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Sample records for individual decision-making determines

  1. Pupil-Linked Arousal Determines Variability in Perceptual Decision Making

    PubMed Central

    Murphy, Peter R.; Vandekerckhove, Joachim; Nieuwenhuis, Sander

    2014-01-01

    Decision making between several alternatives is thought to involve the gradual accumulation of evidence in favor of each available choice. This process is profoundly variable even for nominally identical stimuli, yet the neuro-cognitive substrates that determine the magnitude of this variability are poorly understood. Here, we demonstrate that arousal state is a powerful determinant of variability in perceptual decision making. We measured pupil size, a highly sensitive index of arousal, while human subjects performed a motion-discrimination task, and decomposed task behavior into latent decision making parameters using an established computational model of the decision process. In direct contrast to previous theoretical accounts specifying a role for arousal in several discrete aspects of decision making, we found that pupil diameter was uniquely related to a model parameter representing variability in the rate of decision evidence accumulation: Periods of increased pupil size, reflecting heightened arousal, were characterized by greater variability in accumulation rate. Pupil diameter also correlated trial-by-trial with specific patterns of behavior that collectively are diagnostic of changing accumulation rate variability, and explained substantial individual differences in this computational quantity. These findings provide a uniquely clear account of how arousal state impacts decision making, and may point to a relationship between pupil-linked neuromodulation and behavioral variability. They also pave the way for future studies aimed at augmenting the precision with which people make decisions. PMID:25232732

  2. Pupil-linked arousal determines variability in perceptual decision making.

    PubMed

    Murphy, Peter R; Vandekerckhove, Joachim; Nieuwenhuis, Sander

    2014-09-01

    Decision making between several alternatives is thought to involve the gradual accumulation of evidence in favor of each available choice. This process is profoundly variable even for nominally identical stimuli, yet the neuro-cognitive substrates that determine the magnitude of this variability are poorly understood. Here, we demonstrate that arousal state is a powerful determinant of variability in perceptual decision making. We measured pupil size, a highly sensitive index of arousal, while human subjects performed a motion-discrimination task, and decomposed task behavior into latent decision making parameters using an established computational model of the decision process. In direct contrast to previous theoretical accounts specifying a role for arousal in several discrete aspects of decision making, we found that pupil diameter was uniquely related to a model parameter representing variability in the rate of decision evidence accumulation: Periods of increased pupil size, reflecting heightened arousal, were characterized by greater variability in accumulation rate. Pupil diameter also correlated trial-by-trial with specific patterns of behavior that collectively are diagnostic of changing accumulation rate variability, and explained substantial individual differences in this computational quantity. These findings provide a uniquely clear account of how arousal state impacts decision making, and may point to a relationship between pupil-linked neuromodulation and behavioral variability. They also pave the way for future studies aimed at augmenting the precision with which people make decisions.

  3. [Impulsivity and decision making in alcohol-addicted individuals].

    PubMed

    Kałwa, Agnieszka

    2013-01-01

    Decision making processes are the research problem, that has been increasingly undertaken. Alcohol addiction is a disease associated with unfavorable decision making, in spite of its negative consequences. Impulsivity plays an important role in alcoholics' decision making. It can be understood in terms of behavioral and/or cognitive flexibility disorders, that manifest in cognitive function disorders, making it difficult or even impossible to quickly and adequately assess the situation and to adjust behavior according to its requirements.. Neurobiological and genetic research indicate the existing relationship between impulsivity and certain genetic predisposition. In alcohol addicts, impulsivity can be understood also in terms of specific personality traits, e.g. novelty seeking according to the theory of Cloninger. Although the concept of impulsivity itself has been the main topic of many studies, not many of them concern also decision making processes. In studies concerning alcoholics' decision making, the relationship between this processes and behavioral impulsivity defined in many different ways, has been noticed. Some of these works define unfavorable decision making processes itself as a feature of impulsivity. Based on the results of theoretical works and research studies, it seems that it would be worth to define more precisely the concept of impulsivity, in order to determine its effect on decision making. The assessment of whether - and to what extent - the two variables (impulsivity and decision making) can be considered as separate should also be taken into account.

  4. Does narrative information bias individual's decision making? A systematic review.

    PubMed

    Winterbottom, Anna; Bekker, Hilary L; Conner, Mark; Mooney, Andrew

    2008-12-01

    Including narratives in health-care interventions is increasingly popular. However, narrative information may bias individual's decision making, resulting in patients making poorer decisions. This systematic review synthesises the evidence about the persuasiveness of narrative information on individuals' decision making. Seventeen studies met the review criteria; 41% of studies employed first person narration, 59% third person. Narrative information influenced decision making more than the provision of no additional information and/or statistically based information in approximately a third of the studies (5/17); studies employing first person narratives were twice as likely to find an effect. There was some evidence that narrative information encouraged the use of heuristic rather than systematic processing. However, there was little consistency in the methods employed and the narratives' content to provide evidence on why narratives affect the decision process and outcome, whether narratives facilitate or bias decision making, and/or whether narratives affect the quality of the decision being made. Until evidence is provided on why and how narratives influence decision making, the use of narratives in interventions to facilitate medical decision making should be treated cautiously.

  5. Neural markers of individual differences in decision-making

    PubMed Central

    Kable, Joseph W.; Levy, Ifat

    2017-01-01

    In the last few years, neuroscientists have begun to identify associations between individual differences in decision-making and features of neuroanatomy and neurophysiology. Different tendencies in decision making, such as tolerance for risk, delay or effort, have been linked to various neurobiological measures, such as morphometry, structural connectivity, functional connectivity or the function of neurotransmitter systems. Though far from immutable, these neural features may nonetheless be suitable as relatively stable biomarkers for different decision traits. The establishment of such markers would achieve one of the stated goals of neuroeconomics, which is to improve the prediction of economic behavior across different contexts.

  6. Impaired visual decision-making in individuals with amblyopia

    PubMed Central

    Farzin, Faraz; Norcia, Anthony M.

    2011-01-01

    This study examined the effects of amblyopia on perceptual decision-making processes to determine the consequences of visual deprivation on development of higher-level cortical networks outside of visual cortex. A variant of the Eriksen flanker task was used to measure response time and accuracy for decisions made in the presence of response-selection conflict. Performance of adults with amblyopia was compared to that of neurotypical participants of the same age. Additionally, simple and choice reaction time tasks presented in the visual and the auditory modality were used to control for factors such as feature visibility, crowding, and motor execution speed. A selective deficit in response time for visual decisions was found when individuals with amblyopia used either the amblyopic or non-amblyopic (dominant) eye, and this deficit was independent of visual acuity, motor time, and performance accuracy. In trial conditions that provoked response-selection conflict, responses were significantly delayed in amblyopic relative to neurotypical participants, and were not subject to standard trial sequence effects. Our results indicate that, beyond the known effects of abnormal visual experience on visual cortex, suboptimal binocular input during a developmental critical period may also impact cortical connections to downstream areas of the brain, including parietal and frontal cortex, that are believed to underlie decision and response-selection processes. PMID:22147222

  7. Neural systems underlying individual differences in intertemporal decision making

    PubMed Central

    Elton, Amanda; Smith, Christopher T.; Parrish, Michael H.; Boettiger, Charlotte A.

    2016-01-01

    Excessively choosing immediate over larger future rewards, or delay discounting (DD), associates with multiple clinical conditions. Individual differences in DD likely depend on variations in the activation of and functional interactions between networks, representing possible endophenotypes for associated disorders, including alcohol use disorders (AUDs). Numerous fMRI studies have probed the neural bases of DD, but investigations of large-scale networks remains scant. We addressed this gap by testing whether activation within large-scale networks during “Now/Later” decision-making predicts individual differences in DD. To do so, we scanned 95 social drinkers (18–40 years; 50 females) using fMRI during hypothetical choices between small monetary amounts available “today” or larger amounts available later. We identified neural networks engaged during Now/Later choice using independent component analysis (ICA) and tested the relationship between component activation and degree of DD. The activity of two components during Now/Later choice correlated with individual DD rates: a temporal lobe network positively correlated with DD, while a frontoparietal-striatal network negatively correlated with DD. Activation differences between these networks predicted individual differences in DD and their negative correlation during Now/Later choice suggests functional competition. A generalized psychophysiological interactions (gPPI) analysis confirmed a decrease in their functional connectivity during decision-making. The functional connectivity of these two networks negatively correlates with alcohol-related harm, potentially implicating these networks in AUDs. These findings provide novel insight into the neural underpinnings of individual differences in impulsive decision making with potential implications for addiction and related disorders in which impulsivity is a defining feature. PMID:27779911

  8. Neural Systems Underlying Individual Differences in Intertemporal Decision-making.

    PubMed

    Elton, Amanda; Smith, Christopher T; Parrish, Michael H; Boettiger, Charlotte A

    2017-03-01

    Excessively choosing immediate over larger future rewards, or delay discounting (DD), associates with multiple clinical conditions. Individual differences in DD likely depend on variations in the activation of and functional interactions between networks, representing possible endophenotypes for associated disorders, including alcohol use disorders (AUDs). Numerous fMRI studies have probed the neural bases of DD, but investigations of large-scale networks remain scant. We addressed this gap by testing whether activation within large-scale networks during Now/Later decision-making predicts individual differences in DD. To do so, we scanned 95 social drinkers (18-40 years old; 50 women) using fMRI during hypothetical choices between small monetary amounts available "today" or larger amounts available later. We identified neural networks engaged during Now/Later choice using independent component analysis and tested the relationship between component activation and degree of DD. The activity of two components during Now/Later choice correlated with individual DD rates: A temporal lobe network positively correlated with DD, whereas a frontoparietal-striatal network negatively correlated with DD. Activation differences between these networks predicted individual differences in DD, and their negative correlation during Now/Later choice suggests functional competition. A generalized psychophysiological interactions analysis confirmed a decrease in their functional connectivity during decision-making. The functional connectivity of these two networks negatively correlates with alcohol-related harm, potentially implicating these networks in AUDs. These findings provide novel insight into the neural underpinnings of individual differences in impulsive decision-making with potential implications for addiction and related disorders in which impulsivity is a defining feature.

  9. Individual differences in attention influence perceptual decision making.

    PubMed

    Nunez, Michael D; Srinivasan, Ramesh; Vandekerckhove, Joachim

    2015-01-01

    Sequential sampling decision-making models have been successful in accounting for reaction time (RT) and accuracy data in two-alternative forced choice tasks. These models have been used to describe the behavior of populations of participants, and explanatory structures have been proposed to account for between individual variability in model parameters. In this study we show that individual differences in behavior from a novel perceptual decision making task can be attributed to (1) differences in evidence accumulation rates, (2) differences in variability of evidence accumulation within trials, and (3) differences in non-decision times across individuals. Using electroencephalography (EEG), we demonstrate that these differences in cognitive variables, in turn, can be explained by attentional differences as measured by phase-locking of steady-state visual evoked potential (SSVEP) responses to the signal and noise components of the visual stimulus. Parameters of a cognitive model (a diffusion model) were obtained from accuracy and RT distributions and related to phase-locking indices (PLIs) of SSVEPs with a single step in a hierarchical Bayesian framework. Participants who were able to suppress the SSVEP response to visual noise in high frequency bands were able to accumulate correct evidence faster and had shorter non-decision times (preprocessing or motor response times), leading to more accurate responses and faster response times. We show that the combination of cognitive modeling and neural data in a hierarchical Bayesian framework relates physiological processes to the cognitive processes of participants, and that a model with a new (out-of-sample) participant's neural data can predict that participant's behavior more accurately than models without physiological data.

  10. Individual differences in decision making by foraging hummingbirds.

    PubMed

    Morgan, Kate V; Hurly, T Andrew; Healy, Susan D

    2014-11-01

    For both humans and animals preference for one option over others can be influenced by the context in which the options occur. In animals, changes in preference could be due to comparative decision-making or to changes in the energy state of the animal when making decisions. We investigated which of these possibilities better explained the response of wild hummingbirds to the addition of a decoy option to a set of two options by presenting Rufous hummingbirds (Selasphorus rufus) with a foraging experiment with two treatments. In each treatment the birds were presented with a binary choice between two options and a trinary choice with three options. In treatment one the binary choice was between a volume option and a concentration option, whereas in treatment two the same volume option was presented alongside an alternative concentration option. In the trinary choice, birds were presented with the same options as in the binary choice plus one of two inferior options. Birds changed their preferences when a poorer option was added to the choice set: birds increased their preference for the same option when in the presence of either decoy. Which option differed across individuals and the changes in preference were not readily explained by either energy maximisation or the decoy effect. The consistency in response within individuals, however, would suggest that the individual itself brings an extra dimension to context-dependent decision-making. This article is part of a Special Issue entitled: Cognition in the wild. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Counseling Individuals Who Experience Career Decision-Making Difficulties.

    ERIC Educational Resources Information Center

    Stewart, John

    1995-01-01

    Career decision making is a process that continues throughout the life span. But the process can be impeded by lack of occupational exploration, vocational indecision, and lack of realism in vocational choice. Each obstacle is examined and intervention strategies to assist in decision making are proposed. (Author)

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

    DTIC Science & Technology

    2008-06-01

    35 SDVF Single Dimensional Value Function . . . . . . . . . . . . . 44 ENAER Empresa Nacional de Aeronautica...trainees. These values also branch out to the sub-tier values. In order to familiarize individuals with the terms and expressions, these cri- teria...make it look more understandable for someone who is not familiar with those terms. ”Stability” is placed under ”Flying Quality”. 37 Apparently, when all

  13. Effects of Environmental Stress on Individual Decision Making

    DTIC Science & Technology

    1987-12-15

    explanatory construct. These concepts as originally conceived, referred to nonspecific physiological changes in brain activity mediated by the •• ,1 ;:· ,i...technology, intensive diagnostic and life-saving activities , · and a need for highly significant decision-making by the entire ICTJ staff 1...threats were necessary for adrenal activity (i.e., epinephrine) in the stress response, contrary to Selye’s position that pathogens were

  14. Deliberation before determination: the definition and evaluation of good decision making

    PubMed Central

    Elwyn, Glyn; Miron‐Shatz, Talya

    2009-01-01

    Abstract Objectives  In this article, we examine definitions of suggested approaches to measure the concept of good decisions, highlight the ways in which they converge, and explain why we have concerns about their emphasis on post‐hoc estimations and post‐decisional outcomes, their prescriptive concept of knowledge, and their lack of distinction between the process of deliberation, and the act of decision determination. Background  There has been a steady trend to involve patients in decision making tasks in clinical practice, part of a shift away from paternalism towards the concept of informed choice. An increased understanding of the uncertainties that exist in medicine, arising from a weak evidence base and, in addition, the stochastic nature of outcomes at the individual level, have contributed to shifting the responsibility for decision making from physicians to patients. This led to increasing use of decision support and communication methods, with the ultimate aim of improving decision making by patients. Interest has therefore developed in attempting to define good decision making and in the development of measurement approaches. Method  We pose and reflect whether decisions can be judged good or not, and, if so, how this goodness might be evaluated. Results  We hypothesize that decisions cannot be measured by reference to their outcomes and offer an alternative means of assessment, which emphasizes the deliberation process rather than the decision’s end results. We propose decision making comprises a pre‐decisional process and an act of decision determination and consider how this model of decision making serves to develop a new approach to evaluating what constitutes a good decision making process. We proceed to offer an alternative, which parses decisions into the pre‐decisional deliberation process, the act of determination and post‐decisional outcomes. Discussion  Evaluating the deliberation process, we propose, should comprise

  15. Survey of Literature Pertaining to Decision Making Styles and Individual Factors

    DTIC Science & Technology

    2005-10-01

    IPIP scales ). It may be suggested that individuals who are more agreeable and conscientious are more flexible in their decision making strategy and...intuitive, but may score high on both scales . In this literature review, the terms NDM and intuitive decision making are used interchangeably...The items of their scale were found to differentiate among three decision making styles: analytical, intuitive and regret-based (or avoidant

  16. Individual Empowerment: How Community Health Workers Operationalize Self-Determination, Self-Sufficiency, and Decision-Making Abilities of Low-Income Mothers

    ERIC Educational Resources Information Center

    Becker, Julie; Kovach, Andrea Crivelli; Gronseth, Dickie Lynn

    2004-01-01

    The purposes of this study were to operationalize individual empowerment within the context of the MOMobile Program, to explore the relationships formed between MOMobile Advocates and their clients, and to develop an appropriate survey instrument for assessing the impact of a Community Health Worker (CHW) intervention in a community-based social…

  17. Individual Empowerment: How Community Health Workers Operationalize Self-Determination, Self-Sufficiency, and Decision-Making Abilities of Low-Income Mothers

    ERIC Educational Resources Information Center

    Becker, Julie; Kovach, Andrea Crivelli; Gronseth, Dickie Lynn

    2004-01-01

    The purposes of this study were to operationalize individual empowerment within the context of the MOMobile Program, to explore the relationships formed between MOMobile Advocates and their clients, and to develop an appropriate survey instrument for assessing the impact of a Community Health Worker (CHW) intervention in a community-based social…

  18. Shared decision-making in the care of individuals with diabetes.

    PubMed

    Serrano, V; Rodriguez-Gutierrez, R; Hargraves, I; Gionfriddo, M R; Tamhane, S; Montori, V M

    2016-06-01

    People with diabetes often live with other chronic conditions and lead complicated lives. Determining what is the best management decision for a patient requires consideration of each individual's personal, social and biomedical context, what he or she values, the reasons he or she has to value the available options, and the relative contribution of each option in terms of benefits, harms, costs and inconveniences. Empathic conversations between patients and clinicians to diagnose the patient situation that necessitates action and the range of evidence-based actions that best address the situation, so-called shared decision-making, are essential to the personalized care of people with diabetes. The aim of the present review was to present key elements of shared decision-making and propose three different approaches for its application. The first approach focuses on transferring information to patients so that they can make decisions. The second approach, choice, focuses on cultivating the individual's ability to give voice to which choice is best for them. The third approach, conversation, establishes an empathic conversational environment through which the individual with diabetes and their clinician think and talk through how to address the problems of living with diabetes and related illnesses. These approaches are manifest in the design of evidence-based decision aids created to support shared decision-making. In randomized trials, decision aids can efficiently improve patient's knowledge, satisfaction, risk awareness, decisional conflict and involvement. Further research, however, is needed to better understand when and how to promote the empathic conversations, patient, clinician and service and policy contexts necessary to routinely implement shared decision-making in different at scale healthcare systems. In the interim, sufficient evidence and tools exist for persons with diabetes and their clinicians to gain expertise in making decisions together.

  19. Theoretical Application of Holland's Theory to Individual Decision-Making Styles: Implications for Career Counselors

    ERIC Educational Resources Information Center

    Miller, Mark J.; Miller, Thomas A.

    2005-01-01

    Career decision making is an important aspect of career choice and career development. This theoretical article explores the relationship between J. L. Holland's (1997) 6 dimensions of personality and individual decision-making styles. Implications for career counselors are also provided.

  20. Theoretical Application of Holland's Theory to Individual Decision-Making Styles: Implications for Career Counselors

    ERIC Educational Resources Information Center

    Miller, Mark J.; Miller, Thomas A.

    2005-01-01

    Career decision making is an important aspect of career choice and career development. This theoretical article explores the relationship between J. L. Holland's (1997) 6 dimensions of personality and individual decision-making styles. Implications for career counselors are also provided.

  1. Individual Differences in Decision-Making and Confidence: Capturing Decision Tendencies in a Fictitious Medical Test

    ERIC Educational Resources Information Center

    Jackson, Simon A.; Kleitman, Sabina

    2014-01-01

    Decision-making is a complex process that is largely studied from an experimental perspective or in specific organizational contexts. As such, no generalizable framework exists with which to study decision-making from an individual differences perspective for predictive/selection purposes. By generalising a context-specific decision model proposed…

  2. Individual Differences in Decision-Making and Confidence: Capturing Decision Tendencies in a Fictitious Medical Test

    ERIC Educational Resources Information Center

    Jackson, Simon A.; Kleitman, Sabina

    2014-01-01

    Decision-making is a complex process that is largely studied from an experimental perspective or in specific organizational contexts. As such, no generalizable framework exists with which to study decision-making from an individual differences perspective for predictive/selection purposes. By generalising a context-specific decision model proposed…

  3. Decision making under explicit risk is impaired in individuals with human immunodeficiency virus (HIV).

    PubMed

    Fujiwara, Esther; Tomlinson, Sara E; Purdon, Scot E; Gill, M John; Power, Christopher

    2015-01-01

    Human immunodeficiency virus (HIV) can affect the frontal-striatal brain regions, which are known to subserve decision-making functions. Previous studies have reported impaired decision making among HIV+ individuals using the Iowa Gambling Task, a task that assesses decision making under ambiguity. Previous study populations often had significant comorbidities such as past or present substance use disorders and/or hepatitis C virus coinfection, complicating conclusions about the unique contributions of HIV-infection to decision making. Decision making under explicit risk has very rarely been examined in HIV+ individuals and was tested here using the Game of Dice Task (GDT). We examined decision making under explicit risk in the GDT in 20 HIV+ individuals without substance use disorder or HCV coinfection, including a demographically matched healthy control group (n = 20). Groups were characterized on a standard neuropsychological test battery. For the HIV+ group, several disease-related parameters (viral load, current and nadir CD4 T-cell count) were included. Analyses focused on the GDT and spanned between-group (t-tests; analysis of covariance, ANCOVA) as well as within-group comparisons (Pearson/Spearman correlations). HIV+ individuals were impaired in the GDT, compared to healthy controls (p = .02). Their decision-making impairments were characterized by less advantageous choices and more random choice strategies, especially towards the end of the task. Deficits in the GDT in the HIV+ group were related to executive dysfunctions, slowed processing/motor speed, and current immune system status (CD4+ T-cell levels, ps < .05). Decision making under explicit risk in the GDT can occur in HIV-infected individuals without comorbidities. The correlational patterns may point to underlying fronto-subcortical dysfunctions in HIV+ individuals. The GDT provides a useful measure to assess risky decision making in this population and should be tested in larger studies.

  4. Individual Differences in Information Processing in Networked Decision Making

    DTIC Science & Technology

    2015-03-31

    processing in terms of their impact on the timeliness and accuracy of decisions. In this paper, we address this problem by introducing an agent-based model...for corroboration. Based on a novel way of modeling the degree of problem difficulty, we investigate the impact of individual differences in networked...agents mod- els have incorporated the notion of bounded rational- ity [Carley et al., 2009], the impact of individual differ- ences especially in the NC

  5. >From individual choice to group decision-making

    NASA Astrophysics Data System (ADS)

    Galam, Serge; Zucker, Jean-Daniel

    2000-12-01

    Some universal features are independent of both the social nature of the individuals making the decision and the nature of the decision itself. On this basis a simple magnet like model is built. Pair interactions are introduced to measure the degree of exchange among individuals while discussing. An external uniform field is included to account for a possible pressure from outside. Individual biases with respect to the issue at stake are also included using local random fields. A unique postulate of minimum conflict is assumed. The model is then solved with emphasis on its psycho-sociological implications. Counter-intuitive results are obtained. At this stage no new physical technicality is involved. Instead the full psycho-sociological implications of the model are drawn. Few cases are then detailed to enlight them. In addition, several numerical experiments based on our model are shown to give both an insight on the dynamics of the model and suggest further research directions.

  6. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors.

    PubMed

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions.

  7. Individual responsibility as ground for priority setting in shared decision-making.

    PubMed

    Sandman, Lars; Gustavsson, Erik; Munthe, Christian

    2016-10-01

    Given healthcare resource constraints, voices are being raised to hold patients responsible for their health choices. In parallel, there is a growing trend towards shared decision-making, aiming to empower patients and give them more control over healthcare decisions. More power and control over decisions is usually taken to mean more responsibility for them. The trend of shared decision-making would therefore seem to strengthen the case for invoking individual responsibility in the healthcare priority setting. To analyse whether the implementation of shared decision-making would strengthen the argument for invoking individual responsibility in the healthcare priority setting using normative analysis. Shared decision-making does not constitute an independent argument in favour of employing individual responsibility since these notions rest on different underlying values. However, if a health system employs shared decision-making, individual responsibility may be used to limit resource implications of accommodating patient preferences outside professional standards and goals. If a healthcare system employs individual responsibility, high level dynamic shared decision-making implying a joint deliberation resulting in a decision where both parties are willing to revise initial standpoints may disarm common objections to the applicability of individual responsibility by virtue of making patients more likely to exercise adequate control of their own actions. However, if communication strategies applied in the shared decision-making are misaligned to the patient's initial capacities, arguments against individual responsibility might, on the other hand, gain strength. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Psychopathic individuals exhibit but do not avoid regret during counterfactual decision making

    PubMed Central

    Baskin-Sommers, Arielle; Stuppy-Sullivan, Allison M.; Buckholtz, Joshua W.

    2016-01-01

    Psychopathy is associated with persistent antisocial behavior and a striking lack of regret for the consequences of that behavior. Although explanatory models for psychopathy have largely focused on deficits in affective responsiveness, recent work indicates that aberrant value-based decision making may also play a role. On that basis, some have suggested that psychopathic individuals may be unable to effectively use prospective simulations to update action value estimates during cost–benefit decision making. However, the specific mechanisms linking valuation, affective deficits, and maladaptive decision making in psychopathy remain unclear. Using a counterfactual decision-making paradigm, we found that individuals who scored high on a measure of psychopathy were as or more likely than individuals low on psychopathy to report negative affect in response to regret-inducing counterfactual outcomes. However, despite exhibiting intact affective regret sensitivity, they did not use prospective regret signals to guide choice behavior. In turn, diminished behavioral regret sensitivity predicted a higher number of prior incarcerations, and moderated the relationship between psychopathy and incarceration history. These findings raise the possibility that maladaptive decision making in psychopathic individuals is not a consequence of their inability to generate or experience negative emotions. Rather, antisocial behavior in psychopathy may be driven by a deficit in the generation of forward models that integrate information about rules, costs, and goals with stimulus value representations to promote adaptive behavior. PMID:27911790

  9. Uncertain Futures: Individual Risk and Social Context in Decision-Making in Cancer Screening

    PubMed Central

    Lee, Simon J. Craddock

    2010-01-01

    A core logic of cancer control and prevention, like much in public health, turns on the notion of decision-making under conditions of uncertainty. Population-level data are increasingly used to develop risk profiles, or estimates, that clinicians and the consumer public may use to guide individual decisions about cancer screening. Individual risk perception forms a piece of a larger social economy of decision-making and choice that makes population screening possible. Individual decision-making depends on accessing and interpreting available clinical information, filtered through the lens of personal values and both cognitive and affective behavioral processes. That process is also mediated by changing social roles and interpersonal relationships. This paper begins to elucidate the influence of this “social context” within the complexity of cancer screening. Reflecting on current work in risk and health, I consider how ethnographic narrative methods can enrich this model. PMID:20563321

  10. Uncertain Futures: Individual Risk and Social Context in Decision-Making in Cancer Screening.

    PubMed

    Lee, Simon J Craddock

    2010-04-01

    A core logic of cancer control and prevention, like much in public health, turns on the notion of decision-making under conditions of uncertainty. Population-level data are increasingly used to develop risk profiles, or estimates, that clinicians and the consumer public may use to guide individual decisions about cancer screening. Individual risk perception forms a piece of a larger social economy of decision-making and choice that makes population screening possible. Individual decision-making depends on accessing and interpreting available clinical information, filtered through the lens of personal values and both cognitive and affective behavioral processes. That process is also mediated by changing social roles and interpersonal relationships. This paper begins to elucidate the influence of this "social context" within the complexity of cancer screening. Reflecting on current work in risk and health, I consider how ethnographic narrative methods can enrich this model.

  11. Sex and HIV serostatus differences in decision making under risk among substance-dependent individuals.

    PubMed

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV- substance-dependent men and women. HIV+ participants made significantly poorer decisions than HIV- participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ substance-dependent individuals (SDIs). Potential factors for the HIV+ women's relatively greater impairment are discussed.

  12. Individual behavioral and neurochemical markers of unadapted decision-making processes in healthy inbred mice.

    PubMed

    Pittaras, Elsa; Callebert, Jacques; Chennaoui, Mounir; Rabat, Arnaud; Granon, Sylvie

    2016-12-01

    One of the hallmarks of decision-making processes is the inter-individual variability between healthy subjects. These behavioral patterns could constitute risk factors for the development of psychiatric disorders. Therefore, finding predictive markers of safe or risky decision-making is an important challenge for psychiatry research. We set up a mouse gambling task (MGT)-adapted from the human Iowa gambling task with uncertain contingencies between response and outcome that furthermore enables the emergence of inter-individual differences. Mice (n = 54) were further individually characterized for locomotive, emotional and cognitive behavior. Individual basal rates of monoamines and brain activation after the MGT were assessed in brain regions related to reward, emotion or cognition. In a large healthy mice population, 44 % showed a balanced strategy with limited risk-taking and flexible choices, 29 % showed a safe but rigid strategy, while 27 % adopted risky behavior. Risky mice took also more risks in other apparatus behavioral devices and were less sensitive to reward. No difference existed between groups regarding anxiety, working memory, locomotion and impulsivity. Safe/rigid mice exhibited a hypoactivation of prefrontal subareas, a high level of serotonin in the orbitofrontal cortex combined with a low level of dopamine in the putamen that predicted the emergence of rigid behavior. By contrast, high levels of dopamine, serotonin and noradrenalin in the hippocampus predicted the emergence of more exploratory and risky behaviors. The coping of C57bl/6J mice in MGT enables the determination of extreme patterns of choices either safe/rigid or risky/flexible, related to specific neurochemical and behavioral markers.

  13. Individual differences in bodily freezing predict emotional biases in decision making.

    PubMed

    Ly, Verena; Huys, Quentin J M; Stins, John F; Roelofs, Karin; Cools, Roshan

    2014-01-01

    Instrumental decision making has long been argued to be vulnerable to emotional responses. Literature on multiple decision making systems suggests that this emotional biasing might reflect effects of a system that regulates innately specified, evolutionarily preprogrammed responses. To test this hypothesis directly, we investigated whether effects of emotional faces on instrumental action can be predicted by effects of emotional faces on bodily freezing, an innately specified response to aversive relative to appetitive cues. We tested 43 women using a novel emotional decision making task combined with posturography, which involves a force platform to detect small oscillations of the body to accurately quantify postural control in upright stance. On the platform, participants learned whole body approach-avoidance actions based on monetary feedback, while being primed by emotional faces (angry/happy). Our data evidence an emotional biasing of instrumental action. Thus, angry relative to happy faces slowed instrumental approach relative to avoidance responses. Critically, individual differences in this emotional biasing effect were predicted by individual differences in bodily freezing. This result suggests that emotional biasing of instrumental action involves interaction with a system that controls innately specified responses. Furthermore, our findings help bridge (animal and human) decision making and emotion research to advance our mechanistic understanding of decision making anomalies in daily encounters as well as in a wide range of psychopathology.

  14. Individual differences in bodily freezing predict emotional biases in decision making

    PubMed Central

    Ly, Verena; Huys, Quentin J. M.; Stins, John F.; Roelofs, Karin; Cools, Roshan

    2014-01-01

    Instrumental decision making has long been argued to be vulnerable to emotional responses. Literature on multiple decision making systems suggests that this emotional biasing might reflect effects of a system that regulates innately specified, evolutionarily preprogrammed responses. To test this hypothesis directly, we investigated whether effects of emotional faces on instrumental action can be predicted by effects of emotional faces on bodily freezing, an innately specified response to aversive relative to appetitive cues. We tested 43 women using a novel emotional decision making task combined with posturography, which involves a force platform to detect small oscillations of the body to accurately quantify postural control in upright stance. On the platform, participants learned whole body approach-avoidance actions based on monetary feedback, while being primed by emotional faces (angry/happy). Our data evidence an emotional biasing of instrumental action. Thus, angry relative to happy faces slowed instrumental approach relative to avoidance responses. Critically, individual differences in this emotional biasing effect were predicted by individual differences in bodily freezing. This result suggests that emotional biasing of instrumental action involves interaction with a system that controls innately specified responses. Furthermore, our findings help bridge (animal and human) decision making and emotion research to advance our mechanistic understanding of decision making anomalies in daily encounters as well as in a wide range of psychopathology. PMID:25071491

  15. Negative mood induction normalizes decision making in male cocaine dependent individuals.

    PubMed

    Fernández-Serrano, María José; Moreno-López, Laura; Pérez-García, Miguel; Viedma-Del Jesús, María I; Sánchez-Barrera, María B; Verdejo-García, Antonio

    2011-10-01

    Decision making is thought to play a key role in psychostimulant relapse, but very few studies have addressed the issue of how to counteract decision-making deficits in addicted individuals. According to the somatic marker framework, pervasive decision-making problems in addicted individuals may relate to abnormalities in the processing of emotional signals that work to anticipate the prospective outcomes of potential decisions. The present study was conducted to test whether the induction of different emotional states (positive, negative, or drug-related) could either normalize or further impair decision-making performance in male cocaine polysubstance-using individuals (CPSI), as indexed by the Iowa gambling task (IGT). Forty-two CPSI and 65 healthy control individuals (all males) were randomly allocated in four affective conditions using a parallel-group design. Participants in the different conditions performed the IGT during exposure to neutral, positive, negative, or drug-related sets of affective images. The results showed that the CPSI exposed to the negative affective context showed a preference for the risk-averse safe choices of the IGT and had a net performance indistinguishable from that of controls. On the other hand, CPSI exposed to positive, drug-related, and neutral contexts showed the typical pattern of disadvantageous performance in the IGT and performed significantly poorer than controls. The impact of the negative mood induction could not be explained in terms of baseline differences in decision-making skills, personality traits related to sensitivity to reward/punishment, or trait positive/negative affect. We conclude that negative mood induction can normalize decision-making performance in male CPSI, which may have important implications for the treatment of cocaine use-related disorders.

  16. Impaired decision-making under risk in individuals with alcohol dependence

    PubMed Central

    Brevers, Damien; Bechara, Antoine; Cleeremans, Axel; Kornreich, Charles; Verbanck, Paul; Noël, Xavier

    2014-01-01

    Background Alcohol dependence is associated with poor decision-making under ambiguity, that is, when decisions are to be made in the absence of known probabilities of reward and loss. However, little is known regarding decisions made by individuals with alcohol dependence in the context of known probabilities (decision under risk). In this study, we investigated the relative contribution of these distinct aspects of decision making to alcohol dependence. Methods Thirty recently detoxified and sober asymptomatic alcohol-dependent individuals, and thirty healthy control participants were tested for decision-making under ambiguity (using the Iowa Gambling Task), and decision-making under-risk (using the Cups Task and Coin Flipping Task). We also tested their capacities for working memory storage (Digit-span Forward), and dual-tasking (Operation-span Task). Results Compared to healthy control participants, alcohol-dependent individuals made disadvantageous decisions on the Iowa Gambling Task, reflecting poor decisions under ambiguity. They also made more risky choices on the Cups and Coin Flipping Tasks reflecting poor decision-making under risk. In addition, alcohol-dependent participants showed some working memory impairments, as measured by the dual tasking, and the degree of this impairment correlated with high-risk decision-making, thus suggesting a relationship between processes sub-serving working memory and risky decisions. Conclusion These results suggest that alcohol dependent individuals are impaired in their ability to decide optimally in multiple facets of uncertainty (i.e., both risk and ambiguity), and that at least some aspects of these deficits are linked to poor working memory processes. PMID:24948198

  17. Decision-Making Models with Sets of Strategies for Applications to Individuals and Groups in Higher Education.

    ERIC Educational Resources Information Center

    Gill, Wanda E.

    Three decision-making models that have applications for college presidents and administrators are reviewed. While both individual and group decision-making are addressed, emphasis is placed on the importance of group decisions on institutional policy planning. The model of Edmund M. Burke (1979) presents specific decision-making strategies in…

  18. The Multifold Relationship Between Memory and Decision Making: An Individual-differences Study

    PubMed Central

    Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

    2014-01-01

    Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 to 80 years, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory, and semantic memory, respectively, and six main components of decision-making competence. In line with the hypotheses, working memory was positively related with the more cognitively-demanding tasks (Resistance to Framing, Applying Decision Rules, and Under/Overconfidence), whereas episodic memory was positively associated with a more experience-based judgment task (Recognizing Social Norms). Furthermore, semantic memory was positively related with two more knowledge-based decision-making tasks (Consistency in Risk Perception and Resistance to Sunk Costs). Finally, the age-related decline observed in some of the decision-making tasks was (partially or totally) mediated by the age-related decline in working memory or episodic memory. These findings are discussed in relation to the functional roles fulfilled by different memory processes in judgment and decision-making tasks. PMID:23565790

  19. The multifold relationship between memory and decision making: an individual-differences study.

    PubMed

    Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M; Nilsson, Lars-Göran

    2013-09-01

    Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory, and semantic memory, respectively, and 6 main components of decision-making competence. In line with the hypotheses, working memory was positively related with the more cognitively demanding tasks (Resistance to Framing, Applying Decision Rules, and Under/Overconfidence), whereas episodic memory was positively associated with a more experience-based judgment task (Recognizing Social Norms). Furthermore, semantic memory was positively related with 2 more knowledge-based decision-making tasks (Consistency in Risk Perception and Resistance to Sunk Costs). Finally, the age-related decline observed in some of the decision-making tasks was (partially or totally) mediated by the age-related decline in working memory or episodic memory. These findings are discussed in relation to the functional roles fulfilled by different memory processes in judgment and decision-making tasks.

  20. Sex and HIV serostatus differences in decision making under risk among substance dependent individuals

    PubMed Central

    Martin, Eileen; Gonzalez, Raul; Vassileva, Jasmin; Maki, Pauline M.; Bechara, Antoine; Brand, Matthias

    2016-01-01

    HIV+ individuals with and without substance use disorders make significantly poorer decisions when information about the probability and magnitude of wins and losses is not available. We administered the Game of Dice Task, a measure of decision making under risk that provides this information explicitly, to 92 HIV+ and 134 HIV− substance dependent men and women. HIV+ participants made significantly poorer decisions compared with HIV− participants, but this deficit appeared more prominent among HIV+ women. These data indicate that decision making under risk is impaired among HIV+ SDIs. Potential factors for the HIV+ women’s relatively greater impairment are discussed. PMID:26882176

  1. The Multifold Relationship between Memory and Decision Making: An Individual-Differences Study

    ERIC Educational Resources Information Center

    Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

    2013-01-01

    Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory,…

  2. The Multifold Relationship between Memory and Decision Making: An Individual-Differences Study

    ERIC Educational Resources Information Center

    Del Missier, Fabio; Mäntylä, Timo; Hansson, Patrik; Bruine de Bruin, Wändi; Parker, Andrew M.; Nilsson, Lars-Göran

    2013-01-01

    Several judgment and decision-making tasks are assumed to involve memory functions, but significant knowledge gaps on the memory processes underlying these tasks remain. In a study on 568 adults between 25 and 80 years of age, hypotheses were tested on the specific relationships between individual differences in working memory, episodic memory,…

  3. 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

  4. 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

  5. Determinants of judgment and decision making quality: the interplay between information processing style and situational factors

    PubMed Central

    Ayal, Shahar; Rusou, Zohar; Zakay, Dan; Hochman, Guy

    2015-01-01

    A framework is presented to better characterize the role of individual differences in information processing style and their interplay with contextual factors in determining decision making quality. In Experiment 1, we show that individual differences in information processing style are flexible and can be modified by situational factors. Specifically, a situational manipulation that induced an analytical mode of thought improved decision quality. In Experiment 2, we show that this improvement in decision quality is highly contingent on the compatibility between the dominant thinking mode and the nature of the task. That is, encouraging an intuitive mode of thought led to better performance on an intuitive task but hampered performance on an analytical task. The reverse pattern was obtained when an analytical mode of thought was encouraged. We discuss the implications of these results for the assessment of decision making competence, and suggest practical directions to help individuals better adjust their information processing style to the situation at hand and make optimal decisions. PMID:26284011

  6. Determinants of Evidence Use in Academic Librarian Decision Making

    ERIC Educational Resources Information Center

    Koufogiannakis, Denise

    2015-01-01

    The objective of this qualitative study was to identify and explain challenges encountered by academic librarians when trying to incorporate evidence into their practice. The findings resulted in the identification of five main determinants that act as either obstacles or enablers of evidence use. The identification of these determinants provide…

  7. Determinants of Evidence Use in Academic Librarian Decision Making

    ERIC Educational Resources Information Center

    Koufogiannakis, Denise

    2015-01-01

    The objective of this qualitative study was to identify and explain challenges encountered by academic librarians when trying to incorporate evidence into their practice. The findings resulted in the identification of five main determinants that act as either obstacles or enablers of evidence use. The identification of these determinants provide…

  8. Reproductive decision-making among individuals at risk for familial amyotrophic lateral sclerosis.

    PubMed

    Hartzfeld, Deborah E H; Siddique, Nailah; Victorson, David; O'Neill, Suzanne; Kinsley, Lisa; Siddique, Teepu

    2015-03-01

    This qualitative study explored the reproductive decision-making process in individuals at 50% risk for familial amyotrophic lateral sclerosis (FALS) from families with a known genetic mutation. We spoke with 10 individuals utilizing a semi-structured interview. Participants had a first-degree relative with FALS, made reproductive decisions in the past 30 years and did not know their genetic status during decision-making. We delineated themes emerging in individuals who chose to have children, those who chose not to have children, and themes describing the process in general. Results showed that those who chose to have children believed that regardless of disease, life is productive. They compared ALS relatively favorably to other diseases, always planned on having children, and hoped for a cure. Individuals who chose not to have children had extensive experience with ALS and caretaking, saw ALS as an inevitable tragedy, and avoided serious relationships. In consultation with partners, individuals considered other reproductive options. Conversations varied in length, and often strengthened relationships. Children experiencing death of a parent was a primary concern. In conclusion, the reproductive decision-making process is complex. Results can guide future research and provide direction for healthcare professionals when discussing the family planning process and prior to predictive genetic testing.

  9. 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

  10. How you named your child: understanding the relationship between individual decision making and collective outcomes.

    PubMed

    Gureckis, Todd M; Goldstone, Robert L

    2009-10-01

    We examine the interdependence between individual and group behavior surrounding a somewhat arbitrary, real-world decision: selecting a name for one's child. Using a historical database of the names given to children over the last century in the United States, we find that naming choices are influenced by both the frequency of a name in the general population, and by its ''momentum'' in the recent past in the sense that names which are growing in popularity are preferentially chosen. This bias toward rising names is a recent phenomena: In the early part of the 20th century, increasing popularity of a name from one time period to the next correlated with a decrease in future popularity. However, more recently this trend has reversed. We evaluate a number of formal models that detail how individual decision-making strategies, played out in a large population of interacting agents, can explain these empirical observations. We argue that cognitive capacities for change detection, the encoding of frequency in memory, and biases toward novel or incongruous stimuli may interact with the behavior of other decision makers to determine the distribution and dynamics of cultural tokens such as names.

  11. A computational approach to characterizing the impact of social influence on individuals' vaccination decision making.

    PubMed

    Xia, Shang; Liu, Jiming

    2013-01-01

    In modeling individuals vaccination decision making, existing studies have typically used the payoff-based (e.g., game-theoretical) approaches that evaluate the risks and benefits of vaccination. In reality, whether an individual takes vaccine or not is also influenced by the decisions of others, i.e., due to the impact of social influence. In this regard, we present a dual-perspective view on individuals decision making that incorporates both the cost analysis of vaccination and the impact of social influence. In doing so, we consider a group of individuals making their vaccination decisions by both minimizing the associated costs and evaluating the decisions of others. We apply social impact theory (SIT) to characterize the impact of social influence with respect to individuals interaction relationships. By doing so, we propose a novel modeling framework that integrates an extended SIT-based characterization of social influence with a game-theoretical analysis of cost minimization. We consider the scenario of voluntary vaccination against an influenza-like disease through a series of simulations. We investigate the steady state of individuals' decision making, and thus, assess the impact of social influence by evaluating the coverage of vaccination for infectious diseases control. Our simulation results suggest that individuals high conformity to social influence will increase the vaccination coverage if the cost of vaccination is low, and conversely, will decrease it if the cost is high. Interestingly, if individuals are social followers, the resulting vaccination coverage would converge to a certain level, depending on individuals' initial level of vaccination willingness rather than the associated costs. We conclude that social influence will have an impact on the control of an infectious disease as they can affect the vaccination coverage. In this respect, our work can provide a means for modeling the impact of social influence as well as for estimating the

  12. Clinical decision making and preference assessment for individuals with intellectual and developmental disabilities.

    PubMed

    Virués-Ortega, Javier; Pritchard, Kristen; Grant, Robin L; North, Sebastian; Hurtado-Parrado, Camilo; Lee, May S H; Temple, Bev; Julio, Flávia; Yu, C T

    2014-03-01

    Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are available and selecting the appropriate method is crucial to provide reliable and meaningful results. The authors conducted a systematic review of the preference assessment literature, and developed an evidence-informed, decision-making model to guide practitioners in the selection of preference assessment methods for a given assessment scenario. The proposed decision-making model could be a useful tool to increase the usability and uptake of preference assessment methodology in applied settings.

  13. Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

    PubMed

    Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

    2016-01-01

    Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

  14. A rough set approach for determining weights of decision makers in group decision making

    PubMed Central

    Yang, Qiang; Du, Ping-an; Wang, Yong; Liang, Bin

    2017-01-01

    This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs’ decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member’ decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs’ evaluations and selections. PMID:28234974

  15. A rough set approach for determining weights of decision makers in group decision making.

    PubMed

    Yang, Qiang; Du, Ping-An; Wang, Yong; Liang, Bin

    2017-01-01

    This study aims to present a novel approach for determining the weights of decision makers (DMs) based on rough group decision in multiple attribute group decision-making (MAGDM) problems. First, we construct a rough group decision matrix from all DMs' decision matrixes on the basis of rough set theory. After that, we derive a positive ideal solution (PIS) founded on the average matrix of rough group decision, and negative ideal solutions (NISs) founded on the lower and upper limit matrixes of rough group decision. Then, we obtain the weight of each group member and priority order of alternatives by using relative closeness method, which depends on the distances from each individual group member' decision to the PIS and NISs. Through comparisons with existing methods and an on-line business manager selection example, the proposed method show that it can provide more insights into the subjectivity and vagueness of DMs' evaluations and selections.

  16. Individual decision making in the non-purchase of long-term care insurance.

    PubMed

    Curry, Leslie A; Robison, Julie; Shugrue, Noreen; Keenan, Patricia; Kapp, Marshall B

    2009-08-01

    Although prior research suggests that economic, behavioral, and psychosocial factors influence decisions not to purchase long-term care insurance, few studies have examined the interplay among these factors in depth and from the consumer's point of view. This study was intended to further illuminate these considerations, generate hypotheses about non-purchasing decisions, and inform the design of policies that are responsive to concerns and preferences of potential purchasers. Qualitative study using 32 in-depth interviews and 6 focus groups, following a grounded theory approach. Five themes characterize decisions not to purchase long-term care insurance: (a) the determination that a policy is "too costly" reflects highly individualized and complex trade-offs not solely economic in nature, (b) non-purchasers are skeptical about the viability and integrity of private insurance companies and seek an unbiased source of information, (c) family dynamics play an important role in insurance decisions, (d) contemplating personal risk for long-term care triggers psychological responses that have implications for decision making, and (e) non-purchasers feel inadequately informed and overwhelmed by the process of deciding whether to purchase long-term care insurance. States are seeking to offset escalating Medicaid long-term care expenditures through a variety of policy mechanisms, including stimulating individual purchase of long-term care insurance. Findings suggest that economic incentives such as lowering premiums will be necessary but not sufficient to attract appropriate candidates. Attention to behavioral and psychosocial factors is essential to designing incentives that are responsive to concerns and preferences of potential purchasers.

  17. Novel Statistical Approach to Determine Inflammatory Bowel Disease: Patients' Perspectives on Shared Decision Making.

    PubMed

    Siegel, Corey A; Lofland, Jennifer H; Naim, Ahmad; Gollins, Jan; Walls, Danielle M; Rudder, Laura E; Reynolds, Chuck

    2016-02-01

    Limited information is available on patients' perspectives of shared decision-making practices used in inflammatory bowel disease (IBD). The aim of this study was to examine patient insights regarding shared decision making among patients with IBD using novel statistical technology to analyze qualitative data. Two 10-patient focus groups (10 ulcerative colitis patients and 10 Crohn's disease patients) were conducted in Chicago in January 2012 to explore patients' experiences, concerns, and preferences related to shared decision making. Key audio excerpts of focus group insights were embedded within a 25-min online patient survey and used for moment-to-moment affect trace analysis. A total of 355 IBD patients completed the survey (ulcerative colitis 51 %; Crohn's disease 49 %; female 54 %; 18-50 years of age 50 %). The majority of patients (66 %) reported increased satisfaction when they participated in shared decision making. Three unique patient clusters were identified based on their involvement in shared decision making: satisfied, content, and dissatisfied. Satisfied patients (18 %) had a positive physician relationship and a high level of trust with their physician. Content patients (48 %) had a moderate level of trust with their physician. Dissatisfied patients (34 %) had a life greatly affected by IBD, a low level of trust of their physician, a negative relationship with their physician, were skeptical of decisions, and did not rely on their physician for assistance. This study provides valuable insights regarding patients' perceptions of the shared decision-making process in IBD treatment using a novel moment-to-moment hybrid technology approach. Patient perspectives in this study indicate an increased desire for shared decision making in determining an optimal IBD treatment plan.

  18. Accuracy enhancement in a fuzzy expert decision making system through appropriate determination of membership functions and its application in a medical diagnostic decision making system.

    PubMed

    Das, Suddhasattwa; Roy Chowdhury, Shubhajit; Saha, Hiranmay

    2012-06-01

    The paper attempts to improve the accuracy of a fuzzy expert decision making system by tuning the parameters of type-2 sigmoid membership functions of fuzzy input variables and hence determining the most appropriate type-1 membership function. The current work mathematically models the variability of human decision making process using type-2 fuzzy sets. Moreover, an index of accuracy of a fuzzy expert system has been proposed and determined analytically. It has also been ascertained that there exists only one rule in the rule base whose associated mapping for the ith linguistic variable maps to the same value as the maximum value of the membership function for the ith linguistic variable. The improvement in decision making accuracy was successfully verified in a medical diagnostic decision making system for renal diagnostic applications. Based on the accuracy estimations applied over a set of pathophysiological parameters, viz. body mass index, glucose, urea, creatinine, systolic and diastolic blood pressure, appropriate type-1 fuzzy sets of these parameters have been determined assuming normal distribution of type-1 membership function values in type-2 fuzzy sets. The type-1 fuzzy sets so determined have been used to develop an FPGA based smart processor. Using the processor, renal diagnosis of patients has been performed with an accuracy of 98.75%.

  19. Individual differences in risk preference predict neural responses during financial decision-making.

    PubMed

    Engelmann, Jan B; Tamir, Diana

    2009-09-22

    We investigated the neural correlates of subjective valuations during a task involving risky choices about lotteries. Because expected value was held constant across all lotteries, decisions were influenced by subjective preferences, which manifest behaviorally as risk-seeking or risk-averse attitudes. To isolate structures encoding risk preference during choice, we probed for areas showing increased activation as a function of selected risk-level. Such response patterns were obtained in anterior (ACC) and posterior cingulate cortex (PCC), superior frontal gyrus, caudate nucleus, and substantia nigra. Behavioral results revealed the presence of risk-averse and risk-neutral individuals. In parallel, brain signals revealed modulation of activity by risk attitude during choice. Correlations between risk-seeking attitudes and neural activity during risky choice were obtained in superior and inferior frontal gyri, medial and lateral orbitofrontal cortex, and parahippocampal gyrus, while correlations with risk-averse attitudes were found in the caudate. The dynamics of neural responses relevant to each stage of the task (decision, anticipation, outcome) were investigated via timeseries and conjunction analyses. Though the networks engaged in each of the task stages were mostly distinct, regions within ACC, PCC and caudate were consistently activated during each decision-making phase. These results demonstrate (1) that subjective assessments of risk, as well as individual attitudes toward risk, play a significant role in modulating activity within brain regions recruited during decision-making, and (2) that ACC, PCC and caudate are relevant during each phase of a decision-making task requiring subjective valuations, strengthening the role of these regions in self-referential subjective valuations during choice.

  20. The Cumulative Effects of Acute Alcohol Consumption, Individual Differences and Situational Perceptions on Sexual Decision Making*

    PubMed Central

    ABBEY, ANTONIA; SAENZ, CHRISTOPHER; BUCK, PHILIP O.

    2015-01-01

    Objective Past alcohol administration research has produced mixed findings regarding the role of acute alcohol consumption on sexual decision making. The purpose of this study was to evaluate a more complex theoretical model that places alcohol's acute effects in context, through the inclusion of background measures as well as affective and cognitive responses to the specific situation. Method College students (90 men, 90 women) completed a survey that included measures of individual difference characteristics and past experiences; approximately 1 month later, they participated in an alcohol administration study. Participants were randomly assigned to one of three drink conditions (sober, placebo, alcohol), after which they read a story about a couple that wanted to have sex, but had no condoms available. Results In hierarchical multiple regression analyses, acute alcohol consumption significantly predicted participants’ perceived likelihood that they would have sex without a condom in such a situation; an earlier step included gender, impulsivity, self-reported alcohol expectancies, frequency of heavy drinking, lifetime number of sexual partners and frequency of condom use. There was no significant effect associated with the expectancy that one had consumed alcohol. Neither was there a significant interaction between drink condition and self-reported alcohol expectancies. Conclusions Through the inclusion of measures of individual differences and responses to the specific situation, this study provides a more nuanced understanding of the factors that affect college students’ sexual decision making, compared with laboratory studies that examine the effects of acute alcohol consumption in isolation. Alcohol consumption explained a significant yet relatively small amount of variance. Researchers need to consider the broader context to understand how intoxication influences sexual decision making. PMID:15830907

  1. The contribution of ecosystem services to place utility as a determinant of migration decision-making

    NASA Astrophysics Data System (ADS)

    Adams, Helen; Adger, W. Neil

    2013-03-01

    Environment migration research has sought to provide an account of how environmental risks and resources affect migration and mobility. Part of that effort has focused on the role of the environment in providing secure livelihoods through provisioning ecosystem services. However, many of the models of environment migration linkages fail to acknowledge the importance of social and psychological factors in the decision to migrate. Here, we seek to provide a more comprehensive model of migration decision-making under environmental change by investigating the attachment people form to place, and the role of the environment in creating that attachment. We hypothesize that environmental factors enter the migration decision-making process through their contribution to place utility, defined as a function of both affective and instrumental bonds to location, and that ecosystem services, the aspects of ecosystems that create wellbeing, contribute to both components of place utility. We test these ideas in four rural highland settlements in Peru sampled along an altitudinal gradient. We find that non-economic ecosystem services are important in creating place attachment and that ecological place attachment exists independently of use of provisioning ecosystem services. Individuals’ attitudes to ecosystem services vary with the type of ecosystem services available at a location and the degree of rurality. While social and economic factors are the dominant drivers of migration in these locations, a loss of non-provisioning ecosystem services leads to a decrease in place utility and commitment to place, determining factors in the decision to migrate. The findings suggest that policy interventions encouraging migration as an adaptation to environmental change will have limited success if they only focus on provisioning services. A much wider set of individuals will experience a decrease in place utility, and migration will be unable to alleviate that decrease since the factors

  2. Reproductive decision-making and determinants of contraceptive use in HIV-infected women.

    PubMed

    Williams, H A; Watkins, C E; Risby, J A

    1996-06-01

    Perinatal transmission and reproductive decisions of HIV-infected women can be categorized in statistical and epidemiological terms. These reports and figures, however, do little to fully explain the complexities of human relationships, life experiences, personal and cultural influences, and situational and environmental variables that impact on the HIV-infected woman regarding reproductive decision-making. It is only with genuine attempts to understand the woman's perspective and the dynamic and unique variables that influence reproductive decision-making, as well as maintaining a non-judgmental and culturally sensitive perspective, can we hope to assist women, and society as a whole, in coming to terms with the complexities of HIV and reproductive decision-making. Further study is needed to identify factors that influence reproductive decision-making in HIV-infected women. The determinants of contraceptive use regarding demographic factors, barriers to contraceptive use, and factors that contribute to successful contraceptive use in this population must be understood if efforts to reduce the number of unplanned pregnancies are to be successful. More conclusive data are needed on the safety and efficacy of oral contraceptives in HIV-infected women as well as data that describe the effects of longer acting hormonal contraceptives such as levonorgestrel implants (Norplant; Wyeth-Ayerst, Philadelphia, PA) and injectable medroxyprogesterone acetate (Depo Provera; Upjohn Company, Kalamazoo, MI). More research is needed to determine the effects of patient education and counseling and closer follow-up on effective long-term contraception in HIV-infected women.

  3. Individual freedoms versus collective responsibility: immunization decision-making in the face of occasionally competing values.

    PubMed

    Salmon, Daniel A; Omer, Saad B

    2006-09-27

    transparency of the decision making process.

  4. Individualism-Collectivism as a Boundary Condition for Effectiveness of Minority Influence in Decision Making.

    PubMed

    Ng, K. Yee; Van Dyne, Linn

    2001-03-01

    Results of this experiment demonstrate that individualists and collectivists react differently to minority influence. Based on the distinction between objectivity and preference norms in the minority influence literature, we hypothesize that individualism and collectivism influence (A) responses to minority influence (focusing on the target of influence) and (B) effectiveness of minority influence (focusing on the influence agent). Our results replicate past research and demonstrate improved decision quality for individuals exposed to a minority perspective. Moreover, minority influence targets with high horizontal individualism and low horizontal collectivism made higher quality decisions. Influence targets with high vertical collectivism demonstrated higher quality decisions when the influence agent held a high status position in the group. Results also demonstrate that influence agents with high vertical individualism experienced less role stress than those with low vertical individualism. Finally, influence agents with low role stress were more effective in influencing the decision making of others. We discuss our findings in terms of boundary conditions to the minority influence process. Copyright 2000 Academic Press.

  5. Integration of individual and social information for decision-making in groups of different sizes

    PubMed Central

    Goïame, Sidney; O'Connor, David A.; Dreher, Jean-Claude

    2017-01-01

    When making judgments in a group, individuals often revise their initial beliefs about the best judgment to make given what others believe. Despite the ubiquity of this phenomenon, we know little about how the brain updates beliefs when integrating personal judgments (individual information) with those of others (social information). Here, we investigated the neurocomputational mechanisms of how we adapt our judgments to those made by groups of different sizes, in the context of jury decisions for a criminal. By testing different theoretical models, we showed that a social Bayesian inference model captured changes in judgments better than 2 other models. Our results showed that participants updated their beliefs by appropriately weighting individual and social sources of information according to their respective credibility. When investigating 2 fundamental computations of Bayesian inference, belief updates and credibility estimates of social information, we found that the dorsal anterior cingulate cortex (dACC) computed the level of belief updates, while the bilateral frontopolar cortex (FPC) was more engaged in individuals who assigned a greater credibility to the judgments of a larger group. Moreover, increased functional connectivity between these 2 brain regions reflected a greater influence of group size on the relative credibility of social information. These results provide a mechanistic understanding of the computational roles of the FPC-dACC network in steering judgment adaptation to a group’s opinion. Taken together, these findings provide a computational account of how the human brain integrates individual and social information for decision-making in groups. PMID:28658252

  6. The Impact of Disappointment in Decision Making: Inter-Individual Differences and Electrical Neuroimaging

    PubMed Central

    Tzieropoulos, Hélène; de Peralta, Rolando Grave; Bossaerts, Peter; Andino, Sara L. Gonzalez

    2011-01-01

    Disappointment, the emotion experienced when faced to reward prediction errors (RPEs), considerably impacts decision making (DM). Individuals tend to modify their behavior in an often unpredictable way just to avoid experiencing negative emotions. Despite its importance, disappointment remains much less studied than regret and its impact on upcoming decisions largely unexplored. Here, we adapted the Trust Game to effectively elicit, quantify, and isolate disappointment by relying on the formal definition provided by Bell's in economics. We evaluated the effects of experienced disappointment and elation on future cooperation and trust as well as the rationality and utility of the different behavioral and neural mechanisms used to cope with disappointment. All participants in our game trusted less and particularly expected less from unknown opponents as a result of disappointing outcomes in the previous trial but not necessarily after elation indicating that behavioral consequences of positive and negative RPEs are not the same. A large variance in the tolerance to disappointment was observed across subjects, with some participants needing only a small disappointment to impulsively bias their subsequent decisions. As revealed by high-density EEG recordings the most tolerant individuals – who thought twice before making a decision and earned more money – relied on different neural generators to contend with neutral and unexpected outcomes. This study thus provides some support to the idea that different neural systems underlie reflexive and reflective decisions within the same individuals as predicted by the dual-system theory of social judgment and DM. PMID:21258645

  7. Dopamine Beta Hydroxylase Genotype Identifies Individuals Less Susceptible to Bias in Computer-Assisted Decision Making

    PubMed Central

    Parasuraman, Raja; de Visser, Ewart; Lin, Ming-Kuan; Greenwood, Pamela M.

    2012-01-01

    Computerized aiding systems can assist human decision makers in complex tasks but can impair performance when they provide incorrect advice that humans erroneously follow, a phenomenon known as “automation bias.” The extent to which people exhibit automation bias varies significantly and may reflect inter-individual variation in the capacity of working memory and the efficiency of executive function, both of which are highly heritable and under dopaminergic and noradrenergic control in prefrontal cortex. The dopamine beta hydroxylase (DBH) gene is thought to regulate the differential availability of dopamine and norepinephrine in prefrontal cortex. We therefore examined decision-making performance under imperfect computer aiding in 100 participants performing a simulated command and control task. Based on two single nucleotide polymorphism (SNPs) of the DBH gene, −1041 C/T (rs1611115) and 444 G/A (rs1108580), participants were divided into groups of low and high DBH enzyme activity, where low enzyme activity is associated with greater dopamine relative to norepinephrine levels in cortex. Compared to those in the high DBH enzyme activity group, individuals in the low DBH enzyme activity group were more accurate and speedier in their decisions when incorrect advice was given and verified automation recommendations more frequently. These results indicate that a gene that regulates relative prefrontal cortex dopamine availability, DBH, can identify those individuals who are less susceptible to bias in using computerized decision-aiding systems. PMID:22761865

  8. Real-life decision making in college students. II: Do individual differences show reliable effects?

    PubMed

    Galotti, Kathleen M; Tandler, Jane M; Wiener, Hillary J D

    2014-01-01

    First-year undergraduates participated in a short-term longitudinal study of real-life decision making over their first 14 months of college. They were surveyed about 7 different decisions: choosing courses for upcoming terms (on 3 different occasions), choosing an academic major (twice), planning for the upcoming summer, and planning for sophomore-year housing. They also completed a survey of self-reported decision-making styles and the Need for Cognition survey (Cacioppo & Petty, 1982) to assess their focus on rationality and enjoyment of analytic thinking. Results showed few statistically significant correlations between stylistic measures and behavioral measures of decision making, in either the amount of information considered or the way in which the information integration tracked predictions of linear models of decision making applied to each participant's data. However, there were consistent correlations, across the 7 decisions, between stylistic measures and affective reactions to, or retrospective descriptions of, episodes of decision making. We suggest that decision-making styles instruments may better reflect the construction of narratives of self as a decision maker more than they do actual behavior during decision making.

  9. Individual versus group decision making: Jurors' reliance on central and peripheral information to evaluate expert testimony.

    PubMed

    Salerno, Jessica M; Bottoms, Bette L; Peter-Hagene, Liana C

    2017-01-01

    To investigate dual-process persuasion theories in the context of group decision making, we studied low and high need-for-cognition (NFC) participants within a mock trial study. Participants considered plaintiff and defense expert scientific testimony that varied in argument strength. All participants heard a cross-examination of the experts focusing on peripheral information (e.g., credentials) about the expert, but half were randomly assigned to also hear central information highlighting flaws in the expert's message (e.g., quality of the research presented by the expert). Participants rendered pre- and post-group-deliberation verdicts, which were considered "scientifically accurate" if the verdicts reflected the strong (versus weak) expert message, and "scientifically inaccurate" if they reflected the weak (versus strong) expert message. For individual participants, we replicated studies testing classic persuasion theories: Factors promoting reliance on central information (i.e., central cross-examination, high NFC) improved verdict accuracy because they sensitized individual participants to the quality discrepancy between the experts' messages. Interestingly, however, at the group level, the more that scientifically accurate mock jurors discussed peripheral (versus central) information about the experts, the more likely their group was to reach the scientifically accurate verdict. When participants were arguing for the scientifically accurate verdict consistent with the strong expert message, peripheral comments increased their persuasiveness, which made the group more likely to reach the more scientifically accurate verdict.

  10. [Determinants of clinical decision making in primary care: opinion of physicians].

    PubMed

    Larizgoitia Jáuregui, I; Rodríguez Bermúdez, J R; Granados Navarrete, A

    1998-11-15

    The effective dissemination of scientific information and its adoption by clinicians is the desired outcome of research and the path towards evidence based clinical practice. However, the link between both ends, is not direct and not always attained. Many other determinants play decisive roles in clinical decision making. Their nature, relationship and relative importance are not well understood. We conducted a survey among primary care physicians to ascertain their perception on factors related to clinical decision making. The questionnaire was specifically developed and was administered in face to face interviews by trained interviewers. A multistage clustered sample of 800 physicians representative of all Spanish primary care physicians, was drawn out of Health Service Payroll lists. Frequencies and multivariate logistic regressions were performed using SUDAAN 7.0. Spanish physicians seem to pay special importance to organizational aspects, such as daily demand, administrative regulations or prescription costs. Expert opinion and textbooks appear as the principal source of information, systematic literature reviews are unknown for most physicians. Finally, the majority of them perceive the need for more education. Primary care physicians perceive organizational limitations to their decision making process and are willing to improve their medical knowledge. Additionally, they may benefit from strategies towards the spread of evidence based medicine built on these results, such as using experts to effectively convey evidence based information, increasing opportunities for more education, or developing evidence based sources following textbooks advantages.

  11. Impact of personal economic environment and personality factors on individual financial decision making.

    PubMed

    Prinz, Susanne; Gründer, Gerhard; Hilgers, Ralf D; Holtemöller, Oliver; Vernaleken, Ingo

    2014-01-01

    This study on healthy young male students aimed to enlighten the associations between an individual's financial decision making and surrogate makers for environmental factors covering long-term financial socialization, the current financial security/responsibility, and the personal affinity to financial affairs as represented by parental income, funding situation, and field of study. A group of 150 male young healthy students underwent two versions of the Holt and Laury (2002) lottery paradigm (matrix and random sequential version). Their financial decision was mainly driven by the factor "source of funding": students with strict performance control (grants, scholarships) had much higher rates of relative risk aversion (RRA) than subjects with support from family (ΔRRA = 0.22; p = 0.018). Personality scores only modestly affected the outcome. In an ANOVA, however, also the intelligence quotient significantly and relevantly contributed to the explanation of variance; the effects of parental income and the personality factors "agreeableness" and "openness" showed moderate to modest - but significant - effects. These findings suggest that environmental factors more than personality factors affect risk aversion.

  12. Neural substrates of risky decision making in individuals with Internet addiction.

    PubMed

    Seok, Ji-Woo; Lee, Kyung Hwa; Sohn, Sunju; Sohn, Jin-Hun

    2015-10-01

    With the wide and rapid expansion of computers and smartphones, Internet use has become an essential part of life and an important tool that serves various purposes. Despite the advantages of Internet use, psychological and behavioral problems, including Internet addiction, have been reported. In response to growing concern, researchers have focused on the characteristics of Internet addicts. However, relatively little is known about the behavioral and neural mechanisms that underlie Internet addiction, especially with respect to risky decision making, which is an important domain frequently reported in other types of addictions. To examine the neural characteristics of decision making in Internet addicts, Internet addicts and healthy controls were scanned while they performed a financial decision-making task. Relative to healthy controls, Internet addicts showed (1) more frequent risky decision making; (2) greater activation in the dorsal anterior cingulate cortex and the left caudate nucleus, which are brain regions involved in conflict monitoring and reward, respectively; and (3) less activation in the ventrolateral prefrontal cortex, an area associated with cognitive control/regulation. These findings suggest that risky decision making may be an important behavioral characteristic of Internet addiction and that altered brain function in regions associated with conflict monitoring, reward and cognitive control/regulation might be critical biological risk factors for Internet addiction. © The Royal Australian and New Zealand College of Psychiatrists 2015.

  13. Individual differences in response to uncertainty and decision making: The role of behavioral inhibition system and need for closure.

    PubMed

    Jaśko, Katarzyna; Czernatowicz-Kukuczka, Aneta; Kossowska, Małgorzata; Czarna, Anna Z

    In two studies, we examined the influence of behavioral inhibition system (BIS) and need for closure (NFC) on information processing in decision making. We expected that BIS would regulate behavior in a decisional context and that this relationship would be mediated by epistemic motivation expressed by NFC. In addition, drawing on contradictory findings in the literature on anxiety, NFC, and information processing, we investigated the moderating role of decision rules. The results supported our predictions. BIS was strongly and positively related to NFC, and through NFC it was related to decision-making style. Moreover, decision task characteristics moderated the relationship between NFC and decision making. When a task did not offer a confident decision rule, high NFC participants prolonged the information search more than low NFC individuals. However, when a reliable strategy was suggested, high NFC participants behaved in line with it. These results are discussed within an uncertainty management framework.

  14. Youth Activity Involvement, Neighborhood Adult Support, Individual Decision Making Skills, and Early Adolescent Delinquent Behaviors: Testing a Conceptual Model

    ERIC Educational Resources Information Center

    Crean, Hugh F.

    2012-01-01

    This study examines a cross-sectional structural equation model of participation in youth activities, neighborhood adult support, individual decision making skills, and delinquent behavior in urban middle school youths (n = 2611). Results indicate extracurricular activity participation had both direct and indirect associations with delinquent…

  15. Youth Activity Involvement, Neighborhood Adult Support, Individual Decision Making Skills, and Early Adolescent Delinquent Behaviors: Testing a Conceptual Model

    ERIC Educational Resources Information Center

    Crean, Hugh F.

    2012-01-01

    This study examines a cross-sectional structural equation model of participation in youth activities, neighborhood adult support, individual decision making skills, and delinquent behavior in urban middle school youths (n = 2611). Results indicate extracurricular activity participation had both direct and indirect associations with delinquent…

  16. Individual differences in decision making and reward processing predict changes in cannabis use: a prospective functional magnetic resonance imaging study.

    PubMed

    Cousijn, Janna; Wiers, Reinout W; Ridderinkhof, K Richard; van den Brink, Wim; Veltman, Dick J; Porrino, Linda J; Goudriaan, Anna E

    2013-11-01

    Decision-making deficits are thought to play an important role in the development and persistence of substance use disorders. Individual differences in decision-making abilities and their underlying neurocircuitry may, therefore, constitute an important predictor for the course of substance use and the development of substance use disorders. Here, we investigate the predictive value of decision making and neural mechanisms underlying decision making for future cannabis use and problem severity in a sample of heavy cannabis users. Brain activity during a monetary decision-making task (Iowa gambling task) was compared between 32 heavy cannabis users and 41 matched non-using controls using functional magnetic resonance imaging. In addition, within the group of heavy cannabis users, associations were examined between task-related brain activations, cannabis use and cannabis use-related problems at baseline, and change in cannabis use and problem severity after a 6-month follow-up. Despite normal task performance, heavy cannabis users compared with controls showed higher activation during wins in core areas associated with decision making. Moreover, within the group of heavy cannabis users, win-related activity and activity anticipating loss outcomes in areas generally involved in executive functions predicted change in cannabis use after 6 months. These findings are consistent with previous studies and point to abnormal processing of motivational information in heavy cannabis users. A new finding is that individuals who are biased toward immediate rewards have a higher probability of increasing drug use, highlighting the importance of the relative balance between motivational processes and regulatory executive processes in the development of substance use disorders.

  17. Displacing the Psychology of the Individual in Ethical Decision-Making: The Social Constructivism Model

    ERIC Educational Resources Information Center

    Cottone, R. Rocco

    2004-01-01

    A social constructivism model of ethical decision-making is summarized and related to the Canadian Counseling Association Code of Ethics. Social constructivism is described as an intellectual movement that allows for a biological and social conception of human understanding, thereby superceding or displacing psychological theory. The theoretical…

  18. Expert Knowledge-Based Automatic Sleep Stage Determination by Multi-Valued Decision Making Method

    NASA Astrophysics Data System (ADS)

    Wang, Bei; Sugi, Takenao; Kawana, Fusae; Wang, Xingyu; Nakamura, Masatoshi

    In this study, an expert knowledge-based automatic sleep stage determination system working on a multi-valued decision making method is developed. Visual inspection by a qualified clinician is adopted to obtain the expert knowledge database. The expert knowledge database consists of probability density functions of parameters for various sleep stages. Sleep stages are determined automatically according to the conditional probability. Totally, four subjects were participated. The automatic sleep stage determination results showed close agreements with the visual inspection on sleep stages of awake, REM (rapid eye movement), light sleep and deep sleep. The constructed expert knowledge database reflects the distributions of characteristic parameters which can be adaptive to variable sleep data in hospitals. The developed automatic determination technique based on expert knowledge of visual inspection can be an assistant tool enabling further inspection of sleep disorder cases for clinical practice.

  19. Genetic Factors of Individual Differences in Decision Making in Economic Behavior: A Japanese Twin Study using the Allais Problem

    PubMed Central

    Shikishima, Chizuru; Hiraishi, Kai; Yamagata, Shinji; Ando, Juko; Okada, Mitsuhiro

    2015-01-01

    Why does decision making differ among individuals? People sometimes make seemingly inconsistent decisions with lower expected (monetary) utility even when objective information of probabilities and reward are provided. It is noteworthy, however, that a certain proportion of people do not provide anomalous responses, choosing the alternatives with higher expected utility, thus appearing to be more “rational.” We investigated the genetic and environmental influences on these types of individual differences in decision making using a classical Allais problem task. Participants were 1,199 Japanese adult twins aged 20–47. Univariate genetic analysis revealed that approximately a third of the Allais problem response variance was explained by genetic factors and the rest by environmental factors unique to individuals and measurement error. The environmental factor shared between families did not contribute to the variance. Subsequent multivariate genetic analysis clarified that decision making using the expected utility theory was associated with general intelligence and that the association was largely mediated by the same genetic factor. We approach the mechanism underlying two types of “rational” decision making from the perspective of genetic correlations with cognitive abilities. PMID:26617546

  20. Predicting individual differences in decision-making process from signature movement styles: an illustrative study of leaders

    PubMed Central

    Connors, Brenda L.; Rende, Richard; Colton, Timothy J.

    2013-01-01

    There has been a surge of interest in examining the utility of methods for capturing individual differences in decision-making style. We illustrate the potential offered by Movement Pattern Analysis (MPA), an observational methodology that has been used in business and by the US Department of Defense to record body movements that provide predictive insight into individual differences in decision-making motivations and actions. Twelve military officers participated in an intensive 2-h interview that permitted detailed and fine-grained observation and coding of signature movements by trained practitioners using MPA. Three months later, these subjects completed four hypothetical decision-making tasks in which the amount of information sought out before coming to a decision, as well as the time spent on the tasks, were under the partial control of the subject. A composite MPA indicator of how a person allocates decision-making actions and motivations to balance both Assertion (exertion of tangible movement effort on the environment to make something occur) and Perspective (through movements that support shaping in the body to perceive and create a suitable viewpoint for action) was highly correlated with the total number of information draws and total response time—individuals high on Assertion reached for less information and had faster response times than those high on Perspective. Discussion focuses on the utility of using movement-based observational measures to capture individual differences in decision-making style and the implications for application in applied settings geared toward investigations of experienced leaders and world statesmen where individuality rules the day. PMID:24069012

  1. Using an ethical decision-making model to determine consequences for student plagiarism.

    PubMed

    Kiehl, Ermalynn M

    2006-06-01

    The incidence of plagiarism, intentional or unintentional, in the professional nursing arena has increased in recent years, as has the occurrence of plagiarism among nursing students. Strategies for cheating have become very sophisticated with the use of aids such as personal digital assistants, camera phones, and instant messaging. Cheating on written papers has also increased. The Internet provides students with ready-made research and academic papers, and access to Web sites on a plethora of topics. In this article, I describe my experience with plagiarism of ethics papers during students' final semester before graduation. How I discovered the plagiarized work and used the A-B-C-D-E ethical decision-making model in determining the student consequences for the event are presented.

  2. Resisting the siren call of individualism in pediatric decision-making and the role of relational interests.

    PubMed

    Salter, Erica K

    2014-02-01

    The siren call of individualism is compelling. And although we have recognized its dangerous allure in the realm of adult decision-making, it has had profound and yet unnoticed dangerous effects in pediatric decision-making as well. Liberal individualism as instantiated in the best interest standard conceptualizes the child as independent and unencumbered and the goal of child rearing as rational autonomous adulthood, a characterization that is both ontologically false and normatively dangerous. Although a notion of the individuated child might have a place in establishing a threshold of care obligated and enforced by the state, beyond this context we should turn our attention more explicitly to the relational interests of children.

  3. Determinants and outcomes of decision-making, group coordination and social interactions during a foraging experiment in a wild primate.

    PubMed

    Pyritz, Lennart W; Fichtel, Claudia; Huchard, Elise; Kappeler, Peter M

    2013-01-01

    Social animals have to coordinate joint movements to maintain group cohesion, but the latter is often compromised by diverging individual interests. A widespread behavioral mechanism to achieve coordination relies on shared or unshared consensus decision-making. If consensus costs are high, group fission represents an alternative tactic. Exploring determinants and outcomes of spontaneous group decisions and coordination of free-ranging animals is methodologically challenging. We therefore conducted a foraging experiment with a group of wild redfronted lemurs (Eulemur rufifrons) to study decision outcomes, coordination of movements, individual foraging benefits and social interactions in response to the presentation of drinking platforms with varying baiting patterns. Behavioral observations were complemented with data from recordings of motion detector cameras installed at the platforms. The animal's behavior in the experimental conditions was compared to natural group movements. We could not determine the type of consensus decision-making because the group visited platforms randomly. The group fissioned during 23.3% of platform visits, and fissioning resulted in more individuals drinking simultaneously. As under natural conditions, adult females initiated most group movements, but overtaking by individuals of different age and sex classes occurred in 67% of movements to platforms, compared to only 18% during other movements. As a result, individual resource intake at the platforms did not depend on departure position, age or sex, but on arrival order. Aggression at the platforms did not affect resource intake, presumably due to low supplanting rates. Our findings highlight the diversity of coordination processes and related consequences for individual foraging benefits in a primate group living under natural conditions.

  4. Determinants and Outcomes of Decision-Making, Group Coordination and Social Interactions during a Foraging Experiment in a Wild Primate

    PubMed Central

    Pyritz, Lennart W.; Fichtel, Claudia; Huchard, Elise; Kappeler, Peter M.

    2013-01-01

    Social animals have to coordinate joint movements to maintain group cohesion, but the latter is often compromised by diverging individual interests. A widespread behavioral mechanism to achieve coordination relies on shared or unshared consensus decision-making. If consensus costs are high, group fission represents an alternative tactic. Exploring determinants and outcomes of spontaneous group decisions and coordination of free-ranging animals is methodologically challenging. We therefore conducted a foraging experiment with a group of wild redfronted lemurs (Eulemur rufifrons) to study decision outcomes, coordination of movements, individual foraging benefits and social interactions in response to the presentation of drinking platforms with varying baiting patterns. Behavioral observations were complemented with data from recordings of motion detector cameras installed at the platforms. The animal's behavior in the experimental conditions was compared to natural group movements. We could not determine the type of consensus decision-making because the group visited platforms randomly. The group fissioned during 23.3% of platform visits, and fissioning resulted in more individuals drinking simultaneously. As under natural conditions, adult females initiated most group movements, but overtaking by individuals of different age and sex classes occurred in 67% of movements to platforms, compared to only 18% during other movements. As a result, individual resource intake at the platforms did not depend on departure position, age or sex, but on arrival order. Aggression at the platforms did not affect resource intake, presumably due to low supplanting rates. Our findings highlight the diversity of coordination processes and related consequences for individual foraging benefits in a primate group living under natural conditions. PMID:23326392

  5. Decision making.

    PubMed

    Chambers, David W

    2011-01-01

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

  6. 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

  7. Individualized decision-making in IVF: calculating the chances of pregnancy.

    PubMed

    van Loendersloot, L L; van Wely, M; Repping, S; Bossuyt, P M M; van der Veen, F

    2013-11-01

    Are we able to develop a model to calculate the chances of pregnancy prior to the start of the first IVF cycle as well as after one or more failed cycles? Our prediction model enables the accurate individualized calculation of the probability of an ongoing pregnancy with IVF. To improve counselling, patient selection and clinical decision-making in IVF, a number of prediction models have been developed. These models are of limited use as they were developed before current clinical and laboratory protocols were established. This was a cohort study. The development set included 2621 cycles in 1326 couples who had been treated with IVF or ICSI between January 2001 and July 2009. The validation set included additional data from 515 cycles in 440 couples treated between August 2009 and April 2011. The outcome of interest was an ongoing pregnancy after transfer of fresh or frozen-thawed embryos from the same stimulated IVF cycle. If a couple became pregnant after an IVF/ICSI cycle, the follow-up was at a gestational age of at least 11 weeks. Women treated with IVF or ICSI between January 2001 and April 2011 in a university hospital. IVF/ICSI cycles were excluded in the case of oocyte or embryo donation, surgically retrieved spermatozoa, patients positive for human immunodeficiency virus, modified natural IVF and cycles cancelled owing to poor ovarian stimulation, ovarian hyperstimulation syndrome or other unexpected medical or non-medical reasons. Thirteen variables were included in the final prediction model. For all cycles, these were female age, duration of subfertility, previous ongoing pregnancy, male subfertility, diminished ovarian reserve, endometriosis, basal FSH and number of failed IVF cycles. After the first cycle: fertilization, number of embryos, mean morphological score per Day 3 embryo, presence of 8-cell embryos on Day 3 and presence of morulae on Day 3 were also included. In validation, the model had moderate discriminative capacity (c-statistic 0

  8. Novelty seeking is related to individual risk preference and brain activation associated with risk prediction during decision making

    PubMed Central

    Wang, Ying; Liu, Ying; Yang, Lizhuang; Gu, Feng; Li, Xiaoming; Zha, Rujing; Wei, Zhengde; Pei, Yakun; Zhang, Peng; Zhou, Yifeng; Zhang, Xiaochu

    2015-01-01

    Novelty seeking (NS) is a personality trait reflecting excitement in response to novel stimuli. High NS is usually a predictor of risky behaviour such as drug abuse. However, the relationships between NS and risk-related cognitive processes, including individual risk preference and the brain activation associated with risk prediction, remain elusive. In this fMRI study, participants completed the Tridimensional Personality Questionnaire to measure NS and performed a probabilistic decision making task. Using a mathematical model, we estimated individual risk preference. Brain regions associated with risk prediction were determined via fMRI. The NS score showed a positive correlation with risk preference and a negative correlation with the activation elicited by risk prediction in the right posterior insula (r-PI), left anterior insula (l-AI), right striatum (r-striatum) and supplementary motor area (SMA). Within these brain regions, only the activation associated with risk prediction in the r-PI showed a correlation with NS after controlling for the effect of risk preference. Resting-state functional connectivity between the r-PI and r-striatum/l-AI was negatively correlated with NS. Our results suggest that high NS may be associated with less aversion to risk and that the r-PI plays an important role in relating risk prediction to NS. PMID:26065910

  9. Motivational deficits in effort-based decision making in individuals with subsyndromal depression, first-episode and remitted depression patients.

    PubMed

    Yang, Xin-Hua; Huang, Jia; Zhu, Cui-Ying; Wang, Ye-Fei; Cheung, Eric F C; Chan, Raymond C K; Xie, Guang-Rong

    2014-12-30

    Anhedonia is a hallmark symptom of major depressive disorder (MDD). Preliminary findings suggest that anhedonia is characterized by reduced reward anticipation and motivation of obtaining reward. However, relatively little is known about reward-based decision-making in depression. We tested the hypothesis that anhedonia in MDD may reflect specific impairments in motivation on reward-based decision-making and the deficits might be associated with depressive symptoms severity. In study 1, individuals with and without depressive symptoms performed the modified version of the Effort Expenditure for Rewards Task (EEfRT), a behavioral measure of cost/benefit decision-making. In study 2, MDD patients, remitted MDD patients and healthy controls were recruited for the same procedures. We found evidence for decreased willingness to make effort for rewards among individuals with subsyndromal depression; the effect was amplified in MDD patients, but dissipated in patients with remitted depression. We also found that reduced anticipatory and consummatory pleasure predicted decreased willingness to expend efforts to obtain rewards in MDD patients. For individuals with subsyndromal depression, the impairments were correlated with anticipatory anhedonia but not consummatory anhedonia. These data offer novel evidence that motivational deficits in MDD are correlated with depression severity and predicted by self-reported anhedonia.

  10. Group Dynamics and Decision Making: Backcountry Recreationists in Avalanche Terrain

    ERIC Educational Resources Information Center

    Bright, Leslie Shay

    2010-01-01

    The purpose of this study was to describe and determine the prevalence of decision-making characteristics of recreational backcountry groups when making a decision of where to travel and ride in avalanche terrain from the perspective of individuals. Decision-making characteristics encompassed communication, decision-making processes, leadership,…

  11. Group Dynamics and Decision Making: Backcountry Recreationists in Avalanche Terrain

    ERIC Educational Resources Information Center

    Bright, Leslie Shay

    2010-01-01

    The purpose of this study was to describe and determine the prevalence of decision-making characteristics of recreational backcountry groups when making a decision of where to travel and ride in avalanche terrain from the perspective of individuals. Decision-making characteristics encompassed communication, decision-making processes, leadership,…

  12. Decision-making for non-invasive prenatal testing for Down syndrome: Hong Kong Chinese women's preferences for individual vs relational autonomy.

    PubMed

    Lau, J Y C; Yi, H; Ahmed, S

    2016-05-01

    Individual autonomy in antenatal screening is internationally recognized and supported. Policy and practice guidelines in various countries place emphasis on the woman's right to make her own decision and are related to concepts such as self-determination, independence, and self-sufficiency. In contrast, the dominant perspective in Chinese medical ethics suggests that the family is pivotal in making medical decisions, hence providing support for relational autonomy. This study explored Hong Kong Chinese pregnant women's preferences for individual vs relational autonomy for non-invasive prenatal testing (NIPT) for Down syndrome. A qualitative study was carried out using semi-structured interviews with 36 women who had undertaken NIPT in Hong Kong. The findings show that most Hong Kong Chinese women valued aspects of both relational and individual autonomy in decision-making for NIPT. Women expected support from doctors as experts on the topic and wanted to involve their husband in decision-making while retaining control over the outcome. Somewhat surprisingly, the findings do not provide support for the involvement of family members in decision-making for NIPT. The adequacy of current interpretations of autonomy in prenatal testing policies as an individual approach needs discussion, where policy developers need to find a balance between individual and relational approaches. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Pack-Year Cigarette Smoking History for Determination of Lung Cancer Screening Eligibility. Comparison of the Electronic Medical Record versus a Shared Decision-making Conversation.

    PubMed

    Modin, Hannah E; Fathi, Joelle T; Gilbert, Christopher R; Wilshire, Candice L; Wilson, Andrew K; Aye, Ralph W; Farivar, Alexander S; Louie, Brian E; Vallières, Eric; Gorden, Jed A

    2017-08-01

    Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision-making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision-making, and the potential for the electronic medical record (EMR) to identify eligible individuals have not been well described. Our objectives were to assess the eligibility of individuals referred for lung cancer screening and compare information extracted from the EMR to information derived from a shared decision-making conversation for the determination of eligibility for lung cancer screening. We performed a retrospective analysis of individuals referred to a centralized lung cancer screening program serving a five-hospital health services system in Seattle, Washington between October 2014 and January 2016. Demographics, referral, and outcomes data were collected. A pack-year smoking history derived from the EMR was compared with the pack-year history obtained during a shared decision-making conversation performed by a licensed nurse professional representing the lung cancer screening program. A total of 423 individuals were referred to the program, of whom 59.6% (252 of 423) were eligible. Of those, 88.9% (224 of 252) elected screening. There was 96.2% (230 of 239) discordance in pack-year smoking history between the EMR and the shared decision-making conversation. The EMR underreported pack-years of smoking for 85.2% (196 of 230) of the participants, with a median difference of 29.2 pack-years. If identification of eligible individuals relied solely on the accuracy of the pack-year smoking history recorded in the EMR, 53.6% (128 of 239) would have failed to meet the 30-pack-year threshold for screening. Many individuals referred for lung cancer screening may be ineligible. Overreliance on the EMR for identification of individuals at risk may lead to missed opportunities

  14. Multidisciplinary Child Protection Decision Making About Physical Abuse: Determining Substantiation Thresholds and Biases

    PubMed Central

    Jent, Jason F.; Eaton, Cyd K.; Knickerbocker, Lauren; Lambert, Walter F.; Merrick, Melissa T.; Dandes, Susan K.

    2011-01-01

    The current study examined the threshold at which multidisciplinary child protection team (CPT) professionals substantiate physical abuse allegations and the extent that they utilize potentially biased constructs in their decision making when presented with the same case evidence. State legal definitions of child maltreatment are broad. Therefore, the burden of interpretation is largely on CPT professionals who must determine at what threshold physical acts by parents surpass corporal discipline and constitute child physical abuse. Biased or subjective decisions may be made if certain case-specific characteristics or CPT professionals’ personal characteristics are used in making physical abuse determinations. Case vignettes with visual depictions of inflicted injuries were sent to CPT professionals in Florida and their substantiation decisions, personal beliefs about corporal discipline, and coercive discipline were collected. Results of the study demonstrated relatively high agreement among professionals across vignettes about what constitutes physical abuse. Further, CPT professionals strongly considered their perceptions of the severity of inflicted injuries in substantiation decisions. Although case specific characteristics did not bias decisions in a systematic way, some CPT professional characteristics influenced the substantiation of physical abuse. Practice implications and future directions of research are discussed. PMID:21804681

  15. Prioritizing the Determinants of Social-health Inequality in Iran: A Multiple Attribute Decision Making Application

    PubMed Central

    Zaboli, Rouhollah; Tourani, Sogand; Seyedin, Seyed Hesam; Oliaie Manesh, Alireza

    2014-01-01

    Background: One of the main challenges of healthcare systems of developing countries is health inequality. Health inequality means inequality in individuals’ ability and proper functioning, resulting in inequality in social status and living conditions, which thwarts social interventions implemented by the government. Objectives: This study aimed to determine and prioritize the social determinants of health inequality in Iran. Materials and Methods: This was a mixed method study with two phases of qualitative and quantitative research. The study population consisted of experts dealing with social determinants of health. A purposive, stratified and non-random sampling method was used. Semi-structured interviews were conducted to collect qualitative data along with a multiple attribute decision making method for the quantitative phase of the research in which the TOPSIS technique was employed for prioritization. The qualitative findings were entered into NVivo for analysis, as were the quantitative data entered into MATLAB software. Results: The results approved the suitability of the conceptual framework of social determinants of health suggested by the WHO (world health organization) for studying social determinants of health inequality; however, this framework general and theoretical rather than a guideline for practice. Thus, in this study, 15 themes and 31 sub-themes were determined as social determinants of social health inequality in Iran. Based on the findings of the quantitative phase of our research, socioeconomic status, living facilities such as housing, and social integrity had the greatest effect on decreasing health inequality. Conclusions: A major part of the inequality in health distribution is avoidable because they are mostly caused by adjustable factors like economic conditions, educational conditions, employment, living facilities, etc. As in the majority of developing countries the living and health conditions are the same as Iran, the

  16. Impaired decision making under ambiguity but not under risk in individuals with pathological buying-behavioral and psychophysiological evidence.

    PubMed

    Trotzke, Patrick; Starcke, Katrin; Pedersen, Anya; Müller, Astrid; Brand, Matthias

    2015-09-30

    Pathological buying (PB) is described as dysfunctional buying behavior, associated with harmful consequences. It is discussed whether decision-making deficits are related to PB, because affected individuals often choose the short-term rewarding option of buying despite persistent negative long-term consequences. We investigated 30 patients suffering from PB and 30 matched control participants with two different decision-making tasks: the Iowa Gambling Task (IGT) measures decisions under ambiguity and involves emotional feedback processing, whereas the Game of Dice Task (GDT) measures decisions under risk and can be solved strategically. Potential emotional and cognitive correlates of decision making were investigated by assessing skin conductance response (SCR) and executive functioning. In comparison to the control participants, the patients showed more disadvantageous decisions under ambiguity in the IGT. These data were supported by the SCR results: patients failed to generate SCRs that usually occur before disadvantageous decisions. The physiological and behavioral performance on decisions under risk and executive functioning did not differ between groups. Thus, deficits in emotional feedback processing might be one potential factor in etiology and pathogenesis of PB and should be considered in theory and treatment.

  17. Impact of personal economic environment and personality factors on individual financial decision making

    PubMed Central

    Prinz, Susanne; Gründer, Gerhard; Hilgers, Ralf D.; Holtemöller, Oliver; Vernaleken, Ingo

    2014-01-01

    This study on healthy young male students aimed to enlighten the associations between an individual’s financial decision making and surrogate makers for environmental factors covering long-term financial socialization, the current financial security/responsibility, and the personal affinity to financial affairs as represented by parental income, funding situation, and field of study. A group of 150 male young healthy students underwent two versions of the Holt and Laury (2002) lottery paradigm (matrix and random sequential version). Their financial decision was mainly driven by the factor “source of funding”: students with strict performance control (grants, scholarships) had much higher rates of relative risk aversion (RRA) than subjects with support from family (ΔRRA = 0.22; p = 0.018). Personality scores only modestly affected the outcome. In an ANOVA, however, also the intelligence quotient significantly and relevantly contributed to the explanation of variance; the effects of parental income and the personality factors “agreeableness” and “openness” showed moderate to modest – but significant – effects. These findings suggest that environmental factors more than personality factors affect risk aversion. PMID:24624100

  18. Decision-making in the critically ill neonate: cultural background v individual life experiences.

    PubMed Central

    Hammerman, C; Kornbluth, E; Lavie, O; Zadka, P; Aboulafia, Y; Eidelman, A I

    1997-01-01

    OBJECTIVES: In treating critically ill neonates, situations occasionally arise in which aggressive medical treatment prolongs the inevitable death rather than prolonging life. Decisions as to limitation of neonatal medical intervention remain controversial and the primary responsibility of the generally unprepared family. This research was designed to study response patterns of expectant mothers towards treatment of critically ill and/or malformed infants. DESIGN/SETTING: Attitudes were studied via comprehensive questionnaires divided into three sections: 1-Sociodemographic data and prior personal experience with perinatal problems; 2-Theoretical philosophical principles used in making medical ethical decisions; and 3-Hypothetical case scenarios with choices of treatment options. SUBJECTS AND RESULTS: Six hundred and fifty pregnant women were studied. Maternal birthplace (p = 0.005) and level of religious observance (p = 0.02) were strongly associated with the desire for maximally aggressive medical intervention in the hypothetical case scenario. Specific personal experiences such as infertility problems, previous children with serious mental or physical problems were not correlated with the selection of different treatment choices. Of the theoretical principles studied, only the desire to preserve life at all costs was significantly associated with the choice for maximal medical treatment (p = 0.003). CONCLUSIONS: Maternal ethnocultural background and philosophical principles more profoundly influenced medical ethical decision-making than did specific personal life experiences. PMID:9220330

  19. Medicine Based Evidence for Individualized Decision Making: Case Study of Systemic Lupus Erythematosus.

    PubMed

    Wivel, Ashley E; Lapane, Kate; Kleoudis, Christi; Singer, Burton H; Horwitz, Ralph I

    2017-07-12

    To guide management decisions for an index patient, evidence is required from comparisons between approximate matches to the profile of the index case, where some matches contain responses to treatment and others act as controls. We describe a method for constructing clinically relevant histories/profiles using data collected but unreported from 2 recent phase 3 randomized controlled trials assessing belimumab in subjects with clinically active and serologically positive systemic lupus erythematosus. Outcome was the Systemic lupus erythematosus Responder Index (SRI) measured at 52 weeks. Among 1175 subjects, we constructed an algorithm utilizing 11 trajectory variables including 4 biological, 2 clinical, and 5 social/behavioral. Across all biological and social/behavioral variables, the proportion of responders based on the SRI whose value indicated clinical worsening or no improvement ranged from 27.5% to 42.3%. Kappa values suggested poor agreement, indicating that each biological and patient-reported outcome provides different information than gleaned from the SRI. The richly detailed patient profiles needed to guide decision-making in clinical practice are sharply at odds with the limited information utilized in conventional randomized controlled trial analyses. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Accommodation Decision Making for Postsecondary Students With Learning Disabilities: Individually Tailored or One Size Fits All?

    PubMed

    Weis, Robert; Dean, Emily L; Osborne, Karen J

    2016-09-01

    Clinicians uniformly recommend accommodations for college students with learning disabilities; however, we know very little about which accommodations they select and the validity of their recommendations. We examined the assessment documentation of a large sample of community college students receiving academic accommodations for learning disabilities to determine (a) which accommodations their clinicians recommended and (b) whether clinicians' recommendations were supported by objective data gathered during the assessment process. In addition to test and instructional accommodations, many clinicians recommended that students with learning disabilities should have different educational expectations, standards, and methods of evaluation (i.e., grading) than their nondisabled classmates. Many of their recommendations for accommodations were not supported by objective evidence from students' history, diagnosis, test data, and current functioning. Furthermore, clinicians often recommended accommodations that were not specific to the student's diagnosis or area of disability. Our findings highlight the need for individually selected accommodations matched to students' needs and academic contexts.

  1. Correlation between Social Determinants of Health and Women's Empowerment in Reproductive Decision-Making among Iranian Women.

    PubMed

    Kiani, Zahra; Simbar, Masuomeh; Dolatian, Mahrokh; Zayeri, Farid

    2016-09-01

    Women empowerment is one of millennium development goals which is effective on fertility, population's stability and wellbeing. The influence of social determinants of health (SDH) on women empowerment is documented, however the correlation between SDH and women's empowerment in fertility has not been figured out yet. This study was conducted to assess correlation between social determinants of health and women's empowerment in reproductive decisions. This was a descriptive-correlation study on 400 women who attended health centers affiliated to Shahid Beheshti University of Medical Sciences Tehran-Iran. Four hundred women were recruited using multistage cluster sampling method. The tools for data collection were 6 questionnaires including; 1) socio-demographic characteristics 2) women's empowerment in reproductive decision-making, 3) perceived social support, 4) self-esteem, 5) marital satisfaction, 6) access to health services. Data were analyzed by SPSS-17 and using Pearson and Spearman correlation tests. Results showed 82.54 ± 14.00 (Mean±SD) of total score 152 of women's empowerment in reproductive decision making. All structural and intermediate variables were correlated with women's empowerment in reproductive decisions. The highest correlations were demonstrated between education (among structural determinants; r= 0.44, P< 0.001), and Self-esteem (among intermediate determinants; r= 0.34, P< 0.001) with women's empowerment in fertility decision making. Social determinants of health have a significant correlation with women's empowerment in reproductive decision-making.

  2. Physicians' personal values in determining medical decision-making capacity: a survey study.

    PubMed

    Hermann, Helena; Trachsel, Manuel; Biller-Andorno, Nikola

    2015-09-01

    Decision-making capacity (DMC) evaluations are complex clinical judgements with important ethical implications for patients' self-determination. They are achieved not only on descriptive grounds but are inherently normative and, therefore, dependent on the values held by those involved in the DMC evaluation. To date, the issue of whether and how physicians' personal values relate to DMC evaluation has never been empirically investigated. The present survey study aimed to investigate this question by exploring the relationship between physicians' value profiles and the use of risk-relative standards in capacity evaluations. The findings indicate that physicians' personal values are of some significance in this regard. Those physicians with relatively high scores on the value types of achievement, power-resource, face and conformity to interpersonal standards were more likely to apply risk-relative criteria in a range of situations, using more stringent assessment standards when interventions were riskier. By contrast, those physicians who strongly emphasise hedonism, conformity to rules and universalism concern were more likely to apply equal standards regardless of the consequences of a decision. Furthermore, it has been shown that around a quarter of all respondents do not appreciate that their values impact on their DMC evaluations, highlighting a need to better sensitise physicians in this regard. The implications of these findings are discussed, especially in terms of the moral status of the potential and almost unavoidable influence of physicians' values. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context.

    PubMed

    Jefford, Elaine; Jomeen, Julie; Martin, Colin R

    2016-04-28

    midwifery practice'. EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous.

  4. Sexuality Education for Individuals with Autism Spectrum Disorders: Critical Issues and Decision Making Guidelines

    ERIC Educational Resources Information Center

    Travers, Jason; Tincani, Matt

    2010-01-01

    Individuals with autism spectrum disorders (ASD) present unique needs regarding sexuality education. While the topic of sexuality has received increased attention in the fields of intellectual and developmental disabilities generally, less consideration has focused on the unique needs of individuals with ASD specifically. This paper presents one…

  5. The Effects of Individual Differences in Cognitive Styles on decision-Making Accuracy and Latency

    DTIC Science & Technology

    2003-02-01

    L., Grenblo, P., & Dean, J. B. (2002). Judgmental self-doubt: beliefs about one’s judgmental prowess. Personality and Individual Differences , 33 741...1998). Personal need for structure, the Einstellung task, and the effects of stress. Personality and Individual Differences , 24, 305-310. 29. Somers, M

  6. The Work Experiences of Transgender Individuals: Negotiating the Transition and Career Decision-Making Processes

    ERIC Educational Resources Information Center

    Budge, Stephanie L.; Tebbe, Esther N.; Howard, Kimberly A. S.

    2010-01-01

    This study explored the work experiences of individuals who have started transitioning from their biological sex to a different gender expression through 18 interviews of transgender-identified individuals. Thirteen of the participants identified as male-to-female transsexuals, 2 participants identified as female-to-male transsexuals, 2…

  7. The Work Experiences of Transgender Individuals: Negotiating the Transition and Career Decision-Making Processes

    ERIC Educational Resources Information Center

    Budge, Stephanie L.; Tebbe, Esther N.; Howard, Kimberly A. S.

    2010-01-01

    This study explored the work experiences of individuals who have started transitioning from their biological sex to a different gender expression through 18 interviews of transgender-identified individuals. Thirteen of the participants identified as male-to-female transsexuals, 2 participants identified as female-to-male transsexuals, 2…

  8. Sexuality Education for Individuals with Autism Spectrum Disorders: Critical Issues and Decision Making Guidelines

    ERIC Educational Resources Information Center

    Travers, Jason; Tincani, Matt

    2010-01-01

    Individuals with autism spectrum disorders (ASD) present unique needs regarding sexuality education. While the topic of sexuality has received increased attention in the fields of intellectual and developmental disabilities generally, less consideration has focused on the unique needs of individuals with ASD specifically. This paper presents one…

  9. The effects of individual differences, prior experience and cognitive load on the transfer of dynamic decision-making performance.

    PubMed

    Nicholson, Brad; O'Hare, David

    2014-01-01

    Situational awareness is recognised as an important factor in the performance of individuals and teams in dynamic decision-making (DDM) environments (Salmon et al. 2014 ). The present study was designed to investigate whether the scores on the WOMBAT™ Situational Awareness and Stress Tolerance Test (Roscoe and North 1980 ) would predict the transfer of DDM performance from training under different levels of cognitive load to a novel situation. Participants practised a simulated firefighting task under either low or high conditions of cognitive load and then performed a (transfer) test in an alternative firefighting environment under an intermediate level of cognitive load. WOMBAT™ test scores were a better predictor of DDM performance than scores on the Raven Matrices. Participants with high WOMBAT™ scores performed better regardless of their training condition. Participants with recent gaming experience who practised under low cognitive load showed better practice phase performance but worse transfer performance than those who practised under high cognitive load. The relationship between task experience, situational awareness ability, cognitive load and the transfer of dynamic decision-making (DDM) performance was investigated. Results showed that the WOMBAT™ test predicted transfer of DDM performance regardless of task cognitive load. The effects of cognitive load on performance varied according to previous task-relevant experience.

  10. Matriarchal Decision-Making.

    ERIC Educational Resources Information Center

    Warner, Linda Sue

    In contrast to European cultures, many American Indian societies have been matriarchal. Indian women have had a great deal of power, both as individuals and as groups, and have held various leadership roles within their tribes. Traditionally, Indian women have worked in partnership with men, and decision-making has been related to consensus…

  11. Individual Differences and Fitting Methods for the Two-Choice Diffusion Model of Decision Making

    PubMed Central

    Ratcliff, Roger; Childers, Russ

    2015-01-01

    Methods of fitting the diffusion model were examined with a focus on what the model can tell us about individual differences. Diffusion model parameters were obtained from the fits to data from two experiments and consistency of parameter values, individual differences, and practice effects were examined using different numbers of observations from each subject. Two issues were examined, first, what sizes of differences between groups can be obtained to distinguish between groups and second, what sizes of differences would be needed to find individual subjects that had a deficit relative to a control group. The parameter values from the experiments provided ranges that were used in a simulation study to examine recovery of individual differences. This study used several diffusion model fitting programs, fitting methods, and published packages. In a second simulation study, 64 sets of simulated data from each of 48 sets of parameter values (spanning the range of typical values obtained from fits to data) were fit with the different methods and biases and standard deviations in recovered model parameters were compared across methods. Finally, in a third simulation study, a comparison between a standard chi-square method and a hierarchical Bayesian method was performed. The results from these studies can be used as a starting point for selecting fitting methods and as a basis for understanding the strengths and weaknesses of using diffusion model analyses to examine individual differences in clinical, neuropsychological, and educational testing. PMID:26236754

  12. The Trail Less Traveled: Individual Decision-Making and Its Effect on Group Behavior

    PubMed Central

    Lanan, Michele C.; Dornhaus, Anna; Jones, Emily I.; Waser, Andrew; Bronstein, Judith L.

    2012-01-01

    Social insect colonies are complex systems in which the interactions of many individuals lead to colony-level collective behaviors such as foraging. However, the emergent properties of collective behaviors may not necessarily be adaptive. Here, we examine symmetry breaking, an emergent pattern exhibited by some social insects that can lead colonies to focus their foraging effort on only one of several available food patches. Symmetry breaking has been reported to occur in several ant species. However, it is not clear whether it arises as an unavoidable epiphenomenon of pheromone recruitment, or whether it is an adaptive behavior that can be controlled through modification of the individual behavior of workers. In this paper, we used a simulation model to test how symmetry breaking is affected by the degree of non-linearity of recruitment, the specific mechanism used by individuals to choose between patches, patch size, and forager number. The model shows that foraging intensity on different trails becomes increasingly asymmetric as the recruitment response of individuals varies from linear to highly non-linear, supporting the predictions of previous work. Surprisingly, we also found that the direction of the relationship between forager number (i.e., colony size) and asymmetry varied depending on the specific details of the decision rule used by individuals. Limiting the size of the resource produced a damping effect on asymmetry, but only at high forager numbers. Variation in the rule used by individual ants to choose trails is a likely mechanism that could cause variation among the foraging behaviors of species, and is a behavior upon which selection could act. PMID:23112880

  13. Standardized Individuality: Cosmopolitanism and Educational Decision-Making in an Atlantic Canadian Rural Community

    ERIC Educational Resources Information Center

    Corbett, Michael J.

    2010-01-01

    With the rise of network society, consumerism, individualization, globalization and contemporary change forces, students are pressured to both perform well in standardized academic assessments while at the same time constructing a non-standard, unique project of the self. I argue that this generates a particular set of place-based tensions for…

  14. Clinical Decision Making and Preference Assessment for Individuals with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Virués-Ortega, Javier; Pritchard, Kristen; Grant, Robin L.; North, Sebastian; Hurtado-Parrado, Camilo; Lee, May S. H.; Temple, Bev; Julio, Flavia; Yu, C. T.

    2014-01-01

    Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are…

  15. Clinical Decision Making and Preference Assessment for Individuals with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Virués-Ortega, Javier; Pritchard, Kristen; Grant, Robin L.; North, Sebastian; Hurtado-Parrado, Camilo; Lee, May S. H.; Temple, Bev; Julio, Flavia; Yu, C. T.

    2014-01-01

    Individuals with intellectual or developmental disabilities are able to reliably express their likes and dislikes through direct preference assessment. Preferred items tend to function as rewards and can therefore be used to facilitate the acquisition of new skills and promote task engagement. A number of preference assessment methods are…

  16. Standardized Individuality: Cosmopolitanism and Educational Decision-Making in an Atlantic Canadian Rural Community

    ERIC Educational Resources Information Center

    Corbett, Michael J.

    2010-01-01

    With the rise of network society, consumerism, individualization, globalization and contemporary change forces, students are pressured to both perform well in standardized academic assessments while at the same time constructing a non-standard, unique project of the self. I argue that this generates a particular set of place-based tensions for…

  17. Effects of Using a Web-Based Individualized Education Program Decision-Making Tutorial

    ERIC Educational Resources Information Center

    Shriner, James G.; Carty, Susan J.; Rose, Chad A.; Shogren, Karrie A.; Kim, Myungjin; Trach, John S.

    2013-01-01

    This study explored the effects of a web-based decision support system ("Tutorial") for writing standards-based Individualized Education Programs (IEPs). A total of 35 teachers and 154 students participated across two academic years. Participants were assigned to one of three intervention groups based on level of "Tutorial"…

  18. Correlation between Social Determinants of Health and Women’s Empowerment in Reproductive Decision-Making among Iranian Women

    PubMed Central

    Kiani, Zahra; Simbar, Masuomeh; Dolatian, Mahrokh; Zayeri, Farid

    2016-01-01

    Background and Objectives: Women empowerment is one of millennium development goals which is effective on fertility, population’s stability and wellbeing. The influence of social determinants of health (SDH) on women empowerment is documented, however the correlation between SDH and women’s empowerment in fertility has not been figured out yet. This study was conducted to assess correlation between social determinants of health and women’s empowerment in reproductive decisions. Material and Methods: This was a descriptive-correlation study on 400 women who attended health centers affiliated to Shahid Beheshti University of Medical Sciences Tehran-Iran. Four hundred women were recruited using multistage cluster sampling method. The tools for data collection were 6 questionnaires including; 1) socio-demographic characteristics 2) women’s empowerment in reproductive decision-making, 3) perceived social support, 4) self-esteem, 5) marital satisfaction, 6) access to health services. Data were analyzed by SPSS-17 and using Pearson and Spearman correlation tests. Results: Results showed 82.54 ± 14.00 (Mean±SD) of total score 152 of women’s empowerment in reproductive decision making. All structural and intermediate variables were correlated with women’s empowerment in reproductive decisions. The highest correlations were demonstrated between education (among structural determinants; r= 0.44, P< 0.001), and Self-esteem (among intermediate determinants; r= 0.34, P< 0.001) with women’s empowerment in fertility decision making. Conclusion: Social determinants of health have a significant correlation with women’s empowerment in reproductive decision-making. PMID:27157184

  19. Of goals and habits: age-related and individual differences in goal-directed decision-making.

    PubMed

    Eppinger, Ben; Walter, Maik; Heekeren, Hauke R; Li, Shu-Chen

    2013-01-01

    In this study we investigated age-related and individual differences in habitual (model-free) and goal-directed (model-based) decision-making. Specifically, we were interested in three questions. First, does age affect the balance between model-based and model-free decision mechanisms? Second, are these age-related changes due to age differences in working memory (WM) capacity? Third, can model-based behavior be affected by manipulating the distinctiveness of the reward value of choice options? To answer these questions we used a two-stage Markov decision task in in combination with computational modeling to dissociate model-based and model-free decision mechanisms. To affect model-based behavior in this task we manipulated the distinctiveness of reward probabilities of choice options. The results show age-related deficits in model-based decision-making, which are particularly pronounced if unexpected reward indicates the need for a shift in decision strategy. In this situation younger adults explore the task structure, whereas older adults show perseverative behavior. Consistent with previous findings, these results indicate that older adults have deficits in the representation and updating of expected reward value. We also observed substantial individual differences in model-based behavior. In younger adults high WM capacity is associated with greater model-based behavior and this effect is further elevated when reward probabilities are more distinct. However, in older adults we found no effect of WM capacity. Moreover, age differences in model-based behavior remained statistically significant, even after controlling for WM capacity. Thus, factors other than decline in WM, such as deficits in the in the integration of expected reward value into strategic decisions may contribute to the observed impairments in model-based behavior in older adults.

  20. Information provision and attentive listening as determinants of patient perceptions of shared decision-making around chronic illnesses.

    PubMed

    Del Río-Lanza, Ana-Belén; Suárez-Álvarez, Leticia; Suárez-Vázquez, Ana; Vázquez-Casielles, Rodolfo

    2016-01-01

    While chronic illnesses are a major concern of the health system worldwide, little is known about patients-physicians communication. Growing demand for patient-centered care and shared decision-making have increased the interest for patients-physicians communication. Based on previous literature, we propose a model in which the effect of information provision and attentive listening over patients' perceptions of shared decision-making (PPSDM) is mediated by the variables self-efficacy and proactivity. Primary data were collected between April and August 2014 through an online survey of patients with haemophilia. Haemophilia is a chronic disease in which many options of treatment are available. The right option depends, to some extent, on patient's preferences. In this context, great uncertainty exists when choosing treatment option and shared decision-making plays an essential role. A total of 181 patients with haemophilia participated in the survey. The psychometric properties of the measurement scales were evaluated by means of a confirmatory factor analysis. A structural equation model was designed. Results show that provision of information and attentive listening determine PPSDM through patients' self-efficacy and proactivity in requesting information. It is important to incorporate communication training in medical education, particularly provision of information and attentive listening. These skills help the healthcare professional to gain a deeper understanding of the patient. Furthermore, provision of information and attentive listening are fundamental in helping patients not to undervalue their personal knowledge and expertise in relation to their doctors. These strategies encourage them to adopt a more active position in requesting information. Encouraging a proactive behaviour of patients and their relatives helps them to realize the need to participate and to make them feel that they are part of the decision-making process.

  1. Inter-Individual Decision-Making Differences in the Effects of Cingulate, Orbitofrontal, and Prelimbic Cortex Lesions in a Rat Gambling Task

    PubMed Central

    Rivalan, Marion; Coutureau, Etienne; Fitoussi, Aurélie; Dellu-Hagedorn, Françoise

    2011-01-01

    Deficits in decision-making is a hallmark of several neuropsychiatric pathologies but is also observed in some healthy individuals that could be at risk to develop these pathologies. Poor decision-making can be revealed experimentally in humans using the Iowa gambling task, through the inability to select options that ensure long term gains over larger immediate gratification. We devised an analogous task in the rat, based on uncertainty and conflicting choices, the rat gambling task (RGT). It similarly reveals good and poor performers within a single session. Using this task, we investigated the role of three prefrontal cortical areas, the orbitofrontal, prelimbic, and cingulate cortices on decision-making, taking into account inter-individual variability in behavioral performances. Here, we show that these three distinct subregions are differentially engaged to solve the RGT. Cingulate cortex lesion mainly delayed good decision-making whereas prelimbic and orbitofrontal cortices induced different patterns of inadapted behaviors in the task, indicating varying degree of functional specialization of these three areas. Their contribution largely depended on the level of adaptability demonstrated by each individual to the constraint of the task. The inter-individual differences in the effect of prefrontal cortex area lesions on decision-making revealed in this study open new perspectives in the search for vulnerability markers to develop disorders related to executive dysfunctioning. PMID:21559308

  2. Maladaptive decision making and substance use outcomes in high-risk individuals: preliminary evidence for the role of 5-HTTLPR variation.

    PubMed

    O'Brien, Jessica W; Lichenstein, Sarah D; Hill, Shirley Y

    2014-07-01

    Individuals with multiple alcohol-dependent (AD) relatives are at increased risk for substance use disorders (SUDs). Prospective, longitudinal studies of high-risk (HR) individuals afford the opportunity to determine potential risk markers of SUDs. The current study assessed the effect of familial risk and genetic variation on Iowa Gambling Task (IGT) performance and tested for an association between IGT performance and SUD outcomes. Individuals from multiplex AD families (n = 63) and low-risk (LR; n = 45) control families, ages 16-34 years, were tested using a computerized version of the IGT. SUD outcomes were assessed at approximately yearly intervals. 5-HTTLPR and COMT genotypes were available for the majority of participants (n = 86). HR offspring showed poorer performance overall on the IGT and especially poor performance on the final trial block (Block 5), indicating a failure to improve decision making with previous experience. The 5-HTTLPR short-allele homozygote participants performed worse than long-allele carriers, with HR S/S carriers exhibiting particularly poor performance. There was no main effect of COMT on IGT performance and no significant COMT by Risk interaction. Significantly more individuals in the HR than LR group met criteria for SUD. Importantly, disadvantageous performance on IGT Block 5 was significantly associated with an earlier age at SUD onset. This is the first study to show that both familial risk of SUD and 5-HTTLPR variation impact performance on the IGT. Poorer IGT performance was associated with earlier onset of SUD, suggesting that HR individuals who fail to appropriately attend to long-term costs and benefits during a decision-making task are especially at risk for developing SUD in adolescence and young adulthood.

  3. Composite collective decision-making

    PubMed Central

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

    2015-01-01

    Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. PMID:26019155

  4. Decision Making at a Subcellular Level Determines the Outcome of Bacteriophage Infection

    PubMed Central

    Zeng, Lanying; Skinner, Samuel O.; Sippy, Jean; Feiss, Michael; Golding, Ido

    2010-01-01

    SUMMARY When the process of cell-fate determination is examined at single-cell resolution, it is often observed that individual cells undergo different fates even when subject to identical conditions. This “noisy” phenotype is usually attributed to the inherent stochasticity of chemical reactions in the cell. Here we demonstrate how the observed single-cell heterogeneity can be explained by a cascade of decisions occurring at the sub-cellular level. We follow the post-infection decision in bacteriophage lambda at single-virus resolution, and show that a choice between lysis and lysogeny is first made at the level of the individual virus. The decisions by all viruses infecting a single cell are then integrated in a precise (noise-free) way, such that only a unanimous vote by all viruses leads to the establishment of lysogeny. By detecting and integrating over the sub-cellular “hidden variables”, we are able to predict the level of noise measured at the single-cell level. PMID:20478257

  5. Careership: A Sociological Theory of Career Decision Making.

    ERIC Educational Resources Information Center

    Hodkinson, Phil; Sparkes, Andrew C.

    1997-01-01

    Observes that the current discourse on the school-to-work transition pivots on career decision-making; two views of decision-making exist: one focusing on socially-structured pathways and one focusing on individual freedom to choose. Presents a new model that avoids the pitfalls of social determinism and views young people as completely free…

  6. Do individual differences in Iowa Gambling Task performance predict adaptive decision making for risky gains and losses?

    PubMed

    Weller, Joshua A; Levin, Irwin P; Bechara, Antoine

    2010-02-01

    We relate performance on the Iowa Gambling Task (IGT), a widely used, but complex, neuropsychological task of executive function in which mixed outcomes (gains and losses) are experienced together, to performance on a relatively simpler descriptive task, the Cups task, which isolates adaptive decision making for achieving gains and avoiding losses. We found that poor IGT performance was associated with suboptimal decision making on Cups, especially for risky losses, suggesting that losses are weighted more than gains in the IGT. These findings were significant beyond several notable gender differences in which men outperformed women. Implications for the neuropsychological study of risk are discussed.

  7. Transient emotional events and individual affective traits affect emotion recognition in a perceptual decision-making task

    PubMed Central

    Garcia Quesada, Maria; Antico, Lia; Bavelier, Daphne; Vuilleumier, Patrik; Pichon, Swann

    2017-01-01

    Both affective states and personality traits shape how we perceive the social world and interpret emotions. The literature on affective priming has mostly focused on brief influences of emotional stimuli and emotional states on perceptual and cognitive processes. Yet this approach does not fully capture more dynamic processes at the root of emotional states, with such states lingering beyond the duration of the inducing external stimuli. Our goal was to put in perspective three different types of affective states (induced affective states, more sustained mood states and affective traits such as depression and anxiety) and investigate how they may interact and influence emotion perception. Here, we hypothesized that absorption into positive and negative emotional episodes generate sustained affective states that outlast the episode period and bias the interpretation of facial expressions in a perceptual decision-making task. We also investigated how such effects are influenced by more sustained mood states and by individual affect traits (depression and anxiety) and whether they interact. Transient emotional states were induced using movie-clips, after which participants performed a forced-choice emotion classification task with morphed facial expressions ranging from fear to happiness. Using a psychometric approach, we show that negative (vs. neutral) clips increased participants’ propensity to classify ambiguous faces as fearful during several minutes. In contrast, positive movies biased classification toward happiness only for those clips perceived as most absorbing. Negative mood, anxiety and depression had a stronger effect than transient states and increased the propensity to classify ambiguous faces as fearful. These results provide the first evidence that absorption and different temporal dimensions of emotions have a significant effect on how we perceive facial expressions. PMID:28151976

  8. Transient emotional events and individual affective traits affect emotion recognition in a perceptual decision-making task.

    PubMed

    Qiao-Tasserit, Emilie; Garcia Quesada, Maria; Antico, Lia; Bavelier, Daphne; Vuilleumier, Patrik; Pichon, Swann

    2017-01-01

    Both affective states and personality traits shape how we perceive the social world and interpret emotions. The literature on affective priming has mostly focused on brief influences of emotional stimuli and emotional states on perceptual and cognitive processes. Yet this approach does not fully capture more dynamic processes at the root of emotional states, with such states lingering beyond the duration of the inducing external stimuli. Our goal was to put in perspective three different types of affective states (induced affective states, more sustained mood states and affective traits such as depression and anxiety) and investigate how they may interact and influence emotion perception. Here, we hypothesized that absorption into positive and negative emotional episodes generate sustained affective states that outlast the episode period and bias the interpretation of facial expressions in a perceptual decision-making task. We also investigated how such effects are influenced by more sustained mood states and by individual affect traits (depression and anxiety) and whether they interact. Transient emotional states were induced using movie-clips, after which participants performed a forced-choice emotion classification task with morphed facial expressions ranging from fear to happiness. Using a psychometric approach, we show that negative (vs. neutral) clips increased participants' propensity to classify ambiguous faces as fearful during several minutes. In contrast, positive movies biased classification toward happiness only for those clips perceived as most absorbing. Negative mood, anxiety and depression had a stronger effect than transient states and increased the propensity to classify ambiguous faces as fearful. These results provide the first evidence that absorption and different temporal dimensions of emotions have a significant effect on how we perceive facial expressions.

  9. Patient-Centred Decision-Making? Biocitizens between Evidence-Based Medicine and Self-Determination

    ERIC Educational Resources Information Center

    Jørgensen, Marianne Winther

    2015-01-01

    Nikolas Rose's work on contemporary biopower centres the "biocitizen" as a subject governed through freedom and made individually responsible in matters of health. This article argues that a focus on its conditions of possibility will enable a better contextualisation of the biocitizen as merely one subject position among others. Using a…

  10. Manifestation Determination Reviews and School Team Decision-Making with Students with Emotional/Behavioral Disabilities

    ERIC Educational Resources Information Center

    Walker, Jennifer D.

    2013-01-01

    Manifestation determination teams are required by law to determine the relationship between a student's disability and behaviors that lead to disciplinary action when a student with a disability is either excluded from school for more than 10 days, is put in an interim alternative placement, or is under consideration for a change in placement.…

  11. Manifestation Determination Reviews and School Team Decision-Making with Students with Emotional/Behavioral Disabilities

    ERIC Educational Resources Information Center

    Walker, Jennifer D.

    2013-01-01

    Manifestation determination teams are required by law to determine the relationship between a student's disability and behaviors that lead to disciplinary action when a student with a disability is either excluded from school for more than 10 days, is put in an interim alternative placement, or is under consideration for a change in placement.…

  12. Teachers' Grading Decision Making

    ERIC Educational Resources Information Center

    Isnawati, Ida; Saukah, Ali

    2017-01-01

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

  13. How do patient perceived determinants influence the decision-making process to accept or decline preimplantation genetic screening?

    PubMed

    Gebhart, Marty Brown; Hines, Randall S; Penman, Alan; Holland, Aimee Chism

    2016-01-01

    Identify the determinants that influence the patient's decision-making process when deciding to accept or decline preimplantation genetic screening (PGS) in a given IVF cycle. Pilot, retrospective, cross-sectional study that used a questionnaire containing a combination of quantitative and qualitative items. Private practice IVF clinic. Patients and partners initiating an IVF treatment cycle, both autologous and donor, between October 2012 and January 2015. None. Identification of patient perceived determinants and the importance of each on the decision to accept or decline PGS. Responses from the questionnaire (N = 117) were returned, and of these, 60% accepted PGS. The female response rate was 75% (N = 88) and the male response rate was 25% (N = 29). Ninety-eight percent were Christian (N = 112) and 88% college educated (N = 102) with 39% (N = 40) having some postgraduate education. Sixty-eight percent (N = 79) had no knowledge of PGS before the IVF cycle; however, after provider education, 92% (N = 108) correctly identified that PGS was elective and 93% (N = 109) reported sufficient knowledge to make an informed decision to accept or decline PGS. The additional cost of screening, the provider information and influence, and social support or acceptance from partner, family, and/or friends, were the three statistically significant variables affecting the decision. This is the first study, to the authors' knowledge, to identify and assess the determinants of the patient decision-making process when presented with the choice of PGS. Several factors contribute to the patient-perceived determinants when choosing to accept or decline PGS, including cost, religious and ethical beliefs and values, social and family support, provider influences, and the past reproductive experience of the patient. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  14. An Ethical Decision-Making Model to Determine Authorship Credit in Published Faculty-Student Collaborations

    ERIC Educational Resources Information Center

    Foster, Ryan D.; Ray, Dee C.

    2012-01-01

    Publishing research is imperative to both counselor educators and students in counseling programs. Furthermore, faculty-student publication collaborations can often be a mutually beneficial professional endeavor. However, determining order of authorship can be a complex ethical issue. The authors review prior research to illustrate the…

  15. My Lived Experiences Are More Important Than Your Probabilities: The Role of Individualized Risk Estimates for Decision Making about Participation in the Study of Tamoxifen and Raloxifene (STAR).

    PubMed

    Holmberg, Christine; Waters, Erika A; Whitehouse, Katie; Daly, Mary; McCaskill-Stevens, Worta

    2015-11-01

    Decision-making experts emphasize that understanding and using probabilistic information are important for making informed decisions about medical treatments involving complex risk-benefit tradeoffs. Yet empirical research demonstrates that individuals may not use probabilities when making decisions. To explore decision making and the use of probabilities for decision making from the perspective of women who were risk-eligible to enroll in the Study of Tamoxifen and Raloxifene (STAR). We conducted narrative interviews with 20 women who agreed to participate in STAR and 20 women who declined. The project was based on a narrative approach. Analysis included the development of summaries of each narrative, and thematic analysis with developing a coding scheme inductively to code all transcripts to identify emerging themes. Interviewees explained and embedded their STAR decisions within experiences encountered throughout their lives. Such lived experiences included but were not limited to breast cancer family history, a personal history of breast biopsies, and experiences or assumptions about taking tamoxifen or medicines more generally. Women's explanations of their decisions about participating in a breast cancer chemoprevention trial were more complex than decision strategies that rely solely on a quantitative risk-benefit analysis of probabilities derived from populations In addition to precise risk information, clinicians and risk communicators should recognize the importance and legitimacy of lived experience in individual decision making. © The Author(s) 2015.

  16. The power of subliminal and supraliminal eye contact on social decision making: An individual-difference perspective.

    PubMed

    Luo, Yiqi; Zhang, Shen; Tao, Ran; Geng, Haiyan

    2016-02-01

    We conducted two experiments to explore how social decision making is influenced by the interaction of eye contact and social value orientation (SVO). Specifically, participants with a Prosocial (Prosocials) or a Proself (Proselfs) SVO played Prisoner Dilemma games with a computer partner following supraliminal (Experiment 1) and subliminal (Experiment 2) direct gaze from that partner. Results showed that participants made more cooperative decisions after supraliminal eye contact than no eye contact, and the effect only existed for the Prosocials but not for the Proselfs. Nevertheless, when the computer partner made a subliminal eye contact with the participants, although more cooperative choices were found among the Prosocials following subliminal eye contact, relative to no contact, the Proselfs demonstrated reduced cooperation rates. These findings suggest that Prosocials and Proselfs interpreted eye contact in distinct ways at different levels of awareness, which led to various social decision making. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Categorization = Decision Making + Generalization

    PubMed Central

    Seger, Carol A; Peterson, Erik J.

    2013-01-01

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

  18. Pharmacy patronage: identifying key factors in the decision making process using the determinant attribute approach.

    PubMed

    Franic, Duska M; Haddock, Sarah M; Tucker, Leslie Tootle; Wooten, Nathan

    2008-01-01

    To use the determinant attribute approach, a research method commonly used in marketing to identify the wants of various consumer groups, to evaluate consumer pharmacy choice when having a prescription order filled in different pharmacy settings. Cross sectional. Community independent, grocery store, community chain, and discount store pharmacies in Georgia between April 2005 and April 2006. Convenience sample of adult pharmacy consumers (n = 175). Survey measuring consumer preferences on 26 attributes encompassing general pharmacy site features (16 items), pharmacist characteristics (5 items), and pharmacy staff characteristics (5 items). 26 potential determinant attributes for pharmacy selection. 175 consumers were surveyed at community independent (n = 81), grocery store (n = 44), community chain (n = 27), or discount store (n = 23) pharmacy settings. The attributes of pharmacists and staff at all four pharmacy settings were shown to affect pharmacy patronage motives, although consumers frequenting non-community independent pharmacies were also motivated by secondary convenience factors, e.g., hours of operation, and prescription coverage. Most consumers do not perceive pharmacies as merely prescription-distribution centers that vary only by convenience. Prescriptions are not just another economic good. Pharmacy personnel influence pharmacy selection; therefore, optimal staff selection and training is likely the greatest asset and most important investment for ensuring pharmacy success.

  19. Perinatal Decision Making for Preterm Infants with Congenital Heart Disease: Determinable Risk Factors for Mortality.

    PubMed

    Lynema, Stephanie; Fifer, Carlen G; Laventhal, Naomi T

    2016-06-01

    For premature infants with congenital heart disease (CHD), it may be unclear when the burdens of treatment outweigh potential benefits. Parents may thus have to choose between comfort care at birth and medical stabilization until surgical repair is feasible. Better defined outcome data, including risk factors for mortality, are needed to counsel expectant parents who are considering intensive care for premature infants with CHD. We sought to evaluate outcomes in this population to inform expectant parents considering intensive versus palliative care at birth. We performed a retrospective cohort study of infants born <34 weeks who received intensive care with critical or moderately severe CHD predicted to require surgery in the neonatal period or the first 6 months of life. 46 % of 54 infants survived. Among non-survivors, 74 % died prior to surgery (median age 24 days). Of the infants that underwent surgery, 75 % survived. Survival was lower among infants <32 weeks gestational age (GA) (p = 0.013), with birth weight (BW) <1500 g (p = 0.011), or with extra-cardiac anomalies (ECA) (p = 0.015). GA and ECA remained significant risk factors for mortality in multiple logistic regression analysis. In summary, GA < 32 weeks, BW < 1500 g, and ECA are determinable prenatally and were significant risk factors for mortality. The majority of infants who survived to cardiac intervention survived neonatal hospitalization, whereas most of the infants who died did so prior to surgery. For some expectant parents, this early declaration of mortality may support a trial of intensive care while avoiding burdensome interventions.

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

    PubMed

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

    2013-01-01

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

  1. Interorganizational decision making.

    NASA Technical Reports Server (NTRS)

    Tuite, M. (Editor); Chisholm, R.; Radnor, M.

    1972-01-01

    The papers are both theoretical and applied. They include contributions from a spectrum of academic specializations and from practitioners representing several organizations. The papers are divided into theoretical and applied groupings reflecting a variety of systems levels and institutional examples, and into those papers which emphasized the organization structure requirements of interorganizational decision making, those that emphasized the behavioral requirements of interorganizational decision making, and those that developed decision technologies for interorganizational decision making.

  2. Jumping to Conclusions Style along the Continuum of Delusions: Delusion-Prone Individuals Are Not Hastier in Decision Making than Healthy Individuals

    PubMed Central

    So, Suzanne Ho-wai; Kwok, Nate Tsz-kit

    2015-01-01

    Literature comparing ‘jumping to conclusions’ (JTC) between patients and healthy controls has demonstrated the importance of the reasoning bias in the development of delusions. When groups that vary along the entire delusional continuum are included, the relationship between JTC and delusionality is less clear. This study compared JTC and delusional dimensions between 28 patients with delusions, 35 delusion-prone individuals and 32 non-delusion-prone individuals. Delusion proneness was defined by an established threshold based on the Peters et al. Delusions Inventory. Two versions of the beads task (85:15 and 60:40) were used to measure JTC. As hypothesized, patients manifested hastier data gathering than the two non-clinical groups on both beads tasks. However, delusion-prone individuals did not manifest a hastier decision making style than non-delusion prone individuals. Instead, non-delusion-prone participants showed more JTC bias than delusion-prone individuals on the easier beads task. There was no evidence for a dose-response relationship between JTC and delusional dimensions, with correlations between JTC and PDI scores found in the non-delusion-prone group only. The present finding confirms the link between an extreme JTC bias and the presence of clinical delusions, and argues against a linear relationship between JTC and delusionality along the symptomatic continuum. PMID:25793772

  3. Conceptual Knowledge Influences Decision Making Differently in Individuals with High or Low Cognitive Flexibility: An ERP Study

    PubMed Central

    Dong, Xiaofei; Du, Xiumin; Qi, Bing

    2016-01-01

    Objective Studies using the Iowa Gambling Task (IGT) have distinguished between good and bad decision makers and have provided an explanation for deficits in decision making. Previous studies have demonstrated a link between Wisconsin Card Sorting Test (WCST) performance and IGT performance, but the results were not consistent and failed to explain why WCST performance can predict IGT performance. The present study aimed to demonstrate that WCST performance can predict IGT performance and to identify the cognitive component of the WCST that affects IGT performance using event-related potentials (ERPs). Methods In this study, 39 healthy subjects (5 subjects were excluded) were divided into a high group and a low group based on their global score on the WCST. A single-choice version of the IGT was used to eliminate the impact of retrieval strategies on the choice evaluation process and interference due to uncorrelated decks. Differences in the underlying neural mechanisms and explicit knowledge between the two groups during the three stages of the decision-making process were described. Results Based on the information processing perspective, we divided the decision-making process into three stages: choice evaluation, response selection, and feedback processing. The behavioral results showed that the highly cognitively flexible participants performed better on the IGT and acquired more knowledge of the task. The ERP results showed that during the choice evaluation stage, the P300 recorded from central and parietal regions when a bad deck appeared was larger in the high group participants than in the low group participants. During the response selection stage, the effect of choice type was significant only in the frontal region in the high group, with a larger effect for passing. During the feedback evaluation stage, a larger FRN was evoked for a loss than for a win in the high group, whereas the FRN effect was absent in the low group. Conclusion Compared with the

  4. The Colorado Individual Performance Profile for Hearing-Impaired Students: A Data-Driven Approach to Decision Making.

    ERIC Educational Resources Information Center

    Yoshinaga-Itano, Christine; Ruberry, Joan

    1992-01-01

    The Colorado Individual Performance Profile for Hearing-Impaired Students is presented as a tool for providing objective criteria for determining appropriate levels of educational services. The profile rates each student's audiological acuity, communication, English language skills, social-emotional development, life skills, cognition, and other…

  5. Improving Decision Making.

    ERIC Educational Resources Information Center

    Mehallis, Mantha, Ed.

    1981-01-01

    This collection of essays focuses on the importance of accurate and timely information for effective decision making. First, Ivan Lach considers the proliferation of statewide planning and policy formation and discusses problems with and ways to improve statewide research. Next, Cheryl Opacinch focuses on decision making for federal postsecondary…

  6. Case-based ethics instruction: the influence of contextual and individual factors in case content on ethical decision-making.

    PubMed

    Bagdasarov, Zhanna; Thiel, Chase E; Johnson, James F; Connelly, Shane; Harkrider, Lauren N; Devenport, Lynn D; Mumford, Michael D

    2013-09-01

    Cases have been employed across multiple disciplines, including ethics education, as effective pedagogical tools. However, the benefit of case-based learning in the ethics domain varies across cases, suggesting that not all cases are equal in terms of pedagogical value. Indeed, case content appears to influence the extent to which cases promote learning and transfer. Consistent with this argument, the current study explored the influences of contextual and personal factors embedded in case content on ethical decision-making. Cases were manipulated to include a clear description of the social context and the goals of the characters involved. Results indicated that social context, specifically the description of an autonomy-supportive environment, facilitated execution of sense making processes and resulted in greater decision ethicality. Implications for designing optimal cases and case-based training programs are discussed.

  7. Decision-making process related to treatment and management in Korean women with breast cancer: Finding the right individualized healthcare trajectory.

    PubMed

    Kim, Kkotbong; Yang, Jinhyang

    2017-06-01

    After being diagnosed with breast cancer, women must make a number of decisions about their treatment and management. When the decision-making process among breast cancer patients is ineffective, it results in harm to their health. Little is known about the decision-making process of breast cancer patients during the entire course of treatment and management. We investigated women with breast cancer to explore the decision-making processes related to treatment and management. Eleven women participated, all of whom were receiving treatment or management in Korea. The average participant age was 43.5years. For data collection and analysis, a grounded theory methodology was used. Through constant comparative analyses, a core category emerged that we referred to as "finding the right individualized healthcare trajectory." The decision-making process occurred in four phases: turmoil, exploration, balance, and control. The turmoil phase included weighing the credibility of information and lowering the anxiety level. The exploration phase included assessing the expertise/promptness of medical treatment and evaluating the effectiveness of follow-up management. The balance phase included performing analyses from multiple angles and rediscovering value as a human being. The control phase included constructing an individualized management system and following prescribed and other management options. It is important to provide patients with accurate information related to the treatment and management of breast cancer so that they can make effective decisions. Healthcare providers should engage with patients on issues related to their disease, understand the burden placed on patients because of issues related to their sex, and ensure that the patient has a sufficient support system. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for breast cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. What factors determine the choice of public engagement undertaken by health technology assessment decision-making organizations?

    PubMed

    Wortley, Sally; Street, Jackie; Lipworth, Wendy; Howard, Kirsten

    2016-09-19

    Purpose Public engagement in health technology assessment (HTA) is increasingly considered crucial for good decision making. Determining the "right" type of engagement activity is key in achieving the appropriate consideration of public values. Little is known about the factors that determine how HTA organizations (HTAOs) decide on their method of public engagement, and there are a number of possible factors that might shape these decisions. The purpose of this paper is to understand the potential drivers of public engagement from an organizational perspective. Design/methodology/approach The published HTA literature is reviewed alongside existing frameworks of public engagement in order to elucidate key factors influencing the choice of public engagement process undertaken by HTAOs. A conceptual framework is then developed to illustrate the factors identified from the literature that appear to influence public engagement choice. Findings Determining the type of public engagement undertaken in HTA is based on multiple factors, some of which are not always explicitly acknowledged. These factors included the: perceived complexity of the policy-making issue, perceived impact of the decision, transparency and opportunities for public involvement in governance, as well as time and resource constraints. The influences of these factors vary depending on the context, indicating that a one size fits all approach to public engagement may not be effective. Originality/value Awareness of the various factors that might influence the type of public engagement undertaken would enable decision makers to reflect on their choices and be more accountable and transparent about their choice of engagement process in eliciting public values and preferences in a HTAO.

  9. Decision Making and Cancer

    PubMed Central

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

    2014-01-01

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

  10. Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression

    PubMed Central

    Barr, Paul J; Forcino, Rachel C; Mishra, Manish; Blitzer, Rachel; Elwyn, Glyn

    2016-01-01

    Objective To identify information priorities for consumers and clinicians making depression treatment decisions and assess shared decision-making (SDM) in routine depression care. Design 20 questions related to common features of depression treatments were provided. Participants were initially asked to select which features were important, and in a second stage they were asked to rank their top 5 ‘important features’ in order of importance. Clinicians were asked to provide rankings according to both consumer and clinician perspectives. Consumers completed CollaboRATE, a measure of SDM. Multiple logistic regression analysis identified consumer characteristics associated with CollaboRATE scores. Setting Online cross-sectional surveys fielded in September to December 2014. Participants We administered surveys to convenience samples of US adults with depression and clinicians who treat depression. Consumer sampling was targeted to reflect age, gender and educational attainment of adults with depression in the USA. Primary outcome measures Information priority rankings; CollaboRATE, a 3-item consumer-reported measure of SDM. Results 972 consumers and 244 clinicians completed the surveys. The highest ranked question for both consumers and clinicians was ‘Will the treatment work?’ Clinicians were aware of consumers’ priorities, yet did not always prioritise that information themselves, particularly insurance coverage and cost of treatment. Only 18% of consumers reported high levels of SDM. Working with a psychiatrist (OR 1.87; 95% CI 1.07 to 3.26) and female gender (OR 2.04; 95% CI 1.25 to 3.34) were associated with top CollaboRATE scores. Conclusions While clinicians know what information is important to consumers making depression treatment decisions, they do not always address these concerns. This mismatch, coupled with low SDM, adversely affects the quality of depression care. Development of a decision support intervention based on our findings can improve

  11. Ten myths about decision-making capacity.

    PubMed

    Ganzini, Linda; Volicer, Ladislav; Nelson, William A; Fox, Ellen; Derse, Arthur R

    2005-01-01

    As a matter of practical reality, what role patients will play in decisions about their health care is determined by whether their clinicians judge them to have decision-making capacity. Because so much hinges on assessments of capacity, clinicians who work with patients have an ethical obligation to understand this concept. This article, based on a report prepared by the National Ethics Committee (NEC) of the Veterans Health Administration (VHA), seeks to provide clinicians with practical information about decision-making capacity and how it is assessed. A study of clinicians and ethics committee chairs carried out under the auspices of the NEC identified the following 10 common myths clinicians hold about decision-making capacity: (1) decision-making capacity and competency are the same; (2) lack of decision-making capacity can be presumed when patients go against medical advice; (3) there is no need to assess decision-making capacity unless patients go against medical advice; (4) decision-making capacity is an "all or nothing" phenomenon; (5) cognitive impairment equals lack of decision-making capacity; (6) lack of decision-making capacity is a permanent condition; (7) patients who have not been given relevant and consistent information about their treatment lack decision-making capacity; (8) all patients with certain psychiatric disorders lack decision-making capacity; (9) patients who are involuntarily committed lack decision-making capacity; and (10) only mental health experts can assess decision-making capacity. By describing and debunking these common misconceptions, this article attempts to prevent potential errors in the clinical assessment of decision-making capacity, thereby supporting patients' right to make choices about their own health care.

  12. Ten myths about decision-making capacity.

    PubMed

    Ganzini, Linda; Volicer, Ladislav; Nelson, William A; Fox, Ellen; Derse, Arthur R

    2004-01-01

    As a matter of practical reality, what role patients will play in decisions about their health care is determined by whether their clinicians judge them to have decision-making capacity. Because so much hinges on assessments of capacity, clinicians who work with patients have an ethical obligation to understand this concept. This article, based on a report prepared by the National Ethics Committee (NEC) of the Veterans Health Administration (VHA), seeks to provide clinicians with practical information about decision-making capacity and how it is assessed. A study of clinicians and ethics committee chairs carried out under the auspices of the NEC identified the following 10 common myths clinicians hold about decision-making capacity: (1) decision-making capacity and competency are the same; (2) lack of decision-making capacity can be presumed when patients go against medical advice; (3) there is no need to assess decision-making capacity unless patients go against medical advice; (4) decision-making capacity is an "all or nothing" phenomenon; (5) cognitive impairment equals lack of decision-making capacity; (6) lack of decision-making capacity is a permanent condition; (7) patients who have not been given relevant and consistent information about their treatment lack decision-making capacity; (8) all patients with certain psychiatric disorders lack decision-making capacity; (9) patients who are involuntarily committed lack decision-making capacity; and (10) only mental health experts can assess decision-making capacity. By describing and debunking these common misconceptions, this article attempts to prevent potential errors in the clinical assessment of decision-making capacity, thereby supporting patients' right to make choices about their own health care.

  13. Sustaining the Army Training Mission by Re-Thinking Decision Support Systems: Shifting from Decision-Making Individuals to Sense-Making Agents

    DTIC Science & Technology

    2004-12-01

    traditional concept of decision making as a basically rational process ( Simon 1960). In an effort to reconceptualize decision making, this paper...originates in organization science ( Simon 1960). Decision Support Systems are computer technologies used to support complex decision making in...technical tools supporting the traditional concept of decision making as a basically rational process ( Simon 1960). The techno-centric character of DSS

  14. Individual Variations in Maternal Care Early in Life Correlate with Later Life Decision-Making and c-Fos Expression in Prefrontal Subregions of Rats

    PubMed Central

    van Hasselt, Felisa N.; de Visser, Leonie; Tieskens, Jacintha M.; Cornelisse, Sandra; Baars, Annemarie M.; Lavrijsen, Marla; Krugers, Harm J.; van den Bos, Ruud; Joëls, Marian

    2012-01-01

    Early life adversity affects hypothalamus-pituitary-adrenal axis activity, alters cognitive functioning and in humans is thought to increase the vulnerability to psychopathology–e.g. depression, anxiety and schizophrenia- later in life. Here we investigated whether subtle natural variations among individual rat pups in the amount of maternal care received, i.e. differences in the amount of licking and grooming (LG), correlate with anxiety and prefrontal cortex-dependent behavior in young adulthood. Therefore, we examined the correlation between LG received during the first postnatal week and later behavior in the elevated plus maze and in decision-making processes using a rodent version of the Iowa Gambling Task (rIGT). In our cohort of male and female animals a high degree of LG correlated with less anxiety in the elevated plus maze and more advantageous choices during the last 10 trials of the rIGT. In tissue collected 2 hrs after completion of the task, the correlation between LG and c-fos expression (a marker of neuronal activity) was established in structures important for IGT performance. Negative correlations existed between rIGT performance and c-fos expression in the lateral orbitofrontal cortex, prelimbic cortex, infralimbic cortex and insular cortex. The insular cortex correlations between c-fos expression and decision-making performance depended on LG background; this was also true for the lateral orbitofrontal cortex in female rats. Dendritic complexity of insular or infralimbic pyramidal neurons did not or weakly correlate with LG background. We conclude that natural variations in maternal care received by pups may significantly contribute to later-life decision-making and activity of underlying brain structures. PMID:22693577

  15. Decision Making in Action

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  16. Emotion and decision making.

    PubMed

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

    2015-01-03

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

  17. Decision Making in Action

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  18. COGNITIVE PROCESSES IN CAREER DECISION-MAKING.

    ERIC Educational Resources Information Center

    HILTON, THOMAS L.; AND OTHERS

    THE PROBLEM OF THIS LONGITUDINAL STUDY WAS TO IDENTIFY THE COGNITIVE PROCESSES WHICH ARE INVOLVED IN CAREER DECISION-MAKING AND THE LONG-TERM EFFECTS OF THESE PROCESSES ON CAREER DEVELOPMENT. AREAS OF CONCERN WERE (1) IDENTIFICATION OF STRATEGIES BY WHICH AN INDIVIDUAL CAN OVERCOME DECISION-MAKING DIFFICULTY, (2) ASSESSMENT OF THE SHORT-TERM…

  19. Structure and Style in Career Decision Making.

    ERIC Educational Resources Information Center

    Kortas, Linda; And Others

    1992-01-01

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

  20. Designing for Decision Making

    ERIC Educational Resources Information Center

    Jonassen, David H.

    2012-01-01

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

  1. Sustainability Based Decision Making

    EPA Science Inventory

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

  2. Participative Decision-Making.

    ERIC Educational Resources Information Center

    Lindelow, John; And Others

    Chapter 6 in a volume on school leadership, this chapter makes a case for the use of participative decision-making (PDM) at the school-site level, outlines guidelines for its implementation, and describes the experiences of some schools with PDM systems. It begins by citing research indicating the advantages of PDM, including better decisions,…

  3. Repeated Causal Decision Making

    ERIC Educational Resources Information Center

    Hagmayer, York; Meder, Bjorn

    2013-01-01

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

  4. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

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

  5. Decision Making In Orienteering.

    ERIC Educational Resources Information Center

    Almeida, Katia

    1997-01-01

    Eight psychometric instruments were administered to 10 elite male Portuguese orienteers. The cognitive process involved in decision making did not differ between the best orienteers and the others. This group of athletes had a high capacity for work realization and a strong need to be in control of interpersonal situations. (Author/SV)

  6. Sustainability Based Decision Making

    EPA Science Inventory

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

  7. Shared Decision Making.

    ERIC Educational Resources Information Center

    Lashway, Larry

    1997-01-01

    In shared decision making (SDM), principals collaborate with teachers and sometimes parents to take actions aimed at improving instruction and school climate. While research on SDM outcomes is still inconclusive, the literature shows that SDM brings both benefits and problems, and that the principal is a key figure. This brief offers a sampling of…

  8. Designing for Decision Making

    ERIC Educational Resources Information Center

    Jonassen, David H.

    2012-01-01

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

  9. The Use of Individual Growth and Developmental Indicators for Progress Monitoring and Intervention Decision Making in Early Education

    ERIC Educational Resources Information Center

    Walker, Dale; Carta, Judith J.; Greenwood, Charles R.; Buzhardt, Joseph F.

    2008-01-01

    Progress monitoring tools have been shown to be essential elements in current approaches to intervention problem-solving models. Such tools have been valuable not only in marking individual children's level of performance relative to peers but also in measuring change in skill level in a way that can be attributed to intervention and development.…

  10. Limited role of culture conversion for decision-making in individual patient care and for advancing novel regimens to confirmatory clinical trials.

    PubMed

    Phillips, Patrick P J; Mendel, Carl M; Burger, Divan A; Crook, Angela M; Crook, Angela; Nunn, Andrew J; Dawson, Rodney; Diacon, Andreas H; Gillespie, Stephen H

    2016-02-04

    Despite recent increased clinical trials activity, no regimen has proved able to replace the standard 6-month regimen for drug-sensitive tuberculosis. Understanding the relationship between microbiological markers measured during treatment and long-term clinical outcomes is critical to evaluate their usefulness for decision-making for both individual patient care and for advancing novel regimens into time-consuming and expensive pivotal phase III trials. Using data from the randomized controlled phase III trial REMoxTB, we evaluated sputum-based markers of speed of clearance of bacilli: time to smear negative status; time to culture negative status on LJ or in MGIT; daily rate of change of log10(TTP) to day 56; and smear or culture results at weeks 6, 8 or 12; as individual- and trial-level surrogate endpoints for long-term clinical outcome. Time to culture negative status on LJ or in MGIT, time to smear negative status and daily rate of change in log10(TTP) were each independent predictors of clinical outcome, adjusted for treatment (p <0.001). However, discrimination between low and high risk patients, as measured by the c-statistic, was modest and not much higher than the reference model adjusted for BMI, history of smoking, HIV status, cavitation, gender and MGIT TTP. Culture conversion during treatment for tuberculosis, however measured, has only a limited role in decision-making for advancing regimens into phase III trials or in predicting the outcome of treatment for individual patients. REMoxTB ClinicalTrials.gov number: NCT00864383.

  11. [Decision-making in health].

    PubMed

    Tabuteau, Didler

    2008-01-01

    A number of different types of health decisions and choices can be distinguished from a wide range: individual decisions, health policy decisions, health action decisions, regulatory decisions regarding the health system, micro-level health decisions and decisions made outside of the health sector. With regard to health-related matters, decision-making is characterised by the level of uncertainty, the complexity of the health system and its structure, the role of urgency and the obligation to act; however, there is a significant emotional factor in these decisions and the supremacy of the individual in the decision-making process. On the policy side, health-related decision-making poses questions concerning the role of expertise and necessitates the development of public debate. The issue of a better balance between the quest for security and safety and respect for civil liberties and rights should be more and more acute in the future. As for the matter of health financing, namely through social security and insurance, it calls for a re-examination of the economic analysis of health decisions and policy and the development of a more coherent position on the right to health versus the right to universal coverage.

  12. Decision-Making Rationale for Educational Testing.

    ERIC Educational Resources Information Center

    Clifford, Margaret M.

    Decision-making Rationale for Educational Testing (DRET) is a proposal intended to reduce the misuse of achievement tests. It assumes 1) measurement is intended to facilitate decision-making, 2) the choice of an instrument, the identification of examinees and the use of test results is determined by the decision for which the measurement is to be…

  13. Distributed Decision Making Environment.

    DTIC Science & Technology

    1982-12-01

    of a DDM Testbed 69 4.3.2 Design of Experiments on Distributed 71 Mission Planning 5. AUTOMATED DECISION MAKING TECHNIQUES 76 5.1 SEQUENTIAL...missile assignment scenario. A sequential assignment algorithm has been fully computer implemented and preliminary experiments with it have been run. An...implementation of a distributed version in which several humans can participate in experiments simultaneously. The distributed version will allow L1 us to

  14. Predicting end-stage renal disease: Bayesian perspective of information transfer in the clinical decision-making process at the individual level.

    PubMed

    Dimitrov, Borislav D; Perna, Annalisa; Ruggenenti, Piero; Remuzzi, Giuseppe

    2003-05-01

    Predicting outcomes such as end-stage renal disease (ESRD) by integration and better utilization at individual level of epidemiologic data may facilitate clinical decision-making processes. To predict individual ESRD risk in an average patient in the United States, ESRD prevalence and levels of uncertainty and conditional risk factors independence were considered by population data (1998) and pooled analysis of 11 randomized trials. Data integration and input were by decision-tree simulation approach (simple, parallel, and sequential scenarios) and Bayes' theorem. Sensitivity analysis and risk profiles were employed to address uncertainty and assess different risk factor combinations. A health state values, associated with ESRD outcome levels, were taken from the literature. In this theoretical study, we provided a scholarly example about the use of two known risk factors (urinary protein >/=3 g/day and systolic blood pressure >/=140 mm Hg) to predict individual ESRD risk in an average patient in the United States. The highest posterior (decisional) probability of ESRD occurrence (risk of 3.61% to 5.07%) in the individual patient was associated with the worst health state, as assessed by multidimensional scenarios when both risk factors were present. Decision tree models through an empirical Bayesian approach may serve to predict the individual ESRD risk on the basis of simple epidemiologic, demographic, and clinical information that is easily available already at the first patient evaluation.

  15. Confidence-related decision making.

    PubMed

    Insabato, Andrea; Pannunzi, Mario; Rolls, Edmund T; Deco, Gustavo

    2010-07-01

    Neurons have been recorded that reflect in their firing rates the confidence in a decision. Here we show how this could arise as an emergent property in an integrate-and-fire attractor network model of decision making. The attractor network has populations of neurons that respond to each of the possible choices, each biased by the evidence for that choice, and there is competition between the attractor states until one population wins the competition and finishes with high firing that represents the decision. Noise resulting from the random spiking times of individual neurons makes the decision making probabilistic. We also show that a second attractor network can make decisions based on the confidence in the first decision. This system is supported by and accounts for neuronal responses recorded during decision making and makes predictions about the neuronal activity that will be found when a decision is made about whether to stay with a first decision or to abort the trial and start again. The research shows how monitoring can be performed in the brain and this has many implications for understanding cognitive functioning.

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  18. Decision making in midwifery: rationality and intuition.

    PubMed

    Steinhauer, Suyai

    2015-04-01

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

  19. Energy Reserves, Information Need and a Pinch of Personality Determine Decision-Making on Route in Partially Migratory Blue Tits

    PubMed Central

    Nilsson, Jan-Åke; Mettke-Hofmann, Claudia

    2016-01-01

    In facultative partial migrants some individuals in a population are migratory and others are resident and individuals decide each year anew which strategy to choose. While the proportion of birds migrating is in part determined by environmental conditions and competitive abilities, the timing of individual departure and behaviours on route are little understood. Individuals encounter different environmental conditions when migrating earlier or later. Based on cost/ benefit considerations we tested whether behaviours on route were affected by time constraints, personality and/or age in a partially migrating population of Blue tits (Cyanistes caeruleus). We captured female Blue tits on migration at the Southern tip of Sweden during early, peak and late migration and measured latency to feed in an unfamiliar environment, exploration of a novel object and hesitation to feed beside a novel object (neophobia). Lean birds and birds with long wings started feeding earlier when released into the cage indicating that foraging decisions were mainly determined by energetic needs (lean and large birds). However, juveniles commenced feeding later with progression of the migratory season in concordance with predictions about personality effects. Furthermore, lean birds started to explore earlier than birds with larger fat reserves again indicating an effect of maintaining threshold energy reserves. Moreover, late migrating juveniles, started to explore earlier than early migrating juveniles possibly due to time constraints to find high-quality foraging patches or a suitable winter home. Finally, neophobia did not change over the migratory season indicating that this behaviour is not compromised by time constraints. The results overall indicate that decisions on route are mainly governed by energetic requirements and current needs to learn about the environment and only to a small extent by differences in personality. PMID:27732602

  20. Energy Reserves, Information Need and a Pinch of Personality Determine Decision-Making on Route in Partially Migratory Blue Tits.

    PubMed

    Nilsson, Anna L K; Nilsson, Jan-Åke; Mettke-Hofmann, Claudia

    2016-01-01

    In facultative partial migrants some individuals in a population are migratory and others are resident and individuals decide each year anew which strategy to choose. While the proportion of birds migrating is in part determined by environmental conditions and competitive abilities, the timing of individual departure and behaviours on route are little understood. Individuals encounter different environmental conditions when migrating earlier or later. Based on cost/ benefit considerations we tested whether behaviours on route were affected by time constraints, personality and/or age in a partially migrating population of Blue tits (Cyanistes caeruleus). We captured female Blue tits on migration at the Southern tip of Sweden during early, peak and late migration and measured latency to feed in an unfamiliar environment, exploration of a novel object and hesitation to feed beside a novel object (neophobia). Lean birds and birds with long wings started feeding earlier when released into the cage indicating that foraging decisions were mainly determined by energetic needs (lean and large birds). However, juveniles commenced feeding later with progression of the migratory season in concordance with predictions about personality effects. Furthermore, lean birds started to explore earlier than birds with larger fat reserves again indicating an effect of maintaining threshold energy reserves. Moreover, late migrating juveniles, started to explore earlier than early migrating juveniles possibly due to time constraints to find high-quality foraging patches or a suitable winter home. Finally, neophobia did not change over the migratory season indicating that this behaviour is not compromised by time constraints. The results overall indicate that decisions on route are mainly governed by energetic requirements and current needs to learn about the environment and only to a small extent by differences in personality.

  1. Ethical decision making in the conduct of research: role of individual, contextual and organizational factors. Commentary on "Science, human nature, and a new paradigm for ethics education".

    PubMed

    Langlais, Philip J

    2012-09-01

    Despite the importance of scientific integrity to the well-being of society, recent findings suggest that training and mentoring in the responsible conduct of research are not very reliable or effective inhibitors of research misbehavior. Understanding how and why individual scientists decide to behave in ways that conform to or violate norms and standards of research is essential to the development of more effective training programs and the creation of more supportive environments. Scholars in business management, psychology, and other disciplines have identified many important factors that affect ethical behavior, including individual, contextual, and organizational factors. Surprisingly little research has been conducted to examine the role of these factors in either the development of ethical decision-making skills, or their applicability to ethical issues commonly encountered in research and other scholarly and professional activities. Interdisciplinary approaches combined with research and discipline relevant paradigms should greatly enhance understanding of the individual contextual and organizational factors involved in ethical and unethical research conduct. Such studies will inform and facilitate the development of more effective ethics education programs in the sciences and engineering professions.

  2. Decision making in neonatologia.

    PubMed

    Paterlini, G; Tagliabue, P

    2010-06-01

    The field of neonatology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is characterized by a high level of uncertainty. A sample of neonatologists in different countries received a questionnaire including vignette cases for which no clear consensus exists regarding the (probabilistic) prognosis. They were asked to (I) assess the probability of various outcomes (death, severe impairment) and (II) choose a treatment to be offered to the parents. Information on the physicians' professional and socio-demographic characteristics and their ethical "values" was also collected. The goal of this international survey is to understand the prognosis and to analyze decision making by professionals in the context of life and death in medicine. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. Seventy percent of those invited responded to the questionnaire (International 60-80%). Italian neonatologists seem to be quite pessimistic about the prognosis of infants at high risk of death or long term disabilities, they show a pro-life attitude, but in a certain proportion are willing to change their minds if requested by parents. Furthermore personal opinions predominate in the decision-making process and the contribution of team meeting and/or ethic consultation seem not significantly modify the decisions.

  3. Decision Making Processes and Outcomes

    PubMed Central

    Hicks Patrick, Julie; Steele, Jenessa C.; Spencer, S. Melinda

    2013-01-01

    The primary aim of this study was to examine the contributions of individual characteristics and strategic processing to the prediction of decision quality. Data were provided by 176 adults, ages 18 to 93 years, who completed computerized decision-making vignettes and a battery of demographic and cognitive measures. We examined the relations among age, domain-specific experience, working memory, and three measures of strategic information search to the prediction of solution quality using a 4-step hierarchical linear regression analysis. Working memory and two measures of strategic processing uniquely contributed to the variance explained. Results are discussed in terms of potential advances to both theory and intervention efforts. PMID:24282638

  4. Neural Basis of Strategic Decision Making.

    PubMed

    Lee, Daeyeol; Seo, Hyojung

    2016-01-01

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

  5. Clinical models of decision making in addiction.

    PubMed

    Koffarnus, Mikhail N; Kaplan, Brent A

    2017-08-26

    As research on decision making in addiction accumulates, it is increasingly clear that decision-making processes are dysfunctional in addiction and that this dysfunction may be fundamental to the initiation and maintenance of addictive behavior. How drug-dependent individuals value and choose among drug and nondrug rewards is consistently different from non-dependent individuals. The present review focuses on the assessment of decision-making in addiction. We cover the common behavioral tasks that have shown to be fruitful in decision-making research and highlight analytical and graphical considerations, when available, to facilitate comparisons within and among studies. Delay discounting tasks, drug demand tasks, drug choice tasks, the Iowa Gambling Task, and the Balloon Analogue Risk Task are included. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Simulated Models Suggest That Price per Calorie Is the Dominant Price Metric That Low-Income Individuals Use for Food Decision Making.

    PubMed

    Beheshti, Rahmatollah; Igusa, Takeru; Jones-Smith, Jessica

    2016-11-01

    The price of food has long been considered one of the major factors that affects food choices. However, the price metric (e.g., the price of food per calorie or the price of food per gram) that individuals predominantly use when making food choices is unclear. Understanding which price metric is used is especially important for studying individuals with severe budget constraints because food price then becomes even more important in food choice. We assessed which price metric is used by low-income individuals in deciding what to eat. With the use of data from NHANES and the USDA Food and Nutrient Database for Dietary Studies, we created an agent-based model that simulated an environment representing the US population, wherein individuals were modeled as agents with a specific weight, age, and income. In our model, agents made dietary food choices while meeting their budget limits with the use of 1 of 3 different metrics for decision making: energy cost (price per calorie), unit price (price per gram), and serving price (price per serving). The food consumption patterns generated by our model were compared to 3 independent data sets. The food choice behaviors observed in 2 of the data sets were found to be closest to the simulated dietary patterns generated by the price per calorie metric. The behaviors observed in the third data set were equidistant from the patterns generated by price per calorie and price per serving metrics, whereas results generated by the price per gram metric were further away. Our simulations suggest that dietary food choice based on price per calorie best matches actual consumption patterns and may therefore be the most salient price metric for low-income populations. © 2016 American Society for Nutrition.

  7. Simulation of human decision making

    DOEpatents

    Forsythe, J. Chris; Speed, Ann E.; Jordan, Sabina E.; Xavier, Patrick G.

    2008-05-06

    A method for computer emulation of human decision making defines a plurality of concepts related to a domain and a plurality of situations related to the domain, where each situation is a combination of at least two of the concepts. Each concept and situation is represented in the computer as an oscillator output, and each situation and concept oscillator output is distinguishable from all other oscillator outputs. Information is input to the computer representative of detected concepts, and the computer compares the detected concepts with the stored situations to determine if a situation has occurred.

  8. Decision making in ruminant orthopedics.

    PubMed

    Fessler, J F; Adams, S B

    1996-03-01

    Decision making in ruminant orthopedics is determined by many factors, the most of important of which is age, size, and value of the patient, the nature of the injury, the prognosis for effective treatment and satisfactory healing, the intentions of the client, and the experiences of the veterinarian. Ruminant orthopedics currently is expanding to include the treatment of llamas and small ruminants as companion animals in addition to the treatment of valuable livestock. The future promises increasing sophistication in treatments and an ever higher quality of patient care.

  9. Intergroup Conflict and Rational Decision Making

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Colakkadioglu, Oguzhan; Celik, D. Billur

    2016-01-01

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

  11. [Decision Making and Electrodermal Activity].

    PubMed

    Kobayakawa, Mutsutaka

    2016-08-01

    Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process.

  12. Neural substrates of approach-avoidance conflict decision-making.

    PubMed

    Aupperle, Robin L; Melrose, Andrew J; Francisco, Alex; Paulus, Martin P; Stein, Murray B

    2015-02-01

    Animal approach-avoidance conflict paradigms have been used extensively to operationalize anxiety, quantify the effects of anxiolytic agents, and probe the neural basis of fear and anxiety. Results from human neuroimaging studies support that a frontal-striatal-amygdala neural circuitry is important for approach-avoidance learning. However, the neural basis of decision-making is much less clear in this context. Thus, we combined a recently developed human approach-avoidance paradigm with functional magnetic resonance imaging (fMRI) to identify neural substrates underlying approach-avoidance conflict decision-making. Fifteen healthy adults completed the approach-avoidance conflict (AAC) paradigm during fMRI. Analyses of variance were used to compare conflict to nonconflict (avoid-threat and approach-reward) conditions and to compare level of reward points offered during the decision phase. Trial-by-trial amplitude modulation analyses were used to delineate brain areas underlying decision-making in the context of approach/avoidance behavior. Conflict trials as compared to the nonconflict trials elicited greater activation within bilateral anterior cingulate cortex, anterior insula, and caudate, as well as right dorsolateral prefrontal cortex (PFC). Right caudate and lateral PFC activation was modulated by level of reward offered. Individuals who showed greater caudate activation exhibited less approach behavior. On a trial-by-trial basis, greater right lateral PFC activation related to less approach behavior. Taken together, results suggest that the degree of activation within prefrontal-striatal-insula circuitry determines the degree of approach versus avoidance decision-making. Moreover, the degree of caudate and lateral PFC activation related to individual differences in approach-avoidance decision-making. Therefore, the approach-avoidance conflict paradigm is ideally suited to probe anxiety-related processing differences during approach-avoidance decision-making

  13. Neural substrates of approach-avoidance conflict decision-making

    PubMed Central

    Aupperle, Robin L.; Melrose, Andrew J.; Francisco, Alex; Paulus, Martin P.; Stein, Murray B.

    2014-01-01

    Animal approach-avoidance conflict paradigms have been used extensively to operationalize anxiety, quantify the effects of anxiolytic agents, and probe the neural basis of fear and anxiety. Results from human neuroimaging studies support that a frontal-striatal-amygdala neural circuitry is important for approach-avoidance learning. However, the neural basis of decision-making is much less clear in this context. Thus, we combined a recently developed human approach-avoidance paradigm with functional magnetic resonance imaging (fMRI) to identify neural substrates underlying approach-avoidance conflict decision-making. Fifteen healthy adults completed the approach-avoidance conflict (AAC) paradigm during fMRI. Analyses of variance were used to compare conflict to non-conflict (avoid-threat and approach-reward) conditions and to compare level of reward points offered during the decision phase. Trial-by-trial amplitude modulation analyses were used to delineate brain areas underlying decision-making in the context of approach/avoidance behavior. Conflict trials as compared to the non-conflict trials elicited greater activation within bilateral anterior cingulate cortex (ACC), anterior insula, and caudate, as well as right dorsolateral prefrontal cortex. Right caudate and lateral PFC activation was modulated by level of reward offered. Individuals who showed greater caudate activation exhibited less approach behavior. On a trial-by-trial basis, greater right lateral PFC activation related to less approach behavior. Taken together, results suggest that the degree of activation within prefrontal-striatal-insula circuitry determines the degree of approach versus avoidance decision-making. Moreover, the degree of caudate and lateral PFC activation is related to individual differences in approach-avoidance decision-making. Therefore, the AAC paradigm is ideally suited to probe anxiety-related processing differences during approach-avoidance decision-making. PMID:25224633

  14. Automatic Sleep Stage Determination by Multi-Valued Decision Making Based on Conditional Probability with Optimal Parameters

    NASA Astrophysics Data System (ADS)

    Wang, Bei; Sugi, Takenao; Wang, Xingyu; Nakamura, Masatoshi

    Data for human sleep study may be affected by internal and external influences. The recorded sleep data contains complex and stochastic factors, which increase the difficulties for the computerized sleep stage determination techniques to be applied for clinical practice. The aim of this study is to develop an automatic sleep stage determination system which is optimized for variable sleep data. The main methodology includes two modules: expert knowledge database construction and automatic sleep stage determination. Visual inspection by a qualified clinician is utilized to obtain the probability density function of parameters during the learning process of expert knowledge database construction. Parameter selection is introduced in order to make the algorithm flexible. Automatic sleep stage determination is manipulated based on conditional probability. The result showed close agreement comparing with the visual inspection by clinician. The developed system can meet the customized requirements in hospitals and institutions.

  15. Brain Areas Consistently Linked to Individual Differences in Perceptual Decision-Making in Younger as Well as Older Adults before and after Training

    ERIC Educational Resources Information Center

    Kuhn, Simone; Schmiedek, Florian; Schott, Bjorn; Ratcliff, Roger; Heinze, Hans-Jochen; Duzel, Emrah; Lindenberger, Ulman; Lovden, Martin

    2011-01-01

    Perceptual decision-making performance depends on several cognitive and neural processes. Here, we fit Ratcliff's diffusion model to accuracy data and reaction-time distributions from one numerical and one verbal two-choice perceptual-decision task to deconstruct these performance measures into the rate of evidence accumulation (i.e., drift rate),…

  16. Brain Areas Consistently Linked to Individual Differences in Perceptual Decision-Making in Younger as Well as Older Adults before and after Training

    ERIC Educational Resources Information Center

    Kuhn, Simone; Schmiedek, Florian; Schott, Bjorn; Ratcliff, Roger; Heinze, Hans-Jochen; Duzel, Emrah; Lindenberger, Ulman; Lovden, Martin

    2011-01-01

    Perceptual decision-making performance depends on several cognitive and neural processes. Here, we fit Ratcliff's diffusion model to accuracy data and reaction-time distributions from one numerical and one verbal two-choice perceptual-decision task to deconstruct these performance measures into the rate of evidence accumulation (i.e., drift rate),…

  17. Improving decision making in crisis.

    PubMed

    Higgins, Guy; Freedman, Jennifer

    2013-01-01

    The most critical activity during emergencies or crises is making decisions about what to do next. This paper provides insights into the challenges that people face in making decisions at any time, but particularly during emergencies and crises. It also introduces the reader to the concept of different sense-making/decision-making domains, the human behaviours that can adversely affect decision making - decision derailers - and ways in which emergency responders can leverage this knowledge to make better decisions. While the literature on decision making is extensive, this paper is focused on those aspects that apply particularly to decision making in emergencies or times of crisis.

  18. An optimised IGRT correction vector determined from a displacement vector field: a proof of principle of a decision-making aid for re-planning.

    PubMed

    Stoiber, Eva Maria; Schwarz, Michael; Debus, Jürgen; Bendl, Rolf; Giske, Kristina

    2014-01-01

    To present a new method that determines an optimised IGRT couch correction vector from a displacement vector field (DVF). The DVF is computed by a deformable image registration (DIR) method. The proposed method can improve the quality of volume-of-interest (VOI) alignment in image guided radiation therapy (IGRT), and can serve as a decision-making aid for re-planning. The proposed method was demonstrated using the CT data sets of 11 head-and-neck cancer patients with daily kilovoltage control-CTs. A DVF was computed for each control-CT using a DIR method. The DVF was used for voxel tracking and re-contouring of the VOIs in the control-CTs. Then a rigid body transformation, which could be used as couch correction vector, was optimised. The aim of the optimisation process was to find a vector and rotations that map the deformed VOIs into a specified territory. This territory was defined by a margin extension of the VOIs at the time of the planning process. Within this extension, VOI motion and deformation was tolerated. The objective function in the optimisation process was the sum of all volume fractions outside the defined territories. The proposed method was able to find a correction vector, which resulted in a coverage of the target volumes of at least 98% in 52.3% of all fractions. In contrast, a standard IGRT correction using a rigid registration method only fulfilled this criterion in 22.6% of all fractions. The optimisation process took an average of 1.5 minutes per fraction. The knowledge of the deformation of the anatomy allows the determination of an optimised rigid correction vector using our method. The method ensures controlled mapping of the VOIs despite small deformations. If no optimised vector can be determined, re-planning should be considered. Thus, our method can also serve as a decision-making aid for re-planning.

  19. Mindful judgment and decision making.

    PubMed

    Weber, Elke U; Johnson, Eric J

    2009-01-01

    A full range of psychological processes has been put into play to explain judgment and choice phenomena. Complementing work on attention, information integration, and learning, decision research over the past 10 years has also examined the effects of goals, mental representation, and memory processes. In addition to deliberative processes, automatic processes have gotten closer attention, and the emotions revolution has put affective processes on a footing equal to cognitive ones. Psychological process models provide natural predictions about individual differences and lifespan changes and integrate across judgment and decision making (JDM) phenomena. "Mindful" JDM research leverages our knowledge about psychological processes into causal explanations for important judgment and choice regularities, emphasizing the adaptive use of an abundance of processing alternatives. Such explanations supplement and support existing mathematical descriptions of phenomena such as loss aversion or hyperbolic discounting. Unlike such descriptions, they also provide entry points for interventions designed to help people overcome judgments or choices considered undesirable.

  20. A critical assessment of supported decision-making for persons aging with intellectual disabilities.

    PubMed

    Kohn, Nina A; Blumenthal, Jeremy A

    2014-01-01

    Supported decision-making is increasingly being promoted as an alternative to guardianship for persons aging with intellectual disabilities. Proponents argue that supported decision-making, unlike guardianship, empowers persons with disabilities by providing them with help in making their own decisions, rather than simply providing someone else to make decisions for them. To evaluate the empirical support for these claims, we reviewed the evidence base on supported decision-making. Our review found little such empirical research, suggesting that significant further research is warranted to determine whether--and under what conditions--supported decision-making can benefit persons with intellectual disabilities. Indeed, without more empirical evidence as to how supported decision-making functions in practice, it is too early to rule out the possibility it may actually disempower individuals with disabilities by facilitating undue influence by their alleged supporters. We therefore suggest several key areas for future research. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    PubMed Central

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

    2015-01-01

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

  2. A decision-making tool to determine economic feasibility and break-even prices for artisan cheese operations.

    PubMed

    Durham, Catherine A; Bouma, Andrea; Meunier-Goddik, Lisbeth

    2015-12-01

    Artisan cheese makers lack access to valid economic data to help them evaluate business opportunities and make important business decisions such as determining cheese pricing structure. The objective of this study was to utilize an economic model to evaluate the net present value (NPV), internal rate of return, and payback period for artisan cheese production at different annual production volumes. The model was also used to determine the minimum retail price necessary to ensure positive NPV for 5 different cheese types produced at 4 different production volumes. Milk type, cheese yield, and aging time all affected variable costs. However, aged cheeses required additional investment for aging space (which needs to be larger for longer aging times), as did lower yield cheeses (by requiring larger-volume equipment for pasteurization and milk handling). As the volume of milk required increased, switching from vat pasteurization to high-temperature, short-time pasteurization was necessary for low-yield cheeses before being required for high-yield cheeses, which causes an additional increase in investment costs. Because of these differences, high-moisture, fresh cow milk cheeses can be sold for about half the price of hard, aged goat milk cheeses at the largest production volume or for about two-thirds the price at the lowest production volume examined. For example, for the given model assumptions, at an annual production of 13,608kg of cheese (30,000 lb), a fresh cow milk mozzarella should be sold at a minimum retail price of $27.29/kg ($12.38/lb), whereas a goat milk Gouda needs a minimum retail price of $49.54/kg ($22.47/lb). Artisan cheese makers should carefully evaluate annual production volumes. Although larger production volumes decrease average fixed cost and improve production efficiency, production can reach volumes where it becomes necessary to sell through distributors. Because distributors might pay as little as 35% of retail price, the retail price needs

  3. Fluctuating capacity and advance decision-making in Bipolar Affective Disorder — Self-binding directives and self-determination

    PubMed Central

    Gergel, Tania; Owen, Gareth S.

    2015-01-01

    For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being ‘protected’ through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician–patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research. PMID:25939286

  4. Fluctuating capacity and advance decision-making in Bipolar Affective Disorder - Self-binding directives and self-determination.

    PubMed

    Gergel, Tania; Owen, Gareth S

    2015-01-01

    For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts to establish such provision are hampered by very valid, but also paralysing ethical, clinical and legal concerns. Effectively, the autonomy and rights of people with bipolar are being 'protected' through being denied an opportunity to protect themselves. From a standpoint firmly rooted in the clinical context and experience of mania, this article argues that an SBD, based on a patient-centred evaluation of capacity to make treatment decisions (DMC-T) and grounded within the clinician-patient relationship, could represent a legitimate and ethically coherent form of self-determination. After setting out background information on fluctuating capacity, mania and advance directives, this article proposes a framework for constructing such an SBD, and considers common objections, possible solutions and suggestions for future research.

  5. Understanding Optimal Decision-Making

    DTIC Science & Technology

    2015-06-01

    decision- making. 14. SUBJECT TERMS optimal decision-making, regret, Iowa gambling task, exponentially weighted moving average, change point...Iowa Gambling Task ......................................................... 3 2. Convoy Task...81 ix LIST OF FIGURES Figure 1. The Iowa Gambling Task screenshot (from Sacchi, 2014

  6. Citizen Participation in Decision Making.

    ERIC Educational Resources Information Center

    Paddock, Susan C.; Sferra, Bobbie A.

    This handbook for parents defines and describes the process of citizen participation in educational decision making. After describing the history of citizen involvement, the booklet answers questions regarding why and how community members can become involved in policy formation. Problems in participatory decision making and strategies for…

  7. Electronic Communication and Decision Making.

    ERIC Educational Resources Information Center

    Feldman, M. S.; Sarbaugh-Thompson, M.

    1996-01-01

    Electronic communication can either facilitate or sabotage decision-making contexts. This article formulates recommendations about when and how to use electronic communication to enhance decision making and describes various decision contexts. Solutions to communication problems such as groupthink, social deadlock, bureaucratic isolation from…

  8. Decision Making and Health Education.

    ERIC Educational Resources Information Center

    Duryea, Elias J.

    1983-01-01

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

  9. Decision Making and Health Education.

    ERIC Educational Resources Information Center

    Duryea, Elias J.

    1983-01-01

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

  10. Electronic Communication and Decision Making.

    ERIC Educational Resources Information Center

    Feldman, M. S.; Sarbaugh-Thompson, M.

    1996-01-01

    Electronic communication can either facilitate or sabotage decision-making contexts. This article formulates recommendations about when and how to use electronic communication to enhance decision making and describes various decision contexts. Solutions to communication problems such as groupthink, social deadlock, bureaucratic isolation from…

  11. Decision making in psychiatric emergencies.

    PubMed

    Murdach, A D

    1987-01-01

    Social workers increasingly are being required to assist clients in emergency situations. Such conditions typically require rapid decision making and quick action. In this article, the processes practitioners use in their interventions in psychiatric emergencies are examined. This examination is based on concepts derived from cognitive psychology and decision-making theory. Implications for practice and training also are discussed.

  12. Decision making in surgical oncology.

    PubMed

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients.

  13. Citizen Participation in Decision Making.

    ERIC Educational Resources Information Center

    Paddock, Susan C.; Sferra, Bobbie A.

    This handbook for parents defines and describes the process of citizen participation in educational decision making. After describing the history of citizen involvement, the booklet answers questions regarding why and how community members can become involved in policy formation. Problems in participatory decision making and strategies for…

  14. Decision making in family medicine

    PubMed Central

    Labrecque, Michel; Ratté, Stéphane; Frémont, Pierre; Cauchon, Michel; Ouellet, Jérôme; Hogg, William; McGowan, Jessie; Gagnon, Marie-Pierre; Njoya, Merlin; Légaré, France

    2013-01-01

    Abstract Objective To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process. Design Randomized trial. Setting Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que. Participants Fifteen second-year family medicine residents. Intervention Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database. Main outcome measures The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine’s effect on the decision-making process in clinical practice. Results Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either

  15. Predictors of Decision Making in Families at Risk for Inherited Breast/Ovarian Cancer

    PubMed Central

    Mellon, Suzanne; Janisse, James; Gold, Robin; Cichon, Michelle; Berry-Bobovski, Lisa; Tainsky, Michael A.; Simon, Michael S.

    2014-01-01

    Objective The purpose of this study was to identify factors associated with decision making about inherited cancer risk information within families and determine the interdependence between survivors’ and relatives’ decision making. Design A descriptive, cross-sectional design using a population-based sample of 146 dyads (N=292) was used. Analyses included multilevel modeling using the Actor-Partner-Interdependence Model Main Outcome Measure Decision making was the main outcome, along with the pros and cons in making a decision regarding inherited cancer risk information. Results Overall, results indicate several individual and family factors that survivors and female relatives contribute toward their own and each other’s decision making about inherited cancer risk information. Individual factors included the individual’s perceptions of their family communication and their family’s cancer history. Among family dyadic factors, survivors and family members’ age, communication and coping style influenced the decision making of the other member of the dyad. Cancer worries and a monitoring coping style affected both seeking and avoiding decision making for survivors and their relatives. Conclusions In view of the importance of genetic information upon family health outcomes, it is critical to address both individual and family factors that may influence decision making about cancer risk information and surveillance options for all members within the family. PMID:19210016

  16. Stereotype threat affects financial decision making.

    PubMed

    Carr, Priyanka B; Steele, Claude M

    2010-10-01

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

  17. The amygdala and decision making

    PubMed Central

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

    2010-01-01

    Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala’s role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize “somatic marker” type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an “impulsive,” habit type system that triggers emotional responses to immediate outcomes. PMID:20920513

  18. The involvement of the striatum in decision making.

    PubMed

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

    2016-03-01

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

  19. The involvement of the striatum in decision making

    PubMed Central

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

    2016-01-01

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

  20. Decision making on fitness landscapes

    NASA Astrophysics Data System (ADS)

    Arthur, R.; Sibani, P.

    2017-04-01

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

  1. The neuroscience of social decision-making.

    PubMed

    Rilling, James K; Sanfey, Alan G

    2011-01-01

    Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory setting, and a variety of neuroscience methods have been used to probe the underlying neural systems. This approach is informing our knowledge of the neural mechanisms that support decisions about trust, reciprocity, altruism, fairness, revenge, social punishment, social norm conformity, social learning, and competition. Neural systems involved in reward and reinforcement, pain and punishment, mentalizing, delaying gratification, and emotion regulation are commonly recruited for social decisions. This review also highlights the role of the prefrontal cortex in prudent social decision-making, at least when social environments are relatively stable. In addition, recent progress has been made in understanding the neural bases of individual variation in social decision-making.

  2. Vocational Decision-Making Interview. Administration Manual.

    ERIC Educational Resources Information Center

    Czerlinsky, Thomas; McCray, Paul M.

    This guide is intended to assist rehabilitation counselors, school guidance personnel, and others involved in administering and interpreting the results of the Vocational Decision-Making Interview (VDMI). (The VDMI is a structured interview instrument that was developed to facilitate the assessment of an individual's vocational decision-making…

  3. A meta-synthesis related to infant feeding decision making.

    PubMed

    Nelson, Antonia M

    2012-01-01

    The purpose of this metasynthesis was to synthesize the findings of qualitative research studies related to infant feeding decision making and contribute to an increased understanding of this phenomenon. Noblit and Hare's (1988) metaethnographic, comparative method of synthesizing qualitative studies was utilized. Computerized searches were conducted using the CINAHL, MEDLINE, PsycINFO, and the SocINDEX databases. Articles from indexed journals related to infant feeding decision making published from 1990 to 2011 were reviewed. Fourteen qualitative studies were identified, and all were included in the metasynthesis. Findings were extracted from individual studies and organized in tables to place them in juxtaposition with each other. Comparisons were then made across studies and metaphors written to express a new, broader interpretation. Two processes emerged as central to maternal infant feeding decision making: making a personal choice and defending the choice. In addition six themes were identified indicative of issues that influenced these two processes: knowing "breast is best", disapproval of public breastfeeding, sense of personal comfort, level of confidence/commitment, need for support, and perceived lifestyle compatibility. There is a need for healthcare providers to support women with infant feeding decision making by helping them address issues suggested by this metasynthesis while at the same time respecting their right to self-determination.

  4. Strategies for Teaching Clinical Decision-Making.

    ERIC Educational Resources Information Center

    Boney, Jo; Baker, Jacqueline D.

    1997-01-01

    Research and a literature review suggest that nurses lack skills for effective clinical decision making. An educational program that facilitated development of critical thinking focused on four qualities: determining accuracy of information, determining bias, identifying inconsistencies in reasoning, and evaluating the strength of an argument. (SK)

  5. Decision making: the neuroethological turn

    PubMed Central

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

    2014-01-01

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

  6. Synaptic dynamics and decision making

    PubMed Central

    Deco, Gustavo; Rolls, Edmund T.; Romo, Ranulfo

    2010-01-01

    During decision making between sequential stimuli, the first stimulus must be held in memory and then compared with the second. Here, we show that in systems that encode the stimuli by their firing rate, neurons can use synaptic facilitation not only to remember the first stimulus during the delay but during the presentation of the second stimulus so that they respond to a combination of the first and second stimuli, as has been found for “partial differential” neurons recorded in the ventral premotor cortex during vibrotactile flutter frequency decision making. Moreover, we show that such partial differential neurons provide important input to a subsequent attractor decision-making network that can then compare this combination of the first and second stimuli with inputs from other neurons that respond only to the second stimulus. Thus, both synaptic facilitation and neuronal attractor dynamics can account for sequential decision making in such systems in the brain. PMID:20360555

  7. Decision making: the neuroethological turn.

    PubMed

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

    2014-06-04

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

  8. Mental Illness Disclosure Decision Making.

    PubMed

    Pahwa, Rohini; Fulginiti, Anthony; Brekke, John S; Rice, Eric

    2017-04-10

    Disclosure related to mental illness has been linked to various positive outcomes, including better mental health. However, many individuals with serious mental illness (SMI) continue to practice non-disclosure. Even though disclosure inherently occurs within the context of one's social relationships, research has generally conceptualized mental illness disclosure as an individual level phenomenon and neglected to consider preferences concerning to whom an individual discloses and the factors that influence this decision. The current study uses the disclosure decision-making model (DD-MM) by Greene (2009) to better understand the processes of mental illness disclosure preference and selective disclosure for individuals with SMI (n = 60) using multivariate random intercept logistic regression with an emphasis on the constituent factors of disclosure preference at both individual and relational levels. The majority of participants were found to practice selective disclosure, with 68% of the participants identifying at least 1 network member to whom they could disclose. Family members and friends were central to the selective disclosure process, comprising the greatest proportion of network members who, both were and were not identified as preferred confidants. Women were found to show higher odds of preference for mental illness disclosure than men. Having lower perceived social support was associated with lower odds of disclosure preference. Among relational factors, greater relationship availability and lower dyadic tangible social support were associated with lower odds of disclosure preference. Practice and research implications of using social network analysis to get a deeper understanding of disclosure and disclosure preference are discussed, including implications for future interventions targeting stigma reduction. (PsycINFO Database Record

  9. Wildfire Decision Making Under Uncertainty

    NASA Astrophysics Data System (ADS)

    Thompson, M.

    2013-12-01

    Decisions relating to wildfire management are subject to multiple sources of uncertainty, and are made by a broad range of individuals, across a multitude of environmental and socioeconomic contexts. In this presentation I will review progress towards identification and characterization of uncertainties and how this information can support wildfire decision-making. First, I will review a typology of uncertainties common to wildfire management, highlighting some of the more salient sources of uncertainty and how they present challenges to assessing wildfire risk. This discussion will cover the expanding role of burn probability modeling, approaches for characterizing fire effects, and the role of multi-criteria decision analysis, and will provide illustrative examples of integrated wildfire risk assessment across a variety of planning scales. Second, I will describe a related uncertainty typology that focuses on the human dimensions of wildfire management, specifically addressing how social, psychological, and institutional factors may impair cost-effective risk mitigation. This discussion will encompass decision processes before, during, and after fire events, with a specific focus on active management of complex wildfire incidents. An improved ability to characterize uncertainties faced in wildfire management could lead to improved delivery of decision support, targeted communication strategies, and ultimately to improved wildfire management outcomes.

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

    PubMed

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

    2017-07-01

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

  11. International Students Decision-Making Process

    ERIC Educational Resources Information Center

    Cubillo, Jose Maria; Sanchez, Joaquin; Cervino, Julio

    2006-01-01

    Purpose--The purpose of this paper is to propose a theoretical model that integrates the different groups of factors which influence the decision-making process of international students, analysing different dimensions of this process and explaining those factors which determine students' choice. Design/methodology/approach--A hypothetical model…

  12. Career Decision-Making and Corporate Responsibility

    ERIC Educational Resources Information Center

    Sainty, Rosemary

    2008-01-01

    This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…

  13. International Students Decision-Making Process

    ERIC Educational Resources Information Center

    Cubillo, Jose Maria; Sanchez, Joaquin; Cervino, Julio

    2006-01-01

    Purpose--The purpose of this paper is to propose a theoretical model that integrates the different groups of factors which influence the decision-making process of international students, analysing different dimensions of this process and explaining those factors which determine students' choice. Design/methodology/approach--A hypothetical model…

  14. Emerging Educational Institutional Decision-Making Matrix

    ERIC Educational Resources Information Center

    Ashford-Rowe, Kevin H.; Holt, Marnie

    2011-01-01

    The "emerging educational institutional decision-making matrix" is developed to allow educational institutions to adopt a rigorous and consistent methodology of determining which of the myriad of emerging educational technologies will be the most compelling for the institution, particularly ensuring that it is the educational or pedagogical but…

  15. Pilot Decision-Making in Irreversible Emergencies

    ERIC Educational Resources Information Center

    Winter, Scott R.

    2013-01-01

    The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

  16. Collaborative Strategic Decision Making in School Districts

    ERIC Educational Resources Information Center

    Brazer, S. David; Rich, William; Ross, Susan A.

    2010-01-01

    Purpose: The dual purpose of this paper is to determine how superintendents in US school districts work with stakeholders in the decision-making process and to learn how different choices superintendents make affect decision outcomes. Design/methodology/approach: This multiple case study of three school districts employs qualitative methodology to…

  17. Career Decision-Making and Corporate Responsibility

    ERIC Educational Resources Information Center

    Sainty, Rosemary

    2008-01-01

    This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…

  18. Pilot Decision-Making in Irreversible Emergencies

    ERIC Educational Resources Information Center

    Winter, Scott R.

    2013-01-01

    The purpose of this study was to determine if a reflexive learning treatment utilizing select case studies could enhance the decision-making of pilots who encounter an irreversible emergency. Participants, who consisted of members of the subject university's professional pilot program, were divided into either a control or experimental group and…

  19. Collaborative Strategic Decision Making in School Districts

    ERIC Educational Resources Information Center

    Brazer, S. David; Rich, William; Ross, Susan A.

    2010-01-01

    Purpose: The dual purpose of this paper is to determine how superintendents in US school districts work with stakeholders in the decision-making process and to learn how different choices superintendents make affect decision outcomes. Design/methodology/approach: This multiple case study of three school districts employs qualitative methodology to…

  20. Shared clinical decision making. A Saudi Arabian perspective.

    PubMed

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

    2015-12-01

    To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia.   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.  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).  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.

  1. Cognitive, social, and neural determinants of diminished decision-making and financial exploitation risk in aging and dementia: A review and new model.

    PubMed

    Spreng, R Nathan; Karlawish, Jason; Marson, Daniel C

    2016-01-01

    In this article we will briefly review how changes in brain and in cognitive and social functioning, across the spectrum from normal to pathological aging, can lead to decision-making impairments that increase abuse risk in many life domains (e.g., health care, social engagement, financial management). The review will specifically focus on emerging research identifying neural, cognitive, and social markers of declining financial decision-making capacity in older adults. We will highlight how these findings are opening avenues for early detection and new interventions to reduce exploitation risk.

  2. 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

  3. Speed versus accuracy in collective decision making.

    PubMed Central

    Franks, Nigel R; Dornhaus, Anna; Fitzsimmons, Jon P; Stevens, Martin

    2003-01-01

    We demonstrate a speed versus accuracy trade-off in collective decision making. House-hunting ant colonies choose a new nest more quickly in harsh conditions than in benign ones and are less discriminating. The errors that occur in a harsh environment are errors of judgement not errors of omission because the colonies have discovered all of the alternative nests before they initiate an emigration. Leptothorax albipennis ants use quorum sensing in their house hunting. They only accept a nest, and begin rapidly recruiting members of their colony, when they find within it a sufficient number of their nest-mates. Here we show that these ants can lower their quorum thresholds between benign and harsh conditions to adjust their speed-accuracy trade-off. Indeed, in harsh conditions these ants rely much more on individual decision making than collective decision making. Our findings show that these ants actively choose to take their time over judgements and employ collective decision making in benign conditions when accuracy is more important than speed. PMID:14667335

  4. The neurobiological effects of stress on adolescent decision making.

    PubMed

    Galván, A; Rahdar, A

    2013-09-26

    Relative to other developmental periods, adolescence is characterized by risky decision making, increased perceived stress and heightened reactivity to acute stress. It is also during this time that individuals undergo significant neurodevelopment in brain regions that process decision making and stress. In this review, we summarize what is currently known about stress during adolescence, how it impacts risky decision-making, and how acute stress may exert neurobiological effects on circuitry that subserves decision-making in the developing brain. We conclude by suggesting future research directions that may help the field gain traction on this important, but relatively understudied, question. Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Impaired decision-making and brain shrinkage in alcoholism.

    PubMed

    Le Berre, A-P; Rauchs, G; La Joie, R; Mézenge, F; Boudehent, C; Vabret, F; Segobin, S; Viader, F; Allain, P; Eustache, F; Pitel, A-L; Beaunieux, H

    2014-03-01

    Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (P<0.001, uncorrected). Decision-making deficits in alcoholism may result from impairment of both emotional and cognitive networks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Substituted decision making: elder guardianship.

    PubMed

    Leatherman, Martha E; Goethe, Katherine E

    2009-11-01

    The goal of this column is to help experienced clinicians navigate the judicial system when they are confronted with requests for capacity evaluations that involve guardianship (conservatorship). The interface between the growing elderly medical population and increasing requests for substituted decision making is becoming more complex. This column will help practicing psychiatrists understand the medical, legal, and societal factors involved in adult guardianship. Such understanding is necessary in order to effectively perform guardianship evaluations and adequately inform courts, patients, and families about the psychiatric diagnoses central to substituted decision making.

  7. Decision Making in the Airplane

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  8. Decision Making in the Airplane

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  9. Determining Consistency of Tillage Direction with Soil Erosion Protection Requirements as The Element of Decision-Making Process in Planning and Applying Land Consolidation

    NASA Astrophysics Data System (ADS)

    Bozek, Piotr; Janus, Jaroslaw; Taszakowski, Jaroslaw; Glowacka, Agnieszka

    2016-10-01

    Water erosion is one of the factors which have negative effect on soil productivity. It often leads to irreversible soil degradation, making soil worthless for agricultural activities. One way of preventing water erosion is making the direction of cultivation perpendicular to the direction of rainwater run-off. Matching the direction with the shape of parcels boundaries in small and extended ones is often possible only through changes in the configuration of property boundaries, which is possible only in the process of land consolidation. The article presents methodology of qualifying the areas for changes in boundaries configuration and cultivation direction in view of existing erosion risk. A computation process was suggested that uses, among others, LIDAR data to model the terrain shape precisely as well as cadastral data that defines the geometry of parcels and, resulting from it, the direction of cultivation and form of use. The suggested process includes also the information on the texture of soil upper horizons from soil agricultural maps. The RUSLE erosion model was applied and the computation process took place in ArcGIS environment with the use of dedicated algorithms suggested and implemented to solve the formulated problem. Computations were conducted for test area of several hundred hectares which was characterized by vast diversity of soil types and landforms. The results prove the usefulness of the suggested method as an element of systems that support decision-making processes used in the stage of determining objects chosen for the realization of consolidating processes (including local consolidation, which covers only chosen fragment of a village). They can also be used in the stage of completing detailed plans of parcels distribution in land consolidation process. The importance of the method is particularly seen in the analysis of areas where land fragmentation indices are unfavourable. Especially in these cases, without the reorganization of

  10. The impact of joint partner decision making on obstetric choices and outcomes among Malawian women.

    PubMed

    Rao, Nisha; Esber, Allahna; Turner, Abigail; Chilewani, Joseph; Banda, Venson; Norris, Alison

    2016-10-01

    To determine the effects of joint partner decision making on obstetric choices and outcomes in Malawi. Between July 15, 2014 and February 25, 2015, interviews were performed with women who reported at least one lifetime pregnancy in Lilongwe District, Malawi as part of a cross-sectional study of reproductive decision making. Logistic regression models were applied to examine associations of joint decision making with delivery location and obstetric complications. The study population included 860 women. Women who engaged in joint decision making with partners (adjusted odds ratio [aOR] 4.9; 95% confidence interval [CI] 3.3-7.2) and women whose partners made obstetric-care decisions alone (aOR 3.2; 95% CI 2.4-4.4) were more likely to undergo delivery at a healthcare facility compared with women who made obstetric-care decisions individually. In comparison with women who made obstetric decisions individually, no difference in the likelihood of experiencing obstetric complications was observed for women who engaged in joint decision making (aOR 1.1; 95% CI 0.7-1.7) or for women whose partners made decisions individually (aOR 0.8; 95% CI 0.5-1.3). In rural Malawi, partner involvement in obstetric decision making was associated with improved obstetric choices. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Audience affects decision-making in a marmoset communication network.

    PubMed

    Toarmino, Camille R; Wong, Lauren; Miller, Cory T

    2017-01-01

    An audience can have a profound effect on the dynamics of communicative interactions. As a result, non-human primates often adjust their social decision-making strategies depending on the audience composition at a given time. Here we sought to test how the unique vocal behaviour of multiple audience members affected decisions to communicate. To address this issue, we developed a novel experimental paradigm in which common marmosets directly interacted with multiple 'virtual monkeys' (VMs), each of whom represented an individual marmoset with distinct vocal behaviour. This active social signalling paradigm provided subjects an opportunity to interact with and learn about the behaviour of each VM in the network and apply this knowledge in subsequent communicative decisions. We found that subjects' propensity to interact with particular VMs was determined by the behaviour of each VM in the audience and suggests that marmoset social decision-making strategies are highly adaptive to nuances of the immediate communication network.

  12. Immunizing Children: A Qualitative Analysis of Future Parental Decision Making.

    PubMed

    Espeleta, Hannah C; Beasley, Lana O; Ridings, Leigh E; Smith, Tyler J; Shields, Jennifer D

    2017-10-01

    Vaccinations are considered one of public health's greatest accomplishments. Despite evidence for vaccine effectiveness, uptake levels are still well below the Centers for Disease Control and Prevention's guidelines. The immunization decision-making process for parents is complex and depends on factors associated with knowledge and experiences. This qualitative study sought to expand on a previous decision-making model for immunizations by examining how individuals receive vaccination information, determining the role of experience in influencing decisions, and understanding how young adults might locate vaccination information in the future. Three focus groups were conducted with 29 undergraduate students without children. Results suggest that young adults exhibit an awareness of information regarding vaccine use and effectiveness, value doctor opinions and recommendations, and desire more robust research on vaccinations. Implications of these results include the importance of (1) disseminating vaccination education to young adults, (2) enhancing consistency/trust between medical professionals and youth, and (3) expanding public policy to increase vaccine uptake.

  13. Clinical decision making associated with an undetected odontoid fracture in an older individual referred to physical therapy for the treatment of neck pain.

    PubMed

    Ross, Michael D; Cheeks, John M

    2008-07-01

    Resident's case problem. The purpose of this paper is to provide the examination of and decision-making process for a patient referred to physical therapy for the treatment of neck pain following trauma. She was found to have an underlying odontoid fracture that precluded physical therapy intervention. This case involved a 73-year-old woman who had a sudden onset of neck and left upper extremity pain after a fall 15 days prior to her initial physical therapy visit. Conventional cervical spine radiographs completed 1 day prior to her initial physical therapy visit were negative for a fracture. However, several components of this patient's history and physical examination were consistent with a condition for which physical therapy intervention would not be indicated until more definitive cervical spine diagnostic imaging had been completed; more specifically, the physical therapist was primarily concerned about the possibility of an undetected fracture. The referring physician was contacted and immediate magnetic resonance imaging was requested, which revealed a type II fracture of the odontoid. Thirty-four days after her fall, the patient underwent a C1-C2 fusion. When evaluating patients with neck pain who have a history of cervical spine trauma, it is important that physical therapists understand the clinical findings associated with cervical spine fractures, as these findings provide guidance for the use of cervical spine diagnostic imaging and medical referral prior to implementing physical therapy interventions. Diagnosis, level 4.

  14. Teaching Empathy and Ethical Decision Making in Business Schools

    ERIC Educational Resources Information Center

    Baker, Diane F.

    2017-01-01

    Researchers in behavioral ethics seek to understand how individuals respond to the ethical dilemmas in their lives. In any given situation, multiple social and psychological variables interact to influence ethical decision making. The purpose of this article is to explore how one such variable, empathy, affects the ethical decision-making process…

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

    ERIC Educational Resources Information Center

    James, Constance R.; Smith, J. Goosby

    2007-01-01

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

  16. Decision Making: The Underdeveloped Skill

    ERIC Educational Resources Information Center

    Phelps, Robert

    1974-01-01

    Business educators should give students specific training in a methodology which will enable them to make logical, systematic, and rational decisions. Kepner-Tregoe Analysis (KTA), a decision making model, is described and illustrated with an example of a student buying his first car. (SC)

  17. Ethical Decision Making: Basic Issues

    ERIC Educational Resources Information Center

    Bradley, Loretta J.; Hendricks, C. Bret

    2008-01-01

    Among counselors, ethical dilemmas occur often. Although ethical dilemmas are challenging, they can be solved by implementing a code of ethics and/or an ethical decision-making model. Using case studies, the authors illustrate how counselors can make informed, accurate decisions that are made to protect the welfare of the client. It also helps…

  18. Decision Making: A Linear Process.

    ERIC Educational Resources Information Center

    Hewes, Dorothy W.

    1998-01-01

    Describes a linear process of decision making to enhance management skills of day care directors. Includes decision-processing flow chart compiled from several professional disciplines to help managers recognize flexibility of linear system. Provides analysis of flow-chart steps to balance both artistic and pragmatic considerations. (LBT)

  19. Enhanced decision making through neuroscience

    NASA Astrophysics Data System (ADS)

    Szu, Harold; Jung, TP; Makeig, Scott

    2012-06-01

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

  20. Decision Making and Environmental Problems

    ERIC Educational Resources Information Center

    Thompson, Bertha Boya

    1977-01-01

    Suggests a decision-making model that can be applied by high school students to a variety of environmental problems, and illustrates how the model can be used to make decisions concerning future energy shortages. Provides criteria for judging allocation priorities of limited resources and stimulates awareness of alternative solutions to energy…

  1. Decision Making and Environmental Problems

    ERIC Educational Resources Information Center

    Thompson, Bertha Boya

    1977-01-01

    Suggests a decision-making model that can be applied by high school students to a variety of environmental problems, and illustrates how the model can be used to make decisions concerning future energy shortages. Provides criteria for judging allocation priorities of limited resources and stimulates awareness of alternative solutions to energy…

  2. Electroencephalogy (EEG) Feedback in Decision-Making

    DTIC Science & Technology

    2015-08-26

    P.O. Box 12211 Research Triangle Park, NC 27709-2211 Brain -Computer Interface, Training, Decision Making REPORT DOCUMENTATION PAGE 11. SPONSOR...approach traditionally used in single-trial BCI ( Brain -Computer Interface) tasks suggested a similar effect-size and scalp distribution. However...screener   Individual differences in brain morphology, skin conductance, and skull shape can all lead to varying levels of signal-to-noise in

  3. "Don't worry, it's just poker!"--experience, self-rumination and self-reflection as determinants of decision-making in on-line poker.

    PubMed

    Palomäki, Jussi; Laakasuo, Michael; Salmela, Mikko

    2013-09-01

    On-line poker is a game of chance and skill. The construct of poker playing skill has both a technical (game strategy-related) and an emotional (emotion regulation-related) aspect. A correlational on-line study (N = 354) was conducted to assess differences in technical skills and emotional characteristics related to poker playing style between experienced and inexperienced poker players. Results suggest that, with respect to emotional characteristics, experienced poker players engage in less self-rumination and more self-reflection, as compared to inexperienced players. Experienced poker players are also able to make better decisions, by mathematical standards, in a poker decision-making environment, as assessed by two fictitious on-line poker decision-making scenarios. Furthermore, this study provides supportive evidence that experienced poker players conceptualize the construct of "luck" differently from inexperienced players. A new poker playing experience scale (PES) for accurately measuring poker playing experience is presented in this paper.

  4. Structuring Decision-Making in Multidisciplinary Teams.

    ERIC Educational Resources Information Center

    Kabler, Michael L.; Genshaft, Judy L.

    1983-01-01

    Three areas related to decision making are discussed: (1) a research survey summary of multidisciplinary team decision making (MTD); (2) four approaches for structuring MTD decision making; and (3) styles of leadership as a factor that impacts on the decision-making teams. (Author/PN)

  5. An ABC for decision making.

    PubMed

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.

  6. Dynamics of Sequential Decision Making

    NASA Astrophysics Data System (ADS)

    Rabinovich, Mikhail I.; Huerta, Ramón; Afraimovich, Valentin

    2006-11-01

    We suggest a new paradigm for intelligent decision-making suitable for dynamical sequential activity of animals or artificial autonomous devices that depends on the characteristics of the internal and external world. To do it we introduce a new class of dynamical models that are described by ordinary differential equations with a finite number of possibilities at the decision points, and also include rules solving this uncertainty. Our approach is based on the competition between possible cognitive states using their stable transient dynamics. The model controls the order of choosing successive steps of a sequential activity according to the environment and decision-making criteria. Two strategies (high-risk and risk-aversion conditions) that move the system out of an erratic environment are analyzed.

  7. Group performance and decision making.

    PubMed

    Kerr, Norbert L; Tindale, R Scott

    2004-01-01

    Theory and research on small group performance and decision making is reviewed. Recent trends in group performance research have found that process gains as well as losses are possible, and both are frequently explained by situational and procedural contexts that differentially affect motivation and resource coordination. Research has continued on classic topics (e.g., brainstorming, group goal setting, stress, and group performance) and relatively new areas (e.g., collective induction). Group decision making research has focused on preference combination for continuous response distributions and group information processing. New approaches (e.g., group-level signal detection) and traditional topics (e.g., groupthink) are discussed. New directions, such as nonlinear dynamic systems, evolutionary adaptation, and technological advances, should keep small group research vigorous well into the future.

  8. An ABC for decision making*

    PubMed Central

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. PMID:25987751

  9. Promoting Maintenance and Generalization through Cognitive Decision Making Training

    ERIC Educational Resources Information Center

    Fore, Cecil, III; Riser, Susan E.

    2005-01-01

    This article investigates issues in the areas of work outcomes, self-determination, career decision-making skills, person centered planning, and transitional planning for students with disabilities. In particular, training in cognitive decision-making is suggested for students with mild disabilities. Educators and schools are charged with…

  10. When Consensus Decision-Making Fails: A Case Study.

    ERIC Educational Resources Information Center

    Savage, Grant T.

    Habermas's theory of dialogue was used to evaluate the process of decision making that occurred in a labor-management committee's meeting to discuss flextime. The study attempted to determine why, at that meeting, the committee's consensus process of decision making failed. W.R. Bion's theory of unconscious group motives was also used to…

  11. Human Factors Influencing Decision Making

    DTIC Science & Technology

    1998-07-01

    Einhom and Hogarth (1979) Mynatt , Doherty, and Tweney (1977) Wason and Johnson-Laird (1972) 2. Decision making Models: These are not usually mathematical...395-416. Mynatt , C. R., M. E. Doherty, and R. D. Tweney. "Confirmation bias in a simulated research environment: an experimental study of scientific...Telephone Interview, 1998. Mynatt , C. R., M. E. Doherty, and R. D. Tweney. "Confirmation bias in a simulated research environment: an experimental

  12. Writing as decision-making

    NASA Technical Reports Server (NTRS)

    Souther, J. W.

    1981-01-01

    The need to teach informational writing as a decision-making process is discussed. Situational analysis, its relationship to decisions in writing, and the need for relevant assignments are considered. Teaching students to ask the right questions is covered. The need to teach writing responsiveness is described. Three steps to get started and four teaching techniques are described. The information needs of the 'expert' and the 'manager' are contrasted.

  13. Writing as decision-making

    NASA Technical Reports Server (NTRS)

    Souther, J. W.

    1981-01-01

    The need to teach informational writing as a decision-making process is discussed. Situational analysis, its relationship to decisions in writing, and the need for relevant assignments are considered. Teaching students to ask the right questions is covered. The need to teach writing responsiveness is described. Three steps to get started and four teaching techniques are described. The information needs of the 'expert' and the 'manager' are contrasted.

  14. Clinical judgment and decision making.

    PubMed

    Garb, Howard N

    2005-01-01

    When clinical psychologists make judgments, are they likely to be correct or incorrect? The following topics are reviewed: (a) methodological advances in evaluating the validity of descriptions of personality and psychopathology, (b) recent findings on the cognitive processes of clinicians, and (c) the validity of judgments and utility of decisions made by mental health professionals. Results from research on clinical judgment and decision making and their relationship to conflicts within the field of clinical psychology are discussed.

  15. Probabilistic Network Approach to Decision-Making

    NASA Astrophysics Data System (ADS)

    Nicolis, Grégoire; Nicolis, Stamatios C.

    2015-06-01

    A probabilistic approach to decision-making is developed in which the states of the underlying stochastic process, assumed to be of the Markov type, represent the competing options. The principal parameters determining the dominance of a particular option versus the others are identified and the transduction of information associated to the transitions between states is quantified using a set of entropy-like quantities.

  16. The effect of extrinsic noise on cellular decision making

    NASA Astrophysics Data System (ADS)

    Roberts, Elijah; Assaf, Michael; Luthey-Schulten, Zaida; Goldenfeld, Nigel

    2013-03-01

    Many cellular processes are not deterministic, i.e., genetically identical cells can display different phenotypic behavior even in identical environments. Such processes involve cellular decision making, in which individual cells randomly make choices determining their fate. One view is that the stochastic nature of cellular decision making is due to noise present in the biomolecular interaction networks. Most previous work has focused on the role of intrinsic noise of these networks. Yet, especially in the high copy-number regime, extrinsic noise may be much more significant, likely governing the overall dynamics. Here we develop a theoretical framework describing the combined effect of intrinsic and extrinsic noise on the stochastic dynamics of genetic switches responsible for cellular decision making. We do so by devising a semi-classical theory accounting for extrinsic noise as an effective species. Our theory, corroborated by extensive Monte-Carlo simulations, is tested on a simple bistable self-regulating gene model, and is then generalized to gain insight on the behavior of the lac genetic switch under extrinsic noise. We show that extrinsic noise not only significantly lowers the escape time from a phenotypic state, but can fundamentally change the actual escape process.

  17. Game theory and neural basis of social decision making.

    PubMed

    Lee, Daeyeol

    2008-04-01

    Decision making in a social group has two distinguishing features. First, humans and other animals routinely alter their behavior in response to changes in their physical and social environment. As a result, the outcomes of decisions that depend on the behavior of multiple decision makers are difficult to predict and require highly adaptive decision-making strategies. Second, decision makers may have preferences regarding consequences to other individuals and therefore choose their actions to improve or reduce the well-being of others. Many neurobiological studies have exploited game theory to probe the neural basis of decision making and suggested that these features of social decision making might be reflected in the functions of brain areas involved in reward evaluation and reinforcement learning. Molecular genetic studies have also begun to identify genetic mechanisms for personal traits related to reinforcement learning and complex social decision making, further illuminating the biological basis of social behavior.

  18. Rational Decision-Making in Inhibitory Control

    PubMed Central

    Shenoy, Pradeep; Yu, Angela J.

    2011-01-01

    An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability. PMID:21647306

  19. Decision-making cognition in neurodegenerative diseases.

    PubMed

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

    2010-11-01

    A large proportion of human social neuroscience research has focused on the issue of decision-making. Impaired decision-making is a symptomatic feature of a number of neurodegenerative diseases, but the nature of these decision-making deficits depends on the particular disease. Thus, examining the qualitative differences in decision-making impairments associated with different neurodegenerative diseases could provide valuable information regarding the underlying neural basis of decision-making. Nevertheless, few comparative reports of decision-making across patient groups exist. In this Review, we examine the neuroanatomical substrates of decision-making in relation to the neuropathological changes that occur in Alzheimer disease, frontotemporal dementia, Parkinson disease and Huntington disease. We then examine the main findings from studies of decision-making in these neurodegenerative diseases. Finally, we suggest a number of recommendations that future studies could adopt to aid our understanding of decision-making cognition.

  20. Strategic Decision Making and Group Decision Support Systems.

    ERIC Educational Resources Information Center

    McGrath, Michael Robert

    1986-01-01

    Institutional strategic decisions require the participation of every individual with a significant stake in the solution, and group decision support systems are being developed to respond to the political and consensual problems of collective decision-making. (MSE)

  1. [Decision-making and schizophrenia].

    PubMed

    Adida, M; Maurel, M; Kaladjian, A; Fakra, E; Lazerges, P; Da Fonseca, D; Belzeaux, R; Cermolacce, M; Azorin, J-M

    2011-12-01

    Abnormalities involving the prefrontal cortex (PFC) have long been postulated to underpin the pathophysiology of schizophrenia. Investigations of PFC integrity have focused mainly on the dorsolateral PFC (DLPFC) and abnormalities in this region have been extensively documented. However, defects in schizophrenia may extend to other prefrontal regions, including the ventromedial PFC (VMPFC), and evidence of VMPFC abnormalities comes from neuropathological, structural and functional studies. Patients with acquired brain injury to the VMPFC display profound disruption of social behaviour and poor judgment in their personal lives. The Iowa Gambling Task (IGT) was developed to assess decision-making in these neurological cases : it presents a series of 100 choices from four card decks that differ in the distribution of rewarding and punishing outcomes. Whilst healthy volunteers gradually develop a preference for the two "safe" decks over the course of the task, patients with VMPFC lesions maintain a preference for the two "risky" decks which are associated with high reinforcement in the short term, but significant long-term debt. Interestingly, damage to VMPFC may cause both poor performance on the IGT and lack of insight concerning the acquired personality modification. Recently, our group reported a trait-related decisionmaking impairment in the three phases of bipolar disorder. In a PET study, VMPFC dysfunction was shown in bipolar manic patients impaired on a decision-making task and an association between decision-making cognition and lack of insight was described in mania. A quantitative association between grey matter volume of VMPFC and memory impairment was previously reported in schizophrenia. Research suggests that lack of insight is a prevalent feature in schizophrenia patients, like auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. Because schizophrenia is associated with significant social or occupational

  2. An operational structured decision making framework for ...

    EPA Pesticide Factsheets

    Pressure to develop an operational framework for decision makers to employ the concepts of ecosystem goods and services for assessing changes to human well-being has been increasing since these concepts gained widespread notoriety after the Millennium Ecosystem Assessment Report. Many conceptual frameworks have been proposed, but most do not propose methodologies and tools to make this approach to decision making implementable. Building on common components of existing conceptual frameworks for ecosystem services and human well-being assessment we apply a structured decision making approach to develop a standardized operational framework and suggest tools and methods for completing each step. The structured decision making approach consists of six steps: 1) Clarify the Decision Context 2) Define Objectives and Evaluation Criteria 3) Develop Alternatives 4) Estimate Consequences 5) Evaluate Trade-Offs and Select and 6) Implement and Monitor. These six steps include the following activities, and suggested tools, when applied to ecosystem goods and services and human well-being conceptual frameworks: 1) Characterization of decision specific human beneficiaries using the Final Ecosystem Goods and Services (FEGS) approach and Classification System (FEGS-CS) 2) Determine beneficiaries’ relative priorities for human well-being domains in the Human Well-Being Index (HWBI) through stakeholder engagement and identify beneficiary-relevant metrics of FEGS using the Nat

  3. Assessing clinical decision making: is the ideal system feasible?

    PubMed

    Dubois, R W; Brook, R H

    1988-01-01

    While caring for patients, physicians make a variety of decisions. Can current methods adequately determine whether these decisions are correct? If not, what improvements are needed? This paper begins with a review of several explicit methods to assess physician decision making. It then describes a more comprehensive system that would use Bayesian logic to assess whether a physician responded appropriately to the needs of an individual patient. Although sophisticated branching logic may be theoretically desirable, it may not be feasible. The paper concludes by proposing an explicit, potentially practical method that would judiciously use branching logic.

  4. Expert decision-making strategies

    NASA Technical Reports Server (NTRS)

    Mosier, Kathleen L.

    1991-01-01

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

  5. Reverse mortgage decision-making.

    PubMed

    Leviton, R

    2001-01-01

    Reverse mortgages have been suggested as a promising financial tool to help low-income older homeowners who want to remain in their houses. However, actual use of this option has been much below early estimates of potential demand. This study explored response to the new option through open-ended interviews of homeowners who had received reverse mortgage counseling. Decision-making was influenced by attachment to home, family input, and financial attitudes, including desire to leave a legacy. In general, homeowners took reverse mortgages only as a "last resort" that enabled them to maintain their independence.

  6. Aging and consumer decision making

    PubMed Central

    Carpenter, Stephanie M.; Yoon, Carolyn

    2013-01-01

    Research on consumer decision making and aging is especially important for fostering a better understanding of ways to maintain consumer satisfaction and high decision quality across the life span. We provide a review of extant research on the effects of normal aging on cognition and decision processes and how these age-related processes are influenced by task environment, meaningfulness of the task, and consumer expertise. We consider how research centered on these topics generates insights about changes in consumption decisions that occur with aging and identify a number of gaps and directions for future research. PMID:22360794

  7. Individualizing treatment targets for elderly patients with type 2 diabetes: factors influencing clinical decision making in the 24-week, randomized INTERVAL study.

    PubMed

    Strain, W David; Agarwal, Abhijit S; Paldánius, Päivi M

    2017-03-05

    We tested the feasibility of setting individualized glycemic goals and factors influencing targets set in a clinical trial in elderly patients with type 2 diabetes.A 24-week, randomized, double-blind, placebo-controlled study was conducted in 45 outpatient centers in seven European countries. 278 drug-naïve or inadequately controlled (mean HbA1c 7.9%) patients with type 2 diabetes aged ≥70 years with HbA1c levels ≥7.0% and ≤10.0% were enrolled. Investigator-defined individualized HbA1c targets and the impact of baseline characteristics on individualized treatment targets was evaluated.The average individualized HbA1c target was set at 7.0%. HbA1c at baseline predicted a target setting such that higher the HbA1c, more aggressive was the target (P<0.001). Men were more likely to be set aggressive targets than women (P=0.026). Frailty status of patients showed a trend towards significance (P=0.068), whereas diabetes duration, age, or polypharmacy did not. There was heterogeneity between countries regarding how baseline factors were viewed.Despite training and guidance to individualize HbA1c goals, targets were still set in line with conventional values. A strong influence of country-specific guidelines on target setting was observed; confirming the importance of further education to implement new international guidelines in older adults.

  8. Decision making under uncertain categorization

    PubMed Central

    Chen, Stephanie Y.; Ross, Brian H.; Murphy, Gregory L.

    2014-01-01

    Two experiments investigated how category information is used in decision making under uncertainty and whether the framing of category information influences how it is used. Subjects were presented with vignettes in which the categorization of a critical item was ambiguous and were asked to choose among a set of actions with the goal of attaining the desired outcome for the main character in the story. The normative decision making strategy was to base the decision on all possible categories; however, research on a related topic, category-based induction, has found that people often only consider a single category when making predictions when categorization is uncertain. These experiments found that subjects tend to consider multiple categories when making decisions, but do so both when it is and is not appropriate, suggesting that use of multiple categories is not driven by an understanding of whether categories are relevant to the decision. Similarly, although a framing manipulation increased the rate of multiple-category use, it did so in situations in which multiple-category use both was and was not appropriate. PMID:25309475

  9. Cognitive Psychology Meets Psychometric Theory: On the Relation between Process Models for Decision Making and Latent Variable Models for Individual Differences

    ERIC Educational Resources Information Center

    van der Maas, Han L. J.; Molenaar, Dylan; Maris, Gunter; Kievit, Rogier A.; Borsboom, Denny

    2011-01-01

    This article analyzes latent variable models from a cognitive psychology perspective. We start by discussing work by Tuerlinckx and De Boeck (2005), who proved that a diffusion model for 2-choice response processes entails a 2-parameter logistic item response theory (IRT) model for individual differences in the response data. Following this line…

  10. Cognitive Psychology Meets Psychometric Theory: On the Relation between Process Models for Decision Making and Latent Variable Models for Individual Differences

    ERIC Educational Resources Information Center

    van der Maas, Han L. J.; Molenaar, Dylan; Maris, Gunter; Kievit, Rogier A.; Borsboom, Denny

    2011-01-01

    This article analyzes latent variable models from a cognitive psychology perspective. We start by discussing work by Tuerlinckx and De Boeck (2005), who proved that a diffusion model for 2-choice response processes entails a 2-parameter logistic item response theory (IRT) model for individual differences in the response data. Following this line…

  11. Measuring Shared Decision Making in Psychiatric Care

    PubMed Central

    Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.

    2014-01-01

    Objective Shared decision making is widely recognized to facilitate effective health care; tools are needed to measure the level of shared decision making in psychiatric practice. Methods A coding scheme assessing shared decision making in medical settings (1) was adapted, including creation of a manual. Trained raters analyzed 170 audio recordings of psychiatric medication check-up visits. Results Inter-rater reliability among three raters for a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of nine elements of shared decision making and 100% for the overall agreement between provider and consumer. Just over half of the decisions met minimum criteria for shared decision making. Shared decision making was not related to length of visit after controlling for complexity of decision. Conclusions The shared decision making rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts. PMID:22854725

  12. Cocaine Dependent Individuals and Gamblers Present Different Associative Learning Anomalies in Feedback-Driven Decision Making: A Behavioral and ERP Study

    PubMed Central

    Torres, Ana; Catena, Andrés; Cándido, Antonio; Maldonado, Antonio; Megías, Alberto; Perales, José C.

    2013-01-01

    Several recent studies have demonstrated that addicts behave less flexibly than healthy controls in the probabilistic reversal learning task (PRLT), in which participants must gradually learn to choose between a probably rewarded option and an improbably rewarded one, on the basis of corrective feedback, and in which preferences must adjust to abrupt reward contingency changes (reversals). In the present study, pathological gamblers (PG) and cocaine dependent individuals (CDI) showed different learning curves in the PRLT. PG also showed a reduced electroencephalographic response to feedback (Feedback-Related Negativity, FRN) when compared to controls. CDI’s FRN was not significantly different either from PG or from healthy controls. Additionally, according to Standardized Low-Resolution Electromagnetic Tomography analysis, cortical activity in regions of interest (previously selected by virtue of their involvement in FRN generation in controls) strongly differed between CDI and PG. However, the nature of such anomalies varied within-groups across individuals. Cocaine use severity had a strong deleterious impact on the learning asymptote, whereas gambling intensity significantly increased reversal cost. These two effects have remained confounded in most previous studies, which can be hiding important associative learning differences between different populations of addicts. PMID:23516173

  13. Cocaine Dependent Individuals and Gamblers Present Different Associative Learning Anomalies in Feedback-Driven Decision Making: A Behavioral and ERP Study.

    PubMed

    Torres, Ana; Catena, Andrés; Cándido, Antonio; Maldonado, Antonio; Megías, Alberto; Perales, José C

    2013-01-01

    Several recent studies have demonstrated that addicts behave less flexibly than healthy controls in the probabilistic reversal learning task (PRLT), in which participants must gradually learn to choose between a probably rewarded option and an improbably rewarded one, on the basis of corrective feedback, and in which preferences must adjust to abrupt reward contingency changes (reversals). In the present study, pathological gamblers (PG) and cocaine dependent individuals (CDI) showed different learning curves in the PRLT. PG also showed a reduced electroencephalographic response to feedback (Feedback-Related Negativity, FRN) when compared to controls. CDI's FRN was not significantly different either from PG or from healthy controls. Additionally, according to Standardized Low-Resolution Electromagnetic Tomography analysis, cortical activity in regions of interest (previously selected by virtue of their involvement in FRN generation in controls) strongly differed between CDI and PG. However, the nature of such anomalies varied within-groups across individuals. Cocaine use severity had a strong deleterious impact on the learning asymptote, whereas gambling intensity significantly increased reversal cost. These two effects have remained confounded in most previous studies, which can be hiding important associative learning differences between different populations of addicts.

  14. Critical care nurses' use of decision-making strategies.

    PubMed

    Aitken, Leanne M

    2003-07-01

    Effective decision-making has the potential to facilitate improvements in health care. This paper reports several aspects of a study which used "thinking aloud" within a concept attainment framework to examine the decision-making processes of expert critical care nurses in relation to haemodynamic monitoring. The purpose of this study was to examine whether hypotheses were used in the decision-making process and, if so, were hypotheses deactivated when no longer relevant. In addition, the strategies that were used during the decision-making process were examined. Eight expert critical care nurses consented to participate in the study after ethics clearance was obtained from both the University and Hospital ethics committees. The majority of expert critical care nurse participants in this study demonstrated extensive use of hypotheses to explain the relationship between attributes and concepts. There was no evidence of specific deactivation of hypotheses when they were no longer relevant. Participants demonstrated use of a range of decision-making strategies, with a Focus Gambling Strategy being the most common. The reason for using different decision-making strategies was not clear and may represent variation between decision-makers or between scenarios for each individual decision-maker. Recommendations are made to help improve critical care nurses' decision-making.

  15. "Piensa" twice: on the foreign language effect in decision making.

    PubMed

    Costa, Albert; Foucart, Alice; Arnon, Inbal; Aparici, Melina; Apesteguia, Jose

    2014-02-01

    In this article, we assess to what extent decision making is affected by the language in which a given problem is presented (native vs. foreign). In particular, we aim to ask whether the impact of various heuristic biases in decision making is diminished when the problems are presented in a foreign language. To this end, we report four main studies in which more than 700 participants were tested on different types of individual decision making problems. In the first study, we replicated Keysar et al.'s (2012) recent observation regarding the foreign language effect on framing effects related to loss aversion. In the second section, we assessed whether the foreign language effect is present in other types of framing problems that involve psychological accounting biases rather than gain/loss dichotomies. In the third section, we studied the foreign language effect in several key aspects of the theory of decision making under risk and uncertainty. In the fourth study, we assessed the presence of a foreign language effect in the cognitive reflection test, a test that includes logical problems that do not carry emotional connotations. The absence of such an effect in this test suggests that foreign language leads to a reduction of heuristic biases in decision making across a range of decision making situations and provide also some evidence about the boundaries of the phenomenon. We explore several potential factors that may underlie the foreign language effect in decision making. Copyright © 2013 Elsevier B.V. All rights reserved.

  16. Impaired Decision Making in Adolescent Suicide Attempters

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  17. Facets of Career Decision-Making Difficulties

    ERIC Educational Resources Information Center

    Amir, Tami; Gati, Itamar

    2006-01-01

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

  18. Facets of Career Decision-Making Difficulties

    ERIC Educational Resources Information Center

    Amir, Tami; Gati, Itamar

    2006-01-01

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

  19. Impaired Decision Making in Adolescent Suicide Attempters

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  20. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  1. Graphic Representations as Tools for Decision Making.

    ERIC Educational Resources Information Center

    Howard, Judith

    2001-01-01

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

  2. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  3. Decision making: rational or hedonic?

    PubMed Central

    Cabanac, Michel; Bonniot-Cabanac, Marie-Claude

    2007-01-01

    Three experiments studied the hedonicity of decision making. Participants rated their pleasure/displeasure while reading item-sentences describing political and social problems followed by different decisions (Questionnaire 1). Questionnaire 2 was multiple-choice, grouping the items from Questionnaire 1. In Experiment 1, participants answered Questionnaire 2 rapidly or slowly. Both groups selected what they had rated as pleasant, but the 'leisurely' group maximized pleasure less. In Experiment 2, participants selected the most rational responses. The selected behaviors were pleasant but less than spontaneous behaviors. In Experiment 3, Questionnaire 2 was presented once with items grouped by theme, and once with items shuffled. Participants maximized the pleasure of their decisions, but the items selected on Questionnaires 2 were different when presented in different order. All groups maximized pleasure equally in their decisions. These results support that decisions are made predominantly in the hedonic dimension of consciousness. PMID:17848195

  4. Crew decision making under stress

    NASA Technical Reports Server (NTRS)

    Orasanu, J.

    1992-01-01

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

  5. A prospective study comparing the predictions of doctors versus models for treatment outcome of lung cancer patients: a step towards individualized care and shared decision making

    PubMed Central

    Oberije, Cary; Nalbantov, Georgi; Dekker, Andre; Boersma, Liesbeth; Borger, Jacques; Reymen, Bart; van Baardwijk, Angela; Wanders, Rinus; De Ruysscher, Dirk; Steyerberg, Ewout; Dingemans, Anne-Marie; Lambin, Philippe

    2015-01-01

    Background Decision Support Systems, based on statistical prediction models, have the potential to change the way medicine is being practiced, but their application is currently hampered by the astonishing lack of impact studies. Showing the theoretical benefit of using these models could stimulate conductance of such studies. In addition, it would pave the way for developing more advanced models, based on genomics, proteomics and imaging information, to further improve the performance of the models. Purpose In this prospective single-center study, previously developed and validated statistical models were used to predict the two-year survival (2yrS), dyspnea (DPN), and dysphagia (DPH) outcomes for lung cancer patients treated with chemo radiation. These predictions were compared to probabilities provided by doctors and guideline-based recommendations currently used. We hypothesized that model predictions would significantly outperform predictions from doctors. Materials and Methods Experienced radiation oncologists (ROs) predicted all outcomes at two timepoints: 1) after the first consultation of the patient, and 2) after the radiation treatment plan was made. Differences in the performances of doctors and models were assessed using Area under the Curve (AUC) analysis. Results A total number of 155 patients were included. At timepoint #1 the differences in AUCs between the ROs and the models were 0.15, 0.17, and 0.20 (for 2yrS, DPN, and DPH respectively), with p-values of 0.02, 0.07, and 0.03. Comparable differences at timepoint #2 were not statistically significant due to the limited number of patients. Comparison to guideline-based recommendations also favored the models. Conclusions The models substantially outperformed ROs’ predictions and guideline-based recommendations currently used in clinical practice. Identification of risk groups on the basis of the models facilitates individualized treatment, and should be further investigated in clinical impact

  6. Situational Variables in Expert Pilot Decision Making

    NASA Technical Reports Server (NTRS)

    Fischer, Ute; Orasanu, Judith; Wich, Mike; Hart, Sandra G. (Technical Monitor)

    1994-01-01

    In traditional laboratory studies of decision making, the experimenter structures the problem, defines the goal and specifies available information. In contrast, when people make decisions in non-laboratory environments characterized as complex, dynamic and consequential, they must first identify the problem and determine what information and responses are relevant. The present research was designed to investigate which situational aspects are important to experienced pilots making aviation decisions. Twenty-eight professional pilots were asked to sort descriptions of 22 aircraft incidents into piles involving similar types of major decisions. Preliminary analyses suggest four underlying variables: time pressure, risk level, available resources, and certainty of goal attainment.

  7. Situational Variables in Expert Pilot Decision Making

    NASA Technical Reports Server (NTRS)

    Fischer, Ute; Orasanu, Judith; Wich, Mike; Hart, Sandra G. (Technical Monitor)

    1994-01-01

    In traditional laboratory studies of decision making, the experimenter structures the problem, defines the goal and specifies available information. In contrast, when people make decisions in non-laboratory environments characterized as complex, dynamic and consequential, they must first identify the problem and determine what information and responses are relevant. The present research was designed to investigate which situational aspects are important to experienced pilots making aviation decisions. Twenty-eight professional pilots were asked to sort descriptions of 22 aircraft incidents into piles involving similar types of major decisions. Preliminary analyses suggest four underlying variables: time pressure, risk level, available resources, and certainty of goal attainment.

  8. Self-Stigma and Consumer Participation in Shared Decision Making in Mental Health Services.

    PubMed

    Hamann, Johannes; Bühner, Markus; Rüsch, Nicolas

    2017-08-01

    People with mental illness struggle with symptoms and with public stigma. Some accept common prejudices and lose self-esteem, resulting in shame and self-stigma, which may affect their interactions with mental health professionals. This study explored whether self-stigma and shame are associated with consumers' preferences for participation in medical decision making and their behavior in psychiatric consultations. In a cross-sectional study conducted in Germany, 329 individuals with a diagnosis of a schizophrenia spectrum disorder or an affective disorder and their psychiatrists provided sociodemographic and illness-related information. Self-stigma, shame, locus of control, and views about clinical decision making were assessed by self-report. Psychiatrists rated their impression of the decision-making behavior of consumers. Regression analyses and structural equation modeling were used to determine the association of self-stigma and shame with clinical decision making. Self-stigma was not related to consumers' participation preferences, but it was associated with some aspects of communicative behavior. Active and critical behavior (for example, expressing views, daring to challenge the doctor's opinion, and openly speaking out about disagreements with the doctor) was associated with less shame, less self-stigma, more self-responsibility, less attribution of external control to powerful others, and more years of education. Self-stigma and shame were associated with less participative and critical behavior, which probably leads to clinical encounters that involve less shared decision making and more paternalistic decision making. Paternalistic decision making may reinforce self-stigma and lead to poorer health outcomes. Therefore, interventions that reduce self-stigma and increase consumers' critical and participative communication may improve health outcomes.

  9. Understanding behavioral intent to participate in shared decision-making in medically uncertain situations.

    PubMed

    Maffei, Roxana M; Dunn, K; Zhang, J; Hsu, C E; Holmes, J H

    2012-01-01

    subjects. By understanding a subject's disposition with regard to coping, researchers were better able to make connections between a subject's prior experiences, their knowledge seeking activities, and their intent to participate in SDM. Despite having information and social support, the subjects still had to cope with the idea of uncertainty before determining how to proceed with regard to shared decision-making. In addition, the coping category reinforced the importance of information seeking behaviors and preferences for shared decision-making. This study applies and extends the field of behavioral and health informatics to assist medical practice and decision-making in situations of medical uncertainty. More specifically, this study led to the development of a category framework that facilitates the identification of an individual's needs and motivational factors with regard to their intent to participate in shared decision-making in situations of medical uncertainty.

  10. Healthcare decision-making in end stage renal disease-patient preferences and clinical correlates.

    PubMed

    Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip

    2015-11-14

    commencement of dialysis. ESRD patients prefer to receive information, but this does not always imply active involvement in decision-making. By understanding modifiable and non-modifiable factors which affect patient preferences for involvement in healthcare decision-making, health professionals may acknowledge the need to accommodate individual patient preferences to the extent determined by the individual patient factors.

  11. A Design Pattern for Decentralised Decision Making

    PubMed Central

    Valentini, Gabriele; Fernández-Oto, Cristian; Dorigo, Marco

    2015-01-01

    The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera). The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling. PMID:26496359

  12. Maintaining Homeostasis by Decision-Making

    PubMed Central

    Korn, Christoph W.; Bach, Dominik R.

    2015-01-01

    Living organisms need to maintain energetic homeostasis. For many species, this implies taking actions with delayed consequences. For example, humans may have to decide between foraging for high-calorie but hard-to-get, and low-calorie but easy-to-get food, under threat of starvation. Homeostatic principles prescribe decisions that maximize the probability of sustaining appropriate energy levels across the entire foraging trajectory. Here, predictions from biological principles contrast with predictions from economic decision-making models based on maximizing the utility of the endpoint outcome of a choice. To empirically arbitrate between the predictions of biological and economic models for individual human decision-making, we devised a virtual foraging task in which players chose repeatedly between two foraging environments, lost energy by the passage of time, and gained energy probabilistically according to the statistics of the environment they chose. Reaching zero energy was framed as starvation. We used the mathematics of random walks to derive endpoint outcome distributions of the choices. This also furnished equivalent lotteries, presented in a purely economic, casino-like frame, in which starvation corresponded to winning nothing. Bayesian model comparison showed that—in both the foraging and the casino frames—participants’ choices depended jointly on the probability of starvation and the expected endpoint value of the outcome, but could not be explained by economic models based on combinations of statistical moments or on rank-dependent utility. This implies that under precisely defined constraints biological principles are better suited to explain human decision-making than economic models based on endpoint utility maximization. PMID:26024504

  13. Incorporating environmental justice into environmental decision making

    SciTech Connect

    Wolfe, A.K.; Vogt, D.P.; Hwang, Ho-Ling

    1995-07-01

    Executive Order 12898, signed on February 11, 1994, broadly states that federal activities, programs, and policies should not produce disproportionately high and adverse impacts on minority and low-income populations. Moreover, the Order indicates that these populations should not be denied the benefits of, or excluded from participation in, these activities, programs, and policies. Because a presidential memorandum accompanying the order said that National Environmental Policy Act (NEPA) documents should begin to address environmental justice immediately, much attention has been paid to assessment-related issues. Also important, a topic that appears to have received relatively little attention, is how decision makers should be expected to use information about environmental justice in their decision making. This paper discusses issues surrounding the use of environmental justice information in the decision-making process by focusing on the following five main topics: (1) the importance, or weight, attached to environmental justice within larger decision-making contexts; (2) the potential tension between localized environmental justice issues and regional or national issues and needs; (3) the use of environmental justice information to develop (perhaps in concert with affected minority and low-income communities) appropriate mitigation strategies, or to establish conditions under which activities, programs, and policies may be accepted locally; (4) the general implications of shifting the distribution of broadly defined risks, costs, and benefits among different population groups; and (5) the implications of implementing environmental justice on an individual, ad hoc basis rather than within a larger environmental justice framework. This paper raises the issues and discusses the implications of alternative approaches to them.

  14. Maintaining homeostasis by decision-making.

    PubMed

    Korn, Christoph W; Bach, Dominik R

    2015-05-01

    Living organisms need to maintain energetic homeostasis. For many species, this implies taking actions with delayed consequences. For example, humans may have to decide between foraging for high-calorie but hard-to-get, and low-calorie but easy-to-get food, under threat of starvation. Homeostatic principles prescribe decisions that maximize the probability of sustaining appropriate energy levels across the entire foraging trajectory. Here, predictions from biological principles contrast with predictions from economic decision-making models based on maximizing the utility of the endpoint outcome of a choice. To empirically arbitrate between the predictions of biological and economic models for individual human decision-making, we devised a virtual foraging task in which players chose repeatedly between two foraging environments, lost energy by the passage of time, and gained energy probabilistically according to the statistics of the environment they chose. Reaching zero energy was framed as starvation. We used the mathematics of random walks to derive endpoint outcome distributions of the choices. This also furnished equivalent lotteries, presented in a purely economic, casino-like frame, in which starvation corresponded to winning nothing. Bayesian model comparison showed that--in both the foraging and the casino frames--participants' choices depended jointly on the probability of starvation and the expected endpoint value of the outcome, but could not be explained by economic models based on combinations of statistical moments or on rank-dependent utility. This implies that under precisely defined constraints biological principles are better suited to explain human decision-making than economic models based on endpoint utility maximization.

  15. Episodic memories predict adaptive value-based decision-making.

    PubMed

    Murty, Vishnu P; FeldmanHall, Oriel; Hunter, Lindsay E; Phelps, Elizabeth A; Davachi, Lila

    2016-05-01

    Prior research illustrates that memory can guide value-based decision-making. For example, previous work has implicated both working memory and procedural memory (i.e., reinforcement learning) in guiding choice. However, other types of memories, such as episodic memory, may also influence decision-making. Here we test the role for episodic memory-specifically item versus associative memory-in supporting value-based choice. Participants completed a task where they first learned the value associated with trial unique lotteries. After a short delay, they completed a decision-making task where they could choose to reengage with previously encountered lotteries, or new never before seen lotteries. Finally, participants completed a surprise memory test for the lotteries and their associated values. Results indicate that participants chose to reengage more often with lotteries that resulted in high versus low rewards. Critically, participants not only formed detailed, associative memories for the reward values coupled with individual lotteries, but also exhibited adaptive decision-making only when they had intact associative memory. We further found that the relationship between adaptive choice and associative memory generalized to more complex, ecologically valid choice behavior, such as social decision-making. However, individuals more strongly encode experiences of social violations-such as being treated unfairly, suggesting a bias for how individuals form associative memories within social contexts. Together, these findings provide an important integration of episodic memory and decision-making literatures to better understand key mechanisms supporting adaptive behavior.

  16. Shared decision making interventions for people with mental health conditions.

    PubMed

    Duncan, Edward; Best, Catherine; Hagen, Suzanne

    2010-01-20

    One person in every four will suffer from a diagnosable mental health condition during their life course. Such conditions can have a devastating impact on the lives of the individual, their family and society. Increasingly partnership models of mental health care have been advocated and enshrined in international healthcare policy. Shared decision making is one such partnership approach. Shared decision making is a form of patient-provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This is advocated on the basis that patients have a right to self-determination and also in the expectation that it will increase treatment adherence. To assess the effects of provider-, consumer- or carer-directed shared decision making interventions for people of all ages with mental health conditions, on a range of outcomes including: patient satisfaction, clinical outcomes, and health service outcomes. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), PsycINFO (1967 to November 2008), CINAHL (1982 to November 2008), British Nursing Index and Archive (1985 to November 2008) and SIGLE (1890 to September 2005 (database end date)). We also searched online trial registers and the bibliographies of relevant papers, and contacted authors of included studies. Randomised controlled trials (RCTs), quasi-randomised controlled trials (q-RCTs), controlled before-and-after studies (CBAs); and interrupted time series (ITS) studies of interventions to increase shared decision making in people with mental health conditions (by DSM or ICD-10 criteria). Data on recruitment methods, eligibility criteria, sample characteristics, interventions, outcome measures, participant flow and outcome data from each study were extracted by one author and checked by another. Data are presented in a narrative

  17. The Effects of Cognitive Restructuring and Decision-Making Training on Career Indecision.

    ERIC Educational Resources Information Center

    Mitchell, Lynda K.; Krumboltz, John D.

    1987-01-01

    Designed a cognitive restructuring intervention for individuals having difficulty with career decision making, which proved more effective than decision-making training and a no-treatment control condition in reducing anxiety about career decision making and in encouraging vocational exploratory behavior. Cognitive restructuring clients used…

  18. The Career Decision-Making Competence: A New Construct for the Career Realm

    ERIC Educational Resources Information Center

    Ceschi, Andrea; Costantini, Arianna; Phillips, Susan D.; Sartori, Riccardo

    2017-01-01

    Purpose: This paper aims to link findings from laboratory-based decision-making research and decision-making competence (DMC) aspects that may be central for career-related decision-making processes. Past research has identified individual differences in rational responses in decision situations, which the authors refer to as DMC. Although there…

  19. The Career Decision-Making Competence: A New Construct for the Career Realm

    ERIC Educational Resources Information Center

    Ceschi, Andrea; Costantini, Arianna; Phillips, Susan D.; Sartori, Riccardo

    2017-01-01

    Purpose: This paper aims to link findings from laboratory-based decision-making research and decision-making competence (DMC) aspects that may be central for career-related decision-making processes. Past research has identified individual differences in rational responses in decision situations, which the authors refer to as DMC. Although there…

  20. Working memory capacity as controlled attention in tactical decision making.

    PubMed

    Furley, Philip A; Memmert, Daniel

    2012-06-01

    The controlled attention theory of working memory capacity (WMC, Engle 2002) suggests that WMC represents a domain free limitation in the ability to control attention and is predictive of an individual's capability of staying focused, avoiding distraction and impulsive errors. In the present paper we test the predictive power of WMC in computer-based sport decision-making tasks. Experiment 1 demonstrated that high-WMC athletes were better able at focusing their attention on tactical decision making while blocking out irrelevant auditory distraction. Experiment 2 showed that high-WMC athletes were more successful at adapting their tactical decision making according to the situation instead of relying on prepotent inappropriate decisions. The present results provide additional but also unique support for the controlled attention theory of WMC by demonstrating that WMC is predictive of controlling attention in complex settings among different modalities and highlight the importance of working memory in tactical decision making.

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  2. Family functionality and parental characteristics as determinants of sexual decision-making of in-school youths in a semi-urban area of Southwest Nigeria.

    PubMed

    Adebayo, Ayodeji M; Ajuonu, Ezidinma J; Betiku, Benson O

    2016-11-01

    Though research findings have indicated that family characteristics have a bearing on sexual behavior, there is a paucity of published literature on the role of family functionality and parental characteristics on adolescent sexual decision-making. This study was designed to assess the role of family function and parental influence on sexual behavior of in-school youths in secondary schools in a sub-urban area of Southwest Nigeria. A descriptive cross-sectional study was conducted among secondary school students using semi-structured interviewer-assisted questionnaire. Information was obtained on the sexual behavior and parent-child characteristics. Family functionality was assessed using family APGAR standardized instrument. Association was established using χ2-test for qualitative variables and t-test for quantitative variables at p=0.05. Mean age of respondents was 14.8±2.2 years. Majority were from monogamous family setting (70.7%) and lived with their families (75.6%). About a quarter (26.8%) was from dysfunctional families and 9.2% had ever had sexual intercourse. Recent sexual engagement in the preceding 1 month was reported (47.4%). The mean score for parental monitoring, father-child communication, mother-child communication, and parental disapproval of sex were 10.4±2.2, 9.3±2.3, 9.8±2.4, and 10.4±2.3, respectively. There was a significant association between parental monitoring (t=3.9, p≤0.001), mother-child communication (t=3.03, p=0.003), and parental disapproval of sex (t=5, p≤0.001); and sexual experience. This study showed that parental influence had a vital role in the sexual behavior of young persons. Advocacy and health education interventions are needed among parents regarding their role in the sexual behavior of in-school youths.

  3. Patient-reported outcomes in randomised controlled trials of colorectal cancer: an analysis determining the availability of robust data to inform clinical decision-making

    PubMed Central

    Whale, Katie; Fish, Daniel; Fayers, Peter; Cafaro, Valentina; Pusic, Andrea; Blazeby, Jane M.; Efficace, Fabio

    2016-01-01

    Purpose Randomised controlled trials (RCTs) are the most robust study design measuring outcomes of colorectal cancer (CRC) treatments, but to influence clinical practice trial design and reporting of patient-reported outcomes (PROs) must be of high quality. Objectives of this study were as follows: to examine the quality of PRO reporting in RCTs of CRC treatment; to assess the availability of robust data to inform clinical decision-making; and to investigate whether quality of reporting improved over time. Methods A systematic review from January 2004–February 2012 identified RCTs of CRC treatment describing PROs. Relevant abstracts were screened and manuscripts obtained. Methodological quality was assessed using International Society for Quality of Life Research—patient-reported outcome reporting standards. Changes in reporting quality over time were established by comparison with previous data, and risk of bias was assessed with the Cochrane risk of bias tool. Results Sixty-six RCTs were identified, seven studies (10 %) reported survival benefit favouring the experimental treatment, 35 trials (53 %) identified differences in PROs between treatment groups, and the clinical significance of these differences was discussed in 19 studies (29 %). The most commonly reported treatment type was chemotherapy (n = 45; 68 %). Improvements over time in key methodological issues including the documentation of missing data and the discussion of the clinical significance of PROs were found. Thirteen trials (20 %) had high-quality reporting. Conclusions Whilst improvements in PRO quality reporting over time were found, several recent studies still fail to robustly inform clinical practice. Quality of PRO reporting must continue to improve to maximise the clinical impact of PRO findings. PMID:25910987

  4. Social Influences in Sequential Decision Making

    PubMed Central

    Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

    2016-01-01

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

  5. Neurobiology of decision-making in adolescents.

    PubMed

    Shad, Mujeeb U; Bidesi, Anup S; Chen, Li-Ann; Thomas, Binu P; Ernst, Monique; Rao, Uma

    2011-02-02

    The study examined the relationship between risk-taking behavior during selection of monetary rewards and activations in the anterior cingulate cortex (ACC), orbitofrontal cortex (OFC) and medial prefrontal cortex (mPFC), brain regions that are associated with decision-making. Thirty-three adolescents with no personal or family history of any psychiatric illness were administered the Wheel of Fortune (WOF) task using a functional magnetic resonance imaging protocol. The WOF is a computerized two-choice, probabilistic monetary reward task. Selection of a reward, particularly a low-probability/high-magnitude reward choice, induced greater activations in dorsal ACC, ventrolateral OFC and mPFC than the control condition. Although similar findings have been reported by earlier studies, the results from this study were not impacted by reaction times and expected values and persisted even after controlling for sociodemographic factors. Post hoc analysis revealed greater activation of ACC and mPFC in response to selection of rewards of larger magnitude than those of smaller magnitude when the probability of reward was maintained constant. Adolescents with greater frequency of high-risk behavior (defined as low-probability/high-magnitude reward choice) had lower activation of ACC, OFC and mPFC than those who engaged in this behavior less frequently. These findings suggest individual differences in prefrontal cortical function with regards to decision-making process in adolescents.

  6. Multistable binary decision making on networks

    NASA Astrophysics Data System (ADS)

    Lucas, Andrew; Lee, Ching Hua

    2013-03-01

    We propose a simple model for a binary decision making process on a graph, motivated by modeling social decision making with cooperative individuals. The model is similar to a random field Ising model or fiber bundle model, but with key differences in behavior on heterogeneous networks. For many types of disorder and interactions between the nodes, we predict with mean field theory discontinuous phase transitions that are largely independent of network structure. We show how these phase transitions can also be understood by studying microscopic avalanches and describe how network structure enhances fluctuations in the distribution of avalanches. We suggest theoretically the existence of a “glassy” spectrum of equilibria associated with a typical phase, even on infinite graphs, so long as the first moment of the degree distribution is finite. This behavior implies that the model is robust against noise below a certain scale and also that phase transitions can switch from discontinuous to continuous on networks with too few edges. Numerical simulations suggest that our theory is accurate.

  7. Childhood malignancies and decision making.

    PubMed

    Holder, A R

    1992-01-01

    Failure to obtain "adequate" medical care for a child constitutes child neglect, which may be used as the basis for prosecution of parents, removal of the child from the home, or court-ordered medical treatment. "Adequate" care is usually construed as that which is given by a licensed physician, but, in case of dispute, courts almost never engage in choosing one medical approach over another. The principle that parents may not refuse medical care, however, is made very difficult when children have malignancies--the long-term nature of the treatment means that, if the child is left at home, court order or not, the parents may flee with their child. Removing the child from the home, however, adds that trauma to the ill child's burdens. Questions should be asked before making a request to a court to order a therapy which will prolong but not save a child's life if the parents would prefer to spare their child the side effects. Parents, however, may always refuse to permit their child to participate in research studies, no matter how promising. Adolescents are increasingly believed to be capable of medical decision making; most courts, however, would not allow an adolescent to refuse life-saving treatment.

  8. Decision-making mechanisms in the brain

    NASA Astrophysics Data System (ADS)

    Deco, Gustavo; Rolls, Edmund T.

    2007-02-01

    Behavioral, neurophysiological, and theoretical studies are converging to a common theory of decision-making that assumes an underlying diffusion process which integrates both the accumulation of perceptual and cognitive evidence for making the decision and motor choice in one unifying neural network. In particular, neuronal activity in the ventral premotor cortex (VPC) is related to decision-making while trained monkeys compare two mechanical vibrations applied sequentially to the tip of a finger to report which of the two stimuli have the higher frequency (Romo et al. 2004, Neuron 41: 165). In particular, neurons were found whose response depended only on the difference between the two applied frequencies, the sign of that difference being the determining factor for correct task performance. We describe an integrate-and-fire attractor model with realistic synaptic dynamics including AMPA, NMDA and GABA synapses which can reproduce the decision-making related response selectivity of VPC neurons during the comparison period of the task. Populations of neurons for each decision in the biased competition attractor receive a bias input that depends on the firing rates of neurons in the VPC that code for the two vibrotactile frequencies. It was found that if the connectivity parameters of the network are tuned, using mean-field techniques, so that the network has two possible stable stationary final attractors respectively related to the two possible decisions, then the firing rate of the neurons in whichever attractor wins reflects the sign of the difference in the frequencies being compared but not the absolute frequencies. Thus Weber's law for frequency comparison is not encoded by the firing rate of the neurons in these attractors. An analysis of the nonstationary evolution of the dynamics of the network model shows that Weber's law is implemented in the probability of transition from the initial spontaneous firing state to one of the two possible attractor states

  9. Time Management and the Military Decision Making Process

    DTIC Science & Technology

    1992-12-18

    This monograph analyzes the military decision making process in terms of time management in order to determine if a timeline will expedite the...process. The monograph begins by establishing the importance of time and time management in planning. This section provides a general discussion of time, an...Perhaps using some of the techniques that other armies use will facilitate time management .... Time management , Decision making, Timeline, Mission analysis, Wargaming, Courses of action, OPORD, Brigade OPS.

  10. Decision Making in Recovery-Oriented Mental Health Care

    PubMed Central

    Matthias, Marianne S.; Salyers, Michelle P.; Rollins, Angela L.; Frankel, Richard M.

    2014-01-01

    Objective Patient-centered communication has been linked to patient satisfaction, treatment adherence and outcomes. Shared decision making (SDM) has been advocated as an important and ethically essential aspect of patient-centered care, but SDM has received relatively little attention in mental health care, despite studies indicating that consumers want to be involved in decisions. This is particularly important in a recovery-oriented system, where consumers are active participants in their treatment and rehabilitation. Because medication management is a key component of recovery from severe mental illnesses, this study explores how consumers and providers make decisions in medication management consultations. Methods Four providers (3 psychiatrists, 1 nurse practitioner) and 40 consumers with severe mental illness (10 consumers per provider) were recruited from a community mental health center with a recovery-oriented focus. We directly observed 40 medication management appointments. Observations were audio recorded and transcribed. We used emergent thematic analysis to characterize decision making processes. Results Providers initiated most decisions, although they often invited consumers to participate in decision making. Decisions initiated by consumers elicited a greater degree of discussion and disagreement, but also frequently resulted in consumers’ preferences prevailing. Consultations generally exhibited more characteristics of person-centeredness than SDM. Conclusions and Implications for Practice While we observed a high degree of person-centeredness, SDM was not prevalent. Interventions helping consumers to take greater initiative when working with service providers may be helpful. For example, programs using tools such as peer instruction, internet-based software, and individual case-manager instruction all have shown promise for enhancing SDM in mental health treatment. Further research is needed to determine the degree of SDM in other settings (e

  11. [Group communication and decision-making strategies].

    PubMed

    García-Retamero, Rocío; Takezawa, Masanori; Gigerenzer, Gerd

    2008-11-01

    In daily life, people frequently make inferences about current and future states of the world. Most of these inferences are not made individually, but by exchanging information about which strategies could be used with other people. In an experiment, we analyzed whether exchanging information socially increased the probability of selecting the most adaptive strategy. In our experiment, take-the-best (TTB; Gigerenzer & Goldstein, 1996), a simple heuristic that employs one-reason decision making, achieved the highest payoff. Results showed that the fit of TTB increased substantially across trial blocks when participants were allowed to exchange information with other group members. In contrast, when participants made inferences individually, they did not select the most adaptive strategy even after seven trial blocks. Overall, our results support the hypothesis that group communication increases the likelihood that participants select the most adaptive strategy for making inferences.

  12. Decision making under stress: a selective review.

    PubMed

    Starcke, Katrin; Brand, Matthias

    2012-04-01

    Many decisions must be made under stress, and many decision situations elicit stress responses themselves. Thus, stress and decision making are intricately connected, not only on the behavioral level, but also on the neural level, i.e., the brain regions that underlie intact decision making are regions that are sensitive to stress-induced changes. The purpose of this review is to summarize the findings from studies that investigated the impact of stress on decision making. The review includes those studies that examined decision making under stress in humans and were published between 1985 and October 2011. The reviewed studies were found using PubMed and PsycInfo searches. The review focuses on studies that have examined the influence of acutely induced laboratory stress on decision making and that measured both decision-making performance and stress responses. Additionally, some studies that investigated decision making under naturally occurring stress levels and decision-making abilities in patients who suffer from stress-related disorders are described. The results from the studies that were included in the review support the assumption that stress affects decision making. If stress confers an advantage or disadvantage in terms of outcome depends on the specific task or situation. The results also emphasize the role of mediating and moderating variables. The results are discussed with respect to underlying psychological and neural mechanisms, implications for everyday decision making and future research directions.

  13. Determinants of Coverage Decisions in Health Insurance Marketplaces: Consumers' Decision-Making Abilities and the Amount of Information in Their Choice Environment

    PubMed Central

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

    2015-01-01

    Objective To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace. Study Setting Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161). Study Design We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total estimated annual costs of the cheapest plan available). Data Collection Primary data were collected using an online questionnaire. Principal Findings Uninsured who were more numerate showed higher health insurance comprehension; those with more health insurance comprehension made choices of health insurance plans more consistent with their stated preferences; and those who made choices more concordant with their stated preferences were less likely to choose a plan that cost more than $500 in excess of the cheapest plan available. Conclusions Increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces. PMID:24779769

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

    PubMed

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

    2016-09-25

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

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

    PubMed Central

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

    2016-01-01

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

  16. Elucidating Poor Decision-Making in a Rat Gambling Task

    PubMed Central

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

    2013-01-01

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

  17. A cross-sectional survey to assess the migraineur's medication decision-making beliefs: determining when a migraine is triptan-worthy.

    PubMed

    Landy, Stephen H; Turner, Ira M; Runken, M Chris; Lee, Mechele; Sulcs, Ellen; Bell, Christopher F

    2013-01-01

    To investigate the factors that influence a migraineur's beliefs regarding oral triptans for the acute treatment of migraines and to provide further insight into patients' decision-making process when faced with migraine. A multicenter, cross-sectional, observational study of subjects currently prescribed an oral triptan medication for the acute treatment of migraine headaches. Subjects were recruited from 6 headache clinics and one primary care practice in the United States. Enrolled subjects completed a questionnaire that could be completed either at the site as part of the visit or at home. The questionnaire comprised 27 questions assessing demographic characteristics, migraine history, migraine frequency and severity, and general beliefs about migraine treatments. The study population was stratified into 2 cohorts (Early Treatment and Delayed Treatment) based on how they typically use their oral triptan to treat a typical migraine. A total 506 subjects were enrolled in the study, of which 502 were stratified into the Early Treatment cohort (41.2%) and Delayed Treatment cohort (58.8%). Demographic and clinical characteristics were generally similar between the 2 cohorts. In terms of general treatment patterns, there were notable differences between the Delayed and Early Treatment cohorts, with the Delayed Treatment cohort significantly more likely to take an over-the-counter (OTC) or non-triptan medication first (P ≤ .001) and only take a triptan if the OTC or non-triptan medication did not work (P ≤ .001). Furthermore, 55% of the Delayed Treatment cohort delayed taking a triptan to be certain that the headache was a migraine (vs 32% of the Early Treatment cohort; P ≤ .001). When asked to specify the reasons for delaying treatment with a triptan, the Delayed Treatment cohort had, in general, greater concerns about using their oral triptan in comparison with the Early Treatment cohort. In particular, respondents were primarily concerned with

  18. Participatory modeling and structured decision making

    USGS Publications Warehouse

    Robinson, Kelly F.; Fuller, Angela K.

    2016-01-01

    Structured decision making (SDM) provides a framework for making sound decisions even when faced with uncertainty, and is a transparent, defensible, and replicable method used to understand complex problems. A hallmark of SDM is the explicit incorporation of values and science, which often includes participation from multiple stakeholders, helping to garner trust and ultimately result in a decision that is more likely to be implemented. The core steps in the SDM process are used to structure thinking about natural resources management choices, and include: (1) properly defining the problem and the decision context, (2) determining the objectives that help describe the aspirations of the decision maker, (3) devising management actions or alternatives that can achieve those objectives, (4) evaluating the outcomes or consequences of each alternative on each of the objectives, (5) evaluating trade-offs, and (6) implementing the decision. Participatory modeling for SDM includes engaging stakeholders in some or all of the steps of the SDM process listed above. In addition, participatory modeling often is crucial for creating qualitative and quantitative models of how the system works, providing data for these models, and eliciting expert opinion when data are unavailable. In these ways, SDM provides a framework for decision making in natural resources management that includes participation from stakeholder groups throughout the process, including the modeling phase.

  19. Decision-making and accountability: differences of distribution.

    PubMed

    Goodwin, Dawn

    2014-01-01

    The cognitive and individual framing of clinical decision-making has been undermined in the social sciences by attempts to reframe decision-making as being distributed. In various ways, shifts in understanding in social science research and theorising have wrested clinical decision-making away from the exclusive domain of medical practice and shared it throughout the healthcare disciplines. The temporality of decision-making has been stretched from discrete moments of cognition to being incrementally built over many instances of time and place, and the contributors towards decision-making have been expanded to include non-humans such as policies, guidelines and technologies. However, frameworks of accountability fail to recognise this distributedness and instead emphasise independence of thought and autonomy of action. In this article I illustrate this disparity by contrasting my ethnographic accounts of clinical practice with the professional codes of practice produced by the General Medical Council and the Nursing and Midwifery Council. I argue that a 'thicker' concept of accountability is needed; one that can accommodate the diffuseness of decision-making and the dependencies incurred in collaborative work. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  20. Competence and Quality in Real-Life Decision Making

    PubMed Central

    2015-01-01

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

  1. Shared decision-making in epilepsy management.

    PubMed

    Pickrell, W O; Elwyn, G; Smith, P E M

    2015-06-01

    Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Decision Making in the Information Age

    DTIC Science & Technology

    2007-11-02

    editor at Harvard Business Review , wrote an essay called, When to Trust Your Gut. The essay describes intuitive decision-making in business leaders...9 Peter F. Drucker, "The Effective Decision," in Harvard Business Review on Decision Making, Boston, MA: Harvard Business School Publishing, 2001, pp...2-3. Hereafter cited as Drucker, HBR. 10 Drucker, HBR, p. 2. 11 Amitai Etzioni, "Humble Decision Making," in Harvard Business Review on Decision

  3. Planning and Decision Making for Care Transitions

    PubMed Central

    Sörensen, Silvia; Mak, Wingyun; Pinquart, Martin

    2015-01-01

    The need to plan for future health care and residential adjustments increases with age, growing frailty, and restrictions in coverage of long-term care and will continue to grow with population aging. Older adults’ lack of financial preparation for health care costs, insufficient knowledge about available options, and inadequate communication about care-related values has become an increasing public health challenge. This chapter describes a model of Preparation for Future Care (PFC), which encompasses different levels and domains of planning. Research about the extent to which planning is helpful in navigating care transitions is reviewed, and barriers and facilitators of planning including individual, familial, cultural, and national long-term care policy factors are discussed. Planning in the context of dementia and practical approaches that can be taken to enhance PFC is addressed, as well as recommendations for future research in the area of planning and decision making in the context of care transitions. PMID:26207079

  4. Quality of decision making and group norms.

    PubMed

    Postmes, T; Spears, R; Cihangir, S

    2001-06-01

    Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas consensus norms did not. This effect appeared to be mediated by the perceived value of shared and unshared information: Consensus norm groups valued shared information more highly than critical groups did, and valence was a good predictor of decision outcome. In addition, the 2nd study showed that the group norm manipulation has no impact on individual decisions, consistent with the assumption that this is a group effect. Results suggest that the content of group norms is an important factor influencing the quality of group decision-making processes and that the content of group norms may be related to the group's proneness for groupthink.

  5. Shared Decision Making and Serious Mental Illness

    PubMed Central

    Mahone, Irma H.

    2011-01-01

    This study examined medication decision making by 84 persons with serious mental illness, specifically examining relationships among perceived coercion, decisional capacity, preferences for involvement and actual participation, and the outcomes of medication adherence and QoL. Multiple and logistic regression analysis were used in this cross-sectional, descriptive study, controlling for demographic, socio-economic and utilization variables. Appreciation was positively related to medication adherence behaviors for the past six months. Females, older individuals and those living independently were more likely to have taken all their medications over the past six months. Neither client participation, preference, nor preference-participation agreement was found to be associated with better medication adherence or QoL. PMID:15305278

  6. Decision making: from neuroscience to psychiatry.

    PubMed

    Lee, Daeyeol

    2013-04-24

    Adaptive behaviors increase the likelihood of survival and reproduction and improve the quality of life. However, it is often difficult to identify optimal behaviors in real life due to the complexity of the decision maker's environment and social dynamics. As a result, although many different brain areas and circuits are involved in decision making, evolutionary and learning solutions adopted by individual decision makers sometimes produce suboptimal outcomes. Although these problems are exacerbated in numerous neurological and psychiatric disorders, their underlying neurobiological causes remain incompletely understood. In this review, theoretical frameworks in economics and machine learning and their applications in recent behavioral and neurobiological studies are summarized. Examples of such applications in clinical domains are also discussed for substance abuse, Parkinson's disease, attention-deficit/hyperactivity disorder, schizophrenia, mood disorders, and autism. Findings from these studies have begun to lay the foundations necessary to improve diagnostics and treatment for various neurological and psychiatric disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Instructional decision making of high school science teachers

    NASA Astrophysics Data System (ADS)

    Carver, Jeffrey S.

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

  8. Governing for a Healthy Population: Towards an Understanding of How Decision-Making Will Determine Our Global Health in a Changing Climate

    PubMed Central

    Bowen, Kathryn J.; Friel, Sharon; Ebi, Kristie; Butler, Colin D.; Miller, Fiona; McMichael, Anthony J.

    2011-01-01

    Enhancing the adaptive capacity of individuals, communities, institutions and nations is pivotal to protecting and improving human health and well-being in the face of systemic social inequity plus dangerous climate change. However, research on the determinants of adaptive capacity in relation to health, particularly concerning the role of governance, is in its infancy. This paper highlights the intersections between global health, climate change and governance. It presents an overview of these key concerns, their relation to each other, and the potential that a greater understanding of governance may present opportunities to strengthen policy and action responses to the health effects of climate change. Important parallels between addressing health inequities and sustainable development practices in the face of global environmental change are also highlighted. We propose that governance can be investigated through two key lenses within the earth system governance theoretical framework; agency and architecture. These two governance concepts can be evaluated using methods of social network research and policy analysis using case studies and is the subject of further research. PMID:22470278

  9. Excessive Internet gaming and decision making: do excessive World of Warcraft players have problems in decision making under risky conditions?

    PubMed

    Pawlikowski, Mirko; Brand, Matthias

    2011-08-15

    The dysfunctional behavior of excessive Internet gamers, such as preferring the immediate reward (to play World of Warcraft) despite the negative long-term consequences may be comparable with the dysfunctional behavior in substance abusers or individuals with behavioral addictions, e.g. pathological gambling. In these disorders, general decision-making deficits have been demonstrated. Hence, the aim of the present work was to examine decision-making competences of excessive World of Warcraft players. Nineteen excessive Internet gamers (EIG) and a control group (CG) consisting of 19 non-gamers were compared with respect to decision-making abilities. The Game of Dice Task (GDT) was applied to measure decision-making under risky conditions. Furthermore psychological-psychiatric symptoms were assessed in both groups. The EIG showed a reduced decision-making ability in the GDT. Furthermore the EIG group showed a higher psychological-psychiatric symptomatology in contrast to the CG. The results indicate that the reduced decision-making ability of EIG is comparable with patients with other forms of behavioral addiction (e.g. pathological gambling), impulse control disorders or substance abusers. Thus, these results suggest that excessive Internet gaming may be based on a myopia for the future, meaning that EIG prefer to play World of Warcraft despite the negative long-term consequences in social or work domains of life. 2011 Elsevier Ltd. All rights reserved.

  10. Incorporating affective bias in models of human decision making

    NASA Technical Reports Server (NTRS)

    Nygren, Thomas E.

    1991-01-01

    Research on human decision making has traditionally focused on how people actually make decisions, how good their decisions are, and how their decisions can be improved. Recent research suggests that this model is inadequate. Affective as well as cognitive components drive the way information about relevant outcomes and events is perceived, integrated, and used in the decision making process. The affective components include how the individual frames outcomes as good or bad, whether the individual anticipates regret in a decision situation, the affective mood state of the individual, and the psychological stress level anticipated or experienced in the decision situation. A focus of the current work has been to propose empirical studies that will attempt to examine in more detail the relationships between the latter two critical affective influences (mood state and stress) on decision making behavior.

  11. Competency and common law: why and how decision-making capacity criteria should be drawn from the capacity-determination process.

    PubMed

    Baron, C H

    2000-06-01

    Determining competence to request physician-assisted suicide should be no more difficult than determining competence to refuse life-prolonging treatment. In both cases, criteria and procedures should be developed out of the process of actually making capacity determinations; they should not be promulgated a priori. Because patient demeanor plays a critical role in capacity determinations, it should be made part of the record of such determinations through greater use of video- and audiotapes.

  12. Decision-Making Strategies for College Students

    ERIC Educational Resources Information Center

    Morey, Janis T.; Dansereau, Donald F.

    2010-01-01

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

  13. Decision Making from a Small Group Perspective.

    ERIC Educational Resources Information Center

    Goldberg, Alvin A.; Hannegan, David W., Jr.

    This paper applies some of the research done on small group decision-making to the process of identification and selection of colleges by high school students. It argues that, since the decisions that are reached are often group decisions, or are at least strongly influenced by groups, an understanding of group decision-making processes can be…

  14. Decision Making: New Paradigm for Education.

    ERIC Educational Resources Information Center

    Wales, Charles E.; And Others

    1986-01-01

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

  15. Decision Making in Educational Settings. Fastback 211.

    ERIC Educational Resources Information Center

    Sharman, Charles S.

    This booklet reviews decision-making, an important part of administrative processes, from the perspective of school teachers and other educators. The two most commonly used processes are the rational decision-making process (identify the problem, evaluate the problem, collect information, identify alternative solutions, select and implement…

  16. Ethical Decision-Making for Homeland Security

    DTIC Science & Technology

    2013-09-01

    the work of homeland security. Philosophical underpinnings include virtue ethics, deontology, utilitarianism , decision-making practices, and values...deontology, utilitarianism , torture, terrorism, Canadian Defense Ethics Program, Wildfire Leadership Development Program, DRIVE 15. NUMBER OF PAGES...security. Philosophical underpinnings include virtue ethics, deontology, utilitarianism , decision- making practices, and values common to the

  17. Influence of framing on medical decision making

    PubMed Central

    Gong, Jingjing; Zhang, Yan; Feng, Jun; Huang, Yonghua; Wei, Yazhou; Zhang, Weiwei

    2013-01-01

    Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision making. Unfortunately, research is still inconsistent as to how so many variables impact framing effects in medical decision making. Additionally, much attention should be paid to the framing effect not only in hypothetical scenarios but also in clinical experience. PMID:27034630

  18. Health care decision-making capacity: a legal perspective for long-term care providers.

    PubMed

    Zimring, Stuart D

    2006-06-01

    While federal law establishes guidelines that designated facilities must follow in providing information about a patient's rights regarding self-determination in the health care decision-making process, state law determines the decision-making process and the legal requirements pertaining thereto. A person's capacity to make health care decisions or to have the authority and capacity to delegate the right to make such decisions is a legal conclusion based on statutory and common law principles. This article discusses the legal perspective of capacity in health care decision making and the legal framework of the question of whether or not a person has the capacity to make health care decisions. Western civilization's concepts of personal autonomy and self-determination are at the core of health care decision making, but health care providers must be aware that other cultures do not always share that value system. Sensitivity to multicultural diversity in this context is imperative to maintain individual self-esteem and respect, both for the patient and the patient's family.

  19. Preferences of acutely ill patients for participation in medical decision-making.

    PubMed

    Wilkinson, C; Khanji, M; Cotter, P E; Dunne, O; O'Keeffe, S T

    2008-04-01

    To determine patient preferences for information and for participation in decision-making, and the determinants of these preferences in patients recently admitted to an acute hospital. Prospective questionnaire-based study. Medical wards of an acute teaching hospital. One hundred and fifty-two consecutive acute medical inpatients, median age 74 years. Standardised assessment included abbreviated mental test and subjective measure of severity of illness. Patients' desire for information was assessed using a 5-point Likert scale, and their desire for a role in medical decision-making using the Degner Control of Preferences Scale. Of the 152 patients, 93 (61%) favoured a passive approach to decision-making (either "leave all decisions to the doctor" or "doctor makes final decision but seriously considers my opinion." In contrast, 101 (66%) patients sought "very extensive" or "a lot" of information about their condition. No significant effects of age, sex, socio-economic group or severity of acute illness on desire for information or the Degner scale result were found. There was no agreement between patients' preferences on the Degner scale and their doctors' predictions of those preferences. Acute medical inpatients want to receive a lot of information about their illness, but most prefer a relatively passive role in decision-making. The only way to determine individual patient preferences is to ask them; preferences cannot be predicted from clinical or sociodemographic data.

  20. Reduced model-based decision-making in schizophrenia.

    PubMed

    Culbreth, Adam J; Westbrook, Andrew; Daw, Nathaniel D; Botvinick, Matthew; Barch, Deanna M

    2016-08-01

    Individuals with schizophrenia have a diminished ability to use reward history to adaptively guide behavior. However, tasks traditionally used to assess such deficits often rely on multiple cognitive and neural processes, leaving etiology unresolved. In the current study, we adopted recent computational formalisms of reinforcement learning to distinguish between model-based and model-free decision-making in hopes of specifying mechanisms associated with reinforcement-learning dysfunction in schizophrenia. Under this framework, decision-making is model-free to the extent that it relies solely on prior reward history, and model-based if it relies on prospective information such as motivational state, future consequences, and the likelihood of obtaining various outcomes. Model-based and model-free decision-making was assessed in 33 schizophrenia patients and 30 controls using a 2-stage 2-alternative forced choice task previously demonstrated to discern individual differences in reliance on the 2 forms of reinforcement-learning. We show that, compared with controls, schizophrenia patients demonstrate decreased reliance on model-based decision-making. Further, parameter estimates of model-based behavior correlate positively with IQ and working memory measures, suggesting that model-based deficits seen in schizophrenia may be partially explained by higher-order cognitive deficits. These findings demonstrate specific reinforcement-learning and decision-making deficits and thereby provide valuable insights for understanding disordered behavior in schizophrenia. (PsycINFO Database Record

  1. Autonomous decision making and moral capacities.

    PubMed

    Moser, Albine; Houtepen, Rob; van der Bruggen, Harry; Spreeuwenberg, Cor; Widdershoven, Guy

    2009-03-01

    This article examines how people with type 2 diabetes perceive autonomous decision making and which moral capacities they consider important in diabetes nurses' support of autonomous decision making. Fifteen older adults with type 2 diabetes were interviewed in a nurse-led unit. First, the data were analysed using the grounded theory method. The participants described a variety of decision-making processes in the nurse and family care-giver context. Later, descriptions of the decision-making processes were analysed using hermeneutic text interpretation. We suggest first- and second-order moral capacities that nurses specializing in diabetes need to promote the autonomous decision making of their patients. We recommend nurses to engage in ongoing, interactive reflective practice to further develop these moral capacities.

  2. Toward a Psychology of Surrogate Decision Making.

    PubMed

    Tunney, Richard J; Ziegler, Fenja V

    2015-11-01

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

  3. Entrustment Decision Making in Clinical Training.

    PubMed

    Ten Cate, Olle; Hart, Danielle; Ankel, Felix; Busari, Jamiu; Englander, Robert; Glasgow, Nicholas; Holmboe, Eric; Iobst, William; Lovell, Elise; Snell, Linda S; Touchie, Claire; Van Melle, Elaine; Wycliffe-Jones, Keith

    2016-02-01

    The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee's development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors' aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment.

  4. Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease.

    PubMed

    Harwood, Lori; Clark, Alexander M

    2012-03-01

    Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology.

  5. Patient participation in collective healthcare decision making: the Dutch model.

    PubMed

    van de Bovenkamp, Hester M; Trappenburg, Margo J; Grit, Kor J

    2010-03-01

    To study whether the Dutch participation model is a good model of participation. Patient participation is on the agenda, both on the individual and the collective level. In this study, we focus on the latter by looking at the Dutch model in which patient organizations are involved in many formal decision-making processes. This model can be described as neo-corporatist. We did 52 interviews with actors in the healthcare field, 35 of which were interviews with representatives of patient organizations and 17 with actors that involved patient organizations in their decision making. Dutch patient organizations have many opportunities to participate in formal healthcare decision making and, as a result, have become institutionalized. Although there were several examples identified in which patient organizations were able to influence decision making, patient organizations remain in a dependent position, which they try to overcome through professionalization. Although this model of participation gives patient organizations many opportunities to participate, it also causes important tensions. Many organizations cannot cope with all the participation possibilities attributed to them. This participation abundance can therefore cause redistribution effects. Furthermore, their dependent position leads to the danger of being put to instrumental use. Moreover, professionalization causes tensions concerning empowerment possibilities and representativeness. Conclusion Although the Dutch model tries to make patient organizations an equal party in healthcare decision making, this goal is not reached in practice. It is therefore important to study more closely which subjects patients can and should contribute to, and in what way.

  6. Stages of dysfunctional decision-making in addiction.

    PubMed

    Verdejo-Garcia, Antonio; Chong, Trevor T-J; Stout, Julie C; Yücel, Murat; London, Edythe D

    2017-02-16

    Drug use is a choice with immediate positive outcomes, but long-term negative consequences. Thus, the repeated use of drugs in the face of negative consequences suggests dysfunction in the cognitive mechanisms underpinning decision-making. This cognitive dysfunction can be mapped into three stages: the formation of preferences involving valuation of decision options; choice implementation including motivation, self-regulation and inhibitory processes; and feedback processing implicating reinforcement learning. This article reviews behavioral studies that have examined alterations in these three stages of decision-making in people with substance use disorders. Relative to healthy individuals, those with alcohol, cannabis, stimulant and opioid use disorders value risky options more highly during the formation of preferences; have a greater appetite for superficially attractive rewards during choice implementation; and are both more efficient in learning from rewards and less efficient in learning from losses during feedback processing. These observed decision-making deficits are most likely due to both premorbid factors and drug-induced effects. Because decision-making deficits have been prospectively associated with a greater risk of drug relapse, we advocate for greater research on modulating the component stages that give rise to dysfunctional decision-making in disorders of addiction.

  7. Using M and S to Improve Human Decision Making and Achieve Effective Problem Solving in an International Environment

    NASA Technical Reports Server (NTRS)

    Christie, Vanessa L.; Landess, David J.

    2012-01-01

    In the international arena, decision makers are often swayed away from fact-based analysis by their own individual cultural and political bias. Modeling and Simulation-based training can raise awareness of individual predisposition and improve the quality of decision making by focusing solely on fact vice perception. This improved decision making methodology will support the multinational collaborative efforts of military and civilian leaders to solve challenges more effectively. The intent of this experimental research is to create a framework that allows decision makers to "come to the table" with the latest and most significant facts necessary to determine an appropriate solution for any given contingency.

  8. Small-group decision making can be effective management tool.

    PubMed

    Kennedy, R

    1978-01-01

    One of the key components of effective management is the ability to make decisions. To more effectively assist hospital supervisors and managers in dealing with and making appropriate judgments, educators need to examine carefully the processes involved in decision making and how they impact on both the individual and the group. The following discussion of structured small-group decision making is adapted from an independent study of the literature undertaken by this author to dissect these processes and how they impact on the decisions made.

  9. Decision Making on the Labor and Delivery Unit: An Investigation of Influencing Factors.

    PubMed

    Gregory, Megan E; Sonesh, Shirley C; Feitosa, Jennifer; Benishek, Lauren E; Hughes, Ashley M; Salas, Eduardo

    2017-09-01

    Objective The aim of this study was to describe the relationship between negative affect (NA), decision-making style, time stress, and decision quality in health care. Background Health care providers must often make swift, high-stakes decisions. Influencing factors of the decision-making process in this context have been understudied. Method Within a sample of labor and delivery nurses, physicians, and allied personnel, we used self-report measures to examine the impact of trait factors, including NA, decision-making style, and perceived time stress, on decision quality in a situational judgment test (Study 1). In Study 2, we observed the influence of state NA, state decision-making style, state time stress, and their relationship with decision quality on real clinical decisions. Results In Study 1, we found that trait NA significantly predicted avoidant decision-making style. Furthermore, those who were higher on trait time stress and trait avoidant decision-making style exhibited poorer decisions. In Study 2, we observed associations between state NA with state avoidant and analytical decision-making styles. We also observed that these decision-making styles, when considered in tandem with time stress, were influential in predicting clinical decision quality. Conclusion NA predicts some decision-making styles, and decision-making style can affect decision quality under time stress. This is particularly true for state factors. Application Individual differences, such as affect and decision-making style, should be considered during selection. Training to reduce time stress perceptions should be provided.

  10. Modelling decision-making by pilots

    NASA Technical Reports Server (NTRS)

    Patrick, Nicholas J. M.

    1993-01-01

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

  11. [Nursing contribution in health decision making].

    PubMed

    Mosqueda-Díaz, Angélica; Mendoza-Parra, Sara; Jofré-Aravena, Viviane

    2014-01-01

    Decision making in health is a frequent situation, although potentially difficult, depending on patient/user characteristics and the context or the situation of health. This causes decisional conflicts in patients/users. The present study proposes to analyze the decision making process in health, conceptually, and nurses' contributions to understand and confront the phenomenon. The Ottawa the Model of Decisions Making in Health, proposed by Annette O'Connor, arises as a useful tool that enables nurses to carry out effective interventions with persons who face decision problems. Patients/users can assume a more active participation in the decisions on their own health.

  12. Influencing factors in MMR immunisation decision making.

    PubMed

    Hill, Marie C; Cox, Carol L

    Immunisation decision making is not a straightforward process for parents. Many factors influence parental decision making on whether they immunise their child with the measles, mumps and rubella (MMR) vaccine. The feasibility study described in this article provides insight into influencing factors associated with decisions regarding the immunisation of children by parents. The study findings suggest that the practice nurse is a credible source of information for parents seeking informed decision making. At a time when the incidence of measles and mumps is rising in the UK, the provision of appropriate information by the practice nurse has the potential to increase uptake of the MMR vaccine.

  13. Personality and Health Care Decision-Making Style

    PubMed Central

    Flynn, Kathryn E.; Smith, Maureen A.

    2008-01-01

    Using the Wisconsin Longitudinal Study Graduate Survey (N = 5,830), a population-based cohort of older adults (most aged 63–66 years), we explored relationships between five factors of personality and four preference types that account for multiple components of the health care decision-making process (information exchange, deliberation, and selection of treatment choice). After adjustment for personal, health, social, and economic factors, we found that increased conscientiousness and openness to experience and decreased agreeableness and neuroticism corresponded to preferring the most active decision-making style compared with the least active. A better understanding of how personality traits relate to patient decision-making styles may help clinicians tailor treatment discussions to the needs and preferences of individual patients. PMID:17906167

  14. Substituted judgment: the limitations of autonomy in surrogate decision making.

    PubMed

    Torke, Alexia M; Alexander, G Caleb; Lantos, John

    2008-09-01

    Substituted judgment is often invoked as a guide for decision making when a patient lacks decision making capacity and has no advance directive. Using substituted judgment, doctors and family members try to make the decision that the patient would have made if he or she were able to make decisions. However, empirical evidence suggests that the moral basis for substituted judgment is unsound. In spite of this, many physicians and bioethicists continue to rely on the notion of substituted judgment. Given compelling evidence that the use of substituted judgment has insurmountable flaws, other approaches should be considered. One approach provides limits on decision making using a best interest standard based on community norms. A second approach uses narrative techniques and focuses on each patient's dignity and individuality rather than his or her autonomy.

  15. Decision-making and Anticipation in Pill Bugs (Armadillidium vulgare)

    NASA Astrophysics Data System (ADS)

    Moriyama, Tohru; Migita, Masao

    2004-08-01

    In the previous study, decision-making of the direction of motion was found in pill bugs. In the present experiment, we find that they autonomously choose specific places for the decision-making. Each individual was placed in a circle track surrounded by water. Small columnar marks were placed in the center of the track at equal intervals. At first, when they encountered the marks, they moved along and passed it. After some minutes, they tended to mount on the top of the marks, stayed for a while and swung the antennae as if they searched for the direction of motion. As time went on, they sometimes traced several marks. It seemed that they anticipated the appearance of the mark in advance to use it for decision-making of the direction of the next motion. In another circle track surrounded by wall, such behaviors were not observed.

  16. The Career Decision-Making Process of Chinese American Youth

    ERIC Educational Resources Information Center

    Okubo, Yuki; Yeh, Christine J.; Lin, Pei-Ying; Fujita, Kotoko; Shea, J. Mun-Yi

    2007-01-01

    The authors investigated how negotiating two cultural expectations may influence the career decision-making process of Chinese youth. In-depth interviews were conducted with 8 participants addressing issues of role models, career interests, and individuals with whom they discussed career concerns. Consensual Qualitative Research (C. E. Hill, B. J.…

  17. Neural Correlates of Decision Making on a Gambling Task

    ERIC Educational Resources Information Center

    Carlson, Stephanie M.; Zayas, Vivian; Guthormsen, Amy

    2009-01-01

    Individual differences in affective decision making were examined by recording event-related potentials (ERPs) while 74 typically developing 8-year-olds (38 boys, 36 girls) completed a 4-choice gambling task (Hungry Donkey Task; E. A. Crone & M. W. van der Molen, 2004). ERP results indicated: (a) a robust P300 component in response to feedback…

  18. The Adaptability of Career Decision-Making Profiles

    ERIC Educational Resources Information Center

    Gadassi, Reuma; Gati, Itamar; Dayan, Amira

    2012-01-01

    The Career Decision-Making Profiles questionnaire (CDMP; Gati, Landman, Davidovitch, Asulin-Peretz, & Gadassi, 2010) uses a new model for characterizing the way individuals make decisions based on the simultaneous use of 11 dimensions. The present study investigated which pole of each dimension is more adaptive. Using the data of 383 young…

  19. The Adaptability of Career Decision-Making Profiles

    ERIC Educational Resources Information Center

    Gadassi, Reuma; Gati, Itamar; Dayan, Amira

    2012-01-01

    The Career Decision-Making Profiles questionnaire (CDMP; Gati, Landman, Davidovitch, Asulin-Peretz, & Gadassi, 2010) uses a new model for characterizing the way individuals make decisions based on the simultaneous use of 11 dimensions. The present study investigated which pole of each dimension is more adaptive. Using the data of 383 young…

  20. How Decisions Emerge: Action Dynamics in Intertemporal Decision Making

    ERIC Educational Resources Information Center

    Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas

    2013-01-01

    In intertemporal decision making, individuals prefer smaller rewards delivered sooner over larger rewards delivered later, often to an extent that seems irrational from an economical perspective. This behavior has been attributed to a lack of self-control and reflection, the nonlinearity of human time perception, and several other sources.…

  1. Understanding and Interpreting Career Decision-Making Difficulties

    ERIC Educational Resources Information Center

    Amir, Tamar; Gati, Itamar; Kleiman, Tali

    2008-01-01

    This research develops and tests a procedure for interpreting individuals' responses in multiscale career assessments, using the Career Decision-Making Difficulties Questionnaire (CDDQ). In Study 1, criteria for ascertaining the credibility of responses were developed, based on the judgments of 39 career-counseling experts. In Study 2, the…

  2. Dysfunctional Thinking and Difficulties in Career Decision Making

    ERIC Educational Resources Information Center

    Kleiman, Tali; Gati, Itamar; Peterson, Gary; Sampson, James; Reardon, Robert; Lenz, Janet

    2004-01-01

    The present study examined the relationships between two measures of career readiness and difficulties--the Career Thoughts Inventory (CTI) and the Career Decision-Making Difficulties Questionnaire (CDDQ)--as well as the relations between these measures and the individual's degree of decidedness regarding his or her career plans. A total of 192…

  3. Career Decision-Making Profiles of Italian Adolescents

    ERIC Educational Resources Information Center

    Ginevra, Maria Cristina; Nota, Laura; Soresi, Salvatore; Gati, Itamar

    2012-01-01

    The goal of the present study was to test the psychometric properties of the Italian version of the "Career Decision-Making Profile" ("CDMP") questionnaire with a sample of 1,835 adolescents. Gati, Landman, Davidovitch, Asulin-Peretz, and Gadassi suggested that the way individuals make career decisions should not be described…

  4. Children and Families' Involvement in Social Work Decision Making

    ERIC Educational Resources Information Center

    Gallagher, Michael; Smith, Mark; Hardy, Mark; Wilkinson, Heather

    2012-01-01

    This review summarises the research literature on children's and parents' involvement in social work decision making, which is regarded, in policy terms, as increasingly important. In practice, however, it tends to be messy, difficult and compromised. Different individuals or groups may have different understandings of participation and related…

  5. Health-Related Decision-Making in HIV Disease

    PubMed Central

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

    2016-01-01

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

  6. The Relationships between Cognitive Ability and Dynamic Decision Making

    ERIC Educational Resources Information Center

    Gonzalez, C.; Thomas, R.P.; Vanyukov, P.

    2005-01-01

    This study investigated the relationships between cognitive ability (as assessed by the Raven Progressive Matrices Test [RPM] and the Visual-Span Test [VSPAN]) and individuals' performance in three dynamic decision making (DDM) tasks (i.e., regular Water Purification Plant [WPP], Team WPP, and Firechief). Participants interacted repeatedly with…

  7. Neural Correlates of Decision Making on a Gambling Task

    ERIC Educational Resources Information Center

    Carlson, Stephanie M.; Zayas, Vivian; Guthormsen, Amy

    2009-01-01

    Individual differences in affective decision making were examined by recording event-related potentials (ERPs) while 74 typically developing 8-year-olds (38 boys, 36 girls) completed a 4-choice gambling task (Hungry Donkey Task; E. A. Crone & M. W. van der Molen, 2004). ERP results indicated: (a) a robust P300 component in response to feedback…

  8. The Nature of Democratic Decision Making and the Democratic Panacea

    ERIC Educational Resources Information Center

    Shaw, Robert K.

    2011-01-01

    "Democracy thrives because it helps individuals identify with the society of which they are members and because it provides for legitimate decision-making and exercise of power." With this statement, the Council of Europe raises for us some fundamental questions: what is the practice of democracy, its merits and its limitations? A…

  9. The Risky Shift in Policy Decision Making: A Comparative Analysis

    ERIC Educational Resources Information Center

    Wilpert, B.; And Others

    1976-01-01

    Based on analysis of data on 432 decision-makers from around the world, this study examines the decision-making phenomenon that individuals tend to move toward riskier decisions after group discussion. Findings of the analysis contradicted earlier studies, showing a consistent shift toward greater risk avoidance. Available from Elsevier Scientific…

  10. The Risky Shift in Policy Decision Making: A Comparative Analysis

    ERIC Educational Resources Information Center

    Wilpert, B.; And Others

    1976-01-01

    Based on analysis of data on 432 decision-makers from around the world, this study examines the decision-making phenomenon that individuals tend to move toward riskier decisions after group discussion. Findings of the analysis contradicted earlier studies, showing a consistent shift toward greater risk avoidance. Available from Elsevier Scientific…

  11. Prefrontal Brain Activity Predicts Temporally Extended Decision-Making Behavior

    ERIC Educational Resources Information Center

    Yarkoni, Tal; Braver, Todd S.; Gray, Jeremy R.; Green, Leonard

    2005-01-01

    Although functional neuroimaging studies of human decision-making processes are increasingly common, most of the research in this area has relied on passive tasks that generate little individual variability. Relatively little attention has been paid to the ability of brain activity to predict overt behavior. Using functional magnetic resonance…

  12. EVALUATION OF A TECHNIQUE FOR CLASSROOM PRACTICE IN DECISION MAKING.

    ERIC Educational Resources Information Center

    ABRAHAMS, NORMAN M.

    A STUDY WAS CONDUCTED TO EVALUATE, IN TERMS OF STUDENT INTEREST AND INSTRUCTIONAL EFFECTIVENESS, INDIVIDUALLY ADMINISTERED NOTEBOOK EXERCISES IN ANTI-AIR WARFARE DECISION MAKING. IN A FIVE DAY TRAINING SESSION, AN EXPERIMENTAL CLASS OF NAVAL OFFICERS RECEIVED NOTEBOOK EXERCISES IN ADDITION TO LECTURES, WHILE A CONTROL GROUP HAD ONLY THE LECTURES.…

  13. The Relationships between Cognitive Ability and Dynamic Decision Making

    ERIC Educational Resources Information Center

    Gonzalez, C.; Thomas, R.P.; Vanyukov, P.

    2005-01-01

    This study investigated the relationships between cognitive ability (as assessed by the Raven Progressive Matrices Test [RPM] and the Visual-Span Test [VSPAN]) and individuals' performance in three dynamic decision making (DDM) tasks (i.e., regular Water Purification Plant [WPP], Team WPP, and Firechief). Participants interacted repeatedly with…

  14. How Decisions Emerge: Action Dynamics in Intertemporal Decision Making

    ERIC Educational Resources Information Center

    Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas

    2013-01-01

    In intertemporal decision making, individuals prefer smaller rewards delivered sooner over larger rewards delivered later, often to an extent that seems irrational from an economical perspective. This behavior has been attributed to a lack of self-control and reflection, the nonlinearity of human time perception, and several other sources.…

  15. Career Decision-Making Profiles of Italian Adolescents

    ERIC Educational Resources Information Center

    Ginevra, Maria Cristina; Nota, Laura; Soresi, Salvatore; Gati, Itamar

    2012-01-01

    The goal of the present study was to test the psychometric properties of the Italian version of the "Career Decision-Making Profile" ("CDMP") questionnaire with a sample of 1,835 adolescents. Gati, Landman, Davidovitch, Asulin-Peretz, and Gadassi suggested that the way individuals make career decisions should not be described…

  16. Societal Boundaries on Cybernetic Action or Decision-Making.

    ERIC Educational Resources Information Center

    Schulman, Rosalind; Steg, Doreen E.

    This paper discusses the development, application, and implications of a statistical technique--a concordance index--for measuring the restrictions and constrictions (legal and societal) which inhibit individual decision making and adapting behavior. It was found that as sophistication sets in there will be less and less tolerance of these…

  17. Goal Setting and Decision Making by At-Risk Youth

    ERIC Educational Resources Information Center

    Galotti, Kathleen M.; Kozberg, Steven F.; Gustafon, Mary

    2009-01-01

    Typically, adolescence is a time when individuals begin to make consequential, life-framing decisions. However, much of the decision-making literature focuses on high-risk decisions, such as the use of drugs and alcohol, while much less is known about how adolescents make positive decisions, for example, regarding their educational or career…

  18. Children and Families' Involvement in Social Work Decision Making

    ERIC Educational Resources Information Center

    Gallagher, Michael; Smith, Mark; Hardy, Mark; Wilkinson, Heather

    2012-01-01

    This review summarises the research literature on children's and parents' involvement in social work decision making, which is regarded, in policy terms, as increasingly important. In practice, however, it tends to be messy, difficult and compromised. Different individuals or groups may have different understandings of participation and related…

  19. Dysfunctional Thinking and Difficulties in Career Decision Making

    ERIC Educational Resources Information Center

    Kleiman, Tali; Gati, Itamar; Peterson, Gary; Sampson, James; Reardon, Robert; Lenz, Janet

    2004-01-01

    The present study examined the relationships between two measures of career readiness and difficulties--the Career Thoughts Inventory (CTI) and the Career Decision-Making Difficulties Questionnaire (CDDQ)--as well as the relations between these measures and the individual's degree of decidedness regarding his or her career plans. A total of 192…

  20. 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.

  1. Research Using In Vivo Simulation of Meta-Organizational Shared Decision Making (SDM). Task 3: Testing the Shared Decision Making Framework in Vivo

    DTIC Science & Technology

    2011-12-01

    simulation exercise. Focus groups and meetings with individual reviewers also involved unstructured discussion of the scenarios. This generated...tasks focused on communication issues. Expert reviewers suggested that one task focus on either evacuation or on health and safety issues of responders...Research Using In Vivo Simulation of Meta- Organizational Shared Decision Making (SDM) Task 3: Testing the Shared Decision Making Framework in

  2. Collective decision making in cohesive flocks

    NASA Astrophysics Data System (ADS)

    Bhattacharya, K.; Vicsek, Tamás

    2010-09-01

    Most of us must have been fascinated by the eye-catching displays of collectively moving animals. Schools of fish can move in a rather orderly fashion and then change direction amazingly abruptly. There are a large number of further examples both from the living and the non-living world for phenomena during which the many interacting, permanently moving units seem to arrive at a common behavioural pattern taking place in a short time. As a paradigm of this type of phenomena we consider the problem of how birds arrive at a decision resulting in their synchronized landing. We introduce a simple model to interpret this process. Collective motion prior to landing is modelled using a simple self-propelled particle (SPP) system with a new kind of boundary condition, while the tendency and the sudden propagation of the intention of landing are introduced through rules analogous to the random field Ising model in an external field. We show that our approach is capable of capturing the most relevant features of collective decision making in a system of units with variance of individual intentions and being under an increasing level of pressure to switch states. We find that as a function of the few parameters of our model the collective switching from the flying to the landing state is indeed much sharper than the distribution of individual landing intentions. The transition is accompanied by a number of interesting features discussed in this paper.

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

    NASA Astrophysics Data System (ADS)

    Flaming, Susan C.

    2007-12-01

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

  4. Analysis of the decision-making process of nurse managers: a collective reflection.

    PubMed

    Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

    2015-01-01

    to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

  5. Risk, Reward, and Economic Decision Making in Aging

    PubMed Central

    Mitchell, Suzanne H.; Harbaugh, William T.; Janowsky, Jeri S.

    2012-01-01

    Objectives. Older adults’ decision quality is considered to be worse than that of younger adults. This age-related difference is often attributed to reductions in risk tolerance. Little is known about the circumstances that affect older adults’ decisions and whether risk attitudes directly influence economic decisions. We measure the influence of risk attitudes on age-related differences in decision making in both nonsocial and social contexts. Methods. Risk attitudes and economic decision making were measured in 30 healthy older adults and 29 healthy younger adults. Results. Older adults report being less impulsive, sensation seeking and risk tolerant than younger adults. Age did not affect a measure of nonsocial economic decision making. Older adults were more likely to reject unfair divisions of money during an economic social-bargaining game and more likely to make equitable divisions of money during social-giving game. These age-related differences were determined in part by individuals’ self-reported risk taking. Discussion. We conclude that age-related differences in decision making are domain specific and that some social economic decision making is influenced by risk attitudes. Older adults are more risk avoidant, but this does not alter their willingness to wait for reward in a nonsocial context. Perceiving more risk is associated with an unwillingness to accept an unfair offer in social economic contexts and ultimately leads to poorer outcomes for older adults. PMID:21926401

  6. [Treatment Decision-Making Process of Cancer Patients].

    PubMed

    Lee, Shiu-Yu C Katie

    2016-10-01

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

  7. 24 CFR 55.20 - Decision making process.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Development FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Procedures for Making Determinations on Floodplain Management and Protection of Wetlands § 55.20 Decision making process. Except for actions covered... wetlands. The steps to be followed in the decisionmaking process are as follows: (a) Step 1. Determine...

  8. Career Decision Making and Its Evaluation.

    ERIC Educational Resources Information Center

    Miller-Tiedeman, Anna

    1979-01-01

    The author discusses a career decision-making program which she designed and implemented using a pyramidal model of exploration, crystallization, choice, and classification. Her article outlines the value of rigorous evaluation techniques applied by the local practitioner. (MF)

  9. The functional neuroanatomy of decision-making.

    PubMed

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

    2012-01-01

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

  10. Computational Cognition and Robust Decision Making

    DTIC Science & Technology

    2013-03-06

    processes underlying human performance in complex problem solving tasks; 2. Achieving robust and seamless symbiosis between humans and systems in...prediction, planning, scheduling, and decision making. Challenges and Strategy: • Seek computational principles for optimal symbiosis of mixed human

  11. Teacher Participation in School Decision-Making.

    ERIC Educational Resources Information Center

    Razzell, Arthur

    1979-01-01

    Based partly on his experience at Ravenscote County Middle School, the author illustrates the increasing inappropriateness and indefensibility of headteacher autocracy and the dividends to be reaped from full staff participation in decision making. (Editor)

  12. Computer Graphics and Administrative Decision-Making.

    ERIC Educational Resources Information Center

    Yost, Michael

    1984-01-01

    Reduction in prices now makes it possible for almost any institution to use computer graphics for administrative decision making and research. Current and potential uses of computer graphics in these two areas are discussed. (JN)

  13. [An ethical decision-making tool. Training for decision-making in crisis or end-of-life situations].

    PubMed

    Gomas, J M

    We developed a patient-centered decision making tool to help healthcare teams make ethical decisions in crisis or end-of-life situations. This tool is the fruit of 15 years of healthcare experience and discussions on ethical issues with patients suffering from cancer, severe handicaps or terminal disease. It has been enriched by experience acquired since the publication of earlier work in the nineties. A three-step decision-making process is proposed providing a methodic aid for management decisions which remain unique for each individual patient.

  14. Children's participation in decision-making: balancing protection with shared decision-making using a situational perspective.

    PubMed

    Coyne, Imelda; Harder, Maria

    2011-12-01

    Children's participation in decision-making in the health care setting is complex because parents and health professionals tend to take a protective stance towards children to act in their best interest. Children prefer to be protected in some situations and to share decision-making in others. Adults in the health care setting need to consider children as individuals, rather than as a homogenous group, and take into account that a child's competence and preferences will depend on the circumstances in every situation. This article argues for a situational perspective of children's participation to act in the child's best interest and to balance protection with shared decision-making, according to children's rights and desires.

  15. [Decision-making in a physician's practice].

    PubMed

    Shaposhnikov, A V

    2006-01-01

    The article covers modern principles of the decision-making method, used in medicine and gastroenterology, in particular. These principles are based upon taking into consideration psychosocial features of a doctor and a patient, types of doctor's thinking and pathologic processes, as well as the effect of a range of negative factors, such as conformism, engageness of a doctor, neurotism etc. The author pioneers the treatment of decision-making in medicine.

  16. Decision Making and the Limits of Evidence

    PubMed Central

    Boyko, Matthew; Iancu, Daniela; Lesiuk, Howard; Dowlatshahi, Dar

    2015-01-01

    We report the case of a pregnant woman treated for acute ischemic stroke and review the literature on acute stroke treatment in pregnancy. To our knowledge, this is the first case reporting the successful use of intravenous tissue plasminogen activator and a stent retriever for acute stroke in pregnancy. We then use this case to consider the way medical knowledge is used in therapeutic decision making and argue that decision making necessarily extends beyond the limits of clinical trial evidence. PMID:27053984

  17. Participative Decision Making in Curriculum.

    ERIC Educational Resources Information Center

    Knoop, Robert; O'Reilly, Robert

    This study attempts to render more specific the curriculum decisionmaking models of Goodlad and Myers. Perceived and desired loci and methods of making curriculum decisions in the secondary schools were determined by secondary school personnel in Ontario schools. Results indicated that teachers desired to have their ideas considered rather than to…

  18. Decision making cognition in primary progressive aphasia.

    PubMed

    Gleichgerrcht, Ezequiel; Torralva, Teresa; Roca, María; Szenkman, Daniela; Ibanez, Agustin; Richly, Pablo; Pose, Mariángeles; Manes, Facundo

    2012-01-01

    We sought to investigate the decision making profile of Primary Progressive Aphasia (PPA) by assessing patients diagnosed with this disease (n = 10), patients diagnosed with behavioral variant frontotemporal dementia (bvFTD, n = 35), and matched controls (n = 14) using the Iowa Gambling Task, a widely used test that mimics real-life decision making. Participants were also evaluated with a complete neuropsychological battery. Patients with PPA were unable to adopt an advantageous strategy on the IGT, which resulted in a flat performance, different to that exhibited by both controls (who showed advantageous decision making) and bvFTD patients (who showed risk-appetitive behavior). The decision making profile of PPA patients was not associated with performance on language tasks and did not differ between sub-variants of the disease (namely, semantic dementia and progressive nonfluent aphasia). Investigating decision making in PPA is crucial both from a theoretical perspective, as it can shed light about the way in which language interacts with other cognitive functions, as well as a clinical standpoint, as it could lead to a more objective detection of impairments of decision making deficits in this condition.

  19. Decision Making Cognition in Primary Progressive Aphasia

    PubMed Central

    Gleichgerrcht, Ezequiel; Torralva, Teresa; Roca, María; Szenkman, Daniela; Ibanez, Agustin; Richly, Pablo; Pose, Mariángeles; Manes, Facundo

    2012-01-01

    We sought to investigate the decision making profile of Primary Progressive Aphasia (PPA) by assessing patients diagnosed with this disease (n = 10), patients diagnosed with behavioral variant frontotemporal dementia (bvFTD, n = 35), and matched controls (n = 14) using the Iowa Gambling Task, a widely used test that mimics real-life decision making. Participants were also evaluated with a complete neuropsychological battery. Patients with PPA were unable to adopt an advantageous strategy on the IGT, which resulted in a flat performance, different to that exhibited by both controls (who showed advantageous decision making) and bvFTD patients (who showed risk-appetitive behavior). The decision making profile of PPA patients was not associated with performance on language tasks and did not differ between sub-variants of the disease (namely, semantic dementia and progressive nonfluent aphasia). Investigating decision making in PPA is crucial both from a theoretical perspective, as it can shed light about the way in which language interacts with other cognitive functions, as well as a clinical standpoint, as it could lead to a more objective detection of impairments of decision making deficits in this condition. PMID:22207422

  20. Dispositional optimism, self-framing and medical decision-making.

    PubMed

    Zhao, Xu; Huang, Chunlei; Li, Xuesong; Zhao, Xin; Peng, Jiaxi

    2015-03-01

    Self-framing is an important but underinvestigated area in risk communication and behavioural decision-making, especially in medical settings. The present study aimed to investigate the relationship among dispositional optimism, self-frame and decision-making. Participants (N = 500) responded to the Life Orientation Test-Revised and self-framing test of medical decision-making problem. The participants whose scores were higher than the middle value were regarded as highly optimistic individuals. The rest were regarded as low optimistic individuals. The results showed that compared to the high dispositional optimism group, participants from the low dispositional optimism group showed a greater tendency to use negative vocabulary to construct their self-frame, and tended to choose the radiation therapy with high treatment survival rate, but low 5-year survival rate. Based on the current findings, it can be concluded that self-framing effect still exists in medical situation and individual differences in dispositional optimism can influence the processing of information in a framed decision task, as well as risky decision-making.

  1. Influence of branding on preference-based decision making.

    PubMed

    Philiastides, Marios G; Ratcliff, Roger

    2013-07-01

    Branding has become one of the most important determinants of consumer choices. Intriguingly, the psychological mechanisms of how branding influences decision making remain elusive. In the research reported here, we used a preference-based decision-making task and computational modeling to identify which internal components of processing are affected by branding. We found that a process of noisy temporal integration of subjective value information can model preference-based choices reliably and that branding biases are explained by changes in the rate of the integration process itself. This result suggests that branding information and subjective preference are integrated into a single source of evidence in the decision-making process, thereby altering choice behavior.

  2. User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

    PubMed Central

    2013-01-01

    Background Procurement and distribution of long-lasting insecticidal nets (LLINs) in the African region has decreased from 145 million in 2010 to 66 million nets in 2012. As resources for LLIN distribution appear to stagnate, it is important to understand the users’ perception of the life span of a net and at what point and why they stop using it. In order to get the most value out of distributed nets and to ensure that they are used for as long as possible, programmes must communicate to users about how to assess useful net life and how to extend it. Methods Data were collected from 114 respondents who participated in 56 in-depth interviews (IDIs) and eight focus group discussions (FGDs) in August 2012 in eight regions in Senegal. Households were eligible for the study if they owned at least one net and had an available household member over the age of 18. Data were coded by a team of four coders in ATLAS.ti using a primarily deductive approach. Results Respondents reported assessing useful net life using the following criteria: the age of net, the number and size of holes and the presence of mosquitoes in the net at night. If they had the means to do so, many respondents preferred the acquisition of a new net rather than the continued use of a very torn net. However, respondents would preferentially use newer nets, saving older, but useable nets for the future or sharing them with family or friends. Participants reported observing alternative uses of nets, primarily for nets that were considered expired. Conclusions The results indicate that decisions regarding the end of net life vary among community members in Senegal, but are primarily related to net integrity. Additional research is needed into user-determined end of net life as well as care and repair behaviours, which could extend useful net life. The results from this study and from future research on this topic should be used to understand current behaviours and develop communication programmes to

  3. A collaborative approach to supporting communication in the assessment of decision-making capacity.

    PubMed

    Zuscak, Simon John; Peisah, Carmelle; Ferguson, Alison

    2016-01-01

    This paper explores the clinical implications of acquired communication disorders in decisional capacity. Discipline-specific contributions are discussed in a multidisciplinary context, with a specific focus on the role of speech and language pathologists (SLPs). Key rehabilitation issues in determining decisional capacity are identified. The impact of communication impairment on capacity is discussed in light of the research literature relating to supportive communication and collaborative practice that respects human rights. Guidelines are presented for professionals involved in the assessment of the decisional capacity of individuals with communication disorders of neurological origin. They guide an assessor through: assessing cognition, language and speech; determining preferred communication domains; and practical strategies and considerations for maximising communication. There is a dearth of guidelines available that deal with augmenting and supporting communication of individuals with acquired communication disorders of neurological origin when it comes to assessing legal decision-making capacity. Capacity assessment is a multidisciplinary realm, and the involvement of SLPs is key to maximising the decision-making capacity of these individuals. All clinicians have an obligation to maximise client autonomy and participation in decision-making. Assessments of capacity should involve a general cognitive ability assessment, followed by a decision-specific assessment tool or question set for the decision facing the patient. The involvement of speech and language pathologists (SLPs) is key to assess and facilitate capacity determinations in instances of cognitive-communication disorder. Impairments in different aspects of auditory comprehension require different accommodations.

  4. Understanding antibiotic decision making in surgery-a qualitative analysis.

    PubMed

    Charani, E; Tarrant, C; Moorthy, K; Sevdalis, N; Brennan, L; Holmes, A H

    2017-10-01

    To investigate the characteristics and culture of antibiotic decision making in the surgical specialty. A qualitative study including ethnographic observation and face-to-face interviews with participants from six surgical teams at a teaching hospital in London was conducted. Over a 3-month period: (a) 30 ward rounds (WRs) (100 h) were observed, (b) face-to-face follow-up interviews took place with 13 key informants, (c) multidisciplinary meetings on the management of surgical patients and daily practice on wards were observed. Applying these methods provided rich data for characterizing the antibiotic decision making in surgery and enabled cross-validation and triangulation of the findings. Data from the interview transcripts and the observational notes were coded and analysed iteratively until saturation was reached. The surgical team is in a state of constant flux with individuals having to adjust to the context in which they work. The demands placed on the team to be in the operating room, and to address the surgical needs of the patient mean that the responsibility for antibiotic decision making is uncoordinated and diffuse. Antibiotic decision making is considered by surgeons as a secondary task, commonly delegated to junior members of their team and occurs in the context of disjointed communication. There is lack of clarity around medical decision making for treating infections in surgical patients. The result is sub-optimal and uncoordinated antimicrobial management. Developing the role of a perioperative clinician may help to improve patient-level outcomes and optimize decision making. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Not All Patients Want to Participate in Decision Making

    PubMed Central

    Levinson, Wendy; Kao, Audiey; Kuby, Alma; Thisted, Ronald A

    2005-01-01

    BACKGROUND The Institute of Medicine calls for physicians to engage patients in making clinical decisions, but not every patient may want the same level of participation. OBJECTIVES 1) To assess public preferences for participation in decision making in a representative sample of the U.S. population. 2) To understand how demographic variables and health status influence people's preferences for participation in decision making. DESIGN AND PARTICIPANTS A population-based survey of a fully representative sample of English-speaking adults was conducted in concert with the 2002 General Social Survey (N= 2,765). Respondents expressed preferences ranging from patient-directed to physician-directed styles on each of 3 aspects of decision making (seeking information, discussing options, making the final decision). Logistic regression was used to assess the relationships of demographic variables and health status to preferences. MAIN RESULTS Nearly all respondents (96%) preferred to be offered choices and to be asked their opinions. In contrast, half of the respondents (52%) preferred to leave final decisions to their physicians and 44% preferred to rely on physicians for medical knowledge rather than seeking out information themselves. Women, more educated, and healthier people were more likely to prefer an active role in decision making. African-American and Hispanic respondents were more likely to prefer that physicians make the decisions. Preferences for an active role increased with age up to 45 years, but then declined. CONCLUSION This population-based study demonstrates that people vary substantially in their preferences for participation in decision making. Physicians and health care organizations should not assume that patients wish to participate in clinical decision making, but must assess individual patient preferences and tailor care accordingly. PMID:15987329

  6. [Kairos. Decision-making in medical ethics].

    PubMed

    Jousset, David

    2014-06-01

    This paper assesses the decision making patterns in medical ethics: the formalized pattern of decision science, the meditative pattern of an art of judgement and lastly the still-to-be-elaborated pattern of kairology or sense of the right time. The ethical decision is to be thought out in the conditions of medical action while resorting to the philosophical concepts that shed light on the issue. And it is precisely where medicine and philosophy of human action meet that the Greek notion of kairos, or "propitious moment", evokes the critical point where decision has to do with what is vital. Reflection shows that this kairos can be thought out outside the sacrificial pattern (deciding comes down to killing a possibility) by understanding the opportune moment as a sign of ethical action, as the condition for the formation of the subject (making a decision) and finally as a new relationship to time, including in the context of medical urgency. Thus with an approach to clinical ethics centred on the relation to the individual, the focus is less on the probabilistic knowledge of the decidable than on the meaning of the decision, and the undecidable comes to be accepted as an infinite dimension going beyond the limits of our acts, which makes the contingency and the grandeur of human responsibility.

  7. Imitation versus payoff: Duality of the decision-making process demonstrates criticality and consensus formation

    NASA Astrophysics Data System (ADS)

    Turalska, M.; West, B. J.

    2014-11-01

    We consider a dual model of decision making, in which an individual forms its opinion based on contrasting mechanisms of imitation and rational calculation. The decision-making model (DMM) implements imitating behavior by means of a network of coupled two-state master equations that undergoes a phase transition at a critical value of a control parameter. The evolutionary spatial game, being a generalization of the prisoner's dilemma game, is used to determine in objective fashion the cooperative or anticooperative strategy adopted by individuals. Interactions between two sources of dynamics increases the domain of initial states attracted to phase transition dynamics beyond that of the DMM network in isolation. Additionally, on average the influence of the DMM on the game increases the final observed fraction of cooperators in the system.

  8. Models of Affective Decision Making

    PubMed Central

    Charpentier, Caroline J.; De Neve, Jan-Emmanuel; Li, Xinyi; Roiser, Jonathan P.; Sharot, Tali

    2016-01-01

    Intuitively, how you feel about potential outcomes will determine your decisions. Indeed, an implicit assumption in one of the most influential theories in psychology, prospect theory, is that feelings govern choice. Surprisingly, however, very little is known about the rules by which feelings are transformed into decisions. Here, we specified a computational model that used feelings to predict choices. We found that this model predicted choice better than existing value-based models, showing a unique contribution of feelings to decisions, over and above value. Similar to the value function in prospect theory, our feeling function showed diminished sensitivity to outcomes as value increased. However, loss aversion in choice was explained by an asymmetry in how feelings about losses and gains were weighted when making a decision, not by an asymmetry in the feelings themselves. The results provide new insights into how feelings are utilized to reach a decision. PMID:27071751

  9. The adaptability of career decision-making profiles.

    PubMed

    Gadassi, Reuma; Gati, Itamar; Dayan, Amira

    2012-10-01

    The Career Decision-Making Profiles questionnaire (CDMP; Gati, Landman, Davidovitch, Asulin-Peretz, & Gadassi, 2010) uses a new model for characterizing the way individuals make decisions based on the simultaneous use of 11 dimensions. The present study investigated which pole of each dimension is more adaptive. Using the data of 383 young adults who were about to make a career choice, we assessed the individuals' decision status and the associations of the dimensions Emotional and Personality-related Career decision-making Difficulties (EPCD; Saka, Gati, & Kelly, 2008) and personality factors (NEO Personality Inventory-Revised; Costa & McCrae, 1992). The results suggest that, as hypothesized, comprehensive Information gathering, analytic Information processing, a more internal Locus of control, more Effort invested, less Procrastination, greater Speed of making the final decision, less Dependence on others, and less Desire to please others were more adaptive in making career decisions. However, contrary to our hypotheses, high Aspiration for an ideal occupation was more adaptive for the decision-making process, Willingness to compromise was not associated with more adaptive decision making, and the results regarding Consulting with others were mixed. Gender differences in the CDMP dimensions and counseling implications are discussed.

  10. Altered Decision-Making under Risk in Obesity.

    PubMed

    Navas, Juan F; Vilar-López, Raquel; Perales, José C; Steward, Trevor; Fernández-Aranda, Fernando; Verdejo-García, Antonio

    2016-01-01

    The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions). The aims of this study were: [1] to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight; [2] to examine the associations between body mass index (BMI) and decision-making, and the degree to which these associations are modulated by reward sensitivity. Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT) and decision-making under ambiguity via the Iowa Gambling Task (IGT). Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance), independently of reward sensitivity. Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices.

  11. Altered Decision-Making under Risk in Obesity

    PubMed Central

    Navas, Juan F.; Vilar-López, Raquel; Perales, José C.; Steward, Trevor; Fernández-Aranda, Fernando; Verdejo-García, Antonio

    2016-01-01

    Background The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions). The aims of this study were: [1] to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight; [2] to examine the associations between body mass index (BMI) and decision-making, and the degree to which these associations are modulated by reward sensitivity. Methods Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT) and decision-making under ambiguity via the Iowa Gambling Task (IGT). Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). Results Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance), independently of reward sensitivity. Conclusions Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices. PMID:27257888

  12. Shared Problem Models and Crew Decision Making

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  13. Decision Making in Narcolepsy with Cataplexy

    PubMed Central

    Bayard, Sophie; Abril, Beatriz; Yu, Huan; Scholz, Sabine; Carlander, Bertrand; Dauvilliers, Yves

    2011-01-01

    Objectives: To investigate decision-making and addictive behaviors in narcolepsy-cataplexy (NC). NC is caused by the loss of hypothalamic neurons that produce hypocretins. The hypocretin system plays a crucial role in sleep, wakefulness, and energy homeostasis, and is also involved in emotion regulation, reward processing, and addiction. Setting: Academic sleep center. Patients: 23 subject with NC and 23 matched healthy controls. Design: We used the Iowa Gambling Task (IGT) to assess decision making under ambiguity condition based on emotional feedback processing and the Game of Dice Task (GDT) to assess decision making under risk condition. All participants underwent a semi-structured psychiatric interview and completed the Beck Depression Inventory-II and the UPPS Impulsive Behavior Scale. Patients underwent one night of polysomnography followed by an MSLT, with neuropsychological evaluation performed between MSLT sessions. Measurements and Results: NC patients had higher depressive symptoms and showed a significant lack of perseverance. One NC patient had a past history of drug dependence. NC patients also exhibited selective reduced IGT performance and normal performance on the GDT. No clinical or polysomnographic characteristics were associated with increased sensitivity to reward and/or decreased sensitivity to punishment. However, lack of perseverance in NC patients was associated with disadvantageous decision making on the IGT. Conclusion: We demonstrated a lack of perseverance and a selective reduced performance on decision making under ambiguity in NC in contrast to normal decision making under explicit conditions. Patients with narcolepsy-cataplexy may opt for choices with higher immediate emotional valence, regardless of higher future punishment, to compensate for their reduced reactivity to emotional stimuli. Citation: Bayard S; Abril B; Yu H; Scholz S; Carlander B; Dauvilliers Y. Decision making in narcolepsy with cataplexy. SLEEP 2011

  14. Shared Problem Models and Crew Decision Making

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  15. Data-Driven Decision Making. Information Capsule. Volume 0605

    ERIC Educational Resources Information Center

    Blazer, Christie

    2006-01-01

    The federal No Child Left Behind Act and its mandate for adequate yearly progress has placed unprecedented demands on districts to use evidence to support their school improvement efforts. Research has not yet determined if data-driven decision making leads to improvements in teaching and learning since most outcomes reported to date are based on…

  16. Authoritarianism and Time as Influences on Decision Making. Final Report.

    ERIC Educational Resources Information Center

    Traylor, Elwood B.

    This study examined the decision-making process of prospective teachers to determine to what extent authoritarianism influences decisions about the validity of categorical syllogisms with attitudinally relevant conclusions. The Minnesota Teacher Attitude Inventory (MTAI) and the California F Scale were administered to 100 education students to…

  17. Advertising Practitioner's Ethical Decision-Making: The Utilitarian Viewpoint.

    ERIC Educational Resources Information Center

    Overstreet, Charles William

    A study compared the decision making process of large and small advertising agencies to determine if the size of the agency, in terms of gross annual billing, had any effect on adherence to the rules set forth in the American Association of Advertising's Standards of Practice. Forty agency employees, 20 from agencies with billings less than $2.5…

  18. Advertising Practitioner's Ethical Decision-Making: The Utilitarian Viewpoint.

    ERIC Educational Resources Information Center

    Overstreet, Charles William

    A study compared the decision making process of large and small advertising agencies to determine if the size of the agency, in terms of gross annual billing, had any effect on adherence to the rules set forth in the American Association of Advertising's Standards of Practice. Forty agency employees, 20 from agencies with billings less than $2.5…

  19. The Students Decision Making in Solving Discount Problem

    ERIC Educational Resources Information Center

    Abdillah; Nusantara, Toto; Subanji; Susanto, Hery; Abadyo

    2016-01-01

    This research is reviewing students' process of decision making intuitively, analytically, and interactively. The research done by using discount problem which specially created to explore student's intuition, analytically, and interactively. In solving discount problems, researcher exploring student's decision in determining their attitude which…

  20. Reproductive Health Decision-Making in Perinatally HIV-Infected Adolescents and Young Adults

    PubMed Central

    Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

    2013-01-01

    With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a “think tank” session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed. PMID:22736033

  1. Decision Making for Partial Carpal Fusions

    PubMed Central

    Bain, Gregory Ian; McGuire, Duncan Thomas

    2012-01-01

    Limited wrist fusions are effective surgical procedures for providing pain relief while preserving motion of the wrist in patients with localized arthritis of the carpus. In deciding which motion-preserving procedure to perform, the etiology of the arthritis, which joints are involved, and which are spared should be determined. The main principle is to fuse the involved joints and to allow motion through the uninvolved joints. In this article, we discuss the various traumatic and nontraumatic conditions causing arthritis of the wrist and the treatment options for those conditions. Common indications for limited wrist fusions include scapholunate advanced collapse and scaphoid nonunion advanced collapse. Options for treating these conditions include three- and four-corner fusions as well as a proximal row carpectomy. This paper discusses which procedures are the most appropriate as well as the outcomes of these procedures. If the basic principles of limited wrist fusions are adhered to, a good outcome can be obtained. The authors' surgical technique and decision-making processes are discussed. PMID:24179713

  2. Money Related Decommissioning and Funding Decision Making

    SciTech Connect

    Goodman, Lynne S.

    2008-01-15

    'Money makes the world go round', as the song says. It definitely influences decommissioning decision-making and financial assurance for future decommissioning. This paper will address two money-related decommissioning topics. The first is the evaluation of whether to continue or to halt decommissioning activities at Fermi 1. The second is maintaining adequacy of financial assurance for future decommissioning of operating plants. Decommissioning costs considerable money and costs are often higher than originally estimated. If costs increase significantly and decommissioning is not well funded, decommissioning activities may be deferred. Several decommissioning projects have been deferred when decision-makers determined future spending is preferable than current spending, or when costs have risen significantly. Decommissioning activity timing is being reevaluated for the Fermi 1 project. Assumptions for waste cost-escalation significantly impact the decision being made this year on the Fermi 1 decommissioning project. They also have a major impact on the estimated costs for decommissioning currently operating plants. Adequately funding full decommissioning during plant operation will ensure that the users who receive the benefit pay the full price of the nuclear-generated electricity. Funding throughout operation also will better ensure that money is available following shutdown to allow decommissioning to be conducted without need for additional funds.

  3. Liberal rationalism and medical decision-making.

    PubMed

    Savulescu, Julian

    1997-04-01

    I contrast Robert Veatch's recent liberal vision of medical decision-making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values -- 'deep value pairing'. The goal of choice is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true -- that there really are states which are good for people regardless of whether they desire to be in them -- then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician.

  4. Cognitive reflection vs. calculation in decision making.

    PubMed

    Sinayev, Aleksandr; Peters, Ellen

    2015-01-01

    Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.

  5. Cognitive reflection vs. calculation in decision making

    PubMed Central

    Sinayev, Aleksandr; Peters, Ellen

    2015-01-01

    Scores on the three-item Cognitive Reflection Test (CRT) have been linked with dual-system theory and normative decision making (Frederick, 2005). In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT's ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes); Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1) or calculated using proportions (Studies 1 and 2). These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead. PMID:25999877

  6. [Brain mechanisms involved in decision-making].

    PubMed

    Martínez-Selva, J M; Sánchez-Navarro, J P; Bechara, A; Román, F

    To review the studies on brain mechanisms in decision making within the framework of the somatic marker hypothesis, and based on experiments employing the Iowa Gambling Task. An overview of the somatic marker hypothesis is presented together with the review of the main results obtained from research in brain damaged patients, and normal subjects with functional neuroimaging studies, that have led to the identification of the neural structures involved in decision making in humans. The main region involved in decision making is the ventromedial prefrontal cortex, that integrates sensory, mnesic and emotional information relevant to the task. Other structures intervening in the various relevant processes in decision making are the amygdala (processing and encoding of the emotional signal and its association with contextual stimuli) and the cingulate cortex (process monitoring and response inhibition, especially in situations of uncertainty). The prefrontal dorsolateral cortex would also be involved through the necessary activation of the working memory in the decision making process, especially in the case of complex tasks.

  7. Capturing a Commander's decision making style

    NASA Astrophysics Data System (ADS)

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

    2017-05-01

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

  8. Consideration of shared decision making in nursing: a review of clinicians' perceptions and interventions.

    PubMed

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

    2009-10-02

    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.

  9. Risk-taking and decision-making in youth: relationships to addiction vulnerability

    PubMed Central

    Balogh, Kornelia N.; Mayes, Linda C.; Potenza, Marc N.

    2013-01-01

    Background Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Methods Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Results Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Conclusions Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors. PMID:24294500

  10. Decision-making on shared sanitation in the informal settlements of Kisumu, Kenya.

    PubMed

    Simiyu, Sheillah; Swilling, Mark; Cairncross, Sandy

    2017-10-01

    Unlike most quantitative studies that investigate decision-making on investing in sanitation, this study adopted a qualitative approach to investigate decision-making on shared sanitation in the informal settlements of Kisumu city, in Kenya. Using a grounded theory approach, landlords and tenants were interviewed to identify sanitation decisions, individuals involved in decision-making and factors influencing decision-making. The results indicate that the main sanitation decisions are on investment, emptying, repair and cleaning. Landlords make investment, emptying and repair decisions, while tenants make cleaning decisions. Absentee landlords are less involved in most decision-making compared to live-in landlords, who rarely consult tenants in decision-making. Tenants make decisions after consultations with a third party and often collectively with other tenants. Sanitation interventions in informal settlements should thus, target landlords and tenants, with investment efforts being directed at landlords and maintenance efforts at tenants.

  11. Analytical group decision making in natural resources: Methodology and application

    USGS Publications Warehouse

    Schmoldt, D.L.; Peterson, D.L.

    2000-01-01

    Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups have provided insights into the impediments to effective group processes and on techniques that can be applied in a group context. Nevertheless, little integration and few applications of these results have occurred in resource management decision processes, where formal groups are integral, either directly or indirectly. A group decision-making methodology is introduced as an effective approach for temporary, formal groups (e.g., workshops). It combines the following three components: (1) brainstorming to generate ideas; (2) the analytic hierarchy process to produce judgments, manage conflict, enable consensus, and plan for implementation; and (3) a discussion template (straw document). Resulting numerical assessments of alternative decision priorities can be analyzed statistically to indicate where group member agreement occurs and where priority values are significantly different. An application of this group process to fire research program development in a workshop setting indicates that the process helps focus group deliberations; mitigates groupthink, nondecision, and social loafing pitfalls; encourages individual interaction; identifies irrational judgments; and provides a large amount of useful quantitative information about group preferences. This approach can help facilitate scientific assessments and other decision-making processes in resource management.

  12. Expert decision making in relation to unanticipated blood glucose levels.

    PubMed

    Paterson, B; Thorne, S

    2000-04-01

    How people (N = 22) with long-standing Type I diabetes make everyday self-care decisions, specifically in regard to unanticipated blood glucose levels (UBGLs) was investigated using grounded theory. Participants differentiated between decisions made in familiar and typical situations and those made in novel situations. Decisions made in familiar situations were straightforward, arising from a confident appraisal of the cause of the UBGL. The primary focus of decision making in response to an UBGL in familiar situations was the decision about the course of action. The focus in unfamiliar situations was the appraisal of the cause of the UBGL. It was characterized by the participants' lack of confidence and by a non-linear progression in which the individual retraced previous phases of the decision-making process or proceeded to tangential steps. Participants matched the features of previously encountered situations to construct a story that explained the events in order to generate some plausible hypotheses. A number of contextual and mediating variables were identified as influencing the decision-making process and the decisions they made. The findings of this research demonstrate that the decision maker's familiarity with the situation influences the nature of the decision-making processes that are used.

  13. Assessing decision making in young adult romantic relationships.

    PubMed

    Vennum, Amber; Fincham, Frank D

    2011-09-01

    Romantic relationships among young adults are rich with ambiguity and without a clear, universal progression emphasizing the need for active decision making. Lack of active decision making in romantic relationships can lead to increases in constraints (e.g. pregnancy, shared living space or finances) that promote the continuation of relationships that would have otherwise ended, leading to increased risk of relationship distress. Because there is no available assessment of thoughtfulness regarding relationship decisions, the authors of the present studies report data on the development of one such scale, the Relationship Deciding Scale (RDS). Study 1 (N = 995) reveals the factor structure of the RDS and provides reliability data for the emergent subscales. In Study 2 (N = 963), the obtained three-factor structure (Relationship Confidence, Knowledge of Warning Signs, and Deciding) is tested via confirmatory factor analysis, demonstrates convergent and discriminant validity, and is shown to predict relationship characteristics 14 weeks later. Study 3 (N = 805) shows the sensitivity of the three factors to change through examination of the influence of a semester-long intervention targeted at increasing decision making in relationships. Use of this scale for identifying and intervening with couples or individuals who lack active decision making in relationships may decrease their risk for future relationship distress.

  14. Principles for ethical treatment decision-making in veterinary oncology.

    PubMed

    Rohrer Bley, C

    2017-08-31

    Many owners of companion animals with cancer are overwhelmed by having to choose the "right course of action." With the aim of reducing the burden on owners who are forced to act as surrogates for their animals, this work discusses principles that apply to ethical treatment decision-making for animal patients with cancer. Four principles frequently used for ethical decision-making in human medicine will be considered for their potential applicability in veterinary medicine. As a result of these considerations, preliminary guidelines are presented, along which a decision-making discussion can be held. The deliberate integration of the non-maleficence and beneficence principles into the purely empirical facts of what is medically possible helps to maintain a moral perspective in specialized veterinary medicine. At the same time, such guidelines may contribute to individual decision-making in a way that animal patients neither have to endure unnecessarily severe side effects, nor that they are euthanized prematurely. © 2017 John Wiley & Sons Ltd.

  15. Women's preferences for contraceptive counseling and decision making.

    PubMed

    Dehlendorf, Christine; Levy, Kira; Kelley, Allison; Grumbach, Kevin; Steinauer, Jody

    2013-08-01

    Little is known about what women value in their interactions with family planning providers and in decision making about contraception. We conducted semistructured interviews with 42 black, white and Latina patients. Transcripts were coded using modified grounded theory. While women wanted control over the ultimate selection of a method, most also wanted their provider to participate in the decision-making process in a way that emphasized the women's values and preferences. Women desired an intimate, friend-like relationship with their providers and also wanted to receive comprehensive information about options, particularly about side effects. More black and Spanish-speaking Latinas, as compared to whites and English-speaking Latinas, felt that providers should only share their opinion if it is elicited by a patient or if they make their rationale clear to the patient. While, in the absence of medical contraindications, decision making about contraception has often been conceptualized as a woman's autonomous decision, our data indicate that providers of contraceptive counseling can participate in the decision-making process within limits. Differences in preferences seen by race/ethnicity illustrate one example of the importance of individualizing counseling to match women's preferences. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Impaired decision-making in psychopathic heroin addicts.

    PubMed

    Vassileva, Jasmin; Petkova, Pavlina; Georgiev, Stefan; Martin, Eileen M; Tersiyski, Ruslan; Raycheva, Margarita; Velinov, Vladimir; Marinov, Peter

    2007-01-12

    Substance-dependent individuals (SDIs) often show neurocognitive deficits in decision-making, such that their choices are biased toward the greatest immediate reward rather than the optimal future outcome. However, studies of SDIs are often hampered by two significant methodological challenges: polysubstance dependence and comorbid conditions, which are independently associated with neurocognitive impairments. We addressed these methodological challenges by testing heroin addicts in Bulgaria, where heroin addiction is highly prevalent but polysubstance dependence is rare. The goal of the current study was to evaluate the potential contribution of psychopathy to decision-making processes among this group of Bulgarian heroin addicts. We tested 78 male currently abstaining heroin addicts, classified as psychopathic or non-psychopathic using the Hare Psychopathy Checklist, Revised (PCL-R). Psychopathic heroin addicts showed notable deficits in decision-making in that they made significantly more disadvantageous decisions relative to non-psychopathic heroin addicts. Results indicate that the presence of psychopathy may exacerbate decision-making deficits in heroin addicts.

  17. Depressive Symptoms Enhance Loss-Minimization, but Attenuate Gain-Maximization in History-Dependent Decision-Making

    ERIC Educational Resources Information Center

    Maddox, W. Todd; Gorlick, Marissa A.; Worthy, Darrell A.; Beevers, Christopher G.

    2012-01-01

    Individuals with depressive symptoms typically show deficits in decision-making. However, most work has emphasized decision-making under gain-maximization conditions. A gain-maximization framework may undermine decision-making when depressive symptoms are present because depressives are generally more sensitive to losses than gains. The present…

  18. Cognitive processes in anesthesiology decision making.

    PubMed

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

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

  19. Shared decision-making in nursing education.

    PubMed

    Parker, Francine M; Morris, Arlene H

    2004-07-01

    Shared decision-making is an effective management strategy that may have positive implications for nurse educators facing curricular and course delivery issues. Use of shared or participative decision-making recognizes that decisions made for the overall good of the organization should include those integrally involved, i.e., faculty, students and administration. Ultimately, effective student learning should be the outcome of decisions related to curricular and content delivery. In this anecdotal paper, the authors present shared decision-making (SDM) as a management strategy that may be effectively utilized in a range of situations in educational settings. An exemplar is presented regarding changes in course delivery methods at two sister schools of nursing. Strategies to promote successful implementation, as well as challenges in initiating SDM, are discussed. The information presented in this paper can benefit nurse educators by offering a collaborative approach to the issues of evolving nursing curricula and content delivery.

  20. Hippocampal-cortical interaction in decision making.

    PubMed

    Yu, Jai Y; Frank, Loren M

    2015-01-01

    When making a decision it is often necessary to consider the available alternatives in order to choose the most appropriate option. This deliberative process, where the pros and cons of each option are considered, relies on memories of past actions and outcomes. The hippocampus and prefrontal cortex are required for memory encoding, memory retrieval and decision making, but it is unclear how these areas support deliberation. Here we examine the potential neural substrates of these processes in the rat. The rat is a powerful model to investigate the network mechanisms underlying deliberation in the mammalian brain given the anatomical and functional conservation of its hippocampus and prefrontal cortex to other mammalian systems. Importantly, it is amenable to large scale neural recording while performing laboratory tasks that exploit its natural decision-making behavior. Focusing on findings in the rat, we discuss how hippocampal-cortical interactions could provide a neural substrate for deliberative decision making.

  1. Decision making in narcolepsy with cataplexy.

    PubMed

    Bayard, Sophie; Abril, Beatriz; Yu, Huan; Scholz, Sabine; Carlander, Bertrand; Dauvilliers, Yves

    2011-01-01

    To investigate decision-making and addictive behaviors in narcolepsy-cataplexy (NC). NC is caused by the loss of hypothalamic neurons that produce hypocretins. The hypocretin system plays a crucial role in sleep, wakefulness, and energy homeostasis, and is also involved in emotion regulation, reward processing, and addiction. Academic sleep center. 23 subject with NC and 23 matched healthy controls. We used the Iowa Gambling Task (IGT) to assess decision making under ambiguity condition based on emotional feedback processing and the Game of Dice Task (GDT) to assess decision making under risk condition. All participants underwent a semi-structured psychiatric interview and completed the Beck Depression Inventory-II and the UPPS Impulsive Behavior Scale. Patients underwent one night of polysomnography followed by an MSLT, with neuropsychological evaluation performed between MSLT sessions. NC patients had higher depressive symptoms and showed a significant lack of perseverance. One NC patient had a past history of drug dependence. NC patients also exhibited selective reduced IGT performance and normal performance on the GDT. No clinical or polysomnographic characteristics were associated with increased sensitivity to reward and/or decreased sensitivity to punishment. However, lack of perseverance in NC patients was associated with disadvantageous decision making on the IGT. We demonstrated a lack of perseverance and a selective reduced performance on decision making under ambiguity in NC in contrast to normal decision making under explicit conditions. Patients with narcolepsy-cataplexy may opt for choices with higher immediate emotional valence, regardless of higher future punishment, to compensate for their reduced reactivity to emotional stimuli.

  2. Computer modeling of human decision making

    NASA Technical Reports Server (NTRS)

    Gevarter, William B.

    1991-01-01

    Models of human decision making are reviewed. Models which treat just the cognitive aspects of human behavior are included as well as models which include motivation. Both models which have associated computer programs, and those that do not, are considered. Since flow diagrams, that assist in constructing computer simulation of such models, were not generally available, such diagrams were constructed and are presented. The result provides a rich source of information, which can aid in construction of more realistic future simulations of human decision making.

  3. The art of decision-making.

    PubMed

    Clancy, Thomas R

    2003-06-01

    As important as sound decision-making is, many executives neglect to utilize any formal decisionmaking process. As many executives know, making the wrong decision can be disastrous, if not career ending. In today's high-pressure, complex, and challenging healthcare environment, it makes sense to follow a tried and true process for making decisions. The author examines the traditional method of problem identification, setting objectives, listing alternatives and consequences, and selecting the best solution in the decision-making process as well as new research in this field.

  4. Gender and internet consumers' decision-making.

    PubMed

    Yang, Chyan; Wu, Chia-Chun

    2007-02-01

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

  5. Communicating statin evidence to support shared decision-making.

    PubMed

    Barrett, Bruce; Ricco, Jason; Wallace, Margaret; Kiefer, David; Rakel, Dave

    2016-04-06

    The practice of clinical medicine rests on a foundation of ethical principles as well as scientific knowledge. Clinicians must artfully balance the principle of beneficence, doing what is best for patients, with autonomy, allowing patients to make their own well-informed health care decisions. The clinical communication process is complicated by varying degrees of confidence in scientific evidence regarding patient-oriented benefits, and by the fact that most medical options are associated with possible harms as well as potential benefits. Evidence-based clinical guidelines often neglect patient-oriented issues involved with the thoughtful practice of shared decision-making, where individual values, goals, and preferences should be prioritized. Guidelines on the use of statin medications for preventing cardiovascular events are a case in point. Current guidelines endorse the use of statins for people whose 10-year risk of cardiovascular events is as low as 7.5%. Previous guidelines set the 10-year risk benchmark at 20%. Meta-analysis of randomized trials suggests that statins can reduce cardiovascular event rates by about 25%, bringing 10-year risk from 7.5 to 5.6%, for example, or from 20 to 15%. Whether or not these benefits should justify the use of statins for individual patients depends on how those advantages are valued in comparison with disadvantages, such as side effect risks, and with inconveniences associated with taking a pill each day and visiting clinicians and laboratories regularly. Whether or not the overall benefit-harm balance justifies the use of a medication for an individual patient cannot be determined by a guidelines committee, a health care system, or even the attending physician. Instead, it is the individual patient who has a fundamental right to decide whether or not taking a drug is worthwhile. Researchers and professional organizations should endeavor to develop shared decision-making tools that provide up-to-date best evidence in

  6. Foundations of medical decision-making for older adults with cardiovascular disease.

    PubMed

    Lipman, Hannah I; Kalra, Ankur; Kirkpatrick, James N

    2015-07-01

    In order to help older adults with cardiovascular disease navigate complex decisions, clinicians must know tenets of medical ethics and have good communication skills. The elements of decision making capacity and informed consent are reviewed, using relevant clinical examples to illustrate the basic concepts. The shared decision making model, by which clinician and patient work together to determine the plan of care, is described. Useful communication techniques to implement shared decision making are suggested.

  7. The capacity for ethical decisions: the relationship between working memory and ethical decision making.

    PubMed

    Martin, April; Bagdasarov, Zhanna; Connelly, Shane

    2015-04-01

    Although various models of ethical decision making (EDM) have implicitly called upon constructs governed by working memory capacity (WMC), a study examining this relationship specifically has not been conducted. Using a sense making framework of EDM, we examined the relationship between WMC and various sensemaking processes contributing to EDM. Participants completed an online assessment comprised of a demographic survey, intelligence test, various EDM measures, and the Automated Operation Span task to determine WMC. Results indicated that WMC accounted for unique variance above and beyond ethics education, exposure to ethical issues, and intelligence in several sensemaking processes. Additionally, a marginally significant effect of WMC was also found with reference to EDM. Individual differences in WMC appear likely to play an important role in the ethical decision-making process, and future researchers may wish to consider their potential influences.

  8. Brief Moral Decision-Making Questionnaire: A Rasch-derived short form of the Greene dilemmas.

    PubMed

    Carmona-Perera, Martina; Caracuel, Alfonso; Pérez-García, Miguel; Verdejo-García, Antonio

    2015-06-01

    In this study, we developed the Brief Moral Decision-Making Questionnaire (BrMoD) as a standardized brief form of the dilemmas compiled by Greene and colleagues (Greene, Sommerville, Nystrom, Darley, & Cohen, 2001). An initial Rasch analysis was conducted over responses to 60 dilemmas to retain the most appropriate items. The psychometric properties of the 32-item brief instrument were determined in a community sample of 133 individuals using analyses from both the Rasch model and the classical test theory. The BrMoD scores showed appropriate reliability and construct validity. Differences between dilemma categories proposed by Greene et al. were observed in the BrMoD by measuring the difficulty of decisions and response times of the participants. In addition, there was no differential item functioning by the demographic variables. Therefore, the BrMoD is a good tool for assessing moral decision making in research or professional fields. (c) 2015 APA, all rights reserved).

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

    ERIC Educational Resources Information Center

    Sari, Enver

    2008-01-01

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

  10. Motivational interviewing and shared decision making in primary care.

    PubMed

    Sonntag, Ulrike; Wiesner, Julia; Fahrenkrog, Sandra; Renneberg, Babette; Braun, Vittoria; Heintze, Christoph

    2012-04-01

    The aim of this study was to assess general practitioners' (GP) readiness to involve obese patients in therapy decision making and to determine whether they integrate motivational interviewing techniques. Fifty-eight preventive Check-up 35 encounters with overweight and obese patients in primary care were audio recorded in 12 GP practices. The use of motivational interviewing techniques was rated with the Behavior Change Counseling Index (BECCI). The involvement in medical decisions was rated with the Observing Patient Involvement Scale (OPTION). OPTION and BECCI scores were low (means=0.71 and 1.65), indicating minimal implementation of shared decision making and motivational interviewing in preventive encounters with these patients. GPs used more motivational interviewing for patients with a BMI>30 kg/m(2) than for those with a BMI<30 kg/m(2). Female GPs had significantly higher shared decision making scores, indicating that they prefer to involve patients in medical decisions. GPs differed significantly in their use of both approaches. Shared decision making and motivational interviewing, though known to be successful strategies in lifestyle counseling, are rarely used during obesity encounters in our sample of German GPs. GPs should be sensitized and trained in the application of these methods. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  11. A Structured approach to incidental take decision making

    USGS Publications Warehouse

    McGowan, Conor P.

    2013-01-01

    Decision making related to incidental take of endangered species under U.S. law lends itself well to a structured decision making approach. Incidental take is the permitted killing, harming, or harassing of a protected species under the law as long as that harm is incidental to an otherwise lawful activity and does not “reduce appreciably the probability of survival and recovery in the wild.” There has been inconsistency in the process used for determining incidental take allowances across species and across time for the same species, and structured decision making has been proposed to improve decision making. I use an example decision analysis to demonstrate the process and its applicability to incidental take decisions, even under significant demographic uncertainty and multiple, competing objectives. I define the example problem, present an objectives statement and a value function, use a simulation model to assess the consequences of a set of management actions, and evaluate the tradeoffs among the different actions. The approach results in transparent and repeatable decisions.

  12. Problems in the decision making process: a review.

    PubMed

    Evans, D

    1990-12-01

    Decision making is an integral part of the intensive care nurse's role, but many factors can disrupt this process. It is important that the nurse has an understanding of how defective decision making patterns can develop. Experience, the role of the nurse, uncertainty and conflict all exert major influences on the decision making process. The conditions that determine what type of decision making pattern emerges are; the seriousness of the risks as a result of the decision; if there is hope of finding a better solution; and how much time is available to search for the solution. The patterns that may emerge include vigilance, complacency, defensive avoidance and hypervigilance. Vigilance is said to be the optimum pattern, this is when all alternatives to the decision are analysed and interpreted in an unbiased manner. Defensive avoidance is the decision makers attempt to avoid or postpone the stress of the decision. It is manifested by procrastination, shifting of responsibility or rationalisation. Hypervigilance, or panic, represents a frantic search for a solution and a shifting back and forth between alternatives with a failure to see obvious faults in the possible solutions.

  13. Colorectal cancer patients’ attitudes towards involvement in decision making

    PubMed Central

    Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A.; Susnerwala, Shabbir S.

    2009-01-01

    Abstract Objectives  To design and administer an attitude rating scale, exploring colorectal cancer patients’ views of involvement in decision making. To examine the impact of socio‐demographic and/or treatment‐related factors on decision making. To conduct principal components analysis to determine if the scale could be simplified into a number of factors for future clinical utility. Methods  An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross‐sectional survey approach. Results  375 questionnaires were returned (81.7% response). For patients it was important to be informed and involved in the decision‐making process. Information was not always used to make decisions as patients placed their trust in medical expertise. Women had more positive opinions on decision making and were more likely to want to make decisions. Written information was understood to a greater degree than verbal information. The scale could be simplified to a number of factors, indicating clinical utility. Conclusion  Few studies have explored the attitudes of colorectal cancer patients towards involvement in decision making. This study presents new insights into how patients view the concept of participation; important when considering current policy imperatives in the UK of involving service users in all aspects of care and treatment. PMID:19250150

  14. Neural basis of decision making guided by emotional outcomes

    PubMed Central

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

    2015-01-01

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

  15. 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.

  16. Medical decision-making: an argument for narrative and metaphor.

    PubMed

    Hall, Katherine

    2002-01-01

    This study examines the processes of decision-making used by intensive care (critical care) specialists. Ninety-nine specialists completed a questionnaire involving three clinical cases, using a novel methodology investigating the role of uncertainty and temporal-related factors, and exploring a range of ethical issues. Validation and triangulation of the results was done via a comparison study with a medically lay, but highly informed group of 37 law students. For both study groups, constructing reasons for a decision was largely an interpretative and imaginative exercise that went beyond the data (as presented), commonly resulting in different reasons supporting the same conclusions and similar reasons supporting opposite conclusions. The skills of ethical imagination and interpretation were related to an individual's prior lived experience, construed in the broadest sense. Application of these skills of ethical imagination and interpretation always occurred, to some degree, in a state of uncertainty and almost always involved temporal relationships. Using these results, a theory of ethical decision-making is proffered. Three levels or types of reasoning processes may be present. Type I decision-making involves the application of rules, usually in a deductive fashion. Type II decision-making is characterised by a process where a plurality of reasons are balanced, weighed and sifted with each other. Type III decision-making is intimately linked with respondents lived experiences and 'crafts' the content of type I and II reasoning processes, via the application of ethical imagination and interpretation. Relationships between these three types of reasoning processes, and with narrative ethics, are also discussed.

  17. Consumer and relationship factors associated with shared decision making in mental health consultations.

    PubMed

    Matthias, Marianne S; Fukui, Sadaaki; Kukla, Marina; Eliacin, Johanne; Bonfils, Kelsey A; Firmin, Ruth L; Oles, Sylwia K; Adams, Erin L; Collins, Linda A; Salyers, Michelle P

    2014-12-01

    This study explored the association between shared decision making and consumers' illness management skills and consumer-provider relationships. Medication management appointments for 79 consumers were audio recorded. Independent coders rated overall shared decision making, minimum level of shared decision making, and consumer-provider agreement for 63 clients whose visit included a treatment decision. Mental health diagnoses, medication adherence, patient activation, illness management, working alliance, and length of consumer-provider relationships were also assessed. Correlation analyses were used to determine relationships among measures. Overall shared decision making was not associated with any variables. Minimum levels of shared decision making were associated with higher scores on the bond subscale of the Working Alliance Inventory, indicating a higher degree of liking and trust, and with better medication adherence. Agreement was associated with shorter consumer-provider relationships. Consumer-provider relationships and shared decision making might have a more nuanced association than originally thought.

  18. Women's autonomy in decision making for health care in South Asia.

    PubMed

    Senarath, Upul; Gunawardena, Nalika Sepali

    2009-04-01

    This article aims to discuss women's autonomy in decision making on health care, and its determinants in 3 South Asian countries, using nationally representative surveys. Women's participation either alone or jointly in household decisions on their own health care was considered as an indicator of women's autonomy in decision making. The results revealed that decisions of women's health care were made without their participation in the majority of Nepal (72.7%) and approximately half of Bangladesh (54.3%) and Indian (48.5%) households. In Sri Lanka, decision making for contraceptive use was a collective responsibility in the majority (79.7%). Women's participation in decision making significantly increased with age, education, and number of children. Women who were employed and earned cash had a stronger say in household decision making than women who did not work or worked not for cash. Rural and poor women were less likely to be involved in decision making than urban or rich women.

  19. Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness

    PubMed Central

    Epstein, Ronald M.; Street, Richard L.

    2011-01-01

    In the context of serious illness, individuals usually rely on others to help them think and feel their way through difficult decisions. To help us to understand why, when, and how individuals involve trusted others in sharing information, deliberation, and decision making, we offer the concept of shared mind—ways in which new ideas and perspectives can emerge through the sharing of thoughts, feelings, perceptions, meanings, and intentions among 2 or more people. We consider how shared mind manifests in relationships and organizations in general, building on studies of collaborative cognition, attunement, and sensemaking. Then, we explore how shared mind might be promoted through communication, when appropriate, and the implications of shared mind for decision making and patient autonomy. Next, we consider a continuum of patient-centered approaches to patient-clinician interactions. At one end of the continuum, an interactional approach promotes knowing the patient as a person, tailoring information, constructing preferences, achieving consensus, and promoting relational autonomy. At the other end, a transactional approach focuses on knowledge about the patient, information-as-commodity, negotiation, consent, and individual autonomy. Finally, we propose that autonomy and decision making should consider not only the individual perspectives of patients, their families, and members of the health care team, but also the perspectives that emerge from the interactions among them. By drawing attention to shared mind, clinicians can observe in what ways they can promote it through bidirectional sharing of information and engaging in shared deliberation. PMID:21911765

  20. Heterogeneous Preference and Local Nonlinearity in Consensus Decision Making

    NASA Astrophysics Data System (ADS)

    Hartnett, Andrew T.; Schertzer, Emmanuel; Levin, Simon A.; Couzin, Iain D.

    2016-01-01

    In recent years, a large body of research has focused on unveiling the fundamental physical processes that living systems utilize to perform functions, such as coordinated action and collective decision making. Here, we demonstrate that important features of collective decision making among higher organisms are captured effectively by a novel formulation of well-characterized physical spin systems, where the spin state is equivalent to two opposing preferences, and a bias in the preferred state represents the strength of individual opinions. We reveal that individuals (spins) without a preference (unbiased or uninformed) play a central role in collective decision making, both in maximizing the ability of the system to achieve consensus (via enhancement of the propagation of spin states) and in minimizing the time taken to do so (via a process reminiscent of stochastic resonance). Which state (option) is selected collectively, however, is shown to depend strongly on the nonlinearity of local interactions. Relatively linear social response results in unbiased individuals reinforcing the majority preference, even in the face of a strongly biased numerical minority (thus promoting democratic outcomes). If interactions are highly nonlinear, however, unbiased individuals exert the opposite influence, promoting a strongly biased minority and inhibiting majority preference. These results enhance our understanding of physical computation in biological collectives and suggest new avenues to explore in the collective dynamics of spin systems.

  1. ACED IT: A Tool for Improved Ethical and Moral Decision-Making

    ERIC Educational Resources Information Center

    Kreitler, Crystal Mata; Stenmark, Cheryl K.; Rodarte, Allen M.; Piñón DuMond, Rebecca

    2014-01-01

    Numerous examples of unethical organizational decision-making highlighted in the media have led many to question the general moral perception and ethical judgments of individuals. The present study examined two forms of a straightforward ethical decision-making (EDM) tool (ACED IT cognitive map) that could be a relatively simple instrument for…

  2. An Inservice Program for Improving Team Participation in Educational Decision-Making.

    ERIC Educational Resources Information Center

    Anderlini, Lyn Starr

    1983-01-01

    An inservice program entitled The Team Approach to Educational Decision-Making: Inservice for Multidisciplinary Teams is described. It provides instruction in team theory, communication skills, and problem-solving techniques to create more active and effective team participation in the Individual Education Program decision-making processes to meet…

  3. Decision Making and Problem Solving. A Resource Manual for Business Educators.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This manual contains materials that business teachers can use to teach their students decision-making and problem-solving skills. Each of the five sections can be used individually or in sequence. The following topics are covered: decision making; approaches to problem solving; everyday life problem solving; creative problem solving; and business…

  4. ACED IT: A Tool for Improved Ethical and Moral Decision-Making

    ERIC Educational Resources Information Center

    Kreitler, Crystal Mata; Stenmark, Cheryl K.; Rodarte, Allen M.; Piñón DuMond, Rebecca

    2014-01-01

    Numerous examples of unethical organizational decision-making highlighted in the media have led many to question the general moral perception and ethical judgments of individuals. The present study examined two forms of a straightforward ethical decision-making (EDM) tool (ACED IT cognitive map) that could be a relatively simple instrument for…

  5. Adults with Autism Show Increased Sensitivity to Outcomes at Low Error Rates during Decision-Making

    ERIC Educational Resources Information Center

    Minassian, Arpi; Paulus, Martin; Lincoln, Alan; Perry, William

    2007-01-01

    Decision-making is an important function that can be quantified using a two-choice prediction task. Individuals with Autistic Disorder (AD) often show highly restricted and repetitive behavior that may interfere with adaptive decision-making. We assessed whether AD adults showed repetitive behavior on the choice task that was unaffected by…

  6. The Three-Part Harmony of Adult Learning, Critical Thinking, and Decision-Making

    ERIC Educational Resources Information Center

    Moore, Kyle

    2010-01-01

    Adult learning, critical thinking, and decision-making are fields that receive attention individually, although they are interspersed with elements of each other's theories and philosophies. In addressing adult learning precepts, it is essential to include critical thinking and decision-making. One without the other creates weakness; all must be…

  7. Clinical Decision Making of Rural Novice Nurses

    ERIC Educational Resources Information Center

    Seright, Teresa J.

    2010-01-01

    The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent…

  8. Goal-Proximity Decision-Making

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  9. Decision-Making in Alaskan Native Education.

    ERIC Educational Resources Information Center

    Hopkins, Thomas R.

    The decision-making process of the Alaskan Eskimo is examined, particularly with reference to educational administration in the school systems. It is reported that the effect of outside influence in making decisions has predominated since about 1867 and that, even at the present time, only superficial decisions are made at a local level. According…

  10. Goal Directedness and Decision Making in Infants

    ERIC Educational Resources Information Center

    Kenward, Ben; Folke, Sara; Holmberg, Jacob; Johansson, Alexandra; Gredeback, Gustaf

    2009-01-01

    The term "goal directed" conventionally refers to either of 2 separate process types--motor processes organizing action oriented toward physical targets and decision-making processes that select these targets by integrating desire for and knowledge of action outcomes. Even newborns are goal directed in the first sense, but the status of…

  11. Information Dominance in Military Decision Making.

    DTIC Science & Technology

    1999-06-04

    This study considers how ABCS (Army Battle Command System) capabilities achieve information dominance and how they influence the military decision...making process. The work examines how ABCS enables commanders and staffs to achieve information dominance at the brigade and battalion levels. Further...future digitized systems that will gain information dominance for the future commander. It promotes the continued development information dominance technologies

  12. Nature of Science and Decision-Making

    ERIC Educational Resources Information Center

    Khishfe, Rola

    2012-01-01

    The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…

  13. The Delphi Decision-Making Process.

    ERIC Educational Resources Information Center

    Spinelli, Teri

    1983-01-01

    Reports generalizations about specific patterns emerging from a panel employing a decision-making Delphi process that attempted to forecast the long-range general environment for higher education in Michigan. Participating were 24 influential persons with knowledge of factors important within the state. (Author/RH)

  14. Coordination in Decision-Making Organizations,

    DTIC Science & Technology

    1988-01-01

    2, Modelisation et Application, Masson, Paris. Chyen, G. H-L., and A.H. Levis, 1985, "Analysis of Preprocessors and Decision Aids in Organizations...34Decision Aiding and Coordination in Decision-making Organizations," S.M. Thesis , LIDS-TH-1737, Laboratory for Information and Decision Systems, MIT

  15. Incorporating Science into Decision-Making

    USGS Publications Warehouse

    Karl, Herman A.; Turner, Christine E.

    2003-01-01

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

  16. URBAN DECISION-MAKING, THE UNIVERSITY'S ROLE.

    ERIC Educational Resources Information Center

    BAILEY, STEPHEN K.

    THE AUTHOR EXAMINES THE VARIOUS WAYS IN WHICH THE UNIVERSITY CAN AND SHOULD INFLUENCE URBAN DECISION MAKING. THE CENTRAL UNIVERSITY ROLE IS SENSITIZING THE DECISION MAKERS AND THE CITIZENS TO HUMAN MISERY, SUCH AS BIGOTRY, SQUALOR, DISEASE, UGLINESS, POVERTY, AND IGNORANCE. LONG-RANGE ROLES ARE PINPOINTING THE PROBLEMS URBAN DECISION MAKERS SHOULD…

  17. Transformational Leadership & Decision Making in Schools

    ERIC Educational Resources Information Center

    Brower, Robert E.; Balch, Bradley V.

    2005-01-01

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

  18. Patient decision-making for clinical genetics.

    PubMed

    Anderson, Gwen

    2007-03-01

    Medicine is incorporating genetic services into all avenues of health-care, ranging from the rarest to the most common diseases. Cognitive theories of decision-making still dominate professionals' understanding of patient decision-making about how to use genetic information and whether to have testing. I discovered a conceptual model of decision-making while carrying out a phenomenological-hermeneutic descriptive study of a convenience sample of 12 couples who were interviewed while deciding whether to undergo prenatal genetic testing. Thirty-two interviews were conducted with 12 men and 12 women separately. Interviews were transcribed verbatim and all data were analyzed using three levels of coding that were sorted into 30 categories and then abstracted into three emergent meta-themes that described men's and women's attempts to make sense and find meaning in how to best use prenatal genetic technology. Their descriptions of how they thought about, communicated, and coped with their decision were so detailed it was possible to discern nine different types of thinking they engaged in while deciding to accept or decline testing. They believed that decision-making is a process of working through your own personal style of thinking. This might include only one or any combination of the following types of thinking: analytical, ethical, moral, reflective, practical, hypothetical, judgmental, scary, and second sight, as described in detail by these 12 couples.

  19. Student decision making in large group discussion

    NASA Astrophysics Data System (ADS)

    Kustusch, Mary Bridget; Ptak, Corey; Sayre, Eleanor C.; Franklin, Scott V.

    2015-04-01

    It is increasingly common in physics classes for students to work together to solve problems and perform laboratory experiments. When students work together, they need to negotiate the roles and decision making within the group. We examine how a large group of students negotiates authority as part of their two week summer College Readiness Program at Rochester Institute of Technology. The program is designed to develop metacognitive skills in first generation and Deaf and hard-of-hearing (DHH) STEM undergraduates through cooperative group work, laboratory experimentation, and explicit reflection exercises. On the first full day of the program, the students collaboratively developed a sign for the word ``metacognition'' for which there is not a sign in American Sign Language. This presentation will focus on three aspects of the ensuing discussion: (1) how the instructor communicated expectations about decision making; (2) how the instructor promoted student-driven decision making rather than instructor-driven policy; and (3) one student's shifts in decision making behavior. We conclude by discussing implications of this research for activity-based physics instruction.

  20. Medical Decision-Making by Psychiatry Residents

    ERIC Educational Resources Information Center

    El-Mallakh, Rif; Zinner, Jill; Mackey, Amanda; Tamas, Rebecca L.; Martin, Chanley M.; Dalton, Jerad; Dhaliwal, Nitu; Luddington, Nicole; Numan, Farhad U.; Nunes, Ross; Taylor, Stephen; Ye, Lu

    2007-01-01

    Objective: Several conspiring factors have resulted in an increase in the level of medical burden in psychiatric patients. Psychiatry residents require increasing levels of medical sophistication. To assess the medical decision-making of psychiatry residents, the authors examined the outcome in subjects initially seen in the emergency psychiatric…