Sample records for making design decisions

  1. Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

    PubMed

    Dhukaram, Anandhi Vivekanandan; Baber, Chris

    2015-06-01

    Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    NASA Astrophysics Data System (ADS)

    Li, Yongchang

    In systems engineering, design and operation of systems are two main problems which always attract researcher's attentions. The accomplishment of activities in these problems often requires proper decisions to be made so that the desired goal can be achieved, thus, decision making needs to be carefully fulfilled in the design and operation of systems. Design is a decision making process which permeates through out the design process, and is at the core of all design activities. In modern aircraft design, more and more attention is paid to the conceptual and preliminary design phases so as to increase the odds of choosing a design that will ultimately be successful at the completion of the design process, therefore, decisions made during these early design stages play a critical role in determining the success of a design. Since aerospace systems are complex systems with interacting disciplines and technologies, the Decision Makers (DMs) dealing with such design problems are involved in balancing the multiple, potentially conflicting attributes/criteria, transforming a large amount of customer supplied guidelines into a solidly defined set of requirement definitions. Thus, one could state with confidence that modern aerospace system design is a Multiple Criteria Decision Making (MCDM) process. A variety of existing decision making methods are available to deal with this type of decision problems. The selection of the most appropriate decision making method is of particular importance since inappropriate decision methods are likely causes of misleading engineering design decisions. With no sufficient knowledge about each of the methods, it is usually difficult for the DMs to find an appropriate analytical model capable of solving their problems. In addition, with the complexity of the decision problem and the demand for more capable methods increasing, new decision making methods are emerging with time. These various methods exacerbate the difficulty of the selection of an appropriate decision making method. Furthermore, some DMs may be exclusively using one or two specific methods which they are familiar with or trust and not realizing that they may be inappropriate to handle certain classes of the problems, thus yielding erroneous results. These issues reveal that in order to ensure a good decision a suitable decision method should be chosen before the decision making process proceeds. The first part of this dissertation proposes an MCDM process supported by an intelligent, knowledge-based advisor system referred to as Multi-Criteria Interactive Decision-Making Advisor and Synthesis process (MIDAS), which is able to facilitate the selection of the most appropriate decision making method and which provides insight to the user for fulfilling different preferences. The second part of this dissertation presents an autonomous decision making advisor which is capable of dealing with ever-evolving real time information and making autonomous decisions under uncertain conditions. The advisor encompasses a Markov Decision Process (MDP) formulation which takes uncertainty into account when determines the best action for each system state. (Abstract shortened by UMI.)

  3. Enhancing Decision Topology Assessment in Engineering Design

    DTIC Science & Technology

    2014-04-10

    in engineering design decision making. References 1. Clemen , R. T., 1997, Making Hard Decisions, Second Edition, Duxbury Press. 2. Hazelrigg, G. A...United Kingdom. 6. Lewis, K., Chen, W. and L. C. Schmidt , Editors, 2006, Decision Making in Engineering Design, ASME Press, New York. 7. Myers

  4. Marine Steam Condenser Design Optimization.

    DTIC Science & Technology

    1983-12-01

    to make design decisions to obtain a feasible design. CONNIN, as do most optimizers, requires complete control in determining all iterative design...neutralize all the places where such design decisions are made. By removing the ability for CONDIP to make any design decisions it became totally passive...dependent on CONNIN for design decisions , does not have that capability. Pemeabering that CONHIN requires a complete once-through analysis in order to

  5. Making the case for evidence-based design in healthcare: a descriptive case study of organizational decision making.

    PubMed

    Shoemaker, Lorie K; Kazley, Abby Swanson; White, Andrea

    2010-01-01

    The aim of this study was to describe the organizational decision-making process used in the selection of evidence-based design (EBD) concepts, the criteria used to make these decisions, and the extent to which leadership style may have influenced the decision-making process. Five research questions were formulated to frame the direction of this study, including: (1) How did healthcare leaders learn of innovations in design? (2) How did healthcare leaders make decisions in the selection of healthcare design concepts? (3) What criteria did healthcare leaders use in the decision-making process? (4) How did healthcare leaders consider input from the staff in design decisions? and (5) To what extent did the leadership style of administrators affect the outcomes of the decision-making process? Current issues affecting healthcare in the community led the principal investigator's organization to undertake an ambitious facilities expansion project. As part of its planning process, the organization learned of EBD principles that seemingly had a positive impact on patient care and safety and staff working conditions. Although promising, a paucity of empirical research addressed the cost/benefit of incorporating many EBD concepts into one hospital setting, and there was no research that articulated the organizational decision-making process used by healthcare administrators when considering the use of EBD in expansion projects. A mixed-method, descriptive, qualitative, single-case study and quantitative design were used to address the five research questions. The Systems Research Organizing Model provided the theoretical framework. A variety of data collection methods was used, including interviews of key respondents, the review of documentary evidence, and the Multifactor Leadership Questionnaire. A participatory process was used throughout the design decision phases, involving staff at all levels of the organization. The Internet and architects facilitated learning about EBD. Financial considerations were a factor in decision making. The prevalence of the transformational leadership style among the organization's administrators exceeded the U.S. mean.

  6. Development of shared decision-making resources to help inform difficult healthcare decisions: An example focused on dysvascular partial foot and transtibial amputations.

    PubMed

    Quigley, Matthew; Dillon, Michael P; Fatone, Stefania

    2018-02-01

    Shared decision making is a consultative process designed to encourage patient participation in decision making by providing accurate information about the treatment options and supporting deliberation with the clinicians about treatment options. The process can be supported by resources such as decision aids and discussion guides designed to inform and facilitate often difficult conversations. As this process increases in use, there is opportunity to raise awareness of shared decision making and the international standards used to guide the development of quality resources for use in areas of prosthetic/orthotic care. To describe the process used to develop shared decision-making resources, using an illustrative example focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Development process: The International Patient Decision Aid Standards were used to guide the development of the decision aid and discussion guide focused on decisions about the level of dysvascular partial foot amputation or transtibial amputation. Examples from these shared decision-making resources help illuminate the stages of development including scoping and design, research synthesis, iterative development of a prototype, and preliminary testing with patients and clinicians not involved in the development process. Lessons learnt through the process, such as using the International Patient Decision Aid Standards checklist and development guidelines, may help inform others wanting to develop similar shared decision-making resources given the applicability of shared decision making to many areas of prosthetic-/orthotic-related practice. Clinical relevance Shared decision making is a process designed to guide conversations that help patients make an informed decision about their healthcare. Raising awareness of shared decision making and the international standards for development of high-quality decision aids and discussion guides is important as the approach is introduced in prosthetic-/orthotic-related practice.

  7. The design of patient decision support interventions: addressing the theory-practice gap.

    PubMed

    Elwyn, Glyn; Stiel, Mareike; Durand, Marie-Anne; Boivin, Jacky

    2011-08-01

    Although an increasing number of decision support interventions for patients (including decision aids) are produced, few make explicit use of theory. We argue the importance of using theory to guide design. The aim of this work was to address this theory-practice gap and to examine how a range of selected decision-making theories could inform the design and evaluation of decision support interventions. We reviewed the decision-making literature and selected relevant theories. We assessed their key principles, theoretical pathways and predictions in order to determine how they could inform the design of two core components of decision support interventions, namely, information and deliberation components and to specify theory-based outcome measures. Eight theories were selected: (1) the expected utility theory; (2) the conflict model of decision making; (3) prospect theory; (4) fuzzy-trace theory; (5) the differentiation and consolidation theory; (6) the ecological rationality theory; (7) the rational-emotional model of decision avoidance; and finally, (8) the Attend, React, Explain, Adapt model of affective forecasting. Some theories have strong relevance to the information design (e.g. prospect theory); some are more relevant to deliberation processes (conflict theory, differentiation theory and ecological validity). None of the theories in isolation was sufficient to inform the design of all the necessary components of decision support interventions. It was also clear that most work in theory-building has focused on explaining or describing how humans think rather than on how tools could be designed to help humans make good decisions. It is not surprising therefore that a large theory-practice gap exists as we consider decision support for patients. There was no relevant theory that integrated all the necessary contributions to the task of making good decisions in collaborative interactions. Initiatives such as the International Patient Decision Aids Standards Collaboration influence standards for the design of decision support interventions. However, this analysis points to the need to undertake more work in providing theoretical foundations for these interventions. © 2010 Blackwell Publishing Ltd.

  8. Digital technology and clinical decision making in depression treatment: Current findings and future opportunities.

    PubMed

    Hallgren, Kevin A; Bauer, Amy M; Atkins, David C

    2017-06-01

    Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined. Discussions of these opportunities are organized around three established movements designed to enhance clinical decision making for depression treatment, including measurement-based care, integrated care, and personalized medicine. Research, design, and implementation efforts may support clinical decision making for depression by (1) improving tools to incorporate depression symptom data into existing electronic health record systems, (2) enhancing measurement of treatment fidelity and treatment processes, (3) harnessing smartphone and biosensor data to inform clinical decision making, (4) enhancing tools that support communication and care coordination between patients and providers and within provider teams, and (5) leveraging treatment and outcome data from electronic health record systems to support personalized depression treatment. The current climate of rapid changes in both healthcare and digital technologies facilitates an urgent need for research, design, and implementation of digital technologies that explicitly support clinical decision making. Ensuring that such tools are efficient, effective, and usable in frontline treatment settings will be essential for their success and will require engagement of stakeholders from multiple domains. © 2017 Wiley Periodicals, Inc.

  9. Naturalistic Decision Making: Implications for Design

    DTIC Science & Technology

    1993-04-01

    Cognitive Task Analysis Decision Making Design Engineer Design System Human-Computer Interface System Development 15. NUMBER OF PAGES 182 16...people use to select a course of action. The SOAR explains how stress affects the decision making of both individuals and teams. COGNITIVE TASK ANALYSIS : This...procedures for Cognitive Task Analysis , contrasting the strengths and weaknesses of each, and showing how a Cognitive Task Analysis

  10. 47 CFR 1.1202 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... in the form of texts, such as by Internet electronic mail. (c) Decision-making personnel. Any member... designated as part of a separate trial staff shall not be considered a decision-making person in the designated proceeding. Unseparated Bureau or Office staff shall be considered decision-making personnel with...

  11. Analyzing the effectiveness of teaching and factors in clinical decision-making.

    PubMed

    Hsieh, Ming-Chen; Lee, Ming-Shinn; Chen, Tsung-Ying; Tsai, Tsuen-Chiuan; Pai, Yi-Fong; Sheu, Min-Muh

    2017-01-01

    The aim of this study is to prepare junior physicians, clinical education should focus on the teaching of clinical decision-making. This research is designed to explore teaching of clinical decision-making and to analyze the benefits of an "Analogy guide clinical decision-making" as a learning intervention for junior doctors. This study had a "quasi-experimental design" and was conducted in a medical center in eastern Taiwan. Participants and Program Description: Thirty junior doctors and three clinical teachers were involved in the study. The experimental group (15) received 1 h of instruction from the "Analogy guide for teaching clinical decision-making" every day for 3 months. Program Evaluation: A "Clinical decision-making self-evaluation form" was used as the assessment tool to evaluate participant learning efficiency before and after the teaching program. Semi-structured qualitative research interviews were also conducted. We found using the analogy guide for teaching clinical decision-making could help enhance junior doctors' self-confidence. Important factors influencing clinical decision-making included workload, decision-making, and past experience. Clinical teaching using the analogy guide for clinical decision-making may be a helpful tool for training and can contribute to a more comprehensive understanding of decision-making.

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

    PubMed Central

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

    2007-01-01

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

  13. Intersubjective decision-making for computer-aided forging technology design

    NASA Astrophysics Data System (ADS)

    Kanyukov, S. I.; Konovalov, A. V.; Muizemnek, O. Yu.

    2017-12-01

    We propose a concept of intersubjective decision-making for problems of open-die forging technology design. The intersubjective decisions are chosen from a set of feasible decisions using the fundamentals of the decision-making theory in fuzzy environment according to the Bellman-Zadeh scheme. We consider the formalization of subjective goals and the choice of membership functions for the decisions depending on subjective goals. We study the arrangement of these functions into an intersubjective membership function. The function is constructed for a resulting decision, which is chosen from a set of feasible decisions. The choice of the final intersubjective decision is discussed. All the issues are exemplified by a specific technological problem. The considered concept of solving technological problems under conditions of fuzzy goals allows one to choose the most efficient decisions from a set of feasible ones. These decisions correspond to the stated goals. The concept allows one to reduce human participation in automated design. This concept can be used to develop algorithms and design programs for forging numerous types of forged parts.

  14. Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

    PubMed

    Liu, Shuyan; Schad, Daniel J; Kuschpel, Maxim S; Rapp, Michael A; Heinz, Andreas

    2016-01-01

    Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

  15. Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making

    PubMed Central

    Kuschpel, Maxim S.; Rapp, Michael A.; Heinz, Andreas

    2016-01-01

    Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes. PMID:26982326

  16. A framework for designing and analyzing binary decision-making strategies in cellular systems†

    PubMed Central

    Porter, Joshua R.; Andrews, Burton W.; Iglesias, Pablo A.

    2015-01-01

    Cells make many binary (all-or-nothing) decisions based on noisy signals gathered from their environment and processed through noisy decision-making pathways. Reducing the effect of noise to improve the fidelity of decision-making comes at the expense of increased complexity, creating a tradeoff between performance and metabolic cost. We present a framework based on rate distortion theory, a branch of information theory, to quantify this tradeoff and design binary decision-making strategies that balance low cost and accuracy in optimal ways. With this framework, we show that several observed behaviors of binary decision-making systems, including random strategies, hysteresis, and irreversibility, are optimal in an information-theoretic sense for various situations. This framework can also be used to quantify the goals around which a decision-making system is optimized and to evaluate the optimality of cellular decision-making systems by a fundamental information-theoretic criterion. As proof of concept, we use the framework to quantify the goals of the externally triggered apoptosis pathway. PMID:22370552

  17. Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure

    ERIC Educational Resources Information Center

    Khemka, Ishita; Hickson, Linda; Mallory, Sarah B.

    2016-01-01

    This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from…

  18. Glossary

    MedlinePlus

    ... healthcare A document that designates the person you trust to make medical decisions on your behalf if ... healthcare: a document that designates the person you trust to make medical decisions on your behalf if ...

  19. 78 FR 36434 - Revisions to Rules of Practice

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-18

    ... federal holidays, make grammatical corrections, and remove the reference to part-day holidays. Rule 3001... section, the following categories of persons are designated ``decision-making personnel'': (i) The.... The following categories of person are designated ``non-decision-making personnel'': (i) All...

  20. Configural displays can improve nutrition-related. decisions: an application of the proximity compatibility principle.

    PubMed

    Marino, Christopher J; Mahan, Robert R

    2005-01-01

    The nutrition label format currently used by consumers to make dietary-related decisions presents significant information-processing demands for integration-based decisions; however, those demands were not considered as primary factors when the format was adopted. Labels designed in accordance with known principles of cognitive psychology might enhance the kind of decision making that food labeling was intended to facilitate. Three experiments were designed on the basis of the proximity compatibility principle (PCP) to investigate the relationship between nutrition label format and decision making; the experiments involved two types of integration decisions and one type of filtering decision. Based on the PCP, decision performance was measured to test the overall hypothesis that matched task-display tandems would result in better decision performance than would mismatched tandems. In each experiment, a statistically significant increase in mean decision performance was found when the display design was cognitively matched to the demands of the task. Combined, the results from all three experiments support the general hypothesis that task-display matching is a design principle that may enhance the utility of nutrition labeling in nutrition-related decision making. Actual or potential applications of this research include developing robust display solutions that aid in less effortful assimilation of nutrition-related information for consumers.

  1. 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…

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

    ERIC Educational Resources Information Center

    Guay, Frederic

    2005-01-01

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

  3. Insular neural system controls decision-making in healthy and methamphetamine-treated rats

    PubMed Central

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-01-01

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making. PMID:26150496

  4. Insular neural system controls decision-making in healthy and methamphetamine-treated rats.

    PubMed

    Mizoguchi, Hiroyuki; Katahira, Kentaro; Inutsuka, Ayumu; Fukumoto, Kazuya; Nakamura, Akihiro; Wang, Tian; Nagai, Taku; Sato, Jun; Sawada, Makoto; Ohira, Hideki; Yamanaka, Akihiro; Yamada, Kiyofumi

    2015-07-21

    Patients suffering from neuropsychiatric disorders such as substance-related and addictive disorders exhibit altered decision-making patterns, which may be associated with their behavioral abnormalities. However, the neuronal mechanisms underlying such impairments are largely unknown. Using a gambling test, we demonstrated that methamphetamine (METH)-treated rats chose a high-risk/high-reward option more frequently and assigned higher value to high returns than control rats, suggestive of changes in decision-making choice strategy. Immunohistochemical analysis following the gambling test revealed aberrant activation of the insular cortex (INS) and nucleus accumbens in METH-treated animals. Pharmacological studies, together with in vivo microdialysis, showed that the insular neural system played a crucial role in decision-making. Moreover, manipulation of INS activation using designer receptor exclusively activated by designer drug technology resulted in alterations to decision-making. Our findings suggest that the INS is a critical region involved in decision-making and that insular neural dysfunction results in risk-taking behaviors associated with altered decision-making.

  5. 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…

  6. Identifying design considerations for a shared decision aid for use at the point of outpatient clinical care: An ethnographic study at an inner city clinic.

    PubMed

    Hajizadeh, Negin; Perez Figueroa, Rafael E; Uhler, Lauren M; Chiou, Erin; Perchonok, Jennifer E; Montague, Enid

    2013-03-06

    Computerized decision aids could facilitate shared decision-making at the point of outpatient clinical care. The objective of this study was to investigate whether a computerized shared decision aid would be feasible to implement in an inner-city clinic by evaluating the current practices in shared decision-making, clinicians' use of computers, patient and clinicians' attitudes and beliefs toward computerized decision aids, and the influence of time on shared decision-making. Qualitative data analysis of observations and semi-structured interviews with patients and clinicians at an inner-city outpatient clinic. The findings provided an exploratory look at the prevalence of shared decision-making and attitudes about health information technology and decision aids. A prominent barrier to clinicians engaging in shared decision-making was a lack of perceived patient understanding of medical information. Some patients preferred their clinicians make recommendations for them rather than engage in formal shared decision-making. Health information technology was an integral part of the clinic visit and welcomed by most clinicians and patients. Some patients expressed the desire to engage with health information technology such as viewing their medical information on the computer screen with their clinicians. All participants were receptive to the idea of a decision aid integrated within the clinic visit although some clinicians were concerned about the accuracy of prognostic estimates for complex medical problems. We identified several important considerations for the design and implementation of a computerized decision aid including opportunities to: bridge clinician-patient communication about medical information while taking into account individual patients' decision-making preferences, complement expert clinician judgment with prognostic estimates, take advantage of patient waiting times, and make tasks involved during the clinic visit more efficient. These findings should be incorporated into the design and implementation of a computerized shared decision aid at an inner-city hospital.

  7. Structuring Disaster Recovery Infrastructure Decisions: Lessons from Boulder County's 2013 Flood Recovery

    NASA Astrophysics Data System (ADS)

    Clavin, C.; Petropoulos, Z.

    2017-12-01

    Recovery phase decision making processes, as compared to mitigation and response phase decision making processes, require communities make significant financial and capital decisions in the months after a disaster. Collectively, these investments may significantly contribute to the resilience of a community to future hazards. Pre-disaster administrative decisions are well-established within existing planning processes. Post-event recovery requires community decision makers to quickly evaluate technical proposals and manage significant recovery financial resources to ensure their community rebuilds in a manner that will be more resilient to future events. These technical and administrative hurdles in the aftermath of a disaster create a challenging atmosphere to make sound, scientifically-informed decisions leading to resilient recovery. In September 2013, a 1,000-year rain event that resulted in flooding throughout the Front Range of Colorado, significantly impacting Boulder County. While the event is long past, disaster recovery efforts still continue in parts of Boulder County. Boulder County officials formed a county collaborative that adapted the NIST Community Resilience Planning Guide for Buildings and Infrastructure Systems to facilitate a goals-based multi-criteria decision making process. Rather than use hazard-based information to guide infrastructure design, the county's decision process established time-to-recovery goals for infrastructure systems that were used as criteria for project design. This presentation explores the decision-making process employed by Boulder County to specify design standards for resilient rebuilding of infrastructure systems and examine how this infrastructure planning model could be extrapolated to other situations where there is uncertainty regarding future infrastructure design standards.

  8. Data-Based Decision-Making: Developing a Method for Capturing Teachers' Understanding of CBM Graphs

    ERIC Educational Resources Information Center

    Espin, Christine A.; Wayman, Miya Miura; Deno, Stanley L.; McMaster, Kristen L.; de Rooij, Mark

    2017-01-01

    In this special issue, we explore the decision-making aspect of "data-based decision-making". The articles in the issue address a wide range of research questions, designs, methods, and analyses, but all focus on data-based decision-making for students with learning difficulties. In this first article, we introduce the topic of…

  9. Demonstrating Empathy: A Phenomenological Study of Instructional Designers Making Instructional Strategy Decisions for Adult Learners

    ERIC Educational Resources Information Center

    Vann, Linda S.

    2017-01-01

    Instructional designers are tasked with making instructional strategy decisions to facilitate achievement of learning outcomes as part of their professional responsibilities. While the instructional design process includes learner analysis, that analysis alone does not embody opportunities to assist instructional designers with demonstrations of…

  10. Understanding Decision Making in Teachers' Curriculum Design Approaches

    ERIC Educational Resources Information Center

    Boschman, Ferry; McKenney, Susan; Voogt, Joke

    2014-01-01

    The goal of this study was to reach a better understanding of the intuitive decisions teachers make when designing a technology-rich learning environment. A multiple case-study design was employed to examine what kinds of factors (external priorities, existing orientations or practical concerns) influence design interactions of teams of…

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

    PubMed

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

    2008-03-01

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

  12. Decision making technical support study for the US Army's Chemical Stockpile Disposal Program

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

    Feldman, D.L.; Dobson, J.E.

    1990-08-01

    This report examines the adequacy of current command and control systems designed to make timely decisions that would enable sufficient warning and protective response to an accident at the Edgewood area of Aberdeen Proving Ground (APG), Maryland, and at Pine Bluff Arsenal (PBA), Arkansas. Institutional procedures designed to facilitate rapid accident assessment, characterization, warning, notification, and response after the onset of an emergency and computer-assisted decision-making aids designed to provide salient information to on- and-off-post emergency responders are examined. The character of emergency decision making at APG and PBA, as well as potential needs for improvements to decision-making practices, procedures,more » and automated decision-support systems (ADSSs), are described and recommendations are offered to guide equipment acquisition and improve on- and off-post command and control relationships. We recommend that (1) a continued effort be made to integrate on- and off-post command control, and decision-making procedures to permit rapid decision making; (2) the pathways for alert and notification among on- and off-post officials be improved and that responsibilities and chain of command among off-post agencies be clarified; (3) greater attention be given to organizational and social context factors that affect the adequacy of response and the likelihood that decision-making systems will work as intended; and (4) faster improvements be made to on-post ADSSs being developed at APG and PBA, which hold considerable promise for depicting vast amounts of information. Phased development and procurement of computer-assisted decision-making tools should be undertaken to balance immediate needs against available resources and to ensure flexibility, equity among sites, and compatibility among on- and off-post systems. 112 refs., 6 tabs.« less

  13. Surrogate decision making: do we have to trade off accuracy and procedural satisfaction?

    PubMed

    Frey, Renato; Hertwig, Ralph; Herzog, Stefan M

    2014-02-01

    Making surrogate decisions on behalf of incapacitated patients can raise difficult questions for relatives, physicians, and society. Previous research has focused on the accuracy of surrogate decisions (i.e., the proportion of correctly inferred preferences). Less attention has been paid to the procedural satisfaction that patients' surrogates and patients attribute to specific approaches to making surrogate decisions. The objective was to investigate hypothetical patients' and surrogates' procedural satisfaction with specific approaches to making surrogate decisions and whether implementing these preferences would lead to tradeoffs between procedural satisfaction and accuracy. Study 1 investigated procedural satisfaction by assigning participants (618 in a mixed-age but relatively young online sample and 50 in an older offline sample) to the roles of hypothetical surrogates or patients. Study 2 (involving 64 real multigenerational families with a total of 253 participants) investigated accuracy using 24 medical scenarios. Hypothetical patients and surrogates had closely aligned preferences: Procedural satisfaction was highest with a patient-designated surrogate, followed by shared surrogate decision-making approaches and legally assigned surrogates. These approaches did not differ substantially in accuracy. Limitations are that participants' preferences regarding existing and novel approaches to making surrogate decisions can only be elicited under hypothetical conditions. Next to decision making by patient-designated surrogates, shared surrogate decision making is the preferred approach among patients and surrogates alike. This approach appears to impose no tradeoff between procedural satisfaction and accuracy. Therefore, shared decision making should be further studied in representative samples of the general population, and if people's preferences prove to be robust, they deserve to be weighted more strongly in legal frameworks in addition to patient-designated surrogates.

  14. Challenging the Academically Adrift: A New Decision-Making Tool to Help Improve Student Commitment to Academic Preparation

    ERIC Educational Resources Information Center

    Davis, Carolyn D.

    2013-01-01

    This paper describes research in progress concerning the development and use of a newly created tool, the Decision-Making Grid, which was designed to teach undergraduate management students to develop and use metacognitive regulation skills to improve decision-making by requiring students to construct improved decision-making models in a boundedly…

  15. A hybrid fuzzy logic/constraint satisfaction problem approach to automatic decision making in simulation game models.

    PubMed

    Braathen, Sverre; Sendstad, Ole Jakob

    2004-08-01

    Possible techniques for representing automatic decision-making behavior approximating human experts in complex simulation model experiments are of interest. Here, fuzzy logic (FL) and constraint satisfaction problem (CSP) methods are applied in a hybrid design of automatic decision making in simulation game models. The decision processes of a military headquarters are used as a model for the FL/CSP decision agents choice of variables and rulebases. The hybrid decision agent design is applied in two different types of simulation games to test the general applicability of the design. The first application is a two-sided zero-sum sequential resource allocation game with imperfect information interpreted as an air campaign game. The second example is a network flow stochastic board game designed to capture important aspects of land manoeuvre operations. The proposed design is shown to perform well also in this complex game with a very large (billionsize) action set. Training of the automatic FL/CSP decision agents against selected performance measures is also shown and results are presented together with directions for future research.

  16. Integrating Decision Making and Mental Health Interventions Research: Research Directions

    PubMed Central

    Wills, Celia E.; Holmes-Rovner, Margaret

    2006-01-01

    The importance of incorporating patient and provider decision-making processes is in the forefront of the National Institute of Mental Health (NIMH) agenda for improving mental health interventions and services. Key concepts in patient decision making are highlighted within a simplified model of patient decision making that links patient-level/“micro” variables to services-level/“macro” variables via the decision-making process that is a target for interventions. The prospective agenda for incorporating decision-making concepts in mental health research includes (a) improved measures for characterizing decision-making processes that are matched to study populations, complexity, and types of decision making; (b) testing decision aids in effectiveness research for diverse populations and clinical settings; and (c) improving the understanding and incorporation of preference concepts in enhanced intervention designs. PMID:16724158

  17. 39 CFR 3001.7 - Ex parte communications.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Applicability § 3001.7 Ex parte communications. (a) Definitions—(1) Decision-making Commission personnel... persons are designated “decision-making Commission personnel”: (i) The Commissioners and their personal... involved in the decisional process. (2) Non-decision-making Commission personnel. The following categories...

  18. Decision-Making under Criteria Uncertainty

    NASA Astrophysics Data System (ADS)

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

    2018-05-01

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

  19. The Design of an IEP Decision Aid: A Tool for Diverse Parents of Children with Autism

    ERIC Educational Resources Information Center

    Schuttler, Jessica Oeth

    2012-01-01

    Decision-making is a universal process that occurs constantly in life. Parent participation in educational decision-making is recognized as important by special education law, by special education and school psychology literature (Christenson & Sheridan, 2001; IDEIA, 2004;). Partnership in decision-making is especially important for parents of…

  20. A queueing model of pilot decision making in a multi-task flight management situation

    NASA Technical Reports Server (NTRS)

    Walden, R. S.; Rouse, W. B.

    1977-01-01

    Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

  1. 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).

  2. Beyond Decision Making for Outdoor Leaders: Expanding the Safety Behavior Research Agenda

    ERIC Educational Resources Information Center

    Jackson, Jeff S.

    2016-01-01

    The study of safety behaviour of designated outdoor leaders primarily revolves around their decision making and judgement. The last ten years, however, have seen relatively little peer-reviewed research regarding guide or instructor safety cognition and behaviour. The narrow decision making focus of modern work makes for a field of study…

  3. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  4. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  5. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  6. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  7. 41 CFR 102-74.250 - What information must the Designated Official use to make a decision to activate the Occupant...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... decision to activate the Occupant Emergency Organization based upon the best available information... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What information must the Designated Official use to make a decision to activate the Occupant Emergency Organization? 102-74...

  8. Education Leaders' Decision-Making Processes about Educational Facilities in a University Multiple Stakeholder Environment

    ERIC Educational Resources Information Center

    Kelting, Scott

    2011-01-01

    This research is a retrospective case study designed to document and analyze the process of decision-making by educational leaders and stakeholders at a four-year university. For this study, educational leaders and key stakeholders agreed to extensive interviews about the decisions made during the design, construction, and post-occupancy phases of…

  9. Application of Grey Relational Analysis to Decision-Making during Product Development

    ERIC Educational Resources Information Center

    Hsiao, Shih-Wen; Lin, Hsin-Hung; Ko, Ya-Chuan

    2017-01-01

    A multi-attribute decision-making (MADM) approach was proposed in this study as a prediction method that differs from the conventional production and design methods for a product. When a client has different dimensional requirements, this approach can quickly provide a company with design decisions for each product. The production factors of a…

  10. Systematic review of the empirical investigation of resources to support decision-making regarding BRCA1 and BRCA2 genetic testing in women with breast cancer.

    PubMed

    Grimmett, Chloe; Pickett, Karen; Shepherd, Jonathan; Welch, Karen; Recio-Saucedo, Alejandra; Streit, Elke; Seers, Helen; Armstrong, Anne; Cutress, Ramsey I; Evans, D Gareth; Copson, Ellen; Meiser, Bettina; Eccles, Diana; Foster, Claire

    2018-05-01

    Identify existing resources developed and/or evaluated empirically in the published literature designed to support women with breast cancer making decisions regarding genetic testing for BRCA1/2 mutations. Systematic review of seven electronic databases. Studies were included if they described or evaluated resources that were designed to support women with breast cancer in making a decision to have genetic counselling or testing for familial breast cancer. Outcome and process evaluations, using any type of study design, as well as articles reporting the development of decision aids, were eligible for inclusion. Total of 9 publications, describing 6 resources were identified. Resources were effective at increasing knowledge or understanding of hereditary breast cancer. Satisfaction with resources was high. There was no evidence that any resource increased distress, worry or decisional conflict. Few resources included active functionalities for example, values-based exercises, to support decision-making. Tailored resources supporting decision-making may be helpful and valued by patients and increase knowledge of hereditary breast cancer, without causing additional distress. Clinicians should provide supportive written information to patients where it is available. However, there is a need for robustly developed decision tools to support decision-making around genetic testing in women with breast cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Toward a Psychology of Surrogate Decision Making.

    PubMed

    Tunney, Richard J; Ziegler, Fenja V

    2015-11-01

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

  12. The loss of reason in patient decision aid research: do checklists damage the quality of informed choice interventions?

    PubMed

    Bekker, Hilary L

    2010-03-01

    To discuss whether using the International Patient Decision Aids Standards (IPDAS) Collaboration checklist as a gold standard to judge interventions' quality is premature and potentially detrimental to the validity of resources designed to help patients make treatment choices. Conceptual review integrating the science behind individuals' decision making with the demands of designing complex, healthcare interventions. Patient decision aids are promoted as interventions to help professionals engage in shared and/or patient-centred care. The IPDAS domains were informed by experts' opinions of best practice. Decision scientists study how individuals make decisions, what biases their choices and how best to support decisions. There is debate from decision scientists about which component parts are the active ingredients that help people make decisions. Interventions to help patients make choices have different purposes, component parts and outcomes to those facilitating professional-patient communications. The IPDAS checklist will change to respond to new evidence from the decision sciences. Adhering uncritically to the IPDAS checklist may reduce service variation but is not sufficient to ensure interventions enable good patient decision making. Developers must be encouraged to reason about the IPDAS checklist to identify those component parts that do (not) meet their intervention's purpose. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  13. Swift and Smart Decision Making: Heuristics that Work

    ERIC Educational Resources Information Center

    Hoy, Wayne K.; Tarter, C. J.

    2010-01-01

    Purpose: The aim of this paper is to examine the research literature on decision making and identify and develop a set of heuristics that work for school decision makers. Design/methodology/approach: This analysis is a synthesis of the research on decision-making heuristics that work. Findings: A set of nine rules for swift and smart decision…

  14. Military Medical Decision Support for Homeland Defense During Emergency

    DTIC Science & Technology

    2004-12-01

    abstraction hierarchy, three levels of information requirement for designing emergency training interface are recognized. These are epistemological ...support human decision making process is considered to be decision-centric. A typical decision-centric interface is supported by at least four design ... Designing Emergency Training Interface ......................................................................................... 5 Epistemological

  15. Effects of anger and sadness on attentional patterns in decision making: an eye-tracking study.

    PubMed

    Xing, Cai

    2014-02-01

    Past research examining the effect of anger and sadness on decision making has associated anger with a relatively more heuristic decision-making approach. However, it is unclear whether angry and sad individuals differ while attending to decision-relevant information. An eye-tracking experiment (N=87) was conducted to examine the role of attention in links between emotion and decision making. Angry individuals looked more and earlier toward heuristic cues while making decisions, whereas sad individuals did not show such bias. Implications for designing persuasive messages and studying motivated visual processing were discussed.

  16. Achieving a Risk-Informed Decision-Making Environment at NASA: The Emphasis of NASA's Risk Management Policy

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon

    2010-01-01

    This slide presentation reviews the evolution of risk management (RM) at NASA. The aim of the RM approach at NASA is to promote an approach that is heuristic, proactive, and coherent across all of NASA. Risk Informed Decision Making (RIDM) is a decision making process that uses a diverse set of performance measures along with other considerations within a deliberative process to inform decision making. RIDM is invoked for key decisions such as architecture and design decisions, make-buy decisions, and budget reallocation. The RIDM process and how it relates to the continuous Risk Management (CRM) process is reviewed.

  17. Heuristics in Managing Complex Clinical Decision Tasks in Experts’ Decision Making

    PubMed Central

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

    2016-01-01

    Background Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. Objective The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. Method After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. Results We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Conclusion Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Application Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design. PMID:27275019

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

    PubMed

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

    2014-09-01

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

  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. Hospice Decision Making: Diagnosis Makes a Difference

    ERIC Educational Resources Information Center

    Waldrop, Deborah P.; Meeker, Mary Ann

    2012-01-01

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

  1. The Measurement and Correlates of Career Decision Making.

    ERIC Educational Resources Information Center

    Harren, Vincent A.; Kass, Richard A.

    This paper presents a theoretical framework for understanding career decision making (CDM); introduces an instrument, Assessment of Career Decision Making (ACDM) to measure CDM with college students; and presents correlational data on sex role and cognitive style factors hypothesized to influence CDM. The ACDM, designed to measure the Tiedeman and…

  2. The Effectiveness of a Career Decision-Making Course

    ERIC Educational Resources Information Center

    Fouad, Nadya; Cotter, Elizabeth W.; Kantamneni, Neeta

    2009-01-01

    This study examined the effectiveness of a college career course designed to increase career decision-making confidence and facilitate career exploration. Participants were 73 students from a large Midwestern university (65.6% women, 34.4% men, mean age 18.56). Students were given questionnaires assessing career decision-making difficulties,…

  3. School-Based Decision Making: A Principal-Agent Perspective.

    ERIC Educational Resources Information Center

    Ferris, James M.

    1992-01-01

    A principal-agent framework is used to examine potential gains in educational performance and potential threats to public accountability that school-based decision-making proposals pose. Analysis underscores the need to tailor the design of decentralized decision making to the sources of poor educational performance and threats to school…

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

    PubMed

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

    2017-01-01

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

  5. Suggestions for Designers of Navy Electronic Equipment. 1989 Edition. Revision B

    DTIC Science & Technology

    1989-07-01

    his design and the weak links in the reliability chain. From this information, he can make more reasonable decisions as to the need for design changes...SYSTEMS CENTER San Diego. Caifornl 92152-5000 ~89 12 12 084 It is a pleasure to make available this 1989 -Suggestions for Designers of Navy Electronic...the costs of supporting equipment for mission operations. The factors relate to early design decisions . Design deficiencies or design weaknesses in

  6. Toward a Theoretical Model of Decision-Making and Resistance to Change among Higher Education Online Course Designers

    ERIC Educational Resources Information Center

    Dodd, Bucky J.

    2013-01-01

    Online course design is an emerging practice in higher education, yet few theoretical models currently exist to explain or predict how the diffusion of innovations occurs in this space. This study used a descriptive, quantitative survey research design to examine theoretical relationships between decision-making style and resistance to change…

  7. Modeling the customer in electronic commerce.

    PubMed

    Helander, M G; Khalid, H M

    2000-12-01

    This paper reviews interface design of web pages for e-commerce. Different tasks in e-commerce are contrasted. A systems model is used to illustrate the information flow between three subsystems in e-commerce: store environment, customer, and web technology. A customer makes several decisions: to enter the store, to navigate, to purchase, to pay, and to keep the merchandize. This artificial environment must be designed so that it can support customer decision-making. To retain customers it must be pleasing and fun, and create a task with natural flow. Customers have different needs, competence and motivation, which affect decision-making. It may therefore be important to customize the design of the e-store environment. Future ergonomics research will have to investigate perceptual aspects, such as presentation of merchandize, and cognitive issues, such as product search and navigation, as well as decision making while considering various economic parameters. Five theories on e-commerce research are presented.

  8. Evaluation of a Decision-Making Curriculum for Teaching Adolescents with Disabilities to Resist Negative Peer Pressure.

    PubMed

    Khemka, Ishita; Hickson, Linda; Mallory, Sarah B

    2016-07-01

    This study was designed to assess the impact of a decision-making curriculum (PEER-DM) on the social peer relationship knowledge and self-protective decision-making skills of adolescents with disabilities in hypothetical situations involving negative peer pressure. A randomized design was used to assign students with disabilities from self-contained special education classes to an intervention group (n = 22) or a wait-list control group (n = 20). ANCOVA analyses, using pretest scores as covariates, indicated that students who were trained on PEER-DM had significantly higher effective decision-making action and correct risk perception scores, relative to participants in the control group. This study provides supporting evidence that PEER-DM is a promising intervention for students with disabilities, including those with identified autism spectrum disorders, during transition years to help them develop a better understanding of positive and negative peer relationships and learn systematic decision-making skills for improved handling of social situations in the school and community, especially situations involving negative peer pressure. The study adds credence to using systematic, strategy-based decision making interventions designed to address the cognitive, emotional and motivational processes underlying adolescent decision making in sensitive interpersonal situations involving peer pressure. The study points to the lack of preparedness to handle situations of negative peer pressure as a serious social and health risk for adolescents with disabilities that deserves urgent and concerted attention in transition services programming. Implications for future curriculum-development efforts and replication of treatment findings are discussed. Future research examining disability-specific patterns of decision-making in peer situations and comparisons with typically developing populations is recommended.

  9. ASK Talks with Gary Klein

    NASA Technical Reports Server (NTRS)

    Klein, Gary

    2004-01-01

    Gary Klein, PH.D., is chief scientist of Klein Associates, Inc., a company he founded in 1978 to better understand how to improve decision making in individuals and teams. The company has 30 employees working on projects for both government and commercial clients. Dr. Klein is one of the founders of the field of naturalistic decision making. His work on recognitional decision making has been influential for the design of new systems and interfaces, and for the development of decision training programs. He has extended his work on decision making to describe problem detection, opinion generation, sense making, and planning.

  10. Globally optimal trial design for local decision making.

    PubMed

    Eckermann, Simon; Willan, Andrew R

    2009-02-01

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

  11. Counterfactual Thinking and Ethical Decision Making: A New Approach to an Old Problem for Marketing Education

    ERIC Educational Resources Information Center

    Celuch, Kevin; Saxby, Carl

    2013-01-01

    The present study extends understanding of the self-regulatory aspects of ethical decision making by integrating and exploring relationships among counterfactual thinking, attribution, anticipatory emotions, and ethical decision-making constructs and processes. Specifically, we examine the effects of a manipulation designed to stimulate a…

  12. 45 CFR 2522.420 - What basic criteria does the Corporation use in making funding decisions?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... making funding decisions? 2522.420 Section 2522.420 Public Welfare Regulations Relating to Public Welfare... Selection of AmeriCorps Programs § 2522.420 What basic criteria does the Corporation use in making funding decisions? In evaluating your application for funding, the Corporation will assess: (a) Your program design...

  13. Data Informed Decision Making--Perspectives of Oklahoma Superintendents

    ERIC Educational Resources Information Center

    Kettles, Thomas D.

    2017-01-01

    This descriptive, multiple case study was designed to convey a clear portrayal of the DIDM practice of six superintendents and to provide a description of what these superintendents employ during their decision making process. The ability of local education leaders to strategically influence the use of data for decision making has a large effect…

  14. A qualitative study of nulliparous women's decision making on mode of delivery under China's two-child policy.

    PubMed

    Gu, Chunyi; Zhu, Xinli; Ding, Yan; Setterberg Simone; Wang, Xiaojiao; Tao, Hua; Zhang, Yu

    2018-07-01

    To explore nulliparous women's perceptions of decision making regarding mode of delivery under China's two-child policy. Qualitative descriptive design with in-depth semi-structured interviews. Postnatal wards at a tertiary specialized women's hospital in Shanghai, China. 21 nulliparous women 2-3 days postpartum were purposively sampled until data saturation. In-depth semi-structured interviews were conducted between October 8th, 2015 and January 31st, 2016. Two overarching descriptive categories were identified: (1) women's decision-making process: stability versus variability, and (2) factors affecting decision making: variety versus interactivity. Four key themes emerged from each category: (1) initial decision making with certainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise, anticipated caesarean delivery; (2) initial decision making with uncertainty: anticipated trial of labour, failed trial of labour, 'shy away' and compromise; (3) internal factors affecting decision making: knowledge and attitude, and childbirth self-efficacy; and (4) external factors affecting decision making: social support, and the situational environment. At the initial period of China's two-child policy, nulliparous women have perceived their decision-making process regarding mode of delivery as one with complexity and uncertainty, influenced by both internal and external factors. This may have implications for the obstetric setting to develop a well-designed decision support system for pregnant women during the entire pregnancy periods. And it is recommended that care providers should assess women's preferences for mode of delivery from early pregnancy and provide adequate perinatal support and continuity of care for them. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. On acquiring decision making skills for endovascular interventions.

    PubMed

    Lanzer, Peter; Prechelt, Lutz

    2008-11-01

    To improve interventional training we propose a staged rational approach for decision making and skill acquisition. Education and training for endovascular interventions should start to develop the learners' decision-making skills by learning from explicit representations of master interventionist's tacit decision-making knowledge through implementation of the notions of generic interventional modules, interventional strategic and tactical designs. We hope that these suggestions will encourage action, stimulate dialogue and advance the precision of our learning, procedures, practice and patient care.

  16. A decision-making tool for incorporating sustainability measures into pavement design : research project capsule.

    DOT National Transportation Integrated Search

    2016-10-01

    The objective of the proposed study is to conceive and develop a decision-making tool : for evaluating sustainability of pavement designs based on a cradle-to-grave analysis. : This tool will utilize EPDs to enhance the reliability of the assessment ...

  17. Teaching science for public understanding: Developing decision-making abilities

    NASA Astrophysics Data System (ADS)

    Siegel, Marcelle A.

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

  18. When life imitates art: surrogate decision making at the end of life.

    PubMed

    Shapiro, Susan P

    2007-01-01

    The privileging of the substituted judgment standard as the gold standard for surrogate decision making in law and bioethics has constrained the research agenda in end-of-life decision making. The empirical literature is inundated with a plethora of "Newlywed Game" designs, in which potential patients and potential surrogates respond to hypothetical scenarios to see how often they "get it right." The preoccupation with determining the capacity of surrogates to accurately reproduce the judgments of another makes a number of assumptions that blind scholars to the variables central to understanding how surrogates actually make medical decisions on behalf of another. These assumptions include that patient preferences are knowable, surrogates have adequate and accurate information, time stands still, patients get the surrogates they want, patients want and surrogates utilize substituted judgment criteria, and surrogates are disinterested. This article examines these assumptions and considers the challenges of designing research that makes them problematic.

  19. Preaching What We Practice: Teaching Ethical Decision-Making to Computer Security Professionals

    NASA Astrophysics Data System (ADS)

    Fleischmann, Kenneth R.

    The biggest challenge facing computer security researchers and professionals is not learning how to make ethical decisions; rather it is learning how to recognize ethical decisions. All too often, technology development suffers from what Langdon Winner terms technological somnambulism - we sleepwalk through our technology design, following past precedents without a second thought, and fail to consider the perspectives of other stakeholders [1]. Computer security research and practice involves a number of opportunities for ethical decisions. For example, decisions about whether or not to automatically provide security updates involve tradeoffs related to caring versus user autonomy. Decisions about online voting include tradeoffs between convenience and security. Finally, decisions about routinely screening e-mails for spam involve tradeoffs of efficiency and privacy. It is critical that these and other decisions facing computer security researchers and professionals are confronted head on as value-laden design decisions, and that computer security researchers and professionals consider the perspectives of various stakeholders in making these decisions.

  20. A Framework to Determine New System Requirements Under Design Parameter and Demand Uncertainties

    DTIC Science & Technology

    2015-04-30

    relegates quantitative complexities of decision-making to the method and designates trade-space exploration to the practitioner. We demonstrate the...quantitative complexities of decision-making to the method and designates trade-space exploration to the practitioner. We demonstrate the approach...play a critical role in determining new system requirements. Scope and Method of Approach The early stages of the design process have substantial

  1. Making Informed Decisions: The Role of Information Literacy in Ethical and Effective Engineering Design

    ERIC Educational Resources Information Center

    Fosmire, Michael

    2017-01-01

    Engineering designers must make evidence-based decisions when applying the practical tools and techniques of their discipline to human problems. Information literacy provides a structure for determining information gaps, locating appropriate and relevant information, applying that information effectively, and documenting and managing the knowledge…

  2. Risk assessment as standard work in design.

    PubMed

    Morrill, Patricia W

    2013-01-01

    This case study article examines a formal risk assessment as part of the decision making process for design solutions in high risk areas. The overview of the Failure Modes and Effects Analysis (FMEA) tool with examples of its application in hospital building projects will demonstrate the benefit of those structured conversations. This article illustrates how two hospitals used FMEA when integrating operational processes with building projects: (1) adjacency decision for Intensive Care Unit (ICU); and (2) distance concern for handling of specimens from Surgery to Lab. Both case studies involved interviews that exposed facility solution concerns. Just-in-time studies using the FMEA followed the same risk assessment process with the same workshop facilitator involving structured conversations in analyzing risks. In both cases, participants uncovered key areas of risk enabling them to take the necessary next steps. While the focus of this article is not the actual design solution, it is apparent that the risk assessment brought clarity to the situations resulting in prompt decision making about facility solutions. Hospitals are inherently risky environments; therefore, use of the formal risk assessment process, FMEA, is an opportunity for design professionals to apply more rigor to design decision making when facility solutions impact operations in high risk areas. Case study, decision making, hospital, infection control, strategy, work environment.

  3. Evaluating the Intervention of an Ethics Class in Students' Ethical Decision-Making

    ERIC Educational Resources Information Center

    Walker, Marquita

    2011-01-01

    In this pilot study, the author evaluated the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to elicit changes in ethical decision-making by comparing students' cognitive and affective perceptions about…

  4. An Examination of Accelerated and Basic Baccalaureate Nursing Students' Perceptions of Clinical Decision Making

    ERIC Educational Resources Information Center

    Krumwiede, Kelly A.

    2010-01-01

    Developing decision-making skills is essential in education in order to be a competent nurse. The purpose of this study was to examine and compare the perceptions of clinical decision-making skills of students enrolled in accelerated and basic baccalaureate nursing programs. A comparative descriptive research design was used for this study.…

  5. Effectiveness of an Electronic Performance Support System on Computer Ethics and Ethical Decision-Making Education

    ERIC Educational Resources Information Center

    Kert, Serhat Bahadir; Uz, Cigdem; Gecu, Zeynep

    2014-01-01

    This study examined the effectiveness of an electronic performance support system (EPSS) on computer ethics education and the ethical decision-making processes. There were five different phases to this ten month study: (1) Writing computer ethics scenarios, (2) Designing a decision-making framework (3) Developing EPSS software (4) Using EPSS in a…

  6. The Role of Intent in Ethical Decision Making: The Ethical Choice Model

    ERIC Educational Resources Information Center

    King, Christine; Powell, Toni

    2007-01-01

    This paper reviews the major theories, studies and models concerning ethical decision making in organizations. The authors drew upon Jones' Model (1991) as the foundation for their Ethical Choice Model, which is designed to further clarify the ethical decision making process as it relates to the construct of intentionality. The model, illustrated…

  7. Examination of a Group Counseling Model of Career Decision Making with College Students

    ERIC Educational Resources Information Center

    Rowell, P. Clay; Mobley, A. Keith; Kemer, Gulsah; Giordano, Amanda

    2014-01-01

    The authors examined the effectiveness of a group career counseling model (Pyle, K. R., 2007) on college students' career decision-making abilities. They used a Solomon 4-group design and found that students who participated in the career counseling groups had significantly greater increases in career decision-making abilities than those who…

  8. Theory-informed design of values clarification methods: a cognitive psychological perspective on patient health-related decision making.

    PubMed

    Pieterse, Arwen H; de Vries, Marieke; Kunneman, Marleen; Stiggelbout, Anne M; Feldman-Stewart, Deb

    2013-01-01

    Healthcare decisions, particularly those involving weighing benefits and harms that may significantly affect quality and/or length of life, should reflect patients' preferences. To support patients in making choices, patient decision aids and values clarification methods (VCM) in particular have been developed. VCM intend to help patients to determine the aspects of the choices that are important to their selection of a preferred option. Several types of VCM exist. However, they are often designed without clear reference to theory, which makes it difficult for their development to be systematic and internally coherent. Our goal was to provide theory-informed recommendations for the design of VCM. Process theories of decision making specify components of decision processes, thus, identify particular processes that VCM could aim to facilitate. We conducted a review of the MEDLINE and PsycINFO databases and of references to theories included in retrieved papers, to identify process theories of decision making. We selected a theory if (a) it fulfilled criteria for a process theory; (b) provided a coherent description of the whole process of decision making; and (c) empirical evidence supports at least some of its postulates. Four theories met our criteria: Image Theory, Differentiation and Consolidation theory, Parallel Constraint Satisfaction theory, and Fuzzy-trace Theory. Based on these, we propose that VCM should: help optimize mental representations; encourage considering all potentially appropriate options; delay selection of an initially favoured option; facilitate the retrieval of relevant values from memory; facilitate the comparison of options and their attributes; and offer time to decide. In conclusion, our theory-based design recommendations are explicit and transparent, providing an opportunity to test each in a systematic manner. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Decisions Matter: Using a Decision-Making Framework with Contemporary Student Affairs Case Studies

    ERIC Educational Resources Information Center

    Vaccaro, Annemarie; McCoy, Brian; Champagne, Delight; Siegel, Michael

    2013-01-01

    "Decisions Matter" is an innovative guide designed to help novice student affairs professionals develop effective decision-making skills. Written by seasoned student affairs educators and practitioners, this book contains a systematic method for solving a wide range of complex problems. In this exceptional instructional tool, the authors…

  10. The influence of the dorsolateral prefrontal cortex on attentional behavior and decision making. A t-DCS study on emotionally vs. functionally designed objects.

    PubMed

    Colombo, Barbara; Balzarotti, Stefania; Mazzucchelli, Nicla

    2016-04-01

    Prior research has shown that right dorsolateral prefrontal cortex may be crucial in cognitive control of affective impulses during decision making. The present study examines whether modulation of r-DLPFC with transcranial direct current stimulation influences attentional behavior and decision-making in a purchase task requiring participants to choose either emotional/attractive or functional/useful objects. 30 participants were shown sixteen pairs of emotionally or functionally designed products while their eye-movements were recorded. Participants were asked to judge aesthetics and usefulness of each object, and to decide which object of each pair they would buy. Results revealed that participants decided to buy the functionally designed objects more often regardless of condition; however, participants receiving anodal stimulation were faster in decision making. Although stimulation of r-DLPFC did not affect the actual purchasing choice and had little effect on visual exploration during decision making, it influenced perceived usefulness and attractiveness, with temporary inhibition of r-DLPFC leading to evaluate functional objects as less attractive. Finally, anodal stimulation led to judge the objects as more useful. The implications of these results are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Minimization In Digital Design As A Meta-Planning Problem

    NASA Astrophysics Data System (ADS)

    Ho, William P. C.; Wu, Jung-Gen

    1987-05-01

    In our model-based expert system for automatic digital system design, we formalize the design process into three sub-processes - compiling high-level behavioral specifications into primitive behavioral operations, grouping primitive operations into behavioral functions, and grouping functions into modules. Consideration of design minimization explicitly controls decision-making in the last two subprocesses. Design minimization, a key task in the automatic design of digital systems, is complicated by the high degree of interaction among the time sequence and content of design decisions. In this paper, we present an AI approach which directly addresses these interactions and their consequences by modeling the minimization prob-lem as a planning problem, and the management of design decision-making as a meta-planning problem.

  12. New approaches for real time decision support systems

    NASA Technical Reports Server (NTRS)

    Hair, D. Charles; Pickslay, Kent

    1994-01-01

    NCCOSC RDT&E Division (NRaD) is conducting research into ways of improving decision support systems (DSS) that are used in tactical Navy decision making situations. The research has focused on the incorporation of findings about naturalistic decision-making processes into the design of the DSS. As part of that research, two computer tools were developed that model the two primary naturalistic decision-making strategies used by Navy experts in tactical settings. Current work is exploring how best to incorporate the information produced by those tools into an existing simulation of current Navy decision support systems. This work has implications for any applications involving the need to make decisions under time constraints, based on incomplete or ambiguous data.

  13. 'Kids need to talk too': inclusive practices for children's healthcare education and participation.

    PubMed

    Koller, Donna

    2017-09-01

    To examine how children with chronic medical conditions view healthcare education and decision-making and to propose the application of the universal design for learning in paediatric settings. Children and adolescents with chronic medical conditions tend to be excluded from healthcare decision-making. In schools, the universal design for learning promotes access to education and participation in school communities for all children, regardless of their disabilities or medical needs, rendering it an appropriate model for children's participation in healthcare decision-making. This article presents findings from a qualitative study with 26 children and adolescents with chronic medical conditions about their views and experiences with healthcare education and decision-making. Twenty-six children and adolescents with chronic medical conditions were interviewed using semi-structured interviews. Findings provide evidence that clinical practices often fail to provide equal opportunities for paediatric patients to understand their condition, share their views and/or participate in decisions regarding their care. In response to ongoing concerns about paediatric decision-making, we propose that the universal design for learning be adapted in paediatrics. The model presents exemplary programmes as inclusive, accounting for the needs of all children through multiple means of engagement and expression. A discussion of how the principles of universal design for learning could be applied in paediatric settings is offered for the purpose of advancing ethical and psychosocial care for all children regardless of their age, developmental capacity or condition. © 2016 John Wiley & Sons Ltd.

  14. 29 CFR 2509.96-1 - Interpretive bulletin relating to participant investment education.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...., regarding general investment principles and strategies, to assist them in making investment decisions. 29..., whose investment decisions will directly affect their income at retirement, with information designed to assist them in making investment and retirement-related decisions appropriate to their particular...

  15. Weather to Make a Decision

    ERIC Educational Resources Information Center

    Hoyle, Julie E.; Mjelde, James W.; Litzenberg, Kerry K.

    2006-01-01

    DECIDE is a teacher-friendly, integrated approach designed to stimulate learning by allowing students to make decisions about situations they face in their lives while using scientific weather principles. This learning unit integrates weather science, decision theory, mathematics, statistics, geography, and reading in a context of decision…

  16. Designing Tools for Supporting User Decision-Making in e-Commerce

    NASA Astrophysics Data System (ADS)

    Sutcliffe, Alistair; Al-Qaed, Faisal

    The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.

  17. Teacher's Guide to Canal. The Middlesex Canal: A Role Playing Exercise.

    ERIC Educational Resources Information Center

    Holmes, Cary W.; Tedesco, Paul H.

    The document consists of a role-playing game and related teacher's guide designed to illustrate decision-making processes leading to the building of the Middlesex Canal in Massachusetts in 1793. The primary educational objective is to involve students in the decision-making process through role play. The game is designed to facilitate…

  18. Security Design Flaws That Affect Usability in Online Banking

    ERIC Educational Resources Information Center

    Gurlen, Stephanie

    2013-01-01

    As the popularity of online banking Websites has increased, the security of these sites has become increasingly critical as attacks against these sites are on the rise. However, the design decisions made during construction of the sites could make usability more difficult, where the user has difficulty making good security decisions. This study…

  19. Adolescent Sexual Decision-Making: An Integrative Review.

    PubMed

    Hulton, Linda J.

    2001-10-03

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

  20. Evaluating the Intervention of an Ethics' Class in Students' Ethical Decision-Making: A Summative Review

    ERIC Educational Resources Information Center

    Walker, Marquita

    2013-01-01

    This summative evaluation is the result of two years' of data reflecting the impact of an ethics class in terms of students' ethical decision-making. The research compares aggregate responses from scenario-based pre- and post-survey open-ended survey questions designed to measure changes in ethical decision-making by comparing students' cognitive…

  1. Decision making for wildfires: A guide for applying a risk management process at the incident level

    Treesearch

    Mary A. Taber; Lisa M. Elenz; Paul G. Langowski

    2013-01-01

    This publication focuses on the thought processes and considerations surrounding a risk management process for decision making on wildfires. The publication introduces a six element risk management cycle designed to encourage sound risk-informed decision making in accordance with Federal wildland fire policy, although the process is equally applicable to non-Federal...

  2. Just in Time: How Evidence-on-Demand Services Support Decision Making in Ontario's Child and Youth Mental Health Sector

    ERIC Educational Resources Information Center

    Notarianni, Maryann; Sundar, Purnima; Carter, Charles

    2016-01-01

    Using the best available evidence to inform decision making is important for the design or delivery of effective health-related services and broader public policy. Several studies identify barriers and facilitators to evidence-informed decision making in Canadian health settings. This paper describes how the Ontario Centre of Excellence for Child…

  3. A Multimethod Analysis of Shared Decision-Making in Hospice Interdisciplinary Team Meetings Including Family Caregivers

    PubMed Central

    Washington, Karla T.; Oliver, Debra Parker; Gage, L. Ashley; Albright, David L.; Demiris, George

    2015-01-01

    Background Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. Aim We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. Design We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Setting/participants Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Results Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in health care delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. Conclusions The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. PMID:26281854

  4. Tailoring and evaluating an intervention to improve shared decision-making among seniors with dementia, their caregivers, and healthcare providers: study protocol for a randomized controlled trial.

    PubMed

    Giguere, Anik M C; Lawani, Moulikatou Adouni; Fortier-Brochu, Émilie; Carmichael, Pierre-Hugues; Légaré, France; Kröger, Edeltraut; Witteman, Holly O; Voyer, Philippe; Caron, Danielle; Rodríguez, Charo

    2018-06-25

    The increasing prevalence of Alzheimer's disease and other forms of dementia raises new challenges to ensure that healthcare decisions are informed by research evidence and reflect what is important for seniors and their caregivers. Therefore, we aim to evaluate a tailored intervention to help healthcare providers empower seniors and their caregivers in making health-related decisions. In two phases, we will: (1) design and tailor the intervention; and (2) implement and evaluate it. We will use theory and user-centered design to tailor an intervention comprising a distance professional training program on shared decision-making and five shared decision-making tools dealing with difficult decisions often faced by seniors with dementia and their caregivers. Each tool will be designed in two versions, one for clinicians and one for patients. We will recruit 49 clinicians and 27 senior/caregiver to participate in three cycles of design-evaluation-feedback of each intervention components. Besides think-aloud and interview approaches, users will also complete questionnaires based on the Theory of Planned Behavior to identify the factors most likely to influence their adoption of shared decision-making after exposure to the intervention. We will then modify the intervention by adding/enhancing behavior-change techniques targeting these factors. We will evaluate the effectiveness of this tailored intervention before/after implementation, in a two-armed, clustered randomized trial. We will enroll a convenience sample of six primary care clinics (unit of randomization) in the province of Quebec and recruit the clinicians who practice there (mostly family physicians, nurses, and social workers). These clinics will then be randomized to immediate exposure to the intervention or delayed exposure. Overall, we will recruit 180 seniors with dementia, their caregivers, and their healthcare providers. We will evaluate the impact of the intervention on patient involvement in the decision-making process, decisional comfort, patient and caregiver personal empowerment in relation to their own healthcare, patient quality of life, caregiver burden, and decisional regret. The intervention will empower patients and their caregivers in their healthcare, by fostering their participation as partners during the decision-making process and by ensuring they make informed decisions congruent with their values and priorities. ClinicalTrials.org, NCT02956694 . Registered on 31 October 2016.

  5. Training in Decision-making Strategies: An approach to enhance students' competence to deal with socio-scientific issues

    NASA Astrophysics Data System (ADS)

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2013-10-01

    Dealing with socio-scientific issues in science classes enables students to participate productively in controversial discussions concerning ethical topics, such as sustainable development. In this respect, well-structured decision-making processes are essential for elaborate reasoning. To foster decision-making competence, a computer-based programme was developed that trains secondary school students (grades 11-13) in decision-making strategies. The main research question is: does training students to use these strategies foster decision-making competence? In addition, the influence of meta-decision aids was examined. Students conducted a task analysis to select an appropriate strategy prior to the decision-making process. Hence, the second research question is: does combining decision-making training with a task analysis enhance decision-making competence at a higher rate? To answer these questions, 386 students were tested in a pre-post-follow-up control-group design that included two training groups (decision-making strategies/decision-making strategies combined with a task analysis) and a control group (decision-making with additional ecological information instead of strategic training). An open-ended questionnaire was used to assess decision-making competence in situations related to sustainable development. The decision-making training led to a significant improvement in the post-test and the follow-up, which was administered three months after the training. Long-term effects on the quality of the students' decisions were evident for both training groups. Gains in competence when reflecting upon the decision-making processes of others were found, to a lesser extent, in the training group that received the additional meta-decision training. In conclusion, training in decision-making strategies is a promising approach to deal with socio-scientific issues related to sustainable development.

  6. Nurse manager cognitive decision-making amidst stress and work complexity.

    PubMed

    Shirey, Maria R; Ebright, Patricia R; McDaniel, Anna M

    2013-01-01

      The present study provides insight into nurse manager cognitive decision-making amidst stress and work complexity.   Little is known about nurse manager decision-making amidst stress and work complexity. Because nurse manager decisions have the potential to impact patient care quality and safety, understanding their decision-making processes is useful for designing supportive interventions.   This qualitative descriptive study interviewed 21 nurse managers from three hospitals to answer the research question: What decision-making processes do nurse managers utilize to address stressful situations in their nurse manager role? Face-to-face interviews incorporating components of the Critical Decision Method illuminated expert-novice practice differences. Content analysis identified one major theme and three sub-themes.   The present study produced a cognitive model that guides nurse manager decision-making related to stressful situations. Experience in the role, organizational context and situation factors influenced nurse manager cognitive decision-making processes.   Study findings suggest that chronic exposure to stress and work complexity negatively affects nurse manager health and their decision-making processes potentially threatening individual, patient and organizational outcomes.   Cognitive decision-making varies based on nurse manager experience and these differences have coaching and mentoring implications. This present study contributes a current understanding of nurse manager decision-making amidst stress and work complexity. © 2012 Blackwell Publishing Ltd.

  7. Shared Decision-Making for Nursing Practice: An Integrative Review.

    PubMed

    Truglio-Londrigan, Marie; Slyer, Jason T

    2018-01-01

    Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.

  8. Coding Theory Information Theory and Radar

    DTIC Science & Technology

    2005-01-01

    the design and synthesis of artificial multiagent systems and for the understanding of human decision-making processes. This... altruism that may exist in a complex society. SGT derives its ability to account simultaneously for both group and individual interests from the structure of ...satisficing decision theory as a model of human decision mak- ing. 2 Multi-Attribute Decision Making Many decision problems involve the consideration of

  9. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation

    PubMed Central

    Cox, Christopher E.; Lewis, Carmen L.; Hanson, Laura C.; Hough, Catherine L.; Kahn, Jeremy M.; White, Douglas B.; Song, Mi-Kyung; Tulsky, James A.; Carson, Shannon S.

    2013-01-01

    Objective Shared decision making is inadequate in intensive care units (ICUs). Decision aids can improve decision making quality, though their role in an ICU setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation. Setting ICUs at three medical centers. Subjects 53 surrogate decision makers and 58 physicians. Design and interventions We developed the decision aid using defined methodological guidelines. After an iterative revision process, formative cognitive testing was performed among surrogate-physician dyads. Next, we compared the decision aid to usual care control in a prospective, before/after design study. Measurements and main results Primary outcomes were physician-surrogate discordance for expected patient survival, comprehension of relevant medical information, and the quality of communication. Compared to control, the intervention group had lower surrogate-physician discordance (7 [10] vs 43 [21]), greater comprehension (11.4 [0.7] vs 6.1 [3.7]), and improved quality of communication (8.7 [1.3] vs 8.4 [1.3]) (all p<0.05) post-intervention. Hospital costs were lower in the intervention group ($110,609 vs $178,618; p=0.044); mortality did not differ by group (38% vs 50%, p=0.95). 94% of surrogates and 100% of physicians reported that the decision aid was useful in decision making. Conclusion We developed a prolonged mechanical ventilation decision aid that is feasible, acceptable, and associated with both improved decision making quality and less resource utilization. Further evaluation using a randomized controlled trial design is needed to evaluate the decision aid's effect on long-term patient and surrogate outcomes. PMID:22635048

  10. Refining a brief decision aid in stable CAD: cognitive interviews.

    PubMed

    Kelly-Blake, Karen; Clark, Stacie; Dontje, Katherine; Olomu, Adesuwa; Henry, Rebecca C; Rovner, David R; Rothert, Marilyn L; Holmes-Rovner, Margaret

    2014-02-13

    We describe the results of cognitive interviews to refine the "Making Choices©" Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD). We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the "think aloud" interview technique to assess the clarity, usefulness, and design of each page of the DA. Participants identified three main messages: 1) patients have multiple options based on stress tests and they should be discussed with a physician, 2) take care of yourself, 3) the stress test is the gold standard for determining the severity of your heart disease. Revisions corrected the inaccurate assumption of item number three. Cognitive interviews proved critical for engaging patients in the development process and highlighted the necessity of clear message development and use of design principles that make decision materials easy to read and easy to use. Cognitive interviews appear to contribute critical information from the patient perspective to the overall systematic development process for designing decision aids.

  11. Nanotechnology on a dime: building affordable research facilities

    NASA Astrophysics Data System (ADS)

    DiBattista, Jeff; Clare, Donna; Lynch, David

    2005-08-01

    Designing buildings to house nanotechnology research presents a multitude of well-recognized challenges to architectural and engineering design teams, from environmental control to spatial arrangements to operational functionality. These technical challenges can be solved with relative ease on projects with large budgets: designers have the option of selecting leading-edge systems without undue regard for their expense. This is reflected in the construction cost of many nanotechnology research facilities that run well into the hundreds of millions of dollars. Smaller universities and other institutions need not be shut out of the nanotechnology research field simply because their construction budgets are tens of millions of dollars or less. The key to success for these less expensive projects lies with making good strategic decisions: identifying priorities for the facility in terms of what it will is--and will not--provide to the researchers. Making these strategic decisions puts bounds on the tactical, technical problems that the design team at large must address, allowing them to focus their efforts on the key areas for success. The process and challenges of this strategic decision-making process are examined, with emphasis placed on the types of decisions that must be made and the factors that must be considered when making them. Case study examples of projects undertaken at the University of Alberta are used to illustrate how strategic-level decision-making sets the stage for cutting-edge success on a modest budget.

  12. Developing Digital Dashboard Management for Learning System Dynamic Cooperative Simulation Behavior of Indonesia. (Study on Cooperative Information Organization in the Ministry of Cooperatives and SME)

    NASA Astrophysics Data System (ADS)

    Eni, Yuli; Aryanto, Rudy

    2014-03-01

    There are problems being experienced by the Ministry of cooperatives and SME (Small and Medium Enterprise) including the length of time in the decision by the Government to establish a policy that should be taken for local cooperatives across the province of Indonesia. The decision-making process is still analyzed manually, so that sometimes the decisions taken are also less appropriate, effective and efficient. The second problem is the lack of monitoring data cooperative process province that is too much, making it difficult for the analysis of dynamic information to be useful. Therefore the authors want to fix the system that runs by using digital dashboard management system supported by the modeling of system dynamics. In addition, the author also did the design of a system that can support the system. Design of this system is aimed to ease the experts, head, and the government to decide (DSS - Decision Support System) accurately effectively and efficiently, because in the system are raised alternative simulation in a description of the decision to be taken and the result from the decision. The system is expected to be designed dan simulated can ease and expedite the decision making. The design of dynamic digital dashboard management conducted by method of OOAD (Objects Oriented Analysis and Design) complete with UML notation.

  13. Patients’ priorities for treatment decision making during periods of incapacity: quantitative survey

    PubMed Central

    RID, ANNETTE; WESLEY, ROBERT; PAVLICK, MARK; MAYNARD, SHARON; ROTH, KATALIN; WENDLER, DAVID

    2017-01-01

    Objective Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. Method We employed a self-administered, quantitative survey of patients in a tertiary care center. Results Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Significance of Results Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients’ treatment preferences. Clinicians should also discuss and document patients’ priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making. PMID:25273677

  14. Patients' priorities for treatment decision making during periods of incapacity: quantitative survey.

    PubMed

    Rid, Annette; Wesley, Robert; Pavlick, Mark; Maynard, Sharon; Roth, Katalin; Wendler, David

    2015-10-01

    Clinical practice aims to respect patient autonomy by basing treatment decisions for incapacitated patients on their own preferences. Yet many patients do not complete an advance directive, and those who do frequently just designate a family member to make decisions for them. This finding raises the concern that clinical practice may be based on a mistaken understanding of patient priorities. The present study aimed to collect systematic data on how patients prioritize the goals of treatment decision making. We employed a self-administered, quantitative survey of patients in a tertiary care center. Some 80% or more of the 1169 respondents (response rate = 59.8%) ranked six of eight listed goals for treatment decision making as important. When asked which goal was most important, 38.8% identified obtaining desired or avoiding unwanted treatments, 20.0% identified minimizing stress or financial burden on their family, and 14.6% identified having their family help to make treatment decisions. No single goal was designated as most important by 25.0% of participants. Patients endorsed three primary goals with respect to decision making during periods of incapacity: being treated consistent with their own preferences; minimizing the burden on their family; and involving their family in the decision-making process. However, no single goal was prioritized by a clear majority of patients. These findings suggest that advance care planning should not be limited to documenting patients' treatment preferences. Clinicians should also discuss and document patients' priorities for how decisions are to be made. Moreover, future research should evaluate ways to modify current practice to promote all three of patients primary goals for treatment decision making.

  15. Transcranial Alternating Current Stimulation Modulates Risky Decision Making in a Frequency-Controlled Experiment

    PubMed Central

    Awasthi, Bhuvanesh

    2017-01-01

    Abstract In this study, we investigated the effect of transcranial alternating current stimulation (tACS) on voluntary risky decision making and executive control in humans. Stimulation was delivered online at 5 Hz (θ), 10 Hz (α), 20 Hz (β), and 40 Hz (γ) on the left and right frontal area while participants performed a modified risky decision-making task. This task allowed participants to voluntarily select between risky and certain decisions associated with potential gains or losses, while simultaneously measuring the cognitive control component (voluntary switching) of decision making. The purpose of this experimental design was to test whether voluntary risky decision making and executive control can be modulated with tACS in a frequency-specific manner. Our results revealed a robust effect of a 20-Hz stimulation over the left prefrontal area that significantly increased voluntary risky decision making, which may suggest a possible link between risky decision making and reward processing, underlined by β-oscillatory activity. PMID:29379865

  16. Transcranial Alternating Current Stimulation Modulates Risky Decision Making in a Frequency-Controlled Experiment.

    PubMed

    Yaple, Zachary; Martinez-Saito, Mario; Feurra, Matteo; Shestakova, Anna; Klucharev, Vasily

    2017-01-01

    In this study, we investigated the effect of transcranial alternating current stimulation (tACS) on voluntary risky decision making and executive control in humans. Stimulation was delivered online at 5 Hz (θ), 10 Hz (α), 20 Hz (β), and 40 Hz (γ) on the left and right frontal area while participants performed a modified risky decision-making task. This task allowed participants to voluntarily select between risky and certain decisions associated with potential gains or losses, while simultaneously measuring the cognitive control component (voluntary switching) of decision making. The purpose of this experimental design was to test whether voluntary risky decision making and executive control can be modulated with tACS in a frequency-specific manner. Our results revealed a robust effect of a 20-Hz stimulation over the left prefrontal area that significantly increased voluntary risky decision making, which may suggest a possible link between risky decision making and reward processing, underlined by β-oscillatory activity.

  17. Investigation and design of a Project Management Decision Support System for the 4950th Test Wing.

    DTIC Science & Technology

    1986-03-01

    all decision makers is the need for memory aids (reports, hand written notes, mental memory joggers, etc.). 4. Even in similar decision making ... memories to synthesize a decision- making process based on their individual styles, skills, and knowledge (Sprague, 1982: 106). Control mechanisms...representations shown in Figures 4.9 and 4.10 provide a means to this objective. By enabling a manager to make and record reasonable changes to

  18. Optimal and Nonoptimal Computer-Based Test Designs for Making Pass-Fail Decisions

    ERIC Educational Resources Information Center

    Hambleton, Ronald K.; Xing, Dehui

    2006-01-01

    Now that many credentialing exams are being routinely administered by computer, new computer-based test designs, along with item response theory models, are being aggressively researched to identify specific designs that can increase the decision consistency and accuracy of pass-fail decisions. The purpose of this study was to investigate the…

  19. Resource Analysis of Cognitive Process Flow Used to Achieve Autonomy

    DTIC Science & Technology

    2016-03-01

    to be used as a decision - making aid to guide system designers and program managers not necessarily familiar with cognitive pro- cessing, or resource...implementing end-to-end cognitive processing flows multiplies and the impact of these design decisions on efficiency and effectiveness increases [1]. The...end-to-end cognitive systems and alternative computing technologies, then system design and acquisition personnel could make systematic analyses and

  20. The Pathways fertility preservation decision aid website for women with cancer: development and field testing.

    PubMed

    Woodard, Terri L; Hoffman, Aubri S; Covarrubias, Laura A; Holman, Deborah; Schover, Leslie; Bradford, Andrea; Hoffman, Derek B; Mathur, Aakrati; Thomas, Jerah; Volk, Robert J

    2018-02-01

    To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14). Field-testing (n = 20 survivors) assessed post-decision aid scores on the Fertility Preservation Knowledge Scale, feasibility of assessing women's decision-making values while using the website, and website usability/acceptability ratings. Iterative stakeholder engagement optimized the Pathways decision aid website to meet survivors' and providers' needs, including providing patient-friendly information and novel features such as interactive value clarification exercises, testimonials that model shared decision making, financial/referral resources, and a printable personal summary. Survivors scored an average of 8.2 out of 13 (SD 1.6) on the Fertility Preservation Knowledge Scale. They rated genetic screening and having a biological child as strong factors in their decision-making, and 71% indicated a preference for egg freezing. Most women (> 85%) rated Pathways favorably, and all women (100%) said they would recommend it to other women. The Pathways decision aid is a usable and acceptable tool to help women learn about fertility preservation. The Pathways decision aid may help women make well-informed values-based decisions and prevent future infertility-related distress.

  1. Designing Dynamic Adaptive Policy Pathways using Many-Objective Robust Decision Making

    NASA Astrophysics Data System (ADS)

    Kwakkel, Jan; Haasnoot, Marjolijn

    2017-04-01

    Dealing with climate risks in water management requires confronting a wide variety of deeply uncertain factors, while navigating a many dimensional space of trade-offs amongst objectives. There is an emerging body of literature on supporting this type of decision problem, under the label of decision making under deep uncertainty. Two approaches within this literature are Many-Objective Robust Decision Making, and Dynamic Adaptive Policy Pathways. In recent work, these approaches have been compared. One of the main conclusions of this comparison was that they are highly complementary. Many-Objective Robust Decision Making is a model based decision support approach, while Dynamic Adaptive Policy Pathways is primarily a conceptual framework for the design of flexible strategies that can be adapted over time in response to how the future is actually unfolding. In this research we explore this complementarity in more detail. Specifically, we demonstrate how Many-Objective Robust Decision Making can be used to design adaptation pathways. We demonstrate this combined approach using a water management problem, in the Netherlands. The water level of Lake IJselmeer, the main fresh water resource of the Netherlands, is currently managed through discharge by gravity. Due to climate change, this won't be possible in the future, unless water levels are changed. Changing the water level has undesirable flood risk and spatial planning consequences. The challenge is to find promising adaptation pathways that balance objectives related to fresh water supply, flood risk, and spatial issues, while accounting for uncertain climatic and land use change. We conclude that the combination of Many-Objective Robust Decision Making and Dynamic Adaptive Policy Pathways is particularly suited for dealing with deeply uncertain climate risks.

  2. Stochastic model for fatigue crack size and cost effective design decisions. [for aerospace structures

    NASA Technical Reports Server (NTRS)

    Hanagud, S.; Uppaluri, B.

    1975-01-01

    This paper describes a methodology for making cost effective fatigue design decisions. The methodology is based on a probabilistic model for the stochastic process of fatigue crack growth with time. The development of a particular model for the stochastic process is also discussed in the paper. The model is based on the assumption of continuous time and discrete space of crack lengths. Statistical decision theory and the developed probabilistic model are used to develop the procedure for making fatigue design decisions on the basis of minimum expected cost or risk function and reliability bounds. Selections of initial flaw size distribution, NDT, repair threshold crack lengths, and inspection intervals are discussed.

  3. Development of a Support Tool for Complex Decision-Making in the Provision of Rural Maternity Care

    PubMed Central

    Hearns, Glen; Klein, Michael C.; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

    2010-01-01

    Context: Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. Objective: To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Design: Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Setting: Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Participants: Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). Results: We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Conclusions: Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology. PMID:21286270

  4. Philosophy versus Student Need? A Reply to Smith and Hilton.

    ERIC Educational Resources Information Center

    Rainforth, Beverly

    1994-01-01

    This response to Smith and Hilton (1994) suggests that those authors reject philosophical bases for decision making regarding program design for students with mental retardation while actually proposing their own philosophical base for such decision making. The importance of philosophy in guiding decisions and practice over the last several…

  5. Efficiency of Fiscal Allocations in Site-Based Empowered Schools

    ERIC Educational Resources Information Center

    Meyer, Jerome Jay

    2011-01-01

    This study implemented a two phase concurrent mixed-methods design to generate a greater understanding of how elementary schools with increased autonomy in fiscal decision making allocated their money, how their site-based decisions affected allocative efficiency, and how increased autonomy affected site-based decision making when compared with a…

  6. 50 CFR 660.18 - Certification and decertification procedures for observers, catch monitors, catch monitor...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... designee) will designate a NMFS observer certification official who will make decisions for the Observer... of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false... appeal pursuant to paragraph (c) of this section. (c) Appeals process—(1) Decisions. Decisions on appeals...

  7. Examining key design decisions involved in developing a serious game for child sexual abuse prevention.

    PubMed

    Stieler-Hunt, Colleen; Jones, Christian M; Rolfe, Ben; Pozzebon, Kay

    2014-01-01

    This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken.

  8. Examining key design decisions involved in developing a serious game for child sexual abuse prevention

    PubMed Central

    Stieler-Hunt, Colleen; Jones, Christian M.; Rolfe, Ben; Pozzebon, Kay

    2014-01-01

    This paper presents a case study of the key decisions made in the design of Orbit, a child sexual abuse prevention computer game targeted at school students between 8 and 10 years of age. Key decisions include providing supported delivery for the target age group, featuring adults in the program, not over-sanitizing game content, having a focus on building healthy self-concept of players, making the game engaging and relatable for all players and evaluating the program. This case study has implications for the design of Serious Games more generally, including that research should underpin game design decisions, game designers should consider ways of bridging the game to real life, the learning that arises from the game should go beyond rote-learning, designers should consider how the player can make the game-world their own and comprehensive evaluations of Serious Games should be undertaken. PMID:24550880

  9. Lay Referral Patterns Involved in Cardiac Treatment Decision Making among Middle-Aged and Older Adults

    ERIC Educational Resources Information Center

    Schoenberg, Nancy E.; Amey, Cheryl H.; Stoller, Eleanor Palo; Muldoon, Susan B.

    2003-01-01

    Purpose: This study examined age and contextually related factors that are influential in lay referral patterns during cardiac treatment decision making. Design and Methods: A complementary design was used. The Myocardial Infarction (MI) Onset Study identified demographic correlates of who sought medical care for 1,388 MI (heart attack) survivors.…

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  11. Teachers' Thoughts on Student Decision Making during Engineering Design Lessons

    ERIC Educational Resources Information Center

    Meyer, Helen

    2018-01-01

    In this paper, I share the results of a study of teachers' ideas about student decision-making at entry into a professional development program to integrate engineering into their instruction. The framework for the Engineering Design Process (EDP) was based on a Challenge-Based Learning (CBL) model. The EDP embedded within the CBL model suggests…

  12. Decision-Making under Ambiguity Is Modulated by Visual Framing, but Not by Motor vs. Non-Motor Context. Experiments and an Information-Theoretic Ambiguity Model

    PubMed Central

    Grau-Moya, Jordi; Ortega, Pedro A.; Braun, Daniel A.

    2016-01-01

    A number of recent studies have investigated differences in human choice behavior depending on task framing, especially comparing economic decision-making to choice behavior in equivalent sensorimotor tasks. Here we test whether decision-making under ambiguity exhibits effects of task framing in motor vs. non-motor context. In a first experiment, we designed an experience-based urn task with varying degrees of ambiguity and an equivalent motor task where subjects chose between hitting partially occluded targets. In a second experiment, we controlled for the different stimulus design in the two tasks by introducing an urn task with bar stimuli matching those in the motor task. We found ambiguity attitudes to be mainly influenced by stimulus design. In particular, we found that the same subjects tended to be ambiguity-preferring when choosing between ambiguous bar stimuli, but ambiguity-avoiding when choosing between ambiguous urn sample stimuli. In contrast, subjects’ choice pattern was not affected by changing from a target hitting task to a non-motor context when keeping the stimulus design unchanged. In both tasks subjects’ choice behavior was continuously modulated by the degree of ambiguity. We show that this modulation of behavior can be explained by an information-theoretic model of ambiguity that generalizes Bayes-optimal decision-making by combining Bayesian inference with robust decision-making under model uncertainty. Our results demonstrate the benefits of information-theoretic models of decision-making under varying degrees of ambiguity for a given context, but also demonstrate the sensitivity of ambiguity attitudes across contexts that theoretical models struggle to explain. PMID:27124723

  13. Decision-Making under Ambiguity Is Modulated by Visual Framing, but Not by Motor vs. Non-Motor Context. Experiments and an Information-Theoretic Ambiguity Model.

    PubMed

    Grau-Moya, Jordi; Ortega, Pedro A; Braun, Daniel A

    2016-01-01

    A number of recent studies have investigated differences in human choice behavior depending on task framing, especially comparing economic decision-making to choice behavior in equivalent sensorimotor tasks. Here we test whether decision-making under ambiguity exhibits effects of task framing in motor vs. non-motor context. In a first experiment, we designed an experience-based urn task with varying degrees of ambiguity and an equivalent motor task where subjects chose between hitting partially occluded targets. In a second experiment, we controlled for the different stimulus design in the two tasks by introducing an urn task with bar stimuli matching those in the motor task. We found ambiguity attitudes to be mainly influenced by stimulus design. In particular, we found that the same subjects tended to be ambiguity-preferring when choosing between ambiguous bar stimuli, but ambiguity-avoiding when choosing between ambiguous urn sample stimuli. In contrast, subjects' choice pattern was not affected by changing from a target hitting task to a non-motor context when keeping the stimulus design unchanged. In both tasks subjects' choice behavior was continuously modulated by the degree of ambiguity. We show that this modulation of behavior can be explained by an information-theoretic model of ambiguity that generalizes Bayes-optimal decision-making by combining Bayesian inference with robust decision-making under model uncertainty. Our results demonstrate the benefits of information-theoretic models of decision-making under varying degrees of ambiguity for a given context, but also demonstrate the sensitivity of ambiguity attitudes across contexts that theoretical models struggle to explain.

  14. Factors and outcomes of decision making for cancer clinical trial participation.

    PubMed

    Biedrzycki, Barbara A

    2011-09-01

    To describe factors and outcomes related to the decision-making process regarding participation in a cancer clinical trial. Cross-sectional, descriptive. Urban, academic, National Cancer Institute-designated comprehensive cancer center in the mid-Atlantic United States. 197 patients with advanced gastrointestinal cancer. Mailed survey using one investigator-developed instrument, eight instruments used in published research, and a medical record review. disease context, sociodemographics, hope, quality of life, trust in healthcare system, trust in health professional, preference for research decision control, understanding risks, and information. decision to accept or decline research participation and satisfaction with this decision. All of the factors within the Research Decision Making Model together predicted cancer clinical trial participation and satisfaction with this decision. The most frequently preferred decision-making style for research participation was shared (collaborative) (83%). Multiple factors affect decision making for cancer clinical trial participation and satisfaction with this decision. Shared decision making previously was an unrecognized factor and requires further investigation. Enhancing the process of research decision making may facilitate an increase in cancer clinical trial enrollment rates. Oncology nurses have unique opportunities as educators and researchers to support shared decision making by those who prefer this method for deciding whether to accept or decline cancer clinical trial participation.

  15. 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

  16. Reproductive health decision-making in perinatally HIV-infected adolescents and young adults.

    PubMed

    Fair, Cynthia; Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

    2013-07-01

    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.

  17. Designing a rapid response program to support evidence-informed decision-making in the Americas region: using the best available evidence and case studies.

    PubMed

    Haby, Michelle M; Chapman, Evelina; Clark, Rachel; Barreto, Jorge; Reveiz, Ludovic; Lavis, John N

    2016-08-18

    The objective of this work was to inform the design of a rapid response program to support evidence-informed decision-making in health policy and practice for the Americas region. Specifically, we focus on the following: (1) What are the best methodological approaches for rapid reviews of the research evidence? (2) What other strategies are needed to facilitate evidence-informed decision-making in health policy and practice? and (3) How best to operationalize a rapid response program? The evidence used to inform the design of a rapid response program included (i) two rapid reviews of methodological approaches for rapid reviews of the research evidence and strategies to facilitate evidence-informed decision-making, (ii) supplementary literature in relation to the "shortcuts" that could be considered to reduce the time needed to complete rapid reviews, (iii) four case studies, and (iv) supplementary literature to identify additional operational issues for the design of the program. There is no agreed definition of rapid reviews in the literature and no agreed methodology for conducting them. Better reporting of rapid review methods is needed. The literature found in relation to shortcuts will be helpful in choosing shortcuts that maximize timeliness while minimizing the impact on quality. Evidence for other strategies that can be used concurrently to facilitate the uptake of research evidence, including evidence drawn from rapid reviews, is presented. Operational issues that need to be considered in designing a rapid response program include the implications of a "user-pays" model, the importance of recruiting staff with the right mix of skills and qualifications, and ensuring that the impact of the model on research use in decision-making is formally evaluated. When designing a new rapid response program, greater attention needs to be given to specifying the rapid review methods and reporting these in sufficient detail to allow a quality assessment. It will also be important to engage in other strategies to facilitate the uptake of the rapid reviews and to evaluate the chosen model in order to make refinements and add to the evidence base for evidence-informed decision-making.

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

    PubMed

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

    2016-04-01

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

  19. Hesitant Fuzzy Thermodynamic Method for Emergency Decision Making Based on Prospect Theory.

    PubMed

    Ren, Peijia; Xu, Zeshui; Hao, Zhinan

    2017-09-01

    Due to the timeliness of emergency response and much unknown information in emergency situations, this paper proposes a method to deal with the emergency decision making, which can comprehensively reflect the emergency decision making process. By utilizing the hesitant fuzzy elements to represent the fuzziness of the objects and the hesitant thought of the experts, this paper introduces the negative exponential function into the prospect theory so as to portray the psychological behaviors of the experts, which transforms the hesitant fuzzy decision matrix into the hesitant fuzzy prospect decision matrix (HFPDM) according to the expectation-levels. Then, this paper applies the energy and the entropy in thermodynamics to take the quantity and the quality of the decision values into account, and defines the thermodynamic decision making parameters based on the HFPDM. Accordingly, a whole procedure for emergency decision making is conducted. What is more, some experiments are designed to demonstrate and improve the validation of the emergency decision making procedure. Last but not the least, this paper makes a case study about the emergency decision making in the firing and exploding at Port Group in Tianjin Binhai New Area, which manifests the effectiveness and practicability of the proposed method.

  20. Shared Decision-Making for Nursing Practice: An Integrative Review

    PubMed Central

    Truglio-Londrigan, Marie; Slyer, Jason T.

    2018-01-01

    Background: Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. Objective: To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. Methods: An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Results: Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. Conclusion: A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions. PMID:29456779

  1. Stress-induced cortisol facilitates threat-related decision making among police officers.

    PubMed

    Akinola, Modupe; Mendes, Wendy Berry

    2012-02-01

    Previous research suggests that cortisol can affect cognitive functions such as memory, decision making, and attentiveness to threat-related cues. Here, we examine whether increases in cortisol, brought on by an acute social stressor, influence threat-related decision making. Eighty-one police officers completed a standardized laboratory stressor and then immediately completed a computer simulated decision-making task designed to examine decisions to accurately shoot or not shoot armed and unarmed Black and White targets. Results indicated that police officers who had larger cortisol increases to the social-stress task subsequently made fewer errors when deciding to shoot armed Black targets relative to armed White targets, suggesting that hypothalamic pituitary adrenal (HPA) activation may exacerbate vigilance for threat cues. We conclude with a discussion of the implications of threat-initiated decision making.

  2. The Impact of Multifaceted Osteoporosis Group Education on Patients' Decision-Making regarding Treatment Options and Lifestyle Changes.

    PubMed

    Jensen, Annesofie L; Wind, Gitte; Langdahl, Bente Lomholt; Lomborg, Kirsten

    2018-01-01

    Patients with chronic diseases like osteoporosis constantly have to make decisions related to their disease. Multifaceted osteoporosis group education (GE) may support patients' decision-making. This study investigated multifaceted osteoporosis GE focusing on the impact of GE on patients' decision-making related to treatment options and lifestyle. An interpretive description design using ethnographic methods was utilized with 14 women and three men diagnosed with osteoporosis who attended multifaceted GE. Data consisted of participant observation during GE and individual interviews. Attending GE had an impact on the patients' decision-making in all educational themes. Patients decided on new ways to manage osteoporosis and made decisions regarding bone health and how to implement a lifestyle ensuring bone health. During GE, teachers and patients shared evidence-based knowledge and personal experiences and preferences, respectively, leading to a two-way exchange of information and deliberation about recommendations. Though teachers and patients explored the implications of the decisions and shared their preferences, teachers stressed that the patients ultimately had to make the decision. Teachers therefore refrained from participating in the final step of the decision-making process. Attending GE has an impact on the patients' decision-making as it can initiate patient reflection and support decision-making.

  3. [A study on participation in clinical decision making by home healthcare nurses].

    PubMed

    Kim, Se Young

    2010-12-01

    This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses' participation in clinical decision making in cases where they can identify and solve the patient health problems.

  4. Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform.

    PubMed

    Hoffman, Aubri S; Llewellyn-Thomas, Hilary A; Tosteson, Anna N A; O'Connor, Annette M; Volk, Robert J; Tomek, Ivan M; Andrews, Steven B; Bartels, Stephen J

    2014-12-12

    Over 100 trials show that patient decision aids effectively improve patients' information comprehension and values-based decision making. However, gaps remain in our understanding of several fundamental and applied questions, particularly related to the design of interactive, personalized decision aids. This paper describes an interdisciplinary development process for, and early field testing of, a web-based patient decision support research platform, or virtual decision lab, to address these questions. An interdisciplinary stakeholder panel designed the web-based research platform with three components: a) an introduction to shared decision making, b) a web-based patient decision aid, and c) interactive data collection items. Iterative focus groups provided feedback on paper drafts and online prototypes. A field test assessed a) feasibility for using the research platform, in terms of recruitment, usage, and acceptability; and b) feasibility of using the web-based decision aid component, compared to performance of a videobooklet decision aid in clinical care. This interdisciplinary, theory-based, patient-centered design approach produced a prototype for field-testing in six months. Participants (n = 126) reported that: the decision aid component was easy to use (98%), information was clear (90%), the length was appropriate (100%), it was appropriately detailed (90%), and it held their interest (97%). They spent a mean of 36 minutes using the decision aid and 100% preferred using their home/library computer. Participants scored a mean of 75% correct on the Decision Quality, Knowledge Subscale, and 74 out of 100 on the Preparation for Decision Making Scale. Completing the web-based decision aid reduced mean Decisional Conflict scores from 31.1 to 19.5 (p < 0.01). Combining decision science and health informatics approaches facilitated rapid development of a web-based patient decision support research platform that was feasible for use in research studies in terms of recruitment, acceptability, and usage. Within this platform, the web-based decision aid component performed comparably with the videobooklet decision aid used in clinical practice. Future studies may use this interactive research platform to study patients' decision making processes in real-time, explore interdisciplinary approaches to designing web-based decision aids, and test strategies for tailoring decision support to meet patients' needs and preferences.

  5. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    PubMed

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  6. Decision Support Systems Project. Design Review Conference, October 14-15, 1984. Summary Report of Findings.

    ERIC Educational Resources Information Center

    Tetlow, William L.

    Findings of a conference that reviewed and evaluated design decisions concerning the Decision Support System (DSS) Demonstrator are summarized. The DSS Demonstrator was designed by the National Center for Higher Education Management Systems as an example of the way in which microcomputer technology can support and make more effective planning and…

  7. An integrated, ethically driven environmental model of clinical decision making in emergency settings.

    PubMed

    Wolf, Lisa

    2013-02-01

    To explore the relationship between multiple variables within a model of critical thinking and moral reasoning. A quantitative descriptive correlational design using a purposive sample of 200 emergency nurses. Measured variables were accuracy in clinical decision-making, moral reasoning, perceived care environment, and demographics. Analysis was by bivariate correlation using Pearson's product-moment correlation coefficients, chi square and multiple linear regression analysis. The elements as identified in the integrated ethically-driven environmental model of clinical decision-making (IEDEM-CD) corrected depict moral reasoning and environment of care as factors significantly affecting accuracy in decision-making. The integrated, ethically driven environmental model of clinical decision making is a framework useful for predicting clinical decision making accuracy for emergency nurses in practice, with further implications in education, research and policy. A diagnostic and therapeutic framework for identifying and remediating individual and environmental challenges to accurate clinical decision making. © 2012, The Author. International Journal of Nursing Knowledge © 2012, NANDA International.

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

    PubMed

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

    2018-03-01

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

  9. Characterization of Decision Making Behaviors Associated with Human Systems Integration (HSI) Design Tradeoffs: Subject Matter Expert Interviews

    DTIC Science & Technology

    2014-11-18

    this research was to characterize the naturalistic decision making process used in Naval Aviation acquisition to assess cost, schedule and...Naval Aviation acquisitions can be identified, which can support the future development of new processes and tools for training and decision making...part of Department of Defense acquisition processes , HSI ensures that operator, maintainer and sustainer considerations are incorporated into

  10. Aggregating School Based Findings to Support Decision Making: Implications for Educational Leadership

    ERIC Educational Resources Information Center

    Kaniuka, Theodore S.; Vitale, Michael R.; Romance, Nancy R.

    2013-01-01

    Successful school reform is dependent on the quality of decisions made by educational leaders. In such decision making, educational leaders are charged with using sound research findings as the basis for choosing school reform initiatives. As part of the debate regarding the usability of various evaluative research designs in providing information…

  11. Designing an Alternative Teaching Approach (Feedback Lecture) through the Use of Guided Decision-Making.

    ERIC Educational Resources Information Center

    Osterman, Dean

    This chapter explains how the Guided Design method of teaching can be used to solve problems, and how this method was used in the development of a new method of teaching. Called the Feedback Lecture, this method is illustrated through an example, and research data on its effectiveness is presented. The Guided Decision-Making Process is also…

  12. A Grounded Theory Approach to the Development of a Framework for Researching Children's Decision-Making Skills within Design and Technology Education

    ERIC Educational Resources Information Center

    Mettas, Alexandros; Norman, Eddie

    2011-01-01

    This paper discusses the establishment of a framework for researching children's decision-making skills in design and technology education through taking a grounded theory approach. Three data sources were used: (1) analysis of available literature; (2) curriculum analysis and interviews with teachers concerning their practice in relation to their…

  13. Age Effects and Heuristics in Decision Making*

    PubMed Central

    Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael

    2011-01-01

    Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subjects. Second, heuristics differ by age with older subjects relying more on suboptimal decision rules. In a heuristics validation experiment, older subjects make worse decisions than younger subjects. PMID:22544977

  14. Age Effects and Heuristics in Decision Making.

    PubMed

    Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael

    2012-05-01

    Using controlled experiments, we examine how individuals make choices when faced with multiple options. Choice tasks are designed to mimic the selection of health insurance, prescription drug, or retirement savings plans. In our experiment, available options can be objectively ranked allowing us to examine optimal decision making. First, the probability of a person selecting the optimal option declines as the number of options increases, with the decline being more pronounced for older subjects. Second, heuristics differ by age with older subjects relying more on suboptimal decision rules. In a heuristics validation experiment, older subjects make worse decisions than younger subjects.

  15. Multi-disciplinary decision making in general practice.

    PubMed

    Kirby, Ann; Murphy, Aileen; Bradley, Colin

    2018-04-09

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

  16. 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)

  17. Enhancing Shared Decision Making Through Carefully Designed Interventions That Target Patient And Provider Behavior.

    PubMed

    Tai-Seale, Ming; Elwyn, Glyn; Wilson, Caroline J; Stults, Cheryl; Dillon, Ellis C; Li, Martina; Chuang, Judith; Meehan, Amy; Frosch, Dominick L

    2016-04-01

    Patient-provider communication and shared decision making are essential for primary care delivery and are vital contributors to patient experience and health outcomes. To alleviate communication shortfalls, we designed a novel, multidimensional intervention aimed at nudging both patients and primary care providers to communicate more openly. The intervention was tested against an existing intervention, which focused mainly on changing patients' behaviors, in four primary care clinics involving 26 primary care providers and 300 patients. Study results suggest that compared to usual care, both the novel and existing interventions were associated with better patient reports of how well primary care providers engaged them in shared decision making. Future research should build on the work in this pilot to rigorously examine the comparative effectiveness and scalability of these interventions to improve shared decision making at the point of care. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Evaluating a Web-Based MMR Decision Aid to Support Informed Decision-Making by UK Parents: A Before-and-After Feasibility Study

    ERIC Educational Resources Information Center

    Jackson, Cath; Cheater, Francine M.; Peacock, Rose; Leask, Julie; Trevena, Lyndal

    2010-01-01

    Objective: The objective of this feasibility study was to evaluate the acceptability and potential effectiveness of a web-based MMR decision aid in supporting informed decision-making for the MMR vaccine. Design: This was a prospective before-and-after evaluation. Setting: Thirty parents of children eligible for MMR vaccination were recruited from…

  19. Governors' Institute on Community Design

    EPA Pesticide Factsheets

    This page describes the Governors' Institute on Community Design, which helps governors and their staff make informed decisions about investments and policy decisions that influence the economic health and physical development of their states.

  20. Parental decision-making for medically complex infants and children: an integrated literature review.

    PubMed

    Allen, Kimberly A

    2014-09-01

    Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms 'parents and decision-making' to obtain English language publications from 2000 to June 2013. The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent-provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital heart disease. Thus comparisons across other child illness categories cannot be made. Most studies also used cross-sectional and/or retrospective research designs, which led to researchers and clinicians having limited understanding of how factors change over time for parents. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Factors that impact on emergency nurses' ethical decision-making ability.

    PubMed

    Alba, Barbara

    2016-11-10

    Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.

  2. Clarifying values: an updated review

    PubMed Central

    2013-01-01

    Background Consensus guidelines have recommended that decision aids include a process for helping patients clarify their values. We sought to examine the theoretical and empirical evidence related to the use of values clarification methods in patient decision aids. Methods Building on the International Patient Decision Aid Standards (IPDAS) Collaboration’s 2005 review of values clarification methods in decision aids, we convened a multi-disciplinary expert group to examine key definitions, decision-making process theories, and empirical evidence about the effects of values clarification methods in decision aids. To summarize the current state of theory and evidence about the role of values clarification methods in decision aids, we undertook a process of evidence review and summary. Results Values clarification methods (VCMs) are best defined as methods to help patients think about the desirability of options or attributes of options within a specific decision context, in order to identify which option he/she prefers. Several decision making process theories were identified that can inform the design of values clarification methods, but no single “best” practice for how such methods should be constructed was determined. Our evidence review found that existing VCMs were used for a variety of different decisions, rarely referenced underlying theory for their design, but generally were well described in regard to their development process. Listing the pros and cons of a decision was the most common method used. The 13 trials that compared decision support with or without VCMs reached mixed results: some found that VCMs improved some decision-making processes, while others found no effect. Conclusions Values clarification methods may improve decision-making processes and potentially more distal outcomes. However, the small number of evaluations of VCMs and, where evaluations exist, the heterogeneity in outcome measures makes it difficult to determine their overall effectiveness or the specific characteristics that increase effectiveness. PMID:24625261

  3. Utilizing computerized entertainment education in the development of decision aids for lower literate and naïve computer users.

    PubMed

    Jibaja-Weiss, Maria L; Volk, Robert J

    2007-01-01

    Decision aids have been developed by using various delivery methods, including interactive computer programs. Such programs, however, still rely heavily on written information, health and digital literacy, and reading ease. We describe an approach to overcome these potential barriers for low-literate, underserved populations by making design considerations for poor readers and naïve computer users and by using concepts from entertainment education to engage the user and to contextualize the content for the user. The system design goals are to make the program both didactic and entertaining and the navigation and graphical user interface as simple as possible. One entertainment education strategy, the soap opera, is linked seamlessly to interactive learning modules to enhance the content of the soap opera episodes. The edutainment decision aid model (EDAM) guides developers through the design process. Although designing patient decision aids that are educational, entertaining, and targeted toward poor readers and those with limited computer skills is a complex task, it is a promising strategy for aiding this population. Entertainment education may be a highly effective approach to promoting informed decision making for patients with low health literacy.

  4. Bayesian design of decision rules for failure detection

    NASA Technical Reports Server (NTRS)

    Chow, E. Y.; Willsky, A. S.

    1984-01-01

    The formulation of the decision making process of a failure detection algorithm as a Bayes sequential decision problem provides a simple conceptualization of the decision rule design problem. As the optimal Bayes rule is not computable, a methodology that is based on the Bayesian approach and aimed at a reduced computational requirement is developed for designing suboptimal rules. A numerical algorithm is constructed to facilitate the design and performance evaluation of these suboptimal rules. The result of applying this design methodology to an example shows that this approach is potentially a useful one.

  5. Decision aids for randomised controlled trials: a qualitative exploration of stakeholders’ views

    PubMed Central

    Gillies, Katie; Skea, Zoë C; Campbell, Marion K

    2014-01-01

    Objectives To explore stakeholders’ perceptions of decision aids designed to support the informed consent decision-making process for randomised controlled trials. Design Qualitative semistructured interviews. Participants were provided with prototype trial decision aids in advance to stimulate discussion. Interviews were analysed using an established interpretive approach. Participants 23 stakeholders: Trial Managers (n=5); Research Nurses (n=5); Ethics Committee Chairs (n=5); patients (n=4) and Clinical Principal Investigators (n=4). Setting Embedded within two ongoing randomised controlled trials. All interviews conducted with UK-based participants. Results Certain key aspects (eg, values clarification exercises, presentation of probabilities, experiences of others and balance of options) in the prototype decision aids were perceived by all stakeholders as having a significant advantage (over existing patient information leaflets) in terms of supporting well informed appropriate decisions. However, there were some important differences between the stakeholder groups on specific content (eg, language used in the section on positive and negative features of taking part in a trial and the overall length of the trial decision aids). Generally the stakeholders believed trial decision aids have the potential to better engage potential participants in the decision-making process and allow them to make more personally relevant decisions about their participation. Conclusions Compared to existing patient information leaflets, stakeholders perceived decision aids for trial participation to have the potential to promote a more ‘informed’ decision-making process. Further efforts to develop, refine and formally evaluate trial decision aids should be explored. PMID:25138811

  6. UML Profiles for Design Decisions and Non-Functional Requirements

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

    Zhu, Liming; Gorton, Ian

    2007-06-30

    A software architecture is composed of a collection of design decisions. Each design decision helps or hinders certain Non-Functional Requirements (NFR). Current software architecture views focus on expressing components and connectors in the system. Design decisions and their relationships with non-functional requirements are often captured in separate design documentation, not explicitly expressed in any views. This disassociation makes architecture comprehension and architecture evolution harder. In this paper, we propose a UML profile for modeling design decisions and an associated UML profile for modeling non-functional requirements in a generic way. The two UML profiles treat design decisions and nonfunctional requirements asmore » first-class elements. Modeled design decisions always refer to existing architectural elements and thus maintain traceability between the two. We provide a mechanism for checking consistency over this traceability. An exemplar is given as« less

  7. Public preferences for engagement in Health Technology Assessment decision-making: protocol of a mixed methods study.

    PubMed

    Wortley, Sally; Tong, Allison; Lancsar, Emily; Salkeld, Glenn; Howard, Kirsten

    2015-07-14

    Much attention in recent years has been given to the topic of public engagement in health technology assessment (HTA) decision-making. HTA organizations spend substantial resources and time on undertaking public engagement, and numerous studies have examined challenges and barriers to engagement in the decision-making process however uncertainty remains as to optimal methods to incorporate the views of the public in HTA decision-making. Little research has been done to ascertain whether current engagement processes align with public preferences and to what extent their desire for engagement is dependent on the question being asked by decision-makers or the characteristics of the decision. This study will examine public preferences for engagement in Australian HTA decision-making using an exploratory mixed methods design. The aims of this study are to: 1) identify characteristics about HTA decisions that are important to the public in determining whether public engagement should be undertaken on a particular topic, 2) determine which decision characteristics influence public preferences for the extent, or type of public engagement, and 3) describe reasons underpinning these preferences. Focus group participants from the general community, aged 18-70 years, will be purposively sampled from the Australian population to ensure a wide range of demographic groups. Each focus group will include a general discussion on public engagement as well as a ranking exercise using a modified nominal group technique (NGT). The NGT will inform the design of a discrete choice study to quantitatively assess public preferences for engagement in HTA decision-making. The proposed research seeks to investigate under what circumstances and how the public would like their views and preferences to be considered in health technology assessments. HTA organizations regularly make decisions about when and how public engagement should occur but without consideration of the public's preferences on the method and extent of engagement. This information has the potential to assist decision-makers in tailoring engagement approaches, and may be particularly useful in decisions with potential for conflict where clarification of public values and preferences could strengthen the decision-making process.

  8. Choosing an out-of-hospital birth centre: Exploring women's decision-making experiences.

    PubMed

    Wood, Rebecca J; Mignone, Javier; Heaman, Maureen I; Robinson, Kristine J; Roger, Kerstin Stieber

    2016-08-01

    the primary objective for this study was to explore women's experiences of choosing to plan a birth at an out-of-hospital birth centre. We sought to understand how women make the choice to plan for an out-of-hospital birth and the meaning that women ascribe to this decision-making process. a qualitative phenomenological study was conducted in Winnipeg, Canada with a sample of seventeen post partum women who represent the socio-demographic characteristics of the actual users of the Birth Centre in Winnipeg. The women participated in semistructured interviews. Through a feminist perspective and using interpretative phenomenological analysis (IPA), each participant's experience of birthplace decision-making was explored. six themes emerged through the analysis: (1) Making the decision in the context of relationships; (2) Exercising personal agency; (3) An expression of one's ideology; (4) Really thinking it through; (5) Fitting into the eligibility criteria; and (6) The psychology of the space. The findings suggested that a woman's sense of safety was related to each of these themes. the birth centre decision-making experience has many similarities to the homebirth decision-making process. The visceral impact of the physical design of the facility plays an important role and differentiates the birth centre decision from other birth setting options. The concept of relational autonomy was emphasised in this study, in that women make the decision in the context of their relationships with their midwives and partners. The study has implications for midwifery practice and health-care policy related to: client education on birth settings, design of birth environments, validation of the birth centre concept, and upholding the women-centred midwifery model of care. The study highlighted the importance of increasing access to out-of-hospital birth centres. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The Impact of Health and Financial Literacy on Decision Making in Community-Based Older Adults

    PubMed Central

    James, Bryan D.; Boyle, Patricia A.; Bennett, Jarred S.; Bennett, David A.

    2012-01-01

    Background Health and financial literacy have been linked to the health and well-being of older adults, yet there are few data on how health and financial literacy actually impact decision making regarding healthcare and economic choices in advanced age. Objective To examine the association of health and financial literacy with decision making in older adults. Method Data came from 525 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Health and financial literacy were assessed via a series of questions designed to measure comprehension of health and financial information and concepts. The two scores were averaged to yield a total literacy score. A modified, 12-item version of the Decision-Making Competence Assessment Tool was used to measure financial and healthcare decision making (6 items each), using materials designed to approximate those used in real world settings. All 12 items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex and education. Secondary models adjusted for global cognitive function, income, depression and chronic medical conditions. Results On average, participants correctly answered 67% of the literacy questions (health literacy = 61.6%, SD = 18.8% and financial literacy = 72.5%, SD = 16.0%). After adjustment for cognitive function, the total literacy score was positively associated with the decision-making total score (estimate = 0.64, SE = 0.08, p < 0.001), as well as healthcare (estimate = 0.37, SE = 0.5, p < 0.001) and financial decision making (estimate = 0.28, SE = 0.05, p < 0.001). Further, total literacy, health and financial literacy all were independently associated with decision making in models adjusted for covariates including income, depression, and chronic medical conditions (all p values < 0.001). Finally, there was evidence of effect modification such that the beneficial association between literacy and healthcare decision making was stronger among older persons, poorer persons and persons at the lower ranges of cognitive ability. Conclusion Among community based older persons without dementia, higher levels of health and financial literacy were associated with better decision making, suggesting that improvements in literacy could facilitate better decision making and lead to better health and quality of life in later years. PMID:22739454

  10. The impact of health and financial literacy on decision making in community-based older adults.

    PubMed

    James, Bryan D; Boyle, Patricia A; Bennett, Jarred S; Bennett, David A

    2012-01-01

    Health and financial literacy have been linked to the health and well-being of older adults, yet there are few data on how health and financial literacy actually impact decision making regarding healthcare and economic choices in advanced age. To examine the association of health and financial literacy with decision making in older adults. Data came from 525 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Health and financial literacy were assessed via a series of questions designed to measure comprehension of health and financial information and concepts. The two scores were averaged to yield a total literacy score. A modified, 12-item version of the Decision-Making Competence Assessment Tool was used to measure financial and healthcare decision making (6 items each), using materials designed to approximate those used in real world settings. All 12 items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex and education. Secondary models adjusted for global cognitive function, income, depression and chronic medical conditions. On average, participants correctly answered 67% of the literacy questions (health literacy = 61.6%, SD = 18.8% and financial literacy = 72.5%, SD = 16.0%). After adjustment for cognitive function, the total literacy score was positively associated with the decision-making total score (estimate = 0.64, SE = 0.08, p < 0.001), as well as healthcare (estimate = 0.37, SE = 0.5, p < 0.001) and financial decision making (estimate = 0.28, SE = 0.05, p < 0.001). Further, total literacy, health and financial literacy all were independently associated with decision making in models adjusted for covariates including income, depression, and chronic medical conditions (all p values < 0.001). Finally, there was evidence of effect modification such that the beneficial association between literacy and healthcare decision making was stronger among older persons, poorer persons and persons at the lower ranges of cognitive ability. Among community based older persons without dementia, higher levels of health and financial literacy were associated with better decision making, suggesting that improvements in literacy could facilitate better decision making and lead to better health and quality of life in later years. Copyright © 2012 S. Karger AG, Basel.

  11. The Design and Development of an Intelligent Planning Aid

    DTIC Science & Technology

    1986-07-01

    reasons why widening the scope of TACPLAK’s applicability make sense. First# plan execution and monitoring (and the re-planning that then occurs) are...Orsssnu, contracting officer’s representative I», KKY voees o Decision Making Tactical Planning Taxonomy Problem Solving ii M ifrntitr *r MM* I...planning aid. It documents the development of a decision- making , planning, and decision-aiding analytical framework comprising a set of models, s generic

  12. Couple decision making and use of cultural scripts in Malawi.

    PubMed

    Mbweza, Ellen; Norr, Kathleen F; McElmurry, Beverly

    2008-01-01

    To examine the decision-making processes of husband and wife dyads in matrilineal and patrilineal marriage traditions of Malawi in the areas of money, food, pregnancy, contraception, and sexual relations. Qualitative grounded theory using simultaneous interviews of 60 husbands and wives (30 couples). Data were analyzed according to the guidelines of simultaneous data collection and analysis. The analysis resulted in development of core categories and categories of decision-making process. Data matrixes were used to identify similarities and differences within couples and across cases. Most couples reported using a mix of final decision-making approaches: husband-dominated, wife-dominated, and shared. Gender based and nongender based cultural scripts provided rationales for their approaches to decision making. Gender based cultural scripts (husband-dominant and wife-dominant) were used to justify decision-making approaches. Non-gender based cultural scripts (communicating openly, maintaining harmony, and children's welfare) supported shared decision making. Gender based cultural scripts were used in decision making more often among couples from the district with a patrilineal marriage tradition and where the husband had less than secondary school education and was not formally employed. Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Nurses who work with women and families should be aware of the variations that occur in actual couple decision-making approaches. Shared decision making can be used to encourage the involvement of men in reproductive health programs.

  13. Using Multimedia Questionnaires to Study Influences on the Decisions Mathematics Teachers Make in Instructional Situations

    ERIC Educational Resources Information Center

    Herbst, Patricio; Chazan, Daniel; Kosko, Karl W.; Dimmel, Justin; Erickson, Ander

    2016-01-01

    This paper describes instruments designed to use multimedia to study at scale the instructional decisions that mathematics teachers make as well as teachers' recognition of elements of the context of their work that might influence those decision. This methodological contribution shows how evidence of constructs like instructional norm and…

  14. Use of Indigenous Knowledge in Environmental Decision-Making by Communities in the Kumaon Himalayas

    ERIC Educational Resources Information Center

    Honwad, Sameer

    2010-01-01

    This study is designed to find out how people in rural communities residing in the middle Himalayas use indigenous knowledge to support environmental decisions while addressing water and land use related concerns. The study not only serves to enrich our understanding of community decision-making, especially as connected to land use and ecological…

  15. Designing Visual Aids That Promote Risk Literacy: A Systematic Review of Health Research and Evidence-Based Design Heuristics.

    PubMed

    Garcia-Retamero, Rocio; Cokely, Edward T

    2017-06-01

    Background Effective risk communication is essential for informed decision making. Unfortunately, many people struggle to understand typical risk communications because they lack essential decision-making skills. Objective The aim of this study was to review the literature on the effect of numeracy on risk literacy, decision making, and health outcomes, and to evaluate the benefits of visual aids in risk communication. Method We present a conceptual framework describing the influence of numeracy on risk literacy, decision making, and health outcomes, followed by a systematic review of the benefits of visual aids in risk communication for people with different levels of numeracy and graph literacy. The systematic review covers scientific research published between January 1995 and April 2016, drawn from the following databases: Web of Science, PubMed, PsycINFO, ERIC, Medline, and Google Scholar. Inclusion criteria were investigation of the effect of numeracy and/or graph literacy, and investigation of the effect of visual aids or comparison of their effect with that of numerical information. Thirty-six publications met the criteria, providing data on 27,885 diverse participants from 60 countries. Results Transparent visual aids robustly improved risk understanding in diverse individuals by encouraging thorough deliberation, enhancing cognitive self-assessment, and reducing conceptual biases in memory. Improvements in risk understanding consistently produced beneficial changes in attitudes, behavioral intentions, trust, and healthy behaviors. Visual aids were found to be particularly beneficial for vulnerable and less skilled individuals. Conclusion Well-designed visual aids tend to be highly effective tools for improving informed decision making among diverse decision makers. We identify five categories of practical, evidence-based guidelines for heuristic evaluation and design of effective visual aids.

  16. Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

    PubMed Central

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

    2015-01-01

    Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

  17. Cultural influences on the physician-patient encounter: The case of shared treatment decision-making.

    PubMed

    Charles, Cathy; Gafni, Amiram; Whelan, Tim; O'Brien, Mary Ann

    2006-11-01

    In this paper we discuss the influence of culture on the process of treatment decision-making, and in particular, shared treatment decision-making in the physician-patient encounter. We explore two key issues: (1) the meaning of culture and the ways that it can affect treatment decision-making; (2) cultural issues and assumptions underlying the development and use of treatment decision aids. This is a conceptual paper. Based on our knowledge and reading of the key literature in the treatment decision-making field, we looked for written examples where cultural influences were taken into account when discussing the physician-patient encounter and when designing instruments (decision aids) to help patients participate in making decisions. Our assessment of the situation is that to date, and with some recent exceptions, research in the above areas has not been culturally sensitive. We suggest that more research attention should be focused on exploring potential cultural variations in the meaning of and preferences for shared decision-making as well as on the applicability across cultural groups of decision aids developed to facilitate patient participation in treatment decision-making with physicians. Both patients and physicians need to be aware of the cultural assumptions underlying the development and use of decision aids and assess their cultural sensitivity to the needs and preferences of patients in diverse cultural groups.

  18. Family health care decision making and self-efficacy with patients with ALS at the end of life

    PubMed Central

    NOLAN, MARIE T.; KUB, JOAN; HUGHES, MARK T.; TERRY, PETER B.; ASTROW, ALAN B.; CARBO, CYNTHIA A.; THOMPSON, RICHARD E.; CLAWSON, LORA; TEXEIRA, KENNETH; SULMASY, DANIEL P.

    2008-01-01

    Objective: Persons with ALS differ from those with other terminal illnesses in that they commonly retain capacity for decision making close to death. The role patients would opt to have their families play in decision making at the end of life may therefore be unique. This study compared the preferences of patients with ALS for involving family in health care decisions at the end of life with the actual involvement reported by the family after death. Methods: A descriptive correlational design with 16 patient–family member dyads was used. Quantitative findings were enriched with in-depth interviews of a subset of five family members following the patient's death. Results: Eighty-seven percent of patients had issued an advance directive. Patients who would opt to make health care decisions independently (i.e., according to the patient's preferences alone) were most likely to have their families report that decisions were made in the style that the patient preferred. Those who preferred shared decision making with family or decision making that relied upon the family were more likely to have their families report that decisions were made in a style that was more independent than preferred. When interviewed in depth, some family members described shared decision making although they had reported on the survey that the patient made independent decisions. Significance of results: The structure of advance directives may suggest to families that independent decision making is the ideal, causing them to avoid or underreport shared decision making. Fear of family recriminations may also cause family members to avoid or underreport shared decision making. Findings from this study might be used to guide clinicians in their discussions of treatments and health care decision making with persons with ALS and their families. PMID:18662421

  19. Visual Communication and Cognition in Everyday Decision-Making.

    PubMed

    Jaenichen, Claudine

    2017-01-01

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

  20. Colorectal cancer patients' attitudes towards involvement in decision making.

    PubMed

    Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A; Susnerwala, Shabbir S

    2009-03-01

    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. An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross-sectional survey approach. 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. 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.

  1. Effects of an educational programme on shared decision-making among Korean nurses.

    PubMed

    Jo, Kae-Hwa; An, Gyeong-Ju

    2015-12-01

    This study was conducted to examine the effects of an educational programme on shared decision-making on end-of-life care performance, moral sensitivity and attitude towards shared decision-making among Korean nurses. A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. Forty-one clinical nurses were recruited as participants from two different university hospitals located in Daegu, Korea. Twenty nurses in the control group received no intervention, and 21 nurses in the experimental group received the educational programme on shared decision-making. Data were collected with a questionnaire covering end-of-life care performance, moral sensitivity and attitude towards shared decision-making. Analysis of the data was done with the chi-square test, t-test and Fisher's exact test using SPSS/Win 17.0 (SPSS, Inc., Chicago, IL, USA). The experimental group showed significantly higher scores in moral sensitivity and attitude towards shared decision-making after the intervention compared with the control group. This study suggests that the educational programme on shared decision-making was effective in increasing the moral sensitivity and attitude towards shared decision-making among Korean nurses. © 2014 Wiley Publishing Asia Pty Ltd.

  2. An exploration of clinical decision making in mental health triage.

    PubMed

    Sands, Natisha

    2009-08-01

    Mental health (MH) triage is a specialist area of clinical nursing practice that involves complex decision making. The discussion in this article draws on the findings of a Ph.D. study that involved a statewide investigation of the scope of MH triage nursing practice in Victoria, Australia. Although the original Ph.D. study investigated a number of core practices in MH triage, the focus of the discussion in this article is specifically on the findings related to clinical decision making in MH triage, which have not previously been published. The study employed an exploratory descriptive research design that used mixed data collection methods including a survey questionnaire (n = 139) and semistructured interviews (n = 21). The study findings related to decision making revealed a lack of empirically tested evidence-based decision-making frameworks currently in use to support MH triage nursing practice. MH triage clinicians in Australia rely heavily on clinical experience to underpin decision making and have little of knowledge of theoretical models for practice, such as methodologies for rating urgency. A key recommendation arising from the study is the need to develop evidence-based decision-making frameworks such as clinical guidelines to inform and support MH triage clinical decision making.

  3. Hospice decision making: diagnosis makes a difference.

    PubMed

    Waldrop, Deborah P; Meeker, Mary Ann

    2012-10-01

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

  4. Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

    PubMed

    Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

    2014-12-14

    The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making. This study makes an important contribution to understanding how evidence is used within the public health LG context. ACTRN12609000953235.

  5. System Sketch: A Visualization Tool to Improve Community Decision Making

    EPA Science Inventory

    Making decisions in coastal and estuarine management requires a comprehensive understanding of the linkages between environmental, social, and economic systems. SystemSketch is a web-based scoping tool designed to assist resource managers in characterizing their systems, explorin...

  6. General Formalism of Decision Making Based on Theory of Open Quantum Systems

    NASA Astrophysics Data System (ADS)

    Asano, M.; Ohya, M.; Basieva, I.; Khrennikov, A.

    2013-01-01

    We present the general formalism of decision making which is based on the theory of open quantum systems. A person (decision maker), say Alice, is considered as a quantum-like system, i.e., a system which information processing follows the laws of quantum information theory. To make decision, Alice interacts with a huge mental bath. Depending on context of decision making this bath can include her social environment, mass media (TV, newspapers, INTERNET), and memory. Dynamics of an ensemble of such Alices is described by Gorini-Kossakowski-Sudarshan-Lindblad (GKSL) equation. We speculate that in the processes of evolution biosystems (especially human beings) designed such "mental Hamiltonians" and GKSL-operators that any solution of the corresponding GKSL-equation stabilizes to a diagonal density operator (In the basis of decision making.) This limiting density operator describes population in which all superpositions of possible decisions has already been resolved. In principle, this approach can be used for the prediction of the distribution of possible decisions in human populations.

  7. Temporal lobe epilepsy surgery: what do patients want to know?

    PubMed

    Choi, Hyunmi; Pargeon, Kim; Bausell, Rebecca; Wong, John B; Mendiratta, Anil; Bakken, Suzanne

    2011-11-01

    Patients with pharmacoresistant temporal lobe epilepsy (TLE) contemplating brain surgery must make a complex treatment decision involving trade-offs. Patient decision aids, containing information on the risks and benefits of treatment interventions, increase patient knowledge and facilitate shared decision making between patients and physicians. We conducted five focus groups to describe the information patients need to make informed decisions about TLE surgery. Twenty patients who had undergone TLE surgery described the information used in their decision-making process, and evaluated the potential for a patient decision aid to assist other patients who are considering surgery. Thematic analysis revealed information needs that were both experiential (i.e., learning about other patients' experiences through testimonials) and factual (i.e., individualized statistical information). Patients also made suggestions on how this information should be delivered to patients. These data will accelerate the development of a patient decision aid designed to assist TLE patients in their decision making about epilepsy surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Decomposition-Based Decision Making for Aerospace Vehicle Design

    NASA Technical Reports Server (NTRS)

    Borer, Nicholas K.; Mavris, DImitri N.

    2005-01-01

    Most practical engineering systems design problems have multiple and conflicting objectives. Furthermore, the satisfactory attainment level for each objective ( requirement ) is likely uncertain early in the design process. Systems with long design cycle times will exhibit more of this uncertainty throughout the design process. This is further complicated if the system is expected to perform for a relatively long period of time, as now it will need to grow as new requirements are identified and new technologies are introduced. These points identify a need for a systems design technique that enables decision making amongst multiple objectives in the presence of uncertainty. Traditional design techniques deal with a single objective or a small number of objectives that are often aggregates of the overarching goals sought through the generation of a new system. Other requirements, although uncertain, are viewed as static constraints to this single or multiple objective optimization problem. With either of these formulations, enabling tradeoffs between the requirements, objectives, or combinations thereof is a slow, serial process that becomes increasingly complex as more criteria are added. This research proposal outlines a technique that attempts to address these and other idiosyncrasies associated with modern aerospace systems design. The proposed formulation first recasts systems design into a multiple criteria decision making problem. The now multiple objectives are decomposed to discover the critical characteristics of the objective space. Tradeoffs between the objectives are considered amongst these critical characteristics by comparison to a probabilistic ideal tradeoff solution. The proposed formulation represents a radical departure from traditional methods. A pitfall of this technique is in the validation of the solution: in a multi-objective sense, how can a decision maker justify a choice between non-dominated alternatives? A series of examples help the reader to observe how this technique can be applied to aerospace systems design and compare the results of this so-called Decomposition-Based Decision Making to more traditional design approaches.

  9. Design for sustainability of industrial symbiosis based on emergy and multi-objective particle swarm optimization.

    PubMed

    Ren, Jingzheng; Liang, Hanwei; Dong, Liang; Sun, Lu; Gao, Zhiqiu

    2016-08-15

    Industrial symbiosis provides novel and practical pathway to the design for the sustainability. Decision support tool for its verification is necessary for practitioners and policy makers, while to date, quantitative research is limited. The objective of this work is to present an innovative approach for supporting decision-making in the design for the sustainability with the implementation of industrial symbiosis in chemical complex. Through incorporating the emergy theory, the model is formulated as a multi-objective approach that can optimize both the economic benefit and sustainable performance of the integrated industrial system. A set of emergy based evaluation index are designed. Multi-objective Particle Swarm Algorithm is proposed to solve the model, and the decision-makers are allowed to choose the suitable solutions form the Pareto solutions. An illustrative case has been studied by the proposed method, a few of compromises between high profitability and high sustainability can be obtained for the decision-makers/stakeholders to make decision. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. 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

  11. Shared decision making in designing new healthcare environments-time to begin improving quality.

    PubMed

    Elf, Marie; Fröst, Peter; Lindahl, Göran; Wijk, Helle

    2015-03-21

    Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users' perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

  12. Cost or Quality?

    ERIC Educational Resources Information Center

    Purzer, Senay; Duncan-Wiles, Daphne; Strobel, Johannes

    2013-01-01

    Hopscotch, basketball, or hide-and-seek? Children have many choices at recess, and while making these choices they must consider and make trade-offs. The way they make these decisions is not that different from the thought processes engineers use when making design trade-offs. Engineers have to make trade-offs because a design that meets all…

  13. Career Choices: Reducing Sex-Role Stereotyping in Careers. A Model Career Decision-Making Program to Reduce the Effects of Sex-Role Stereotyping in the Career Choices of Senior High Students. Final Project Performance Report.

    ERIC Educational Resources Information Center

    Murphy, Jody

    A model career decision-making program to reduce the effects of sex-role stereotyping in career choices of senior high school students was conducted at Columbine High School (Lakewood, Colorado). Project goals included the following: (1) to provide students with self-awareness and career-decision-making activities designed to broaden options these…

  14. Considerations of informed consent and decision-making competence in older adults with cognitive impairment.

    PubMed

    Mayo, Ann M; Wallhagen, Margaret I

    2009-04-01

    Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research. Copyright 2009, SLACK Incorporated.

  15. Data Management & Decision Making. Technical Report No. 14.

    ERIC Educational Resources Information Center

    Speedie, Stuart M.; Sanders, Susan

    "Data Management and Decision Making" is a set of instructional materials designed to teach practicing and potential educational administrators about the uses of operations research in educational administration. It consists of five units--"Operations Research in Education,""PERT/CPM: A Planning and Analysis…

  16. Zero-Based Budgeting.

    ERIC Educational Resources Information Center

    Wichowski, Chester

    1979-01-01

    The zero-based budgeting approach is designed to achieve the greatest benefit with the fewest undesirable consequences. Seven basic steps make up the zero-based decision-making process: (1) identifying program goals, (2) classifying goals, (3) identifying resources, (4) reviewing consequences, (5) developing decision packages, (6) implementing a…

  17. Game Theory and Risk-Based Levee System Design

    NASA Astrophysics Data System (ADS)

    Hui, R.; Lund, J. R.; Madani, K.

    2014-12-01

    Risk-based analysis has been developed for optimal levee design for economic efficiency. Along many rivers, two levees on opposite riverbanks act as a simple levee system. Being rational and self-interested, land owners on each river bank would tend to independently optimize their levees with risk-based analysis, resulting in a Pareto-inefficient levee system design from the social planner's perspective. Game theory is applied in this study to analyze decision making process in a simple levee system in which the land owners on each river bank develop their design strategies using risk-based economic optimization. For each land owner, the annual expected total cost includes expected annual damage cost and annualized construction cost. The non-cooperative Nash equilibrium is identified and compared to the social planner's optimal distribution of flood risk and damage cost throughout the system which results in the minimum total flood cost for the system. The social planner's optimal solution is not feasible without appropriate level of compensation for the transferred flood risk to guarantee and improve conditions for all parties. Therefore, cooperative game theory is then employed to develop an economically optimal design that can be implemented in practice. By examining the game in the reversible and irreversible decision making modes, the cost of decision making myopia is calculated to underline the significance of considering the externalities and evolution path of dynamic water resource problems for optimal decision making.

  18. A mechanism for value-sensitive decision-making.

    PubMed

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

    2013-01-01

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

  19. The influence of anticipated pride and guilt on pro-environmental decision making.

    PubMed

    Schneider, Claudia R; Zaval, Lisa; Weber, Elke U; Markowitz, Ezra M

    2017-01-01

    The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one's positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one's negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt.

  20. Assessment of Healthcare Decision-making Capacity

    PubMed Central

    Palmer, Barton W.; Harmell, Alexandrea L.

    2016-01-01

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

  1. Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

    NASA Astrophysics Data System (ADS)

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2017-02-01

    Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

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

    PubMed

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

    2014-01-01

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

  3. The development of a decision aid for tinnitus.

    PubMed

    Pryce, Helen; Durand, Marie-Anne; Hall, Amanda; Shaw, Rachel; Culhane, Beth-Anne; Swift, Sarah; Straus, Jean; Marks, Elizabeth; Ward, Melanie; Chilvers, Katie

    2018-05-09

    To develop a decision aid for tinnitus care that would meet international consensus for decision aid quality. A mixed methods design that included qualitative in-depth interviews, literature review, focus groups, user testing and readability checking. Patients and clinicians who have clinical experience of tinnitus. A decision aid for tinnitus care was developed. This incorporates key evidence of efficacy for the most frequently used tinnitus care options, together with information derived from patient priorities when deciding which choice to make. The decision aid has potential to enable shared decision making between clinicians and patients in audiology. The decision aid meets consensus standards.

  4. Nurses' decision-making process in cases of physical restraint in acute elderly care: a qualitative study.

    PubMed

    Goethals, S; Dierckx de Casterlé, B; Gastmans, C

    2013-05-01

    The increasing vulnerability of patients in acute elderly care requires constant critical reflection in ethically charged situations such as when employing physical restraint. Qualitative evidence concerning nurses' decision making in cases of physical restraint is limited and fragmented. A thorough understanding of nurses' decision-making process could be useful to understand how nurses reason and make decisions in ethically laden situations. The aims of this study were to explore and describe nurses' decision-making process in cases of physical restraint. We used a qualitative interview design inspired by the Grounded Theory approach. Data analysis was guided by the Qualitative Analysis Guide of Leuven. Twelve hospitals geographically spread throughout the five provinces of Flanders, Belgium. Twenty-one acute geriatric nurses interviewed between October 2009 and April 2011 were purposively and theoretically selected, with the aim of including nurses having a variety of characteristics and experiences concerning decisions on using physical restraint. In cases of physical restraint in acute elderly care, nurses' decision making was never experienced as a fixed decision but rather as a series of decisions. Decision making was mostly reasoned upon and based on rational arguments; however, decisions were also made routinely and intuitively. Some nurses felt very certain about their decisions, while others experienced feelings of uncertainty regarding their decisions. Nurses' decision making is an independent process that requires nurses to obtain a good picture of the patient, to be constantly observant, and to assess and reassess the patient's situation. Coming to thoughtful and individualized decisions requires major commitment and constant critical reflection. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Incorporating BDI Agents into Human-Agent Decision Making Research

    NASA Astrophysics Data System (ADS)

    Kamphorst, Bart; van Wissen, Arlette; Dignum, Virginia

    Artificial agents, people, institutes and societies all have the ability to make decisions. Decision making as a research area therefore involves a broad spectrum of sciences, ranging from Artificial Intelligence to economics to psychology. The Colored Trails (CT) framework is designed to aid researchers in all fields in examining decision making processes. It is developed both to study interaction between multiple actors (humans or software agents) in a dynamic environment, and to study and model the decision making of these actors. However, agents in the current implementation of CT lack the explanatory power to help understand the reasoning processes involved in decision making. The BDI paradigm that has been proposed in the agent research area to describe rational agents, enables the specification of agents that reason in abstract concepts such as beliefs, goals, plans and events. In this paper, we present CTAPL: an extension to CT that allows BDI software agents that are written in the practical agent programming language 2APL to reason about and interact with a CT environment.

  6. Advanced Information Technology in Simulation Based Life Cycle Design

    NASA Technical Reports Server (NTRS)

    Renaud, John E.

    2003-01-01

    In this research a Collaborative Optimization (CO) approach for multidisciplinary systems design is used to develop a decision based design framework for non-deterministic optimization. To date CO strategies have been developed for use in application to deterministic systems design problems. In this research the decision based design (DBD) framework proposed by Hazelrigg is modified for use in a collaborative optimization framework. The Hazelrigg framework as originally proposed provides a single level optimization strategy that combines engineering decisions with business decisions in a single level optimization. By transforming this framework for use in collaborative optimization one can decompose the business and engineering decision making processes. In the new multilevel framework of Decision Based Collaborative Optimization (DBCO) the business decisions are made at the system level. These business decisions result in a set of engineering performance targets that disciplinary engineering design teams seek to satisfy as part of subspace optimizations. The Decision Based Collaborative Optimization framework more accurately models the existing relationship between business and engineering in multidisciplinary systems design.

  7. Interventions to support shared decision-making for women with heavy menstrual bleeding: A systematic review.

    PubMed

    Zandstra, D; Busser, J A S; Aarts, J W M; Nieboer, T E

    2017-04-01

    This review studies women's preferences for shared decision-making about heavy menstrual bleeding treatment and evaluates interventions that support shared decision-making and their effectiveness. PubMed, Cochrane, Embase, Medline and ClinicalTrials.gov were searched. Three research questions were predefined: 1) What is the range of perspectives gathered in studies that examine women facing a decision related to heavy menstrual bleeding management?; 2) What types of interventions have been developed to support shared decision-making for women experiencing heavy menstrual bleeding?; and 3) In what way might women benefit from interventions that support shared decision-making? All original studies were included if the study population consisted of women experiencing heavy menstrual bleeding. We used the TIDieR (Template for Intervention: Description and Replication) checklist to assess the quality of description and the reproducibility of interventions. Interventions were categorized using Grande et al. guidelines and collated and summarized outcomes measures into three categories: 1) patient-reported outcomes; 2) observer-reported outcomes; and 3) doctor-reported outcomes. Fifteen studies were included. Overall, patients preferred to decide together with their doctor (74%). Women's previsit preference was the strongest predictor for treatment choice in two studies. Information packages did not have a statistically significant effect on treatment choice or satisfaction. However, adding a structured interview or decision aid to increase patient involvement did show a positive effect on treatment choice and results, patient satisfaction and shared decision-making related outcomes. In conclusion shared decision-making is becoming more important in the care of women with heavy menstrual bleeding. Structured interviews or well-designed (computerized) tools such as decision aids seem to facilitate this process, but there is room for improvement. A shared treatment choice is only possible after careful provision of information, elicitation of patients' preferences and integrating those preferences. Interventions should be designed accordingly. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. School Principals' Decision-Making Behaviour in the Management of Innovation.

    ERIC Educational Resources Information Center

    McGeown, Vincent

    1979-01-01

    A rating scale operationalized a model for the adoption and implementation of educational innovation. Phases were designated: creating a climate for change; analyzing antecedent conditions; generating alternatives; initiating change adoption; implementing change; and evaluating change outcomes. Principals' decision-making behavior was the best…

  9. Georgia 4-H Consumer Judging.

    ERIC Educational Resources Information Center

    Blackburn, Mary Ellen; Hall, Doris N.

    Materials are provided for a consumer education activity designed to help teenagers make knowledgeable, rational decisions when purchasing goods and services. A student manual describes how the activity--a consumer judging contest--works. Information is provided on how consumers make decisions. Topics include: needs versus wants; sources of…

  10. Market analysis of collecting fundamental roadway data elements to support the highway safety improvement program.

    DOT National Transportation Integrated Search

    2011-06-01

    Quality data are the foundation for making important decisions regarding the design, operation, and safety of : roadways. Using roadway and traffic data together with crash data can help agencies to make decisions that are : fiscally responsible and ...

  11. Formative Justice: The Regulative Principle of Education

    ERIC Educational Resources Information Center

    McClintock, Robert

    2016-01-01

    Background/Context: Concepts of justice relevant to making personal and public decisions about education. Purpose: To clarify a concept of formative justice that persons and the public often ignore in making decisions about educational effort. Setting: "The windmills of your mind" Research Design: Reflective essay.…

  12. 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…

  13. Farmer responses to multiple stresses in the face of global change: Assessing five case studies to enhance adaptation

    NASA Astrophysics Data System (ADS)

    Nicholas, K. A.; Feola, G.; Lerner, A. M.; Jain, M.; Montefrio, M.

    2013-12-01

    The global challenge of sustaining agricultural livelihoods and yields in the face of growing populations and increasing climate change is the topic of intense research. The role of on-the-ground decision-making by individual farmers actually producing food, fuel, and fiber is often studied in individual cases to determine its environmental, economic, and social effects. However, there are few efforts to link across studies in a way that provides opportunities to better understand empirical farmer behavior, design effective policies, and be able to aggregate from case studies to a broader scale. Here we synthesize existing literature to identify four general factors affecting farmer decision-making: local technical and socio-cultural contexts; actors and institutions involved in decision-making; multiple stressors at broader scales; and the temporal gradient of decision-making. We use these factors to compare five cases that illustrate agricultural decision-making and its impacts: cotton and castor farming in Gujarat, India; swidden cultivation of upland rice in the Philippines; potato cultivation in Andean Colombia; winegrowing in Northern California; and maize production in peri-urban central Mexico. These cases span a geographic and economic range of production systems, but we find that we are able to make valid comparisons and draw lessons common across all cases by using the four factors as an organizing principle. We also find that our understanding of why farmers make the decisions they do changes if we neglect to examine even one of the four general factors guiding decision-making. This suggests that these four factors are important to understanding farmer decision-making, and can be used to guide the design and interpretation of future studies, as well as be the subject of further research in and of themselves to promote an agricultural system that is resilient to climate and other global environmental changes.

  14. Spatial education: improving conservation delivery through space-structured decision making

    USGS Publications Warehouse

    Moore, Clinton T.; Shaffer, Terry L.; Gannon, Jill J.

    2013-01-01

    Adaptive management is a form of structured decision making designed to guide management of natural resource systems when their behaviors are uncertain. Where decision making can be replicated across units of a landscape, learning can be accelerated, and biological processes can be understood in a larger spatial context. Broad-based partnerships among land management agencies, exemplified by Landscape Conservation Cooperatives (conservation partnerships created through the U.S. Department of the Interior), are potentially ideal environments for implementing spatially structured adaptive management programs.

  15. Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges.

    PubMed

    Mustafa, Reem A; Wiercioch, Wojtek; Cheung, Adrienne; Prediger, Barbara; Brozek, Jan; Bossuyt, Patrick; Garg, Amit X; Lelgemann, Monika; Büehler, Diedrich; Schünemann, Holger J

    2017-12-01

    In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

    PubMed

    Dolan, James G

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

  17. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare

    PubMed Central

    Dolan, James G.

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers. Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine “hard data” with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings. The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP) PMID:21394218

  18. Family involvement in medical decision-making: Perceptions of nursing and psychology students.

    PubMed

    Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

    2016-05-01

    Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. How to determine decisional capacity in critically ill patients. Presume the patient can make decisions unless proven otherwise.

    PubMed

    Fleming, C; Momin, Z A; Brensilver, J M; Brandstetter, R D

    1995-03-01

    Decisional capacity includes ability to comprehend information, to make an informed choice, and to communicate that choice; it is specific to the decision at hand. Presume a patient has decisional capacity; an evaluation of incapacity must be justified. Administer a standardized mental status test to help assess alertness, attention, memory, and reasoning ability. A patient scoring below 10 on the Folstein Mini-Mental State Examination (maximum score, 30) probably does not have decisional capacity; one scoring from 10 to 15 probably can designate a proxy but not make complex health care decisions. Obtain psychiatric consultations for a patient who exhibits psychological barriers to decision making.

  20. Mission at Mubasi - A Simulation for Leadership Development

    NASA Technical Reports Server (NTRS)

    Cummings, Pau; Aude, Steven; Fallesen, Jon

    2012-01-01

    The United States Army is investing in simulations as a way of providing practice for leader decision making. Such simulations, grounded in lessons learned from deployment experienced leaders, place less experienced and more junior leaders in challenging situations they might soon be confronted with. And given increased demands on the Army to become more efficient, while maintaining acceptable levels of mission readiness, simulations offer a cost effective complement to live field training. So too, the design parameters of such a simulation can be made to reinforce specific behavior responses which teach leaders known theory and application of effective (and ineffective) decision making. With this in mind, the Center for Army Leadership (CAL) determined that decision-making was of critical importance. Specifically, the following aspects of decision-making were viewed as particularly important for today's Army leaders: 1) Decision dilemmas, in the form of equally appealing or equally unappealing choices, such that there is no clear "right" or "wrong" choice 2) Making decisions with incomplete or ambiguous information, and 3) Predicting and experiencing second- and third-order consequences of decisions. It is decision making in such a setting or environment that Army leaders are increasingly confronted with given the full spectrum of military operations they must be prepared for. This paper details the approach and development of this decision making simulation.

  1. The impact of simulation sequencing on perceived clinical decision making.

    PubMed

    Woda, Aimee; Hansen, Jamie; Paquette, Mary; Topp, Robert

    2017-09-01

    An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students' perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources. Copyright © 2017. Published by Elsevier Ltd.

  2. Factors influencing women's perceptions of shared decision making during labor and delivery: Results from a large-scale cohort study of first childbirth.

    PubMed

    Attanasio, Laura B; Kozhimannil, Katy B; Kjerulff, Kristen H

    2018-06-01

    To examine correlates of shared decision making during labor and delivery. Data were from a cohort of women who gave birth to their first baby in Pennsylvania, 2009-2011 (N = 3006). We used logistic regression models to examine the association between labor induction and mode of delivery in relation to women's perceptions of shared decision making, and to investigate race/ethnicity and SES as potential moderators. Women who were Black and who did not have a college degree or private insurance were less likely to report high shared decision making, as well as women who underwent labor induction, instrumental vaginal or cesarean delivery. Models with interaction terms showed that the reduction in odds of shared decision making associated with cesarean delivery was greater for Black women than for White women. Women in marginalized social groups were less likely to report shared decision making during birth and Black women who delivered by cesarean had particularly low odds of shared decision making. Strategies designed to improve the quality of patient-provider communication, information sharing, and shared decision making must be attentive to the needs of vulnerable groups to ensure that such interventions reduce rather than widen disparities. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Evidence-Based and Value-Based Decision Making About Healthcare Design: An Economic Evaluation of the Safety and Quality Outcomes.

    PubMed

    Zadeh, Rana; Sadatsafavi, Hessam; Xue, Ryan

    2015-01-01

    This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language. Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization's operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process. To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety. In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages. Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures. © The Author(s) 2015.

  4. Visualization-based decision support for value-driven system design

    NASA Astrophysics Data System (ADS)

    Tibor, Elliott

    In the past 50 years, the military, communication, and transportation systems that permeate our world, have grown exponentially in size and complexity. The development and production of these systems has seen ballooning costs and increased risk. This is particularly critical for the aerospace industry. The inability to deal with growing system complexity is a crippling force in the advancement of engineered systems. Value-Driven Design represents a paradigm shift in the field of design engineering that has potential to help counteract this trend. The philosophy of Value-Driven Design places the desires of the stakeholder at the forefront of the design process to capture true preferences and reveal system alternatives that were never previously thought possible. Modern aerospace engineering design problems are large, complex, and involve multiple levels of decision-making. To find the best design, the decision-maker is often required to analyze hundreds or thousands of combinations of design variables and attributes. Visualization can be used to support these decisions, by communicating large amounts of data in a meaningful way. Understanding the design space, the subsystem relationships, and the design uncertainties is vital to the advancement of Value-Driven Design as an accepted process for the development of more effective, efficient, robust, and elegant aerospace systems. This research investigates the use of multi-dimensional data visualization tools to support decision-making under uncertainty during the Value-Driven Design process. A satellite design system comprising a satellite, ground station, and launch vehicle is used to demonstrate effectiveness of new visualization methods to aid in decision support during complex aerospace system design. These methods are used to facilitate the exploration of the feasible design space by representing the value impact of system attribute changes and comparing the results of multi-objective optimization formulations with a Value-Driven Design formulation. The visualization methods are also used to assist in the decomposition of a value function, by representing attribute sensitivities to aid with trade-off studies. Lastly, visualization is used to enable greater understanding of the subsystem relationships, by displaying derivative-based couplings, and the design uncertainties, through implementation of utility theory. The use of these visualization methods is shown to enhance the decision-making capabilities of the designer by granting them a more holistic view of the complex design space.

  5. Practical Guide for the Selection of Audio Visual Media. General Criteria System and Evaluation Procedure for Educational Media Decisions.

    ERIC Educational Resources Information Center

    Klepzig, H. J.; Weiss, M.

    Designed to aid in making concrete decisions on the acquisition and use of media, the criteria system and evaluation procedure described is a multiphase, objective-based decision making process. This report includes guidelines for setting up goal systems and developing criteria for the evaluation of media based on a goal system; an outline of…

  6. Superintendents and Principals Need Quality Public Information That Informs Decisions, Empowers Action. Don't Make Decisions in the Dark

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2014

    2014-01-01

    District superintendents or school principals need to be able to access and use high-quality data to make good decisions. Often this data is collected and stored locally, but information that is publicly reported by the state can provide additional value. Although public reporting in a few states is designed to serve information needs, states'…

  7. Making trials matter: pragmatic and explanatory trials and the problem of applicability

    PubMed Central

    Treweek, Shaun; Zwarenstein, Merrick

    2009-01-01

    Randomised controlled trials are the best research design for decisions about the effect of different interventions but randomisation does not, of itself, promote the applicability of a trial's results to situations other than the precise one in which the trial was done. While methodologists and trialists have rightly paid great attention to internal validity, much less has been given to applicability. This narrative review is aimed at those planning to conduct trials, and those aiming to use the information in them. It is intended to help the former group make their trials more widely useful and to help the latter group make more informed decisions about the wider use of existing trials. We review the differences between the design of most randomised trials (which have an explanatory attitude) and the design of trials more able to inform decision making (which have a pragmatic attitude) and discuss approaches used to assert applicability of trial results. If we want evidence from trials to be used in clinical practice and policy, trialists should make every effort to make their trial widely applicable, which means that more trials should be pragmatic in attitude. PMID:19493350

  8. Testing the effects of a decision aid for prostate cancer screening.

    PubMed

    Rubel, Stephanie K; Miller, Jacqueline W; Stephens, Robert L; Xu, Ye; Scholl, Lawrence E; Holden, E Wayne; Stroud, Leonardo A; Volk, Robert J

    2010-04-01

    There is an ever-growing trend toward more patient involvement in making health care decisions. This trend has been accompanied by the development of "informed decision-making" interventions to help patients become more engaged and comfortable with making these decisions. We describe the effects of a prostate cancer screening decision aid on knowledge, beliefs about screening, risk perception, control preferences, decisional conflict, and decisional anxiety. Data were collected from 200 males aged 50-70 years in the general population who randomly were assigned to exposure to the decision aid or no exposure as a control condition. A Solomon four-group design was used to test for possible pretest sensitization effects and to assess the effects of exposure to the decision aid. No significant pretest sensitization effects were found. Analysis of the exposure effects found that knowledge increased significantly for those exposed to the decision aid compared with those unexposed. Exposure to the decision aid also had some influence on decreasing both decisional conflict and decisional anxiety. Decision aids can play an important role in increasing patients' knowledge and decreasing anxiety when asked to make health care decisions.

  9. Checkerboard--A Way to Financial Awareness.

    ERIC Educational Resources Information Center

    Dawson, Rod

    1986-01-01

    Describes Checkerboard, a game-like exercise designed to teach financial awareness, control, and appraisal to managers and reinforce the principle that all people in managerial positions make decisions, all of which incur costs and generate benefits. Students are guided by discovery and discussion toward improved financial decision making. (MBR)

  10. Accuracy of intuition in clinical decision-making among novice clinicians.

    PubMed

    Price, Amanda; Zulkosky, Kristen; White, Krista; Pretz, Jean

    2017-05-01

    To assess the reliance on intuitive and analytical approaches during clinical decision-making among novice clinicians and whether that reliance is associated with accurate decision-making. Nurse educators and managers tend to emphasize analysis over intuition during clinical decision-making though nurses typically report some reliance on intuition in their practice. We hypothesized that under certain conditions, reliance on intuition would support accurate decision-making, even among novices. This study utilized an experimental design with clinical complication (familiar vs. novel) and decision phase (cue acquisition, diagnosis and action) as within-subjects' factors, and simulation role (observer, family, auxiliary nurse and primary nurse) as between-subjects' factor. We examined clinical decision-making accuracy among final semester pre-licensure nursing students in a simulation experience. Students recorded their reasoning about emerging clinical complications with their patient during two distinct points in the simulation; one point involved a familiar complication and the other a relatively novel complication. All data were collected during Spring 2015. Although most participants relied more heavily on analysis than on intuition, use of intuition during the familiar complication was associated with more accurate decision-making, particularly in guiding attention to relevant cues. With the novel complication, use of intuition appeared to hamper decision-making, particularly for those in an observer role. Novice clinicians should be supported by educators and nurse managers to note when their intuitions are likely to be valid. Our findings emphasize the integrated nature of intuition and analysis in clinical decision-making. © 2016 John Wiley & Sons Ltd.

  11. Decision-making about prenatal genetic testing among pregnant Korean-American women.

    PubMed

    Jun, Myunghee; Thongpriwan, Vipavee; Choi, Jeeyae; Sook Choi, Kyung; Anderson, Gwen

    2018-01-01

    to understand the prenatal genetic testing decision-making processes among pregnant Korean-American women. a qualitative, descriptive research design. referrals and snowball sampling techniques were used to recruit 10 Korean-American women who had been recommended for amniocentesis during pregnancy in the United States (U.S.). All participants were born in Korea and had immigrated to the U.S. The number of years living in the U.S. ranged from 4 to 11 (M=5.7). various regional areas of the U.S. the researchers conducted face-to-face or phone interviews using semi-structured interview guides. The interviews were conducted in the Korean language and lasted approximately 50-100minutes. The interview guides focused on the decision-making process and experiences with prenatal genetic testing, as well as reflections on the decisions. Four core themes emerged related to the participants' decision-making processes, according to their descriptions. These themes are (1) facing the challenges of decision-making, (2) seeking support, (3) determining one's preferred role in the decision-making process, and (4) feeling uncomfortable with the degree of patient autonomy in U.S. health care. researchers concluded that many distinctive factors influence the decision-making processes used by pregnant Korean-American women. The results have the potential to improve shared decision-making practices regarding prenatal genetic testing. clinicians need to understand the sociocultural underpinnings of pregnant Korean-American immigrants regarding prenatal genetic screening and testing as an initial step to engage these patients in shared decision-making. Published by Elsevier Ltd.

  12. [The Role and Function of Informatics Nurses in Information Technology Decision-Making].

    PubMed

    Lee, Tso-Ying

    2017-08-01

    The medical environment has changed greatly with the coming of the information age, and, increasingly, the operating procedures for medical services have been altered in keeping with the trend toward mobile, paperless services. Informatization has the potential to improve the working efficiency of medical personnel, enhance patient care safety, and give medical organizations a positive image. Informatics nurses play an important role in the decision-making processes that accompany informatization. As one of the decision-making links in the information technology lifecycle, this role affects the success of the development and operation of information systems. The present paper examines the functions and professional knowledge that informatics nurses must possess during the technology lifecycle, the four stages of which include: planning, analysis, design/development/revision, and implementation/assessment/support/maintenance. The present paper further examines the decision-making shortcomings and errors that an informatics nurses may make during the decision-making process. We hope that this paper will serve as an effective and useful reference for informatics nurses during the informatization decision-making process.

  13. Understanding older adults' medication decision making and behavior: A study on over-the-counter (OTC) anticholinergic medications.

    PubMed

    Holden, Richard J; Srinivas, Preethi; Campbell, Noll L; Clark, Daniel O; Bodke, Kunal S; Hong, Youngbok; Boustani, Malaz A; Ferguson, Denisha; Callahan, Christopher M

    2018-03-06

    Older adults purchase and use over-the-counter (OTC) medications with potentially significant adverse effects. Some OTC medications, such as those with anticholinergic effects, are relatively contraindicated for use by older adults due to evidence of impaired cognition and other adverse effects. To inform the design of future OTC medication safety interventions for older adults, this study investigated consumers' decision making and behavior related to OTC medication purchasing and use, with a focus on OTC anticholinergic medications. The study had a cross-sectional design with multiple methods. A total of 84 adults participated in qualitative research interviews (n = 24), in-store shopper observations (n = 39), and laboratory-based simulated OTC shopping tasks (n = 21). Simulated shopping participants also rank-ordered eight factors on their importance for OTC decision making. Findings revealed that many participants had concerns about medication adverse effects, generally, but were not aware of age-related risk associated with the use of anticholinergic medications. Analyses produced a map of the workflow of OTC-related behavior and decision making as well as related barriers such as difficulty locating medications or comparing them to an alternative. Participants reported effectiveness, adverse effects or health risks, and price as most important to their OTC medication purchase and use decisions. A persona analysis identified two types of consumers: the habit follower, who frequently purchased OTC medications and considered them safe; and the deliberator, who was more likely to weigh their options and consider alternatives to OTC medications. A conceptual model of OTC medication purchase and use is presented. Drawing on study findings and behavioral theories, the model depicts dual processes for OTC medication decision making - habit-based and deliberation-based - as well as the antecedents and consequences of decision making. This model suggests several design directions for consumer-oriented interventions to promote OTC medication safety. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Knowledge translation strategies to improve the use of evidence in public health decision making in local government: intervention design and implementation plan

    PubMed Central

    2013-01-01

    Background Knowledge translation strategies are an approach to increase the use of evidence within policy and practice decision-making contexts. In clinical and health service contexts, knowledge translation strategies have focused on individual behavior change, however the multi-system context of public health requires a multi-level, multi-strategy approach. This paper describes the design of and implementation plan for a knowledge translation intervention for public health decision making in local government. Methods Four preliminary research studies contributed findings to the design of the intervention: a systematic review of knowledge translation intervention effectiveness research, a scoping study of knowledge translation perspectives and relevant theory literature, a survey of the local government public health workforce, and a study of the use of evidence-informed decision-making for public health in local government. A logic model was then developed to represent the putative pathways between intervention inputs, processes, and outcomes operating between individual-, organizational-, and system-level strategies. This formed the basis of the intervention plan. Results The systematic and scoping reviews identified that effective and promising strategies to increase access to research evidence require an integrated intervention of skill development, access to a knowledge broker, resources and tools for evidence-informed decision making, and networking for information sharing. Interviews and survey analysis suggested that the intervention needs to operate at individual and organizational levels, comprising workforce development, access to evidence, and regular contact with a knowledge broker to increase access to intervention evidence; develop skills in appraisal and integration of evidence; strengthen networks; and explore organizational factors to build organizational cultures receptive to embedding evidence in practice. The logic model incorporated these inputs and strategies with a set of outcomes to measure the intervention’s effectiveness based on the theoretical frameworks, evaluation studies, and decision-maker experiences. Conclusion Documenting the design of and implementation plan for this knowledge translation intervention provides a transparent, theoretical, and practical approach to a complex intervention. It provides significant insights into how practitioners might engage with evidence in public health decision making. While this intervention model was designed for the local government context, it is likely to be applicable and generalizable across sectors and settings. Trial registration Australia New Zealand Clinical Trials Register ACTRN12609000953235. PMID:24107358

  15. A software development and evolution model based on decision-making

    NASA Technical Reports Server (NTRS)

    Wild, J. Christian; Dong, Jinghuan; Maly, Kurt

    1991-01-01

    Design is a complex activity whose purpose is to construct an artifact which satisfies a set of constraints and requirements. However the design process is not well understood. The software design and evolution process is the focus of interest, and a three dimensional software development space organized around a decision-making paradigm is presented. An initial instantiation of this model called 3DPM(sub p) which was partly implemented, is presented. Discussion of the use of this model in software reuse and process management is given.

  16. Application of Design of Experiments and Surrogate Modeling within the NASA Advanced Concepts Office, Earth-to-Orbit Design Process

    NASA Technical Reports Server (NTRS)

    Zwack, Matthew R.; Dees, Patrick D.; Holt, James B.

    2016-01-01

    Decisions made during early conceptual design can have a profound impact on life-cycle cost (LCC). Widely accepted that nearly 80% of LCC is committed. Decisions made during early design must be well informed. Advanced Concepts Office (ACO) at Marshall Space Flight Center aids in decision making for launch vehicles. Provides rapid turnaround pre-phase A and phase A studies. Provides customer with preliminary vehicle sizing information, vehicle feasibility, and expected performance.

  17. The Mother’s Autonomy in Decision Making (MADM) scale: Patient-led development and psychometric testing of a new instrument to evaluate experience of maternity care

    PubMed Central

    Vedam, Saraswathi; Stoll, Kathrin; Martin, Kelsey; Rubashkin, Nicholas; Partridge, Sarah; Thordarson, Dana; Jolicoeur, Ganga

    2017-01-01

    Shared decision making (SDM) is core to person-centered care and is associated with improved health outcomes. Despite this, there are no validated scales measuring women’s agency and ability to lead decision making during maternity care. Objective To develop and validate a new instrument that assesses women’s autonomy and role in decision making during maternity care. Design Through a community-based participatory research process, service users designed, content validated, and administered a cross-sectional quantitative survey, including 31 items on the experience of decision-making. Setting and participants Pregnancy experiences (n = 2514) were reported by 1672 women who saw a single type of primary maternity care provider in British Columbia. They described care by a midwife, family physician or obstetrician during 1, 2 or 3 maternity care cycles. We conducted psychometric testing in three separate samples. Main outcome measures We assessed reliability, item-to-total correlations, and the factor structure of the The Mothers’ Autonomy in Decision Making (MADM) scale. We report MADM scores by care provider type, length of prenatal appointments, preferences for role in decision-making, and satisfaction with experience of decision-making. Results The MADM scale measures a single construct: autonomy in decision-making during maternity care. Cronbach alphas for the scale exceeded 0.90 for all samples and all provider groups. All item-to-total correlations were replicable across three samples and exceeded 0.7. Eigenvalue and scree plots exhibited a clear 90-degree angle, and factor analysis generated a one factor scale. MADM median scores were highest among women who were cared for by midwives, and 10 or more points lower for those who saw physicians. Increased time for prenatal appointments was associated with higher scale scores, and there were significant differences between providers with respect to average time spent in prenatal appointments. Midwifery care was associated with higher MADM scores, even during short prenatal appointments (<15 minutes). Among women who preferred to lead decisions around their care (90.8%), and who were dissatisfied with their experience of decision making, MADM scores were very low (median 14). Women with physician carers were consistently more likely to report dissatisfaction with their involvement in decision making. Discussion The Mothers Autonomy in Decision Making (MADM) scale is a reliable instrument for assessment of the experience of decision making during maternity care. This new scale was developed and content validated by community members representing various populations of childbearing women in BC including women from vulnerable populations. MADM measures women’s ability to lead decision making, whether they are given enough time to consider their options, and whether their choices are respected. Women who experienced midwifery care reported greater autonomy than women under physician care, when engaging in decision-making around maternity care options. Differences in models of care, professional education, regulatory standards, and compensation for prenatal visits between midwives and physicians likely affect the time available for these discussions and prioritization of a shared decision making process. Conclusion The MADM scale reflects person-driven priorities, and reliably assesses interactions with maternity providers related to a person’s ability to lead decision-making over the course of maternity care. PMID:28231285

  18. Investigating the Heart Pump Implant Decision Process: Opportunities for Decision Support Tools to Help

    PubMed Central

    Yang, Qian; Zimmerman, John; Steinfeld, Aaron; Carey, Lisa; Antaki, James F.

    2016-01-01

    Clinical decision support tools (DSTs) are computational systems that aid healthcare decision-making. While effective in labs, almost all these systems failed when they moved into clinical practice. Healthcare researchers speculated it is most likely due to a lack of user-centered HCI considerations in the design of these systems. This paper describes a field study investigating how clinicians make a heart pump implant decision with a focus on how to best integrate an intelligent DST into their work process. Our findings reveal a lack of perceived need for and trust of machine intelligence, as well as many barriers to computer use at the point of clinical decision-making. These findings suggest an alternative perspective to the traditional use models, in which clinicians engage with DSTs at the point of making a decision. We identify situations across patients’ healthcare trajectories when decision supports would help, and we discuss new forms it might take in these situations. PMID:27833397

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

    NASA Astrophysics Data System (ADS)

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

    2016-05-01

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

  20. Negotiation and Decision Making with Collaborative Software: How MarineMap 'Changed the Game' in California's Marine Life Protected Act Initiative.

    PubMed

    Cravens, Amanda E

    2016-02-01

    Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study-which draws on data from approximately 60 semi-structured interviews and an online survey--examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

  1. Negotiation and Decision Making with Collaborative Software: How MarineMap `Changed the Game' in California's Marine Life Protected Act Initiative

    NASA Astrophysics Data System (ADS)

    Cravens, Amanda E.

    2016-02-01

    Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study—which draws on data from approximately 60 semi-structured interviews and an online survey—examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

  2. Decision aids to increase living donor kidney transplantation

    PubMed Central

    Gander, Jennifer C.; Gordon, Elisa J.; Patzer, Rachel E.

    2017-01-01

    Purpose of review For the more than 636,000 adults with end-stage renal disease (ESRD) in the U.S., kidney transplantation is the preferred treatment compared to dialysis. Living donor kidney transplantation (LDKT) comprised 31% of kidney transplantations in 2015, an 8% decrease since 2004. We aimed to summarize the current literature on decision aids that could be used to improve LDKT rates. Recent findings Decision aids are evidence-based tools designed to help patients and their families make difficult treatment decisions. LDKT decision aids can help ESRD patients, patients’ family and friends, and healthcare providers engage in treatment decisions and thereby overcome multifactorial LDKT barriers. Summary We identified 12 LDKT decision aids designed to provide information about LDKT, and/or to help ESRD patients identify potential living donors, and/or to help healthcare providers make decisions about treatment for ESRD or living donation. Of these, 4 were shown to be effective in increasing LDKT, donor inquiries, LDKT knowledge, and willingness to discuss LDKT. Although each LDKT decision aid has limitations, adherence to decision aid development guidelines may improve decision aid utilization and access to LDKT. PMID:29034143

  3. The effect of high-fidelity patient simulation on the critical thinking and clinical decision-making skills of new graduate nurses.

    PubMed

    Maneval, Rhonda; Fowler, Kimberly A; Kays, John A; Boyd, Tiffany M; Shuey, Jennifer; Harne-Britner, Sarah; Mastrine, Cynthia

    2012-03-01

    This study was conducted to determine whether the addition of high-fidelity patient simulation to new nurse orientation enhanced critical thinking and clinical decision-making skills. A pretest-posttest design was used to assess critical thinking and clinical decision-making skills in two groups of graduate nurses. Compared with the control group, the high-fidelity patient simulation group did not show significant improvement in mean critical thinking or clinical decision-making scores. When mean scores were analyzed, both groups showed an increase in critical thinking scores from pretest to posttest, with the high-fidelity patient simulation group showing greater gains in overall scores. However, neither group showed a statistically significant increase in mean test scores. The effect of high-fidelity patient simulation on critical thinking and clinical decision-making skills remains unclear. Copyright 2012, SLACK Incorporated.

  4. Selection of Film Clips and Development of a Video for the Investigation of Sexual Decision Making among Men Who Have Sex with Men

    PubMed Central

    Woolf-King, Sarah E.; Maisto, Stephen; Carey, Michael; Vanable, Peter

    2013-01-01

    Experimental research on sexual decision making is limited, despite the public health importance of such work. We describe formative work conducted in advance of an experimental study designed to evaluate the effects of alcohol intoxication and sexual arousal on risky sexual decision making among men who have sex with men. In Study 1, we describe the procedures for selecting and validating erotic film clips (to be used for the experimental manipulation of arousal). In Study 2, we describe the tailoring of two interactive role-play videos to be used to measure risk perception and communication skills in an analog risky sex situation. Together, these studies illustrate a method for creating experimental stimuli to investigate sexual decision making in a laboratory setting. Research using this approach will support experimental research that affords a stronger basis for drawing causal inferences regarding sexual decision making. PMID:19760530

  5. DECISION ANALYSIS OF INCINERATION COSTS IN SUPERFUND SITE REMEDIATION

    EPA Science Inventory

    This study examines the decision-making process of the remedial design (RD) phase of on-site incineration projects conducted at Superfund sites. Decisions made during RD affect the cost and schedule of remedial action (RA). Decision analysis techniques are used to determine the...

  6. The effect of four user interface concepts on visual scan pattern similarity and information foraging in a complex decision making task.

    PubMed

    Starke, Sandra D; Baber, Chris

    2018-07-01

    User interface (UI) design can affect the quality of decision making, where decisions based on digitally presented content are commonly informed by visually sampling information through eye movements. Analysis of the resulting scan patterns - the order in which people visually attend to different regions of interest (ROIs) - gives an insight into information foraging strategies. In this study, we quantified scan pattern characteristics for participants engaging with conceptually different user interface designs. Four interfaces were modified along two dimensions relating to effort in accessing information: data presentation (either alpha-numerical data or colour blocks), and information access time (all information sources readily available or sequential revealing of information required). The aim of the study was to investigate whether a) people develop repeatable scan patterns and b) different UI concepts affect information foraging and task performance. Thirty-two participants (eight for each UI concept) were given the task to correctly classify 100 credit card transactions as normal or fraudulent based on nine transaction attributes. Attributes varied in their usefulness of predicting the correct outcome. Conventional and more recent (network analysis- and bioinformatics-based) eye tracking metrics were used to quantify visual search. Empirical findings were evaluated in context of random data and possible accuracy for theoretical decision making strategies. Results showed short repeating sequence fragments within longer scan patterns across participants and conditions, comprising a systematic and a random search component. The UI design concept showing alpha-numerical data in full view resulted in most complete data foraging, while the design concept showing colour blocks in full view resulted in the fastest task completion time. Decision accuracy was not significantly affected by UI design. Theoretical calculations showed that the difference in achievable accuracy between very complex and simple decision making strategies was small. We conclude that goal-directed search of familiar information results in repeatable scan pattern fragments (often corresponding to information sources considered particularly important), but no repeatable complete scan pattern. The underlying concept of the UI affects how visual search is performed, and a decision making strategy develops. This should be taken in consideration when designing for applied domains. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Decision Making in Computer-Simulated Experiments.

    ERIC Educational Resources Information Center

    Suits, J. P.; Lagowski, J. J.

    A set of interactive, computer-simulated experiments was designed to respond to the large range of individual differences in aptitude and reasoning ability generally exhibited by students enrolled in first-semester general chemistry. These experiments give students direct experience in the type of decision making needed in an experimental setting.…

  8. Mixing Methods in Assessing Coaches' Decision Making

    ERIC Educational Resources Information Center

    Vergeer, Ineke; Lyle, John

    2007-01-01

    Mixing methods has recently achieved respectability as an appropriate approach to research design, offering a variety of advantages (Tashakkori & Teddlie, 2003). The purpose of this paper is to outline and evaluate a mixed methods approach within the domain of coaches' decision making. Illustrated with data from a policy-capturing study on…

  9. The RCM as a Decision Making Process.

    ERIC Educational Resources Information Center

    Chambers, Jay G.; And Others

    In most educational literature, the subject of costs has been isolated from curriculum, personnel, and program effectiveness. A dichotomy has existed between fiscal and curricular decision-making. The Resource Cost Model (RCM) was designed to help policymakers measure to what extent differences in the costs of educational services are attributable…

  10. Modelling Human Emotions for Tactical Decision-Making Games

    ERIC Educational Resources Information Center

    Visschedijk, Gillian C.; Lazonder, Ard W.; van der Hulst, Anja; Vink, Nathalie; Leemkuil, Henny

    2013-01-01

    The training of tactical decision making increasingly occurs through serious computer games. A challenging aspect of designing such games is the modelling of human emotions. Two studies were performed to investigate the relation between fidelity and human emotion recognition in virtual human characters. Study 1 compared five versions of a virtual…

  11. Teacher Decision Making and the Implementation of an Integrated Arts Curriculum

    ERIC Educational Resources Information Center

    Devono, Mary K.

    2009-01-01

    This study examines the impact of teacher decision making upon implementing an integrated arts curriculum. Qualitative research methods, including interviews, lesson plan document analysis, and teacher discussion of student artwork comprise the research data from eight elementary classroom teachers. This study is designed to add to the descriptive…

  12. Collegiate Aviation Review. September 1994.

    ERIC Educational Resources Information Center

    Barker, Ballard M., Ed.

    This document contains four papers on aviation education. The first paper, "Why Aren't We Teaching Aeronautical Decision Making?" (Richard J. Adams), reviews 15 years of aviation research into the causes of human performance errors in aviation and provides guidelines for designing the next generation of aeronautical decision-making materials.…

  13. Examining One High School's Restructuring Efforts within "Garbage Can" Decision Making Theory.

    ERIC Educational Resources Information Center

    Shindler, John V.

    A study examined decision making within one large urban high school's restructuring efforts, using an emergent qualitative case-study design. Data, collected over a 2-year period, included formal and informal interviews, participant and nonparticipant observations, surveys, and documents. Results of data analysis supported matching the…

  14. Corporate dashboard for payphone service

    NASA Astrophysics Data System (ADS)

    Siraj, Fadzilah; Shadan, Hezlin

    2015-12-01

    Making assured that managements are kept abreast of what is happening in the company is not an easy task. The quantity of data generated by the business process is astonishing large and non-centralized. The challenge facing business organizations is how to extract, load, transform data, and then deliver useful information to key decision makers. The major challenge for the payphone industries is in making a good decision, particularly to increase quality of service, customer satisfaction while achieving high revenue. With current practice, the process is very time consuming and therefore, a systematic and informative corporate dashboard needs to be provided especially for managerial level in supporting their decision making process. This paper proposed a dashboard application design that provides a single-screen display of relevant information such as the phone performance and coin collection reports, as well as generated revenue to enable faster and more effective decision making. The development of the dashboard is divided into requirement, design and implementation phases. The implementation using real data has demonstrated the potential use of the dashboard. The evaluation results indicate that the dashboard can be used as a tool that can support payphone operation works and decision process by providing the analytical analysis of the KPI report and the performance status. In addition, the results can be used as a guideline for the dashboard developer to understand the process and focuses on the key elements and the principle in designing the effective dashboard.

  15. A systematic approach to embedded biomedical decision making.

    PubMed

    Song, Zhe; Ji, Zhongkai; Ma, Jian-Guo; Sputh, Bernhard; Acharya, U Rajendra; Faust, Oliver

    2012-11-01

    An embedded decision making is a key feature for many biomedical systems. In most cases human life directly depends on correct decisions made by these systems, therefore they have to work reliably. This paper describes how we applied systems engineering principles to design a high performance embedded classification system in a systematic and well structured way. We introduce the structured design approach by discussing requirements capturing, specifications refinement, implementation and testing. Thereby, we follow systems engineering principles and execute each of these processes as formal as possible. The requirements, which motivate the system design, describe an automated decision making system for diagnostic support. These requirements are refined into the implementation of a support vector machine (SVM) algorithm which enables us to integrate automated decision making in embedded systems. With a formal model we establish functionality, stability and reliability of the system. Furthermore, we investigated different parallel processing configurations of this computationally complex algorithm. We found that, by adding SVM processes, an almost linear speedup is possible. Once we established these system properties, we translated the formal model into an implementation. The resulting implementation was tested using XMOS processors with both normal and failure cases, to build up trust in the implementation. Finally, we demonstrated that our parallel implementation achieves the speedup, predicted by the formal model. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed

    Obeidat, Rana; Khrais, Huthaifah I

    2016-01-01

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

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

    PubMed

    Hughes, K K; Dvorak, E M

    1997-01-01

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

  18. A review of the literature: midwifery decision-making and birth.

    PubMed

    Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

    2010-12-01

    Clinical decision-making was initially studied in medicine where hypothetico-deductive reasoning is the model for decision-making. The nursing perspective on clinical decision-making has largely been shaped by Patricia Benner's ground breaking work. Benner claimed expert nurses use humanistic-intuitive ways of making clinical decisions rather than the 'rational reasoning' as claimed by medicine. Clinical decision-making in midwifery is not the same as either nursing or medical decision-making because of the woman-midwife partnership where the woman is the ultimate decision-maker. CINHAL, Medline and Cochrane databases were systematically searched using key words derived from the guiding question. A review of the decision-making research literature in midwifery was undertaken where studies were published in English. The selection criteria for papers were: only research papers of direct relevance to the guiding research question were included in the review. Decision-making is under-researched in midwifery and more specifically birth, as only 4 research articles met the inclusion criteria in this review. Three of the studies involved qualified midwives, and one involved student midwives. Two studies were undertaken in England, one in Scotland and one in Sweden. The major findings synthesised from this review, are that; (1) midwifery decision-making during birth is socially negotiated involving hierarchies of surveillance and control; (2) the role of the woman in shared decision-making during birth has not been explored by midwifery research; (3) clinical decision-making encompasses clinical reasoning as essential but not sufficient for midwives to actually implement their preferred decision. We argue that existing research does not inform the discipline of the complexity of midwifery clinical decision-making during birth. A well-designed study would involve investigating the clinical reasoning skills of the midwife, her relationship with the woman, the context of the particular birthing unit and the employment status of the midwife. The role of the woman as decision-maker in her own care during birth also needs careful research attention. Copyright © 2010 Australian College of Midwives. All rights reserved.

  19. The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

    PubMed Central

    Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

    2009-01-01

    Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes introduced by the participants. We will conduct within-case and cross-case analyses of the data. Discussion The question of the role of economic evaluation in FPs' decision-making is of great interest to scientists, health care practitioners, managers and policy-makers, as well as to consultants, industry, and society. It is believed that the proposed research approach will make an original contribution to the development of knowledge, both empirical and theoretical. PMID:19210787

  20. Emotion expression, decision-making and well-being.

    PubMed

    Xiao, Erte

    2008-01-01

    This chapter discusses the role of emotion expression in decision-making. To understand connections between emotion and decision it is helpful first to differentiate between emotion experience and emotion expression. Understanding how emotion expression influences decision-making is important as a practical matter. However, in contrast to emotion experience, economic research has paid little attention to the significance of emotion expression in decision-making. I review recent studies on emotion expression, paying specific attention to possible connections between emotion expression, punishment, fair economic exchange, and well-being. In contrast to emotions, which are typically difficult to control, I suggest that opportunities for emotion expression can feasibly be manipulated through appropriately designed policies. I further suggest that this approach may have the ability to positively affect well-being and economic outcomes. VALUE OF THE CHAPTER: The chapter provides new perspectives on how policy-makers can benefit by understanding the effect of emotion expression in decision-making. The chapter also suggests future research to improve our understanding of emotion expression.

  1. Study design and hierarchy of evidence for surgical decision making.

    PubMed

    Sprague, Sheila; McKay, Paula; Thoma, Achilleas

    2008-04-01

    This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

  2. Independence and shared decision making: the role of smart home technology in empowering older adults.

    PubMed

    Demiris, George

    2009-01-01

    This study aims to explore the concepts of independence and shared decision making in the context of smart home technologies for older adults. We conducted a Delphi study with three rounds involving smart home designers, and researchers as well as community dwelling older adults. While there were differences in the way different stakeholders define these concepts, the study findings provide clear implications for the design, implementation and evaluation of smart home applications.

  3. Can conservation contracts co-exist with change? Payment for ecosystem services in the context of adaptive decision-making and sustainability.

    PubMed

    Hayes, Tanya; Murtinho, Felipe; Cárdenas Camacho, Luis Mario; Crespo, Patricio; McHugh, Sarah; Salmerón, David

    2015-01-01

    This paper considers the ability of payment for ecosystem services (PES) programs to operate in the context of dynamic and complex social-ecological systems. Drawing on the experiences of two different PES programs in Latin America, we examine how PES institutions fit with the tenets of adaptive decision-making for sustainable resource management. We identify how the program goals and the connection to the market influence the incentive structure, information gathering, learning and feedback processes, and the structure of decision-making rights, specifically the ability to make and modify resource-use rules. Although limited in their generalizability, findings from the two case studies suggest a tension between the contractual model of PES and adaptive decision-making in natural resource systems. PES programs are not inherently decentralized, flexible management tools, as PES contracts tend to restrict decision-making rights and offer minimal flexibility mechanisms to change resource-use practices over the duration of the contract period. Furthermore, PES design and flexibility is heavily dependent on the goals and mission of the buyer and the respective market. If PES is to facilitate sustainable resource management, greater attention is needed to assess how the institutional design of the PES contracts influence the motivation and capacity of participants and program officers alike to adaptively manage the respective resource systems.

  4. Can Conservation Contracts Co-exist with Change? Payment for Ecosystem Services in the Context of Adaptive Decision-Making and Sustainability

    NASA Astrophysics Data System (ADS)

    Hayes, Tanya; Murtinho, Felipe; Cárdenas Camacho, Luis Mario; Crespo, Patricio; McHugh, Sarah; Salmerón, David

    2015-01-01

    This paper considers the ability of payment for ecosystem services (PES) programs to operate in the context of dynamic and complex social-ecological systems. Drawing on the experiences of two different PES programs in Latin America, we examine how PES institutions fit with the tenets of adaptive decision-making for sustainable resource management. We identify how the program goals and the connection to the market influence the incentive structure, information gathering, learning and feedback processes, and the structure of decision-making rights, specifically the ability to make and modify resource-use rules. Although limited in their generalizability, findings from the two case studies suggest a tension between the contractual model of PES and adaptive decision-making in natural resource systems. PES programs are not inherently decentralized, flexible management tools, as PES contracts tend to restrict decision-making rights and offer minimal flexibility mechanisms to change resource-use practices over the duration of the contract period. Furthermore, PES design and flexibility is heavily dependent on the goals and mission of the buyer and the respective market. If PES is to facilitate sustainable resource management, greater attention is needed to assess how the institutional design of the PES contracts influence the motivation and capacity of participants and program officers alike to adaptively manage the respective resource systems.

  5. Systematic design for trait introgression projects.

    PubMed

    Cameron, John N; Han, Ye; Wang, Lizhi; Beavis, William D

    2017-10-01

    Using an Operations Research approach, we demonstrate design of optimal trait introgression projects with respect to competing objectives. We demonstrate an innovative approach for designing Trait Introgression (TI) projects based on optimization principles from Operations Research. If the designs of TI projects are based on clear and measurable objectives, they can be translated into mathematical models with decision variables and constraints that can be translated into Pareto optimality plots associated with any arbitrary selection strategy. The Pareto plots can be used to make rational decisions concerning the trade-offs between maximizing the probability of success while minimizing costs and time. The systematic rigor associated with a cost, time and probability of success (CTP) framework is well suited to designing TI projects that require dynamic decision making. The CTP framework also revealed that previously identified 'best' strategies can be improved to be at least twice as effective without increasing time or expenses.

  6. A double-slit experiment for non-classical interference effects in decision making.

    PubMed

    La Mura, Pierfrancesco

    2014-01-01

    We discuss the possible nature and role of non-physical entanglement, and the classical vs. non-classical interface, in models of human decision-making. We also introduce an experimental setting designed after the double-slit experiment in physics, and discuss how it could be used to discriminate between classical and non-classical interference effects in human decisions. Copyright © 2013 Cognitive Science Society, Inc.

  7. Local School Board Members Need Quality Public Information That Informs Decisions, Empowers Action. Don't Make Decisions in the Dark

    ERIC Educational Resources Information Center

    Data Quality Campaign, 2014

    2014-01-01

    Local school board members need to be able to access and use high-quality data to make good decisions. Often this data is collected and stored locally, but information that is publicly reported by the state can provide additional value. Most state public reporting is designed to serve information needs, and are geared toward compliance with state…

  8. Mainstreaming Climate Change: Recent and Ongoing Efforts to Understand, Improve, and Expand Consideration of Climate Change in Federal Water Resources Planning

    NASA Astrophysics Data System (ADS)

    Ferguson, I. M.; McGuire, M.; Broman, D.; Gangopadhyay, S.

    2017-12-01

    The Bureau of Reclamation is a Federal agency tasked with developing and managing water supply and hydropower projects in the Western U.S. Climate and hydrologic variability and change significantly impact management actions and outcomes across Reclamation's programs and initiatives, including water resource planning and operations, infrastructure design and maintenance, hydropower generation, and ecosystem restoration, among others. Planning, design, and implementation of these programs therefore requires consideration of future climate and hydrologic conditions will impact program objectives. Over the past decade, Reclamation and other Federal agencies have adopted new guidelines, directives, and mandates that require consideration of climate change in water resources planning and decision making. Meanwhile, the scientific community has developed a large number of climate projections, along with an array of models, methods, and tools to facilitate consideration of climate projections in planning and decision making. However, water resources engineers, planners, and decision makers continue to face challenges regarding how best to use the available data and tools to support major decisions, including decisions regarding infrastructure investments and long-term operating criteria. This presentation will discuss recent and ongoing research towards understanding, improving, and expanding consideration of climate projections and related uncertainties in Federal water resources planning and decision making. These research efforts address a variety of challenges, including: How to choose between available climate projection datasets and related methods, models, and tools—many of which are considered experimental or research tools? How to select an appropriate decision framework when design or operating alternatives may differ between climate scenarios? How to effectively communicate results of a climate impacts analysis to decision makers? And, how to improve robustness and resilience of water resources systems in the face of significant uncertainty? Discussion will focus on the intersection between technical challenges and decision making paradigms and the need for improved scientist-decision maker engagement through the lens of this Federal water management agency.

  9. Do educational interventions improve nurses' clinical decision making and judgement? A systematic review.

    PubMed

    Thompson, Carl; Stapley, Sally

    2011-07-01

    Despite the growing popularity of decision making in nursing curricula, the effectiveness of educational interventions to improve nursing judgement and decision making is unknown. We sought to synthesise and summarise the comparative evidence for educational interventions to improve nursing judgements and clinical decisions. A systematic review. Electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, CINAHL and PsycINFO, Social Sciences Citation Index, OpenSIGLE conference proceedings and hand searching nursing journals. Studies published since 1960, reporting any educational intervention that aimed to improve nurses' clinical judgements or decision making were included. Studies were assessed for relevance and quality. Data extracted included study design; educational setting; the nature of participants; whether the study was concerned with the clinical application of skills or the application of theory; the type of decision targeted by the intervention (e.g. diagnostic reasoning) and whether the evaluation of the intervention focused on efficacy or effectiveness. A narrative approach to study synthesis was used due to heterogeneity in interventions, study samples, outcomes and settings and incomplete reporting of effect sizes. From 5262 initial citations 24 studies were included in the review. A variety of educational approaches were reported. Study quality and content reporting was generally poor. Pedagogical theories were widely used but use of decision theory (with the exception of subjective expected utility theory implicit in decision analysis) was rare. The effectiveness and efficacy of interventions was mixed. Educational interventions to improve nurses' judgements and decisions are complex and the evidence from comparative studies does little to reduce the uncertainty about 'what works'. Nurse educators need to pay attention to decision, as well as pedagogical, theory in the design of interventions. Study design and reporting requires improvement to maximise the information contained in reports of educational interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. From science to action: Principles for undertaking environmental research that enables knowledge exchange and evidence-based decision-making.

    PubMed

    Cvitanovic, C; McDonald, J; Hobday, A J

    2016-12-01

    Effective conservation requires knowledge exchange among scientists and decision-makers to enable learning and support evidence-based decision-making. Efforts to improve knowledge exchange have been hindered by a paucity of empirically-grounded guidance to help scientists and practitioners design and implement research programs that actively facilitate knowledge exchange. To address this, we evaluated the Ningaloo Research Program (NRP), which was designed to generate new scientific knowledge to support evidence-based decisions about the management of the Ningaloo Marine Park in north-western Australia. Specifically, we evaluated (1) outcomes of the NRP, including the extent to which new knowledge informed management decisions; (2) the barriers that prevented knowledge exchange among scientists and managers; (3) the key requirements for improving knowledge exchange processes in the future; and (4) the core capacities that are required to support knowledge exchange processes. While the NRP generated expansive and multidisciplinary science outputs directly relevant to the management of the Ningaloo Marine Park, decision-makers are largely unaware of this knowledge and little has been integrated into decision-making processes. A range of barriers prevented efficient and effective knowledge exchange among scientists and decision-makers including cultural differences among the groups, institutional barriers within decision-making agencies, scientific outputs that were not translated for decision-makers and poor alignment between research design and actual knowledge needs. We identify a set of principles to be implemented routinely as part of any applied research program, including; (i) stakeholder mapping prior to the commencement of research programs to identify all stakeholders, (ii) research questions to be co-developed with stakeholders, (iii) implementation of participatory research approaches, (iv) use of a knowledge broker, and (v) tailored knowledge management systems. Finally, we articulate the individual, institutional and financial capacities that must be developed to underpin successful knowledge exchange strategies. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Understandings of the nature of science and decision making on science and technology based issues

    NASA Astrophysics Data System (ADS)

    Bell, Randy L.; Lederman, Norman G.

    2003-05-01

    The purpose of this investigation was to explicate the role of the nature of science in decision making on science and technology based issues and to delineate factors and reasoning associated with these types of decisions. Twenty-one volunteer participants purposively selected from the faculty of geographically diverse universities completed an open-ended questionnaire and follow-up interview designed to assess their decision making on science and technology based issues. Participants were subsequently placed in one of two groups based upon their divergent views of the nature of science as assessed by a second open-ended questionnaire and follow-up interview. Profiles of each group's decision making were then constructed, based on participants' previous responses to the decision making questionnaire and follow-up interviews. Finally, the two groups' decisions, decision influencing factors, and decision making strategies were compared. No differences were found between the decisions of the two groups, despite their disparate views of the nature of science. Participants in both groups based their decisions primarily on personal values, morals/ethics, and social concerns. While all participants considered scientific evidence in their decision making, most did not require absolute proof, even though many participants held absolute conceptions of the nature of science. Overall, the nature of science did not figure prominently in either group's decisions. These findings contrast with basic assumptions of current science education reform efforts and call for a re-examination of the goals of nature of science instruction. Developing better decision making skills - even on science and technology based issues - may involve other factors, including more value-based instruction and attention to intellectual/moral development.

  12. Variation in choice of study design: findings from the Epidemiology Design Decision Inventory and Evaluation (EDDIE) survey.

    PubMed

    Stang, Paul E; Ryan, Patrick B; Overhage, J Marc; Schuemie, Martijn J; Hartzema, Abraham G; Welebob, Emily

    2013-10-01

    Researchers using observational data to understand drug effects must make a number of analytic design choices that suit the characteristics of the data and the subject of the study. Review of the published literature suggests that there is a lack of consistency even when addressing the same research question in the same database. To characterize the degree of similarity or difference in the method and analysis choices made by observational database research experts when presented with research study scenarios. On-line survey using research scenarios on drug-effect studies to capture method selection and analysis choices that follow a dependency branching based on response to key questions. Voluntary participants experienced in epidemiological study design solicited for participation through registration on the Observational Medical Outcomes Partnership website, membership in particular professional organizations, or links in relevant newsletters. Description (proportion) of respondents selecting particular methods and making specific analysis choices based on individual drug-outcome scenario pairs. The number of questions/decisions differed based on stem questions of study design, time-at-risk, outcome definition, and comparator. There is little consistency across scenarios, by drug or by outcome of interest, in the decisions made for design and analyses in scenarios using large healthcare databases. The most consistent choice was the cohort study design but variability in the other critical decisions was common. There is great variation among epidemiologists in the design and analytical choices that they make when implementing analyses in observational healthcare databases. These findings confirm that it will be important to generate empiric evidence to inform these decisions and to promote a better understanding of the impact of standardization on research implementation.

  13. An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial.

    PubMed

    Hoffman, Aubri S; Lowenstein, Lisa M; Kamath, Geetanjali R; Housten, Ashley J; Leal, Viola B; Linder, Suzanne K; Jibaja-Weiss, Maria L; Raju, Gottumukkala S; Volk, Robert J

    2017-04-15

    Colorectal cancer screening rates for African American patients remain suboptimal. Patient decision aids designed with an entertainment-education approach have been shown to improve saliency and foster informed decision making. The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior. Eighty-nine participants were randomized to view 1) a patient decision aid video containing culturally tailored information about colorectal cancer screening options and theory-based support in decision making presented in an entertainment-education format or 2) an attention control video about hypertension that contained similarly detailed information. Participants met with their clinician and then completed follow-up questionnaires assessing their knowledge, decisional conflict, self-advocacy, attitudes, perceived social norms, and intentions. At 3 months, completion of screening was assessed by chart review. Viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy. No significant differences were observed in participants' attitudes, norms, or intentions. At three months, 23% of all patients had completed a colonoscopy. Designing targeted, engaging patient decision aids for groups that receive suboptimal screening holds promise for improving patient decision making and self-advocacy. Additional research is warranted to investigate the effectiveness of such aids in clinical practices with suboptimal screening rates and on downstream behaviors (such as repeat testing). Cancer 2017;123:1401-1408. © 2016 American Cancer Society. © 2016 American Cancer Society.

  14. Value of Information and Prospect theory as tools to involve decision-makers in water-related design, operation and planning of water systems

    NASA Astrophysics Data System (ADS)

    Alfonso, Leonardo

    2013-04-01

    The role of decision-makers is to take the outputs from hydrological and hydraulic analyses and, in some extent, use them as inputs to make decisions that are related to planning, design and operation of water systems. However, the use of these technical analyses is frequently limited, since there are other non-hydrological issues that must be considered, that may end up in very different solutions than those envisaged by the purely technical ones. A possibility to account for the nature of the human decisions under uncertainty is by exploring the use of concepts from decision theory and behavioural economics, such as Value of Information and Prospect Theory and embed them into the methodologies we use in the hydrology practice. Three examples are presented to illustrate these multidisciplinary interactions. The first one, for monitoring network design, uses Value of Information within a methodology to locate water level stations in a complex canal of networks in the Netherlands. The second example, for operation, shows how the Value of Information concept can be used to formulate alternative methods to evaluate flood risk according to the set of options available for decision-making during a flood event. The third example, for planning, uses Prospect Theory concepts to understand how the "losses hurt more than gains feel good" effect can determine the final decision of urbanise or not a flood-prone area. It is demonstrated that decision theory and behavioural economic principles are promising to evaluate the complex decision-making process in water-related issues.

  15. 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

  16. A framework to support decision making in the selection of sustainable drainage system design alternatives.

    PubMed

    Wang, Mingming; Sweetapple, Chris; Fu, Guangtao; Farmani, Raziyeh; Butler, David

    2017-10-01

    This paper presents a new framework for decision making in sustainable drainage system (SuDS) scheme design. It integrates resilience, hydraulic performance, pollution control, rainwater usage, energy analysis, greenhouse gas (GHG) emissions and costs, and has 12 indicators. The multi-criteria analysis methods of entropy weight and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were selected to support SuDS scheme selection. The effectiveness of the framework is demonstrated with a SuDS case in China. Indicators used include flood volume, flood duration, a hydraulic performance indicator, cost and resilience. Resilience is an important design consideration, and it supports scheme selection in the case study. The proposed framework will help a decision maker to choose an appropriate design scheme for implementation without subjectivity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The influence of anticipated pride and guilt on pro-environmental decision making

    PubMed Central

    Zaval, Lisa; Weber, Elke U.; Markowitz, Ezra M.

    2017-01-01

    The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one’s positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one’s negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt. PMID:29190758

  18. Hirarchical emotion calculation model for virtual human modellin - biomed 2010.

    PubMed

    Zhao, Yue; Wright, David

    2010-01-01

    This paper introduces a new emotion generation method for virtual human modelling. The method includes a novel hierarchical emotion structure, a group of emotion calculation equations and a simple heuristics decision making mechanism, which enables virtual humans to perform emotionally in real-time according to their internal and external factors. Emotion calculation equations used in this research were derived from psychologic emotion measurements. Virtual humans can utilise the information in virtual memory and emotion calculation equations to generate their own numerical emotion states within the hierarchical emotion structure. Those emotion states are important internal references for virtual humans to adopt appropriate behaviours and also key cues for their decision making. A simple heuristics theory is introduced and integrated into decision making process in order to make the virtual humans decision making more like a real human. A data interface which connects the emotion calculation and the decision making structure together has also been designed and simulated to test the method in Virtools environment.

  19. Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal

    PubMed Central

    2013-01-01

    Background Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. Method The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. Results The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. Conclusion The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources. PMID:23849617

  20. Older adults newly diagnosed with symptomatic myeloma and treatment decision making.

    PubMed

    Tariman, Joseph D; Doorenbos, Ardith; Schepp, Karen G; Singhal, Seema; Berry, Donna L

    2014-07-01

    To describe the preferences for participation in decision making of older adult patients newly diagnosed with symptomatic myeloma and to explore the association between sociodemographic variables and decisional role preferences. Descriptive, cross-sectional design. Participants' homes and two large academic cancer centers in Seattle, WA, and Chicago, IL. A convenience sample of 20 older adults (60 years of age and older) with symptomatic myeloma diagnosed within the past six months. The Control Preferences Scale was administered followed by an in-person, one-time, semistructured interview. Role preferences for participation in treatment decision making, age, gender, race, work status, personal relationship status, education, and income. Fifty-five percent of the participants preferred a shared role with the physician and 40% preferred to make the decisions after seriously considering the opinion of their physicians. Only one participant preferred to leave the decision to the doctor, as long as the doctor considered the patient's treatment preferences. The study findings indicate that older adults newly diagnosed with myeloma want to participate in treatment decision making. Oncology nurses must respect the patient's desired role preference and oncology clinicians must listen to the patient and allow him or her to be autonomous in making treatment decisions. Nurses and other oncology clinicians can elicit a patient's preferred level of participation in treatment decision making. Oncology nurses can make sure patients receive disease- and treatment-related information, encourage them to express their decisional role preference to the physician, develop a culture of mutual respect and value their desire for autonomy for treatment decision making, acknowledge that the right to make a treatment choice belongs to the patient, and provide support during treatment decision making throughout the care continuum.

  1. Impairment in risk-sensitive decision-making in older suicide attempters with depression

    PubMed Central

    Clark, L; Dombrovski, AY; Siegle, GJ; Butters, MA; Shollenberger, CL; Sahakian, BJ; Szanto, K

    2010-01-01

    Suicidal behavior is a potentially lethal complication of late-life depression. In younger adults, suicide has been linked to abnormal decision-making ability. Given that there are substantial age-related decreases in decision-making ability, and that older adults experience environmental stressors that require effective decision-making, we reasoned that impaired decision-making may be particularly relevant to suicidal behavior in the elderly. We thus compared performance on a probabilistic decision-making task that does not involve working memory (“Cambridge Gamble Task”) in four groups of older adults: 1) individuals with major depression and a history of suicide attempt (n=25), 2) individuals with major depression with active suicidal ideation but no suicide attempt (n=13), 3) individuals with major depression without suicidality (n=35), and 4) non-depressed control subjects (n=22). There was a significant effect of group on quality of decision-making, whereby the suicide attempters exhibited poorer ability to choose the likely outcome, compared with the non-suicidal depressed and non-depressed comparison subjects. There were no group differences in betting behavior. The suicide attempters differed in several aspects of social problem-solving on a self-report scale. Quality of decision-making was negatively correlated with the score on the impulsive/careless problem-solving subscale. These data suggest that older suicide attempters have a deficit in risk-sensitive decision-making, extending observations in younger adults. More specifically, older suicide attempters seem to neglect outcome probability and make poor choices. These impairments may precipitate and perpetuate suicidal crisis in depressed elders. Identification of decision-making impairment in suicidal elders may help with designing effective interventions. PMID:21443349

  2. Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal.

    PubMed

    Adhikari, Shiva Raj; Supakankunti, Siripen; Khan, M Mahmud

    2013-07-12

    Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources.

  3. Blame attribution as a moderator of perceptions of sexual orientation-based hate crimes.

    PubMed

    Cramer, Robert J; Chandler, Joseph F; Wakeman, Emily E

    2010-05-01

    Blame attribution is a valuable mechanism explaining decision making. However, present literature mainly employs blame attribution as a dependent variable. The shortcoming of this fact is that blame attribution offers a potentially valuable explanatory mechanism for decision making. The authors designed two studies to investigate blame attribution as a moderator of sentencing decisions in sexual orientation-based hate crimes. Study 1 showed that mock jurors punished perpetrators of hate crimes more severely than a control condition. Also, degree of victim blame influenced punitive decision making. In Study 2, mock jurors extended findings that perpetrators of hate crimes are more harshly punished than those of other types of crimes. Victim and perpetrator blame failed to moderate decision making in this more complex scenario. Results are discussed in relation to hate crimes definitions and attribution theory.

  4. A Prototype Decision Support System for the Location of Military Water Points.

    DTIC Science & Technology

    1980-06-01

    create an environ- ment which is conductive to an efficient man/machine decision making system . This could be accomplished by designing the operating...Figure 12. Flowchart of Program COMPUTE 50 Procedure This Decision Support System was designed to be interactive. That is, it requests data from the user...Pg. 82-114, 1974. 24. Geoffrion, A.M. and G.W. Graves, "Multicomodity Distribution System Design by Benders Partition", Management Science, Vol. 20, Pg

  5. Performing a secondary executive task with affective stimuli interferes with decision making under risk conditions.

    PubMed

    Gathmann, Bettina; Pawlikowski, Mirko; Schöler, Tobias; Brand, Matthias

    2014-05-01

    Previous studies demonstrated that executive functions are crucial for advantageous decision making under risk and that therefore decision making is disrupted when working memory capacity is demanded while working on a decision task. While some studies also showed that emotions can affect decision making under risk, it is unclear how affective processing and executive functions predict decision-making performance in interaction. The current experimental study used a between-subjects design to examine whether affective pictures (positive and negative pictures compared to neutral pictures), included in a parallel executive task (working memory 2-back task), have an impact on decision making under risk as assessed by the Game of Dice Task (GDT). Moreover, the performance GDT plus 2-back task was compared to the performance in the GDT without any additional task (GDT solely). The results show that the performance in the GDT differed between groups (positive, negative, neutral, and GDT solely). The groups with affective pictures, especially those with positive pictures in the 2-back task, showed more disadvantageous decisions in the GDT than the groups with neutral pictures and the group performing the GDT without any additional task. However, executive functions moderated the effect of the affective pictures. Regardless of affective influence, subjects with good executive functions performed advantageously in the GDT. These findings support the assumption that executive functions and emotional processing interact in predicting decision making under risk.

  6. PubMed Central

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

    2014-01-01

    Background: Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decisionmaking by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework. Methods: We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts. Results: Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of informationseeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented. Interpretation: CAM-related decision-making by patients with cancer occurs as a nonlinear, complex, dynamic process. The conceptual framework presented here identifies influential factors within that process, as well as patients' unique needs during different phases. The framework can guide the development and evaluation of theorybased decision-support programs that are responsive to patients' beliefs and preferences. PMID:25009685

  7. Poverty and Economic Decision-Making: Evidence from Changes in Financial Resources at Payday

    PubMed Central

    Carvalho, Leandro S.; Meier, Stephan; Wang, Stephanie W.

    2016-01-01

    We study the effect of financial resources on decision-making. Low-income U.S. households are randomly assigned to receive an online survey before or after payday. The survey collects measures of cognitive function and administers risk and intertemporal choice tasks. The study design generates variation in cash, checking and savings balances, and expenditures. Before-payday participants behave as if they are more present-biased when making intertemporal choices about monetary rewards but not when making intertemporal choices about non-monetary real-effort tasks. Nor do we find before-after differences in risk-taking, the quality of decision-making, the performance in cognitive function tasks, or in heuristic judgments. PMID:28003681

  8. Continuous track paths reveal additive evidence integration in multistep decision making.

    PubMed

    Buc Calderon, Cristian; Dewulf, Myrtille; Gevers, Wim; Verguts, Tom

    2017-10-03

    Multistep decision making pervades daily life, but its underlying mechanisms remain obscure. We distinguish four prominent models of multistep decision making, namely serial stage, hierarchical evidence integration, hierarchical leaky competing accumulation (HLCA), and probabilistic evidence integration (PEI). To empirically disentangle these models, we design a two-step reward-based decision paradigm and implement it in a reaching task experiment. In a first step, participants choose between two potential upcoming choices, each associated with two rewards. In a second step, participants choose between the two rewards selected in the first step. Strikingly, as predicted by the HLCA and PEI models, the first-step decision dynamics were initially biased toward the choice representing the highest sum/mean before being redirected toward the choice representing the maximal reward (i.e., initial dip). Only HLCA and PEI predicted this initial dip, suggesting that first-step decision dynamics depend on additive integration of competing second-step choices. Our data suggest that potential future outcomes are progressively unraveled during multistep decision making.

  9. An Engineering Educator's Decision Support Tool for Improving Innovation in Student Design Projects

    ERIC Educational Resources Information Center

    Ozaltin, Nur Ozge; Besterfield-Sacre, Mary; Clark, Renee M.

    2015-01-01

    Learning how to design innovatively is a critical process skill for undergraduate engineers in the 21st century. To this end, our paper discusses the development and validation of a Bayesian network decision support tool that can be used by engineering educators to make recommendations that positively impact the innovativeness of product designs.…

  10. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

    PubMed

    Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

    2015-02-01

    Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

  11. Designing for knowledge: bridging socio-hydrological monitoring and beyond

    NASA Astrophysics Data System (ADS)

    Mao, F.; Clark, J.; Buytaert, W.; Ochoa-Tocachi, B. F.; Hannah, D. M.

    2016-12-01

    Many methods and applications have been developed to research socio-hydrological systems, such as participatory monitoring, environmental big data processing and sensor network data transmission. However, these data-centred activities are insufficient to guarantee successful knowledge co-generation, decision making or governance. This research suggests a shift of attentions in designing socio-hydrological monitoring tools, from designing for data to designing for knowledge (DfK). Compared to the former strategy, DfK has at least three features as follows. (1) Why monitor? DfK demands the data produced by the newly introduced monitoring application to have potentials to generate socio-hydrological knowledge that supports decision making or management. It means that when designing a monitoring tool, we should not only answer how to collect data, but also questions such as how to best use the collected data in the form of knowledge. (2) What is the role of monitoring? DfK admits that the socio-hydrological data and knowledge generated by monitoring is just one of many kinds to support decision making and management. It means that the importance of monitoring and scientific evidence should not be overestimated, and knowledge cogeneration and synthesis should be considered in advance in the monitoring design process. (3) Who participate? DfK implies a wider engagement of stakeholders, which is not restricted between volunteers as data collectors and providers, and scientist and researcher communities as main data users. It requires a broader consideration of users, including not only data collectors, processors and interpreters, but also local and indigenous knowledge providers, and decision makers who use the knowledge and data. In summary, this research proposes a knowledge-centred strategy in designing participatory socio-hydrological monitoring tools, in order to make monitoring more useful and effective.

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

    NASA Astrophysics Data System (ADS)

    Fox, Matthew D.

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

  13. Decision making in urological surgery.

    PubMed

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

    2012-06-01

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

  14. Acquisition and production of skilled behavior in dynamic decision-making tasks

    NASA Technical Reports Server (NTRS)

    Kirlik, Alex

    1990-01-01

    Ongoing research investigating perceptual and contextual influences on skilled human performance in dynamic decision making environments is discussed. The research is motivated by two general classes of findings in recent decision making research. First, many studies suggest that the concrete context in which a task is presented has strong influences on the psychological processes used to perform the task and on subsequent performance. Second, studies of skilled behavior in a wide variety of task environments typically implicate the perceptual system as an important contributor to decision-making performance, either in its role as a mediator between the current decision context and stored knowledge, or as a mechanism capable of directly initiating activity through the development of a 'trained eye.' Both contextual and perceptual influences place limits on the ability of traditional utility-theoretic accounts of decision-making to guide display design, as variance in behavior due to contextual factors or the development of a perceptual skill is left unexplained. The author outlines a framework in which to view questions of perceptual and contextual influences on behavior and describe an experimental task and analysis technique which will be used to diagnose the possible role of perception in skilled decision making performance.

  15. Research on web-based decision support system for sports competitions

    NASA Astrophysics Data System (ADS)

    Huo, Hanqiang

    2010-07-01

    This paper describes the system architecture and implementation technology of the decision support system for sports competitions, discusses the design of decision-making modules, management modules and security of the system, and proposes the development idea of building a web-based decision support system for sports competitions.

  16. Sound credit scores and financial decisions despite cognitive aging.

    PubMed

    Li, Ye; Gao, Jie; Enkavi, A Zeynep; Zaval, Lisa; Weber, Elke U; Johnson, Eric J

    2015-01-06

    Age-related deterioration in cognitive ability may compromise the ability of older adults to make major financial decisions. We explore whether knowledge and expertise accumulated from past decisions can offset cognitive decline to maintain decision quality over the life span. Using a unique dataset that combines measures of cognitive ability (fluid intelligence) and of general and domain-specific knowledge (crystallized intelligence), credit report data, and other measures of decision quality, we show that domain-specific knowledge and expertise provide an alternative route for sound financial decisions. That is, cognitive aging does not spell doom for financial decision-making in domains where the decision maker has developed expertise. These results have important implications for public policy and for the design of effective interventions and decision aids.

  17. CRIS Case Study Materials in Ethical Decision Making.

    ERIC Educational Resources Information Center

    Blanning, James R.

    Designed for secondary-level classroom discussion, these materials contain nine, short case studies of ethical dilemmas. The cast studies focus mainly on incidents and issues relevant to high school students. Discussion questions for each case study require students to examine the case, discuss the issue, and make an ethical decision about how…

  18. Managerial Analysis and Decision Support: A Guidebook and Case Studies

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers (NJ3), 2004

    2004-01-01

    Developed and edited by the National Association of College and University Business Officers' (NACUBO's) Accounting Principles Council, this guidebook, written by highly experienced, seasoned college and university leaders, is designed to help readers make sense of today's world and provide the right tools to make the right decisions. The book,…

  19. Administrative Technology and the School Executive: Applying the Systems Approach to Educational Administration.

    ERIC Educational Resources Information Center

    Knezevich, Stephen J., Ed.

    In this era of rapid social change, educational administrators have discovered that new approaches to problem solving and decision making are needed. Systems analysis could afford a promising approach to administrative problems by providing a number of systematic techniques designed to sharpen administrative decision making, enhance efficiency,…

  20. Foundation Degree Students and Their Educational Decision-Making

    ERIC Educational Resources Information Center

    Greenbank, Paul

    2009-01-01

    Purpose: The purpose of this paper is to examine the decision-making process of students who decided to study for a foundation degree. Design/methodology/approach: The research involved interviewing 30 students who were on, or had recently completed, a business-related foundation degree. Findings: This study found that students were not adopting a…

  1. Fostering Innovation Through Robotics Exploration

    DTIC Science & Technology

    2015-06-01

    16 Jan 09. 13. SUPPLEMENTARY NOTES 14. ABSTRACT This effort enhanced Robotics STEM activities by incorporating Cognitive tutors at key points to...make important mathematical decision or implement critical calculations. Program utilized Cognitive Tutor Authoring tools for designing problem...activities by incorporating cognitive tutors at key points to make important mathematical decision or implement critical calculations. The program

  2. Working against Ourselves: Decision Making in a Small Rural School District

    ERIC Educational Resources Information Center

    Patterson, Jean A.; Koenigs, Andrew; Mohn, Gordon; Rasmussen, Cheryl

    2006-01-01

    Purpose: The purpose of this paper is to examine decision making and resource allocation in a small, rural district in a Midwestern state of the USA during a time of economic retrenchment. Design/methodology/approach: Qualitative case study methods were used, including focus groups and personal interviews with current and former district…

  3. Teacher Participation in Decision Making and Its Impact on School and Teachers

    ERIC Educational Resources Information Center

    Sarafidou, Jasmin-Olga; Chatziioannidis, Georgios

    2013-01-01

    Purpose: The purpose of this paper is to examine teacher involvement in different domains of decision making in Greek primary schools and explore associations with school and teacher variables. Design/methodology/approach: A survey employing self-administered questionnaires, with a Likert-type scale assessing teachers' actual and desired…

  4. Decision Making. Level Two/Three. Career Guidance.

    ERIC Educational Resources Information Center

    Cooper, Irene; And Others

    Materials contained in this career guidance unit are designed to provide the seven-, eight-, or nine-year-old student with a framework of logical steps for decision making and problem solving. The seventeen activities included in the unit vary in length from thirty to sixty minutes; the entire unit requires approximately ten hours of instructional…

  5. Sustainability and Ethics as Decision-Making Paradigms in Engineering Curricula

    ERIC Educational Resources Information Center

    El-Zein, Abbas; Airey, David; Bowden, Peter; Clarkeburn, Henriikka

    2008-01-01

    Purpose: The aim of this paper is to explore the rationale for teaching sustainability and engineering ethics within a decision-making paradigm, and critically appraise ways of achieving related learning outcomes. Design/methodology/approach: The paper presents the experience of the School of Civil Engineering at the University of Sydney in…

  6. The Effects of Scenario Planning on Participant Decision-Making Style

    ERIC Educational Resources Information Center

    Chermack, Thomas J.; Nimon, Kim

    2008-01-01

    This research examines changes in decision-making styles as a result of participation in scenario planning. A quasi-experimental pretest-posttest design and several nonparametric tests were used to analyze data gathered from research participants in a technology firm in the Northeastern United States. Results show that participants tend to…

  7. Blame Attribution as a Moderator of Perceptions of Sexual Orientation-Based Hate Crimes

    ERIC Educational Resources Information Center

    Cramer, Robert J.; Chandler, Joseph F.; Wakeman, Emily E.

    2010-01-01

    Blame attribution is a valuable mechanism explaining decision making. However, present literature mainly employs blame attribution as a dependent variable. The shortcoming of this fact is that blame attribution offers a potentially valuable explanatory mechanism for decision making. The authors designed two studies to investigate blame attribution…

  8. Practical Steps for Informing Literacy Instruction: A Diagnostic Decision-Making Model.

    ERIC Educational Resources Information Center

    Kibby, Michael W.

    This monograph presents a diagnostic decision-making model for reading, elementary, and special education teachers to use as a guide in assessing and evaluating students' reading abilities to design and provide more appropriate reading instruction. The model in the monograph gives an overall perspective or gestalt of the components and strategies…

  9. A Curriculum For Choosing.

    ERIC Educational Resources Information Center

    Winocur, S. Lee

    This guide addresses the problem of decision-making in young children and the effect of a particular curriculum on the improvement of children's ability in this area. The term and the process of decision-making are defined, and career implications are discussed. The last section of the guide outlines a program designed to help teachers assist…

  10. Design and Evaluation of Simulations for the Development of Complex Decision-Making Skills.

    ERIC Educational Resources Information Center

    Hartley, Roger; Varley, Glen

    2002-01-01

    Command and Control Training Using Simulation (CACTUS) is a computer digital mapping system used by police to manage large-scale public events. Audio and video records of adaptive training scenarios using CACTUS show how the simulation develops decision-making skills for strategic and tactical event management. (SK)

  11. Improving Decision Making Skill Using an Online Volcanic Crisis Simulation: Impact of Data Presentation Format

    ERIC Educational Resources Information Center

    Barclay, Elizabeth J.; Renshaw, Carl E.; Taylor, Holly A.; Bilge, A. Reyan

    2011-01-01

    Creating effective computer-based learning exercises requires an understanding of optimal user interface designs for improving higher order cognitive skills. Using an online volcanic crisis simulation previously shown to improve decision making skill, we find that a user interface using a graphical presentation of the volcano monitoring data…

  12. The Impact of School-Based Decision Making: A Case Study.

    ERIC Educational Resources Information Center

    Etheridge, Carol Plata; Hall, Mary Lee

    As a last resort to catalyze change in its innercity schools, Memphis City School District (Tennessee) designated seven schools as school-based decision-making (SBDM) sites in April 1989. In the same month, Memphis State University researchers were appointed official observers/researchers of SBDM implementation. Not to be confused with…

  13. The Structure of Knowledge and Departmental Social Organization.

    ERIC Educational Resources Information Center

    Adkinson, Judith

    1979-01-01

    This case study of three university departments was designed to generate substantive theory about decision-making in academic departments. Homans' social systems theory was used as a framework, and it is shown that the rate of interaction affects the crystallization of norm structures and processes of influence and decision-making. (Author/LBH)

  14. Entrepreneurial Decision Making Styles and Learning Strategies Preferences

    ERIC Educational Resources Information Center

    Hestand, Yana

    2012-01-01

    Scope and Method of Study: The scope of this study was the decision making styles and the learning strategies preferences among entrepreneurs. The study utilized a descriptive research design. Internet was utilized as a data collection tool, Participant in the study were 240 entrepreneurs from the Oklahoma state, Tulsa county members of the SBA.…

  15. Improving the Process of Career Decision Making: An Action Research Approach

    ERIC Educational Resources Information Center

    Greenbank, Paul

    2011-01-01

    Purpose: This study adopts an action research approach with the aim of improving the process of career decision making among undergraduates in a business school at a "new" university in the UK. Design/methodology/approach: The study utilised unfreezing techniques, multiple case studies in conjunction with the principle of analogical…

  16. Decision-Making: Are Plants More Rational than Animals?

    PubMed

    Schmid, Bernhard

    2016-07-25

    A new study presents a novel experimental design and allows a test of risk sensitivity in plants. Faced with a choice between constant and variable resource supply, they make a rational decision for the option that maximizes fitness, a fact rarely observed in animals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Education and Training in Ethical Decision Making: Comparing Context and Orientation

    ERIC Educational Resources Information Center

    Perri, David F.; Callanan, Gerard A.; Rotenberry, Paul F.; Oehlers, Peter F.

    2009-01-01

    Purpose: The purpose of this paper is to present a teaching methodology for improving the understanding of ethical decision making. This pedagogical approach is applicable in college courses and in corporate training programs. Design/methodology/approach: Participants are asked to analyze a set of eight ethical dilemmas with differing situational…

  18. Instructional Design for Advanced Learners: Training Recognition Skills to Hasten Expertise

    ERIC Educational Resources Information Center

    Fadde, Peter Jae

    2009-01-01

    Expertise in domains ranging from sports to surgery involves a process of recognition-primed decision-making (RPD) in which experts make rapid, intuitive decisions based on recognizing critical features of dynamic performance situations. While the development of expert RPD is assumed to require years of domain experience, the transition from…

  19. Perspective Taking and Decision-Making in Educational Game Play: A Mixed-Methods Study

    ERIC Educational Resources Information Center

    Hilliard, Lacey J.; Buckingham, Mary H.; Geldhof, G. John; Gansert, Patricia; Stack, Caroline; Gelgoot, Erin S.; Bers, Marina U.; Lerner, Richard M.

    2018-01-01

    Video games have the potential to be contexts for moral learning. We investigated whether "Quandary," a video game designed to promote ethical thinking and moral considerations for decision-making, would help promote positive skills such as perspective taking and empathy in adolescents. We examined the effect of playing…

  20. Classroom Assessment: Concepts and Applications. Fourth Edition.

    ERIC Educational Resources Information Center

    Airasian, Peter W.

    This book is designed for students taking a first course in classroom assessment and measurement. It shows how assessment principles apply to the full range of teacher decision making and not just the formal evaluation of student learning. The book is organized in a way that follows the natural progression of teachers' decision making, from…

  1. Involvement of people with dementia in making decisions about their lives: a qualitative study that appraises shared decision-making concerning daycare

    PubMed Central

    Groen-van de Ven, Leontine; Smits, Carolien; de Graaff, Fuusje; Span, Marijke; Eefsting, Jan; Jukema, Jan; Vernooij-Dassen, Myrra

    2017-01-01

    Objective To explore how people with dementia, their informal caregivers and their professionals participate in decision making about daycare and to develop a typology of participation trajectories. Design A qualitative study with a prospective, multiperspective design, based on 244 semistructured interviews, conducted during three interview rounds over the course of a year. Analysis was by means of content analysis and typology construction. Setting Community settings and nursing homes in the Netherlands. Participants 19 people with dementia, 36 of their informal caregivers and 38 of their professionals (including nurses, daycare employees and case managers). Results The participants’ responses related to three critical points in the decision-making trajectory about daycare: (1) the initial positive or negative expectations of daycare; (2) negotiation about trying out daycare by promoting, resisting or attuning to others; and (3) trying daycare, which resulted in positive or negative reactions from people with dementia and led to a decision. The ways in which care networks proceeded through these three critical points resulted in a typology of participation trajectories, including (1) working together positively toward daycare, (2) bringing conflicting perspectives together toward trying daycare and (3) not reaching commitment to try daycare. Conclusion Shared decision making with people with dementia is possible and requires and adapted process of decision making. Our results show that initial preferences based on information alone may change when people with dementia experience daycare. It is important to have a try-out period so that people with dementia can experience daycare without having to decide whether to continue it. Whereas shared decision making in general aims at moving from initial preferences to informed preferences, professionals should focus more on moving from initial preferences to experienced preferences for people with dementia. Professionals can play a crucial role in facilitating the possibilities for a try-out period. PMID:29133329

  2. 3D technology of Sony Bloggie has no advantage in decision-making of tennis serve direction: A randomized placebo-controlled study.

    PubMed

    Liu, Sicong; Ritchie, Jason; Sáenz-Moncaleano, Camilo; Ward, Savanna K; Paulsen, Cody; Klein, Tyler; Gutierrez, Oscar; Tenenbaum, Gershon

    2017-06-01

    This study aimed at exploring whether 3D technology enhances tennis decision-making under the conceptual framework of human performance model. A 3 (skill-level: varsity, club, recreational) × 3 (experimental condition: placebo, weak 3D [W3D], strong 3D [S3D]) between-participant design was used. Allocated to experimental conditions by a skill-level stratified randomization, 105 tennis players judged tennis serve direction from video scenarios and rated their perceptions of enjoyment, flow, and presence during task performance. Results showed that varsity players made more accurate decisions than less skilled ones. Additionally, applying 3D technology to typical video displays reduced tennis players' decision-making accuracy, although wearing the 3D glasses led to a placebo effect that shortened the decision-making reaction time. The unexpected negative effect of 3D technology on decision-making was possibly due to participants being more familiar to W3D than to S3D, and relatedly, a suboptimal task-technology match. Future directions for advancing this area of research are offered. Highlights 3D technology augments binocular depth cues to tradition video displays, and thus results in the attainment of more authentic visual representation. This process enhances task fidelity in researching perceptual-cognitive skills in sports. The paper clarified both conceptual and methodological difficulties in testing 3D technology in sports settings. Namely, the nomenclature of video footage (with/without 3D technology) and the possible placebo effect (arising from wearing glasses of 3D technology) merit researchers' attention. Participants varying in level of domain-specific expertise were randomized into viewing conditions using a placebo-controlled design. Measurement consisted of both participants' subjective experience (i.e., presence, flow, and enjoyment) and objective performance (i.e., accuracy and reaction time) in a decision-making task. Findings revealed that wearing glasses of 3D technology resulted in a placebo effect that shortened participants' reaction times in decision-making. Moreover, participants' decision-making accuracy decreased when viewing video scenarios using 3D technology. The findings generated meaningful implications regarding applying 3D technology to sports research.

  3. Failure detection system design methodology. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Chow, E. Y.

    1980-01-01

    The design of a failure detection and identification system consists of designing a robust residual generation process and a high performance decision making process. The design of these two processes are examined separately. Residual generation is based on analytical redundancy. Redundancy relations that are insensitive to modelling errors and noise effects are important for designing robust residual generation processes. The characterization of the concept of analytical redundancy in terms of a generalized parity space provides a framework in which a systematic approach to the determination of robust redundancy relations are developed. The Bayesian approach is adopted for the design of high performance decision processes. The FDI decision problem is formulated as a Bayes sequential decision problem. Since the optimal decision rule is incomputable, a methodology for designing suboptimal rules is proposed. A numerical algorithm is developed to facilitate the design and performance evaluation of suboptimal rules.

  4. A simple threshold rule is sufficient to explain sophisticated collective decision-making.

    PubMed

    Robinson, Elva J H; Franks, Nigel R; Ellis, Samuel; Okuda, Saki; Marshall, James A R

    2011-01-01

    Decision-making animals can use slow-but-accurate strategies, such as making multiple comparisons, or opt for simpler, faster strategies to find a 'good enough' option. Social animals make collective decisions about many group behaviours including foraging and migration. The key to the collective choice lies with individual behaviour. We present a case study of a collective decision-making process (house-hunting ants, Temnothorax albipennis), in which a previously proposed decision strategy involved both quality-dependent hesitancy and direct comparisons of nests by scouts. An alternative possible decision strategy is that scouting ants use a very simple quality-dependent threshold rule to decide whether to recruit nest-mates to a new site or search for alternatives. We use analytical and simulation modelling to demonstrate that this simple rule is sufficient to explain empirical patterns from three studies of collective decision-making in ants, and can account parsimoniously for apparent comparison by individuals and apparent hesitancy (recruitment latency) effects, when available nests differ strongly in quality. This highlights the need to carefully design experiments to detect individual comparison. We present empirical data strongly suggesting that best-of-n comparison is not used by individual ants, although individual sequential comparisons are not ruled out. However, by using a simple threshold rule, decision-making groups are able to effectively compare options, without relying on any form of direct comparison of alternatives by individuals. This parsimonious mechanism could promote collective rationality in group decision-making.

  5. Shared Decision-Making as the Future of Emergency Cardiology.

    PubMed

    Probst, Marc A; Noseworthy, Peter A; Brito, Juan P; Hess, Erik P

    2018-02-01

    Shared decision-making is playing an increasingly large role in emergency cardiovascular care. Although there are many challenges to successfully performing shared decision-making in the emergency department, there are numerous clinical scenarios in which it should be used. In this article, we explore new research and emerging decision aids in the following emergency care scenarios: (1) low-risk chest pain; (2) new-onset atrial fibrillation; and (3) moderate-risk syncope. These decision aids are designed to engage patients and facilitate shared decision-making for specific treatment and disposition (admit vs discharge) decisions. We then offer a 3-step, practical approach to performing shared decision-making in the acute care setting, on the basis of broad stakeholder input and previous conceptual work. Step 1 involves simply acknowledging that a clinical decision needs to be made. Step 2 involves a shared discussion about the working diagnosis and the options for care in the context of the patient's values, preferences, and circumstances. The third and final step requires the patient and provider to agree on a plan of action regarding further medical care. The implementation of shared decision-making in emergency cardiology has the potential to shift the paradigm of clinical practice from paternalism toward mutualism and improve the quality and experience of care for our patients. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  6. 48 CFR 34.003 - Responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... shall identify the key decision points of each major system acquisition and the agency official(s) for making those decisions. (c) Systems acquisitions normally designated as major are those programs that, as... management attention, including specific agency-head decisions. The agency procedures may establish...

  7. Patient involvement in decision-making: a cross-sectional study in a Malaysian primary care clinic

    PubMed Central

    Ambigapathy, Ranjini; Ng, Chirk Jenn

    2016-01-01

    Objective Shared decision-making has been advocated as a useful model for patient management. In developing Asian countries such as Malaysia, there is a common belief that patients prefer a passive role in clinical consultation. As such, the objective of this study was to determine Malaysian patients’ role preference in decision-making and the associated factors. Design A cross-sectional study. Setting Study was conducted at an urban primary care clinic in Malaysia in 2012. Participants Patients aged >21 years were chosen using systematic random sampling. Methods Consenting patients answered a self-administered questionnaire, which included demographic data and their preferred and actual role before and after consultation. Doctors were asked to determine patients’ role preference. The Control Preference Scale was used to assess patients’ role preference. Primary outcome Prevalence of patients’ preferred role in decision-making. Secondary outcomes (1) Actual role played by the patient in decision-making. (2) Sociodemographic factors associated with patients’ preferred role in decision-making. (3) Doctors’ perception of patients’ involvement in decision-making. Results The response rate was 95.1% (470/494). Shared decision-making was preferred by 51.9% of patients, followed by passive (26.3%) and active (21.8%) roles in decision-making. Higher household income was significantly associated with autonomous role preference (p=0.018). Doctors’ perception did not concur with patients’ preferred role. Among patients whom doctors perceived to prefer a passive role, 73.5% preferred an autonomous role (p=0.900, κ=0.006). Conclusions The majority of patients attending the primary care clinic preferred and played an autonomous role in decision-making. Doctors underestimated patients’ preference to play an autonomous role. PMID:26729393

  8. Children's participation in shared decision-making: children, adolescents, parents and healthcare professionals' perspectives and experiences.

    PubMed

    Coyne, Imelda; Amory, Aislinn; Kiernan, Gemma; Gibson, Faith

    2014-06-01

    Despite decision-making featuring throughout the trajectory of cancer care, children's participation in decision-making remains an area much under-researched and complicated by conflicting opinions. This study explored children's participation in shared decision-making (SDM) from multiple perspectives from one haematology/oncology unit in Ireland. Qualitative research design was used to explore participants' experiences of children's decision-making. Interviews were conducted with children(1) aged 7-16 years (n = 20), their parents (n = 22) and healthcare professionals (n = 40). Data were managed with the aid of NVivo (version 8). Parents and children's roles in decision-making were significantly influenced by the seriousness of the illness. Cancer is a life-threatening illness and so the treatment 'had to be done'. Children were not involved in major decisions (treatment decisions) as refusal was not an option. They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, making treatment more palatable, giving back a sense of control and building trusting relationships. These choices were termed 'small' decisions that would not compromise the child's welfare. Some adolescents were aware that choices were not 'real' decisions since they were not allowed to refuse and expressed feelings of frustration. Healthcare professionals and parents controlled the process of SDM and the children's accounts revealed that they held a minimal role. Children appeared content that adults held responsibility for the major treatment decisions. However, they desired and valued receiving information, voicing their preferences and choosing how treatments were administered to them. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Developing and pilot testing a shared decision-making intervention for dialysis choice.

    PubMed

    Finderup, Jeanette; Jensen, Jens K D; Lomborg, Kirsten

    2018-04-17

    Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality. This study reflects the first two phases of a complex intervention design: phase 1, the development process and phase 2, feasibility and piloting. Because decision aids were a part of the intervention, the International Patient Decision Aid Standards were considered. The pilot test included both the intervention and the feasibility of the validated shared decision-making questionnaire (SDM Q9) and the Decision Quality Measure (DQM) applied to evaluate the intervention. A total of 137 patients tested the intervention. After the intervention, 80% of the patients chose dialysis at home reflecting an increase of 23% in starting dialysis at home prior to the study. The SDM Q9 showed the majority of the patients experienced this intervention as shared decision-making. An intervention based on shared decision-making supported by decision aids seemed to increase the number of patients choosing home dialysis. The SDM Q9 and DQM were feasible evaluation tools. Further research is needed to gain insight into the patients' experiences of involvement and the implications for their choice of dialysis modality. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  10. 39 CFR 775.8 - Environmental evaluation guidelines.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... that integrates natural and social sciences and environmental design in planning and making decisions... for early decision on whether detailed environmental impact statements must be prepared.) (4) Study...

  11. 39 CFR 775.8 - Environmental evaluation guidelines.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... that integrates natural and social sciences and environmental design in planning and making decisions... for early decision on whether detailed environmental impact statements must be prepared.) (4) Study...

  12. 39 CFR 775.8 - Environmental evaluation guidelines.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... that integrates natural and social sciences and environmental design in planning and making decisions... for early decision on whether detailed environmental impact statements must be prepared.) (4) Study...

  13. 39 CFR 775.8 - Environmental evaluation guidelines.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... that integrates natural and social sciences and environmental design in planning and making decisions... for early decision on whether detailed environmental impact statements must be prepared.) (4) Study...

  14. 39 CFR 775.8 - Environmental evaluation guidelines.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... that integrates natural and social sciences and environmental design in planning and making decisions... for early decision on whether detailed environmental impact statements must be prepared.) (4) Study...

  15. 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

    The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general 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.

  16. Behavioral Stage of Change and Dialysis Decision-Making

    PubMed Central

    McGrail, Anna; Lewis, Steven A.; Schold, Jesse; Lawless, Mary Ellen; Sehgal, Ashwini R.; Perzynski, Adam T.

    2015-01-01

    Background and objectives Behavioral stage of change (SoC) algorithms classify patients’ readiness for medical treatment decision-making. In the precontemplation stage, patients have no intention to take action within 6 months. In the contemplation stage, action is intended within 6 months. In the preparation stage, patients intend to take action within 30 days. In the action stage, the change has been made. This study examines the influence of SoC on dialysis modality decision-making. Design, setting, participants, & measurements SoC and relevant covariates were measured, and associations with dialysis decision-making were determined. In-depth interviews were conducted with 16 patients on dialysis to elicit experiences. Qualitative interview data informed the survey design. Surveys were administered to adults with CKD (eGFR≤25 ml/min/1.73 m2) from August, 2012 to June, 2013. Multivariable logistic regression modeled dialysis decision-making with predictors: SoC, provider connection, and dialysis knowledge score. Results Fifty-five patients completed the survey (71% women, 39% white, and 59% black), and median annual income was $17,500. In total, 65% of patients were in the precontemplation/contemplation (thinking) and 35% of patients were in the preparation/maintenance (acting) SoC; 62% of patients had made dialysis modality decisions. Doctors explaining modality options, higher dialysis knowledge scores, and fewer lifestyle barriers were associated with acting versus thinking SoC (all P<0.02). Patients making modality decisions had doctors who explained dialysis options (76% versus 43%), were in the acting versus the thinking SoC (50% versus 10%), had higher dialysis knowledge scores (1.4 versus 0.5), and had lower eGFR (13.9 versus 16.8 ml/min/1.73 m2; all P<0.05). In adjusted analyses, dialysis knowledge was significantly associated with decision-making (odds ratio, 4.2; 95% confidence interval, 1.4 to 12.9; P=0.01), and SoC was of borderline significance (odds ratio, 5.8; 95% confidence interval, 1.0 to 32.6; P=0.05). The model C statistic was 0.87. Conclusions Dialysis decision-making was associated with SoC, dialysis knowledge, and physicians discussing treatment options. Future studies determining ways to assist patients with CKD in making satisfying modality decisions are warranted. PMID:25591499

  17. Acceptance of shared decision making with reference to an electronic library of decision aids (arriba-lib) and its association to decision making in patients: an evaluation study.

    PubMed

    Hirsch, Oliver; Keller, Heidemarie; Krones, Tanja; Donner-Banzhoff, Norbert

    2011-07-07

    Decision aids based on the philosophy of shared decision making are designed to help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes. A patient decision aid can be regarded as a complex intervention because it consists of several presumably relevant components. Decision aids have rarely been field tested to assess patients' and physicians' attitudes towards them. It is also unclear what effect decision aids have on the adherence to chosen options. The electronic library of decision aids (arriba-lib) to be used within the clinical encounter has a modular structure and contains evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. We conducted an evaluation study in which 29 primary care physicians included 192 patients. After the consultation, patients filled in questionnaires and were interviewed via telephone two months later. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Patients were highly satisfied with arriba-lib and the process of shared decision making. Two-thirds of patients reached in the telephone interview wanted to be counselled again with arriba-lib. There was a high congruence between preferred and perceived decision making. Of those patients reached in the telephone interview, 80.7% said that they implemented the decision, independent of gender and education. Elderly patients were more likely to say that they implemented the decision. Shared decision making with our multi-modular electronic library of decision aids (arriba-lib) was accepted by a high number of patients. It has positive associations to general aspects of decision making in patients. It can be used for patient groups with a wide range of individual characteristics.

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

    PubMed

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

    2017-12-12

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

  19. The influence of fatigue on decision-making in athletes: a systematic review.

    PubMed

    Almonroeder, Thomas Gus; Tighe, Sarah Marie; Miller, Taylor Matthew; Lanning, Christopher Ray

    2018-06-14

    A potential challenge associated with sports is that athletes must often perform the cognitive processing associated with decision-making (i.e., movement selection) when fatigued. The purpose of this systematic review was to summarise studies that have analysed the extent to which fatigue influences the effects of decision-making on lower extremity mechanics during execution of common sports manoeuvres. We specifically focused on mechanics associated with ACL injury risk. Reviewers searched the PubMed, SPORTDiscus, CINAHL and Web of Science databases. The search identified 183 unique articles. Five of these articles met our eligibility criteria. Two of the studies incorporated fatigue protocols where athletes progressed to exhaustion and found that the effects of decision-making on mechanics were more pronounced with fatigue. The nature of the results appears to indicate that fatigue may compromise an athlete's cognitive processing in a manner that diminishes their ability to control movement when rapid decision-making is required. However, three subsequent studies utilised fatigue protocols designed to mimic sports participation and found that fatigue did not influence the effects of decision-making on mechanics. In general, these findings appear to indicate that fatigue may only affect the cognitive processing associated with decision-making when athletes approach a state of exhaustion.

  20. [The effects of case-based learning using video on clinical decision making and learning motivation in undergraduate nursing students].

    PubMed

    Yoo, Moon-Sook; Park, Jin-Hee; Lee, Si-Ra

    2010-12-01

    The purpose of this study was to examine the effects of case-base learning (CBL) using video on clinical decision-making and learning motivation. This research was conducted between June 2009 and April 2010 as a nonequivalent control group non-synchronized design. The study population was 44 third year nursing students who enrolled in a college of nursing, A University in Korea. The nursing students were divided into the CBL and the control group. The intervention was the CBL with three cases using video. The controls attended a traditional live lecture on the same topics. With questionnaires objective clinical decision-making, subjective clinical decision-making, and learning motivation were measured before the intervention, and 10 weeks after the intervention. Significant group differences were observed in clinical decision-making and learning motivation. The post-test scores of clinical decision-making in the CBL group were statistically higher than the control group. Learning motivation was also significantly higher in the CBL group than in the control group. These results indicate that CBL using video is effective in enhancing clinical decision-making and motivating students to learn by encouraging self-directed learning and creating more interest and curiosity in learning.

  1. ‘They leave at least believing they had a part in the discussion’: Understanding decision aid use and patient–clinician decision-making through qualitative research

    PubMed Central

    Tiedje, Kristina; Shippee, Nathan D.; Johnson, Anna M.; Flynn, Priscilla M.; Finnie, Dawn M.; Liesinger, Juliette T.; May, Carl R.; Olson, Marianne E.; Ridgeway, Jennifer L.; Shah, Nilay D.; Yawn, Barbara P.; Montori, Victor M.

    2013-01-01

    Objective This study explores how patient decision aids (DAs) for antihyperglycemic agents and statins, designed for use during clinical consultations, are embedded into practice, examining how patients and clinicians understand and experience DAs in primary care visits. Methods We conducted semistructured in-depth interviews with patients (n = 22) and primary care clinicians (n = 19), and videorecorded consultations (n = 44). Two researchers coded all transcripts. Inductive analyses guided by grounded theory led to the identification of themes. Video and interview data were compared and organized by themes. Results DAs used during consultations became flexible artifacts, incorporated into existing decision making roles for clinicians (experts, authority figures, persuaders, advisors) and patients (drivers of healthcare, learners, partners). DAs were applied to different decision making steps (deliberation, bargaining, convincing, case assessment), and introduced into an existing knowledge context (participants’ literacy regarding shared decision-making (SDM) and DAs). Conclusion DAs’ flexible use during consultations effectively provided space for discussion, even when SDM was not achieved. DAs can be used within any decision-making model. Practice implications Clinician training in DA use and SDM practice may be needed to facilitate DA implementation and promote more ideal-type forms of sharing in decision making. PMID:23598292

  2. Neural reactivation links unconscious thought to decision-making performance.

    PubMed

    Creswell, John David; Bursley, James K; Satpute, Ajay B

    2013-12-01

    Brief periods of unconscious thought (UT) have been shown to improve decision making compared with making an immediate decision (ID). We reveal a neural mechanism for UT in decision making using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Participants (N = 33) encoded information on a set of consumer products (e.g. 48 attributes describing four different cars), and we manipulated whether participants (i) consciously thought about this information (conscious thought), (ii) completed a difficult 2-back working memory task (UT) or (iii) made an immediate decision about the consumer products (ID) in a within-subjects blocked design. To differentiate UT neural activity from 2-back working memory neural activity, participants completed an independent 2-back task and this neural activity was subtracted from neural activity occurring during the UT 2-back task. Consistent with a neural reactivation account, we found that the same regions activated during the encoding of complex decision information (right dorsolateral prefrontal cortex and left intermediate visual cortex) continued to be activated during a subsequent 2-min UT period. Moreover, neural reactivation in these regions was predictive of subsequent behavioral decision-making performance after the UT period. These results provide initial evidence for post-encoding unconscious neural reactivation in facilitating decision making.

  3. Neural reactivation links unconscious thought to decision-making performance

    PubMed Central

    Bursley, James K.; Satpute, Ajay B.

    2013-01-01

    Brief periods of unconscious thought (UT) have been shown to improve decision making compared with making an immediate decision (ID). We reveal a neural mechanism for UT in decision making using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging. Participants (N = 33) encoded information on a set of consumer products (e.g. 48 attributes describing four different cars), and we manipulated whether participants (i) consciously thought about this information (conscious thought), (ii) completed a difficult 2-back working memory task (UT) or (iii) made an immediate decision about the consumer products (ID) in a within-subjects blocked design. To differentiate UT neural activity from 2-back working memory neural activity, participants completed an independent 2-back task and this neural activity was subtracted from neural activity occurring during the UT 2-back task. Consistent with a neural reactivation account, we found that the same regions activated during the encoding of complex decision information (right dorsolateral prefrontal cortex and left intermediate visual cortex) continued to be activated during a subsequent 2-min UT period. Moreover, neural reactivation in these regions was predictive of subsequent behavioral decision-making performance after the UT period. These results provide initial evidence for post-encoding unconscious neural reactivation in facilitating decision making. PMID:23314012

  4. Manager`s views of public involvement

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

    Branch, K.M.; Heerwagen, J.; Bradbury, J.

    1995-12-01

    Four issues commonly form the framework for debates about the acceptability of proposed projects or technologies--the substantive decision or technological choice; the treatment of the community by the proponent organization; the way the decision-making process has been structured and managed; and the status of institutional safeguards and protection. One of the clear messages of cultural theory is that differences in perspectives are a normal and inevitable part of society, and that attempts to resolve differences by persuasion are not likely to work. These findings are useful when considering the goals and possibilities of public involvement as a decision-making tool, andmore » when designing or evaluating public involvement training programs for managers. The research reported here examines the viewpoints and concerns of managers and decision-makers about the four issues identified above, with particular emphasis on their perspectives and concerns about opening decision-making processes to the public and about managers` roles and responsibilities for structuring and managing open decision-making processes. Implications of these findings for public involvement training for managers is also discussed. The data presented in this paper were obtained from face-to-face interviews with managers and decision-makers with experience managing a variety of hazardous waste management decision-making processes. We conducted these interviews in the course of four separate research projects: needs assessments to support the design and development of a public involvement training program for managers; a study of community residents` and managers` perspectives on the chemical stockpile disposal program; an evaluation of the effectiveness of public involvement training for managers in the Department of Energy; and a study to develop indicators of the benefits and costs of public involvement.« less

  5. Multi-criteria Integrated Resource Assessment (MIRA)

    EPA Pesticide Factsheets

    MIRA is an approach that facilitates stakeholder engagement for collaborative multi-objective decision making. MIRA is designed to facilitate and support an inclusive, explicit, transparent, iterative learning-based decision process.

  6. Tire Changes, Fresh Air, and Yellow Flags: Challenges in Predictive Analytics for Professional Racing.

    PubMed

    Tulabandhula, Theja; Rudin, Cynthia

    2014-06-01

    Our goal is to design a prediction and decision system for real-time use during a professional car race. In designing a knowledge discovery process for racing, we faced several challenges that were overcome only when domain knowledge of racing was carefully infused within statistical modeling techniques. In this article, we describe how we leveraged expert knowledge of the domain to produce a real-time decision system for tire changes within a race. Our forecasts have the potential to impact how racing teams can optimize strategy by making tire-change decisions to benefit their rank position. Our work significantly expands previous research on sports analytics, as it is the only work on analytical methods for within-race prediction and decision making for professional car racing.

  7. How do persons with dementia participate in decision making related to health and daily care? A multi-case study

    PubMed Central

    2012-01-01

    Background Many countries have passed laws giving patients the right to participate in decisions about health care. People with dementia cannot be assumed to be incapable of making decisions on their diagnosis alone as they may have retained cognitive abilities. The purpose of this study was to gain a better understanding of how persons with dementia participated in making decisions about health care and how their family carers and professional caregivers influenced decision making. Methods This Norwegian study had a qualitative multi-case design. The triad in each of the ten cases consisted of the person with dementia, the family carer and the professional caregiver, in all 30 participants. Inclusion criteria for the persons with dementia were: (1) 67 years or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2, moderate dementia; (3) able to communicate verbally. The family carers and professional caregivers were then asked to participate. A semi-structured interview guide was used in interviews with family carers and professional caregivers. Field notes were written after participant observation of interactions between persons with dementia and professional caregivers during morning care or activities at a day centre. How the professional caregivers facilitated decision making was the focus of the observations that varied in length from 30 to 90 minutes. The data were analyzed using framework analysis combined with a hermeneutical interpretive approach. Results Professional caregivers based their assessment of mental competence on experience and not on standardized tests. Persons with dementia demonstrated variability in how they participated in decision making. Pseudo-autonomous decision making and delegating decision making were new categories that emerged. Autonomous decision making did occur but shared decision making was the most typical pattern. Reduced mental capacity, lack of available choices or not being given the opportunity to participate led to non-involvement. Not all decisions were based on logic; personal values and relationships were also considered. Conclusions Persons with moderate dementia demonstrated variability in how they participated in decision making. Optimal involvement was facilitated by positioning them as capable of influencing decisions, assessing decision-specific competence, clarifying values and understanding the significance of relationships and context. PMID:22870952

  8. Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

    PubMed

    Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

    2016-09-01

    To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

  9. Does ambiguity aversion influence the framing effect during decision making?

    PubMed

    Osmont, Anaïs; Cassotti, Mathieu; Agogué, Marine; Houdé, Olivier; Moutier, Sylvain

    2015-04-01

    Decision-makers present a systematic tendency to avoid ambiguous options for which the level of risk is unknown. This ambiguity aversion is one of the most striking decision-making biases. Given that human choices strongly depend on the options' presentation, the purpose of the present study was to examine whether ambiguity aversion influences the framing effect during decision making. We designed a new financial decision-making task involving the manipulation of both frame and uncertainty levels. Thirty-seven participants had to choose between a sure option and a gamble depicting either clear or ambiguous probabilities. The results revealed a clear preference for the sure option in the ambiguity condition regardless of frame. However, participants presented a framing effect in both the risk and ambiguity conditions. Indeed, the framing effect was bidirectional in the risk condition and unidirectional in the ambiguity condition given that it did not involve preference reversal but only a more extreme choice tendency.

  10. A Bayesian paradigm for decision-making in proof-of-concept trials.

    PubMed

    Pulkstenis, Erik; Patra, Kaushik; Zhang, Jianliang

    2017-01-01

    Decision-making is central to every phase of drug development, and especially at the proof of concept stage where risk and evidence must be weighed carefully, often in the presence of significant uncertainty. The decision to proceed or not to large expensive Phase 3 trials has significant implications to both patients and sponsors alike. Recent experience has shown that Phase 3 failure rates remain high. We present a flexible Bayesian quantitative decision-making paradigm that evaluates evidence relative to achieving a multilevel target product profile. A framework for operating characteristics is provided that allows the drug developer to design a proof-of-concept trial in light of its ability to support decision-making rather than merely achieve statistical significance. Operating characteristics are shown to be superior to traditional p-value-based methods. In addition, discussion related to sample size considerations, application to interim futility analysis and incorporation of prior historical information is evaluated.

  11. Development of a digital clinical pathway for emergency medicine: Lessons from usability testing and implementation failure.

    PubMed

    Gutenstein, Marc; Pickering, John W; Than, Martin

    2018-06-01

    Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol. Technical authoring was successful, however, usability testing revealed that the user experience and the flexibility of workflow within the application were critical barriers to implementation. Emergency medicine and acute care decision support systems face particular challenges to existing models of linear workflow that should be deliberately addressed in digital pathway design. We make key recommendations regarding digital pathway design in emergency medicine.

  12. Pharmacotherapies for decreasing maladaptive choice in drug addiction: Targeting the behavior and the drug.

    PubMed

    Perkins, Frank N; Freeman, Kevin B

    2018-01-01

    Drug addiction can be conceptualized as a disorder of maladaptive decision making in which drugs are chosen at the expense of pro-social, nondrug alternatives. The study of decision making in drug addiction has focused largely on the role of impulsivity as a facilitator of addiction, in particular the tendency for drug abusers to choose small, immediate gains over larger but delayed outcomes (i.e., delay discounting). A parallel line of work, also focused on decision making in drug addiction, has focused on identifying the determinants underlying the choice to take drugs over nondrug alternatives (i.e., drug vs. nondrug choice). Both tracks of research have been valuable tools in the development of pharmacotherapies for treating maladaptive decision making in drug addiction, and a number of common drugs have been studied in both designs. However, we have observed that there is little uniformity in the administration regimens of potential treatments between the designs, which hinders congruence in the development of single treatment strategies to reduce both impulsive behavior and drug choice. The current review provides an overview of the drugs that have been tested in both delay-discounting and drug-choice designs, and focuses on drugs that reduced the maladaptive choice in both designs. Suggestions to enhance congruence between the findings in future studies are provided. Finally, we propose the use of a hybridized, experimental approach that may enable researchers to test the effectiveness of therapeutics at decreasing impulsive and drug choice in a single design. Published by Elsevier Inc.

  13. Issues in Developing a Normative Descriptive Model for Dyadic Decision Making

    NASA Technical Reports Server (NTRS)

    Serfaty, D.; Kleinman, D. L.

    1984-01-01

    Most research in modelling human information processing and decision making has been devoted to the case of the single human operator. In the present effort, concepts from the fields of organizational behavior, engineering psychology, team theory and mathematical modelling are merged in an attempt to consider first the case of two cooperating decisionmakers (the Dyad) in a multi-task environment. Rooted in the well-known Dynamic Decision Model (DDM), the normative descriptive approach brings basic cognitive and psychophysical characteristics inherent to human behavior into a team theoretic analytic framework. An experimental paradigm, involving teams in dynamic decision making tasks, is designed to produce the data with which to build the theoretical model.

  14. Learning Theory Expertise in the Design of Learning Spaces: Who Needs a Seat at the Table?

    ERIC Educational Resources Information Center

    Rook, Michael M.; Choi, Koun; McDonald, Scott P.

    2015-01-01

    This study highlights the impact of including stakeholders with expertise in learning theory in a learning space design process. We present the decision-making process during the design of the Krause Innovation Studio on the campus of the Pennsylvania State University to draw a distinction between the architect and faculty member's decision-making…

  15. 76 FR 56466 - Notice of Intent to Prepare an Environmental Document and Proposed Plan Amendment for the West...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-13

    ... Vehicle Access Element of the CDCA Plan for the WEMO area; and (2) Alternative processes for designating.... Identification of the process and decision criteria that should be used to designate routes in the sub-regional... analysis, and guide the entire process from plan decision-making to route designation review in order to...

  16. Who has the D? How clear decision roles enhance organizational performance.

    PubMed

    Rogers, Paul; Blenko, Marcia

    2006-01-01

    Decisions are the coin of the realm in business. But even in highly respected companies, decisions can get stuck inside the organization like loose change. As a result, the entire decision-making process can stall, usually at one of four bottlenecks: global versus local, center versus business unit, function versus function, and inside versus outside partners. Decision-making bottlenecks can occur whenever there is ambiguity or tension over who gets to decide what. For example, do marketers or product developers get to decide the features of a new product? Should a major capital investment depend on the approval of the business unit that will own it, or should headquarters make the final call? Which decisions can be delegated to an outsourcing partner, and which must be made internally? Bain consultants Paul Rogers and Marcia Blenko use an approach called RAPID (recommend, agree, perform, input, and decide) to help companies unclog their decision-making bottlenecks by explicitly defining roles and responsibilities. For example, British American Tobacco struck a new balance between global and local decision making to take advantage of the company's scale while maintaining its agility in local markets. At Wyeth Pharmaceuticals, a growth opportunity revealed the need to push more decisions down to the business units. And at the UK department-store chain John Lewis, buyers and sales staff clarified their decision roles in order to implement a new strategy for selling its salt and pepper mills. When revamping its decision-making process, a company must take some practical steps: Align decision roles with the most important sources of value, make sure that decisions are made by the right people at the right levels of the organization, and let the people who will live with the new process help design it.

  17. Decision-making in chronic ecstasy users: a systematic review.

    PubMed

    Betzler, Felix; Viohl, Leonard; Romanczuk-Seiferth, Nina

    2017-01-01

    Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  18. PRA and Conceptual Design

    NASA Technical Reports Server (NTRS)

    DeMott, Diana; Fuqua, Bryan; Wilson, Paul

    2013-01-01

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

  19. The influence of discrete emotions on judgement and decision-making: a meta-analytic review.

    PubMed

    Angie, Amanda D; Connelly, Shane; Waples, Ethan P; Kligyte, Vykinta

    2011-12-01

    During the past three decades, researchers interested in emotions and cognition have attempted to understand the relationship that affect and emotions have with cognitive outcomes such as judgement and decision-making. Recent research has revealed the importance of examining more discrete emotions, showing that same-valence emotions (e.g., anger and fear) differentially impact judgement and decision-making outcomes. Narrative reviews of the literature (Lerner & Tiedens, 2006 ; Pham, 2007 ) have identified some under-researched topics, but provide a limited synthesis of findings. The purpose of this study was to review the research examining the influence of discrete emotions on judgement and decision-making outcomes and provide an assessment of the observed effects using a meta-analytic approach. Results, overall, show that discrete emotions have moderate to large effects on judgement and decision-making outcomes. However, moderator analyses revealed differential effects for study-design characteristics and emotion-manipulation characteristics by emotion type. Implications are discussed.

  20. 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.

  1. Applied Empiricism: Ensuring the Validity of Causal Response to Intervention Decisions

    ERIC Educational Resources Information Center

    Kilgus, Stephen P.; Collier-Meek, Melissa A.; Johnson, Austin H.; Jaffery, Rose

    2014-01-01

    School personnel make a variety of decisions within multitiered problem-solving frameworks, including the decision to assign a student to group-based support, to design an individualized support plan, or classify a student as eligible for special education. Each decision is founded upon a judgment regarding whether the student has responded to…

  2. Designing a Decision Support System (DSS) for Academic Library Managers Using Preprogrammed Application Software on a Microcomputer.

    ERIC Educational Resources Information Center

    McDonald, Joseph

    1986-01-01

    Focusing on management decisions in academic libraries, this article compares management information systems (MIS) with decision support systems (DSS) and discusses the decision-making process, information needs of library managers, sources of data, reasons for choosing microcomputer, preprogrammed application software, prototyping a system, and…

  3. Clinical Decision-Making in Community Children’s Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment

    PubMed Central

    Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

    2014-01-01

    Background Mental health professionals’ decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective The present study explored the role of prior training in evidence-based treatments on clinicians’ assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Methods Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog “think aloud” method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. Results MANOVA results were significant for EBT training status such that EBT trained clinicians’ displayed cognitive processes more closely aligned with “expert” decision-makers and non-EBT trained clinicians’ decision processes were more similar to “novice” decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. Conclusion This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians’ decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice. PMID:25892901

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

  5. The Impact of Video Gaming on Decision-Making and Teamworking Skills

    ERIC Educational Resources Information Center

    Campus-Wide Information Systems, 2005

    2005-01-01

    Purpose: To discuss the considerable impact of video gaming on young players' decision-making and teamworking skills, and the belief that video games provide an invaluable "training camp" for business. Design/methodology/approach: An interview with John Beck, the author of the book Got Game: How a New Generation of Gamers Is Reshaping Business…

  6. Land Ethics for Bureau of Land Management Employees

    Treesearch

    Duane DePaepe

    1992-01-01

    With increased public concern for public lands resource steward-ship, the Bureau of Land Management is more and more expected to make what is perceived as "right decisions." The ethical dimensions of often highly complex decision making processes have become more and more apparent. The baseline research presented here is designed to promote a land ethic...

  7. Making the Right Decisions: Leadership in 1-to-1 Computing in Education

    ERIC Educational Resources Information Center

    Towndrow, Phillip A.; Vallance, Michael

    2013-01-01

    Purpose: The purpose of this paper is to detail the necessity for more informed decision making and leadership in the implementation of 1-to-1 computing in education. Design/methodology/approach: The contexts of high-tech countries of Singapore and Japan are used as case studies to contextualize and support four evidence-based recommendations for…

  8. Introducing Decision Making under Uncertainty and Strategic Considerations in Engineering Design

    ERIC Educational Resources Information Center

    Kosmopoulou, Georgia; Jog, Chintamani; Freeman, Margaret; Papavassiliou, Dimitrios V.

    2010-01-01

    Chemical Engineering graduates will face challenges at the workplace that even their peers who graduated a few years ago were not expected to face. One such major challenge is the management and operation of companies and plants under conditions of uncertainty and the need to make decisions in competitive situations. Modern developments in…

  9. Factors Affecting Long-Term-Care Residents' Decision-Making Processes as They Formulate Advance Directives

    ERIC Educational Resources Information Center

    Lambert, Heather C.; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E. D.

    2005-01-01

    Purpose: The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. Design and Methods: This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a…

  10. The Contribution of Information Acquisition and Management Capacity to Administrators' Decision-Making Effectiveness in Tertiary Institutions in South-Western Nigeria

    ERIC Educational Resources Information Center

    Fabunmi, Martins; Erwat, Eseza Akiror

    2008-01-01

    This study investigated through empirical methods the extent to which information acquisition and information management capacity of administrators in tertiary institutions in South-Western Nigeria contributed to their decision-making effectiveness. It adopted the ex post facto survey research design, using the random sampling technique to select…

  11. Policymakers Dependence on Evidence in Education Decision Making in Oyo State Ministry of Education

    ERIC Educational Resources Information Center

    Babalola, Joel B.; Gbolahan, Sowunmi

    2016-01-01

    This study investigated policymaker dependence on evidence in education decision making in Oyo State Ministry of Education. The study was conducted under a descriptive survey design, 44 out of the 290 policymakers of the Ministry and Board of Education across the State were purposively selected for the study. Descriptive statistics of frequency…

  12. The Academic Game. A Simulation of Policy-Making in a University For 8 to 20 Players.

    ERIC Educational Resources Information Center

    Jaques, David

    The Academic Game, considered a valuable exercise for academics and administrators in investigating some of the problems of decision-making and possible ways of facilitating organizational decisions, is described. The major objective of the game is to achieve on agreed promotion policy. The roles and organization structure are designed to ensure…

  13. Facilitating Adoption of News Tool to Develop Clinical Decision Making

    ERIC Educational Resources Information Center

    Brown, Robin T.

    2017-01-01

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

  14. Examining Data-Driven Decision Making in Private/Religious Schools

    ERIC Educational Resources Information Center

    Hanks, Jason Edward

    2011-01-01

    The purpose of this study was to investigate non-mandated data-driven decision making in private/religious schools. The school culture support of data use, teacher use of data, leader facilitation of using data, and the availability of data were investigated in three schools. A quantitative survey research design was used to explore the research…

  15. Decision Making under Uncertainty: The Case of Adoption vs. Foster Care.

    ERIC Educational Resources Information Center

    Ambrosino, Robert J.

    This report provides a detailed description of Decision Analysis, a program designed to help social services administrators make informed judgments about the impact of implementing various program alternatives which compete for funding. A familiar example, whether to place a child in long term foster care or a permanent adoptive home is used to…

  16. Systematic behavior research for understanding consumer decision making.

    PubMed

    Lin, Chin-Feng

    2009-05-01

    This study incorporates means-end chain (MEC) theory and dynamic programming for understanding the implications of consumer decision making. The conceptual framework of this study can help programmers design information systems for analyzing consumption behaviors. Such analyses will provide marketers with meaningful information for formulating marketing strategies. The main contributions of this article are as follows: (1) to enable researchers to obtain information for consumer cognitive hierarchies utilizing an information system, (2) to enhance the functions of traditional MEC methodology and provide an integrated method for analyzing consumption information, and (3) to construct an information system for analyzing consumer decision-making processes.

  17. How the win-lose balance situation affects subsequent decision-making: functional magnetic resonance imaging evidence from a gambling task.

    PubMed

    Dong, G; Lin, X; Zhou, H; Lu, Q

    2014-07-11

    Humans have been consistently shown to be bad at making decisions, especially in disadvantageous situations. In this study, we designed a task that simulates real-life non-strategic gambling to examine the effect of win-lose balance situations (WIN, LOSS, TIE) on decision-making. In behavioral performances, participants showed shorter response time (RT) in LOSS than in WIN and TIE conditions. Imaging results revealed that decisions in WIN are associated with increased brain activations in the posterior cingulate cortex; decisions in LOSS are associated with increased brain activations in the insula and decreased activations in the inferior frontal gyrus (IFG). Positive correlation was found between brain activation in IFG and RT in LOSS. Overall, we concluded that, in disadvantageous conditions, participants are frustrated by their negative results and tend to make a random selection without full consideration. In advantageous conditions, participants' motivations to gamble are elicited and they tend to engage in more endeavors in making decisions. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  18. Concurrent engineering design and management knowledge capture

    NASA Technical Reports Server (NTRS)

    1990-01-01

    The topics are presented in viewgraph form and include the following: real-time management, personnel management, project management, conceptual design and decision making; the SITRF design problem; and the electronic-design notebook.

  19. Sound credit scores and financial decisions despite cognitive aging

    PubMed Central

    Li, Ye; Gao, Jie; Enkavi, A. Zeynep; Zaval, Lisa; Weber, Elke U.; Johnson, Eric J.

    2015-01-01

    Age-related deterioration in cognitive ability may compromise the ability of older adults to make major financial decisions. We explore whether knowledge and expertise accumulated from past decisions can offset cognitive decline to maintain decision quality over the life span. Using a unique dataset that combines measures of cognitive ability (fluid intelligence) and of general and domain-specific knowledge (crystallized intelligence), credit report data, and other measures of decision quality, we show that domain-specific knowledge and expertise provide an alternative route for sound financial decisions. That is, cognitive aging does not spell doom for financial decision-making in domains where the decision maker has developed expertise. These results have important implications for public policy and for the design of effective interventions and decision aids. PMID:25535381

  20. Collaborating with Youth to Inform and Develop Tools for Psychotropic Decision Making

    PubMed Central

    Murphy, Andrea; Gardner, David; Kutcher, Stan; Davidson, Simon; Manion, Ian

    2010-01-01

    Introduction: Youth oriented and informed resources designed to support psychopharmacotherapeutic decision-making are essentially unavailable. This article outlines the approach taken to design such resources, the product that resulted from the approach taken, and the lessons learned from the process. Methods: A project team with psychopharmacology expertise was assembled. The project team reviewed best practices regarding medication educational materials and related tools to support decisions. Collaboration with key stakeholders who were thought of as primary end-users and target groups occurred. A graphic designer and a plain language consultant were also retained. Results: Through an iterative and collaborative process over approximately 6 months, Med Ed and Med Ed Passport were developed. Literature and input from key stakeholders, in particular youth, was instrumental to the development of the tools and materials within Med Ed. A training program utilizing a train-the-trainer model was developed to facilitate the implementation of Med Ed in Ontario, which is currently ongoing. Conclusion: An evidence-informed process that includes youth and key stakeholder engagement is required for developing tools to support in psychopharmacotherapeutic decision-making. The development process fostered an environment of reciprocity between the project team and key stakeholders. PMID:21037916

  1. Recycling Decisions and Green Design.

    ERIC Educational Resources Information Center

    Lave, Lester B.; And Others

    1994-01-01

    Explores the facts and perceptions regarding recycling, what can be done to make products more environmentally compatible, and how to think about recycling decisions in a more helpful way. (Contains 39 references.) (MDH)

  2. A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

    PubMed

    Washington, Karla T; Oliver, Debra Parker; Gage, L Ashley; Albright, David L; Demiris, George

    2016-03-01

    Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

  3. New perspectives for motivating better decisions in older adults

    PubMed Central

    Strough, JoNell; de Bruin, Wändi Bruine; Peters, Ellen

    2015-01-01

    Decision-making competence in later adulthood is affected by declines in cognitive skills, and age-related changes in affect and experience can sometimes compensate. However, recent findings suggest that age-related changes in motivation also affect the extent to which adults draw from experience, affect, and deliberative skills when making decisions. To date, relatively little attention has been given to strategies for addressing age-related changes in motivation to promote better decisions in older adults. To address this limitation, we draw from diverse literatures to suggest promising intervention strategies for motivating older recipients’ motivation to make better decisions. We start by reviewing the life-span developmental literature, which suggests that older adults’ motivation to put effort into decisions depends on the perceived personal relevance of decisions as well as their self-efficacy (i.e., confidence in applying their ability and knowledge). Next, we discuss two approaches from the health intervention design literature, the mental models approach and the patient activation approach, which aim to improve motivation for decision making by improving personal relevance or by building self-efficacy or confidence to use new information and skills. Using examples from these literatures, we discuss how to construct interventions to motivate good decisions in later adulthood. PMID:26157398

  4. Complementary Cognitive Capabilities, Economic Decision-Making, and Aging

    PubMed Central

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

    2014-01-01

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

  5. Development of a Model of Interprofessional Shared Clinical Decision Making in the ICU: A Mixed-Methods Study.

    PubMed

    DeKeyser Ganz, Freda; Engelberg, Ruth; Torres, Nicole; Curtis, Jared Randall

    2016-04-01

    To develop a model to describe ICU interprofessional shared clinical decision making and the factors associated with its implementation. Ethnographic (observations and interviews) and survey designs. Three ICUs (two in Israel and one in the United States). A convenience sample of nurses and physicians. None. Observations and interviews were analyzed using ethnographic and grounded theory methodologies. Questionnaires included a demographic information sheet and the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration. From observations and interviews, we developed a conceptual model of the process of shared clinical decision making that involves four stepped levels, proceeding from the lowest to the highest levels of collaboration: individual decision, information exchange, deliberation, and shared decision. This process is influenced by individual, dyadic, and system factors. Most decisions were made at the lower two levels. Levels of perceived collaboration were moderate with no statistically significant differences between physicians and nurses or between units. Both qualitative and quantitative data corroborated that physicians and nurses from all units were similarly and moderately satisfied with their level of collaboration and shared decision making. However, most ICU clinical decision making continues to take place independently, where there is some sharing of information but rarely are decisions made collectively. System factors, such as interdisciplinary rounds and unit culture, seem to have a strong impact on this process. This study provides a model for further study and improvement of interprofessional shared decision making.

  6. Complementary cognitive capabilities, economic decision making, and aging.

    PubMed

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

    2013-09-01

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

  7. A Hybrid Backward-Forward Iterative Model for Improving Capacity Building of Earth Observations for Sustainable Societal Application

    NASA Astrophysics Data System (ADS)

    Hossain, F.; Iqbal, N.; Lee, H.; Muhammad, A.

    2015-12-01

    When it comes to building durable capacity for implementing state of the art technology and earth observation (EO) data for improved decision making, it has been long recognized that a unidirectional approach (from research to application) often does not work. Co-design of capacity building effort has recently been recommended as a better alternative. This approach is a two-way street where scientists and stakeholders engage intimately along the entire chain of actions from design of research experiments to packaging of decision making tools and each party provides an equal amount of input. Scientists execute research experiments based on boundary conditions and outputs that are defined as tangible by stakeholders for decision making. On the other hand, decision making tools are packaged by stakeholders with scientists ensuring the application-specific science is relevant. In this talk, we will overview one such iterative capacity building approach that we have implemented for gravimetry-based satellite (GRACE) EO data for improved groundwater management in Pakistan. We call our approach a hybrid approach where the initial step is a forward model involving a conventional short-term (3 day) capacity building workshop in the stakeholder environment addressing a very large audience. In this forward model, the net is cast wide to 'shortlist' a set of highly motivated stakeholder agency staffs who are then engaged more directly in 1-1 training. In the next step (the backward model), these short listed staffs are then brought back in the research environment of the scientists (supply) for 1-1 and long-term (6 months) intense brainstorming, training, and design of decision making tools. The advantage of this backward model is that it allows for a much better understanding for scientists of the ground conditions and hurdles of making a EO-based scientific innovation work for a specific decision making problem that is otherwise fundamentally impossible in conventional training workshops. We demonstrate here our experience of implementing this hybrid model for capacity building for groundwater management for Pakistan Council for Research on Water Resources (PCRWR) with the ultimate goal of empowering naitonal agencies in their ability to monitor groundwater storage changes independently from satellites.

  8. LIFE CYCLE ASSESSMENT IN MANAGEMENT, PRODUCT AND PROCESS DESIGN, AND POLICY DECISION MAKING: A CONFERENCE REPORT

    EPA Science Inventory

    On 24 September 2003, life cycle assessment (LCA) practitioners and decision makers gathered at the InLCA/LCM Conference in Seattle, Washington, USA (see http://www.lcacenter.org/InLCA-LCM03/index.html) to discuss the role of LCA in management, product design, process development...

  9. Instructional Design as Knowledge Management: A Knowledge-in-Practice Approach to Choosing Instructional Methods

    ERIC Educational Resources Information Center

    McIver, Derrick; Fitzsimmons, Stacey; Flanagan, David

    2016-01-01

    Decisions about instructional methods are becoming more complex, with options ranging from problem sets to experiential service-learning projects. However, instructors not trained in instructional design may make these important decisions based on convenience, comfort, or trends. Instead, this article draws on the knowledge management literature…

  10. Critical Issues in Telecollaborative Task Design

    ERIC Educational Resources Information Center

    O'Dowd, R.; Waire, P.

    2009-01-01

    In this article we examine how instructors make decisions about task design in telecollaboration and the factors that influence these decisions during the actual implementation of the tasks. We begin with a review of the recent literature of online intercultural exchanges to identify and describe a typology of 12 different types of tasks and task…

  11. Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial.

    PubMed

    Niedermeier, Martin; Weisleitner, Andreas; Lamm, Claus; Ledochowski, Larissa; Frühauf, Anika; Wille, Maria; Burtscher, Martin; Kopp, Martin

    2017-05-01

    Decision making is impaired in hypoxic environments, which may have serious or even lethal consequences for mountaineers. An acclimatisation period prior to high altitude exposures may help to overcome adverse effects of hypoxia. Thus, we investigated possible effects of short-term pre-acclimatisation on decision making in hypoxia. In a randomized controlled study design, 52 healthy participants were allocated to a hypoxia group (HG: short-term pre-acclimatisation by the use of intermittent hypoxia 7×1h at F i O 2 =12.6%, equivalent to 4500m) or a control group (CG: sham pre-acclimatisation 7×1h at F i O 2 =20.9%, equivalent to 600m). The number of risky decisions was assessed using the Game of Dice Task at four time points during a 12-hours stay in hypoxia (F i O 2 =12.6%). 42 (HG: 27, CG: 25) participants completed the study. The number of risky decisions was significantly (p=0.048 as determined by 4×2 ANCOVA) reduced in the hypoxia group compared to the control group, partial η 2 =0.11, when the age-effect on decision making was controlled. Self-reported positive affective valence prior to decision making was negatively related to the number of risky decisions, r<-0.38. Short-term pre-acclimatisation might influence decision making in hypoxia in a positive way and might be considered as a risk-reducing preparation method prior to exposures to hypoxic environments. Positive affective states seem to have a medium-sized protective effect against risky decision making. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Clinical decision-making described by Swedish prehospital emergency care nurse students - An exploratory study.

    PubMed

    Nilsson, Tomas; Lindström, Veronica

    2016-07-01

    The purpose of this study was to explore the PECN students' clinical decision-making during a seven-week clinical rotation in the ambulance services. Developing expertise in prehospital emergency care practices requires both theoretical and empirical learning. A prehospital emergency care nurse (PECN) is a Registered Nurse (RN) with one year of additional training in emergency care. There has been little investigation of how PECN students describe their decision-making during a clinical rotation. A qualitative study design was used, and 12 logbooks written by the Swedish PECN students were analysed using content analysis. The students wrote about 997 patient encounters - ambulance assignments during their clinical rotation. Four themes emerged as crucial for the students' decision-making: knowing the patient, the context-situation awareness in the ambulance service, collaboration, and evaluation. Based on the themes, students made decisions on how to respond to patients' illnesses. The PECN students used several variables in their decision-making. The decision- making was an on-going process during the whole ambulance assignment. The university has the responsibility to guide the students during their transition from an RN to a PECN. The findings of the study can support the educators and clinical supervisors in developing the programme of study for becoming a PECN. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Now or Later? An fMRI study of the effects of endogenous opioid blockade on a decision-making network

    PubMed Central

    Boettiger, Charlotte A.; Kelley, Elizabeth A.; Mitchell, Jennifer M.; D’Esposito, Mark; Fields, Howard L.

    2009-01-01

    Previously, we found that distinct brain areas predict individual selection bias in decisions between small immediate (“Now”) and larger delayed rewards (“Later”). Furthermore, such selection bias can be manipulated by endogenous opioid blockade. To test whether blocking endogenous opioids with Naltrexone (NTX) alters brain activity during decision-making in areas predicting individual bias, we compared fMRI BOLD signal correlated with Now versus Later decision-making after acute administration of NTX (50 mg) or placebo. We tested abstinent alcoholics and control subjects in a double-blind two-session design. We defined regions of interest (ROI) centered on activation peaks predicting Now versus Later selection bias. NTX administration significantly increased BOLD signal during decision-making in the right lateral orbital gyrus ROI, an area where enhanced activity during decision-making predicts Later bias. Exploratory analyses identified additional loci where BOLD signal during decision-making was enhanced (left orbitofrontal cortex, left inferior temporal gyrus, and cerebellum) or reduced (right superior temporal pole) by NTX. Additional analyses identified sites, including the right lateral orbital gyrus, in which NTX effects on BOLD signal predicted NTX effects on selection bias. These data agree with opioid receptor expression in human frontal and temporal cortices, and suggest possible mechanisms of NTX’s therapeutic effects. PMID:19258022

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

    PubMed

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

    2009-05-01

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

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

    Radojcic, Riko; Nowak, Matt; Nakamoto, Mark

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

  16. Cognitive considerations for helmet-mounted display design

    NASA Astrophysics Data System (ADS)

    Francis, Gregory; Rash, Clarence E.

    2010-04-01

    Helmet-mounted displays (HMDs) are designed as a tool to increase performance. To achieve this, there must be an accurate transfer of information from the HMD to the user. Ideally, an HMD would be designed to accommodate the abilities and limitations of users' cognitive processes. It is not enough for the information (whether visual, auditory, or tactual) to be displayed; the information must be perceived, attended, remembered, and organized in a way that guides appropriate decision-making, judgment, and action. Following a general overview, specific subtopics of cognition, including perception, attention, memory, knowledge, decision-making, and problem solving are explored within the context of HMDs.

  17. Translational Cognition for Decision Support in Critical Care Environments: A Review

    PubMed Central

    Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

    2008-01-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

  18. Translational cognition for decision support in critical care environments: a review.

    PubMed

    Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

    2008-06-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

  19. Cognitive and Emotional Factors Predicting Decisional Conflict among High-Risk Breast Cancer Survivors Who Receive Uninformative BRCA1/2 Results

    PubMed Central

    Rini, Christine; O’Neill, Suzanne C.; Valdimarsdottir, Heiddis; Goldsmith, Rachel E.; DeMarco, Tiffani A.; Peshkin, Beth N.; Schwartz, Marc D.

    2012-01-01

    Objective To investigate high-risk breast cancer survivors’ risk reduction decision making and decisional conflict after an uninformative BRCA1/2 test. Design Prospective, longitudinal study of 182 probands undergoing BRCA1/2 testing, with assessments 1-, 6-, and 12-months post-disclosure. Measures Primary predictors were health beliefs and emotional responses to testing assessed 1-month post-disclosure. Main outcomes included women’s perception of whether they had made a final risk management decision (decision status) and decisional conflict related to this issue. Results There were four patterns of decision making, depending on how long it took women to make a final decision and the stability of their decision status across assessments. Late decision makers and non-decision makers reported the highest decisional conflict; however, substantial numbers of women—even early and intermediate decision makers—reported elevated decisional conflict. Analyses predicting decisional conflict 1- and 12-months post-disclosure found that, after accounting for controls and decision status, health beliefs and emotional factors predicted decisional conflict at different timepoints, with health beliefs more important one month after test disclosure and health beliefs more important one year later. Conclusion Many of these women may benefit from decision making assistance. PMID:19751083

  20. Decision-making strategies: ignored to the detriment of healthcare training and delivery?

    PubMed Central

    Desmond, Chris; Brubaker, Kathryn A.; Ellner, Andrew L.

    2013-01-01

    Context: People do not always make health-related decisions which reflect their best interest – best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods: We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings: The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions: These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care. PMID:25264501

  1. Decision-making strategies: ignored to the detriment of healthcare training and delivery?

    PubMed

    Desmond, Chris; Brubaker, Kathryn A; Ellner, Andrew L

    2013-01-01

    Context : People do not always make health-related decisions which reflect their best interest - best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods : We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings : The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions : These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care.

  2. The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

    PubMed

    Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

    2013-06-01

    The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

  3. Integrated model for assessing the cost and CO2 emission (IMACC) for sustainable structural design in ready-mix concrete.

    PubMed

    Hong, Taehoon; Ji, Changyoon; Park, Hyoseon

    2012-07-30

    Cost has traditionally been considered the most important factor in the decision-making process. Recently, along with the consistent interest in environmental problems, environmental impact has also become a key factor. Accordingly, there is a need to develop a method that simultaneously reflects the cost and environmental impact in the decision-making process. This study proposed an integrated model for assessing the cost and CO(2) emission (IMACC) at the same time. IMACC is a model that assesses the cost and CO(2) emission of the various structural-design alternatives proposed in the structural-design process. To develop the IMACC, a standard on assessing the cost and CO(2) emission generated in the construction stage was proposed, along with the CO(2) emission factors in the structural materials, based on such materials' strengths. Moreover, using the economic and environmental scores that signify the cost and CO(2) emission reduction ratios, respectively, a method of selecting the best design alternative was proposed. To verify the applicability of IMACC, practical application was carried out. Structural designs were assessed, each of which used 21, 24, 27, and 30 MPa ready-mix concrete (RMC). The use of IMACC makes it easy to verify what the best design is. Results show the one that used 27 MPa RMC was the best design. Therefore, the proposed IMACC can be used as a tool for supporting the decision-making process in selecting the best design alternative. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Developing an Analytical Framework: Incorporating Ecosystem Services into Decision Making - Proceedings of a Workshop

    USGS Publications Warehouse

    Hogan, Dianna; Arthaud, Greg; Pattison, Malka; Sayre, Roger G.; Shapiro, Carl

    2010-01-01

    The analytical framework for understanding ecosystem services in conservation, resource management, and development decisions is multidisciplinary, encompassing a combination of the natural and social sciences. This report summarizes a workshop on 'Developing an Analytical Framework: Incorporating Ecosystem Services into Decision Making,' which focused on the analytical process and on identifying research priorities for assessing ecosystem services, their production and use, their spatial and temporal characteristics, their relationship with natural systems, and their interdependencies. Attendees discussed research directions and solutions to key challenges in developing the analytical framework. The discussion was divided into two sessions: (1) the measurement framework: quantities and values, and (2) the spatial framework: mapping and spatial relationships. This workshop was the second of three preconference workshops associated with ACES 2008 (A Conference on Ecosystem Services): Using Science for Decision Making in Dynamic Systems. These three workshops were designed to explore the ACES 2008 theme on decision making and how the concept of ecosystem services can be more effectively incorporated into conservation, restoration, resource management, and development decisions. Preconference workshop 1, 'Developing a Vision: Incorporating Ecosystem Services into Decision Making,' was held on April 15, 2008, in Cambridge, MA. In preconference workshop 1, participants addressed what would have to happen to make ecosystem services be used more routinely and effectively in conservation, restoration, resource management, and development decisions, and they identified some key challenges in developing the analytical framework. Preconference workshop 3, 'Developing an Institutional Framework: Incorporating Ecosystem Services into Decision Making,' was held on October 30, 2008, in Albuquerque, NM; participants examined the relationship between the institutional framework and the use of ecosystem services in decision making.

  5. Design of an Aircrew Scheduling Decision Aid for the 6916th Electronic Security Squadron.

    DTIC Science & Technology

    1987-06-01

    Security Classification) Design of an Aircrew Scheduling Decision Aid for the 6916th Electronic Security Squadron 12. PERSONAL AUTHOR(S) Thomas J. Kopf...Because of the great number of possible scheduling alternatives, it is difficult to find an optimal solution to-the scheduling problem. Additionally...changes to the original schedule make it even more difficult to find an optimal solution. The emergence of capable microcompu- ters, decision support

  6. Internet use and decision making in community-based older adults

    PubMed Central

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

    2013-01-01

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

  7. Trait-related decision-making impairment in the three phases of bipolar disorder.

    PubMed

    Adida, Marc; Jollant, Fabrice; Clark, Luke; Besnier, Nathalie; Guillaume, Sébastien; Kaladjian, Arthur; Mazzola-Pomietto, Pascale; Jeanningros, Régine; Goodwin, Guy M; Azorin, Jean-Michel; Courtet, Philippe

    2011-08-15

    In bipolar disorder (BD), little is known about how deficits in neurocognitive functions such as decision-making are related to phase of illness. We predicted that manic, depressed, and euthymic bipolar patients (BPs) would display impaired decision-making, and we tested whether clinical characteristics could predict patients' decision-making performance. Subjects (N = 317; age range: 18-65 years) including 167 BPs (45 manic and 32 depressed inpatients, and 90 euthymic outpatients) and 150 age-, IQ-, and gender-matched healthy control (HC) participants, were included within three university psychiatric hospitals using a cross-sectional design. The relationship between predictor variables and decision-making was assessed by one-step multivariate analysis. The main outcome measures were overall decision-making ability on the Iowa Gambling Task (IGT) and an index of sensitivity to punishment frequency. Manic, depressed, and euthymic BPs selected significantly more cards from the risky decks than HCs (p < .001, p < .01, and p < .05, respectively), with no significant differences between the three BD groups. However, like HCs, BPs preferred decks that yielded infrequent penalties over those yielding frequent penalties. In multivariate analysis, decision-making impairment was significantly (p < .001) predicted by low level of education, high depressive scores, family history of BD, use of benzodiazepines, and nonuse of serotonin and norepinephrine reuptake inhibitor (SNRI) antidepressants. BPs have a trait-related impairment in decision-making that does not vary across illness phase. However, some subtle differences between the BD groups in the individual deck analyses may point to subtle state influences on reinforcement mechanisms, in addition to a more fundamental trait impairment in risk-sensitive decision making. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Hierarchical analysis of bridge decision makers : the role of new technology adoption in the timber bridge market : special project fiscal year 1992

    DOT National Transportation Integrated Search

    1995-08-01

    Bridge design engineers and local highway officials make bridge replacement decisions across the : United States. The Analytical Hierarchy Process was used to characterize the bridge material selection : decision of these individuals. State Departmen...

  9. Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions?

    PubMed Central

    Sivell, Stephanie; Edwards, Adrian; Elwyn, Glyn; Manstead, Antony S. R.

    2010-01-01

    Abstract Objective  To describe the evidence about factors influencing breast cancer patients’ surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). Background  A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients’ representations of their breast cancer and predicting surgery choices. Design  Literature search and narrative synthesis of data. Synthesis  Twenty‐six studies reported women’s surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. Conclusions  The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients’ surgery choices. PMID:20579123

  10. A survey of decision tree classifier methodology

    NASA Technical Reports Server (NTRS)

    Safavian, S. R.; Landgrebe, David

    1991-01-01

    Decision tree classifiers (DTCs) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps the most important feature of DTCs is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issues. After considering potential advantages of DTCs over single-state classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

  11. A survey of decision tree classifier methodology

    NASA Technical Reports Server (NTRS)

    Safavian, S. Rasoul; Landgrebe, David

    1990-01-01

    Decision Tree Classifiers (DTC's) are used successfully in many diverse areas such as radar signal classification, character recognition, remote sensing, medical diagnosis, expert systems, and speech recognition. Perhaps, the most important feature of DTC's is their capability to break down a complex decision-making process into a collection of simpler decisions, thus providing a solution which is often easier to interpret. A survey of current methods is presented for DTC designs and the various existing issue. After considering potential advantages of DTC's over single stage classifiers, subjects of tree structure design, feature selection at each internal node, and decision and search strategies are discussed.

  12. Development of a support tool for complex decision-making in the provision of rural maternity care.

    PubMed

    Hearns, Glen; Klein, Michael C; Trousdale, William; Ulrich, Catherine; Butcher, David; Miewald, Christiana; Lindstrom, Ronald; Eftekhary, Sahba; Rosinski, Jessica; Gómez-Ramírez, Oralia; Procyk, Andrea

    2010-02-01

    Decisions in the organization of safe and effective rural maternity care are complex, difficult, value laden and fraught with uncertainty, and must often be based on imperfect information. Decision analysis offers tools for addressing these complexities in order to help decision-makers determine the best use of resources and to appreciate the downstream effects of their decisions. To develop a maternity care decision-making tool for the British Columbia Northern Health Authority (NH) for use in low birth volume settings. Based on interviews with community members, providers, recipients and decision-makers, and employing a formal decision analysis approach, we sought to clarify the influences affecting rural maternity care and develop a process to generate a set of value-focused objectives for use in designing and evaluating rural maternity care alternatives. Four low-volume communities with variable resources (with and without on-site births, with or without caesarean section capability) were chosen. Physicians (20), nurses (18), midwives and maternity support service providers (4), local business leaders, economic development officials and elected officials (12), First Nations (women [pregnant and non-pregnant], chiefs and band members) (40), social workers (3), pregnant women (2) and NH decision-makers/administrators (17). We developed a Decision Support Manual to assist with assessing community needs and values, context for decision-making, capacity of the health authority or healthcare providers, identification of key objectives for decision-making, developing alternatives for care, and a process for making trade-offs and balancing multiple objectives. The manual was deemed an effective tool for the purpose by the client, NH. Beyond assisting the decision-making process itself, the methodology provides a transparent communication tool to assist in making difficult decisions. While the manual was specifically intended to deal with rural maternity issues, the NH decision-makers feel the method can be easily adapted to assist decision-making in other contexts in medicine where there are conflicting objectives, values and opinions. Decisions on the location of new facilities or infrastructure, or enhancing or altering services such as surgical or palliative care, would be examples of complex decisions that might benefit from this methodology.

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

    PubMed Central

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

    2014-01-01

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

  14. Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study

    PubMed Central

    Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

    2018-01-01

    ABSTRACT Purpose: Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. Method: The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. Results: The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. Conclusion: The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures. PMID:29405889

  15. Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study.

    PubMed

    Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

    2018-12-01

    Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

  16. Consumer Decision-Making Styles for Sport Apparel: Gender Comparisons between College Consumers

    ERIC Educational Resources Information Center

    Bae, Sungwon; Miller, John

    2009-01-01

    The purpose of this study was to identify the decision-making styles of college students for sports apparel. Modifying the Consumer Style Inventory (CSI) developed by Sproles and Kendall (1986), a quantitative research design was developed to analyze the effect of seven factors. Eight-hundred and twenty-two subjects composed of 376 male and 446…

  17. Project S.P.I.C.E. Special Partnership in Career Education. Decision Making/Beginning Competency. A Teaching Module.

    ERIC Educational Resources Information Center

    Volusia County Schools, Daytona Beach, FL.

    This fourth in a series of six teaching modules on decision making/beginning competency is part of the Special Partnership in Career Education (SPICE) program, which was designed to provide career awareness and exploration information to junior high-aged educable mentally handicapped students. The module follows a typical format that includes two…

  18. Motivational Activities for High School Economics, Keyed to the New York State Syllabus "Economics and Economic Decision Making."

    ERIC Educational Resources Information Center

    Dawson, George G.

    This manual provides secondary school teachers with ideas for relating economics to student needs, interests, and experiences. The tentative syllabus "Economics and Economic Decision Making," designed for 12th grade social studies by the New York State Education Department in 1987, is used as a guide. Motivational activities for the 18…

  19. Ethical Leadership in Education and Its Relation to Ethical Decision-Making: The Case of Arab School Leaders in Israel

    ERIC Educational Resources Information Center

    Arar, Khalid; Haj, Ibrahim; Abramovitz, Ruth; Oplatka, Izhar

    2016-01-01

    Purpose: The purpose of this paper is to investigate ethical leadership in the context of the Arab educational system in Israel. It questions the relations of ethical leadership dimensions with decision making as well as background characteristics of the educational leaders. Design/methodology/approach: Arab educational leaders (n=150) from…

  20. Developing a Decision-Making Plan for the Reading Teacher. Learning Package No. 25.

    ERIC Educational Resources Information Center

    Smith, Carl, Comp.

    Originally developed for the Department of Defense Schools (DoDDS) system, this learning package on developing a decision-making plan for the reading teacher is designed for teachers who wish to upgrade or expand their teaching skills on their own. The package includes a comprehensive search of the ERIC database; a lecture giving an overview on…

  1. Decision-Making and the Law in Higher Education--Emphasis on Student Rights: Essay and Bibliography.

    ERIC Educational Resources Information Center

    Tice, Terrence N.

    The essay and bibliography presented here are designed for general use among those concerned with questions of campus rights and responsibilities and with the application of legal principles in campus decision-making. The primary focus is on student rights issues. The discussion falls into three parts: (1) "Law and Morality in the Open Society" is…

  2. The Evolving Role of the Courts in Educational Policy: The Tension between Judicial, Scientific, and Democratic Decision Making in "Kitzmiller v. Dover"

    ERIC Educational Resources Information Center

    Superfine, Benjamin Michael

    2009-01-01

    In "Kitzmiller v. Dover" (2005), a court defined science to decide the legitimacy of teaching intelligent design to high school biology students. This study analyzes "Kitzmiller" in light of the complex and interrelated tensions between judicial, scientific, and democratic decision making that lie at the heart of modern…

  3. Planning a school physics experiment

    NASA Astrophysics Data System (ADS)

    Blasiak, Wladyslaw

    1986-09-01

    One is continually faced with the need to make decisions; physics, might form the vehicle for teaching the difficult art of decision making. Teachers should direct the abilities and skills of their students toward optimising the choices with which they are faced. Examples of such choices occur in the design of physics experiments and this therefore offers a good opportunity for such instruction.

  4. Decision Making Regarding Access to Training and Development in Medium-Sized Enterprises: An Exploratory Study Using the Critical Incident Technique

    ERIC Educational Resources Information Center

    Coetzer, Alan; Redmond, Janice; Sharafizad, Jalleh

    2012-01-01

    Purpose: The purpose of this paper is to develop an understanding of factors that impinge on managerial decision-making processes regarding employee access to structured training and development (T&D) opportunities that are at least partially funded by the firm. Design/methodology/approach: Semi-structured interviews incorporating the Critical…

  5. Evaluating a Teaching Module on Ethically Responsible Evidence-Based Practice Decision Making in an Advanced Micro Practice Course

    ERIC Educational Resources Information Center

    Wong, Rose

    2017-01-01

    This article adds to the growing body of literature on the use of evidence-based practice (EBP) in social work. Specifically, it examines a 9-hour EBP educational model designed to prepare MSW students for appropriate decision-making strategies in working with multicultural client populations. The model places emphasis on identification and…

  6. Assessing the Desired and Actual Levels of Teachers' Participation in Decision-Making in Secondary Schools of Ethiopia

    ERIC Educational Resources Information Center

    Bademo, Yismaw; Tefera, Bekalu Ferede

    2016-01-01

    This study was conducted to assess the desired and actual levels of teachers' participation in decision-making process in Ethiopian secondary schools. For this, the study employed a cross-sectional survey design collecting data from sampled secondary school teachers (n = 258) found in Assosa Zone, Benishangual Gumuz Regional state, Ethiopia.…

  7. Goal Setting, Decision-Making Skills and Academic Performance of Undergraduate Distance Learners: Implications for Retention and Support Services

    ERIC Educational Resources Information Center

    Tanglang, Nebath; Ibrahim, Aminu Kazeem

    2015-01-01

    The study adopted an ex-post facto research design. Randomization sampling technique was used to select 346 undergraduate distance learners and the learners were grouped into four, High and Low Goal setter learners and High and Low Decision-making skills learners. The instruments for data collection were Undergraduate Academic Goal Setting Scale…

  8. Fair Play: Developing Self-Concept and Decision-Making Skills in the Middle School. Implementation Handbook.

    ERIC Educational Resources Information Center

    Florida State Univ., Tallahassee.

    This handbook is designed to assist schools in carrying out the following goals of the Fair Play program: to strengthen and expand students' female or male self-concepts, to increase their decision-making skills, and to increase their academic achievement by changing their stereotypic attitude toward particular content areas. The Fair Play program…

  9. Making Meaningful Decisions about Time, Workload and Pedagogy in the Digital Age: The Course Resource Appraisal Model

    ERIC Educational Resources Information Center

    Kennedy, Eileen; Laurillard, Diana; Horan, Bernard; Charlton, Patricia

    2015-01-01

    This article reports on a design-based research project to create a modelling tool to analyse the costs and learning benefits involved in different modes of study. The Course Resource Appraisal Model (CRAM) provides accurate cost-benefit information so that institutions are able to make more meaningful decisions about which kind of…

  10. Randomized Controlled Trial to Evaluate an Abuse Prevention Curriculum for Women and Men with Intellectual and Developmental Disabilities

    ERIC Educational Resources Information Center

    Hickson, Linda; Khemka, Ishita; Golden, Harriet; Chatzistyli, Aikaterini

    2015-01-01

    This study was designed (a) to assess the impact of the "ESCAPE-DD" curriculum on the decision-making skills of adults with intellectual and developmental disabilities (IDD) in hypothetical situations of abuse, (b) to examine the role of problem awareness, and (c) to identify factors associated with posttest decision-making performance.…

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

    PubMed

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

    2016-09-01

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

  12. Biomedical Informatics for Computer-Aided Decision Support Systems: A Survey

    PubMed Central

    Belle, Ashwin; Kon, Mark A.; Najarian, Kayvan

    2013-01-01

    The volumes of current patient data as well as their complexity make clinical decision making more challenging than ever for physicians and other care givers. This situation calls for the use of biomedical informatics methods to process data and form recommendations and/or predictions to assist such decision makers. The design, implementation, and use of biomedical informatics systems in the form of computer-aided decision support have become essential and widely used over the last two decades. This paper provides a brief review of such systems, their application protocols and methodologies, and the future challenges and directions they suggest. PMID:23431259

  13. The relationship between female adolescent self-esteem, decision making, and contraceptive behavior.

    PubMed

    Commendador, Kathleen

    2007-11-01

    To examine the relationship between female adolescent self-esteem, decision making, and contraceptive behavior in multiethnic, 14- to 17-year-olds, residing on the Big Island of Hawaii. This was a descriptive cross-sectional survey design using a convenience sample of 98 female adolescents aged 14-17 who came to five different clinics on the Big Island of Hawaii for health care. Along with a brief demographic questionnaire, global self-esteem was measured by Rosenberg's Self-Esteem Scale, decision making was measured by the Flinders Adolescent Decision Making Questionnaire, and sexual activity and contraception use was measured by a nonnormed Sexual History and Contraceptive Use Questionnaire developed for this study. Descriptive statistics, logistic regression, and correlations were used to analyze associations and correlations between age, global self-esteem, decision self-esteem, decision coping (vigilant and maladaptive), and contraceptive use for sexually active female adolescents. No significant associations or correlations were found between age, global self-esteem, decision self-esteem, decision coping (vigilance), and the decision to use contraception in sexually active adolescent females. There was, however, significant negative correlation (p < .05) between overall maladaptive decision making and contraceptive use in sexually active female adolescents. This suggests that sexually active adolescent females with higher maladaptive scores are less likely to use contraception. There was also significant association (p < .05) between maladaptive decision making in contraceptive use and sexually active female adolescents. For every one unit increase on the maladaptive scale, the odds of using contraception were estimated to decrease by 7%. Adolescence is a period of transition that involves biological, cognitive, psychological, and social changes. During the vulnerable transition period of adolescence, decisions relating to contraception may occur. Interventions focused on improving decision-making skills and stimulating thinking around not only sexual issues but also on relationship and communication in adolescent issues may facilitate more competent decision making. Understanding the relationship between female adolescent self-esteem, decision making, and contraceptive behavior has contributed to the knowledge base about female contraceptive behavior. Gaining further insight into these relationships will help healthcare professionals provide counseling and health care to female adolescents.

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

    PubMed Central

    Bunn, Frances; Goodman, Claire

    2018-01-01

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

  15. Information and decision-making needs among people with mental disorders: a systematic review of the literature.

    PubMed

    Tlach, Lisa; Wüsten, Caroline; Daubmann, Anne; Liebherz, Sarah; Härter, Martin; Dirmaier, Jörg

    2015-12-01

    Assessment of users' information and decision-making needs is one key step in the development of decision-support interventions. To identify patients' information and decision-making needs as a pre-requisite for the development of high-quality web-based patient decision aids (PtDAs) for common mental disorders. A systematic MEDLINE search for papers published until December 2012 was conducted, and reference lists of included articles and relevant reviews were searched. Original studies containing data on information or decision-making needs of adults with depression, anxiety disorders, somatoform disorders, alcohol-related disorders and schizophrenia were included. Data extraction was performed using a standardized form, and data synthesis was conducted using a theory-based deductive approach by two independent reviewers. Studies were quality assessed using the Mixed Methods Appraisal Tool. Twelve studies were included focusing on information needs or the identification of decisions patients with depression and schizophrenia were facing. No studies were found for the other mental disorders. Overall, seven information needs categories were identified with the topics 'basic facts', 'treatment' and 'coping' being of major relevance. Six decision categories were identified of which decisions on 'medication' and 'treatment setting' were most often classified. This review reveals that patients with schizophrenia and depression show extensive information and decision-making needs. The identified needs can initially inform the design of PtDAs for schizophrenia and depression. However, there is an urgent need to investigate information and decision-making needs among patients with other mental disorders. © 2014 John Wiley & Sons Ltd.

  16. Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department

    PubMed Central

    Melnick, Edward R.; Lopez, Kevin; Hess, Erik P.; Abujarad, Fuad; Brandt, Cynthia A.; Shiffman, Richard N.; Post, Lori A.

    2015-01-01

    Context: Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider’s already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a clinical scenario that could benefit from CDS but has failed previous implementation attempts. Case Description: This case study follows the user-centered design (UCD) approach to build a bedside aid that is useful and usable, and that promotes shared decision-making between patients and their providers using a tablet computer at the bedside. The patient-centered decision support design process focuses on the prototype build using agile software development, but also describes the following: (1) the requirement gathering phase including triangulated qualitative research (focus groups and cognitive task analysis) to understand current challenges, (2) features for patient education, the physician, and shared decision-making, (3) system architecture and technical requirements, and (4) future plans for formative usability testing and field testing. Lessons Learned: We share specific lessons learned and general recommendations from critical insights gained in the patient-centered decision support design process about early stakeholder engagement, EHR integration, external expert feedback, challenges to two users on a single device, project management, and accessibility. Conclusions: Successful implementation of this tool will require seamless integration into the provider’s workflow. This protocol can create an effective interface for shared decision-making and safe resource reduction at the bedside in the austere and dynamic clinical environment of the ED and is generalizable for these purposes in other clinical environments as well. PMID:26290885

  17. Back to the Bedside: Developing a Bedside Aid for Concussion and Brain Injury Decisions in the Emergency Department.

    PubMed

    Melnick, Edward R; Lopez, Kevin; Hess, Erik P; Abujarad, Fuad; Brandt, Cynthia A; Shiffman, Richard N; Post, Lori A

    2015-01-01

    Current information-rich electronic health record (EHR) interfaces require large, high-resolution screens running on desktop computers. This interface compromises the provider's already limited time at the bedside by physically separating the patient from the doctor. The case study presented here describes a patient-centered clinical decision support (CDS) design process that aims to bring the physician back to the bedside by integrating a patient decision aid with CDS for shared use by the patient and provider on a touchscreen tablet computer for deciding whether or not to obtain a CT scan for minor head injury in the emergency department, a clinical scenario that could benefit from CDS but has failed previous implementation attempts. This case study follows the user-centered design (UCD) approach to build a bedside aid that is useful and usable, and that promotes shared decision-making between patients and their providers using a tablet computer at the bedside. The patient-centered decision support design process focuses on the prototype build using agile software development, but also describes the following: (1) the requirement gathering phase including triangulated qualitative research (focus groups and cognitive task analysis) to understand current challenges, (2) features for patient education, the physician, and shared decision-making, (3) system architecture and technical requirements, and (4) future plans for formative usability testing and field testing. We share specific lessons learned and general recommendations from critical insights gained in the patient-centered decision support design process about early stakeholder engagement, EHR integration, external expert feedback, challenges to two users on a single device, project management, and accessibility. Successful implementation of this tool will require seamless integration into the provider's workflow. This protocol can create an effective interface for shared decision-making and safe resource reduction at the bedside in the austere and dynamic clinical environment of the ED and is generalizable for these purposes in other clinical environments as well.

  18. A conceptual framework for effectively anticipating water-quality changes resulting from changes in agricultural activities

    USGS Publications Warehouse

    Capel, Paul D.; Wolock, David M.; Coupe, Richard H.; Roth, Jason L.

    2018-01-10

    Agricultural activities can affect water quality and the health of aquatic ecosystems; many water-quality issues originate with the movement of water, agricultural chemicals, and eroded soil from agricultural areas to streams and groundwater. Most agricultural activities are designed to sustain or increase crop production, while some are designed to protect soil and water resources. Numerous soil- and water-protection practices are designed to reduce the volume and velocity of runoff and increase infiltration. This report presents a conceptual framework that combines generalized concepts on the movement of water, the environmental behavior of chemicals and eroded soil, and the designed functions of various agricultural activities, as they relate to hydrology, to create attainable expectations for the protection of—with the goal of improving—water quality through changes in an agricultural activity.The framework presented uses two types of decision trees to guide decision making toward attainable expectations regarding the effectiveness of changing agricultural activities to protect and improve water quality in streams. One decision tree organizes decision making by considering the hydrologic setting and chemical behaviors, largely at the field scale. This decision tree can help determine which agricultural activities could effectively protect and improve water quality in a stream from the movement of chemicals, or sediment, from a field. The second decision tree is a chemical fate accounting tree. This decision tree helps set attainable expectations for the permanent removal of sediment, elements, and organic chemicals—such as herbicides and insecticides—through trapping or conservation tillage practices. Collectively, this conceptual framework consolidates diverse hydrologic settings, chemicals, and agricultural activities into a single, broad context that can be used to set attainable expectations for agricultural activities. This framework also enables better decision making for future agricultural activities as a means to reduce current, and prevent new, water-quality issues.

  19. Effects of Information Visualization on Older Adults' Decision-Making Performance in a Medicare Plan Selection Task: A Comparative Usability Study.

    PubMed

    Price, Margaux M; Crumley-Branyon, Jessica J; Leidheiser, William R; Pak, Richard

    2016-06-01

    Technology gains have improved tools for evaluating complex tasks by providing environmental supports (ES) that increase ease of use and improve performance outcomes through the use of information visualizations (info-vis). Complex info-vis emphasize the need to understand individual differences in abilities of target users, the key cognitive abilities needed to execute a decision task, and the graphical elements that can serve as the most effective ES. Older adults may be one such target user group that would benefit from increased ES to mitigate specific declines in cognitive abilities. For example, choosing a prescription drug plan is a necessary and complex task that can impact quality of life if the wrong choice is made. The decision to enroll in one plan over another can involve comparing over 15 plans across many categories. Within this context, the large amount of complex information and reduced working memory capacity puts older adults' decision making at a disadvantage. An intentionally designed ES, such as an info-vis that reduces working memory demand, may assist older adults in making the most effective decision among many options. The objective of this study is to examine whether the use of an info-vis can lower working memory demands and positively affect complex decision-making performance of older adults in the context of choosing a Medicare prescription drug plan. Participants performed a computerized decision-making task in the context of finding the best health care plan. Data included quantitative decision-making performance indicators and surveys examining previous history with purchasing insurance. Participants used a colored info-vis ES or a table (no ES) to perform the decision task. Task difficulty was manipulated by increasing the number of selection criteria used to make an accurate decision. A repeated measures analysis was performed to examine differences between the two table designs. Twenty-three older adults between the ages of 66 and 80 completed the study. There was a main effect for accuracy such that older adults made more accurate decisions in the color info-vis condition than the table condition. In the low difficulty condition, participants were more successful at choosing the correct answer when the question was about the gap coverage attribute in the info-vis condition. Participants also made significantly faster decisions in the info-vis condition than in the table condition. Reducing the working memory demand of the task through the use of an ES can improve decision accuracy, especially when selection criteria is only focused on a single attribute of the insurance plan.

  20. Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses.

    PubMed

    Syrowatka, Ania; Krömker, Dörthe; Meguerditchian, Ari N; Tamblyn, Robyn

    2016-01-26

    Patient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids. The first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making. Relevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making. Of 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than others. Integration of content control improved quality of decision making (SMD 0.59 vs 0.23 for knowledge; SMD 0.39 vs 0.29 for decisional conflict). In contrast, tailoring reduced quality of decision making (SMD 0.40 vs 0.71 for knowledge; SMD 0.25 vs 0.52 for decisional conflict). Similarly, patient narratives also reduced quality of decision making (SMD 0.43 vs 0.65 for knowledge; SMD 0.17 vs 0.46 for decisional conflict). Results were varied for different types of explicit values clarification, feedback, and social support. Integration of media rich or interactive features into computer-based decision aids can improve quality of preference-sensitive decision making. However, this is an emerging field with limited evidence to guide use. The systematic review and thematic synthesis identified features that have been integrated into available computer-based decision aids, in an effort to facilitate reporting of these features and to promote integration of such features into decision aids. The meta-analyses and associated subgroup analyses provide preliminary evidence to support integration of specific features into future decision aids. Further research can focus on clarifying independent contributions of specific features through experimental designs and refining the designs of features to improve effectiveness.

  1. Dying cancer patients talk about physician and patient roles in DNR decision making

    PubMed Central

    Eliott, Jaklin A.; Olver, Ian

    2011-01-01

    Abstract Background  Within medical and bioethical discourse, there are many models depicting the relationships between, and roles of, physician and patient in medical decision making. Contestation similarly exists over the roles of physician and patient with regard to the decision not to provide cardiopulmonary resuscitation (CPR) following cardiac arrest [the do‐not‐resuscitate or do‐not‐resuscitate (DNR) decision], but there is little analysis of patient perspectives. Objective  Analyse what patients with cancer within weeks before dying say about the decision to forego CPR and the roles of patient and physician in this decision. Design and participants  Discursive analysis of qualitative data gathered during semi‐structured interviews with 28 adult cancer patients close to death and attending palliative or oncology clinics of an Australian teaching hospital. Results  Participants’ descriptions of appropriate patient or physician roles in decisions about CPR appeared related to how they conceptualized the decision: as a personal or a medical issue, with patient and doctor respectively identified as appropriate decision makers; or alternatively, both medical and personal, with various roles assigned embodying different versions of a shared decision‐making process. Participants’ endorsement of physicians as decision makers rested upon physicians’ enactment of the rational, knowledgeable and compassionate expert, which legitimized entrusting them to make the DNR decision. Where this was called into question, physicians were positioned as inappropriate decision makers. Conclusion  When patients’ and physicians’ understandings of the best decision, or of the preferred role of either party, diverge, conflict may ensue. In order to elicit and negotiate with patient preferences, flexibility is required during clinical interactions about decision making. PMID:20860782

  2. Subjective costs drive overly patient foraging strategies in rats on an intertemporal foraging task.

    PubMed

    Wikenheiser, Andrew M; Stephens, David W; Redish, A David

    2013-05-14

    Laboratory studies of decision making often take the form of two-alternative, forced-choice paradigms. In natural settings, however, many decision problems arise as stay/go choices. We designed a foraging task to test intertemporal decision making in rats via stay/go decisions. Subjects did not follow the rate-maximizing strategy of choosing only food items associated with short delays. Instead, rats were often willing to wait for surprisingly long periods, and consequently earned a lower rate of food intake than they might have by ignoring long-delay options. We tested whether foraging theory or delay discounting models predicted the behavior we observed but found that these models could not account for the strategies subjects selected. Subjects' behavior was well accounted for by a model that incorporated a cost for rejecting potential food items. Interestingly, subjects' cost sensitivity was proportional to environmental richness. These findings are at odds with traditional normative accounts of decision making but are consistent with retrospective considerations having a deleterious influence on decisions (as in the "sunk-cost" effect). More broadly, these findings highlight the utility of complementing existing assays of decision making with tasks that mimic more natural decision topologies.

  3. Subjective costs drive overly patient foraging strategies in rats on an intertemporal foraging task

    PubMed Central

    Wikenheiser, Andrew M.; Stephens, David W.; Redish, A. David

    2013-01-01

    Laboratory studies of decision making often take the form of two-alternative, forced-choice paradigms. In natural settings, however, many decision problems arise as stay/go choices. We designed a foraging task to test intertemporal decision making in rats via stay/go decisions. Subjects did not follow the rate-maximizing strategy of choosing only food items associated with short delays. Instead, rats were often willing to wait for surprisingly long periods, and consequently earned a lower rate of food intake than they might have by ignoring long-delay options. We tested whether foraging theory or delay discounting models predicted the behavior we observed but found that these models could not account for the strategies subjects selected. Subjects’ behavior was well accounted for by a model that incorporated a cost for rejecting potential food items. Interestingly, subjects’ cost sensitivity was proportional to environmental richness. These findings are at odds with traditional normative accounts of decision making but are consistent with retrospective considerations having a deleterious influence on decisions (as in the “sunk-cost” effect). More broadly, these findings highlight the utility of complementing existing assays of decision making with tasks that mimic more natural decision topologies. PMID:23630289

  4. Assessment of cognitive bias in decision-making and leadership styles among critical care nurses: a mixed methods study.

    PubMed

    Lean Keng, Soon; AlQudah, Hani Nawaf Ibrahim

    2017-02-01

    To raise awareness of critical care nurses' cognitive bias in decision-making, its relationship with leadership styles and its impact on care delivery. The relationship between critical care nurses' decision-making and leadership styles in hospitals has been widely studied, but the influence of cognitive bias on decision-making and leadership styles in critical care environments remains poorly understood, particularly in Jordan. Two-phase mixed methods sequential explanatory design and grounded theory. critical care unit, Prince Hamza Hospital, Jordan. Participant sampling: convenience sampling Phase 1 (quantitative, n = 96), purposive sampling Phase 2 (qualitative, n = 20). Pilot tested quantitative survey of 96 critical care nurses in 2012. Qualitative in-depth interviews, informed by quantitative results, with 20 critical care nurses in 2013. Descriptive and simple linear regression quantitative data analyses. Thematic (constant comparative) qualitative data analysis. Quantitative - correlations found between rationality and cognitive bias, rationality and task-oriented leadership styles, cognitive bias and democratic communication styles and cognitive bias and task-oriented leadership styles. Qualitative - 'being competent', 'organizational structures', 'feeling self-confident' and 'being supported' in the work environment identified as key factors influencing critical care nurses' cognitive bias in decision-making and leadership styles. Two-way impact (strengthening and weakening) of cognitive bias in decision-making and leadership styles on critical care nurses' practice performance. There is a need to heighten critical care nurses' consciousness of cognitive bias in decision-making and leadership styles and its impact and to develop organization-level strategies to increase non-biased decision-making. © 2016 John Wiley & Sons Ltd.

  5. Factors associated with oncology patients' involvement in shared decision making during chemotherapy.

    PubMed

    Colley, Alexis; Halpern, Jodi; Paul, Steven; Micco, Guy; Lahiff, Maureen; Wright, Fay; Levine, Jon D; Mastick, Judy; Hammer, Marilyn J; Miaskowski, Christine; Dunn, Laura B

    2017-11-01

    Oncology patients are increasingly encouraged to play an active role in treatment decision making. While previous studies have evaluated relationships between demographic characteristics and decision-making roles, less is known about the association of symptoms and psychological adjustment characteristics (eg, coping styles and personality traits) and decision-making roles. As part of a larger study of symptom clusters, patients (n = 765) receiving chemotherapy for breast, gastrointestinal, gynecological, or lung cancer provided information on demographic, clinical, symptom, and psychological adjustment characteristics. Patient-reported treatment decision-making roles (ie, preferred role and role actually played) were assessed using the Control Preferences Scale. Differences among patients, who were classified as passive, collaborative, or active, were evaluated using χ 2 analyses and analyses of variance. Over half (56.3%) of the patients reported that they both preferred and actually played a collaborative role. Among those patients with concordant roles, those who were older, those with less education and lower income, and those who were less resilient were more likely to prefer a passive role. Several psychological adjustment characteristics were associated with decision-making role, including coping style, personality, and fatalism. Oncology patients' preferences for involvement in treatment decision making are associated with demographic characteristics as well as with symptoms and psychological adjustment characteristics, such as coping style and personality. These results reaffirm the complexities of predicting patients' preferences for involvement in decision making. Further study is needed to determine if role or coping style may be influenced by interventions designed to teach adaptive coping skills. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Simulation software: engineer processes before reengineering.

    PubMed

    Lepley, C J

    2001-01-01

    People make decisions all the time using intuition. But what happens when you are asked: "Are you sure your predictions are accurate? How much will a mistake cost? What are the risks associated with this change?" Once a new process is engineered, it is difficult to analyze what would have been different if other options had been chosen. Simulating a process can help senior clinical officers solve complex patient flow problems and avoid wasted efforts. Simulation software can give you the data you need to make decisions. The author introduces concepts, methodologies, and applications of computer aided simulation to illustrate their use in making decisions to improve workflow design.

  7. An optimal brain can be composed of conflicting agents

    PubMed Central

    Livnat, Adi; Pippenger, Nicholas

    2006-01-01

    Many behaviors have been attributed to internal conflict within the animal and human mind. However, internal conflict has not been reconciled with evolutionary principles, in that it appears maladaptive relative to a seamless decision-making process. We study this problem through a mathematical analysis of decision-making structures. We find that, under natural physiological limitations, an optimal decision-making system can involve “selfish” agents that are in conflict with one another, even though the system is designed for a single purpose. It follows that conflict can emerge within a collective even when natural selection acts on the level of the collective only. PMID:16492775

  8. Focus group positioning and analysis: a commentary on adjuncts for enhancing the design of health care research.

    PubMed

    Johnson, B C

    1990-01-01

    As health care competition increases, and as the penalties for making poor decisions become potentially more devastating, market research continues to play an increasingly important role in the decision-making process for hospitals. Concern over the appropriate use of market research and the costs related to it remains high. As such, efficiency in research design and clarity in research outcome are clearly the goals. This paper examines the focus group process and its adjunctive role in enhancing the overall design of health care market research. Specifically, the function and placement of focus groups within the research plan as well as several methods of creative focus group analysis are considered within the context of an effective research design.

  9. Dynamic fMRI of a decision-making task

    NASA Astrophysics Data System (ADS)

    Singh, Manbir; Sungkarat, Witaya

    2008-03-01

    A novel fMRI technique has been developed to capture the dynamics of the evolution of brain activity during complex tasks such as those designed to evaluate the neural basis of decision-making under different situations. A task called the Iowa Gambling Task was used as an example. Six normal human volunteers were studied. The task was presented inside a 3T MRI and a dynamic fMRI study of the approximately 2s period between the beginning and end of the decision-making period was conducted by employing a series of reference functions, separated by 200 ms, designed to capture activation at different time-points within this period. As decision-making culminates with a button-press, the timing of the button press was chosen as the reference (t=0) and corresponding reference functions were shifted backward in steps of 200ms from this point up to the time when motor activity from the previous button press became predominant. SPM was used to realign, high-pass filter (cutoff 200s), normalize to the Montreal Neurological Institute (MNI) Template using a 12 parameter affine/non-linear transformation, 8mm Gaussian smoothing, and event-related General Linear Model analysis for each of the shifted reference functions. The t-score of each activated voxel was then examined to find its peaking time. A random effect analysis (p<0.05) showed prefrontal, parietal and bi-lateral hippocampal activation peaking at different times during the decision making period in the n=6 group study.

  10. Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

    PubMed

    Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

    2016-06-01

    Although barriers to shared decision making in intensive care units are well documented, there are currently no easily scaled interventions to overcome these problems. We sought to assess stakeholders' perceptions of the acceptability, usefulness, and design suggestions for a tablet-based tool to support communication and shared decision making in ICUs. We conducted in-depth semi-structured interviews with 58 key stakeholders (30 surrogates and 28 ICU care providers). Interviews explored stakeholders' perceptions about the acceptability of a tablet-based tool to support communication and shared decision making, including the usefulness of modules focused on orienting families to the ICU, educating them about the surrogate's role, completing a question prompt list, eliciting patient values, educating about treatment options, eliciting perceptions about prognosis, and providing psychosocial support resources. The interviewer also elicited stakeholders' design suggestions for such a tool. We used constant comparative methods to identify key themes that arose during the interviews. Overall, 95% (55/58) of participants perceived the proposed tool to be acceptable, with 98% (57/58) of interviewees finding six or more of the seven content domains acceptable. Stakeholders identified several potential benefits of the tool including that it would help families prepare for the surrogate role and for family meetings as well as give surrogates time and a framework to think about the patient's values and treatment options. Key design suggestions included: conceptualize the tool as a supplement to rather than a substitute for surrogate-clinician communication; make the tool flexible with respect to how, where, and when surrogates can access the tool; incorporate interactive exercises; use video and narration to minimize the cognitive load of the intervention; and build an extremely simple user interface to maximize usefulness for individuals with low computer literacy. There is broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. A qualitative evaluation of the crucial attributes of contextual information necessary in EHR design to support patient-centered medical home care.

    PubMed

    Weir, Charlene R; Staggers, Nancy; Gibson, Bryan; Doing-Harris, Kristina; Barrus, Robyn; Dunlea, Robert

    2015-04-16

    Effective implementation of a Primary Care Medical Home model of care (PCMH) requires integration of patients' contextual information (physical, mental, social and financial status) into an easily retrievable information source for the healthcare team and clinical decision-making. This project explored clinicians' perceptions about important attributes of contextual information for clinical decision-making, how contextual information is expressed in CPRS clinical documentation as well as how clinicians in a highly computerized environment manage information flow related to these areas. A qualitative design using Cognitive Task Analyses and a modified Critical Incident Technique were used. The study was conducted in a large VA with a fully implemented EHR located in the western United States. Seventeen providers working in a PCMH model of care in Primary Care, Home Based Care and Geriatrics reported on a recent difficult transition requiring contextual information for decision-making. The transcribed interviews were qualitatively analyzed for thematic development related to contextual information using an iterative process and multiple reviewers with ATLAS@ti software. Six overarching themes emerged as attributes of contextual information: Informativeness, goal language, temporality, source attribution, retrieval effort, and information quality. These results indicate that specific attributes are needed to in order for contextual information to fully support clinical decision-making in a Medical Home care delivery environment. Improved EHR designs are needed for ease of contextual information access, displaying linkages across time and settings, and explicit linkages to both clinician and patient goals. Implications relevant to providers' information needs, team functioning and EHR design are discussed.

  12. Decision blocks: A tool for automating decision making in CLIPS

    NASA Technical Reports Server (NTRS)

    Eick, Christoph F.; Mehta, Nikhil N.

    1991-01-01

    The human capability of making complex decision is one of the most fascinating facets of human intelligence, especially if vague, judgemental, default or uncertain knowledge is involved. Unfortunately, most existing rule based forward chaining languages are not very suitable to simulate this aspect of human intelligence, because of their lack of support for approximate reasoning techniques needed for this task, and due to the lack of specific constructs to facilitate the coding of frequently reoccurring decision block to provide better support for the design and implementation of rule based decision support systems. A language called BIRBAL, which is defined on the top of CLIPS, for the specification of decision blocks, is introduced. Empirical experiments involving the comparison of the length of CLIPS program with the corresponding BIRBAL program for three different applications are surveyed. The results of these experiments suggest that for decision making intensive applications, a CLIPS program tends to be about three times longer than the corresponding BIRBAL program.

  13. Decision Support Model for Introduction of Gamification Solution Using AHP

    PubMed Central

    2014-01-01

    Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform. PMID:24892075

  14. Decision support model for introduction of gamification solution using AHP.

    PubMed

    Kim, Sangkyun

    2014-01-01

    Gamification means the use of various elements of game design in nongame contexts including workplace collaboration, marketing, education, military, and medical services. Gamification is effective for both improving workplace productivity and motivating employees. However, introduction of gamification is not easy because the planning and implementation processes of gamification are very complicated and it needs interdisciplinary knowledge such as information systems, organization behavior, and human psychology. Providing a systematic decision making method for gamification process is the purpose of this paper. This paper suggests the decision criteria for selection of gamification platform to support a systematic decision making process for managements. The criteria are derived from previous works on gamification, introduction of information systems, and analytic hierarchy process. The weights of decision criteria are calculated through a survey by the professionals on game, information systems, and business administration. The analytic hierarchy process is used to derive the weights. The decision criteria and weights provided in this paper could support the managements to make a systematic decision for selection of gamification platform.

  15. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

    PubMed

    Pieterse, Arwen H; de Vries, Marieke

    2013-09-01

    Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

  16. On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis

    PubMed Central

    Pieterse, Arwen H.; de Vries, Marieke

    2011-01-01

    Abstract Background  Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference‐sensitive health‐care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic‐based VCMs. Objective  To critically analyse the suitability of the ‘take the best’ (TTB) and ‘tallying’ fast and frugal heuristics in the context of patient decision making. Strategy  Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. Conclusion  The specific nature of patient preference‐sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. PMID:21902770

  17. Incapacitated Surrogates: A New and Increasing Dilemma in Hospital Care.

    PubMed

    Smith, Karen L; Fedel, Patrice; Heitman, Jay

    2017-01-01

    A power of attorney for healthcare (POAHC) form gives designated individuals legal status to make healthcare decisions when patients are unable to convey their decisions to medical staff. Completion of a POAHC form is crucial in the provision of comprehensive healthcare, since it helps to ensure that patients' interests, values, and preferences are represented in decisions about their medical treatment. Because increasing numbers of people suffer from debilitating illness and cognitive deficits, healthcare systems may be called upon to navigate the complexities of patients' care without clear directives from the patients themselves. Hence, the healthcare industry encourages all individuals to complete a POAHC form to ensure that persons who have the patients' trust are able to act as their surrogate decision makers. However, sometimes POAHC agents, even when they are patients' trusted agents, lack the capacity to make fully informed decisions that are in the patients' best interests. We describe designated surrogate decision makers who have impaired or diminished judgment capacity as incapacitated surrogates. Decision making that is obviously flawed or questionable is a significant impediment to providing timely and appropriate care to patients. Moreover, failure to redress these issues in a timely and efficient manner can result in significant costs to an institution and a diminished quality of patient care. The authors offer a legal, ethical, and interdisciplinary framework to help navigate cases of incapacitated surrogates. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

  18. Selection of adequate site location during early stages of construction project management: A multi-criteria decision analysis approach

    NASA Astrophysics Data System (ADS)

    Marović, Ivan; Hanak, Tomaš

    2017-10-01

    In the management of construction projects special attention should be given to the planning as the most important phase of decision-making process. Quality decision-making based on adequate and comprehensive collaboration of all involved stakeholders is crucial in project’s early stages. Fundamental reasons for existence of this problem arise from: specific conditions of construction industry (final products are inseparable from the location i.e. location has a strong influence of building design and its structural characteristics as well as technology which will be used during construction), investors’ desires and attitudes, and influence of socioeconomic and environment aspects. Considering all mentioned reasons one can conclude that selection of adequate construction site location for future investment is complex, low structured and multi-criteria problem. To take into account all the dimensions, the proposed model for selection of adequate site location is devised. The model is based on AHP (for designing the decision-making hierarchy) and PROMETHEE (for pairwise comparison of investment locations) methods. As a result of mixing basis feature of both methods, operational synergies can be achieved in multi-criteria decision analysis. Such gives the decision-maker a sense of assurance, knowing that if the procedure proposed by the presented model has been followed, it will lead to a rational decision, carefully and systematically thought out.

  19. Medical Decision-Making Among Adolescents with Neonatal Brachial Plexus Palsy and their Families: A Qualitative Study

    PubMed Central

    Squitieri, Lee; Larson, Bradley P.; Chang, Kate W-C; Yang, Lynda J-S.; Chung, Kevin C.

    2016-01-01

    Background Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with NBPP and their families faced with making complex treatment decisions. The experiences of these patients and their parents were analyzed to identify key factors in the decision-making process. Patients and Methods Eighteen adolescents with residual NBPP deficits between the ages of 10 to 17 years along with their parents were included in the present study. A qualitative research design was employed involving the use of separate one hour, in person, semi-structured interviews, which were audio recorded and transcribed. Grounded theory was applied by two independent members of the research team to identify recurrent themes and ultimately create a codebook that was then applied to the data. Results Medical decision-making among adolescents with NBPP and their families is multifaceted and individualized, comprised of both patient and system dependent factors. Four codes pertaining to the medical decision-making process were identified: 1) knowledge acquisition, 2) multidisciplinary care, 3) adolescent autonomy, and 4) patient expectations and treatment desires. Overall, parental decision-making was heavily influenced by system dependent factors, while adolescents largely based their medical decision-making on individual treatment desires to improve function and/or aesthetics. Conclusions There are many areas for improving the delivery of information and health care organization among adolescents with NBPP and their families. We recommend the development of educational interdisciplinary programs and decision aids containing evidence-based management guidelines targeted toward primary care providers and patients. We believe that a computer-based learning module may provide the best avenue to achieve maximum penetrance and convenience of information sharing. PMID:23714810

  20. Current understanding of decision-making in adolescents with cancer: A narrative systematic review

    PubMed Central

    Day, Emma; Jones, Louise; Langner, Richard; Bluebond-Langner, Myra

    2016-01-01

    Background: Policy guidance and bioethical literature urge the involvement of adolescents in decisions about their healthcare. It is uncertain how roles and expectations of adolescents, parents and healthcare professionals influence decision-making and to what extent this is considered in guidance. Aims: To identify recent empirical research on decision-making regarding care and treatment in adolescent cancer: (1) to synthesise evidence to define the role of adolescents, parents and healthcare professionals in the decision-making process and (2) to identify gaps in research. Design: A narrative systematic review of qualitative, quantitative and mixed-methods research. We adopted a textual approach to synthesis, using a theoretical framework of interactionism to interpret findings. Data Sources: The databases MEDLINE, PsycINFO, SCOPUS, EMBASE and CINHAL were searched from 2001 through May 2015 for publications on decision-making for adolescents (13–19 years) with cancer. Results: Twenty-eight articles were identified. Adolescents and parents initially find it difficult to participate in decision-making due to a lack of options in the face of protocol-driven care. Parent and adolescent preferences for information and response to loss of control vary between individuals and over time. No studies indicate parental or adolescent preference for a high degree of independence in decision-making. Conclusion: Striving to make parents and adolescents fully informed or urge them towards more independence than they prefer may add to distress and confusion. This may interfere with their ability to participate in their preferred way in decisions about care and treatment. Future research should include analysis of on-ground interactions among parents, adolescents and clinicians across the trajectory. PMID:27160700

  1. TACtic- A Multi Behavioral Agent for Trading Agent Competition

    NASA Astrophysics Data System (ADS)

    Khosravi, Hassan; Shiri, Mohammad E.; Khosravi, Hamid; Iranmanesh, Ehsan; Davoodi, Alireza

    Software agents are increasingly being used to represent humans in online auctions. Such agents have the advantages of being able to systematically monitor a wide variety of auctions and then make rapid decisions about what bids to place in what auctions. They can do this continuously and repetitively without losing concentration. To provide a means of evaluating and comparing (benchmarking) research methods in this area the trading agent competition (TAC) was established. This paper describes the design, of TACtic. Our agent uses multi behavioral techniques at the heart of its decision making to make bidding decisions in the face of uncertainty, to make predictions about the likely outcomes of auctions, and to alter the agent's bidding strategy in response to the prevailing market conditions.

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

    PubMed

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

    2015-01-01

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

  3. Linking data to decision-making: applying qualitative data analysis methods and software to identify mechanisms for using outcomes data.

    PubMed

    Patel, Vaishali N; Riley, Anne W

    2007-10-01

    A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate.

  4. Preliminary testing of a just‐in‐time, user‐defined values clarification exercise to aid lower literate women in making informed breast cancer treatment decisions

    PubMed Central

    Jibaja‐Weiss, Maria L.; Volk, Robert J.; Friedman, Lois C.; Granchi, Thomas S.; Neff, Nancy E.; Spann, Stephen J.; Robinson, Emily K.; Aoki, Noriaki; Robert Beck, J.

    2006-01-01

    Abstract Objective  To report on the initial testing of a values clarification exercise utilizing a jewellery box within a computerized patient decision aid (CPtDA) designed to assist women in making a surgical breast cancer treatment decision. Design  Pre‐post design, with patients interviewed after diagnosis, and then after completing the CPtDA sometime later at their preoperative visit. Sample  Fifty‐one female patients, who are low literate and naïve computer users, newly diagnosed with early stage breast cancer from two urban public hospitals. Intervention  A computerized decision aid that combines entertainment‐education (edutainment) with enhanced (factual) content. An interactive jewellery box is featured to assist women in: (1) recording and reflecting over issues of concern with possible treatments, (2) deliberating over surgery decision, and (3) communicating with physician and significant others. Outcomes  Patients’ use of the jewellery box to store issues during completion of the CPtDA, and perceived clarity of values in making a treatment decision, as measured by a low literacy version of the Decisional Conflict Scale (DCS). Results  Over half of the participants utilized the jewellery box to store issues they found concerning about the treatments. On average, users flagged over 13 issues of concern with the treatments. Scores on the DCS Uncertainty and Feeling Unclear about Values subscales were lower after the intervention compared to before the decision was made. Conclusions  A values clarification exercise using an interactive jewellery box may be a promising method for promoting informed treatment decision making by low literacy breast cancer patients. PMID:16911136

  5. Role of pharmacoeconomic analysis in R&D decision making: when, where, how?

    PubMed

    Miller, Paul

    2005-01-01

    Pharmacoeconomics is vitally important to drug manufacturers in terms of communicating to external decision-makers (payers, prescribers, patients) the value of their products, achieving regulatory and reimbursement approval and contributing to commercial success. Since development of new drugs is long, costly and risky, and decisions must be made how to allocate considerable research and development (R&D) resources, pharmacoeconomics also has an essential role informing internal decision-making (within a company) during drug development. The use of pharmacoeconomics in early development phases is likely to enhance the efficiency of R&D resource use and also provide a solid foundation for communicating product value to external decision-makers further downstream, increasing the likelihood of regulatory (reimbursement) approval and commercial success. This paper puts the case for use of pharmacoeconomic analyses earlier in the development process and outlines five techniques (clinical trial simulation [CTS], option pricing [OP], investment appraisal [IA], threshold analysis [TA] and value of information [VOI] analysis) that can provide useful input into the design of clinical development programmes, portfolio management and optimal pricing strategy. CTS can estimate efficacy and tolerability profiles before clinical data are available. OP can show the value of different clinical programme designs, sequencing of studies and stop decisions. IA can compare expected net present value (NPV) of different product profiles or study designs. TA can be used to understand development drug profile requirements given partial data. VOI can assist risk management by quantifying uncertainty and assessing the economic viability of gathering further information on the development drug. No amount of pharmacoeconomic data can make a bad drug good; what it can do is enhance the drug developers understanding of the characteristics of that drug. Decision-making, in light of this information, is likely to be better than that without it, whether it leads to faster termination of uneconomic projects or the allocation of more appropriate resources to attractive projects.

  6. Theory-based design and field-testing of an intervention to support women choosing surgery for breast cancer: BresDex.

    PubMed

    Sivell, Stephanie; Marsh, William; Edwards, Adrian; Manstead, Antony S R; Clements, Alison; Elwyn, Glyn

    2012-02-01

    Design and undertake usability and field-testing evaluation of a theory-guided decision aid (BresDex) in supporting women choosing surgery for early breast cancer. An extended Theory of Planned Behavior (TPB) and the Common Sense Model of Illness Representations (CSM) guided the design of BresDex. BresDex was evaluated and refined across 3 cycles by interviewing 6 women without personal history of breast cancer, 8 women with personal history of breast cancer who had completed treatment and 11 women newly diagnosed with breast cancer. Participants were interviewed for views on content, presentation (usability) and perceived usefulness towards deciding on treatment (utility). Framework analysis was used, guided by the extended TPB and the CSM. BresDex was positively received in content and presentation (usability). It appeared an effective support to decision-making and useful source for further information, particularly in clarifying attitudes, social norms and perceived behavioral control, and presenting consequences of decisions (utility). This study illustrates the potential benefit of the extended TPB and CSM in designing a decision aid to support women choosing breast cancer surgery. BresDex could provide decision-making support and serve as an additional source of information, to complement the care received from the clinical team. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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

    PubMed Central

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

    2011-01-01

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

  8. Using Visualization in Cockpit Decision Support Systems

    NASA Technical Reports Server (NTRS)

    Aragon, Cecilia R.

    2005-01-01

    In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

  9. Influential factors on treatment decision making among patients with colorectal cancer: A scoping review.

    PubMed

    Cranley, Nicole M; Curbow, Barbara; George, Thomas J; Christie, Juliette

    2017-09-01

    In recent years, a greater emphasis has been placed on shared decision-making (SDM) techniques between providers and patients with the goal of helping patients make informed decisions about their care and subsequently to improve patient health outcomes. Previous research has shown variability in treatment decision-making among patients with colorectal cancer (CRC), and there is little comprehensive information available to help explain this variability. Thus, the purpose of this study was to evaluate the current state of the literature on factors that are influential in treatment decision-making among patients with CRC. A priori search terms using Boolean connectors were used to examine PubMed, PsycINFO, Web of Science, CINAHL, and MEDLINE for relevant studies. Eligibility criteria for inclusion in the study included patients with CRC and examination of influences on CRC treatment decision-making. All relevant data were extracted including, author, title and year, study methodology, and study results. Findings (n = 13) yielded influences in four areas: informational, patient treatment goals, patient role preferences, and relationship with provider. Quality of life and trust in physician were rated a high priority among patients when making decisions between different therapeutic options. Several studies found that patients wanted to be informed and involved but did not necessarily want to make autonomous treatment choices, with many preferring a more passive role. Providers who initiate a dialog to better understand their patients' treatment goals can establish rapport, increase patient understanding of treatment options, and help patients assume their desired role in their decision-making. Overall, there were a small number of studies that met all inclusion criteria with most used a cross-sectional design.

  10. Early Design Energy Analysis Using Building Information Modeling Technology

    DTIC Science & Technology

    2011-11-01

    building, (a) floor plan and (b) 3D image. ....................................... 50 Figure 28. Comparison of different energy estimates...when they make the biggest impact on building life-cycle costs. Traditionally, most building energy analyses have been conducted late in design, by...complete energy analysis. This method enables project teams to make energy conscious decisions early in design when they impact building life-cycle

  11. End-of-Life Decision Making for Nursing Home Residents with Dementia: A Survey of Nursing Home Social Services Staff

    ERIC Educational Resources Information Center

    Lacey, Debra

    2006-01-01

    The purpose of this survey was to describe nursing home social services staff roles and perceptions related to end-of-life medical decision making for nursing home residents in endstage dementia. Using a self-designed questionnaire, 138 nursing home social services staff from across New York State answered questions about advance directives,…

  12. Linking science and decision making to promote an ecology for the city: practices and opportunities

    Treesearch

    Morgan Grove; Daniel L. Childers; Michael Galvin; Sarah J. Hines; Tischa Munoz-Erickson; Erika S. Svendsen

    2016-01-01

    To promote urban sustainability and resilience, there is an increasing demand for actionable science that links science and decision making based on social–ecological knowledge. Approaches, frameworks, and practices for such actionable science are needed and have only begun to emerge. We propose that approaches based on the co- design and co- production of knowledge...

  13. Improving the Career Decision-Making Behaviour of Working Class Students: Do Economic Barriers Stand in the Way?

    ERIC Educational Resources Information Center

    Greenbank, Paul; Hepworth, Sue

    2008-01-01

    Purpose: This paper aims to examine the extent to which economic factors influence the career decision-making process of working class students. Design/methodology/approach: The study involved an initial survey of 165 final-year students from a range of degree programmes. It was followed by in-depth interviews with 30 working class students.…

  14. Structural Equation Models of Management and Decision-Making Styles with Job Satisfaction of Academic Staff in Malaysian Research University

    ERIC Educational Resources Information Center

    Amzat, Ismail Hussein; Idris, Datuk Abdul Rahman

    2012-01-01

    Purpose: The purpose of this paper is to discuss the effect of management and decision-making styles on the job satisfaction of academic staff in a Malaysian Research University. Design/methodology/approach: The sample consisted of 218 respondents. The instruments used in the study were the Teacher Job Satisfaction Questionnaire and the Decision…

  15. Case Study: An Examination of the Decision Making Process for Selecting Simulations for an Online MBA Program

    ERIC Educational Resources Information Center

    Neely, Pat; Tucker, Jan

    2013-01-01

    Purpose: Simulations are designed as activities which imitate real world scenarios and are often used to teach and enhance skill building. The purpose of this case study is to examine the decision making process and outcomes of a faculty committee tasked with examining simulations in the marketplace to determine if the simulations could be used as…

  16. Call for shared decision making in China: Challenges and opportunities.

    PubMed

    Yao, Mi; Finnikin, Samuel; Cheng, K K

    2017-06-01

    China's healthcare system has undergone extensive changes over recent years and the most recent reforms are designed to shift the emphasis away from hospital based services towards a more primary care based system. There is an increasing recognition that shared decision making needs to play a central role in the delivery of healthcare in China, but there are several significant barriers to overcome before this aspiration becomes a reality. Doctor-patient relationships in China are poor, consultations are often brief transactions and levels of trust are low. Implementing a shared decision making process developed in the Western World may be hampered by cultural differences, although this remains an under-researched area. There is, however, a suggestion that the academic community is starting to take an interest in encouraging shared decision making in practice and indications that the Chinese public may be willing to consider this new approach to healthcare. Copyright © 2017. Published by Elsevier GmbH.

  17. An Agent-Based Model of Farmer Decision Making in Jordan

    NASA Astrophysics Data System (ADS)

    Selby, Philip; Medellin-Azuara, Josue; Harou, Julien; Klassert, Christian; Yoon, Jim

    2016-04-01

    We describe an agent based hydro-economic model of groundwater irrigated agriculture in the Jordan Highlands. The model employs a Multi-Agent-Simulation (MAS) framework and is designed to evaluate direct and indirect outcomes of climate change scenarios and policy interventions on farmer decision making, including annual land use, groundwater use for irrigation, and water sales to a water tanker market. Land use and water use decisions are simulated for groups of farms grouped by location and their behavioural and economic similarities. Decreasing groundwater levels, and the associated increase in pumping costs, are important drivers for change within Jordan'S agricultural sector. We describe how this is considered by coupling of agricultural and groundwater models. The agricultural production model employs Positive Mathematical Programming (PMP), a method for calibrating agricultural production functions to observed planted areas. PMP has successfully been used with disaggregate models for policy analysis. We adapt the PMP approach to allow explicit evaluation of the impact of pumping costs, groundwater purchase fees and a water tanker market. The work demonstrates the applicability of agent-based agricultural decision making assessment in the Jordan Highlands and its integration with agricultural model calibration methods. The proposed approach is designed and implemented with software such that it could be used to evaluate a variety of physical and human influences on decision making in agricultural water management.

  18. Dissociation between decision-making under risk and decision-making under ambiguity in premanifest and manifest Huntington's disease.

    PubMed

    Adjeroud, Najia; Besnard, Jeremy; Verny, Christophe; Prundean, Adriana; Scherer, Clarisse; Gohier, Bénédicte; Bonneau, Dominique; Massioui, Nicole El; Allain, Philippe

    2017-08-01

    We investigated decision-making under ambiguity (DM-UA) and decision making under risk (DM-UR) in individuals with premanifest and manifest Huntington's disease (HD). Twenty individuals with premanifest HD and 23 individuals with manifest HD, on one hand, and 39 healthy individuals divided into two control groups, on the other, undertook a modified version of the Iowa Gambling Task (IGT), an adaptation of a DM-UA task, and a modified version of the Game of Dice Task (GDT), an adaptation of a DM-UR task. Participants also filled in a questionnaire of impulsivity and responded to cognitive tests specifically designed to assess executive functions. Compared to controls, individuals with premanifest HD were unimpaired in performing executive tests as well as in decision-making tasks, except for the Stroop task. In contrast, individuals with manifest HD were impaired in both the IGT and executive tasks, but not in the GDT. No sign of impulsivity was observed in individuals with premanifest or manifest HD. Our results suggest that the progression of HD impairs DM-UA without affecting DM-UR, and indicate that decision-making abilities are preserved during the premanifest stage of HD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Use of Probabilistic Risk Assessment in Shuttle Decision Making Process

    NASA Technical Reports Server (NTRS)

    Boyer, Roger L.; Hamlin, Teri, L.

    2011-01-01

    This slide presentation reviews the use of Probabilistic Risk Assessment (PRA) to assist in the decision making for the shuttle design and operation. Probabilistic Risk Assessment (PRA) is a comprehensive, structured, and disciplined approach to identifying and analyzing risk in complex systems and/or processes that seeks answers to three basic questions: (i.e., what can go wrong? what is the likelihood of these occurring? and what are the consequences that could result if these occur?) The purpose of the Shuttle PRA (SPRA) is to provide a useful risk management tool for the Space Shuttle Program (SSP) to identify strengths and possible weaknesses in the Shuttle design and operation. SPRA was initially developed to support upgrade decisions, but has evolved into a tool that supports Flight Readiness Reviews (FRR) and near real-time flight decisions. Examples of the use of PRA for the shuttle are reviewed.

  20. From research to evidence-informed decision making: a systematic approach

    PubMed Central

    Poot, Charlotte C; van der Kleij, Rianne M; Brakema, Evelyn A; Vermond, Debbie; Williams, Siân; Cragg, Liza; van den Broek, Jos M; Chavannes, Niels H

    2018-01-01

    Abstract Background Knowledge creation forms an integral part of the knowledge-to-action framework aimed at bridging the gap between research and evidence-informed decision making. Although principles of science communication, data visualisation and user-centred design largely impact the effectiveness of communication, their role in knowledge creation is still limited. Hence, this article aims to provide researchers a systematic approach on how knowledge creation can be put into practice. Methods A systematic two-phased approach towards knowledge creation was formulated and executed. First, during a preparation phase the purpose and audience of the knowledge were defined. Subsequently, a developmental phase facilitated how the content is ‘said’ (language) and communicated (channel). This developmental phase proceeded via two pathways: a translational cycle and design cycle, during which core translational and design components were incorporated. The entire approach was demonstrated by a case study. Results The case study demonstrated how the phases in this systematic approach can be operationalised. It furthermore illustrated how created knowledge can be delivered. Conclusion The proposed approach offers researchers a systematic, practical and easy-to-implement tool to facilitate effective knowledge creation towards decision-makers in healthcare. Through the integration of core components of knowledge creation evidence-informed decision making will ultimately be optimized. PMID:29538728

  1. Reasoning and Action: Implementation of a Decision-Making Program in Sport.

    PubMed

    Gil-Arias, Alexander; Moreno, M Perla; García-Mas, Alex; Moreno, Alberto; García-González, Luíz; Del Villar, Fernando

    2016-09-20

    The objective of this study was to apply a decision training programme, based on the use of video-feedback and questioning, in real game time, in order to improve decision-making in volleyball attack actions. A three-phase quasi-experimental design was implemented: Phase A (pre-test), Phase B (Intervention) and Phase C (Retention). The sample was made up of 8 female Under-16 volleyball players, who were divided into two groups: experimental group (n = 4) and control group (n = 4). The independent variable was the decision training program, which was applied for 11 weeks in a training context, more specifically in a 6x6 game situation. The player had to analyze the reasons and causes of the decision taken. The dependent variable was decision-making, which was assessed based on systematic observation, using the "Game Performance Assessment Instrument" (GPAI) (Oslin, Mitchell, & Griffin, 1998). Results showed that, after applying the decision training program, the experimental group showed a significantly higher average percentage of successful decisions than the control group F(1, 6) = 11.26; p = .015; η2 p = .652; 95% CI [056, 360]. These results highlight the need to complement the training process with cognitive tools such as video-feedback and questioning in order to improve athletes' decision-making.

  2. Emotional and Social Factors influence Poker Decision Making Accuracy.

    PubMed

    Laakasuo, Michael; Palomäki, Jussi; Salmela, Mikko

    2015-09-01

    Poker is a social game, where success depends on both game strategic knowledge and emotion regulation abilities. Thus, poker provides a productive environment for studying the effects of emotional and social factors on micro-economic decision making. Previous research indicates that experiencing negative emotions, such as moral anger, reduces mathematical accuracy in poker decision making. Furthermore, various social aspects of the game—such as losing against "bad players" due to "bad luck"—seem to fuel these emotional states. We designed an Internet-based experiment, where participants' (N = 459) mathematical accuracy in five different poker decision making tasks were assessed. In addition, we manipulated the emotional and social conditions under which the tasks were presented, in a 2 × 2 experimental setup: (1) Anger versus neutral emotional state—participants were primed either with an anger-inducing, or emotionally neutral story, and (2) Social cue versus non-social cue—during the tasks, either an image of a pair of human eyes was "following" the mouse cursor, or an image of a black moving box was presented. The results showed that anger reduced mathematical accuracy of decision making only when participants were "being watched" by a pair of moving eyes. Experienced poker players made mathematically more accurate decisions than inexperienced ones. The results contribute to current understanding on how emotional and social factors influence decision making accuracy in economic games.

  3. Structured decision making as a framework for large-scale wildlife harvest management decisions

    USGS Publications Warehouse

    Robinson, Kelly F.; Fuller, Angela K.; Hurst, Jeremy E.; Swift, Bryan L.; Kirsch, Arthur; Farquhar, James F.; Decker, Daniel J.; Siemer, William F.

    2016-01-01

    Fish and wildlife harvest management at large spatial scales often involves making complex decisions with multiple objectives and difficult tradeoffs, population demographics that vary spatially, competing stakeholder values, and uncertainties that might affect management decisions. Structured decision making (SDM) provides a formal decision analytic framework for evaluating difficult decisions by breaking decisions into component parts and separating the values of stakeholders from the scientific evaluation of management actions and uncertainty. The result is a rigorous, transparent, and values-driven process. This decision-aiding process provides the decision maker with a more complete understanding of the problem and the effects of potential management actions on stakeholder values, as well as how key uncertainties can affect the decision. We use a case study to illustrate how SDM can be used as a decision-aiding tool for management decision making at large scales. We evaluated alternative white-tailed deer (Odocoileus virginianus) buck-harvest regulations in New York designed to reduce harvest of yearling bucks, taking into consideration the values of the state wildlife agency responsible for managing deer, as well as deer hunters. We incorporated tradeoffs about social, ecological, and economic management concerns throughout the state. Based on the outcomes of predictive models, expert elicitation, and hunter surveys, the SDM process identified management alternatives that optimized competing objectives. The SDM process provided biologists and managers insight about aspects of the buck-harvest decision that helped them adopt a management strategy most compatible with diverse hunter values and management concerns.

  4. Training surgeons in shared decision-making with cancer patients aged 65 years and older: a pilot study.

    PubMed

    Geessink, Noralie H; Schoon, Yvonne; Olde Rikkert, Marcel Gm; van Goor, Harry

    2017-01-01

    Treatment decision-making in older patients with colorectal (CRC) or pancreatic cancer (PC) needs improvement. We introduced the EASYcare in Geriatric Onco-surgery (EASY-GO) intervention to optimize the shared decision-making (SDM) process among these patients. The EASY-GO intervention comprised a working method with geriatric assessment and SDM training for surgeons. A non-equivalent control group design was used. Newly diagnosed CRC/PC patients aged ≥65 years were included. Primary patient-reported experiences were the quality of SDM (SDM-Q-9, range 0-100), involvement in decision-making (Visual Analog Scale for Involvement in the decision-making process [range 0-10]), satisfaction about decision-making (Visual Analog Scale for Satisfaction concerning the decision-making process [range 0-10]), and decisional regret (Decisional Regret Scale [DRS], range 0-100). Only for DRS, lower scores are better. A total of 71.4% of the involved consultants and 42.9% of the involved residents participated in the EASY-GO training. Only 4 trained surgeons consulted patients both before (n=19) and after (n=19) training and were consequently included in the analyses. All patient-reported experience measures showed a consistent but non-significant change in the direction of improved decision-making after training. According to surgeons, decisions were significantly more often made together with the patient after training (before, 38.9% vs after, 73.7%, p =0.04). Sub-analyses per diagnosis showed that patient experiences among older PC patients consistent and clinically relevant changed in the direction of improved decision-making after training (SDM-Q-9 +13.4 [95% CI -7.9; 34.6], VAS-I +0.27 [95% CI -1.1; 1.6], VAS-S +0.88 [95% CI -0.5; 2.2], DRS -10.3 [95% CI -27.8; 7.1]). This pilot study strengthens the practical potential of the intervention's concept among older surgical cancer patients.

  5. Developing a video intervention to model effective patient-physician communication and health-related decision-making skills for a multiethnic audience.

    PubMed

    Richter, D L; Greaney, M L; McKeown, R E; Cornell, C E; Littleton, M A; Pulley, L; Groff, J Y; Byrd, T L; Herman, C J

    2001-01-01

    The ENDOW study is a multisite, community-based project designed to improve decision-making and patient-physician communication skills for midlife African-American, white, and Hispanic women facing decisions about hysterectomy. Based on results of initial focus groups, a patient education video was developed in English and Spanish to serve as the centerpiece of various interventions. The video uses community women to model appropriate decision-making and patient-physician communication skills. Women in the target populations rated the video as useful to very useful and would recommend it to others. The use of theory-driven approaches and pilot testing of draft products resulted in the production of a well-accepted, useful video suitable for diverse populations in intervention sites in several states.

  6. A probabilistic multi-criteria decision making technique for conceptual and preliminary aerospace systems design

    NASA Astrophysics Data System (ADS)

    Bandte, Oliver

    It has always been the intention of systems engineering to invent or produce the best product possible. Many design techniques have been introduced over the course of decades that try to fulfill this intention. Unfortunately, no technique has succeeded in combining multi-criteria decision making with probabilistic design. The design technique developed in this thesis, the Joint Probabilistic Decision Making (JPDM) technique, successfully overcomes this deficiency by generating a multivariate probability distribution that serves in conjunction with a criterion value range of interest as a universally applicable objective function for multi-criteria optimization and product selection. This new objective function constitutes a meaningful Xnetric, called Probability of Success (POS), that allows the customer or designer to make a decision based on the chance of satisfying the customer's goals. In order to incorporate a joint probabilistic formulation into the systems design process, two algorithms are created that allow for an easy implementation into a numerical design framework: the (multivariate) Empirical Distribution Function and the Joint Probability Model. The Empirical Distribution Function estimates the probability that an event occurred by counting how many times it occurred in a given sample. The Joint Probability Model on the other hand is an analytical parametric model for the multivariate joint probability. It is comprised of the product of the univariate criterion distributions, generated by the traditional probabilistic design process, multiplied with a correlation function that is based on available correlation information between pairs of random variables. JPDM is an excellent tool for multi-objective optimization and product selection, because of its ability to transform disparate objectives into a single figure of merit, the likelihood of successfully meeting all goals or POS. The advantage of JPDM over other multi-criteria decision making techniques is that POS constitutes a single optimizable function or metric that enables a comparison of all alternative solutions on an equal basis. Hence, POS allows for the use of any standard single-objective optimization technique available and simplifies a complex multi-criteria selection problem into a simple ordering problem, where the solution with the highest POS is best. By distinguishing between controllable and uncontrollable variables in the design process, JPDM can account for the uncertain values of the uncontrollable variables that are inherent to the design problem, while facilitating an easy adjustment of the controllable ones to achieve the highest possible POS. Finally, JPDM's superiority over current multi-criteria decision making techniques is demonstrated with an optimization of a supersonic transport concept and ten contrived equations as well as a product selection example, determining an airline's best choice among Boeing's B-747, B-777, Airbus' A340, and a Supersonic Transport. The optimization examples demonstrate JPDM's ability to produce a better solution with a higher POS than an Overall Evaluation Criterion or Goal Programming approach. Similarly, the product selection example demonstrates JPDM's ability to produce a better solution with a higher POS and different ranking than the Overall Evaluation Criterion or Technique for Order Preferences by Similarity to the Ideal Solution (TOPSIS) approach.

  7. Study protocol: Improving patient choice in treating low back pain (IMPACT - LBP): A randomised controlled trial of a decision support package for use in physical therapy

    PubMed Central

    2011-01-01

    Background Low back pain is a common and costly condition. There are several treatment options for people suffering from back pain, but there are few data on how to improve patients' treatment choices. This study will test the effects of a decision support package (DSP), designed to help patients seeking care for back pain to make better, more informed choices about their treatment within a physiotherapy department. The package will be designed to assist both therapist and patient. Methods/Design Firstly, in collaboration with physiotherapists, patients and experts in the field of decision support and decision aids, we will develop the DSP. The work will include: a literature and evidence review; secondary analysis of existing qualitative data; exploration of patients' perspectives through focus groups and exploration of experts' perspectives using a nominal group technique and a Delphi study. Secondly, we will carry out a pilot single centre randomised controlled trial within NHS Coventry Community Physiotherapy. We will randomise physiotherapists to receive either training for the DSP or not. We will randomly allocate patients seeking treatment for non specific low back pain to either a physiotherapist trained in decision support or to receive usual care. Our primary outcome measure will be patient satisfaction with treatment at three month follow-up. We will also estimate the cost-effectiveness of the intervention, and assess the value of conducting further research. Discussion Informed shared decision-making should be an important part of any clinical consultation, particularly when there are several treatments, which potentially have moderate effects. The results of this pilot will help us determine the benefits of improving the decision-making process in clinical practice on patient satisfaction. Trial registration Current Controlled Trials ISRCTN46035546 PMID:21352528

  8. Understanding decision-making towards housework among women with upper limb repetitive strain injury.

    PubMed

    Cheung, Therma W C; Clemson, Lindy; O'Loughlin, Kate; Shuttleworth, Russell

    2016-02-01

    Among women with upper limb repetitive strain injury (RSI), occupational therapy interventions include education to facilitate ergonomic practices in housework. From a client-centred perspective, an understanding of women's decision-making about housework is needed to design effective occupational therapy programmes. This study addresses a gap in research in this area by exploring women's views about changing housework habits. The aim was to construct a conceptual representation to explain decision-making in housework by drawing on experiences of a sample of Singapore Chinese women with upper limb RSI from one hand therapy clinic. Based on a constructivist grounded theory methodology, data were collected through in-depth interviewing with 15 women. Interviews were audiotaped and transcribed. Data were analysed with line by line coding, focussed coding and axial coding with constant comparison throughout data collection. Decision-making in housework among these women involved three main themes: (i) emotional attachment to housework; (ii) cognitively informed decision; and (iii) emotionally influenced decision. Women with upper limb RSI had to make cognitive decisions for or against a change in housework to manage their condition. However, the women's cognitively informed decisions were shaped by their emotional attachment to housework. As such, they experienced strong emotional barriers to changing their housework practices even when they had cognitively accepted the necessity and possibility of making a change. Therapists need to be aware that counselling to address the emotional barriers experienced by women is important during ergonomic education. © 2016 Occupational Therapy Australia.

  9. Interdisciplinary Collaborative Learning: Using Decision Analysts to Enhance Undergraduate International Management Education

    ERIC Educational Resources Information Center

    Palocsay, Susan W.; White, Marion M.; Zimmerman, D. Kent

    2004-01-01

    This article describes an experiential learning activity designed to promote the development of decision-making skills in international management students at the undergraduate level. Students from an undergraduate management science course in decision analysis served as consultants on a case assigned to teams in an international management class.…

  10. Decisions about Drug Use. Adolescent Decisions Curriculum.

    ERIC Educational Resources Information Center

    Brion-Meisels, Steven; And Others

    This teacher's manual for drug abuse education is one volume of a six volume curriculum for the secondary level, designed to provide a systematic, group-oriented approach to decision-making in areas crucial to adolescent development: drug (substance) use and abuse, sexuality and social relationships, juvenile law, work and people and government.…

  11. Adults' decision-making about the electronic waste issue: The role of the nature of science conceptualizations and moral concerns in socio-scientific decision-making

    NASA Astrophysics Data System (ADS)

    Yu, Yuqing

    Socio-scientific issues have become increasingly important in Science-Technology-Society (STS) education as a means to make science learning more relevant to students' lives. This study used the e-waste issue as a context to investigate two aspects of socio-scientific decision-making: (1) the relationship between the nature of science (NOS) conceptualizations and decision-making; and (2) moral concerns involved in the process of decision-making. This study contributes to the field of socio-scientific issue research and STS education in the following ways. First, it is the first study that performed meta-analysis to seek the relationship between the NOS understanding and decision-making. This study concludes that valuable NOS conceptualizations that are highly related to the socio-scientific issue under investigation, rather than general NOS understanding, exert statistically significant influences on decision-making. Second, this study empirically examined the Multiple Responses Model (MRM), which enables the transfer of qualitative NOS responses into quantitative data, and hence, inferential statistics. The current study justifies the significance of unidimensionality to the application of the MRM. It addresses the limitations associated with the MRM and provides implications for future use of the MRM in other contexts. Finally, the study explores the role of moral concerns in socio-scientific decision-making. Eight participants engaged in interviews that were designed to elicit their reactions and feelings regarding the issue of exporting e-waste to poor countries. Qualitative analyses demonstrated that moral considerations were significant influences on decision-making. In addition, participants' action responses revealed that they were motivated to take action to help the environment. The study has implications for socio-scientific issue studies in other contexts and for teacher education programs that use socio-scientific issues to advance teachers' reasoning and discourse skills.

  12. Effects of Information Availability on Command-and-Control Decision Making: Performance, Trust, and Situation Awareness.

    PubMed

    Marusich, Laura R; Bakdash, Jonathan Z; Onal, Emrah; Yu, Michael S; Schaffer, James; O'Donovan, John; Höllerer, Tobias; Buchler, Norbou; Gonzalez, Cleotilde

    2016-03-01

    We investigated how increases in task-relevant information affect human decision-making performance, situation awareness (SA), and trust in a simulated command-and-control (C2) environment. Increased information is often associated with an improvement of SA and decision-making performance in networked organizations. However, previous research suggests that increasing information without considering the task relevance and the presentation can impair performance. We used a simulated C2 task across two experiments. Experiment 1 varied the information volume provided to individual participants and measured the speed and accuracy of decision making for task performance. Experiment 2 varied information volume and information reliability provided to two participants acting in different roles and assessed decision-making performance, SA, and trust between the paired participants. In both experiments, increased task-relevant information volume did not improve task performance. In Experiment 2, increased task-relevant information volume reduced self-reported SA and trust, and incorrect source reliability information led to poorer task performance and SA. These results indicate that increasing the volume of information, even when it is accurate and task relevant, is not necessarily beneficial to decision-making performance. Moreover, it may even be detrimental to SA and trust among team members. Given the high volume of available and shared information and the safety-critical and time-sensitive nature of many decisions, these results have implications for training and system design in C2 domains. To avoid decrements to SA, interpersonal trust, and decision-making performance, information presentation within C2 systems must reflect human cognitive processing limits and capabilities. © 2016, Human Factors and Ergonomics Society.

  13. The angular gyrus and visuospatial attention in decision-making under risk.

    PubMed

    Studer, Bettina; Cen, Danlu; Walsh, Vincent

    2014-12-01

    Recent neuroimaging studies on decision-making under risk indicate that the angular gyrus (AG) is sensitive to the probability and variance of outcomes during choice. A separate body of research has established the AG as a key area in visual attention. The current study used repetitive transcranial magnetic stimulation (rTMS) in healthy volunteers to test whether the causal contribution of the AG to decision-making is independent of or linked to the guidance of visuospatial attention. A within-subject design compared decision making on a laboratory gambling task under three conditions: following rTMS to the AG, following rTMS to the premotor cortex (PMC, as an active control condition) and without TMS. The task presented two different trial types, 'visual' and 'auditory' trials, which entailed a high versus minimal demand for visuospatial attention, respectively. Our results showed a systematic effect of rTMS to the AG upon decision-making behavior in visual trials. Without TMS and following rTMS to the control region, decision latencies reflected the odds of winning; this relationship was disrupted by rTMS to the AG. In contrast, no significant effects of rTMS to the AG (or to the PMC) upon choice behavior in auditory trials were found. Thus, rTMS to the AG affected decision-making only in the task condition requiring visuospatial attention. The current findings suggest that the AG contributes to decision-making by guiding attention to relevant information about reward and punishment in the visual environment. Copyright © 2014. Published by Elsevier Inc.

  14. Clinical decision making: how surgeons do it.

    PubMed

    Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

    2013-06-01

    Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  15. Decision-making and motivation to participate in biomedical research in southwest Nigeria.

    PubMed

    Osamor, Pauline E; Kass, Nancy

    2012-08-01

    Motivations and decision-making styles that influence participation in biomedical research vary across study types, cultures, and countries. While there is a small amount of literature on informed consent in non-western cultures, few studies have examined how participants make the decision to join research. This study was designed to identify the factors motivating people to participate in biomedical research in a traditional Nigerian community, assess the degree to which participants involve others in the decision-making process, and examine issues of autonomy in decision-making for research. A descriptive cross-sectional study was conducted with 100 adults (50 men, 50 women) in an urban Nigerian community who had participated in a biomedical research study. Subjects were interviewed using a survey instrument. Two-thirds of the respondents reported participating in the biomedical study to learn more about their illness, while 30% hoped to get some medical care. Over three-quarters (78%) of participants discussed the enrollment decision with someone else and 39% reported obtaining permission from a spouse or family member to participate in the study. Women were more than twice as likely as men to report obtaining permission from someone else before participating. More specifically, half of the female participants reported seeking permission from a spouse before enrolling. The findings suggest that informed consent in this community is understood and practised as a relational activity that involves others in the decision making process. Further studies are needed in non-Western countries concerning autonomy, decision-making, and motivation to participate in research studies. © 2012 Blackwell Publishing Ltd.

  16. Risk Communication Emergency Response Preparedness: Contextual Assessment of the Protective Action Decision Model.

    PubMed

    Heath, Robert L; Lee, Jaesub; Palenchar, Michael J; Lemon, Laura L

    2018-02-01

    Studies are continuously performed to improve risk communication campaign designs to better prepare residents to act in the safest manner during an emergency. To that end, this article investigates the predictive ability of the protective action decision model (PADM), which links environmental and social cues, predecision processes (attention, exposure, and comprehension), and risk decision perceptions (threat, alternative protective actions, and stakeholder norms) with protective action decision making. This current quasi-longitudinal study of residents (N = 400 for each year) in a high-risk (chemical release) petrochemical manufacturing community investigated whether PADM core risk perceptions predict protective action decision making. Telephone survey data collected at four intervals (1995, 1998, 2002, 2012) reveal that perceptions of protective actions and stakeholder norms, but not of threat, currently predict protective action decision making (intention to shelter in place). Of significance, rather than threat perceptions, perception of Wally Wise Guy (a spokes-character who advocates shelter in place) correlates with perceptions of protective action, stakeholder norms, and protective action decision making. Wally's response-efficacy advice predicts residents' behavioral intentions to shelter in place, thereby offering contextually sensitive support and refinement for PADM. © 2017 Society for Risk Analysis.

  17. Decision-Making Process Related to Participation in Phase I Clinical Trials: A Nonsystematic Review of the Existing Evidence.

    PubMed

    Gorini, Alessandra; Mazzocco, Ketti; Pravettoni, Gabriella

    2015-01-01

    Due to the lack of other treatment options, patient candidates for participation in phase I clinical trials are considered the most vulnerable, and many ethical concerns have emerged regarding the informed consent process used in the experimental design of such trials. Starting with these considerations, this nonsystematic review is aimed at analyzing the decision-making processes underlying patients' decision about whether to participate (or not) in phase I trials in order to clarify the cognitive and emotional aspects most strongly implicated in this decision. Considering that there is no uniform decision calculus and that many different variables other than the patient-physician relationship (including demographic, clinical, and personal characteristics) may influence patients' preferences for and processing of information, we conclude that patients' informed decision-making can be facilitated by creating a rigorously developed, calibrated, and validated computer tool modeled on each single patient's knowledge, values, and emotional and cognitive decisional skills. Such a tool will also help oncologists to provide tailored medical information that is useful to improve the shared decision-making process, thereby possibly increasing patient participation in clinical trials. © 2015 S. Karger AG, Basel.

  18. A Generalized Quantum-Inspired Decision Making Model for Intelligent Agent

    PubMed Central

    Loo, Chu Kiong

    2014-01-01

    A novel decision making for intelligent agent using quantum-inspired approach is proposed. A formal, generalized solution to the problem is given. Mathematically, the proposed model is capable of modeling higher dimensional decision problems than previous researches. Four experiments are conducted, and both empirical experiments results and proposed model's experiment results are given for each experiment. Experiments showed that the results of proposed model agree with empirical results perfectly. The proposed model provides a new direction for researcher to resolve cognitive basis in designing intelligent agent. PMID:24778580

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

    PubMed Central

    2013-01-01

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

  20. Towards ethical decision support and knowledge management in neonatal intensive care.

    PubMed

    Yang, L; Frize, M; Eng, P; Walker, R; Catley, C

    2004-01-01

    Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.

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