Science.gov

Sample records for surgical decision-making process

  1. Decision making in surgical oncology.

    PubMed

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

    2011-09-01

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

  2. Decision making in surgical oncology.

    PubMed

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

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients. PMID:20719499

  3. Decision Making Processes and Outcomes

    PubMed Central

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

    2013-01-01

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

  4. Nonrational processes in ethical decision making.

    PubMed

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

    2011-10-01

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

  5. Cognitive processes in anesthesiology decision making.

    PubMed

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

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

  6. 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…

  7. Nonrational Processes in Ethical Decision Making

    ERIC Educational Resources Information Center

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

    2011-01-01

    Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…

  8. Breast restoration decision making: enhancing the process.

    PubMed

    Reaby, L L

    1998-06-01

    The purpose of this study was to explore the breast restoration decision-making patterns used by women who opted to have their breast cancer treated by mastectomy. Sixty-four women wearing external breast prostheses and 31 women with breast reconstructions were interviewed. Modified versions of Simon's notion of "bounded rationality" and Janis and Mann's conflict model provided the conceptual scaffolding for the study. Five breast restoration decision-making patterns emerged from the analysis of the interview data: (a) Enlightened (actively seeks information, considers positive and negative aspects, and demonstrates deliberation on the alternatives), (b) Contented (passively accepts minimum information on alternatives because of a preference toward a particular type), (c) Sideliner (uncritically adopts any alternative that is easy and simple to implement), (d) Shifter (gives over the decision to others), and (e) Panic-stricken (can make no rational decision on alternatives). In the prosthesis group, the major pattern used was the Sideliner, and in the reconstruction group it was the Contented. None of the participants used the Enlightened pattern. The data indicated that there was no evidence of active information-seeking behavior or deliberation on the alternatives as part of the women's decision-making process. The findings suggest a need for a registered nurse oncology specialist to be accessible to women during the period when decisions regarding breast restoration are made. This professional has the knowledge to interact effectively with these women and serve as their advocate during the decision-making process. Implications for professional practice and a model for competent breast restoration decision making are presented.

  9. Thoracolumbar spine trauma: Evaluation and surgical decision-making

    PubMed Central

    Joaquim, Andrei F.; Patel, Alpesh A.

    2013-01-01

    Introduction: Thoracolumbar spine trauma is the most common site of spinal cord injury, with clinical and epidemiological importance. Materials and Methods: We performed a comprehensive literature review on the management and treatment of TLST. Results: Currently, computed tomography is frequently used as the primary diagnostic test in TLST, with magnetic resonance imaging used in addition to assess disc, ligamentous, and neurological injury. The Thoracolumbar Injury Classification System is a new injury severity score created to help the decision-making process between conservative versus surgical treatment. When decision for surgery is made, early procedures are feasible, safe, can improve outcomes, and reduce healthcare costs. Surgical treatment is individualized based on the injury characteristics and surgeon's experience, as there is no evidence-based for the superiority of one technique over the other. Conclusions: The correct management of TLST involves multiple steps, such as a precise diagnosis, classification, and treatment. The TLICS can improve care and communication between spine surgeons, resulting in a more standardized treatment. PMID:24381449

  10. Evacuation decision-making: process and uncertainty

    SciTech Connect

    Mileti, D.; Sorensen, J.; Bogard, W.

    1985-09-01

    The purpose was to describe the processes of evacuation decision-making, identify and document uncertainties in that process and discuss implications for federal assumption of liability for precautionary evacuations at nuclear facilities under the Price-Anderson Act. Four major categories of uncertainty are identified concerning the interpretation of hazard, communication problems, perceived impacts of evacuation decisions and exogenous influences. Over 40 historical accounts are reviewed and cases of these uncertainties are documented. The major findings are that all levels of government, including federal agencies experience uncertainties in some evacuation situations. Second, private sector organizations are subject to uncertainties at a variety of decision points. Third, uncertainties documented in the historical record have provided the grounds for liability although few legal actions have ensued. Finally it is concluded that if liability for evacuations is assumed by the federal government, the concept of a ''precautionary'' evacuation is not useful in establishing criteria for that assumption. 55 refs., 1 fig., 4 tabs.

  11. Decision-making processes of youth.

    PubMed

    Moore, J W; Jensen, B; Hauck, W E

    1990-01-01

    Research supports the theory that after administrators make a decision, feedback, both positive and negative, and also the administrators' perceived security vis-à-vis their position affect their level of commitment to a course of action. However, this research fails to recognize that subjects of college age playing administrators in the simulated, experimental treatments which have been presented in the research had nothing personally to lose if they made a bad decision--an orientation contradictory to the reality of most actual administrative positions. Additionally, the research ignores the interactional effects of the personality of decision makers in terms of their anxiety levels and the judgments they make. This study took both of these considerations into account by creating a decision-making situation within which prospective administrators made monetary commitments to long-term goals while their anxiety level, both as a basic personality attribute and an index of the reality of the decision-making process, was monitored under conditions of varying levels of job insecurity and resistance to their policies in relation to their decisions. Analyses revealed that contrary to the results of past research which used college students as subjects: (1) there is a significant negative correlation between levels of anxiety and commitments to previously chosen courses of action; (2) there are no significant effects of job security on commitment; and, most importantly, (3) high resistance to a policy decision leads to significantly less monetary commitments to long-term goals. The findings suggest that the basis for the contradictory results lies with the anxiety level of decision makers and the realism of experiencing a loss by making poor decisions. PMID:2264508

  12. School Board Decision Making: An Analysis of the Process

    ERIC Educational Resources Information Center

    Crum, Karen S.

    2007-01-01

    The goal of this study was to analyze the characteristics in the school board decision-making process and to discover whether school board members are aware of the characteristics surrounding the school board's decision-making process. Specifically, this study examines the decision-making process of a school board in Virginia, and it provides…

  13. Information Processing in Decision-Making Systems

    PubMed Central

    van der Meer, Matthijs; Kurth-Nelson, Zeb; Redish, A. David

    2015-01-01

    Decisions result from an interaction between multiple functional systems acting in parallel to process information in very different ways, each with strengths and weaknesses. In this review, the authors address three action-selection components of decision-making: The Pavlovian system releases an action from a limited repertoire of potential actions, such as approaching learned stimuli. Like the Pavlovian system, the habit system is computationally fast but, unlike the Pavlovian system permits arbitrary stimulus-action pairings. These associations are a “forward” mechanism; when a situation is recognized, the action is released. In contrast, the deliberative system is flexible but takes time to process. The deliberative system uses knowledge of the causal structure of the world to search into the future, planning actions to maximize expected rewards. Deliberation depends on the ability to imagine future possibilities, including novel situations, and it allows decisions to be taken without having previously experienced the options. Various anatomical structures have been identified that carry out the information processing of each of these systems: hippocampus constitutes a map of the world that can be used for searching/imagining the future; dorsal striatal neurons represent situation-action associations; and ventral striatum maintains value representations for all three systems. Each system presents vulnerabilities to pathologies that can manifest as psychiatric disorders. Understanding these systems and their relation to neuroanatomy opens up a deeper way to treat the structural problems underlying various disorders. PMID:22492194

  14. Gastroesophageal reflux disease: A review of surgical decision making

    PubMed Central

    Moore, Maureen; Afaneh, Cheguevara; Benhuri, Daniel; Antonacci, Caroline; Abelson, Jonathan; Zarnegar, Rasa

    2016-01-01

    Gastroesophageal reflux disease (GERD) is a very common disorder with increasing prevalence. It is estimated that up to 20%-25% of Americans experience symptoms of GERD weekly. Excessive reflux of acidic often with alkaline bile salt gastric and duodenal contents results in a multitude of symptoms for the patient including heartburn, regurgitation, cough, and dysphagia. There are also associated complications of GERD including erosive esophagitis, Barrett’s esophagus, stricture and adenocarcinoma of the esophagus. While first line treatments for GERD involve mainly lifestyle and non-surgical therapies, surgical interventions have proven to be effective in appropriate circumstances. Anti-reflux operations are aimed at creating an effective barrier to reflux at the gastroesophageal junction and thus attempt to improve physiologic and mechanical issues that may be involved in the pathogenesis of GERD. The decision for surgical intervention in the treatment of GERD, moreover, requires an objective confirmation of the diagnosis. Confirmation is achieved using various preoperative evaluations including: ambulatory pH monitoring, esophageal manometry, upper endoscopy (esophagogastroduodenoscopy) and barium swallow. Upon confirmation of the diagnosis and with appropriate patient criteria met, an anti-reflux operation is a good alternative to prolonged medical therapy. Currently, minimally invasive gastro-esophageal fundoplication is the gold standard for surgical intervention of GERD. Our review outlines the many factors that are involved in surgical decision-making. We will review the prominent features that reflect appropriate anti-reflux surgery and present suggestions that are pertinent to surgical practices, based on evidence-based studies. PMID:26843915

  15. Decision-Making Processes of Youth.

    ERIC Educational Resources Information Center

    Moore, J. William; And Others

    1990-01-01

    Undergraduates (n=142) participated in study on decision making in which prospective administrators made monetary commitments to long-term goals under varying conditions. Found significant negative correlation between anxiety level and commitments to previously chosen courses of action; no significant effects of job security on commitment; and…

  16. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  17. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  18. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  19. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  20. 44 CFR 9.6 - Decision-making process.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process. (a) Purpose. The purpose of this section is to set out the floodplain management and wetlands... the decision-making process was initially designed to address the floodplain Order's requirements,...

  1. A decision-making process in shared governance.

    PubMed

    Recker, D; Bess, C; Wellens, H

    1996-05-01

    Shared governance teams require a good decision making process. After identifying the root cause of a problem, finding a solution that addresses the right issues begins. An issues flow chart and decision-making process were developed to help teams better identify and solve problems.

  2. Biomolecular decision-making process for self assembly.

    SciTech Connect

    Osbourn, Gordon Cecil

    2005-01-01

    The brain is often identified with decision-making processes in the biological world. In fact, single cells, single macromolecules (proteins) and populations of molecules also make simple decisions. These decision processes are essential to survival and to the biological self-assembly and self-repair processes that we seek to emulate. How do these tiny systems make effective decisions? How do they make decisions in concert with a cooperative network of other molecules or cells? How can we emulate the decision-making behaviors of small-scale biological systems to program and self-assemble microsystems? This LDRD supported research to answer these questions. Our work included modeling and simulation of protein populations to help us understand, mimic, and categorize molecular decision-making mechanisms that nonequilibrium systems can exhibit. This work is an early step towards mimicking such nanoscale and microscale biomolecular decision-making processes in inorganic systems.

  3. Dissolving decision making? Models and their roles in decision-making processes and policy at large.

    PubMed

    Zeiss, Ragna; van Egmond, Stans

    2014-12-01

    This article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making. Attention is paid to three aspects of the wider context of the models: a) the history of the construction process; b) (changes in) the political and scientific environments; and c) the use in policy processes over longer periods of time. Models are more successfully used when they are constructed in a stable political and scientific environment. Stability and certainty within a scientific field seems to be a key predictor for the usefulness of models for policy making. The economic model is more disputed than the ecology-based model and the model that has its theoretical foundation in physics and chemistry. The roles models play in policy processes are too complex to be considered as straightforward technocratic powers. PMID:25549446

  4. [Decision-making process and health management councils: theoretical approaches].

    PubMed

    Wendhausen, Agueda; Cardoso, Sandra de Mello

    2007-01-01

    With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area. However, in relation to the health councils in particular, there is still much to be done, including improving the quality of the decision-making process. This work aims to place the decision-making process in its theoretical context in terms of participatory democracy, elements which make up, factors which influence its development, and finally, to explore some possibilities of this theoretical basis to analyze the practices of the health councils in the area of health. It is hoped that it will make a theoretical contribution to the analyses carried out in this area, in order to provide a decision-making process that is more inclusive in terms of participation.

  5. Evolution of quantum-like modeling in decision making processes

    SciTech Connect

    Khrennikova, Polina

    2012-12-18

    The application of the mathematical formalism of quantum mechanics to model behavioral patterns in social science and economics is a novel and constantly emerging field. The aim of the so called 'quantum like' models is to model the decision making processes in a macroscopic setting, capturing the particular 'context' in which the decisions are taken. Several subsequent empirical findings proved that when making a decision people tend to violate the axioms of expected utility theory and Savage's Sure Thing principle, thus violating the law of total probability. A quantum probability formula was devised to describe more accurately the decision making processes. A next step in the development of QL-modeling in decision making was the application of Schroedinger equation to describe the evolution of people's mental states. A shortcoming of Schroedinger equation is its inability to capture dynamics of an open system; the brain of the decision maker can be regarded as such, actively interacting with the external environment. Recently the master equation, by which quantum physics describes the process of decoherence as the result of interaction of the mental state with the environmental 'bath', was introduced for modeling the human decision making. The external environment and memory can be referred to as a complex 'context' influencing the final decision outcomes. The master equation can be considered as a pioneering and promising apparatus for modeling the dynamics of decision making in different contexts.

  6. Evolution of quantum-like modeling in decision making processes

    NASA Astrophysics Data System (ADS)

    Khrennikova, Polina

    2012-12-01

    The application of the mathematical formalism of quantum mechanics to model behavioral patterns in social science and economics is a novel and constantly emerging field. The aim of the so called 'quantum like' models is to model the decision making processes in a macroscopic setting, capturing the particular 'context' in which the decisions are taken. Several subsequent empirical findings proved that when making a decision people tend to violate the axioms of expected utility theory and Savage's Sure Thing principle, thus violating the law of total probability. A quantum probability formula was devised to describe more accurately the decision making processes. A next step in the development of QL-modeling in decision making was the application of Schrödinger equation to describe the evolution of people's mental states. A shortcoming of Schrödinger equation is its inability to capture dynamics of an open system; the brain of the decision maker can be regarded as such, actively interacting with the external environment. Recently the master equation, by which quantum physics describes the process of decoherence as the result of interaction of the mental state with the environmental 'bath', was introduced for modeling the human decision making. The external environment and memory can be referred to as a complex 'context' influencing the final decision outcomes. The master equation can be considered as a pioneering and promising apparatus for modeling the dynamics of decision making in different contexts.

  7. Privatized Student Housing and the Decision-Making Process

    ERIC Educational Resources Information Center

    Aska, Aaron C.

    2012-01-01

    This study will examine the decision-making process used to construct privatized student housing as well as the factors that contribute to that process among public four-year institutions in New Jersey. A growing number of public universities are exploring ways to develop successful public private partnerships (P3s) in an effort to improve…

  8. Investigating the Decision-Making Process of Standard Setting Participants

    ERIC Educational Resources Information Center

    Papageorgiou, Spiros

    2010-01-01

    Despite the growing interest of the language testing community in standard setting, primarily due to the use of the Common European Framework of Reference (CEFR-Council of Europe, 2001), the participants' decision-making process in the CEFR standard setting context remains unexplored. This study attempts to fill in this gap by analyzing these…

  9. Problems in the decision making process: a review.

    PubMed

    Evans, D

    1990-12-01

    Decision making is an integral part of the intensive care nurse's role, but many factors can disrupt this process. It is important that the nurse has an understanding of how defective decision making patterns can develop. Experience, the role of the nurse, uncertainty and conflict all exert major influences on the decision making process. The conditions that determine what type of decision making pattern emerges are; the seriousness of the risks as a result of the decision; if there is hope of finding a better solution; and how much time is available to search for the solution. The patterns that may emerge include vigilance, complacency, defensive avoidance and hypervigilance. Vigilance is said to be the optimum pattern, this is when all alternatives to the decision are analysed and interpreted in an unbiased manner. Defensive avoidance is the decision makers attempt to avoid or postpone the stress of the decision. It is manifested by procrastination, shifting of responsibility or rationalisation. Hypervigilance, or panic, represents a frantic search for a solution and a shifting back and forth between alternatives with a failure to see obvious faults in the possible solutions.

  10. Problems in the decision making process: a review.

    PubMed

    Evans, D

    1990-12-01

    Decision making is an integral part of the intensive care nurse's role, but many factors can disrupt this process. It is important that the nurse has an understanding of how defective decision making patterns can develop. Experience, the role of the nurse, uncertainty and conflict all exert major influences on the decision making process. The conditions that determine what type of decision making pattern emerges are; the seriousness of the risks as a result of the decision; if there is hope of finding a better solution; and how much time is available to search for the solution. The patterns that may emerge include vigilance, complacency, defensive avoidance and hypervigilance. Vigilance is said to be the optimum pattern, this is when all alternatives to the decision are analysed and interpreted in an unbiased manner. Defensive avoidance is the decision makers attempt to avoid or postpone the stress of the decision. It is manifested by procrastination, shifting of responsibility or rationalisation. Hypervigilance, or panic, represents a frantic search for a solution and a shifting back and forth between alternatives with a failure to see obvious faults in the possible solutions. PMID:2273233

  11. Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams.

    PubMed

    Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

    2015-01-01

    There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making. PMID:26958244

  12. Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams

    PubMed Central

    Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

    2015-01-01

    There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making. PMID:26958244

  13. Use of PRA in Shuttle Decision Making Process

    NASA Technical Reports Server (NTRS)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

    How do you use PRA to support an operating program? This presentation will explore how the Shuttle Program Management has used the Shuttle PRA in its decision making process. It will reveal how the PRA has evolved from a tool used to evaluate Shuttle upgrades like Electric Auxiliary Power Unit (EAPU) to a tool that supports Flight Readiness Reviews (FRR) and real-time flight decisions. Specific examples of Shuttle Program decisions that have used the Shuttle PRA as input will be provided including how it was used in the Hubble Space Telescope (HST) manifest decision. It will discuss the importance of providing management with a clear presentation of the analysis, applicable assumptions and limitations, along with estimates of the uncertainty. This presentation will show how the use of PRA by the Shuttle Program has evolved overtime and how it has been used in the decision making process providing specific examples.

  14. A decision-making process model of young online shoppers.

    PubMed

    Lin, Chin-Feng; Wang, Hui-Fang

    2008-12-01

    Based on the concepts of brand equity, means-end chain, and Web site trust, this study proposes a novel model called the consumption decision-making process of adolescents (CDMPA) to understand adolescents' Internet consumption habits and behavioral intention toward particular sporting goods. The findings of the CDMPA model can help marketers understand adolescents' consumption preferences and habits for developing effective Internet marketing strategies.

  15. Primary osseous tumors of the pediatric spinal column: review of pathology and surgical decision making.

    PubMed

    Ravindra, Vijay M; Eli, Ilyas M; Schmidt, Meic H; Brockmeyer, Douglas L

    2016-08-01

    Spinal column tumors are rare in children and young adults, accounting for only 1% of all spine and spinal cord tumors combined. They often present diagnostic and therapeutic challenges. In this article, the authors review the current management of primary osseous tumors of the pediatric spinal column and highlight diagnosis, management, and surgical decision making. PMID:27476845

  16. Primary osseous tumors of the pediatric spinal column: review of pathology and surgical decision making.

    PubMed

    Ravindra, Vijay M; Eli, Ilyas M; Schmidt, Meic H; Brockmeyer, Douglas L

    2016-08-01

    Spinal column tumors are rare in children and young adults, accounting for only 1% of all spine and spinal cord tumors combined. They often present diagnostic and therapeutic challenges. In this article, the authors review the current management of primary osseous tumors of the pediatric spinal column and highlight diagnosis, management, and surgical decision making.

  17. Introduction of new vaccines: decision-making process in Bangladesh.

    PubMed

    Uddin, Jasim; Sarma, Haribondhu; Bari, Tajul I; Koehlmoos, Tracey P

    2013-06-01

    The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern

  18. Vocationally Mature Coping Strategies and Progress in the Decision-Making Process: A Canonical Analysis.

    ERIC Educational Resources Information Center

    Phillips, Susan D.; Strohmer, Douglas C.

    1983-01-01

    Examined the relationship between factors influencing career development and the decision-making process in 174 students. Results suggested that planning orientation will hinder or facilitate movement beyond the exploratory phase of decision making, and decision-making skills reduce the effort of the prechoice portion of decision making. (WAS)

  19. Dissociating sensory from decision processes in human perceptual decision making

    PubMed Central

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

    2015-01-01

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

  20. Decision-making processes: the case of collective movements.

    PubMed

    Petit, Odile; Bon, Richard

    2010-07-01

    Besides focusing on the adaptive significance of collective movements, it is crucial to study the mechanisms and dynamics of decision-making processes at the individual level underlying the higher-scale collective movements. It is now commonly admitted that collective decisions emerge from interactions between individuals, but how individual decisions are taken, i.e. how far they are modulated by the behaviour of other group members, is an under-investigated question. Classically, collective movements are viewed as the outcome of one individual's initiation (the leader) for departure, by which all or some of the other group members abide. Individuals assuming leadership have often been considered to hold a specific social status. This hierarchical or centralized control model has been challenged by recent theoretical and experimental findings, suggesting that leadership can be more distributed. Moreover, self-organized processes can account for collective movements in many different species, even in those that are characterized by high cognitive complexity. In this review, we point out that decision-making for moving collectively can be reached by a combination of different rules, i.e. individualized (based on inter-individual differences in physiology, energetic state, social status, etc.) and self-organized (based on simple response) ones for any species, context and group size.

  1. International Patients’ Travel Decision Making Process- A Conceptual Framework

    PubMed Central

    KHAN, Mohammad Jamal; CHELLIAH, Shankar; HARON, Mahmod Sabri

    2016-01-01

    Background: Role of information source, perceived benefits and risks, and destination image has significantly been examined in travel and tourism literature; however, in medical tourism it is yet to be examined thoroughly. The concept discussed in this article is drawn form well established models in tourism literature. Methods: The purpose of this research was to identify the source of information, travel benefits and perceived risks related to movement of international patients and develop a conceptual model based on well-established theory. Thorough database search (Science Direct, utmj.org, nih.gov, nchu.edu.tw, palgrave-journals, medretreat, Biomedcentral) was performed to fulfill the objectives of the study. Results: International patients always concern about benefits and risks related to travel. These benefits and risks form images of destination in the minds of international patients. Different sources of information make international patients acquaint about the associated benefits and risks, which later leads to development of intention to visit. This conceptual paper helps in establishing model for decision-making process of international patients in developing visit intention. Conclusion: Ample amount of literature is available detailing different factors involved in travel decision making of international patients; however literature explaining relationship between these factors is scarce. PMID:27114978

  2. Qualitative modeling of the decision-making process using electrooculography.

    PubMed

    Marandi, Ramtin Zargari; Sabzpoushan, S H

    2015-12-01

    A novel method based on electrooculography (EOG) has been introduced in this work to study the decision-making process. An experiment was designed and implemented wherein subjects were asked to choose between two items from the same category that were presented within a limited time. The EOG and voice signals of the subjects were recorded during the experiment. A calibration task was performed to map the EOG signals to their corresponding gaze positions on the screen by using an artificial neural network. To analyze the data, 16 parameters were extracted from the response time and EOG signals of the subjects. Evaluation and comparison of the parameters, together with subjects' choices, revealed functional information. On the basis of this information, subjects switched their eye gazes between items about three times on average. We also found, according to statistical hypothesis testing-that is, a t test, t(10) = 71.62, SE = 1.25, p < .0001-that the correspondence rate of a subjects' gaze at the moment of selection with the selected item was significant. Ultimately, on the basis of these results, we propose a qualitative choice model for the decision-making task.

  3. Qualitative modeling of the decision-making process using electrooculography.

    PubMed

    Marandi, Ramtin Zargari; Sabzpoushan, S H

    2015-12-01

    A novel method based on electrooculography (EOG) has been introduced in this work to study the decision-making process. An experiment was designed and implemented wherein subjects were asked to choose between two items from the same category that were presented within a limited time. The EOG and voice signals of the subjects were recorded during the experiment. A calibration task was performed to map the EOG signals to their corresponding gaze positions on the screen by using an artificial neural network. To analyze the data, 16 parameters were extracted from the response time and EOG signals of the subjects. Evaluation and comparison of the parameters, together with subjects' choices, revealed functional information. On the basis of this information, subjects switched their eye gazes between items about three times on average. We also found, according to statistical hypothesis testing-that is, a t test, t(10) = 71.62, SE = 1.25, p < .0001-that the correspondence rate of a subjects' gaze at the moment of selection with the selected item was significant. Ultimately, on the basis of these results, we propose a qualitative choice model for the decision-making task. PMID:25515839

  4. Contingency Management and Deliberative Decision-Making Processes.

    PubMed

    Regier, Paul S; Redish, A David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

  5. Contingency Management and Deliberative Decision-Making Processes.

    PubMed

    Regier, Paul S; Redish, A David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation.

  6. Contingency Management and Deliberative Decision-Making Processes

    PubMed Central

    Regier, Paul S.; Redish, A. David

    2015-01-01

    Contingency management is an effective treatment for drug addiction. The current explanation for its success is rooted in alternative reinforcement theory. We suggest that alternative reinforcement theory is inadequate to explain the success of contingency management and produce a model based on demand curves that show how little the monetary rewards offered in this treatment would affect drug use. Instead, we offer an explanation of its success based on the concept that it accesses deliberative decision-making processes. We suggest that contingency management is effective because it offers a concrete and immediate alternative to using drugs, which engages deliberative processes, improves the ability of those deliberative processes to attend to non-drug options, and offsets more automatic action-selection systems. This theory makes explicit predictions that can be tested, suggests which users will be most helped by contingency management, and suggests improvements in its implementation. PMID:26082725

  7. Information processing as a paradigm for decision making.

    PubMed

    Oppenheimer, Daniel M; Kelso, Evan

    2015-01-01

    For decades, the dominant paradigm for studying decision making--the expected utility framework--has been burdened by an increasing number of empirical findings that question its validity as a model of human cognition and behavior. However, as Kuhn (1962) argued in his seminal discussion of paradigm shifts, an old paradigm cannot be abandoned until a new paradigm emerges to replace it. In this article, we argue that the recent shift in researcher attention toward basic cognitive processes that give rise to decision phenomena constitutes the beginning of that replacement paradigm. Models grounded in basic perceptual, attentional, memory, and aggregation processes have begun to proliferate. The development of this new approach closely aligns with Kuhn's notion of paradigm shift, suggesting that this is a particularly generative and revolutionary time to be studying decision science. PMID:25559114

  8. Corticostriatal Interactions during Learning, Memory Processing, and Decision Making.

    PubMed

    Pennartz, Cyriel M A; Berke, Joshua D; Graybiel, Ann M; Ito, Rutsuko; Lansink, Carien S; van der Meer, Matthijs; Redish, A David; Smith, Kyle S; Voorn, Pieter

    2009-10-14

    This mini-symposium aims to integrate recent insights from anatomy, behavior, and neurophysiology, highlighting the anatomical organization, behavioral significance, and information-processing mechanisms of corticostriatal interactions. In this summary of topics, which is not meant to provide a comprehensive survey, we will first review the anatomy of corticostriatal circuits, comparing different ways by which "loops" of cortical-basal ganglia circuits communicate. Next, we will address the causal importance and systems-neurophysiological mechanisms of corticostriatal interactions for memory, emphasizing the communication between hippocampus and ventral striatum during contextual conditioning. Furthermore, ensemble recording techniques have been applied to compare information processing in the dorsal and ventral striatum to predictions from reinforcement learning theory. We will next discuss how neural activity develops in corticostriatal areas when habits are learned. Finally, we will evaluate the role of GABAergic interneurons in dynamically transforming cortical inputs into striatal output during learning and decision making.

  9. Information processing as a paradigm for decision making.

    PubMed

    Oppenheimer, Daniel M; Kelso, Evan

    2015-01-01

    For decades, the dominant paradigm for studying decision making--the expected utility framework--has been burdened by an increasing number of empirical findings that question its validity as a model of human cognition and behavior. However, as Kuhn (1962) argued in his seminal discussion of paradigm shifts, an old paradigm cannot be abandoned until a new paradigm emerges to replace it. In this article, we argue that the recent shift in researcher attention toward basic cognitive processes that give rise to decision phenomena constitutes the beginning of that replacement paradigm. Models grounded in basic perceptual, attentional, memory, and aggregation processes have begun to proliferate. The development of this new approach closely aligns with Kuhn's notion of paradigm shift, suggesting that this is a particularly generative and revolutionary time to be studying decision science.

  10. Surgical Decision Making for the Elderly Patients in Severe Head Injuries

    PubMed Central

    Shim, Jae-Jun; Yoon, Seok-Man; Oh, Jae-Sang; Bae, Hack-Gun; Doh, Jae-Won

    2014-01-01

    Objective Age is a strong predictor of mortality in traumatic brain injuries. A surgical decision making is difficult especially for the elderly patients with severe head injuries. We studied so-called 'withholding a life-saving surgery' over a two year period at a university hospital. Methods We collected data from 227 elderly patients. In 35 patients with Glasgow Coma Score 3-8, 28 patients had lesions that required operation. A life-saving surgery was withheld in 15 patients either by doctors and/or the families (Group A). Surgery was performed in 13 patients (Group B). We retrospectively examined the medical records and radiological findings of these 28 patients. We calculated the predicted probability of 6 month mortality (IPM) and 6 month unfavorable outcome (IPU) to compare the result of decision by the International Mission for Prognosis and Analysis of Clinical Trials in TBI (IMPACT) calculator. Results Types of the mass lesion did not affect on the surgical decision making. None of the motor score 1 underwent surgery, while all patients with reactive pupils underwent surgery. Causes of injury or episodes of hypoxia/hypotension might have affected on the decision making, however, their role was not distinct. All patients in the group A died. In the group B, the outcome was unfavorable in 11 of 13 patients. Patients with high IPM or IPU were more common in group A than group B. Wrong decisions brought futile cares. Conclusion Ethical training and developing decision-making skills are necessary including shared decision making. PMID:25024822

  11. The shared leadership process in decision-making teams.

    PubMed

    Bergman, Jacqueline Z; Rentsch, Joan R; Small, Erika E; Davenport, Shaun W; Bergman, Shawn M

    2012-01-01

    The present study examined the process of shared leadership in 45 ad hoc decision-making teams. Each team member's leadership behavior (n = 180) was assessed by behaviorally coding videotapes of the teams' discussions. The within-team patterns of leadership behavior were examined using cluster analysis. Results indicated that the likelihood of a team experiencing a full range of leadership behavior increased to the extent that multiple team members shared leadership, and that teams with shared leadership experienced less conflict, greater consensus, and higher intragroup trust and cohesion than teams without shared leadership. This study supports previous findings that shared leadership contributes to overall team functioning, and begins to delineate the extent to which team members may naturally share leadership.

  12. Decision-making processes: sensitivity to sequentially experienced outcome probabilities.

    PubMed

    Boyer, Ty W

    2007-05-01

    A computerized sequential event sampling decision-making task was administered to 187 5- to 10-year-olds and adults Participants made a series of choices between alternatives that differed in win probability (Study 1) or win and loss probability (Study 2). Intuitive and more explicit measures were used. Study 1 revealed that, across ages, participants demonstrated intuitive sensitivity to probability; however, adult participants evidenced greater sensitivity than did children, and younger children failed to demonstrate more explicit understanding of probability. Study 2 also revealed that children were intuitively sensitive to probability; however, the inclusion of loss had limited impact on decision processes. These findings and their relevance to cognitive developmental theory are discussed.

  13. 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.

  14. Mass Spectrometry Imaging as a Tool for Surgical Decision-Making

    PubMed Central

    Calligaris, David; Norton, Isaiah; Feldman, Daniel R.; Ide, Jennifer L.; Dunn, Ian F.; Eberlin, Livia S.; Cooks, R. Graham; Jolesz, Ferenc A.; Golby, Alexandra J.; Santagata, Sandro; Agar, Nathalie Y.

    2014-01-01

    Despite significant advances in image-guided therapy, surgeons are still too often left with uncertainty when deciding to remove tissue. This binary decision between removing and leaving tissue during surgery implies that the surgeon should be able to distinguish tumor from healthy tissue. In neurosurgery, current image-guidance approaches such as magnetic resonance imaging (MRI) combined with neuro-navigation offer a map as to where the tumor should be, but the only definitive method to characterize the tissue at stake is histopathology. While extremely valuable information is derived from this gold standard approach, it is limited to very few samples during surgery and is not practically used for the delineation of tumor margins. The development and implementation of faster, comprehensive and complementary approaches for tissue characterization are required to support surgical decision-making – an incremental and iterative process with tumor removed in multiple and often minute biopsies. The development of atmospheric pressure ionization sources makes it possible to analyze tissue specimens with little to no sample preparation. Here, we highlight the value of desorption electrospray ionization (DESI) as one of many available approaches for the analysis of surgical tissue. Twelve surgical samples resected from a patient during surgery were analyzed and diagnosed as glioblastoma (GBM) tumor or necrotic tissue by standard histopathology, and mass spectrometry results were further correlated to histopathology for critical validation of the approach. The use of a robust statistical approach reiterated results from the qualitative detection of potential biomarkers of these tissue types. The correlation of the MS and histopathology results to magnetic resonance images brings significant insight into tumor presentation that could not only serve to guide tumor resection, but that is worthy of more detailed studies on our understanding of tumor presentation on MRI. PMID

  15. Space Launch System Complex Decision-Making Process

    NASA Technical Reports Server (NTRS)

    Lyles, Garry; Flores, Tim; Hundley, Jason; Monk, Timothy; Feldman,Stuart

    2012-01-01

    The Space Shuttle program has ended and elements of the Constellation Program have either been cancelled or transitioned to new NASA exploration endeavors. The National Aeronautics and Space Administration (NASA) has worked diligently to select an optimum configuration for the Space Launch System (SLS), a heavy lift vehicle that will provide the foundation for future beyond low earth orbit (LEO) large-scale missions for the next several decades. From Fall 2010 until Spring 2011, an SLS decision-making framework was formulated, tested, fully documented, and applied to multiple SLS vehicle concepts at NASA from previous exploration architecture studies. This was a multistep process that involved performing figure of merit (FOM)-based assessments, creating Pass/Fail gates based on draft threshold requirements, performing a margin-based assessment with supporting statistical analyses, and performing sensitivity analysis on each. This paper focuses on the various steps and methods of this process (rather than specific data) that allowed for competing concepts to be compared across a variety of launch vehicle metrics in support of the successful completion of the SLS Mission Concept Review (MCR) milestone.

  16. Multiple-reason decision making based on automatic processing.

    PubMed

    Glöckner, Andreas; Betsch, Tilmann

    2008-09-01

    It has been repeatedly shown that in decisions under time constraints, individuals predominantly use noncompensatory strategies rather than complex compensatory ones. The authors argue that these findings might be due not to limitations of cognitive capacity but instead to limitations of information search imposed by the commonly used experimental tool Mouselab (J. W. Payne, J. R. Bettman, & E. J. Johnson, 1988). The authors tested this assumption in 3 experiments. In the 1st experiment, information was openly presented, whereas in the 2nd experiment, the standard Mouselab program was used under different time limits. The results indicate that individuals are able to compute weighted additive decision strategies extremely quickly if information search is not restricted by the experimental procedure. In a 3rd experiment, these results were replicated using more complex decision tasks, and the major alternative explanations that individuals use more complex heuristics or that they merely encode the constellation of cues were ruled out. In sum, the findings challenge the fundaments of bounded rationality and highlight the importance of automatic processes in decision making.

  17. Shared Surgical Decision-Making and Youth Resilience: Correlates of Satisfaction with Clinical Outcomes

    PubMed Central

    Kapp-Simon, Kathleen A; Edwards, Todd; Ruta, Caroline; Bellucci, Claudia Crilly; Aspirnall, Cassandra L.; Strauss, Ronald P; Topolski, Tari D.; Rumsey, Nichola J; Patrick, Donald L

    2015-01-01

    The aim of this study was to identify factors associated with youth satisfaction with surgical procedures performed to address oral cleft or craniofacial conditions (CFC). It was hypothesized that youth mental health, participation in decision-making, perceived consequences of living with a CFC, and coping strategies would be associated with satisfaction with past surgeries. Two hundred and three youth between the ages of 11 and 18 (Mean age = 14.5. SD = 2.0; 61% male; 78% oral cleft) completed a series of questionnaires measuring depression, self-esteem, participation in decision-making, condition severity, negative and positive consequences of having a CFC, coping, and satisfaction with past surgeries. Multiple Regression Analysis using boot-strapping techniques found that youth participation in decision making, youth perception of positive consequences of having a CFC, and coping accounted for 32% of the variance in satisfaction with past surgeries (p < .001). Youth age, sex, and assessment of condition severity were not significantly associated with satisfaction with surgical outcome. Depression, self-esteem, and negative consequences of having a CFC were not associated with satisfaction with past surgeries. Youth should be actively involved in the decision for craniofacial surgery. Youth who were more satisfied with their surgical outcomes also viewed themselves as having gained from the experience of living with a CFC. They felt that having a CFC made them stronger people and they believed that they were more accepting of others and more in touch with others’ feelings because of what they had been through. PMID:26114527

  18. Decision-Making Processes: Sensitivity to Sequentially Experienced Outcome Probabilities

    ERIC Educational Resources Information Center

    Boyer, Ty W.

    2007-01-01

    A computerized sequential event sampling decision-making task was administered to 187 5- to 10-year-olds and adults. Participants made a series of choices between alternatives that differed in win probability (Study 1) or win and loss probability (Study 2). Intuitive and more explicit measures were used. Study 1 revealed that, across ages,…

  19. Memory and Processing Limits in Decision-Making.

    ERIC Educational Resources Information Center

    Klapp, Stuart T.

    According to the classical working memory perspective, tasks such as command and control decision-making should be performed less effectively if extraneous material must be retained in short-term memory. Only marginal support for this prediction was obtained for a simulation involving scheduling trucking and transportation missions, although…

  20. Diagnostic accuracy and receiver-operating characteristics curve analysis in surgical research and decision making.

    PubMed

    Søreide, Kjetil; Kørner, Hartwig; Søreide, Jon Arne

    2011-01-01

    In surgical research, the ability to correctly classify one type of condition or specific outcome from another is of great importance for variables influencing clinical decision making. Receiver-operating characteristic (ROC) curve analysis is a useful tool in assessing the diagnostic accuracy of any variable with a continuous spectrum of results. In order to rule a disease state in or out with a given test, the test results are usually binary, with arbitrarily chosen cut-offs for defining disease versus health, or for grading of disease severity. In the postgenomic era, the translation from bench-to-bedside of biomarkers in various tissues and body fluids requires appropriate tools for analysis. In contrast to predetermining a cut-off value to define disease, the advantages of applying ROC analysis include the ability to test diagnostic accuracy across the entire range of variable scores and test outcomes. In addition, ROC analysis can easily examine visual and statistical comparisons across tests or scores. ROC is also favored because it is thought to be independent from the prevalence of the condition under investigation. ROC analysis is used in various surgical settings and across disciplines, including cancer research, biomarker assessment, imaging evaluation, and assessment of risk scores.With appropriate use, ROC curves may help identify the most appropriate cutoff value for clinical and surgical decision making and avoid confounding effects seen with subjective ratings. ROC curve results should always be put in perspective, because a good classifier does not guarantee the expected clinical outcome. In this review, we discuss the fundamental roles, suggested presentation, potential biases, and interpretation of ROC analysis in surgical research.

  1. Analysis of the decision-making process leading to appendectomy: a grounded theory study.

    PubMed

    Larsson, Gerry; Weibull, Henrik; Larsson, Bodil Wilde

    2004-11-01

    The aim was to develop a theoretical understanding of the decision-making process leading to appendectomy. A qualitative interview study was performed in the grounded theory tradition using the constant comparative method to analyze data. The study setting was one county hospital and two local hospitals in Sweden, where 11 surgeons and 15 surgical nurses were interviewed. A model was developed which suggests that surgeons' decision making regarding appendectomy is formed by the interplay between their medical assessment of the patient's condition and a set of contextual characteristics. The latter consist of three interacting factors: (1) organizational conditions, (2) the professional actors' individual characteristics and interaction, and (3) the personal characteristics of the patient and his or her family or relatives. In case the outcome of medical assessment is ambiguous, the risk evaluation and final decision will be influenced by an interaction of the contextual characteristics. It was concluded that, compared to existing, rational models of decision making, the model presented identified potentially important contextual characteristics and an outline on when they come into play.

  2. Influence of 1.5-Tesla intraoperative MR imaging on surgical decision making.

    PubMed

    Hall, W A; Liu, H; Maxwell, R E; Truwit, C L

    2003-01-01

    To determine the frequency that high-field magnetic resonance (MR) imaging sequences influenced surgical decision making during intraoperative MR-guided surgery. From January 1997 to February 2001, 346 MR-guided procedures were performed using a 1.5-Tesla MR system (NT-ACS, Philips Medical Systems). This system can perform functional MR imaging (fMRI), diffusion weighted imaging (DWI), MR spectroscopy (MRS), MR angiography (MRA), and MR venography (MRV) in addition to T1-weighted, T2-weighted, and turbo FLAIR (fluid-attenuated inversion recovery) imaging. FMRI was used to determine areas of brain activation for language, motor function, and memory. DWI was utilized after tumor resection to exclude cerebral ischemia or infarction. MRS was obtained to identify areas of elevated choline that were suspected to correlate with tumor presence. MRA and MRV localized vascular structures adjacent to tumors prior to resection. The intraoperative procedures performed included 140 brain biopsies of which 82 utilized a trajectory guide and prospective stereotaxy. MRS was used in 42 biopsies (30%), of which 29 had turbo spectroscopic imaging (TSI) and 21 had single voxel spectroscopy (SVS). In all biopsy cases, diagnostic tissue was obtained. There were 103 tumor resections of which 18 (17%) had MRS. Functional MRI was used in 17 cases; 3 biopsies (2%) and 14 planned resections (14%). Speech function was localized in 3 cases, memory function in 3, and motor function in 11. In one case where the motor function of the tongue was intimately involved with a low-grade glioma, resection was not attempted. DWI was used in less than 10% of tumor resections. MRA and MRV were performed in 3 (3%) and 2 (2%) of tumor resections, respectively. The imaging capabilities (i.e., fMRI, DWI, MRA, MRV) associated with high-field intraoperative MR influenced surgical decision making primarily for tumor resections. MRS influenced target selection during brain biopsy.

  3. An Assessment of Decision-Making Processes in Dual-Career Marriages.

    ERIC Educational Resources Information Center

    Kingsbury, Nancy M.

    As large numbers of women enter the labor force, decision making and power processes have assumed greater importance in marital relationships. A sample of 51 (N=101) dual-career couples were interviewed to assess independent variables predictive of process power, process outcome, and subjective outcomes of decision making in dual-career families.…

  4. Climate Change Scenario Planning in Alaska's National Parks: Stakeholder Involvement in the Decision-Making Process

    SciTech Connect

    Ernst, Kathleen M; Van Riemsdijk, Dr. Micheline

    2013-01-01

    This article studies the participation of stakeholders in climate change decision-making in Alaska s National Parks. We place stakeholder participation within literatures on environmental and climate change decision-making. We conducted participant observation and interviews in two planning workshops to investigate the decision-making process, and our findings are three-fold. First, the inclusion of diverse stakeholders expanded climate change decision-making beyond National Park Service (NPS) institutional constraints. Second, workshops of the Climate Change Scenario Planning Project (CCSPP) enhanced institutional understandings of participants attitudes towards climate change and climate change decision-making. Third, the geographical context of climate change influences the decision-making process. As the first regional approach to climate change decision-making within the NPS, the CCSPP serves as a model for future climate change planning in public land agencies. This study shows how the participation of stakeholders can contribute to robust decisions, may move climate change decision-making beyond institutional barriers, and can provide information about attitudes towards climate change decision-making.

  5. A Case Study of the Decision-Making Process of Educational Leaders When Considering Program Implementation

    ERIC Educational Resources Information Center

    Laird, Scott

    2012-01-01

    The purpose of this study was to discover what school leaders considered during the decision-making process when adding a transitional kindergarten program and how the decision was made. This study investigated the decision-making process for superintendents and principals by examining decisions made by rural, suburban, and large school…

  6. Free-Choice Learning Suited to Women's Participation Needs in Environmental Decision-Making Processes

    ERIC Educational Resources Information Center

    Skanavis, Constantina; Sakellari, Maria

    2012-01-01

    United Nations mandates recognize the need to promote the full participation of women in environmental decision-making processes on the basis of gender equality. But, there remains a profound lack of effective women's participation in some sectors of environmental decision-making. Free-choice environmental learning offers an effective educational…

  7. The Use of Art in the Medical Decision-Making Process of Oncology Patients

    ERIC Educational Resources Information Center

    Czamanski-Cohen, Johanna

    2012-01-01

    The introduction of written informed consent in the 1970s created expectations of shared decision making between doctors and patients that has led to decisional conflict for some patients. This study utilized a collaborative, intrinsic case study approach to the decision-making process of oncology patients who participated in an open art therapy…

  8. Stakeholders' Perception of Who Influences the Decision-Making Processes in Ontario's Public Postsecondary Education Institutions

    ERIC Educational Resources Information Center

    Powell, Billroy

    2008-01-01

    This paper reports the findings of a study conducted on stakeholders' perception of who influences the decision-making processes in Ontario's public postsecondary education institutions. The study identified and interviewed representatives of those stakeholder groups that are frequently written about as the main forces behind decision making in…

  9. Disciplined Decision Making in an Interdisciplinary Environment: Some Implications for Clinical Applications of Statistical Process Control.

    ERIC Educational Resources Information Center

    Hantula, Donald A.

    1995-01-01

    Clinical applications of statistical process control (SPC) in human service organizations are considered. SPC is seen as providing a standard set of criteria that serves as a common interface for data-based decision making, which may bring decision making under the control of established contingencies rather than the immediate contingencies of…

  10. Climate change scenario planning in Alaska's National Parks: Stakeholder involvement in the decision-making process

    SciTech Connect

    Ernst, Kathleen M; Van Riemsdijk, Dr. Micheline

    2013-01-01

    This article studies the participation of stakeholders in climate change decision-making in Alaska s National Parks. We place stakeholder participation within literatures on environmental and climate change decision-making. We conducted participant observation and interviews in two planning workshops to investigate the decision-making process, and our findings are three-fold. First, the inclusion of diverse stakeholders expanded climate change decision-making beyond National Park Service (NPS) institutional constraints. Second, workshops of the Climate Change Scenario Planning Project (CCSPP) enhanced institutional understandings of participants attitudes towards climate change and climate change decision-making. Third, the geographical context of climate change influences the decisionmaking process. As the first regional approach to climate change decision-making within the NPS, the CCSPP serves as a model for future climate change planning in public land agencies. This study shows how the participation of stakeholders can contribute to robust decisions, may move climate change decision-making beyond institutional barriers, and can provide information about attitudes towards climate change decision-making.

  11. Interpersonal influences on patients’ surgical decision making: the role of close others

    PubMed Central

    Rini, Christine; Jandorf, Lina; Goldsmith, Rachel E.; Manne, Sharon L.; Harpaz, Noam; Itzkowitz, Steven H.

    2011-01-01

    Patients make medical decisions in consultation with their partner, family, and friends. However, little is known about the ways in which these close others influence their decisions, particularly with respect to discrete decisions such as those related to medical treatments. This cross-sectional study investigated their influence on the surgical decisions of inflammatory bowel disease patients referred for surgery to remove their colon (N = 91). Guided by research on social control and classic research on power and influence in close relationships, we identified four types of close other decision influence: persuasion, assistance with understanding, indirect influence, and negative influence. Linear logistic and regression analyses showed that patients were more likely to have surgery when their close other used persuasion, and they reported lower decisional conflict when their close other helped them understand the decision. Patients were less likely to have surgery and reported greater decisional conflict when their close other used negative influence tactics. Findings demonstrate the importance of considering social context when investigating patient decision making. PMID:21308408

  12. The Computational Complexity of Valuation and Motivational Forces in Decision-Making Processes.

    PubMed

    Redish, A David; Schultheiss, Nathan W; Carter, Evan C

    2016-01-01

    The concept of value is fundamental to most theories of motivation and decision making. However, value has to be measured experimentally. Different methods of measuring value produce incompatible valuation hierarchies. Taking the agent's perspective (rather than the experimenter's), we interpret the different valuation measurement methods as accessing different decision-making systems and show how these different systems depend on different information processing algorithms. This identifies the translation from these multiple decision-making systems into a single action taken by a given agent as one of the most important open questions in decision making today. We conclude by looking at how these different valuation measures accessing different decision-making systems can be used to understand and treat decision dysfunction such as in addiction. PMID:25981912

  13. A neurocognitive model of the ethical decision-making process: implications for study and practice.

    PubMed

    Reynolds, Scott J

    2006-07-01

    The field of business ethics is entrenched in a cognitive approach that portrays the ethical decision-making process as a completely deliberate and reasoned exercise. In light of growing concerns about the veracity of this approach, I build upon current knowledge of how the brain functions to present a neurocognitive model of ethical decision making. The model suggests that ethical decision making involves 2 interrelated yet functionally distinct cycles, a reflexive pattern matching cycle and a higher order conscious reasoning cycle, and thereby describes not only reasoned analysis, but also the intuitive and retrospective aspects of ethical decision making. The model sparks research in new areas, holds significant implications for the study of ethical decision making, and provides suggestions for improving ethical behavior in organizations.

  14. Decision-Making in the Surgical Treatment of Breast Cancer: Factors Influencing Women’s Choices for Mastectomy and Breast Conserving Surgery

    PubMed Central

    Bellavance, Emily Catherine; Kesmodel, Susan Beth

    2016-01-01

    One of the most difficult decisions a woman can be faced with when choosing breast cancer treatment is whether or not to undergo breast conserving surgery or mastectomy. The factors that influence these treatment decisions are complex and involve issues regarding access to health care, concerns for cancer recurrence, and the impact of surgery on body image and sexuality. Understanding these factors will help practitioners to improve patient education and to better guide patients through this decision-making process. Although significant scientific and societal advances have been made in improving women’s choices for the breast cancer treatment, there are still deficits in the decision-making processes surrounding the surgical treatment of breast cancer. Further research is needed to define optimal patient education and shared decision-making practices in this area. PMID:27066455

  15. [Clinical decision making and critical thinking in the nursing diagnostic process].

    PubMed

    Müller-Staub, Maria

    2006-10-01

    The daily routine requires complex thinking processes of nurses, but clinical decision making and critical thinking are underestimated in nursing. A great demand for educational measures in clinical judgement related with the diagnostic process was found in nurses. The German literature hardly describes nursing diagnoses as clinical judgements about human reactions on health problems / life processes. Critical thinking is described as an intellectual, disciplined process of active conceptualisation, application and synthesis of information. It is gained through observation, experience, reflection and communication and leads thinking and action. Critical thinking influences the aspects of clinical decision making a) diagnostic judgement, b) therapeutic reasoning and c) ethical decision making. Human reactions are complex processes and in their course, human behavior is interpreted in the focus of health. Therefore, more attention should be given to the nursing diagnostic process. This article presents the theoretical framework of the paper "Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies".

  16. Patient participation in the medical decision-making process in haemato-oncology--a qualitative study.

    PubMed

    Ernst, J; Berger, S; Weißflog, G; Schröder, C; Körner, A; Niederwieser, D; Brähler, E; Singer, S

    2013-09-01

    Cancer patients are showing increased interest in shared decision-making. Patients with haematological illnesses, however, express considerably less desire for shared decision-making as compared with other oncological patient groups. The goal of the current project was to identify the reasons for the lower desire for shared decision-making among patients with haematological illness. We conducted qualitative, semi-structured interviews with 11 haematological patients (39-70 years old) after the beginning of therapy concerning the course and evaluation of medical shared decision-making. The patients were often overwhelmed by the complexity of the illness and the therapy and did not want to assume any responsibility in medical decision-making. They reported a great deal of distress and very traditional paternalistic role expectations with regards to their health care providers, which limited the patients' ability to partake in the decision-making process. In contrast to the socio-cultural support for many other oncological diseases, haematological diseases are not as well supported, e.g. there is a lack of self-help materials, systematic provision of information and support groups for patients, which may be related to a lower empowerment of this patient population. Results show the limits of patient participation in the context of highly complicated medical conditions. In addition to already researched preferences of the physicians and patients for shared decision-making, future research should pay greater attention to the process and other variables relevant to this aspect of the doctor-patient relationship.

  17. Theory of mind and decision-making processes are impaired in Parkinson's disease.

    PubMed

    Xi, Chunhua; Zhu, Youling; Mu, Yanfang; Chen, Bing; Dong, Bin; Cheng, Huaidong; Hu, Panpan; Zhu, Chunyan; Wang, Kai

    2015-02-15

    Prefrontal cortex plays a vital role in the theory of mind (ToM) and decision making, as shown in functional brain imaging and lesion studies. Considering the primary neuropathology of Parkinson's disease (PD) involving the frontal lobe system, patients with PD are expected to exhibit deficits in ToM and social decision making. The aim of this study was to investigate affective ToM and decision making in patients with PD and healthy controls (HC) in a task assessing affective ToM (Reading the Mind in the Eyes, RME) and two decision-making tasks (Iowa Gambling Task, IGT; Game of Dice Task, GDT). Consistent with previous findings, patients with PD were impaired in the affective ToM task, and when making decisions under ambiguity and in risk situations. The score of emotion recognition in the RME task was negatively correlated with the severity of the disease and positively correlated with the total number of advantageous cards chosen in the IGT. However, the final capital in the GDT was correlated with memory impairment. The present study implies that affective ToM and decision making under ambiguity may share similar neural mechanisms, while decision making under ambiguity and decision making under risk may involve processing within different neural networks. PMID:25435317

  18. Involvement of Women in the Governance Process: Decision Making.

    ERIC Educational Resources Information Center

    Radley, Virginia L.

    This document somewhat humorously deals with the topic of women's participation in the administrative process. The author commences by presenting procedures necessary for women to achieve success in administrative circles acceptable to academic deans of the "old school." Then she presents the qualities necessary to be accepted by the personnel…

  19. Gambling with your life: the process of breast cancer treatment decision making in Chinese women.

    PubMed

    Lam, Wendy Wt; Fielding, Richard; Chan, Miranda; Chow, Louis; Or, Amy

    2005-01-01

    Treatment decision making (TDM) studies have primarily focused on assessing TDM quality and predominantly presume rational analytic processes as the gold standard. In a grounded theory study of 22 Hong Kong Chinese women following breast surgery who completed an in-depth interview exploring the process of TDM in breast cancer (BC), narrative data showed that discovery of a breast abnormality and emotional responses to BC diagnosis influence the TDM process. Lack of guidance from surgeons impaired TDM. Decisions were, for the most part, made using intuitive, pragmatic and emotionally driven criteria in the absence of complete information. The experience of TDM, which was likened to gambling, did not end once the decision was made but unfolded while waiting for surgery and the post-operative report. In this waiting period, women were emotionally overwhelmed by fear of death and the uncertainty of the surgical outcome, and equivocated over whether they had made the 'right' choice. This suggests that Chinese women feel they are gambling with their lives during TDM. These women are particularly emotionally vulnerable whilst waiting for their surgery and the post-surgical clinical pathology results. Providing emotional support is particularly important at this time when these women are overwhelmed by uncertainty.

  20. Detecting fast, online reasoning processes in clinical decision making.

    PubMed

    Flores, Amanda; Cobos, Pedro L; López, Francisco J; Godoy, Antonio

    2014-06-01

    In an experiment that used the inconsistency paradigm, experienced clinical psychologists and psychology students performed a reading task using clinical reports and a diagnostic judgment task. The clinical reports provided information about the symptoms of hypothetical clients who had been previously diagnosed with a specific mental disorder. Reading times of inconsistent target sentences were slower than those of control sentences, demonstrating an inconsistency effect. The results also showed that experienced clinicians gave different weights to different symptoms according to their relevance when fluently reading the clinical reports provided, despite the fact that all the symptoms were of equal diagnostic value according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The diagnostic judgment task yielded a similar pattern of results. In contrast to previous findings, the results of the reading task may be taken as direct evidence of the intervention of reasoning processes that occur very early, rapidly, and online. We suggest that these processes are based on the representation of mental disorders and that these representations are particularly suited to fast retrieval from memory and to making inferences. They may also be related to the clinicians' causal reasoning. The implications of these results for clinician training are also discussed. PMID:24274045

  1. [Cognitive changes in decision making process underlying prosocial behavior].

    PubMed

    Takemura, K; Takagi, O

    1987-08-01

    Using a method of monitoring information acquisition, 76 subjects were instructed to simulate the information search process in which they selected a behavior from available behavioral alternatives which were expected to occur in a situation where donating behavior was needed. In order to measure the cognitive changes, they were asked to rate the importance of behavioral attributes both before and after the decision task. After the decision task, they were asked to rate the inner states. (1) Defensive cognitive changes were found which increased the importance of behavioral costs and decreased the importance of personal moral obligation feelings. This pattern of changes was consistent with the Schwartz & Howard model (1981, 1982, 1984). (2) The defensive cognitive changes were related to the information search strategies. This pattern of relationship partly confirmed the prediction derived from the Schwartz & Howard model (1981, 1982, 1984). (3) The result that the cognitive changes were not related to the inner states was inconsistent with the model of either Piliavin, Dovidio, Gaertner, & Clark (1981, 1982) or Schwartz & Howard (1981, 1982, 1984). An alternative model was proposed and discussed.

  2. Who decides? The decision-making process of juvenile judges concerning minors with mental disorders.

    PubMed

    Cappon, Leen

    2016-01-01

    Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision.

  3. Fuzzy methods in decision making process - A particular approach in manufacturing systems

    NASA Astrophysics Data System (ADS)

    Coroiu, A. M.

    2015-11-01

    We are living in a competitive environment, so we can see and understand that the most of manufacturing firms do the best in order to accomplish meeting demand, increasing quality, decreasing costs, and delivery rate. In present a stake point of interest is represented by the development of fuzzy technology. A particular approach for this is represented through the development of methodologies to enhance the ability to managed complicated optimization and decision making aspects involving non-probabilistic uncertainty with the reason to understand, development, and practice the fuzzy technologies to be used in fields such as economic, engineering, management, and societal problems. Fuzzy analysis represents a method for solving problems which are related to uncertainty and vagueness; it is used in multiple areas, such as engineering and has applications in decision making problems, planning and production. As a definition for decision making process we can use the next one: result of mental processes based upon cognitive process with a main role in the selection of a course of action among several alternatives. Every process of decision making can be represented as a result of a final choice and the output can be represented as an action or as an opinion of choice. Different types of uncertainty can be discovered in a wide variety of optimization and decision making problems related to planning and operation of power systems and subsystems. The mixture of the uncertainty factor in the construction of different models serves for increasing their adequacy and, as a result, the reliability and factual efficiency of decisions based on their analysis. Another definition of decision making process which came to illustrate and sustain the necessity of using fuzzy method: the decision making is an approach of choosing a strategy among many different projects in order to achieve some purposes and is formulated as three different models: high risk decision, usual risk

  4. 14 CFR 1216.303 - NEPA process in NASA planning and decision making.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false NEPA process in NASA planning and decision...) § 1216.303 NEPA process in NASA planning and decision making. (a) NEPA requires the systematic... the NEPA process with NASA project and program planning improves Agency decisions and ensures that:...

  5. 14 CFR § 1216.303 - NEPA process in NASA planning and decision making.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 5 2014-01-01 2014-01-01 false NEPA process in NASA planning and decision... Act (NEPA) § 1216.303 NEPA process in NASA planning and decision making. (a) NEPA requires the... integration of the NEPA process with NASA project and program planning improves Agency decisions and...

  6. Cognitive processes as integrative component for developing expert decision-making systems: a workflow centered framework.

    PubMed

    Jalote-Parmar, Ashis; Badke-Schaub, Petra; Ali, Wajid; Samset, Eigil

    2010-02-01

    The development of expert decision-making systems, which improve task performance and reduce errors within an intra-operative clinical workspace, is critically dependent on two main aspects: (a) Analyzing the clinical requirements and cognitive processes within the workflow and (b) providing an optimal context for accurate situation awareness through effective intra-operative information visualization. This paper presents a workflow centered framework and its theoretical underpinnings to design expert decision-making systems. The framework integrates knowledge of the clinical workflow based on the requirements within the clinical workspace. Furthermore, it builds upon and integrates the theory of situation awareness into system design to improve decision-making. As an application example, this framework has been used to design an intra-operative visualization system (IVS), which provides image guidance to the clinicians to perform minimally invasive procedure. An evaluative study, comparing the traditional ultrasound guided procedure with the new developed IVS, has been conducted with expert intervention radiologists and medical students. The results reveal significant evidence for improved decision-making when using the IVS. Therefore, it can be stated that this study demonstrates the benefits of integrating knowledge of cognitive processes into system development to support clinical decision-making and hence improvement of task performance and prevention of errors.

  7. The role of orbitofrontal cortex in decision making: a component process account.

    PubMed

    Fellows, Lesley K

    2007-12-01

    Clinical accounts of the effects of damage to orbitofrontal cortex (OFC) have provided important clues about the functions of this region in humans. Patients with OFC injury can demonstrate relatively isolated difficulties with decision making, and the development of laboratory tasks that captured these difficulties was an important advance. However, much of the work to date has been limited by the use of a single, complex decision-making task and by a narrow focus on risky decisions. A fuller understanding of the neural basis of decision making requires identification of the simpler components that underlie this complex behavior. Here, I review evidence that OFC lesions disrupt reversal learning in humans, as in animals, and show that this deficit in reversal learning is an important mechanism underlying the difficulties of such patients in the Iowa gambling task. Reversal learning, in turn, can be decomposed into simpler processes: a failure to rapidly learn from negative feedback may be the critical difficulty for OFC patients. OFC damage can also affect forms of decision making that do not require trial-by-trial learning. Preference judgment is a simple form of decision making that requires comparing the relative value of options. Humans with OFC lesions are more inconsistent in their choices, even in very simple preference judgment tasks. These results are broadly consistent with the view that OFC is critically involved in representing the relative value of stimuli, but also raise the possibility that this region plays distinct roles in reinforcement learning and value-based judgment. PMID:17846161

  8. Using Communication Models to Analyze Decision-Making in the Developmental Process.

    ERIC Educational Resources Information Center

    Silverblank, Francine

    This paper uses two communication models, Goffman's theatrical model and Harris' psychological model, to illustrate the communication process as it occurs in curriculum projects and to analyze the processes by which people influence each other--decision making and nondecision making. It is suggested that viewing such projects from diverse…

  9. An Assessment of Decision-Making Styles/Processes of Consumer Education Students.

    ERIC Educational Resources Information Center

    Bertelson, Catherine L.

    1986-01-01

    Reports on a study to determine the decision-making processes and styles used by consumer education students when confronted with a consumer credit problem. Tests were administered to 27 secondary students. Findings revealed that gender determines to a great extent the process and style used. (Author/CH)

  10. Superintendents' Perceptions of Utilizing a Democratic Decision-Making Process in Learning Communities

    ERIC Educational Resources Information Center

    Kruppe, Amy

    2011-01-01

    The purpose of this study was to examine the decision-making processes of superintendents. Using a democratic lens and ethic of care, this researcher used a multiple case study design to examine two superintendents' perceptions of their processes. Analysis of interview data from the two cases showed that superintendents use a deliberative…

  11. A Dual-Process Approach to Health Risk Decision Making: The Prototype Willingness Model

    ERIC Educational Resources Information Center

    Gerrard, Meg; Gibbons, Frederick X.; Houlihan, Amy E.; Stock, Michelle L.; Pomery, Elizabeth A.

    2008-01-01

    Although dual-process models in cognitive, personality, and social psychology have stimulated a large body of research about analytic and heuristic modes of decision making, these models have seldom been applied to the study of adolescent risk behaviors. In addition, the developmental course of these two kinds of information processing, and their…

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

    ERIC Educational Resources Information Center

    Booth, Sara

    2013-01-01

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

  13. “And I think that we can fix it”: Mental Models used in High-Risk Surgical Decision Making

    PubMed Central

    Kruser, Jacqueline M; Pecanac, Kristen E; Brasel, Karen J; Cooper, Zara; Steffens, Nicole; McKneally, Martin; Schwarze, Margaret L

    2014-01-01

    Objective To examine how surgeons use the “fix-it” model to communicate with patients before high-risk operations. Background The “fix-it” model characterizes disease as an isolated abnormality that can be restored to normal form and function through medical intervention. This mental model is familiar to patients and physicians, but it is ineffective for chronic conditions and treatments that cannot achieve normalcy. Overuse may lead to permissive decision making favoring intervention. Efforts to improve surgical decision making will need to consider how mental models function in clinical practice, including “fix-it”. Methods We observed surgeons who routinely perform high-risk surgery during preoperative discussions with patients. We used qualitative content analysis to explore the use of “fix-it” in 48 audio-recorded conversations. Results Surgeons used the “fix-it” model for two separate purposes during preoperative conversations; 1) as an explanatory tool to facilitate patient understanding of disease and surgery and 2) as a deliberation framework to assist in decision making. Although surgeons commonly used “fix-it” as an explanatory model, surgeons explicitly discussed limitations of the “fix-it” model as an independent rationale for operating as they deliberated about the value of surgery. Conclusions While the use of “fix-it” is familiar for explaining medical information to patients, surgeons recognize that the model can be problematic for determining the value of an operation. Whether patients can transition between understanding how their disease is fixed with surgery to a subsequent deliberation about whether they should have surgery is unclear and may have broader implications for surgical decision making. PMID:25749396

  14. Implementing Georeferencing in the Decision-Making Process of a Health Care Provider in Uruguay.

    PubMed

    Silva Layes, Elizabeth; Morales, Fernando; Leivas, Julio

    2015-01-01

    Proper management of information is not only essential but also critical in any organization's decision making process. Data integration and spacial visualization are the key features of georeferencial systems, which bring support to decision making in epidemiology as well as sanitary planning.This paper shows the development of a georeferential system that interacts with the data provided by the Health Care System.Thereby allowing creation of viable methods which will help to improve patient care, treatments, and interventions through building space-time relationships.

  15. Decision making, procedural compliance, and outcomes definition in U.S. forest service planning processes

    SciTech Connect

    Stern, Marc J.; Predmore, S. Andrew

    2011-04-15

    The National Environmental Policy Act (NEPA) dictates a process of analyzing and disclosing the likely impacts of proposed agency actions on the human environment. This study addresses two key questions related to NEPA implementation in the U.S. Forest Service: 1) how do Interdisciplinary (ID) team leaders and decision makers conceptualize the outcomes of NEPA processes? And 2), how does NEPA relate to agency decision making? We address these questions through two separate online surveys that posed questions about recently completed NEPA processes - the first with the ID team leaders tasked with carrying out the processes, and the second with the line officers responsible for making the processes' final decisions. Outcomes of NEPA processes include impacts on public relations, on employee morale and team functioning, on the achievement of agency goals, and on the achievement of NEPA's procedural requirements (disclosure) and substantive intent (minimizing negative environmental impacts). Although both tended to view public relations outcomes as important, decision makers' perceptions of favorable outcomes were more closely linked to the achievement of agency goals and process efficiency than was the case for ID team leaders. While ID team leaders' responses suggest that they see decision making closely integrated with the NEPA process, decision makers more commonly decoupled decision making from the NEPA process. These findings suggest a philosophical difference between ID team leaders and decision makers that may pose challenges for both the implementation and the evaluation of agency NEPA. We discuss the pros and cons of integrating NEPA with decision making or separating the two. We conclude that detaching NEPA from decision making poses greater risks than integrating them.

  16. Review of Current International Decision-Making Processes for Newborn Screening: Lessons for Australia

    PubMed Central

    Metternick-Jones, Selina Carolyne; Lister, Karla Jane; Dawkins, Hugh J. S.; White, Craig Anthony; Weeramanthri, Tarun Stephen

    2015-01-01

    Newborn bloodspot screening has been operating successfully in Australia for almost 50 years. Recently, the development of new technologies and treatments has led to calls for the addition of new conditions to the screening programs. Internationally, it is recognized by governments that national policies for newborn screening should support transparent and evidence-based decision making, and promote consistency between states within a country. Australia is lagging behind the international community, and currently has no national policies or decision-making processes, agreed by government, to support its newborn screening programs. In contrast, New Zealand (NZ), the United Kingdom (UK), and the United States of America (US) have robust and transparent processes to assess conditions for screening, which have been developed by, and have pathways to, government. This review provides detail on the current policy environment for newborn screening in Australia, highlighting that there are a number of risks to the programs resulting from the lack of a decision-making process. It also describes the processes used to assess conditions for newborn screening in the US, UK, and NZ. These examples highlight the benefits of developing a national decision-making process, including ensuring that screening is evidence based and effective. These examples also provide models that might be considered for Australia, as well as other countries currently seeking to introduce or expand newborn bloodspot screening. PMID:26442241

  17. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  18. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  19. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  20. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  1. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS Pt....

  2. Decision Making and Information Processing under Various Uncertainty Conditions. Final Report.

    ERIC Educational Resources Information Center

    Schipper, Lowell M.; Doherty, Michael

    Seven experiments were conducted concerning decision making and information processing under conditions of uncertainty. Several different experimental tasks were used; all presented the subject with multiple independent sources of information regarding the likelihood that some event would occur. Study 1 subjects were Air Force pilots; all other…

  3. Multiple Case Studies of Public Library Systems in New York State: Service Decision-Making Processes

    ERIC Educational Resources Information Center

    Ren, Xiaoai

    2012-01-01

    This research examined the functions and roles of public library systems in New York State and the services they provide for individual libraries and the public. The dissertation further studied the service decision-making processes at three selected New York State cooperative public library systems. Public library systems have played an important…

  4. 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 encoding, and…

  5. Quantifying Japanese Residents' Preferences for Public Meetings in Watershed Decision-Making Process

    ERIC Educational Resources Information Center

    Sakagami, Masaji; Ohno, Tomohiko; Tanaka, Takuya

    2010-01-01

    In this article, we quantified Japanese residents' potential preferences for public participation, specifically public meetings, concerning regional environmental issues in Yodo River watershed decision-making process. We conducted a choice experiments (CE) survey in the Yodo River watershed in Japan. Our findings confirmed that residents assign a…

  6. Group Decision Making in Higher Education Using the Analytic Hierarchy Process.

    ERIC Educational Resources Information Center

    Liberatore, Matthew J.; Nydick, Robert L.

    1997-01-01

    Examines application of the analytic hierarchy process (AHP) to group decision-making and evaluation situations in higher education. The approach is illustrated by (1) evaluation of academic research papers at Villanova University (Pennsylvania), and (2) a suggested adaptation for the more complex problem of institutionwide strategic planning.…

  7. Child Care Decision Making: Understanding Priorities and Processes Used by Low-Income Families in Minnesota

    ERIC Educational Resources Information Center

    Forry, Nicole; Isner, Tabitha K.; Daneri, Maria P.; Tout, Kathryn

    2014-01-01

    Research Findings: Few studies have described parents' child care decision-making process, yet understanding how parents make child care choices is fundamental to developing effective services to promote the selection of high-quality care. This study used latent profile analysis to distinguish subgroups of low-income parents identified as…

  8. Special Education Eligibility: An Examination of the Decision-Making Process

    ERIC Educational Resources Information Center

    Kirkland, Erin K. B.

    2012-01-01

    The purpose of this study was to investigate the influence of private practitioner and educational advocate opinions on school-based administrators' decision-making thought processes when making a recommendation for special education eligibility. Special education eligibility is a school-based team decision that involves multiple…

  9. Domestic Abuse and Child Contact: Positioning Children in the Decision-Making Process

    ERIC Educational Resources Information Center

    Holt, Stephanie

    2011-01-01

    Drawing on a three-year Irish research study, this paper focuses on the decision-making process in child contact, specifically the assessment and management of risk of continuing abuse to young people previously exposed to domestic abuse. A mixed methodological approach involved the completion of survey questionnaires by 219 mothers and the…

  10. Evidence of different underlying processes in pattern recall and decision-making.

    PubMed

    Gorman, Adam D; Abernethy, Bruce; Farrow, Damian

    2015-01-01

    The visual search characteristics of expert and novice basketball players were recorded during pattern recall and decision-making tasks to determine whether the two tasks shared common visual-perceptual processing strategies. The order in which participants entered the pattern elements in the recall task was also analysed to further examine the nature of the visual-perceptual strategies and the relative emphasis placed upon particular pattern features. The experts demonstrated superior performance across the recall and decision-making tasks [see also Gorman, A. D., Abernethy, B., & Farrow, D. (2012). Classical pattern recall tests and the prospective nature of expert performance. The Quarterly Journal of Experimental Psychology, 65, 1151-1160; Gorman, A. D., Abernethy, B., & Farrow, D. (2013a). Is the relationship between pattern recall and decision-making influenced by anticipatory recall? The Quarterly Journal of Experimental Psychology, 66, 2219-2236)] but a number of significant differences in the visual search data highlighted disparities in the processing strategies, suggesting that recall skill may utilize different underlying visual-perceptual processes than those required for accurate decision-making performance in the natural setting. Performance on the recall task was characterized by a proximal-to-distal order of entry of the pattern elements with participants tending to enter the players located closest to the ball carrier earlier than those located more distal to the ball carrier. The results provide further evidence of the underlying perceptual processes employed by experts when extracting visual information from complex and dynamic patterns. PMID:25662705

  11. Inferential Judgments Affecting the Decision-Making Process in the Attorney General's Commission on Pornography.

    ERIC Educational Resources Information Center

    Gouran, Dennis S.

    Although the Attorney General's Commission on Pornography, also known as the Meese Commission, has been criticized excessively at times for threatening freedom of speech and press and individual rights to privacy, an analysis of its "Final Report" reveals numerous deficiencies in the Commission's decision-making process. These deficiencies,…

  12. Effective Decision Making within the Organization: A Comparison of Regular, NGT, and Delphi Group Processes.

    ERIC Educational Resources Information Center

    Crawford, John E.; Cossitt, William B.

    Three group processes--regular face-to-face interacting groups, the nominal group technique (NGT), and Delphi procedures--were compared in terms of their ability to facilitate the quantitative and qualitative productivity of a decision making group. The results unequivocally supported the superiority of the Delphi procedures. Findings also tended…

  13. Teachers and Decision-Making Processes: An Italian Exploratory Study on Individual and Collaborative Decisions

    ERIC Educational Resources Information Center

    Parmigiani, Davide

    2012-01-01

    This research was aimed at highlighting the decision-making processes of Italian teachers; in particular, we have focused on individual and collaborative decisions developed both during meetings and in the classroom. The study has underlined the features of teachers' decisions when decisions are made in groups and individually. A questionnaire was…

  14. The Decision-Making Process for Requests for Late Termination of Pregnancy in Israel.

    ERIC Educational Resources Information Center

    Gagin, Roni; Oded, Ofrah; Cohen, Mimi; Itskovitz, Joseph

    2001-01-01

    This paper outlines and reflects on current procedures in Israel for requesting a late termination of pregnancy (LTP) and the subsequent decision-making processes, using data collected in 1995-97 from 183 women. Discusses the responsibility of the health system and social workers to address the need for enhanced support for women requesting LTPs.…

  15. Evidence of different underlying processes in pattern recall and decision-making.

    PubMed

    Gorman, Adam D; Abernethy, Bruce; Farrow, Damian

    2015-01-01

    The visual search characteristics of expert and novice basketball players were recorded during pattern recall and decision-making tasks to determine whether the two tasks shared common visual-perceptual processing strategies. The order in which participants entered the pattern elements in the recall task was also analysed to further examine the nature of the visual-perceptual strategies and the relative emphasis placed upon particular pattern features. The experts demonstrated superior performance across the recall and decision-making tasks [see also Gorman, A. D., Abernethy, B., & Farrow, D. (2012). Classical pattern recall tests and the prospective nature of expert performance. The Quarterly Journal of Experimental Psychology, 65, 1151-1160; Gorman, A. D., Abernethy, B., & Farrow, D. (2013a). Is the relationship between pattern recall and decision-making influenced by anticipatory recall? The Quarterly Journal of Experimental Psychology, 66, 2219-2236)] but a number of significant differences in the visual search data highlighted disparities in the processing strategies, suggesting that recall skill may utilize different underlying visual-perceptual processes than those required for accurate decision-making performance in the natural setting. Performance on the recall task was characterized by a proximal-to-distal order of entry of the pattern elements with participants tending to enter the players located closest to the ball carrier earlier than those located more distal to the ball carrier. The results provide further evidence of the underlying perceptual processes employed by experts when extracting visual information from complex and dynamic patterns.

  16. Categorization = Decision Making + Generalization

    PubMed Central

    Seger, Carol A; Peterson, Erik J.

    2013-01-01

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

  17. Clinical errors that can occur in the treatment decision-making process in psychotherapy.

    PubMed

    Park, Jake; Goode, Jonathan; Tompkins, Kelley A; Swift, Joshua K

    2016-09-01

    Clinical errors occur in the psychotherapy decision-making process whenever a less-than-optimal treatment or approach is chosen when working with clients. A less-than-optimal approach may be one that a client is unwilling to try or fully invest in based on his/her expectations and preferences, or one that may have little chance of success based on contraindications and/or limited research support. The and the models are two decision-making models that are frequently used within psychology, but both are associated with an increased likelihood of errors in the treatment decision-making process. In particular, these models fail to integrate all three components of the definition of evidence-based practice in psychology (American Psychological Association, 2006). In this article we describe both models and provide examples of clinical errors that can occur in each. We then introduce the shared decision-making model as an alternative that is less prone to clinical errors. (PsycINFO Database Record PMID:27505457

  18. Neural Signatures of Controlled and Automatic Retrieval Processes in Memory-based Decision-making.

    PubMed

    Khader, Patrick H; Pachur, Thorsten; Weber, Lilian A E; Jost, Kerstin

    2016-01-01

    Decision-making often requires retrieval from memory. Drawing on the neural ACT-R theory [Anderson, J. R., Fincham, J. M., Qin, Y., & Stocco, A. A central circuit of the mind. Trends in Cognitive Sciences, 12, 136-143, 2008] and other neural models of memory, we delineated the neural signatures of two fundamental retrieval aspects during decision-making: automatic and controlled activation of memory representations. To disentangle these processes, we combined a paradigm developed to examine neural correlates of selective and sequential memory retrieval in decision-making with a manipulation of associative fan (i.e., the decision options were associated with one, two, or three attributes). The results show that both the automatic activation of all attributes associated with a decision option and the controlled sequential retrieval of specific attributes can be traced in material-specific brain areas. Moreover, the two facets of memory retrieval were associated with distinct activation patterns within the frontoparietal network: The dorsolateral prefrontal cortex was found to reflect increasing retrieval effort during both automatic and controlled activation of attributes. In contrast, the superior parietal cortex only responded to controlled retrieval, arguably reflecting the sequential updating of attribute information in working memory. This dissociation in activation pattern is consistent with ACT-R and constitutes an important step toward a neural model of the retrieval dynamics involved in memory-based decision-making.

  19. Know the risk, take the win: how executive functions and probability processing influence advantageous decision making under risk conditions.

    PubMed

    Brand, Matthias; Schiebener, Johannes; Pertl, Marie-Theres; Delazer, Margarete

    2014-01-01

    Recent models on decision making under risk conditions have suggested that numerical abilities are important ingredients of advantageous decision-making performance, but empirical evidence is still limited. The results of our first study show that logical reasoning and basic mental calculation capacities predict ratio processing and that ratio processing predicts decision making under risk. In the second study, logical reasoning together with executive functions predicted probability processing (numeracy and probability knowledge), and probability processing predicted decision making under risk. These findings suggest that increasing an individual's understanding of ratios and probabilities should lead to more advantageous decisions under risk conditions. PMID:25252799

  20. Preoperative evaluation and surgical decision-making in pediatric epilepsy surgery

    PubMed Central

    Ducis, Katrina; Guan, Jian; Karsy, Michael

    2016-01-01

    Epilepsy is a common disease in the pediatric population, and the majority of cases are controlled with medications and lifestyle modification. For the children whose seizures are pharmacoresistant, continued epileptic activity can have a severely detrimental impact on cognitive development. Early referral of children with drug-resistant seizures to a pediatric epilepsy surgery center for evaluation is critical to achieving optimal patient outcomes. There are several components to a thorough presurgical evaluation, including a detailed medical history and physical examination, noninvasive testing including electroencephalogram, magnetic resonance imaging (MRI) of the brain, and often metabolic imaging. When necessary, invasive diagnostic testing using intracranial monitoring can be used. The identification of an epileptic focus may allow resection or disconnection from normal brain structures, with the ultimate goal of complete seizure remission. Additional operative measures can decrease seizure frequency and/or intensity if a clear epileptic focus cannot be identified. In this review, we will discuss the nuances of presurgical evaluation and decision-making in the management of children with drug-resistant epilepsy (DRE). PMID:27709099

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

    PubMed

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

    2015-01-01

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

  2. Cochlear Implant: the complexity involved in the decision making process by the family1

    PubMed Central

    Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

    2014-01-01

    Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

  3. Process control and risky decision-making: moderation by general mental ability and need for cognition.

    PubMed

    Burkolter, Dina; Kluge, Annette

    2012-01-01

    Human factors and ergonomics research could benefit from focusing more strongly on individual differences--especially trait variables. The present study suggests the analysis of moderator effects as a promising way to enhance understanding of trait variables and process control performance. Process control performance was studied by analysing moderator effects of general mental ability (GMA) and need for cognition (NC) on risky decision-making (RDM) and performance. Fifty engineering students were trained on a process control task using a computer-based simulation for three hours and tested twice thereafter. Risky decision-making was measured using a computerised gambling task while GMA and NC were assessed with questionnaires. Risky decision-making in interaction with each GMA and NC explained variance in performance over and above variance explained by the single effects. In conclusion, the analysis of moderator effects between individual difference variables and process control performance seems promising. Practitioner Summary: Individual difference variables affect learning and performance, but have often not been studied to any great extent in human factors research. This article suggests a promising approach to studying individual differences--moderator analyses--and illustrates how such differences can lead to a better understanding of what determines process control performance. PMID:22897454

  4. [Nurses' subjectivity production and the decision-making in the process of care].

    PubMed

    Busanello, Josefine; Lunardi Filho, Wilson Danilo; Kerber, Nalú Pereira da Costa

    2013-06-01

    This study aimed to understand the relationship between Nurse's production of subjectivity and the decision-making in the process of Nursing care. A qualitative design of research was conducted. The investigation was carried out with twelve nurses who work at the Associação de Caridade Santa Casa do Rio Grande, a hospital located in Rio Grande, RS, Brazil. For data collection, focus group technique was used three meetings were conducted in december 2011. The results were presented in semantic categories: Capitalist System: maintenance of employment bond; Submission System: institutionalized culture and vision of society; Nursing Hierarchical System; and Values System: feeling of guilt and lack of professional recognition. The capitalist system mediates, mainly, the behavior that prevails in the decision-making process in Nursing care. PMID:24015473

  5. Information Technology Process Improvement Decision-Making: An Exploratory Study from the Perspective of Process Owners and Process Managers

    ERIC Educational Resources Information Center

    Lamp, Sandra A.

    2012-01-01

    There is information available in the literature that discusses information technology (IT) governance and investment decision making from an executive-level perception, yet there is little information available that offers the perspective of process owners and process managers pertaining to their role in IT process improvement and investment…

  6. Decision making software for effective selection of treatment train alternative for wastewater using analytical hierarchy process.

    PubMed

    Prasad, A D; Tembhurkar, A R

    2013-10-01

    Proper selection of treatment process and synthesis of treatment train is complex engineering activity requires crucial decision making during planning and designing of any Wastewater Treatment Plant (WWTP). Earlier studies on process selection mainly considered cost as the most important selection criteria and number of studies focused on cost optimization models using dynamic programming, geometric programming and nonlinear programming. However, it has been noticed that traditional cost analysis alone cannot be applied to evaluate Treatment Train (TT) alternatives, as number of important non-tangible factors cannot be easily expressed in monetary units. Recently researches focus on use of multi-criteria technique for selection of treatment process. AHP provides a powerful tool for multi-hierarchy and multi-variable system overcoming limitation of traditional techniques. The AHP model designed to facilitate proper decision making and reduce the margin of errors during optimization due to number of parameters in the hierarchy levels has been used in this study. About 14 important factors and 13 sub factors were identified for the selection of treatment alternatives for wastewater and sludge stream although cost is one of the most important selection criteria. The present paper provides details of developing a soft-tool called "ProSelArt" using an AHP model aiding for proper decision making. PMID:25906585

  7. Disciplined decision making in an interdisciplinary environment: some implications for clinical applications of statistical process control.

    PubMed Central

    Hantula, D A

    1995-01-01

    This paper explores some of the implications the statistical process control (SPC) methodology described by Pfadt and Wheeler (1995) may have for analyzing more complex performances and contingencies in human services or health care environments at an organizational level. Service delivery usually occurs in an organizational system that is characterized by functional structures, high levels of professionalism, subunit optimization, and organizational suboptimization. By providing a standard set of criteria and decision rules, SPC may provide a common interface for data-based decision making, may bring decision making under the control of the contigencies that are established by these rules rather than the immediate contingencies of data fluctuation, and may attenuate escalation of failing treatments. SPC is culturally consistent with behavior analysis, sharing an emphasis on data-based decisions, measurement over time, and graphic analysis of data, as well as a systemic view of organizations. PMID:7592155

  8. The Rational Adolescent: Strategic Information Processing during Decision Making Revealed by Eye Tracking

    PubMed Central

    Kwak, Youngbin; Payne, John W.; Cohen, Andrew L.; Huettel, Scott A.

    2015-01-01

    Adolescence is often viewed as a time of irrational, risky decision-making – despite adolescents' competence in other cognitive domains. In this study, we examined the strategies used by adolescents (N=30) and young adults (N=47) to resolve complex, multi-outcome economic gambles. Compared to adults, adolescents were more likely to make conservative, loss-minimizing choices consistent with economic models. Eye-tracking data showed that prior to decisions, adolescents acquired more information in a more thorough manner; that is, they engaged in a more analytic processing strategy indicative of trade-offs between decision variables. In contrast, young adults' decisions were more consistent with heuristics that simplified the decision problem, at the expense of analytic precision. Collectively, these results demonstrate a counter-intuitive developmental transition in economic decision making: adolescents' decisions are more consistent with rational-choice models, while young adults more readily engage task-appropriate heuristics. PMID:26388664

  9. Temporal dynamics of prediction error processing during reward-based decision making.

    PubMed

    Philiastides, Marios G; Biele, Guido; Vavatzanidis, Niki; Kazzer, Philipp; Heekeren, Hauke R

    2010-10-15

    Adaptive decision making depends on the accurate representation of rewards associated with potential choices. These representations can be acquired with reinforcement learning (RL) mechanisms, which use the prediction error (PE, the difference between expected and received rewards) as a learning signal to update reward expectations. While EEG experiments have highlighted the role of feedback-related potentials during performance monitoring, important questions about the temporal sequence of feedback processing and the specific function of feedback-related potentials during reward-based decision making remain. Here, we hypothesized that feedback processing starts with a qualitative evaluation of outcome-valence, which is subsequently complemented by a quantitative representation of PE magnitude. Results of a model-based single-trial analysis of EEG data collected during a reversal learning task showed that around 220ms after feedback outcomes are initially evaluated categorically with respect to their valence (positive vs. negative). Around 300ms, and parallel to the maintained valence-evaluation, the brain also represents quantitative information about PE magnitude, thus providing the complete information needed to update reward expectations and to guide adaptive decision making. Importantly, our single-trial EEG analysis based on PEs from an RL model showed that the feedback-related potentials do not merely reflect error awareness, but rather quantitative information crucial for learning reward contingencies.

  10. The detrimental effects of emotional process dysregulation on decision-making in substance dependence

    PubMed Central

    Murphy, Anna; Taylor, Eleanor; Elliott, Rebecca

    2012-01-01

    Substance dependence is complex and multifactorial, with many distinct pathways involved in both the development and subsequent maintenance of addictive behaviors. Various cognitive mechanisms have been implicated, including impulsivity, compulsivity, and impaired decision-making. These mechanisms are modulated by emotional processes, resulting in increased likelihood of initial drug use, sustained substance dependence, and increased relapse during periods of abstinence. Emotional traits, such as sensation-seeking, are risk factors for substance use, and chronic drug use can result in further emotional dysregulation via effects on reward, motivation, and stress systems. We will explore theories of hyper and hypo sensitivity of the brain reward systems that may underpin motivational abnormalities and anhedonia. Disturbances in these systems contribute to the biasing of emotional processing toward cues related to drug use at the expense of natural rewards, which serves to maintain addictive behavior, via enhanced drug craving. We will additionally focus on the sensitization of the brain stress systems that result in negative affect states that continue into protracted abstinence that is may lead to compulsive drug-taking. We will explore how these emotional dysregulations impact upon decision-making controlled by goal-directed and habitual action selections systems, and, in combination with a failure of prefrontal inhibitory control, mediate maladaptive decision-making observed in substance dependent individuals such that they continue drug use in spite of negative consequences. An understanding of the emotional impacts on cognition in substance dependent individuals may guide the development of more effective therapeutic interventions. PMID:23162443

  11. Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats.

    PubMed

    Hales, Claire A; Robinson, Emma S J; Houghton, Conor J

    2016-01-01

    Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward.

  12. [Translational research and its contribution to the decision making process in health policies].

    PubMed

    Cabieses, Báltica; Espinoza, Manuel A

    2011-06-01

    Recently, the translational research model (TR) has been established as a key feature in health worldwide. The objectives of this review are: (1) to define the TR and describe its complex nature; (2) to identify the components of the TR; (3) to link the TR to the decision-making process in health policies; (4) to recognize frequent obstacles and challenges of the association between the TR and the decision-making process in health policies. A systematic literature review was conducted in scientific databases and selected grey literature was done including TR and health policy as key words. We found 60 papers. Results show that the concept of TR and its theoretical formulation has evolved over time and has only recently incorporated the complexity that exists in the transference of scientific knowledge to health. International literature shows different applications of the TR in both research and clinical practice. The application of the TR to public health and health policy decision making is relatively new but necessary and could become a priority for health policies in the countries.

  13. Planetary protection, legal ambiguity and the decision making process for Mars sample return.

    PubMed

    Race, M S

    1996-01-01

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under National Environmental Policy Act (NEPA); uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertanities about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions.

  14. Temporal dynamics of prediction error processing during reward-based decision making.

    PubMed

    Philiastides, Marios G; Biele, Guido; Vavatzanidis, Niki; Kazzer, Philipp; Heekeren, Hauke R

    2010-10-15

    Adaptive decision making depends on the accurate representation of rewards associated with potential choices. These representations can be acquired with reinforcement learning (RL) mechanisms, which use the prediction error (PE, the difference between expected and received rewards) as a learning signal to update reward expectations. While EEG experiments have highlighted the role of feedback-related potentials during performance monitoring, important questions about the temporal sequence of feedback processing and the specific function of feedback-related potentials during reward-based decision making remain. Here, we hypothesized that feedback processing starts with a qualitative evaluation of outcome-valence, which is subsequently complemented by a quantitative representation of PE magnitude. Results of a model-based single-trial analysis of EEG data collected during a reversal learning task showed that around 220ms after feedback outcomes are initially evaluated categorically with respect to their valence (positive vs. negative). Around 300ms, and parallel to the maintained valence-evaluation, the brain also represents quantitative information about PE magnitude, thus providing the complete information needed to update reward expectations and to guide adaptive decision making. Importantly, our single-trial EEG analysis based on PEs from an RL model showed that the feedback-related potentials do not merely reflect error awareness, but rather quantitative information crucial for learning reward contingencies. PMID:20510376

  15. Diffusion Modelling Reveals the Decision Making Processes Underlying Negative Judgement Bias in Rats

    PubMed Central

    Hales, Claire A.; Robinson, Emma S. J.; Houghton, Conor J.

    2016-01-01

    Human decision making is modified by emotional state. Rodents exhibit similar biases during interpretation of ambiguous cues that can be altered by affective state manipulations. In this study, the impact of negative affective state on judgement bias in rats was measured using an ambiguous-cue interpretation task. Acute treatment with an anxiogenic drug (FG7142), and chronic restraint stress and social isolation both induced a bias towards more negative interpretation of the ambiguous cue. The diffusion model was fit to behavioural data to allow further analysis of the underlying decision making processes. To uncover the way in which parameters vary together in relation to affective state manipulations, independent component analysis was conducted on rate of information accumulation and distances to decision threshold parameters for control data. Results from this analysis were applied to parameters from negative affective state manipulations. These projected components were compared to control components to reveal the changes in decision making processes that are due to affective state manipulations. Negative affective bias in rodents induced by either FG7142 or chronic stress is due to a combination of more negative interpretation of the ambiguous cue, reduced anticipation of the high reward and increased anticipation of the low reward. PMID:27023442

  16. Planetary protection, legal ambiguity and the decision making process for Mars sample return

    NASA Technical Reports Server (NTRS)

    Race, M. S.

    1996-01-01

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under National Environmental Policy Act (NEPA); uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertanities about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions.

  17. Planetary protection, legal ambiguity and the decision making process for Mars sample return.

    PubMed

    Race, M S

    1996-01-01

    As scientists and mission planners develop planetary protection requirements for future Mars sample return missions, they must recognize the socio-political context in which decisions about the mission will be made and pay careful attention to public concerns about potential back contamination of Earth. To the extent that planetary protection questions are unresolved or unaddressed at the time of an actual mission, they offer convenient footholds for public challenges in both legal and decision making realms, over which NASA will have little direct control. In this paper, two particular non-scientific areas of special concern are discussed in detail: 1) legal issues and 2) the decision making process. Understanding these areas is critical for addressing legitimate public concerns as well as for fulfilling procedural requirements regardless whether sample return evokes public controversy. Legal issues with the potential to complicate future missions include: procedural review under National Environmental Policy Act (NEPA); uncertainty about institutional control and authority; conflicting regulations and overlapping jurisdictions; questions about international treaty obligations and large scale impacts; uncertanities about the nature of the organism; and constitutional and regulatory concerns about quarantine, public health and safety. In light of these important legal issues, it is critical that NASA consider the role and timing of public involvement in the decision making process as a way of anticipating problem areas and preparing for legitimate public questions and challenges to sample return missions. PMID:11538983

  18. Development of a requirements management system for technical decision - making processes in the geological disposal project

    SciTech Connect

    Hiroyoshi Ueda; Katsuhiko Ishiguro; Kazumi Kitayama; Kiyoshi Oyamada; Shoko Sato

    2007-07-01

    NUMO (Nuclear Waste Management Organization of Japan) has a responsibility for implementing geological disposal of vitrified HLW (High-Level radioactive Waste) in the Japanese nuclear waste management programme. Its staged siting procedure was initiated in 2002 by an open call for volunteer sites. Careful management strategy and methodology for the technical decision-making at every milestone are required to prepare for the volunteer site application and the site investigation stages after that. The formal Requirement Management System (RMS) is planned to support the computerized implementation of the specific management methodology, termed the NUMO Structured Approach (NSA). This planned RMS will help for comprehensive management of the decision-making processes in the geological disposal project, change management towards the anticipated project deviations, efficient project driving such as well programmed R and D etc. and structured record-keeping regarding the past decisions, which leads to soundness of the project in terms of the long-term continuity. The system should have handling/management functions for the database including the decisions/requirements in the project in consideration, their associated information and the structures composed of them in every decision-making process. The information relating to the premises, boundary conditions and time plan of the project should also be prepared in the system. Effective user interface and efficient operation on the in-house network are necessary. As a living system for the long-term formal use, flexibility to updating is indispensable. In advance of the formal system development, two-year activity to develop the preliminary RMS was already started. The purpose of this preliminary system is to template the decision/requirement structure, prototype the decision making management and thus show the feasibility of the innovative RMS. The paper describes the current status of the development, focusing on the

  19. Development of an instrument to understand the child protective services decision-making process, with a focus on placement decisions.

    PubMed

    Dettlaff, Alan J; Christopher Graham, J; Holzman, Jesse; Baumann, Donald J; Fluke, John D

    2015-11-01

    When children come to the attention of the child welfare system, they become involved in a decision-making process in which decisions are made that have a significant effect on their future and well-being. The decision to remove children from their families is particularly complex; yet surprisingly little is understood about this decision-making process. This paper presents the results of a study to develop an instrument to explore, at the caseworker level, the context of the removal decision, with the objective of understanding the influence of the individual and organizational factors on this decision, drawing from the Decision Making Ecology as the underlying rationale for obtaining the measures. The instrument was based on the development of decision-making scales used in prior decision-making studies and administered to child protection caseworkers in several states. Analyses included reliability analyses, principal components analyses, and inter-correlations among the resulting scales. For one scale regarding removal decisions, a principal components analysis resulted in the extraction of two components, jointly identified as caseworkers' decision-making orientation, described as (1) an internal reference to decision-making and (2) an external reference to decision-making. Reliability analyses demonstrated acceptable to high internal consistency for 9 of the 11 scales. Full details of the reliability analyses, principal components analyses, and inter-correlations among the seven scales are discussed, along with implications for practice and the utility of this instrument to support the understanding of decision-making in child welfare.

  20. Household Decision-Making Process: It's Effect on School Dropout Behavior for Girls in the Secondary School Level in Bangladesh

    ERIC Educational Resources Information Center

    Shahidul, S. M.

    2013-01-01

    This study aims to understand the parents' household decision-making process with respect to allowing girls to drop out of school, an area that has, thus far, been overlooked in the research regarding school dropouts. This paper has examined the household decision-making process between fathers and mothers and explores how their respective levels…

  1. Decision making under uncertainty: a neural model based on partially observable markov decision processes.

    PubMed

    Rao, Rajesh P N

    2010-01-01

    A fundamental problem faced by animals is learning to select actions based on noisy sensory information and incomplete knowledge of the world. It has been suggested that the brain engages in Bayesian inference during perception but how such probabilistic representations are used to select actions has remained unclear. Here we propose a neural model of action selection and decision making based on the theory of partially observable Markov decision processes (POMDPs). Actions are selected based not on a single "optimal" estimate of state but on the posterior distribution over states (the "belief" state). We show how such a model provides a unified framework for explaining experimental results in decision making that involve both information gathering and overt actions. The model utilizes temporal difference (TD) learning for maximizing expected reward. The resulting neural architecture posits an active role for the neocortex in belief computation while ascribing a role to the basal ganglia in belief representation, value computation, and action selection. When applied to the random dots motion discrimination task, model neurons representing belief exhibit responses similar to those of LIP neurons in primate neocortex. The appropriate threshold for switching from information gathering to overt actions emerges naturally during reward maximization. Additionally, the time course of reward prediction error in the model shares similarities with dopaminergic responses in the basal ganglia during the random dots task. For tasks with a deadline, the model learns a decision making strategy that changes with elapsed time, predicting a collapsing decision threshold consistent with some experimental studies. The model provides a new framework for understanding neural decision making and suggests an important role for interactions between the neocortex and the basal ganglia in learning the mapping between probabilistic sensory representations and actions that maximize rewards.

  2. Real-Time Internet Connections: Implications for Surgical Decision Making in Laparoscopy

    PubMed Central

    Broderick, Timothy J.; Harnett, Brett M.; Doarn, Charles R.; Rodas, Edgar B.; Merrell, Ronald C.

    2001-01-01

    Objective To determine whether a low-bandwidth Internet connection can provide adequate image quality to support remote real-time surgical consultation. Summary Background Data Telemedicine has been used to support care at a distance through the use of expensive equipment and broadband communication links. In the past, the operating room has been an isolated environment that has been relatively inaccessible for real-time consultation. Recent technological advances have permitted videoconferencing over low-bandwidth, inexpensive Internet connections. If these connections are shown to provide adequate video quality for surgical applications, low-bandwidth telemedicine will open the operating room environment to remote real-time surgical consultation. Methods Surgeons performing a laparoscopic cholecystectomy in Ecuador or the Dominican Republic shared real-time laparoscopic images with a panel of surgeons at the parent university through a dial-up Internet account. The connection permitted video and audio teleconferencing to support real-time consultation as well as the transmission of real-time images and store-and-forward images for observation by the consultant panel. A total of six live consultations were analyzed. In addition, paired local and remote images were “grabbed” from the video feed during these laparoscopic cholecystectomies. Nine of these paired images were then placed into a Web-based tool designed to evaluate the effect of transmission on image quality. Results The authors showed for the first time the ability to identify critical anatomic structures in laparoscopy over a low-bandwidth connection via the Internet. The consultant panel of surgeons correctly remotely identified biliary and arterial anatomy during six laparoscopic cholecystectomies. Within the Web-based questionnaire, 15 surgeons could not blindly distinguish the quality of local and remote laparoscopic images. Conclusions Low-bandwidth, Internet-based telemedicine is inexpensive

  3. The impact of radioimmunoguided surgery (RIGS) on surgical decision-making in colorectal cancer

    SciTech Connect

    Nieroda, C.A.; Mojzisik, C.; Sardi, A.; Ferrara, P.; Hinkle, G.; Thurston, M.O.; Martin, E.W. Jr. )

    1989-11-01

    Radioimmunoguided surgery (RIGS system) was performed in ten patients with rectal or low sigmoid colon carcinoma with the use of a hand-held gamma detector (Neoprobe 1000) intraoperatively and externally after injection of radiolabeled (125I) monoclonal antibody to detect pelvic and metastatic tumor. Fifteen procedures, including six exploratory laparotomies, four transperineal explorations, two transsacral explorations, one transvaginal biopsy, one brachytherapy, and one transanal polypectomy, were performed. Two patients had previous low anterior resection, seven abdominoperineal resection, and one a rectal polypectomy. Five patients had previous pelvic radiation therapy. Reoperation was indicated by elevated CEA levels in seven patients (70 percent), persistent pelvic pain in six (60 percent), and a suspicious radiologic study in seven (70 percent). RIGS system localized tumors verified by histopatholoy in all ten patients (100 percent); one patient with a positive CT scan and probe findings lacked histopathologic confirmation on frozen section, but had a tumor confirmed on permanent histology. Five major abdominal operations were avoided; in five patients major modifications were made in the surgical procedure based on probe findings. Six received chemotherapy or radiation therapy based on findings of the RIGS system. In six patients with negative or equivocal CT scans, the RIGS system localized histopathologically confirmed tumor. Major abdominal procedures can be avoided, the surgical approach modified, and other modes of therapy instituted earlier with the use of the RIGS system.

  4. An analytical hierarchy process for decision making of high-level-waste management

    SciTech Connect

    Wang, J.H.C.; Jang, W.

    1995-12-01

    To prove the existence value of nuclear technology for the world of post cold war, demonstration of safe rad-waste disposal is essential. High-level-waste (HLW) certainly is the key issue to be resolved. To assist a rational and persuasive process on various disposal options, an Analytical Hierarchy Process (AHP) for the decision making of HLW management is presented. The basic theory and rationale are discussed, and applications are shown to illustrate the usefulness of the AHP. The authors wish that the AHP can provide a better direction for the current doomed situations of Taiwan nuclear industry, and to exchange with other countries for sharing experiences on the HLW management.

  5. Decision making using AHP (Analytic Hierarchy Process) and fuzzy set theory in waste management

    SciTech Connect

    Chung, J.Y.; Lee, K.J.; Kim, C.D.

    1995-12-31

    The major problem is how to consider the differences in opinions, when many experts are involved in decision making process. This paper provides a simple general methodology to treat the differences in various opinions. The authors determined the grade of membership through the process of magnitude estimation derived from pairwise comparisons and AHP developed by Saaty. They used fuzzy set theory to consider the differences in opinions and obtain the priorities for each alternative. An example, which can be applied to radioactive waste management, also was presented. The result shows a good agreement with the results of averaging methods.

  6. THE IMPACT OF BREAST MRI ON SURGICAL DECISION-MAKING: ARE PATIENTS AT RISK FOR MASTECTOMY?

    PubMed Central

    Pettit, Kelli; Swatske, Mary Ellen; Gao, Feng; Salavaggione, Lorena; Gillanders, William E.; Aft, Rebecca L.; Monsees, Barbara S.; Eberlein, Timothy J.; Margenthaler, Julie A.

    2014-01-01

    Background and Objectives The goal of the current study was to determine whether MRI impacts multidisciplinary treatment planning and if it leads to increased mastectomy rates. Methods A retrospective review was conducted of 441 patients treated for breast cancer between January 2005 and May 2008 who underwent breast MRI. Data included number of additional findings and their imaging and pathologic work-up. This was analyzed to determine impact of MRI on treatment planning. Results Of 441 patients, 45% had ≥1 additional finding on MRI. Of 410 patients with complete records, 29% had changes in the treatment plan, including 36 patients who were initially considered for breast conservation but proceeded directly to mastectomy based on MRI findings of suspected multicentricity. Twenty-three of those patients did not have a biopsy of the MRI lesion, with 87% having unicentric disease on final pathology. Overall, the mastectomy rate was 44%, which was significantly increased compared to patients not undergoing MRI (32%, p<0.05). Conclusions Breast MRI alters the treatment planning for many patients with newly-diagnosed breast cancer. Mastectomy rates are increased when MRI results alone direct surgical planning. Biopsy of MRI-identified lesions should be performed to avoid over-treatment. PMID:19757442

  7. Culinary Decision Making.

    ERIC Educational Resources Information Center

    Curtis, Rob

    1987-01-01

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

  8. Adolescents’ risky decision-making activates neural networks related to social cognition and cognitive control processes

    PubMed Central

    Rodrigo, María José; Padrón, Iván; de Vega, Manuel; Ferstl, Evelyn C.

    2014-01-01

    This study examines by means of functional magnetic resonance imaging the neural mechanisms underlying adolescents’ risk decision-making in social contexts. We hypothesize that the social context could engage brain regions associated with social cognition processes and developmental changes are also expected. Sixty participants (adolescents: 17–18, and young adults: 21–22 years old) read narratives describing typical situations of decision-making in the presence of peers. They were asked to make choices in risky situations (e.g., taking or refusing a drug) or ambiguous situations (e.g., eating a hamburger or a hotdog). Risky as compared to ambiguous scenarios activated bilateral temporoparietal junction (TPJ), bilateral middle temporal gyrus (MTG), right medial prefrontal cortex, and the precuneus bilaterally; i.e., brain regions related to social cognition processes, such as self-reflection and theory of mind (ToM). In addition, brain structures related to cognitive control were active [right anterior cingulate cortex (ACC), bilateral dorsolateral prefrontal cortex (DLPFC), bilateral orbitofrontal cortex], whereas no significant clusters were obtained in the reward system (ventral striatum). Choosing the dangerous option involved a further activation of control areas (ACC) and emotional and social cognition areas (temporal pole). Adolescents employed more neural resources than young adults in the right DLPFC and the right TPJ in risk situations. When choosing the dangerous option, young adults showed a further engagement in ToM related regions (bilateral MTG) and in motor control regions related to the planning of actions (pre-supplementary motor area). Finally, the right insula and the right superior temporal gyrus were more activated in women than in men, suggesting more emotional involvement and more intensive modeling of the others’ perspective in the risky conditions. These findings call for more comprehensive developmental accounts of decision-making

  9. Adolescents' risky decision-making activates neural networks related to social cognition and cognitive control processes.

    PubMed

    Rodrigo, María José; Padrón, Iván; de Vega, Manuel; Ferstl, Evelyn C

    2014-01-01

    This study examines by means of functional magnetic resonance imaging the neural mechanisms underlying adolescents' risk decision-making in social contexts. We hypothesize that the social context could engage brain regions associated with social cognition processes and developmental changes are also expected. Sixty participants (adolescents: 17-18, and young adults: 21-22 years old) read narratives describing typical situations of decision-making in the presence of peers. They were asked to make choices in risky situations (e.g., taking or refusing a drug) or ambiguous situations (e.g., eating a hamburger or a hotdog). Risky as compared to ambiguous scenarios activated bilateral temporoparietal junction (TPJ), bilateral middle temporal gyrus (MTG), right medial prefrontal cortex, and the precuneus bilaterally; i.e., brain regions related to social cognition processes, such as self-reflection and theory of mind (ToM). In addition, brain structures related to cognitive control were active [right anterior cingulate cortex (ACC), bilateral dorsolateral prefrontal cortex (DLPFC), bilateral orbitofrontal cortex], whereas no significant clusters were obtained in the reward system (ventral striatum). Choosing the dangerous option involved a further activation of control areas (ACC) and emotional and social cognition areas (temporal pole). Adolescents employed more neural resources than young adults in the right DLPFC and the right TPJ in risk situations. When choosing the dangerous option, young adults showed a further engagement in ToM related regions (bilateral MTG) and in motor control regions related to the planning of actions (pre-supplementary motor area). Finally, the right insula and the right superior temporal gyrus were more activated in women than in men, suggesting more emotional involvement and more intensive modeling of the others' perspective in the risky conditions. These findings call for more comprehensive developmental accounts of decision-making in

  10. [Treatment discontinuation and obligation to treat: an extended model for the decision-making process].

    PubMed

    Joppich, R; Elsner, F; Radbruch, L

    2006-05-01

    Social developments and medical progress in the last decades have led to a significant change of values in medicine, which spans from the cornerstone of the patient's autonomy to the increasingly difficult decision-making process related to available medical treatments. This conflict exaggerates with end-of-life situations, where a purely palliative approach to the therapy is applied, or in cases of reduced ability for patient's consent. From a legal point of view, many uncertainties have been clarified in recent years. The patient's autonomy has been strengthened, however, the law requires the doctor to review and carefully balance the treatment options so that a new and modified patient-doctor relationship is often necessary in this difficult decision-making process. The doctor should no longer retreat into the classical role of a neutral advisor and leave the complete responsibility of medical decisions to the patient. Instead, in order for the patient to be able to make a balanced and individually tailored autonomous decision, the doctor needs to bring in his medical expertise along with his own personal experiences and personal opinions, as long as he clearly differentiates between personal and professional views. This way the patient will be empowered to make complex medical decisions, considering his personal situation and previous experiences as well as his own set of values. For complex situations medical practitioners can find support from reflection within the treatment team, or through an external ethical advisory panel. Algorithms can be helpful to illustrate the steps in a decision-making process and thus support medical staff in situations of difficult medical decisions.

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

    PubMed Central

    Clarinval, Caroline; Biller-Andorno, Nikola

    2014-01-01

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

  12. Factors Affecting the Corporate Decision-Making Process of Air Transport Manufacturers

    NASA Technical Reports Server (NTRS)

    Ollila, R. G.; Hill, J. D.; Noton, B. R.; Duffy, M. A.; Epstein, M. M.

    1976-01-01

    Fuel economy is a pivotal question influencing the future sale and utilization of commercial aircraft. The NASA Aircraft Energy Efficiency (ACEE) Program Office has a program intended to accelerate the readiness of advanced technologies for energy efficient aircraft. Because the decision to develop a new airframe or engine is a major financial hazard for manufacturers, it is important to know what factors influence the decision making process. A method is described for identifying and ranking individuals and organizations involved at each stage of commercial air transport development, and the barriers that must be overcome in adopting new technologies.

  13. Process of allogeneic hematopoietic cell transplantation decision making for older adults.

    PubMed

    Randall, J; Keven, K; Atli, T; Ustun, C

    2016-05-01

    Allogeneic hematopoietic cell transplantation (alloHCT) may be the only curative option for some older adults with hematologic malignancies, and its associated risks of significant morbidity and mortality warrant a clear, informed decision-making process. As older adults have not been transplanted routinely until recent years, younger people have been the prototypical group around whom the current process has developed. Yet, this process is applied to older adults who have different considerations than younger patients when making their transplant decision. Older adults do not have the open-ended lives of younger patients and are entitled to consider how to spend their remaining time. They also possess maturity and experience, and with proper knowledge, they can make informed choices rather than moving forward in the transplant process unaware. Notably, older patients face similar problems with the informed decision-making process in nephrology. Strategies such as providing education about alloHCT gradually and repeatedly during induction, presenting recent knowledge from the literature in plain language, and utilizing a team approach to patient education may help older adults make the best decision about transplant in light of their situation and values. Understanding when and how older adults decide on alloHCT is an important first step to further exploring this problem. PMID:26457910

  14. Dual Processes in Decision Making and Developmental Neuroscience: A Fuzzy-Trace Model.

    PubMed

    Reyna, Valerie F; Brainerd, Charles J

    2011-09-01

    From Piaget to the present, traditional and dual-process theories have predicted improvement in reasoning from childhood to adulthood, and improvement has been observed. However, developmental reversals-that reasoning biases emerge with development -have also been observed in a growing list of paradigms. We explain how fuzzy-trace theory predicts both improvement and developmental reversals in reasoning and decision making. Drawing on research on logical and quantitative reasoning, as well as on risky decision making in the laboratory and in life, we illustrate how the same small set of theoretical principles apply to typical neurodevelopment, encompassing childhood, adolescence, and adulthood, and to neurological conditions such as autism and Alzheimer's disease. For example, framing effects-that risk preferences shift when the same decisions are phrases in terms of gains versus losses-emerge in early adolescence as gist-based intuition develops. In autistic individuals, who rely less on gist-based intuition and more on verbatim-based analysis, framing biases are attenuated (i.e., they outperform typically developing control subjects). In adults, simple manipulations based on fuzzy-trace theory can make framing effects appear and disappear depending on whether gist-based intuition or verbatim-based analysis is induced. These theoretical principles are summarized and integrated in a new mathematical model that specifies how dual modes of reasoning combine to produce predictable variability in performance. In particular, we show how the most popular and extensively studied model of decision making-prospect theory-can be derived from fuzzy-trace theory by combining analytical (verbatim-based) and intuitive (gist-based) processes.

  15. Elective surgical referral guidelines - background educational material or essential shared decision making tool? A survey of GPs' in England

    PubMed Central

    2011-01-01

    Background To investigate general practitioners' (GPs') attitudes to guidelines for elective surgical referral in England. To understand their use of guidelines, and attitudes to shared decision making in the referral decision. Methods A questionnaire was developed which investigated attitudes to and use of guidelines. It was given to a stratified random sample 30% (n = 310) drawn from GP lists of 10 English health districts (primary care trusts (PCTs)). GPs were invited to respond online, by telephone, fax or post. Data were analysed using descriptive statistics and backwards stepwise logistic regression. Results Responses were representative of GPs in England, but (despite up to 6 contacts per non-responder) the overall response rate was 41.6% (n = 129; with the range across PCTs of 25-61%). Most responding GPs indicated support for referral guidelines but 18% reported that they had never used them. Less than three per cent reported use for most or all referral decisions. The odds of using guidelines decreased with increasing age, with a ten year increase in age associated with halving odds of use (OR = 0.53, 95%CI = 0.29-0.90). Over 50% of GPs wanted good access to electronic guidelines with expert information and advice on guideline availability. Almost all (>89%) GPs agreed with sharing referral decisions with patients. Female doctors (OR = 5.2, 95%CI: 1.02-26.3) were more likely to agree with this than male GPs as were those working in larger compared to small or single handed practices (OR = 5.3, 95%CI: 1.4-19.9). Conclusions This group of responding GPs was supportive of guidelines but used them in different ways. Referral guidelines should have an educational component for background reading; include key messages for internalisation and application; and incorporate mechanisms to facilitate accessibility and appropriate shared decision making with patients. PMID:21878103

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

    PubMed

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

    2015-01-01

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

  17. Modification of the Decision-Making Capability in the Social Force Model for the Evacuation Process

    NASA Astrophysics Data System (ADS)

    Zainuddin, Zarita; Shuaib, Mohammed

    2010-01-01

    The Social Force Model is one of the most successful microscopic pedestrian models that represent the well-organized phenomena of the pedestrian flow. The model has been modified for evacuation process by incorporating physical forces when contact exists, on one hand, and incorporating factors into the preferred velocity to govern the individual's behavior corresponding to the situation under consideration (normal or evacuation) on the other hand. The latter incorporation has enhanced the ability of the model to represent the decision-making process of pedestrians. However, the variety of pedestrian's abilities to make decisions in emergency situations has not been incorporated properly into the model. In this article we enhance the decision-making capability of the independent pedestrians first by improving the assessment process of selecting an exit from the set of exits available in the physical environment by considering a new factor (crowd at exits); and second, by incorporating following crowds as a new feature for those who are independent. A simulation of an emergency situation inside a room is performed to validate our work.

  18. Improving petroleum contaminated land remediation decision-making through the MCA weighting process.

    PubMed

    Balasubramaniam, Anopama; Boyle, Alexander Rohan; Voulvoulis, Nikolaos

    2007-01-01

    Internationally petroleum contamination is widespread, posing serious environmental risks including surface and groundwater contamination, thus remediation is essential. The implementation of remediation options is becoming more complex with the increasing influence of stakeholders on the outcome of decision-making processes. Acceptance of remediation schemes during implementation can be increased by involving stakeholders and the public in the decision-making stage. In petroleum remediation involving multiple stakeholders, Multicriteria Analysis has been employed due to its ability to incorporate the preferences of each stakeholder through weighting. The research focused on investigating ways to improve the weighting process. The study demonstrated the utility of SWING, and determined which type of participant and how many participants to include in the decision process, through the application of ELECTRE III and Weighted Summation. It was recommended that a mixture of stakeholders, the public and experts be involved. The total number of participants will be limited by the choice of participatory and weighting methods. The careful selection of participants, as well as the choice of participatory and weighting methods, can minimize the subjectivity involved in MCA weighting, thereby lending decisions in petroleum remediation greater legitimacy.

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

    PubMed Central

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

    2015-01-01

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

  20. Decision making by NICE: examining the influences of evidence, process and context.

    PubMed

    Cerri, Karin H; Knapp, Martin; Fernández, José-Luis; Fernandez, Jose-Luis

    2014-04-01

    The National Institute for Health and Clinical Excellence (NICE) provides guidance to the National Health Service (NHS) in England and Wales on funding and use of new technologies. This study examined the impact of evidence, process and context factors on NICE decisions in 2004-2009. A data set of NICE decisions pertaining to pharmaceutical technologies was created, including 32 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. With multinomial logistic regression, the relative contribution of explanatory variables on NICE decisions was assessed. A total of 65 technology appraisals (118 technologies) were analysed. Of the technologies, 27% were recommended, 58% were restricted and 14% were not recommended by NICE for NHS funding. The multinomial model showed significant associations (p ⩽ 0.10) between NICE outcome and four variables: (i) demonstration of statistical superiority of the primary endpoint in clinical trials by the appraised technology; (ii) the incremental cost-effectiveness ratio (ICER); (iii) the number of pharmaceuticals appraised within the same appraisal; and (iv) the appraisal year. Results confirm the value of a comprehensive and multivariate approach to understanding NICE decision making. New factors affecting NICE decision making were identified, including the effect of clinical superiority, and the effect of process and socio-economic factors.

  1. Understanding and shifting drug-related decisions: contributions of automatic decision-making processes.

    PubMed

    Carpenter, Kenneth M; Bedi, Gillinder; Vadhan, Nehal P

    2015-08-01

    While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.

  2. Understanding and shifting drug-related decisions: Contributions of automatic decision-making processes

    PubMed Central

    Carpenter, Kenneth M.; Bedi, Gillinder; Vadhan, Nehal P.

    2015-01-01

    While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse, and may offer important avenues for developing novel intervention strategies. PMID:26084667

  3. Blocking serotonin but not dopamine reuptake alters neural processing during perceptual decision making.

    PubMed

    Costa, Vincent D; Kakalios, Laura C; Averbeck, Bruno B

    2016-10-01

    Dopamine and serotonin have opponent interactions on aspects of impulsivity. Therefore we wanted to test the hypothesis that dopamine and serotonin would have opposing effects on speed-accuracy trade offs in a perceptual decision making task. Unlike other behavioral measures of impulsivity, perceptual decision making allows us to determine whether decreasing premature responses, often interpreted as decreased impulsivity, corresponds to increased behavioral performance. We administered GBR-12909 (a dopamine transporter blocker), escitalopram (a serotonin transporter blocker), or saline in separate sessions to 3 rhesus macaques. We found that animals had slower reaction times (RTs) on escitalopram than on GBR-12909 or saline. However, they were also least accurate on escitalopram. Animals were faster, although nonsignificantly, on GBR than saline and had equivalent accuracy. Administration of GBR-12909 did cause animals to be faster in error trials than correct trials. Therefore, from the point of view of RTs the animals were less impulsive on escitalopram. However, the decreased accuracy of the monkeys shows that they were not able to make use of their slower response times to make more accurate decisions. Therefore, impulsivity was reduced on escitalopram, but at the expense of a slower information-processing rate in the perceptual inference task. (PsycINFO Database Record

  4. Blocking serotonin but not dopamine reuptake alters neural processing during perceptual decision making.

    PubMed

    Costa, Vincent D; Kakalios, Laura C; Averbeck, Bruno B

    2016-10-01

    Dopamine and serotonin have opponent interactions on aspects of impulsivity. Therefore we wanted to test the hypothesis that dopamine and serotonin would have opposing effects on speed-accuracy trade offs in a perceptual decision making task. Unlike other behavioral measures of impulsivity, perceptual decision making allows us to determine whether decreasing premature responses, often interpreted as decreased impulsivity, corresponds to increased behavioral performance. We administered GBR-12909 (a dopamine transporter blocker), escitalopram (a serotonin transporter blocker), or saline in separate sessions to 3 rhesus macaques. We found that animals had slower reaction times (RTs) on escitalopram than on GBR-12909 or saline. However, they were also least accurate on escitalopram. Animals were faster, although nonsignificantly, on GBR than saline and had equivalent accuracy. Administration of GBR-12909 did cause animals to be faster in error trials than correct trials. Therefore, from the point of view of RTs the animals were less impulsive on escitalopram. However, the decreased accuracy of the monkeys shows that they were not able to make use of their slower response times to make more accurate decisions. Therefore, impulsivity was reduced on escitalopram, but at the expense of a slower information-processing rate in the perceptual inference task. (PsycINFO Database Record PMID:27513807

  5. Blocking serotonin but not dopamine reuptake alters neural processing during perceptual decision making

    PubMed Central

    Costa, Vincent D.; Kakalios, Laura; Averbeck, Bruno B.

    2016-01-01

    Dopamine and serotonin have opponent interactions on aspects of impulsivity. Therefore we wanted to test the hypothesis that dopamine and serotonin would have opposing effects on speed-accuracy trade-offs in a perceptual decision making task. Unlike other behavioral measures of impulsivity, perceptual decision making allows us to determine whether decreasing premature responses, often interpreted as decreased impulsivity, corresponds to increased behavioral performance. We administered GBR-12909 (a dopamine transporter blocker), escitalopram (a serotonin transporter blocker) or saline in separate sessions to three rhesus macaques. We found that animals had slower reaction times on escitalopram than on GBR-12909 or saline. However, they were also least accurate on escitalopram. Animals were faster, although non-significantly, on GBR than saline and had equivalent accuracy. Administration of GBR-12909 did cause animals to be faster in error trials than correct trials. Therefore, from the point of view of reaction times the animals were less impulsive on escitalopram. However, the decreased accuracy shows that they were not able to make use of the slower response time to make more accurate decisions. Therefore, impulsivity was reduced on escitalopram, but at the expense of information processing rate in the perceptual inference task. PMID:27513807

  6. Approach of decision making based on the analytic hierarchy process for urban landscape management.

    PubMed

    Srdjevic, Zorica; Lakicevic, Milena; Srdjevic, Bojan

    2013-03-01

    This paper proposes a two-stage group decision making approach to urban landscape management and planning supported by the analytic hierarchy process. The proposed approach combines an application of the consensus convergence model and the weighted geometric mean method. The application of the proposed approach is shown on a real urban landscape planning problem with a park-forest in Belgrade, Serbia. Decision makers were policy makers, i.e., representatives of several key national and municipal institutions, and experts coming from different scientific fields. As a result, the most suitable management plan from the set of plans is recognized. It includes both native vegetation renewal in degraded areas of park-forest and continued maintenance of its dominant tourism function. Decision makers included in this research consider the approach to be transparent and useful for addressing landscape management tasks. The central idea of this paper can be understood in a broader sense and easily applied to other decision making problems in various scientific fields.

  7. 76 FR 58807 - An Assessment of Decision-Making Processes: Evaluation of Where Land Protection Planning Can...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... Incorporate Climate Change Information-- Release of Final Report AGENCY: Environmental Protection Agency (EPA... Decision-Making Processes: Evaluation of Where Land Protection Planning can Incorporate Climate Change... planning can incorporate climate change impacts information into programs. The assessment revealed...

  8. How Effective Is a Virtual Consultation Process in Facilitating Multidisciplinary Decision-Making for Malignant Epidural Spinal Cord Compression?

    SciTech Connect

    Fitzpatrick, David; Grabarz, Daniel; Wang, Lisa; Bezjak, Andrea; Fehlings, Michael G.; Fosker, Christopher; Rampersaud, Raja; Wong, Rebecca K.S.

    2012-10-01

    Purpose: The purpose of this study was to assess the accuracy of a virtual consultation (VC) process in determining treatment strategy for patients with malignant epidural spinal cord compression (MESCC). Methods and Materials: A prospective clinical database was maintained for patients with MESCC. A virtual consultation process (involving exchange of key predetermined clinical information and diagnostic imaging) facilitated rapid decision-making between oncologists and spinal surgeons. Diagnostic imaging was reviewed retrospectively (by R.R.) for surgical opinions in all patients. The primary outcome was the accuracy of virtual consultation opinion in predicting the final treatment recommendation. Results: After excluding 20 patients who were referred directly to the spinal surgeon, 125 patients were eligible for virtual consultation. Of the 46 patients who had a VC, surgery was recommended in 28 patients and actually given to 23. A retrospective review revealed that 5/79 patients who did not have a VC would have been considered surgical candidates. The overall accuracy of the virtual consultation process was estimated at 92%. Conclusion: The VC process for MESCC patients provides a reliable means of arriving at a multidisciplinary opinion while minimizing patient transfer. This can potentially shorten treatment decision time and enhance clinical outcomes.

  9. Visual anticipation biases conscious decision making but not bottom-up visual processing

    PubMed Central

    Mathews, Zenon; Cetnarski, Ryszard; Verschure, Paul F. M. J.

    2015-01-01

    Prediction plays a key role in control of attention but it is not clear which aspects of prediction are most prominent in conscious experience. An evolving view on the brain is that it can be seen as a prediction machine that optimizes its ability to predict states of the world and the self through the top-down propagation of predictions and the bottom-up presentation of prediction errors. There are competing views though on whether prediction or prediction errors dominate the formation of conscious experience. Yet, the dynamic effects of prediction on perception, decision making and consciousness have been difficult to assess and to model. We propose a novel mathematical framework and a psychophysical paradigm that allows us to assess both the hierarchical structuring of perceptual consciousness, its content and the impact of predictions and/or errors on conscious experience, attention and decision-making. Using a displacement detection task combined with reverse correlation, we reveal signatures of the usage of prediction at three different levels of perceptual processing: bottom-up fast saccades, top-down driven slow saccades and consciousnes decisions. Our results suggest that the brain employs multiple parallel mechanism at different levels of perceptual processing in order to shape effective sensory consciousness within a predicted perceptual scene. We further observe that bottom-up sensory and top-down predictive processes can be dissociated through cognitive load. We propose a probabilistic data association model from dynamical systems theory to model the predictive multi-scale bias in perceptual processing that we observe and its role in the formation of conscious experience. We propose that these results support the hypothesis that consciousness provides a time-delayed description of a task that is used to prospectively optimize real time control structures, rather than being engaged in the real-time control of behavior itself. PMID:25741290

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  11. Medical Decision Making for Patients Without Proxies: The Effect of Personal Experience in the Deliberative Process.

    PubMed

    Robichaud, Allyson L

    2015-01-01

    The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent--or informed refusal--is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee to serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. PMID:26752395

  12. Analytic hierarchy process as module for productivity evaluation and decision-making of the operation theater.

    PubMed

    Ezzat, Abdelrahman E M; Hamoud, Hesham S

    2016-01-01

    The analytic hierarchy process (AHP) is a theory of measurement through pairwise comparisons and relies on the judgments of experts to derive priority scales, these scales that measure intangibles in relative terms. The aim of the article was to develop a model for productivity measurement of the operation theater (OT), which could be applied as a model for quality improvement and decision-making. AHP is used in this article to evolve such a model. The steps consist of identifying the critical success factors for measuring the productivity of OT, identifying subfactors that inflauence the critical factors, comparing the pairwise, deriving their relative importance and ratings, and calculating the cumulative effect according to the attributes in OT. The cumulative productivitycan be calculated by the end and can be compared Ideal productivity to measure the productive of OT in percentage fraction. Hence, the productivity could be calculated. Hence, AHP is a very useful model to measure the productivity in OT. PMID:26955599

  13. Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary

    PubMed Central

    Pai, Vinay M; Rodgers, Mary; Conroy, Richard; Luo, James; Zhou, Ruixia; Seto, Belinda

    2014-01-01

    In April 2012, the National Institutes of Health organized a two-day workshop entitled ‘Natural Language Processing: State of the Art, Future Directions and Applications for Enhancing Clinical Decision-Making’ (NLP-CDS). This report is a summary of the discussions during the second day of the workshop. Collectively, the workshop presenters and participants emphasized the need for unstructured clinical notes to be included in the decision making workflow and the need for individualized longitudinal data tracking. The workshop also discussed the need to: (1) combine evidence-based literature and patient records with machine-learning and prediction models; (2) provide trusted and reproducible clinical advice; (3) prioritize evidence and test results; and (4) engage healthcare professionals, caregivers, and patients. The overall consensus of the NLP-CDS workshop was that there are promising opportunities for NLP and CDS to deliver cognitive support for healthcare professionals, caregivers, and patients. PMID:23921193

  14. Group decision making with the analytic hierarchy process in benefit-risk assessment: a tutorial.

    PubMed

    Hummel, J Marjan; Bridges, John F P; IJzerman, Maarten J

    2014-01-01

    The analytic hierarchy process (AHP) has been increasingly applied as a technique for multi-criteria decision analysis in healthcare. The AHP can aid decision makers in selecting the most valuable technology for patients, while taking into account multiple, and even conflicting, decision criteria. This tutorial illustrates the procedural steps of the AHP in supporting group decision making about new healthcare technology, including (1) identifying the decision goal, decision criteria, and alternative healthcare technologies to compare, (2) structuring the decision criteria, (3) judging the value of the alternative technologies on each decision criterion, (4) judging the importance of the decision criteria, (5) calculating group judgments, (6) analyzing the inconsistency in judgments, (7) calculating the overall value of the technologies, and (8) conducting sensitivity analyses. The AHP is illustrated via a hypothetical example, adapted from an empirical AHP analysis on the benefits and risks of tissue regeneration to repair small cartilage lesions in the knee.

  15. Health professionals' perceptions about the decision-making process in the care of pediatric patients

    PubMed Central

    Trotta, Eliana de Andrade; Scarpa, Fernanda Cristina; Halal, Michel George El; Goldim, José Roberto; Carvalho, Paulo Roberto Antonacci

    2016-01-01

    Objective To evaluate the perceptions of physicians, nurses and nursing technicians of their participation in the decision-making process surrounding life support limitation in terminally ill pediatric patients, with comparisons by professional category. Methods A cross-sectional study was conducted in the pediatric intensive care unit of a tertiary public university hospital with the participation of physicians, nurses and nursing technicians. The MacArthur Admission Experience Survey Voice Scale was used to assess and quantify the perceptions of professionals who assisted 17 pediatric patients with life support limitation within 24 hours after the outcome of each patient was determined. All professionals working in the unit (n = 117) who were potentially eligible for the study received a free and informed consent form prior to the occurrence of the cases studied. Results Study participants included 25/40 (62.5%) physicians, 10/17 (58.8%) nurses and 41/60 (68.3%) nursing technicians, representing 65% of the eligible professionals identified. The questionnaire return rate was higher for physicians than technicians (p = 0.0258). A perceived lack of voice was reported in all three professional categories at varying rates that were lower for physicians than for nurses and nursing technicians (p < 0.00001); there was no difference between the latter (p = 0.7016). In the three professional categories studied, three subscale items were reported. For two of the three statements, there were significant differences between physicians and nurses (p = 0.004) and between physicians and nursing technicians (p = 0.001). For one of the statements, there was no difference among the three professional categories. Conclusion Respondents perceived a lack of voice in the decision-making process at varying rates across the three categories of studied professionals who assisted terminally ill pediatric patients with life support limitation, with physicians expressing lowered rates of

  16. Teaching ethics to engineers: ethical decision making parallels the engineering design process.

    PubMed

    Bero, Bridget; Kuhlman, Alana

    2011-09-01

    In order to fulfill ABET requirements, Northern Arizona University's Civil and Environmental engineering programs incorporate professional ethics in several of its engineering courses. This paper discusses an ethics module in a 3rd year engineering design course that focuses on the design process and technical writing. Engineering students early in their student careers generally possess good black/white critical thinking skills on technical issues. Engineering design is the first time students are exposed to "grey" or multiple possible solution technical problems. To identify and solve these problems, the engineering design process is used. Ethical problems are also "grey" problems and present similar challenges to students. Students need a practical tool for solving these ethical problems. The step-wise engineering design process was used as a model to demonstrate a similar process for ethical situations. The ethical decision making process of Martin and Schinzinger was adapted for parallelism to the design process and presented to students as a step-wise technique for identification of the pertinent ethical issues, relevant moral theories, possible outcomes and a final decision. Students had greatest difficulty identifying the broader, global issues presented in an ethical situation, but by the end of the module, were better able to not only identify the broader issues, but also to more comprehensively assess specific issues, generate solutions and a desired response to the issue.

  17. Decision Making Under Objective Risk Conditions-a Review of Cognitive and Emotional Correlates, Strategies, Feedback Processing, and External Influences.

    PubMed

    Schiebener, Johannes; Brand, Matthias

    2015-06-01

    While making decisions under objective risk conditions, the probabilities of the consequences of the available options are either provided or calculable. Brand et al. (Neural Networks 19:1266-1276, 2006) introduced a model describing the neuro-cognitive processes involved in such decisions. In this model, executive functions associated with activity in the fronto-striatal loop are important for developing and applying decision-making strategies, and for verifying, adapting, or revising strategies according to feedback. Emotional rewards and punishments learned from such feedback accompany these processes. In this literature review, we found support for the role of executive functions, but also found evidence for the importance of further cognitive abilities in decision making. Moreover, in addition to reflective processing (driven by cognition), decisions can be guided by impulsive processing (driven by anticipation of emotional reward and punishment). Reflective and impulsive processing may interact during decision making, affecting the evaluation of available options, as both processes are affected by feedback. Decision-making processes are furthermore modulated by individual attributes (e.g., age), and external influences (e.g., stressors). Accordingly, we suggest a revised model of decision making under objective risk conditions.

  18. Graphics Processing Unit-Based Bioheat Simulation to Facilitate Rapid Decision Making Associated with Cryosurgery Training.

    PubMed

    Keelan, Robert; Zhang, Hong; Shimada, Kenji; Rabin, Yoed

    2016-04-01

    This study focuses on the implementation of an efficient numerical technique for cryosurgery simulations on a graphics processing unit as an alternative means to accelerate runtime. This study is part of an ongoing effort to develop computerized training tools for cryosurgery, with prostate cryosurgery as a developmental model. The ability to perform rapid simulations of various test cases is critical to facilitate sound decision making associated with medical training. Consistent with clinical practice, the training tool aims at correlating the frozen region contour and the corresponding temperature field with the target region shape. The current study focuses on the feasibility of graphics processing unit-based computation using C++ accelerated massive parallelism, as one possible implementation. Benchmark results on a variety of computation platforms display between 3-fold acceleration (laptop) and 13-fold acceleration (gaming computer) of cryosurgery simulation, in comparison with the more common implementation on a multicore central processing unit. While the general concept of graphics processing unit-based simulations is not new, its application to phase-change problems, combined with the unique requirements for cryosurgery optimization, represents the core contribution of the current study.

  19. Cultural influences on the neural correlate of moral decision making processes.

    PubMed

    Han, Hyemin; Glover, Gary H; Jeong, Changwoo

    2014-02-01

    This study compares the neural substrate of moral decision making processes between Korean and American participants. By comparison with Americans, Korean participants showed increased activity in the right putamen associated with socio-intuitive processes and right superior frontal gyrus associated with cognitive control processes under a moral-personal condition, and in the right postcentral sulcus associated with mental calculation in familiar contexts under a moral-impersonal condition. On the other hand, American participants showed a significantly higher degree of activity in the bilateral anterior cingulate cortex (ACC) associated with conflict resolution under the moral-personal condition, and in the right medial frontal gyrus (MFG) associated with simple cognitive branching in non-familiar contexts under the moral-impersonal condition when a more lenient threshold was applied, than Korean participants. These findings support the ideas of the interactions between the cultural background, education, and brain development, proposed in the field of cultural psychology and educational psychology. The study introduces educational implications relevant to moral psychologists and educators.

  20. Cultural influences on the neural correlate of moral decision making processes.

    PubMed

    Han, Hyemin; Glover, Gary H; Jeong, Changwoo

    2014-02-01

    This study compares the neural substrate of moral decision making processes between Korean and American participants. By comparison with Americans, Korean participants showed increased activity in the right putamen associated with socio-intuitive processes and right superior frontal gyrus associated with cognitive control processes under a moral-personal condition, and in the right postcentral sulcus associated with mental calculation in familiar contexts under a moral-impersonal condition. On the other hand, American participants showed a significantly higher degree of activity in the bilateral anterior cingulate cortex (ACC) associated with conflict resolution under the moral-personal condition, and in the right medial frontal gyrus (MFG) associated with simple cognitive branching in non-familiar contexts under the moral-impersonal condition when a more lenient threshold was applied, than Korean participants. These findings support the ideas of the interactions between the cultural background, education, and brain development, proposed in the field of cultural psychology and educational psychology. The study introduces educational implications relevant to moral psychologists and educators. PMID:24263193

  1. Combined Economic and Hydrologic Modeling to Support Collaborative Decision Making Processes

    NASA Astrophysics Data System (ADS)

    Sheer, D. P.

    2008-12-01

    For more than a decade, the core concept of the author's efforts in support of collaborative decision making has been a combination of hydrologic simulation and multi-objective optimization. The modeling has generally been used to support collaborative decision making processes. The OASIS model developed by HydroLogics Inc. solves a multi-objective optimization at each time step using a mixed integer linear program (MILP). The MILP can be configured to include any user defined objective, including but not limited too economic objectives. For example, an estimated marginal value for water for crops and M&I use were included in the objective function to drive trades in a model of the lower Rio Grande. The formulation of the MILP, constraints and objectives, in any time step is conditional: it changes based on the value of state variables and dynamic external forcing functions, such as rainfall, hydrology, market prices, arrival of migratory fish, water temperature, etc. It therefore acts as a dynamic short term multi-objective economic optimization for each time step. MILP is capable of solving a general problem that includes a very realistic representation of the physical system characteristics in addition to the normal multi-objective optimization objectives and constraints included in economic models. In all of these models, the short term objective function is a surrogate for achieving long term multi-objective results. The long term performance for any alternative (especially including operating strategies) is evaluated by simulation. An operating rule is the combination of conditions, parameters, constraints and objectives used to determine the formulation of the short term optimization in each time step. Heuristic wrappers for the simulation program have been developed improve the parameters of an operating rule, and are initiating research on a wrapper that will allow us to employ a genetic algorithm to improve the form of the rule (conditions, constraints

  2. A conceptual framework for automating the operational and strategic decision-making process in the health care delivery system.

    PubMed

    Ruohonen, Toni; Ennejmy, Mohammed

    2013-01-01

    Making reliable and justified operational and strategic decisions is a really challenging task in the health care domain. So far, the decisions have been made based on the experience of managers and staff, or they are evaluated with traditional methods, using inadequate data. As a result of this kind of decision-making process, attempts to improve operations usually have failed or led to only local improvements. Health care organizations have a lot of operational data, in addition to clinical data, which is the key element for making reliable and justified decisions. However, it is progressively problematic to access it and make usage of it. In this paper we discuss about the possibilities how to exploit operational data in the most efficient way in the decision-making process. We'll share our future visions and propose a conceptual framework for automating the decision-making process.

  3. Social provocation modulates decision making and feedback processing: Examining the trajectory of development in adolescent participants.

    PubMed

    Pincham, Hannah L; Wu, Claire; Killikelly, Clare; Vuillier, Laura; Fearon, R M Pasco

    2015-10-01

    Increasingly, research is turning to the ways in which social context impacts decision making and feedback processing in adolescents. The current study recorded electroencephalography to examine the trajectory of development across adolescence, with a focus on how social context impacts cognition and behaviour. To that end, younger (10-12 years) and older (14-16 years) adolescents played a modified Taylor Aggression Paradigm against two virtual opponents: a low-provoker and a high-provoker. During the task's decision phase (where participants select punishment for their opponent), we examined two event-related potentials: the N2 and the late positive potential (LPP). During the outcome phase (where participants experience win or loss feedback), we measured the feedback related negativity (FRN). Although N2 amplitudes did not vary with provocation, LPP amplitudes were enhanced under high provocation for the younger group, suggesting that emotional reactivity during the decision phase was heightened for early adolescents. During the outcome phase, the FRN was reduced following win outcomes under high provocation for both groups, suggesting that a highly provocative social opponent may influence the reward response. Collectively, the data argue that social context is an important factor modulating neural responses in adolescent behavioural and brain development.

  4. Searching Choices: Quantifying Decision-Making Processes Using Search Engine Data.

    PubMed

    Moat, Helen Susannah; Olivola, Christopher Y; Chater, Nick; Preis, Tobias

    2016-07-01

    When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision-making process.

  5. Power to Punish Norm Violations Affects the Neural Processes of Fairness-Related Decision Making.

    PubMed

    Cheng, Xuemei; Zheng, Li; Li, Lin; Guo, Xiuyan; Wang, Qianfeng; Lord, Anton; Hu, Zengxi; Yang, Guang

    2015-01-01

    Punishing norm violations is considered an important motive during rejection of unfair offers in the ultimatum game (UG). The present study investigates the impact of the power to punish norm violations on people's responses to unfairness and associated neural correlates. In the UG condition participants had the power to punish norm violations, while an alternate condition, the impunity game (IG), was presented where participants had no power to punish norm violations since rejection only reduced the responder's income to zero. Results showed that unfair offers were rejected more often in UG compared to IG. At the neural level, anterior insula and dorsal anterior cingulate cortex were more active when participants received and rejected unfair offers in both UG and IG. Moreover, greater dorsolateral prefrontal cortex activity was observed when participants rejected than accepted unfair offers in UG but not in IG. Ventromedial prefrontal cortex activation was higher in UG than IG when unfair offers were accepted as well as when rejecting unfair offers in IG as opposed to UG. Taken together, our results demonstrate that the power to punish norm violations affects not only people's behavioral responses to unfairness but also the neural correlates of the fairness-related social decision-making process.

  6. Recruit, screen, and hire: staff selection and the decision-making process.

    PubMed

    Melville, S D

    1977-01-01

    This article focuses on the role of the clinician-manager in staff selection. The duties of the clinician-manager in a mental health center include those tasks described as "recruit, screen, and hire" but little or no guidance on the steps involved in this sequence of events is available. The "how" of hiring is transmitted by word of mouth, by following another's example, or by trial and error. This article examines the component parts of staff selection from the assimilation of procedures, rules, and regulation of the public authority under which a particular mental health center operates, to the compilation of a "short list" of those to be screened and finally the risk taking and decision-making process by the clinician-manager who makes the choice. Some speculation on the emotional impact it has on the clinician-manager is examined. The impact of personal value judgments of the selector are considered. Recommendations are made for the inclusion of training in staff selection by academic programs for mental health administrators.

  7. Group Dynamics: Toward a Study of the Administrative/Supervisory Leadership Role Within Group Decision-Making Processes.

    ERIC Educational Resources Information Center

    McGowan, Francis, II

    Group processes are an integral part of the educational enterprise, but "effectiveness of group processes" does not necessarily follow from the simple act of group formation. The administrator has the responsibility of exercising effective group leadership. Group formation, group task functions or assignments, and decision-making processes are…

  8. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice.

  9. Dual Processing Model for Medical Decision-Making: An Extension to Diagnostic Testing.

    PubMed

    Tsalatsanis, Athanasios; Hozo, Iztok; Kumar, Ambuj; Djulbegovic, Benjamin

    2015-01-01

    Dual Processing Theories (DPT) assume that human cognition is governed by two distinct types of processes typically referred to as type 1 (intuitive) and type 2 (deliberative). Based on DPT we have derived a Dual Processing Model (DPM) to describe and explain therapeutic medical decision-making. The DPM model indicates that doctors decide to treat when treatment benefits outweigh its harms, which occurs when the probability of the disease is greater than the so called "threshold probability" at which treatment benefits are equal to treatment harms. Here we extend our work to include a wider class of decision problems that involve diagnostic testing. We illustrate applicability of the proposed model in a typical clinical scenario considering the management of a patient with prostate cancer. To that end, we calculate and compare two types of decision-thresholds: one that adheres to expected utility theory (EUT) and the second according to DPM. Our results showed that the decisions to administer a diagnostic test could be better explained using the DPM threshold. This is because such decisions depend on objective evidence of test/treatment benefits and harms as well as type 1 cognition of benefits and harms, which are not considered under EUT. Given that type 1 processes are unique to each decision-maker, this means that the DPM threshold will vary among different individuals. We also showed that when type 1 processes exclusively dominate decisions, ordering a diagnostic test does not affect a decision; the decision is based on the assessment of benefits and harms of treatment. These findings could explain variations in the treatment and diagnostic patterns documented in today's clinical practice. PMID:26244571

  10. Using social network analysis to examine the decision-making process on new vaccine introduction in Nigeria.

    PubMed

    Wonodi, C B; Privor-Dumm, L; Aina, M; Pate, A M; Reis, R; Gadhoke, P; Levine, O S

    2012-05-01

    The decision-making process to introduce new vaccines into national immunization programmes is often complex, involving many stakeholders who provide technical information, mobilize finance, implement programmes and garner political support. Stakeholders may have different levels of interest, knowledge and motivations to introduce new vaccines. Lack of consensus on the priority, public health value or feasibility of adding a new vaccine can delay policy decisions. Efforts to support country-level decision-making have largely focused on establishing global policies and equipping policy makers with the information to support decision-making on new vaccine introduction (NVI). Less attention has been given to understanding the interactions of policy actors and how the distribution of influence affects the policy process and decision-making. Social network analysis (SNA) is a social science technique concerned with explaining social phenomena using the structural and relational features of the network of actors involved. This approach can be used to identify how information is exchanged and who is included or excluded from the process. For this SNA of vaccine decision-making in Nigeria, we interviewed federal and state-level government officials, officers of bilateral and multilateral partner organizations, and other stakeholders such as health providers and the media. Using data culled from those interviews, we performed an SNA in order to map formal and informal relationships and the distribution of influence among vaccine decision-makers, as well as to explore linkages and pathways to stakeholders who can influence critical decisions in the policy process. Our findings indicate a relatively robust engagement of key stakeholders in Nigeria. We hypothesized that economic stakeholders and implementers would be important to ensure sustainable financing and strengthen programme implementation, but some economic and implementation stakeholders did not appear centrally on

  11. Roles of the Different Sub-Regions of the Insular Cortex in Various Phases of the Decision-Making Process

    PubMed Central

    Droutman, Vita; Bechara, Antoine; Read, Stephen J.

    2015-01-01

    This paper presents a coherent account of the role of the insular cortex (IC) in decision-making. We follow a conceptualization of decision-making that is very close to one previously proposed by Ernst and Paulus (2005): that the decision process is a progression of four phases: (1) re-focusing attention; (2) evaluation; (3) action; and (4) outcome processing, and we present evidence for the insula’s role in all these phases. We review the existing work on insula’s functional anatomy that subdivides the IC into posterior, dorsal anterior and ventral anterior regions. We re-map the results provided by the existing literature into these subdivisions wherever possible, to identify the components’ role in each decision making phase. In addition, we identify a self-regulating quality of the IC focused on harm avoidance. PMID:26635559

  12. Thermodynamic view on decision-making process: emotions as a potential power vector of realization of the choice.

    PubMed

    Pakhomov, Anton; Sudin, Natalya

    2013-12-01

    This research is devoted to possible mechanisms of decision-making in frames of thermodynamic principles. It is also shown that the decision-making system in reply to emotion includes vector component which seems to be often a necessary condition to transfer system from one state to another. The phases of decision-making system can be described as supposed to be nonequilibrium and irreversible to which thermodynamics laws are applied. The mathematical model of a decision choice, proceeding from principles of the nonlinear dynamics considering instability of movement and bifurcation is offered. The thermodynamic component of decision-making process on the basis of vector transfer of energy induced by emotion at the given time is surveyed. It is proposed a three-modular model of decision making based on principles of thermodynamics. Here it is suggested that at entropy impact due to effect of emotion, on the closed system-the human brain,-initially arises chaos, then after fluctuations of possible alternatives which were going on-reactions of brain zones in reply to external influence, an order is forming and there is choice of alternatives, according to primary entrance conditions and a state of the closed system. Entropy calculation of a choice expectation of negative and positive emotion shows judgment possibility of existence of "the law of emotion conservation" in accordance with several experimental data. PMID:24427219

  13. Beyond Self-Report: Emerging Methods for Capturing Individual Differences in Decision-Making Process

    PubMed Central

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

    2016-01-01

    People vary in the way in which they approach decision-making, which impacts real-world behavior. There has been a surge of interest in moving beyond reliance on self-report measures to capture such individual differences. Particular emphasis has been placed on devising and applying a range of methodologies that include experimental, neuroscience, and observational paradigms. This paper provides a selective review of recent studies that illustrate the methods and yield of these approaches in terms of generating a deeper understanding of decision-making style and the notable differences that can be found across individuals. PMID:26973589

  14. Personal decision-making processes for living related liver transplantation in children.

    PubMed

    Goldschmidt, Imeke; Migal, Katarina; Rückert, Norbert; van Dick, Rolf; Pfister, Eva Doreen; Becker, Thomas; Richter, Nicolas; Lehner, Frank; Baumann, Ulrich

    2015-02-01

    Living related liver transplantation (LRLT) is a valuable transplant option for children with end-stage liver disease who face long waiting times on regular waiting lists. The subjection of a healthy adult to a potentially life-threatening operation can raise issues of freedom of choice, fear, and family conflict for the potential donors. We examined attitudes, fears, and influencing factors in the decision-making process for living liver donation for children in order to identify factors to improve support for living liver donors in the future. In a retrospective, questionnaire-based survey of 93 adults evaluated for living liver donation between 1997 and 2010, 47 of whom actually proceeded to donation, we asked about attitudes, motivation, fears, influencing factors, and well-being during the LRLT evaluation process and during the donation period. Answers were recorded on Likert scales and compared with Pearson's rho correlation and the Mann-Whitney U test as appropriate. Although there was a strong sense of a lack of alternatives among the donors, the majority of the donors felt free in their decision to donate. Donors who were asked to donate for a relative who was not their own child appeared at higher risk of lacking support and of feeling coerced. Family and social support and good and empathic information about the donation process were identified as key factors for donor well-being. In conclusion, potential living liver donors need to have adequate, sufficient, and empathic information, and they need to be provided a supportive framework, including family support, in order to promote their well-being. Care needs to be taken in identifying and counseling potential donors at risk of feeling coerced into donation. PMID:25504770

  15. Retrospective study of emerging themes in the decision-making process of patients considering amputation.

    PubMed

    Rassin, Michal; Tzevlin, Valeria; Malul, Einat; Harel, Shimrit; Shakhar, Hadar

    2012-06-01

    How patients make decisions about their future treatment has been sparsely study and with respect to limb amputation, a particularly difficult decision, not at all. An examination of this should furnish nurses vital knowledge about how patients come to the decision to give or refuse this consent. To reach as deep understanding as possible of how from the patients' point of view they reach the decision to consent to the amputation of a lower limb. The research was conducted in the qualitative method. Thirty lower-limb amputees (aged 32-88) took part in the study. In-depth interviews were held with the participants. The data were processed by means of content analysis. The main thematic categories identified were, in the chronological order of their appearance: 'The trail of torment leading to the decision to amputate', 'The turning point--taking the decision' "I just couldn't take any more pain" "We opt for life, we don't want to die". The more protracted and pain-filled the 'the trail of torment' the more mentally prepared patients were to give consent to amputation. Asked to look back on their choice, almost all interviewees had no regrets and even found virtues in it. The patients' decisions represented a mix of their grasp of the medical information supplied them by their doctors, their own personal values--opting for life prevailing over the desire for a whole body, and consideration for their family. The patients saw the decision-making process about amputation as a process of achieving consensus between themselves, their doctors and their family.

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

    PubMed

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

    2013-11-01

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

  17. Health care policy in theory and practice: a review of the process as a product of rational decision-making.

    PubMed

    Prosono, M

    1998-01-01

    Decisions are not made in a vacuum. Both theories and practical circumstances influence how reason and decision-making are conceived. In this article, the focus is on organizations and their impact on shaping the decision-making process. Organizational theories, management philosophies, and structural considerations are reviewed, with emphasis placed on how they influence the search for information, the conceptualization of data, the possible uses of knowledge, and the formation of behavioral goals. Accordingly, decision-making is contextualized; organizational assumptions are linked to the reasonableness of a decision. As modern writers say, the "taken-for-grantedness" of an organization is illustrated to be tied inextricably to the nature of reason and assessments of rationality.

  18. Distributed multisensor processing, decision making, and control under constrained resources for remote health and environmental monitoring

    NASA Astrophysics Data System (ADS)

    Talukder, Ashit; Sheikh, Tanwir; Chandramouli, Lavanya

    2004-04-01

    Previous field-deployable distributed sensing systems for health/biomedical applications and environmental sensing have been designed for data collection and data transmission at pre-set intervals, rather than for on-board processing These previous sensing systems lack autonomous capabilities, and have limited lifespans. We propose the use of an integrated machine learning architecture, with automated planning-scheduling and resource management capabilities that can be used for a variety of autonomous sensing applications with very limited computing, power, and bandwidth resources. We lay out general solutions for efficient processing in a multi-tiered (three-tier) machine learning framework that is suited for remote, mobile sensing systems. Novel dimensionality reduction techniques that are designed for classification are used to compress each individual sensor data and pass only relevant information to the mobile multisensor fusion module (second-tier). Statistical classifiers that are capable of handling missing/partial sensory data due to sensor failure or power loss are used to detect critical events and pass the information to the third tier (central server) for manual analysis and/or analysis by advanced pattern recognition techniques. Genetic optimisation algorithms are used to control the system in the presence of dynamic events, and also ensure that system requirements (i.e. minimum life of the system) are met. This tight integration of control optimisation and machine learning algorithms results in a highly efficient sensor network with intelligent decision making capabilities. The applicability of our technology in remote health monitoring and environmental monitoring is shown. Other uses of our solution are also discussed.

  19. Donor Motivations and Decision Making: Understanding the Major Gift Development Process from a Donor's Perspective

    ERIC Educational Resources Information Center

    Morrison, Anna Lee

    2015-01-01

    Higher education is faced with a challenge to its traditional funding structure. As a result, academic programs must seek alternative sources of support. Chief among these sources is philanthropy in the form of major gifts. Insight into donor motivations and decision making when approached to consider a major gift may help to maximize the success…

  20. A Mixed Methodological Analysis of the Role of Culture in the Clinical Decision-Making Process

    ERIC Educational Resources Information Center

    Hays, Danica G.; Prosek, Elizabeth A.; McLeod, Amy L.

    2010-01-01

    Even though literature indicates that particular cultural groups receive more severe diagnoses at disproportionate rates, there has been minimal research that addresses how culture interfaces specifically with clinical decision making. This mixed methodological study of 41 counselors indicated that cultural characteristics of both counselors and…

  1. Career Decision Making: The Limits of Rationality and the Abundance of Non-Conscious Processes

    ERIC Educational Resources Information Center

    Krieshok, Thomas S.; Black, Michael D.; McKay, Robyn A.

    2009-01-01

    The terms of work have changed, with multiple transitions now characterizing the arc of a typical career. This article examines an ongoing shift in the area of vocational decision making, as it moves from a place where "it's all about the match" to one closer to "it's all about adapting to change". We review literatures on judgment and decision…

  2. Factors Influencing New Entrant Dairy Farmer's Decision-Making Process around Technology Adoption

    ERIC Educational Resources Information Center

    McDonald, Roberta; Heanue, Kevin; Pierce, Karina; Horan, Brendan

    2016-01-01

    Purpose: The aims of this paper are to (1) evaluate the main factors influencing grazing system technology adoption among new entrant (NE) dairy farmers within Europe and the Irish pasture-based dairy industry, and (2) to determine the extent to which economic factors influence decision-making around technology adoption and use among NEs to the…

  3. Community College Presidents' Decision-Making Processes during a Potential Crisis

    ERIC Educational Resources Information Center

    Berry, Judith Kaye

    2013-01-01

    This case study addressed how community college presidents make decisions under conditions that can escalate to full-scale crises. The purpose of this study was to gather data to support the development of alternative models or refinement of existing models for crisis decision making on community college campuses, using an abbreviated…

  4. Elementary Principal Decision-Making Process during Crisis Situations in One Northern New Jersey District

    ERIC Educational Resources Information Center

    Torley, Marilyn

    2011-01-01

    The purpose of this qualitative study was to investigate how school administrators respond during a crisis. Relevant research pertaining to crisis decision-making will be presented, focusing on the three steps of crisis decision theory (a) assessing the severity of the negative event (b) determining response options, and (c) evaluating response…

  5. The Decision-Making Process in Language Program Placement: Test and Nontest Factors Interacting in Context

    ERIC Educational Resources Information Center

    Plakans, Lia; Burke, Maureen

    2013-01-01

    The use of tests has been targeted as a critical point in validity, which suggests that contexts for test use warrant closer investigation. This article describes a study of decision making during test use in the context of a university intensive English language program. Over a period of 2 1/2 years, data were collected by audio-recording…

  6. Modulators of decision making.

    PubMed

    Doya, Kenji

    2008-04-01

    Human and animal decisions are modulated by a variety of environmental and intrinsic contexts. Here I consider computational factors that can affect decision making and review anatomical structures and neurochemical systems that are related to contextual modulation of decision making. Expectation of a high reward can motivate a subject to go for an action despite a large cost, a decision that is influenced by dopamine in the anterior cingulate cortex. Uncertainty of action outcomes can promote risk taking and exploratory choices, in which norepinephrine and the orbitofrontal cortex appear to be involved. Predictable environments should facilitate consideration of longer-delayed rewards, which depends on serotonin in the dorsal striatum and dorsal prefrontal cortex. This article aims to sort out factors that affect the process of decision making from the viewpoint of reinforcement learning theory and to bridge between such computational needs and their neurophysiological substrates.

  7. The Role of Psychological Adjustment in the Decision-making Process for Voluntary Termination of Pregnancy

    PubMed Central

    Sereno, Sara; Leal, Isabel; Maroco, João

    2013-01-01

    Background This study's objective was to evaluate the role of psychological adjustment in the decision-making process to have an abortion and explore individual variables that might influence this decision. Methods In this cross-sectional study, we sequentially enrolled 150 women who made the decision to voluntarily terminate a pregnancy in Maternity Dr. Alfredo da Costa, in Lisbon, Portugal, between September 2008 and June 2009. The instruments were the Depression, Anxiety and Stress Scale (DASS), Satisfaction with Social Support Scale (SSSS), Emotional Assessment Scale (EAS), Decision Conflict Scale (DCS), and Beliefs and Values Questionnaire (BVQ). We analyzed the data using Student's T-tests, MANOVA, ANOVA, Tukey's post-hoc tests and CATPCA. Statistically significant effects were accepted for p<0.05. Results The participants found the decision difficult and emotionally demanding, although they also identified it as a low conflict decision. The prevailing emotions were sadness, fear and stress; but despite these feelings, the participants remained psychologically adjusted in the moment they decided to have an abortion. The resolution to terminate the pregnancy was essentially shared with supportive people and it was mostly motivated by socio-economic issues. The different beliefs and values found in this sample, and their possible associations are discussed. Conclusion Despite high levels of stress, the women were psychologically adjusted at the time of making the decision to terminate the pregnancy. However, opposing what has been previously reported, the women presented high levels of sadness and fear, showing that this decision was hard to make, triggering disruptive emotions. PMID:24163799

  8. A transdisciplinary approach to the decision-making process in extreme prematurity

    PubMed Central

    2014-01-01

    Background A wide range of dilemmas encountered in the health domain can be addressed more efficiently by a transdisciplinary approach. The complex context of extreme prematurity, which is raising important challenges for caregivers and parents, warrants such an approach. Methods In the present work, experts from various disciplinary fields, namely biomedical, epidemiology, psychology, ethics, and law, were enrolled to participate in a reflection. Gathering a group of experts could be very demanding, both in terms of time and resources, so we created a web-based discussion forum to facilitate the exchanges. The participants were mandated to solve two questions: “Which parameters should be considered before delivering survival care to a premature baby born at the threshold of viability?” and “Would it be acceptable to give different information to parents according to the sex of the baby considering that outcome differences exist between sexes?” Results The discussion forum was performed over a period of nine months and went through three phases: unidisciplinary, interdisciplinary and transdisciplinary, which required extensive discussions and the preparation of several written reports. Those steps were successfully achieved and the participants finally developed a consensual point of view regarding the initial questions. This discussion board also led to a concrete knowledge product, the publication of the popularized results as an electronic book. Conclusions We propose, with our transdisciplinary analysis, a relevant and innovative complement to existing guidelines regarding the decision-making process for premature infants born at the threshold of viability, with an emphasis on the respective responsabilities of the caregivers and the parents. PMID:25023324

  9. 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…

  10. Modeling the Occupational/Career Decision-Making Processes of Intellectually Gifted Adolescents: A Competing Models Strategy

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2014-01-01

    This study developed and empirically tested two related models of the occupational/career decision-making processes of gifted adolescents using a competing models strategy. The two models that guided the study, which acknowledged cultural orientations, social influences from the family, occupational/career values, and characteristics of…

  11. Analysis of Korean High School Students' Decision-Making Processes in Solving a Problem Involving Biological Knowledge

    ERIC Educational Resources Information Center

    Hong, Jung-Lim; Chang, Nam-Kee

    2004-01-01

    In this study, the cognitive characteristics of students' decision-making processes centered on phases, difficulties, and strategies are analysed in the personal dailylife context involving biological knowledge. The subjects were first year science and general high school students in Seoul, Korea; 6 female students and 7 male students. The…

  12. Decision-Making Processes of SME in Cloud Computing Adoption to Create Disruptive Innovation: Mediating Effect of Collaboration

    ERIC Educational Resources Information Center

    Sonthiprasat, Rattanawadee

    2014-01-01

    THE PROBLEM. The purpose of this quantitative correlation study was to assess the relationship between different Cloud service levels of effective business innovation for SMEs. In addition, the new knowledge gained from the benefits of Cloud adoption with knowledge sharing would enhance the decision making process for businesses to consider the…

  13. An Assessment of Decision-Making Processes: Evaluation of Where Land Protection Planning Can Incorporate Climate Change Information (Final Report)

    EPA Science Inventory

    This report, prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA), is a review of decision-making processes of selected la...

  14. 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…

  15. High School Students' Career Decision-Making Process: Development and Validation of the Study Choice Task Inventory

    ERIC Educational Resources Information Center

    Germeijs, Veerle; Verschueren, Karine

    2006-01-01

    During adolescence, one important career-related decision is the choice of a study in higher education. In this article, a new set of measures for different tasks (i.e., orientation, exploration, commitment) that can be distinguished during this career decision-making process was constructed: the Study Choice Task Inventory (SCTI). A sample of 946…

  16. Adolescent Decision-Making Processes regarding University Entry: A Model Incorporating Cultural Orientation, Motivation and Occupational Variables

    ERIC Educational Resources Information Center

    Jung, Jae Yup

    2013-01-01

    This study tested a newly developed model of the cognitive decision-making processes of senior high school students related to university entry. The model incorporated variables derived from motivation theory (i.e. expectancy-value theory and the theory of reasoned action), literature on cultural orientation and occupational considerations. A…

  17. A Mixed Method Inquiry into the Perceptions of the Faculty Senate Concerning the Budget Decision-Making Process

    ERIC Educational Resources Information Center

    Higgins, Jeremy Keith

    2013-01-01

    Historically universities have been academically focused institutions; however, in recent years they have begun to resemble a corporate business. The purpose of this dissertation was to determine the faculty senate's perceptions of the budget decision-making process at a public institution of higher education in Texas. The institution under study…

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

    ERIC Educational Resources Information Center

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

    2015-01-01

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

  19. The Effects of Cognitive Process and Decision Making Training in Reading Experience on Meaningful Learning with Underachieving College Students

    ERIC Educational Resources Information Center

    Dean, Rebecca J.

    2010-01-01

    The ability of underprepared college students to read and learn from their reading is essential to their academic success and to their ability to persist towards completing their degree. The purposes of this study were to (a) assess the relationship between the cognitive processes of reading-based decision making and meaningful learning and (b)…

  20. [Decision Making and Electrodermal Activity].

    PubMed

    Kobayakawa, Mutsutaka

    2016-08-01

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

  1. [Decision Making and Electrodermal Activity].

    PubMed

    Kobayakawa, Mutsutaka

    2016-08-01

    Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process. PMID:27503819

  2. How organizational context affects bioethical decision-making: pharmacists' management of gatekeeping processes in retail and hospital settings.

    PubMed

    Chiarello, Elizabeth

    2013-12-01

    Social science studies of bioethics demonstrate that ethics are highly contextual, functioning differently across local settings as actors make daily decisions "on the ground." Sociological studies that demonstrate the key role organizations play in shaping ethical decision-making have disproportionately focused on physicians and nurses working in hospital settings where they contend with life and death issues. This study broadens our understanding of the contexts of ethical decision-making by empirically examining understudied healthcare professionals - pharmacists - working in two organizational settings, retail and hospital, where they act as gatekeepers to regulated goods and services as they contend with ethical issues ranging from the serious to the mundane. This study asks: How do organizations shape pharmacists' identification, negotiation, and resolution of ethical challenges; in other words, how do organizations shape pharmacists' gatekeeping processes? Based on 95 semi-structured interviews with U.S. pharmacists practicing in retail and hospital pharmacies conducted between September 2009 and May 2011, this research finds that organizations influence ethical decision-making by shaping how pharmacists construct four gatekeeping processes: medical, legal, fiscal, and moral. Each gatekeeping process manifests differently across organizations due to how these settings structure inter-professional power dynamics, proximity to patients, and means of accessing information. Findings suggest new directions for theorizing about ethical decision-making in medical contexts by drawing attention to new ethical actors, new organizational settings, an expanded definition of ethical challenges, and a broader conceptualization of gatekeeping.

  3. Imitation versus payoff: Duality of the decision-making process demonstrates criticality and consensus formation

    NASA Astrophysics Data System (ADS)

    Turalska, M.; West, B. J.

    2014-11-01

    We consider a dual model of decision making, in which an individual forms its opinion based on contrasting mechanisms of imitation and rational calculation. The decision-making model (DMM) implements imitating behavior by means of a network of coupled two-state master equations that undergoes a phase transition at a critical value of a control parameter. The evolutionary spatial game, being a generalization of the prisoner's dilemma game, is used to determine in objective fashion the cooperative or anticooperative strategy adopted by individuals. Interactions between two sources of dynamics increases the domain of initial states attracted to phase transition dynamics beyond that of the DMM network in isolation. Additionally, on average the influence of the DMM on the game increases the final observed fraction of cooperators in the system.

  4. Imitation versus payoff: Duality of the decision-making process demonstrates criticality and consensus formation.

    PubMed

    Turalska, M; West, B J

    2014-11-01

    We consider a dual model of decision making, in which an individual forms its opinion based on contrasting mechanisms of imitation and rational calculation. The decision-making model (DMM) implements imitating behavior by means of a network of coupled two-state master equations that undergoes a phase transition at a critical value of a control parameter. The evolutionary spatial game, being a generalization of the prisoner's dilemma game, is used to determine in objective fashion the cooperative or anticooperative strategy adopted by individuals. Interactions between two sources of dynamics increases the domain of initial states attracted to phase transition dynamics beyond that of the DMM network in isolation. Additionally, on average the influence of the DMM on the game increases the final observed fraction of cooperators in the system.

  5. [The impact of guidelines, standards and economic restrictions on clinical decision-making processes].

    PubMed

    Linden, Michael

    2004-05-01

    Guidelines aim at improving clinical decision-making. Contrary to textbooks and reviews that want to improve medical knowledge, guidelines try to influence medical behaviour. Scientific models of clinical decision-making such as the action theory and empirical data on the effects of guidelines suggest that guidelines will not always reach their goals but can instead even lead to a deterioration in the quality of medical care. Therefore there is a need for controlled clinical trials to investigate whether guideline-exposed physicians yield better patient outcomes than guideline-naïve physicians. Guidelines should only be regarded as evidence-based if their positive effects have been empirically demonstrated. PMID:15250387

  6. Sensory shelf life estimation of minimally processed lettuce considering two stages of consumers' decision-making process.

    PubMed

    Ares, Gastón; Giménez, Ana; Gámbaro, Adriana

    2008-01-01

    The aim of the present work was to study the influence of context, particularly the stage of the decision-making process (purchase vs consumption stage), on sensory shelf life of minimally processed lettuce. Leaves of butterhead lettuce were placed in common polypropylene bags and stored at 5, 10 and 15 degrees C. Periodically, a panel of six assessors evaluated the appearance of the samples, and a panel of 40 consumers evaluated their appearance and answered "yes" or "no" to the questions: "Imagine you are in a supermarket, you want to buy a minimally processed lettuce, and you find a package of lettuce with leaves like this, would you normally buy it?" and "Imagine you have this leaf of lettuce stored in your refrigerator, would you normally consume it?". Survival analysis was used to calculate the shelf lives of minimally processed lettuce, considering both decision-making stages. Shelf lives estimated considering rejection to purchase were significantly lower than those estimated considering rejection to consume. Therefore, in order to be conservative and assure the products' quality, shelf life should be estimated considering consumers' rejection to purchase instead of rejection to consume, as traditionally has been done. On the other hand, results from logistic regressions of consumers' rejection percentage as a function of the evaluated appearance attributes suggested that consumers considered them differently while deciding whether to purchase or to consume minimally processed lettuce.

  7. Toward theoretical understanding of the fertility preservation decision-making process: Examining information processing among young women with cancer

    PubMed Central

    Hershberger, Patricia E.; Finnegan, Lorna; Altfeld, Susan; Lake, Sara; Hirshfeld-Cytron, Jennifer

    2014-01-01

    Background Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. Objective The purpose of this paper is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Methods Using a grounded theory approach, 27 women with cancer participated in individual, semi-structured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by five dimensions within the Contemplate phase of the decision-making process framework. Results In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Conclusion Better understanding of theoretical underpinnings surrounding women’s information processes can facilitate decision support and improve clinical care. PMID:24552086

  8. Embedding health policy and systems research into decision-making processes in low- and middle-income countries

    PubMed Central

    2013-01-01

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization’s Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

  9. Embedding health policy and systems research into decision-making processes in low- and middle-income countries.

    PubMed

    Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul

    2013-01-01

    Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems. PMID:23924162

  10. Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

    PubMed Central

    2012-01-01

    Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in

  11. Shared clinical decision making

    PubMed Central

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

    2015-01-01

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

  12. Blunted feedback processing during risky decision making in adolescents with a parental history of substance use disorders.

    PubMed

    Euser, Anja S; Greaves-Lord, Kirstin; Crowley, Michael J; Evans, Brittany E; Huizink, Anja C; Franken, Ingmar H A

    2013-11-01

    Risky decision making, a hallmark phenotype of substance use disorders (SUD), is thought to be associated with deficient feedback processing. Whether these aberrations are present prior to SUD onset or reflect merely a consequence of chronic substance use on the brain remains unclear. The present study investigated whether blunted feedback processing during risky decision making reflects a biological predisposition to SUD. We assessed event-related potentials elicited by positive and negative feedback during performance of a modified version of the Balloon Analogue Risk Task (BART) among high-risk adolescents with a parental history of SUD (HR; n = 61) and normal-risk controls (NR; n = 91). HR males made significantly more risky and faster decisions during the BART than did NR controls. Moreover, HR adolescents showed significantly reduced P300 amplitudes in response to both positive and negative feedback as compared to NR controls. These differences were not secondary to prolonged substance use exposure. Results are discussed in terms of feedback-specific processes. Reduced P300 amplitudes in the BART may reflect poor processing of feedback at the level of overall salience, which may keep people from effectively predicting the probability of future gains and losses. Though conclusions are tentative, blunted feedback processing during risky decision making may represent a promising endophenotypic vulnerability marker for SUD. PMID:24229553

  13. Data quality and processing for decision making: divergence between corporate strategy and manufacturing processes

    NASA Astrophysics Data System (ADS)

    McNeil, Ronald D.; Miele, Renato; Shaul, Dennis

    2000-10-01

    Information technology is driving improvements in manufacturing systems. Results are higher productivity and quality. However, corporate strategy is driven by a number of factors and includes data and pressure from multiple stakeholders, which includes employees, managers, executives, stockholders, boards, suppliers and customers. It is also driven by information about competitors and emerging technology. Much information is based on processing of data and the resulting biases of the processors. Thus, stakeholders can base inputs on faulty perceptions, which are not reality based. Prior to processing, data used may be inaccurate. Sources of data and information may include demographic reports, statistical analyses, intelligence reports (e.g., marketing data), technology and primary data collection. The reliability and validity of data as well as the management of sources and information is critical element to strategy formulation. The paper explores data collection, processing and analyses from secondary and primary sources, information generation and report presentation for strategy formulation and contrast this with data and information utilized to drive internal process such as manufacturing. The hypothesis is that internal process, such as manufacturing, are subordinate to corporate strategies. The impact of possible divergence in quality of decisions at the corporate level on IT driven, quality-manufacturing processes based on measurable outcomes is significant. Recommendations for IT improvements at the corporate strategy level are given.

  14. A functional difference in information processing between orbitofrontal cortex and ventral striatum during decision-making behaviour.

    PubMed

    Stott, Jeffrey J; Redish, A David

    2014-11-01

    Both orbitofrontal cortex (OFC) and ventral striatum (vStr) have been identified as key structures that represent information about value in decision-making tasks. However, the dynamics of how this information is processed are not yet understood. We recorded ensembles of cells from OFC and vStr in rats engaged in the spatial adjusting delay-discounting task, a decision-making task that involves a trade-off between delay to and magnitude of reward. Ventral striatal neural activity signalled information about reward before the rat's decision, whereas such reward-related signals were absent in OFC until after the animal had committed to its decision. These data support models in which vStr is directly involved in action selection, but OFC processes decision-related information afterwards that can be used to compare the predicted and actual consequences of behaviour. PMID:25267815

  15. [Neural mechanisms of decision making].

    PubMed

    Funahashi, Shintaro

    2008-09-01

    Decision-making plays an important role in the transformation of incoming sensory information to purposeful actions. Many decisions have important biological and social consequences, while others may have a more limited impact on our everyday life. The neural mechanisms of decision-making currently constitute an important subject under intense investigation in the field of cognitive and behavioral neuroscience. Among the investigations, on this topic, those involving sensory discrimination tasks using visual motion have provided a wealth of information about the nature of the neural circuitry required to perform perceptual decision-making. For example, by using a motion discrimination task, Shadlen and Newsome have shown an essential role of area LIP in perceptual decision-making. On the other hand, the importance of reward and reward expectations as determinants of decision-making is increasingly appreciated. In particular, reinforcement learning and economic theories, such as game theory, have provided valuable insights into the brain functions related to decision-making. By using a competitive game analogous to matching pennies against a computer, Lee's group showed that in monkeys, previous selections modulated prefrontal neural activity and that this modulation affected the current choice behavior. The prefrontal cortex has been shown to participate in decision-making in free-choice conditions. By using a task involving the free choice of 1 target from multiple saccade targets, Funahashi's group examined the prefrontal participation in decision-making in a free-choice condition. They compared the activities of prefrontal neurons during an oculomotor delay task with forced-choice conditions and free-choice conditions and identified the neural components reflecting the underlying decision-making processes. Although several attempts have been made to understand the neural mechanisms of decision-making, further investigations are required to fully understand these

  16. 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.

  17. Social Networks Influence Hispanic College Women’s HPV Vaccine Uptake Decision-making Processes

    PubMed Central

    Stephens, Dionne P.; Thomas, Tami L.

    2014-01-01

    This qualitative study was designed to assess current and preferred social networks that influence human papillomavirus (HPV) vaccine decision making in a sample of Hispanic college women. Individual, semi-structured interviews were conducted with 41 Hispanic college women attending a large southeastern Hispanic-serving institution. Television commercials and discussions with mothers were found to be the most influential social networks for current HPV vaccination beliefs. Internet sites, close family members, and healthcare providers’ communications were preferred social networks for HPV vaccine information. Perceived accessibility and sense of comfort influenced the order in which these social networks’ communications would be accepted. Findings suggest that Hispanic college women utilize specific social networks to gather information and make decisions about HPV vaccination. Continued efforts are needed to promote further understanding of the purpose of the HPV vaccine via these preferred sources of information. PMID:25599082

  18. Pediatric cochlear implantation: a qualitative study of parental decision-making processes in Flanders, Belgium.

    PubMed

    Hardonk, Stefan; Bosteels, Sigrid; Desnerck, Greetje; Loots, Gerrit; Van Hove, Geert; Van Kerschaver, Erwin; Vanroelen, Christophe; Louckx, Fred

    2010-01-01

    Factors contributing to parents' decision when they choose between cochlear implantation (CI) and traditional hearing aids for their child were examined. The subjects were children with severe/profound hearing loss, born 1999-2001, registered in the universal neonatal hearing screening program in the Flanders region of Belgium. Qualitative data collected retrospectively from parents were subjected to thematic content analysis. In their responses to professional advice, parents were segmented into 3 groups: (a) those whose primary considerations were the importance of oral language development and the relative potential of CI and traditional hearing aids; (b) those for whom alternative factors (e.g., medical risks, ethical issues) were paramount, even in the face of professional advocacy of CI; (c) those who followed professional advice against CI. The researchers conclude that care professionals should be sensitive to the impact of their advice and other factors in parental decision making.

  19. Preserving the Self: The Process of Decision Making About Hereditary Breast Cancer and Ovarian Cancer Risk Reduction

    PubMed Central

    Howard, A. Fuchsia; Balneaves, Lynda G.; Bottorff, Joan L.; Rodney, Patricia

    2016-01-01

    Women who carry BRCA1 or BRCA2 (BRCA1/2) gene mutations have up to an 88% lifetime risk of breast cancer and up to a 65% lifetime risk of ovarian cancer. Strategies to address these risks include cancer screening and risk-reducing surgery (i.e., mastectomy and salpingo-oophorectomy). We conducted a grounded theory study with 22 BRCA1/2 mutation-carrier women to understand how women make decisions about these risk-reducing strategies. Preserving the self was the overarching decision-making process evident in the participants’ descriptions. This process was shaped by contextual conditions including the characteristics of health services, the nature of hereditary breast and ovarian cancer risk-reduction decisions, gendered roles, and the women’s perceived proximity to cancer. The women engaged in five decision-making styles, and these were characterized by the use of specific decision-making approaches. These findings provide theoretical insights that could inform the provision of decisional support to BRCA1/2 carriers. PMID:20980697

  20. Instruments to assess the perception of physicians in the decision-making process of specific clinical encounters: a systematic review

    PubMed Central

    Légaré, France; Moher, David; Elwyn, Glyn; LeBlanc, Annie; Gravel, Karine

    2007-01-01

    Background The measurement of processes and outcomes that reflect the complexity of the decision-making process within specific clinical encounters is an important area of research to pursue. A systematic review was conducted to identify instruments that assess the perception physicians have of the decision-making process within specific clinical encounters. Methods For every year available up until April 2007, PubMed, PsycINFO, Current Contents, Dissertation Abstracts and Sociological Abstracts were searched for original studies in English or French. Reference lists from retrieved studies were also consulted. Studies were included if they reported a self-administered instrument evaluating physicians' perceptions of the decision-making process within specific clinical encounters, contained sufficient description to permit critical appraisal and presented quantitative results based on administering the instrument. Two individuals independently assessed the eligibility of the instruments and abstracted information on their conceptual underpinnings, main evaluation domain, development, format, reliability, validity and responsiveness. They also assessed the quality of the studies that reported on the development of the instruments with a modified version of STARD. Results Out of 3431 records identified and screened for evaluation, 26 potentially relevant instruments were assessed; 11 met the inclusion criteria. Five instruments were published before 1995. Among those published after 1995, five offered a corresponding patient version. Overall, the main evaluation domains were: satisfaction with the clinical encounter (n = 2), mutual understanding between health professional and patient (n = 2), mental workload (n = 1), frustration with the clinical encounter (n = 1), nurse-physician collaboration (n = 1), perceptions of communication competence (n = 2), degree of comfort with a decision (n = 1) and information on medication (n = 1). For most instruments (n = 10), some

  1. Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics

    PubMed Central

    Allen, Peter J.; Dorozenko, Kate P.; Roberts, Lynne D.

    2016-01-01

    Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these “experts” were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid

  2. Difficult Decisions: A Qualitative Exploration of the Statistical Decision Making Process from the Perspectives of Psychology Students and Academics.

    PubMed

    Allen, Peter J; Dorozenko, Kate P; Roberts, Lynne D

    2016-01-01

    Quantitative research methods are essential to the development of professional competence in psychology. They are also an area of weakness for many students. In particular, students are known to struggle with the skill of selecting quantitative analytical strategies appropriate for common research questions, hypotheses and data types. To begin understanding this apparent deficit, we presented nine psychology undergraduates (who had all completed at least one quantitative methods course) with brief research vignettes, and asked them to explicate the process they would follow to identify an appropriate statistical technique for each. Thematic analysis revealed that all participants found this task challenging, and even those who had completed several research methods courses struggled to articulate how they would approach the vignettes on more than a very superficial and intuitive level. While some students recognized that there is a systematic decision making process that can be followed, none could describe it clearly or completely. We then presented the same vignettes to 10 psychology academics with particular expertise in conducting research and/or research methods instruction. Predictably, these "experts" were able to describe a far more systematic, comprehensive, flexible, and nuanced approach to statistical decision making, which begins early in the research process, and pays consideration to multiple contextual factors. They were sensitive to the challenges that students experience when making statistical decisions, which they attributed partially to how research methods and statistics are commonly taught. This sensitivity was reflected in their pedagogic practices. When asked to consider the format and features of an aid that could facilitate the statistical decision making process, both groups expressed a preference for an accessible, comprehensive and reputable resource that follows a basic decision tree logic. For the academics in particular, this aid

  3. Intraoperative frozen sections of the regional lymph nodes contribute to surgical decision-making in non-small cell lung cancer patients

    PubMed Central

    Li, Wei; Yang, Xue-Ning; Liao, Ri-Qiang; Nie, Qiang; Dong, Song; Zhai, Hao-Ran

    2016-01-01

    Background Individualization of pulmonary parenchymal resection and lymphadenectomy in lung cancer patients will likely become more important as surgical innovation. This study explored the utility of intraoperative pathological frozen sections of regional lymph nodes in non-small cell lung cancer (NSCLC) patients. Methods Patients with NSCLC underwent intraoperative sampling of N1 station lymph nodes depending on the location of the tumor, any other suspicious lymph nodes were also biopsied. The contribution of frozen-section analysis to surgical decision-making was evaluated. Results Of 74 lung cancer patients who underwent intraoperative frozen section analysis of lymph nodes, the positive rate was 18/74 (24.3%). The extents of agreement between preoperative N staging (cN) and intraoperative N staging (sN), cN staging and postoperative N staging (pN), and sN staging and pN staging were 62.2% (46/74), 63.5% (47/74), and 71.6% (53/74), respectively. When frozen section was combined with evaluation of pulmonary function and intrathoracic adhesions, surgical strategies were modified during operations in 18 cases (5 sN-positive, 13 sN-negative). Of these patients, five underwent extensive pulmonary parenchymal resection, and four had conservative lung parenchymal resection. In nine patients, the extent of lymph node dissection (LND) was changed. Conclusions Intraoperative frozen section of regional lymph nodes led to 24.3% operative strategies modification in lung cancer. Frozen section analysis may make an important contribution to surgical decision-making in terms of pulmonary parenchymal resection and LND. PMID:27621849

  4. Interaction between assessment and instruction in science: A teacher's decision-making process

    NASA Astrophysics Data System (ADS)

    Brownstein, Erica Marie

    This study describes the interaction between assessment and instruction in a secondary science classroom. This research examines a chemistry teacher in an AP class in a midwestern urban setting interactively assessing his students and how knowledge gained during that assessment affected his instructional decision-making. The theoretical framework includes reflection-in-action, the zone of proximal development, and social constructivism. The primary question that guided the study was: What is the interaction between assessment and instruction in a science classroom? The three sub questions were: How does a teacher gain knowledge of students' thinking? How does a teacher use knowledge of his students' thinking in interactive instructional decisions? What are the components of his interactive instructional decisions? Participant observation of the classroom occurred over a four month period. The elicit interview technique was used immediately following class to discuss interactive instructional decisions with the teacher. Data sources included videotapes, interviews, field notes, classroom documents, intern journal, and member checking from which triangulation was possible. The goal was to examine and understand interactive decisions that had an impact on instruction. The results indicated that the students were in a safe, accepting environment and that student levels of understanding chemistry were indeterminate, low, medium, and high. Impacts on teacher decision making were pedagogical content knowledge, assessing context, and knowledge of the student. It was found that to gain knowledge of student thinking, the teacher listened, examined student work, asked questions, and made statements. Questions the teacher asked were to probe, lead, or clarify student knowledge. Statements the teacher made would clarify or restate student words. The teacher used his understanding of student knowledge to make instructional decisions by recognizing student knowledge, connecting

  5. Argument structure hierarchy system and method for facilitating analysis and decision-making processes

    DOEpatents

    Janssen, Terry

    2000-01-01

    A system and method for facilitating decision-making comprising a computer program causing linkage of data representing a plurality of argument structure units into a hierarchical argument structure. Each argument structure unit comprises data corresponding to a hypothesis and its corresponding counter-hypothesis, data corresponding to grounds that provide a basis for inference of the hypothesis or its corresponding counter-hypothesis, data corresponding to a warrant linking the grounds to the hypothesis or its corresponding counter-hypothesis, and data corresponding to backing that certifies the warrant. The hierarchical argument structure comprises a top level argument structure unit and a plurality of subordinate level argument structure units. Each of the plurality of subordinate argument structure units comprises at least a portion of the grounds of the argument structure unit to which it is subordinate. Program code located on each of a plurality of remote computers accepts input from one of a plurality of contributors. Each input comprises data corresponding to an argument structure unit in the hierarchical argument structure and supports the hypothesis or its corresponding counter-hypothesis. A second programming code is adapted to combine the inputs into a single hierarchical argument structure. A third computer program code is responsive to the second computer program code and is adapted to represent a degree of support for the hypothesis and its corresponding counter-hypothesis in the single hierarchical argument structure.

  6. The decision-making process of workers in using sick time.

    PubMed

    Sandal, Candace L; Click, Elizabeth R; Dowling, Donna A; Guzik, Arlene

    2014-08-01

    The cost of employee absenteeism in the United States is significant in terms of sick pay, overtime costs, replacement personnel compensation, and lost productivity. Little is known about what workers consider when deciding to use sick time. Previous studies have examined work absence from an array of perspectives, including resulting work strain, job satisfaction, and job security, but absenteeism in the workplace has not been examined in terms of decision making. To scrutinize workers' decisions about using sick time, a descriptive pilot study was undertaken with a convenience sample (n = 94) of working college students. The responses to the survey revealed that the majority of the workers (73.4%) used sick time because they were too ill to work. These results are in direct opposition to previous research and suggest that workers may need education about preventing and managing minor illnesses before an absence is needed. Supporting and engaging employees and their significant others in healthy worker programs, regular surveillance examinations, and illness prevention strategies are wise investments in companies' financial futures. Future research should include a comparative study of worker absenteeism between worksites with occupational health nurses and those without nurses. PMID:25101929

  7. A Study of Secondary Students' Decision-Making Processes with Respect to Information Use, Particularly Students' Judgements of Relevance and Reliability

    ERIC Educational Resources Information Center

    Watson, Curtis L.

    2010-01-01

    This report details an ongoing investigation of the decision-making processes of a group of secondary school students in south-eastern Australia undertaking information search tasks. The study is situated in the field of information seeking and use, and, more broadly, in decision making. Research questions focus on students' decisions about the…

  8. Multi criteria decision making to select the suitable method for the preparation of nanoparticles using an analytical hierarchy process.

    PubMed

    Velmurugan, R; Selvamuthukumar, S; Manavalan, R

    2011-11-01

    Selecting the right method for the preparation of nanoparticles is a crucial decision. A wrong decision can result in the product having to be formulated and developed again. One tool that can be useful in determining the most appropriate method is the Analytical Hierarchy Process (AHP). AHP has been employed in almost all areas related to decision-making problems. In this paper, the results of a case study illustrate that the AHP concept can assist designers in the effective evaluation of various methods available for the preparation of nanoparticles. This paper presents the methodology of selecting the most suitable method for preparing nanoparticles using the analytical hierarchy process.

  9. A Retrospective Study Evaluating the Impact of Preoperative Breast MRI on Surgical Decision-Making in Young Patients (≤50 Years) with Invasive Breast Cancer

    PubMed Central

    Mukherjee, Som D.; Hodgson, Nicole; Lovrics, Peter J.; Dhamanaskar, Kavita; Minuk, Terry; Chambers, Shelley; Sussman, Jonathan

    2016-01-01

    INTRODUCTION Breast magnetic resonance imaging (MRI) is considered a more sensitive diagnostic test for detecting invasive breast cancer than mammography or breast ultrasound. Breast MRI may be particularly useful in younger premenopausal women with higher density breast tissue for differentiating between dense fibroglandular breast tissue and breast malignancies. The main objective of this study was to determine the impact of preoperative breast MRI on surgical decision-making in young women with breast cancer. METHODS A retrospective review of patients with newly diagnosed invasive breast cancer and age of ≤50 years was performed. All patients underwent physical examination, preoperative mammogram, breast ultrasound, and bilateral breast MRI. Two breast cancer surgeons reviewed the preoperative mammogram report, breast ultrasound report, and physical examination summary and were asked if they would recommend a lumpectomy, a quandrantectomy, or a mastectomy. A few weeks later, the two surgeons were shown the same information with the breast MRI report and were asked what type of surgery they would now recommend. In each case, MRI was classified by two adjudicators as having affected the surgical outcome in a positive, negative, or neutral fashion. A positive impact was defined as the situation where breast MRI detected additional disease that was not found on physical examination, mammogram, or breast ultrasound and led to an appropriate change in surgical management. A negative impact was defined as the situation where breast MRI led the surgeon to recommend more extensive surgery, with less extensive disease actually found at pathology. No impact was defined as the situation where MRI findings did not alter surgical recommendations or outcomes. RESULTS Of 37 patients whose charts were reviewed, five patients were deemed to be ineligible due to having received neoadjuvant chemotherapy, having previous breast implants, or having had their tumor fully excised

  10. Multiple Sclerosis Decreases Explicit Counterfactual Processing and Risk Taking in Decision Making

    PubMed Central

    Simioni, Samanta; Schluep, Myriam; Bault, Nadège; Coricelli, Giorgio; Kleeberg, Joerg; Du Pasquier, Renaud A.; Gschwind, Markus; Vuilleumier, Patrik; Annoni, Jean-Marie

    2012-01-01

    Introduction Deficits in decision making (DM) are commonly associated with prefrontal cortical damage, but may occur with multiple sclerosis (MS). There are no data concerning the impact of MS on tasks evaluating DM under explicit risk, where different emotional and cognitive components can be distinguished. Methods We assessed 72 relapsing-remitting MS (RRMS) patients with mild to moderate disease and 38 healthy controls in two DM tasks involving risk with explicit rules: (1) The Wheel of Fortune (WOF), which probes the anticipated affects of decisions outcomes on future choices; and (2) The Cambridge Gamble Task (CGT) which measures risk taking. Participants also underwent a neuropsychological and emotional assessment, and skin conductance responses (SCRs) were recorded. Results In the WOF, RRMS patients showed deficits in integrating positive counterfactual information (p<0.005) and greater risk aversion (p<0.001). They reported less negative affect than controls (disappointment: p = 0.007; regret: p = 0.01), although their implicit emotional reactions as measured by post-choice SCRs did not differ. In the CGT, RRMS patients differed from controls in quality of DM (p = 0.01) and deliberation time (p = 0.0002), the latter difference being correlated with attention scores. Such changes did not result in overall decreases in performance (total gains). Conclusions The quality of DM under risk was modified by MS in both tasks. The reduction in the expression of disappointment coexisted with an increased risk aversion in the WOF and alexithymia features. These concomitant emotional alterations may have implications for better understanding the components of explicit DM and for the clinical support of MS patients. PMID:23227201

  11. Decision-Making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis1

    PubMed Central

    Shen, Megan Johnson; Nelson, Christian J.; Peters, Ellen; Slovin, Susan F.; Hall, Simon J.; Hall, Matt; Herrera, Phapichaya Chaoprang; Leventhal, Elaine A.; Leventhal, Howard; Diefenbach, Michael A.

    2014-01-01

    Background Prostate cancer survivors with a rising prostate specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physician and patients who experience a rising PSA after definitive treatment for prostate cancer. Methods In-depth interviews were conducted with 34 prostate cancer survivors who had been diagnosed with a rising PSA (i.e., biochemical failure) within the past 12 months. Survivors were asked about their experiences and affective responses after being diagnosed with a rising PSA and while weighing potential treatment options. In addition, patients were asked about their decision-making process for the initial prostate cancer treatment. Results Compared to the initial diagnosis, survivors with a rising PSA reported increased negative affect following their diagnosis, concern about the treatability of their disease, increased planning and health behavior change, heightened levels of worry preceding doctor’s appointments (especially prior to the discussion of PSA testing results), and a strong reliance on physicians’ treatment recommendations. Conclusions Prostate cancer survivors’ decision-making processes for the treatment of a rising PSA are markedly different from those of the initial diagnosis of prostate cancer. Because patients experience heightened distress and rely more heavily on their physicians’ recommendations with a rising PSA, interactions with the health care provider provide an excellent opportunity to address and assist patients with managing the uncertainty and distress inherent with rising PSA levels. PMID:25385751

  12. The decision-making process for the fate of frozen embryos by Japanese infertile women: a qualitative study

    PubMed Central

    2012-01-01

    Background Previous studies have found that the decision-making process for stored unused frozen embryos involves much emotional burden influenced by socio-cultural factors. This study aims to ascertain how Japanese patients make a decision on the fate of their frozen embryos: whether to continue storage discard or donate to research. Methods Ten Japanese women who continued storage, 5 who discarded and 16 who donated to research were recruited from our infertility clinic. Tape-recorded interviews were transcribed and analyzed for emergent themes. Results A model of patients’ decision-making processes for the fate of frozen embryos was developed, with a common emergent theme, “coming to terms with infertility” resulting in either acceptance or postponing acceptance of their infertility. The model consisted of 5 steps: 1) the embryo-transfer moratorium was sustained, 2) the “Mottainai”- embryo and having another child were considered; 3) cost reasonability was taken into account; 4) partner’s opinion was confirmed to finally decide whether to continue or discontinue storage. Those discontinuing, then contemplated 5): the effect of donation. Great emotional conflict was expressed in the theme, steps 2, 4, and 5. Conclusions Patients’ 5 step decision-making process for the fate of frozen embryos was profoundly affected by various Japanese cultural values and moral standards. At the end of their decision, patients used culturally inherent values and standards to come to terms with their infertility. While there is much philosophical discussion on the moral status of the embryo worldwide, this study, with actual views of patients who own them, will make a significant contribution to empirical ethics from the practical viewpoint. PMID:22607034

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

    NASA Technical Reports Server (NTRS)

    Hicks, Karen Campbell

    2015-01-01

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

  14. Enrolling adolescents in asthma research: Adolescent, parent, and physician influence in the decision-making process

    PubMed Central

    Brody, Janet L.; Annett, Robert D.; Scherer, David G.; Turner, Charles; Dalen, Jeanne

    2009-01-01

    to concur with the final research participation decision, felt less comfortable, and were less likely to feel they influenced the decision. Conclusions Parents’ views on research decisions take precedence over adolescents’ views in most circumstances. Physician-investigator relationships may reduce parental resistance to participation and enhance adolescent decision-making autonomy when research participation is desired by the adolescent. PMID:19544171

  15. A new intuitionistic fuzzy rule-based decision-making system for an operating system process scheduler.

    PubMed

    Butt, Muhammad Arif; Akram, Muhammad

    2016-01-01

    We present a new intuitionistic fuzzy rule-based decision-making system based on intuitionistic fuzzy sets for a process scheduler of a batch operating system. Our proposed intuitionistic fuzzy scheduling algorithm, inputs the nice value and burst time of all available processes in the ready queue, intuitionistically fuzzify the input values, triggers appropriate rules of our intuitionistic fuzzy inference engine and finally calculates the dynamic priority (dp) of all the processes in the ready queue. Once the dp of every process is calculated the ready queue is sorted in decreasing order of dp of every process. The process with maximum dp value is sent to the central processing unit for execution. Finally, we show complete working of our algorithm on two different data sets and give comparisons with some standard non-preemptive process schedulers.

  16. A new intuitionistic fuzzy rule-based decision-making system for an operating system process scheduler.

    PubMed

    Butt, Muhammad Arif; Akram, Muhammad

    2016-01-01

    We present a new intuitionistic fuzzy rule-based decision-making system based on intuitionistic fuzzy sets for a process scheduler of a batch operating system. Our proposed intuitionistic fuzzy scheduling algorithm, inputs the nice value and burst time of all available processes in the ready queue, intuitionistically fuzzify the input values, triggers appropriate rules of our intuitionistic fuzzy inference engine and finally calculates the dynamic priority (dp) of all the processes in the ready queue. Once the dp of every process is calculated the ready queue is sorted in decreasing order of dp of every process. The process with maximum dp value is sent to the central processing unit for execution. Finally, we show complete working of our algorithm on two different data sets and give comparisons with some standard non-preemptive process schedulers. PMID:27652120

  17. Psychiatric morbidity among Egyptian breast cancer patients and their partners and its impact on surgical decision-making

    PubMed Central

    El-Hadidy, Mohamed A; Elnahas, Waleed; Hegazy, Mohamed AF; Hafez, Mohamed T; Refky, Basel; Wahab, Khaled M Abdel

    2012-01-01

    Introduction Psychiatric morbidities, especially cases of anxiety and depression, are prevalent among breast cancer patients and their partners. Patients and methods Fifty-four early diagnosed breast cancer patients and their partners were compared with 50 healthy couples to assess psychiatric morbidity and the impact of various factors upon patients’ surgical choice. Results It was found that 18.5%, 22.2%, and 3.7% of husbands had generalized anxiety disorder, major depressive disorder, and panic disorder, respectively. It was also found that 38.8%, 29.6%, and 9.2% of the patients had major depressive disorder, generalized anxiety disorder, and panic disorder, respectively. Depression and anxiety scores were high in both partners in love-based, well-adjusted marriages, within the middle socioeconomic class, and among educated couples. Among the well-known factors related to surgical treatment choice (age, parity, tumor size, pathology, grade, lymph node status), only age and psychological morbidity (in the patients and their partners) had a significant impact on treatment choice. Conclusion Patients of middle socioeconomic class, the well educated, and those in love-based marriages had a higher likelihood of suffering different types of psychological morbidities and were more likely to choose breast conservation or reconstruction than mastectomy. PMID:24367191

  18. Plastic neo-vaginal construction in Mayer-Rokitansky-Küster-Hauser syndrome: an expert opinion paper on the decision-making treatment process

    PubMed Central

    Torres-de la Roche, Luz Angela; Devassy, Rajesh; Gopalakrishnan, Sreelatha; de Wilde, Maya Sophie; Herrmann, Anja; Larbig, Angelika; De Wilde, Rudy Leon

    2016-01-01

    Vaginal agenesis is a congenital anomaly that affects the life of one of each four thousand women around the world. There is a trend that patients request immediate surgical correction, instead of passive vaginal dilatation. Therefore a differentiated counselling should be provided. We present a comparative chart, based on published evidence, with aspect to the available techniques, which will facilitate the decision-making process in the clinical practice. From our point of view, the best results are achieved with techniques that combine the advantages of the minimal-invasive surgery with those derived of the use of peritoneum as covering tissue of the neovagina. Nevertheless there is a lack on interdisciplinary consensus about the best option to restore the physical and sexual quality of life. PMID:26904393

  19. Single-process versus multiple-strategy models of decision making: evidence from an information intrusion paradigm.

    PubMed

    Söllner, Anke; Bröder, Arndt; Glöckner, Andreas; Betsch, Tilmann

    2014-02-01

    When decision makers are confronted with different problems and situations, do they use a uniform mechanism as assumed by single-process models (SPMs) or do they choose adaptively from a set of available decision strategies as multiple-strategy models (MSMs) imply? Both frameworks of decision making have gathered a lot of support, but only rarely have they been contrasted with each other. Employing an information intrusion paradigm for multi-attribute decisions from givens, SPM and MSM predictions on information search, decision outcomes, attention, and confidence judgments were derived and tested against each other in two experiments. The results consistently support the SPM view: Participants seemingly using a "take-the-best" (TTB) strategy do not ignore TTB-irrelevant information as MSMs would predict, but adapt the amount of information searched, choose alternative choice options, and show varying confidence judgments contingent on the quality of the "irrelevant" information. The uniformity of these findings underlines the adequacy of the novel information intrusion paradigm and comprehensively promotes the notion of a uniform decision making mechanism as assumed by single-process models.

  20. The Lisbon new international airport: The story of a decision-making process and the role of Strategic Environmental Assessment

    SciTech Connect

    Partidario, Maria R.; Coutinho, Miguel

    2011-04-15

    This is the brief story of a decision process and the role of Strategic Environmental Assessment in government political decision-making. Following a prolonged, and agitated, decision process, initiated in the 1960s, the Government of Portugal in 2005 took the final decision to build the new international airport of Lisbon at the controversial location of Ota, 40 km north of Lisbon. The detailed project design and EIA were started. However this decision would change in 2007 due to the challenge raised by a private sponsored study that identified an alternative location for the airport at Campo de Tiro de Alcochete (CTA). This new site, which had never been considered as an option before, appeared to avoid many of the problems that caused public controversy at the Ota site. The Government, pressured by this challenge, promoted a strategic comparative assessment between the two sites. The result of this study was the choice of CTA as the preferred location. This paper discusses this radical change in the decision from a socio-political perspective. It will highlight the relevance of Strategic Environmental Assessment (SEA), and the strategic and constructive approach it enables in mega-project decision-making.

  1. An Extension of XACML to Improve the Performance of Decision Making Processes When Dealing with Stable Conditions

    NASA Astrophysics Data System (ADS)

    Laborde, Romain; Desprats, Thierry

    XACML (eXtensible Access Control Markup Language) is an XML-based language for access control that has been standardized by OASIS. In this language, any entities involved in access control (i.e. users, resources, actions and environment) are specified by a set of attributes. This specification also includes the description of an architecture that explains how the policy decision point (PDP) retrieves the needed attributes values when it evaluates the policy to take its authorization decision. In this paper, we show that retrieving attributes values using a synchronous method as it is stated in XACML specification can be a bottleneck to the performance of the authorization decision making process. Especially, it is true when getting an attribute value is long and when the changing of this value doesn’t impact the policy result frequently. Thus, we propose an improvement of the XACML architecture. It uses an asynchronous approach that accelerates the decision making process when PDP deals with expressions that include such attributes. Experimental results prove the performance is improved.

  2. Fracture risk assessment: improved evaluation of vertebral integrity among metastatic cancer patients to aid in surgical decision-making

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Camp, Jon J.; Holmes, David R.; Huddleston, Paul M.; Lu, Lichun; Yaszemski, Michael J.; Robb, Richard A.

    2012-03-01

    Failure of the spine's structural integrity from metastatic disease can lead to both pain and neurologic deficit. Fractures that require treatment occur in over 30% of bony metastases. Our objective is to use computed tomography (CT) in conjunction with analytic techniques that have been previously developed to predict fracture risk in cancer patients with metastatic disease to the spine. Current clinical practice for cancer patients with spine metastasis often requires an empirical decision regarding spinal reconstructive surgery. Early image-based software systems used for CT analysis are time consuming and poorly suited for clinical application. The Biomedical Image Resource (BIR) at Mayo Clinic, Rochester has developed an image analysis computer program that calculates from CT scans, the residual load-bearing capacity in a vertebra with metastatic cancer. The Spine Cancer Assessment (SCA) program is built on a platform designed for clinical practice, with a workflow format that allows for rapid selection of patient CT exams, followed by guided image analysis tasks, resulting in a fracture risk report. The analysis features allow the surgeon to quickly isolate a single vertebra and obtain an immediate pre-surgical multiple parallel section composite beam fracture risk analysis based on algorithms developed at Mayo Clinic. The analysis software is undergoing clinical validation studies. We expect this approach will facilitate patient management and utilization of reliable guidelines for selecting among various treatment option based on fracture risk.

  3. Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.

    PubMed

    Olié, Emilie; Ding, Yang; Le Bars, Emmanuelle; de Champfleur, Nicolas Menjot; Mura, Thibault; Bonafé, Alain; Courtet, Philippe; Jollant, Fabrice

    2015-12-30

    Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters. PMID:26483212

  4. Processing of decision-making and social threat in patients with history of suicidal attempt: A neuroimaging replication study.

    PubMed

    Olié, Emilie; Ding, Yang; Le Bars, Emmanuelle; de Champfleur, Nicolas Menjot; Mura, Thibault; Bonafé, Alain; Courtet, Philippe; Jollant, Fabrice

    2015-12-30

    Suicidal vulnerability has been related to impaired value-based decision-making and increased sensitivity to social threat, mediated by the prefrontal cortex. Using functional magnetic resonance imaging, we aimed at replicating these previous findings by measuring brain activation during the Iowa Gambling Task and an emotional faces viewing task. Participants comprised 15 euthymic suicide attempters (history of depression and suicidal behavior) who were compared with 23 euthymic patient controls (history of depression without suicidal history) and 35 healthy controls. The following five model-based regions of interest were investigated: the orbitofrontal cortex (OFC), ventrolateral prefrontal cortex (VLPFC), anterior cingulate cortex (ACC), medial (MPFC) and dorsal prefrontal cortex (DPFC). Suicide attempters relative to patient controls showed (1) increased response to angry vs. neutral faces in the left OFC and the VLPFC, as previously reported; (2) increased response to wins vs. losses in the right OFC, DPFC and ACC; (3) decreased response to risky vs. safe choices in the left DPFC; and (4) decreased response to sad vs. neutral faces in the right ACC. This study links impaired valuation processing (here for signals of social threat, sadness and reward) to prefrontal cortex dysfunction in suicide attempters. These long-term deficits may underlie the impaired decision-making and social difficulties found in suicide attempters.

  5. Propulsion Airframe Aeroacoustics Technology Evaluation and Selection Using a Multi-Attribute Decision Making Process and Non-Deterministic Design

    NASA Technical Reports Server (NTRS)

    Burg, Cecile M.; Hill, Geoffrey A.; Brown, Sherilyn A.; Geiselhart, Karl A.

    2004-01-01

    The Systems Analysis Branch at NASA Langley Research Center has investigated revolutionary Propulsion Airframe Aeroacoustics (PAA) technologies and configurations for a Blended-Wing-Body (BWB) type aircraft as part of its research for NASA s Quiet Aircraft Technology (QAT) Project. Within the context of the long-term NASA goal of reducing the perceived aircraft noise level by a factor of 4 relative to 1997 state of the art, major configuration changes in the propulsion airframe integration system were explored with noise as a primary design consideration. An initial down-select and assessment of candidate PAA technologies for the BWB was performed using a Multi-Attribute Decision Making (MADM) process consisting of organized brainstorming and decision-making tools. The assessments focused on what effect the PAA technologies had on both the overall noise level of the BWB and what effect they had on other major design considerations such as weight, performance and cost. A probabilistic systems analysis of the PAA configurations that presented the best noise reductions with the least negative impact on the system was then performed. Detailed results from the MADM study and the probabilistic systems analysis will be published in the near future.

  6. 18F-FDG PET-CT after Neoadjuvant Chemoradiotherapy in Esophageal Cancer Patients to Optimize Surgical Decision Making

    PubMed Central

    Anderegg, Maarten C. J.; de Groof, Elisabeth J.; Gisbertz, Suzanne S.; Bennink, Roel J.; Lagarde, Sjoerd M.; Klinkenbijl, Jean H. G.; Dijkgraaf, Marcel G. W.; Bergman, Jacques J. G. H. M.; Hulshof, Maarten C. C. M.; van Laarhoven, Hanneke W. M.; van Berge Henegouwen, Mark I.

    2015-01-01

    Background Prognosis of esophageal cancer patients can be significantly improved by neoadjuvant chemoradiotherapy (nCRT). Given the aggressive nature of esophageal tumors, it is conceivable that in a significant portion of patients treated with nCRT, dissemination already becomes manifest during the period of nCRT. The aim of this retrospective study was to determine the value and diagnostic accuracy of PET-CT after neoadjuvant chemoradiotherapy to identify patients with metastases preoperatively in order to prevent non-curative surgery. Methods From January 2011 until February 2013 esophageal cancer patients deemed eligible for a curative approach with nCRT and surgical resection underwent a PET-CT after completion of nCRT. If abnormalities on PET-CT were suspected metastases, histological proof was acquired. A clinical decision model was designed to assess the cost-effectiveness of this diagnostic strategy. Results 156 patients underwent a PET-CT after nCRT. In 31 patients (19.9%) PET-CT showed abnormalities suspicious for dissemination, resulting in 17 cases of proven metastases (10.9%). Of the patients without proven metastases 133 patients were operated. In 6 of these 133 cases distant metastases were detected intraoperatively, corresponding to 4.5% false-negative results. The standard introduction of a post-neoadjuvant therapy PET-CT led to a reduction of overall health care costs per patient compared to a scenario without restaging with PET-CT ($34,088 vs. $36,490). Conclusion In 10.9% of esophageal cancer patients distant metastases were detected by standard PET-CT after neoadjuvant chemoradiotherapy. To avoid non-curative resections we advocate post-neoadjuvant therapy PET-CT as a cost-effective step in the standard work-up of candidates for surgery. PMID:26529313

  7. Word Processing as Decision-Making: Writers' Choices of Writing Media.

    ERIC Educational Resources Information Center

    Haas, Christina

    A study examined two writers and their use of word processing and pen and paper in order to set up and draw out the important variables that influence writers' decisions about word processing. Subjects, a college freshman and an engineer, were interviewed about their writing processes and were observed in their natural environment. Results…

  8. Decision making: the neuroethological turn

    PubMed Central

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

    2014-01-01

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

  9. Decision making: the neuroethological turn.

    PubMed

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

    2014-06-01

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

  10. Drug induced sleep endoscopy in the decision-making process of children with obstructive sleep apnea.

    PubMed

    Galluzzi, Francesca; Pignataro, Lorenzo; Gaini, Renato Maria; Garavello, Werner

    2015-03-01

    Tonsillectomy and adenoidectomy (T&A) is currently recommended in children with Obstructive Sleep Apnea (OSA). However, the condition persists after surgery in about one third of cases. It has been suggested that Drug Induced Sleep Endoscopy (DISE) may be of help for planning a more targeted and effective surgical treatment but evidence is yet weak. The aim of this review is to draw recommendation on the use of DISE in children with OSA. More specifically, we aimed at determine the proportion of cases whose treatment may be influenced by DISE findings. A comprehensive search of articles published from February 1983 to January 2014 listed in the PubMed/MEDLINE databases was performed. The search terms used were: "endoscopy" or "nasoendoscopy" or "DISE" and "obstructive sleep apnea" and "children" or "child" or "pediatric." The main outcome was the rate of naive children with hypertrophic tonsils and/or adenoids. The assumptions are that clinical diagnosis of hypertrophic tonsils and/or adenoids is reliable and does not require DISE, and that exclusive T&A may solve OSA in the vast majority of cases even in the presence of other concomitant sites of obstruction. Five studies were ultimately selected and all were case series. The median (range) number of studied children was 39 (15-82). Mean age varied from 3.2 to 7.8 years. The combined estimate rate of OSA consequent to hypertrophic tonsils and/or adenoids was 71% (95%CI: 64-77%). In children with Down Syndrome, the combined estimated rate of hypertrophic tonsils and/or adenoids was 62% (95%CI: 44-79%). Our findings show that DISE may be of benefit in a minority of children with OSA since up to two thirds of naive cases presents with hypertrophic tonsils and/or adenoids. Its use should be limited to those whose clinical evaluation is unremarkable or when OSA persists after T&A.

  11. Processing ambiguity in a linguistic context: decision-making difficulties in non-aphasic patients with behavioral variant frontotemporal degeneration

    PubMed Central

    Spotorno, Nicola; Healey, Meghan; McMillan, Corey T.; Rascovsky, Katya; Irwin, David J.; Clark, Robin; Grossman, Murray

    2015-01-01

    Some extent of ambiguity is ubiquitous in everyday conversations. For example, words have multiple meaning and very common pronouns, like “he” and “she” (anaphoric pronouns), have little meaning on their own and refer to a noun that has been previously introduced in the discourse. Ambiguity triggers a decision process that is not a subroutine of language processing but rather a more general domain resource. Therefore non-aphasic patients with limited decision-making capability can encounter severe limitation in language processing due to extra linguistic limitations. In the present study, we test patients with behavioral variant frontotemporal degeneration (bvFTD), focusing on anaphora as a paradigmatic example of ambiguity resolution in the linguistic domain. bvFTD is characterized by gray matter (GM) atrophy in prefrontal cortex, but relative sparing of peri-Sylvian cortex. A group of patients with parietal disease due to corticobasal syndrome (CBS) was also tested here in order to investigate the specific role of prefrontal cortex in the task employed in the current study. Participants were presented with a pair of sentences in which the first sentence contained two nouns while the second contained a pronoun. In the experimental (ambiguous) condition, both nouns are plausible referents of the pronoun, thus requiring decision-making resources. The results revealed that bvFTD patients are significantly less accurate than healthy seniors in identifying the correct referent of a pronoun in the ambiguous condition, although CBS patients were as accurate as healthy seniors. Imaging analyses related bvFTD patients’ performance to GM atrophy in ventromedial prefrontal cortex (vmPFC). These results suggest that bvFTD patients have difficulties in decision processes that involve the resolution of an ambiguity. PMID:26578928

  12. Pig farmers' perceptions, attitudes, influences and management of information in the decision-making process for disease control.

    PubMed

    Alarcon, Pablo; Wieland, Barbara; Mateus, Ana L P; Dewberry, Chris

    2014-10-01

    The objectives of this study were (1) to explore the factors involved in the decision-making process used by pig farmers for disease control and (2) to investigate pig farmers' attitudes and perceptions about different information sources relating to disease control. In 2011 a qualitative study involving 20 face-to-face interviews with English pig farmers was conducted. The questionnaire was composed of three parts. The first part required farmers to identify two diseases they had experienced and which were difficult to recognize and/or control. They were asked to report how the disease problem was recognized, how the need for control was decided, and what affected the choice of control approach. For the latter, a structure related to the Theory of Planned Behaviour was used. Their verbal responses were classified as associated with: (1) attitude and beliefs, (2) subjective norms, or (3) perceived behavioural control (PBC). In the second part, five key sources of information for disease control (Defra, BPEX, research from academia, internet and veterinarians) and the factors related to barriers to knowledge were investigated. Interviews were recorded and transcribed. A qualitative analysis of the text of the interview transcripts was carried out using templates. Drivers for disease control were 'pig mortality', 'feeling of entering in an economically critical situation', 'animal welfare' and 'feeling of despair'. Veterinarians were perceived by several participating farmers as the most trusted information source on disease control. However, in particular non-sustainable situations, other producers, and especially experiences from abroad, seemed to considerably influence the farmers' decision-making. 'Lack of knowledge', 'farm structure and management barriers' and 'economic constrains' were identified in relation to PBC. Several negative themes, such as 'lack of communication', 'not knowing where to look', and 'information bias' were associated with research from

  13. Influences in the Decision-Making Process for Careers as a Speech-Language Pathologist or an Audiologist.

    ERIC Educational Resources Information Center

    Brodsky, Martin B.; Cooke, Paul A.

    2000-01-01

    Students and professionals (N=297) in speech-language pathology and audiology were surveyed about career decision making. Decision-making factors were similar across both professions, with personal factors being the most influential. Employment and education factors were also critical. Early course work also played a significant role. (Author/MKA)

  14. Impaired Decision Making in Adolescent Suicide Attempters

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. Decision Making in Adults with ADHD

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  16. Some implications of the technology assessment function for the effective public decision-making process

    NASA Technical Reports Server (NTRS)

    Mayo, L. H.

    1971-01-01

    A preliminary provisional assessment of the prospects for the establishment of an adequate technology assessment function and the implications of the assessment function for the public decision process are presented. Effects of the technology assessment function on each phase of the public decision process and briefly explored. Significant implications during the next decade are projected with respect to the following phases: invention and development of alternative means (technological configurations); evaluation, selection and promotion of preferred courses of action; and modification of statutory scheme or social action program as an outcome of continuing monitoring and appraisal.

  17. Remote Sensing: A valuable tool in the Forest Service decision making process. [in Utah

    NASA Technical Reports Server (NTRS)

    Stanton, F. L.

    1975-01-01

    Forest Service studies for integrating remotely sensed data into existing information systems highlight a need to: (1) re-examine present methods of collecting and organizing data, (2) develop an integrated information system for rapidly processing and interpreting data, (3) apply existing technological tools in new ways, and (4) provide accurate and timely information for making right management decisions. The Forest Service developed an integrated information system using remote sensors, microdensitometers, computer hardware and software, and interactive accessories. Their efforts substantially reduce the time it takes for collecting and processing data.

  18. Small Employer Decision-Making with Australia's New Apprenticeship System: Process-Oriented Research.

    ERIC Educational Resources Information Center

    Rowlands, Bruce; Chappell, Clive

    2002-01-01

    A qualitative study examined 18 small and medium-sized business owners' decision to adopt or reject Australia's new apprenticeship system. Participation was based on three interconnected processes: psychological commitment, financial justification, and operational choice. Contextual elements in the internal and external environment influenced…

  19. 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...

  20. Parallel Process and Isomorphism: A Model for Decision Making in the Supervisory Triad

    ERIC Educational Resources Information Center

    Koltz, Rebecca L.; Odegard, Melissa A.; Feit, Stephen S.; Provost, Kent; Smith, Travis

    2012-01-01

    Parallel process and isomorphism are two supervisory concepts that are often discussed independently but rarely discussed in connection with each other. These two concepts, philosophically, have different historical roots, as well as different implications for interventions with regard to the supervisory triad. The authors examine the difference…

  1. Dual Processes in Decision Making and Developmental Neuroscience: A Fuzzy-Trace Model

    ERIC Educational Resources Information Center

    Reyna, Valerie F.; Brainerd, Charles J.

    2011-01-01

    From Piaget to the present, traditional and dual-process theories have predicted improvement in reasoning from childhood to adulthood, and improvement has been observed. However, developmental reversals--that reasoning biases emerge with development--have also been observed in a growing list of paradigms. We explain how fuzzy-trace theory predicts…

  2. An Examination of the Decision-Making Process Used by Designers in Multiple Disciplines

    ERIC Educational Resources Information Center

    Stefaniak, Jill E.; Tracey, Monica W.

    2014-01-01

    Design-thinking is an inductive and participatory process in which designers are required to manage constraints, generate solutions, and follow project timelines in order to complete project goals. The researchers used this exploration study to look at how designers in various disciplinary fields approach design projects. Designers were asked to…

  3. Towards Understanding the Negotiation and Decision-Making Process of Withdrawal from College: A Qualitative Approach

    ERIC Educational Resources Information Center

    Irwin, Mary Ann

    2010-01-01

    This qualitative research project focused on the interviews of 27 low socio-economic students at a research university in the southwestern United States. The students had already withdrawn from the university or were in the process of withdrawing. The study seeks to provide increased understanding of how students negotiate the decision-making…

  4. Quantum-Like Model for Decision Making Process in Two Players Game. A Non-Kolmogorovian Model

    NASA Astrophysics Data System (ADS)

    Asano, Masanari; Ohya, Masanori; Khrennikov, Andrei

    2011-03-01

    In experiments of games, players frequently make choices which are regarded as irrational in game theory. In papers of Khrennikov (Information Dynamics in Cognitive, Psychological and Anomalous Phenomena. Fundamental Theories of Physics, Kluwer Academic, Norwell, 2004; Fuzzy Sets Syst. 155:4-17, 2005; Biosystems 84:225-241, 2006; Found. Phys. 35(10):1655-1693, 2005; in QP-PQ Quantum Probability and White Noise Analysis, vol. XXIV, pp. 105-117, 2009), it was pointed out that statistics collected in such the experiments have "quantum-like" properties, which can not be explained in classical probability theory. In this paper, we design a simple quantum-like model describing a decision-making process in a two-players game and try to explain a mechanism of the irrational behavior of players. Finally we discuss a mathematical frame of non-Kolmogorovian system in terms of liftings (Accardi and Ohya, in Appl. Math. Optim. 39:33-59, 1999).

  5. Deontological and utilitarian inclinations in moral decision making: a process dissociation approach.

    PubMed

    Conway, Paul; Gawronski, Bertram

    2013-02-01

    Dual-process theories of moral judgment suggest that responses to moral dilemmas are guided by two moral principles: the principle of deontology states that the morality of an action depends on the intrinsic nature of the action (e.g., harming others is wrong regardless of its consequences); the principle of utilitarianism implies that the morality of an action is determined by its consequences (e.g., harming others is acceptable if it increases the well-being of a greater number of people). Despite the proposed independence of the moral inclinations reflecting these principles, previous work has relied on operationalizations in which stronger inclinations of one kind imply weaker inclinations of the other kind. The current research applied Jacoby's (1991) process dissociation procedure to independently quantify the strength of deontological and utilitarian inclinations within individuals. Study 1 confirmed the usefulness of process dissociation for capturing individual differences in deontological and utilitarian inclinations, revealing positive correlations of both inclinations to moral identity. Moreover, deontological inclinations were uniquely related to empathic concern, perspective-taking, and religiosity, whereas utilitarian inclinations were uniquely related to need for cognition. Study 2 demonstrated that cognitive load selectively reduced utilitarian inclinations, with deontological inclinations being unaffected. In Study 3, a manipulation designed to enhance empathy increased deontological inclinations, with utilitarian inclinations being unaffected. These findings provide evidence for the independent contributions of deontological and utilitarian inclinations to moral judgments, resolving many theoretical ambiguities implied by previous research. PMID:23276267

  6. The decision making process regarding the withdrawal or withholding of potential life-saving treatments in a children's hospital

    PubMed Central

    Street, K.; Ashcroft, R.; Henderson, J.; Campbell, A.

    2000-01-01

    Objectives—To investigate the factors considered by staff, and the practicalities involved in the decision making process regarding the withdrawal or withholding of potential life-sustaining treatment in a children's hospital. To compare our current practice with that recommended by the Royal College of Paediatrics and Child Health (RCPCH) guidelines, published in 1997. Design—A prospective, observational study using self-reported questionnaires. Setting—Tertiary paediatric hospital. Patients and participants—Consecutive patients identified during a six-month period, about whom a formal discussion took place between medical staff, nursing staff and family regarding the withholding or withdrawal of potentially life-sustaining treatments. The primary physician and primary nurse involved in the discussion were identified. Method—Two questionnaires completed independently by the primary physician and nurse. Results—Twenty-two patients were identified (median age 1 year; range 1 day—34 years). In 20 cases treatment was withdrawn or withheld, in two cases treatment was continued. Nursing staff considered family wishes and family perceptions of patient suffering as significantly more important factors in decision making than medical staff, who considered prognostic factors as most important. In only two cases were the patient's expressed wishes apparently available. In most cases staff considered the patient's best interests were served and the process would not be enhanced by the involvement of an independent ethics committee. The exceptions were those cases in which treatment was continued following disagreement between parties. Conclusions—Our current practice is consistent with that recommended by the RCPCH. The contribution of the patient, provision of staff counselling and general practitioner (GP) involvement were identified as areas for improvement. Key Words: Withdrawal • limitation • life-sustaining • therapy • treatment PMID:11055037

  7. System and method for integrating hazard-based decision making tools and processes

    DOEpatents

    Hodgin, C. Reed

    2012-03-20

    A system and method for inputting, analyzing, and disseminating information necessary for identified decision-makers to respond to emergency situations. This system and method provides consistency and integration among multiple groups, and may be used for both initial consequence-based decisions and follow-on consequence-based decisions. The system and method in a preferred embodiment also provides tools for accessing and manipulating information that are appropriate for each decision-maker, in order to achieve more reasoned and timely consequence-based decisions. The invention includes processes for designing and implementing a system or method for responding to emergency situations.

  8. Perceptual grouping does not affect multi-attribute decision making if no processing costs are involved.

    PubMed

    Ettlin, Florence; Bröder, Arndt

    2015-05-01

    Adaptive strategy selection implies that a decision strategy is chosen based on its fit to the task and situation. However, other aspects, such as the way information is presented, can determine information search behavior; especially when the application of certain strategies over others is facilitated. But are such display effects on multi-attribute decisions also at work when the manipulation does not entail differential costs for different decision strategies? Three Mouselab experiments with hidden information and one eye tracking experiment with an open information board revealed that decision behavior is unaffected by purely perceptual manipulations of the display based on Gestalt principles; that is, based on manipulations that induce no noteworthy processing costs for different information search patterns. We discuss our results in the context of previous findings on display effects; specifically, how the combination of these findings and our results reveal the crucial role of differential processing costs for different strategies for the emergence of display effects. This finding describes a boundary condition of the commonly acknowledged influence of information displays and is in line with the ideas of adaptive strategy selection and cost-benefit tradeoffs.

  9. Different roads to the same destination - The impact of impulsivity on decision-making processes under risk within a rewarding context in a healthy male sample.

    PubMed

    Dinu-Biringer, Ramona; Nees, Frauke; Falquez, Rosalux; Berger, Moritz; Barnow, Sven

    2016-02-28

    The results of research about the influences of impulsivity on decision-making in situations of risk have been inconsistent. In this study, we used functional magnetic resonance imaging to examine the neural correlates of decision-making under risk in 12 impulsive, as defined by the Barratt Impulsiveness Scale-11, and 13 normal men. Although both groups showed similar decision-making behavior, neural activation regarding decision-making processes differed significantly. Impulsive persons revealed stronger activation in the (ventro-) medial prefrontal cortex and less deactivation of the orbitofrontal cortex while playing for potential gains. These brain regions might be associated with the emotional components of decision-making processes. Significant differences in brain areas linked to cognitive decision-making components were not found. This activation pattern might be seen as an indication for a hypersensitivity to rewarding cues in impulsive persons and might be linked to the propensity for inappropriate risk-taking behavior in persons with more extreme impulsivity levels, especially in situations in which they have a strong emotional involvement in the decision process.

  10. Development of Energy Models for Production Systems and Processes to Inform Environmentally Benign Decision-Making

    NASA Astrophysics Data System (ADS)

    Diaz-Elsayed, Nancy

    Between 2008 and 2035 global energy demand is expected to grow by 53%. While most industry-level analyses of manufacturing in the United States (U.S.) have traditionally focused on high energy consumers such as the petroleum, chemical, paper, primary metal, and food sectors, the remaining sectors account for the majority of establishments in the U.S. Specifically, of the establishments participating in the Energy Information Administration's Manufacturing Energy Consumption Survey in 2006, the non-energy intensive" sectors still consumed 4*109 GJ of energy, i.e., one-quarter of the energy consumed by the manufacturing sectors, which is enough to power 98 million homes for a year. The increasing use of renewable energy sources and the introduction of energy-efficient technologies in manufacturing operations support the advancement towards a cleaner future, but having a good understanding of how the systems and processes function can reduce the environmental burden even further. To facilitate this, methods are developed to model the energy of manufacturing across three hierarchical levels: production equipment, factory operations, and industry; these methods are used to accurately assess the current state and provide effective recommendations to further reduce energy consumption. First, the energy consumption of production equipment is characterized to provide machine operators and product designers with viable methods to estimate the environmental impact of the manufacturing phase of a product. The energy model of production equipment is tested and found to have an average accuracy of 97% for a product requiring machining with a variable material removal rate profile. However, changing the use of production equipment alone will not result in an optimal solution since machines are part of a larger system. Which machines to use, how to schedule production runs while accounting for idle time, the design of the factory layout to facilitate production, and even the

  11. Using analytic hierarchy process approach in ontological multicriterial decision making - Preliminary considerations

    NASA Astrophysics Data System (ADS)

    Wasielewska, K.; Ganzha, M.

    2012-10-01

    In this paper we consider combining ontologically demarcated information with Saaty's Analytic Hierarchy Process (AHP) [1] for the multicriterial assessment of offers during contract negotiations. The context for the proposal is provided by the Agents in Grid project (AiG; [2]), which aims at development of an agent-based infrastructure for efficient resource management in the Grid. In the AiG project, software agents representing users can either (1) join a team and earn money, or (2) find a team to execute a job. Moreover, agents form teams, managers of which negotiate with clients and workers terms of potential collaboration. Here, ontologically described contracts (Service Level Agreements) are the results of autonomous multiround negotiations. Therefore, taking into account relatively complex nature of the negotiated contracts, multicriterial assessment of proposals plays a crucial role. The AHP method is based on pairwise comparisons of criteria and relies on the judgement of a panel of experts. It measures how well does an offer serve the objective of a decision maker. In this paper, we propose how the AHP method can be used to assess ontologically described contract proposals.

  12. [Decision-making process and administrative practice: managing the State Health Secretariat in Bahia, Brazil].

    PubMed

    Coelho, Thereza Christina Bahia; Paim, Jairnilson Silva

    2005-01-01

    This case study is based on research performed by the Bahia State Health Secretariat (SESAB), aimed at analyzing management practices during the implementation of a State government administrative reform. The institutional agenda shows evidence of limited participation by civil society and technical and operational staff in problem selection and prioritization, resulting from a work process pressured by high-level executive government staff. Decisions regarding "output" (projects, services, and activities) were made under the responsibility of subordinate operational levels and did not appear as issues in the institutional routine. Concerns related to "input" (financial and human resources) consumed most of the high-level efforts, with internal and external negotiations and compromises to assure access to them. Meanwhile the possible "outcome", namely public health status, represents the "occult subject" of the institutional discourse. Information emerges in institutional disputes as a technical "power resource" in its medical, epidemiological, health, and administrative dimensions. The issue of government "representation" and allied interests is based on ideological dispositions and authoritarian practices, thus contradicting the need for management transparency and modernization. PMID:16158142

  13. Identifying the processes underpinning anticipation and decision-making in a dynamic time-constrained task.

    PubMed

    Roca, André; Ford, Paul R; McRobert, Allistair P; Mark Williams, A

    2011-08-01

    A novel, representative task was used to examine skill-based differences in the perceptual and cognitive processes underlying performance on a dynamic, externally paced task. Skilled and less skilled soccer players were required to move and interact with life-size, action sequences involving 11 versus 11 soccer situations filmed from the perspective of a central defender in soccer. The ability of participants to anticipate the intentions of their opponents and to make decisions about how they should respond was measured across two separate experiments. In Experiment 1, visual search behaviors were examined using an eye-movement registration system. In Experiment 2, retrospective verbal reports of thinking were gathered from a new sample of skilled and less skilled participants. Skilled participants were more accurate than less skilled participants at anticipating the intentions of opponents and in deciding on an appropriate course of action. The skilled players employed a search strategy involving more fixations of shorter duration in a different sequential order and toward more disparate and informative locations in the display when compared with the less skilled counterparts. The skilled players generated a greater number of verbal report statements with a higher proportion of evaluation, prediction, and planning statements than the less skilled players, suggesting they employed more complex domain-specific memory representations to solve the task. Theoretical, methodological, and practical implications are discussed.

  14. Shared decision making

    MedlinePlus

    ... Shared decision making to improve care and reduce costs. N Engl J Med . 2013 Jan 3;368(1):6-8. ... UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David ...

  15. Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

    DOE PAGES

    Hoover, Mark D.; Myers, David S.; Cash, Leigh J.; Guilmette, Raymond A.; Kreyling, Wolfgang G.; Oberdörster, Günter; Smith, Rachel; Cassata, James R.; Boecker, Bruce B.; Grissom, Michael P.

    2015-01-01

    The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are alreadymore » present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.« less

  16. Application of an informatics-based decision-making framework and process to the assessment of radiation safety in nanotechnology.

    PubMed

    Hoover, Mark D; Myers, David S; Cash, Leigh J; Guilmette, Raymond A; Kreyling, Wolfgang G; Oberdörster, Günter; Smith, Rachel; Cassata, James R; Boecker, Bruce B; Grissom, Michael P

    2015-02-01

    The National Council on Radiation Protection and Measurements (NCRP) established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between ∼1 and 100 nm, where unique phenomena enable novel applications. While the full report is in preparation, this paper presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are already present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.

  17. Application of an Informatics-Based Decision-Making Framework and Process to the Assessment of Radiation Safety in Nanotechnology

    SciTech Connect

    Hoover, Mark D.; Myers, David S.; Cash, Leigh J.; Guilmette, Raymond A.; Kreyling, Wolfgang G.; Oberdörster, Günter; Smith, Rachel; Cassata, James R.; Boecker, Bruce B.; Grissom, Michael P.

    2015-01-01

    The National Council on Radiation Protection and Measurements (NCRP) has established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between approximately 1 and 100 nanometers, where unique phenomena enable novel applications. While the full report is in preparation, this article presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are already present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.

  18. Does it matter whether physicians' recommendations are given early or late in the decision-making process? An experimental study among patients with schizophrenia

    PubMed Central

    Hamann, Johannes; Kissling, Werner; Mendel, Rosmarie

    2016-01-01

    Objectives Physicians' recommendations are seen as an essential component in many models of medical decision-making, including shared decision-making. It is, however, unclear at what time in the decision-making process the recommendation is best given, not to adversely influence patient preferences. Within the present study we wanted to evaluate at what time in the decision-making process a doctor's recommendation is best given, not to adversely influence patient preferences. Design We performed an experimental study involving hypothetical decisions vignettes and compared the influence of 3 conditions (no advice, early advice, late advice) on patients' decision-making. Setting N=21 psychiatric hospitals in Germany. Participants N=208 inpatients suffering from schizophrenia. Primary and secondary outcome measures The main outcome was the number of patients choosing the option in each experimental condition that had been less preferable to most patients during pretests. Additional outcome measures were patient satisfaction and reactance. Results Patients in the ‘late advice’ condition more often (n=49) accepted an advice that was against their preferences compared with the other conditions (n=36 for ‘early advice’, p=0.024). Conclusions Although giving advice is an important part of every doctor's daily practice and is seen as an essential element of shared decision-making, hitherto there has been little empirical evidence relating to the influence of physicians' advice on patients' decision-making behaviour. With our study we could show that the point in time an advice is given by a physician does have an influence on patients' decisional behaviour even if the mechanism of this effect is not yet understood. PMID:27638491

  19. Perceptual decision making for baseball pitch recognition: using P300 latency and amplitude to index attentional processing.

    PubMed

    Radlo, S J; Janelle, C M; Barba, D A; Frehlich, S G

    2001-03-01

    This study was designed to examine the perceptual and attentional processes associated with the effects of administering a cost-benefit precuing paradigm to intermediate and advance-level baseball batters. Psychophysiological and performance data obtained from 10 advanced and 10 intermediate-level players were compared. A total of 400 pitches (200 fastballs, 200 curveballs) was randomly presented via a large projection screen, and participants pressed one of two buttons to indicate the type of pitch thrown. Verbal precues were given for 300 of the pitches. Of those, 75% were valid, and 25% were invalid. Electroencephalographic data collected from the P location was used to assess the latency and amplitude of P300. Analysis of variance (Skill Level x Precue x Pitch) for P300 and reaction time (RT) indicated that intermediate batters produced shorter P300 latencies, larger P300 amplitudes, longer RTs, and less correct responses than the advanced batters; the effects were more pronounced for the curveballs. These results suggest that intermediate batters are less efficient in their perceptual decision-making processes due to greater limitations in attentional capacity when compared with advanced batters.

  20. Assessment and limits of the existent seasonal forecasts as support for the decision making process in the Sahel

    NASA Astrophysics Data System (ADS)

    Bacci, Maurizio; Genesio, Lorenzo; di Vecchia, Andrea; Tarchiani, Vieri; Vignaroli, Patrizio

    2010-05-01

    production of new outputs translating climate forecast in impact forecast. The paper provides an assessment of the existing seasonal forecast products available for West African and highlighting the relevance of information for decision-making process. Moreover, it underlines the actual limits of the seasonal forecast products and the improvements needed to achieve more useful information for the end-user. The operational framework is the Food Crises Prevention Calendar (CPC) , which characterizes the crisis level in order to identify the appropriate information for decision makers in terms of timing, content and format. The study intend to differentiate Regional and National needs, evidencing that working at different scales is not only a resolution problem.

  1. Disparities in Water and Sewer Services in North Carolina: An Analysis of the Decision-Making Process

    PubMed Central

    Gibson, Jacqueline MacDonald

    2015-01-01

    Objectives. We examined the factors that affect access to municipal water and sewer service for unincorporated communities relying on wells and septic tanks. Methods. Using a multisite case study design, we conducted in-depth, semistructured interviews with 25 key informants from 3 unincorporated communities in Hoke, New Hanover, and Transylvania counties, North Carolina, July through September 2013. Interviewees included elected officials, health officials, utility providers, and community members. We coded the interviews in ATLAS.ti to identify common themes. Results. Financing for water and sewer service emerged as the predominant factor that influenced decisions to extend these services. Improved health emerged as a minor factor, suggesting that local officials may not place a high emphasis on the health benefits of extending public water and sewer services. Awareness of failed septic systems in communities can prompt city officials to extend sewer service to these areas; however, failed systems are often underreported. Conclusions. Understanding the health costs and benefits of water and sewer extension and integrating these findings into the local decision-making process may help address disparities in access to municipal services. PMID:26270307

  2. Metrological Needs for Monitoring Aquatic Environments: From the Demonstration of Metrological Traceability to the Decision Making Process

    NASA Astrophysics Data System (ADS)

    Lardy-Fontan, Sophie; Guigues, Nathalie; Lalere, Béatrice; Vaslin-Reimann, Sophie

    2014-08-01

    In Europe, the implementation of the Water Framework Directive WFD, in 2001, marks a strong standpoint. In addition to its objectives of a return to good chemical and good ecological status by the year 2015, it fixes the achievement of trends over space and time. The new requirements that arise from the WFD put considerable financial pressure on water management authorities. Because the overall decision-making process relies most of the time on acquired data, it puts considerable pressures on the display of high quality biological as well as chemical environmental measurements. However, performing measurements implies that i) the demonstration of their metrological traceability ii) the evidence of their achievement thanks to accurate and sensitive analytical methods and iii) their statement with a reliable estimate of expanded uncertainty is thoroughly addressed. Moreover, the measurement representativeness, especially in highly dynamic environment, is of prime interest in a context where comparability over space and time is needed. As a consequence, considerable challenges are dwelt on metrologists with great emphasis on parameters that are under regulation. This paper will discuss a panorama of the unavoidable metrological questions that have to be addressed: from the definition of the measurand to the final estimation of uncertainty; from the initial performances demonstration of methods to the final demonstration of mastery and capabilities through inter comparison laboratories and reference materials. A focus will be made on upcoming alternative monitoring approaches that are seldom addressed from a metrological point of view.

  3. The FDA's decision-making process: isn't it time to temper the principle of protective paternalism?

    PubMed

    Brandt, Lawrence J

    2008-05-01

    The authors conducted a well-designed, multinational, large study of women younger than 65 yr of age with irritable bowel syndrome (IBS) with a mixed pattern of diarrhea and constipation (IBS-M) or constipation (IBS-C) and showed that a statistically greater percentage of patients in each group responded to tegaserod compared with patients treated with placebo. Practicality looms large, however, in that the Food and Drug Administration (FDA) disallowed the continued marketing of tegaserod because of cardiovascular safety concerns, and it now is only available under a restricted access program. The wisdom of this decision aside, it is disturbing that the FDA revealed a zero-tolerance for any significant risk of disease when a drug (e.g., tegaserod) was used for a nonlife-threatening condition; the FDA chose to neglect any potential benefit of significant improvement in quality of life, while at the same time allowing the continued availability of sildenifil for erectile dysfunction and other medications (e.g., rosiglitazone and nonsteroidal anti-inflammatory drugs [NSAIDs]), each with a far greater risk of cardiovascular complications. Whether tegaserod will be re-released and, if so, under what conditions, is yet to be determined, as is the question of whether the FDA will decide to allow a more transparent decision-making process with input from all interested parties affected by their decision. PMID:18477347

  4. Cognitive flexibility in adolescence: Neural and behavioral mechanisms of reward prediction error processing in adaptive decision making during development

    PubMed Central

    Hauser, Tobias U.; Iannaccone, Reto; Walitza, Susanne; Brandeis, Daniel; Brem, Silvia

    2015-01-01

    Adolescence is associated with quickly changing environmental demands which require excellent adaptive skills and high cognitive flexibility. Feedback-guided adaptive learning and cognitive flexibility are driven by reward prediction error (RPE) signals, which indicate the accuracy of expectations and can be estimated using computational models. Despite the importance of cognitive flexibility during adolescence, only little is known about how RPE processing in cognitive flexibility deviates between adolescence and adulthood. In this study, we investigated the developmental aspects of cognitive flexibility by means of computational models and functional magnetic resonance imaging (fMRI). We compared the neural and behavioral correlates of cognitive flexibility in healthy adolescents (12–16 years) to adults performing a probabilistic reversal learning task. Using a modified risk-sensitive reinforcement learning model, we found that adolescents learned faster from negative RPEs than adults. The fMRI analysis revealed that within the RPE network, the adolescents had a significantly altered RPE-response in the anterior insula. This effect seemed to be mainly driven by increased responses to negative prediction errors. In summary, our findings indicate that decision making in adolescence goes beyond merely increased reward-seeking behavior and provides a developmental perspective to the behavioral and neural mechanisms underlying cognitive flexibility in the context of reinforcement learning. PMID:25234119

  5. Public funding of pharmaceuticals in The Netherlands: investigating the effect of evidence, process and context on CVZ decision-making.

    PubMed

    Cerri, Karin H; Knapp, Martin; Fernandez, Jose-Luis

    2014-09-01

    The College Voor Zorgverzekeringen (CVZ) provides guidance to the Dutch healthcare system on funding and use of new pharmaceutical technologies. This study examined the impact of evidence, process and context factors on CVZ decisions in 2004-2009. A data set of CVZ decisions pertaining to pharmaceutical technologies was created, including 29 variables extracted from published information. A three-category outcome variable was used, defined as the decision to 'recommend', 'restrict' or 'not recommend' a technology. Technologies included in list 1A/1B or on the expensive drug list were considered recommended; those included in list 2 or for which patient co-payment is required were considered restricted; technologies not included on any reimbursement list were classified as 'not recommended'. Using multinomial logistic regression, the relative contribution of explanatory variables on CVZ decisions was assessed. In all, 244 technology appraisals (256 technologies) were analysed, with 51%, of technologies recommended, 33% restricted and 16% not recommended by CVZ for funding. The multinomial model showed significant associations (p ≤ 0.10) between CVZ outcome and several variables, including: (1) use of an active comparator and demonstration of statistical superiority of the primary endpoint in clinical trials, (2) pharmaceutical budget impact associated with introduction of the technology, (3) therapeutic indication and (4) prevalence of the target population. Results confirm the value of a comprehensive and multivariate approach to understanding CVZ decision-making.

  6. Escharotomies, fasciotomies and carpal tunnel release in burn patients--review of the literature and presentation of an algorithm for surgical decision making.

    PubMed

    Piccolo, N S; Piccolo, M S; Piccolo, P D P; Piccolo-Daher, R; Piccolo, N D P; Piccolo, M T S

    2007-06-01

    Escharotomies are usually performed in patients with circumferential third degree burns of the extremities or anterior trunk. Fasciotomies are recommended for patients who sustained high voltage (or associated crush) injuries, with entrance or exit wounds in one or more extremities. Carpal tunnel release is practiced routinely in some services for cases of electrical injury. We have reviewed the literature which provides relatively little information as to when should these procedures actually be performed and what would happen if they were not done. We present a series of patients treated at our institution when an algorithm was used for surgical decision making as to when (or not) to operate (perform an escharotomy, a fasciotomy or a carpal tunnel release), based on clinical signs and monitoring alternatives, using the oximeter and the Doppler flowmeter. 13 938 burn patients were treated at our institution during the year of 2005. Of these, 571, with an average of 22.3 % TBSA, were treated as inpatients. Of these, 58 (10.3 %) had circumferential or electrical burns of one or more extremities. Patients were monitored hourly from admission and decision to operate was based on clinical signs and in absent or below 90 % oximetry, regardless of Doppler flow signs. 68 % were males, 6 (11.3 %) patients had immediate escharotomies, while 4 (7.5 %) had immediate fasciotomies. 2 of these patients were operated regardless of positive Doppler sign but no oximetry. All patients recovered oximetry over 90 % immediately after the operations. 3 patients had negative Doppler sign but oximetry > 90 % and were not operated. 3 patients had carpal tunnel releases based on oximetry < 90 % and symptoms of compression of the median nerve. Patients who were not operated fared well with no signs or symptoms of impairment of circulation or nerve damage up to their 3 and 6 months reevaluations. PMID:17602377

  7. Applying decision-making tools to national e-waste recycling policy: an example of Analytic Hierarchy Process.

    PubMed

    Lin, Chun-Hsu; Wen, Lihchyi; Tsai, Yue-Mi

    2010-05-01

    As policy making is in essence a process of discussion, decision-making tools have in many cases been proposed to resolve the differences of opinion among the different parties. In our project that sought to promote a country's performance in recycling, we used the Analytic Hierarchy Process (AHP) to evaluate the possibilities and determine the priority of the addition of new mandatory recycled waste, also referred to as Due Recycled Wastes, from candidate waste appliances. The evaluation process started with the collection of data based on telephone interviews and field investigations to understand the behavior of consumers as well as their overall opinions regarding the disposal of certain waste appliances. With the data serving as background information, the research team then implemented the Analytic Hierarchy Process using the information that formed an incomplete hierarchy structure in order to determine the priority for recycling. Since the number of objects to be evaluated exceeded the number that the AHP researchers had suggested, we reclassified the objects into four groups and added one more level of pair-wise comparisons, which substantially reduced the inconsistency in the judgment of the AHP participants. The project was found to serve as a flexible and achievable application of AHP to the environmental policy-making process. In addition, based on the project's outcomes derived from the project as a whole, the research team drew conclusions regarding the government's need to take back 15 of the items evaluated, and suggested instruments that could be used or recycling regulations that could be changed in the future. Further analysis on the top three items recommended by the results of the evaluation for recycling, namely, Compact Disks, Cellular Phones and Computer Keyboards, was then conducted to clarify their concrete feasibility. After the trial period for recycling ordered by the Taiwan Environmental Protection Administration, only Computer

  8. Applying decision-making tools to national e-waste recycling policy: an example of Analytic Hierarchy Process.

    PubMed

    Lin, Chun-Hsu; Wen, Lihchyi; Tsai, Yue-Mi

    2010-05-01

    As policy making is in essence a process of discussion, decision-making tools have in many cases been proposed to resolve the differences of opinion among the different parties. In our project that sought to promote a country's performance in recycling, we used the Analytic Hierarchy Process (AHP) to evaluate the possibilities and determine the priority of the addition of new mandatory recycled waste, also referred to as Due Recycled Wastes, from candidate waste appliances. The evaluation process started with the collection of data based on telephone interviews and field investigations to understand the behavior of consumers as well as their overall opinions regarding the disposal of certain waste appliances. With the data serving as background information, the research team then implemented the Analytic Hierarchy Process using the information that formed an incomplete hierarchy structure in order to determine the priority for recycling. Since the number of objects to be evaluated exceeded the number that the AHP researchers had suggested, we reclassified the objects into four groups and added one more level of pair-wise comparisons, which substantially reduced the inconsistency in the judgment of the AHP participants. The project was found to serve as a flexible and achievable application of AHP to the environmental policy-making process. In addition, based on the project's outcomes derived from the project as a whole, the research team drew conclusions regarding the government's need to take back 15 of the items evaluated, and suggested instruments that could be used or recycling regulations that could be changed in the future. Further analysis on the top three items recommended by the results of the evaluation for recycling, namely, Compact Disks, Cellular Phones and Computer Keyboards, was then conducted to clarify their concrete feasibility. After the trial period for recycling ordered by the Taiwan Environmental Protection Administration, only Computer

  9. Experiences from active membership and participation in decision-making processes and age in moral reasoning and goal orientation of referees.

    PubMed

    Proios, Miltiadis; Doganis, George

    2003-02-01

    The purpose of the present study was to investigate the effect of experiences of active membership and participation in decision-making processes and age on moral reasoning and goal orientations of referees in sport. The sample consisted of 148 referees of whom 56 judged soccer, 55 basketball, and 37 handball. Their ages ranged from 17 to 50 years (M=36.6, SD=7.4). Of the total number of referees, 8.3% have no experiences from active membership and participation in decision-making processes in organizations (social, athletic, political), 53.1% were simply active members, and 38.6% were involved in decision-making in their respective organizations. A two-way multivariate analysis of variance showed an interaction between experiences and age on moral reasoning and goal orientation of referees.

  10. Planning versus action: Different decision-making processes predict plans to change one's diet versus actual dietary behavior.

    PubMed

    Kiviniemi, Marc T; Brown-Kramer, Carolyn R

    2015-05-01

    Most health decision-making models posit that deciding to engage in a health behavior involves forming a behavioral intention which then leads to actual behavior. However, behavioral intentions and actual behavior may not be functionally equivalent. Two studies examined whether decision-making factors predicting dietary behaviors were the same as or distinct from those predicting intentions. Actual dietary behavior was proximally predicted by affective associations with the behavior. By contrast, behavioral intentions were predicted by cognitive beliefs about behaviors, with no contribution of affective associations. This dissociation has implications for understanding individual regulation of health behaviors and for behavior change interventions.

  11. Planning versus action: Different decision-making processes predict plans to change one's diet versus actual dietary behavior.

    PubMed

    Kiviniemi, Marc T; Brown-Kramer, Carolyn R

    2015-05-01

    Most health decision-making models posit that deciding to engage in a health behavior involves forming a behavioral intention which then leads to actual behavior. However, behavioral intentions and actual behavior may not be functionally equivalent. Two studies examined whether decision-making factors predicting dietary behaviors were the same as or distinct from those predicting intentions. Actual dietary behavior was proximally predicted by affective associations with the behavior. By contrast, behavioral intentions were predicted by cognitive beliefs about behaviors, with no contribution of affective associations. This dissociation has implications for understanding individual regulation of health behaviors and for behavior change interventions. PMID:25903243

  12. A method to assess how interactive water simulation tools influence transdisciplinary decision-making processes in water management

    NASA Astrophysics Data System (ADS)

    Leskens, Johannes

    2015-04-01

    In modern water management, often transdisciplinary work sessions are organized in which various stakeholders participate to jointly define problems, choose measures and divide responsibilities to take actions. Involved stakeholders are for example policy analysts or decision-makers from municipalities, water boards or provinces, representatives of pressure groups and researchers from knowledge institutes. Parallel to this increasing attention for transdisciplinary work sessions, we see a growing availability of interactive IT-tools that can be applied during these sessions. For example, dynamic flood risk maps have become recently available that allow users during a work sessions to instantaneously assess the impact of storm surges or dam breaches, displayed on digital maps. Other examples are serious games, realistic visualizations and participatory simulations. However, the question is if and how these interactive IT-tools contribute to better decision-making. To assess this, we take the process of knowledge construction during a work session as a measure for the quality of decision-making. Knowledge construction can be defined as the process in which ideas, perspectives and opinions of different stakeholders, all having their own expertise and experience, are confronted with each other and new shared meanings towards water management issues are created. We present an assessment method to monitor the process of knowledge construction during work sessions in water management in which interactive IT tools are being used. The assessment method is based on a literature review, focusing on studies in which knowledge construction was monitored in other contexts that water management. To test the applicability of the assessment method, we applied it during a multi-stakeholder work session in Westland, located in the southwest of the Netherlands. The discussions during the work session were observed by camera. All statements, expressed by the various members of a

  13. An Examination of the Career Development and Decision-Making Process of Female Division I Student-Athletes Attending a Mississippi Institution of Higher Learning

    ERIC Educational Resources Information Center

    Winstead, Jennifer

    2009-01-01

    The career development and decision-making process of student-athletes has been found to be a complex process (Brown, Glastetter-Fender, & Shelton, 2000; Lally & Kerr, 2005; and Sandstedt, Cox, Martens, Ward, Webber, & Ivey, 2004). Intertwined with issues not found within the general student population career development and decision-making…

  14. Emotion and decision making.

    PubMed

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

    2015-01-01

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

  15. Decision Making in Action

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

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

  16. Utilization of Participatory Electronic Technology in Group Communication and Decision-Making Processes. AIR 1983 Annual Forum Paper.

    ERIC Educational Resources Information Center

    Roberts, Adrian R.; Garg, Devendra P.

    The use of an electronic feedback system, the Anonymous Audience Response System (AARS), in educational decision making is described, and the results of use studies in North Carolina are discussed. The AARS insures anonymity of an individual participant's responses, and at the same time, provides immediate feedback of the group's collective…

  17. Formal operational thinking: the role of cognitive-developmental processes in adolescent decision-making about pregnancy and contraception.

    PubMed

    Gordon, D E

    1990-07-01

    The role of formal operational thinking in adolescent decision-making about pregnancy and contraception is explored through an integration of the cognitive-developmental and pregnancy-contraception literatures. The ways in which cognitive-developmental change mechanisms initiate or hinder formal thinking on pregnancy-contraception are considered, and implications for counseling pregnant adolescents are discussed. PMID:2200271

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

    PubMed Central

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

    2013-01-01

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

  19. Sustainability Based Decision Making

    EPA Science Inventory

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

  20. Matriarchal Decision-Making.

    ERIC Educational Resources Information Center

    Warner, Linda Sue

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

  1. 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…

  2. Participative Decision-Making.

    ERIC Educational Resources Information Center

    Lindelow, John; And Others

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

  3. Participative Decision-Making.

    ERIC Educational Resources Information Center

    Lindelow, John; And Others

    Chapter 7 of a revised volume on school leadership, this chapter advocates the use of participative decision-making (PDM) at the school site level, outlines implementation guidelines, and describes the experiences of some schools with PDM systems. A cornerstone of a reform movement to make organizational operations more democratic and less…

  4. Repeated Causal Decision Making

    ERIC Educational Resources Information Center

    Hagmayer, York; Meder, Bjorn

    2013-01-01

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

  5. Quantitative Decision Making.

    ERIC Educational Resources Information Center

    Baldwin, Grover H.

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

  6. Enhanced decision making through neuroscience

    NASA Astrophysics Data System (ADS)

    Szu, Harold; Jung, TP; Makeig, Scott

    2012-06-01

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

  7. Decision Making in Educational Settings. Fastback 211.

    ERIC Educational Resources Information Center

    Sharman, Charles S.

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

  8. The Treatment Decision-Making Process: Age Differences in a Sample of Women Recently Diagnosed with Nonrecurrent Early-Stage Breast Cancer.

    ERIC Educational Resources Information Center

    Petrisek, Ann C.; Laliberte, Linda L.; Allen, Susan M.; Mor, Vincent

    1997-01-01

    Using retrospective, self-report data collected from women recently diagnosed with breast cancer (N=179), examines the influence of age differences in the treatment decision-making process. Findings indicate that older women were less likely than their younger counterparts to have desired participation in therapy selection or sought out medical…

  9. How They Decide: A Case Study Examining the Decision Making Process for Keeping or Cutting Music Education in a K-12 Public School District

    ERIC Educational Resources Information Center

    Major, Marci L.

    2010-01-01

    The purpose of this study was to examine and understand the decision making process for keeping or cutting music programs in one selected public school district. Berkley School District, in the Detroit suburb of Berkley, Michigan, has not made extreme cuts to the music program in over ten years, nor have they specifically targeted their music…

  10. A Comparative Case Study of the Influence of Educational Governance Team Decision-Making Processes on District Climate and Student Achievement

    ERIC Educational Resources Information Center

    Thompson, Debra A.

    2010-01-01

    This study explored how the educational governance team, composed of the superintendent and school board, can, in their collaborative efforts and decision-making processes, influence school district climate and impact student achievement. Though in form and function, school boards have not changed much in their almost 200 years of existence,…

  11. How They Decide: A Case Study Examining the Decision-Making Process for Keeping or Cutting Music in a K-12 Public School District

    ERIC Educational Resources Information Center

    Major, Marci L.

    2013-01-01

    This study was designed to examine the decision-making process for keeping or cutting the music program in one selected public school district. Lekbery School District, in the Detroit suburb of Lekbery, Michigan, had not made extreme cuts to the music program in over 10 years, nor had it specifically targeted the music program when budgets cuts…

  12. Teachers' Experiences with the Data-Driven Decision Making Process in Increasing Students' Reading Achievement in a Title I Elementary Public School

    ERIC Educational Resources Information Center

    Atkinson, Linton

    2015-01-01

    This paper is a research dissertation based on a qualitative case study conducted on Teachers' Experiences within a Data-Driven Decision Making (DDDM) process. The study site was a Title I elementary school in a large school district in Central Florida. Background information is given in relation to the need for research that was conducted on the…

  13. Exploring the Decision-Making Process of Hispanic Adults to Pursue Citizenship in Siler City, North Carolina: A Narrative Analysis Using Photovoice

    ERIC Educational Resources Information Center

    Caye, Joanne Snyder

    2014-01-01

    The aim of this qualitative research study is to understand the decision-making process of Hispanic adults who have lived in the United States at least 15 years, have English as a second language, have less education than other recent immigrant waves, and have become citizens within the past four years. Narrative inquiry and photovoice were the…

  14. Based on reception in general with bit-by-bit decision-making algorithm for signal processing in fiber optic telecommunication systems

    NASA Astrophysics Data System (ADS)

    Burdin, Vladimir A.; Kartashevsky, Vyacheslav G.; Grigorov, Igor V.

    2016-03-01

    This paper presents «reception in general with bit-by-bit decision-making» algorithm, which is the alternative to Viterbi algorithm. It is proposed to use it for fiber-optic transmission systems. It's features is compared with the Viterbi algorithm for digital signal processing in optical communication channels.

  15. Theoretical aspects and modelling of cellular decision making, cell killing and information-processing in photodynamic therapy of cancer

    PubMed Central

    2013-01-01

    Background The aim of this report is to provide a mathematical model of the mechanism for making binary fate decisions about cell death or survival, during and after Photodynamic Therapy (PDT) treatment, and to supply the logical design for this decision mechanism as an application of rate distortion theory to the biochemical processing of information by the physical system of a cell. Methods Based on system biology models of the molecular interactions involved in the PDT processes previously established, and regarding a cellular decision-making system as a noisy communication channel, we use rate distortion theory to design a time dependent Blahut-Arimoto algorithm where the input is a stimulus vector composed of the time dependent concentrations of three PDT related cell death signaling molecules and the output is a cell fate decision. The molecular concentrations are determined by a group of rate equations. The basic steps are: initialize the probability of the cell fate decision, compute the conditional probability distribution that minimizes the mutual information between input and output, compute the cell probability of cell fate decision that minimizes the mutual information and repeat the last two steps until the probabilities converge. Advance to the next discrete time point and repeat the process. Results Based on the model from communication theory described in this work, and assuming that the activation of the death signal processing occurs when any of the molecular stimulants increases higher than a predefined threshold (50% of the maximum concentrations), for 1800s of treatment, the cell undergoes necrosis within the first 30 minutes with probability range 90.0%-99.99% and in the case of repair/survival, it goes through apoptosis within 3-4 hours with probability range 90.00%-99.00%. Although, there is no experimental validation of the model at this moment, it reproduces some patterns of survival ratios of predicted experimental data. Conclusions

  16. Toward sustainability: a case study demonstrating transdisciplinary learning through the selection and use of indicators in a decision-making process.

    PubMed

    Stahl, Cynthia; Cimorelli, Alan; Mazzarella, Christine; Jenkins, Bill

    2011-07-01

    The purpose of this article is to use a case study example to demonstrate how a transparent, transdisciplinary approach to decision making allows the US Environmental Protection Agency Region III (USEPA Region III) to fulfill its decision-making responsibilities while taking critical steps toward engaging in sustainability discussions. The case study goals were to use information about environmental condition to inform staff and fiscal resource prioritization and allocation for the federal 2010 fiscal year. This article will use a select group of 3 indicators to show 1) that data are not the same as indicators, 2) the feasibility of using disparate data in the same analysis, and 3) specific discussions about indicators can lead to transdisciplinary learning, supporting more informed decision making. We show that, when used in a transdisciplinary learning process, these indicator lessons provide a stepping stone for organizations like USEPA Region III to consider sustainability as more than just a lofty, ethical concept. Instead, these kinds of organizations can more routinely and substantively address sustainability through a progression of individual decisions. We discuss how sustainability can be linked to decision making through a process that requires stakeholders to articulate and confront their values. In this process, selecting indicators and understanding what those choices imply regarding the issues that are highlighted and the population affected is part of the assessment of environmental condition, which is the focus of the case study.

  17. The Sweet-Home project: audio processing and decision making in smart home to improve well-being and reliance.

    PubMed

    Vacher, Michel; Chahuara, Pedro; Lecouteux, Benjamin; Istrate, Dan; Portet, Francois; Joubert, Thierry; Sehili, Mohamed; Meillon, Brigitte; Bonnefond, Nicolas; Fabre, Sébastien; Roux, Camille; Caffiau, Sybille

    2013-01-01

    The Sweet-Home project aims at providing audio-based interaction technology that lets the user have full control over their home environment, at detecting distress situations and at easing the social inclusion of the elderly and frail population. This paper presents an overview of the project focusing on the implemented techniques for speech and sound recognition as context-aware decision making with uncertainty. A user experiment in a smart home demonstrates the interest of this audio-based technology.

  18. Ethical issues in communication of diagnosis and end-of-life decision-making process in some of the Romanian Roma communities.

    PubMed

    Roman, Gabriel; Enache, Angela; Pârvu, Andrada; Gramma, Rodica; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice

    2013-08-01

    Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor-patient relationship. The study aims to explore the Roma's beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the "silence conspiracy" being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient's autonomy. We identified ethical dilemmas concerning autonomy, lack of patients' real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient's right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community.

  19. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  20. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  1. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  2. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  3. 36 CFR 1010.13 - Trust decision-making procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the...

  4. Writing as decision-making

    NASA Technical Reports Server (NTRS)

    Souther, J. W.

    1981-01-01

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

  5. Decision Making: Rational, Nonrational, and Irrational.

    ERIC Educational Resources Information Center

    Simon, Herbert A.

    1993-01-01

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

  6. The process of processing: exploring the validity of Neisser's perceptual cycle model with accounts from critical decision-making in the cockpit.

    PubMed

    Plant, Katherine L; Stanton, Neville A

    2015-01-01

    The perceptual cycle model (PCM) has been widely applied in ergonomics research in domains including road, rail and aviation. The PCM assumes that information processing occurs in a cyclical manner drawing on top-down and bottom-up influences to produce perceptual exploration and actions. However, the validity of the model has not been addressed. This paper explores the construct validity of the PCM in the context of aeronautical decision-making. The critical decision method was used to interview 20 helicopter pilots about critical decision-making. The data were qualitatively analysed using an established coding scheme, and composite PCMs for incident phases were constructed. It was found that the PCM provided a mutually exclusive and exhaustive classification of the information-processing cycles for dealing with critical incidents. However, a counter-cycle was also discovered which has been attributed to skill-based behaviour, characteristic of experts. The practical applications and future research questions are discussed. Practitioner Summary: This paper explores whether information processing, when dealing with critical incidents, occurs in the manner anticipated by the perceptual cycle model. In addition to the traditional processing cycle, a reciprocal counter-cycle was found. This research can be utilised by those who use the model as an accident analysis framework.

  7. An ABC for decision making.

    PubMed

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

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

  8. An ABC for decision making*

    PubMed Central

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

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

  9. Decision making in midwifery: rationality and intuition.

    PubMed

    Steinhauer, Suyai

    2015-04-01

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

  10. Narrative message targets within the decision-making process to undergo screening colonoscopy among Latinos: a qualitative study.

    PubMed

    Hennelly, Marie Oliva; Sly, Jamilia R; Villagra, Cristina; Jandorf, Lina

    2015-06-01

    Colorectal cancer (CRC) is a preventable yet leading cause of cancer mortality among Latinos in the USA. Cultural targeting and narrative messaging are two strategies to increase the low screening colonoscopy rates among Latinos. This study identifies key messages for educational interventions aiming to increase screening colonoscopy used among Latinos and proposes a model to understand the relationship between factors involved in colonoscopy decision-making. Individual in-depth interviews were conducted with 12 Latino participants primarily of Puerto Rican descent on the topics of CRC knowledge, barriers and facilitators to colonoscopy use, and the use of narrative in colorectal health messaging. Knowledge about colorectal anatomy and the anesthesia component of colonoscopy procedure is low. Fear of procedure-related pain and fear of treatment-related burden following a cancer diagnosis are significant barriers to colonoscopy. Fear of disease-related suffering and death following a cancer diagnosis and fear of regret are strong facilitators and can be augmented by cancer narratives. Storytelling is commonly used in Latino culture and is an acceptable method to educate the Latino community about CRC screening via colonoscopy. Machismo is a unique barrier to colonoscopy for Latino men via homophobia and reluctance to seek healthcare. A preliminary model to understand factors in colonoscopy decision-making among Latinos is presented. Counseling practices and educational interventions that use culturally targeted narrative health messaging to mediate fears and increase colonoscopy knowledge may increase screening colonoscopy use among Latinos.

  11. [Decision-making in health].

    PubMed

    Tabuteau, Didler

    2008-01-01

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

  12. A Comparison Model of Reinforcement-Learning and Win-Stay-Lose-Shift Decision-Making Processes: A Tribute to W.K. Estes

    PubMed Central

    Worthy, Darrell A.; Maddox, W. Todd

    2013-01-01

    W.K. Estes often championed an approach to model development whereby an existing model was augmented by the addition of one or more free parameters, and a comparison between the simple and more complex, augmented model determined whether the additions were justified. Following this same approach we utilized Estes’ (1950) own augmented learning equations to improve the fit and plausibility of a win-stay-lose-shift (WSLS) model that we have used in much of our recent work. Estes also championed models that assumed a comparison between multiple concurrent cognitive processes. In line with this, we develop a WSLS-Reinforcement Learning (RL) model that assumes that the output of a WSLS process that provides a probability of staying or switching to a different option based on the last two decision outcomes is compared with the output of an RL process that determines a probability of selecting each option based on a comparison of the expected value of each option. Fits to data from three different decision-making experiments suggest that the augmentations to the WSLS and RL models lead to a better account of decision-making behavior. Our results also support the assertion that human participants weigh the output of WSLS and RL processes during decision-making. PMID:25214675

  13. An application of the rational choice approach to the offending process of sex offenders: a closer look at the decision-making.

    PubMed

    Beauregard, Eric; Leclerc, Benoît

    2007-06-01

    Although the study of both offense processes and implicit theories provides in-depth knowledge about the decision-making of sex offenders, these studies focus solely on the internal psychological processes of the offender leading to the commission of a sexual assault. These studies neglect to look specifically at the offender's decision-making during the offense in interaction with the immediate situations encountered at the offense scene, such as the choices of behavior while interacting with the victim in a specific context. Based on a rational choice approach, this study investigates the decision-making involved in the offending process of 69 serial sexual offenders who have committed their crimes against stranger victims. Semi-structured interviews were conducted with offenders in order to identify the rationale behind their actions during the pre-crime phase (premeditation of the crime, estimation of risk of apprehension by the offender, and forensic awareness of the offender), crime phase (use of a weapon, use of restraints, use of a vehicle, and level of force used), and the post-crime phase (event leading to the end of crime and victim release site location choice). Results show that sex offenders, even if traditionally described as "irrational" and impulsive individuals, are capable, up to a certain point, of an analysis of the costs/benefits related to their actions. Moreover, results emphasize the important role of situational factors, such as victim resistance, on the decision-making process of sex offenders. Implications of the results are briefly discussed in regard of clinical practice and crime prevention.

  14. Somatic markers, working memory, and decision making.

    PubMed

    Hinson, John M; Jameson, Tina L; Whitney, Paul

    2002-12-01

    The somatic marker hypothesis formulated by Damasio (e.g., 1994; Damasio, Tranel, & Damasio, 1991) argues that affective reactions ordinarily guide and simplify decision making. Although originally intended to explain decision-making deficits in people with specific frontal lobe damage, the hypothesis also applies to decision-making problems in populations without brain injury. Subsequently, the gambling task was developed by Bechara (Bechara, Damasio, Damasio, & Anderson, 1994) as a diagnostic test of decision-making deficit in neurological populations. More recently, the gambling task has been used to explore implications of the somatic marker hypothesis, as well as to study suboptimal decision making in a variety of domains. We examined relations among gambling task decision making, working memory (WM) load, and somatic markers in a modified version of the gambling task. Increased WM load produced by secondary tasks led to poorer gambling performance. Declines in gambling performance were associated with the absence of the affective reactions that anticipate choice outcomes and guide future decision making. Our experiments provide evidence that WM processes contribute to the development of somatic markers. If WM functioning is taxed, somatic markers may not develop, and decision making may thereby suffer. PMID:12641178

  15. 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.

  16. Joint federal research and development process to meet state and local needs. Part 1. Science and technology and political decision making

    SciTech Connect

    Wise, H F; Smith, L K; Einsweiler, R C; Jensen, D E

    1980-10-01

    This part of the handbook addresses the basic how to do it - how states and local governments can identify complex and cross-cutting issues and develop and manage scientific and technical resources in seeking policy solutions to such issues. The following subjects are discussed: background statement of the issue; the research/decision-making process; defining problems and identifying research components; research and decision-making strategies; how to identify existing knowledge or ongoing research in the area of policy concern; and managing multi-disciplinary research. The fourteen agencies involved in this effort include: US Departments of Energy, Agriculture, Transportation, Housing and Urban Development, Environmental Protection Agency, and National Science Foundation. (PSB)

  17. Aging and consumer decision making

    PubMed Central

    Carpenter, Stephanie M.; Yoon, Carolyn

    2013-01-01

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

  18. An Exploration of Decision-Making Processes on Infant Delivery Site from the Perspective of Pregnant Women, New Mothers, and Their Families in Northern Karnataka, India.

    PubMed

    Blanchard, Andrea Katryn; Bruce, Sharon Gail; Jayanna, Krishnamurthy; Gurav, Kaveri; Mohan, Haranahalli L; Avery, Lisa; Moses, Stephen; Blanchard, James Frederick; Ramesh, Banadakoppa M

    2015-09-01

    This study was conducted to explore the decision-making processes regarding sites for delivery of infants among women, their husbands, and mothers-in-law in a rural area of northern Karnataka state, south India. Qualitative semi-structured, individual in-depth interviews were conducted in 2010 among 110 pregnant women, new mothers, husbands and mothers-in-law. Interviews were conducted by trained local researchers in participants' languages and then translated into English. Decisions were made relationally, as family members weighed their collective attitudes and experiences towards a home, private or public delivery. Patterns of both concordance and discordance between women and their families' preferences for delivery site were present. The voice of pregnant women and new mothers was not always subordinate to that of other family members. Still, the involvement of husbands and mothers-in-law was important in decision-making, indicating the need to consider the influence of household gender and power dynamics. All respondent types also expressed shifts in social context and cultural attitudes towards increasing preference for hospital delivery. An appreciation of the interdependence of family members' roles in delivery site decision-making, and how they are influenced by the socio-cultural context, must be considered in frameworks used to guide the development of relevant interventions to improve the utilization and quality of maternal, neonatal and child health services.

  19. Expert decision-making strategies

    NASA Technical Reports Server (NTRS)

    Mosier, Kathleen L.

    1991-01-01

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

  20. Evidence-based process for decision-making in the analysis of legal demands for medicines in Brazil.

    PubMed

    Figueiredo, Tatiana Aragão; Osorio-de-Castro, Claudia Garcia Serpa; Pepe, Vera Lúcia Edais

    2013-11-01

    Legal actions have been playing a significant role as an alternative pathway to access to medicines in Brazil. These lawsuits demand medicines used in Primary Health Care as well as medicines that are still in clinical research and have not been market approved by the Brazilian National Agency for Sanitary Surveillance (ANVISA). The goal was to analyze medicines demanded through lawsuits brought to the judicial district which includes the city of Rio de Janeiro, Brazil, from July/2007 to June/2008. The medicines in 281 lawsuits were examined for their respective indications, classified according to their presence in publicly-funded lists, market approval by ANVISA, compliance with national clinical guidelines, existence of alternative therapies in lists and support of indication by scientific evidence. Six different categories were described, which are deemed useful to managers and the Judiciary in decision-making. The support of evidence is of utmost importance for medicines that are not included in public funding lists and also for those with no available therapeutic alternatives.

  1. Political anticipation: observing and understanding global socio-economic trends with a view to guide the decision-making processes

    NASA Astrophysics Data System (ADS)

    Caillol, Marie-Hélène

    2012-01-01

    Political anticipation (PA), as practiced by Laboratoire Européen d'Anticipation Politique, is a method for improving the capacity to understand trends and forecast events with the aim of influencing events on a large or small scale. Our operational definition of anticipation is 'To foresee in order to act.' Intended to be efficient and of immediate use, PA is conceived as a decision-making tool for all types of decision-makers: politicians, economists, administrators, business leaders, private investors, educators, as well as heads of households. Everyone, in a professional or private role, makes important decisions (for employees, for business operations and commerce, for family, for investments, for jurisdictions, and for the country and economic zone, among other areas in which the polis is involved). Given the dynamics of reality in our times, every decision appears as a wager on the future. It is also related to the wish or desire to obtain the best outcome for risk assumed (which a wager entails) and the effort expended.

  2. Evidence-based process for decision-making in the analysis of legal demands for medicines in Brazil.

    PubMed

    Figueiredo, Tatiana Aragão; Osorio-de-Castro, Claudia Garcia Serpa; Pepe, Vera Lúcia Edais

    2013-11-01

    Legal actions have been playing a significant role as an alternative pathway to access to medicines in Brazil. These lawsuits demand medicines used in Primary Health Care as well as medicines that are still in clinical research and have not been market approved by the Brazilian National Agency for Sanitary Surveillance (ANVISA). The goal was to analyze medicines demanded through lawsuits brought to the judicial district which includes the city of Rio de Janeiro, Brazil, from July/2007 to June/2008. The medicines in 281 lawsuits were examined for their respective indications, classified according to their presence in publicly-funded lists, market approval by ANVISA, compliance with national clinical guidelines, existence of alternative therapies in lists and support of indication by scientific evidence. Six different categories were described, which are deemed useful to managers and the Judiciary in decision-making. The support of evidence is of utmost importance for medicines that are not included in public funding lists and also for those with no available therapeutic alternatives. PMID:25402244

  3. Neural Basis of Strategic Decision Making.

    PubMed

    Lee, Daeyeol; Seo, Hyojung

    2016-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  5. 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

  6. [Decision making in cannabis users].

    PubMed

    Alameda Bailén, Jose Ramón; Paíno Quesada, Susana; Mogedas Valladares, Ana Isabel

    2012-01-01

    Several neuropsychological studies have shown that chronic cannabis users have cognitive impairments, including decision-making process. Therefore, this study aims to evaluate the process, through the somatic marker hypothesis in a sample of 41 cannabis users compared with a control group of equal size, and to analyze the influence of age, sex, education level, age of onset and amount of daily consumption. In order to do that, the software "Cartas" (similar to the Iowa Gambling Task), was used, implementing its two versions: normal and reverse. The results show significant differences between cannabis users and control group in the normal and reverse task execution. By block analysis, the control group obtained higher scores in the normal task execution, however, in the reverse task, the differences between groups are present in the initial task execution but not final task execution. None of the analyzed variables (age, sex ...) are significantly related to task performance. These results suggest the existence of alterations in the decision making process of consumers cannabis, which may relate to the difficulty in generating somatic markers, and not for insensitivity punishments insensitivity.

  7. Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration.

    PubMed

    Marraccini, Marisa E; Weyandt, Lisa L; Rossi, Joseph S; Gudmundsdottir, Bergljot Gyda

    2016-08-01

    Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. (PsycINFO Database Record

  8. Neurocognitive enhancement or impairment? A systematic meta-analysis of prescription stimulant effects on processing speed, decision-making, planning, and cognitive perseveration.

    PubMed

    Marraccini, Marisa E; Weyandt, Lisa L; Rossi, Joseph S; Gudmundsdottir, Bergljot Gyda

    2016-08-01

    Increasing numbers of adults, particularly college students, are misusing prescription stimulants primarily for cognitive/academic enhancement, so it is critical to explore whether empirical findings support neurocognitive benefits of prescription stimulants. Previous meta-analytic studies have supported small benefits from prescription stimulants for the cognitive domains of inhibitory control and memory; however, no meta-analytic studies have examined the effects on processing speed or the potential impairment on other domains of cognition, including planning, decision-making, and cognitive perseveration. Therefore, the present study conducted a meta-analysis of the available literature examining the effects of prescription stimulants on specific measures of processing speed, planning, decision-making, and cognitive perseveration among healthy adult populations. The meta-analysis results indicated a positive influence of prescription stimulant medication on processing speed accuracy, with an overall mean effect size of g = 0.282 (95% CI [0.077, 0.488]; n = 345). Neither improvements nor impairments were revealed for planning time, planning accuracy, advantageous decision-making, or cognitive perseveration; however, findings are limited by the small number of studies examining these outcomes. Findings support that prescription stimulant medication may indeed act as a neurocognitive enhancer for accuracy measures of processing speed without impeding other areas of cognition. Considering that adults are already engaging in illegal use of prescription stimulants for academic enhancement, as well as the potential for stimulant misuse to have serious side effects, the establishment of public policies informed by interdisciplinary research surrounding this issue, whether restrictive or liberal, is of critical importance. (PsycINFO Database Record PMID:27454675

  9. Optimization of the decision-making process for the selection of therapeutics to undergo clinical testing for spinal cord injury in the North American Clinical Trials Network.

    PubMed

    Guest, James; Harrop, James S; Aarabi, Bizhan; Grossman, Robert G; Fawcett, James W; Fehlings, Michael G; Tator, Charles H

    2012-09-01

    The North American Clinical Trials Network (NACTN) includes 9 clinical centers funded by the US Department of Defense and the Christopher Reeve Paralysis Foundation. Its purpose is to accelerate clinical testing of promising therapeutics in spinal cord injury (SCI) through the development of a robust interactive infrastructure. This structure includes key committees that serve to provide longitudinal guidance to the Network. These committees include the Executive, Data Management, and Neurological Outcome Assessments Committees, and the Therapeutic Selection Committee (TSC), which is the subject of this manuscript. The NACTN brings unique elements to the SCI field. The Network's stability is not restricted to a single clinical trial. Network members have diverse expertise and include experts in clinical care, clinical trial design and methodology, pharmacology, preclinical and clinical research, and advanced rehabilitation techniques. Frequent systematic communication is assigned a high value, as is democratic process, fairness and efficiency of decision making, and resource allocation. This article focuses on how decision making occurs within the TSC to rank alternative therapeutics according to 2 main variables: quality of the preclinical data set, and fit with the Network's aims and capabilities. This selection process is important because if the Network's resources are committed to a therapeutic, alternatives cannot be pursued. A proposed methodology includes a multicriteria decision analysis that uses a Multi-Attribute Global Inference of Quality matrix to quantify the process. To rank therapeutics, the TSC uses a series of consensus steps designed to reduce individual and group bias and limit subjectivity. Given the difficulties encountered by industry in completing clinical trials in SCI, stable collaborative not-for-profit consortia, such as the NACTN, may be essential to clinical progress in SCI. The evolution of the NACTN also offers substantial

  10. Improving decision making in crisis.

    PubMed

    Higgins, Guy; Freedman, Jennifer

    2013-01-01

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

  11. Intergroup conflict and rational decision making.

    PubMed

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

    2014-01-01

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

  12. Intergroup Conflict and Rational Decision Making

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Bright, Leslie Shay

    2010-01-01

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

  14. Decision making in family medicine

    PubMed Central

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

    2013-01-01

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

  15. Decision Making and Health Education.

    ERIC Educational Resources Information Center

    Duryea, Elias J.

    1983-01-01

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

  16. Reclaiming their lives: The decision-making process in living liver donation – An interpretative phenomenological case study analysis of one couple

    PubMed Central

    McGregor, Lesley M.; Dickson, Adele; Flowers, Paul; Hayes, Peter C.; O’Carroll, Ronan E.

    2014-01-01

    Objectives: Adult-to-adult living liver donation (LLD) is a controversial procedure due to the risk to the healthy donor. The decision to proceed with LLD is an important, yet under-researched area. This study aims to explore the decision-making process of the donor and recipient independently, and within the donor–recipient dyad. Design: A longitudinal, qualitative analysis of the LLD decision from the perspective of a LLD donor–recipient dyad. Methods: In-depth interviews were conducted with the donor and recipient separately on three occasions: pre LLD, six weeks post and six months post LLD. Transcripts were subject to interpretative phenomenological analysis. Results: During the pre-LLD interviews, a series of intra- and interpersonal negotiations were reported as both the donor and recipient grappled to make a decision about LLD. Following the decision, the focus then centred on the consequences of the decision and making sense of unanticipated outcomes. By six months post LLD, both were able to reflect on adapting to the changes their decision had ultimately caused. Conclusions: This case study offers a unique insight into the risk assessment and decision-making demands of LLD and the results can help support future LLD candidates. PMID:24991986

  17. Roadmapping Process Improvements by Experience at the Idaho National Engineering and Environmental Laboratory High Level Waste Program and Synergistic Interfaces with Decision-Making

    SciTech Connect

    Murphy, James Anthony; Olson, Arlin Leland

    2001-02-01

    Six technology roadmaps were developed for various technologies under consideration for the treatment of sodium bearing liquid and calcine wastes. In the process of creating these roadmaps, a number of process improvements were identified for each of the formal roadmapping phases as described in the Department of Energy’s draft roadmapping guidance. The lessons learned, presented as beneficial improvements to the Idaho National Engineering and Environmental Laboratory (INEEL) High Level Waste Program, are proposed to be added to the draft guidance. Additionally, synergistic interfaces between the roadmapping and decision-making processes were observed and reported on. With these improvements, technology roadmapping has become an effective integration tool at the INEEL for planning technology development.

  18. Composite collective decision-making

    PubMed Central

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

    2015-01-01

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

  19. Composite collective decision-making.

    PubMed

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

    2015-06-22

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

  20. Composite collective decision-making.

    PubMed

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

    2015-06-22

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

  1. How does the context and design of participatory decision-making processes affect their outcomes? Evidence from sustainable land management in global drylands.

    NASA Astrophysics Data System (ADS)

    de Vente, Joris; Reed, Mark; Stringer, Lindsay; Valente, Sandra; Newig, Jens

    2014-05-01

    It is widely accepted that the design of participatory processes in environmental management needs to be adapted to local contexts. Yet, it is not clear which elements of process design are universal, making it difficult to design processes that deliver beneficial outcomes across different contexts. We used empirical evidence to analyse the extent to which context and process design can enable or impede stakeholder participation and facilitate beneficial environmental and social outcomes in a range of decision-making contexts where stakeholders are engaged in environmental management. To explore the role of national-scale context on the outcomes of participatory processes, we interviewed facilitators from a process that was replicated across 13 dryland study sites around the world, which focussed on selecting Sustainable Land Management (SLM) options in close collaboration with stakeholders. To explore the role of process design and local context, we interviewed participants and facilitators in 11 case studies in Spain and Portugal in which different process designs were used. Interview data were analysed using a combination of quantitative and qualitative approaches to characterise relationships between process design, context and process outcomes. The similarity of outcomes across the 13 international study sites suggested that the national socio-cultural context in which a participatory process is conducted has little impact on its outcomes. However, analysis of cases from Spain and Portugal showed that some aspects of local context may affect outcomes. Having said this, factors associated with process design and participant selection played a more significant role in influencing outcomes in both countries. Processes that led to more beneficial outcomes for the environment and/or participants were likely to include: the legitimate representation of stakeholders; professional facilitation including structured methods for eliciting and aggregating information and

  2. Health Impact Assessment (HIA) and EnviroAtlas: Integrating Ecosystem Services into the Decision-Making Process-Guide

    EPA Science Inventory

    This document was created to highlight the many ways that the U.S. EPA EnviroAtlas suite of ecosystem services tools can be used to aid in the Health Impact Assessment (HIA) process. Ecosystems provide numerous services and benefits to individuals, communities, businesses, and ot...

  3. Experiential and Contextual Factors That Shape Engineering Interest and Educational Decision-Making Processes among Female Students

    ERIC Educational Resources Information Center

    Swan, Amy

    2015-01-01

    This qualitative study explores the formation of educational and vocational goals among female first-year engineering students at two community colleges and one four-year institution, as well as contextual influences on this process. Participants' pathways to college are also explored, as well as their pathways into engineering. The findings…

  4. Inertia and Decision Making.

    PubMed

    Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Li, Jiahui

    2016-01-01

    Decision inertia is the tendency to repeat previous choices independently of the outcome, which can give rise to perseveration in suboptimal choices. We investigate this tendency in probability-updating tasks. Study 1 shows that, whenever decision inertia conflicts with normatively optimal behavior (Bayesian updating), error rates are larger and decisions are slower. This is consistent with a dual-process view of decision inertia as an automatic process conflicting with a more rational, controlled one. We find evidence of decision inertia in both required and autonomous decisions, but the effect of inertia is more clear in the latter. Study 2 considers more complex decision situations where further conflict arises due to reinforcement processes. We find the same effects of decision inertia when reinforcement is aligned with Bayesian updating, but if the two latter processes conflict, the effects are limited to autonomous choices. Additionally, both studies show that the tendency to rely on decision inertia is positively associated with preference for consistency.

  5. When, where, why and with whom homeless women engage in risky sexual behaviors: A framework for understanding complex and varied decision-making processes

    PubMed Central

    Ryan, Gery W.; Stern, Stefanie A.; Hilton, Lara; Tucker, Joan S.; Kennedy, David P.; Golinelli, Daniela; Wenzel, Suzanne L.

    2010-01-01

    Impoverished women worldwide are at high risk for contracting HIV/AIDS. This study explores how homeless women make risky sex decisions and the role that alcohol and drugs play in this process. We analyze 56 in-depth qualitative descriptions of recent sexual episodes among 28 women living in shelters in Los Angeles, California, USA. The sample (age 18–63) was 46% African American, 21% Hispanic/Latina, and 21% white. Findings suggest that: (1) homeless women engage in multiple types of relationships and sexual behaviors; (2) emotion and attachment play critical roles in women’s risky sex choices; and (3) the role of alcohol and drugs on such choices varies across relationship commitment. Understanding the complexity of sexual decision-making among this population has implications for developing successful risk reduction interventions. PMID:20485467

  6. Using surveys in public participation processes for risk decision making: the case of the 2003 British GM Nation? Public debate.

    PubMed

    Pidgeon, Nick F; Poortinga, Wouter; Rowe, Gene; Jones, Tom-Horlick; Walls, John; O'Riordan, Tim

    2005-04-01

    This article takes as its case study the "GM Nation?" public debate, a major participation process on the commercialization of agricultural biotechnology, which occurred in Britain during the summer of 2003. We investigate possible self-selection biases in over 36,000 open questionnaire responses on the risks and benefits of genetically modified crops and food obtained during GM Nation? A comparison sample of equivalent responses from a statistically representative sample (n = 1,363) of the British general public obtained shortly after the conclusion of the debate is reported. This comparison shows that the GM Nation? open responses were indeed not fully representative of British "public opinion" regarding agricultural biotechnology. Rather, such opinion is not a unitary whole, but fragmented, with considerable ambivalence coexisting alongside outright opposition to GM agriculture. The methodological implications for multistage participation processes are discussed: in particular, the need to anticipate outcomes of complex design decisions, and to include representative public surveys as standard where measures of broader public attitudes to risk are an important objective.

  7. Inertia and Decision Making

    PubMed Central

    Alós-Ferrer, Carlos; Hügelschäfer, Sabine; Li, Jiahui

    2016-01-01

    Decision inertia is the tendency to repeat previous choices independently of the outcome, which can give rise to perseveration in suboptimal choices. We investigate this tendency in probability-updating tasks. Study 1 shows that, whenever decision inertia conflicts with normatively optimal behavior (Bayesian updating), error rates are larger and decisions are slower. This is consistent with a dual-process view of decision inertia as an automatic process conflicting with a more rational, controlled one. We find evidence of decision inertia in both required and autonomous decisions, but the effect of inertia is more clear in the latter. Study 2 considers more complex decision situations where further conflict arises due to reinforcement processes. We find the same effects of decision inertia when reinforcement is aligned with Bayesian updating, but if the two latter processes conflict, the effects are limited to autonomous choices. Additionally, both studies show that the tendency to rely on decision inertia is positively associated with preference for consistency. PMID:26909061

  8. Under the radar: how unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities.

    PubMed

    Dovidio, John F; Fiske, Susan T

    2012-05-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love-hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  9. Under the Radar: How Unexamined Biases in Decision-Making Processes in Clinical Interactions Can Contribute to Health Care Disparities

    PubMed Central

    Fiske, Susan T.

    2012-01-01

    Several aspects of social psychological science shed light on how unexamined racial/ethnic biases contribute to health care disparities. Biases are complex but systematic, differing by racial/ethnic group and not limited to love–hate polarities. Group images on the universal social cognitive dimensions of competence and warmth determine the content of each group's overall stereotype, distinct emotional prejudices (pity, envy, disgust, pride), and discriminatory tendencies. These biases are often unconscious and occur despite the best intentions. Such ambivalent and automatic biases can influence medical decisions and interactions, systematically producing discrimination in health care and ultimately disparities in health. Understanding how these processes may contribute to bias in health care can help guide interventions to address racial and ethnic disparities in health. PMID:22420809

  10. An expert system supporting decision making process for sustainable groundwater use in main alluvial aquifers in Slovenia

    NASA Astrophysics Data System (ADS)

    Souvent, Petra; Vižintin, Goran; Celarc, Sašo; Čenčur Curk, Barbara

    2016-04-01

    The expert decision support system for groundwater management in the shallow alluvial aquifers was developed to assist the decision makers to quantify available groundwater for a given alluvial aquifer and provide additional information about quantity of groundwater available for water rights licensing. The system links numerical groundwater flow models with the water permits and concessions databases in a complex decision support system. Six regional stand-alone groundwater models are used in the process of the assessment of groundwater quantitative status as well as for assessing availability of groundwater resources during the period of maximum water consumption and minimum groundwater recharge. Model runs have been realized in a steady state and are calibrated to a medium-low hydrological field conditions, because water quantities for all already granted as well as to-be granted water rights have to be ensured in any time for several years. The major goal of the expert decision support system is therefore to provide control mechanisms in order to verify the water rights licensing for the sustainable use of groundwater resources. The system enables that the water quantity data from water permits and concessions in conjunction with the results of numerical groundwater modeling are used in the managing process of granting new water rights to users in terms of their long-term access to groundwater (sufficient quantity of groundwater) and in relation to the water rights of other users (co-impact of groundwater pumping). Also, groundwater access must be managed in such a way that it does not cause unacceptable local impacts (pumping must not lower the water level for more than 2/3 of water body in the medium-low hydrological conditions).

  11. Development of a Transparent Interactive Decision Interrogator to Facilitate the Decision-Making Process in Health Care

    PubMed Central

    Bujkiewicz, Sylwia; Jones, Hayley E.; Lai, Monica C.W.; Cooper, Nicola J.; Hawkins, Neil; Squires, Hazel; Abrams, Keith R.; Spiegelhalter, David J.; Sutton, Alex J.

    2011-01-01

    Background Decisions about the use of new technologies in health care are often based on complex economic models. Decision makers frequently make informal judgments about evidence, uncertainty, and the assumptions that underpin these models. Objectives Transparent interactive decision interrogator (TIDI) facilitates more formal critique of decision models by decision makers such as members of appraisal committees of the National Institute for Health and Clinical Excellence in the UK. By allowing them to run advanced statistical models under different scenarios in real time, TIDI can make the decision process more efficient and transparent, while avoiding limitations on pre-prepared analysis. Methods TIDI, programmed in Visual Basic for applications within Excel, provides an interface for controlling all components of a decision model developed in the appropriate software (e.g., meta-analysis in WinBUGS and the decision model in R) by linking software packages using RExcel and R2WinBUGS. TIDI's graphical controls allow the user to modify assumptions and to run the decision model, and results are returned to an Excel spreadsheet. A tool displaying tornado plots helps to evaluate the influence of individual parameters on the model outcomes, and an interactive meta-analysis module allows the user to select any combination of available studies, explore the impact of bias adjustment, and view results using forest plots. We demonstrate TIDI using an example of a decision model in antenatal care. Conclusion Use of TIDI during the NICE appraisal of tumor necrosis factor-alpha inhibitors (in psoriatic arthritis) successfully demonstrated its ability to facilitate critiques of the decision models by decision makers. PMID:21839417

  12. Neural Basis of Strategic Decision Making.

    PubMed

    Lee, Daeyeol; Seo, Hyojung

    2016-01-01

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

  13. Decision making, risky behavior, and alcoholism.

    PubMed

    Camchong, Jazmin; Endres, Michael; Fein, George

    2014-01-01

    Alcoholism can be described as a disorder characterized by impulsive decision-making processes, wherein potential short-term appetitive outcomes of drinking (e.g., intoxication) are deemed more important than potential long-term aversive consequences of drinking (e.g., drunk-driving arrests). Separate but interrelated neurocognitive pathways to impulsive decision making exist - one reflected by weak "top-down" executive control over impulsive and compulsive urges to consume alcohol, the other reflected by a strong "bottom-up" appetitive drive in impulsive and compulsive urges to consume alcohol. We present behavioral evidence of poor executive control and strong appetitive drive and neural evidence describing differences in functional and organizational patterns in brain executive control and appetitive drive networks. We discuss how these behavioral and neural aspects of alcoholism are associated with impulsive decision making and risky behavior in alcoholics, and how these patterns differ at different stages of alcoholism dependence and recovery.

  14. The involvement of the striatum in decision making.

    PubMed

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

    2016-03-01

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

  15. The involvement of the striatum in decision making.

    PubMed

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

    2016-03-01

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

  16. The involvement of the striatum in decision making

    PubMed Central

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

    2016-01-01

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

  17. Heuristic decision making.

    PubMed

    Gigerenzer, Gerd; Gaissmaier, Wolfgang

    2011-01-01

    As reflected in the amount of controversy, few areas in psychology have undergone such dramatic conceptual changes in the past decade as the emerging science of heuristics. Heuristics are efficient cognitive processes, conscious or unconscious, that ignore part of the information. Because using heuristics saves effort, the classical view has been that heuristic decisions imply greater errors than do "rational" decisions as defined by logic or statistical models. However, for many decisions, the assumptions of rational models are not met, and it is an empirical rather than an a priori issue how well cognitive heuristics function in an uncertain world. To answer both the descriptive question ("Which heuristics do people use in which situations?") and the prescriptive question ("When should people rely on a given heuristic rather than a complex strategy to make better judgments?"), formal models are indispensable. We review research that tests formal models of heuristic inference, including in business organizations, health care, and legal institutions. This research indicates that (a) individuals and organizations often rely on simple heuristics in an adaptive way, and (b) ignoring part of the information can lead to more accurate judgments than weighting and adding all information, for instance for low predictability and small samples. The big future challenge is to develop a systematic theory of the building blocks of heuristics as well as the core capacities and environmental structures these exploit.

  18. Neuroethology of Decision-making

    PubMed Central

    Adams, Geoffrey K.; Watson, Karli K.; Pearson, John; Platt, Michael L.

    2012-01-01

    A neuroethological approach to decision-making considers the effect of evolutionary pressures on neural circuits mediating choice. In this view, decision systems are expected to enhance fitness with respect to the local environment, and particularly efficient solutions to specific problems should be conserved, expanded, and repurposed to solve other problems. Here, we discuss basic prerequisites for a variety of decision systems from this viewpoint. We focus on two of the best-studied and most widely represented decision problems. First, we examine patch leaving, a prototype of environmentally based switching between action patterns. Second, we consider social information seeking, a process resembling foraging with search costs. We argue that while the specific neural solutions to these problems sometimes differ across species, both the problems themselves and the algorithms instantiated by biological hardware are repeated widely throughout nature. The behavioral and mathematical study of ubiquitous decision processes like patch leaving and social information seeking thus provides a powerful new approach to uncovering the fundamental design structure of nervous systems. PMID:22902613

  19. Wildfire Decision Making Under Uncertainty

    NASA Astrophysics Data System (ADS)

    Thompson, M.

    2013-12-01

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

  20. Consumer Decision Making in a Global Context.

    ERIC Educational Resources Information Center

    Lusby, Linda A.

    This document examines the underlying rationale for the development of a global approach in consumer studies. The concept of consumer ethics is discussed and the consumer decision-making process is placed within an ecosystem perspective of the marketplace. The model developed introduces educators, marketers, and consumers to a more global…

  1. 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…

  2. 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…

  3. Cost Utility: An Aid to Decision Making.

    ERIC Educational Resources Information Center

    Costa, Crist H.

    A set of procedures were developed which assist in structuring tasks and objectives in a manner to permit rational decision making. The model uses a jury of experts to rank various objectives and program processes in terms of their importance. Values are generated which relate to costs in the form of a utility-cost ratio. The model was tested in a…

  4. Identity development, intelligence structure, and interests: a cross-sectional study in a group of Italian adolescents during the decision-making process

    PubMed Central

    Pellerone, Monica; Passanisi, Alessia; Bellomo, Mario Filippo Paolo

    2015-01-01

    Background Forming one’s identity is thought to be the key developmental task of adolescence, but profound changes in personality traits also occur in this period. The negotiation of complex social settings, the creation of an integrated identity, and career choice are major tasks of adolescence. The adolescent, having to make choices for his or her future, has not only to consider his or her own aspirations and interests but also to possess a capacity for exploration and commitment; in fact, career commitments can be considered as a fit between the study or career that is chosen and personal values, skills, and preferences. Methods The objective of the study reported here was to investigate the role of identity on profile of interests; the relation between identity and decisional style; the correlation between identity, aptitudes, interests, and school performance; and the predictive variables to school success. The research involved 417 Italian students who live in Enna, a small city located in Sicily, Italy, aged 16–19 years (197 males and 220 females) in the fourth year (mean =17.2, standard deviation =0.52) and the fifth year (mean =18.2, standard deviation =0.64) of senior secondary school. The research lasted for one school year; the general group of participants consisted of 470 students, and although all participants agreed to be part of the research, there was a dropout rate of 11.28%. They completed the Ego Identity Process Questionnaire to measure their identity development, the Intelligence Structure Test to investigate aptitudes, the Self-Directed Search to value interests, and General Decision Making Style questionnaire to describe their individual decisional style. Results The data showed that high-school performance was positively associated with rational decision-making style and identity diffusion predicted the use of avoidant style. Interests were related to identity exploration; the differentiation of preferences was related to identity

  5. A system of system lenses for leadership decision-making.

    PubMed

    Cady, Phil

    2016-01-01

    The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems.

  6. Decision Making in the Airplane

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  7. Substituted decision making: elder guardianship.

    PubMed

    Leatherman, Martha E; Goethe, Katherine E

    2009-11-01

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

  8. Weighing up the costs of seeking health care for dengue symptoms: a grounded theory study of backpackers' decision-making processes.

    PubMed

    Vajta, Bálint; Holberg, Mette; Mills, Jane; McBride, William J H

    2015-01-01

    Dengue fever, a mosquito-borne virus, is an ongoing public health issue in North Queensland. Importation of dengue fever by travellers visiting or returning to Australia can lead to epidemics. The mosquito can acquire the virus in the symptomatic viraemic phase, so timely recognition of cases is important to prevent epidemics. There is a gap in the literature about backpackers' knowledge of dengue fever and the decision-making process they use when considering utilising the Australian health-care system. This study uses grounded theory methods to construct a theory that explains the process backpackers use when seeking health care. Fifty semi-structured interviews with backpackers, hostel receptionists, travel agents and pharmacists were analysed, resulting in identification of a core category: 'weighing up the costs of seeking health care'. This core category has three subcategories: 'self-assessment of health status', 'wait-and-see' and 'seek direction'. Findings from this study identified key areas where health promotion material and increased access to health-care professionals could reduce the risk of backpackers spreading dengue fever. PMID:26509208

  9. A two-layered diffusion model traces the dynamics of information processing in the valuation-and-choice circuit of decision making.

    PubMed

    Piu, Pietro; Fargnoli, Francesco; Innocenti, Alessandro; Rufa, Alessandra

    2014-01-01

    A circuit of evaluation and selection of the alternatives is considered a reliable model in neurobiology. The prominent contributions of the literature to this topic are reported. In this study, valuation and choice of a decisional process during Two-Alternative Forced-Choice (TAFC) task are represented as a two-layered network of computational cells, where information accrual and processing progress in nonlinear diffusion dynamics. The evolution of the response-to-stimulus map is thus modeled by two linked diffusive modules (2LDM) representing the neuronal populations involved in the valuation-and-decision circuit of decision making. Diffusion models are naturally appropriate for describing accumulation of evidence over the time. This allows the computation of the response times (RTs) in valuation and choice, under the hypothesis of ex-Wald distribution. A nonlinear transfer function integrates the activities of the two layers. The input-output map based on the infomax principle makes the 2LDM consistent with the reinforcement learning approach. Results from simulated likelihood time series indicate that 2LDM may account for the activity-dependent modulatory component of effective connectivity between the neuronal populations. Rhythmic fluctuations of the estimate gain functions in the delta-beta bands also support the compatibility of 2LDM with the neurobiology of DM.

  10. A Two-Layered Diffusion Model Traces the Dynamics of Information Processing in the Valuation-and-Choice Circuit of Decision Making

    PubMed Central

    2014-01-01

    A circuit of evaluation and selection of the alternatives is considered a reliable model in neurobiology. The prominent contributions of the literature to this topic are reported. In this study, valuation and choice of a decisional process during Two-Alternative Forced-Choice (TAFC) task are represented as a two-layered network of computational cells, where information accrual and processing progress in nonlinear diffusion dynamics. The evolution of the response-to-stimulus map is thus modeled by two linked diffusive modules (2LDM) representing the neuronal populations involved in the valuation-and-decision circuit of decision making. Diffusion models are naturally appropriate for describing accumulation of evidence over the time. This allows the computation of the response times (RTs) in valuation and choice, under the hypothesis of ex-Wald distribution. A nonlinear transfer function integrates the activities of the two layers. The input-output map based on the infomax principle makes the 2LDM consistent with the reinforcement learning approach. Results from simulated likelihood time series indicate that 2LDM may account for the activity-dependent modulatory component of effective connectivity between the neuronal populations. Rhythmic fluctuations of the estimate gain functions in the delta-beta bands also support the compatibility of 2LDM with the neurobiology of DM. PMID:25254039

  11. Teaching Rational Decision-Making.

    ERIC Educational Resources Information Center

    Woolever, Roberts

    1978-01-01

    Presented is an outline of a college course, "Education in American Society," that focused on teaching students rational decision-making skills while examining current issues in American Education. The outline is followed by student comments, reactions, and evaluations of the course. (JMD)

  12. Ethical Decision Making: Basic Issues

    ERIC Educational Resources Information Center

    Bradley, Loretta J.; Hendricks, C. Bret

    2008-01-01

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

  13. Strategies for cellular decision-making

    PubMed Central

    Perkins, Theodore J; Swain, Peter S

    2009-01-01

    Stochasticity pervades life at the cellular level. Cells receive stochastic signals, perform detection and transduction with stochastic biochemistry, and grow and die in stochastic environments. Here we review progress in going from the molecular details to the information-processing strategies cells use in their decision-making. Such strategies are fundamentally influenced by stochasticity. We argue that the cellular decision-making can only be probabilistic and occurs at three levels. First, cells must infer from noisy signals the probable current and anticipated future state of their environment. Second, they must weigh the costs and benefits of each potential response, given that future. Third, cells must decide in the presence of other, potentially competitive, decision-makers. In this context, we discuss cooperative responses where some individuals can appear to sacrifice for the common good. We believe that decision-making strategies will be conserved, with comparatively few strategies being implemented by different biochemical mechanisms in many organisms. Determining the strategy of a decision-making network provides a potentially powerful coarse-graining that links systems and evolutionary biology to understand biological design. PMID:19920811

  14. Collective decision-making in microbes.

    PubMed

    Ross-Gillespie, Adin; Kümmerli, Rolf

    2014-01-01

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

  15. Collective decision-making in microbes

    PubMed Central

    Ross-Gillespie, Adin; Kümmerli, Rolf

    2014-01-01

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

  16. A conceptual model of family surrogate end-of-life decision-making process in the nursing home setting: goals of care as guiding stars.

    PubMed

    Bern-Klug, Mercedes

    2014-01-01

    An increasing proportion of dying is occurring in America's nursing homes (NH). Family members are involved in (and affected by) medical decision-making on behalf of NH residents approaching the end of life, especially when the resident is cognitively impaired. This article proposes an empirically derived conceptual model of the key factors NH family surrogate decision-makers consider when establishing or changing goals of care and the iterative process as applied to the NH setting. This model also establishes the importance of family social role expectations toward their loved one as well as the concept, "stance toward dying," as key in establishing or changing the main goal of care. NH staff and physicians can use the model as a framework for providing information and support to family members. Research is needed to better understand how to prepare staff and settings to support family surrogate decision-makers, in particular around setting goals of care. The model can be generalized beyond nursing homes.

  17. Social Equity Decision Making: Narrative Explorations with Elementary Teachers

    ERIC Educational Resources Information Center

    Fuxa, Robin Lynn

    2012-01-01

    In this critical postmodern narrative study, I explore with my participants their decision making process/es around social equity issues (race, class, gender, social class, sexual identity, religion, etc.) in their teaching. The purpose of this study is to facilitate a closer examination of this important decision making process--when and how to…

  18. Health, Trust, or “Just Understood”: Explicit and Implicit Condom Decision-Making Processes Among Black, White, and Interracial Same-Sex Male Couples

    PubMed Central

    Campbell, Chadwick K.; Gómez, Anu Manchikanti; Dworkin, Shari; Wilson, Patrick A.; Grisham, Kirk; McReynolds, Jaih; Vielehr, Peter; Hoff, Colleen

    2013-01-01

    Among gay and bisexual men, primary partners are a leading source of HIV infection. Trust, intimacy, and advancements in HIV treatment may impact same-sex male couples’ decisions to engage in unprotected anal intercourse (UAI). This qualitative study explored how Black, White and interracial couples discussed, and made decisions regarding condoms. Qualitative interviews were conducted with 48 same-sex male couples in the New York and San Francisco metropolitan areas. Stratified purposive sampling was used to include Black (n = 16), White (n = 17), and interracial (Black-White) (n = 15) couples. Twenty-six couples were concordant HIV-negative and 22 were HIV-discordant. Interviews were recorded, transcribed, coded, and analyzed using a grounded theory approach. Some couples described explicit processes, which involved active discussion, while others described implicit processes, where condom-use decisions occurred without any explicit discussion. These processes also differed by race and HIV status. Black couples tended to report condom-use as “just understood.” White, HIV-discordant couples decided not to use condoms, with some identifying the HIV-positive partner’s suppressed viral load and high CD4 count as deciding factors. After an unplanned episode of UAI, White, HIV-negative couples tended to discontinue condom use while Black HIV-negative couples decided to revert to using condoms. HIV prevention efforts focused on same-sex, male couples must consider the explicit/implicit nature of condom decision-making processes. Understanding differences in these processes and considering relationship dynamics, across race and HIV status, can promote the development of innovative couple–level, HIV prevention interventions. PMID:23912774

  19. Considering Risk and Resilience in Decision-Making

    NASA Technical Reports Server (NTRS)

    Torres-Pomales, Wilfredo

    2015-01-01

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

  20. Knowledge Utilization and Power in University Decision Making.

    ERIC Educational Resources Information Center

    Guskin, Alan E.

    1980-01-01

    Information use in senior-level university decision-making councils involves organizational, interpersonal, and individual processes. Leadership styles emphasizing a group-process team approach to decision making are best for utilizing information to form policy. (Available from: Jossey-Bass, Inc. 433 California St., San Francisco, CA 94104,…

  1. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    PubMed

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

  2. An Assessment of Decision-Making Processes: The Feasibility of Incorporating Climate Change Information into Land Protection Planning (External Review Draft)

    EPA Science Inventory

    This report was prepared by the Global Change Research Program (GCRP) in the National Center for Environmental Assessment (NCEA) of the Office of Research and Development (ORD) at the U.S. Environmental Protection Agency (EPA). This draft report is a review of decision-making pro...

  3. Operationalizing Consumer Decision Making and Choice in the VR Process. Institute on Rehabilitation Issues (21st, Baltimore, Maryland, March 1995). Report from the Study Group.

    ERIC Educational Resources Information Center

    Fry, Ronald R., Ed.

    This document is the product of meetings of the Prime Study Group of the Institute on Rehabilitation Issues, whose mission was to: examine consumer choice and decision making in rehabilitation; review the legislation and consumer movements leading to greater consumer choice; identify the roles and responsibilities of the consumer, the counselor,…

  4. The role of additional computed tomography in the decision-making process on the secondary prevention in patients after systemic cerebral thrombolysis

    PubMed Central

    Sobolewski, Piotr; Kozera, Grzegorz; Szczuchniak, Wiktor; Nyka, Walenty M

    2016-01-01

    Introduction Patients with ischemic stroke undergoing intravenous (iv)-thrombolysis are routinely controlled with computed tomography on the second day to assess stroke evolution and hemorrhagic transformation (HT). However, the benefits of an additional computed tomography (aCT) performed over the next days after iv-thrombolysis have not been determined. Methods We retrospectively screened 287 Caucasian patients with ischemic stroke who were consecutively treated with iv-thrombolysis from 2008 to 2012. The results of computed tomography performed on the second (control computed tomography) and seventh (aCT) day after iv-thrombolysis were compared in 274 patients (95.5%); 13 subjects (4.5%), who died before the seventh day from admission were excluded from the analysis. Results aCTs revealed a higher incidence of HT than control computed tomographies (14.2% vs 6.6%; P=0.003). Patients with HT in aCT showed higher median of National Institutes of Health Stroke Scale score on admission than those without HT (13.0 vs 10.0; P=0.01) and higher presence of ischemic changes >1/3 middle cerebral artery territory (66.7% vs 35.2%; P<0.01). Correlations between presence of HT in aCT and National Institutes of Health Stroke Scale score on admission (rpbi 0.15; P<0.01), and the ischemic changes >1/3 middle cerebral artery (phi=0.03) existed, and the presence of HT in aCT was associated with 3-month mortality (phi=0.03). Conclusion aCT after iv-thrombolysis enables higher detection of HT, which is related to higher 3-month mortality. Thus, patients with severe middle cerebral artery infarction may benefit from aCT in the decision-making process on the secondary prophylaxis. PMID:26730196

  5. Nicotinic alteration of decision-making.

    PubMed

    Naudé, Jérémie; Dongelmans, Malou; Faure, Philippe

    2015-09-01

    Addiction to nicotine is characterized by impulses, urges and lack of self-control towards cigarettes. A key element in the process of addiction is the development of habits oriented towards nicotine consumption that surpass flexible systems as a consequence of a gradual adaptation to chronic drug exposure. However, the long-term effects of nicotine on brain circuits also induce wide changes in decision-making processes, affecting behaviors unrelated to cigarettes. This review aims at providing an update on the implications of nicotine on general decision-making processes, with an emphasis on impulsivity and risk-taking. As impulsivity is a rather ambiguous behavioral trait, we build on economic and normative theories to better characterize these nicotine-induced alterations in decision-making. Nonetheless, experimental data are sparse and often contradictory. We will discuss how the latest findings on the neurobiological basis of choice behavior may help disentangling these issues. We focus on the role of nicotine acetylcholine receptors and their different subunits, and on the spatio-temporal dynamics (i.e. diversity of the neural circuits, short- and long-term effects) of both endogenous acetylcholine and nicotine action. Finally, we try to link these neurobiological results with neuro-computational models of attention, valuation and action, and of the role of acetylcholine in these decision processes. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'. PMID:25498234

  6. Nicotinic alteration of decision-making.

    PubMed

    Naudé, Jérémie; Dongelmans, Malou; Faure, Philippe

    2015-09-01

    Addiction to nicotine is characterized by impulses, urges and lack of self-control towards cigarettes. A key element in the process of addiction is the development of habits oriented towards nicotine consumption that surpass flexible systems as a consequence of a gradual adaptation to chronic drug exposure. However, the long-term effects of nicotine on brain circuits also induce wide changes in decision-making processes, affecting behaviors unrelated to cigarettes. This review aims at providing an update on the implications of nicotine on general decision-making processes, with an emphasis on impulsivity and risk-taking. As impulsivity is a rather ambiguous behavioral trait, we build on economic and normative theories to better characterize these nicotine-induced alterations in decision-making. Nonetheless, experimental data are sparse and often contradictory. We will discuss how the latest findings on the neurobiological basis of choice behavior may help disentangling these issues. We focus on the role of nicotine acetylcholine receptors and their different subunits, and on the spatio-temporal dynamics (i.e. diversity of the neural circuits, short- and long-term effects) of both endogenous acetylcholine and nicotine action. Finally, we try to link these neurobiological results with neuro-computational models of attention, valuation and action, and of the role of acetylcholine in these decision processes. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'.

  7. Has Lean improved organizational decision making?

    PubMed

    Simons, Pascale; Benders, Jos; Bergs, Jochen; Marneffe, Wim; Vandijck, Dominique

    2016-06-13

    Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability. PMID:27256776

  8. Has Lean improved organizational decision making?

    PubMed

    Simons, Pascale; Benders, Jos; Bergs, Jochen; Marneffe, Wim; Vandijck, Dominique

    2016-06-13

    Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability.

  9. Making tough choices: HIV ethical decision making.

    PubMed

    1999-05-01

    A panel of the American Psychological Association (APA) has developed a simple, user friendly process to facilitate ethical and clinical decision making in cases involving HIV disease. The model is based on the five ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice. This article examines how the model could be applied to a hypothetical case of a private practice client and his therapist. The ethical question in this case concerns whether to reveal a patient's serostatus to his wife.

  10. How social cognition can inform social decision making.

    PubMed

    Lee, Victoria K; Harris, Lasana T

    2013-01-01

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

  11. How social cognition can inform social decision making

    PubMed Central

    Lee, Victoria K.; Harris, Lasana T.

    2013-01-01

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

  12. "I'm Keeping Those There, Are You?": The Role of a New User Interface Paradigm--Separate Control of Shared Space (SCOSS)--in the Collaborative Decision-Making Process

    ERIC Educational Resources Information Center

    Kerawalla, Lucinda; Pearce, Darren; Yuill, Nicola; Luckin, Rosemary; Harris, Amanda

    2008-01-01

    We take a socio-cultural approach to comparing how dual control of a new user interface paradigm--Separate Control of Shared Space (SCOSS)--and dual control of a single user interface can work to mediate the collaborative decision-making process between pairs of children carrying out a multiple categorisation word task on a shared computer.…

  13. An Instructional System for Consumer Decision-Making: Teacher's Manual.

    ERIC Educational Resources Information Center

    Suchman, J. Richard; DiSario, Martha R.

    An instructional system is presented for building the competencies of adult basic education students in making consumer decisions, and offers a guide to teachers who wish to design their own decision-making problems for students. The first four chapters provide a brief introduction, discuss the rational consumer decision-making process and the…

  14. The Cyclical Nature of Decision Making: An Exploratory Empirical Investigation.

    ERIC Educational Resources Information Center

    Segal, Uma A.

    1982-01-01

    Examined whether different levels of task complexity result in variations in group decision making. Groups (N=7) discussed problems varying in levels of complexity. Findings suggested that group decision making is a cyclical process with the number of cycles affected by task complexity. (RC)

  15. Aging and the neuroeconomics of decision making: A review.

    PubMed

    Brown, Stephen B R E; Ridderinkhof, K Richard

    2009-12-01

    Neuroeconomics refers to a combination of paradigms derived from neuroscience, psychology, and economics for the study of decision making and is an area that has received considerable scientific attention in the recent literature. Using realistic laboratory tasks, researchers seek to study the neurocognitive processes underlying economic decision making and outcome-based decision learning, as well as individual differences in these processes and the social and affective factors that modulate them. To this point, one question has remained largely unanswered: What happens to decision-making processes and their neural substrates during aging? After all, aging is associated with neurocognitive change, which may affect outcome-based decision making. In our study, we use the subjective expected utility model-a well-established decision-making model in economics-as a descriptive framework. After a short survey of the brain areas and neurotransmitter systems associated with outcome-based decision making-and of the effects of aging thereon-we review a number of decision-making studies. Their general data pattern indicates that the decision-making process is changed by age: The elderly perform less efficiently than younger participants, as demonstrated, for instance, by the smaller total rewards that the elderly acquire in lab tasks. These findings are accounted for in terms of age-related deficiencies in the probability and value parameters of the subjective expected utility model. Finally, we discuss some implications and suggestions for future research.

  16. Decision-Making Involvement of Individuals with Dementia

    ERIC Educational Resources Information Center

    Menne, Heather L.; Whitlatch, Carol J.

    2007-01-01

    Purpose: Research underscores how autonomy and decision-making involvement may help to enhance the quality of life of older adults; however, individuals with dementia are often excluded from decision making that is related to their daily functioning. In this study we use a modified version of the Stress Process Model to consider the stress process…

  17. Stress in Decision-Making: Three Causes, Three Cures.

    ERIC Educational Resources Information Center

    Bates, Don

    This paper is a brief description of a conference presentation consisting of a 2.5-hour clinic session on decision-making. A motion picture, "The Making of a Decision," followed by a lively discussion, was used to illustrate the strenghts and weaknesses of administrators in their decision-making process. Presented in the film are three different…

  18. Decision Technology Systems: A Vehicle to Consolidate Decision Making Support.

    ERIC Educational Resources Information Center

    Forgionne, Guisseppi A.

    1991-01-01

    Discussion of management decision making and the support needed to manage successfully highlights a Decision Technology System (DTS) that integrates other information systems. Topics discussed include computer information systems (CISs); knowledge gateways; the decision-making process; decision support systems (DSS); expert systems; and facility…

  19. Zeno's paradox in decision-making.

    PubMed

    Yearsley, James M; Pothos, Emmanuel M

    2016-04-13

    Classical probability theory has been influential in modelling decision processes, despite empirical findings that have been persistently paradoxical from classical perspectives. For such findings, some researchers have been successfully pursuing decision models based on quantum theory (QT). One unique feature of QT is the collapse postulate, which entails that measurements (or in decision-making, judgements) reset the state to be consistent with the measured outcome. If there is quantum structure in cognition, then there has to be evidence for the collapse postulate. A striking, a prioriprediction, is that opinion change will be slowed down (under idealized conditions frozen) by continuous judgements. In physics, this is the quantum Zeno effect. We demonstrate a quantum Zeno effect in decision-making in humans and so provide evidence that advocates the use of quantum principles in decision theory, at least in some cases. PMID:27053743

  20. Involving the motor system in decision making.

    PubMed

    Wyss, Reto; König, Peter; Verschure, Paul F M J

    2004-02-01

    The control of behaviour is usually understood in terms of three distinct components: sensory processing, decision making and movement control. Recently, this view has been questioned on the basis of physiological and behavioural data, blurring the distinction between these three stages. This raises the question to what extent the motor system itself can contribute to the interpretation of behavioural situations. To investigate this question we use a neural model of sensory motor integration applied to a behaving mobile robot performing a navigation task. We show that the population response of the motor system provides a substrate for the categorization of behavioural situations. This categorization allows for the assessment of the complexity of a behavioural situation and regulates whether higher-level decision making is required to resolve behavioural conflicts. Our model lends credence to an emerging reconceptualization of behavioural control where the motor system can be considered as part of a high-level perceptual system.

  1. Clinical decision making of nurses working in hospital settings.

    PubMed

    Bjørk, Ida Torunn; Hamilton, Glenys A

    2011-01-01

    This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

  2. Better clinical decision making and reducing diagnostic error.

    PubMed

    Croskerry, P; Nimmo, G R

    2011-06-01

    A major amount of our time working in clinical practice involves thinking and decision making. Perhaps it is because decision making is such a commonplace activity that it is assumed we can all make effective decisions. However, this is not the case and the example of diagnostic error supports this assertion. Until quite recently there has been a general nihilism about the ability to change the way that we think, but it is now becoming accepted that if we can think about, and understand, our thinking processes we can improve our decision making, including diagnosis. In this paper we review the dual process model of decision making and highlight ways in which decision making can be improved through the application of this model to our day-to-day practice and by the adoption of de-biasing strategies and critical thinking. PMID:21677922

  3. Simulation of human decision making

    DOEpatents

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

    2008-05-06

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

  4. Reverse mortgage decision-making.

    PubMed

    Leviton, R

    2001-01-01

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

  5. Venture Capital Investment Selection Decision-making Base on Fuzzy Theory

    NASA Astrophysics Data System (ADS)

    Zhang, Xubo

    Venture capital investment decision-making is the most important issue in venture capital investment selection. There are higher uncertainty and complexity in venture capital investment decision-making process. This paper analysis these uncertain risk in venture capital investment decision-making base the previous studies. Attributed the venture capital candidate firms' select to fuzzy optimal decision-making. Build a risk-weight fuzzy optimal return model to avoid the decision-making risk. Get the optimal solution set.

  6. The analytic network process for the pharmaceutical sector: Multi criteria decision making to select the suitable method for the preparation of nanoparticles

    PubMed Central

    2012-01-01

    Background This paper presents the methodology for assessing and selecting the most appropriate procedure for the preparation of nanoparticles by implementing the analytical network process. The commonly utilized nanoparticle preparation methods are Polymer Precipitation, Interfacial polymer deposition, Complex Coacervation, Cross linking, Emulsion solvent diffusion, Homogenization and Polymerization method. There are numerous parameters to be considered in groundwork of nanoparticles that departs the conclusion manufacturer in bias. One has to address a number of components in alignment to determine and choose the optimum conclusion choices, because an unsuitable conclusion could lead to the eventual merchandise having to be formulated and developed again. For this cause in this paper, we study selecting the most appropriate procedure for the preparation of nanoparticles utilizing one of the multi criteria-decision making techniques, Analytic Network Process. Methodology The main goal was determined. The criteria and sub-criteria that affect the main goal were determined. The alternatives for the problem were determined. The interactions between criteria, sub-criteria, and alternatives respect to the main goal were determined. The super matrixes according to the network were assembled and then weighted super matrix and limit super matrix were then constructed. The values of this limit matrix are the desired priorities of the elements with respect to the goal. The alterative with the highest priority was finally chosen as the best alternative. Results The emulsion solvent diffusion technique (M-5) has the highest value (0.434379) among the alternative methods that are applicable to the preparation of the nanoparticles. The second highest is Polymer Precipitation (M-1) with a value of 0.178798, and the lowest value or last choice is Cross Linking (M-4) with a value of only 0.024516. The alternative with the highest priority would achieve the goal, i.e., the best

  7. “I didn’t even know what I was looking for”: A qualitative study of the decision-making processes of Canadian medical tourists

    PubMed Central

    2012-01-01

    Background Medical tourism describes the private purchase and arrangement of medical care by patients across international borders. Increasing numbers of medical facilities in countries around the world are marketing their services to a receptive audience of international patients, a phenomenon that has largely been made possible by the growth of the Internet. The growth of the medical tourism industry has raised numerous concerns around patient safety and global health equity. In spite of these concerns, there is a lack of empirical research amongst medical tourism stakeholders. One such gap is a lack of engagement with medical tourists themselves, where there is currently little known about how medical tourists decide to access care abroad. We address this gap through examining aspects of Canadian medical tourists’ decision-making processes. Methods Semi-structured phone interviews were administered to 32 Canadians who had gone abroad as medical tourists. Interviews touched on motivations, assessment of risks, information seeking processes, and experiences at home and abroad. A thematic analysis of the interview transcripts followed. Results Three overarching themes emerged from the interviews: (1) information sources consulted; (2) motivations, considerations, and timing; and (3) personal and professional supports drawn upon. Patient testimonials and word of mouth connections amongst former medical tourists were accessed and relied upon more readily than the advice of family physicians. Neutral, third-party information sources were limited, which resulted in participants also relying on medical tourism facilitators and industry websites. Conclusions While Canadian medical tourists are often thought to be motivated by wait times for surgery, cost and availability of procedures were common primary and secondary motivations for participants, demonstrating that motivations are layered and dynamic. The findings of this analysis offer a number of important factors

  8. Toxicology in business decision making.

    PubMed

    Deisler, P F

    1982-12-01

    More than ever before, toxicology and its sister health sciences and technologies are needed as members of the business team to ensure sound business decision making for both new and existing businesses. Yet the marriage of toxicology and business is an uneasy one since toxicology is both the bringer of bad news and a major resource for the solution of problems. Both business and toxicology have much to learn about each other to make the marriage work and to make full use of toxicology's scientific advice in reaching sound decisions on the safe production, distribution, and handling of a company's products. Toxicology also has a central and difficult role in helping business navigate the turbulent waters of regulation or of potential or actual litigation. From his own experience in organizing a corporate health, safety, and environmental department, the author describes the concepts that must be understood and the marshaling of resources needed to ensure that toxicology can play its full role in business decision making.

  9. Causal evidence for frontal cortex organization for perceptual decision making

    PubMed Central

    Nee, Derek Evan; Riddle, Justin; Larson, Alina Sue; D’Esposito, Mark

    2016-01-01

    Although recent research has shown that the frontal cortex has a critical role in perceptual decision making, an overarching theory of frontal functional organization for perception has yet to emerge. Perceptual decision making is temporally organized such that it requires the processes of selection, criterion setting, and evaluation. We hypothesized that exploring this temporal structure would reveal a large-scale frontal organization for perception. A causal intervention with transcranial magnetic stimulation revealed clear specialization along the rostrocaudal axis such that the control of successive stages of perceptual decision making was selectively affected by perturbation of successively rostral areas. Simulations with a dynamic model of decision making suggested distinct computational contributions of each region. Finally, the emergent frontal gradient was further corroborated by functional MRI. These causal results provide an organizational principle for the role of frontal cortex in the control of perceptual decision making and suggest specific mechanistic contributions for its different subregions. PMID:27162349

  10. Couple Decision Making and Use of Cultural Scripts in Malawi

    PubMed Central

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

    2011-01-01

    Purpose 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. Methods 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. Findings 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. Conclusions Nongender based cultural scripts to encourage shared decision making can be used in designing culturally tailored reproductive health interventions for couples. Clinical Relevance 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. PMID:18302586

  11. Decision making: rational or hedonic?

    PubMed Central

    Cabanac, Michel; Bonniot-Cabanac, Marie-Claude

    2007-01-01

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

  12. Ethics of everyday decision making.

    PubMed

    Kearney, Gina; Penque, Sue

    2012-04-01

    Evidence suggests that checklists can prevent episodes of patient harm and they are increasingly being used in patient care to ensure that procedures are being carried out. However, checklists cannot do so alone and in some situations the checklist might indicate that an intervention has been undertaken when it has not. Healthcare providers, particularly nurses, must consider not only the increase in the use of checklists, but also the way in which they present a context for ethical decision making. This article examines the ethical dimensions of using checklists, played out in the context of a scenario, and suggests that failure to take ethics into account when considering checklists might perpetuate rather than prevent unsafe practices or errors. The article is set in a US context, but the issues are relevant to healthcare settings in any part of the world.

  13. Crew decision making under stress

    NASA Technical Reports Server (NTRS)

    Orasanu, J.

    1992-01-01

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

  14. Reengineering a surgical service line: focusing on core process improvement.

    PubMed

    Kelly, D L; Pestotnik, S L; Coons, M C; Lelis, J W

    1997-01-01

    Integrating principles from a variety of theory has led to the development of a conceptual framework for reengineering in a clinical care delivery setting to improve the value of services provided to the customer. A conceptual framework involving the identification of three high level core processes to reengineer can provide clarity and focus for clinicians to begin directing reengineering efforts. Those core processes are: clinical management of the patient's medical needs, patient operational processes to support the clinical processes, and administrative decision-making processes to support the implementation of the clinical and operational processes. Improvement in any one of these areas has the potential to increase value, but the concurrent targeting of these core processes for reengineering has provided a synergy that has accelerated the achievement of the desired outcomes in the area of surgical services. PMID:9161059

  15. Facets of Career Decision-Making Difficulties

    ERIC Educational Resources Information Center

    Amir, Tami; Gati, Itamar

    2006-01-01

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

  16. Graphic Representations as Tools for Decision Making.

    ERIC Educational Resources Information Center

    Howard, Judith

    2001-01-01

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

  17. Status of dual control theory. [stochastic decision making

    NASA Technical Reports Server (NTRS)

    Tse, E.

    1975-01-01

    Theoretical studies of decision making and stochastic processes are discussed. Several approaches are described for an improved performing control method. It is shown that control performance is highly dependent on the knowledge of the unknown parameters in the system.

  18. Intergenerational risk decision making: a practical example.

    PubMed

    Kadak, A C

    2000-12-01

    There is no such thing as intergenerational decision making, at least not yet. In fact, there is no such thing as intragenerational decision making in the context of maximizing overall social good given resource limitations, there are just decisions being made in an ad hoc fashion. Even if one assumes that there is such a thing as intragenerational decision making, no uniform standard or guidance exists to make societal decisions for the common good. Risks to society are judged unevenly within the same agency and across agencies. Decisions are made in isolation and not weighed in the societal context of what is intra or intergenerationally important. The National Academy of Public Administration (NAPA) has set forth a framework for intergenerational decision making that provides a consistent and fair basis for making tough decisions in order to address difficult issues such as the long-term disposal of nuclear wastes. NAPA recognizes that there is an intergenerational obligation that must encompass broader questions than the narrow issue of waste disposal since resources are finite and needs are great. The fundamental principles are based on sustainability with the overarching objective that "no generation should needlessly, now or in the future, deprive its successors of the opportunity to enjoy a quality of life equivalent to its own." Coupled with this objective are four supporting principles of trusteeship, sustainability, chain of obligation, and precaution. The NAPA process also recognizes that no decision can be final and that a "rolling future" view is better than making decisions for "all time." It attempts to balance the needs of the present with those of the future in an open and transparent process that is aimed at producing a decision, not just endless analysis. The U.S. Congress and president should develop a rational standard by which to judge laws that involve intra and intergenerational issues relative to the overall societal good. Present

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

    NASA Technical Reports Server (NTRS)

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

    1995-01-01

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

  20. Decision-making mechanisms in the brain

    NASA Astrophysics Data System (ADS)

    Deco, Gustavo; Rolls, Edmund T.

    2007-02-01

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

  1. The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level

    PubMed Central

    Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

    2016-01-01

    This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico. PMID:27128933

  2. The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level.

    PubMed

    Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

    2016-04-27

    This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico.

  3. The Role of Science in Advising the Decision Making Process: A Pathway for Building Effective Climate Change Mitigation Policies in Mexico at the Local Level.

    PubMed

    Barraza, Roberto; Velazquez-Angulo, Gilberto; Flores-Tavizón, Edith; Romero-González, Jaime; Huertas-Cardozo, José Ignacio

    2016-01-01

    This study examines a pathway for building urban climate change mitigation policies by presenting a multi-dimensional and transdisciplinary approach in which technical, economic, environmental, social, and political dimensions interact. Now, more than ever, the gap between science and policymaking needs to be bridged; this will enable judicious choices to be made in regarding energy and climate change mitigation strategies, leading to positive social impacts, in particular for the populations at-risk at the local level. Through a case study in Juarez, Chihuahua, Mexico, we propose a multidimensional and transdisciplinary approach with the role of scientist as policy advisers to improve the role of science in decision-making on mitigation policies at the local level in Mexico. PMID:27128933

  4. Incorporating environmental justice into environmental decision making

    SciTech Connect

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

    1995-07-01

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

  5. Decision-Making Theories and Career Assessment: A Psychometric Evaluation of the Decision Making Inventory

    ERIC Educational Resources Information Center

    Hardin, Erin E.; Leong, Frederick T. L.

    2004-01-01

    To address criticisms that the empirical literature on assessment of career decision making has tended to lack a theoretical base, the present study explored the relevance of a general theory of decision making to career decision making by assessing the psychometric properties of the Decision Making Inventory (DMI), designed to measure Johnson's…

  6. Instructional decision making of high school science teachers

    NASA Astrophysics Data System (ADS)

    Carver, Jeffrey S.

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

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

    PubMed

    Unguru, Yoram

    2011-08-01

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

  8. Decision making in bipolar disorder: a cognitive modeling approach.

    PubMed

    Yechiam, Eldad; Hayden, Elizabeth P; Bodkins, Misty; O'Donnell, Brian F; Hetrick, William P

    2008-11-30

    A formal modeling approach was used to characterize decision-making processes in bipolar disorder. Decision making was examined in 28 bipolar patients (14 acute and 14 remitted) and 25 controls using the Iowa Gambling Task (Bechara et al., 1994), a decision-making task used for assessing cognitive impulsivity. To disentangle motivational and cognitive aspects of decision-making processes, we applied a formal cognitive model to the performance on the Iowa Gambling Task. The model has three parameters: The relative impact of rewards and punishments on evaluations, the impact of recent and past payoffs, and the degree of choice consistency. The results indicated that acute bipolar patients were characterized by low choice consistency, or a tendency to make erratic choices. Low choice consistency improved the prediction of acute bipolar disorder beyond that provided by cognitive functioning and self-report measures of personality and temperament. PMID:18848361

  9. Decision making in bipolar disorder: a cognitive modeling approach.

    PubMed

    Yechiam, Eldad; Hayden, Elizabeth P; Bodkins, Misty; O'Donnell, Brian F; Hetrick, William P

    2008-11-30

    A formal modeling approach was used to characterize decision-making processes in bipolar disorder. Decision making was examined in 28 bipolar patients (14 acute and 14 remitted) and 25 controls using the Iowa Gambling Task (Bechara et al., 1994), a decision-making task used for assessing cognitive impulsivity. To disentangle motivational and cognitive aspects of decision-making processes, we applied a formal cognitive model to the performance on the Iowa Gambling Task. The model has three parameters: The relative impact of rewards and punishments on evaluations, the impact of recent and past payoffs, and the degree of choice consistency. The results indicated that acute bipolar patients were characterized by low choice consistency, or a tendency to make erratic choices. Low choice consistency improved the prediction of acute bipolar disorder beyond that provided by cognitive functioning and self-report measures of personality and temperament.

  10. Collaborative decision making for sustainable development

    SciTech Connect

    Kinsley, M.J.

    1995-12-31

    For many years, economic development has mean industrial recruitment where business-at-any-cost was preached by a small elite, where civic discord replaced civic discussion, where families made more money but had less to spend, where residents learned to lock their doors, where communities changed from the unique to commonplace and a thousand towns looked alike. But now, scores of communities are saying no to old, worn-out approaches to development and embracing a new kind of development that respects the community and the environment. Created collaboratively by people from all walks of community life, this new approach is called sustainable community economic development. Though new, sustainable development is based on traditional values of stewardship and working together. Its principles are powerful in their simplicity. Its lessons enrich community decision making. This paper describes these principles and lessons. It introduces a community decision-making process that applies them and suggests the kinds of results you can expect from such a process in your town.

  11. Naturalistic Decision Making For Power System Operators

    SciTech Connect

    Greitzer, Frank L.; Podmore, Robin; Robinson, Marck; Ey, Pamela

    2009-06-23

    Abstract: Motivation -- As indicated by the Blackout of 2003, the North American interconnected electric system is vulnerable to cascading outages and widespread blackouts. Investigations of large scale outages often attribute the causes to the three T’s: Trees, Training and Tools. A systematic approach has been developed to document and understand the mental processes that an expert power system operator uses when making critical decisions. The approach has been developed and refined as part of a capability demonstration of a high-fidelity real-time power system simulator under normal and emergency conditions. To examine naturalistic decision making (NDM) processes, transcripts of operator-to-operator conversations are analyzed to reveal and assess NDM-based performance criteria. Findings/Design -- The results of the study indicate that we can map the Situation Awareness Level of the operators at each point in the scenario. We can also identify clearly what mental models and mental simulations are being performed at different points in the scenario. As a result of this research we expect that we can identify improved training methods and improved analytical and visualization tools for power system operators. Originality/Value -- The research applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message -- The NDM approach provides an ideal framework for systematic training management and mitigation to accelerate learning in team-based training scenarios with high-fidelity power grid simulators.

  12. The hidden traps in decision making.

    PubMed

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

    1999-01-01

    Bad decisions can often be traced back to the way the decisions were made--the alternatives were not clearly defined, the right information was not collected, the costs and benefits were not accurately weighed. But sometimes the fault lies not in the decision-making process but rather in the mind of the decision maker. The way the human brain works can sabotage the choices we make. Eight psychological traps that are particularly likely to affect the way we make business decisions are examined. The anchoring trap leads us to give disproportionate weight to the first information we receive. The status-quo trap biases us toward maintaining the current situation--even when better alternatives exist. The sunk-cost trap inclines us to perpetuate the mistakes of the past. The confirming-evidence trap leads us to seek out information supporting an existing predilection and to discount opposing information. The framing trap occurs when we misstate a problem, undermining the entire decision-making process. The overconfidence trap makes us over-estimate the accuracy of our forecasts. The prudence trap leads us to be overcautious when we make estimates about uncertain events. And the recallability trap leads us to give undue weight to recent, dramatic events. The best way to avoid all the traps is awareness--forewarned is forearmed. The authors show how to take action to ensure that important business decisions are sound and reliable.

  13. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    PubMed

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care. PMID:21391078

  14. [Decision making: biological bases and limitations].

    PubMed

    Portera Sánchez, A

    2000-01-01

    In the human brain, simple molecules and complex circuits are constantly making decisions which are indispensable for our survival and also to accomplish a variety of daily activities such as walking, memorizing, conversing, composing music, painting or poetry.... All are the result of the integration of many neural systems that perceive many and simultaneous visual, tactile, auditory and/or mental stimuli. Once synthetized, they are immediately transmitted to the corresponding executive systems, thus completing the fascinating functional loop of decision-making: a) perception of stimuli or information which originate in the environment, b) selection and elaboration of the decision which is considered more appropriate or attractive according to personal experience or intuition and c) execution. If these neural nets have been damaged or haven failed to develop the mechanisms of facilitation or inhibition that govern them become unbalanced. If inhibition is reduced, excessive and violent behaviour is expressed as in patients suffering from manic phases. Conversely, if inhibition is excessive, decision making mechanisms are not operative. In either case, behaviour is not "reasonable" and does not follow prototypical patterns. All these processes must be the consequence of a constant molecular activity full of micro-decisions whose effectiveness depends on the histological and biochemical integrity of the neurons. This microenvironment is responsible for all types of decisions of all forms of life and represents one of the fundamental successes of evolution.

  15. Naturalistic Decision Making for Power System Operators

    SciTech Connect

    Greitzer, Frank L.; Podmore, Robin; Robinson, Marck; Ey, Pamela

    2010-02-01

    Motivation – Investigations of large-scale outages in the North American interconnected electric system often attribute the causes to three T’s: Trees, Training and Tools. To document and understand the mental processes used by expert operators when making critical decisions, a naturalistic decision making (NDM) model was developed. Transcripts of conversations were analyzed to reveal and assess NDM-based performance criteria. Findings/Design – An item analysis indicated that the operators’ Situation Awareness Levels, mental models, and mental simulations can be mapped at different points in the training scenario. This may identify improved training methods or analytical/ visualization tools. Originality/Value – This study applies for the first time, the concepts of Recognition Primed Decision Making, Situation Awareness Levels and Cognitive Task Analysis to training of electric power system operators. Take away message – The NDM approach provides a viable framework for systematic training management to accelerate learning in simulator-based training scenarios for power system operators and teams.

  16. Neurobiology of Decision-Making in Adolescents

    PubMed Central

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

    2010-01-01

    The study examined the relationship between risk-taking behavior during selection of monetary rewards and activations in the anterior cingulate cortex (ACC), orbitofrontal cortex (OFC) and medial prefrontal cortex (mPFC), brain regions that are associated with decision-making. Thirty-three adolescents with no personal or family history of any psychiatric illness were administered the Wheel of Fortune (WOF) task using a functional magnetic resonance imaging protocol. The WOF is a computerized two-choice, probabilistic monetary reward task. Selection of a reward, particularly a low-probability/high-magnitude reward choice, induced greater activations in dorsal ACC, ventrolateral OFC and mPFC than the control condition. Although similar findings have been reported by earlier studies, the results from this study were not impacted by reaction times and expected values and persisted even after controlling for sociodemographic factors. Post-hoc analysis revealed greater activation of ACC and mPFC in response to selection of rewards of larger magnitude than those of smaller magnitude when the probability of reward was maintained constant. Adolescents with greater frequency of high-risk behavior (defined as low-probability/high magnitude reward choice) had lower activation of ACC, OFC and mPFC than those who engaged in this behavior less frequently. These findings suggest individual differences in prefrontal cortical function with regards to decision-making process in adolescents. PMID:20933020

  17. Evidence, values, guidelines and rational decision-making.

    PubMed

    Barrett, Bruce

    2012-02-01

    Medical decision-making involves choices, which can lead to benefits or to harms. Most benefits and harms may or may not occur, and can be minor or major when they do. Medical research, especially randomized controlled trials, provides estimates of chance of occurrence and magnitude of event. Because there is no universally accepted method for weighing harms against benefits, and because the ethical principle of autonomy mandates informed choice by patient, medical decision-making is inherently an individualized process. It follows that the practice of aiming for universal implementation of standardized guidelines is irrational and unethical. Irrational because the possibility of benefits is implicitly valued more than the possibility of comparable harms, and unethical because guidelines remove decision making from the patient and give it instead to a physician, committee or health care system. This essay considers the cases of cancer screening and diabetes management, where guidelines often advocate universal implementation, without regard to informed choice and individual decision-making.

  18. Informed Consent in Decision-Making in Pediatric Practice.

    PubMed

    Katz, Aviva L; Webb, Sally A

    2016-08-01

    Informed consent should be seen as an essential part of health care practice; parental permission and childhood assent is an active process that engages patients, both adults and children, in their health care. Pediatric practice is unique in that developmental maturation allows, over time, for increasing inclusion of the child's and adolescent's opinion in medical decision-making in clinical practice and research. This technical report, which accompanies the policy statement "Informed Consent in Decision-Making in Pediatric Practice" was written to provide a broader background on the nature of informed consent, surrogate decision-making in pediatric practice, information on child and adolescent decision-making, and special issues in adolescent informed consent, assent, and refusal. It is anticipated that this information will help provide support for the recommendations included in the policy statement. PMID:27456510

  19. Practice Makes Perfect: Prospective Teachers Develop Skills in Decision-Making.

    ERIC Educational Resources Information Center

    John, Martha Tyler; Norton, Robert

    Preservice teachers must develop decision making skills and feel comfortable with decision making processes. Prospective teachers at MidAmerican Nazarene College (MNU), Kansas, are involved in a research based output system called the Decision-Making Packet (DMP). DMP's are units of study that allow students choice and require their pupils to take…

  20. Career Decision-Making Characteristics of Primary Education Students in Greece

    ERIC Educational Resources Information Center

    Sidiropoulou-Dimakakou, Despina; Mylonas, Kostas; Argyropoulou, Katerina; Drosos, Nikos

    2013-01-01

    The present study aims at investigating career decision-making process of 6th grade students with the use of the Childhood Career Decision-Making Questionnaire (CCDMQ). CCDMQ offers scores for the following three decision-making dimensions: (a) "Concerns/fears regarding career future", (b) "Investment ?n decision-making…

  1. An STS Case Study about Students' Decision Making on the Waste Issue.

    ERIC Educational Resources Information Center

    Kortland, Koos

    1996-01-01

    Assesses students' existing and developing decision-making ability against the background of a normative model of the decision making process. Results indicate that after a unit on household packaging waste the students' arguments about a decision making situation improved in terms of validity and clarity of the criteria used. Contains 16…

  2. How High School Students Construct Decision-Making Strategies for Choosing Colleges

    ERIC Educational Resources Information Center

    Govan, George V.; Patrick, Sondra; Yen, Cherng-Jyn

    2006-01-01

    This study examined how high school seniors construct decision-making strategies for choosing a college to attend. To comprehend their decision-making strategies, we chose to examine this process through the theoretical lens of bounded rationality, which brings to light the complexity in constructing a college choice decision-making strategy…

  3. Between Safety and Risk: A Model for Outdoor Adventure Decision Making.

    ERIC Educational Resources Information Center

    Boyes, Michael A.; O'Hare, David

    2003-01-01

    Decision making by outdoor adventure educators revolves around balancing risk and competence. A model of outdoor adventure decision making is presented that draws on naturalistic decision-making processes and emphasizes the importance of situational recognition and prior experience. Leaders draw key information from the natural environment,…

  4. Decision-Making in Child Welfare: A Self Instructional Manual. Publication No. 12.

    ERIC Educational Resources Information Center

    Campbell, Margaret M., Ed.; And Others

    Information on the process of decision-making, hints on how to function in team decision-making, and materials on how to prepare clients for decision-making in team meetings for the beginning level child welfare worker are provided in this self-instructional manual. Techniques are discussed for improving the quality of decisions made by the…

  5. Delay discounting without decision-making: medial prefrontal cortex and amygdala activations reflect immediacy processing and correlate with impulsivity and anxious-depressive traits

    PubMed Central

    Ludwig, Vera U.; Nüsser, Corinna; Goschke, Thomas; Wittfoth-Schardt, Dina; Wiers, Corinde E.; Erk, Susanne; Schott, Björn H.; Walter, Henrik

    2015-01-01

    Humans value rewards less when these are delivered in the future as opposed to immediately, a phenomenon referred to as delay discounting. While delay discounting has been studied during the anticipation of rewards and in the context of intertemporal decision-making, little is known about its neural correlates in the outcome phase (during reward delivery) and their relation to personality. Personality traits that have been associated with increased delay discounting include impulsivity and, potentially, anxious-depressive traits. Here we performed functional magnetic resonance imaging (fMRI) in 72 healthy participants while they carried out a monetary incentive delay (MID) task with a delay manipulation. In sixty percent of the experimental trials, participants won rewards that differed in magnitude (0.05€, 0.50€ or 1€) and delay until delivery (immediately, 10 days, or 100 days). A factor analysis on questionnaires yielded two factors reflecting Impulsivity and Anxiety/Depression, which we used to examine potential relationships between personality and delay discounting. When winning a reward, medial prefrontal cortex (mPFC) activation was higher for immediate compared to delayed rewards. Moreover, amygdala activation correlated with reward magnitude for immediate but not for delayed rewards. Amygdala activation to winning immediate rewards was higher in more impulsive participants, while mPFC activation to winning immediate rewards was higher in more anxious-depressed participants. Our results uncover neural correlates of delay discounting during reward delivery, and suggest that impulsivity and subclinical anxious-depressive traits are related to stronger neural responses for winning immediate relative to delayed rewards. PMID:26578910

  6. Delay discounting without decision-making: medial prefrontal cortex and amygdala activations reflect immediacy processing and correlate with impulsivity and anxious-depressive traits.

    PubMed

    Ludwig, Vera U; Nüsser, Corinna; Goschke, Thomas; Wittfoth-Schardt, Dina; Wiers, Corinde E; Erk, Susanne; Schott, Björn H; Walter, Henrik

    2015-01-01

    Humans value rewards less when these are delivered in the future as opposed to immediately, a phenomenon referred to as delay discounting. While delay discounting has been studied during the anticipation of rewards and in the context of intertemporal decision-making, little is known about its neural correlates in the outcome phase (during reward delivery) and their relation to personality. Personality traits that have been associated with increased delay discounting include impulsivity and, potentially, anxious-depressive traits. Here we performed functional magnetic resonance imaging (fMRI) in 72 healthy participants while they carried out a monetary incentive delay (MID) task with a delay manipulation. In sixty percent of the experimental trials, participants won rewards that differed in magnitude (0.05€, 0.50€ or 1€) and delay until delivery (immediately, 10 days, or 100 days). A factor analysis on questionnaires yielded two factors reflecting Impulsivity and Anxiety/Depression, which we used to examine potential relationships between personality and delay discounting. When winning a reward, medial prefrontal cortex (mPFC) activation was higher for immediate compared to delayed rewards. Moreover, amygdala activation correlated with reward magnitude for immediate but not for delayed rewards. Amygdala activation to winning immediate rewards was higher in more impulsive participants, while mPFC activation to winning immediate rewards was higher in more anxious-depressed participants. Our results uncover neural correlates of delay discounting during reward delivery, and suggest that impulsivity and subclinical anxious-depressive traits are related to stronger neural responses for winning immediate relative to delayed rewards.

  7. Decision-Making Strategies for College Students

    ERIC Educational Resources Information Center

    Morey, Janis T.; Dansereau, Donald F.

    2010-01-01

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

  8. Stress alters personal moral decision making.

    PubMed

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

    2012-04-01

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

  9. Entrustment Decision Making in Clinical Training.

    PubMed

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

    2016-02-01

    The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee's development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors' aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment. PMID:26630606

  10. Stress alters personal moral decision making.

    PubMed

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

    2012-04-01

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

  11. The decision-making process for senior cancer patients: treatment allocation of older women with operable breast cancer in the UK

    PubMed Central

    Morgan, Jenna L.; Richards, Paul; Zaman, Osama; Ward, Sue; Collins, Karen; Robinson, Thompson; Cheung, Kwok-Leung; Audisio, Riccardo A.; Reed, Malcolm W.; Wyld, Lynda

    2015-01-01

    Objective Up to 40% of women over 70 years with primary operable breast cancer in the UK are treated with primary endocrine therapy (PET) as an alternative to surgery. A variety of factors are important in determining treatment for older breast cancer patients. This study aimed to identify the patient and tumor factors associated with treatment allocation in this population. Methods Prospectively collected data on treatment received (surgery vs. PET) were analysed with multivariable logistic regression using the variables age, modified Charlson Comorbidity Index (CCI), activities of daily living (ADL) score, Mini-Mental State Examination (MMSE) score, HER2 status, tumour size, grade and nodal status. Results Data were available for 1,122 cancers in 1,098 patients recruited between February 2013 and June 2015 from 51 UK hospitals. About 78% of the population were treated surgically, with the remainder being treated with PET. Increasing patient age at diagnosis, increasing CCI score, large tumor size (5 cm or more) and dependence in one or more ADL categories were all strongly associated with non-surgical treatment (P<0.05). Conclusion Increasing comorbidity, large tumor size and reduced functional ability are associated with reduced likelihood of surgical treatment of breast cancer in older patients. However, age itself remains a significant factor for non-surgical treatment; reinforcing the need for evidence-based guidelines. PMID:26779368

  12. Survey of the Definition of Fetal Viability and the Availability, Indications, and Decision Making Processes for Post-Viability Termination of Pregnancy for Fetal Abnormalities and Health Conditions in Canada.

    PubMed

    Hull, Danna; Davies, Gregory; Armour, Christine M

    2016-06-01

    The purpose of this study was to explore the definition of fetal viability and the availability, indications, and decision making processes for post-viability termination of pregnancy for fetal abnormalities and health conditions in Canada. An online survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Geneticists, and the Canadian Society for Maternal-Fetal Medicine who provide direct counselling to, or management of, prenatal patients in Canada (total sample size 815). Results of this study showed that the majority of respondents indicated that their centre will offer post-viability termination of pregnancy (98/123; 80 %). Sixty-seven percent (68/101) of respondents reported the definition of fetal viability to be 24 weeks' gestation. Most respondents reported that a collaborative decision making process was used to determine if post-viability termination of pregnancy would be offered (136/170; 80 %). For conditions presumed to be lethal/likely lethal, the majority of respondents would "sometimes" or "always" offer post-viability termination of pregnancy, whereas for conditions presumed to have a mild effect, the majority of respondents would "rarely" or "never" offer post-viability termination of pregnancy. Ninety percent (77/86) of respondents reported that perinatal hospice is offered as an alternative to termination of pregnancy. In conclusion, this study suggests that although post-viability termination is available in many provinces in Canada, variation in the definition of fetal viability and indications appear to exist. While these variations may lead to unequal access to post-viability termination of pregnancy across Canada, they might also represent the complexity of the decision making process and the importance of examining individual factors to ensure that the most appropriate decision is made in each case. PMID:26536885

  13. Survey of the Definition of Fetal Viability and the Availability, Indications, and Decision Making Processes for Post-Viability Termination of Pregnancy for Fetal Abnormalities and Health Conditions in Canada.

    PubMed

    Hull, Danna; Davies, Gregory; Armour, Christine M

    2016-06-01

    The purpose of this study was to explore the definition of fetal viability and the availability, indications, and decision making processes for post-viability termination of pregnancy for fetal abnormalities and health conditions in Canada. An online survey of members of the Canadian Association of Genetic Counsellors, the Canadian College of Medical Geneticists, and the Canadian Society for Maternal-Fetal Medicine who provide direct counselling to, or management of, prenatal patients in Canada (total sample size 815). Results of this study showed that the majority of respondents indicated that their centre will offer post-viability termination of pregnancy (98/123; 80 %). Sixty-seven percent (68/101) of respondents reported the definition of fetal viability to be 24 weeks' gestation. Most respondents reported that a collaborative decision making process was used to determine if post-viability termination of pregnancy would be offered (136/170; 80 %). For conditions presumed to be lethal/likely lethal, the majority of respondents would "sometimes" or "always" offer post-viability termination of pregnancy, whereas for conditions presumed to have a mild effect, the majority of respondents would "rarely" or "never" offer post-viability termination of pregnancy. Ninety percent (77/86) of respondents reported that perinatal hospice is offered as an alternative to termination of pregnancy. In conclusion, this study suggests that although post-viability termination is available in many provinces in Canada, variation in the definition of fetal viability and indications appear to exist. While these variations may lead to unequal access to post-viability termination of pregnancy across Canada, they might also represent the complexity of the decision making process and the importance of examining individual factors to ensure that the most appropriate decision is made in each case.

  14. Distributed decision-making for space operations

    NASA Technical Reports Server (NTRS)

    Hornstein, Rhoda Shaller; Gardner, J. A.; Willoughby, J. K.

    1990-01-01

    A programmatic and technical perspective in the context of future space applications is presented, that includes some of the management challenges that arise as the decision-making process becomes increasingly more decentralized. Three challenges are discussed: (1) the degree to which the planners must communicate with each other and with those who are seeking space operations resources, (2) the collection, management, employment and dissemination of the information needed to make decisions, and (3) the challenges connected with schedule integration. The technical perspective presented leads to recommended adaptations to the normal scheduling algorithms that retain the 'degrees of freedom' in the planning result. It is shown that these adaptations are specific technical responses to the programmatic challenges discussed.

  15. How Expert Advice Influences Decision Making

    PubMed Central

    Meshi, Dar; Biele, Guido; Korn, Christoph W.; Heekeren, Hauke R.

    2012-01-01

    People often use expert advice when making decisions in our society, but how we are influenced by this advice has yet to be understood. To address this, using functional magnetic resonance imaging, we provided expert and novice advice to participants during an estimation task. Participants reported that they valued expert advice more than novice advice, and activity in the ventral striatum correlated with this valuation, even before decisions with the advice were made. When using advice, participants compared their initial opinion to their advisor’s opinion. This comparison, termed the “opinion difference”, influenced advice utilization and was represented in reward-sensitive brain regions. Finally, the left lateral orbitofrontal cortex integrated both the size of the opinion difference and the advisor’s level of expertise, and average activity in this area correlated with mean advice utilization across participants. Taken together, these findings provide neural evidence for how advice engenders behavioral change during the decision-making process. PMID:23185425

  16. Examining Decision-Making Regarding Environmental Information

    SciTech Connect

    Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner

    2001-10-01

    Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be

  17. Public involvement in science and decision making.

    PubMed

    Till, J E; Meyer, K R

    2001-04-01

    commitments encountered when making scientific decisions in a public forum. Although the process was time consuming for the scientists responsible for the calculations, a more technically defensible as well as publicly acceptable soil action level emerged. The technical approach developed during the project has been recommended for use as a decision-making tool for cleanup of the site. PMID:11281205

  18. The hidden traps in decision making.

    PubMed

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

    1998-01-01

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

  19. Primum Non Nocere: is shared decision-making the answer?

    PubMed

    Santhirapala, Ramai; Moonesinghe, Ramani

    2016-01-01

    Surgical ambition is rising, with the Royal College of Surgeons reporting an increase in the number of procedures by a million over the past decade (Royal College of Surgeons. Surgery and the NHS in Numbers. Available from https://www.rcseng.ac.uk). Underpinning, this is a rapidly growing population, especially those in the over 85 age group, coupled with rising perioperative expertise; options for surgery are now present where conditions were once managed conservatively. Matching the right patient to the right procedure has never been so pertinent (Bader, Am Soc Anesthesiol 78(6), 2014). At the heart of these increasingly complex decisions, which may prove fatal or result in serious morbidity, lies the aspiration of shared decision-making (SDM) (Glance et al., N Engl J Med 370:1379-81, 2014). Shared decision-making is a patient-centred approach taking into account the beliefs, preferences and views of the patient as an expert in what is right for them, supported by clinicians who are the experts in diagnostics and valid therapeutic options (Coulter and Collins, Making shared decision-making a reality: no decision about me, without me, 2011). It has been described as the pinnacle of patient-centred care (Barry et al., N Engl J Med 366:780-1, 2012). In this commentary, we explore further the concept of shared decision-making, supported by a recent article which highlights critical deficits in current perioperative practice (Ankuda et al., Patient Educ Couns 94(3):328-33, 2014). This article was chosen for the purposes of this commentary as it is a large study across several surgical specialties investigating preoperative shared decision-making, and to our knowledge, the only of this kind. PMID:27313845

  20. Primum Non Nocere: is shared decision-making the answer?

    PubMed

    Santhirapala, Ramai; Moonesinghe, Ramani

    2016-01-01

    Surgical ambition is rising, with the Royal College of Surgeons reporting an increase in the number of procedures by a million over the past decade (Royal College of Surgeons. Surgery and the NHS in Numbers. Available from https://www.rcseng.ac.uk). Underpinning, this is a rapidly growing population, especially those in the over 85 age group, coupled with rising perioperative expertise; options for surgery are now present where conditions were once managed conservatively. Matching the right patient to the right procedure has never been so pertinent (Bader, Am Soc Anesthesiol 78(6), 2014). At the heart of these increasingly complex decisions, which may prove fatal or result in serious morbidity, lies the aspiration of shared decision-making (SDM) (Glance et al., N Engl J Med 370:1379-81, 2014). Shared decision-making is a patient-centred approach taking into account the beliefs, preferences and views of the patient as an expert in what is right for them, supported by clinicians who are the experts in diagnostics and valid therapeutic options (Coulter and Collins, Making shared decision-making a reality: no decision about me, without me, 2011). It has been described as the pinnacle of patient-centred care (Barry et al., N Engl J Med 366:780-1, 2012). In this commentary, we explore further the concept of shared decision-making, supported by a recent article which highlights critical deficits in current perioperative practice (Ankuda et al., Patient Educ Couns 94(3):328-33, 2014). This article was chosen for the purposes of this commentary as it is a large study across several surgical specialties investigating preoperative shared decision-making, and to our knowledge, the only of this kind.