previously published results demonstrated concurrence with standard regression techniques while providing additional insights regarding the role of the funding environment and the structure of decision-maker preferences.

Hydraulic Modeling and Evolutionary Optimization for Enhanced Real-Time Decision Support of Combined Sewer Overflows

NASA Astrophysics Data System (ADS)

Zimmer, A. L.; Minsker, B. S.; Schmidt, A. R.; Ostfeld, A.

2011-12-01

Real-time mitigation of combined sewer overflows (CSOs) requires evaluation of multiple operational strategies during rapidly changing rainfall events. Simulation models for hydraulically complex systems can effectively provide decision support for short time intervals when coupled with efficient optimization. This work seeks to reduce CSOs for a test case roughly based on the North Branch of the Chicago Tunnel and Reservoir Plan (TARP), which is operated by the Metropolitan Water Reclamation District of Greater Chicago (MWRDGC). The North Branch tunnel flows to a junction with the main TARP system. The Chicago combined sewer system alleviates potential CSOs by directing high interceptor flows through sluice gates and dropshafts to a deep tunnel. Decision variables to control CSOs consist of sluice gate positions that control water flow to the tunnel as well as a treatment plant pumping rate that lowers interceptor water levels. A physics-based numerical model is used to simulate the hydraulic effects of changes in the decision variables. The numerical model is step-wise steady and conserves water mass and momentum at each time step by iterating through a series of look-up tables. The look-up tables are constructed offline to avoid extensive real-time calculations, and describe conduit storage and water elevations as a function of flow. A genetic algorithm (GA) is used to minimize CSOs at each time interval within a moving horizon framework. Decision variables are coded at 15-minute increments and GA solutions are two hours in duration. At each 15-minute interval, the algorithm identifies a good solution for a two-hour rainfall forecast. Three GA modifications help reduce optimization time. The first adjustment reduces the search alphabet by eliminating sluice gate positions that do not influence overflow volume. The second GA retains knowledge of the best decision at the previous interval by shifting the genes in the best previous sequence to initialize search at the new interval. The third approach is a micro-GA with a small population size and high diversity. Current tunnel operations attempt to avoid dropshaft geysers by simultaneously closing all sluice gates when the downstream end of the deep tunnel pressurizes. In an effort to further reduce CSOs, this research introduces a constraint that specifies a maximum allowable tunnel flow to prevent pressurization. The downstream junction depth is bounded by two flow conditions: a low tunnel water level represents inflow from the main system only, while a higher level includes main system flow as well as all possible North Branch inflow. If the lower of the two tunnel levels is pressurized, no North Branch flow is allowed to enter the junction. If only the higher level pressurizes, a linear rating is used to restrict the total North Branch flow below the volume that pressurizes the boundary. The numerical model is successfully calibrated to EPA SWMM and efficiently portrays system hydraulics in real-time. Results on the three GA approaches as well as impacts of various policies for the downstream constraint will be presented at the conference.

Parents' preferences strongly influence their decisions to withhold prescribed opioids when faced with analgesic trade-off dilemmas for children: a prospective observational study.

PubMed

Voepel-Lewis, Terri; Zikmund-Fisher, Brian J; Smith, Ellen Lavoie; Zyzanski, Sarah; Tait, Alan R

2015-08-01

Despite parents' stated desire to treat pain in their children, recent studies have critiqued their underuse of prescribed analgesics to treat pain in their children after painful procedures. Parents' analgesic preferences, including their perceived importance of providing pain relief or avoiding adverse drug effects may have important implications for their analgesic decisions, yet no studies have evaluated the influence of preferences on decisions to withhold prescribed opioids for children. We prospectively explored how parents' preferences influenced decisions to withhold prescribed opioids when faced with hypothetical dilemmas and after hospital discharge. Prospective Observational Study Design: Phase 1 included hypothetical analgesic decisions and Phase 2, real analgesic decisions after hospital discharge. Large tertiary care pediatric hospital in the Midwest of the United States. Five-hundred seven parents whose children underwent a painful surgical procedure requiring an opioid prescription were included. At baseline, parents completed surveys assessing their pain relief preference (i.e., their rated importance of pain relief relative to adverse drug event avoidance), preferred treatment thresholds (i.e., pain level at which they would give an opioid), adverse drug event understanding, and hypothetical trade-off decisions (i.e., scenarios presenting variable pain and adverse drug event symptoms in a child). After discharge, parents recorded all analgesics they gave their child as well as pain scores at the time of administration. Higher preference to provide pain relief (over avoid analgesic risk) lessened the likelihood that parents would withhold the prescribed opioid when adverse drug event symptoms were present together with high pain scores in the hypothetical scenarios. Additionally, higher preferred treatment thresholds increased the likelihood of parents withholding opioids during their hypothetical decision-making as well as at home. The strong influence of these preferences weakened the effect of opioid ADE understanding on decisions to withhold opioids when ADEs (i.e., nausea/vomiting or oversedation) were present together with high pain. Findings from this study suggest that preferences strongly influence and may interfere with parents' effective and safe analgesic decision-making when conflicting symptoms (i.e., high pain and an ADE) are present. To improve effective analgesic use, there is a need to shape parents' preferences and improve their understanding of safe actions that will treat pain when ADE symptoms are present. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Implications of Growth Policy for Postsecondary Education. A Model and Proposed Course of Action. Working Paper.

ERIC Educational Resources Information Center

Perelman, Lewis J.; Bergquist, William H.

A 5-month project was undertaken at the Western Interstate Commission for Higher Education to do a preliminary study of the implications of growth policy for postsecondary education. The decision to focus on this level of education was based on the belief that the existing problems of growth and its limits have become too urgent to be left to…

Artificial Intelligence (Al) Center of Excellence at the University of Pennsylvania

DTIC Science & Technology

1995-07-01

Approach and repel behaviors were implemented in order to study higher level behavioral simulation . Parallel algorithms for motion planning (as a...of decision-making accuracy can be specified for this graph-reduction process. We have also developed a mixed qualitative/quantitative simulation ...system, called QobiSIM. QobiSIM has been used to develop a cardiovascular simulation to be incorporated into the TraumAID system. This cardiovascular

Analysis of Satellite Communication as a Method to Meet Information Exchange Requirements for the Enhanced Company Concept

DTIC Science & Technology

2008-09-01

For the technical support and on the job training: Donovan Dinger, Swe-Dish Michael Clement, NPS CENETIX Lab Maj Cornell, MCTSSA Eric Gay , MCTSSA...OPERATION ENDURING FREEDOM (OEF). Of note, the Battalion’s current operations officer, Capt Jeremiah Salame, a company commander during the 2006...was for higher headquarters or even high level decision makers 10 Capt Salame (1/7 Battalion

Ventral striatal dopamine reflects behavioral and neural signatures of model-based control during sequential decision making.

PubMed

Deserno, Lorenz; Huys, Quentin J M; Boehme, Rebecca; Buchert, Ralph; Heinze, Hans-Jochen; Grace, Anthony A; Dolan, Raymond J; Heinz, Andreas; Schlagenhauf, Florian

2015-02-03

Dual system theories suggest that behavioral control is parsed between a deliberative "model-based" and a more reflexive "model-free" system. A balance of control exerted by these systems is thought to be related to dopamine neurotransmission. However, in the absence of direct measures of human dopamine, it remains unknown whether this reflects a quantitative relation with dopamine either in the striatum or other brain areas. Using a sequential decision task performed during functional magnetic resonance imaging, combined with striatal measures of dopamine using [(18)F]DOPA positron emission tomography, we show that higher presynaptic ventral striatal dopamine levels were associated with a behavioral bias toward more model-based control. Higher presynaptic dopamine in ventral striatum was associated with greater coding of model-based signatures in lateral prefrontal cortex and diminished coding of model-free prediction errors in ventral striatum. Thus, interindividual variability in ventral striatal presynaptic dopamine reflects a balance in the behavioral expression and the neural signatures of model-free and model-based control. Our data provide a novel perspective on how alterations in presynaptic dopamine levels might be accompanied by a disruption of behavioral control as observed in aging or neuropsychiatric diseases such as schizophrenia and addiction.

Identification of water quality management policy of watershed system with multiple uncertain interactions using a multi-level-factorial risk-inference-based possibilistic-probabilistic programming approach.

PubMed

Liu, Jing; Li, Yongping; Huang, Guohe; Fu, Haiyan; Zhang, Junlong; Cheng, Guanhui

2017-06-01

In this study, a multi-level-factorial risk-inference-based possibilistic-probabilistic programming (MRPP) method is proposed for supporting water quality management under multiple uncertainties. The MRPP method can handle uncertainties expressed as fuzzy-random-boundary intervals, probability distributions, and interval numbers, and analyze the effects of uncertainties as well as their interactions on modeling outputs. It is applied to plan water quality management in the Xiangxihe watershed. Results reveal that a lower probability of satisfying the objective function (θ) as well as a higher probability of violating environmental constraints (q i ) would correspond to a higher system benefit with an increased risk of violating system feasibility. Chemical plants are the major contributors to biological oxygen demand (BOD) and total phosphorus (TP) discharges; total nitrogen (TN) would be mainly discharged by crop farming. It is also discovered that optimistic decision makers should pay more attention to the interactions between chemical plant and water supply, while decision makers who possess a risk-averse attitude would focus on the interactive effect of q i and benefit of water supply. The findings can help enhance the model's applicability and identify a suitable water quality management policy for environmental sustainability according to the practical situations.

A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study

PubMed Central

Damschroder, Laura J; Fetters, Michael D; Zikmund-Fisher, Brian J; Crabtree, Benjamin F; Hudson, Shawna V; Ruffin IV, Mack T; Fucinari, Juliana; Kang, Minji; Taichman, L Susan; Creswell, John W

2018-01-01

Background Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling. Objective The overall goal of the MiHealth, MiChoice project is to design and implement a theory-driven, Web-based tool that incorporates the US MEC (provider-level intervention) within the vehicle of a contraceptive decision tool for women with chronic medical conditions (patient-level intervention) in community-based primary care settings (practice-level intervention). This will be a 3-phase study that includes a predesign phase, a design phase, and a testing phase in a randomized controlled trial. This study protocol describes phase 1 and aim 1, which is to determine patient-, provider-, and practice-level factors that are relevant to the design and implementation of the contraceptive decision tool. Methods This is a mixed methods implementation study. To customize the delivery of the US MEC in the decision tool, we selected high-priority constructs from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to drive data collection and analysis at the practice and provider level, respectively. A conceptual model that incorporates constructs from the transtheoretical model and the health beliefs model undergirds patient-level data collection and analysis and will inform customization of the decision tool for this population. We will recruit 6 community-based primary care practices and conduct quantitative surveys and semistructured qualitative interviews with women who have chronic medical conditions, their primary care providers (PCPs), and clinic staff, as well as field observations of practice activities. Quantitative survey data will be summarized with simple descriptive statistics and relationships between participant characteristics and contraceptive recommendations (for PCPs), and current contraceptive use (for patients) will be examined using Fisher exact test. We will conduct thematic analysis of qualitative data from interviews and field observations. The integration of data will occur by comparing, contrasting, and synthesizing qualitative and quantitative findings to inform the future development and implementation of the intervention. Results We are currently enrolling practices and anticipate study completion in 15 months. Conclusions This protocol describes the first phase of a multiphase mixed methods study to develop and implement a Web-based decision tool that is customized to meet the needs of women with chronic medical conditions in primary care settings. Study findings will promote contraceptive counseling via shared decision making and reflect evidence-based guidelines for contraceptive selection. Trial Registration ClinicalTrials.gov NCT03153644; https://clinicaltrials.gov/ct2/show/NCT03153644 (Archived by WebCite at http://www.webcitation.org/6yUkA5lK8) PMID:29669707

Supporting Students with Disabilities Entering the Science, Technology, Engineering, and Mathematics Field Disciplines

NASA Astrophysics Data System (ADS)

Dishauzi, Karen M.

Extensive research exists on female, African American, and Hispanic students pursuing Science, Technology, Engineering and Mathematics (STEM) field disciplines. However, little research evaluates students with disabilities and career decision-making relating to STEM field disciplines. This study explored the career decision-making experiences and self-efficacy for students with disabilities. The purpose of this research study was to document experiences and perceptions of students with disabilities who pursue, and may consider pursuing, careers in the STEM field disciplines by exploring the career decision-making self-efficacy of students with disabilities. This study documented the level of influence that the students with disabilities had or may not have had encountered from parents, friends, advisors, counselors, and instructors as they managed their decision-making choice relating to their academic major/career in the STEM or non-STEM field disciplines. A total of 85 respondents of approximately 340 students with disabilities at one Midwestern public university completed a quantitatively designed survey instrument. The Career Decision-Making Self-Efficacy Scale-Short Form by Betz and Hackett was the instrument used, and additional questions were included in the survey. Data analysis included descriptive statistics and analysis of variance. Based upon the results, college students with disabilities are not currently being influenced by individuals and groups of individuals to pursue the STEM field disciplines. This is a cohort of individuals who can be marketed to increase enrollment in STEM programs at academic institutions. This research further found that gender differences at the institution under study did not affect the career decision-making self-efficacy scores. The men did not score any higher in confidence in career decision-making than the women. Disability type did not significantly affect the relationship between the Career Decision-Making Self-Efficacy Total Scores or college major choice. Of the three disability types represented more frequently, the Mental Health disability was found to be a growing disability at the institution under study. This research was found to be beneficial in the documentation of specific levels of influence perceived by students with disabilities from parents, friends, advisors, counselors, and instructors that related to their career decision-making and academic major choices.

Population levels of wellbeing and the association with social capital.

PubMed

Taylor, A W; Kelly, G; Dal Grande, E; Kelly, D; Marin, T; Hey, N; Burke, K J; Licinio, J

2017-07-03

This research investigates wellbeing at the population level across demographic, social and health indicators and assesses the association between wellbeing and social capital. Data from a South Australian monthly chronic disease/risk factor surveillance system of randomly selected adults (mean age 48.7 years; range 16-99) from 2014/5 (n = 5551) were used. Univariable analyses compared wellbeing/social capital indicators, socio-demographic, risk factors and chronic conditions. Multi-nominal logistic regression modelling, adjusting for multiple covariates was used to simultaneously estimate odds ratios for good wellbeing (reference category) versus neither good nor poor, and good wellbeing versus poor wellbeing. 48.6% were male, mean age 48.7 (sd 18.3), 54.3% scored well on all four of the wellbeing indicators, and positive social capital indicators ranged from 93.1% for safety to 50.8% for control over decisions. The higher level of social capital corresponded with the good wellbeing category. Modeling showed higher odds ratios for all social capital variables for the lowest level of wellbeing. These higher odds ratios remained after adjusting for confounders. The relationship between wellbeing, resilience and social capital highlights areas for increased policy focus.

Inhibition of Pre-Supplementary Motor Area by Continuous Theta Burst Stimulation Leads to More Cautious Decision-making and More Efficient Sensory Evidence Integration.

PubMed

Tosun, Tuğçe; Berkay, Dilara; Sack, Alexander T; Çakmak, Yusuf Ö; Balcı, Fuat

2017-08-01

Decisions are made based on the integration of available evidence. The noise in evidence accumulation leads to a particular speed-accuracy tradeoff in decision-making, which can be modulated and optimized by adaptive decision threshold setting. Given the effect of pre-SMA activity on striatal excitability, we hypothesized that the inhibition of pre-SMA would lead to higher decision thresholds and an increased accuracy bias. We used offline continuous theta burst stimulation to assess the effect of transient inhibition of the right pre-SMA on the decision processes in a free-response two-alternative forced-choice task within the drift diffusion model framework. Participants became more cautious and set higher decision thresholds following right pre-SMA inhibition compared with inhibition of the control site (vertex). Increased decision thresholds were accompanied by an accuracy bias with no effects on post-error choice behavior. Participants also exhibited higher drift rates as a result of pre-SMA inhibition compared with the vertex inhibition. These results, in line with the striatal theory of speed-accuracy tradeoff, provide evidence for the functional role of pre-SMA activity in decision threshold modulation. Our results also suggest that pre-SMA might be a part of the brain network associated with the sensory evidence integration.

Comprehending care in a medical home: a usual source of care and patient perceptions about healthcare communication.

PubMed

DeVoe, Jennifer E; Wallace, Lorraine S; Pandhi, Nancy; Solotaroff, Rachel; Fryer, George E

2008-01-01

To examine whether having a usual source of care (USC) is associated with positive patient perceptions of health care communication and to identify demographic factors among patients with a USC that are independently associated with differing reports of how patients perceive their involvement in health care decision making. Cross-sectional analyses of nationally representative data from the 2002 Medical Expenditure Panel Survey. Among adults with a health care visit in the past year (n = approximately 16,700), we measured independent associations between having a USC and patient perceptions of health care communication. Second, among respondents with a USC (n = approximately 18,000), we assessed the independent association between various demographic factors and indicators of patients' perceptions of their autonomy in making health care decisions. Approximately 78% of adults in the United States reported having a USC. Those with a USC were more likely to report that providers always listened to them, always explained things clearly, always showed respect, and always spent enough time with them. Patients who perceived higher levels of decision-making autonomy were non-Hispanic, had health insurance coverage, lived in rural areas, and had higher incomes. Patients with a USC were more likely to perceive positive health care interactions. Certain demographic factors among the subgroups of Medical Expenditure Panel Survey respondents with a USC were associated with patient perceptions of greater decision-making autonomy. Efforts to ensure universal access to a USC must be partnered with broader awareness and training of USC providers to engage patients from various demographic backgrounds equally when making health care decisions at the point of care.

Prostate cancer screening and shared decision-making preferences among African-American members of the Prince Hall Masons.

PubMed

Williams, Randi M; Zincke, Nicole L; Turner, Ralph O; Davis, Jackson L; Davis, Kimberly M; Schwartz, Marc D; Johnson, Lenora; Kerner, Jon F; Taylor, Kathryn L

2008-10-01

Shared decision making (SDM) is recommended as one method to assist men in making an informed decision about prostate cancer screening (PCS). SDM preferences for PCS have not been evaluated among African-American (AA) men. Given AA men's increased risk and the uncertainty surrounding screening, it is critical to determine how to assist AA men in making an informed decision. We assessed the extent to which a sample of AA men wished to engage in SDM regarding PCS and the demographic and psychological characteristics associated with SDM preferences. Participants completed a telephone interview that covered demographic and medical information, SDM preferences, PCS knowledge, decisional conflict, and satisfaction with previous screening decisions. Subjects included 286 AA men aged 40-70, who were members of a Masonic organization. Fifty-seven percent preferred SDM, 36% preferred to make their own decision, and 7% wanted their doctor to decide. A higher level of education and older age were associated with preferring SDM (p<0.05), while men with greater PCS knowledge were more likely to prefer to make the decision independently (p<0.05). Results suggest that physicians need to be prepared to discuss PCS with their patients. Further, more attention may be needed to engage younger, less educated, and less knowledgeable men as they may be less likely to discuss PCS. This understanding of AA men's preferences for PCS decisions helps to clarify the issues that health professionals need to consider when attempting to assist AA men in making a PCS decision. Copyright (c) 2008 John Wiley & Sons, Ltd.

The decision to adopt evidence-based and other innovative mental health practices: risky business?

PubMed

Panzano, Phyllis C; Roth, Dee

2006-08-01

A risk-based decision-making framework was used to examine the decision to adopt innovative mental health practices, including both evidence-based and other research-guided practices. Seventy-eight projects involving decisions to adopt one of four innovative mental health practices were the focus of this study. Key informants with direct knowledge about the adoption decision provided data for hypothesis testing. As predicted, the propensity to adopt an innovative practice-as measured by decision stage-was negatively related to the perceived risk of adopting the practice, positively related to expected capacity to manage risk, and positively related to an organization's past propensity to take risks. Further, perceived risk, anticipated resource availability, and exposure to field-based evidence explained a substantial part of what differentiated adopters from nonadopters. Finally, several features of innovations known to influence innovation adoption decisions were found to be related in expected ways to perceived risk, capacity to manage risk, and risk propensity. This research supports the view that the decision to adopt an innovative mental health practice is a decision made in consideration of risk. Contrary to popular views that early adopters of innovations are willing to take enormous risks, these data offer the novel idea that early adopters act because they see the risks associated with adopting as lower than their nonadopter counterparts, partly because the risks are seen as more manageable. Implications of results are discussed for organizations considering adoption of innovative health care practices and for state or local mental health authorities hoping for a higher level of adoption in their areas.

Less is sometimes more: a comparison of distance-control and navigated-control concepts of image-guided navigation support for surgeons.

PubMed

Luz, Maria; Manzey, Dietrich; Modemann, Susanne; Strauss, Gero

2015-01-01

Image-guided navigation (IGN) systems provide automation support of intra-operative information analysis and decision-making for surgeons. Previous research showed that navigated-control (NC) systems which represent high levels of decision-support and directly intervene in surgeons' workflow provide benefits with respect to patient safety and surgeons' physiological stress but also involve several cost effects (e.g. prolonged surgery duration, reduced secondary-task performance). It was hypothesised that less automated distance-control (DC) systems would provide a better solution in terms of human performance consequences. N = 18 surgeons performed a simulated mastoidectomy with NC, DC and without IGN assistance. Effects on surgical performance, physiological effort, workload and situation awareness (SA) were compared. As expected, DC technology had the same benefits as the NC system but also led to less unwanted side effects on surgery duration, subjective workload and SA. This suggests that IGN systems just providing information analysis support are overall more beneficial than higher automated decision-support. This study investigates human performance consequences of different concepts of IGN support for surgeons. Less automated DC systems turned out to provide advantages for patient safety and surgeons' stress similar to higher automated NC systems with, at the same time, reduced negative consequences on surgery time and subjective workload.

Competence skills help deter smoking among inner city adolescents.

PubMed

Epstein, J A; Griffin, K W; Botvin, G J

2000-03-01

To test whether higher levels of general competence are linked to more frequent use of refusal assertiveness that is in turn related to less subsequent smoking among inner city adolescents. Longitudinal study conducted during three year middle school or junior high school period. A sample of 1459 students attending 22 middle (ages 11-14 years) and junior high (ages 12-15 years) schools in New York City participated. Students completed surveys at baseline, one year follow up, and two year follow up. The students self reported smoking, decision making skills, personal efficacy, and refusal assertiveness. Teams of three to five data collectors administered the questionnaire following a standardised protocol. These data were collected in school during a regular 40 minute class period. Based on the tested structural equation model, decision making and personal efficacy (that is, general competence) predicted higher refusal assertiveness and this greater assertiveness predicted less smoking at the two year follow up. The tested model had a good fit and was parsimonious and consistent with theory. Adolescent smoking prevention programmes often teach refusal skills in order to help youth resist peer pressure to smoke. The present findings suggest that teaching general competence skills as well may help to reduce smoking because youth with better personal efficacy and decision making skills are better able to implement smoking refusal strategies.

Increased ventral-striatal activity during monetary decision making is a marker of problem poker gambling severity.

PubMed

Brevers, Damien; Noël, Xavier; He, Qinghua; Melrose, James A; Bechara, Antoine

2016-05-01

The aim of this study was to examine the impact of different neural systems on monetary decision making in frequent poker gamblers, who vary in their degree of problem gambling. Fifteen frequent poker players, ranging from non-problem to high-problem gambling, and 15 non-gambler controls were scanned using functional magnetic resonance imaging (fMRI) while performing the Iowa Gambling Task (IGT). During IGT deck selection, between-group fMRI analyses showed that frequent poker gamblers exhibited higher ventral-striatal but lower dorsolateral prefrontal and orbitofrontal activations as compared with controls. Moreover, using functional connectivity analyses, we observed higher ventral-striatal connectivity in poker players, and in regions involved in attentional/motor control (posterior cingulate), visual (occipital gyrus) and auditory (temporal gyrus) processing. In poker gamblers, scores of problem gambling severity were positively associated with ventral-striatal activations and with the connectivity between the ventral-striatum seed and the occipital fusiform gyrus and the middle temporal gyrus. Present results are consistent with findings from recent brain imaging studies showing that gambling disorder is associated with heightened motivational-reward processes during monetary decision making, which may hamper one's ability to moderate his level of monetary risk taking. © 2015 Society for the Study of Addiction.

Higher Status Honesty Is Worth More: The Effect of Social Status on Honesty Evaluation

PubMed Central

Blue, Philip R.; Hu, Jie; Zhou, Xiaolin

2018-01-01

Promises are crucial for maintaining trust in social hierarchies. It is well known that not all promises are kept; yet the effect of social status on responses to promises being kept or broken is far from understood, as are the neural processes underlying this effect. Here we manipulated participants’ social status before measuring their investment behavior as Investor in iterated Trust Game (TG). Participants decided how much to invest in their partners, who acted as Trustees in TG, after being informed that their partners of higher or lower social status either promised to return half of the multiplied sum (4 × invested amount), did not promise, or had no opportunity to promise. Event-related potentials (ERPs) were recorded when the participants saw the Trustees’ decisions in which the partners always returned half of the time, regardless of the experimental conditions. Trustee decisions to return or not after promising to do so were defined as honesty and dishonesty, respectively. Behaviorally, participants invested more when Trustees promised than when Trustees had no opportunity to promise, and this effect was greater for higher status than lower status Trustees. Neurally, when viewing Trustees’ return decisions, participants’ medial frontal negativity (MFN) responses (250–310 ms post onset) were more negative when Trustees did not return than when they did return, suggesting that not returning was an expectancy violation. P300 responses were only sensitive to higher status return feedback, and were more positive-going for higher status partner returns than for lower status partner returns, suggesting that higher status returns may have been more rewarding/motivationally significant. Importantly, only participants in low subjective socioeconomic status (SES) evidenced an increased P300 effect for higher status than lower status honesty (honesty – dishonesty), suggesting that higher status honesty was especially rewarding/motivationally significant for participants with low SES. Taken together, our results suggest that in an earlier time window, MFN encodes return valence, regardless of honesty or social status, which are addressed in a later cognitive appraisal process (P300). Our findings suggest that social status influences honesty perception at both a behavioral and neural level, and that subjective SES may modulate this effect. PMID:29615948

Investigation of autistic traits through strategic decision-making in games with adaptive agents.

PubMed

Craig, Alexis B; Grossman, Emily; Krichmar, Jeffrey L

2017-07-17

Autism Spectrum Disorders are characterized by difficulties in communicating and cooperating with other people. Impairment in Theory of Mind (ToM), the ability to infer what another person is thinking, may contribute to these social deficits. The present study assesses the relationship between autistic traits and decision-making in a socioeconomic game environment that measures ToM and cooperation. We quantified participant strategy during game play with computer agents that simulated aspects of ToM or fixed strategy agents with static behaviors or heuristics. Individuals with higher Autism Quotient (AQ) scores cooperated less than subjects with low AQ scores with the ToM agents. In contrast, subjects with higher AQ scores cooperated more with fixed strategy agents. Additionally, subjects with higher AQ scores spent more time than low AQ subjects signaling cooperative intent in games with fixed strategy agents while spending less time signaling cooperation with adaptive agents, indicating a preference toward systemizing behaviors in the face of uncertainty. We conclude that individuals with high levels of autistic traits are less likely to utilize ToM as a cognitive strategy, even when it is beneficial, to achieve a desired outcome.

75 FR 1615 - Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-12

... DEPARTMENT OF ENERGY Amended Record of Decision: Idaho High-Level Waste and Facilities Disposition...-Level Waste and Facilities Disposition Final Environmental Impact Statement. This document corrects an... Record of Decision: Idaho High-Level Waste and Facilities [[Page 1616

Integrating strategic and tactical decisions in livestock supply chain using bi-level programming, case study: Iran poultry supply chain.

PubMed

Teimoury, Ebrahim; Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

Inventory management has frequently been targeted by researchers as one of the most pivotal problems in supply chain management. With the expansion of research studies on inventory management in supply chains, perishable inventory has been introduced and its fundamental differences from non-perishable inventory have been emphasized. This article presents livestock as a type of inventory that has been less studied in the literature. Differences between different inventory types, affect various levels of strategic, tactical and operational decision-making. In most articles, different levels of decision-making are discussed independently and sequentially. In this paper, not only is the livestock inventory introduced, but also a model has been developed to integrate decisions across different levels of decision-making using bi-level programming. Computational results indicate that the proposed bi-level approach is more efficient than the sequential decision-making approach.

Integrating strategic and tactical decisions in livestock supply chain using bi-level programming, case study: Iran poultry supply chain

PubMed Central

Jabbarzadeh, Armin; Babaei, Mohammadhosein

2017-01-01

Inventory management has frequently been targeted by researchers as one of the most pivotal problems in supply chain management. With the expansion of research studies on inventory management in supply chains, perishable inventory has been introduced and its fundamental differences from non-perishable inventory have been emphasized. This article presents livestock as a type of inventory that has been less studied in the literature. Differences between different inventory types, affect various levels of strategic, tactical and operational decision-making. In most articles, different levels of decision-making are discussed independently and sequentially. In this paper, not only is the livestock inventory introduced, but also a model has been developed to integrate decisions across different levels of decision-making using bi-level programming. Computational results indicate that the proposed bi-level approach is more efficient than the sequential decision-making approach. PMID:28982180

Patient Perceptions Regarding the Likelihood of Cure After Surgical Resection of Lung and Colorectal Cancer

PubMed Central

Kim, Yuhree; Winner, Megan; Page, Andrew; Tisnado, Diana M.; Martinez, Kathryn A.; Buettner, Stefan; Ejaz, Aslam; Spolverato, Gaya; Morss, Sydney E.; Pawlik, Timothy M.

2016-01-01

BACKGROUND The objective of the current study was to characterize the prevalence of the expectation that surgical resection of lung or colorectal cancer might be curative. The authors sought to assess patient-level, tumor-level, and communication-level factors associated with the perception of cure. METHODS Between 2003 and 2005, a total of 3954 patients who underwent cancer-directed surgery for lung (30.3%) or colorectal (69.7%) cancer were identified from a population-based and health system-based survey of participants from multiple US regions. RESULTS Approximately 80.0% of patients with lung cancer and 89.7% of those with colorectal cancer responded that surgery would cure their cancer. Even 57.4% and 79.8% of patients with stage IV lung and colorectal cancer, respectively, believed surgery was likely to be curative. On multivariable analyses, the odds ratio (OR) of the perception of curative intent was found to be higher among patients with colorectal versus lung cancer (OR, 2.27). Patients who were female, with an advanced tumor stage, unmarried, and having a higher number of comorbidities were less likely to believe that surgery would cure their cancer; educational level, physical function, and insurance status were not found to be associated with perception of cure. Patients who reported optimal physician communication scores (reference score, 0–80; score of 80–100 [OR, 1.40] and score of 100 [OR, 1.89]) and a shared role in decision-making with their physician (OR, 1.16) or family (OR, 1.17) had a higher odds of perceiving surgery would be curative, whereas patients who reported physician-controlled (OR, 0.56) or family-controlled (OR, 0.72) decision-making were less likely to believe surgery would provide a cure. CONCLUSIONS Greater focus on patient-physician engagement, communication, and barriers to discussing goals of care with patients who are diagnosed with cancer is needed. PMID:26094729

Patient perceptions regarding the likelihood of cure after surgical resection of lung and colorectal cancer.

PubMed

Kim, Yuhree; Winner, Megan; Page, Andrew; Tisnado, Diana M; Martinez, Kathryn A; Buettner, Stefan; Ejaz, Aslam; Spolverato, Gaya; Morss Dy, Sydney E; Pawlik, Timothy M

2015-10-15

The objective of the current study was to characterize the prevalence of the expectation that surgical resection of lung or colorectal cancer might be curative. The authors sought to assess patient-level, tumor-level, and communication-level factors associated with the perception of cure. Between 2003 and 2005, a total of 3954 patients who underwent cancer-directed surgery for lung (30.3%) or colorectal (69.7%) cancer were identified from a population-based and health system-based survey of participants from multiple US regions. Approximately 80.0% of patients with lung cancer and 89.7% of those with colorectal cancer responded that surgery would cure their cancer. Even 57.4% and 79.8% of patients with stage IV lung and colorectal cancer, respectively, believed surgery was likely to be curative. On multivariable analyses, the odds ratio (OR) of the perception of curative intent was found to be higher among patients with colorectal versus lung cancer (OR, 2.27). Patients who were female, with an advanced tumor stage, unmarried, and having a higher number of comorbidities were less likely to believe that surgery would cure their cancer; educational level, physical function, and insurance status were not found to be associated with perception of cure. Patients who reported optimal physician communication scores (reference score, 0-80; score of 80-100 [OR, 1.40] and score of 100 [OR, 1.89]) and a shared role in decision-making with their physician (OR, 1.16) or family (OR, 1.17) had a higher odds of perceiving surgery would be curative, whereas patients who reported physician-controlled (OR, 0.56) or family-controlled (OR, 0.72) decision-making were less likely to believe surgery would provide a cure. Greater focus on patient-physician engagement, communication, and barriers to discussing goals of care with patients who are diagnosed with cancer is needed. © 2015 American Cancer Society.

Student's Local Top-Up Higher Education Choices

ERIC Educational Resources Information Center

Agbola, Frank W.; Cheng, Calvin

2017-01-01

Making decisions about education choices is challenging and difficult for students. Utilising the theory of reasoned action, we specify and estimate a conceptual framework that captures the cognitive process of decision making of students in choosing top-up higher degrees in Hong Kong. Top-up higher or bachelor's degrees are top-up undergraduate…

Knowing Better: Improving Collective Decision Making in Higher Education Shared Governance

ERIC Educational Resources Information Center

Manick, Christopher J. D.

2016-01-01

This dissertation addresses the question: Should higher education governance and decision-making be an elite or collective responsibility? It brings into conversation (i) the debate over the future of shared (i.e. participatory, faculty) governance in higher education, and (ii) research in democratic theory, specifically the epistemic defense of…

Have geopolitics influenced decisions on American health foreign assistance efforts during the Obama presidency?

PubMed Central

Gupta, Vin; Tsai, Alexander C; Mason-Sharma, Alexandre; Goosby, Eric P; Jha, Ashish K; Kerry, Vanessa B

2018-01-01

Background This study sought to characterize the possible relationship between US geopolitical priorities and annual decisions on health foreign assistance among recipient nations between 2009 and 2016. Methods Data on total planned United States (US) foreign aid and health aid were collected for the 194 member nations of the World Health Organization (WHO) from publicly available databases. Trends in per-capita spending were examined between 2009 and 2016 across the six regions of the WHO (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific). Data on US national security threats were obtained from the Council on Foreign Relations’ annual Preventive Priorities Survey. Multivariable regression models were fitted specifying planned health aid as the dependent variable and threat level of a recipient aid nation as the primary independent variable. Results Across the aggregate 80 planned recipient countries of US health aid over the duration of the study period, cumulative planned per-capita spending was stable (US$ 0.65 in both 2009 and 2016). The number of annual planned recipients of this aid declined from 74 in 2009 to 56 in 2016 (24.3% decline), with planned allocations decreasing in the Americas, Eastern Mediterranean, and Europe; corresponding increases were observed in Africa, Southeast Asia, and the Western Pacific. Regression analyses demonstrated a dose-response, whereby higher levels of threat were associated with larger declines in planned spending (critical threat nations: b = -3.81; 95% confidence interval (CI) -5.84 to -1.78, P ≤ 0.001) and one-year lagged (critical threat nations: b = -3.91; 95% CI, -5.94 to -1.88, P ≤ 0.001) analyses. Conclusions Higher threat levels are associated with less health aid. This is a novel finding, as prior studies have demonstrated a strong association between national security considerations and decisions on development aid. PMID:29740500

Have geopolitics influenced decisions on American health foreign assistance efforts during the Obama presidency?

PubMed

Gupta, Vin; Tsai, Alexander C; Mason-Sharma, Alexandre; Goosby, Eric P; Jha, Ashish K; Kerry, Vanessa B

2018-06-01

This study sought to characterize the possible relationship between US geopolitical priorities and annual decisions on health foreign assistance among recipient nations between 2009 and 2016. Data on total planned United States (US) foreign aid and health aid were collected for the 194 member nations of the World Health Organization (WHO) from publicly available databases. Trends in per-capita spending were examined between 2009 and 2016 across the six regions of the WHO (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific). Data on US national security threats were obtained from the Council on Foreign Relations' annual Preventive Priorities Survey. Multivariable regression models were fitted specifying planned health aid as the dependent variable and threat level of a recipient aid nation as the primary independent variable. Across the aggregate 80 planned recipient countries of US health aid over the duration of the study period, cumulative planned per-capita spending was stable (US$ 0.65 in both 2009 and 2016). The number of annual planned recipients of this aid declined from 74 in 2009 to 56 in 2016 (24.3% decline), with planned allocations decreasing in the Americas, Eastern Mediterranean, and Europe; corresponding increases were observed in Africa, Southeast Asia, and the Western Pacific. Regression analyses demonstrated a dose-response, whereby higher levels of threat were associated with larger declines in planned spending (critical threat nations: b = -3.81; 95% confidence interval (CI) -5.84 to -1.78, P  ≤ 0.001) and one-year lagged (critical threat nations: b = -3.91; 95% CI, -5.94 to -1.88, P  ≤ 0.001) analyses. Higher threat levels are associated with less health aid. This is a novel finding, as prior studies have demonstrated a strong association between national security considerations and decisions on development aid.

Hospital incident command system (HICS) performance in Iran; decision making during disasters

PubMed Central

2012-01-01

Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied. PMID:22309772

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.

"Sugar-Ray" School-Based Decision Groups.

ERIC Educational Resources Information Center

Hunt, John J.; And Others

1992-01-01

Investigates differences between high-achieving and low-achieving school-based decision groups in decision making. Decision groups (207 groups of 3 members each) used computer simulations to address problems facing principals concerning fourth grade academic achievement. Higher-achieving groups made more decisions and made a combination of related…

Job strain, occupational category, and hypertension prevalence: The Multi-Ethnic Study of Atherosclerosis

PubMed Central

Landsbergis, Paul A.; Diez-Roux, Ana V.; Fujishiro, Kaori; Baron, Sherry; Kaufman, Joel D.; Meyer, John D.; Koutsouras, George; Shimbo, Daichi; Shrager, Sandi; Stukovsky, Karen Hinckley; Szklo, Moyses

2015-01-01

Objective To assess associations of occupational categories and job characteristics with prevalent hypertension. Methods We analyzed 2,517 Multi-Ethnic Study of Atherosclerosis (MESA) participants, working 20+ hours per week, in 2002–4. Results Higher job decision latitude was associated with a lower prevalence of hypertension, prevalence ratio (PR)=0.78 (95% CI 0.66–0.91) for the top vs. bottom quartile of job decision latitude. However, associations differed by occupation: decision latitude was associated with a higher prevalence of hypertension in healthcare support occupations (interaction p=.02). Occupation modified associations of gender with hypertension: a higher prevalence of hypertension in women (vs men) was observed in healthcare support and in blue-collar occupations (interaction p=.03). Conclusions Lower job decision latitude is associated with hypertension prevalence in many occupations. Further research is needed to determine reasons for differential impact of decision latitude and gender on hypertension across occupations. PMID:26539765

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

PubMed Central

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

2010-01-01

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

Effect of a perspective-taking intervention on the consideration of pain assessment and treatment decisions.

PubMed

Wandner, Laura D; Torres, Calia A; Bartley, Emily J; George, Steven Z; Robinson, Michael E

2015-01-01

Pain is often poorly managed, highlighting the need to better understand and treat patients' pain. Research suggests that pain is assessed and treated differently depending on patient sex, race, and/or age. Perspective-taking, whereby one envisions the perspective of another, has been found to reduce racial disparities in pain management. This study used virtual human (VH) technology to examine whether a perspective-taking intervention impacts pain management decisions. Ninety-six participants were randomized to an online treatment or control group and viewed 16 video clips of VHs with standardized levels of pain. Participants provided ratings on the VHs' pain intensity and their willingness to administer opioids to them. The intervention group received a brief perspective-taking intervention that consisted of having participants imagine how the patient's suffering could affect his/her life, whereas the control group was asked to wait for the next VH videos to load. A LENS model analysis was used to investigate both group level (nomothetic) and individual level (idiographic) decision policies. A LENS model of analysis is typically used as an analog method for capturing how groups of people and individuals use information in their environment to form judgments. Nomothetic results found that participants rated pain higher and were more likely to prescribe opioids to VHs postintervention, irrespective of group. Idiographic results, however, found that the use of cues to make pain management decisions was mitigated by the perspective-taking group. The participants in the perspective-taking group were more likely to think about pain and the patients' perspective during the intervention, while control participants were more likely to reflect on the VHs' sex, race, or age. A brief intervention may alter participants' pain management decisions. These results indicate that a brief intervention might be an initial step toward aligning observers' pain management ratings with those of the patient. Future research is needed to replicate findings in a health care population.

Renewable Energy in Rural Southeastern Arizona: Decision Factors: A Comparison of the Consumer Profiles of Homeowners Who Purchased Renewable Energy Systems With Those Who Performed Other Home Upgrades or Remodeling Projects

NASA Astrophysics Data System (ADS)

Porter, Wayne Eliot

Arizona has an abundant solar resource and technologically mature systems are available to capture it, but solar energy systems are still considered to be an innovative technology. Adoption rates for solar and wind energy systems rise and fall with the political tides, and are relatively low in most rural areas in Arizona. This thesis tests the hypothesis that a consumer profile developed to characterize the adopters of renewable energy technology (RET) systems in rural Arizona is the same as the profile of other area residents who performed renovations, upgrades or additions to their homes. Residents of Santa Cruz and Cochise Counties who had obtained building permits to either install a solar or wind energy system or to perform a substantial renovation or upgrade to their home were surveyed to gather demographic, psychographic and behavioristic data. The data from 133 survey responses (76 from RET adopters and 57 from non-adopters) provided insights about their decisions regarding whether or not to adopt a RET system. The results, which are statistically significant at the 99% level of confidence, indicate that RET adopters had smaller households, were older and had higher education levels and greater income levels than the non-adopters. The research also provides answers to three related questions: First, are the energy conservation habits of RET adopters the same as those of non-adopters? Second, what were the sources of information consulted and the most important factors that motivated the decision to purchase a solar or wind energy system? And finally, are any of the factors which influenced the decision to live in a rural area in southeastern Arizona related to the decision to purchase a renewable energy system? The answers are provided, along with a series of recommendations that are designed to inform marketers and other promoters of RETs about how to utilize these results to help achieve their goals.

[Knowledge of the disease and the advance directives in patients with HIV infection].

PubMed

Miró, Glòria; Pedrol, Enric; Soler, Anna; Serra-Prat, Mateu; Yébenes, Joan Carles; Martínez, Rafael; Capdevila, Josep Antón

2006-04-22

Advanced directives documents (ADD), allow respect and know patient's intentions in health matters, when they are not able by themselves, for decision making. The aim of this study is making a valoration of the knowledgment of this documents in human immunodeficiency virus (HIV) infected patients, as well as their own knowledgment about this patology and possible complications. HIV infected patients controlled in 2 centers (Hospital de Mataró and Hospital de Granollers). Plained interview as a questinonary, that permits evaluate: own knowledge of the patology, received medical information level of satisfaction, patient s medical decision making involving desire, aptitudes in front of different hypothetical health status, and ADD knowledge. Factors associated to both knowledges (patology and ADD) are also evaluated. 74.3% of the interviewed patients, showed a good patology knowledge. This result was associated with: youth, less functional level according to Karnofsky's scale, subjective perception on severity, previous admission at an intensive care unit, chronic hepatopathy, and previous parenteral drugs addiction. In the same way was associated with the negative to depend of mechanical ventilation or another people, and not being uncomfortable talking about this subjects. ADD's knowledge was relationated with the fact of being female (42.0% vs 26.8%; p = 0.024), higher academic formation (55.1% vs 25.5%; p < 0.001) and belief that medical decision making must be done by themselves (78.3% vs 53.6%; p = 0.002). Patology understanding and its complications, may be considered optimal in HIV population. One third of this group, has a good knowledge of ADDs, and is directly relationated with female sex, academic level, and clinical decisions making implication by the patients.

Patients' perspectives on taking warfarin: qualitative study in family practice

PubMed Central

Dantas, Guilherme Coelho; Thompson, Barbara V; Manson, Judith A; Tracy, C Shawn; Upshur, Ross EG

2004-01-01

Background Despite the well-documented benefits of using warfarin to prevent stroke, physicians remain reluctant to initiate therapy, and especially so with the elderly owing to the higher risk of hemorrhage. Prior research suggests that patients are more accepting of the risk of bleeding than are physicians, although there have been few qualitative studies. The aim of this study was to employ qualitative methods to investigate the experience and perspective of individuals taking warfarin. Methods We conducted face-to-face interviews with 21 older patients (12 male, 9 female) who had been taking warfarin for a minimum of six months. Participants were patients at a family practice clinic situated in a large, tertiary care teaching hospital. We used a semistructured interview guide with four main thematic areas: decision-making, knowledge/education, impact, and satisfaction. Data were analysed according to the principles of content analysis. Results and Discussion Participants tended to have minimal input into the decision to initiate warfarin therapy, instead relying in great part on physicians' expertise. There appeared to be low retention of information received regarding the therapy; half the patients in our sample possessed only a superficial level of understanding of the risks and benefits. This notwithstanding, participants reported a high level of satisfaction with the care provided and a low level of impact on their day-to-day lives. Conclusions Minimal patient involvement in the initial decision and modest knowledge did not appear to diminish satisfaction with warfarin management. At the same time, care providers exert a tremendous influence on the initiation of warfarin therapy and should strive to incorporate patient preferences and expectations into the decision-making process. PMID:15268764

Computation and measurement of cell decision making errors using single cell data

PubMed Central

Habibi, Iman; Cheong, Raymond; Levchenko, Andre; Emamian, Effat S.; Abdi, Ali

2017-01-01

In this study a new computational method is developed to quantify decision making errors in cells, caused by noise and signaling failures. Analysis of tumor necrosis factor (TNF) signaling pathway which regulates the transcription factor Nuclear Factor κB (NF-κB) using this method identifies two types of incorrect cell decisions called false alarm and miss. These two events represent, respectively, declaring a signal which is not present and missing a signal that does exist. Using single cell experimental data and the developed method, we compute false alarm and miss error probabilities in wild-type cells and provide a formulation which shows how these metrics depend on the signal transduction noise level. We also show that in the presence of abnormalities in a cell, decision making processes can be significantly affected, compared to a wild-type cell, and the method is able to model and measure such effects. In the TNF—NF-κB pathway, the method computes and reveals changes in false alarm and miss probabilities in A20-deficient cells, caused by cell’s inability to inhibit TNF-induced NF-κB response. In biological terms, a higher false alarm metric in this abnormal TNF signaling system indicates perceiving more cytokine signals which in fact do not exist at the system input, whereas a higher miss metric indicates that it is highly likely to miss signals that actually exist. Overall, this study demonstrates the ability of the developed method for modeling cell decision making errors under normal and abnormal conditions, and in the presence of transduction noise uncertainty. Compared to the previously reported pathway capacity metric, our results suggest that the introduced decision error metrics characterize signaling failures more accurately. This is mainly because while capacity is a useful metric to study information transmission in signaling pathways, it does not capture the overlap between TNF-induced noisy response curves. PMID:28379950

Computation and measurement of cell decision making errors using single cell data.

PubMed

Habibi, Iman; Cheong, Raymond; Lipniacki, Tomasz; Levchenko, Andre; Emamian, Effat S; Abdi, Ali

2017-04-01

In this study a new computational method is developed to quantify decision making errors in cells, caused by noise and signaling failures. Analysis of tumor necrosis factor (TNF) signaling pathway which regulates the transcription factor Nuclear Factor κB (NF-κB) using this method identifies two types of incorrect cell decisions called false alarm and miss. These two events represent, respectively, declaring a signal which is not present and missing a signal that does exist. Using single cell experimental data and the developed method, we compute false alarm and miss error probabilities in wild-type cells and provide a formulation which shows how these metrics depend on the signal transduction noise level. We also show that in the presence of abnormalities in a cell, decision making processes can be significantly affected, compared to a wild-type cell, and the method is able to model and measure such effects. In the TNF-NF-κB pathway, the method computes and reveals changes in false alarm and miss probabilities in A20-deficient cells, caused by cell's inability to inhibit TNF-induced NF-κB response. In biological terms, a higher false alarm metric in this abnormal TNF signaling system indicates perceiving more cytokine signals which in fact do not exist at the system input, whereas a higher miss metric indicates that it is highly likely to miss signals that actually exist. Overall, this study demonstrates the ability of the developed method for modeling cell decision making errors under normal and abnormal conditions, and in the presence of transduction noise uncertainty. Compared to the previously reported pathway capacity metric, our results suggest that the introduced decision error metrics characterize signaling failures more accurately. This is mainly because while capacity is a useful metric to study information transmission in signaling pathways, it does not capture the overlap between TNF-induced noisy response curves.

Ethical decision-making and professional behaviour among nurses: a correlational study.

PubMed

Cerit, Birgül; Dinç, Leyla

2013-03-01

This study examined the relationship between nurses' ethical decision-making levels and their professional behaviours. Data were collected from 225 nurses who were recruited from university hospitals in Ankara using proportionate sampling. Data were analysed using descriptive statistics and Pearson correlations. Most of the nurses were familiar with ethical dilemmas in nursing practice. The Nursing Principled Thinking level was above average, while the Practical Consideration level was average. Nurses' professionalism level was low. There was a positive but weak correlation between professional behaviours of the nurses and their ethical decision-making levels. Increasing nurses' professionalism level can provide a positive contribution to the ethical decision-making level.

Readability of menopause web sites: a cross-sectional study.

PubMed

Charbonneau, Deborah H

2012-01-01

More women are frequently referring to the Internet for health information, yet the readability of information about menopause on the Internet has not been widely studied. To address this gap, this study examined the readability of information about menopause on 25 Internet Web sites. Findings included that information on the Web sites had a reading level higher than the recommended sixth-grade level, and culturally appropriate health information was lacking. Health educators and practitioners are in a pivotal role to help women understand information useful for healthcare decisions. Several criteria are discussed to help practitioners evaluate Web sites.

Examining the job search-turnover relationship: the role of embeddedness, job satisfaction, and available alternatives.

PubMed

Swider, Brian W; Boswell, Wendy R; Zimmerman, Ryan D

2011-03-01

This study examined factors that may help explain under what conditions employee job search effort may most strongly (or weakly) predict subsequent turnover. As predicted, the job search-turnover relationship was stronger when employees had lower levels of job embeddedness and job satisfaction and higher levels of available alternatives. These findings suggest that there may be a number of factors interacting to influence employees' turnover decisions, indicating greater complexity to the process than described in prominent sequential turnover models. PsycINFO Database Record (c) 2011 APA, all rights reserved.

[Competency: general principles and applicability in dementia].

PubMed

Alvaro, L C

2012-06-01

Competency means the capacity to make responsible and balanced decisions. This may be performed in clinical settings (decision-making abilities on treatment or risky diagnostic procedures) and also in daily-life activities (financial matters, nursing home admittance, contracts, etc.). Competency is linked to the ethical principle of autonomy and to a horizontal doctor-patient interaction, far from ancient paternalistic relationships. It is contemplated in the Spanish law as the patient's right to be informed and to make free choices, particularly in cases of dementia. The competency that we assess is the so-called natural or working capacity. It is specific for an action or task. The level of required capacity depends on the decision: higher for critical ones, lower for low-risk decisions. The assessment process requires noting the patient's capacity to understand, analyse, self-refer and apply the information. There are some guides available that may be useful in competency assessments, but nevertheless the final statement must be defined by the physician in charge of the patient and clinical judgement. Capacity is directly related to the level of cognitive deterioration. Nevertheless, specific cognitive tests like MMSE (mini-mental) have a low predictive value. The loss of competency is more associated with the so-called legal standards of incapacity (LS). These encompass a five steps range (LS1-LS5), which may detect the incapacity from the mild levels of dementia. The cortical functions that are the best predictors of incapacity are language and executive dysfunctions. These explain the incapacity in cases of Alzheimer's and Parkinson's disease, and have been studied more. Incapacity is common and it influences the clinical decision-making process. We must be particularly cautious with clinical trials of dementia. It also involves other areas of daily life, particularly financially related ones, where limitations are present from the mild cognitive impairment level. The neurological community has already produced specific and invaluable documents like the one from Sitges, although in our opinion this community has to increase its awareness, and also its involvement as much in the clinical as in the research sides of this field. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

Impulsivity, Sensation Seeking, and Risk-Taking Behaviors among HIV-Positive and HIV-Negative Heroin Dependent Persons

PubMed Central

Paydary, Koosha; Mahin Torabi, Somayeh; SeyedAlinaghi, SeyedAhmad; Noori, Mehri; Noroozi, Alireza; Ameri, Sara; Ekhtiari, Hamed

2016-01-01

Objective. The aim of this study was to compare impulsivity and risky decision making among HIV-positive and negative heroin dependent persons. Methods. We compared different dimensions of impulsivity and risky decision making in two groups of 60 HIV-positive and 60 HIV-negative male heroin dependent persons. Each group was comprised of equal numbers of current (treatment seeker) and former (abstinent) heroin addicts. Data collection tools included Balloon Analogue Risk Task (BART), Iowa Gambling Task (IGT), Barratt Impulsiveness Scale (BIS), and Zuckerman Sensation Seeking Scale (SSS). Results. In SSS, comprised of four subscales including thrill and adventure seeking (TAS), experience seeking (ES), disinhibition (DIS), and boredom susceptibility (BS), there was a borderline difference in DIS (P = 0.08) as HIV-positive group scored higher than HIV-negative group. Also, ES and total score were significantly higher among HIV-positive patients. In BART, HIV-positive subjects scored higher in risk taking than HIV-negative subjects as reflected in higher Average Number of puffs in Successful Balloons (ANSB). In BIS, HIV-positive group scored significantly higher in cognitive impulsivity (CI) (P = 0.03) and nonplanning impulsivity (NPI) (P = 0.05) in comparison to HIV-negative group. Also, current heroin addicts scored significantly higher in NPI compared to former addict HIV-negative participants (P = 0.015). IGT did not show any significant difference between groups. Conclusion. Higher levels of impulsivity and risk taking behaviors among HIV-positive heroin addicts will increase serious concerns regarding HIV transmission from this group to other opiate dependents and healthy people. PMID:27051528

A Cost and Performance System (CAPS) in a Federal agency

NASA Technical Reports Server (NTRS)

Huseonia, W. F.; Penton, P. G.

1994-01-01

Cost and Performance System (CAPS) is an automated system used from the planning phase through implementation to analysis and documentation. Data is retrievable or available for analysis of cost versus performance anomalies. CAPS provides a uniform system across intra- and international elements. A common system is recommended throughout an entire cost or profit center. Data can be easily accumulated and aggregated into higher levels of tracking and reporting of cost and performance.The level and quality of performance or productivity is indicated in the CAPS model and its process. The CAPS model provides the necessary decision information and insight to the principal investigator/project engineer for a successful project management experience. CAPS provides all levels of management with the appropriate detailed level of data.

Blood oxygen level dependent magnetic resonance imaging for detecting pathological patterns in lupus nephritis patients: a preliminary study using a decision tree model.

PubMed

Shi, Huilan; Jia, Junya; Li, Dong; Wei, Li; Shang, Wenya; Zheng, Zhenfeng

2018-02-09

Precise renal histopathological diagnosis will guide therapy strategy in patients with lupus nephritis. Blood oxygen level dependent (BOLD) magnetic resonance imaging (MRI) has been applicable noninvasive technique in renal disease. This current study was performed to explore whether BOLD MRI could contribute to diagnose renal pathological pattern. Adult patients with lupus nephritis renal pathological diagnosis were recruited for this study. Renal biopsy tissues were assessed based on the lupus nephritis ISN/RPS 2003 classification. The Blood oxygen level dependent magnetic resonance imaging (BOLD-MRI) was used to obtain functional magnetic resonance parameter, R2* values. Several functions of R2* values were calculated and used to construct algorithmic models for renal pathological patterns. In addition, the algorithmic models were compared as to their diagnostic capability. Both Histopathology and BOLD MRI were used to examine a total of twelve patients. Renal pathological patterns included five classes III (including 3 as class III + V) and seven classes IV (including 4 as class IV + V). Three algorithmic models, including decision tree, line discriminant, and logistic regression, were constructed to distinguish the renal pathological pattern of class III and class IV. The sensitivity of the decision tree model was better than that of the line discriminant model (71.87% vs 59.48%, P < 0.001) and inferior to that of the Logistic regression model (71.87% vs 78.71%, P < 0.001). The specificity of decision tree model was equivalent to that of the line discriminant model (63.87% vs 63.73%, P = 0.939) and higher than that of the logistic regression model (63.87% vs 38.0%, P < 0.001). The Area under the ROC curve (AUROCC) of the decision tree model was greater than that of the line discriminant model (0.765 vs 0.629, P < 0.001) and logistic regression model (0.765 vs 0.662, P < 0.001). BOLD MRI is a useful non-invasive imaging technique for the evaluation of lupus nephritis. Decision tree models constructed using functions of R2* values may facilitate the prediction of renal pathological patterns.

The effects of mortality salience on escalation of commitment.

PubMed

Yen, Chih-Long; Lin, Chun-Yu

2012-01-01

Based on propositions derived from terror management theory (TMT), the current study proposes that people who are reminded of their mortality exhibit a higher degree of self-justification behavior to maintain their self-esteem. For this reason, they could be expected to stick with their previous decisions and invest an increasing amount of resources in those decisions, despite the fact that negative feedback has clearly indicated that they might be on a course toward failure (i.e., "escalation of commitment"). Our experiment showed that people who were reminded of their mortality were more likely to escalate their level of commitment by maintaining their current course of action. Two imaginary scenarios were tested. One of the scenarios involved deciding whether to send additional troops into the battlefield when previous attempts had failed; the other involved deciding whether to continue developing an anti-radar fighter plane when the enemy had already developed a device to detect it. The results supported our hypothesis that mortality salience increases the tendency to escalate one's level of commitment.

A guide to understanding the variation in premiums in rural health insurance marketplaces.

PubMed

Barker, Abigail R; McBride, Timothy D; Kemper, Leah M; Mueller, Keith

2014-05-01

Key Findings. (1) State-level decisions in implementing the Patient Protection and Affordable Care Act of 2010 (ACA) have led to significant state variation in the design of Health Insurance Marketplace (HIM) rating areas. In some designs, rural counties are grouped together, while in others, rural and urban counties have been deliberately mixed. (2) Urban counties have, on average, approximately one more firm participating in the marketplaces, representing about 11 more plan offerings, than rural counties have. (3) The highest-valued "platinum" plan types are less likely to be available in rural areas. Thus, the overall mix of plan types should be factored into the reporting of average premiums. (4) Levels of competition are likely to have a greater impact on the decisions of firms considering whether to operate in higher-cost areas or not, as those firms must determine how they can pass such costs on to consumers, conditional on the market share they are likely to control.

Mapping regional livelihood benefits from local ecosystem services assessments in rural Sahel

PubMed Central

Sinare, Hanna; Enfors Kautsky, Elin; Ouedraogo, Issa; Gordon, Line J.

2018-01-01

Most current approaches to landscape scale ecosystem service assessments rely on detailed secondary data. This type of data is seldom available in regions with high levels of poverty and strong local dependence on provisioning ecosystem services for livelihoods. We develop a method to extrapolate results from a previously published village scale ecosystem services assessment to a higher administrative level, relevant for land use decision making. The method combines remote sensing (using a hybrid classification method) and interviews with community members. The resulting landscape scale maps show the spatial distribution of five different livelihood benefits (nutritional diversity, income, insurance/saving, material assets and energy, and crops for consumption) that illustrate the strong multifunctionality of the Sahelian landscapes. The maps highlight the importance of a diverse set of sub-units of the landscape in supporting Sahelian livelihoods. We see a large potential in using the resulting type of livelihood benefit maps for guiding future land use decisions in the Sahel. PMID:29389965

Mapping regional livelihood benefits from local ecosystem services assessments in rural Sahel.

PubMed

Malmborg, Katja; Sinare, Hanna; Enfors Kautsky, Elin; Ouedraogo, Issa; Gordon, Line J

2018-01-01

Most current approaches to landscape scale ecosystem service assessments rely on detailed secondary data. This type of data is seldom available in regions with high levels of poverty and strong local dependence on provisioning ecosystem services for livelihoods. We develop a method to extrapolate results from a previously published village scale ecosystem services assessment to a higher administrative level, relevant for land use decision making. The method combines remote sensing (using a hybrid classification method) and interviews with community members. The resulting landscape scale maps show the spatial distribution of five different livelihood benefits (nutritional diversity, income, insurance/saving, material assets and energy, and crops for consumption) that illustrate the strong multifunctionality of the Sahelian landscapes. The maps highlight the importance of a diverse set of sub-units of the landscape in supporting Sahelian livelihoods. We see a large potential in using the resulting type of livelihood benefit maps for guiding future land use decisions in the Sahel.

Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings.

PubMed

Siegfried, Alexa; Heffernan, Megan; Kennedy, Mallory; Meit, Michael

To identify the quality improvement (QI) and performance management benefits reported by public health departments as a result of participating in the national, voluntary program for public health accreditation implemented by the Public Health Accreditation Board (PHAB). We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments when they completed 3 different milestones in the PHAB accreditation process. Leadership from 324 unique state, local, and tribal public health departments in the United States. Public health departments that have achieved PHAB accreditation reported the following QI and performance management benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality; used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported implementation of QI strategies and use of information from QI processes to inform decision making was greater among recently accredited health departments than among health departments that had registered their intent to apply but not yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1 year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently accredited. PHAB accreditation has stimulated QI and performance management activities within public health departments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be reported at a higher level, even 1 year after the accreditation decision.

Use of Video to Facilitate End-of-Life Discussions With Patients With Cancer: A Randomized Controlled Trial

PubMed Central

El-Jawahri, Areej; Podgurski, Lisa M.; Eichler, April F.; Plotkin, Scott R.; Temel, Jennifer S.; Mitchell, Susan L.; Chang, Yuchiao; Barry, Michael J.; Volandes, Angelo E.

2010-01-01

Purpose To determine whether the use of a goals-of-care video to supplement a verbal description can improve end-of-life decision making for patients with cancer. Methods Fifty participants with malignant glioma were randomly assigned to either a verbal narrative of goals-of-care options at the end of life (control), or a video after the same verbal narrative (intervention) in this randomized controlled trial. The video depicts three levels of medical care: life-prolonging care (cardiopulmonary resuscitation [CPR], ventilation), basic care (hospitalization, no CPR), and comfort care (symptom relief). The primary study outcome was participants' preferences for end-of-life care. The secondary outcome was participants' uncertainty regarding decision making (score range, 3 to 15; higher score indicating less uncertainty). Participants' comfort level with the video was also measured. Results Fifty participants were randomly assigned to either the verbal narrative (n = 27) or video (n = 23). After the verbal description, 25.9% of participants preferred life-prolonging care, 51.9% basic care, and 22.2% comfort care. In the video arm, no participants preferred life-prolonging care, 4.4% preferred basic care, 91.3% preferred comfort care, and 4.4% were uncertain (P < .0001). The mean uncertainty score was higher in the video group than in the verbal group (13.7 v 11.5, respectively; P < .002). In the intervention arm, 82.6% of participants reported being very comfortable watching the video. Conclusion Compared with participants who only heard a verbal description, participants who viewed a goals-of-care video were more likely to prefer comfort care and avoid CPR, and were more certain of their end-of-life decision making. Participants reported feeling comfortable watching the video. PMID:19949010

Quality in Higher Education: The Need for Feedback from Students

ERIC Educational Resources Information Center

Okogbaa, Veronica

2016-01-01

Students in higher institutions are part and parcel of the system, thus their opinions should count in decision making concerning the quality of the education they are receiving. This study set out to examine from literature the place of feedback from students and its possible relevance in decision making on quality issues in higher education.…

Individual decision making in relation to participation in cardiovascular screening: a study of revealed and stated preferences.

PubMed

Søgaard, Rikke; Lindholt, Jes; Gyrd-Hansen, Dorte

2013-02-01

The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants' and non-participants' motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening. This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task. Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small. Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.

Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients.

PubMed

Manne, Sharon L; Topham, Neal; Kirstein, Laurie; Virtue, Shannon Myers; Brill, Kristin; Devine, Katie A; Gajda, Tina; Frederick, Sara; Darabos, Katie; Sorice, Kristen

The decision to undergo breast reconstruction (BR) surgery after mastectomy is made during stressful circumstances. Many women do not feel well prepared to make this decision. Using the Ottawa Decision Support Framework, this study aims to describe women's reasons to choose or not choose BR, BR knowledge, decisional preparedness, and decisional conflict about BR. Possible demographic, medical, BR knowledge, and attitudinal correlates of decisional conflict about BR were also evaluated. Participants were 55 women with early-stage breast cancer drawn from the baseline data of a pilot randomized trial evaluating the efficacy of a BR decision support aid for breast cancer patients considering BR. The most highly ranked reasons to choose BR were the desire for breasts to be equal in size, the desire to wake up from surgery with a breast in place, and perceived bother of a scar with no breast. The most highly ranked reasons not to choose BR were related to the surgical risks and complications. Regression analyses indicated that decisional conflict was associated with higher number of reasons not to choose BR and lower levels of decisional preparedness. The results suggest that breast cancer patients considering BR may benefit from decisional support. Healthcare professionals may facilitate decision making by focusing on reasons for each patient's uncertainty and unaddressed concerns. All patients, even those who have consulted with a plastic surgeon and remain uncertain about their decision, may benefit from decision support from a health professional.

Leveraging Embedded Training Systems to Build Higher Level Cognitive Skills in Warfighters

DTIC Science & Technology

2009-10-01

is not just passive, waiting for key information to be presented, but is an active process . The information that is available to military pilots...train situation awareness (SA) skills and knowledge in military settings. SA is the key cognitive construct upon which decision making rests and one...task analyses in the military domain settings that reveal the critical SA elements for a given warfighter role and the challenges they must contend

Examining the relationship between psychosocial working conditions, physical work demands, and leisure time physical activity in Canada.

PubMed

Morassaei, Sara; Smith, Peter M

2011-10-01

To examine the effects of psychosocial working conditions and physical work demands on leisure time physical activity (LTPA). Using path analysis, direct and indirect effects of self-reported working conditions on LTPA levels were assessed in a representative sample of 4167 workers from the 2000 to 2001 Canadian National Population Health Survey. Higher levels of skill discretion and decision latitude were associated with higher LTPA. Physical work demands had opposite effects among men versus women, and skill discretion had a stronger effect among women than among men. Job security had a stronger effect on older workers and those without children younger than 13 years. The results support the influence of the work environment on LTPA and suggest that certain work conditions should be targeted in future interventions seeking to impact participation in physical activity.

Risk management for optimal land use planning integrating ecosystem services values: A case study in Changsha, Middle China.

PubMed

Liang, Jie; Zhong, Minzhou; Zeng, Guangming; Chen, Gaojie; Hua, Shanshan; Li, Xiaodong; Yuan, Yujie; Wu, Haipeng; Gao, Xiang

2017-02-01

Land-use change has direct impact on ecosystem services and alters ecosystem services values (ESVs). Ecosystem services analysis is beneficial for land management and decisions. However, the application of ESVs for decision-making in land use decisions is scarce. In this paper, a method, integrating ESVs to balance future ecosystem-service benefit and risk, is developed to optimize investment in land for ecological conservation in land use planning. Using ecological conservation in land use planning in Changsha as an example, ESVs is regarded as the expected ecosystem-service benefit. And uncertainty of land use change is regarded as risk. This method can optimize allocation of investment in land to improve ecological benefit. The result shows that investment should be partial to Liuyang City to get higher benefit. The investment should also be shifted from Liuyang City to other regions to reduce risk. In practice, lower limit and upper limit for weight distribution, which affects optimal outcome and selection of investment allocation, should be set in investment. This method can reveal the optimal spatial allocation of investment to maximize the expected ecosystem-service benefit at a given level of risk or minimize risk at a given level of expected ecosystem-service benefit. Our results of optimal analyses highlight tradeoffs between future ecosystem-service benefit and uncertainty of land use change in land use decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

Decision support tool for soil sampling of heterogeneous pesticide (chlordecone) pollution.

PubMed

Clostre, Florence; Lesueur-Jannoyer, Magalie; Achard, Raphaël; Letourmy, Philippe; Cabidoche, Yves-Marie; Cattan, Philippe

2014-02-01

When field pollution is heterogeneous due to localized pesticide application, as is the case of chlordecone (CLD), the mean level of pollution is difficult to assess. Our objective was to design a decision support tool to optimize soil sampling. We analyzed the CLD heterogeneity of soil content at 0-30- and 30-60-cm depth. This was done within and between nine plots (0.4 to 1.8 ha) on andosol and ferralsol. We determined that 20 pooled subsamples per plot were a satisfactory compromise with respect to both cost and accuracy. Globally, CLD content was greater for andosols and the upper soil horizon (0-30 cm). Soil organic carbon cannot account for CLD intra-field variability. Cropping systems and tillage practices influence the CLD content and distribution; that is CLD pollution was higher under intensive banana cropping systems and, while upper soil horizon was more polluted than the lower one with shallow tillage (<40 cm), deeper tillage led to a homogenization and a dilution of the pollution in the soil profile. The decision tool we proposed compiles and organizes these results to better assess CLD soil pollution in terms of sampling depth, distance, and unit at field scale. It accounts for sampling objectives, farming practices (cropping system, tillage), type of soil, and topographical characteristics (slope) to design a relevant sampling plan. This decision support tool is also adaptable to other types of heterogeneous agricultural pollution at field level.

Adaptive Flexibility and Maladaptive Routines in Selecting Fast and Frugal Decision Strategies

ERIC Educational Resources Information Center

Broder, Arndt; Schiffer, Stefanie

2006-01-01

Decision routines unburden the cognitive capacity of the decision maker. In changing environments, however, routines may become maladaptive. In 2 experiments with a hypothetical stock market game (n = 241), the authors tested whether decision routines tend to persist at the level of decision strategies rather than at the level of options in…

A multilevel study on the association of observer-assessed working conditions with depressive symptoms among female eldercare workers from 56 work units in 10 care homes in Denmark

PubMed Central

Jakobsen, Louise M; Jorgensen, Anette F B; Thomsen, Birthe L; Greiner, Birgit A; Rugulies, Reiner

2015-01-01

Objectives Eldercare workers in Denmark have a higher prevalence of poor psychological health than other occupational groups. We examined the association between working conditions assessed by trained observers and depressive symptoms assessed by self-report in a study of female Danish eldercare workers. Methods Working conditions were observed based on action regulation theory and defined as (1) regulation requirements, a workplace resource providing opportunity for decision-making and skill development and (2) barriers for task completion. We examined the associations of individual and work unit averaged working conditions with depressive symptoms in a sample of 95 individually observed eldercare workers. Further, we examined the association of work unit averaged working conditions with depressive symptoms in a sample of 205 care workers, including both observed and non-observed individuals. We used regression models that allowed for correlations within work units and care homes and adjusted these models for demographics, job characteristics and stressful life events. Results Higher levels of regulation requirements were associated with lower depressive symptoms at the individual level (p=0.04), but not at the workplace level. Barriers were not associated with depressive symptoms at the individual level. At the workplace level, a higher number of qualitatively different barriers (p=0.04) and a higher number of barriers for equipment use (p=0.03) were associated with lower levels of depressive symptoms in the age and cohabitation adjusted model, however statistical significance was lost in the fully adjusted model. Conclusions Low level of regulation requirements was associated with a high level of depressive symptoms. The study highlights the importance of examining both individual and workplace levels of working conditions. PMID:26560058

Climbing the Academy Ladder in Brazil: Physics

NASA Astrophysics Data System (ADS)

Cotta, Mônica Alonso; Caldas, Marília J.; Barbosa, Marcia C.

2009-04-01

In the last few years, the main Brazilian funding agencies, CNPq and CAPES, have introduced gender awareness projects. This initiative is a starting point for changing the percentage of women at all career levels in physics, but particularly at the top. The change in the percentage of female researchers at the different levels so far has been quite mild; the most likely reason is that the decision committees consist mostly of male researchers. We show that prejudice is still present in the evaluation process. The average number of publications of the female researchers is 72% higher than for the male researchers at the entrance level, indicating that it is harder for women to enter into the research system.

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

PubMed

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

2017-10-01

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

The impact of orthopaedic research evidence on health financing in Australia.

PubMed

Hua, Martin; Myers, Daniel; Host, Lachlan

2018-05-02

In Australia, approval by the Medical Services Advisory Committee (MSAC) is an important step in the implementation of new health technologies. The MSAC considers health technology assessments (HTA) when submitting a recommendation to the Minister of Health on a new technology's suitability for public funding. Despite being such a critical tool in formulating policy, there has been little scrutiny on the impact of limited evidence on the performance of a national HTA agency's mandate. We aim to determine the proportion of HTAs of orthopaedic technologies prepared for the MSAC that were supported by higher levels of evidence for effectiveness, and whether this affected the MSAC's ability to conclude on efficacy. We also investigated whether the availability of higher level evidence affected the performance of cost-effectiveness analyses. We performed a cohort study of all HTAs prepared for the MSAC from 1998 to 2017 with regards to new technologies in orthopaedic surgery. We identified seven HTAs encompassing nine orthopaedic technologies for inclusion. Higher levels of evidence were available for assessing the technology's effectiveness in six out of the nine technologies. The results did not show a statistically significant relationship between the availability of higher level evidence and MSAC's ability to make a clear conclusion on the assessment of effectiveness (P = 0.5). The proportion of HTAs where a cost-effectiveness analysis was performed was significantly higher (P < 0.05) when higher levels of evidence were available for the assessment of effectiveness. The results indicate that there is a paucity of high quality evidence in the formulation of health policy with regards to the implementation of new orthopaedic technologies in the public healthcare system. This represents an opportunity for strong leadership from surgeons to help develop the tools needed for effective clinical decision-making.

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

PubMed Central

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

2011-01-01

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

Robustness Metrics: How Are They Calculated, When Should They Be Used and Why Do They Give Different Results?

NASA Astrophysics Data System (ADS)

McPhail, C.; Maier, H. R.; Kwakkel, J. H.; Giuliani, M.; Castelletti, A.; Westra, S.

2018-02-01

Robustness is being used increasingly for decision analysis in relation to deep uncertainty and many metrics have been proposed for its quantification. Recent studies have shown that the application of different robustness metrics can result in different rankings of decision alternatives, but there has been little discussion of what potential causes for this might be. To shed some light on this issue, we present a unifying framework for the calculation of robustness metrics, which assists with understanding how robustness metrics work, when they should be used, and why they sometimes disagree. The framework categorizes the suitability of metrics to a decision-maker based on (1) the decision-context (i.e., the suitability of using absolute performance or regret), (2) the decision-maker's preferred level of risk aversion, and (3) the decision-maker's preference toward maximizing performance, minimizing variance, or some higher-order moment. This article also introduces a conceptual framework describing when relative robustness values of decision alternatives obtained using different metrics are likely to agree and disagree. This is used as a measure of how "stable" the ranking of decision alternatives is when determined using different robustness metrics. The framework is tested on three case studies, including water supply augmentation in Adelaide, Australia, the operation of a multipurpose regulated lake in Italy, and flood protection for a hypothetical river based on a reach of the river Rhine in the Netherlands. The proposed conceptual framework is confirmed by the case study results, providing insight into the reasons for disagreements between rankings obtained using different robustness metrics.

The influence of differential response on decision-making in child protective service agencies.

PubMed

Janczewski, Colleen E

2015-01-01

Differential response (DR) profoundly changes the decision pathways of public child welfare systems, yet little is known about how DR shapes the experiences of children whose reports receive an investigation rather than an alternate response. Using data from the National Child Abuse and Neglect Data System (NCANDS), this study examined the relationship between DR implementation and decision outcomes in neglect cases, as measured by investigation, substantiation, and removal rates in 297 U.S. counties. Multivariate regression models included county-level measures of child poverty and proportions of African American children. Path analyses were also conducted to identify mediating effects of prior decision points and moderating effects of DR on poverty and race's influence on decision outcomes. Results indicate that compared to non-DR counties, those implementing DR have significantly lower investigation and substantiation rates within county populations but higher substantiation rates among investigated cases. Regression models showed significant reductions in removal rates associated with DR implementation, but these effects became insignificant in path models that accounted for mediation effects of previous decision points. Findings also suggest that DR implementation may reduce the positive association between child poverty rates and investigation rates, but additional studies with larger samples are needed to confirm this moderation effect. Two methods of calculating decision outcomes, population- and decision-based enumeration, were used, and policy and research implications of each are discussed. This study demonstrates that despite their inherit complexity, large administrative datasets such as NCANDS can be used to assess the impact of wide-scale system change across jurisdictions. Copyright © 2014 Elsevier Ltd. All rights reserved.

Trying not to get burned: understanding homeowners' wildfire risk-mitigation behaviors.

PubMed

Brenkert-Smith, Hannah; Champ, Patricia A; Flores, Nicholas

2012-12-01

Three causes have been identified for the spiraling cost of wildfire suppression in the United States: climate change, fuel accumulation from past wildfire suppression, and development in fire-prone areas. Because little is likely to be performed to halt the effects of climate on wildfire risk, and because fuel-management budgets cannot keep pace with fuel accumulation let alone reverse it, changing the behaviors of existing and potential homeowners in fire-prone areas is the most promising approach to decreasing the cost of suppressing wildfires in the wildland-urban interface and increasing the odds of homes surviving wildfire events. Wildfire education efforts encourage homeowners to manage their property to decrease wildfire risk. Such programs may be more effective with a better understanding of the factors related to homeowners' decisions to undertake wildfire risk-reduction actions. In this study, we measured whether homeowners had implemented 12 wildfire risk-mitigation measures in 2 Colorado Front Range counties. We found that wildfire information received from local volunteer fire departments and county wildfire specialists, as well as talking with neighbors about wildfire, were positively associated with higher levels of mitigation. Firsthand experience in the form of preparing for or undertaking an evacuation was also associated with a higher level of mitigation. Finally, homeowners who perceived higher levels of wildfire risk on their property had undertaken higher levels of wildfire-risk mitigation on their property.

Gender in higher level education and professional training in water supply and sanitation.

PubMed

Borba, M

1997-01-01

While more women are participating in training and decision-making in the local-level drinking water and sanitation sectors, this is not occurring at higher levels because of the gender imbalance that remains in higher-level sector education and professional training programs. This imbalance is characterized by gender-biased science curricula and by a lack of female role models. Even in developing countries where female enrollment outstrips that of men in higher education, women commonly prepare for careers in areas that are less valued than sanitary engineering. This imbalance ignores the fact that women can perform technical and managerial skills as competently as men. A similar male-dominated pattern emerges in professional training courses offered by development agencies, especially courses that focus on management issues. Low female school attendance begins when girls must forego primary school attendance to help their mothers in domestic chores, such as fetching water. Inadequate sanitation facilities for girls at schools also pose impediments. Efforts to improve this situation include 1) a promotional brochure developed by the Botswana Ministry of Education to raise awareness of the importance of men's and women's work as technicians and engineers in the water and sanitation sector among secondary school students; 2) creation of free schools and universities in Oman, where the numbers of women in previously male-dominated jobs are increasing; and 3) promotion of female education at the Asian Institute of Technology.

The relative reliability of actively participating and passively observing raters in a simulation-based assessment for selection to specialty training in anaesthesia.

PubMed

Roberts, M J; Gale, T C E; Sice, P J A; Anderson, I R

2013-06-01

Selection to specialty training is a high-stakes assessment demanding valuable consultant time. In one initial entry level and two higher level anaesthesia selection centres, we investigated the feasibility of using staff participating in simulation scenarios, rather than observing consultants, to rate candidate performance. We compared participant and observer scores using four different outcomes: inter-rater reliability; score distributions; correlation of candidate rankings; and percentage of candidates whose selection might be affected by substituting participants' for observers' ratings. Inter-rater reliability between observers was good (correlation coefficient 0.73-0.96) but lower between participants (correlation coefficient 0.39-0.92), particularly at higher level where participants also rated candidates more favourably than did observers. Station rank orderings were strongly correlated between the rater groups at entry level (rho 0.81, p < 0.001) but weaker at the two higher level centres (rho 0.52, p = 0.018; rho 0.58, p = 0.001). Substituting participants' for observers' ratings had less effect once scores were combined with those from other selection centre stations. Selection decisions for 0-20% of candidates could have changed, depending on the numbers of training posts available. We conclude that using participating raters is feasible at initial entry level only. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Issues in Distance Education: A Primer for Higher Education Decision Makers

ERIC Educational Resources Information Center

Beaudoin, Michael

2016-01-01

This chapter presents an overview of current issues related to distance learning in higher education. It identifies central questions, issues, challenges, and opportunities that must be addressed by decision makers, as well as key attributes of effective leaders.

Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study

PubMed Central

Sear, Rebecca

2017-01-01

ABSTRACT Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis—one ‘objective’ (based on an independent assessor’s neighbourhood scores) and one ‘subjective’ (based on respondent’s scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women’s decision making contexts when considering behaviours relevant to public health. PMID:29354262

Local environmental quality positively predicts breastfeeding in the UK's Millennium Cohort Study.

PubMed

Brown, Laura J; Sear, Rebecca

2017-01-01

Background and Objectives: Breastfeeding is an important form of parental investment with clear health benefits. Despite this, rates remain low in the UK; understanding variation can therefore help improve interventions. Life history theory suggests that environmental quality may pattern maternal investment, including breastfeeding. We analyse a nationally representative dataset to test two predictions: (i) higher local environmental quality predicts higher likelihood of breastfeeding initiation and longer duration; (ii) higher socioeconomic status (SES) provides a buffer against the adverse influences of low local environmental quality. Methodology: We ran factor analysis on a wide range of local-level environmental variables. Two summary measures of local environmental quality were generated by this analysis-one 'objective' (based on an independent assessor's neighbourhood scores) and one 'subjective' (based on respondent's scores). We used mixed-effects regression techniques to test our hypotheses. Results: Higher objective, but not subjective, local environmental quality predicts higher likelihood of starting and maintaining breastfeeding over and above individual SES and area-level measures of environmental quality. Higher individual SES is protective, with women from high-income households having relatively high breastfeeding initiation rates and those with high status jobs being more likely to maintain breastfeeding, even in poor environmental conditions. Conclusions and Implications: Environmental quality is often vaguely measured; here we present a thorough investigation of environmental quality at the local level, controlling for individual- and area-level measures. Our findings support a shift in focus away from individual factors and towards altering the landscape of women's decision making contexts when considering behaviours relevant to public health.

Moogle, Google, and Garbage Cans: The Impact of Technology on Decision Making

ERIC Educational Resources Information Center

Sellers, Martin P.

2005-01-01

Decision makers are faced daily with making important and pervasive decisions. This is especially significant in higher education, where decisions about academics will have considerable impact on the next generation of leaders. In place of rational decisions about the substance of learning and instruction, academic administrators make incremental…

Greater decision-making competence is associated with greater expected-value sensitivity, but not overall risk taking: an examination of concurrent validity.

PubMed

Parker, Andrew M; Weller, Joshua A

2015-01-01

Decision-making competence reflects individual differences in the susceptibility to committing decision-making errors, measured using tasks common from behavioral decision research (e.g., framing effects, under/overconfidence, following decision rules). Prior research demonstrates that those with higher decision-making competence report lower incidence of health-risking and antisocial behaviors, but there has been less focus on intermediate processes that may impact real-world decisions, and, in particular, those implicated by normative models. Here we test the associations between measures of youth decision-making competence (Y-DMC) and one such process, the degree to which individuals make choices consistent with maximizing expected value (EV). Using a task involving hypothetical gambles, we find that greater EV sensitivity is associated with greater Y-DMC. Higher Y-DMC scores are associated with (a) choosing risky options when EV favors those options and (b) avoiding risky options when EV favors a certain option. This relationship is stronger for gambles that involved potential losses. The results suggest that Y-DMC captures decision processes consistent with standard normative evaluations of risky decisions.

The role of analogy-guided learning experiences in enhancing students' clinical decision-making skills.

PubMed

Edelen, Bonnie Gilbert; Bell, Alexandra Alice

2011-08-01

The purpose of this study was to address the need for effective educational interventions to promote students' clinical decision making (CDM) within clinical practice environments. Researchers used a quasi-experimental, non-equivalent groups, posttest-only design to assess differences in CDM ability between intervention group students who participated in analogy-guided learning activities and control group students who participated in traditional activities. For the intervention, analogy-guided learning activities were incorporated into weekly group discussions, reflective journal writing, and questioning with clinical faculty. The researcher-designed Assessment of Clinical Decision Making Rubric was used to assess indicators of CDM ability in all students' reflective journal entries. Results indicated that the intervention group demonstrated significantly higher levels of CDM ability in their journals compared with the control group (ES(sm) = 0.52). Recommendations provide nurse educators with strategies to maximize students' development of CDM ability, better preparing students for the demands they face when they enter the profession. Copyright 2011, SLACK Incorporated.

When do business units benefit more from collective citizenship behavior of management teams? An upper echelons perspective.

PubMed

Liu, Wu; Gong, Yaping; Liu, Jun

2014-05-01

Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.

A sequential learning analysis of decisions in organizations to escalate investments despite continuing costs or losses

PubMed Central

Goltz, Sonia M.

1992-01-01

Reinforcement process may underlie decisions frequently found in organizations to escalate investments of time, money and other resources in strategies (e.g., product development, capital investment, plant expansion) that do not result in immediate reinforces. Whereas cognitive biases have been proffered in previous explanations, the present analysis suggested that this persistence is a form of resistance to extinction arising from experiences with past investments that were variably reinforced. This explanation was examined in two experiments by varying the pattern of returns and losses subjects experienced for investment decisions prior to experiencing a series losses. Consistent with the proposed explanation, two conditions resulted in higher levels of recommitment during continuous losses: (a) training using a variable schedule of partial reinforcement, and (b) no training on the task. Results indicate that behavior analysis can be used to understand and control situations in organizations that are prone to escalation, such as investments in the research and development of new product lines and extensions of further loans to customers. PMID:16795785

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

PubMed

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

2014-01-01

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

Hormonal underpinnings of status conflict: Testosterone and cortisol are related to decisions and satisfaction in the hawk-dove game.

PubMed

Mehta, Pranjal H; Lawless DesJardins, Nicole M; van Vugt, Mark; Josephs, Robert A

2017-06-01

A contribution to a special issue on Hormones and Human Competition.Testosterone is theorized to influence status-seeking behaviors such as social dominance and competitive behavior, but supporting evidence is mixed. The present study tested the roles of testosterone and cortisol in the hawk-dove game, a dyadic economic decision-making paradigm in which earnings depend on one's own and the other player's choices. If one person selects the hawk strategy and the other person selects the dove strategy, the player who selected hawk attains a greater financial pay-off (status differentiation). The worst financial outcome occurs when both players choose the hawk strategy (status confrontation). Ninety-eight undergraduate students (42 men) provided saliva samples and played ten rounds of the hawk-dove game with another same-sex participant. In support of the hypothesis that testosterone is related to status concern, individuals higher in basal testosterone made more hawk decisions - decisions that harmed the other player. Acute decreases in cortisol were also associated with more hawk decisions. There was some empirical support for the dual-hormone hypothesis as well: basal testosterone was positively related to satisfaction in the game among low basal-cortisol individuals but not among high basal-cortisol individuals. There were no significant sex differences in these hormonal effects. The present findings align with theories of hormones and status-seeking behavior at the individual level, but they also open up new avenues for research on hormone profiles at the collective level. Our results suggest that the presence of two or more high-testosterone members increases the likelihood of status confrontations over a limited resource that can undermine collective outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Robust Satisficing Decision Making for Unmanned Aerial Vehicle Complex Missions under Severe Uncertainty

PubMed Central

Ji, Xiaoting; Niu, Yifeng; Shen, Lincheng

2016-01-01

This paper presents a robust satisficing decision-making method for Unmanned Aerial Vehicles (UAVs) executing complex missions in an uncertain environment. Motivated by the info-gap decision theory, we formulate this problem as a novel robust satisficing optimization problem, of which the objective is to maximize the robustness while satisfying some desired mission requirements. Specifically, a new info-gap based Markov Decision Process (IMDP) is constructed to abstract the uncertain UAV system and specify the complex mission requirements with the Linear Temporal Logic (LTL). A robust satisficing policy is obtained to maximize the robustness to the uncertain IMDP while ensuring a desired probability of satisfying the LTL specifications. To this end, we propose a two-stage robust satisficing solution strategy which consists of the construction of a product IMDP and the generation of a robust satisficing policy. In the first stage, a product IMDP is constructed by combining the IMDP with an automaton representing the LTL specifications. In the second, an algorithm based on robust dynamic programming is proposed to generate a robust satisficing policy, while an associated robustness evaluation algorithm is presented to evaluate the robustness. Finally, through Monte Carlo simulation, the effectiveness of our algorithms is demonstrated on an UAV search mission under severe uncertainty so that the resulting policy can maximize the robustness while reaching the desired performance level. Furthermore, by comparing the proposed method with other robust decision-making methods, it can be concluded that our policy can tolerate higher uncertainty so that the desired performance level can be guaranteed, which indicates that the proposed method is much more effective in real applications. PMID:27835670

Robust Satisficing Decision Making for Unmanned Aerial Vehicle Complex Missions under Severe Uncertainty.

PubMed

Ji, Xiaoting; Niu, Yifeng; Shen, Lincheng

2016-01-01

This paper presents a robust satisficing decision-making method for Unmanned Aerial Vehicles (UAVs) executing complex missions in an uncertain environment. Motivated by the info-gap decision theory, we formulate this problem as a novel robust satisficing optimization problem, of which the objective is to maximize the robustness while satisfying some desired mission requirements. Specifically, a new info-gap based Markov Decision Process (IMDP) is constructed to abstract the uncertain UAV system and specify the complex mission requirements with the Linear Temporal Logic (LTL). A robust satisficing policy is obtained to maximize the robustness to the uncertain IMDP while ensuring a desired probability of satisfying the LTL specifications. To this end, we propose a two-stage robust satisficing solution strategy which consists of the construction of a product IMDP and the generation of a robust satisficing policy. In the first stage, a product IMDP is constructed by combining the IMDP with an automaton representing the LTL specifications. In the second, an algorithm based on robust dynamic programming is proposed to generate a robust satisficing policy, while an associated robustness evaluation algorithm is presented to evaluate the robustness. Finally, through Monte Carlo simulation, the effectiveness of our algorithms is demonstrated on an UAV search mission under severe uncertainty so that the resulting policy can maximize the robustness while reaching the desired performance level. Furthermore, by comparing the proposed method with other robust decision-making methods, it can be concluded that our policy can tolerate higher uncertainty so that the desired performance level can be guaranteed, which indicates that the proposed method is much more effective in real applications.

Is there a link between the hospital-acquired injurious fall rates in US acute care hospitals and these institutions' implementation levels of computerized systems?

PubMed

Tzeng, Huey-Ming; Hu, Hsou Mei; Yin, Chang-Yi

2011-12-01

Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.

Multi-Attribute Tradespace Exploration in Space System Design

NASA Astrophysics Data System (ADS)

Ross, A. M.; Hastings, D. E.

2002-01-01

The complexity inherent in space systems necessarily requires intense expenditures of resources both human and monetary. The high level of ambiguity present in the early design phases of these systems causes long, highly iterative, and costly design cycles. This paper looks at incorporating decision theory methods into the early design processes to streamline communication of wants and needs among stakeholders and between levels of design. Communication channeled through formal utility interviews and analysis enables engineers to better understand the key drivers for the system and allows a more thorough exploration of the design tradespace. Multi-Attribute Tradespace Exploration (MATE), an evolving process incorporating decision theory into model and simulation- based design, has been applied to several space system case studies at MIT. Preliminary results indicate that this process can improve the quality of communication to more quickly resolve project ambiguity, and enable the engineer to discover better value designs for multiple stakeholders. MATE is also being integrated into a concurrent design environment to facilitate the transfer knowledge of important drivers into higher fidelity design phases. Formal utility theory provides a mechanism to bridge the language barrier between experts of different backgrounds and differing needs (e.g. scientists, engineers, managers, etc). MATE with concurrent design couples decision makers more closely to the design, and most importantly, maintains their presence between formal reviews.

The reward-like nature of social cues that indicate successful altruistic punishment.

PubMed

Mussel, Patrick; Hewig, Johannes; Weiß, Martin

2018-04-27

Altruistic punishment is the attempt to penalize deviant behavior of another person even though it is accompanied by personal costs. Here, we investigated the influence of the reaction on the socioemotional level of the other person following altruistic punishment behavior on future decision making and neural responses. We used a modified ultimatum game, which included an emotional facial feedback of the proposer following the decision of the participant. We found higher acceptance rates for proposers showing a smile upon acceptance or a sad face upon rejection of an offer, compared to proposers showing a neutral facial expression. On the neural level, we found a reversed N2 effect for negative emotional faces in the context of altruistic punishment, compared to a control condition. Specifically, when following the rejection of an unfair offer, negative emotional faces showed a reward-like positivity that might signal successful altruistic punishment. In addition, differential effects for P3 amplitudes might signal the subjective importance of a desired outcome. Our results are in line with the interpretation that rejection of unfair offers in the ultimatum game is due to intended altruistic punishment. Social cues may exhibit reward-like properties when indicating successful altruistic punishment and can influence subsequent decision making. © 2018 Society for Psychophysiological Research.

The Association Between Psychological Distress and Decision Regret During Armed Conflict Among Hospital Personnel.

PubMed

Ben-Ezra, Menachem; Bibi, Haim

2016-09-01

The association between psychological distress and decision regret during armed conflict among hospital personnel is of interest. The objective of this study was to learn of the association between psychological distress and decision regret during armed conflict. Data was collected from 178 hospital personnel in Barzilai Medical Center in Ashkelon, Israel during Operation Protective Edge. The survey was based on intranet data collection about: demographics, self-rated health, life satisfaction, psychological distress and decision regret. Among hospital personnel, having higher psychological distress and being young were associated with higher decision regret. This study adds to the existing knowledge by providing novel data about the association between psychological distress and decision regret among hospital personnel during armed conflict. This data opens a new venue of future research to other potentially detrimental factor on medical decision making and medical error done during crisis.

Normative arguments from experts and peers reduce delay discounting.

PubMed

Senecal, Nicole; Wang, Teresa; Thompson, Elizabeth; Kable, Joseph W

2012-09-01

When making decisions that involve tradeoffs between the quality and timing of desirable outcomes, people consistently discount the value of future outcomes. A puzzling finding regarding such decisions is the extremely high rate at which people discount future monetary outcomes. Most economists would argue that decision-makers should only turn down rates of return that are lower than those available to them elsewhere. Yet the vast majority of studies find discount rates that are significantly higher than market interest rates (Frederick et al., 2002). Here we ask whether a lack of knowledge about the normative strategy can explain high discount rates. In an initial experiment, we find that nearly half of subjects do not spontaneously cite elements of the normative strategy when asked how people should make intertemporal monetary decisions. In two follow-up experiments, we find that after subjects read a "financial guide" detailing the normative strategy, discount rates declined by up to 85%, but were still higher than market interest rates. This decline persisted, though attenuated, for at least one month. In a final experiment, we find that peer-generated advice influences discount rates in a similar manner to "expert" advice, and that arguments focusing on normative considerations are at least as effective as others. These studies show that part of the explanation for high discount rates is a lack of knowledge regarding the normative strategy, and quantify how much discount rates are reduced in response to normative arguments. Given the high level of discounting that remains, however, there are other contributing factors to high discount rates that remain to be quantified.

Normative arguments from experts and peers reduce delay discounting

PubMed Central

Senecal, Nicole; Wang, Teresa; Thompson, Elizabeth; Kable, Joseph W

2013-01-01

When making decisions that involve tradeoffs between the quality and timing of desirable outcomes, people consistently discount the value of future outcomes. A puzzling finding regarding such decisions is the extremely high rate at which people discount future monetary outcomes. Most economists would argue that decision-makers should only turn down rates of return that are lower than those available to them elsewhere. Yet the vast majority of studies find discount rates that are significantly higher than market interest rates (Frederick et al., 2002). Here we ask whether a lack of knowledge about the normative strategy can explain high discount rates. In an initial experiment, we find that nearly half of subjects do not spontaneously cite elements of the normative strategy when asked how people should make intertemporal monetary decisions. In two follow-up experiments, we find that after subjects read a “financial guide” detailing the normative strategy, discount rates declined by up to 85%, but were still higher than market interest rates. This decline persisted, though attenuated, for at least one month. In a final experiment, we find that peer-generated advice influences discount rates in a similar manner to “expert” advice, and that arguments focusing on normative considerations are at least as effective as others. These studies show that part of the explanation for high discount rates is a lack of knowledge regarding the normative strategy, and quantify how much discount rates are reduced in response to normative arguments. Given the high level of discounting that remains, however, there are other contributing factors to high discount rates that remain to be quantified. PMID:23596504

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

PubMed

Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

2015-09-01

Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making remains challenging, it may have patient benefit.

A Blessing or a Curse: An Environmental Decision Case for Secondary and Higher Education

ERIC Educational Resources Information Center

Autrey, Ann; Simmons, Steve; Aikin, Royace

2006-01-01

Decision cases have been used in the United States for higher education in agriculture and natural resources, as well as in extension education. Few cases have been developed for secondary education audiences and fewer yet for both secondary and higher education applications. This case was developed for use in both secondary- and university-level…

A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study.

PubMed

Wu, Justine P; Damschroder, Laura J; Fetters, Michael D; Zikmund-Fisher, Brian J; Crabtree, Benjamin F; Hudson, Shawna V; Ruffin, Mack T; Fucinari, Juliana; Kang, Minji; Taichman, L Susan; Creswell, John W

2018-04-18

Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling. The overall goal of the MiHealth, MiChoice project is to design and implement a theory-driven, Web-based tool that incorporates the US MEC (provider-level intervention) within the vehicle of a contraceptive decision tool for women with chronic medical conditions (patient-level intervention) in community-based primary care settings (practice-level intervention). This will be a 3-phase study that includes a predesign phase, a design phase, and a testing phase in a randomized controlled trial. This study protocol describes phase 1 and aim 1, which is to determine patient-, provider-, and practice-level factors that are relevant to the design and implementation of the contraceptive decision tool. This is a mixed methods implementation study. To customize the delivery of the US MEC in the decision tool, we selected high-priority constructs from the Consolidated Framework for Implementation Research and the Theoretical Domains Framework to drive data collection and analysis at the practice and provider level, respectively. A conceptual model that incorporates constructs from the transtheoretical model and the health beliefs model undergirds patient-level data collection and analysis and will inform customization of the decision tool for this population. We will recruit 6 community-based primary care practices and conduct quantitative surveys and semistructured qualitative interviews with women who have chronic medical conditions, their primary care providers (PCPs), and clinic staff, as well as field observations of practice activities. Quantitative survey data will be summarized with simple descriptive statistics and relationships between participant characteristics and contraceptive recommendations (for PCPs), and current contraceptive use (for patients) will be examined using Fisher exact test. We will conduct thematic analysis of qualitative data from interviews and field observations. The integration of data will occur by comparing, contrasting, and synthesizing qualitative and quantitative findings to inform the future development and implementation of the intervention. We are currently enrolling practices and anticipate study completion in 15 months. This protocol describes the first phase of a multiphase mixed methods study to develop and implement a Web-based decision tool that is customized to meet the needs of women with chronic medical conditions in primary care settings. Study findings will promote contraceptive counseling via shared decision making and reflect evidence-based guidelines for contraceptive selection. ClinicalTrials.gov NCT03153644; https://clinicaltrials.gov/ct2/show/NCT03153644 (Archived by WebCite at http://www.webcitation.org/6yUkA5lK8). ©Justine P Wu, Laura J Damschroder, Michael D Fetters, Brian J Zikmund-Fisher, Benjamin F Crabtree, Shawna V Hudson, Mack T Ruffin IV, Juliana Fucinari, Minji Kang, L Susan Taichman, John W Creswell. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.04.2018.

Production loss among employees perceiving work environment problems.

PubMed

Lohela-Karlsson, Malin; Hagberg, Jan; Bergström, Gunnar

2015-08-01

The overall aim of this explorative study was to investigate the relationship between factors in the psychosocial work environment and work environment-related production loss. Employees at a Swedish university were invited to answer a workplace questionnaire and were selected for this study if they reported having experienced work environment-related problems in the past 7 days (n = 302). A stepwise logistic regression and a modified Poisson regression were used to identify psychosocial work factors associated with work environment-related production loss as well as to identify at what level those factors are associated with production loss. Employees who reported having experienced work environment problems but also fair leadership, good social climate, role clarity and control of decision had significantly lower levels of production loss, whereas employees who reported inequality and high decision demands reported significantly higher levels of production loss. Never or seldom experiencing fair leadership, role clarity, equality, decision demands and good social climate increase the risk of production loss due to work environment problems, compared to those who experience these circumstances frequently, always or most of the time. Several psychosocial work factors are identified as factors associated with a reduced risk of production losses among employees despite the nature of the work environment problem. Knowledge of these factors may be important not only to reduce employee ill-health and the corresponding health-related production loss, but also reduce immediate production loss due to work environment-related problems.

Toward sensor modular autonomy for persistent land intelligence surveillance and reconnaissance (ISR)

NASA Astrophysics Data System (ADS)

Thomas, Paul A.; Marshall, Gillian; Faulkner, David; Kent, Philip; Page, Scott; Islip, Simon; Oldfield, James; Breckon, Toby P.; Kundegorski, Mikolaj E.; Clark, David J.; Styles, Tim

2016-05-01

Currently, most land Intelligence, Surveillance and Reconnaissance (ISR) assets (e.g. EO/IR cameras) are simply data collectors. Understanding, decision making and sensor control are performed by the human operators, involving high cognitive load. Any automation in the system has traditionally involved bespoke design of centralised systems that are highly specific for the assets/targets/environment under consideration, resulting in complex, non-flexible systems that exhibit poor interoperability. We address a concept of Autonomous Sensor Modules (ASMs) for land ISR, where these modules have the ability to make low-level decisions on their own in order to fulfil a higher-level objective, and plug in, with the minimum of preconfiguration, to a High Level Decision Making Module (HLDMM) through a middleware integration layer. The dual requisites of autonomy and interoperability create challenges around information fusion and asset management in an autonomous hierarchical system, which are addressed in this work. This paper presents the results of a demonstration system, known as Sensing for Asset Protection with Integrated Electronic Networked Technology (SAPIENT), which was shown in realistic base protection scenarios with live sensors and targets. The SAPIENT system performed sensor cueing, intelligent fusion, sensor tasking, target hand-off and compensation for compromised sensors, without human control, and enabled rapid integration of ISR assets at the time of system deployment, rather than at design-time. Potential benefits include rapid interoperability for coalition operations, situation understanding with low operator cognitive burden and autonomous sensor management in heterogenous sensor systems.

Research progress on Drosophila visual cognition in China.

PubMed

Guo, AiKe; Zhang, Ke; Peng, YueQin; Xi, Wang

2010-03-01

Visual cognition, as one of the fundamental aspects of cognitive neuroscience, is generally associated with high-order brain functions in animals and human. Drosophila, as a model organism, shares certain features of visual cognition in common with mammals at the genetic, molecular, cellular, and even higher behavioral levels. From learning and memory to decision making, Drosophila covers a broad spectrum of higher cognitive behaviors beyond what we had expected. Armed with powerful tools of genetic manipulation in Drosophila, an increasing number of studies have been conducted in order to elucidate the neural circuit mechanisms underlying these cognitive behaviors from a genes-brain-behavior perspective. The goal of this review is to integrate the most important studies on visual cognition in Drosophila carried out in mainland China during the last decade into a body of knowledge encompassing both the basic neural operations and circuitry of higher brain function in Drosophila. Here, we consider a series of the higher cognitive behaviors beyond learning and memory, such as visual pattern recognition, feature and context generalization, different feature memory traces, salience-based decision, attention-like behavior, and cross-modal leaning and memory. We discuss the possible general gain-gating mechanism implementing by dopamine - mushroom body circuit in fly's visual cognition. We hope that our brief review on this aspect will inspire further study on visual cognition in flies, or even beyond.

Children's Decision-Making Involvement About Research Participation: Associations With Perceived Fairness and Self-Efficacy.

PubMed

Miller, Victoria A; Feudtner, Chris; Jawad, Abbas F

2017-04-01

The primary objective of this study was to examine the associations of children's involvement in decisions about research participation with their perceptions of the decision-making process and self-efficacy. Participants were children (ages 8-17) who enrolled in research studies in the prior 2 months. Children completed a questionnaire that yielded three decision-making involvement subscales: Researcher Engages Child, Researcher Supports Autonomy, and Child Participates. Children reported on fairness of the decision-making process and health-related decision self-efficacy. After adjusting for age, higher scores on Researcher Engages Child were associated with greater self-efficacy, and higher scores on Researcher Supports Autonomy were associated with greater perceived fairness. These data underscore the potential importance of researcher-child interactions about research participation when assent is sought, including proactively involving children in the decision by asking for their opinions and communicating their central role in the decision, which are likely to be more meaningful to children than receiving information or signing a form.

Spatial planning using probabilistic flood maps

NASA Astrophysics Data System (ADS)

Alfonso, Leonardo; Mukolwe, Micah; Di Baldassarre, Giuliano

2015-04-01

Probabilistic flood maps account for uncertainty in flood inundation modelling and convey a degree of certainty in the outputs. Major sources of uncertainty include input data, topographic data, model structure, observation data and parametric uncertainty. Decision makers prefer less ambiguous information from modellers; this implies that uncertainty is suppressed to yield binary flood maps. Though, suppressing information may potentially lead to either surprise or misleading decisions. Inclusion of uncertain information in the decision making process is therefore desirable and transparent. To this end, we utilise the Prospect theory and information from a probabilistic flood map to evaluate potential decisions. Consequences related to the decisions were evaluated using flood risk analysis. Prospect theory explains how choices are made given options for which probabilities of occurrence are known and accounts for decision makers' characteristics such as loss aversion and risk seeking. Our results show that decision making is pronounced when there are high gains and loss, implying higher payoffs and penalties, therefore a higher gamble. Thus the methodology may be appropriately considered when making decisions based on uncertain information.

7 CFR 273.15 - Fair hearings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... further appeal a local decision to a State level fair hearing. State agencies may adopt local level..., the State agency shall assure that the hearing is conducted, a decision is reached, and the household and local agency are notified of the decision. Decisions which result in an increase in household...

Examining Challenges Related to the Production of Actionable Climate Knowledge for Adaptation Decision-Making: A Focus on Climate Knowledge System Producers

NASA Astrophysics Data System (ADS)

Ernst, K.; Preston, B. L.; Tenggren, S.; Klein, R.; Gerger-Swartling, Å.

2017-12-01

Many challenges to adaptation decision-making and action have been identified across peer-reviewed and gray literature. These challenges have primarily focused on the use of climate knowledge for adaptation decision-making, the process of adaptation decision-making, and the needs of the decision-maker. Studies on climate change knowledge systems often discuss the imperative role of climate knowledge producers in adaptation decision-making processes and stress the need for producers to engage in knowledge co-production activities and to more effectively meet decision-maker needs. While the influence of climate knowledge producers on the co-production of science for adaptation decision-making is well-recognized, hardly any research has taken a direct approach to analyzing the challenges that climate knowledge producers face when undertaking science co-production. Those challenges can influence the process of knowledge production and may hinder the creation, utilization, and dissemination of actionable knowledge for adaptation decision-making. This study involves semi-structured interviews, focus groups, and participant observations to analyze, identify, and contextualize the challenges that climate knowledge producers in Sweden face as they endeavor to create effective climate knowledge systems for multiple contexts, scales, and levels across the European Union. Preliminary findings identify complex challenges related to education, training, and support; motivation, willingness, and culture; varying levels of prioritization; professional roles and responsibilities; the type and amount of resources available; and professional incentive structures. These challenges exist at varying scales and levels across individuals, organizations, networks, institutions, and disciplines. This study suggests that the creation of actionable knowledge for adaptation decision-making is not supported across scales and levels in the climate knowledge production landscape. Additionally, enabling the production of actionable knowledge for adaptation decision-making requires multi-level effort beyond the individual level.