Sample records for timely decision making

  1. A timely account of the role of duration in decision making.

    PubMed

    Ariely, D; Zakay, D

    2001-09-01

    The current work takes a general perspective on the role of time in decision making. There are many different relationships and interactions between time and decision making, and no single summary can do justice to this topic. In this paper we will describe a few of the aspects in which time and decision making are interleaved: (a) temporal perspectives of decisions--the various temporal orientations that decision-makers may adopt while making decisions, and the impact of such temporal orientations on the decision process and its outcomes; (b) time as a medium within which decisions take place--the nature of decision processes that occur along time; (c) time as a resource and as a contextual factor--the implications of shortage in time resources and the impact of time limits on decision making processes and performance; (d) time as a commodity--time as the subject matter of decision making. The paper ends with a few general questions on the role of duration in decision making.

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

    PubMed

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

    2017-09-01

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

  3. 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.

  4. Decision-Making Competence, Social Orientation, Time Style, and Perceived Stress.

    PubMed

    Geisler, Martin; Allwood, Carl Martin

    2018-01-01

    Peoples' decision-making competence, defined as tendency to follow normative rational principles in their decision making, is important as it may influence the extent that requirements are met and levels of perceived stress. In addition, perceived stress could be influenced by social orientation and time style; for example, decisions need to comply with given deadlines and the expectations of others. In two studies, with students ( n = 118) and professionals (police investigators, n = 90), we examined how the three individual difference features: decision-making competence, social orientation, and time approach relate to perceived stress. Results showed that social orientation and time approach were related to levels of perceived stress, but decision-making competence was not. These results indicate that social orientation and time approach are important to consider in relation to perceived stress, but the role of decision-making competence may be less important for perceived stress. However, the role of decision-making competence for perceived stress needs to be further researched.

  5. Decision-Making Competence, Social Orientation, Time Style, and Perceived Stress

    PubMed Central

    Geisler, Martin; Allwood, Carl Martin

    2018-01-01

    Peoples’ decision-making competence, defined as tendency to follow normative rational principles in their decision making, is important as it may influence the extent that requirements are met and levels of perceived stress. In addition, perceived stress could be influenced by social orientation and time style; for example, decisions need to comply with given deadlines and the expectations of others. In two studies, with students (n = 118) and professionals (police investigators, n = 90), we examined how the three individual difference features: decision-making competence, social orientation, and time approach relate to perceived stress. Results showed that social orientation and time approach were related to levels of perceived stress, but decision-making competence was not. These results indicate that social orientation and time approach are important to consider in relation to perceived stress, but the role of decision-making competence may be less important for perceived stress. However, the role of decision-making competence for perceived stress needs to be further researched. PMID:29686634

  6. Neuroanatomical basis for recognition primed decision making.

    PubMed

    Hudson, Darren

    2013-01-01

    Effective decision making under time constraints is often overlooked in medical decision making. The recognition primed decision making (RPDM) model was developed by Gary Klein based on previous recognized situations to develop a satisfactory solution to the current problem. Bayes Theorem is the most popular decision making model in medicine but is limited by the need for adequate time to consider all probabilities. Unlike other decision making models, there is a potential neurobiological basis for RPDM. This model has significant implication for health informatics and medical education.

  7. Real-Time Decision Making and Aggressive Behavior in Youth: A Heuristic Model of Response Evaluation and Decision (RED)

    PubMed Central

    Fontaine, Reid Griffith; Dodge, Kenneth A.

    2009-01-01

    Considerable scientific and intervention attention has been paid to judgment and decision-making systems associated with aggressive behavior in youth. However, most empirical studies have investigated social-cognitive correlates of stable child and adolescent aggressiveness, and less is known about real-time decision making to engage in aggressive behavior. A model of real-time decision making must incorporate both impulsive actions and rational thought. The present paper advances a process model (response evaluation and decision; RED) of real-time behavioral judgments and decision making in aggressive youths with mathematic representations that may be used to quantify response strength. These components are a heuristic to describe decision making, though it is doubtful that individuals always mentally complete these steps. RED represents an organization of social–cognitive operations believed to be active during the response decision step of social information processing. The model posits that RED processes can be circumvented through impulsive responding. This article provides a description and integration of thoughtful, rational decision making and nonrational impulsivity in aggressive behavioral interactions. PMID:20802851

  8. Real-Time Decision Making and Aggressive Behavior in Youth: A Heuristic Model of Response Evaluation and Decision (RED).

    PubMed

    Fontaine, Reid Griffith; Dodge, Kenneth A

    2006-11-01

    Considerable scientific and intervention attention has been paid to judgment and decision-making systems associated with aggressive behavior in youth. However, most empirical studies have investigated social-cognitive correlates of stable child and adolescent aggressiveness, and less is known about real-time decision making to engage in aggressive behavior. A model of real-time decision making must incorporate both impulsive actions and rational thought. The present paper advances a process model (response evaluation and decision; RED) of real-time behavioral judgments and decision making in aggressive youths with mathematic representations that may be used to quantify response strength. These components are a heuristic to describe decision making, though it is doubtful that individuals always mentally complete these steps. RED represents an organization of social-cognitive operations believed to be active during the response decision step of social information processing. The model posits that RED processes can be circumvented through impulsive responding. This article provides a description and integration of thoughtful, rational decision making and nonrational impulsivity in aggressive behavioral interactions.

  9. Satisficing in split-second decision making is characterized by strategic cue discounting.

    PubMed

    Oh, Hanna; Beck, Jeffrey M; Zhu, Pingping; Sommer, Marc A; Ferrari, Silvia; Egner, Tobias

    2016-12-01

    Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through satisficing, fast but "good-enough" heuristic decision making that prioritizes some sources of information (cues) while ignoring others. However, the decision-making strategies we adopt under uncertainty and time pressure, for example during emergencies that demand split-second choices, are presently unknown. To characterize these decision strategies quantitatively, the present study examined how people solve a novel multicue probabilistic classification task under varying time pressure, by tracking shifts in decision strategies using variational Bayesian inference. We found that under low time pressure, participants correctly weighted and integrated all available cues to arrive at near-optimal decisions. With increasingly demanding, subsecond time pressures, however, participants systematically discounted a subset of the cue information by dropping the least informative cue(s) from their decision making process. Thus, the human cognitive apparatus copes with uncertainty and severe time pressure by adopting a "drop-the-worst" cue decision making strategy that minimizes cognitive time and effort investment while preserving the consideration of the most diagnostic cue information, thus maintaining "good-enough" accuracy. This advance in our understanding of satisficing strategies could form the basis of predicting human choices in high time pressure scenarios. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  10. The assessment of depressive patients' involvement in decision making in audio-taped primary care consultations.

    PubMed

    Loh, Andreas; Simon, Daniela; Hennig, Katrin; Hennig, Benjamin; Härter, Martin; Elwyn, Glyn

    2006-11-01

    In primary care of depression treatment options such as antidepressants, counseling and psychotherapy are reasonable. Patient involvement could foster adherence and clinical outcome. However, there is a lack of empirical information about the extent to which general practitioners involve patients in decision making processes in this condition, and about the consultation time spent for distinct decision making tasks. Twenty general practice consultations with depressive patients prior to a treatment decision were audio-taped and transcribed. Patient involvement in decision making was assessed with the OPTION-scale and durations of decision making stages were measured. Mean duration of consultations was 16 min, 6s. The mean of the OPTION-items were between 0.0 and 26.9, in a scale range from 0 to 100. Overall, 78.6% of the consultation time was spent for the step "problem definition" (12 min, 42 s). Very low levels of patient involvement in medical decisions were observed in consultations about depression. Physicians used the majority of their time for the definition of the patient's medical problem. To improve treatment decision making in this condition, general practitioners should enhance their decision making competences and be more aware of the time spent in each decision making stage.

  11. Everyday decision-making in dementia: findings from a longitudinal interview study of people with dementia and family carers.

    PubMed

    Samsi, Kritika; Manthorpe, Jill

    2013-06-01

    Exercising choice and control over decisions is central to quality of life. The Mental Capacity Act 2005 (England and Wales) provides a legal framework to safeguard the rights of people with dementia to make their own decisions for as long as possible. The impact of this on long-term planning has been investigated; everyday decision-making in people's own homes remains unexplored. Using a phenomenological approach, we interviewed 12 dyads (one person with dementia + one carer) four times over one year to ascertain experience of decision-making, how decisions were negotiated, and how dynamics changed. Qualitative interviews were conducted in people's own homes, and thematic analysis was applied to transcripts. Respecting autonomy, decision-specificity and best interests underlay most everyday decisions in this sample. Over time, dyads transitioned from supported decision-making, where person with dementia and carer made decisions together, to substituted decision-making, where carers took over much decision-making. Points along this continuum represented carers' active involvement in retaining their relative's engagement through providing cues, reducing options, using retrospective information, and using the best interests principle. Long-term spouse carers seemed most equipped to make substitute decisions for their spouses; adult children and friend carers struggled with this. Carers may gradually take on decision-making for people with dementia. This can bring with it added stresses, such as determining their relative's decision-making capacity and weighing up what is in their best interests. Practitioners and support services should provide timely advice to carers and people with dementia around everyday decision-making, and be mindful how abilities may change.

  12. Are gains in decision-making autonomy during early adolescence beneficial for emotional functioning? The case of the United States and china.

    PubMed

    Qin, Lili; Pomerantz, Eva M; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children often deem as under their authority. Children also reported on their emotional functioning. American children made greater gains over time in decision-making autonomy than did Chinese children. Initial decision-making autonomy predicted enhanced emotional functioning similarly among American and Chinese children. However, gains over time in decision-making autonomy predicted enhanced emotional functioning more in the United States (vs. China) where such gains were normative.

  13. Time Management and the Military Decision Making Process

    DTIC Science & Technology

    1992-12-18

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

  14. Parallel constraint satisfaction in memory-based decisions.

    PubMed

    Glöckner, Andreas; Hodges, Sara D

    2011-01-01

    Three studies sought to investigate decision strategies in memory-based decisions and to test the predictions of the parallel constraint satisfaction (PCS) model for decision making (Glöckner & Betsch, 2008). Time pressure was manipulated and the model was compared against simple heuristics (take the best and equal weight) and a weighted additive strategy. From PCS we predicted that fast intuitive decision making is based on compensatory information integration and that decision time increases and confidence decreases with increasing inconsistency in the decision task. In line with these predictions we observed a predominant usage of compensatory strategies under all time-pressure conditions and even with decision times as short as 1.7 s. For a substantial number of participants, choices and decision times were best explained by PCS, but there was also evidence for use of simple heuristics. The time-pressure manipulation did not significantly affect decision strategies. Overall, the results highlight intuitive, automatic processes in decision making and support the idea that human information-processing capabilities are less severely bounded than often assumed.

  15. Competence and Quality in Real-Life Decision Making.

    PubMed

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

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

  16. Time Perspective and Career Decision-Making Difficulties in Adults

    ERIC Educational Resources Information Center

    Taber, Brian J.

    2013-01-01

    Decision making is not only contingent upon what takes place in the present but also on how one feels about the past and one's hopes for the future. However, when it comes to time perspective and career decision making, vocational psychology has focused exclusively on future time perspective. The present study examines the relations among past,…

  17. Examining Longitudinal Relationships between Dysfunctional Career Thoughts and Career Decision-Making Self-Efficacy in School-to-Work Transition

    ERIC Educational Resources Information Center

    Kim, Boyoung; Lee, Bo Hyun; Ha, Gyuyoung; Lee, Hong Kwon; Lee, Sang Min

    2015-01-01

    This study examines the role of dysfunctional career thoughts between two-wave longitudinal data (Time 1 and Time 2) in career decision-making self-efficacy during school-to-work transition periods. Career decision-making self-efficacy was measured before (Time 1) and after college graduation (Time 2). The results indicated that the growth of…

  18. Integration of professional judgement and decision-making in high-level adventure sports coaching practice.

    PubMed

    Collins, Loel; Collins, Dave

    2015-01-01

    This study examined the integration of professional judgement and decision-making processes in adventure sports coaching. The study utilised a thematic analysis approach to investigate the decision-making practices of a sample of high-level adventure sports coaches over a series of sessions. Results revealed that, in order to make judgements and decisions in practice, expert coaches employ a range of practical and pedagogic management strategies to create and opportunistically use time for decision-making. These approaches include span of control and time management strategies to facilitate the decision-making process regarding risk management, venue selection, aims, objectives, session content, and differentiation of the coaching process. The implication for coaches, coach education, and accreditation is the recognition and training of the approaches that "create time" for the judgements in practice, namely "creating space to think". The paper concludes by offering a template for a more expertise-focused progression in adventure sports coaching.

  19. Goal Setting and Decision Making by At-Risk Youth

    ERIC Educational Resources Information Center

    Galotti, Kathleen M.; Kozberg, Steven F.; Gustafon, Mary

    2009-01-01

    Typically, adolescence is a time when individuals begin to make consequential, life-framing decisions. However, much of the decision-making literature focuses on high-risk decisions, such as the use of drugs and alcohol, while much less is known about how adolescents make positive decisions, for example, regarding their educational or career…

  20. A general theory of intertemporal decision-making and the perception of time.

    PubMed

    Namboodiri, Vijay M K; Mihalas, Stefan; Marton, Tanya M; Hussain Shuler, Marshall G

    2014-01-01

    Animals and humans make decisions based on their expected outcomes. Since relevant outcomes are often delayed, perceiving delays and choosing between earlier vs. later rewards (intertemporal decision-making) is an essential component of animal behavior. The myriad observations made in experiments studying intertemporal decision-making and time perception have not yet been rationalized within a single theory. Here we present a theory-Training-Integrated Maximized Estimation of Reinforcement Rate (TIMERR)-that explains a wide variety of behavioral observations made in intertemporal decision-making and the perception of time. Our theory postulates that animals make intertemporal choices to optimize expected reward rates over a limited temporal window which includes a past integration interval-over which experienced reward rate is estimated-as well as the expected delay to future reward. Using this theory, we derive mathematical expressions for both the subjective value of a delayed reward and the subjective representation of the delay. A unique contribution of our work is in finding that the past integration interval directly determines the steepness of temporal discounting and the non-linearity of time perception. In so doing, our theory provides a single framework to understand both intertemporal decision-making and time perception.

  1. A general theory of intertemporal decision-making and the perception of time

    PubMed Central

    Namboodiri, Vijay M. K.; Mihalas, Stefan; Marton, Tanya M.; Hussain Shuler, Marshall G.

    2014-01-01

    Animals and humans make decisions based on their expected outcomes. Since relevant outcomes are often delayed, perceiving delays and choosing between earlier vs. later rewards (intertemporal decision-making) is an essential component of animal behavior. The myriad observations made in experiments studying intertemporal decision-making and time perception have not yet been rationalized within a single theory. Here we present a theory—Training-Integrated Maximized Estimation of Reinforcement Rate (TIMERR)—that explains a wide variety of behavioral observations made in intertemporal decision-making and the perception of time. Our theory postulates that animals make intertemporal choices to optimize expected reward rates over a limited temporal window which includes a past integration interval—over which experienced reward rate is estimated—as well as the expected delay to future reward. Using this theory, we derive mathematical expressions for both the subjective value of a delayed reward and the subjective representation of the delay. A unique contribution of our work is in finding that the past integration interval directly determines the steepness of temporal discounting and the non-linearity of time perception. In so doing, our theory provides a single framework to understand both intertemporal decision-making and time perception. PMID:24616677

  2. Complex Decision-Making in Heart Failure: A Systematic Review and Thematic Analysis.

    PubMed

    Hamel, Aimee V; Gaugler, Joseph E; Porta, Carolyn M; Hadidi, Niloufar Niakosari

    Heart failure follows a highly variable and difficult course. Patients face complex decisions, including treatment with implantable cardiac defibrillators, mechanical circulatory support, and heart transplantation. The course of decision-making across multiple treatments is unclear yet integral to providing informed and shared decision-making. Recognizing commonalities across treatment decisions could help nurses and physicians to identify opportunities to introduce discussions and support shared decision-making. The specific aims of this review are to examine complex treatment decision-making, specifically implantable cardiac defibrillators, ventricular assist device, and cardiac transplantation, and to recognize commonalities and key points in the decisional process. MEDLINE, CINAHL, PsycINFO, and Web of Science were searched for English-language studies that included qualitative findings reflecting the complexity of heart failure decision-making. Using a 3-step process, findings were synthesized into themes and subthemes. Twelve articles met criteria for inclusion. Participants included patients, caregivers, and clinicians and included decisions to undergo and decline treatment. Emergent themes were "processing the decision," "timing and prognostication," and "considering the future." Subthemes described how participants received and understood information about the therapy, making and changing a treatment decision, timing their decision and gauging health status outcomes in the context of their decision, the influence of a life or death decision, and the future as a factor in their decisional process. Commonalities were present across therapies, which involved the timing of discussions, the delivery of information, and considerations of the future. Exploring this further could help support patient-centered care and optimize shared decision-making interventions.

  3. 42 CFR 405.950 - Time frame for making a redetermination.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... decision-making time frame begins on the date the contractor receives the late-filed request for... filed, the contractor's 60 calendar day decision-making time frame is extended for up to 14 calendar... 42 Public Health 2 2010-10-01 2010-10-01 false Time frame for making a redetermination. 405.950...

  4. Creating value for participants in multistakeholder alliances: The shifting importance of leadership and collaborative decision-making over time.

    PubMed

    D'Aunno, Thomas; Alexander, Jeffrey A; Jiang, Lan

    Multistakeholder alliances that bring together diverse organizations to work on health-related issues are playing an increasingly prominent role in the U.S. health care system. Prior research shows that collaborative decision-making and effective leadership are related to members' perceptions of value for their participation in alliances. Yet, we know little about how collaborative decision-making and leadership might matter over time in multistakeholder alliances. The aim of this study was to advance understanding of the role of collaborative decision-making and leadership in individuals' assessments of the benefits and costs of their participation in multistakeholder alliances over time. We draw on data collected from three rounds of surveys of alliance members (2007-2012) who participated in the Robert Wood Johnson Foundation's Aligning Forces for Quality program. Results from regression analyses indicate that individuals' perceptions of value for their participation in alliances shift over time: Perceived value is higher with collaborative decision-making when alliances are first formed and higher with more effective leadership as time passes after alliance formation. Leaders of multistakeholder alliances may need to vary their behavior over time, shifting their emphasis from inclusive decision-making to task achievement.

  5. A Time-Aware Routing Map for Indoor Evacuation †

    PubMed Central

    Zhao, Haifeng; Winter, Stephan

    2016-01-01

    Knowledge of dynamic environments expires over time. Thus, using static maps of the environment for decision making is problematic, especially in emergency situations, such as evacuations. This paper suggests a fading memory model for mapping dynamic environments: a mechanism to put less trust on older knowledge in decision making. The model has been assessed by simulating indoor evacuations, adopting and comparing various strategies in decision making. Results suggest that fading memory generally improves this decision making. PMID:26797610

  6. Decision Making Among Older Adults at the End of Life: A Theoretical Perspective.

    PubMed

    Romo, Rafael D; Dawson-Rose, Carol S; Mayo, Ann M; Wallhagen, Margaret I

    Understanding changes in decision making among older adults across time is important for health care providers. We examined how older adults with a limited prognosis used their perception of prognosis and health in their decision-making processes and related these findings to prospect theory. The theme of decision making in the context of ambiguity emerged, reflecting how participants used both prognosis and health to value choices, a behavior not fully captured by prospect theory. We propose an extension of the theory that can be used to better visualize decision making at this unique time of life among older adults.

  7. Competence and Quality in Real-Life Decision Making

    PubMed Central

    2015-01-01

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

  8. New approaches for real time decision support systems

    NASA Technical Reports Server (NTRS)

    Hair, D. Charles; Pickslay, Kent

    1994-01-01

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

  9. An Evaluation of Factors Affecting Decision Making among 4th Grade Elementary School Students with Low Socio-Economic Status

    ERIC Educational Resources Information Center

    Kaskaya, Alper; Calp, Sükran; Kuru, Oguzhan

    2017-01-01

    Decision making is one of the most important life skills. While making correct, timely, accurate and appropriate decisions lead to positive changes in one's life, making incorrect decisions may have a negative impact. It is an important issue to examine what the 4th grade students in primary school have about the decision-making ability to be…

  10. Mental fatigue impairs soccer-specific decision-making skill.

    PubMed

    Smith, Mitchell R; Zeuwts, Linus; Lenoir, Matthieu; Hens, Nathalie; De Jong, Laura M S; Coutts, Aaron J

    2016-07-01

    This study aimed to investigate the impact of mental fatigue on soccer-specific decision-making. Twelve well-trained male soccer players performed a soccer-specific decision-making task on two occasions, separated by at least 72 h. The decision-making task was preceded in a randomised order by 30 min of the Stroop task (mental fatigue) or 30 min of reading from magazines (control). Subjective ratings of mental fatigue were measured before and after treatment, and mental effort (referring to treatment) and motivation (referring to the decision-making task) were measured after treatment. Performance on the soccer-specific decision-making task was assessed using response accuracy and time. Visual search behaviour was also assessed throughout the decision-making task. Subjective ratings of mental fatigue and effort were almost certainly higher following the Stroop task compared to the magazines. Motivation for the upcoming decision-making task was possibly higher following the Stroop task. Decision-making accuracy was very likely lower and response time likely higher in the mental fatigue condition. Mental fatigue had unclear effects on most visual search behaviour variables. The results suggest that mental fatigue impairs accuracy and speed of soccer-specific decision-making. These impairments are not likely related to changes in visual search behaviour.

  11. Sex differences in time perception during smoking abstinence.

    PubMed

    Ashare, Rebecca L; Kable, Joseph W

    2015-04-01

    Nicotine withdrawal leads to impulsive decision-making, which reflects a preference for smaller, immediate rewards and often prompts a relapse to smoking. The mechanism by which nicotine withdrawal leads to impulsive decision-making is not well known. An essential dimension of decision-making is time perception. Impulsive decisions reflect intolerance of temporal delays and the perception that time is passing more slowly. Sex may be an important factor in impulsive decision-making and time perception, but no studies have investigated whether sex moderates the effects of nicotine withdrawal on impulsive decision-making and time perception. Thirty-three (12 female) adult smokers completed 2 laboratory sessions: following 24-hr abstinence and once smoking-as-usual (order counterbalanced, abstinence biochemically verified). Participants completed 2 time perception tasks, a decision-making task, and self-report measures of craving, withdrawal, and mood. During time reproduction, males overestimated time during abstinence compared to smoking, whereas there was no session effect for females. On the time discrimination task, smokers were less accurate during abstinence, and this effect tended to be stronger among females. In general, males had higher discounting rates compared with females, but there was no effect of abstinence. The current data suggest that the effect of abstinence on time perception may be stronger in males and that males generally exhibit steeper delay discounting rates. Time perception may be an important mechanism in smoking abstinence. Our future work will investigate the role of time perception in smoking relapse and whether this is moderated by sex. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. Longitudinal associations between mothers' perceptions of nonresidential fathers' investment of resources and influence in decision-making.

    PubMed

    Fagan, Jay; Palkovitz, Rob

    2018-02-01

    Nonresidential fathers are challenged to remain involved with their children across time in both direct and indirect ways, including influencing decision-making around important issues such as school attendance and medical care. An analytic sample of 1,350 families with residential mothers and nonresidential fathers was selected from the Early Childhood Longitudinal Survey-Birth Cohort (ECLS-B) to examine the longitudinal relationships between mothers' reports of nonresidential fathers' influence in decision-making and their provision of resources to their children. Findings indicate that fathers' voluntary contribution of tangible resources (informal child support, caregiving time) when children are 2 years old positively predict fathers' influence in decision-making regarding the care of their 4-year-old children. Fathers' early formal child support is not related to later decision-making. Fathers' communication with mother about the child at 24 months is related to later decision-making among daughters but not sons. Fathers' early decision-making is longitudinally related to later informal child support, caregiving time, and coparenting communication. The findings support the utility of a resource theory of fathering for understanding and predicting observed patterns of father involvement. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Chronic work stress and decreased vagal tone impairs decision making and reaction time in jockeys.

    PubMed

    Landolt, Kathleen; Maruff, Paul; Horan, Ben; Kingsley, Michael; Kinsella, Glynda; O'Halloran, Paul D; Hale, Matthew W; Wright, Bradley J

    2017-10-01

    The inverse relationship between acute stress and decision-making is well documented, but few studies have investigated the impact of chronic stress. Jockeys work exhaustive schedules and have extremely dangerous occupations, with safe performance requiring quick reaction time and accurate decision-making. We used the effort reward imbalance (ERI) occupational stress model to assess the relationship of work stress with indices of stress physiology and decision-making and reaction time. Jockeys (N=32) completed computerised cognitive tasks (Cogstate) on two occasions; September and November (naturally occurring lower and higher stress periods), either side of an acute stress test. Higher ERI was correlated with the cortisol awakening responses (high stress r=-0.37; low stress r=0.36), and with decrements in decision-making comparable to having a blood alcohol concentration of 0.08 in the high stress period (p<0.001) The LF/HF ratio of heart rate variability impacted the association of ERI with decision-making. Potentially, this may be attributed to a 'tipping point' whereby the higher ERI reported by jockeys in the high stress period decreases vagal tone, which may contribute to reduced decision-making abilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Time to decide: Diurnal variations on the speed and quality of human decisions.

    PubMed

    Leone, María Juliana; Fernandez Slezak, Diego; Golombek, Diego; Sigman, Mariano

    2017-01-01

    Human behavior and physiology exhibit diurnal fluctuations. These rhythms are entrained by light and social cues, with vast individual differences in the phase of entrainment - referred as an individual's chronotype - ranging in a continuum between early larks and late owls. Understanding whether decision-making in real-life situations depends on the relation between time of the day and an individual's diurnal preferences has both practical and theoretical implications. However, answering this question has remained elusive because of the difficulty of measuring precisely the quality of a decision in real-life scenarios. Here we investigate diurnal variations in decision-making as a function of an individual's chronotype capitalizing on a vast repository of human decisions: online chess servers. In a chess game, every player has to make around 40 decisions using a finite time budget and both the time and quality of each decision can be accurately determined. We found reliable diurnal rhythms in activity and decision-making policy. During the morning, players adopt a prevention focus policy (slower and more accurate decisions) which is later modified to a promotion focus (faster but less accurate decisions), without daily changes in performance. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Temporal characteristics of decisions in hospital encounters: a threshold for shared decision making? A qualitative study.

    PubMed

    Ofstad, Eirik H; Frich, Jan C; Schei, Edvin; Frankel, Richard M; Gulbrandsen, Pål

    2014-11-01

    To identify and characterize physicians' statements that contained evidence of clinically relevant decisions in encounters with patients in different hospital settings. Qualitative analysis of 50 videotaped encounters from wards, the emergency room (ER) and outpatient clinics in a department of internal medicine at a Norwegian university hospital. Clinical decisions could be grouped in a temporal order: decisions which had already been made, and were brought into the encounter by the physician (preformed decisions), decisions made in the present (here-and-now decisions), and decisions prescribing future actions given a certain course of events (conditional decisions). Preformed decisions were a hallmark in the ward and conditional decisions a main feature of ER encounters. Clinical decisions related to a patient-physician encounter spanned a time frame exceeding the duration of the encounter. While a distribution of decisions over time and space fosters sharing and dilution of responsibility between providers, it makes the decision making process hard to access for patients. In order to plan when and how to involve patients in decisions, physicians need increased awareness of when clinical decisions are made, who usually makes them, and who should make them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Changing Times, Complex Decisions: Presidential Values and Decision Making

    ERIC Educational Resources Information Center

    Hornak, Anne M.; Garza Mitchell, Regina L.

    2016-01-01

    Objective: The objective of this article is to delve more deeply into the thought processes of the key decision makers at community colleges and understand how they make decisions. Specifically, this article focuses on the role of the community college president's personal values in decision making. Method: We conducted interviews with 13…

  17. DECISION-MAKING ALIGNED WITH RAPID-CYCLE EVALUATION IN HEALTH CARE.

    PubMed

    Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm

    2015-01-01

    Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.

  18. Everyday Decision Making in Individuals with Early-Stage Alzheimer's Disease: An Integrative Review of the Literature.

    PubMed

    Davis, Rebecca; Ziomkowski, Mary K; Veltkamp, Amy

    2017-09-01

    Individuals with Alzheimer's disease (AD) demonstrate fluctuation in cognitive abilities that can affect their ability to make decisions. Everyday decision making encompasses the types of decisions about typical daily activities, such as what to eat, what to do, and what to wear. Everyday decisions are encountered many times per day by individuals with AD/dementia and their caregivers. However, not much is known about the ability of individuals with AD/dementia to make these types of decisions. The purpose of the current literature review was to synthesize the evidence regarding everyday decision making in individuals with early-stage AD/dementia. Findings from the review indicate there is beginning evidence that individuals with early to moderate stages of AD/dementia desire to have input in daily decisions, have the ability to state their wishes consistently at times, and having input in decision making is important to their selfhood. The literature revealed few interventions to assist individuals with AD/dementia in everyday decision making. Findings from the review are discussed with implications for nursing practice and research. [Res Gerontol Nurs. 2017; 10(5):240-247.]. Copyright 2017, SLACK Incorporated.

  19. Decisions, decisions: analysis of age, cohort, and time of testing on framing of risky decision options.

    PubMed

    Mayhorn, Christopher B; Fisk, Arthur D; Whittle, Justin D

    2002-01-01

    Decision making in uncertain environments is a daily challenge faced by adults of all ages. Framing decision options as either gains or losses is a common method of altering decision-making behavior. In the experiment reported here, benchmark decision-making data collected in the 1970s by Tversky and Kahneman (1981, 1988) were compared with data collected from current samples of young and older adults to determine whether behavior was consistent across time. Although differences did emerge between the benchmark and the present samples, the effect of framing on decision behavior was relatively stable. The present findings suggest that adults of all ages are susceptible to framing effects. Results also indicated that apparent age differences might be better explained by an analysis of cohort and time-of-testing effects. Actual or potential applications of this research include an understanding of how framing might influence the decision-making behavior of people of all ages in a number of applied contexts, such as product warning interactions and medical decision scenarios.

  20. How the risky features of previous selection affect subsequent decision-making: evidence from behavioral and fMRI measures.

    PubMed

    Dong, Guangheng; Zhang, Yifen; Xu, Jiaojing; Lin, Xiao; Du, Xiaoxia

    2015-01-01

    Human decision making is rarely conducted in temporal isolation. It is often biased and affected by environmental variables, particularly prior selections. In this study, we used a task that simulates a real gambling process to explore the effect of the risky features of a previous selection on subsequent decision making. Compared with decision making after an advantageous risk-taking situation (Risk_Adv), that after a disadvantageous risk-taking situation (Risk_Disadv) is associated with a longer response time (RT, the time spent in making decisions) and higher brain activations in the caudate and the dorsolateral prefrontal cortex (DLPFC). Compared with decisions after Risk_Adv, those after Risk_Disadv in loss trials are associated with higher brain activations in the left superior temporal gyrus (STG) and the precuneus. Brain activity and relevant RTs significantly correlated. Overall, people who experience disadvantageous risk-taking selections tend to focus on current decision making and engage cognitive endeavors in value evaluation and in the regulation of their risk-taking behaviors during decision making.

  1. Shared Problem Models and Crew Decision Making

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

    The importance of crew decision making to aviation safety has been well established through NTSB accident analyses: Crew judgment and decision making have been cited as causes or contributing factors in over half of all accidents in commercial air transport, general aviation, and military aviation. Yet the bulk of research on decision making has not proven helpful in improving the quality of decisions in the cockpit. One reason is that traditional analytic decision models are inappropriate to the dynamic complex nature of cockpit decision making and do not accurately describe what expert human decision makers do when they make decisions. A new model of dynamic naturalistic decision making is offered that may prove more useful for training or aiding cockpit decision making. Based on analyses of crew performance in full-mission simulation and National Transportation Safety Board accident reports, features that define effective decision strategies in abnormal or emergency situations have been identified. These include accurate situation assessment (including time and risk assessment), appreciation of the complexity of the problem, sensitivity to constraints on the decision, timeliness of the response, and use of adequate information. More effective crews also manage their workload to provide themselves with time and resources to make good decisions. In brief, good decisions are appropriate to the demands of the situation and reflect the crew's metacognitive skill. Effective crew decision making and overall performance are mediated by crew communication. Communication contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relation between communication that serves to build performance. Implications of these findings for crew training will be discussed.

  2. The Effects of Conflict, Quality and Time on Small Group Information Use and Behavior in Evaluative Decision-Making Situations.

    ERIC Educational Resources Information Center

    Pflum, Glenn D.; Brown, Robert D.

    This study investigated information needs and use by groups in decision-making processes. Problem contexts were varied by conflict, quality, and time conditions and presented to 89 graduate level education students who simulated school board members making decisions about educational programs. The research hypotheses were: (1) there are no…

  3. Adaptive Strategy Selection in Decision Making.

    DTIC Science & Technology

    1986-07-31

    information processing capabilities of a decision maker, given any " reasonable " time limit for making the decision. If use of a more normative rule...DECISION MAKING JOHN W. PAYNE DTIC DUKE UNIVERSITY L.CT E AUG 13 JAMES R. BETTMAN DUKE. UNIVERSITY ERIC J. JOHNSON CARNEGIE-MELLON UNIVERSITY...REPORT & PERIOD COVERED ADAPTIVE STRATEGY SELECTION IN DECISION MAKING Research 6. PERFORMING ORO. REPORT NUMSER 7. AUTNORfe) e. CONTRACT ON GRANT

  4. Risk-taking and decision-making in youth: relationships to addiction vulnerability.

    PubMed

    Balogh, Kornelia N; Mayes, Linda C; Potenza, Marc N

    2013-03-01

    Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors.

  5. The PRC Decision-Making Process

    DTIC Science & Technology

    2002-03-01

    REPORT DATE March 2002 3. REPORT TYPE AND DATES COVERED Master’s Thesis 4. TITLE AND SUBTITLE The PRC Decision - Making ...of crisis. It explores who has the authority to make decisions in China today and who will have this authority as new leaders...security and foreign policy decision - making during times of crisis. The April 2001 EP-3 incident is examined to assess high-level

  6. Administrative decision making: a stepwise method.

    PubMed

    Oetjen, Reid M; Oetjen, Dawn M; Rotarius, Timothy

    2008-01-01

    Today's health care organizations face tremendous challenges and fierce competition. These pressures impact the decisions that managers must execute on any given day, not to mention the ever-present constraints of time, personnel, competencies, and finances. The importance of making quality and informed decisions cannot be underestimated. Traditional decision making methods are inadequate for today's larger, more complex health care organizations and the rapidly changing health care environment. As a result, today's health care managers and their teams need new approaches to making decisions for their organizations. This article examines the managerial decision making process and offers a model that can be used as a decision making template to help managers successfully navigate the choppy health care seas. The administrative decision making model will enable health care managers and other key decision makers to avoid the common pitfalls of poor decision making and guide their organizations to success.

  7. Brain mechanisms controlling decision making and motor planning.

    PubMed

    Ramakrishnan, Arjun; Murthy, Aditya

    2013-01-01

    Accumulator models of decision making provide a unified framework to understand decision making and motor planning. In these models, the evolution of a decision is reflected in the accumulation of sensory information into a motor plan that reaches a threshold, leading to choice behavior. While these models provide an elegant framework to understand performance and reaction times, their ability to explain complex behaviors such as decision making and motor control of sequential movements in dynamic environments is unclear. To examine and probe the limits of online modification of decision making and motor planning, an oculomotor "redirect" task was used. Here, subjects were expected to change their eye movement plan when a new saccade target appeared. Based on task performance, saccade reaction time distributions, computational models of behavior, and intracortical microstimulation of monkey frontal eye fields, we show how accumulator models can be tested and extended to study dynamic aspects of decision making and motor control. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. The enactment stage of end-of-life decision-making for children.

    PubMed

    Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

    2018-01-11

    Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular emotional and practical implications for parents. Greater understanding of this stage can improve clinician's support for parents as they care for their child.

  9. 32 CFR Enclosure 1 - Requirements for Environmental Considerations-Global Commons

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... the responsible decision-making official to be informed of pertinent environmental considerations. The... making an appropriate record with respect to this requirement is for the decision-maker to sign and date...-making process. Other means of making an appropriate record are also acceptable. 9. Timing. No decision...

  10. Intuition and Moral Decision-Making - The Effect of Time Pressure and Cognitive Load on Moral Judgment and Altruistic Behavior.

    PubMed

    Tinghög, Gustav; Andersson, David; Bonn, Caroline; Johannesson, Magnus; Kirchler, Michael; Koppel, Lina; Västfjäll, Daniel

    2016-01-01

    Do individuals intuitively favor certain moral actions over others? This study explores the role of intuitive thinking-induced by time pressure and cognitive load-in moral judgment and behavior. We conduct experiments in three different countries (Sweden, Austria, and the United States) involving over 1,400 subjects. All subjects responded to four trolley type dilemmas and four dictator games involving different charitable causes. Decisions were made under time pressure/time delay or while experiencing cognitive load or control. Overall we find converging evidence that intuitive states do not influence moral decisions. Neither time-pressure nor cognitive load had any effect on moral judgments or altruistic behavior. Thus we find no supporting evidence for the claim that intuitive moral judgments and dictator game giving differ from more reflectively taken decisions. Across all samples and decision tasks men were more likely to make utilitarian moral judgments and act selfishly compared to women, providing further evidence that there are robust gender differences in moral decision-making. However, there were no significant interactions between gender and the treatment manipulations of intuitive versus reflective decision-making.

  11. Intuition and Moral Decision-Making – The Effect of Time Pressure and Cognitive Load on Moral Judgment and Altruistic Behavior

    PubMed Central

    Bonn, Caroline; Johannesson, Magnus; Kirchler, Michael; Koppel, Lina; Västfjäll, Daniel

    2016-01-01

    Do individuals intuitively favor certain moral actions over others? This study explores the role of intuitive thinking—induced by time pressure and cognitive load—in moral judgment and behavior. We conduct experiments in three different countries (Sweden, Austria, and the United States) involving over 1,400 subjects. All subjects responded to four trolley type dilemmas and four dictator games involving different charitable causes. Decisions were made under time pressure/time delay or while experiencing cognitive load or control. Overall we find converging evidence that intuitive states do not influence moral decisions. Neither time-pressure nor cognitive load had any effect on moral judgments or altruistic behavior. Thus we find no supporting evidence for the claim that intuitive moral judgments and dictator game giving differ from more reflectively taken decisions. Across all samples and decision tasks men were more likely to make utilitarian moral judgments and act selfishly compared to women, providing further evidence that there are robust gender differences in moral decision-making. However, there were no significant interactions between gender and the treatment manipulations of intuitive versus reflective decision-making. PMID:27783704

  12. 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 all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking In response to a problem, This presentation will examine the relations between leadership, communication, decision making and overall crew performance. Implications of these findings for training will be discussed.

  13. 25 CFR 700.291 - Petitions for amendment: Time limits for processing.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... decision on a petition may be extended if the official responsible for making a decision on the petition... collected from facilities other than the facility at which the official responsible for making the decision is located. (2) If the official responsible for making a decision on the petition determines that an...

  14. 43 CFR 2.73 - Petitions for amendments: Time limits for processing.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... processing the request. (2) If the official responsible for making a decision on the petition determines that... decision on a petition may be extended if the official responsible for making a decision on the petition... collected from facilities other than the facility at which the official responsible for making the decision...

  15. Analytical group decision making in natural resources: methodology and application

    Treesearch

    Daniel L. Schmoldt; David L. Peterson

    2000-01-01

    Group decision making is becoming increasingly important in natural resource management and associated scientific applications, because multiple values are treated coincidentally in time and space, multiple resource specialists are needed, and multiple stakeholders must be included in the decision process. Decades of social science research on decision making in groups...

  16. Satisficing in Split-Second Decision Making Is Characterized by Strategic Cue Discounting

    ERIC Educational Resources Information Center

    Oh, Hanna; Beck, Jeffrey M.; Zhu, Pingping; Sommer, Marc A.; Ferrari, Silvia; Egner, Tobias

    2016-01-01

    Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through "satisficing," fast but "good-enough" heuristic decision making that prioritizes some sources of…

  17. When Friends' and Society's Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College.

    PubMed

    Bollich, Kathryn L; Hill, Patrick L; Harms, Peter D; Jackson, Joshua J

    2016-01-01

    Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change.

  18. When Friends’ and Society’s Expectations Collide: A Longitudinal Study of Moral Decision-Making and Personality across College

    PubMed Central

    Bollich, Kathryn L.; Hill, Patrick L.; Harms, Peter D.; Jackson, Joshua J.

    2016-01-01

    Early adulthood is a developmentally important time period, with many novel life events needing to be traversed for the first time. Despite this important transition period, few studies examine the development of moral decision-making processes during this critical life stage. In the present study, college students completed moral decision-making measures during their freshman and senior years of college. Results indicate that, across four years, moral decision-making demonstrates considerable rank-order stability as well as change, such that people become more likely to help a friend relative to following societal rules. To help understand the mechanisms driving changes in moral decision-making processes, we examined their joint development with personality traits, a known correlate that changes during early adulthood in the direction of greater maturity. We found little evidence that personality and moral decision-making developmental processes are related. In sum, findings indicate that while moral decision-making processes are relatively stable across a four-year period, changes do occur which are likely independent of developmental processes driving personality trait change. PMID:26751944

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

    PubMed

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

    2017-01-01

    To develop and validate a new instrument that assesses women's autonomy and role in decision making during maternity care. Through a community-based participatory research process, service users designed, content validated, and administered a cross-sectional quantitative survey, including 31 items on the experience of decision-making. Pregnancy experiences (n = 2514) were reported by 1672 women who saw a single type of primary maternity care provider in British Columbia. They described care by a midwife, family physician or obstetrician during 1, 2 or 3 maternity care cycles. We conducted psychometric testing in three separate samples. We assessed reliability, item-to-total correlations, and the factor structure of the The Mothers' Autonomy in Decision Making (MADM) scale. We report MADM scores by care provider type, length of prenatal appointments, preferences for role in decision-making, and satisfaction with experience of decision-making. The MADM scale measures a single construct: autonomy in decision-making during maternity care. Cronbach alphas for the scale exceeded 0.90 for all samples and all provider groups. All item-to-total correlations were replicable across three samples and exceeded 0.7. Eigenvalue and scree plots exhibited a clear 90-degree angle, and factor analysis generated a one factor scale. MADM median scores were highest among women who were cared for by midwives, and 10 or more points lower for those who saw physicians. Increased time for prenatal appointments was associated with higher scale scores, and there were significant differences between providers with respect to average time spent in prenatal appointments. Midwifery care was associated with higher MADM scores, even during short prenatal appointments (<15 minutes). Among women who preferred to lead decisions around their care (90.8%), and who were dissatisfied with their experience of decision making, MADM scores were very low (median 14). Women with physician carers were consistently more likely to report dissatisfaction with their involvement in decision making. The Mothers Autonomy in Decision Making (MADM) scale is a reliable instrument for assessment of the experience of decision making during maternity care. This new scale was developed and content validated by community members representing various populations of childbearing women in BC including women from vulnerable populations. MADM measures women's ability to lead decision making, whether they are given enough time to consider their options, and whether their choices are respected. Women who experienced midwifery care reported greater autonomy than women under physician care, when engaging in decision-making around maternity care options. Differences in models of care, professional education, regulatory standards, and compensation for prenatal visits between midwives and physicians likely affect the time available for these discussions and prioritization of a shared decision making process. The MADM scale reflects person-driven priorities, and reliably assesses interactions with maternity providers related to a person's ability to lead decision-making over the course of maternity care.

  20. Decision Making in Action: Applying Research to Practice

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Hart, Sandra G. (Technical Monitor)

    1994-01-01

    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 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 all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relations between leadership, communication, decision making and overall crew performance. Implications of these findings for training will be discussed.

  1. Risk-taking and decision-making in youth: relationships to addiction vulnerability

    PubMed Central

    Balogh, Kornelia N.; Mayes, Linda C.; Potenza, Marc N.

    2013-01-01

    Background Decision-making and risk-taking behavior undergo developmental changes during adolescence. Disadvantageous decision-making and increased risk-taking may lead to problematic behaviors such as substance use and abuse, pathological gambling and excessive internet use. Methods Based on MEDLINE searches, this article reviews the literature on decision-making and risk-taking and their relationship to addiction vulnerability in youth. Results Decision-making and risk-taking behaviors involve brain areas that undergoing developmental changes during puberty and young adulthood. Individual differences and peer pressure also relate importantly to decision-making and risk-taking. Conclusions Brain-based changes in emotional, motivational and cognitive processing may underlie risk-taking and decision-making propensities in adolescence, making this period a time of heightened vulnerability for engagement in additive behaviors. PMID:24294500

  2. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study.

    PubMed

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-04-01

    To explore multiple stakeholders' perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators', clinicians', parents' and youths' perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders' knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital's culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors' paediatric hospital.

  3. Expert Decision-Making in Naturalistic Environments: A Summary of Research

    DTIC Science & Technology

    2005-03-01

    a number of descriptive decision theories arose (Plous, 1993). One of these is the rational choice model of decision - making (Janis & Mann, 1977...possible association between time pressure and increased levels of emotion . To date, the role played by emotion in decision - making has not been given... rational choice model seems to describe some decision events and Janis and Mann (1977) have highlighted emotion as a potential influence on decision

  4. Optimal multisensory decision-making in a reaction-time task.

    PubMed

    Drugowitsch, Jan; DeAngelis, Gregory C; Klier, Eliana M; Angelaki, Dora E; Pouget, Alexandre

    2014-06-14

    Humans and animals can integrate sensory evidence from various sources to make decisions in a statistically near-optimal manner, provided that the stimulus presentation time is fixed across trials. Little is known about whether optimality is preserved when subjects can choose when to make a decision (reaction-time task), nor when sensory inputs have time-varying reliability. Using a reaction-time version of a visual/vestibular heading discrimination task, we show that behavior is clearly sub-optimal when quantified with traditional optimality metrics that ignore reaction times. We created a computational model that accumulates evidence optimally across both cues and time, and trades off accuracy with decision speed. This model quantitatively explains subjects's choices and reaction times, supporting the hypothesis that subjects do, in fact, accumulate evidence optimally over time and across sensory modalities, even when the reaction time is under the subject's control.

  5. Visualising Uncertainty for Decision Support

    DTIC Science & Technology

    2016-12-01

    25 4.2.7 The perceived trust level of information in decision making ......... 26 4.3 User issues...crucial to understanding the “reliability” of information , and consequently affect decision making (Deitrick, 2007). Olston and Mackinlay (2002...have long been regarded as a difficult topic since the commander has to make decisions in a limited time frame with information that comes from

  6. A Qualitative Study of Decision Making by First Time Parents for Their Child's Prekindergarten Year Programming

    ERIC Educational Resources Information Center

    Cronin, Timothy David

    2013-01-01

    This study sought to gain a better understanding of how participants made decisions regarding placement for their first-born children for the prekindergarten year. The purpose of this research, to explore participants' decision-making process, was guided by the following research question: "How do parents make decisions to select placements…

  7. 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.

  8. 32 CFR 775.3 - Policy.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Initiate the NEPA processes at the earliest possible time to be an effective decision making tool in the... ensure that environmental issues are fully considered and incorporated into the Federal decision making process. Consequently, actions for which the DON has no decision-making authority and no discretion in...

  9. Dynamic decision making for dam-break emergency management - Part 1: Theoretical framework

    NASA Astrophysics Data System (ADS)

    Peng, M.; Zhang, L. M.

    2013-02-01

    An evacuation decision for dam breaks is a very serious issue. A late decision may lead to loss of lives and properties, but a very early evacuation will incur unnecessary expenses. This paper presents a risk-based framework of dynamic decision making for dam-break emergency management (DYDEM). The dam-break emergency management in both time scale and space scale is introduced first to define the dynamic decision problem. The probability of dam failure is taken as a stochastic process and estimated using a time-series analysis method. The flood consequences are taken as functions of warning time and evaluated with a human risk analysis model (HURAM) based on Bayesian networks. A decision criterion is suggested to decide whether to evacuate the population at risk (PAR) or to delay the decision. The optimum time for evacuating the PAR is obtained by minimizing the expected total loss, which integrates the time-related probabilities and flood consequences. When a delayed decision is chosen, the decision making can be updated with available new information. A specific dam-break case study is presented in a companion paper to illustrate the application of this framework to complex dam-breaching problems.

  10. Educational Decision-Making: Rationality and the Impact of Time

    ERIC Educational Resources Information Center

    Adshead, Lesley; Jamieson, Anne

    2008-01-01

    This paper explores educational decision-making within a life course perspective. It draws on interviews carried out with 34 people, ages 30-81, as part of a longitudinal study into educational experiences of part-time mature students in continuing education at a London university. It considers to what extent their decisions about study are…

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

    PubMed Central

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

    2017-01-01

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

  12. Calcium dynamics regulating the timing of decision-making in C. elegans.

    PubMed

    Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

    2017-05-23

    Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans . We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca 2+ ] i ), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca 2+ ] i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making.

  13. Calcium dynamics regulating the timing of decision-making in C. elegans

    PubMed Central

    Tanimoto, Yuki; Yamazoe-Umemoto, Akiko; Fujita, Kosuke; Kawazoe, Yuya; Miyanishi, Yosuke; Yamazaki, Shuhei J; Fei, Xianfeng; Busch, Karl Emanuel; Gengyo-Ando, Keiko; Nakai, Junichi; Iino, Yuichi; Iwasaki, Yuishi; Hashimoto, Koichi; Kimura, Koutarou D

    2017-01-01

    Brains regulate behavioral responses with distinct timings. Here we investigate the cellular and molecular mechanisms underlying the timing of decision-making during olfactory navigation in Caenorhabditis elegans. We find that, based on subtle changes in odor concentrations, the animals appear to choose the appropriate migratory direction from multiple trials as a form of behavioral decision-making. Through optophysiological, mathematical and genetic analyses of neural activity under virtual odor gradients, we further find that odor concentration information is temporally integrated for a decision by a gradual increase in intracellular calcium concentration ([Ca2+]i), which occurs via L-type voltage-gated calcium channels in a pair of olfactory neurons. In contrast, for a reflex-like behavioral response, [Ca2+]i rapidly increases via multiple types of calcium channels in a pair of nociceptive neurons. Thus, the timing of neuronal responses is determined by cell type-dependent involvement of calcium channels, which may serve as a cellular basis for decision-making. DOI: http://dx.doi.org/10.7554/eLife.21629.001 PMID:28532547

  14. Adaptive sampling of information in perceptual decision-making.

    PubMed

    Cassey, Thomas C; Evens, David R; Bogacz, Rafal; Marshall, James A R; Ludwig, Casimir J H

    2013-01-01

    In many perceptual and cognitive decision-making problems, humans sample multiple noisy information sources serially, and integrate the sampled information to make an overall decision. We derive the optimal decision procedure for two-alternative choice tasks in which the different options are sampled one at a time, sources vary in the quality of the information they provide, and the available time is fixed. To maximize accuracy, the optimal observer allocates time to sampling different information sources in proportion to their noise levels. We tested human observers in a corresponding perceptual decision-making task. Observers compared the direction of two random dot motion patterns that were triggered only when fixated. Observers allocated more time to the noisier pattern, in a manner that correlated with their sensory uncertainty about the direction of the patterns. There were several differences between the optimal observer predictions and human behaviour. These differences point to a number of other factors, beyond the quality of the currently available sources of information, that influences the sampling strategy.

  15. Mechanisms Underlying Decision-Making as Revealed by Deep-Brain Stimulation in Patients with Parkinson's Disease.

    PubMed

    Herz, Damian M; Little, Simon; Pedrosa, David J; Tinkhauser, Gerd; Cheeran, Binith; Foltynie, Tom; Bogacz, Rafal; Brown, Peter

    2018-04-23

    To optimally balance opposing demands of speed and accuracy during decision-making, we must flexibly adapt how much evidence we require before making a choice. Such adjustments in decision thresholds have been linked to the subthalamic nucleus (STN), and therapeutic STN deep-brain stimulation (DBS) has been shown to interfere with this function. Here, we performed continuous as well as closed-loop DBS of the STN while Parkinson's disease patients performed a perceptual decision-making task. Closed-loop STN DBS allowed temporally patterned STN stimulation and simultaneous recordings of STN activity. This revealed that DBS only affected patients' ability to adjust decision thresholds if applied in a specific temporally confined time window during deliberation. Only stimulation in that window diminished the normal slowing of response times that occurred on difficult trials when DBS was turned off. Furthermore, DBS eliminated a relative, time-specific increase in STN beta oscillations and compromised its functional relationship with trial-by-trial adjustments in decision thresholds. Together, these results provide causal evidence that the STN is involved in adjusting decision thresholds in distinct, time-limited processing windows during deliberation. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Analyzing Decision Logs to Understand Decision Making in Serious Crime Investigations.

    PubMed

    Dando, Coral J; Ormerod, Thomas C

    2017-12-01

    Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments. Method A sample of decision logs from British police forces was analyzed qualitatively and quantitatively to explore hypothesis generation and evidence selection by police detectives. Results Analyses revealed diversity in documentation of decisions that did not correlate with case type and identified significant limitations of the decision log approach to supporting investigative decision making. Differences emerged between experienced and less experienced officers' decision log records in exploration of alternative hypotheses, generation of hypotheses, and sources of evidential inquiry opened over phase of investigation. Conclusion The practical use of decision logs is highly constrained by their format and context of use. Despite this, decision log records suggest that experienced detectives display strategic decision making to avoid confirmation and satisficing, which affect less experienced detectives. Application Potential applications of this research include both training in case documentation and the development of new decision log media that encourage detectives, irrespective of experience, to generate multiple hypotheses and optimize the timely selection of evidence to test them.

  17. A Common Mechanism Underlying Food Choice and Social Decisions.

    PubMed

    Krajbich, Ian; Hare, Todd; Bartling, Björn; Morishima, Yosuke; Fehr, Ernst

    2015-10-01

    People make numerous decisions every day including perceptual decisions such as walking through a crowd, decisions over primary rewards such as what to eat, and social decisions that require balancing own and others' benefits. The unifying principles behind choices in various domains are, however, still not well understood. Mathematical models that describe choice behavior in specific contexts have provided important insights into the computations that may underlie decision making in the brain. However, a critical and largely unanswered question is whether these models generalize from one choice context to another. Here we show that a model adapted from the perceptual decision-making domain and estimated on choices over food rewards accurately predicts choices and reaction times in four independent sets of subjects making social decisions. The robustness of the model across domains provides behavioral evidence for a common decision-making process in perceptual, primary reward, and social decision making.

  18. A Common Mechanism Underlying Food Choice and Social Decisions

    PubMed Central

    Krajbich, Ian; Hare, Todd; Bartling, Björn; Morishima, Yosuke; Fehr, Ernst

    2015-01-01

    People make numerous decisions every day including perceptual decisions such as walking through a crowd, decisions over primary rewards such as what to eat, and social decisions that require balancing own and others’ benefits. The unifying principles behind choices in various domains are, however, still not well understood. Mathematical models that describe choice behavior in specific contexts have provided important insights into the computations that may underlie decision making in the brain. However, a critical and largely unanswered question is whether these models generalize from one choice context to another. Here we show that a model adapted from the perceptual decision-making domain and estimated on choices over food rewards accurately predicts choices and reaction times in four independent sets of subjects making social decisions. The robustness of the model across domains provides behavioral evidence for a common decision-making process in perceptual, primary reward, and social decision making. PMID:26460812

  19. Barriers to and facilitators of implementing shared decision making and decision support in a paediatric hospital: A descriptive study

    PubMed Central

    Boland, Laura; McIsaac, Daniel I; Lawson, Margaret L

    2016-01-01

    OBJECTIVE: To explore multiple stakeholders’ perceived barriers to and facilitators of implementing shared decision making and decision support in a tertiary paediatric hospital. METHODS: An interpretive descriptive qualitative study was conducted using focus groups and interviews to examine senior hospital administrators’, clinicians’, parents’ and youths’ perceived barriers to and facilitators of shared decision making and decision support implementation. Data were analyzed using inductive thematic analysis. RESULTS: Fifty-seven stakeholders participated. Six barrier and facilitator themes emerged. The main barrier was gaps in stakeholders’ knowledge of shared decision making and decision support. Facilitators included compatibility between shared decision making and the hospital’s culture and ideal practices, perceptions of positive patient and family outcomes associated with shared decision making, and positive attitudes regarding shared decision making and decision support. However, youth attitudes regarding the necessity and usefulness of a decision support program were a barrier. Two themes were both a barrier and a facilitator. First, stakeholder groups were uncertain which clinical situations are suitable for shared decision making (eg, new diagnoses, chronic illnesses, complex decisions or urgent decisions). Second, the clinical process may be hindered if shared decision making and decision support decrease efficiency and workflow; however, shared decision making may reduce repeat visits and save time over the long term. CONCLUSIONS: Specific knowledge translation strategies that improve shared decision making knowledge and match specific barriers identified by each stakeholder group may be required to promote successful shared decision making and decision support implementation in the authors’ paediatric hospital. PMID:27398058

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

    PubMed

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

    2015-12-15

    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.

  1. 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

  2. Reaching for the Unknown: Multiple Target Encoding and Real-Time Decision-Making in a Rapid Reach Task

    ERIC Educational Resources Information Center

    Chapman, Craig S.; Gallivan, Jason P.; Wood, Daniel K.; Milne, Jennifer L.; Culham, Jody C.; Goodale, Melvyn A.

    2010-01-01

    Decision-making is central to human cognition. Fundamental to every decision is the ability to internally represent the available choices and their relative costs and benefits. The most basic and frequent decisions we make occur as our motor system chooses and executes only those actions that achieve our current goals. Although these interactions…

  3. Talking Points: Women's Information Needs for Informed Decision-Making About Noninvasive Prenatal Testing for Down Syndrome.

    PubMed

    Dane, Aimée C; Peterson, Madelyn; Miller, Yvette D

    2018-03-17

    Adequate knowledge is a vital component of informed decision-making; however, we do not know what information women value when making decisions about noninvasive prenatal testing (NIPT). The current study aimed to identify women's information needs for decision-making about NIPT as a first-tier, non-contingent test with out-of-pocket expense and, in turn, inform best practice by specifying the information that should be prioritized when providing pre-test counseling to women in a time-limited scenario or space-limited decision support tool. We asked women (N = 242) in Australia to indicate the importance of knowing 24 information items when making a decision about NIPT and to choose two information items they would most value. Our findings suggest that women value having complete information when making decisions about NIPT. Information about the accuracy of NIPT and the pros and cons of NIPT compared to other screening and invasive tests were perceived to be most important. The findings of this study can be used to maximize the usefulness of time-limited discussions or space-limited decision support tools, but should not be routinely relied upon as a replacement for provision of full and tailored information when feasible.

  4. 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 contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relations between leadership, communication, decision making and overall crew performance. Implications of these findings for spaceflight and training for offshore installations will be discussed.

  5. Decision Making in Action: Applying Research to Practice

    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 contributes to performance because it assures that all crew members have essential information, but it also regulates and coordinates crew actions and is the medium of collective thinking in response to a problem. This presentation will examine the relations between leadership, communication, decision making and overall crew performance. Implications of these findings for spaceflight and training for offshore installations will be discussed.

  6. What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

    PubMed Central

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

    2016-01-01

    Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

  7. What Is a "Good" Treatment Decision? Decisional Control, Knowledge, Treatment Decision Making, and Quality of Life in Men with Clinically Localized Prostate Cancer.

    PubMed

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J; Homish, D Lynn

    2016-08-01

    We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision-making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision making is an advantageous model for studying patient treatment decision-making dynamics because there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Men with newly diagnosed clinically localized prostate cancer (N = 1529) completed measures of decisional control, prostate cancer knowledge, and decision-making experiences (decisional conflict and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed at 6 months after treatment. More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control, predicted better QOL 6 months after treatment. Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time that they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. © The Author(s) 2016.

  8. 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…

  9. Bounded Rationality and Satisficing in Young People's Web-Based Decision Making.

    ERIC Educational Resources Information Center

    Agosto, Denise E.

    2002-01-01

    Investigated behavioral decision-making theories of bounded rationality and satisficing in relation to young people's decision making in the World Wide Web and considered the role of personal preferences. Results of this study of ninth- and tenth-grade females consider time constraints, information overload, physical constraints, reduction…

  10. Navigating the Decision Space: Shared Medical Decision Making as Distributed Cognition.

    PubMed

    Lippa, Katherine D; Feufel, Markus A; Robinson, F Eric; Shalin, Valerie L

    2017-06-01

    Despite increasing prominence, little is known about the cognitive processes underlying shared decision making. To investigate these processes, we conceptualize shared decision making as a form of distributed cognition. We introduce a Decision Space Model to identify physical and social influences on decision making. Using field observations and interviews, we demonstrate that patients and physicians in both acute and chronic care consider these influences when identifying the need for a decision, searching for decision parameters, making actionable decisions Based on the distribution of access to information and actions, we then identify four related patterns: physician dominated; physician-defined, patient-made; patient-defined, physician-made; and patient-dominated decisions. Results suggests that (a) decision making is necessarily distributed between physicians and patients, (b) differential access to information and action over time requires participants to transform a distributed task into a shared decision, and (c) adverse outcomes may result from failures to integrate physician and patient reasoning. Our analysis unifies disparate findings in the medical decision-making literature and has implications for improving care and medical training.

  11. Staged decision making based on probabilistic forecasting

    NASA Astrophysics Data System (ADS)

    Booister, Nikéh; Verkade, Jan; Werner, Micha; Cranston, Michael; Cumiskey, Lydia; Zevenbergen, Chris

    2016-04-01

    Flood forecasting systems reduce, but cannot eliminate uncertainty about the future. Probabilistic forecasts explicitly show that uncertainty remains. However, as - compared to deterministic forecasts - a dimension is added ('probability' or 'likelihood'), with this added dimension decision making is made slightly more complicated. A technique of decision support is the cost-loss approach, which defines whether or not to issue a warning or implement mitigation measures (risk-based method). With the cost-loss method a warning will be issued when the ratio of the response costs to the damage reduction is less than or equal to the probability of the possible flood event. This cost-loss method is not widely used, because it motivates based on only economic values and is a technique that is relatively static (no reasoning, yes/no decision). Nevertheless it has high potential to improve risk-based decision making based on probabilistic flood forecasting because there are no other methods known that deal with probabilities in decision making. The main aim of this research was to explore the ways of making decision making based on probabilities with the cost-loss method better applicable in practice. The exploration began by identifying other situations in which decisions were taken based on uncertain forecasts or predictions. These cases spanned a range of degrees of uncertainty: from known uncertainty to deep uncertainty. Based on the types of uncertainties, concepts of dealing with situations and responses were analysed and possible applicable concepts where chosen. Out of this analysis the concepts of flexibility and robustness appeared to be fitting to the existing method. Instead of taking big decisions with bigger consequences at once, the idea is that actions and decisions are cut-up into smaller pieces and finally the decision to implement is made based on economic costs of decisions and measures and the reduced effect of flooding. The more lead-time there is in flood event management, the more damage can be reduced. And with decisions based on probabilistic forecasts, partial decisions can be made earlier in time (with a lower probability) and can be scaled up or down later in time when there is more certainty; whether the event takes place or not. Partial decisions are often more cheap, or shorten the final mitigation-time at the moment when there is more certainty. The proposed method is tested on Stonehaven, on the Carron River in Scotland. Decisions to implement demountable defences in the town are currently made based on a very short lead-time due to the absence of certainty. Application showed that staged decision making is possible and gives the decision maker more time to respond to a situation. The decision maker is able to take a lower regret decision with higher uncertainty and less related negative consequences. Although it is not possible to quantify intangible effects, it is part of the analysis to reduce these effects. Above all, the proposed approach has shown to be a possible improvement in economic terms and opens up possibilities of more flexible and robust decision making.

  12. A control-theory model for human decision-making

    NASA Technical Reports Server (NTRS)

    Levison, W. H.; Tanner, R. B.

    1971-01-01

    A model for human decision making is an adaptation of an optimal control model for pilot/vehicle systems. The models for decision and control both contain concepts of time delay, observation noise, optimal prediction, and optimal estimation. The decision making model was intended for situations in which the human bases his decision on his estimate of the state of a linear plant. Experiments are described for the following task situations: (a) single decision tasks, (b) two-decision tasks, and (c) simultaneous manual control and decision making. Using fixed values for model parameters, single-task and two-task decision performance can be predicted to within an accuracy of 10 percent. Agreement is less good for the simultaneous decision and control situation.

  13. 20 CFR 411.205 - What if I disagree with the PM's decision about whether I am making timely progress toward self...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... about whether I am making timely progress toward self-supporting employment? 411.205 Section 411.205 Employees' Benefits SOCIAL SECURITY ADMINISTRATION THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM...-supporting employment? If you disagree with the PM's decision, you may request that we review the decision...

  14. Decision Making and Binge Drinking: A Longitudinal Study

    PubMed Central

    Goudriaan, Anna E.; Grekin, Emily R.; Sher, Kenneth J.

    2009-01-01

    Background: Behavioral decision making, as measured by the Iowa Gambling Task (IGT) is found to be diminished in individuals with substance dependence and other types of disinhibitory psychopathology. However, little is known regarding the relation between heavy alcohol use and decision-making skills in young adults. This study therefore investigated whether binge drinking is related to disadvantageous decision making, as measured by the IGT. We also examined the relation between decision making and impulsivity. Methods: Latent class growth analysis was used to classify college students into 4 groups (each group n = 50, 50% male), based on their binge drinking trajectories over a 2-year time period (precollege through second year of college). Participants were 200 college students, divided in 4 subgroups: (1) low binge drinkers, (2) stable moderate binge drinkers, (3) increasing binge drinkers, and (4) stable high binge drinkers. A measure of decision making, the IGT, impulsivity questionnaires, and multiple indicators of heavy alcohol use were included. Results: The stable high binge-drinking group made less advantageous choices on the IGT than the low binge-drinking group. Impulsivity was not related to decision-making performance. Decision-making performance did not differ by gender, but deck preferences and decision time patterns did differ; women preferred low frequency, high amount punishments to a greater extent than men. Conclusions: Although disadvantageous decision making is related to binge-drinking patterns in emerging adulthood, this relation is independent of impulsivity. Additionally, the association appears attributable to those who engage in heavy (binge) drinking at an early age, but not to age of onset of drinking in general. PMID:17403069

  15. 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.

  16. Evolution of Pediatric Chronic Disease Treatment Decisions: A Qualitative, Longitudinal View of Parents' Decision-Making Process.

    PubMed

    Lipstein, Ellen A; Britto, Maria T

    2015-08-01

    In the context of pediatric chronic conditions, patients and families are called upon repeatedly to make treatment decisions. However, little is known about how their decision making evolves over time. The objective was to understand parents' processes for treatment decision making in pediatric chronic conditions. We conducted a qualitative, prospective longitudinal study using recorded clinic visits and individual interviews. After consent was obtained from health care providers, parents, and patients, clinic visits during which treatment decisions were expected to be discussed were video-recorded. Parents then participated in sequential telephone interviews about their decision-making experience. Data were coded by 2 people and analyzed using framework analysis with sequential, time-ordered matrices. 21 families, including 29 parents, participated in video-recording and interviews. We found 3 dominant patterns of decision evolution. Each consisted of a series of decision events, including conversations, disease flares, and researching of treatment options. Within all 3 patterns there were both constant and evolving elements of decision making, such as role perceptions and treatment expectations, respectively. After parents made a treatment decision, they immediately turned to the next decision related to the chronic condition, creating an iterative cycle. In this study, decision making was an iterative process occurring in 3 distinct patterns. Understanding these patterns and the varying elements of parents' decision processes is an essential step toward developing interventions that are appropriate to the setting and that capitalize on the skills families may develop as they gain experience with a chronic condition. Future research should also consider the role of children and adolescents in this decision process. © The Author(s) 2015.

  17. Strategies in Forecasting Outcomes in Ethical Decision-making: Identifying and Analyzing the Causes of the Problem

    PubMed Central

    Beeler, Cheryl K.; Antes, Alison L.; Wang, Xiaoqian; Caughron, Jared J.; Thiel, Chase E.; Mumford, Michael D.

    2010-01-01

    This study examined the role of key causal analysis strategies in forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to identify and analyze the causes, forecast potential outcomes, and make a decision about each problem. Time pressure and analytic mindset were manipulated while participants worked through these problems. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical causes of the problem was associated with both higher quality forecasts and higher ethicality of decisions. Neither time pressure nor analytic mindset impacted forecasts or ethicality of decisions. Theoretical and practical implications of these findings are discussed. PMID:20352056

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

    PubMed

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

    2013-03-06

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

  19. Decision-making in product portfolios of pharmaceutical research and development – managing streams of innovation in highly regulated markets

    PubMed Central

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success. PMID:25364229

  20. Decision-making in product portfolios of pharmaceutical research and development--managing streams of innovation in highly regulated markets.

    PubMed

    Jekunen, Antti

    2014-01-01

    Decision-making is a core function of any drug development firm. Developing drugs demands a firm to be highly innovative, while at the same time the activity is strictly regulated. Successful drug development offers the right to apply for a long-term patent that confers exclusive marketing rights. This article addresses the issue of what constitutes an adequate portfolio of drugs for a drug development firm and how it might be managed successfully. The paper investigates decision-making in the industry and specifically in the development of oncology drugs from various perspectives: the need for decisions, their timing, decision-making at the project level, the optimal portfolio, tools for portfolio analysis, the evaluation of patents, and finally the importance of the drug portfolio. Drug development decisions as important organizational elements should get more emphasis, and decisions in drug portfolio using modern decision-making methods should be used more widely than what currently happens. Structured, informed decisions would help avoiding late terminations of drugs in Phase III development. An improved research and development pipeline and drug portfolio management are the major elements in the general strategy targeting success.

  1. How attention influences perceptual decision making: Single-trial EEG correlates of drift-diffusion model parameters

    PubMed Central

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

    2016-01-01

    Perceptual decision making can be accounted for by drift-diffusion models, a class of decision-making models that assume a stochastic accumulation of evidence on each trial. Fitting response time and accuracy to a drift-diffusion model produces evidence accumulation rate and non-decision time parameter estimates that reflect cognitive processes. Our goal is to elucidate the effect of attention on visual decision making. In this study, we show that measures of attention obtained from simultaneous EEG recordings can explain per-trial evidence accumulation rates and perceptual preprocessing times during a visual decision making task. Models assuming linear relationships between diffusion model parameters and EEG measures as external inputs were fit in a single step in a hierarchical Bayesian framework. The EEG measures were features of the evoked potential (EP) to the onset of a masking noise and the onset of a task-relevant signal stimulus. Single-trial evoked EEG responses, P200s to the onsets of visual noise and N200s to the onsets of visual signal, explain single-trial evidence accumulation and preprocessing times. Within-trial evidence accumulation variance was not found to be influenced by attention to the signal or noise. Single-trial measures of attention lead to better out-of-sample predictions of accuracy and correct reaction time distributions for individual subjects. PMID:28435173

  2. How attention influences perceptual decision making: Single-trial EEG correlates of drift-diffusion model parameters.

    PubMed

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

    2017-02-01

    Perceptual decision making can be accounted for by drift-diffusion models, a class of decision-making models that assume a stochastic accumulation of evidence on each trial. Fitting response time and accuracy to a drift-diffusion model produces evidence accumulation rate and non-decision time parameter estimates that reflect cognitive processes. Our goal is to elucidate the effect of attention on visual decision making. In this study, we show that measures of attention obtained from simultaneous EEG recordings can explain per-trial evidence accumulation rates and perceptual preprocessing times during a visual decision making task. Models assuming linear relationships between diffusion model parameters and EEG measures as external inputs were fit in a single step in a hierarchical Bayesian framework. The EEG measures were features of the evoked potential (EP) to the onset of a masking noise and the onset of a task-relevant signal stimulus. Single-trial evoked EEG responses, P200s to the onsets of visual noise and N200s to the onsets of visual signal, explain single-trial evidence accumulation and preprocessing times. Within-trial evidence accumulation variance was not found to be influenced by attention to the signal or noise. Single-trial measures of attention lead to better out-of-sample predictions of accuracy and correct reaction time distributions for individual subjects.

  3. Decision-Making Experiences of Patients with Implantable Cardioverter Defibrillators.

    PubMed

    Green, Ariel R; Jenkins, Amy; Masoudi, Frederick A; Magid, David J; Kutner, Jean S; Leff, Bruce; Matlock, Daniel D

    2016-10-01

    When patients are not adequately engaged in decision making, they may be at risk of decision regret. Our objective was to explore patients' perceptions of their decision-making experiences related to implantable cardioverter defibrillators (ICDs). Cross-sectional, mailed survey of 412 patients who received an ICD without cardiac resynchronization therapy for any indication between 2006 and 2009. Patients were asked about decision participation and decision regret. A total of 295 patients with ICDs responded (72% response rate). Overall, 79% reported that they were as involved in the decision as they wanted. However, 28% reported that they were not told of the option of not getting an ICD and 37% did not remember being asked if they wanted an ICD. In total, 19% reported not wanting their ICD at the time of implantation. Those who did not want the ICD were younger (<65 years; 74% vs 43%, P < 0.001), had higher decision regret (31/100 vs 11/100, P < 0.001), and reported less participation in decision making (the doctor "totally" made the decision, 9% vs 3%; P < 0.001). A considerable number of ICD recipients recalled not wanting their ICD at the time of implantation. While these findings may be prone to recall bias, they likely identify opportunities to improve ICD decision making. © 2016 Wiley Periodicals, Inc.

  4. Who Chokes Under Pressure? The Big Five Personality Traits and Decision-Making under Pressure.

    PubMed

    Byrne, Kaileigh A; Silasi-Mansat, Crina D; Worthy, Darrell A

    2015-02-01

    The purpose of the present study was to examine whether the Big Five personality factors could predict who thrives or chokes under pressure during decision-making. The effects of the Big Five personality factors on decision-making ability and performance under social (Experiment 1) and combined social and time pressure (Experiment 2) were examined using the Big Five Personality Inventory and a dynamic decision-making task that required participants to learn an optimal strategy. In Experiment 1, a hierarchical multiple regression analysis showed an interaction between neuroticism and pressure condition. Neuroticism negatively predicted performance under social pressure, but did not affect decision-making under low pressure. Additionally, the negative effect of neuroticism under pressure was replicated using a combined social and time pressure manipulation in Experiment 2. These results support distraction theory whereby pressure taxes highly neurotic individuals' cognitive resources, leading to sub-optimal performance. Agreeableness also negatively predicted performance in both experiments.

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

    PubMed

    Truglio-Londrigan, Marie; Slyer, Jason T

    2018-01-01

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

  6. How can surgeons facilitate resident intraoperative decision-making?

    PubMed

    Hill, Katherine A; Dasari, Mohini; Littleton, Eliza B; Hamad, Giselle G

    2017-10-01

    Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy. In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident. Themes were extracted using inductive methods. Thirty interviews were completed after 15 cases. Facilitators of decision-making included dialogue, safe struggle, and appreciation for retraction. Aberrant case characteristics, anatomic uncertainties, and time pressures provided barriers. Attending-resident mismatches included descriptions of transitioning control to the attending. Reciprocal dialogue, including concept-driven feedback, is helpful during intraoperative teaching. Unanticipated findings impede resident decision-making, and we describe differences in understanding transfers of operative control. Given these factors, we suggest that pre-operative discussions may be beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Midwives׳ decision making about transfers for 'slow' labour in rural New Zealand.

    PubMed

    Patterson, Jean; Skinner, Joan; Foureur, Maralyn

    2015-06-01

    Midwives who provided Lead Maternity Care (LMC) to women in rural areas were invited to share their experiences of decision making around transfer in labour. Ethics approval was obtained from the NZ National Ethics Committee. to explore midwives׳ decision making processes when making transfer decisions for slow labour progress from rural areas to specialist care. individual and group interviews were conducted with a purposive sample of rural midwives. The recalled decision processes of the midwives were subjected to a content and thematic analysis to expose experiences in common and to highlight aspects of probabilistic (normative), heuristic (behavioural), and group decision making theory within the rural context. New Zealand. 15 midwives who provided LMC services to women in their rural areas. 'making the mind shift', 'sitting on the boundary', 'timing the transfer' and 'the community interest' emerged as key themes. The decision processes were also influenced by the woman׳s preferences and the distance and time involved in the transfer. the findings contribute insights into the challenge of making transfer decisions in rural units; particularly for otherwise well women who were experiencing slow labour progress. Knowledge of the fallibility of our heuristic decision making strategies may encourage the practitioner to step back and take a more deliberative, probabilistic view of the situation. In addition to the clinical picture, this process should include the relational and aspirational aspects for the woman, and any logistical challenges of the particular rural context. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2017-11-15

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

  9. Making a Good Group Decision (Low Risk) in Singapore Under an Environment That Has Time and Cost Constraints

    DTIC Science & Technology

    2014-09-01

    decision-making framework to eliminate bias and promote effective communication. Using a collaborative approach built on systems engineering and...framework to eliminate bias and promote effective communication. Using a collaborative approach built on systems engineering and decision-making...Organization .......................................................................................61 2. Bias

  10. The International Study of Leadership in Education: Monitoring Decision Making by School Leaders

    ERIC Educational Resources Information Center

    Wildy, Helen; Forster, Pat; Louden, William; Wallace, John

    2004-01-01

    School principals have difficulty embracing the competing demands of school restructuring. These demands include being accountable for the outcomes of other decision-making groups within, or external to, the school community; having strong views while making decisions collaboratively; and using group processes without wasting the time, commitment,…

  11. 45 CFR 1309.12 - Timely decisions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Timely decisions. 1309.12 Section 1309.12 Public... PROGRAM HEAD START FACILITIES PURCHASE, MAJOR RENOVATION AND CONSTRUCTION Application Procedures § 1309.12 Timely decisions. The responsible HHS official shall promptly review and make final decisions regarding...

  12. Efficient group decision making in workshop settings

    Treesearch

    Daniel L. Schmoldt; David L. Peterson

    2001-01-01

    Public land managers must treat multiple values coincidentally in time and space, which requires the participation of multiple resource specialists and consideration of diverse clientele interests in the decision process. This implies decision making that includes multiple participants, both internally and externally. Decades of social science research on decision...

  13. Methods and decision making on a Mars rover for identification of fossils

    NASA Technical Reports Server (NTRS)

    Eberlein, Susan; Yates, Gigi

    1989-01-01

    A system for automated fusion and interpretation of image data from multiple sensors, including multispectral data from an imaging spectrometer is being developed. Classical artificial intelligence techniques and artificial neural networks are employed to make real time decision based on current input and known scientific goals. Emphasis is placed on identifying minerals which could indicate past life activity or an environment supportive of life. Multispectral data can be used for geological analysis because different minerals have characteristic spectral reflectance in the visible and near infrared range. Classification of each spectrum into a broad class, based on overall spectral shape and locations of absorption bands is possible in real time using artificial neural networks. The goal of the system is twofold: multisensor and multispectral data must be interpreted in real time so that potentially interesting sites can be flagged and investigated in more detail while the rover is near those sites; and the sensed data must be reduced to the most compact form possible without loss of crucial information. Autonomous decision making will allow a rover to achieve maximum scientific benefit from a mission. Both a classical rule based approach and a decision neural network for making real time choices are being considered. Neural nets may work well for adaptive decision making. A neural net can be trained to work in two steps. First, the actual input state is mapped to the closest of a number of memorized states. After weighing the importance of various input parameters, the net produces an output decision based on the matched memory state. Real time, autonomous image data analysis and decision making capabilities are required for achieving maximum scientific benefit from a rover mission. The system under development will enhance the chances of identifying fossils or environments capable of supporting life on Mars

  14. Patient decision making among older individuals with cancer.

    PubMed

    Strohschein, Fay J; Bergman, Howard; Carnevale, Franco A; Loiselle, Carmen G

    2011-07-01

    Patient decision making is an area of increasing inquiry. For older individuals experiencing cancer, variations in health and functional status, physiologic aspects of aging, and tension between quality and quantity of life present unique challenges to treatment-related decision making. We used the pragmatic utility method to analyze the concept of patient decision making in the context of older individuals with cancer. We first evaluated its maturity in existing literature and then posed analytical questions to clarify aspects found to be only partially mature. In this context, we found patient decision making to be an ongoing process, changing with time, reflecting individual and relational components, as well as analytical and emotional ones. Assumptions frequently associated with patient decision making were not consistent with the empirical literature. Careful attention to the multifaceted components of patient decision making among older individuals with cancer provides guidance for research, supportive interventions, and targeted follow-up care.

  15. Stop making plans; start making decisions.

    PubMed

    Mankins, Michael C; Steele, Richard

    2006-01-01

    Many executives have grown skeptical of strategic planning. Is it any wonder? Despite all the time and energy that go into it, strategic planning most often acts as a barrier to good decision making and does little to influence strategy. Strategic planning fails because of two factors: It typically occurs annually, and it focuses on individual business units. As such, the process is completely at odds with the way executives actually make important strategy decisions, which are neither constrained by the calendar nor defined by unit boundaries. Thus, according to a survey of 156 large companies, senior executives often make strategic decisions outside the planning process, in an ad hoc fashion and without rigorous analysis or productive debate. But companies can fix the process if they attack its root problems. A few forward-looking firms have thrown out their calendar-driven, business-unit-focused planning procedures and replaced them with continuous, issues-focused decision making. In doing so, they rely on several basic principles: They separate, but integrate, decision making and plan making. They focus on a few key themes. And they structure strategy reviews to produce real decisions. When companies change the timing and focus of strategic planning, they also change the nature of senior management's discussions about strategy--from "review and approve" to "debate and decide," in which top executives actively think through every major decision and its implications for the company's performance and value. The authors have found that these companies make more than twice as many important strategic decisions per year as companies that follow the traditional planning model.

  16. A Response-Time Approach to Comparing Generalized Rational and Take-the-Best Models of Decision Making

    ERIC Educational Resources Information Center

    Bergert, F. Bryan; Nosofsky, Robert M.

    2007-01-01

    The authors develop and test generalized versions of take-the-best (TTB) and rational (RAT) models of multiattribute paired-comparison inference. The generalized models make allowances for subjective attribute weighting, probabilistic orders of attribute inspection, and noisy decision making. A key new test involves a response-time (RT)…

  17. Defining decision making: a qualitative study of international experts' views on surgical trainee decision making.

    PubMed

    Rennie, Sarah C; van Rij, Andre M; Jaye, Chrystal; Hall, Katherine H

    2011-06-01

    Decision making is a key competency of surgeons; however, how best to assess decisions and decision makers is not clearly established. The aim of the present study was to identify criteria that inform judgments about surgical trainees' decision-making skills. A qualitative free text web-based survey was distributed to recognized international experts in Surgery, Medical Education, and Cognitive Research. Half the participants were asked to identify features of good decisions, characteristics of good decision makers, and essential factors for developing good decision-making skills. The other half were asked to consider these areas in relation to poor decision making. Template analysis of free text responses was performed. Twenty-nine (52%) experts responded to the survey, identifying 13 categories for judging a decision and 14 for judging a decision maker. Twelve features/characteristics overlapped (considered, informed, well timed, aware of limitations, communicated, knowledgeable, collaborative, patient-focused, flexible, able to act on the decision, evidence-based, and coherent). Fifteen categories were generated for essential factors leading to development of decision-making skills that fall into three major themes (personal qualities, training, and culture). The categories compiled from the perspectives of good/poor were predominantly the inverse of each other; however, the weighting given to some categories varied. This study provides criteria described by experts when considering surgical decisions, decision makers, and development of decision-making skills. It proposes a working definition of a good decision maker. Understanding these criteria will enable clinical teachers to better recognize and encourage good decision-making skills and identify poor decision-making skills for remediation.

  18. Measuring shared decision making in the consultation: a comparison of the OPTION and Informed Decision Making instruments.

    PubMed

    Weiss, Marjorie C; Peters, Tim J

    2008-01-01

    To investigate the applied and conceptual relationship between two measures of shared decision making using the OPTION instrument developed in Wales and the Informed Decision Making instrument developed in Seattle, USA using audio-taped consultation data from a UK general practice population. Twelve general practitioners were recruited from 6 general practices in the southwest of England. One hundred twenty-three GP-patient consultations were audio-recorded. Audiotapes were sent off to, and rated by, respective experts in the use of the OPTION and the Informed Decision Making instruments. Compared to earlier work using the Informed Decision Making tool, consultations in this sample were shorter, had fewer decisions and tended to have a greater number of elements present. Similar to previous research using the OPTION, values using the OPTION instrument were low with two items, giving the patient opportunities to ask questions and checking patient understanding, exhibiting the most variability. Using a 'key' decision in each consultation as the basis for comparison, the Informed Decision Making score was not related to the overall OPTION score (Spearman's rho=0.14, p=0.13). Both instruments also predicted different 'best' and 'worst' doctors. Using a Bland-Altman plot for assessing agreement, the mean difference between the two measures was 1.11 (CI 0.66-1.56) and the limits of agreement were -3.94 to 6.16. There were several elements between the two instruments that appeared conceptually similar and correlations for these were generally higher. These were: discussing alternatives or options (Spearman's rho=0.35, p=0.0001), discussion of the patient's role in decision making (Spearman's rho=0.23, p=0.012), discussion of the pros/cons of the alternatives (Spearman's rho=0.20, p=0.024) and assessment of the patient's understanding (Spearman's rho=0.19, p=0.03). Measures of shared decision making are helpful in identifying those shared decision making skills which may be problematic or difficult to integrate into practice and provide a tool by which the development of skills can be assessed over time. Research may implicitly place undue value on those aspects of shared decision making which are most easily measured. Shared decision making tools are a useful way of capturing the presence or absence of specific shared decision making skills and changes in skills acquisition over time. However there may be limits in the extent to which the concept of shared decision making can be measured and that more easily measured skills will be emphasised to the detriment of other important shared decision making skills.

  19. Asynchronous decision making in a memorized paddle pressing task

    NASA Astrophysics Data System (ADS)

    Dankert, James R.; Olson, Byron; Si, Jennie

    2008-12-01

    This paper presents a method for asynchronous decision making using recorded neural data in a binary decision task. This is a demonstration of a technique for developing motor cortical neural prosthetics that do not rely on external cued timing information. The system presented in this paper uses support vector machines and leaky integrate-and-fire elements to predict directional paddle presses. In addition to the traditional metrics of accuracy, asynchronous systems must also optimize the time needed to make a decision. The system presented is able to predict paddle presses with a median accuracy of 88% and all decisions are made before the time of the actual paddle press. An alternative bit rate measure of performance is defined to show that the system proposed here is able to perform the task with the same efficiency as the rats.

  20. Interpersonal relationship modulates the behavioral and neural responses during moral decision-making.

    PubMed

    Zhan, Youlong; Xiao, Xiao; Li, Jin; Liu, Lei; Chen, Jie; Fan, Wei; Zhong, Yiping

    2018-04-13

    Interpersonal relationship (IR) may play an important role in moral decision-making. However, it is little known about how IR influences neural and behavioral responses during moral decision-making. The present study utilized the dilemma scenario-priming paradigm to examine the time course of the different intimate IR (friend, acquaintance, or stranger) impacts on the emotional and cognitive processes during moral decision-making. Results showed that participants made less altruistic decisions with increased decision times and experienced more unpleasure for strangers versus friends and acquaintances. Moreover, at the early moral intuitional process, there was no significance difference observed at N1 under different intimate IR; however, at the emotional process, larger P260 which reflects the dilemma conflicts and negative emotional responses, was elicited when moral decision-making for strangers; at the later cognitive process, such difference was also observed at LPP (300-450 ms) which indexes the later top-down cognitive appraisal and reasoning processes. However, such differences were not observed between friends and acquaintances. Results indicate that IR modulates the emotional and cognitive processes during moral decision-making, suggesting that the closer the IR is, the weaker the dilemma conflicts and emotional responses are, and the more efficient this conflicts are solved. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Goal-Directed Decision Making with Spiking Neurons.

    PubMed

    Friedrich, Johannes; Lengyel, Máté

    2016-02-03

    Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. Copyright © 2016 the authors 0270-6474/16/361529-18$15.00/0.

  2. Goal-Directed Decision Making with Spiking Neurons

    PubMed Central

    Lengyel, Máté

    2016-01-01

    Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. SIGNIFICANCE STATEMENT Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules such that its dynamics devise a near-optimal plan of action. By systematically comparing our model results to experimental data, we show that it reproduces behavioral decision times and choice probabilities as well as neural responses in a rich set of tasks. Our results thus offer the first biologically realistic account for complex goal-directed decision making at a computational, algorithmic, and implementational level. PMID:26843636

  3. The emergency patient's participation in medical decision-making.

    PubMed

    Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

    2016-09-01

    The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

  4. A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

    PubMed

    Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona

    2018-02-01

    Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

  5. Following Human Footsteps: Proposal of a Decision Theory Based on Human Behavior

    NASA Technical Reports Server (NTRS)

    Mahmud, Faisal

    2011-01-01

    Human behavior is a complex nature which depends on circumstances and decisions varying from time to time as well as place to place. The way a decision is made either directly or indirectly related to the availability of the options. These options though appear at random nature, have a solid directional way for decision making. In this paper, a decision theory is proposed which is based on human behavior. The theory is structured with model sets that will show the all possible combinations for making a decision, A virtual and simulated environment is considered to show the results of the proposed decision theory

  6. Fertility Preservation in Pediatric and Adolescent Oncology Patients: The Decision-Making Process of Parents.

    PubMed

    Li, Nancy; Jayasinghe, Yasmin; Kemertzis, Matthew A; Moore, Paddy; Peate, Michelle

    2017-06-01

    Decisions surrounding fertility preservation (FP) in children, adolescents, and adults can be difficult due to the distress of a cancer diagnosis, time constraints for decision-making, and lack of efficacy data. This review examines the decision-making process of oncology patients and their parents (if patients are in the pediatric or adolescent population) to better understand experiences of decisional conflict and regret. Two electronic databases, Embase and Pubmed, were searched using the terms (Decision-making OR Conflict (Psychology) OR Decision regret) AND (Freezing OR Oocyte OR Ovarian tissue OR Semen preservation OR Fertility preservation OR Cryopreservation) AND (Neoplasms OR Cancer OR Chemotherapy OR Drug therapy OR Radiotherapy). Medical Subject Heading terms were utilized where possible. Included articles discussed FP decision-making from the patient's perspective. Thirty-five articles discussing FP decision-making were included (24 in the adult population, 11 in the pediatric and adolescent population). Key themes from these articles included the following: factors considered in FP decision-making, decision-making in established procedures and experimental procedures, decisional conflict and regret, the perceived importance of information, adolescent involvement in decision-making, and ethical considerations in the pediatric population. Unique ethical issues arise in the pediatric and adolescent population. Considering that the decision to pursue FP is known to be difficult in the adult population, decisional conflict and regret may be greater for parents who are making the decision for their child.

  7. The hunt for the perfect discounting function and a reckoning of time perception.

    PubMed

    Namboodiri, Vijay Mk; Hussain Shuler, Marshall G

    2016-10-01

    Making decisions that factor the cost of time is fundamental to survival. Yet, while it is readily appreciated that our perception of time is intimately involved in this process, theories regarding intertemporal decision-making and theories regarding time perception are treated, largely, independently. Even within these respective domains, models providing good fits to data fail to provide insight as to why, from a normative sense, those fits should take their apparent form. Conversely, normative models that proffer a rationalization for why an agent should weigh options in a particular way, or to perceive time in a particular way, fail to account for the full body of well-established experimental evidence. Here we review select, yet key advances in our understanding, identifying conceptual breakthroughs in the fields of intertemporal decision-making and in time perception, as well as their limits and failings in the face of hard-won experimental observation. On this background of accrued knowledge, a new conception unifying the domains of decision-making and time perception is put forward (Training-Integrated Maximization of Reinforcement Rate, TIMERR) to provide a better fit to observations and a more parsimonious reckoning of why we make choices, and thereby perceive time, the way we do. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Effects of length of abstinence on decision-making and craving in methamphetamine abusers.

    PubMed

    Wang, Guibin; Shi, Jie; Chen, Na; Xu, Lingzhi; Li, Jiali; Li, Peng; Sun, Yan; Lu, Lin

    2013-01-01

    The majority of drug abusers are incapable of sustaining abstinence over any length of time. Accumulating evidence has linked intense and involuntary craving, Impulsive decision-making and mood disturbances to risk for relapse. However, little is known about temporal changes of these neuropsychological functions in methamphetamine (METH)-dependent individuals. To investigate the effect of length of abstinence on decision-making, craving (baseline and cue-induced), and emotional state in METH-addicted individuals. In this cross-sectional study, 183 adult METH-dependent patients at an addiction rehabilitation center who were abstinent for 6 days (n = 37), 14 days (n = 33), 1 month (n = 31), 3 months (n = 30), 6 months (n = 26), or 1 year (n = 30) and 39 healthy subjects were administered the Iowa Gambling Task (IGT) to assess decision-making performance. Depression, anxiety, and impulsivity were also examined. One hundred thirty-nine METH abusers who were abstinent for the aforementioned times then underwent a cue session, and subjective and physiological measures were assessed. METH dependent individuals who were abstinent for longer periods of time exhibited better decision-making than those who were abstinent for shorter periods of time. And self-reported emotional symptoms improved with abstinence. METH abusers' ratings of craving decreased with the duration of abstinence, while cue-induced craving increased until 3 months of abstinence and decreased at 6 months and 1 year of abstinence. We present time-dependent alterations in decision-making, emotional state, and the incubation of cue-induced craving in METH-dependent individuals, which might have significant clinical implications for the prevention of relapse.

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

    PubMed Central

    Truglio-Londrigan, Marie; Slyer, Jason T.

    2018-01-01

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

  10. A Social Approach to Decision-Making Capacity: Exploratory Research with People with Experience of Mental Health Treatment

    ERIC Educational Resources Information Center

    McDaid, Shari; Delaney, Sarah

    2011-01-01

    This paper reports on exploratory, qualitative research conducted with eight people with experience of mental health treatment about their understanding of decision-making capacity. While acknowledging that there are times when mental or emotional distress can interfere with the capacity to make decisions, participants described how their capacity…

  11. Predictive Validity of Career Decision-Making Profiles over Time among Chinese College Students

    ERIC Educational Resources Information Center

    Tian, Lin; Guan, Yanjun; Chen, Sylvia Xiaohua; Levin, Nimrod; Cai, Zijun; Chen, Pei; Zhu, Chengfeng; Fu, Ruchunyi; Wang, Yang; Zhang, Shu

    2014-01-01

    Two studies were conducted to validate the Chinese version of the Career Decision-Making Profiles (CDMP) questionnaire, a multidimensional measure of the way individuals make career decisions. Results of Study 1 showed that after dropping 1 item from the original CDMP scale, the 11-factor structure was supported among Chinese college students (N =…

  12. Intelligent data management for real-time spacecraft monitoring

    NASA Technical Reports Server (NTRS)

    Schwuttke, Ursula M.; Gasser, Les; Abramson, Bruce

    1992-01-01

    Real-time AI systems have begun to address the challenge of restructuring problem solving to meet real-time constraints by making key trade-offs that pursue less than optimal strategies with minimal impact on system goals. Several approaches for adapting to dynamic changes in system operating conditions are known. However, simultaneously adapting system decision criteria in a principled way has been difficult. Towards this end, a general technique for dynamically making such trade-offs using a combination of decision theory and domain knowledge has been developed. Multi-attribute utility theory (MAUT), a decision theoretic approach for making one-time decisions is discussed and dynamic trade-off evaluation is described as a knowledge-based extension of MAUT that is suitable for highly dynamic real-time environments, and provides an example of dynamic trade-off evaluation applied to a specific data management trade-off in a real-world spacecraft monitoring application.

  13. Older women public sector workers in Ireland: Decisions about retirement timing.

    PubMed

    Léime, Áine Ní

    2017-01-01

    Older women workers' decision making around retirement is increasingly important given the increasing involvement of older women in paid employment. This article explores influences on the retirement decision making of older women workers in Ireland. It is based on a case study of 57 interviews with women in the Irish civil service exploring work-life decision making. It finds that retirement choices vary according to initial socioeconomic resources and/or life-course trajectories and are particularly affected by gendered caring norms, employment policy, job tenure, and place in organizational hierarchies. Those women with interrupted careers and low pay have fewer choices around retirement timing.

  14. Decision Making in Paediatric Cardiology. Are We Prone to Heuristics, Biases and Traps?

    PubMed

    Ryan, Aedin; Duignan, Sophie; Kenny, Damien; McMahon, Colin J

    2018-01-01

    Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision. Although morbidity and mortality meetings frequently highlight poor outcomes for our patients, they often neglect to analyse the process of thought which underlined those decisions taken. This article attempts to review commonly acknowledged traps in decision making in the behavioural economics world to ascertain whether these heuristics translate to decision making in the paediatric cardiology environment. We also discuss potential individual and collective solutions to pitfalls in decision making.

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

    DTIC Science & Technology

    2005-10-01

    facilitation Rules of engagement (ROE) Deductive reasoning Heuristic(s) Emotion/ Affect Consensus Time pressure Rational decision making Recognition...managers are more likely to use an intuitive decision making style, while Sensing/ Feeling types use more of a rational style. These results were also...performance of the individual, team and organization. Research has indicated that a variety of individual factors affect the way in which people make

  16. Do personal stories make patient decision aids more effective? A critical review of theory and evidence

    PubMed Central

    2013-01-01

    Background Patient decision aids support people to make informed decisions between healthcare options. Personal stories provide illustrative examples of others’ experiences and are seen as a useful way to communicate information about health and illness. Evidence indicates that providing information within personal stories affects the judgments and values people have, and the choices they make, differentially from facts presented in non-narrative prose. It is unclear if including narrative communications within patient decision aids enhances their effectiveness to support people to make informed decisions. Methods A survey of primary empirical research employing a systematic review method investigated the effect of patient decision aids with or without a personal story on people’s healthcare judgements and decisions. Searches were carried out between 2005-2012 of electronic databases (Medline, PsycINFO), and reference lists of identified articles, review articles, and key authors. A narrative analysis described and synthesised findings. Results Of 734 citations identified, 11 were included describing 13 studies. All studies found participants’ judgments and/or decisions differed depending on whether or not their decision aid included a patient story. Knowledge was equally facilitated when the decision aids with and without stories had similar information content. Story-enhanced aids may help people recall information over time and/or their motivation to engage with health information. Personal stories affected both “system 1” (e.g., less counterfactual reasoning, more emotional reactions and perceptions) and “system 2” (e.g., more perceived deliberative decision making, more stable evaluations over time) decision-making strategies. Findings exploring associations with narrative communications, decision quality measures, and different levels of literacy and numeracy were mixed. The pattern of findings was similar for both experimental and real-world studies. Conclusions There is insufficient evidence that adding personal stories to decision aids increases their effectiveness to support people’s informed decision making. More rigorous research is required to elicit evidence about the type of personal story that a) encourages people to make more reasoned decisions, b) discourages people from making choices based on another’s values, and c) motivates people equally to engage with healthcare resources. PMID:24625283

  17. Narrative Interest Standard: A Novel Approach to Surrogate Decision-Making for People With Dementia.

    PubMed

    Wilkins, James M

    2017-06-17

    Dementia is a common neurodegenerative process that can significantly impair decision-making capacity as the disease progresses. When a person is found to lack capacity to make a decision, a surrogate decision-maker is generally sought to aid in decision-making. Typical bases for surrogate decision-making include the substituted judgment standard and the best interest standard. Given the heterogeneous and progressive course of dementia, however, these standards for surrogate decision-making are often insufficient in providing guidance for the decision-making for a person with dementia, escalating the likelihood of conflict in these decisions. In this article, the narrative interest standard is presented as a novel and more appropriate approach to surrogate decision-making for people with dementia. Through case presentation and ethical analysis, the standard mechanisms for surrogate decision-making for people with dementia are reviewed and critiqued. The narrative interest standard is then introduced and discussed as a dementia-specific model for surrogate decision-making. Through incorporation of elements of a best interest standard in focusing on the current benefit-burden ratio and elements of narrative to provide context, history, and flexibility for values and preferences that may change over time, the narrative interest standard allows for elaboration of an enriched context for surrogate decision-making for people with dementia. More importantly, however, a narrative approach encourages the direct contribution from people with dementia in authoring the story of what matters to them in their lives.

  18. Dashboard visualizations: Supporting real-time throughput decision-making.

    PubMed

    Franklin, Amy; Gantela, Swaroop; Shifarraw, Salsawit; Johnson, Todd R; Robinson, David J; King, Brent R; Mehta, Amit M; Maddow, Charles L; Hoot, Nathan R; Nguyen, Vickie; Rubio, Adriana; Zhang, Jiajie; Okafor, Nnaemeka G

    2017-07-01

    Providing timely and effective care in the emergency department (ED) requires the management of individual patients as well as the flow and demands of the entire department. Strategic changes to work processes, such as adding a flow coordination nurse or a physician in triage, have demonstrated improvements in throughput times. However, such global strategic changes do not address the real-time, often opportunistic workflow decisions of individual clinicians in the ED. We believe that real-time representation of the status of the entire emergency department and each patient within it through information visualizations will better support clinical decision-making in-the-moment and provide for rapid intervention to improve ED flow. This notion is based on previous work where we found that clinicians' workflow decisions were often based on an in-the-moment local perspective, rather than a global perspective. Here, we discuss the challenges of designing and implementing visualizations for ED through a discussion of the development of our prototype Throughput Dashboard and the potential it holds for supporting real-time decision-making. Copyright © 2017. Published by Elsevier Inc.

  19. Decision-making strategies: ignored to the detriment of healthcare training and delivery?

    PubMed Central

    Desmond, Chris; Brubaker, Kathryn A.; Ellner, Andrew L.

    2013-01-01

    Context: People do not always make health-related decisions which reflect their best interest – best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods: We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings: The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions: These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care. PMID:25264501

  20. Decision-making strategies: ignored to the detriment of healthcare training and delivery?

    PubMed

    Desmond, Chris; Brubaker, Kathryn A; Ellner, Andrew L

    2013-01-01

    Context : People do not always make health-related decisions which reflect their best interest - best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods : We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings : The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions : These patterns in decision-making call into question basic assumptions our healthcare system makes about the best way to treat patients and deliver care. This literature has implications for the way we train physicians and deliver care.

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

    PubMed

    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.

  2. Planning and conducting meetings effectively, part I: planning a meeting.

    PubMed

    Harolds, Jay

    2011-12-01

    Meetings are held by leaders for many purposes, including conveying information, raising morale, asking for opinions, brain storming, making people part of the problem-solving process, building trust, getting to a consensus, and making decisions. However, many meetings waste time, some undermine the leader's power, and some decrease morale. Part I of this series of articles gives some tips on basic planning for decision-making meetings. Part II of this series of articles analyzes selected components of decision-making meetings. Part III of this series will be on how the chairperson keeps decision-making meetings on track to make them efficient and productive.

  3. An electrophysiological index of changes in risk decision-making strategies.

    PubMed

    Zhang, Dandan; Gu, Ruolei; Wu, Tingting; Broster, Lucas S; Luo, Yi; Jiang, Yang; Luo, Yue-jia

    2013-07-01

    Human decision-making is significantly modulated by previously experienced outcomes. Using event-related potentials (ERPs), we examined whether ERP components evoked by outcome feedbacks could serve as biomarkers to signal the influence of current outcome evaluation on subsequent decision-making. In this study, 18 adult volunteers participated in a simple monetary gambling task, in which they were asked to choose between two options that differed in risk. Their decisions were immediately followed by outcome presentation. Temporospatial principle component analysis (PCA) was applied to the outcome-onset locked ERPs in the 200-1000 ms time window. The PCA factors that approximated classical ERP components (P2, feedback-related negativity, P3a, and P3b) in terms of time course and scalp distribution were tested for their association with subsequent decision-making strategies. Our results revealed that a fronto-central PCA factor approximating the classical P3a was related to changes of decision-making strategies on subsequent trials. The decision to switch between high- and low-risk options resulted in a larger P3a relative to the decision to retain the same choice. According to the results, we suggest that the amplitude of the fronto-central P3a is an electrophysiological index of the influence of current outcome on subsequent risk decision-making. Furthermore, the ERP source analysis indicated that the activations of the frontopolar cortex and sensorimotor cortex were involved in subsequent changes of strategies, which enriches our understanding of the neural mechanisms of adjusting decision-making strategies based on previous experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. An electrophysiological index of changes in risk decision-making strategies

    PubMed Central

    Zhang, Dandan; Gu, Ruolei; Wu, Tingting; Broster, Lucas S.; Luo, Yi; Jiang, Yang; Luo, Yue-jia

    2014-01-01

    Human decision-making is significantly modulated by previously experienced outcomes. Using event-related potentials (ERPs), we examined whether ERP components evoked by outcome feedbacks could serve as biomarkers to signal the influence of current outcome evaluation on subsequent decision-making. In this study, eighteen adult volunteers participated in a simple monetary gambling task, in which they were asked to choose between two options that differed in risk. Their decisions were immediately followed by outcome presentation. Temporospatial principle component analysis (PCA) was applied to the outcome-onset locked ERPs in the -200 – 1000 ms time window. The PCA factors that approximated classical ERP components (P2, feedback-related negativity, P3a, & P3b) in terms of time course and scalp distribution were tested for their association with subsequent decision-making strategies. Our results revealed that a fronto-central PCA factor approximating the classical P3a was related to changes of decision-making strategies on subsequent trials. The decision to switch between high- and low-risk options resulted in a larger P3a relative to the decision to retain the same choice. According to the results, we suggest the amplitude of the fronto-central P3a is an electrophysiological index of the influence of current outcome on subsequent risk decision-making. Furthermore, the ERP source analysis indicated that the activations of the frontopolar cortex and sensorimotor cortex were involved in subsequent changes of strategies, which enriches our understanding of the neural mechanisms of adjusting decision-making strategies based on previous experience. PMID:23643796

  5. Shared decision making after severe stroke-How can we improve patient and family involvement in treatment decisions?

    PubMed

    Visvanathan, Akila; Dennis, Martin; Mead, Gillian; Whiteley, William N; Lawton, Julia; Doubal, Fergus Neil

    2017-12-01

    People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients' expressed wishes (i.e. values). Patients' values also change over time and in different situations. There is limited evidence on successful methods to facilitate this process. Changes targeted at components of shared decision making (e.g. decision aids to provide information and discussing patient values) increase patient satisfaction. How this influences decision making is unclear. Presumably, a "shared decision-making tool" that introduces effective changes at various stages in this process might be helpful after acute stroke. For example, by complementing professional judgement with predictions from prognostic models, clinicians could provide information that is more accurate. Decision aids that are personalized may be helpful. Further qualitative research can provide clinicians with a better understanding of patient values and factors influencing this at different time points after a stroke. The evaluation of this tool in its success to achieve outcomes consistent with patients' values may require more than one clinical trial.

  6. Haste makes waste: Decision making in patients with restless legs syndrome with and without augmentation.

    PubMed

    Heim, Beatrice; Pertl, Marie-Theres; Stefani, Ambra; Delazer, Margarete; Heidbreder, Anna; Zamarian, Laura; Brandauer, Elisabeth; Seppi, Klaus; Högl, Birgit; Poewe, Werner; Djamshidian, Atbin

    2017-01-01

    To investigate decision making in patients with primary restless legs syndrome (RLS) with and without augmentation treated with dopaminergic medication. A total of 64 non-demented RLS patients treated with dopaminergic medication with and without augmentation were included in this study. We used an information sampling task to assess how much evidence participants gather before making a decision. Performance was compared to the results of 21 healthy controls. All patients with and without augmentation gathered less information than healthy controls before making a decision (p<0.001), but there was no difference between the two patient groups (p = 1.0). Furthermore, both patient groups made more irrational decisions (e.g. decisions against the evidence they had at the time) than healthy controls (p≤0.002). In addition, RLS patients with augmentation made significantly more irrational decisions than RLS patients without augmentation (p = 0.037) and controls (p<0.001). Our results show that RLS patients treated with dopaminergic drugs, regardless of having augmentation or not, jumped to conclusions and decided significantly more often against the evidence they had at the time of their decision. However, those with augmentation performed worse than all other groups and made more often irrational decisions, a phenomenon which is also common in patients with substance abuse or behavioural addictions. Thus, jumping to conclusions and deciding with a higher degree of uncertainty as well as irrational decision making is more common in RLS patients treated with dopaminergic medication particularly in those with augmentation.

  7. Research implications of science-informed, value-based decision making.

    PubMed

    Dowie, Jack

    2004-01-01

    In 'Hard' science, scientists correctly operate as the 'guardians of certainty', using hypothesis testing formulations and value judgements about error rates and time discounting that make classical inferential methods appropriate. But these methods can neither generate most of the inputs needed by decision makers in their time frame, nor generate them in a form that allows them to be integrated into the decision in an analytically coherent and transparent way. The need for transparent accountability in public decision making under uncertainty and value conflict means the analytical coherence provided by the stochastic Bayesian decision analytic approach, drawing on the outputs of Bayesian science, is needed. If scientific researchers are to play the role they should be playing in informing value-based decision making, they need to see themselves also as 'guardians of uncertainty', ensuring that the best possible current posterior distributions on relevant parameters are made available for decision making, irrespective of the state of the certainty-seeking research. The paper distinguishes the actors employing different technologies in terms of the focus of the technology (knowledge, values, choice); the 'home base' mode of their activity on the cognitive continuum of varying analysis-to-intuition ratios; and the underlying value judgements of the activity (especially error loss functions and time discount rates). Those who propose any principle of decision making other than the banal 'Best Principle', including the 'Precautionary Principle', are properly interpreted as advocates seeking to have their own value judgements and preferences regarding mode location apply. The task for accountable decision makers, and their supporting technologists, is to determine the best course of action under the universal conditions of uncertainty and value difference/conflict.

  8. The perfect family: decision making in biparental care.

    PubMed

    Akçay, Erol; Roughgarden, Joan

    2009-10-13

    Previous theoretical work on parental decisions in biparental care has emphasized the role of the conflict between evolutionary interests of parents in these decisions. A prominent prediction from this work is that parents should compensate for decreases in each other's effort, but only partially so. However, experimental tests that manipulate parents and measure their responses fail to confirm this prediction. At the same time, the process of parental decision making has remained unexplored theoretically. We develop a model to address the discrepancy between experiments and the theoretical prediction, and explore how assuming different decision making processes changes the prediction from the theory. We assume that parents make decisions in behavioral time. They have a fixed time budget, and allocate it between two parental tasks: provisioning the offspring and defending the nest. The proximate determinant of the allocation decisions are parents' behavioral objectives. We assume both parents aim to maximize the offspring production from the nest. Experimental manipulations change the shape of the nest production function. We consider two different scenarios for how parents make decisions: one where parents communicate with each other and act together (the perfect family), and one where they do not communicate, and act independently (the almost perfect family). The perfect family model is able to generate all the types of responses seen in experimental studies. The kind of response predicted depends on the nest production function, i.e. how parents' allocations affect offspring production, and the type of experimental manipulation. In particular, we find that complementarity of parents' allocations promotes matching responses. In contrast, the relative responses do not depend on the type of manipulation in the almost perfect family model. These results highlight the importance of the interaction between nest production function and how parents make decisions, factors that have largely been overlooked in previous models.

  9. Fuzzy-based decision strategy in real-time strategic games

    NASA Astrophysics Data System (ADS)

    Volna, Eva

    2017-11-01

    The aim of this article is to describe our own gaming artificial intelligence for OpenTTD, which is a real-time building strategy game. A multi-agent system with fuzzy decision-making was used for the proposal itself. The multiagent system was chosen because real-time strategy games achieve great complexity and require decomposition of the problem into individual problems, which are then solved by individual cooperating agents. The system becomes then more stable and easily expandable. The fuzzy approach makes the decision-making process of strategies easier thanks to the use of uncertainty. In the conclusion, own experimental results were compared with other approaches.

  10. The Influence of Emotion on Fairness-Related Decision Making: A Critical Review of Theories and Evidence.

    PubMed

    Zheng, Ya; Yang, Zhong; Jin, Chunlan; Qi, Yue; Liu, Xun

    2017-01-01

    Fairness-related decision making is an important issue in the field of decision making. Traditional theories emphasize the roles of inequity aversion and reciprocity, whereas recent research increasingly shows that emotion plays a critical role in this type of decision making. In this review, we summarize the influences of three types of emotions (i.e., the integral emotion experienced at the time of decision making, the incidental emotion aroused by a task-unrelated dispositional or situational source, and the interaction of emotion and cognition) on fairness-related decision making. Specifically, we first introduce three dominant theories that describe how emotion may influence fairness-related decision making (i.e., the wounded pride/spite model, affect infusion model, and dual-process model). Next, we collect behavioral and neural evidence for and against these theories. Finally, we propose that future research on fairness-related decision making should focus on inducing incidental social emotion, avoiding irrelevant emotion when regulating, exploring the individual differences in emotional dispositions, and strengthening the ecological validity of the paradigm.

  11. The Influence of Emotion on Fairness-Related Decision Making: A Critical Review of Theories and Evidence

    PubMed Central

    Zheng, Ya; Yang, Zhong; Jin, Chunlan; Qi, Yue; Liu, Xun

    2017-01-01

    Fairness-related decision making is an important issue in the field of decision making. Traditional theories emphasize the roles of inequity aversion and reciprocity, whereas recent research increasingly shows that emotion plays a critical role in this type of decision making. In this review, we summarize the influences of three types of emotions (i.e., the integral emotion experienced at the time of decision making, the incidental emotion aroused by a task-unrelated dispositional or situational source, and the interaction of emotion and cognition) on fairness-related decision making. Specifically, we first introduce three dominant theories that describe how emotion may influence fairness-related decision making (i.e., the wounded pride/spite model, affect infusion model, and dual-process model). Next, we collect behavioral and neural evidence for and against these theories. Finally, we propose that future research on fairness-related decision making should focus on inducing incidental social emotion, avoiding irrelevant emotion when regulating, exploring the individual differences in emotional dispositions, and strengthening the ecological validity of the paradigm. PMID:28974937

  12. The child brain computes and utilizes internalized maternal choices

    PubMed Central

    Lim, Seung-Lark; Cherry, J. Bradley C.; Davis, Ann M.; Balakrishnan, S. N.; Ha, Oh-Ryeong; Bruce, Jared M.; Bruce, Amanda S.

    2016-01-01

    As children grow, they gradually learn how to make decisions independently. However, decisions like choosing healthy but less-tasty foods can be challenging for children whose self-regulation and executive cognitive functions are still maturing. We propose a computational decision-making process in which children estimate their mother's choices for them as well as their individual food preferences. By employing functional magnetic resonance imaging during real food choices, we find that the ventromedial prefrontal cortex (vmPFC) encodes children's own preferences and the left dorsolateral prefrontal cortex (dlPFC) encodes the projected mom's choices for them at the time of children's choice. Also, the left dlPFC region shows an inhibitory functional connectivity with the vmPFC at the time of children's own choice. Our study suggests that in part, children utilize their perceived caregiver's choices when making choices for themselves, which may serve as an external regulator of decision-making, leading to optimal healthy decisions. PMID:27218420

  13. Enhanced Requirements for Assessment in a Competency-Based, Time-Variable Medical Education System.

    PubMed

    Gruppen, Larry D; Ten Cate, Olle; Lingard, Lorelei A; Teunissen, Pim W; Kogan, Jennifer R

    2018-03-01

    Competency-based, time-variable medical education has reshaped the perceptions and practices of teachers, curriculum designers, faculty developers, clinician educators, and program administrators. This increasingly popular approach highlights the fact that learning among different individuals varies in duration, foundation, and goal. Time variability places particular demands on the assessment data that are so necessary for making decisions about learner progress. These decisions may be formative (e.g., feedback for improvement) or summative (e.g., decisions about advancing a student). This article identifies challenges to collecting assessment data and to making assessment decisions in a time-variable system. These challenges include managing assessment data, defining and making valid assessment decisions, innovating in assessment, and modeling the considerable complexity of assessment in real-world settings and richly interconnected social systems. There are hopeful signs of creativity in assessment both from researchers and practitioners, but the transition from a traditional to a competency-based medical education system will likely continue to create much controversy and offer opportunities for originality and innovation in assessment.

  14. Economic decision-making in morning/evening-type people as a function of time of day.

    PubMed

    Correa, Angel; Ruiz-Herrera, Noelia; Ruz, Maria; Tonetti, Lorenzo; Martoni, Monica; Fabbri, Marco; Natale, Vincenzo

    2017-01-01

    Decision-making is affected by psychological factors like emotional state or cognitive control, which may also vary with circadian rhythmicity. Here, we tested the influence of chronotype (32 morning-type versus 32 evening-type) and time of day (9 a.m. versus 5 p.m.) on interpersonal decision-making as measured by the Ultimatum Game. Participants had to accept or reject different economic offers proposed by a virtual participant. Acceptance involved distribution of gains as proposed, whereas rejection resulted in no gain for either player. The results of the game showed a deviation from rational performance, as participants usually rejected the unfair offers. This behaviour was similar for both chronotype groups, and in both times of day. This result may reflect the robustness of decision-making strategies across standard circadian phases under ecological conditions. Furthermore, morning-types invested more time than evening-types to respond to high-uncertainty offers. This more cautious decision-making style of morning-types fits with our finding of higher proactive control as compared to evening-types when performing the AX-Continuous Performance Task. In line with the literature on personality traits, our results suggest that morning-types behave with more conscientiousness and less risk-taking than evening-type individuals.

  15. Two Validated Ways of Improving the Ability of Decision-Making in Emergencies; Results from a Literature Review

    PubMed Central

    Khorram-Manesh, Amir; Berlin, Johan; Carlström, Eric

    2016-01-01

    The aim of the current review wasto study the existing knowledge about decision-making and to identify and describe validated training tools.A comprehensive literature review was conducted by using the following keywords: decision-making, emergencies, disasters, crisis management, training, exercises, simulation, validated, real-time, command and control, communication, collaboration, and multi-disciplinary in combination or as an isolated word. Two validated training systems developed in Sweden, 3 level collaboration (3LC) and MacSim, were identified and studied in light of the literature review in order to identify how decision-making can be trained. The training models fulfilled six of the eight identified characteristics of training for decision-making.Based on the results, these training models contained methods suitable to train for decision-making. PMID:27878123

  16. Fifth Dimension Parallel Thinking and Velocity Squared

    DTIC Science & Technology

    2006-12-20

    whether people can make rapid decisions. Regarding time, C.R. Gallistel and Rochel Gelman show that even pigeons can make decisions that require time...Facility may lead to uncharacteristic or illegal behavioral choices, even if these emotions are caused by unrelated incidents. 35 R.J. Gallistel and

  17. Physicians' Perceptions of Shared Decision Making in Chronic Disease and Its Barriers and Facilitators.

    PubMed

    Dodds, Cassandra M; Britto, Maria T; Denson, Lee A; Lovell, Daniel J; Saeed, Shehzad; Lipstein, Ellen A

    2016-04-01

    This study assessed pediatric physicians' use of shared decision making (SDM) in 2 chronic conditions. Most physicians indicated that parent and adolescent trust and emotional readiness facilitated SDM, physicians' preferred approach to decision making. At the same time, they perceived few barriers, other than insurance limitations, to using SDM. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Enhancing The Army Operations Process Through The Incorportation of Holography

    DTIC Science & Technology

    2017-06-09

    the process and gives the user the sense of a noninvasive enhancement to quickly make decisions . Processes and information no longer create...mentally overlaying it onto the process . Data now augments reality and is a noninvasive process to decision making . v ACKNOWLEDGMENTS This paper...environment, augmented on top of reality decreases the amount of time needed to make decisions

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

    ERIC Educational Resources Information Center

    Notarianni, Maryann; Sundar, Purnima; Carter, Charles

    2016-01-01

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

  20. The Genetic and Environmental Etiology of Decision-Making: A Longitudinal Twin Study

    ERIC Educational Resources Information Center

    Tuvblad, Catherine; Gao, Yu; Wang, Pan; Raine, Adrian; Botwick, Theodore; Baker, Laura A.

    2013-01-01

    The present study examined the genetic and environmental etiology of decision-making (Iowa Gambling Task; Bechara, Damasio, Damasio, & Anderson, 1994), in a sample of twins at ages 11-13, 14-15, and 16-18 years. The variance across five 20-trial blocks could be explained by a latent "decision-making" factor within each of the three times of IGT…

  1. Future decision-making without episodic mental time travel.

    PubMed

    Kwan, Donna; Craver, Carl F; Green, Leonard; Myerson, Joel; Boyer, Pascal; Rosenbaum, R Shayna

    2012-06-01

    Deficits in episodic memory are associated with deficits in the ability to imagine future experiences (i.e., mental time travel). We show that K.C., a person with episodic amnesia and an inability to imagine future experiences, nonetheless systematically discounts the value of future rewards, and his discounting is within the range of controls in terms of both rate and consistency. Because K.C. is neither able to imagine personal uses for the rewards nor provide a rationale for selecting larger future rewards over smaller current rewards, this study demonstrates a dissociation between imagining and making decisions involving the future. Thus, although those capable of mental time travel may use it in making decisions about future rewards, these results demonstrate that it is not required for such decisions. Copyright © 2011 Wiley Periodicals, Inc.

  2. Development of a model to guide decision making in amyotrophic lateral sclerosis multidisciplinary care.

    PubMed

    Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

    2015-10-01

    Patients with amyotrophic lateral sclerosis (ALS) face numerous decisions for symptom management and quality of life. Models of decision making in chronic disease and cancer care are insufficient for the complex and changing needs of patients with ALS . The aim was to examine the question: how can decision making that is both effective and patient-centred be enacted in ALS multidisciplinary care? Fifty-four respondents (32 health professionals, 14 patients and eight carers) from two specialized ALS multidisciplinary clinics participated in semi-structured interviews. Interviews were transcribed, coded and analysed thematically. Comparison of stakeholder perspectives revealed six key themes of ALS decision making. These were the decision-making process; patient-centred focus; timing and planning; information sources; engagement with specialized ALS services; and access to non-specialized services. A model, embedded in the specialized ALS multidisciplinary clinic, was derived to guide patient decision making. The model is cyclic, with four stages: 'Participant Engagement'; 'Option Information'; 'Option Deliberation'; and 'Decision Implementation'. Effective and patient-centred decision making is enhanced by the structure of the specialized ALS clinic, which promotes patients' symptom management and quality of life goals. However, patient and carer engagement in ALS decision making is tested by the dynamic nature of ALS, and patient and family distress. Our model optimizes patient-centred decision making, by incorporating patients' cyclic decision-making patterns and facilitating carer inclusion in decision processes. The model captures the complexities of patient-centred decision making in ALS. The framework can assist patients and carers, health professionals, researchers and policymakers in this challenging disease environment. © 2013 John Wiley & Sons Ltd.

  3. Dopaminergic modulation of the trade-off between probability and time in economic decision-making.

    PubMed

    Arrondo, Gonzalo; Aznárez-Sanado, Maite; Fernández-Seara, Maria A; Goñi, Joaquín; Loayza, Francis R; Salamon-Klobut, Ewa; Heukamp, Franz H; Pastor, Maria A

    2015-06-01

    Studies on animals and humans have demonstrated the importance of dopamine in modulating decision-making processes. In this work, we have tested dopaminergic modulation of economic decision-making and its neural correlates by administering either placebo or metoclopramide, a dopamine D2-receptor antagonist, to healthy subjects, during a functional MRI study. The decision-making task combined probability and time delay with a fixed monetary reward. For individual behavioral characterization, we used the Probability Time Trade-off (PTT) economic model, which integrates the traditional trade-offs of reward magnitude-time and reward magnitude-probability into a single measurement, thereby quantifying the subjective value of a delayed and probabilistic outcome. A regression analysis between BOLD signal and the PTT model index permitted to identify the neural substrate encoding the subjective reward-value. Behaviorally, medication reduced the rate of temporal discounting over probability, reflected in medicated subjects being more prone to postpone the reward in order to increase the outcome probability. In addition, medicated subjects showed less activity during the task in the postcentral gyrus as well as frontomedian areas, whereas there were no differences in the ventromedial orbitofrontal cortex (VMOFC) between groups when coding the subjective value. The present study demonstrates by means of behavior and imaging that dopamine modulation alters the probability-time trade-off in human economic decision-making. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  4. Serial, parallel and hierarchical decision making in primates

    PubMed Central

    Zylberberg, Ariel; Lorteije, Jeannette AM; Ouellette, Brian G; De Zeeuw, Chris I; Sigman, Mariano; Roelfsema, Pieter

    2017-01-01

    The study of decision-making has mainly focused on isolated decisions where choices are associated with motor actions. However, problem-solving often involves considering a hierarchy of sub-decisions. In a recent study (Lorteije et al. 2015), we reported behavioral and neuronal evidence for hierarchical decision making in a task with a small decision tree. We observed a first phase of parallel evidence integration for multiple sub-decisions, followed by a phase in which the overall strategy formed. It has been suggested that a 'flat' competition between the ultimate motor actions might also explain these results. A reanalysis of the data does not support the critical predictions of flat models. We also examined the time-course of decision making in other, related tasks and report conditions where evidence integration for successive decisions is decoupled, which excludes flat models. We conclude that the flexibility of decision-making implies that the strategies are genuinely hierarchical. DOI: http://dx.doi.org/10.7554/eLife.17331.001 PMID:28648172

  5. 32 CFR 651.40 - Introduction.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., allowing public review and comment on the proposal and providing a basis for informed decision-making. (b) The NEPA process should support sound, informed, and timely (early) decision-making; not produce...

  6. Decisions, Decisions: The Countless Times Instructional Practice and Reality Meet

    ERIC Educational Resources Information Center

    Miranda, Martina L.

    2014-01-01

    This article examines critical issues related to teacher decision-making in early childhood music classrooms. Through the story of one teacher's experience, we take a closer look at specific criteria to guide decision-making, and strategies to deepen awareness of young children's needs in the music classroom and guide instructional…

  7. Ignorance- versus Evidence-Based Decision Making: A Decision Time Analysis of the Recognition Heuristic

    ERIC Educational Resources Information Center

    Hilbig, Benjamin E.; Pohl, Rudiger F.

    2009-01-01

    According to part of the adaptive toolbox notion of decision making known as the recognition heuristic (RH), the decision process in comparative judgments--and its duration--is determined by whether recognition discriminates between objects. By contrast, some recently proposed alternative models predict that choices largely depend on the amount of…

  8. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management.

    PubMed

    Dexter, Franklin; Epstein, Richard H

    2015-12-01

    As reviewed previously, decision making can be made systematically shortly before the day of surgery based on reducing the hours of overutilized operating room (OR) time and tardiness of case starts (i.e., patient waiting). We subsequently considered in 2008 that such decision making depends on rational anesthesia-hospital agreements specifying anesthesia staffing. Since that prior study, there has been a substantial increase in understanding of the timing of decision making to reduce overutilized OR time. Most decisions substantively influencing overutilized OR time are those made within 1 workday before the day of surgery and on the day of surgery, because only then are ORs sufficiently full that case scheduling and staff assignment decisions affect overutilized OR time. Consequently, anesthesiologists can easily be engaged in such decisions, because generally they must be involved to ensure that the corresponding anesthesia staff assignments are appropriate. Despite this, at hospitals with >8 hours of OR time used daily in each OR, computerized recommendations are superior to intuition because of cognitive biases. Decisions need to be made by a Perioperative Medical Director who has knowledge of the principles of perioperative managerial decision making published in the scientific literature rather than by a committee lacking this competency. Education in the scientific literature, and when different analytical methods should be used, is important. The addition that we make in this article is to show that an agreement between an anesthesia group and a hospital can both reduce overutilized OR time and patient waiting: The anesthesia group and hospital will ensure, hourly, that, when there are case(s) waiting to start, the number of ORs in use for each service will be at least the number that maximizes the efficiency of use of OR time. Neither the anesthesia group nor the hospital will be expected to run more than that number of ORs without mutual agreement. Agreements assure that processes mutually beneficial to organizations, but not necessarily to individuals at each point in time, are performed as designed, especially in the setting of cognitive biases.

  9. Neurodynamics of an election.

    PubMed

    da Rocha, Armando Freitas; Rocha, Fábio Theoto; Burattini, Marcelo Nascimento; Massad, Eduardo

    2010-09-10

    Variables influencing decision-making in real settings, as in the case of voting decisions, are uncontrollable and in many times even unknown to the experimenter. In this case, the experimenter has to study the intention to decide (vote) as close as possible in time to the moment of the real decision (election day). Here, we investigated the brain activity associated with the voting intention declared 1 week before the election day of the Brazilian Firearms Control Referendum about prohibiting the commerce of firearms. Two alliances arose in the Congress to run the campaigns for YES (for the prohibition of firearm commerce) and NO (against the prohibition of firearm commerce) voting. Time constraints imposed by the necessity of studying a reasonable number (here, 32) of voters during a very short time (5 days) made the EEG the tool of choice for recording the brain activity associated with voting decision. Recent fMRI and EEG studies have shown decision-making as a process due to the enrollment of defined neuronal networks. In this work, a special EEG technique is applied to study the topology of the voting decision-making networks and is compared to the results of standard ERP procedures. The results show that voting decision-making enrolled networks in charge of calculating the benefits and risks of the decision of prohibiting or allowing firearm commerce and that the topology of such networks was vote- (i.e., YES/NO-) sensitive. 2010 Elsevier B.V. All rights reserved.

  10. Lessons learned by (from?) an economist working in medical decision making.

    PubMed

    Wakker, Peter P

    2008-01-01

    This article is a personal account of the author's experiences as an economist working in medical decision making. He discusses the differences between economic decision theory and medical decision making and gives examples of the mutual benefits resulting from interactions. In particular, he discusses the pros and cons of different methods for measuring quality of life (or, as economists would call it, utility), including the standard gamble, the time tradeoff, and the healthy-years equivalent methods.

  11. Dynamics of individual perceptual decisions

    PubMed Central

    Clark, Torin K.; Lu, Yue M.; Karmali, Faisal

    2015-01-01

    Perceptual decision making is fundamental to a broad range of fields including neurophysiology, economics, medicine, advertising, law, etc. Although recent findings have yielded major advances in our understanding of perceptual decision making, decision making as a function of time and frequency (i.e., decision-making dynamics) is not well understood. To limit the review length, we focus most of this review on human findings. Animal findings, which are extensively reviewed elsewhere, are included when beneficial or necessary. We attempt to put these various findings and data sets, which can appear to be unrelated in the absence of a formal dynamic analysis, into context using published models. Specifically, by adding appropriate dynamic mechanisms (e.g., high-pass filters) to existing models, it appears that a number of otherwise seemingly disparate findings from the literature might be explained. One hypothesis that arises through this dynamic analysis is that decision making includes phasic (high pass) neural mechanisms, an evidence accumulator and/or some sort of midtrial decision-making mechanism (e.g., peak detector and/or decision boundary). PMID:26467513

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

    PubMed

    Noon, Amy J

    2014-01-01

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

  13. New care home admission following hospitalisation: How do older people, families and professionals make decisions about discharge destination? A case study narrative analysis.

    PubMed

    Rhynas, Sarah J; Garrido, Azucena Garcia; Burton, Jennifer K; Logan, Gemma; MacArthur, Juliet

    2018-03-24

    To gain an in-depth understanding of the decision-making processes involved in the discharge of older people admitted to hospital from home and discharged to a care home, as described in the case records. The decision for an older person to move into a care home is significant and life-changing. The discharge planning literature for older people highlights the integral role of nurses in supporting and facilitating effective discharge. However, little research has been undertaken to explore the experiences of those discharged from hospital to a care home or the processes involved in decision-making. A purposive sample of 10 cases was selected from a cohort of 100 individuals admitted to hospital from home and discharged to a care home. Cases were selected to highlight important personal, relational and structural factors thought to affect the decision-making process. Narrative case studies were created and were thematically analysed to explore the perspectives of each stakeholder group and the conceptualisations of risk which influenced decision-making. Care home discharge decision-making is a complex process involving stakeholders with a range of expertise, experience and perspectives. Decisions take time and considerable involvement of families and the multidisciplinary team. There were significant deficits in documentation which limit the understanding of the process and the patient's voice is often absent from case records. The experiences of older people, families and multidisciplinary team members making care home decisions in the hospital setting require further exploration to identify and define best practice. Nurses have a critical role in the involvement of older people making discharge decisions in hospital, improved documentation of the patient's voice is essential. Health and social care systems must allow older people time to make significant decisions about their living arrangements, adapting to changing medical and social needs. © 2018 John Wiley & Sons Ltd.

  14. Interpatch foraging in honeybees-rational decision making at secondary hubs based upon time and motivation.

    PubMed

    Najera, Daniel A; McCullough, Erin L; Jander, Rudolf

    2012-11-01

    For honeybees, Apis mellifera, the hive has been well known to function as a primary decision-making hub, a place from which foragers decide among various directions, distances, and times of day to forage efficiently. Whether foraging honeybees can make similarly complex navigational decisions from locations away from the hive is unknown. To examine whether or not such secondary decision-making hubs exist, we trained bees to forage at four different locations. Specifically, we trained honeybees to first forage to a distal site "CT" 100 m away from the hive; if food was present, they fed and then chose to go home. If food was not present, the honeybees were trained to forage to three auxiliary sites, each at a different time of the day: A in the morning, B at noon, and C in the afternoon. The foragers learned to check site CT for food first and then efficiently depart to the correct location based upon the time of day if there was no food at site CT. Thus, the honeybees were able to cognitively map motivation, time, and five different locations (Hive, CT, A, B, and C) in two spatial dimensions; these are the contents of the cognitive map used by the honeybees here. While at site CT, we verified that the honeybees could choose between 4 different directions (to A, B, C, and the Hive) and thus label it as a secondary decision-making hub. The observed decision making uncovered here is inferred to constitute genuine logical operations, involving a branched structure, based upon the premises of motivational state, and spatiotemporal knowledge.

  15. Bringing science to the table: Case studies in science-informed decision making on climate change and beyond

    NASA Astrophysics Data System (ADS)

    Goldman, G. T.; Phartiyal, P.; Mulvey, K.

    2016-12-01

    Federal government officials often rely on the research and advice of scientists to inform their decision making around climate change and other complex topics. Decision makers, however, are constrained by the time and accessibility needed to obtain and incorporate scientific information. At the same time, scientists have limited capacity and incentive to devote significant time to communicating their science to decision makers. The Union of Concerned Scientists has employed several strategies to produce policy-relevant scientific work and to facilitate engagement between scientists and decision makers across research areas. This talk will feature lessons learned and key strategies for science-informed decision making around climate change and other areas of the geosciences. Case studies will include conducting targeted sea level rise studies to inform rulemaking at federal agencies, bringing science to policy discussions on hydraulic fracturing, and leveraging the voice of the scientific community on specific policy proposals around climate change disclosure of companies. Recommendations and lessons learned for producing policy-relevant science and effectively communicating it with decision makers will be offered.

  16. 14 CFR 406.141 - Motions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., at any time before the administrative law judge has issued an initial decision in the proceedings... that the party making the motion is entitled to a decision as a matter of law. The party making the..., including affidavits, to the motion. (c) Form and time. Except for oral motions heard on the record, a...

  17. Decision making by superimposing information from parallel cognitive channels

    NASA Astrophysics Data System (ADS)

    Aityan, Sergey K.

    1993-08-01

    A theory of decision making with perception through parallel information channels is presented. Decision making is considered a parallel competitive process. Every channel can provide confirmation or rejection of a decision concept. Different channels provide different impact on the specific concepts caused by the goals and individual cognitive features. All concepts are divided into semantic clusters due to the goals and the system defaults. The clusters can be alternative or complimentary. The 'winner-take-all' concept nodes firing takes place within the alternative cluster. Concepts can be independently activated in the complimentary cluster. A cognitive channel affects a decision concept by sending an activating or inhibitory signal. The complimentary clusters serve for building up complex concepts by superimposing activation received from various channels. The decision making is provided by the alternative clusters. Every active concept in the alternative cluster tends to suppress the competitive concepts in the cluster by sending inhibitory signals to the other nodes of the cluster. The model accounts for a time delay in signal transmission between the nodes and explains decreasing of the reaction time if information is confirmed by different channels and increasing of the reaction time if deceiving information received from the channels.

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

    NASA Astrophysics Data System (ADS)

    Li, Yongchang

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

  19. Shared decision-making in home-care from the nurse's perspective: sitting at the kitchen table--a qualitative descriptive study.

    PubMed

    Truglio-Londrigan, Marie

    2013-10-01

    To come to know, understand and describe the experience of shared decision-making in home-care from the nurse's perspective. The literature presents the concept of shared decision-making as a complex process characterised by a partnership between the healthcare provider and the patient, which is participatory and action oriented with education and negotiation leading to agreement. Few studies have been carried out to explore and describe the events that make up the experiences of shared decision-making in home-care from the nurse's perspective. A qualitative descriptive study was implemented. Semi structured interviews were performed with 10 home-care nurses who were asked to reflect on a time in their practice when they were involved in a shared decision-making process with their patient. All data were analysed using Colaizzi's method. The following Themes were uncovered: Begin where the patient is; Education for shared decision-making; The village and shared decision-making; and Whose decision is it? Each of the four Themes contained Subthemes. The findings of this study present shared decision-making as a complex, multidimensional and fluid process. A thorough understanding of shared decision-making is essential within the multiple contexts in which care is delivered. Nurses in clinical practice need to know and understand the events of the experience of shared decision-making. A more comprehensive understanding of these facts can assist home-care nurses in their practice with regard to the application of shared decision-making. © 2013 Blackwell Publishing Ltd.

  20. Prognostic categories and timing of negative prognostic communication from critical care physicians to family members at end-of-life in an intensive care unit.

    PubMed

    Gutierrez, Karen M

    2013-09-01

    Negative prognostic communication is often delayed in intensive care units, which limits time for families to prepare for end-of-life. This descriptive study, informed by ethnographic methods, was focused on exploring critical care physician communication of negative prognoses to families and identifying timing influences. Prognostic communication of critical care physicians to nurses and family members was observed and physicians and family members were interviewed. Physician perception of prognostic certainty, based on an accumulation of empirical data, and the perceived need for decision-making, drove the timing of prognostic communication, rather than family needs. Although prognoses were initially identified using intuitive knowledge for patients in one of the six identified prognostic categories, utilizing decision-making to drive prognostic communication resulted in delayed prognostic communication to families until end-of-life (EOL) decisions could be justified with empirical data. Providers will better meet the needs of families who desire earlier prognostic information by separating prognostic communication from decision-making and communicating the possibility of a poor prognosis based on intuitive knowledge, while acknowledging the uncertainty inherent in prognostication. This sets the stage for later prognostic discussions focused on EOL decisions, including limiting or withdrawing treatment, which can be timed when empirical data substantiate intuitive prognoses. This allows additional time for families to anticipate and prepare for end-of-life decision-making. © 2012 John Wiley & Sons Ltd.

  1. Recovery and Resilience After a Nuclear Power Plant Disaster: A Medical Decision model for Managing an Effective, Timely, and Balanced Response

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

    Coleman, C. Norman; Blumenthal, Daniel J.

    2013-05-01

    Based on experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, a real-time, medical decision model is presented by which to make key health-related decisions given the central role of health and medical issues in such disasters. Focus is on response and recovery activities that are safe, timely, effective, and well-organized. This approach empowers on-site decision makers to make interim decisions without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Key features of this approach include ongoing assessment, consultation, information, and adaption to the changing conditions. This medical decision model presented ismore » compatible with the existing US National Response Framework structure.« less

  2. An Integrated Decision-Making Model for Categorizing Weather Products and Decision Aids

    NASA Technical Reports Server (NTRS)

    Elgin, Peter D.; Thomas, Rickey P.

    2004-01-01

    The National Airspace System s capacity will experience considerable growth in the next few decades. Weather adversely affects safe air travel. The FAA and NASA are working to develop new technologies that display weather information to support situation awareness and optimize pilot decision-making in avoiding hazardous weather. Understanding situation awareness and naturalistic decision-making is an important step in achieving this goal. Information representation and situation time stress greatly influence attentional resource allocation and working memory capacity, potentially obstructing accurate situation awareness assessments. Three naturalistic decision-making theories were integrated to provide an understanding of the levels of decision making incorporated in three operational situations and two conditions. The task characteristics associated with each phase of flight govern the level of situation awareness attained and the decision making processes utilized. Weather product s attributes and situation task characteristics combine to classify weather products according to the decision-making processes best supported. In addition, a graphical interface is described that affords intuitive selection of the appropriate weather product relative to the pilot s current flight situation.

  3. When work happens in the house: perceptions of how residential care staff choose to spend work time in transitional living units for people with brain injury.

    PubMed

    Chapparo, Christine; Shepherd, Belinda

    2010-01-01

    This naturalistic study explored the influence of various contextual factors on the decision making of residential care staff (RCS) who worked and lived with clients with brain injury in transitional living environments. The findings reported here arose from the results of a larger study that investigated the multiple contextual, personal, professional and theoretical influences on RCS decision making. Eleven residential care staff who were employed in brain injury transitional living units in Sydney, Australia participated. Qualitative data were derived from interviews, participant observation and reviews of videotaped staff and client interactions with the residential care staff. The RCS identified time and organisational motivators as major influences on daily decision making at work. They described how decisions were made by them about how to prioritise time at work from two personal perspectives, that of 'hospital person' and ;house person', adopted relative to contextual influences at the time. Residential care staff who are in close personal contact with clients for long periods of time make decisions about their work that is largely based on their personal notions of running a house'. Further research is required to describe the emergent phenomenon of staff 'house' behaviour.

  4. The Instability of Instability

    DTIC Science & Technology

    1991-05-01

    thermodynamic principles, changes cannot be effected without some cost. The decision - making associated with Model I can be viewed as rational behavior. Consider...number Democratic simple majority voting is perhaps the most widely used method of group decision making i;i our time. Current theory, based on...incorporate any of several plausible characteristics of decision - making , then the instability theorems do not hold and in fact the probability of

  5. Decision-making process of prenatal screening described by pregnant women and their partners.

    PubMed

    Wätterbjörk, Inger; Blomberg, Karin; Nilsson, Kerstin; Sahlberg-Blom, Eva

    2015-10-01

    Pregnant women are often faced with having to decide about prenatal screening for Down's syndrome. However, the decision to participate in or refrain from prenatal screening can be seen as an important decision not only for the pregnant woman but also for both the partners. The aim of this study was to explore the couples' processes of decision making about prenatal screening. A total of 37 semi-structured interviews conducted at two time points were analysed using the interpretive description. The study was carried out in Maternal health-care centres, Örebro County Council, Sweden. Fifteen couples of different ages and with different experiences of pregnancy and childbirth were interviewed. Three different patterns of decision making were identified. For the couples in 'The open and communicative decision-making process', the process was straightforward and rational, and the couples discussed the decision with each other. 'The closed and personal decision-making process' showed an immediate and non-communicative decision making where the couples decided each for themselves. The couples showing 'The searching and communicative decision-making process' followed an arduous road in deciding whether to participate or not in prenatal screening and how to cope with the result. The decision-making process was for some couples a fairly straightforward decision, while for others it was a more complex process that required a great deal of consideration. © 2013 John Wiley & Sons Ltd.

  6. Strategies to facilitate shared decision-making about pediatric oncology clinical trial enrollment: A systematic review.

    PubMed

    Robertson, Eden G; Wakefield, Claire E; Signorelli, Christina; Cohn, Richard J; Patenaude, Andrea; Foster, Claire; Pettit, Tristan; Fardell, Joanna E

    2018-07-01

    We conducted a systematic review to identify the strategies that have been recommended in the literature to facilitate shared decision-making regarding enrolment in pediatric oncology clinical trials. We searched seven databases for peer-reviewed literature, published 1990-2017. Of 924 articles identified, 17 studies were eligible for the review. We assessed study quality using the 'Mixed-Methods Appraisal Tool'. We coded the results and discussions of papers line-by-line using nVivo software. We categorized strategies thematically. Five main themes emerged: 1) decision-making as a process, 2) individuality of the process; 3) information provision, 4) the role of communication, or 5) decision and psychosocial support. Families should have adequate time to make a decision. HCPs should elicit parents' and patients' preferences for level of information and decision involvement. Information should be clear and provided in multiple modalities. Articles also recommended providing training for healthcare professionals and access to psychosocial support for families. High quality, individually-tailored information, open communication and psychosocial support appear vital in supporting decision-making regarding enrollment in clinical trials. These data will usefully inform future decision-making interventions/tools to support families making clinical trial decisions. A solid evidence-base for effective strategies which facilitate shared decision-making is needed. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. What you don't know about making decisions.

    PubMed

    Garvin, D A; Roberto, M A

    2001-09-01

    Most executives think of decision making as a singular event that occurs at a particular point in time. In reality, though, decision making is a process fraught with power plays, politics, personal nuances, and institutional history. Leaders who recognize this make far better decisions than those who persevere in the fantasy that decisions are events they alone control. That said, some decision-making processes are far more effective than others. Most often, participants use an advocacy process, possibly the least productive way to get things done. They view decision making as a contest, arguing passionately for their preferred solutions, presenting information selectively, withholding relevant conflicting data so they can make a convincing case, and standing firm against opposition. Much more powerful is an inquiry process, in which people consider a variety of options and work together to discover the best solution. Moving from advocacy to inquiry requires careful attention to three critical factors: fostering constructive, rather than personal, conflict; making sure everyone knows that their viewpoints are given serious consideration even if they are not ultimately accepted; and knowing when to bring deliberations to a close. The authors discuss in detail strategies for moving from an advocacy to an inquiry process, as well as for fostering productive conflict, true consideration, and timely closure. And they offer a framework for assessing the effectiveness of your process while you're still in the middle of it. Decision making is a job that lies at the very heart of leadership and one that requires a genius for balance: the ability to embrace the divergence that may characterize early discussions and to forge the unity needed for effective implementation.

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

    ERIC Educational Resources Information Center

    Dshemuchadse, Maja; Scherbaum, Stefan; Goschke, Thomas

    2013-01-01

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

  9. 44 CFR 9.8 - Public notice requirements.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... for review and comment at the earliest possible time and throughout the decision-making process; and upon completion of this process, provide the public with an accounting of its final decisions (see § 9... for public involvement in the decision-making process through the provision of public notice upon...

  10. School-Based Decision-Making: The Canadian Perspective.

    ERIC Educational Resources Information Center

    Peters, Frank

    1997-01-01

    In Canada, school-based decision making is a political expedient to co-opt public support for public education at the same time as financial resources to schools are being curtailed. School councils are advisory in nature and have no statutory position in either school or school-system decisions. (17 references) (MLF)

  11. Use of ultrasonography to make management decisions

    USDA-ARS?s Scientific Manuscript database

    Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

  12. Age differences in decision making: a process methodology for examining strategic information processing.

    PubMed

    Johnson, M M

    1990-03-01

    This study explored the use of process tracing techniques in examining the decision-making processes of older and younger adults. Thirty-six college-age and thirty-six retirement-age participants decided which one of six cars they would purchase on the basis of computer-accessed data. They provided information search protocols. Results indicate that total time to reach a decision did not differ according to age. However, retirement-age participants used less information, spent more time viewing, and re-viewed fewer bits of information than college-age participants. Information search patterns differed markedly between age groups. Patterns of retirement-age adults indicated their use of noncompensatory decision rules which, according to decision-making literature (Payne, 1976), reduce cognitive processing demands. The patterns of the college-age adults indicated their use of compensatory decision rules, which have higher processing demands.

  13. In search of tools to aid logical thinking and communicating about medical decision making.

    PubMed

    Hunink, M G

    2001-01-01

    To have real-time impact on medical decision making, decision analysts need a wide variety of tools to aid logical thinking and communication. Decision models provide a formal framework to integrate evidence and values, but they are commonly perceived as complex and difficult to understand by those unfamiliar with the methods, especially in the context of clinical decision making. The theory of constraints, introduced by Eliyahu Goldratt in the business world, provides a set of tools for logical thinking and communication that could potentially be useful in medical decision making. The author used the concept of a conflict resolution diagram to analyze the decision to perform carotid endarterectomy prior to coronary artery bypass grafting in a patient with both symptomatic coronary and asymptomatic carotid artery disease. The method enabled clinicians to visualize and analyze the issues, identify and discuss the underlying assumptions, search for the best available evidence, and use the evidence to make a well-founded decision. The method also facilitated communication among those involved in the care of the patient. Techniques from fields other than decision analysis can potentially expand the repertoire of tools available to support medical decision making and to facilitate communication in decision consults.

  14. Dual conception of risk in the Iowa Gambling Task: effects of sleep deprivation and test-retest gap.

    PubMed

    Singh, Varsha

    2013-01-01

    Risk in the Iowa Gambling Task (IGT) is often understood in terms of intertemporal choices, i.e., preference for immediate outcomes in favor of delayed outcomes is considered risky decision making. According to behavioral economics, healthy decision makers are expected to refrain from choosing the short-sighted immediate gain because, over time (10 trials of the IGT), the immediate gains result in a long term loss (net loss). Instead decision makers are expected to maximize their gains by choosing options that, over time (10 trials), result in delayed or long term gains (net gain). However, task choices are sometimes made on the basis of the frequency of reward and punishment such that frequent rewards/infrequent punishments are favored over infrequent rewards/frequent punishments. The presence of these two attributes (intertemporality and frequency of reward) in IGT decision making may correspond to the emotion-cognition dichotomy and reflect a dual conception of risk. Decision making on the basis of the two attributes was tested under two conditions: delay in retest and sleep deprivation. An interaction between sleep deprivation and time delay was expected to attenuate the difference between the two attributes. Participants were 40 male university students. Analysis of the effects of IGT attribute type (intertemporal vs. frequency of reinforcement), sleep deprivation (sleep deprivation vs. no sleep deprivation), and test-retest gap (short vs. long delay) showed a significant within-subjects effect of IGT attribute type thus confirming the difference between the two attributes. Sleep deprivation had no effect on the attributes, but test-retest gap and the three-way interaction between attribute type, test-retest gap, and sleep deprivation were significantly different. Post-hoc tests revealed that sleep deprivation and short test-retest gap attenuated the difference between the two attributes. Furthermore, the results showed an expected trend of increase in intertemporal decision making at retest suggesting that intertemporal decision making benefited from repeated task exposure. The present findings add to understanding of the emotion-cognition dichotomy. Further, they show an important time-dependent effect of a universally experienced constraint (sleep deprivation) on decision making. It is concluded that risky decision making in the IGT is contingent on the attribute under consideration and is affected by factors such as time elapsed and constraint experienced before the retest.

  15. Frequencies of decision making and monitoring in adaptive resource management

    PubMed Central

    Johnson, Fred A.

    2017-01-01

    Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management implications and extensions. PMID:28800591

  16. Frequencies of decision making and monitoring in adaptive resource management

    USGS Publications Warehouse

    Williams, Byron K.; Johnson, Fred A.

    2017-01-01

    Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management implications and extensions.

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

    PubMed

    Allen, Kimberly A

    2014-09-01

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

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

    PubMed Central

    2017-01-01

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

  19. Outbreak Column 16: Cognitive errors in outbreak decision making.

    PubMed

    Curran, Evonne T

    2015-01-01

    During outbreaks, decisions must be made without all the required information. People, including infection prevention and control teams (IPCTs), who have to make decisions during uncertainty use heuristics to fill the missing data gaps. Heuristics are mental model short cuts that by-and-large enable us to make good decisions quickly. However, these heuristics contain biases and effects that at times lead to cognitive (thinking) errors. These cognitive errors are not made to deliberately misrepresent any given situation; we are subject to heuristic biases when we are trying to perform optimally. The science of decision making is large; there are over 100 different biases recognised and described. Outbreak Column 16 discusses and relates these heuristics and biases to decision making during outbreak prevention, preparedness and management. Insights as to how we might recognise and avoid them are offered.

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

    PubMed

    Nantha, Yogarabindranath Swarna

    2017-11-01

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

  1. Behavioral preference in sequential decision-making and its association with anxiety.

    PubMed

    Zhang, Dandan; Gu, Ruolei

    2018-06-01

    In daily life, people often make consecutive decisions before the ultimate goal is reached (i.e., sequential decision-making). However, this kind of decision-making has been largely overlooked in the literature. The current study investigated whether behavioral preference would change during sequential decisions, and the neural processes underlying the potential changes. For this purpose, we revised the classic balloon analogue risk task and recorded the electroencephalograph (EEG) signals associated with each step of decision-making. Independent component analysis performed on EEG data revealed that four EEG components elicited by periodic feedback in the current step predicted participants' decisions (gamble vs. no gamble) in the next step. In order of time sequence, these components were: bilateral occipital alpha rhythm, bilateral frontal theta rhythm, middle frontal theta rhythm, and bilateral sensorimotor mu rhythm. According to the information flows between these EEG oscillations, we proposed a brain model that describes the temporal dynamics of sequential decision-making. Finally, we found that the tendency to gamble (as well as the power intensity of bilateral frontal theta rhythms) was sensitive to the individual level of trait anxiety in certain steps, which may help understand the role of emotion in decision-making. © 2018 Wiley Periodicals, Inc.

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

    PubMed

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

    2018-01-01

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

  3. 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

  4. 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.

  5. Hospice decision making: diagnosis makes a difference.

    PubMed

    Waldrop, Deborah P; Meeker, Mary Ann

    2012-10-01

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

  6. Ethical safety of deep brain stimulation: A study on moral decision-making in Parkinson's disease.

    PubMed

    Fumagalli, Manuela; Marceglia, Sara; Cogiamanian, Filippo; Ardolino, Gianluca; Picascia, Marta; Barbieri, Sergio; Pravettoni, Gabriella; Pacchetti, Claudio; Priori, Alberto

    2015-07-01

    The possibility that deep brain stimulation (DBS) in Parkinson's disease (PD) alters patients' decisions and actions, even temporarily, raises important clinical, ethical and legal questions. Abnormal moral decision-making can lead to ethical rules violations. Previous experiments demonstrated the subthalamic (STN) activation during moral decision-making. Here we aim to study whether STN DBS can affect moral decision-making in PD patients. Eleven patients with PD and bilateral STN DBS implant performed a computerized moral task in ON and OFF stimulation conditions. A control group of PD patients without DBS implant performed the same experimental protocol. All patients underwent motor, cognitive and psychological assessments. STN stimulation was not able to modify neither reaction times nor responses to moral task both when we compared the ON and the OFF state in the same patient (reaction times, p = .416) and when we compared DBS patients with those treated only with the best medical treatment (reaction times: p = .408, responses: p = .776). Moral judgment is the result of a complex process, requiring cognitive executive functions, problem-solving, anticipations of consequences of an action, conflict processing, emotional evaluation of context and of possible outcomes, and involving different brain areas and neural circuits. Our data show that STN DBS leaves unaffected moral decisions thus implying relevant clinical and ethical implications for DBS consequences on patients' behavior, on decision-making and on judgment ability. In conclusion, the technique can be considered safe on moral behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Clinician time used for decision making: a best case workflow study using cardiovascular risk assessments and Ask Mayo Expert algorithmic care process models.

    PubMed

    North, Frederick; Fox, Samuel; Chaudhry, Rajeev

    2016-07-20

    Risk calculation is increasingly used in lipid management, congestive heart failure, and atrial fibrillation. The risk scores are then used for decisions about statin use, anticoagulation, and implantable defibrillator use. Calculating risks for patients and making decisions based on these risks is often done at the point of care and is an additional time burden for clinicians that can be decreased by automating the tasks and using clinical decision-making support. Using Morae Recorder software, we timed 30 healthcare providers tasked with calculating the overall risk of cardiovascular events, sudden death in heart failure, and thrombotic event risk in atrial fibrillation. Risk calculators used were the American College of Cardiology Atherosclerotic Cardiovascular Disease risk calculator (AHA-ASCVD risk), Seattle Heart Failure Model (SHFM risk), and CHA2DS2VASc. We also timed the 30 providers using Ask Mayo Expert care process models for lipid management, heart failure management, and atrial fibrillation management based on the calculated risk scores. We used the Mayo Clinic primary care panel to estimate time for calculating an entire panel risk. Mean provider times to complete the CHA2DS2VASc, AHA-ASCVD risk, and SHFM were 36, 45, and 171 s respectively. For decision making about atrial fibrillation, lipids, and heart failure, the mean times (including risk calculations) were 85, 110, and 347 s respectively. Even under best case circumstances, providers take a significant amount of time to complete risk assessments. For a complete panel of patients this can lead to hours of time required to make decisions about prescribing statins, use of anticoagulation, and medications for heart failure. Informatics solutions are needed to capture data in the medical record and serve up automatically calculated risk assessments to physicians and other providers at the point of care.

  8. Take the first heuristic, self-efficacy, and decision-making in sport.

    PubMed

    Hepler, Teri J; Feltz, Deborah L

    2012-06-01

    Can taking the first (TTF) option in decision-making lead to the best decisions in sports contexts? And, is one's decision-making self-efficacy in that context linked to TTF decisions? The purpose of this study was to examine the role of the TTF heuristic and self-efficacy in decision-making on a simulated sports task. Undergraduate and graduate students (N = 72) participated in the study and performed 13 trials in each of two video-based basketball decision tasks. One task required participants to verbally generate options before making a final decision on what to do next, while the other task simply asked participants to make a decision regarding the next move as quickly as possible. Decision-making self-efficacy was assessed using a 10-item questionnaire comprising various aspects of decision-making in basketball. Participants also rated their confidence in the final decision. Results supported many of the tenets of the TTF heuristic, such that people used the heuristic on a majority of the trials (70%), earlier generated options were better than later ones, first options were meaningfully generated, and final options were meaningfully selected. Results did not support differences in dynamic inconsistency or decision confidence based on the number of options. Findings also supported the link between self-efficacy and the TTF heuristic. Participants with higher self-efficacy beliefs used TTF more frequently and generated fewer options than those with low self-efficacy. Thus, not only is TTF an important heuristic when making decisions in dynamic, time-pressure situations, but self-efficacy plays an influential role in TTF.

  9. The Role of Future Time Perspective in Career Decision-Making

    ERIC Educational Resources Information Center

    Walker, Terrance L.; Tracey, Terence J. G.

    2012-01-01

    The present study of two hundred and seven university students examined the structural relation of future-orientation (both valence and instrumentality), career decision-making self-efficacy and career indecision (choice/commitment anxiety and lack of readiness) in a sample of 218 college students. Future time perspective was viewed as a key input…

  10. Exploring the Options: Teaching Economic Decision-Making with Poetry

    ERIC Educational Resources Information Center

    Johnson, Theresa L.

    2012-01-01

    High-stakes standardized tests in reading and limited instructional time are two powerful disincentives for teaching economics in the elementary classroom. In this article, integrating instruction in poetry and economic decision-making is presented as one way to maximize the use of scarce instructional time. Following a brief introduction to the…

  11. Deciding about College: How Soon Is Soon Enough?

    ERIC Educational Resources Information Center

    Harding, Jeffrey; Parker, Maggie C.; Toutkoushian, Rob

    2017-01-01

    Background/Context: Prior research has stressed the importance of timing in the college choice process, especially as it relates to receiving early information and making plans and decisions. Little has been done, however, in terms of empirically demonstrating how soon students make their decisions about college and the ways in which the timing of…

  12. A typology of time-scale mismatches and behavioral interventions to diagnose and solve conservation problems

    USGS Publications Warehouse

    Wilson, Robyn S.; Hardisty, David J.; Epanchin-Niell, Rebecca S.; Runge, Michael C.; Cottingham, Kathryn L.; Urban, Dean L.; Maguire, Lynn A.; Hastings, Alan; Mumby, Peter J.; Peters, Debra P.C.

    2016-01-01

    Ecological systems often operate on time scales significantly longer or shorter than the time scales typical of human decision making, which causes substantial difficulty for conservation and management in socioecological systems. For example, invasive species may move faster than humans can diagnose problems and initiate solutions, and climate systems may exhibit long-term inertia and short-term fluctuations that obscure learning about the efficacy of management efforts in many ecological systems. We adopted a management-decision framework that distinguishes decision makers within public institutions from individual actors within the social system, calls attention to the ways socioecological systems respond to decision makers’ actions, and notes institutional learning that accrues from observing these responses. We used this framework, along with insights from bedeviling conservation problems, to create a typology that identifies problematic time-scale mismatches occurring between individual decision makers in public institutions and between individual actors in the social or ecological system. We also considered solutions that involve modifying human perception and behavior at the individual level as a means of resolving these problematic mismatches. The potential solutions are derived from the behavioral economics and psychology literature on temporal challenges in decision making, such as the human tendency to discount future outcomes at irrationally high rates. These solutions range from framing environmental decisions to enhance the salience of long-term consequences, to using structured decision processes that make time scales of actions and consequences more explicit, to structural solutions aimed at altering the consequences of short-sighted behavior to make it less appealing. Additional application of these tools and long-term evaluation measures that assess not just behavioral changes but also associated changes in ecological systems are needed.

  13. A typology of time-scale mismatches and behavioral interventions to diagnose and solve conservation problems.

    PubMed

    Wilson, Robyn S; Hardisty, David J; Epanchin-Niell, Rebecca S; Runge, Michael C; Cottingham, Kathryn L; Urban, Dean L; Maguire, Lynn A; Hastings, Alan; Mumby, Peter J; Peters, Debra P C

    2016-02-01

    Ecological systems often operate on time scales significantly longer or shorter than the time scales typical of human decision making, which causes substantial difficulty for conservation and management in socioecological systems. For example, invasive species may move faster than humans can diagnose problems and initiate solutions, and climate systems may exhibit long-term inertia and short-term fluctuations that obscure learning about the efficacy of management efforts in many ecological systems. We adopted a management-decision framework that distinguishes decision makers within public institutions from individual actors within the social system, calls attention to the ways socioecological systems respond to decision makers' actions, and notes institutional learning that accrues from observing these responses. We used this framework, along with insights from bedeviling conservation problems, to create a typology that identifies problematic time-scale mismatches occurring between individual decision makers in public institutions and between individual actors in the social or ecological system. We also considered solutions that involve modifying human perception and behavior at the individual level as a means of resolving these problematic mismatches. The potential solutions are derived from the behavioral economics and psychology literature on temporal challenges in decision making, such as the human tendency to discount future outcomes at irrationally high rates. These solutions range from framing environmental decisions to enhance the salience of long-term consequences, to using structured decision processes that make time scales of actions and consequences more explicit, to structural solutions aimed at altering the consequences of short-sighted behavior to make it less appealing. Additional application of these tools and long-term evaluation measures that assess not just behavioral changes but also associated changes in ecological systems are needed. © 2015 Society for Conservation Biology.

  14. Response time in economic games reflects different types of decision conflict for prosocial and proself individuals.

    PubMed

    Yamagishi, Toshio; Matsumoto, Yoshie; Kiyonari, Toko; Takagishi, Haruto; Li, Yang; Kanai, Ryota; Sakagami, Masamichi

    2017-06-13

    Behavioral and neuroscientific studies explore two pathways through which internalized social norms promote prosocial behavior. One pathway involves internal control of impulsive selfishness, and the other involves emotion-based prosocial preferences that are translated into behavior when they evade cognitive control for pursuing self-interest. We measured 443 participants' overall prosocial behavior in four economic games. Participants' predispositions [social value orientation (SVO)] were more strongly reflected in their overall game behavior when they made decisions quickly than when they spent a longer time. Prosocially (or selfishly) predisposed participants behaved less prosocially (or less selfishly) when they spent more time in decision making, such that their SVO prosociality yielded limited effects in actual behavior in their slow decisions. The increase (or decrease) in slower decision makers was prominent among consistent prosocials (or proselfs) whose strong preference for prosocial (or proself) goals would make it less likely to experience conflict between prosocial and proself goals. The strong effect of RT on behavior in consistent prosocials (or proselfs) suggests that conflict between prosocial and selfish goals alone is not responsible for slow decisions. Specifically, we found that contemplation of the risk of being exploited by others (social risk aversion) was partly responsible for making consistent prosocials (but not consistent proselfs) spend longer time in decision making and behave less prosocially. Conflict between means rather than between goals (immediate versus strategic pursuit of self-interest) was suggested to be responsible for the time-related increase in consistent proselfs' prosocial behavior. The findings of this study are generally in favor of the intuitive cooperation model of prosocial behavior.

  15. Use of ultrasonography to make reproductive management decisions

    USDA-ARS?s Scientific Manuscript database

    Transrectal ultrasonography has been available for making management decisions since the mid 1980’s. This technology allows for the real-time visualization of internal structures (i.e. ovary and fetus) that are otherwise difficult to evaluate. The use of this technology in making reproductive manag...

  16. Dynamic fMRI of a decision-making task

    NASA Astrophysics Data System (ADS)

    Singh, Manbir; Sungkarat, Witaya

    2008-03-01

    A novel fMRI technique has been developed to capture the dynamics of the evolution of brain activity during complex tasks such as those designed to evaluate the neural basis of decision-making under different situations. A task called the Iowa Gambling Task was used as an example. Six normal human volunteers were studied. The task was presented inside a 3T MRI and a dynamic fMRI study of the approximately 2s period between the beginning and end of the decision-making period was conducted by employing a series of reference functions, separated by 200 ms, designed to capture activation at different time-points within this period. As decision-making culminates with a button-press, the timing of the button press was chosen as the reference (t=0) and corresponding reference functions were shifted backward in steps of 200ms from this point up to the time when motor activity from the previous button press became predominant. SPM was used to realign, high-pass filter (cutoff 200s), normalize to the Montreal Neurological Institute (MNI) Template using a 12 parameter affine/non-linear transformation, 8mm Gaussian smoothing, and event-related General Linear Model analysis for each of the shifted reference functions. The t-score of each activated voxel was then examined to find its peaking time. A random effect analysis (p<0.05) showed prefrontal, parietal and bi-lateral hippocampal activation peaking at different times during the decision making period in the n=6 group study.

  17. Are Gains in Decision-Making Autonomy during Early Adolescence Beneficial for Emotional Functioning? The Case of the United States and China

    ERIC Educational Resources Information Center

    Qin, Lili; Pomerantz, Eva M.; Wang, Qian

    2009-01-01

    This research examined the role of children's decision-making autonomy in their emotional functioning during early adolescence in the United States and China. Four times over the 7th and 8th grades, 825 American and Chinese children (M = 12.73 years) reported on the extent to which they versus their parents make decisions about issues children…

  18. Decision making in high-velocity environments: implications for healthcare.

    PubMed

    Stepanovich, P L; Uhrig, J D

    1999-01-01

    Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

  19. [Barriers and facilitators to implementing shared decision-making in oncology: Patient perceptions].

    PubMed

    Ortega-Moreno, M; Padilla-Garrido, N; Huelva-López, L; Aguado-Correa, F; Bayo-Calero, J; Bayo-Lozano, E

    To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Involvement and Influence of Healthcare Providers, Family Members, and Other Mutation Carriers in the Cancer Risk Management Decision-Making Process of BRCA1 and BRCA2 Mutation Carriers.

    PubMed

    Puski, Athena; Hovick, Shelly; Senter, Leigha; Toland, Amanda Ewart

    2018-03-29

    Deciding between increased cancer screening or prophylactic surgery and the timing of such procedures can be a difficult and complex process for women with BRCA mutations. There are gaps in our understanding of involvement of others in the decision-making process for women with BRCA mutations. This study evaluated the management decision-making process of women with BRCA mutations, focusing on the involvement of others. Grounded theory was used to analyze and code risk management decision-making information from interviews with 20 BRCA mutation carriers. Unaffected at-risk participants with a BRCA mutation, those under age 40, and those with no children described having a difficult time making risk management decisions. Physicians were an integral part of the decision-making process by providing decisional support and management recommendations. Family members and other mutation carriers filled similar yet distinct roles by providing experiential information as well as decisional and emotional support for carriers. Participants described genetic counselors as short-term providers of risk information and management recommendations. The study findings suggest that unaffected at-risk women, women under 40, and those who do not have children may benefit from additional support and information during the decision-making process. Genetic counselors are well trained to help women through this process and connect them with resources, and may be under-utilized in long-term follow-up for women with a BRCA mutation.

  1. A Structured approach to incidental take decision making

    USGS Publications Warehouse

    McGowan, Conor P.

    2013-01-01

    Decision making related to incidental take of endangered species under U.S. law lends itself well to a structured decision making approach. Incidental take is the permitted killing, harming, or harassing of a protected species under the law as long as that harm is incidental to an otherwise lawful activity and does not “reduce appreciably the probability of survival and recovery in the wild.” There has been inconsistency in the process used for determining incidental take allowances across species and across time for the same species, and structured decision making has been proposed to improve decision making. I use an example decision analysis to demonstrate the process and its applicability to incidental take decisions, even under significant demographic uncertainty and multiple, competing objectives. I define the example problem, present an objectives statement and a value function, use a simulation model to assess the consequences of a set of management actions, and evaluate the tradeoffs among the different actions. The approach results in transparent and repeatable decisions.

  2. Aiding Lay Decision Making Using a Cognitive Competencies Approach.

    PubMed

    Maule, A J; Maule, Simon

    2015-01-01

    Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions.

  3. Aiding Lay Decision Making Using a Cognitive Competencies Approach

    PubMed Central

    Maule, A. J.; Maule, Simon

    2016-01-01

    Two prescriptive approaches have evolved to aid human decision making: just in time interventions that provide support as a decision is being made; and just in case interventions that educate people about future events that they may encounter so that they are better prepared to make an informed decision when these events occur. We review research on these two approaches developed in the context of supporting everyday decisions such as choosing an apartment, a financial product or a medical procedure. We argue that the lack of an underlying prescriptive theory has limited the development and evaluation of these interventions. We draw on recent descriptive research on the cognitive competencies that underpin human decision making to suggest new ways of interpreting how and why existing decision aids may be effective and suggest a different way of evaluating their effectiveness. We also briefly outline how our approach has the potential to develop new interventions to support everyday decision making and highlight the benefits of drawing on descriptive research when developing and evaluating interventions. PMID:26779052

  4. 48 CFR 1652.204-72 - Filing health benefit claims/court review of disputed claims.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... beyond his or her control from making the request within the time limit. (2) The Carrier has 30 days... information is required to make a decision on the claim; (iii) Specify the time limit (60 days after the date... that time and give a written notice of its decision to the covered individual and to the Carrier. (f...

  5. Female participation in household decision-making: an analysis of consumer durables' acquisition in Pakistan.

    PubMed

    Mujahid-mukhtar, E; Mukhtar, H

    1991-01-01

    Investigating the nature and degree of female household decision-making in Pakistan, this paper analyzes the influence of women in the purchase consumer durables. The paper also identifies those factors which enable women to play a more active role in the decision-making process. Because women in Pakistan are generally excluded from the public sphere, their level of emancipation is better assessed according to the degree of participation in household decision-making. A good measure of women's power within a household is their influence in the purchase of consumer durables (cars, appliances, etc.), whose expense and life-long nature makes their purchase an important decision. For this study, the authors relied on data from a 1989 nationwide household survey conducted by AERC, which included a information concerning the acquisition of 12 consumer durables as expected. As expected, men make more decisions on the purchase of all consumer goods than women, even for items in which women feel more need than men (e.g. sewing machines, washing machines). The study found that for the needs felt by women for all durable goods, men make 2/3 of all decisions, while women make only 1/3 of decisions. And in cases where the need is felt by men, the men make 93% of the decisions, while women decide only 3 % of the times. The study identified various cultural and economic factors that affect women's decision making power: urban women, women in nuclear families, educated women, and working women generally have more decision making power than rural women, women in extended families, illiterate women, and unemployed women.

  6. 'One also needs a bit of trust in the doctor ... ': a qualitative interview study with pancreatic cancer patients about their perceptions and views on information and treatment decision-making.

    PubMed

    Schildmann, J; Ritter, P; Salloch, S; Uhl, W; Vollmann, J

    2013-09-01

    Information about diagnosis, treatment options and prognosis has been emphasized as a key to empower cancer patients to make treatment decisions reflecting their values. However, surveys indicate that patients' preferences regarding information and treatment decision-making differ. In this qualitative interview study, we explored pancreatic cancer patients' perceptions and preferences on information and treatment decision-making. Qualitative in-depth interviews with patients with pancreatic cancer. Purposive sampling and qualitative analysis were carried out. We identified two stages of information and treatment decision-making. Patients initially emphasize trust in their physician and indicate rather limited interest in details about surgical and medical treatment. In the latter stage of disease, patients perceive themselves more active regarding information seeking and treatment decision-making. All patients discuss their poor prognosis. Reflecting on their own situation, all patients interviewed pointed out that hope was an important driver to undergo further treatment also in advanced stages of the disease. Interviewees unanimously emphasized the difficulty of anticipating the time at which stopping cancer treatment would be the right decision. The findings can serve as starting point for reflection on professional decision-making in pancreatic cancer and larger representative surveys on ethical issues in treatment decision-making in pancreatic cancer.

  7. 3D technology of Sony Bloggie has no advantage in decision-making of tennis serve direction: A randomized placebo-controlled study.

    PubMed

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

    2017-06-01

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

  8. Using the Reliability Theory for Assessing the Decision Confidence Probability for Comparative Life Cycle Assessments.

    PubMed

    Wei, Wei; Larrey-Lassalle, Pyrène; Faure, Thierry; Dumoulin, Nicolas; Roux, Philippe; Mathias, Jean-Denis

    2016-03-01

    Comparative decision making process is widely used to identify which option (system, product, service, etc.) has smaller environmental footprints and for providing recommendations that help stakeholders take future decisions. However, the uncertainty problem complicates the comparison and the decision making. Probability-based decision support in LCA is a way to help stakeholders in their decision-making process. It calculates the decision confidence probability which expresses the probability of a option to have a smaller environmental impact than the one of another option. Here we apply the reliability theory to approximate the decision confidence probability. We compare the traditional Monte Carlo method with a reliability method called FORM method. The Monte Carlo method needs high computational time to calculate the decision confidence probability. The FORM method enables us to approximate the decision confidence probability with fewer simulations than the Monte Carlo method by approximating the response surface. Moreover, the FORM method calculates the associated importance factors that correspond to a sensitivity analysis in relation to the probability. The importance factors allow stakeholders to determine which factors influence their decision. Our results clearly show that the reliability method provides additional useful information to stakeholders as well as it reduces the computational time.

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

    PubMed

    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.

  10. 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

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

    PubMed Central

    Klöckner, Christian A.; Nayum, Alim

    2016-01-01

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

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

    PubMed

    Klöckner, Christian A; Nayum, Alim

    2016-01-01

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

  13. fMRI evidence for a dual process account of the speed-accuracy tradeoff in decision-making.

    PubMed

    Ivanoff, Jason; Branning, Philip; Marois, René

    2008-07-09

    The speed and accuracy of decision-making have a well-known trading relationship: hasty decisions are more prone to errors while careful, accurate judgments take more time. Despite the pervasiveness of this speed-accuracy trade-off (SAT) in decision-making, its neural basis is still unknown. Using functional magnetic resonance imaging (fMRI) we show that emphasizing the speed of a perceptual decision at the expense of its accuracy lowers the amount of evidence-related activity in lateral prefrontal cortex. Moreover, this speed-accuracy difference in lateral prefrontal cortex activity correlates with the speed-accuracy difference in the decision criterion metric of signal detection theory. We also show that the same instructions increase baseline activity in a dorso-medial cortical area involved in the internal generation of actions. These findings suggest that the SAT is neurally implemented by modulating not only the amount of externally-derived sensory evidence used to make a decision, but also the internal urge to make a response. We propose that these processes combine to control the temporal dynamics of the speed-accuracy trade-off in decision-making.

  14. A brief history of decision making.

    PubMed

    Buchanan, Leigh; O'Connell, Andrew

    2006-01-01

    Sometime around the middle of the past century, telephone executive Chester Barnard imported the term decision making from public administration into the business world. There it began to replace narrower terms, like "resource allocation" and "policy making," shifting the way managers thought about their role from continuous, Hamlet-like deliberation toward a crisp series of conclusions reached and actions taken. Yet, decision making is, of course, a broad and ancient human pursuit, flowing back to a time when people sought guidance from the stars. From those earliest days, we have strived to invent better tools for the purpose, from the Hindu-Arabic systems for numbering and algebra, to Aristotle's systematic empiricism, to friar Occam's advances in logic, to Francis Bacon's inductive reasoning, to Descartes's application of the scientific method. A growing sophistication with managing risk, along with a nuanced understanding of human behavior and advances in technology that support and mimic cognitive processes, has improved decision making in many situations. Even so, the history of decision-making strategies--captured in this time line and examined in the four accompanying essays on risk, group dynamics, technology, and instinct--has not marched steadily toward perfect rationalism. Twentieth-century theorists showed that the costs of acquiring information lead executives to make do with only good-enough decisions. Worse, people decide against their own economic interests even when they know better. And in the absence of emotion, it's impossible to make any decisions at all. Erroneous framing, bounded awareness, excessive optimism: The debunking of Descartes's rational man threatens to swamp our confidence in our choices. Is it really surprising, then, that even as technology dramatically increases our access to information, Malcolm Gladwell extols the virtues of gut decisions made, literally, in the blink of an eye?

  15. The roles of the anterior cingulate cortex and its dopamine receptors in self-paced cost-benefit decision making in rats.

    PubMed

    Wang, Shuai; Hu, Shan-Hu; Shi, Yi; Li, Bao-Ming

    2017-03-01

    It has been shown that the anterior cingulate cortex (ACC) and its dopamine system are crucial for decision making that requires physical/emotional effort, but not for all forms of cost-benefit decision making. Previous studies had mostly employed behavioral tasks with two competing cost-reward options that were preset by the experimenters. However, few studies have been conducted using scenarios in which the subjects have full control over the energy/time expenditure required to obtain a proportional reward. Here, we assessed the roles of the ACC and its dopamine system in cost-benefit decision making by utilizing a "do more get more" (DMGM) task and a time-reward trade-off (TRTO) task, wherein the animals were able to self-determine how much effort or time to expend at a nosepoke operandum for a proportional reward. Our results showed that (1) ACC inactivation severely impaired DMGM task performance, with a reduction in the rate of correct responses and a decrease in the effort expended, but did not affect the TRTO task; and (2) blocking ACC D2 receptors had no impact on DMGM task performance in the baseline cost-benefit scenario, but it significantly reduced the attempts to invest increased effort for a large reward when the benefit-cost ratio was reduced by half. In contrast, blocking ACC D1 receptors had no effect on DMGM task performance. These findings suggest that the ACC is required for self-paced effort-based but not for time-reward trade-off decision making. Furthermore, ACC dopamine D2 but not D1 receptors are involved in DMGM decision making.

  16. "If it's worth my time, i will make the time": school-based providers' decision-making about participating in an evidence-based psychotherapy consultation program.

    PubMed

    Lyon, Aaron R; Ludwig, Kristy; Romano, Evalynn; Leonard, Skyler; Stoep, Ann Vander; McCauley, Elizabeth

    2013-11-01

    This study evaluated influences on school-based clinicians' decision-making surrounding participation in a modular psychotherapy training and consultation program lasting one academic year. Clinicians were recruited from three participation groups: those who never engaged, those who engaged and then discontinued, and those who participated fully. Qualitative interviews explored influences on initial and continued participation, as well as differences in decision-making by participation group, knowledge about evidence-based practices, and attitudes toward evidence-based practices. Eight major themes were identified: time, practice utility, intervention/training content, training process, attitudes toward training, social influences, commitment to training, and expectations. Some themes were discussed universally across all comparison groups, while others varied in frequency or content. Recommendations for increasing participation are presented, based on the findings.

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

    PubMed

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

    2013-01-01

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

  18. The time course of saccadic decision making: dynamic field theory.

    PubMed

    Wilimzig, Claudia; Schneider, Stefan; Schöner, Gregor

    2006-10-01

    Making a saccadic eye movement involves two decisions, the decision to initiate the saccade and the selection of the visual target of the saccade. Here we provide a theoretical account for the time-courses of these two processes, whose instabilities are the basis of decision making. We show how the cross-over from spatial averaging for fast saccades to selection for slow saccades arises from the balance between excitatory and inhibitory processes. Initiating a saccade involves overcoming fixation, as can be observed in the countermanding paradigm, which we model accounting both for the temporal evolution of the suppression probability and its dependence on fixation activity. The interaction between the two forms of decision making is demonstrated by predicting how the cross-over from averaging to selection depends on the fixation stimulus in gap-step-overlap paradigms. We discuss how the activation dynamics of our model may be mapped onto neuronal structures including the motor map and the fixation cells in superior colliculus.

  19. A Review of Consequences of Poverty on Economic Decision-Making: A Hypothesized Model of a Cognitive Mechanism.

    PubMed

    Adamkovič, Matúš; Martončik, Marcel

    2017-01-01

    This review focuses on the issue of poverty affecting economic decision-making. By critically evaluating existing studies, the authors propose a structural model detailing the cognitive mechanism involved in how poverty negatively impacts economic decision-making, and explores evidence supporting the basis for the formation of this model. The suggested mechanism consists of a relationship between poverty and four other factors: (1) cognitive load (e.g., experiencing negative affect and stress); (2) executive functions (e.g., attention, working memory, and self-control); (3) intuition/deliberation in decision-making; and (4) economic decision-making (e.g., time-discounting and risk preference), with a final addition of financial literacy as a covariate. This paper focuses on shortfalls in published research, and delves further into the proposed model.

  20. Poor Decision Making is Associated with an Increased Risk of Mortality Among Community-Dwelling Older Persons without Dementia

    PubMed Central

    Boyle, Patricia A.; Wilson, Robert S.; Yu, Lei; Buchman, Aron S.; Bennett, David A.

    2013-01-01

    Background Decision making is thought to be an important determinant of health and well-being across the lifespan, but little is known about the association of decision making with mortality. Methods Participants were 675 older persons without dementia from the Rush Memory and Aging Project, a longitudinal cohort study of aging. Baseline assessments of decision making were used to predict the risk of mortality during up to 4 years of follow-up. Results The mean score on the decision making measure at baseline was 7.1 (SD=2.9, range: 0-12), with lower scores indicating poorer decision making. During up to 4 years of follow-up (mean=1.7 years), 40 (6% of 675) persons died. In a proportional hazards model adjusted for age, sex, and education, the risk of mortality increased by about 20% for each additional decision making error (HR=1.19, 95% CI 1.07, 1.32, p=0.002). Thus, a person who performed poorly on the measure of decision making (score=3, 10th percentile) was about four times more likely to die compared to a person who performed well (score=11, 90th percentile). Further, the association of decision making with mortality persisted after adjustment for the level of cognitive function. Conclusion Poor decision making is associated with an increased risk of mortality in old age even after accounting for cognitive function. PMID:23364306

  1. Poor decision making is associated with an increased risk of mortality among community-dwelling older persons without dementia.

    PubMed

    Boyle, Patricia A; Wilson, Robert S; Yu, Lei; Buchman, Aron S; Bennett, David A

    2013-01-01

    Decision making is thought to be an important determinant of health and well-being across the lifespan, but little is known about the association of decision making with mortality. Participants were 675 older persons without dementia from the Rush Memory and Aging Project, a longitudinal cohort study of aging. Baseline assessments of decision making were used to predict the risk of mortality during up to 4 years of follow-up. The mean score on the decision making measure at baseline was 7.1 (SD = 2.9, range: 0-12), with lower scores indicating poorer decision making. During up to 4 years of follow-up (mean = 1.7 years), 40 (6% of 675) persons died. In a proportional hazards model adjusted for age, sex and education, the risk of mortality increased by about 20% for each additional decision making error (HR = 1.19, 95% CI = 1.07-1.32, p = 0.002). Thus, a person who performed poorly on the measure of decision making (score = 3, 10th percentile) was about 4 times more likely to die compared to a person who performed well (score = 11, 90th percentile). Further, the association of decision making with mortality persisted after adjustment for the level of cognitive function. Poor decision making is associated with an increased risk of mortality in old age even after accounting for cognitive function. Copyright © 2013 S. Karger AG, Basel.

  2. What perceptions do patients have of decision making (DM)? Toward an integrative patient-centered care model. A qualitative study using focus-group interviews.

    PubMed

    Moreau, Alain; Carol, Laurent; Dedianne, Marie Cécile; Dupraz, Christian; Perdrix, Corinne; Lainé, Xavier; Souweine, Gilbert

    2012-05-01

    To understand patients' perceptions of decision making and identify relationships among decision-making models. This qualitative study was made up of four focus group interviews (elderly persons, users of health support groups, students, and rural inhabitants). Participants were asked to report their perceptions of decision making in three written clinical scenarios (hypertension, breast cancer, prostate cancer). The analysis was based on the principles of grounded theory. Most patients perceived decision making as shared decision making, a deliberative question-response interaction with the physician that allowed patients to be experts in obtaining clearer information, participating in the care process, and negotiating compromises with physician preferences. Requesting second opinions allowed patients to maintain control, even within the paternalistic model preferred by elderly persons. Facilitating factors (trust, qualitative non-verbal communication, time to think) and obstacles (serious/emergency situations, perceived inadequate scientific competence, problems making requests, fear of knowing) were also part of shared decision making. In the global concept of patient-centered care, shared decision making can be flexible and can integrate paternalistic and informative models. Physicians' expertise should be associated with biomedical and relational skills through listening to, informing, and advising patients, and by supporting patients' choices. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  3. Rational decision-making about treatment and care in dementia: a contradiction in terms?

    PubMed

    Wolfs, Claire A G; de Vugt, Marjolein E; Verkaaik, Mike; Haufe, Marc; Verkade, Paul-Jeroen; Verhey, Frans R J; Stevens, Fred

    2012-04-01

    To gain caregivers' insights into the decision-making process in dementia patients with regard to treatment and care. Four focus group interviews (n=29). The decision-making process consists of three elementary components: (1) identifying an individual's needs; (2) exploring options; and (3) making a choice. The most important phase is the exploration phase as it is crucial for the acceptance of the disease. Furthermore, the decision is experienced more as an emotional choice than a rational one. It is influenced by personal preferences whereas practical aspects do not seem to play a substantial role. Several aspects make decision-making in dementia different from decision-making in the context of other chronic diseases: (1) the difficulty accepting dementia; (2) the progressive nature of dementia; (3) patient's reliance on surrogate decision-making; and (4) strong emotions. Due to these aspects, the decision-making process is very time-consuming, especially the crucial exploration phase. A more active role is required of both the caregiver and the health care professional especially in the exploration phase, enabling easier acceptance and adjustment to the disease. Acceptance is an important condition for reducing anxiety and resistance to care that may offer significant benefits in the future. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. To dialyse or delay: a qualitative study of older New Zealanders’ perceptions and experiences of decision-making, with stage 5 chronic kidney disease

    PubMed Central

    Lovell, Sarah; Walker, Robert J; Schollum, John B W; Marshall, Mark R; McNoe, Bronwen M; Derrett, Sarah

    2017-01-01

    Background Issues related to renal replacement therapy in elderly people with end stage kidney disease (ESKD) are complex. There is inadequate empirical data related to: decision-making by older populations, treatment experiences, implications of dialysis treatment and treatment modality on quality of life, and how these link to expectations of ageing. Study population Participants for this study were selected from a larger quantitative study of dialysis and predialysis patients aged 65 years or older recruited from three nephrology services across New Zealand. All participants had reached chronic kidney disease (CKD) stage 5 and had undergone dialysis education but had not started dialysis or recently started dialysis within the past 6 months. Methodology Serial qualitative interviews were undertaken to explore the decision-making processes and subsequent treatment experiences of patients with ESKD. Analytical approach: A framework method guided the iterative process of analysis. Decision-making codes were generated within NVivo software and then compared with the body of the interviews. Results Interviews were undertaken with 17 participants. We observed that decision-making was often a fluid process, rather than occurring at a single point in time, and was heavily influenced by perceptions of oneself as becoming old, social circumstances, life events and health status. Limitations This study focuses on participants' experiences of decision-making about treatment and does not include perspectives of their nephrologists or other members of the nephrology team. Conclusions Older patients often delay dialysis as an act of self-efficacy. They often do not commit to a dialysis decision following predialysis education. Delaying decision-making and initiating dialysis were common. This was not seen by participants as a final decision about therapy. Predialysis care and education should be different for older patients, who will delay decision-making until the time of facing obvious uraemic symptoms, threatening blood tests or paternalistic guidance from their nephrologist. Trial registration number Australasian Clinical Trials Registry ACTRN 12611000024943; results. PMID:28360253

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

    NASA Astrophysics Data System (ADS)

    Siegel, Marcelle A.

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

  6. Shared Decision Making and Autonomy Among US Participants with Multiple Sclerosis in the NARCOMS Registry

    PubMed Central

    Thomas, Nina; Tyry, Tuula; Fox, Robert J.; Salter, Amber

    2017-01-01

    Background: Treatment decisions in multiple sclerosis (MS) are affected by many factors and are made by the patient, doctor, or both. With new disease-modifying therapies (DMTs) emerging, the complexity surrounding treatment decisions is increasing, further emphasizing the importance of understanding decision-making preferences. Methods: North American Research Committee on Multiple Sclerosis (NARCOMS) Registry participants completed the Fall 2014 Update survey, which included the Control Preferences Scale (CPS). The CPS consists of five images showing different patient/doctor roles in treatment decision making. The images were collapsed to three categories: patient-centered, shared, and physician-centered decision-making preferences. Associations between decision-making preferences and demographic and clinical factors were evaluated using multivariable logistic regression. Results: Of 7009 participants, 79.3% were women and 93.5% were white (mean [SD] age, 57.6 [10.3] years); 56.7% reported a history of relapses. Patient-centered decision making was most commonly preferred by participants (47.9%), followed by shared decision making (SDM; 42.8%). SDM preference was higher for women and those taking DMTs and increased with age and disease duration (all P < .05). Patient-centered decisions were most common for respondents not taking a DMT at the time of the survey and were preferred by those who had no DMT history compared with those who had previously taken a DMT (P < .0001). There was no difference in SDM preference by current MS disease course after adjusting for other disease-related factors. Conclusions: Responders reported most commonly considering their doctor's opinion before making a treatment decision and making decisions jointly with their doctor. DMT use, gender, and age were associated with decision-making preference. PMID:29270088

  7. Developing an Advanced Environment for Collaborative Computing

    NASA Technical Reports Server (NTRS)

    Becerra-Fernandez, Irma; Stewart, Helen; DelAlto, Martha; DelAlto, Martha; Knight, Chris

    1999-01-01

    Knowledge management in general tries to organize and make available important know-how, whenever and where ever is needed. Today, organizations rely on decision-makers to produce "mission critical" decisions that am based on inputs from multiple domains. The ideal decision-maker has a profound understanding of specific domains that influence the decision-making process coupled with the experience that allows them to act quickly and decisively on the information. In addition, learning companies benefit by not repeating costly mistakes, and by reducing time-to-market in Research & Development projects. Group-decision making tools can help companies make better decisions by capturing the knowledge from groups of experts. Furthermore, companies that capture their customers preferences can improve their customer service, which translates to larger profits. Therefore collaborative computing provides a common communication space, improves sharing of knowledge, provides a mechanism for real-time feedback on the tasks being performed, helps to optimize processes, and results in a centralized knowledge warehouse. This paper presents the research directions. of a project which seeks to augment an advanced collaborative web-based environment called Postdoc, with workflow capabilities. Postdoc is a "government-off-the-shelf" document management software developed at NASA-Ames Research Center (ARC).

  8. Decision making in noisy bistable systems with time-dependent asymmetry

    NASA Astrophysics Data System (ADS)

    Nené, Nuno R.; Zaikin, Alexey

    2013-01-01

    Our work draws special attention to the importance of the effects of time-dependent parameters on decision making in bistable systems. Here, we extend previous studies of the mechanism known as speed-dependent cellular decision making in genetic circuits by performing an analytical treatment of the canonical supercritical pitchfork bifurcation problem with an additional time-dependent asymmetry and control parameter. This model has an analogous behavior to the genetic switch. In the presence of transient asymmetries and fluctuations, slow passage through the critical region in both systems increases substantially the probability of specific decision outcomes. We also study the relevance for attractor selection of reaching maximum values for the external asymmetry before and after the critical region. Overall, maximum asymmetries should be reached at an instant where the position of the critical point allows for compensation of the detrimental effects of noise in retaining memory of the transient asymmetries.

  9. Emergent collective decision-making: Control, model and behavior

    NASA Astrophysics Data System (ADS)

    Shen, Tian

    In this dissertation we study emergent collective decision-making in social groups with time-varying interactions and heterogeneously informed individuals. First we analyze a nonlinear dynamical systems model motivated by animal collective motion with heterogeneously informed subpopulations, to examine the role of uninformed individuals. We find through formal analysis that adding uninformed individuals in a group increases the likelihood of a collective decision. Secondly, we propose a model for human shared decision-making with continuous-time feedback and where individuals have little information about the true preferences of other group members. We study model equilibria using bifurcation analysis to understand how the model predicts decisions based on the critical threshold parameters that represent an individual's tradeoff between social and environmental influences. Thirdly, we analyze continuous-time data of pairs of human subjects performing an experimental shared tracking task using our second proposed model in order to understand transient behavior and the decision-making process. We fit the model to data and show that it reproduces a wide range of human behaviors surprisingly well, suggesting that the model may have captured the mechanisms of observed behaviors. Finally, we study human behavior from a game-theoretic perspective by modeling the aforementioned tracking task as a repeated game with incomplete information. We show that the majority of the players are able to converge to playing Nash equilibrium strategies. We then suggest with simulations that the mean field evolution of strategies in the population resemble replicator dynamics, indicating that the individual strategies may be myopic. Decisions form the basis of control and problems involving deciding collectively between alternatives are ubiquitous in nature and in engineering. Understanding how multi-agent systems make decisions among alternatives also provides insight for designing decentralized control laws for engineering applications from mobile sensor networks for environmental monitoring to collective construction robots. With this dissertation we hope to provide additional methodology and mathematical models for understanding the behavior and control of collective decision-making in multi-agent systems.

  10. Modulation of Saccade Vigor during Value-Based Decision Making.

    PubMed

    Reppert, Thomas R; Lempert, Karolina M; Glimcher, Paul W; Shadmehr, Reza

    2015-11-18

    During value-based decision-making, individuals consider the various options and select the one that provides the maximum subjective value. Although the brain integrates abstract information to compute and compare these values, the only behavioral outcome is often the decision itself. However, if the options are visual stimuli, during deliberation the brain moves the eyes from one stimulus to the other. Previous work suggests that saccade vigor, i.e., peak velocity as a function of amplitude, is greater if reward is associated with the visual stimulus. This raises the possibility that vigor during the free viewing of options may be influenced by the valuation of each option. Here, humans chose between a small, immediate monetary reward and a larger but delayed reward. As the deliberation began, vigor was similar for the saccades made to the two options but diverged 0.5 s before decision time, becoming greater for the preferred option. This difference in vigor increased as a function of the difference in the subjective values that the participant assigned to the delayed and immediate options. After the decision was made, participants continued to gaze at the options, but with reduced vigor, making it possible to infer timing of the decision from the sudden drop in vigor. Therefore, the subjective value that the brain assigned to a stimulus during decision-making affected the motor system via the vigor with which the eyes moved toward that stimulus. We find that, as individuals deliberate between two rewarding options and arrive at a decision, the vigor with which they make saccades to each option reflects a real-time evaluation of that option. With deliberation, saccade vigor diverges between the two options, becoming greater for the option that the individual will eventually choose. The results suggest a shared element between the network that assigns value to a stimulus during the process of decision-making and the network that controls vigor of movements toward that stimulus. Copyright © 2015 the authors 0270-6474/15/3515369-10$15.00/0.

  11. Modulation of Saccade Vigor during Value-Based Decision Making

    PubMed Central

    Lempert, Karolina M.; Glimcher, Paul W.; Shadmehr, Reza

    2015-01-01

    During value-based decision-making, individuals consider the various options and select the one that provides the maximum subjective value. Although the brain integrates abstract information to compute and compare these values, the only behavioral outcome is often the decision itself. However, if the options are visual stimuli, during deliberation the brain moves the eyes from one stimulus to the other. Previous work suggests that saccade vigor, i.e., peak velocity as a function of amplitude, is greater if reward is associated with the visual stimulus. This raises the possibility that vigor during the free viewing of options may be influenced by the valuation of each option. Here, humans chose between a small, immediate monetary reward and a larger but delayed reward. As the deliberation began, vigor was similar for the saccades made to the two options but diverged 0.5 s before decision time, becoming greater for the preferred option. This difference in vigor increased as a function of the difference in the subjective values that the participant assigned to the delayed and immediate options. After the decision was made, participants continued to gaze at the options, but with reduced vigor, making it possible to infer timing of the decision from the sudden drop in vigor. Therefore, the subjective value that the brain assigned to a stimulus during decision-making affected the motor system via the vigor with which the eyes moved toward that stimulus. SIGNIFICANCE STATEMENT We find that, as individuals deliberate between two rewarding options and arrive at a decision, the vigor with which they make saccades to each option reflects a real-time evaluation of that option. With deliberation, saccade vigor diverges between the two options, becoming greater for the option that the individual will eventually choose. The results suggest a shared element between the network that assigns value to a stimulus during the process of decision-making and the network that controls vigor of movements toward that stimulus. PMID:26586823

  12. Dynamic Excitatory and Inhibitory Gain Modulation Can Produce Flexible, Robust and Optimal Decision-making

    PubMed Central

    Niyogi, Ritwik K.; Wong-Lin, KongFatt

    2013-01-01

    Behavioural and neurophysiological studies in primates have increasingly shown the involvement of urgency signals during the temporal integration of sensory evidence in perceptual decision-making. Neuronal correlates of such signals have been found in the parietal cortex, and in separate studies, demonstrated attention-induced gain modulation of both excitatory and inhibitory neurons. Although previous computational models of decision-making have incorporated gain modulation, their abstract forms do not permit an understanding of the contribution of inhibitory gain modulation. Thus, the effects of co-modulating both excitatory and inhibitory neuronal gains on decision-making dynamics and behavioural performance remain unclear. In this work, we incorporate time-dependent co-modulation of the gains of both excitatory and inhibitory neurons into our previous biologically based decision circuit model. We base our computational study in the context of two classic motion-discrimination tasks performed in animals. Our model shows that by simultaneously increasing the gains of both excitatory and inhibitory neurons, a variety of the observed dynamic neuronal firing activities can be replicated. In particular, the model can exhibit winner-take-all decision-making behaviour with higher firing rates and within a significantly more robust model parameter range. It also exhibits short-tailed reaction time distributions even when operating near a dynamical bifurcation point. The model further shows that neuronal gain modulation can compensate for weaker recurrent excitation in a decision neural circuit, and support decision formation and storage. Higher neuronal gain is also suggested in the more cognitively demanding reaction time than in the fixed delay version of the task. Using the exact temporal delays from the animal experiments, fast recruitment of gain co-modulation is shown to maximize reward rate, with a timescale that is surprisingly near the experimentally fitted value. Our work provides insights into the simultaneous and rapid modulation of excitatory and inhibitory neuronal gains, which enables flexible, robust, and optimal decision-making. PMID:23825935

  13. Real-Time Optimal Flood Control Decision Making and Risk Propagation Under Multiple Uncertainties

    NASA Astrophysics Data System (ADS)

    Zhu, Feilin; Zhong, Ping-An; Sun, Yimeng; Yeh, William W.-G.

    2017-12-01

    Multiple uncertainties exist in the optimal flood control decision-making process, presenting risks involving flood control decisions. This paper defines the main steps in optimal flood control decision making that constitute the Forecast-Optimization-Decision Making (FODM) chain. We propose a framework for supporting optimal flood control decision making under multiple uncertainties and evaluate risk propagation along the FODM chain from a holistic perspective. To deal with uncertainties, we employ stochastic models at each link of the FODM chain. We generate synthetic ensemble flood forecasts via the martingale model of forecast evolution. We then establish a multiobjective stochastic programming with recourse model for optimal flood control operation. The Pareto front under uncertainty is derived via the constraint method coupled with a two-step process. We propose a novel SMAA-TOPSIS model for stochastic multicriteria decision making. Then we propose the risk assessment model, the risk of decision-making errors and rank uncertainty degree to quantify the risk propagation process along the FODM chain. We conduct numerical experiments to investigate the effects of flood forecast uncertainty on optimal flood control decision making and risk propagation. We apply the proposed methodology to a flood control system in the Daduhe River basin in China. The results indicate that the proposed method can provide valuable risk information in each link of the FODM chain and enable risk-informed decisions with higher reliability.

  14. Framing of task performance strategies: effects on performance in a multiattribute dynamic decision making environment.

    PubMed

    Nygren, T E

    1997-09-01

    It is well documented that the way a static choice task is "framed" can dramatically alter choice behavior, often leading to observable preference reversals. This framing effect appears to result from perceived changes in the nature or location of a person's initial reference point, but it is not clear how framing effects might generalize to performance on dynamic decision making tasks that are characterized by high workload, time constraints, risk, or stress. A study was conducted to examine the hypothesis that framing can introduce affective components to the decision making process and can influence, either favorably (positive frame) or adversely (negative frame), the implementation and use of decision making strategies in dynamic high-workload environments. Results indicated that negative frame participants were significantly impaired in developing and employing a simple optimal decision strategy relative to a positive frame group. Discussion focuses on implications of these results for models of dynamic decision making.

  15. Stress and Aeronautical Team Decision Making: Strengthening the Weak Links

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith; Rosekind, Mark R. (Technical Monitor)

    1996-01-01

    A model that characterizes pilots'decision making in flight will be presented. Elements of the model that appear most vulnerable to stress will be examined in light of accidents and incidents. The model includes two major components: Situation assessment and choice of a course of action. While based on Klein's Recognition-Primed Decision Making, it is tailored to the aviation environment which includes certain features that may be common to other domains: Primarily, aviation is highly proceduralized and options are generally well known. What appears to make decisions difficult are ambiguity, time pressure, and risk. In addition, decisions must often be made while carrying out the standard procedures of flight, including checklists, review of approach plates, standard briefings, and communication with air traffic controllers or cabin crew. The effects of stressors on decision making by pilots with varying levels of expertise will be explored, along with strategies for strengthening the weak links.

  16. Perceptual Discrimination in Static and Dynamic Noise: The Temporal Relation between Perceptual Encoding and Decision Making

    ERIC Educational Resources Information Center

    Ratcliff, Roger; Smith, Philip L.

    2010-01-01

    The authors report 9 new experiments and reanalyze 3 published experiments that investigate factors affecting the time course of perceptual processing and its effects on subsequent decision making. Stimuli in letter-discrimination and brightness-discrimination tasks were degraded with static and dynamic noise. The onset and the time course of…

  17. Hemorrhage Detection and Segmentation in Traumatic Pelvic Injuries

    PubMed Central

    Davuluri, Pavani; Wu, Jie; Tang, Yang; Cockrell, Charles H.; Ward, Kevin R.; Najarian, Kayvan; Hargraves, Rosalyn H.

    2012-01-01

    Automated hemorrhage detection and segmentation in traumatic pelvic injuries is vital for fast and accurate treatment decision making. Hemorrhage is the main cause of deaths in patients within first 24 hours after the injury. It is very time consuming for physicians to analyze all Computed Tomography (CT) images manually. As time is crucial in emergence medicine, analyzing medical images manually delays the decision-making process. Automated hemorrhage detection and segmentation can significantly help physicians to analyze these images and make fast and accurate decisions. Hemorrhage segmentation is a crucial step in the accurate diagnosis and treatment decision-making process. This paper presents a novel rule-based hemorrhage segmentation technique that utilizes pelvic anatomical information to segment hemorrhage accurately. An evaluation measure is used to quantify the accuracy of hemorrhage segmentation. The results show that the proposed method is able to segment hemorrhage very well, and the results are promising. PMID:22919433

  18. Operating room managerial decision-making on the day of surgery with and without computer recommendations and status displays.

    PubMed

    Dexter, Franklin; Willemsen-Dunlap, Ann; Lee, John D

    2007-08-01

    There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text recommendations about what to do). Anesthesiologists, OR nurses, and housekeepers were given nine simulated scenarios (vignettes) involving multiple ORs to study their decision-making. Participants were randomized to one of four groups, all with an updated paper OR schedule: with/without command display and with/without passive status display. Participants making decisions without command displays performed no better than random chance in terms of increasing the predictability of work hours, reducing over-utilized OR time, and increasing OR efficiency. Status displays had no effect on these end-points, whereas command displays improved the quality of decisions. In the scenarios for which the command displays provided recommendations that adversely affected safety, participants appropriately ignored advice. Anesthesia providers and nursing staff made decisions that increased clinical work per unit time in each OR, even when doing so resulted in an increase in over-utilized OR time, higher staffing costs, unpredictable work hours, and/or mandatory overtime. Organizational culture and socialization during clinical training may be a cause. Command displays showed promise in mitigating this tendency. Additional investigations are in our companion paper.

  19. Mice learn to avoid regret.

    PubMed

    Sweis, Brian M; Thomas, Mark J; Redish, A David

    2018-06-01

    Regret can be defined as the subjective experience of recognizing that one has made a mistake and that a better alternative could have been selected. The experience of regret is thought to carry negative utility. This typically takes two distinct forms: augmenting immediate postregret valuations to make up for losses, and augmenting long-term changes in decision-making strategies to avoid future instances of regret altogether. While the short-term changes in valuation have been studied in human psychology, economics, neuroscience, and even recently in nonhuman-primate and rodent neurophysiology, the latter long-term process has received far less attention, with no reports of regret avoidance in nonhuman decision-making paradigms. We trained 31 mice in a novel variant of the Restaurant Row economic decision-making task, in which mice make decisions of whether to spend time from a limited budget to achieve food rewards of varying costs (delays). Importantly, we tested mice longitudinally for 70 consecutive days, during which the task provided their only source of food. Thus, decision strategies were interdependent across both trials and days. We separated principal commitment decisions from secondary reevaluation decisions across space and time and found evidence for regret-like behaviors following change-of-mind decisions that corrected prior economically disadvantageous choices. Immediately following change-of-mind events, subsequent decisions appeared to make up for lost effort by altering willingness to wait, decision speed, and pellet consumption speed, consistent with past reports of regret in rodents. As mice were exposed to an increasingly reward-scarce environment, we found they adapted and refined distinct economic decision-making strategies over the course of weeks to maximize reinforcement rate. However, we also found that even without changes in reinforcement rate, mice transitioned from an early strategy rooted in foraging to a strategy rooted in deliberation and planning that prevented future regret-inducing change-of-mind episodes from occurring. These data suggest that mice are learning to avoid future regret, independent of and separate from reinforcement rate maximization.

  20. Recent Patterns in Shared Decision Making for Prostate-Specific Antigen Testing in the United States.

    PubMed

    Fedewa, Stacey A; Gansler, Ted; Smith, Robert; Sauer, Ann Goding; Wender, Richard; Brawley, Otis W; Jemal, Ahmedin

    2018-03-01

    Previous studies report infrequent use of shared decision making for prostate-specific antigen (PSA) testing. It is unknown whether this pattern has changed recently considering increased emphasis on shared decision making in prostate cancer screening recommendations. Thus, the objective of this study is to examine recent changes in shared decision making. We conducted a retrospective cross-sectional study among men aged 50 years and older in the United States using 2010 and 2015 National Health Interview Survey (NHIS) data (n = 9,598). Changes in receipt of shared decision making were expressed as adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Analyses were stratified on PSA testing (recent [in the past year] or no testing). Elements of shared decision making assessed included the patient being informed about the advantages only, advantages and disadvantages, and full shared decision making (advantages, disadvantages, and uncertainties). Among men with recent PSA testing, 58.5% and 62.6% reported having received ≥1 element of shared decision making in 2010 and 2015, respectively ( P = .054, aPR = 1.04; 95% CI, 0.98-1.11). Between 2010 and 2015, being told only about the advantages of PSA testing significantly declined (aPR = 0.82; 95% CI, 0.71-0.96) and full shared decision making prevalence significantly increased (aPR = 1.51; 95% CI, 1.28-1.79) in recently tested men. Among men without prior PSA testing, 10% reported ≥1 element of shared decision making, which did not change with time. Between 2010 and 2015, there was no increase in shared decision making among men with recent PSA testing though there was a shift away from only being told about the advantages of PSA testing towards full shared decision making. Many men receiving PSA testing did not receive shared decision making. © 2018 Annals of Family Medicine, Inc.

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

    PubMed

    Gaston, Christine M; Mitchell, Geoffrey

    2005-11-01

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

  2. Value encoding in single neurons in the human amygdala during decision making.

    PubMed

    Jenison, Rick L; Rangel, Antonio; Oya, Hiroyuki; Kawasaki, Hiroto; Howard, Matthew A

    2011-01-05

    A growing consensus suggests that the brain makes simple choices by assigning values to the stimuli under consideration and then comparing these values to make a decision. However, the network involved in computing the values has not yet been fully characterized. Here, we investigated whether the human amygdala plays a role in the computation of stimulus values at the time of decision making. We recorded single neuron activity from the amygdala of awake patients while they made simple purchase decisions over food items. We found 16 amygdala neurons, located primarily in the basolateral nucleus that responded linearly to the values assigned to individual items.

  3. Ubiquitous Working: Do Work Versus Non-work Environments Affect Decision-Making and Concentration?

    PubMed

    Burmeister, Carolin P; Moskaliuk, Johannes; Cress, Ulrike

    2018-01-01

    New communication technologies and mobile devices have enabled knowledge workers to work independently of location and in more than one fixed environment (ubiquitous working). Previous research shows that physical environments can influence cognition and work performance. We manipulated environment (i.e., a virtual office as a typical work environment compared to a virtual garden as a non-work environment ) and time pressure (i.e., inducing time pressure vs. no time pressure ) in order to investigate whether the environment influences decision-making and concentration. N = 109 students participated in this laboratory experiment. We posited (a) that a work environment would activate a work-related schema which in turn would enhance concentration performance and make decisions more risky compared to non-work environments and (b) that the environmental effect is more pronounced if time pressure is present compared to conditions where no time pressure is present. We found modest hypothesis-confirming main effects of environment on decision-making and concentration but no interaction effect with time pressure. As we used an innovative methodology that entails several limitations, future research is needed to give insights into the process and to investigate whether results hold true for all types of work settings, work demands, or work activities.

  4. What is on your mind? Using the perceptual cycle model and critical decision method to understand the decision-making process in the cockpit.

    PubMed

    Plant, Katherine L; Stanton, Neville A

    2013-01-01

    Aeronautical decision-making is complex as there is not always a clear coupling between the decision made and decision outcome. As such, there is a call for process-orientated decision research in order to understand why a decision made sense at the time it was made. Schema theory explains how we interact with the world using stored mental representations and forms an integral part of the perceptual cycle model (PCM); proposed here as a way to understand the decision-making process. This paper qualitatively analyses data from the critical decision method (CDM) based on the principles of the PCM. It is demonstrated that the approach can be used to understand a decision-making process and highlights how influential schemata can be at informing decision-making. The reliability of this approach is established, the general applicability is discussed and directions for future work are considered. This paper introduces the PCM, and the associated schema theory, as a framework to structure and explain data collected from the CDM. The reliability of both the method and coding scheme is addressed.

  5. Modelling emergency decisions: recognition-primed decision making. The literature in relation to an ophthalmic critical incident.

    PubMed

    Bond, Susan; Cooper, Simon

    2006-08-01

    To review and reflect on the literature on recognition-primed decision (RPD) making and influences on emergency decisions with particular reference to an ophthalmic critical incident involving the sub-arachnoid spread of local anaesthesia following the peribulbar injection. This paper critics the literature on recognition-primed decision making, with particular reference to emergency situations. It illustrates the findings by focussing on an ophthalmic critical incident. Systematic literature review with critical incident reflection. Medline, CINAHL and PsychINFO databases were searched for papers on recognition-primed decision making (1996-2004) followed by the 'snowball method'. Studies were selected in accordance with preset criteria. A total of 12 papers were included identifying the recognition-primed decision making as a good theoretical description of acute emergency decisions. In addition, cognitive resources, situational awareness, stress, team support and task complexity were identified as influences on the decision process. Recognition-primed decision-making theory describes the decision processes of experts in time-bound emergency situations and is the foundation for a model of emergency decision making (Fig. 2). Decision theory and models, in this case related to emergency situations, inform practice and enhance clinical effectiveness. The critical incident described highlights the need for nurses to have a comprehensive and in-depth understanding of anaesthetic techniques as well as an ability to manage and resuscitate patients autonomously. In addition, it illustrates how the critical incidents should influence the audit cycle with improvements in patient safety.

  6. Decision-Making in National Security Affairs: Toward a Typology.

    DTIC Science & Technology

    1985-06-07

    decisional model, and thus provide the necessary linkage between observation and application of theory in explaining and/or predicting policy decisions . r...examines theories and models of decision -making processes from an interdisciplinary perspective, with a view toward deriving means by which the behavior of...processes, game theory , linear programming, network and graph theory , time series analysis, and the like. The discipline of decision analysis is a relatively

  7. A Bayesian Attractor Model for Perceptual Decision Making

    PubMed Central

    Bitzer, Sebastian; Bruineberg, Jelle; Kiebel, Stefan J.

    2015-01-01

    Even for simple perceptual decisions, the mechanisms that the brain employs are still under debate. Although current consensus states that the brain accumulates evidence extracted from noisy sensory information, open questions remain about how this simple model relates to other perceptual phenomena such as flexibility in decisions, decision-dependent modulation of sensory gain, or confidence about a decision. We propose a novel approach of how perceptual decisions are made by combining two influential formalisms into a new model. Specifically, we embed an attractor model of decision making into a probabilistic framework that models decision making as Bayesian inference. We show that the new model can explain decision making behaviour by fitting it to experimental data. In addition, the new model combines for the first time three important features: First, the model can update decisions in response to switches in the underlying stimulus. Second, the probabilistic formulation accounts for top-down effects that may explain recent experimental findings of decision-related gain modulation of sensory neurons. Finally, the model computes an explicit measure of confidence which we relate to recent experimental evidence for confidence computations in perceptual decision tasks. PMID:26267143

  8. Monitoring supports performance in a dual-task paradigm involving a risky decision-making task and a working memory task

    PubMed Central

    Gathmann, Bettina; Schiebener, Johannes; Wolf, Oliver T.; Brand, Matthias

    2015-01-01

    Performing two cognitively demanding tasks at the same time is known to decrease performance. The current study investigates the underlying executive functions of a dual-tasking situation involving the simultaneous performance of decision making under explicit risk and a working memory task. It is suggested that making a decision and performing a working memory task at the same time should particularly require monitoring—an executive control process supervising behavior and the state of processing on two tasks. To test the role of a supervisory/monitoring function in such a dual-tasking situation we investigated 122 participants with the Game of Dice Task plus 2-back task (GDT plus 2-back task). This dual task requires participants to make decisions under risk and to perform a 2-back working memory task at the same time. Furthermore, a task measuring a set of several executive functions gathered in the term concept formation (Modified Card Sorting Test, MCST) and the newly developed Balanced Switching Task (BST), measuring monitoring in particular, were used. The results demonstrate that concept formation and monitoring are involved in the simultaneous performance of decision making under risk and a working memory task. In particular, the mediation analysis revealed that BST performance partially mediates the influence of MCST performance on the GDT plus 2-back task. These findings suggest that monitoring is one important subfunction for superior performance in a dual-tasking situation including decision making under risk and a working memory task. PMID:25741308

  9. Experiences of treatment decision making for young people diagnosed with depressive disorders: a qualitative study in primary care and specialist mental health settings

    PubMed Central

    2011-01-01

    Background Clinical guidelines advocate for the inclusion of young people experiencing depression as well as their caregivers in making decisions about their treatment. Little is known, however, about the degree to which these groups are involved, and whether they want to be. This study sought to explore the experiences and desires of young people and their caregivers in relation to being involved in treatment decision making for depressive disorders. Methods Semi-structured interviews were carried out with ten young people and five caregivers from one primary care and one specialist mental health service about their experiences and beliefs about treatment decision making. Interviews were audio taped, transcribed verbatim and analysed using thematic analysis. Results Experiences of involvement for clients varied and were influenced by clients themselves, clinicians and service settings. For caregivers, experiences of involvement were more homogenous. Desire for involvement varied across clients, and within clients over time; however, most clients wanted to be involved at least some of the time. Both clients and caregivers identified barriers to involvement. Conclusions This study supports clinical guidelines that advocate for young people diagnosed with depressive disorders to be involved in treatment decision making. In order to maximise engagement, involvement in treatment decision making should be offered to all clients. Involvement should be negotiated explicitly and repeatedly, as desire for involvement may change over time. Caregiver involvement should be negotiated on an individual basis; however, all caregivers should be supported with information about mental disorders and treatment options. PMID:22151735

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

    PubMed Central

    2018-01-01

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

  11. Shared decision making for patients living with inflammatory arthritis.

    PubMed

    Palmer, Deborah; El Miedany, Yasser

    Providing adequate care for people with inflammatory arthritis is an ongoing challenge. In recent years significant progress has been made in the treatment of inflammatory arthritic conditions. The availability of a wide range of disease-modifying anti-rheumatic drugs as well as biologic therapies has not only improved treatment, but also made treatment decisions much more complex. This wider range of improved treatment options happened at the same time as a clear move towards patient-centred care and implementing shared decision making for both medical and surgical conditions. Implementing shared decision making has been reported to be associated with higher satisfaction and better adherence to therapy. Electronic shared decision making has more recently been suggested as a tool for clinical practice. The aim of this article is to look at further integrating shared decision making in standard rheumatology practice in view of the available evidence and the outcomes of a study looking at a recently developed patient shared decision guide.

  12. Risk-prone individuals prefer the wrong options on a rat version of the Iowa Gambling Task.

    PubMed

    Rivalan, Marion; Ahmed, Serge H; Dellu-Hagedorn, Françoise

    2009-10-15

    Decision making in complex and conflicting situations, as measured in the widely used Iowa Gambling Task (IGT), can be profoundly impaired in psychiatric disorders, such as attention-deficit/hyperactivity disorder, drug addiction, and also in healthy individuals for whom immediate gratification prevails over long-term gain. The cognitive processes underlying these deficits are poorly understood, in part due to a lack of suitable animal models assessing complex decision making with good construct validity. We developed a rat gambling task analogous to the IGT that tracks, for the first time, the ongoing decision process within a single session in an operant cage. Rats could choose between various options. Disadvantageous options, as opposed to advantageous ones, offered bigger immediate food reward but were followed by longer, unpredictable penalties (time-out). The majority of rats can evaluate and deduce favorable options more or less rapidly according to task complexity, whereas others systematically choose disadvantageously. These interindividual differences are stable over time and do not depend on task difficulty or on the level of food restriction. We find that poor decision making does not result from a failure to acquire relevant information but from hypersensitivity to reward and higher risk taking in anxiogenic situations. These results suggest that rats, as well as human poor performers, share similar traits to those observed in decision-making related psychiatric disorders. These traits could constitute risk factors of developing such disorders. The rapid identification of poor decision makers using the rat gambling task should promote the discovery of the specific brain dysfunctions that cause maladapted decision making.

  13. Distributed decision making in action: diagnostic imaging investigations within the bigger picture.

    PubMed

    Makanjee, Chandra R; Bergh, Anne-Marie; Hoffmann, Willem A

    2018-03-01

    Decision making in the health care system - specifically with regard to diagnostic imaging investigations - occurs at multiple levels. Professional role players from various backgrounds are involved in making these decisions, from the point of referral to the outcomes of the imaging investigation. The aim of this study was to map the decision-making processes and pathways involved when patients are referred for diagnostic imaging investigations and to explore distributed decision-making events at the points of contact with patients within a health care system. A two-phased qualitative study was conducted in an academic public health complex with the district hospital as entry point. The first phase included case studies of 24 conveniently selected patients, and the second phase involved 12 focus group interviews with health care providers. Data analysis was based on Rapley's interpretation of decision making as being distributed across time, situations and actions, and including different role players and technologies. Clinical decisions incorporating imaging investigations are distributed across the three vital points of contact or decision-making events, namely the initial patient consultation, the diagnostic imaging investigation and the post-investigation consultation. Each of these decision-making events is made up of a sequence of discrete decision-making moments based on the transfer of retrospective, current and prospective information and its transformation into knowledge. This paper contributes to the understanding of the microstructural processes (the 'when' and 'where') involved in the distribution of decisions related to imaging investigations. It also highlights the interdependency in decision-making events of medical and non-medical providers within a single medical encounter. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

  14. How do small groups make decisions? : A theoretical framework to inform the implementation and study of clinical competency committees.

    PubMed

    Chahine, Saad; Cristancho, Sayra; Padgett, Jessica; Lingard, Lorelei

    2017-06-01

    In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees' competence. However, we currently lack a theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees.This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and evidence-based papers related to small group decision-making. The search was conducted using Google Scholar, Web of Science, MEDLINE, ERIC, and PsycINFO for relevant literature. Using a thematic analysis, two researchers (SC & JP) met four times between April-June 2016 to consolidate the literature included in this review.Three theoretical orientations towards group decision-making emerged from the review: schema, constructivist, and social influence. Schema orientations focus on how groups use algorithms for decision-making. Constructivist orientations focus on how groups construct their shared understanding. Social influence orientations focus on how individual members influence the group's perspective on a decision. Moderators of decision-making relevant to all orientations include: guidelines, stressors, authority, and leadership.Clinical competency committees are the mechanisms by which groups of clinicians will be in charge of interpreting multiple assessment data points and coming to a shared decision about trainee competence. The way in which these committees make decisions can have huge implications for trainee progression and, ultimately, patient care. Therefore, there is a pressing need to build the science of how such group decision-making works in practice. This synthesis suggests a preliminary organizing framework that can be used in the implementation and study of clinical competency committees.

  15. Heuristic and optimal policy computations in the human brain during sequential decision-making.

    PubMed

    Korn, Christoph W; Bach, Dominik R

    2018-01-23

    Optimal decisions across extended time horizons require value calculations over multiple probabilistic future states. Humans may circumvent such complex computations by resorting to easy-to-compute heuristics that approximate optimal solutions. To probe the potential interplay between heuristic and optimal computations, we develop a novel sequential decision-making task, framed as virtual foraging in which participants have to avoid virtual starvation. Rewards depend only on final outcomes over five-trial blocks, necessitating planning over five sequential decisions and probabilistic outcomes. Here, we report model comparisons demonstrating that participants primarily rely on the best available heuristic but also use the normatively optimal policy. FMRI signals in medial prefrontal cortex (MPFC) relate to heuristic and optimal policies and associated choice uncertainties. Crucially, reaction times and dorsal MPFC activity scale with discrepancies between heuristic and optimal policies. Thus, sequential decision-making in humans may emerge from integration between heuristic and optimal policies, implemented by controllers in MPFC.

  16. Applying predictive analytics to develop an intelligent risk detection application for healthcare contexts.

    PubMed

    Moghimi, Fatemeh Hoda; Cheung, Michael; Wickramasinghe, Nilmini

    2013-01-01

    Healthcare is an information rich industry where successful outcomes require the processing of multi-spectral data and sound decision making. The exponential growth of data and big data issues coupled with a rapid increase of service demands in healthcare contexts today, requires a robust framework enabled by IT (information technology) solutions as well as real-time service handling in order to ensure superior decision making and successful healthcare outcomes. Such a context is appropriate for the application of real time intelligent risk detection decision support systems using predictive analytic techniques such as data mining. To illustrate the power and potential of data science technologies in healthcare decision making scenarios, the use of an intelligent risk detection (IRD) model is proffered for the context of Congenital Heart Disease (CHD) in children, an area which requires complex high risk decisions that need to be made expeditiously and accurately in order to ensure successful healthcare outcomes.

  17. Spatial attention during saccade decisions.

    PubMed

    Jonikaitis, Donatas; Klapetek, Anna; Deubel, Heiner

    2017-07-01

    Behavioral measures of decision making are usually limited to observations of decision outcomes. In the present study, we made use of the fact that oculomotor and sensory selection are closely linked to track oculomotor decision making before oculomotor responses are made. We asked participants to make a saccadic eye movement to one of two memorized target locations and observed that visual sensitivity increased at both the chosen and the nonchosen saccade target locations, with a clear bias toward the chosen target. The time course of changes in visual sensitivity was related to saccadic latency, with the competition between the chosen and nonchosen targets resolved faster before short-latency saccades. On error trials, we observed an increased competition between the chosen and nonchosen targets. Moreover, oculomotor selection and visual sensitivity were influenced by top-down and bottom-up factors as well as by selection history and predicted the direction of saccades. Our findings demonstrate that saccade decisions have direct visual consequences and show that decision making can be traced in the human oculomotor system well before choices are made. Our results also indicate a strong association between decision making, saccade target selection, and visual sensitivity. NEW & NOTEWORTHY We show that saccadic decisions can be tracked by measuring spatial attention. Spatial attention is allocated in parallel to the two competing saccade targets, and the time course of spatial attention differs for fast-slow and for correct-erroneous decisions. Saccade decisions take the form of a competition between potential saccade goals, which is associated with spatial attention allocation to those locations. Copyright © 2017 the American Physiological Society.

  18. [The role of information in public health decision-making].

    PubMed

    Cecchi, Catherine

    2008-01-01

    Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. Irrespective of the type of choice to be made, the need for information, knowledge, and know-how is inseparable from that of other tools or regulatory measures required for decision-making. Information is the same as competence, epidemiological and population data, health data, scientific opinion, and expert conferences--all are needed to assist in decision-making. Based on the principle of precaution, information must increasingly take into account the rejection of a society which often reasons on the basis of a presumption of zero-risk, in an idealistic manner, and which also excludes the possibility of new risks. The consumer positions himself as the regulator of decisions, specifically those with regard to the notion of acceptable level of risk. All of the actors involved in the health system are or become at one moment or another public health decision-makers. Their decision might be based either on an analytical approach, or on an intuitive approach. Although the act of decision-making is the least visible part of public health policy, it is certainly the driving force. This process should integrate the perspective of all of the relevant players, including consumers, who are currently situated more and more frequently at the heart of the health system. Public health decision-making is conducted as a function of political, strategic and environmental issues; of lobbies and their power; and of social maturation. Decision-making is a necessity. Making the right choice at the right time requires high quality information, and it is often necessary to respect a certain amount of time for reflection and ripening of an issue in order to make the best possible decision. The media and consumers play an increasingly significant role in public health decision-making and in the ensuing legislative consequences and debates which come as a result. Access to information is changing, especially thanks to the Internet which is completely modifying the global scenery of knowledge and know-how. Information supports decision-making with calculated risk, and it offers the opportunity to make choices and decisions, recognising that "to choose, is sometimes to relinquish".

  19. Robust Decision Making for Improved Mission Assurance

    DTIC Science & Technology

    2014-06-01

    Technology Team (STT) proposed and was approved to receive funding for a set of four research projects advancing foundational decision science and... technology over a three year period of performance. At the time it was approved, the initiative involved 27 collaborating scientists and engineers from five...Appendix E. Sensors Directorate Technologies for Robust Decision Making for Improved Mission Assurance

  20. Chapter 12. Information needs: Boreal owls

    Treesearch

    Gregory D. Hayward

    1994-01-01

    Most humans are reluctant to make decisions without thorough knowledge of the consequences of those decisions. Therefore, a desire for further research is almost universal in any complex management arena. The value of further study is determined, in part, by the cost in time and resources to obtain new information and the cost of making incorrect decisions without the...

  1. Response time in economic games reflects different types of decision conflict for prosocial and proself individuals

    PubMed Central

    Matsumoto, Yoshie; Kiyonari, Toko; Takagishi, Haruto; Li, Yang; Kanai, Ryota; Sakagami, Masamichi

    2017-01-01

    Behavioral and neuroscientific studies explore two pathways through which internalized social norms promote prosocial behavior. One pathway involves internal control of impulsive selfishness, and the other involves emotion-based prosocial preferences that are translated into behavior when they evade cognitive control for pursuing self-interest. We measured 443 participants’ overall prosocial behavior in four economic games. Participants’ predispositions [social value orientation (SVO)] were more strongly reflected in their overall game behavior when they made decisions quickly than when they spent a longer time. Prosocially (or selfishly) predisposed participants behaved less prosocially (or less selfishly) when they spent more time in decision making, such that their SVO prosociality yielded limited effects in actual behavior in their slow decisions. The increase (or decrease) in slower decision makers was prominent among consistent prosocials (or proselfs) whose strong preference for prosocial (or proself) goals would make it less likely to experience conflict between prosocial and proself goals. The strong effect of RT on behavior in consistent prosocials (or proselfs) suggests that conflict between prosocial and selfish goals alone is not responsible for slow decisions. Specifically, we found that contemplation of the risk of being exploited by others (social risk aversion) was partly responsible for making consistent prosocials (but not consistent proselfs) spend longer time in decision making and behave less prosocially. Conflict between means rather than between goals (immediate versus strategic pursuit of self-interest) was suggested to be responsible for the time-related increase in consistent proselfs’ prosocial behavior. The findings of this study are generally in favor of the intuitive cooperation model of prosocial behavior. PMID:28559334

  2. A new web-based framework development for fuzzy multi-criteria group decision-making.

    PubMed

    Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik

    2016-01-01

    Fuzzy multi-criteria group decision making (FMCGDM) process is usually used when a group of decision-makers faces imprecise data or linguistic variables to solve the problems. However, this process contains many methods that require many time-consuming calculations depending on the number of criteria, alternatives and decision-makers in order to reach the optimal solution. In this study, a web-based FMCGDM framework that offers decision-makers a fast and reliable response service is proposed. The proposed framework includes commonly used tools for multi-criteria decision-making problems such as fuzzy Delphi, fuzzy AHP and fuzzy TOPSIS methods. The integration of these methods enables taking advantages of the strengths and complements each method's weakness. Finally, a case study of location selection for landfill waste in Morocco is performed to demonstrate how this framework can facilitate decision-making process. The results demonstrate that the proposed framework can successfully accomplish the goal of this study.

  3. Making It Happen: Student Involvement in Education Planning, Decision Making, and Instruction.

    ERIC Educational Resources Information Center

    Wehmeyer, Michael L., Ed.; Sands, Deanna J., Ed.

    This book provides teachers and other practitioners with a variety of procedures and materials to help students with disabilities become involved in their transition planning to the maximum extent possible. Chapters include: (1) "Student Involvement in Education Planning, Decision Making, and Instruction: An Idea Whose Time Has Arrived" (Michael…

  4. The Role of Patients: Shared Decision-Making.

    PubMed

    Beers, Emily; Lee Nilsen, Marci; Johnson, Jonas T

    2017-08-01

    Shared decision-making affords patients and their families the autonomy to make difficult decisions after receiving comprehensive information about medical facts and treatment options. It is essential that patients' values are respected. The essential steps include first informing patients of the need for a decision, then explaining the various facts involved; after which, it is important to elicit patients' preferences and goals. Once the treatment options and outcomes important to patients are identified, an actual decision can be made. This activity is complex and requires a commitment of time and is enhanced through employment of a multidisciplinary team approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. An entropic barriers diffusion theory of decision-making in multiple alternative tasks

    PubMed Central

    Sigman, Mariano; Cecchi, Guillermo A.

    2018-01-01

    We present a theory of decision-making in the presence of multiple choices that departs from traditional approaches by explicitly incorporating entropic barriers in a stochastic search process. We analyze response time data from an on-line repository of 15 million blitz chess games, and show that our model fits not just the mean and variance, but the entire response time distribution (over several response-time orders of magnitude) at every stage of the game. We apply the model to show that (a) higher cognitive expertise corresponds to the exploration of more complex solution spaces, and (b) reaction times of users at an on-line buying website can be similarly explained. Our model can be seen as a synergy between diffusion models used to model simple two-choice decision-making and planning agents in complex problem solving. PMID:29499036

  6. A Review of Consequences of Poverty on Economic Decision-Making: A Hypothesized Model of a Cognitive Mechanism

    PubMed Central

    Adamkovič, Matúš; Martončik, Marcel

    2017-01-01

    This review focuses on the issue of poverty affecting economic decision-making. By critically evaluating existing studies, the authors propose a structural model detailing the cognitive mechanism involved in how poverty negatively impacts economic decision-making, and explores evidence supporting the basis for the formation of this model. The suggested mechanism consists of a relationship between poverty and four other factors: (1) cognitive load (e.g., experiencing negative affect and stress); (2) executive functions (e.g., attention, working memory, and self-control); (3) intuition/deliberation in decision-making; and (4) economic decision-making (e.g., time-discounting and risk preference), with a final addition of financial literacy as a covariate. This paper focuses on shortfalls in published research, and delves further into the proposed model. PMID:29075221

  7. Evolution of Patient Decision-Making Regarding Medical Treatment of Rheumatoid Arthritis.

    PubMed

    Mathews, Alexandra L; Coleska, Adriana; Burns, Patricia B; Chung, Kevin C

    2016-03-01

    The migration of health care toward a consumer-driven system favors increased patient participation during the treatment decision-making process. Patient involvement in treatment decision discussions has been linked to increased treatment adherence and patient satisfaction. Previous studies have quantified decision-making styles of patients with rheumatoid arthritis (RA); however, none of them have considered the evolution of patient involvement after living with RA for many years. We conducted a qualitative study to determine the decision-making model used by long-term RA patients, and to describe the changes in their involvement over time. Twenty participants were recruited from the ongoing Silicone Arthroplasty in Rheumatoid Arthritis study. Semistructured interviews were conducted and data were analyzed using grounded theory methodology. Nineteen out of 20 participants recalled using the paternalistic decision-making (PDM) model immediately following their diagnosis. Fourteen of the 19 participants who initially used PDM evolved to shared decision-making (SDM). Participants attributed the change in involvement to the development of a trusting relationship with their physician, as well as to becoming educated about the disease. When initially diagnosed with RA, patients may let their physician decide on the best treatment course. However, over time patients may evolve to exercise a more collaborative role. Physicians should understand that even within SDM, each patient can demonstrate a varied amount of autonomy. It is up to the physician to have a discussion with each patient to determine his or her desired level of involvement. © 2016, American College of Rheumatology.

  8. Decision Making in the Balloon Analogue Risk Task (BART): Anterior Cingulate Cortex Signals Loss-Aversion but not the Infrequency of Risky Choices

    PubMed Central

    Fukunaga, Rena; Brown, Joshua W.; Bogg, Tim

    2012-01-01

    The inferior frontal gyrus/anterior insula (IFG/AI) and anterior cingulate cortex (ACC) are key regions involved in risk appraisal during decision making, but accounts of how these regions contribute to decision-making under risk remain contested. To help clarify the roles of these and other related regions, we used a modified version of the Balloon Analogue Risk Task (Lejuez et al., 2002) to distinguish between decision-making and feedback-related processes when participants decided to pursue a gain as the probability of loss increased parametrically. Specifically, we set out to test whether ACC and IFG/AI regions correspond to loss-aversion at the time of decision making in a way that is not confounded with either reward-seeking or infrequency effects. When participants chose to discontinue inflating the balloon (win option), we observed greater ACC and mainly bilateral IFG/AI activity at the time of decision as the probability of explosion increased, consistent with increased loss-aversion but inconsistent with an infrequency effect. In contrast, we found robust vmPFC activity when participants chose to continue inflating the balloon (risky option), consistent with reward-seeking. However, in the cingulate and mainly bilateral IFG regions, BOLD activation decreased when participants chose to inflate the balloon as the probability of explosion increased, findings consistent with a reduced loss-aversion signal. Our results highlight the existence of distinct reward-seeking and loss-averse signals during decision-making, as well as the importance of distinguishing decision and feedback signals. PMID:22707378

  9. A framework for guiding sustainability assessment and on-farm strategic decision making

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

    Coteur, Ine, E-mail: ine.coteur@ilvo.vlaanderen.be; Marchand, Fleur; University of Antwerp, Ecosystem Management Research Group and IMDO, Universiteitsplein 1, 2610 Wilrijk

    Responding to future challenges and societal needs, various actions are taken in agriculture to evolve towards more sustainable farming practices. These actions imply strategic choices and suppose adequate sustainability assessments to identify, measure, evaluate and communicate sustainable development. However, literature is scarce on the link between strategic decision making and sustainability assessment. As questions emerge on how, what and when to measure, the objective of this paper is to construct a framework for guiding sustainability assessment and on-farm strategic decision making. Qualitative research on own experiences from the past and a recent project revealed four categories of actual needs farmers,more » advisors and experts have regarding sustainability assessment: context, flexibility, focus on farm and farmer and communication. These stakeholders' needs are then incorporated into a two-dimensional framework that marries the intrinsic complexity of sustainability assessment tools and the time frame of strategic decision making. The framework allows a farm-specific and flexible approach leading to harmonized actions towards sustainable farming. As this framework is mainly a procedural instrument to guide the use of sustainability assessment tools within strategic decision making, it fits to incorporate, even guide, future research on sustainability assessment tools themselves and on their adoption on farms. - Highlights: • How to link sustainability assessment and on-farm strategic decision making is unclear. • Two-dimensional framework incorporating stakeholders' needs regarding sustainability assessment • Linking complexity of sustainability assessment tools and the time frame of strategic decision making • Farm-specific and flexible approach to harmonize action towards sustainable farming.« less

  10. Participation in medical decision-making across Europe: An international longitudinal multicenter study.

    PubMed

    Bär Deucher, A; Hengartner, M P; Kawohl, W; Konrad, J; Puschner, B; Clarke, E; Slade, M; Del Vecchio, V; Sampogna, G; Égerházi, A; Süveges, Á; Krogsgaard Bording, M; Munk-Jørgensen, P; Rössler, W

    2016-05-01

    The purpose of this paper was to examine national differences in the desire to participate in decision-making of people with severe mental illness in six European countries. The data was taken from a European longitudinal observational study (CEDAR; ISRCTN75841675). A sample of 514 patients with severe mental illness from the study centers in Ulm, Germany, London, England, Naples, Italy, Debrecen, Hungary, Aalborg, Denmark and Zurich, Switzerland were assessed as to desire to participate in medical decision-making. Associations between desire for participation in decision-making and center location were analyzed with generalized estimating equations. We found large cross-national differences in patients' desire to participate in decision-making, with the center explaining 47.2% of total variance in the desire for participation (P<0.001). Averaged over time and independent of patient characteristics, London (mean=2.27), Ulm (mean=2.13) and Zurich (mean=2.14) showed significantly higher scores in desire for participation, followed by Aalborg (mean=1.97), where scores were in turn significantly higher than in Debrecen (mean=1.56). The lowest scores were reported in Naples (mean=1.14). Over time, the desire for participation in decision-making increased significantly in Zurich (b=0.23) and decreased in Naples (b=-0.14). In all other centers, values remained stable. This study demonstrates that patients' desire for participation in decision-making varies by location. We suggest that more research attention be focused on identifying specific cultural and social factors in each country to further explain observed differences across Europe. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. 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

  12. Thinking Fast Increases Framing Effects in Risky Decision Making.

    PubMed

    Guo, Lisa; Trueblood, Jennifer S; Diederich, Adele

    2017-04-01

    Every day, people face snap decisions when time is a limiting factor. In addition, the way a problem is presented can influence people's choices, which creates what are known as framing effects. In this research, we explored how time pressure interacts with framing effects in risky decision making. Specifically, does time pressure strengthen or weaken framing effects? On one hand, research has suggested that framing effects evolve through the deliberation process, growing larger with time. On the other hand, dual-process theory attributes framing effects to an intuitive, emotional system that responds automatically to stimuli. In our experiments, participants made decisions about gambles framed in terms of either gains or losses, and time pressure was manipulated across blocks. Results showed increased framing effects under time pressure in both hypothetical and incentivized choices, which supports the dual-process hypothesis that these effects arise from a fast, intuitive system.

  13. Internal stakeholder group participation in hospital strategic decision-making: making structure fit the moment.

    PubMed

    McDaniel, R R; Ashmos, D P

    1996-01-01

    This study examines the participation of six internal stakeholder groups in hospital strategic decision-making. Results show that internal stakeholder group participation is affected by strategic decision content and by the nature of the hospital's strategy. Results show that the participation of internal stakeholdergroups is associated with lower cost per full-time employee (fte). In particular, when the low participation stakeholder groups do participate, hospitals experience lower cost per fte.

  14. Effective follow-up consultations: the importance of patient-centered communication and shared decision making.

    PubMed

    Brand, Paul L P; Stiggelbout, Anne M

    2013-12-01

    Paediatricians spend a considerable proportion of their time performing follow-up visits for children with chronic conditions, but they rarely receive specific training on how best to perform such consultations. The traditional method of running a follow-up consultation is based on the doctor's agenda, and is problem-oriented. Patients and parents, however, prefer a patient-centered, and solution-focused approach. Although many physicians now recognize the importance of addressing the patient's perspective in a follow-up consultation, a number of barriers hamper its implementation in practice, including time constraints, lack of appropriate training, and a strong tradition of the biomedical, doctor-centered approach. Addressing the patient's perspective successfully can be achieved through shared decision making, clinicians and patients making decisions together based on the best clinical evidence. Research shows that shared decision making not only increases patient, parent, and physician satisfaction with the consultation, but also may improve health outcomes. Shared decision making involves building a physician-patient-parent partnership, agreeing on the problem at hand, laying out the available options with their benefits and risks, eliciting the patient's views and preferences on these options, and agreeing on a course of action. Shared decision making requires specific communication skills, which can be learned, and should be mastered through deliberate practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Humans Optimize Decision-Making by Delaying Decision Onset

    PubMed Central

    Teichert, Tobias; Ferrera, Vincent P.; Grinband, Jack

    2014-01-01

    Why do humans make errors on seemingly trivial perceptual decisions? It has been shown that such errors occur in part because the decision process (evidence accumulation) is initiated before selective attention has isolated the relevant sensory information from salient distractors. Nevertheless, it is typically assumed that subjects increase accuracy by prolonging the decision process rather than delaying decision onset. To date it has not been tested whether humans can strategically delay decision onset to increase response accuracy. To address this question we measured the time course of selective attention in a motion interference task using a novel variant of the response signal paradigm. Based on these measurements we estimated time-dependent drift rate and showed that subjects should in principle be able trade speed for accuracy very effectively by delaying decision onset. Using the time-dependent estimate of drift rate we show that subjects indeed delay decision onset in addition to raising response threshold when asked to stress accuracy over speed in a free reaction version of the same motion-interference task. These findings show that decision onset is a critical aspect of the decision process that can be adjusted to effectively improve decision accuracy. PMID:24599295

  16. Do Not Fear Your Opponent: Suboptimal Changes of a Prevention Strategy when Facing Stronger Opponents

    ERIC Educational Resources Information Center

    Slezak, Diego Fernandez; Sigman, Mariano

    2012-01-01

    The time spent making a decision and its quality define a widely studied trade-off. Some models suggest that the time spent is set to optimize reward, as verified empirically in simple-decision making experiments. However, in a more complex perspective compromising components of regulation focus, ambitions, fear, risk and social variables,…

  17. Emotion and Deliberative Reasoning in Moral Judgment

    PubMed Central

    Cummins, Denise Dellarosa; Cummins, Robert C.

    2012-01-01

    According to an influential dual-process model, a moral judgment is the outcome of a rapid, affect-laden process and a slower, deliberative process. If these outputs conflict, decision time is increased in order to resolve the conflict. Violations of deontological principles proscribing the use of personal force to inflict intentional harm are presumed to elicit negative affect which biases judgments early in the decision-making process. This model was tested in three experiments. Moral dilemmas were classified using (a) decision time and consensus as measures of system conflict and (b) the aforementioned deontological criteria. In Experiment 1, decision time was either unlimited or reduced. The dilemmas asked whether it was appropriate to take a morally questionable action to produce a “greater good” outcome. Limiting decision time reduced the proportion of utilitarian (“yes”) decisions, but contrary to the model’s predictions, (a) vignettes that involved more deontological violations logged faster decision times, and (b) violation of deontological principles was not predictive of decisional conflict profiles. Experiment 2 ruled out the possibility that time pressure simply makes people more like to say “no.” Participants made a first decision under time constraints and a second decision under no time constraints. One group was asked whether it was appropriate to take the morally questionable action while a second group was asked whether it was appropriate to refuse to take the action. The results replicated that of Experiment 1 regardless of whether “yes” or “no” constituted a utilitarian decision. In Experiment 3, participants rated the pleasantness of positive visual stimuli prior to making a decision. Contrary to the model’s predictions, the number of deontological decisions increased in the positive affect rating group compared to a group that engaged in a cognitive task or a control group that engaged in neither task. These results are consistent with the view that early moral judgments are influenced by affect. But they are inconsistent with the view that (a) violation of deontological principles are predictive of differences in early, affect-based judgment or that (b) engaging in tasks that are inconsistent with the negative emotional responses elicited by such violations diminishes their impact. PMID:22973255

  18. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening

    PubMed Central

    2011-01-01

    Background Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Discussion Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Summary Our proposal to augment IDM and SDM approaches with libertarian paternalism strategies is intended to guide patients toward a better decision about testing while maintaining personal freedom of choice. While PSA screening remains controversial and evidence conflicting, a libertarian-paternalism influenced approach to decision making can help prevent the overdiagnosis and overtreatment of prostate cancer. PMID:21510865

  19. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA) screening.

    PubMed

    Wheeler, David C; Szymanski, Konrad M; Black, Amanda; Nelson, David E

    2011-04-21

    Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA) screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM) or shared decision making (SDM) approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP) to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA screening decision-making. Our proposal to augment IDM and SDM approaches with libertarian paternalism strategies is intended to guide patients toward a better decision about testing while maintaining personal freedom of choice. While PSA screening remains controversial and evidence conflicting, a libertarian-paternalism influenced approach to decision making can help prevent the overdiagnosis and overtreatment of prostate cancer.

  20. Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM).

    PubMed

    Balneaves, Lynda G; Truant, Tracy L O; Kelly, Mary; Verhoef, Marja J; Davison, B Joyce

    2007-08-01

    The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.

  1. The neural correlates of risky decision making across short and long runs

    PubMed Central

    Rao, Li-Lin; Dunn, John C.; Zhou, Yuan; Li, Shu

    2015-01-01

    People frequently change their preferences for options of gambles which they play once compared to those they play multiple times. In general, preferences for repeated play gambles are more consistent with the expected values of the options. According to the one-process view, the change in preference is due to a change in the structure of the gamble that is relevant to decision making. According to the two-process view, the change is attributable to a shift in the decision making strategy that is used. To adjudicate between these two theories, we asked participants to choose between gambles played once or 100 times, and to choose between them based on their expected value. Consistent with the two-process theory, we found a set of brain regions that were sensitive to the extent of behavioral change between single and aggregated play and also showed significant (de)activation in the expected value choice task. These results support the view that people change their decision making strategies for risky choice considered once or multiple times. PMID:26516095

  2. Stop wasting valuable time.

    PubMed

    Mankins, Michael C

    2004-09-01

    Companies routinely squander their most precious resource--the time of their top executives. In the typical company, senior executives meet to discuss strategy for only three hours a month. And that time is poorly spent in diffuse discussions never even meant to result in any decision. The price of misused executive time is high. Delayed strategic decisions lead to overlooked waste and high costs, harmful cost reductions, missed new product and business development opportunities, and poor long-term investments. But a few deceptively simple changes in the way top management teams set agendas and structure team meetings can make an enormous difference in their effectiveness. Efficient companies use seven techniques to make the most of the time their top executives spend together. They keep strategy meetings separate from meetings focused on operations. They explore issues through written communications before they meet, so that meeting time is used solely for reaching decisions. In setting agendas, they rank the importance of each item according to its potential to create value for the company. They seek to get issues not only on, but also off, the agenda quickly, keeping to a clear implementation timetable. They make sure they have considered all viable alternatives before deciding a course of action. They use a common language and methodology for reaching decisions. And they insist that, once a decision is made, they stick to it--that there be no more debate or mere grudging compliance. Once leadership teams get the basics right, they can make more fundamental changes in the way they work together. Strategy making can be transformed from a series of fragmented and unproductive events into a streamlined, effective, and continuing management dialogue. In companies that have done this, management meetings aren't a necessary evil; they're a source of real competitive advantage.

  3. Neurons in the Frontal Lobe Encode the Value of Multiple Decision Variables

    PubMed Central

    Kennerley, Steven W.; Dahmubed, Aspandiar F.; Lara, Antonio H.; Wallis, Jonathan D.

    2009-01-01

    A central question in behavioral science is how we select among choice alternatives to obtain consistently the most beneficial outcomes. Three variables are particularly important when making a decision: the potential payoff, the probability of success, and the cost in terms of time and effort. A key brain region in decision making is the frontal cortex as damage here impairs the ability to make optimal choices across a range of decision types. We simultaneously recorded the activity of multiple single neurons in the frontal cortex while subjects made choices involving the three aforementioned decision variables. This enabled us to contrast the relative contribution of the anterior cingulate cortex (ACC), the orbito-frontal cortex, and the lateral prefrontal cortex to the decision-making process. Neurons in all three areas encoded value relating to choices involving probability, payoff, or cost manipulations. However, the most significant signals were in the ACC, where neurons encoded multiplexed representations of the three different decision variables. This supports the notion that the ACC is an important component of the neural circuitry underlying optimal decision making. PMID:18752411

  4. Neural and neurochemical basis of reinforcement-guided decision making.

    PubMed

    Khani, Abbas; Rainer, Gregor

    2016-08-01

    Decision making is an adaptive behavior that takes into account several internal and external input variables and leads to the choice of a course of action over other available and often competing alternatives. While it has been studied in diverse fields ranging from mathematics, economics, ecology, and ethology to psychology and neuroscience, recent cross talk among perspectives from different fields has yielded novel descriptions of decision processes. Reinforcement-guided decision making models are based on economic and reinforcement learning theories, and their focus is on the maximization of acquired benefit over a defined period of time. Studies based on reinforcement-guided decision making have implicated a large network of neural circuits across the brain. This network includes a wide range of cortical (e.g., orbitofrontal cortex and anterior cingulate cortex) and subcortical (e.g., nucleus accumbens and subthalamic nucleus) brain areas and uses several neurotransmitter systems (e.g., dopaminergic and serotonergic systems) to communicate and process decision-related information. This review discusses distinct as well as overlapping contributions of these networks and neurotransmitter systems to the processing of decision making. We end the review by touching on neural circuitry and neuromodulatory regulation of exploratory decision making. Copyright © 2016 the American Physiological Society.

  5. Decision-making capacity should not be decisive in emergencies.

    PubMed

    Hubbeling, Dieneke

    2014-05-01

    Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients and render the process less transparent. Other solutions focus on preferences expressed when patients are not ill, but this information is often not available. The reason for such difficulties with assessing decision-making capacity is that the underlying psychological processes of normal decision-making are not well known and one cannot differentiate between unwise decisions caused by an illness or other factors. The proposed alternative, set out in this paper, is to allow compulsory treatment of patients with decision-making capacity in cases of an emergency, if the refusal is potentially life threatening, but only for a time-limited period. The argument is also made for investigating hindsight agreement, in particular after compulsory measures.

  6. Breast Conservation Therapy Versus Mastectomy: Shared Decision-Making Strategies and Overcoming Decisional Conflicts in Your Patients.

    PubMed

    Margenthaler, Julie A; Ollila, David W

    2016-10-01

    Although breast-conserving therapy is considered the preferred treatment for the majority of women with early-stage breast cancer, mastectomy rates in this group remain high. The patient, physician, and systems factors contributing to a decision for mastectomy are complicated. Understanding the individual patient's values and goals when making this decision is paramount to providing a shared decision-making process that will yield the desired outcome. The cornerstones of this discussion include education of the patient, access to decision-aid tools, and time to make an informed decision. However, it is also paramount for the physician to understand that a significant majority of women with an informed and complete understanding of their surgical choices will still prefer mastectomy. The rates of breast conservation versus mastectomy should not be considered a quality measure alone. Rather, the extent by which patients are informed, involved in decision-making, and undergoing treatments that reflect their goals is the true test of quality. Here we explore some of the factors that impact the patient preference for breast conservation versus mastectomy and how shared decision-making can be maximized for patient satisfaction.

  7. Deciding treatment for miscarriage--experiences of women and healthcare professionals.

    PubMed

    Olesen, Mette Linnet; Graungaard, Anette H; Husted, Gitte R

    2015-06-01

    Women experiencing miscarriage are offered a choice of different treatments to terminate their wanted pregnancy at a time when they are often shocked and distressed. Women's and healthcare professionals' experiences of the decision-making process are not well described. We aimed to gain insight into this process and the circumstances that may affect it. A qualitative study using a grounded theory approach. Data were obtained through semi-structured interviews with six women who had chosen and completed either surgical, medical or expectant treatment for miscarriage and five healthcare professionals involved in the decision-making at an emergency gynaecological department in Denmark. An inductive explorative method was chosen due to limited knowledge about the decision-making process, and a theoretical perspective was not applied until the final analysis. Despite information and pretreatment counselling, choice of treatment was often determined by unspoken emotional considerations, including fear of seeing the foetus or fear of anaesthesia. These considerations were not discussed during the decision-making process, which was a time when the women were under time pressure and experienced emotional distress. Healthcare professionals did not explore women's considerations for choosing a particular treatment and prioritised information differently. We found theory about coping and decision-making in stressful situations useful in increasing our understanding of the women's reactions. In relation to theory about informed consent, our findings suggest that women need more understanding of the treatments before making a decision. This study is limited due to a small sample size, but it generates important findings that need to be examined in a larger sample. Frequently, women did not use information provided about treatment pros and cons in their decision-making process. Because of unspoken thoughts, and women's needs being unexplored by healthcare professionals, information did not target women's needs and their reasoning remained unapparent. © 2014 Nordic College of Caring Science.

  8. An Exploration of Dual Systems via Time Pressure Manipulation in Decision-making Problems

    NASA Astrophysics Data System (ADS)

    Guo, Lisa

    Every day, decisions need to be made where time is a limiting factor. Regardless of situation, time constraints often place a premium on rapid decision-making. Researchers have been interested in studying this human behavior and understanding its underlying cognitive processes. In previous studies, scientists have believed that the cognitive processes underlying decision-making behavior were consistent with dual-process modes of thinking. Critics of dual-process theory question the vagueness of its definition, and claim that single-process accounts can explain the data just as well. My aim is to elucidate the cognitive processes that underlie decisions which involve some level of risk through the experimental manipulation of time pressure. Using this method, I hope to distinguish between competing hypotheses related to the origin of the effect. I will explore three types of decisions that illustrate these concepts: risky decision-making involving gambles, intertemporal choice, and one-shot public goods games involving social cooperation. In our experiments, participants made decisions about gambles framed as either gains or losses; decided upon intertemporal choices for smaller but sooner rewards or larger but later rewards; and played a one-shot public goods game involving social cooperation and contributing an amount of money to a group. In each case, we experimentally manipulated time pressure, either within subjects or among individuals. Results showed under time pressure, increased framing effects under in both hypothetical and incentivized choices; and greater contributions and cooperation among individuals, lending support to the dual process hypothesis that these effects arise from a fast, intuitive system. However, our intertemporal choice experiment showed that time constraints led to increased selection of the larger but later options, which suggests that the magnitude of the reward may play larger role in choice selection under cognitive load than previously studied. This diverges from the current dual-process interpretation that myopic choices under time pressure favor smaller but sooner rewards, and suggests that more studies are needed in this realm to disentangle the intuitive from the deliberative system through the manipulation of cognitive load.

  9. Recovery and resilience after a nuclear power plant disaster: a medical decision model for managing an effective, timely, and balanced response.

    PubMed

    Coleman, C Norman; Blumenthal, Daniel J; Casto, Charles A; Alfant, Michael; Simon, Steven L; Remick, Alan L; Gepford, Heather J; Bowman, Thomas; Telfer, Jana L; Blumenthal, Pamela M; Noska, Michael A

    2013-04-01

    Resilience after a nuclear power plant or other radiation emergency requires response and recovery activities that are appropriately safe, timely, effective, and well organized. Timely informed decisions must be made, and the logic behind them communicated during the evolution of the incident before the final outcome is known. Based on our experiences in Tokyo responding to the Fukushima Daiichi nuclear power plant crisis, we propose a real-time, medical decision model by which to make key health-related decisions that are central drivers to the overall incident management. Using this approach, on-site decision makers empowered to make interim decisions can act without undue delay using readily available and high-level scientific, medical, communication, and policy expertise. Ongoing assessment, consultation, and adaption to the changing conditions and additional information are additional key features. Given the central role of health and medical issues in all disasters, we propose that this medical decision model, which is compatible with the existing US National Response Framework structure, be considered for effective management of complex, large-scale, and large-consequence incidents.

  10. Autonomy, evidence and intuition: nurses and decision-making.

    PubMed

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-07-01

    This paper is a report of a study conducted to examine how nurses represent professional clinical decision-making processes, and to determine what light Jamous and Peloille's 'Indeterminacy/Technicality ratio' concept can shed on these representations. Classic definitions of professional work feature autonomy of decision-making and control over the field of work. Sociologists Jamous and Peloille have described professional work as being high in 'indeterminacy' (the use of tacit judgements) relative to technicality (activity able to be codified). The rise of the evidence-based practice movement has been seen as increasing the realm of technical decision-making in healthcare, and it is relevant to analyse nurses' professional discourse and study how they respond to this increase. Three focus groups with qualified nurses attending post-qualifying courses at a London university were held in 2008. Participants were asked to talk about influences on their decision-making. The discussions were tape-recorded, transcribed and subjected to discourse analysis. Participants described their decision-making as influenced by both indeterminate and technical features. They acknowledged useful influences from both domains, but pointed to their personal 'experience' as the final arbiter of decision-making. Their accounts of decision-making created a sense of professional autonomy while at the same time protecting it against external critique. Pre- and post-registration nurse education could encourage robust discussion of the definition and roles of 'irrational' aspects of decision-making and how these might be understood as components of credible professional practice.

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

    PubMed

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

    2014-07-01

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

  12. Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

    PubMed

    Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

    2018-02-21

    Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient-clinician conversations about lung cancer screening may fall short of guideline-recommended shared decision-making supported by a decision aid. Consequently, patients may be left uncertain about lung cancer screening's rationale, trade-offs, and process.

  13. Young breast cancer patients' involvement in treatment decisions: the major role played by decision-making about surgery.

    PubMed

    Seror, Valérie; Cortaredona, Sébastien; Bouhnik, Anne-Deborah; Meresse, Mégane; Cluze, Camille; Viens, Patrice; Rey, Dominique; Peretti-Watel, Patrick

    2013-11-01

    The objective of this study is to investigate young breast cancer patients' preferred and actual involvement in decision-making about surgery, chemotherapy, and adjuvant endocrine therapy (AET). A total of 442 women aged 18-40 years at the time of the diagnosis participated in the region-wide ELIPPSE40 cohort study (southeastern France). Logistic regression analyses were performed on various factors possibly affecting patients' preferred and perceived involvement in the decisions about their cancer treatment. The women's mean age was 36.8 years at enrollment. Preference for a fully passive role in decision-making was stated by 20.7% of them. It was favored by regular breast surveillance (p = 0.04) and positive experience of being informed about cancer diagnosis (p = 0.02). Patients' preferences were independently associated with their reported involvement in decision-making about surgery (p = 0.01). A fully passive role in decision-making about chemotherapy and AET was more likely to be reported by patients who perceived their involvement in decision-making about surgery as having been fully passive (adjusted odds ratio = 4.8, CI95% [2.7-8.7], and adjusted odds ratio = 9.8, CI95% [3.3-29.2], respectively). This study shows a significant relationship between the use of antidepressants and involvement in decision-making about surgery, and confirms the relationship between impaired quality of life (in the psychological domain) and a fully passive role in decisions about cancer treatment. Patients' involvement in decision-making about chemotherapy and AET was strongly influenced by their experience of decision-making about surgery, regardless of their tumor stage and history of breast or ovarian cancer. When decisions are being made about surgery, special attention should be paid to facilitating breast cancer patients' involvement in the decision-making. Copyright © 2013 John Wiley & Sons, Ltd.

  14. 36 CFR 1250.26 - How quickly will NARA respond to my FOIA request?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... making a decision within 20 working days, we will inform you in writing how long it will take us to... requesters of any complexity in processing their request, which may lengthen the time required to reach a final decision on the release of the records. (b) In most cases, NARA will make a decision on the...

  15. Adult patient decision-making regarding implantation of complex cardiac devices: a scoping review.

    PubMed

    Malecki-Ketchell, Alison; Marshall, Paul; Maclean, Joan

    2017-10-01

    Complex cardiac rhythm management device (CRMD) therapy provides an important treatment option for people at risk of sudden cardiac death. Despite the survival benefit, device implantation is associated with significant physical and psychosocial concerns presenting considerable challenges for the decision-making process surrounding CRMD implantation for patients and physicians. The purpose of this scoping review was to explore what is known about how adult (>16 years) patients make decisions regarding implantation of CRMD therapy. Published, peer reviewed, English language studies from 2000 to 2016 were identified in a search across eight healthcare databases. Eligible studies were concerned with patient decision-making for first time device implantation. Quality assessment was completed using the mixed methods appraisal tool for all studies meeting the inclusion criteria. The findings of eight qualitative and seven quantitative studies, including patients who accepted or declined primary or secondary sudden cardiac death prevention devices, were clustered into two themes: knowledge acquisition and the process of decision-making, exposing similarities and distinctions with the treatment decision-making literature. The review revealed some insight in to the way patients approach decision-making but also exposed a lack of clarity and research activity specific to CRMD patients. Further research is recommended to support the development and application of targeted decision support mechanisms.

  16. Heuristics: foundations for a novel approach to medical decision making.

    PubMed

    Bodemer, Nicolai; Hanoch, Yaniv; Katsikopoulos, Konstantinos V

    2015-03-01

    Medical decision-making is a complex process that often takes place during uncertainty, that is, when knowledge, time, and resources are limited. How can we ensure good decisions? We present research on heuristics-simple rules of thumb-and discuss how medical decision-making can benefit from these tools. We challenge the common view that heuristics are only second-best solutions by showing that they can be more accurate, faster, and easier to apply in comparison to more complex strategies. Using the example of fast-and-frugal decision trees, we illustrate how heuristics can be studied and implemented in the medical context. Finally, we suggest how a heuristic-friendly culture supports the study and application of heuristics as complementary strategies to existing decision rules.

  17. Asymmetric life-history decision-making in butterfly larvae

    PubMed Central

    Aalberg Haugen, Inger M.; Dahlerus, Josefin; Gotthard, Karl; Wiklund, Christer

    2010-01-01

    In temperate environments, insects appearing in several generations in the growth season typically have to decide during the larval period whether to develop into adulthood, or to postpone adult emergence until next season by entering a species-specific diapause stage. This decision is typically guided by environmental cues experienced during development. An early decision makes it possible to adjust growth rate, which would allow the growing larva to respond to time stress involved in direct development, whereas a last-minute decision would instead allow the larva to use up-to-date information about which developmental pathway is the most favourable under the current circumstances. We study the timing of the larval pathway decision-making between entering pupal winter diapause and direct development in three distantly related butterflies (Pieris napi, Araschnia levana and Pararge aegeria). We pinpoint the timing of the larval diapause decision by transferring larvae from first to last instars from long daylength (inducing direct development) to short daylength conditions (inducing diapause), and vice versa. Results show that the pathway decision is typically made in the late instars in all three species, and that the ability to switch developmental pathway late in juvenile life is conditional; larvae more freely switched from diapause to direct development than in the opposite direction. We contend that this asymmetry is influenced by the additional physiological preparations needed to survive the long and cold winter period, and that the reluctance to make a late decision to enter diapause has the potential to be a general trait among temperate insects. PMID:20953962

  18. EEG Classification with a Sequential Decision-Making Method in Motor Imagery BCI.

    PubMed

    Liu, Rong; Wang, Yongxuan; Newman, Geoffrey I; Thakor, Nitish V; Ying, Sarah

    2017-12-01

    To develop subject-specific classifier to recognize mental states fast and reliably is an important issue in brain-computer interfaces (BCI), particularly in practical real-time applications such as wheelchair or neuroprosthetic control. In this paper, a sequential decision-making strategy is explored in conjunction with an optimal wavelet analysis for EEG classification. The subject-specific wavelet parameters based on a grid-search method were first developed to determine evidence accumulative curve for the sequential classifier. Then we proposed a new method to set the two constrained thresholds in the sequential probability ratio test (SPRT) based on the cumulative curve and a desired expected stopping time. As a result, it balanced the decision time of each class, and we term it balanced threshold SPRT (BTSPRT). The properties of the method were illustrated on 14 subjects' recordings from offline and online tests. Results showed the average maximum accuracy of the proposed method to be 83.4% and the average decision time of 2.77[Formula: see text]s, when compared with 79.2% accuracy and a decision time of 3.01[Formula: see text]s for the sequential Bayesian (SB) method. The BTSPRT method not only improves the classification accuracy and decision speed comparing with the other nonsequential or SB methods, but also provides an explicit relationship between stopping time, thresholds and error, which is important for balancing the speed-accuracy tradeoff. These results suggest that BTSPRT would be useful in explicitly adjusting the tradeoff between rapid decision-making and error-free device control.

  19. The Relationships of Self-Esteem, Future Time Perspective, Positive Affect, Social Support, and Career Decision: A Longitudinal Multilevel Study

    PubMed Central

    Park, In-Jo; Kim, Minhee; Kwon, Seungwoo; Lee, Hae-Gyoung

    2018-01-01

    This study aimed, first, to determine whether the intra-individual variability in positive affect was related to the intra-individual variability in career decision-making self-efficacy, and career choice anxiety. The second objective was to examine whether social support moderates the relationship between affect and these outcome variables. The third objective was to find out how career decision-making self-efficacy and career choice anxiety change according to self-esteem and future time perspective. We conducted a study using the daily diary method in which participants were asked to rate their affect or attitudes for 21 consecutive days. In total, 128 university students participated in this study. The main results were as follows. First, positive affect was associated positively with career decision-making self-efficacy and negatively with career choice anxiety. Second, social support had a synergy effect with positive affect to influence career choice anxiety. Third, self-esteem was related positively to career decision-making self-efficacy and negatively to career choice anxiety. We discuss theoretical and practical implications. PMID:29755381

  20. Ecological dynamics of continuous and categorical decision-making: the regatta start in sailing.

    PubMed

    Araújo, Duarte; Davids, Keith; Diniz, Ana; Rocha, Luis; Santos, João Coelho; Dias, Gonçalo; Fernandes, Orlando

    2015-01-01

    Ecological dynamics of decision-making in the sport of sailing exemplifies emergent, conditionally coupled, co-adaptive behaviours. In this study, observation of the coupling dynamics of paired boats during competitive sailing showed that decision-making can be modelled as a self-sustained, co-adapting system of informationally coupled oscillators (boats). Bytracing the spatial-temporal displacements of the boats, time series analyses (autocorrelations, periodograms and running correlations) revealed that trajectories of match racing boats are coupled more than 88% of the time during a pre-start race, via continuous, competing co-adaptions between boats. Results showed that both the continuously selected trajectories of the sailors (12 years of age) and their categorical starting point locations were examples of emergent decisions. In this dynamical conception of decision-making behaviours, strategic positioning (categorical) and continuous displacement of a boat over the course in match-race sailing emerged as a function of interacting task, personal and environmental constraints. Results suggest how key interacting constraints could be manipulated in practice to enhance sailors' perceptual attunement to them in competition.

  1. The Relationships of Self-Esteem, Future Time Perspective, Positive Affect, Social Support, and Career Decision: A Longitudinal Multilevel Study.

    PubMed

    Park, In-Jo; Kim, Minhee; Kwon, Seungwoo; Lee, Hae-Gyoung

    2018-01-01

    This study aimed, first, to determine whether the intra-individual variability in positive affect was related to the intra-individual variability in career decision-making self-efficacy, and career choice anxiety. The second objective was to examine whether social support moderates the relationship between affect and these outcome variables. The third objective was to find out how career decision-making self-efficacy and career choice anxiety change according to self-esteem and future time perspective. We conducted a study using the daily diary method in which participants were asked to rate their affect or attitudes for 21 consecutive days. In total, 128 university students participated in this study. The main results were as follows. First, positive affect was associated positively with career decision-making self-efficacy and negatively with career choice anxiety. Second, social support had a synergy effect with positive affect to influence career choice anxiety. Third, self-esteem was related positively to career decision-making self-efficacy and negatively to career choice anxiety. We discuss theoretical and practical implications.

  2. Rethinking autonomy: decision making between patient and surgeon in advanced illnesses

    PubMed Central

    Hinshaw, Daniel B.

    2016-01-01

    Patients with advanced illness such as advanced stage cancer presenting with the need for possible surgical intervention can be some of the most challenging cases for a surgeon. Often there are multiple factors influencing the decisions made. For patients they are facing not just the effects of the disease on their body, but the stark realization that the disease will also limit their life. Not only are these factors a consideration when patients are making decisions, but also the desire to make the decision that is best for themselves, the autonomous decision. Also included in this process for the patient facing the possible need for an intervention is the surgeon. While patient autonomy remains one of the main principles within medicine, guiding treatment decisions, there is also the surgeon’s autonomy to be considered. Surgeons determine if there is even a possible intervention to be offered to patients, a decision making process that respects surgeons’ autonomous choices and includes elements of paternalism as surgeons utilize their expertise to make decisions. Included in the treatment decisions that are made and the care of the patient is the impact patients’ outcomes have on the surgeon, the inherent drive to be the best for the patient and desire for good outcomes for the patient. While both the patient’s and surgeon’s autonomy are a dynamic interface influencing decision making, the main goal for the patient facing a palliative procedure is that of making treatment decisions based on the concept of shared decision making, always giving primary consideration to the patient’s goals and values. Lastly, regardless of the decision made, it is the responsibility of surgeons to their patients to be a source of support through this challenging time. PMID:27004224

  3. Decision making in pediatric oncology: Views of parents and physicians in two European countries.

    PubMed

    Badarau, Domnita O; Ruhe, Katharina; Kühne, Thomas; De Clercq, Eva; Colita, Anca; Elger, Bernice S; Wangmo, Tenzin

    2017-01-01

    Decision making is a highly complex task when providing care for seriously ill children. Physicians, parents, and children face many challenges when identifying and selecting from available treatment options. This qualitative interview study explored decision-making processes for children with cancer at different stages in their treatment in Switzerland and Romania. Thematic analysis of interviews conducted with parents and oncologists identified decision making as a heterogeneous process in both countries. Various decisions were made based on availability and reasonableness of care options. In most cases, at the time of diagnosis, parents were confronted with a "choiceless choice"-that is, there was only one viable option (a standard protocol), and physicians took the lead in making decisions significant for health outcomes. Parents' and sometimes children's role increased during treatment when they had to make decisions regarding research participation and aggressive therapy or palliative care. Framing these results within the previously described Decisional Priority in Pediatric Oncology Model (DPM) highlights family's more prominent position when making elective decisions regarding quality-of-life or medical procedures, which had little effect on health outcomes. The interdependency between oncologists, parents, and children is always present. Communication, sharing of information, and engaging in discussions about preferences, values, and ultimately care goals should be decision making's foundation. Patient participation in these processes was reported as sometimes limited, but parents and oncologists should continue to probe patients' abilities and desire to be involved in decision making. Future research should expand the DPM and explore how decisional priority and authority can be shared by oncologists with parents and even patients.

  4. Aircraft accident investigation: the decision-making in initial action scenario.

    PubMed

    Barreto, Marcia M; Ribeiro, Selma L O

    2012-01-01

    In the complex aeronautical environment, the efforts in terms of operational safety involve the adoption of proactive and reactive measures. The process of investigation begins right after the occurrence of the aeronautical accident, through the initial action. Thus, it is in the crisis scenario, that the person responsible for the initial action makes decisions and gathers the necessary information for the subsequent phases of the investigation process. Within this scenario, which is a natural environment, researches have shown the fragility of rational models of decision making. The theoretical perspective of naturalistic decision making constitutes a breakthrough in the understanding of decision problems demanded by real world. The proposal of this study was to verify if the initial action, after the occurrence of an accident, and the decision-making strategies, used by the investigators responsible for this activity, are characteristic of the naturalistic decision making theoretical approach. To attend the proposed objective a descriptive research was undertaken with a sample of professionals that work in this activity. The data collected through individual interviews were analyzed and the results demonstrated that the initial action environment, which includes restricted time, dynamic conditions, the presence of multiple actors, stress and insufficient information is characteristic of the naturalistic decision making. They also demonstrated that, when the investigators make their decisions, they use their experience and the mental simulation, intuition, improvisation, metaphors and analogues cases, as strategies, all of them related to the naturalistic approach of decision making, in order to satisfy the needs of the situation and reach the objectives of the initial action in the accident scenario.

  5. The BCD of response time analysis in experimental economics.

    PubMed

    Spiliopoulos, Leonidas; Ortmann, Andreas

    2018-01-01

    For decisions in the wild, time is of the essence. Available decision time is often cut short through natural or artificial constraints, or is impinged upon by the opportunity cost of time. Experimental economists have only recently begun to conduct experiments with time constraints and to analyze response time (RT) data, in contrast to experimental psychologists. RT analysis has proven valuable for the identification of individual and strategic decision processes including identification of social preferences in the latter case, model comparison/selection, and the investigation of heuristics that combine speed and performance by exploiting environmental regularities. Here we focus on the benefits, challenges, and desiderata of RT analysis in strategic decision making. We argue that unlocking the potential of RT analysis requires the adoption of process-based models instead of outcome-based models, and discuss how RT in the wild can be captured by time-constrained experiments in the lab. We conclude that RT analysis holds considerable potential for experimental economics, deserves greater attention as a methodological tool, and promises important insights on strategic decision making in naturally occurring environments.

  6. Real-time data to improve en route decision making and reduce transportation demand.

    DOT National Transportation Integrated Search

    2009-07-01

    One approach to mitigating traffic and strains on the transportation system is to shift focus from supply to demand. : When provided with good information and sufficient motivation, users of a transportation system can make : decisions that will resu...

  7. Informed decision-making in elective major vascular surgery: analysis of 145 surgeon-patient consultations.

    PubMed

    Etchells, Edward; Ferrari, Michel; Kiss, Alex; Martyn, Nikki; Zinman, Deborah; Levinson, Wendy

    2011-06-01

    Prior studies show significant gaps in the informed decision-making process, a central goal of surgical care. These studies have been limited by their focus on low-risk decisions, single visits rather than entire consultations, or both. Our objectives were, first, to rate informed decision-making for major elective vascular surgery based on audiotapes of actual physician-patient conversations and, second, to compare ratings of informed decision-making for first visits to ratings for multiple visits by the same patient over time. We prospectively enrolled patients for whom vascular surgical treatment was a potential option at a tertiary care outpatient vascular surgery clinic. We audio-taped all surgeon-patient conversations, including multiple visits when necessary, until a decision was made. Using an existing method, we evaluated the transcripts for elements of decision-making, including basic elements (e.g., an explanation of the clinical condition), intermediate elements (e.g., risks and benefits) and complex elements (e.g., uncertainty around the decision). We analyzed 145 surgeon-patient consultations. Overall, 45% of consultations contained complex elements, whereas 23% did not contain the basic elements of decision-making. For the 67 consultations that involved multiple visits, ratings were significantly higher when evaluating all visits (50% complex elements) compared with evaluating only the first visit (33% complex elements, p < 0.001.) We found that 45% of consultations contained complex elements, which is higher than prior studies with similar methods. Analyzing decision-making over multiple visits yielded different results than analyzing decision-making for single visits.

  8. Always Gamble on an Empty Stomach: Hunger Is Associated with Advantageous Decision Making

    PubMed Central

    de Ridder, Denise; Kroese, Floor; Adriaanse, Marieke; Evers, Catharine

    2014-01-01

    Three experimental studies examined the counterintuitive hypothesis that hunger improves strategic decision making, arguing that people in a hot state are better able to make favorable decisions involving uncertain outcomes. Studies 1 and 2 demonstrated that participants with more hunger or greater appetite made more advantageous choices in the Iowa Gambling Task compared to sated participants or participants with a smaller appetite. Study 3 revealed that hungry participants were better able to appreciate future big rewards in a delay discounting task; and that, in spite of their perception of increased rewarding value of both food and monetary objects, hungry participants were not more inclined to take risks to get the object of their desire. Together, these studies for the first time provide evidence that hot states improve decision making under uncertain conditions, challenging the conventional conception of the detrimental role of impulsivity in decision making. PMID:25340399

  9. Always gamble on an empty stomach: hunger is associated with advantageous decision making.

    PubMed

    de Ridder, Denise; Kroese, Floor; Adriaanse, Marieke; Evers, Catharine

    2014-01-01

    Three experimental studies examined the counterintuitive hypothesis that hunger improves strategic decision making, arguing that people in a hot state are better able to make favorable decisions involving uncertain outcomes. Studies 1 and 2 demonstrated that participants with more hunger or greater appetite made more advantageous choices in the Iowa Gambling Task compared to sated participants or participants with a smaller appetite. Study 3 revealed that hungry participants were better able to appreciate future big rewards in a delay discounting task; and that, in spite of their perception of increased rewarding value of both food and monetary objects, hungry participants were not more inclined to take risks to get the object of their desire. Together, these studies for the first time provide evidence that hot states improve decision making under uncertain conditions, challenging the conventional conception of the detrimental role of impulsivity in decision making.

  10. Cognitive Reflection, Decision Biases, and Response Times

    PubMed Central

    Alós-Ferrer, Carlos; Garagnani, Michele; Hügelschäfer, Sabine

    2016-01-01

    We present novel evidence on response times and personality traits in standard questions from the decision-making literature where responses are relatively slow (medians around half a minute or above). To this end, we measured response times in a number of incentivized, framed items (decisions from description) including the Cognitive Reflection Test, two additional questions following the same logic, and a number of classic questions used to study decision biases in probability judgments (base-rate neglect, the conjunction fallacy, and the ratio bias). All questions create a conflict between an intuitive process and more deliberative thinking. For each item, we then created a non-conflict version by either making the intuitive impulse correct (resulting in an alignment question), shutting it down (creating a neutral question), or making it dominant (creating a heuristic question). For CRT questions, the differences in response times are as predicted by dual-process theories, with alignment and heuristic variants leading to faster responses and neutral questions to slower responses than the original, conflict questions. For decision biases (where responses are slower), evidence is mixed. To explore the possible influence of personality factors on both choices and response times, we used standard personality scales including the Rational-Experiential Inventory and the Big Five, and used them as controls in regression analysis. PMID:27713710

  11. Cognitive Reflection, Decision Biases, and Response Times.

    PubMed

    Alós-Ferrer, Carlos; Garagnani, Michele; Hügelschäfer, Sabine

    2016-01-01

    We present novel evidence on response times and personality traits in standard questions from the decision-making literature where responses are relatively slow (medians around half a minute or above). To this end, we measured response times in a number of incentivized, framed items (decisions from description) including the Cognitive Reflection Test, two additional questions following the same logic, and a number of classic questions used to study decision biases in probability judgments (base-rate neglect, the conjunction fallacy, and the ratio bias). All questions create a conflict between an intuitive process and more deliberative thinking. For each item, we then created a non-conflict version by either making the intuitive impulse correct (resulting in an alignment question), shutting it down (creating a neutral question), or making it dominant (creating a heuristic question). For CRT questions, the differences in response times are as predicted by dual-process theories, with alignment and heuristic variants leading to faster responses and neutral questions to slower responses than the original, conflict questions. For decision biases (where responses are slower), evidence is mixed. To explore the possible influence of personality factors on both choices and response times, we used standard personality scales including the Rational-Experiential Inventory and the Big Five, and used them as controls in regression analysis.

  12. Reconciliation of Decision-Making Heuristics Based on Decision Trees Topologies and Incomplete Fuzzy Probabilities Sets

    PubMed Central

    Doubravsky, Karel; Dohnal, Mirko

    2015-01-01

    Complex decision making tasks of different natures, e.g. economics, safety engineering, ecology and biology, are based on vague, sparse, partially inconsistent and subjective knowledge. Moreover, decision making economists / engineers are usually not willing to invest too much time into study of complex formal theories. They require such decisions which can be (re)checked by human like common sense reasoning. One important problem related to realistic decision making tasks are incomplete data sets required by the chosen decision making algorithm. This paper presents a relatively simple algorithm how some missing III (input information items) can be generated using mainly decision tree topologies and integrated into incomplete data sets. The algorithm is based on an easy to understand heuristics, e.g. a longer decision tree sub-path is less probable. This heuristic can solve decision problems under total ignorance, i.e. the decision tree topology is the only information available. But in a practice, isolated information items e.g. some vaguely known probabilities (e.g. fuzzy probabilities) are usually available. It means that a realistic problem is analysed under partial ignorance. The proposed algorithm reconciles topology related heuristics and additional fuzzy sets using fuzzy linear programming. The case study, represented by a tree with six lotteries and one fuzzy probability, is presented in details. PMID:26158662

  13. Reconciliation of Decision-Making Heuristics Based on Decision Trees Topologies and Incomplete Fuzzy Probabilities Sets.

    PubMed

    Doubravsky, Karel; Dohnal, Mirko

    2015-01-01

    Complex decision making tasks of different natures, e.g. economics, safety engineering, ecology and biology, are based on vague, sparse, partially inconsistent and subjective knowledge. Moreover, decision making economists / engineers are usually not willing to invest too much time into study of complex formal theories. They require such decisions which can be (re)checked by human like common sense reasoning. One important problem related to realistic decision making tasks are incomplete data sets required by the chosen decision making algorithm. This paper presents a relatively simple algorithm how some missing III (input information items) can be generated using mainly decision tree topologies and integrated into incomplete data sets. The algorithm is based on an easy to understand heuristics, e.g. a longer decision tree sub-path is less probable. This heuristic can solve decision problems under total ignorance, i.e. the decision tree topology is the only information available. But in a practice, isolated information items e.g. some vaguely known probabilities (e.g. fuzzy probabilities) are usually available. It means that a realistic problem is analysed under partial ignorance. The proposed algorithm reconciles topology related heuristics and additional fuzzy sets using fuzzy linear programming. The case study, represented by a tree with six lotteries and one fuzzy probability, is presented in details.

  14. To pass or to fail? Understanding the factors considered by faculty in the clinical evaluation of nursing students.

    PubMed

    DeBrew, Jacqueline Kayler; Lewallen, Lynne Porter

    2014-04-01

    Making the decision to pass or to fail a nursing student is difficult for nurse educators, yet one that all educators face at some point in time. To make this decision, nurse educators draw from their past experiences and personal reflections on the situation. Using the qualitative method of critical incident technique, the authors asked educators to describe a time when they had to make a decision about whether to pass or fail a student in the clinical setting. The findings describe student and faculty factors important in clinical evaluation decisions, demonstrate the benefits of reflective practice to nurse educators, and support the utility of critical incident technique not only as research methodology, but also as a technique for reflective practice. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Criteria for assessing problem solving and decision making in complex environments

    NASA Technical Reports Server (NTRS)

    Orasanu, Judith

    1993-01-01

    Training crews to cope with unanticipated problems in high-risk, high-stress environments requires models of effective problem solving and decision making. Existing decision theories use the criteria of logical consistency and mathematical optimality to evaluate decision quality. While these approaches are useful under some circumstances, the assumptions underlying these models frequently are not met in dynamic time-pressured operational environments. Also, applying formal decision models is both labor and time intensive, a luxury often lacking in operational environments. Alternate approaches and criteria are needed. Given that operational problem solving and decision making are embedded in ongoing tasks, evaluation criteria must address the relation between those activities and satisfaction of broader task goals. Effectiveness and efficiency become relevant for judging reasoning performance in operational environments. New questions must be addressed: What is the relation between the quality of decisions and overall performance by crews engaged in critical high risk tasks? Are different strategies most effective for different types of decisions? How can various decision types be characterized? A preliminary model of decision types found in air transport environments will be described along with a preliminary performance model based on an analysis of 30 flight crews. The performance analysis examined behaviors that distinguish more and less effective crews (based on performance errors). Implications for training and system design will be discussed.

  16. The grey matter correlates of impaired decision-making in multiple sclerosis

    PubMed Central

    Muhlert, Nils; Sethi, Varun; Cipolotti, Lisa; Haroon, Hamied; Parker, Geoff J M; Yousry, Tarek; Wheeler-Kingshott, Claudia; Miller, David; Ron, Maria; Chard, Declan

    2015-01-01

    Objective People with multiple sclerosis (MS) have difficulties with decision-making but it is unclear if this is due to changes in impulsivity, risk taking, deliberation or risk adjustment, and how this relates to brain pathology. Methods We assessed these aspects of decision-making in 105 people with MS and 43 healthy controls. We used a novel diffusion MRI method, diffusion orientational complexity (DOC), as an index of grey matter pathology in regions associated with decision-making and also measured grey matter tissue volumes and white matter lesion volumes. Results People with MS showed less adjustment to risk and slower decision-making than controls. Moreover, impaired decision-making correlated with reduced executive function, memory and processing speed. Decision-making impairments were most prevalent in people with secondary progressive MS. They were seen in patients with cognitive impairment and those without cognitive impairment. On diffusion MRI, people with MS showed DOC changes in all regions except the occipital cortex, relative to controls. Risk adjustment correlated with DOC in the hippocampi and deliberation time with DOC in the medial prefrontal, middle frontal gyrus, anterior cingulate and caudate parcellations and with white matter lesion volumes. Conclusions These data clarify the features of decision-making deficits in MS, and provide the first evidence that they relate to grey and white matter abnormalities seen using MRI. PMID:25006208

  17. The role of the anterior cingulate cortex in women's sexual decision making.

    PubMed

    Rupp, Heather A; James, Thomas W; Ketterson, Ellen D; Sengelaub, Dale R; Janssen, Erick; Heiman, Julia R

    2009-01-02

    Women's sexual decision making is a complex process balancing the potential rewards of conception and pleasure against the risks of possible low paternal care or sexually transmitted infection. Although neural processes underlying social decision making are suggested to overlap with those involved in economic decision making, the neural systems associated with women's sexual decision making are unknown. Using fMRI, we measured the brain activation of 12 women while they viewed photos of men's faces. Face stimuli were accompanied by information regarding each man's potential risk as a sexual partner, indicated by a written description of the man's number of previous sexual partners and frequency of condom use. Participants were asked to evaluate how likely they would be to have sex with the man depicted. Women reported that they would be more likely to have sex with low compared to high risk men. Stimuli depicting low risk men also elicited stronger activation in the anterior cingulate cortex (ACC), midbrain, and intraparietal sulcus, possibly reflecting an influence of sexual risk on women's attraction, arousal, and attention during their sexual decision making. Activation in the ACC was positively correlated with women's subjective evaluations of sex likelihood and response times during their evaluations of high, but not low risk men. These findings provide evidence that neural systems involved in sexual decision making in women overlap with those described previously to underlie nonsexual decision making.

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

    Bernard, Michael Lewis; Smith, Bruce W., 1959-

    Understanding the role of emotional states is critical for predicting the kind of decisions people will make in risky situations. Currently, there is little understanding as to how emotion influences decision-making in situations such as terrorist attacks, natural disasters, pandemics, and combat. To help address this, we used behavioral and neuroimaging methods to examine how emotion states and traits influence decisions. Specifically, this study used a wheel of fortune behavioral task and functional magnetic resonance imaging (fMRI) to examine the effects of emotional states and traits on decision-making pertaining to the degree of risk people are willing to make inmore » specific situations. The behavioral results are reported here. The neural data requires additional time to analyze and will be reported at a future date. Biases caused by emotion states and traits were found regarding the likelihood of making risky decisions. The behavioral results will help provide a solid empirical foundation for modeling the effects of emotion on decision in risky situations.« less

  19. Situationally-Sensitive Knowledge Translation and Relational Decision Making in Hyperacute Stroke: A Qualitative Study

    PubMed Central

    Murtagh, Madeleine J.; Burges Watson, Duika L.; Jenkings, K. Neil; Lie, Mabel L. S.; Mackintosh, Joan E.; Ford, Gary A.; Thomson, Richard G.

    2012-01-01

    Stroke is a leading cause of disability. Early treatment of acute ischaemic stroke with rtPA reduces the risk of longer term dependency but carries an increased risk of causing immediate bleeding complications. To understand the challenges of knowledge translation and decision making about treatment with rtPA in hyperacute stroke and hence to inform development of appropriate decision support we interviewed patients, their family and health professionals. The emergency setting and the symptomatic effects of hyper-acute stroke shaped the form, content and manner of knowledge translation to support decision making. Decision making about rtPA in hyperacute stroke presented three conundrums for patients, family and clinicians. 1) How to allow time for reflection in a severely time-limited setting. 2) How to facilitate knowledge translation regarding important treatment risks and benefits when patient and family capacity is blunted by the effects and shock of stroke. 3) How to ensure patient and family views are taken into account when the situation produces reliance on the expertise of clinicians. Strategies adopted to meet these conundrums were fourfold: face to face communication; shaping decisions; incremental provision of information; and communication tailored to the individual patient. Relational forms of interaction were understood to engender trust and allay anxiety. Shaping decisions with patients was understood as an expression of confidence by clinicians that helped alleviate anxiety and offered hope and reassurance to patients and their family experiencing the shock of the stroke event. Neutral presentations of information and treatment options promoted uncertainty and contributed to anxiety. ‘Drip feeding’ information created moments for reflection: clinicians literally made time. Tailoring information to the particular patient and family situation allowed clinicians to account for social and emotional contexts. The principal responses to the challenges of decision making about rtPA in hyperacute stroke were relational decision support and situationally-sensitive knowledge translation. PMID:22675477

  20. Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitative study.

    PubMed

    Murtagh, Madeleine J; Burges Watson, Duika L; Jenkings, K Neil; Lie, Mabel L S; Mackintosh, Joan E; Ford, Gary A; Thomson, Richard G

    2012-01-01

    Stroke is a leading cause of disability. Early treatment of acute ischaemic stroke with rtPA reduces the risk of longer term dependency but carries an increased risk of causing immediate bleeding complications. To understand the challenges of knowledge translation and decision making about treatment with rtPA in hyperacute stroke and hence to inform development of appropriate decision support we interviewed patients, their family and health professionals. The emergency setting and the symptomatic effects of hyper-acute stroke shaped the form, content and manner of knowledge translation to support decision making. Decision making about rtPA in hyperacute stroke presented three conundrums for patients, family and clinicians. 1) How to allow time for reflection in a severely time-limited setting. 2) How to facilitate knowledge translation regarding important treatment risks and benefits when patient and family capacity is blunted by the effects and shock of stroke. 3) How to ensure patient and family views are taken into account when the situation produces reliance on the expertise of clinicians. Strategies adopted to meet these conundrums were fourfold: face to face communication; shaping decisions; incremental provision of information; and communication tailored to the individual patient. Relational forms of interaction were understood to engender trust and allay anxiety. Shaping decisions with patients was understood as an expression of confidence by clinicians that helped alleviate anxiety and offered hope and reassurance to patients and their family experiencing the shock of the stroke event. Neutral presentations of information and treatment options promoted uncertainty and contributed to anxiety. 'Drip feeding' information created moments for reflection: clinicians literally made time. Tailoring information to the particular patient and family situation allowed clinicians to account for social and emotional contexts. The principal responses to the challenges of decision making about rtPA in hyperacute stroke were relational decision support and situationally-sensitive knowledge translation.

  1. Fast Tracking Data to Informed Decisions: An Advanced Information System to Improve Environmental Understanding and Management (Invited)

    NASA Astrophysics Data System (ADS)

    Minsker, B. S.; Myers, J.; Liu, Y.; Bajcsy, P.

    2010-12-01

    Emerging sensing and information technology are rapidly creating a new paradigm for environmental research and management, in which data from multiple sensors and information sources can guide real-time adaptive observation and decision making. This talk will provide an overview of emerging cyberinfrastructure and three case studies that illustrate their potential: combined sewer overflows in Chicago, hypoxia in Corpus Christi Bay, Texas, and sustainable agriculture in Illinois. An advanced information system for real-time decision making and visual geospatial analytics will be presented as an example of cyberinfrastructure that enables easier implementation of numerous real-time applications.

  2. Are normally sighted, visually impaired, and blind pedestrians accurate and reliable at making street crossing decisions?

    PubMed

    Hassan, Shirin E

    2012-05-04

    The purpose of this study is to measure the accuracy and reliability of normally sighted, visually impaired, and blind pedestrians at making street crossing decisions using visual and/or auditory information. Using a 5-point rating scale, safety ratings for vehicular gaps of different durations were measured along a two-lane street of one-way traffic without a traffic signal. Safety ratings were collected from 12 normally sighted, 10 visually impaired, and 10 blind subjects for eight different gap times under three sensory conditions: (1) visual plus auditory information, (2) visual information only, and (3) auditory information only. Accuracy and reliability in street crossing decision-making were calculated for each subject under each sensory condition. We found that normally sighted and visually impaired pedestrians were accurate and reliable in their street crossing decision-making ability when using either vision plus hearing or vision only (P > 0.05). Under the hearing only condition, all subjects were reliable (P > 0.05) but inaccurate with their street crossing decisions (P < 0.05). Compared to either the normally sighted (P = 0.018) or visually impaired subjects (P = 0.019), blind subjects were the least accurate with their street crossing decisions under the hearing only condition. Our data suggested that visually impaired pedestrians can make accurate and reliable street crossing decisions like those of normally sighted pedestrians. When using auditory information only, all subjects significantly overestimated the vehicular gap time. Our finding that blind pedestrians performed significantly worse than either the normally sighted or visually impaired subjects under the hearing only condition suggested that they may benefit from training to improve their detection ability and/or interpretation of vehicular gap times.

  3. Are Normally Sighted, Visually Impaired, and Blind Pedestrians Accurate and Reliable at Making Street Crossing Decisions?

    PubMed Central

    Hassan, Shirin E.

    2012-01-01

    Purpose. The purpose of this study is to measure the accuracy and reliability of normally sighted, visually impaired, and blind pedestrians at making street crossing decisions using visual and/or auditory information. Methods. Using a 5-point rating scale, safety ratings for vehicular gaps of different durations were measured along a two-lane street of one-way traffic without a traffic signal. Safety ratings were collected from 12 normally sighted, 10 visually impaired, and 10 blind subjects for eight different gap times under three sensory conditions: (1) visual plus auditory information, (2) visual information only, and (3) auditory information only. Accuracy and reliability in street crossing decision-making were calculated for each subject under each sensory condition. Results. We found that normally sighted and visually impaired pedestrians were accurate and reliable in their street crossing decision-making ability when using either vision plus hearing or vision only (P > 0.05). Under the hearing only condition, all subjects were reliable (P > 0.05) but inaccurate with their street crossing decisions (P < 0.05). Compared to either the normally sighted (P = 0.018) or visually impaired subjects (P = 0.019), blind subjects were the least accurate with their street crossing decisions under the hearing only condition. Conclusions. Our data suggested that visually impaired pedestrians can make accurate and reliable street crossing decisions like those of normally sighted pedestrians. When using auditory information only, all subjects significantly overestimated the vehicular gap time. Our finding that blind pedestrians performed significantly worse than either the normally sighted or visually impaired subjects under the hearing only condition suggested that they may benefit from training to improve their detection ability and/or interpretation of vehicular gap times. PMID:22427593

  4. Expert decision-making strategies

    NASA Technical Reports Server (NTRS)

    Mosier, Kathleen L.

    1991-01-01

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

  5. Does training with 3D videos improve decision-making in team invasion sports?

    PubMed

    Hohmann, Tanja; Obelöer, Hilke; Schlapkohl, Nele; Raab, Markus

    2016-01-01

    We examined the effectiveness of video-based decision training in national youth handball teams. Extending previous research, we tested in Study 1 whether a three-dimensional (3D) video training group would outperform a two-dimensional (2D) group. In Study 2, a 3D training group was compared to a control group and a group trained with a traditional tactic board. In both studies, training duration was 6 weeks. Performance was measured in a pre- to post-retention design. The tests consisted of a decision-making task measuring quality of decisions (first and best option) and decision time (time for first and best option). The results of Study 1 showed learning effects and revealed that the 3D video group made faster first-option choices than the 2D group, but differences in the quality of options were not pronounced. The results of Study 2 revealed learning effects for both training groups compared to the control group, and faster choices in the 3D group compared to both other groups. Together, the results show that 3D video training is the most useful tool for improving choices in handball, but only in reference to decision time and not decision quality. We discuss the usefulness of a 3D video tool for training of decision-making skills outside the laboratory or gym.

  6. Sampling and assessment accuracy in mate choice: a random-walk model of information processing in mating decision.

    PubMed

    Castellano, Sergio; Cermelli, Paolo

    2011-04-07

    Mate choice depends on mating preferences and on the manner in which mate-quality information is acquired and used to make decisions. We present a model that describes how these two components of mating decision interact with each other during a comparative evaluation of prospective mates. The model, with its well-explored precedents in psychology and neurophysiology, assumes that decisions are made by the integration over time of noisy information until a stopping-rule criterion is reached. Due to this informational approach, the model builds a coherent theoretical framework for developing an integrated view of functions and mechanisms of mating decisions. From a functional point of view, the model allows us to investigate speed-accuracy tradeoffs in mating decision at both population and individual levels. It shows that, under strong time constraints, decision makers are expected to make fast and frugal decisions and to optimally trade off population-sampling accuracy (i.e. the number of sampled males) against individual-assessment accuracy (i.e. the time spent for evaluating each mate). From the proximate-mechanism point of view, the model makes testable predictions on the interactions of mating preferences and choosiness in different contexts and it might be of compelling empirical utility for a context-independent description of mating preference strength. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. What influences patient decision-making in amyotrophic lateral sclerosis multidisciplinary care? A study of patient perspectives.

    PubMed

    Hogden, Anne; Greenfield, David; Nugus, Peter; Kiernan, Matthew C

    2012-01-01

    Patients with amyotrophic lateral sclerosis (ALS) are required to make decisions concerning quality of life and symptom management over the course of their disease. Clinicians perceive that patients' ability to engage in timely decision-making is extremely challenging. However, we lack patient perspectives on this issue. This study aimed to explore patient experiences of ALS, and to identify factors influencing their decision-making in the specialized multidisciplinary care of ALS. An exploratory study was conducted. Fourteen patients from two specialized ALS multidisciplinary clinics participated in semistructured interviews that were audio recorded and transcribed. Data were analyzed for emergent themes. Decision-making was influenced by three levels of factors, ie, structural, interactional, and personal. The structural factor was the decision-making environment of specialized multidisciplinary ALS clinics, which supported decision-making by providing patients with disease-specific information and specialized care planning. Interactional factors were the patient experiences of ALS, including patients' reaction to the diagnosis, response to deterioration, and engagement with the multidisciplinary ALS team. Personal factors were patients' personal philosophies, including their outlook on life, perceptions of control, and planning for the future. Patient approaches to decision-making reflected a focus on the present, rather than anticipating future progression of the disease and potential care needs. Decision-making for symptom management and quality of life in ALS care is enhanced when the patient's personal philosophy is supported by collaborative relationships between the patient and the multidisciplinary ALS team. Patients valued the support provided by the multidisciplinary team; however, their focus on living in the present diverged from the efforts of health professionals to prepare patients and their carers for the future. The challenge facing health professionals is how best to engage each patient in decision-making for their future needs, to bridge this gap.

  8. Prospective Analysis of Decision Making During Joint Cardiology Cardiothoracic Conference in Treatment of 107 Consecutive Children with Congenital Heart Disease.

    PubMed

    Duignan, Sophie; Ryan, Aedin; O'Keeffe, Dara; Kenny, Damien; McMahon, Colin J

    2018-05-12

    The complexity and potential biases involved in decision making have long been recognised and examined in both the aviation and business industries. More recently, the medical community have started to explore this concept and its particular importance in our field. Paediatric cardiology is a rapidly expanding field and for many of the conditions we treat, there is limited evidence available to support our decision-making. Variability exists within decision-making in paediatric cardiology and this may influence outcomes. There are no validated tools available to support and examine consistent decision-making for various treatment strategies in children with congenital heart disease in a multidisciplinary cardiology and cardiothoracic institution. Our primary objective was to analyse the complexity of decision-making for children with cardiac conditions in the context of our joint cardiology and cardiothoracic conference (JCC). Two paediatric cardiologists acted as investigators by observing the weekly joint cardiology-cardiothoracic surgery conference and prospectively evaluating the degree of complexity of decision-making in the management of 107 sequential children with congenital heart disease discussed. Additionally, the group consensus on the same patients was prospectively assessed to compare this to the independent observers. Of 107 consecutive children discussed at our JCC conference 32 (27%) went on to receive surgical intervention, 20 (17%) underwent catheterisation and 65 (56%) received medical treatment. There were 53 (50%) cases rated as simple by one senior observer, while 54 (50%) were rated as complex to some degree. There was high inter-observer agreement with a Krippendorff's alpha of ≥ 0.8 between 2 observers and between 2 observers and the group consensus as a whole for grading of the complexity of decision-making. Different decisions were occasionally made on patients with the same data set. Discussions revisiting the same patient, in complex cases, resulted in different management decisions being reached in this series. Anchoring of decision-making was witnessed in certain cases. Potential application of decision making algorithms is discussed in making decisions in paediatric cardiology patients. Decision-making in our institution's joint cardiology-cardiothoracic conference proved to be complex in approximately half of our patients. Inconsistency in decision-making for patients with the same diagnosis, and different decisions made for the same complex patient at different time points confounds the reliability of the decision-making process. These novel data highlight the absence of evidence-based medicine for many decisions, occasional lack of consistency and the impact of anchoring, heuristics and other biases in complex cases. Validated decision-making algorithms may assist in providing consistency to decision-making in this setting.

  9. Decision making in the Balloon Analogue Risk Task (BART): anterior cingulate cortex signals loss aversion but not the infrequency of risky choices.

    PubMed

    Fukunaga, Rena; Brown, Joshua W; Bogg, Tim

    2012-09-01

    The inferior frontal gyrus/anterior insula (IFG/AI) and anterior cingulate cortex (ACC) are key regions involved in risk appraisal during decision making, but accounts of how these regions contribute to decision making under risk remain contested. To help clarify the roles of these and other related regions, we used a modified version of the Balloon Analogue Risk Task (Lejuez et al., Journal of Experimental Psychology: Applied, 8, 75-84, 2002) to distinguish between decision-making and feedback-related processes when participants decided to pursue a gain as the probability of loss increased parametrically. Specifically, we set out to test whether the ACC and IFG/AI regions correspond to loss aversion at the time of decision making in a way that is not confounded with either reward-seeking or infrequency effects. When participants chose to discontinue inflating the balloon (win option), we observed greater ACC and mainly bilateral IFG/AI activity at the time of decision as the probability of explosion increased, consistent with increased loss aversion but inconsistent with an infrequency effect. In contrast, we found robust vmPFC activity when participants chose to continue inflating the balloon (risky option), consistent with reward seeking. However, in the cingulate and in mainly bilateral IFG regions, blood-oxygenation-level-dependent activation decreased when participants chose to inflate the balloon as the probability of explosion increased, findings that are consistent with a reduced loss aversion signal. Our results highlight the existence of distinct reward-seeking and loss-averse signals during decision making, as well as the importance of distinguishing between decision and feedback signals.

  10. Comparing perceptual and preferential decision making.

    PubMed

    Dutilh, Gilles; Rieskamp, Jörg

    2016-06-01

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

  11. Decision Support | Solar Research | NREL

    Science.gov Websites

    informed solar decision making with credible, objective, accessible, and timely resources. Solar Energy Decision Support Decision Support NREL provides technical and analytical support to support provide unbiased information on solar policies and issues for state and local government decision makers

  12. Probabilistic Decision Making with Spikes: From ISI Distributions to Behaviour via Information Gain.

    PubMed

    Caballero, Javier A; Lepora, Nathan F; Gurney, Kevin N

    2015-01-01

    Computational theories of decision making in the brain usually assume that sensory 'evidence' is accumulated supporting a number of hypotheses, and that the first accumulator to reach threshold triggers a decision in favour of its associated hypothesis. However, the evidence is often assumed to occur as a continuous process whose origins are somewhat abstract, with no direct link to the neural signals - action potentials or 'spikes' - that must ultimately form the substrate for decision making in the brain. Here we introduce a new variant of the well-known multi-hypothesis sequential probability ratio test (MSPRT) for decision making whose evidence observations consist of the basic unit of neural signalling - the inter-spike interval (ISI) - and which is based on a new form of the likelihood function. We dub this mechanism s-MSPRT and show its precise form for a range of realistic ISI distributions with positive support. In this way we show that, at the level of spikes, the refractory period may actually facilitate shorter decision times, and that the mechanism is robust against poor choice of the hypothesized data distribution. We show that s-MSPRT performance is related to the Kullback-Leibler divergence (KLD) or information gain between ISI distributions, through which we are able to link neural signalling to psychophysical observation at the behavioural level. Thus, we find the mean information needed for a decision is constant, thereby offering an account of Hick's law (relating decision time to the number of choices). Further, the mean decision time of s-MSPRT shows a power law dependence on the KLD offering an account of Piéron's law (relating reaction time to stimulus intensity). These results show the foundations for a research programme in which spike train analysis can be made the basis for predictions about behavior in multi-alternative choice tasks.

  13. Probabilistic Decision Making with Spikes: From ISI Distributions to Behaviour via Information Gain

    PubMed Central

    Caballero, Javier A.; Lepora, Nathan F.; Gurney, Kevin N.

    2015-01-01

    Computational theories of decision making in the brain usually assume that sensory 'evidence' is accumulated supporting a number of hypotheses, and that the first accumulator to reach threshold triggers a decision in favour of its associated hypothesis. However, the evidence is often assumed to occur as a continuous process whose origins are somewhat abstract, with no direct link to the neural signals - action potentials or 'spikes' - that must ultimately form the substrate for decision making in the brain. Here we introduce a new variant of the well-known multi-hypothesis sequential probability ratio test (MSPRT) for decision making whose evidence observations consist of the basic unit of neural signalling - the inter-spike interval (ISI) - and which is based on a new form of the likelihood function. We dub this mechanism s-MSPRT and show its precise form for a range of realistic ISI distributions with positive support. In this way we show that, at the level of spikes, the refractory period may actually facilitate shorter decision times, and that the mechanism is robust against poor choice of the hypothesized data distribution. We show that s-MSPRT performance is related to the Kullback-Leibler divergence (KLD) or information gain between ISI distributions, through which we are able to link neural signalling to psychophysical observation at the behavioural level. Thus, we find the mean information needed for a decision is constant, thereby offering an account of Hick's law (relating decision time to the number of choices). Further, the mean decision time of s-MSPRT shows a power law dependence on the KLD offering an account of Piéron's law (relating reaction time to stimulus intensity). These results show the foundations for a research programme in which spike train analysis can be made the basis for predictions about behavior in multi-alternative choice tasks. PMID:25923907

  14. Framing matters: Effects of framing on older adults’ exploratory decision-making

    PubMed Central

    Cooper, Jessica A.; Blanco, Nathaniel; Maddox, W. Todd

    2016-01-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults’ decision-making performance was preserved when maximizing gains, but declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains-maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subjects behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss-minimization from Experiment 1, and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults’ performance in exploratory decision-making is hindered when framed as loss-minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. PMID:27977218

  15. Framing matters: Effects of framing on older adults' exploratory decision-making.

    PubMed

    Cooper, Jessica A; Blanco, Nathaniel J; Maddox, W Todd

    2017-02-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults' decision-making performance was preserved when maximizing gains, but it declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subject behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss minimization from Experiment 1 and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults' performance in exploratory decision-making is hindered when framed as loss minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  16. A geospatial framework for dynamic route planning using congestion prediction in transportation systems.

    DOT National Transportation Integrated Search

    2011-01-01

    The goal this research is to develop an end-to-end data-driven system, dubbed TransDec : (short for Transportation Decision-Making), to enable decision-making queries in : transportation systems with dynamic, real-time and historical data. With Trans...

  17. What is adaptive about adaptive decision making? A parallel constraint satisfaction account.

    PubMed

    Glöckner, Andreas; Hilbig, Benjamin E; Jekel, Marc

    2014-12-01

    There is broad consensus that human cognition is adaptive. However, the vital question of how exactly this adaptivity is achieved has remained largely open. Herein, we contrast two frameworks which account for adaptive decision making, namely broad and general single-mechanism accounts vs. multi-strategy accounts. We propose and fully specify a single-mechanism model for decision making based on parallel constraint satisfaction processes (PCS-DM) and contrast it theoretically and empirically against a multi-strategy account. To achieve sufficiently sensitive tests, we rely on a multiple-measure methodology including choice, reaction time, and confidence data as well as eye-tracking. Results show that manipulating the environmental structure produces clear adaptive shifts in choice patterns - as both frameworks would predict. However, results on the process level (reaction time, confidence), in information acquisition (eye-tracking), and from cross-predicting choice consistently corroborate single-mechanisms accounts in general, and the proposed parallel constraint satisfaction model for decision making in particular. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making.

    PubMed

    Rosen, Jan B; Brand, Matthias; Kalbe, Elke

    2016-01-01

    Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19-86 years, were tested with a moral decision making task comprising forced choice "everyday life" situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called "positivity effect" and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects and socialized sex roles for higher emotional empathy leading to more altruistic decisions.

  19. Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making

    PubMed Central

    Rosen, Jan B.; Brand, Matthias; Kalbe, Elke

    2016-01-01

    Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19–86 years, were tested with a moral decision making task comprising forced choice “everyday life” situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called “positivity effect” and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects and socialized sex roles for higher emotional empathy leading to more altruistic decisions. PMID:27147990

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

    PubMed

    Zhao, Yue; Wright, David

    2010-01-01

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

  1. Noise, cost and speed-accuracy trade-offs: decision-making in a decentralized system

    PubMed Central

    Marshall, James A.R.; Dornhaus, Anna; Franks, Nigel R.; Kovacs, Tim

    2005-01-01

    Many natural and artificial decision-making systems face decision problems where there is an inherent compromise between two or more objectives. One such common compromise is between the speed and accuracy of a decision. The ability to exploit the characteristics of a decision problem in order to vary between the extremes of making maximally rapid, or maximally accurate decisions, is a useful property of such systems. Colonies of the ant Temnothorax albipennis (formerly Leptothorax albipennis) are a paradigmatic decentralized decision-making system, and have been shown flexibly to compromise accuracy for speed when making decisions during house-hunting. During emigration, a colony must typically evaluate and choose between several possible alternative new nest sites of differing quality. In this paper, we examine this speed-accuracy trade-off through modelling, and conclude that noise and time-cost of assessing alternative choices are likely to be significant for T. albipennis. Noise and cost of such assessments are likely to mean that T. albipennis' decision-making mechanism is Pareto-optimal in one crucial regard; increasing the willingness of individuals to change their decisions cannot improve collective accuracy overall without impairing speed. We propose that a decentralized control algorithm based on this emigration behaviour may be derived for applications in engineering domains and specify the characteristics of the problems to which it should be suited, based on our new results. PMID:16849234

  2. Emotion, decision-making and the brain.

    PubMed

    Chang, Luke J; Sanfey, Alan G

    2008-01-01

    Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.

  3. Surgical Consultation as Social Process: Implications for Shared Decision Making.

    PubMed

    Clapp, Justin T; Arriaga, Alexander F; Murthy, Sushila; Raper, Steven E; Schwartz, J Sanford; Barg, Frances K; Fleisher, Lee A

    2017-12-12

    This qualitative study examines surgical consultation as a social process and assesses its alignment with assumptions of the shared decision-making (SDM) model. SDM stresses the importance of patient preferences and rigorous discussion of therapeutic risks/benefits based on these preferences. However, empirical studies have highlighted discrepancies between SDM and realities of surgical decision making. Qualitative research can inform understanding of the decision-making process and allow for granular assessment of the nature and causes of these discrepancies. We observed consultations between 3 general surgeons and 45 patients considering undergoing 1 of 2 preference-sensitive elective operations: (1) hernia repair, or (2) cholecystectomy. These patients and surgeons also participated in semi-structured interviews. By the time of the consultation, patients and surgeons were predisposed toward certain decisions by preceding events occurring elsewhere. During the visit, surgeons had differential ability to arbitrate surgical intervention and construct the severity of patients' conditions. These upstream dynamics frequently displaced the centrality of the risk/benefit-based consent discussion. The influence of events preceding consultation suggests that decision-making models should account for broader spatiotemporal spans. Given surgeons' authority to define patients' conditions and control service provision, SDM may be premised on an overestimation of patients' power to alter the course of decision making once in a specialist's office. Considering the subordinate role of the risk/benefit discussion in many surgical decisions, it will be important to study if and how the social process of decision making is altered by SDM-oriented decision aids that foreground this discussion.

  4. Influence of acute stress on decision outcomes and heuristics.

    PubMed

    Hepler, Teri J; Kovacs, Attila J

    2017-03-01

    The purpose of this study was to examine the take-the-first (TTF) heuristic and decision outcomes in sports under conditions of no, mental, and physical stress. Participants (N.=68) performed 8 video decision-making trials under each of 3 stress conditions: no stress (counting backwards), mental stress (mental serial subtraction), and physical stress (running on treadmill at 13 RPE). Prior to each decision-making trial, participants were exposed to 30 seconds of stress. The decision-making task required participants to watch a video depicting an offensive situation in basketball and then decide what the player with the ball should do next. No differences were found between the 3 stress conditions on TTF frequency, number of options generated, quality of first generated option, or final decision quality. However, participants performing under conditions of no stress and physical stress generated their first option and made their final decision faster than they did when making decisions under mental stress. Overall, results suggest that mental stress impairs decision speed and that TTF is an ecologically rationale heuristic in dynamic, time-pressured situations.

  5. Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task.

    PubMed

    Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F

    2013-01-01

    An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making.

  6. Decision making in urological surgery.

    PubMed

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

    2012-06-01

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

  7. Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

    PubMed Central

    Laureiro-Martínez, Daniella; Canessa, Nicola; Brusoni, Stefano; Zollo, Maurizio; Hare, Todd; Alemanno, Federica; Cappa, Stefano F.

    2014-01-01

    An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time). We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea) and managers (who are constantly involved in making strategic decisions but have no venture experience) engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex (FPC) previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making. PMID:24478664

  8. Not just for consumers: context effects are fundamental to decision making.

    PubMed

    Trueblood, Jennifer S; Brown, Scott D; Heathcote, Andrew; Busemeyer, Jerome R

    2013-06-01

    Context effects--preference changes that depend on the availability of other options--have attracted a great deal of attention among consumer researchers studying high-level decision tasks. In the experiments reported here, we showed that these effects also arise in simple perceptual-decision-making tasks. This finding casts doubt on explanations limited to consumer choice and high-level decisions, and it indicates that context effects may be amenable to a general explanation at the level of the basic decision process. We demonstrated for the first time that three important context effects from the preferential-choice literature--similarity, attraction, and compromise effects--all occurred within a single perceptual-decision task. Not only do our results challenge previous explanations for context effects proposed by consumer researchers, but they also challenge the choice rules assumed in theories of perceptual decision making.

  9. An engineering approach to modelling, decision support and control for sustainable systems.

    PubMed

    Day, W; Audsley, E; Frost, A R

    2008-02-12

    Engineering research and development contributes to the advance of sustainable agriculture both through innovative methods to manage and control processes, and through quantitative understanding of the operation of practical agricultural systems using decision models. This paper describes how an engineering approach, drawing on mathematical models of systems and processes, contributes new methods that support decision making at all levels from strategy and planning to tactics and real-time control. The ability to describe the system or process by a simple and robust mathematical model is critical, and the outputs range from guidance to policy makers on strategic decisions relating to land use, through intelligent decision support to farmers and on to real-time engineering control of specific processes. Precision in decision making leads to decreased use of inputs, less environmental emissions and enhanced profitability-all essential to sustainable systems.

  10. Naturalistic decision-making in expert badminton players.

    PubMed

    Macquet, A C; Fleurance, P

    2007-09-01

    This paper reports on a study of naturalistic decision-making in expert badminton players. These decisions are frequently taken under time-pressured conditions, yet normally lead to successful performance. Two male badminton teams participated in this study. Self-confrontation interviews were used to collect data. Inductive data analysis revealed three types of intentions during a rally: to maintain the rally; to take the advantage; and to finish the point. It also revealed eight types of decision taken in this situation: to ensure an action; to observe the opponent's response to an action; to realize a limited choice; to influence the opponent's decision; to put pressure on an opponent; to surprise the opponent; to reproduce an efficient action; and to play wide. A frequent decision was to put pressure on the opponent. Different information and knowledge was linked to specific decisions. The results are discussed in relation to research that has considered naturalistic decision-making.

  11. Healthy eating decisions require efficient dietary self-control in children: A mouse-tracking food decision study.

    PubMed

    Ha, Oh-Ryeong; Bruce, Amanda S; Pruitt, Stephen W; Cherry, J Bradley C; Smith, T Ryan; Burkart, Dominic; Bruce, Jared M; Lim, Seung-Lark

    2016-10-01

    Learning how to make healthy eating decisions, (i.e., resisting unhealthy foods and consuming healthy foods), enhances physical development and reduces health risks in children. Although healthy eating decisions are known to be challenging for children, the mechanisms of children's food choice processes are not fully understood. The present study recorded mouse movement trajectories while eighteen children aged 8-13 years were choosing between eating and rejecting foods. Children were inclined to choose to eat rather than to reject foods, and preferred unhealthy foods over healthy foods, implying that rejecting unhealthy foods could be a demanding choice. When children rejected unhealthy foods, mouse trajectories were characterized by large curvature toward an eating choice in the beginning, late decision shifting time toward a rejecting choice, and slowed response times. These results suggested that children exercised greater cognitive efforts with longer decision times to resist unhealthy foods, providing evidence that children require dietary self-control to make healthy eating-decisions by resisting the temptation of unhealthy foods. Developmentally, older children attempted to exercise greater cognitive efforts for consuming healthy foods than younger children, suggesting that development of dietary self-control contributes to healthy eating-decisions. The study also documents that healthy weight children with higher BMIs were more likely to choose to reject healthy foods. Overall, findings have important implications for how children make healthy eating choices and the role of dietary self-control in eating decisions. Published by Elsevier Ltd.

  12. Reduction of influence of task difficulty on perceptual decision making by STN deep brain stimulation.

    PubMed

    Green, Nikos; Bogacz, Rafal; Huebl, Julius; Beyer, Ann-Kristin; Kühn, Andrea A; Heekeren, Hauke R

    2013-09-09

    Neurocomputational models of optimal decision making ascribe a crucial role-the computation of conflict between choice alternatives-to the subthalamic nucleus (STN). Specifically, these models predict that deep brain stimulation (DBS) of the STN will diminish the influence of decision conflict on decision making. In this work, patients with Parkinson's disease judged the direction of motion in random dot stimuli while ON and OFF DBS. To induce decision conflict, we varied the task difficulty (motion coherence), leading to increased reaction time (RT) in trials with greater task difficulty in healthy subjects. Results indicate that DBS significantly influences performance for perceptual decisions under high decision conflict. RT increased substantially OFF DBS as the task became more difficult, and a diffusion model best accounted for behavioral data. In contrast, ON DBS, the influence of task difficulty on RT was significantly reduced and a race model best accounted for the observed data. Individual data fits of evidence accumulation models demonstrate different information processing under distinct DBS states. Furthermore, ON DBS, speed-accuracy tradeoffs affected the magnitude of decision criterion adjustment significantly less compared to OFF DBS. Together, these findings suggest a crucial role for the STN in adjusting decision making during high-conflict trials in perceptual decision making. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Video-based training to improve perceptual-cognitive decision-making performance of Australian football umpires.

    PubMed

    Larkin, Paul; Mesagno, Christopher; Berry, Jason; Spittle, Michael; Harvey, Jack

    2018-02-01

    Decision-making is a central component of the in-game performance of Australian football umpires; however, current umpire training focuses largely on physiological development with decision-making skills development conducted via explicit lecture-style meetings with limited practice devoted to making actual decisions. Therefore, this study investigated the efficacy of a video-based training programme, aimed to provide a greater amount of contextualised visual experiences without explicit instruction, to improve decision-making skills of umpires. Australian football umpires (n = 52) were recruited from metropolitan and regional Division 1 competitions. Participants were randomly assigned to an intervention or control group and classified according to previous umpire game experience (i.e., experienced; less experienced). The intervention group completed a 12-week video-based decision-making training programme, with decision-making performance assessed at pre-training, and 1-week retention and 3-week retention periods. The control group did not complete any video-based training. Results indicated a significant Group (intervention; Control) × Test interaction (F(1, 100) = 3.98; P = 0.02, partial ῆ 2  = 0.074), with follow-up pairwise comparisons indicating significant within-group differences over time for the intervention group. In addition, decision-making performance of the less experienced umpires in the intervention group significantly improved (F(2, 40) = 5.03, P = 0.01, partial ῆ 2  = 0.201). Thus, video-based training programmes may be a viable adjunct to current training programmes to hasten decision-making development, especially for less experienced umpires.

  14. Implementing shared decision-making in routine practice: barriers and opportunities.

    PubMed

    Holmes-Rovner, Margaret; Valade, Diane; Orlowski, Catherine; Draus, Catherine; Nabozny-Valerio, Barbara; Keiser, Susan

    2000-09-01

    OBJECTIVE: Determine feasibility of shared decision-making programmes in fee-for-service hospital systems including physicians' offices and in-patient facilities. DESIGN: Survey and participant observation. Data obtained during Phase 1 of a patient outcome study. SETTINGS AND PARTICIPANTS: Three hospitals in Michigan: one 299-bed rural regional hospital, one 650-bed urban community hospital, one 459-bed urban and suburban teaching hospital. All nurses and physicians who agreed to use the programmes participated in the evaluation (n = 34). INTERVENTION: Two shared decision-making(R) (SDP) multimedia programmes: surgical treatment choice for breast cancer and ischaemic heart disease treatment choice. MAIN OUTCOME MEASURES: (1) clinicians' evaluations of programme quality; (2) challenges in hospital settings; and (3) patient referral rates. RESULTS: SDP programmes were judged to be clear, accurate and about the right length and amount of information. Programmes were judged to be informative and appropriate for patients to see before making a decision. Clinicians were neutral about patients' desire to participate in treatment decision-making. Referral volume to SDPs was lower than expected: 24 patients in 7 months across three hospitals. Implementation challenges centred on time pressures in patient care. CONCLUSIONS: Productivity and time pressure in US health care severely constrain shared decision-making programme implementation. Physician referral may not be a reliable mechanism for patient access. Possible innovations include: (1) incorporation into the informed consent process; (2) provider or payer negotiated requirement in the routine hospital procedure to use the SDP as a quality indicator; and (3) payer reimbursement to professional providers who make SDP programmes available to patients.

  15. Drivers' decision-making when attempting to cross an intersection results from choice between affordances

    PubMed Central

    Marti, Geoffrey; Morice, Antoine H. P.; Montagne, Gilles

    2015-01-01

    In theory, a safe approach to an intersection implies that drivers can simultaneously manage two scenarios: they either choose to cross or to give way to an oncoming vehicle. In this article we formalize the critical time for safe crossing (CTcross) and the critical time for safe stopping (CTstop) to represent crossing and stopping possibilities, respectively. We describe these critical times in terms of affordances and empirically test their respective contribution to the driver's decision-making process. Using a driving simulator, three groups of participants drove cars with identical acceleration capabilities and different braking capabilities. They were asked to try to cross an intersection where there was an oncoming vehicle, if they deemed the maneuver to be safe. If not, they could decide to stop or, as a last resort, make an emergency exit. The intersections were identical among groups. Results showed that although the crossing possibilities (CTcross) were the same for all groups, there were between-group differences in crossing frequency. This suggests that stopping possibilities (CTstop) play a role in the driver's decision-making process, in addition to the crossing possibilities. These results can be accounted for by a behavioral model of decision making, and provide support for the hypothesis of choice between affordances. PMID:25620922

  16. The medical decision model and decision maker tools for management of radiological and nuclear incidents.

    PubMed

    Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

    2014-06-01

    Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

  17. Developpement energetique par modelisation et intelligence territoriale: Un outil de prise de decision participative pour le developpement durable des projets eoliens

    NASA Astrophysics Data System (ADS)

    Vazquez Rascon, Maria de Lourdes

    This thesis focuses on the implementation of a participatory and transparent decision making tool about the wind farm projects. This tool is based on an (argumentative) framework that reflects the stakeholder's values systems involved in these projects and it employs two multicriteria methods: the multicriteria decision aide and the participatory geographical information systems, making it possible to represent this value systems by criteria and indicators to be evaluated. The stakeholder's values systems will allow the inclusion of environmental, economic and social-cultural aspects of wind energy projects and, thus, a sustainable development wind projects vision. This vision will be analyzed using the 16 sustainable principles included in the Quebec's Sustainable Development Act. Four specific objectives have been instrumented to favor a logical completion work, and to ensure the development of a successfultool : designing a methodology to couple the MCDA and participatory GIS, testing the developed methodology by a case study, making a robustness analysis to address strategic issues and analyzing the strengths, weaknesses, opportunities and threads of the developed methodology. Achieving the first goal allowed us to obtain a decision-making tool called Territorial Intelligence Modeling for Energy Development (TIMED approach). The TIMED approach is visually represented by a figure expressing the idea of a co-construction decision and where ail stakeholders are the focus of this methodology. TIMED is composed of four modules: Multi-Criteria decision analysis, participatory geographic Information systems, active involvement of the stakeholders and scientific knowledge/local knowledge. The integration of these four modules allows for the analysis of different implementation scenarios of wind turbines in order to choose the best one based on a participatory and transparent decision-making process that takes into account stakeholders' concerns. The second objective enabled the testing of TIMED in an ex-post experience of a wind farm in operation since 2006. In this test, II people participated representing four stakeholder' categories: the private sector, the public sector, experts and civil society. This test allowed us to analyze the current situation in which wind projects are currently developed in Quebec. The concerns of some stakeholders regarding situations that are not considered in the current context were explored through a third goal. This third objective allowed us to make simulations taking into account the assumptions of strategic levels. Examples of the strategic level are the communication tools used to approach the host community and the park property type. Finally, the fourth objective, a SWOT analysis with the participation of eight experts, allowed us to verify the extent to which TIMED approach succeeded in constructing four fields for participatory decision-making: physical, intellectual, emotional and procedural. From these facts, 116 strengths, 28 weaknesses, 32 constraints and 54 opportunities were identified. Contributions, applications, limitations and extensions of this research are based on giving a participatory decision-making methodology taking into account socio-cultural, environmental and economic variables; making reflection sessions on a wind farm in operation; acquiring MCDA knowledge for participants involved in testing the proposed methodology; taking into account the physical, intellectual, emotional and procedural spaces to al1iculate a participatory decision; using the proposed methodology in renewable energy sources other than wind; the need to an interdisciplinary team for the methodology application; access to quality data; access to information technologies; the right to public participation; the neutrality of experts; the relationships between experts and non-experts; cultural constraints; improvement of designed indicators; the implementation of a Web platform for participatory decision-making and writing a manual on the use of the developed methodology. Keywords: wind farm, multicriteria decision, geographic information systems, TIMED approach, sustainable wind energy projects development, renewable energy, social participation, robustness concern, SWOT analysis.

  18. Decision support system of e-book provider selection for library using Simple Additive Weighting

    NASA Astrophysics Data System (ADS)

    Ciptayani, P. I.; Dewi, K. C.

    2018-01-01

    Each library has its own criteria and differences in the importance of each criterion in choosing an e-book provider for them. The large number of providers and the different importance levels of each criterion make the problem of determining the e-book provider to be complex and take a considerable time in decision making. The aim of this study was to implement Decision support system (DSS) to assist the library in selecting the best e-book provider based on their preferences. The way of DSS works is by comparing the importance of each criterion and the condition of each alternative decision. SAW is one of DSS method that is quite simple, fast and widely used. This study used 9 criteria and 18 provider to demonstrate how SAW work in this study. With the DSS, then the decision-making time can be shortened and the calculation results can be more accurate than manual calculations.

  19. The Decision Tree: A Tool for Achieving Behavioral Change.

    ERIC Educational Resources Information Center

    Saren, Dru

    1999-01-01

    Presents a "Decision Tree" process for structuring team decision making and problem solving about specific student behavioral goals. The Decision Tree involves a sequence of questions/decisions that can be answered in "yes/no" terms. Questions address reasonableness of the goal, time factors, importance of the goal, responsibilities, safety,…

  20. [Shared decision-making in mental health care: a role model from youth mental health care].

    PubMed

    Westermann, G M A; Maurer, J M G

    2015-01-01

    In the communication and interaction between doctor and patient in Western health care there has been a paradigm shift from the paternalistic approach to shared decision-making. To summarise the background situation, recent developments and the current level of shared decision-making in (youth) mental health care. We conducted a critical review of the literature relating to the methodology development, research and the use of counselling and decision-making in mental health care. The majority of patients, professionals and other stakeholders consider shared decision-making to be desirable and important for improving the quality and efficiency of care. Up till recently most research and studies have concentrated on helping patients to develop decision-making skills and on showing patients how and where to access information. At the moment more attention is being given to the development of skills and circumstances that will increase patients' interaction with care professionals and patients' emotional involvement in shared decision-making. In mental health for children and adolescents, more often than in adult mental health care, it has been customary to give more attention to these aspects of shared decision-making, particularly during counselling sessions that mark the transition from diagnosis to treatment. This emphasis has been apparent for a long time in textbooks, daily practice, methodology development and research in youth mental health care. Currently, a number of similar developments are taking place in adult mental health care. Although most health professionals support the policy of shared decision-making, the implementation of the policy in mental health care is still at an early stage. In practice, a number of obstacles still have to be surmounted. However, the experience gained with counselling and decision-making in (youth) mental health care may serve as an example to other sections of mental health care and play an important role in the further development of shared decision-making.

  1. Acting Irrationally to Improve Performance in Stochastic Worlds

    NASA Astrophysics Data System (ADS)

    Belavkin, Roman V.

    Despite many theories and algorithms for decision-making, after estimating the utility function the choice is usually made by maximising its expected value (the max EU principle). This traditional and 'rational' conclusion of the decision-making process is compared in this paper with several 'irrational' techniques that make choice in Monte-Carlo fashion. The comparison is made by evaluating the performance of simple decision-theoretic agents in stochastic environments. It is shown that not only the random choice strategies can achieve performance comparable to the max EU method, but under certain conditions the Monte-Carlo choice methods perform almost two times better than the max EU. The paper concludes by quoting evidence from recent cognitive modelling works as well as the famous decision-making paradoxes.

  2. Instructional Decision Making and Agency of Community College Mathematics Faculty

    ERIC Educational Resources Information Center

    Lande, Elaine; Mesa, Vilma

    2016-01-01

    We investigate the rationale for instructional decisions proposed by two groups of community college mathematics faculty (full-time and part-time), as they discussed animations of trigonometry classes that breached several classroom norms. Although both groups of faculty justify their decisions in similar ways, the way in which they talk differs.…

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

    PubMed

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

    2016-08-01

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

  4. Pregnancy as Foreground in Cystic Fibrosis Carrier Testing Decisions in Primary Care

    PubMed Central

    Williams, Janet K.

    2009-01-01

    Cystic fibrosis carrier testing (CFCT) is among the first of the DNA tests offered prenatally in primary care settings. This paper from a descriptive qualitative study describes the influence of pregnancy in CFCT decisions by women receiving community-based prenatal care. Twenty-seven women receiving prenatal care in Midwestern U.S. primary care clinics completed semistructured interviews. Audiotaped interviews were analyzed using content analysis. Participants described decision-making influences and strategies from the perspective of “being pregnant.” Patterns of attitudes and beliefs include (1) dealing with emotions, (2) pregnancy is natural, and (3) thinking about the baby. Strategies in the decision-making process included (1) reducing stress, (2) choosing what is relevant, (3) doing everything right, (4) wanting to be prepared, (5) delaying information, and (6) trusting God. While other factors were mentioned by some women, major themes reflect the influence of currently being pregnant on the decision-making process. These findings suggest that pregnancy is a powerful influence on the decision-making process and may not be the optimal time to make fully informed decisions regarding genetic carrier testing. Further understanding of factors influencing the genetic testing decision-making process is needed. Offering CFCT prior to conception is advocated. PMID:19309287

  5. Modeling Confidence Judgments, Response Times, and Multiple Choices in Decision Making: Recognition Memory and Motion Discrimination

    PubMed Central

    Ratcliff, Roger; Starns, Jeffrey J.

    2014-01-01

    Confidence in judgments is a fundamental aspect of decision making, and tasks that collect confidence judgments are an instantiation of multiple-choice decision making. We present a model for confidence judgments in recognition memory tasks that uses a multiple-choice diffusion decision process with separate accumulators of evidence for the different confidence choices. The accumulator that first reaches its decision boundary determines which choice is made. Five algorithms for accumulating evidence were compared, and one of them produced proportions of responses for each of the choices and full response time distributions for each choice that closely matched empirical data. With this algorithm, an increase in the evidence in one accumulator is accompanied by a decrease in the others so that the total amount of evidence in the system is constant. Application of the model to the data from an earlier experiment (Ratcliff, McKoon, & Tindall, 1994) uncovered a relationship between the shapes of z-transformed receiver operating characteristics and the behavior of response time distributions. Both are explained in the model by the behavior of the decision boundaries. For generality, we also applied the decision model to a 3-choice motion discrimination task and found it accounted for data better than a competing class of models. The confidence model presents a coherent account of confidence judgments and response time that cannot be explained with currently popular signal detection theory analyses or dual-process models of recognition. PMID:23915088

  6. Food choice decision-making by women with gestational diabetes.

    PubMed

    Hui, Amy Leung; Sevenhuysen, Gustaaf; Harvey, Dexter; Salamon, Elizabeth

    2014-02-01

    To enhance the dietary education presented to women with gestational diabetes (GDM) by exploring the reasons and experiences that women with GDM reported in making their food-choice decisions after receipt of dietary education from a healthcare professional. Food Choice Map (FCM) semi-structured in-depth interviews were conducted with 30 women with GDM living in the Winnipeg area during their pregnancies. Verbatim transcripts were generated from the interviews. A constant comparative method was used to generate common themes to answer research inquiries. Personal food preferences, hunger and cravings were the main factors affecting food choice decision-making in women with GDM. Although the information from healthcare professionals was 1 factor that affected food choice decision-making for most of the participants, more than half of the women, including all the women who were on insulin, reported difficulties in quick adaptation to dietary management in a limited time period. Information from other sources such as family members, friends, and internet were used to cope with the adaptation. These difficulties led to a sense of decreased control of GDM and were accompanied by frustration, especially for women taking insulin. Food choice decision-making varied for this group of women with GDM. Knowledge and information aided in making healthy food choices and in portion control. However, balancing individual needs and blood glucose control in a short time period was felt to be difficult and created frustration. The findings suggested that dietary consultation needs to be personalized and to be time sensitive to promote confidence in self-control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

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

    NASA Technical Reports Server (NTRS)

    Hanagud, S.; Uppaluri, B.

    1975-01-01

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

  8. Leveraging certified nursing assistant documentation and knowledge to improve clinical decision making: the on-time quality improvement program to prevent pressure ulcers.

    PubMed

    Sharkey, Siobhan; Hudak, Sandra; Horn, Susan D; Spector, William

    2011-04-01

    The goal of this article was to enhance understanding of the On-Time Quality Improvement for Long-term Care Program, a practical approach to embed health information technology into quality improvement in nursing homes that leverages certified nursing assistant documentation and knowledge, supports frontline clinical decision making, and establishes proactive intervention for pressure ulcer prevention.

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

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

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

    1990-08-01

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

  10. Value Assessment at the Point of Care: Incorporating Patient Values throughout Care Delivery and a Draft Taxonomy of Patient Values.

    PubMed

    Armstrong, Melissa J; Mullins, C Daniel

    2017-02-01

    Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. In addition, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment that could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement. In this commentary, we propose a taxonomy of values underlying patient decision making and provide examples of how these impact provision of health care. The taxonomy describes four categories of patient values: global, decisional, situational, and external. Global values are personal values impacting decision making at a universal level and can include value traits and life priorities. Decisional values are the values traditionally conceptualized in decision making, including considerations such as efficacy, toxicity, quality of life, convenience, and cost. Situational values are values tied to a specific moment in time that modify patients' existing global and decisional values. Finally, discussion of external values acknowledges that many patients consider values other than their own when making decisions. Recognizing the breadth of values impacting patient decision making has implications for both overall health care delivery and shared decision making because value assessments focusing only on decisional values may miss important patient considerations. This draft taxonomy highlights different values impacting decision making and facilitates a more complete value assessment at the point of care. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Cortical Components of Reaction-Time during Perceptual Decisions in Humans.

    PubMed

    Dmochowski, Jacek P; Norcia, Anthony M

    2015-01-01

    The mechanisms of perceptual decision-making are frequently studied through measurements of reaction time (RT). Classical sequential-sampling models (SSMs) of decision-making posit RT as the sum of non-overlapping sensory, evidence accumulation, and motor delays. In contrast, recent empirical evidence hints at a continuous-flow paradigm in which multiple motor plans evolve concurrently with the accumulation of sensory evidence. Here we employ a trial-to-trial reliability-based component analysis of encephalographic data acquired during a random-dot motion task to directly image continuous flow in the human brain. We identify three topographically distinct neural sources whose dynamics exhibit contemporaneous ramping to time-of-response, with the rate and duration of ramping discriminating fast and slow responses. Only one of these sources, a parietal component, exhibits dependence on strength-of-evidence. The remaining two components possess topographies consistent with origins in the motor system, and their covariation with RT overlaps in time with the evidence accumulation process. After fitting the behavioral data to a popular SSM, we find that the model decision variable is more closely matched to the combined activity of the three components than to their individual activity. Our results emphasize the role of motor variability in shaping RT distributions on perceptual decision tasks, suggesting that physiologically plausible computational accounts of perceptual decision-making must model the concurrent nature of evidence accumulation and motor planning.

  12. Evaluation of Rutter Sigma S6 Ice Navigation Radar on USCGC Healy during Arctic Shield 2014

    DTIC Science & Technology

    2015-03-01

    useful in making decisions about the pressure ridges ahead of time instead of making an immediate decision. Figure 33. CG radar display of... use the radar to help chart an efficient path through an ice field to reduce transit time and fuel expenses. This includes a clear picture of the ice...a ship would be able to use the radar to help chart an efficient path through an ice field to reduce transit time and fuel expenses. This includes

  13. Illuminating hospital discharge planning: staff nurse decision making.

    PubMed

    Rhudy, Lori M; Holland, Diane E; Bowles, Kathryn H

    2010-11-01

    This qualitative study proposed to examine staff RN's decision making related to discharge planning and perceptions of their role. Themes resulting from interviews were "following the script" and "RN as coordinator." The decision to consult a discharge planner occurred when the patient's situation did not follow the RN's expectations. Discharge planning for nonroutine situations was considered disruptive to the RN's workflow. The RN's role was limited to oversight when a discharge planner was involved. Understanding RNs' decision making in this key process provides valuable insights into differentiating routine from nonroutine patient situations and deploying appropriate resources in a timely fashion. Copyright © 2010 Elsevier Inc. All rights reserved.

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

    PubMed

    Shapiro, Susan P

    2007-01-01

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

  15. Perceptions of shared decision making and decision aids among rural primary care clinicians.

    PubMed

    King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

    2012-01-01

    Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

  16. Intelligent Work Process Engineering System

    NASA Technical Reports Server (NTRS)

    Williams, Kent E.

    2003-01-01

    Optimizing performance on work activities and processes requires metrics of performance for management to monitor and analyze in order to support further improvements in efficiency, effectiveness, safety, reliability and cost. Information systems are therefore required to assist management in making timely, informed decisions regarding these work processes and activities. Currently information systems regarding Space Shuttle maintenance and servicing do not exist to make such timely decisions. The work to be presented details a system which incorporates various automated and intelligent processes and analysis tools to capture organize and analyze work process related data, to make the necessary decisions to meet KSC organizational goals. The advantages and disadvantages of design alternatives to the development of such a system will be discussed including technologies, which would need to bedesigned, prototyped and evaluated.

  17. Reasons for family involvement in elective surgical decision-making in Taiwan: a qualitative study.

    PubMed

    Lin, Mei-Ling; Huang, Chuen-Teng; Chen, Ching-Huey

    2017-07-01

    To inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. Making a patient the centre of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking. A qualitative study. In order to record and examine reasons for family involvement in adult patients' surgical decision-making, 12 different family members of 12 elective surgery patients were interviewed for collecting and analysing data. Three major reasons for family involvement emerged from the data analyses: (1) to share responsibility; (2) to ensure the correctness of medical information; and (3) to safeguard the patient's well-being. These findings also reveal that culture is not the only reason for family involvement. Making decision to undergo a surgery is a tough and stressful process for a patient. Family may provide the patient with timely psychological support to assist the patient to communicate with his or her physician(s) and other medical personnel to ensure their rights. It is also found that due to the imbalanced doctor-patient power relationship, a patient may be unable, unwilling to, or even dare not, tell the whole truth about his or her illness or feelings to the medical personnel. Thus, a patient would expect his or her family to undertake such a mission during the informed consent and decision-making processes. The results of this study may provide medical professionals with relevant insights into family involvement in adult patients' surgical decision-making. © 2016 John Wiley & Sons Ltd.

  18. Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data

    PubMed Central

    2011-01-01

    Background No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. Methods A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Results Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Conclusions Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making. PMID:21214905

  19. Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data.

    PubMed

    Dexter, Franklin; Wachtel, Ruth E; Epstein, Richard H

    2011-01-07

    No systematic process has previously been described for a needs assessment that identifies the operating room (OR) management decisions made by the anesthesiologists and nurse managers at a facility that do not maximize the efficiency of use of OR time. We evaluated whether event-based knowledge elicitation can be used practically for rapid assessment of OR management decision-making at facilities, whether scenarios can be adapted automatically from information systems data, and the usefulness of the approach. A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered. Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments. Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.

  20. Managing costs, managing benefits: employer decisions in local health care markets.

    PubMed

    Christianson, Jon B; Trude, Sally

    2003-02-01

    To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. This is an observational study with data collection over a six-year period. The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions.

  1. Précis of Simple heuristics that make us smart.

    PubMed

    Todd, P M; Gigerenzer, G

    2000-10-01

    How can anyone be rational in a world where knowledge is limited, time is pressing, and deep thought is often an unattainable luxury? Traditional models of unbounded rationality and optimization in cognitive science, economics, and animal behavior have tended to view decision-makers as possessing supernatural powers of reason, limitless knowledge, and endless time. But understanding decisions in the real world requires a more psychologically plausible notion of bounded rationality. In Simple heuristics that make us smart (Gigerenzer et al. 1999), we explore fast and frugal heuristics--simple rules in the mind's adaptive toolbox for making decisions with realistic mental resources. These heuristics can enable both living organisms and artificial systems to make smart choices quickly and with a minimum of information by exploiting the way that information is structured in particular environments. In this précis, we show how simple building blocks that control information search, stop search, and make decisions can be put together to form classes of heuristics, including: ignorance-based and one-reason decision making for choice, elimination models for categorization, and satisficing heuristics for sequential search. These simple heuristics perform comparably to more complex algorithms, particularly when generalizing to new data--that is, simplicity leads to robustness. We present evidence regarding when people use simple heuristics and describe the challenges to be addressed by this research program.

  2. Vista goes online: Decision-analytic systems for real-time decision-making in mission control

    NASA Technical Reports Server (NTRS)

    Barry, Matthew; Horvitz, Eric; Ruokangas, Corinne; Srinivas, Sampath

    1994-01-01

    The Vista project has centered on the use of decision-theoretic approaches for managing the display of critical information relevant to real-time operations decisions. The Vista-I project originally developed a prototype of these approaches for managing flight control displays in the Space Shuttle Mission Control Center (MCC). The follow-on Vista-II project integrated these approaches in a workstation program which currently is being certified for use in the MCC. To our knowledge, this will be the first application of automated decision-theoretic reasoning techniques for real-time spacecraft operations. We shall describe the development and capabilities of the Vista-II system, and provide an overview of the use of decision-theoretic reasoning techniques to the problems of managing the complexity of flight controller displays. We discuss the relevance of the Vista techniques within the MCC decision-making environment, focusing on the problems of detecting and diagnosing spacecraft electromechanical subsystems component failures with limited information, and the problem of determining what control actions should be taken in high-stakes, time-critical situations in response to a diagnosis performed under uncertainty. Finally, we shall outline our current research directions for follow-on projects.

  3. Qualitative analysis of patient-centered decision attributes associated with initiating hepatitis C treatment.

    PubMed

    Zuchowski, Jessica L; Hamilton, Alison B; Pyne, Jeffrey M; Clark, Jack A; Naik, Aanand D; Smith, Donna L; Kanwal, Fasiha

    2015-10-01

    In this era of a constantly changing landscape of antiviral treatment options for chronic viral hepatitis C (CHC), shared clinical decision-making addresses the need to engage patients in complex treatment decisions. However, little is known about the decision attributes that CHC patients consider when making treatment decisions. We identify key patient-centered decision attributes, and explore relationships among these attributes, to help inform the development of a future CHC shared decision-making aid. Semi-structured qualitative interviews with CHC patients at four Veterans Health Administration (VHA) hospitals, in three comparison groups: contemplating CHC treatment at the time of data collection (Group 1), recently declined CHC treatment (Group 2), or recently started CHC treatment (Group 3). Participant descriptions of decision attributes were analyzed for the entire sample as well as by patient group and by gender. Twenty-nine Veteran patients participated (21 males, eight females): 12 were contemplating treatment, nine had recently declined treatment, and eight had recently started treatment. Patients on average described eight (range 5-13) decision attributes. The attributes most frequently reported overall were: physical side effects (83%); treatment efficacy (79%), new treatment drugs in development (55%); psychological side effects (55%); and condition of the liver (52%), with some variation based on group and gender. Personal life circumstance attributes (such as availability of family support and the burden of financial responsibilities) influencing treatment decisions were also noted by all participants. Multiple decision attributes were interrelated in highly complex ways. Participants considered numerous attributes in their CHC treatment decisions. A better understanding of these attributes that influence patient decision-making is crucial in order to inform patient-centered clinical approaches to care (such as shared decision-making augmented with relevant decision-making aids) that respond to patients' needs, preferences, and circumstances.

  4. The Australian funding debate on quadrivalent HPV vaccine: a case study for the national pharmaceutical policy.

    PubMed

    Roughead, Elizabeth Ellen; Gilbert, Andrew L; Vitry, Agnes I

    2008-12-01

    To analyse the media and political reactions to the initial decision of the Pharmaceutical Benefits Advisory Committee (PBAC) to reject funding of the quadrivalent human papilloma virus (HPV) vaccine in Australia. A case study, informed by media reports and government documents, was utilised to examine the reactions of key stakeholders; PBAC, consumers, consumer organisations, pharmaceutical industry, politicians, health professionals and the media to the initial decision to reject funding of HPV vaccine. The initial decision to reject funding of the HPV vaccine led to unprecedented public response with over 300 newspaper articles and calls by consumers, health professionals and politicians to intervene in the decision making process. Misunderstanding of the decision making process, particularly cost-effectiveness assessments, the need for an independent process, the legislated inability of a timely and transparent response from policy makers and the lack of a risk mitigation strategy all played a role in the public outcry. Despite 15 years of implementation of cost-effectiveness assessments there is still a need for improving stakeholder understanding of the decision making process and for timely transfer of complete information. Risk mitigation strategies should be considered as part of the communication plan for all decisions.

  5. Savings sharing: rewarding staff for responsible decision-making.

    PubMed

    Jones, Debi

    2005-04-01

    Shortages of professional nurses create a "buyer's market" in which nurses accept temporary assignments for the highest rates and offer little additional time to the primary employer. Use of temporary personnel use salary dollars at an inordinate rate while offering little continuity or support for the organization's standards. Methods for placing decision-making in the hands of the nurses are needed along with a reward system for establishing a pattern of sound decision-making. The author describes a savings sharing program that is gaining credibility in one organization for addressing both objectives.

  6. Parents and end-of-life decision-making for their child: roles and responsibilities.

    PubMed

    Sullivan, Jane; Gillam, Lynn; Monagle, Paul

    2015-09-01

    Whether parents want to be and should be the decision-maker for their child in end-of-life matters are contested clinical and ethical questions. Previous research outcomes are equivocal. A qualitative interview method was used to examine the views and experiences of 25 bereaved parents in end-of-life decision-making for their child. Data were analysed thematically. Three types of decision-making roles were identified: self-determined, guided (both involving active decision-making) and acquiescent (passive).The majority of parents had been active in the decision-making process for their child. They perceived themselves as the ultimate end-of-life decision-maker. This was perceived as part of their parental responsibility. A minority of parents did not consider that they had been an active, ultimate decision-maker. Generally, parents in the self-determined and guided groups reported no negative consequences from their decision-making involvement. Importantly, parents in the acquiescent group described their experience as difficult at the time and subsequently, although not all difficulties related directly to decision-making. Parents considered that in principle parents should be the end-of-life decision-maker for their child, but understood personal characteristics and preference could prevent some parents from taking this role. This study unequivocally supports parents' desire to fulfil the end-of-life decision-making role. It provides a nuanced understanding of parents' roles and contributes evidence for the ethical position that parents should be the end-of-life decision-makers for their child, unless not in the child's best interests. On the whole, parents want this role and can manage its consequences. Indeed, not being the end-of-life decision-maker could be detrimental to parents' well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. Contingent Decision Behavior: A Review and Discussion of Issues.

    DTIC Science & Technology

    1982-02-01

    values) will draw more attention (Yates, et. al., 1978). Studies investigating decision making among partially described alternatives are limited in number...theory that attempts to describe human decison making ." More evidence of range effects is provided in Krzysztofowicz and Ouckstein (1980). A good...activities may move along that intuitive-analytic continuum over time. For that reason he argues that decision researchers need to pay more attention to the

  8. The value of forecasting key-decision variables for rain-fed farming

    NASA Astrophysics Data System (ADS)

    Winsemius, Hessel; Werner, Micha

    2013-04-01

    Rain-fed farmers are highly vulnerable to variability in rainfall. Timely knowledge of the onset of the rainy season, the expected amount of rainfall and the occurrence of dry spells can help rain-fed farmers to plan the cropping season. Seasonal probabilistic weather forecasts may provide such information to farmers, but need to provide reliable forecasts of key variables with which farmers can make decisions. In this contribution, we present a new method to evaluate the value of meteorological forecasts in predicting these key variables. The proposed method measures skill by assessing whether a forecast was useful to this decision. This is done by taking into account the required accuracy of timing of the event to make the decision useful. The method progresses the estimate of forecast skill to forecast value by taking into account the required accuracy that is needed to make the decision valuable, based on the cost/loss ratio of possible decisions. The method is applied over the Limpopo region in Southern Africa. We demonstrate the method using the example of temporary water harvesting techniques. Such techniques require time to construct and must be ready long enough before the occurrence of a dry spell to be effective. The value of the forecasts to the decision used as an example is shown to be highly sensitive to the accuracy in the timing of forecasted dry spells, and the tolerance in the decision to timing error. The skill with which dry spells can be predicted is shown to be higher in some parts of the basin, indicating that these forecasts have higher value for the decision in those parts than in others. Through assessing the skill of forecasting key decision variables to the farmers we show that it is easier to understand if the forecasts have value in reducing risk, or if other adaptation strategies should be implemented.

  9. Virtual Characters: Visual Realism Affects Response Time and Decision-Making

    ERIC Educational Resources Information Center

    Sibuma, Bernadette

    2012-01-01

    This study integrates agent research with a neurocognitive technique to study how character faces affect cognitive processing. The N170 event-related potential (ERP) was used to study face processing during simple decision-making tasks. Twenty-five adults responded to facial expressions (fear/neutral) presented in three designs…

  10. Engaging Pupils in Decision-Making about Biodiversity Conservation Issues

    ERIC Educational Resources Information Center

    Grace, Marcus; Byrne, Jenny

    2010-01-01

    Our pupils' generation will eventually have the daunting responsibility of making decisions about local and global biodiversity. School provides an early opportunity for them to enter into formal discussion about the science and values associated with biodiversity conservation; but the crowded curriculum offers little time for such activities.…

  11. Using Data-Based Inquiry and Decision Making To Improve Instruction.

    ERIC Educational Resources Information Center

    Feldman, Jay; Tung, Rosann

    2001-01-01

    Discusses a study of six schools using data-based inquiry and decision-making process to improve instruction. Findings identified two conditions to support successful implementation of the process: administrative support, especially in providing teachers learning time, and teacher leadership to encourage and support colleagues to own the process.…

  12. A Longitudinal Analysis of Adolescent Decision-Making with the Iowa Gambling Task

    ERIC Educational Resources Information Center

    Almy, Brandon; Kuskowski, Michael; Malone, Stephen M.; Myers, Evan; Luciana, Monica

    2018-01-01

    Many researchers have used the standard Iowa Gambling Task (IGT) to assess decision-making in adolescence given increased risk-taking during this developmental period. Most studies are cross-sectional and do not observe behavioral trajectories over time, limiting interpretation. This longitudinal study investigated healthy adolescents' and young…

  13. Neurally Constrained Modeling of Perceptual Decision Making

    ERIC Educational Resources Information Center

    Purcell, Braden A.; Heitz, Richard P.; Cohen, Jeremiah Y.; Schall, Jeffrey D.; Logan, Gordon D.; Palmeri, Thomas J.

    2010-01-01

    Stochastic accumulator models account for response time in perceptual decision-making tasks by assuming that perceptual evidence accumulates to a threshold. The present investigation mapped the firing rate of frontal eye field (FEF) visual neurons onto perceptual evidence and the firing rate of FEF movement neurons onto evidence accumulation to…

  14. A Three-Phase Model of Retirement Decision Making

    ERIC Educational Resources Information Center

    Feldman, Daniel C.; Beehr, Terry A.

    2011-01-01

    The present article organizes prominent theories about retirement decision making around three different types of thinking about retirement: imagining the possibility of retirement, assessing when it is time to let go of long-held jobs, and putting concrete plans for retirement into action at present. It also highlights important directions for…

  15. Cancer treatment decision-making among young adults with lung and colorectal cancer: a comparison with adults in middle age.

    PubMed

    Mack, Jennifer W; Cronin, Angel; Fasciano, Karen; Block, Susan D; Keating, Nancy L

    2016-09-01

    Our aim is to understand experiences with treatment decision-making among young adults with cancer. We studied patients with lung cancer or colorectal cancer in the Cancer Care Outcomes Research and Surveillance Consortium, a prospective cohort study. We identified 148 young adult patients aged 21-40 years who completed baseline interview questions about cancer treatment decision-making; each was propensity score matched to three middle adult patients aged 41-60 years, for a cohort of 592 patients. Patients were asked about decision-making preferences, family involvement in decision-making, and worries about treatment. An ordinal logistic regression model evaluated factors associated with more treatment worries. Young and middle-aged adults reported similar decision-making preferences (p = 0.80) and roles relative to physicians (p = 0.36). Although family involvement was similar in the age groups (p = 0.21), young adults were more likely to have dependent children in the home (60% younger versus 28% middle-aged adults, p < 0.001). Young adults reported more worries about time away from family (p = 0.002), and, in unadjusted analyses, more cancer treatment-related worries (mean number of responses of 'somewhat' or 'very' worried 2.5 for younger versus 2.2 for middle-aged adults, p = 0.02.) However, in adjusted analyses, worries were associated with the presence of dependent children in the home (odds ratio [OR] 1.55, 95% CI = 1.07-2.24, p = 0.02), rather than age. Young adults involve doctors and family members in decisions at rates similar to middle-aged adults but experience more worries about time away from family. Patients with dependent children are especially likely to experience worries. Treatment decision-making strategies should be based on individual preferences and needs rather than age alone. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Contrasting patient, family, provider, and societal goals at the end of life complicate decision making and induce variability of care after trauma.

    PubMed

    Martin, Niels Douglas; Stefanelli, Anthony; Methvin, Laura; Fischer, Charles; Counsilman, MayJean; Mazandi, Vanessa; Laganosky, Dean; Zubair, Muhammad; Beekley, Alec C; Weinstein, Michael S

    2014-08-01

    End-of-life (EoL) decision making during critical illness and injury is important in facilitating compassionate care that is congruent with patient, family, and societal expectations. Herein, we evaluate factors that may effect and induce variability in practitioner EoL decision making, particularly years in practice, use of advance directives (ADs), and cost. An anonymous, online survey was offered to all active members of the Eastern Association for the Surgery of Trauma (n = 1,359) in June 2012. Demographic information and a series of questions dealing with common potentially influential factors were included. Responses were 5-point Likert scale based. A total of 375 responses (27.6%) were received. Ninety-two percent of the respondents were physicians, 70% were male, and 77% were from Level 1 trauma centers. Of respondents, 65.8% rely on family to make EoL decisions most or all of the time, while 80.7% feel family members are rarely or only sometimes in appropriate emotional states to make such choices. A significant number of practitioners felt comfortable making decisions without family input at all, more so with experienced practitioners as compared with those in practice for less than 15 years (38.2% and 24.1% respectively, p < 0.01).Of the practitioners, 59.6% rely on ADs most or all of the time, only 61.1% agree or strongly agree that ADs are useful, and only 56.3% feel families follow their loved one's ADs most or all of the time. A patient's family support or ability to pay for aftercare was rarely or never considered important by 80.1% of the practitioners, despite 85.1% reporting that quality of life postillness/injury was important most or all of the time. Practitioner comfort and motivation to influence EoL decision making varies with experience level. ADs are not uniformly perceived to be helpful, and costs are uncommonly considered. To improve EoL quality, these factors need to be considered. Care management study, level IV.

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

    PubMed

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

    2015-08-01

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

  18. Initiating decision-making conversations in palliative care: an ethnographic discourse analysis.

    PubMed

    Bélanger, Emmanuelle; Rodríguez, Charo; Groleau, Danielle; Légaré, France; Macdonald, Mary Ellen; Marchand, Robert

    2014-01-01

    Conversations about end-of-life care remain challenging for health care providers. The tendency to delay conversations about care options represents a barrier that impedes the ability of terminally-ill patients to participate in decision-making. Family physicians with a palliative care practice are often responsible for discussing end-of-life care preferences with patients, yet there is a paucity of research directly observing these interactions. In this study, we sought to explore how patients and family physicians initiated decision-making conversations in the context of a community hospital-based palliative care service. This qualitative study combined discourse analysis with ethnographic methods. The field research lasted one year, and data were generated through participant observation and audio-recordings of consultations. A total of 101 consultations were observed longitudinally between 18 patients, 6 family physicians and 2 pivot nurses. Data analysis consisted in exploring the different types of discourses initiating decision-making conversations and how these discourses were affected by the organizational context in which they took place. The organization of care had an impact on decision-making conversations. The timing and origin of referrals to palliative care shaped whether patients were still able to participate in decision-making, and the decisions that remained to be made. The type of decisions to be made also shaped how conversations were initiated. Family physicians introduced decision-making conversations about issues needing immediate attention, such as symptom management, by directly addressing or eliciting patients' complaints. When decisions involved discussing impending death, decision-making conversations were initiated either indirectly, by prompting the patients to express their understanding of the disease and its progression, or directly, by providing a justification for broaching a difficult topic. Decision-making conversations and the initiation thereof were framed by the organization of care and the referral process prior to initial encounters. While symptom management was taken for granted as part of health care professionals' expected role, engaging in decisions regarding preparation for death implicitly remained under patients' control. This work makes important clinical contributions by exposing the rhetorical function of family physicians' discourse when introducing palliative care decisions.

  19. A recurrent network mechanism of time integration in perceptual decisions.

    PubMed

    Wong, Kong-Fatt; Wang, Xiao-Jing

    2006-01-25

    Recent physiological studies using behaving monkeys revealed that, in a two-alternative forced-choice visual motion discrimination task, reaction time was correlated with ramping of spike activity of lateral intraparietal cortical neurons. The ramping activity appears to reflect temporal accumulation, on a timescale of hundreds of milliseconds, of sensory evidence before a decision is reached. To elucidate the cellular and circuit basis of such integration times, we developed and investigated a simplified two-variable version of a biophysically realistic cortical network model of decision making. In this model, slow time integration can be achieved robustly if excitatory reverberation is primarily mediated by NMDA receptors; our model with only fast AMPA receptors at recurrent synapses produces decision times that are not comparable with experimental observations. Moreover, we found two distinct modes of network behavior, in which decision computation by winner-take-all competition is instantiated with or without attractor states for working memory. Decision process is closely linked to the local dynamics, in the "decision space" of the system, in the vicinity of an unstable saddle steady state that separates the basins of attraction for the two alternative choices. This picture provides a rigorous and quantitative explanation for the dependence of performance and response time on the degree of task difficulty, and the reason for which reaction times are longer in error trials than in correct trials as observed in the monkey experiment. Our reduced two-variable neural model offers a simple yet biophysically plausible framework for studying perceptual decision making in general.

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

    PubMed Central

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

    2015-01-01

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

  1. A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

    PubMed

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

    2016-03-01

    Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

  2. Time Management

    ERIC Educational Resources Information Center

    Stoilov, Todor, Ed.

    2012-01-01

    The time management is worthy goal of many human activities. It concerns variety problems related to goals definition, assessment of available resources, control of management policies, scheduling of decisions. This book is an attempt to illustrate the decision making process in time management for different success stories, which can be used as…

  3. Individual differences in intrinsic brain connectivity predict decision strategy.

    PubMed

    Barnes, Kelly Anne; Anderson, Kevin M; Plitt, Mark; Martin, Alex

    2014-10-15

    When humans are provided with ample time to make a decision, individual differences in strategy emerge. Using an adaptation of a well-studied decision making paradigm, motion direction discrimination, we probed the neural basis of individual differences in strategy. We tested whether strategies emerged from moment-to-moment reconfiguration of functional brain networks involved in decision making with task-evoked functional MRI (fMRI) and whether intrinsic properties of functional brain networks, measured at rest with functional connectivity MRI (fcMRI), were associated with strategy use. We found that human participants reliably selected one of two strategies across 2 days of task performance, either continuously accumulating evidence or waiting for task difficulty to decrease. Individual differences in decision strategy were predicted both by the degree of task-evoked activation of decision-related brain regions and by the strength of pretask correlated spontaneous brain activity. These results suggest that spontaneous brain activity constrains strategy selection on perceptual decisions.

  4. Is decision making in hypoxia affected by pre-acclimatisation? A randomized controlled trial.

    PubMed

    Niedermeier, Martin; Weisleitner, Andreas; Lamm, Claus; Ledochowski, Larissa; Frühauf, Anika; Wille, Maria; Burtscher, Martin; Kopp, Martin

    2017-05-01

    Decision making is impaired in hypoxic environments, which may have serious or even lethal consequences for mountaineers. An acclimatisation period prior to high altitude exposures may help to overcome adverse effects of hypoxia. Thus, we investigated possible effects of short-term pre-acclimatisation on decision making in hypoxia. In a randomized controlled study design, 52 healthy participants were allocated to a hypoxia group (HG: short-term pre-acclimatisation by the use of intermittent hypoxia 7×1h at F i O 2 =12.6%, equivalent to 4500m) or a control group (CG: sham pre-acclimatisation 7×1h at F i O 2 =20.9%, equivalent to 600m). The number of risky decisions was assessed using the Game of Dice Task at four time points during a 12-hours stay in hypoxia (F i O 2 =12.6%). 42 (HG: 27, CG: 25) participants completed the study. The number of risky decisions was significantly (p=0.048 as determined by 4×2 ANCOVA) reduced in the hypoxia group compared to the control group, partial η 2 =0.11, when the age-effect on decision making was controlled. Self-reported positive affective valence prior to decision making was negatively related to the number of risky decisions, r<-0.38. Short-term pre-acclimatisation might influence decision making in hypoxia in a positive way and might be considered as a risk-reducing preparation method prior to exposures to hypoxic environments. Positive affective states seem to have a medium-sized protective effect against risky decision making. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Physical mechanism of mind changes and tradeoffs among speed, accuracy, and energy cost in brain decision making: Landscape, flux, and path perspectives

    NASA Astrophysics Data System (ADS)

    Han, Yan; Kun, Zhang; Jin, Wang

    2016-07-01

    Cognitive behaviors are determined by underlying neural networks. Many brain functions, such as learning and memory, have been successfully described by attractor dynamics. For decision making in the brain, a quantitative description of global attractor landscapes has not yet been completely given. Here, we developed a theoretical framework to quantify the landscape associated with the steady state probability distributions and associated steady state curl flux, measuring the degree of non-equilibrium through the degree of detailed balance breaking for decision making. We quantified the decision-making processes with optimal paths from the undecided attractor states to the decided attractor states, which are identified as basins of attractions, on the landscape. Both landscape and flux determine the kinetic paths and speed. The kinetics and global stability of decision making are explored by quantifying the landscape topography through the barrier heights and the mean first passage time. Our theoretical predictions are in agreement with experimental observations: more errors occur under time pressure. We quantitatively explored two mechanisms of the speed-accuracy tradeoff with speed emphasis and further uncovered the tradeoffs among speed, accuracy, and energy cost. Our results imply that there is an optimal balance among speed, accuracy, and the energy cost in decision making. We uncovered the possible mechanisms of changes of mind and how mind changes improve performance in decision processes. Our landscape approach can help facilitate an understanding of the underlying physical mechanisms of cognitive processes and identify the key factors in the corresponding neural networks. Project supported by the National Natural Science Foundation of China (Grant Nos. 21190040, 91430217, and 11305176).

  6. Cognitive Fatigue Destabilizes Economic Decision Making Preferences and Strategies.

    PubMed

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

    2015-01-01

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

  7. On-line confidence monitoring during decision making.

    PubMed

    Dotan, Dror; Meyniel, Florent; Dehaene, Stanislas

    2018-02-01

    Humans can readily assess their degree of confidence in their decisions. Two models of confidence computation have been proposed: post hoc computation using post-decision variables and heuristics, versus online computation using continuous assessment of evidence throughout the decision-making process. Here, we arbitrate between these theories by continuously monitoring finger movements during a manual sequential decision-making task. Analysis of finger kinematics indicated that subjects kept separate online records of evidence and confidence: finger deviation continuously reflected the ongoing accumulation of evidence, whereas finger speed continuously reflected the momentary degree of confidence. Furthermore, end-of-trial finger speed predicted the post-decisional subjective confidence rating. These data indicate that confidence is computed on-line, throughout the decision process. Speed-confidence correlations were previously interpreted as a post-decision heuristics, whereby slow decisions decrease subjective confidence, but our results suggest an adaptive mechanism that involves the opposite causality: by slowing down when unconfident, participants gain time to improve their decisions. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. Decision-making around moving on from full-time education: the roles and experiences of parents of disabled young people with degenerative conditions.

    PubMed

    Maddison, Jane; Beresford, Bryony

    2012-09-01

    Little is known about the decision-making processes that take place within families when a disabled young person is moving on from full-time education and, particularly, parents' roles and experiences. This paper reports the analysis of data collected from a subsample of parents (representing seventeen families) participating in the Choice and Change Project who had discussed choices associated with their child leaving full-time education. (The Choice and Change Project is a longitudinal, qualitative study of choice-making by four different groups of service users including disabled young people with degenerative conditions and their parents.) The data were collected from parents during up to three semi-structured interviews conducted over a thirty-month period. Descriptive theories of decision-making informed the analysis. Parents differed in the extent to which they were actively involved in making choices about the 'destination' of their child after leaving full-time education. To some extent, the ability of the young person to make choices themselves influenced this. Parents who were assuming responsibility for making choices stressed the importance of having relevant information and felt professionals had a key role to play in supporting access to information. Parents used a number of criteria to guide their choice-making, including distance from home, perceived quality of the environment and staff and the young person's responses to the setting. Much of the information needed to make a choice required a visit to all the possible options. Ensuring such visits were positive and useful experiences for themselves and their child could be very difficult; support to achieve these visits was highly valued but not routinely provided. The study also highlights the lack of recognition given to the significant amount of work that many parents undertake to ensure that a choice is realised, and also to the emotional journey parents take when making or assisting in such decisions. © 2012 Blackwell Publishing Ltd.

  9. Are Retrenchment Decisions Rational? The Role of Information in Times of Budgetary Stress.

    ERIC Educational Resources Information Center

    Ashar, Hanna; Shapiro, Jonathan Z.

    1990-01-01

    Analysis of the relationship between performance data and changes in faculty size of 40 departments in a College of Arts and Sciences during a time of financial stress found that the rational choice model was applied to decision making. There was a systematic relationship between objective, evaluative data and policy decisions. (MLW)

  10. Logical-Rule Models of Classification Response Times: A Synthesis of Mental-Architecture, Random-Walk, and Decision-Bound Approaches

    ERIC Educational Resources Information Center

    Fific, Mario; Little, Daniel R.; Nosofsky, Robert M.

    2010-01-01

    We formalize and provide tests of a set of logical-rule models for predicting perceptual classification response times (RTs) and choice probabilities. The models are developed by synthesizing mental-architecture, random-walk, and decision-bound approaches. According to the models, people make independent decisions about the locations of stimuli…

  11. Skill-related differences between athletes and nonathletes in speed discrimination.

    PubMed

    Thomson, Kaivo; Watt, Anthony; Liukkonen, Jarmo

    2008-12-01

    This study examined differences in decision-making time and accurscy as attributes of speed discrimination between participants skilled and less skilled in ball games. A total of 130 men, ages 18 to 28 years (M=21.2, SD=2.6), participated. The athlete sample (skilled group) comprised Estonian National League volleyball (n=26) and basketball players (n=27). The nonathlete sample (less skilled group) included 77 soldiers of the Estonian Defence Force with no reported top level experience in ball games. Speed-discrimination stimuli were images of red square shapes presented moving along the sagittal axis at four different virtual velocities on a computer (PC) screen which represented the frontal plane. Analysis indicated that only decision-making time was significantly different between the elite athlete and nonathlete groups. This finding suggests a possible effect of ball-game skills for decision-making time in speed discrimination.

  12. Heuristic decision making in medicine

    PubMed Central

    Marewski, Julian N.; Gigerenzer, Gerd

    2012-01-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care. PMID:22577307

  13. What Goes Into a Decision? How Nursing Faculty Decide Which Best Practices to Use for Classroom Testing.

    PubMed

    Killingsworth, Erin; Kimble, Laura P; Sudia, Tanya

    2015-01-01

    To explore the decision-making process of BSN faculty when determining which best practices to use for classroom testing. A descriptive, correlational study was conducted with a national sample (N = 127) of full-time BSN faculty. Participants completed a web-based survey incorporating instruments that measured beliefs about evaluation, decision-making, and best practices for item analysis and constructing and revising classroom tests. Study participants represented 31 states and were primarily middle-aged white women. In multiple linear regression analyses, faculty beliefs, contextual factors for decision-making, and decision-making processes accounted for statistically significant amounts of the variance in item analysis and test construction and revision. Strong faculty beliefs that rules were important when evaluating students was a significant predictor of increased use of best practices. Results support that understanding faculty beliefs around classroom testing is important in promoting the use of best practices.

  14. Heuristic decision making in medicine.

    PubMed

    Marewski, Julian N; Gigerenzer, Gerd

    2012-03-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.

  15. How the win-lose balance situation affects subsequent decision-making: functional magnetic resonance imaging evidence from a gambling task.

    PubMed

    Dong, G; Lin, X; Zhou, H; Lu, Q

    2014-07-11

    Humans have been consistently shown to be bad at making decisions, especially in disadvantageous situations. In this study, we designed a task that simulates real-life non-strategic gambling to examine the effect of win-lose balance situations (WIN, LOSS, TIE) on decision-making. In behavioral performances, participants showed shorter response time (RT) in LOSS than in WIN and TIE conditions. Imaging results revealed that decisions in WIN are associated with increased brain activations in the posterior cingulate cortex; decisions in LOSS are associated with increased brain activations in the insula and decreased activations in the inferior frontal gyrus (IFG). Positive correlation was found between brain activation in IFG and RT in LOSS. Overall, we concluded that, in disadvantageous conditions, participants are frustrated by their negative results and tend to make a random selection without full consideration. In advantageous conditions, participants' motivations to gamble are elicited and they tend to engage in more endeavors in making decisions. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  16. Convergence to consensus in heterogeneous groups and the emergence of informal leadership.

    PubMed

    Gavrilets, Sergey; Auerbach, Jeremy; van Vugt, Mark

    2016-07-14

    When group cohesion is essential, groups must have efficient strategies in place for consensus decision-making. Recent theoretical work suggests that shared decision-making is often the most efficient way for dealing with both information uncertainty and individual variation in preferences. However, some animal and most human groups make collective decisions through particular individuals, leaders, that have a disproportionate influence on group decision-making. To address this discrepancy between theory and data, we study a simple, but general, model that explicitly focuses on the dynamics of consensus building in groups composed by individuals who are heterogeneous in preferences, certain personality traits (agreeability and persuasiveness), reputation, and social networks. We show that within-group heterogeneity can significantly delay democratic consensus building as well as give rise to the emergence of informal leaders, i.e. individuals with a disproportionately large impact on group decisions. Our results thus imply strong benefits of leadership particularly when groups experience time pressure and significant conflict of interest between members (due to various between-individual differences). Overall, our models shed light on why leadership and decision-making hierarchies are widespread, especially in human groups.

  17. "It was an Emotional Baby": Previvors' Family Planning Decision-Making Styles about Hereditary Breast and Ovarian Cancer Risk.

    PubMed

    Dean, Marleah; Rauscher, Emily A

    2017-12-01

    Women who test positive for a BRCA genetic mutation are at an increased risk for developing hereditary breast and ovarian cancer and have a 50% chance of passing on their genetic mutation to their children. The purpose of this study was to investigate how women who test positive for a BRCA mutation but have not been diagnosed with cancer make decisions regarding family planning. Analysis of interviews with 20 women revealed they engage in logical and emotional decision-making styles. Although women want to be logical to reduce their hereditary cancer risk, emotions often complicate their decision-making. Women experience fear and worry about a future cancer diagnosis, yet also desire to create a family, particularly having children through natural conception. That is, women negotiate having preventative surgeries in a logical doctor-recommended timeframe but also organize those decisions around emotional desires of motherhood. Overall, this study demonstrates the complex decisions women who test positive for a BRCA mutation must make in regards to genetic testing timing, family planning, and overall quality of life.

  18. Internet use and decision making in community-based older adults

    PubMed Central

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

    2013-01-01

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

  19. Enhanced decision making through neuroscience

    NASA Astrophysics Data System (ADS)

    Szu, Harold; Jung, TP; Makeig, Scott

    2012-06-01

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

  20. Striatal activation reflects urgency in perceptual decision making.

    PubMed

    van Maanen, Leendert; Fontanesi, Laura; Hawkins, Guy E; Forstmann, Birte U

    2016-10-01

    Deciding between multiple courses of action often entails an increasing need to do something as time passes - a sense of urgency. This notion of urgency is not incorporated in standard theories of speeded decision making that assume information is accumulated until a critical fixed threshold is reached. Yet, it is hypothesized in novel theoretical models of decision making. In two experiments, we investigated the behavioral and neural evidence for an "urgency signal" in human perceptual decision making. Experiment 1 found that as the duration of the decision making process increased, participants made a choice based on less evidence for the selected option. Experiment 2 replicated this finding, and additionally found that variability in this effect across participants covaried with activation in the striatum. We conclude that individual differences in susceptibility to urgency are reflected by striatal activation. By dynamically updating a response threshold, the striatum is involved in signaling urgency in humans. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Current decision-making in prostate cancer therapy.

    PubMed

    Cox, Jared; Amling, Christopher L

    2008-05-01

    Prostate cancer continues to be the most prevalent cancer among American men. Localized prostate cancer is commonly diagnosed because of improved screening practices nationwide. Several options exist for the treatment of localized prostate cancer, and this review discusses the decision-making process facing patients diagnosed with this disease. No one treatment for localized prostate cancer has proven superior to date. For this reason patients have been found to use a number of resources to make an informed decision. These include physicians, spouses, family, friends, and different media. Urologists serve as the primary and most influential physicians and play an important role in the decision-making process. Patients, however, are assuming a more active role in this process as time evolves, especially with ease of access to multiple information resources. In deciding on a treatment for localized prostate cancer, patients must weigh the risks and benefits of each option. Urologists must provide patients with up-to-date information on these options and be aware of the different influences that surround these men during the decision-making process.

  2. Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

    PubMed

    Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

    2011-01-12

    Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources.

  3. Assessing the Acceptability and Usability of an Interactive Serious Game in Aiding Treatment Decisions for Patients with Localized Prostate Cancer

    PubMed Central

    2011-01-01

    Background Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men’s awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. Objective This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. Methods The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. Results A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient’s health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Conclusions Serious games are a promising approach to health education and decision support for older men. Participants were receptive to the idea of a serious game as a decision aid in localized prostate cancer. However, usability issues are a major concern for this demographic, as is clarity and transparency of data sources. PMID:21239374

  4. The Teaching Decisions Simulation: An Interactive Vehicle for Mapping Teaching Decisions.

    ERIC Educational Resources Information Center

    Strang, Harold R.

    1996-01-01

    Describes the Teaching Decisions Simulation, a program that allows participants to make decisions regarding lesson plan activities and student and teacher spatial arrangement or interactions. Postlesson feedback includes variables such as completion time and performance measures. Experienced teachers exhibited more deliberation in completing the…

  5. Collaborative Platforms Aid Emergency Decision Making

    NASA Technical Reports Server (NTRS)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  6. Housing decision making methods for initiation development phase process

    NASA Astrophysics Data System (ADS)

    Zainal, Rozlin; Kasim, Narimah; Sarpin, Norliana; Wee, Seow Ta; Shamsudin, Zarina

    2017-10-01

    Late delivery and sick housing project problems were attributed to poor decision making. These problems are the string of housing developer that prefers to create their own approach based on their experiences and expertise with the simplest approach by just applying the obtainable standards and rules in decision making. This paper seeks to identify the decision making methods for housing development at the initiation phase in Malaysia. The research involved Delphi method by using questionnaire survey which involved 50 numbers of developers as samples for the primary stage of collect data. However, only 34 developers contributed to the second stage of the information gathering process. At the last stage, only 12 developers were left for the final data collection process. Finding affirms that Malaysian developers prefer to make their investment decisions based on simple interpolation of historical data and using simple statistical or mathematical techniques in producing the required reports. It was suggested that they seemed to skip several important decision-making functions at the primary development stage. These shortcomings were mainly due to time and financial constraints and the lack of statistical or mathematical expertise among the professional and management groups in the developer organisations.

  7. Psychopharmacology decision-making among pregnant and postpartum women and health providers: informing compassionate and collaborative care women's health.

    PubMed

    Price, Sarah Kye; Bentley, Kia J

    2013-01-01

    Psychopharmaceutical use by pregnant and postpartum women is complicated by the complexity of prescribing as well as the sociocultural context in which medication-related decisions are made. This study sought to advance understanding of decision-making processes and communication experiences regarding use of psychopharmaceuticals during pregnancy by considering both provider and consumer perspectives. An electronic survey was conducted with health care providers (N = 88) and women consumers (N = 83) from July 2010 through October 2011 regarding the perceived costs and benefits of taking mental health medication during and around the time of pregnancy. Descriptive analysis compared and contrasted experiences between the two groups regarding consumer-provider communication, critical incidents and triggers in decision-making, and response to case scenarios crafted around hypothetical client experiences. Both similarities and differences were evident among health care provider and women consumer responses regarding costs, benefits, communication experiences, and case scenario responses. Both quantitative and qualitative survey results indicated the need for more accurate, unbiased, and complete information exchange around mental health and medication. Study results suggested the centrality of the client-provider milieu to guide decision-making and emphasized the expressed need within both groups to create a shared decision-making practice environment characterized by authenticity, non-judgmental decision-making, compassion, humaneness, and reciprocity.

  8. Effect of Implicit Perceptual-Motor Training on Decision-Making Skills and Underpinning Gaze Behavior in Combat Athletes.

    PubMed

    Milazzo, Nicolas; Farrow, Damian; Fournier, Jean F

    2016-08-01

    This study investigated the effect of a 12-session, implicit perceptual-motor training program on decision-making skills and visual search behavior of highly skilled junior female karate fighters (M age = 15.7 years, SD = 1.2). Eighteen participants were required to make (physical or verbal) reaction decisions to various attacks within different fighting scenarios. Fighters' performance and eye movements were assessed before and after the intervention, and during acquisition through the use of video-based and on-mat decision-making tests. The video-based test revealed that following training, only the implicit perceptual-motor group (n = 6) improved their decision-making accuracy significantly compared to a matched motor training (placebo, n = 6) group and a control group (n = 6). Further, the implicit training group significantly changed their visual search behavior by focusing on fewer locations for longer durations. In addition, the session-by-session analysis showed no significant improvement in decision accuracy between training session 1 and all the other sessions, except the last one. Coaches should devote more practice time to implicit learning approaches during perceptual-motor training program to achieve significant decision-making improvements and more efficient visual search strategy with elite athletes. © The Author(s) 2016.

  9. How modifiable factors influence parental decision-making about organ donation.

    PubMed

    Luberda, Kamila; Cleaver, Karen

    2017-11-07

    A global shortage of organs from children and adults available for transplantation is compounded by the failure of next of kin to consent for organs to be donated after death. Non-modifiable and modifiable factors influence decision-making in this area. Modifiable factors are of interest when examining families' decision-making about the donation of organs from their deceased child. A scoping review was undertaken to determine how modifiable factors influence parental decision-making about organ donation. Thematic analysis identified two themes: interactions with healthcare professionals and pre-disposition to organ donation. Satisfaction with experiences of hospital care, the information provided and the way it was communicated, as well as interactions pertaining to emotional support were all found to be modifiable factors that influenced decision making. Likewise, a predisposition to organ donation and knowing the deceased's wishes were associated with the consent decision. Nurses working in critical care environments need to be able to support parents during this difficult time. This article aims to raise awareness of modifiable factors that influence parental decision-making, highlighting their relevance for children's nursing practice. ©2017 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  10. Patient involvement in health care decision making: a review.

    PubMed

    Vahdat, Shaghayegh; Hamzehgardeshi, Leila; Hessam, Somayeh; Hamzehgardeshi, Zeinab

    2014-01-01

    Patient participation means involvement of the patient in decision making or expressing opinions about different treatment methods, which includes sharing information, feelings and signs and accepting health team instructions. Given the importance of patient participation in healthcare decision making which empowers patients and improves services and health outcomes, this study was performed to review previous studies on patient participation in healthcare decision making. To prepare this narrative review article, researchers used general and specific search engines, as well as textbooks addressing this subject for an in-depth study of patient involvement in healthcare decision-making. As a result, 35 (out of 100 relevant) articles and also two books were selected for writing this review article. BASED ON THE REVIEW OF ARTICLES AND BOOKS, TOPICS WERE DIVIDED INTO SIX GENERAL CATEGORIES: definition of participation, importance of patient participation, factors influencing participation of patients in healthcare decisions, method of patient participation, tools for evaluating participation, and benefits and consequences of patient participation in health care decision-making. IN MOST STUDIES, FACTORS INFLUENCING PATIENT PARTICIPATION CONSISTED OF: factors associated with health care professionals such as doctor-patient relationship, recognition of patient's knowledge, allocation of sufficient time for participation, and also factors related to patients such as having knowledge, physical and cognitive ability, and emotional connections, beliefs, values and their experiences in relation to health services.

  11. Behavioural and physiological expression of arousal during decision-making in laying hens☆

    PubMed Central

    Davies, A.C.; Radford, A.N.; Nicol, C.J.

    2014-01-01

    Human studies suggest that prior emotional responses are stored within the brain as associations called somatic markers and are recalled to inform rapid decision-making. Consequently, behavioural and physiological indicators of arousal are detectable in humans when making decisions, and influence decision outcomes. Here we provide the first evidence of anticipatory arousal around the time of decision-making in non-human animals. Chickens were subjected to five experimental conditions, which varied in the number (one versus two), type (mealworms or empty bowl) and choice (same or different) of T-maze goals. As indicators of arousal, heart-rate and head movements were measured when goals were visible but not accessible; latency to reach the goal indicated motivation. We found a greater increase in heart-rate from baseline to the goal-viewing period, more head movements and shorter latencies in all conditions including mealworms compared to those with empty bowls. More head movements when two mealworm bowls were available compared to just one, and prior to occasions when hens accessed an empty bowl rather than declining to move, showed that arousal preceded and influenced decision-making. Our results provide an important foundation for investigating arousal during animal decision-making and suggest that the somatic-marker hypothesis might not only apply to humans. PMID:24432355

  12. Constructing food choice decisions.

    PubMed

    Sobal, Jeffery; Bisogni, Carole A

    2009-12-01

    Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

  13. Evaluating a mobile application for improving clinical laboratory test ordering and diagnosis.

    PubMed

    Meyer, Ashley N D; Thompson, Pamela J; Khanna, Arushi; Desai, Samir; Mathews, Benji K; Yousef, Elham; Kusnoor, Anita V; Singh, Hardeep

    2018-04-20

    Mobile applications for improving diagnostic decision making often lack clinical evaluation. We evaluated if a mobile application improves generalist physicians' appropriate laboratory test ordering and diagnosis decisions and assessed if physicians perceive it as useful for learning. In an experimental, vignette study, physicians diagnosed 8 patient vignettes with normal prothrombin times (PT) and abnormal partial thromboplastin times (PTT). Physicians made test ordering and diagnosis decisions for 4 vignettes using each resource: a mobile app, PTT Advisor, developed by the Centers for Disease Control and Prevention (CDC)'s Clinical Laboratory Integration into Healthcare Collaborative (CLIHC); and usual clinical decision support. Then, physicians answered questions regarding their perceptions of the app's usefulness for diagnostic decision making and learning using a modified Kirkpatrick Training Evaluation Framework. Data from 368 vignettes solved by 46 physicians at 7 US health care institutions show advantages for using PTT Advisor over usual clinical decision support on test ordering and diagnostic decision accuracy (82.6 vs 70.2% correct; P < .001), confidence in decisions (7.5 vs 6.3 out of 10; P < .001), and vignette completion time (3:02 vs 3:53 min.; P = .06). Physicians reported positive perceptions of the app's potential for improved clinical decision making, and recommended it be used to address broader diagnostic challenges. A mobile app, PTT Advisor, may contribute to better test ordering and diagnosis, serve as a learning tool for diagnostic evaluation of certain clinical disorders, and improve patient outcomes. Similar methods could be useful for evaluating apps aimed at improving testing and diagnosis for other conditions.

  14. The participation of parents of disabled children and young people in health and social care decisions.

    PubMed

    McNeilly, P; Macdonald, G; Kelly, B

    2017-11-01

    There is widespread acceptance that parents should be fully involved in decisions about their son or daughter's health and social care. This is reflected in partnership models of practice as well as local and national policy across the United Kingdom. Previous research indicates that parents' experiences of decision making with professionals are mixed. The research reported here aimed to explore parents' experiences of participating in decisions made with professionals about their disabled son or daughter's care. This research used mixed methods including survey methodology and qualitative in depth interviews. The research was conducted in one Trust in Northern Ireland. Participants were 77 parents of children and young people with a range of impairments aged between 3 and 28 years. Three themes emerged from the data: taking the lead, not knowing, and getting the balance right. Parents wanted to be involved in all aspects of decision making. Although parents reported many examples of good practice, there were also times when they did not feel listened to or did not have enough information to inform decisions. Parents in this research recounted positive as well as negative experiences. Parents took on a protective role when decisions were made about their son or daughter and at times, reported the need to "fight" for their child. The provision of information remains problematic for these families, and at times, this created a barrier to parents' participation in decision making. Partnership approaches to care that recognize parents' expertise are particularly important to parents when decisions are made with professionals. © 2017 John Wiley & Sons Ltd.

  15. Liminality and decision making for upper limb surgery in tetraplegia: a grounded theory.

    PubMed

    Dunn, Jennifer A; Hay-Smith, E Jean C; Whitehead, Lisa C; Keeling, Sally

    2013-07-01

    To explore, from the perspective of the person with tetraplegia, the issues that influenced decision making about upper limb surgery and develop a conceptual framework describing the decision making process. Purposive and theoretical sampling of 22 people with tetraplegia, followed by interviews. Ten people had upper limb surgery and 12 had not. Verbatim transcripts were analyzed with constructivist grounded theory. Participants responded to the offer of surgery in one of three ways: yes, let me have it; no thanks; or possibly. Many influences on the decision about surgery had a temporal element, such as hope for the cure or recovery from SCI, inadequate physical or social supports while rehabilitating, life roles and goals, and the avoidance of re-hospitalization. The conceptual framework illustrated that many participants entered a liminal state within which they required a stimulus to review their decision about upper limb surgery. Decision making is a temporal process, and for some the process was a prolonged and liminal one. Therefore, multiple offers for surgery are required to allow for changing thoughts and circumstances throughout an individual's lifetime. Flexibility with regard to timing for surgery and type of rehabilitation may increase the uptake, especially for women. • Multiple offers for upper limb surgery are required throughout an individual's lifetime to account for changing thoughts and priorities. • Identification of the type of support required (informational, emotional) may assist in decreasing the time taken to make the decision about surgery. • Flexibility in surgical and rehabilitation options, especially for women, may increase the uptake of surgery.

  16. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making

    PubMed Central

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-01-01

    Background In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Methods Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Results Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Conclusion Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health. PMID:19094194

  17. Planning ahead in public health? A qualitative study of the time horizons used in public health decision-making.

    PubMed

    Taylor-Robinson, David C; Milton, Beth; Lloyd-Williams, Ffion; O'Flaherty, Martin; Capewell, Simon

    2008-12-18

    In order to better understand factors that influence decisions for public health, we undertook a qualitative study to explore issues relating to the time horizons used in decision-making. Qualitative study using semi-structured interviews. 33 individuals involved in the decision making process around coronary heart disease were purposively sampled from the UK National Health Service (national, regional and local levels), academia and voluntary organizations. Analysis was based on the framework method using N-VIVO software. Interviews were transcribed, coded and emergent themes identified. Many participants suggested that the timescales for public health decision-making are too short. Commissioners and some practitioners working at the national level particularly felt constrained in terms of planning for the long-term. Furthermore respondents felt that longer term planning was needed to address the wider determinants of health and to achieve societal level changes. Three prominent 'systems' issues were identified as important drivers of short term thinking: the need to demonstrate impact within the 4 year political cycle; the requirement to 'balance the books' within the annual commissioning cycle and the disruption caused by frequent re-organisations within the health service. In addition respondents suggested that the tools and evidence base for longer term planning were not well established. Many public health decision and policy makers feel that the timescales for decision-making are too short. Substantial systemic barriers to longer-term planning exist. Policy makers need to look beyond short-term targets and budget cycles to secure investment for long-term improvement in public health.

  18. 'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services.

    PubMed

    Robinson, Suzanne; Glasby, Jon; Allen, Kerry

    2013-11-01

    Public sector organisations are facing one of the most difficult financial periods in history and local decision-makers are tasked with making tough rationing decisions. Withdrawing or limiting services is an emotive and complex task and something the National Health Service has always found difficult. Over time, local authorities have gained significant experience in the closure of care homes - an equally complex and controversial issue. Drawing on local knowledge and best practice examples, this article highlights lessons and themes identified by those decommissioning care home services. We believe that such lessons are relevant to those making disinvestment decisions across public sector services, including health-care. The study employed semi-structured interviews with 12 Directors of Adult Social Services who had been highlighted nationally as having extensive experience of home closures. Interviews were conducted over a 2-week period in March 2011. Results from the study found that having local policy guidance that is perceived as fair and reasonable was advocated by those involved in home closures. Many local policies had evolved over time and had often been developed following experiences of home closures (both good and bad). Decisions to close care home services require a combination of strong leadership, clear strategic goals, a fair decision-making process, strong evidence of the need for change and good communication, alongside wider stakeholder engagement and support. The current financial challenge means that public sector organisations need to make tough choices on investment and disinvestment decisions. Any such decisions need to be influenced by what we know constitutes best practice. Sharing lessons and experiences within and between sectors could well inform and develop decision-making practices. © 2013 John Wiley & Sons Ltd.

  19. An Artificial Neural Network-Based Decision-Support System for Integrated Network Security

    DTIC Science & Technology

    2014-09-01

    group that they need to know in order to make team-based decisions in real-time environments, (c) Employ secure cloud computing services to host mobile...THESIS Presented to the Faculty Department of Electrical and Computer Engineering Graduate School of Engineering and Management Air Force...out-of-the-loop syndrome and create complexity creep. As a result, full automation efforts can lead to inappropriate decision-making despite a

  20. Preferences for Shared Decision Making in Older Adult Patients With Orthopedic Hand Conditions.

    PubMed

    Dardas, Agnes Z; Stockburger, Christopher; Boone, Sean; An, Tonya; Calfee, Ryan P

    2016-10-01

    The practice of medicine is shifting from a paternalistic doctor-patient relationship to a model in which the doctor and patient collaborate to decide optimal treatment. This study aims to determine whether the older orthopedic population desires a shared decision-making approach to care and to identify patient predictors for the preferred type of approach. This cross-sectional investigation enrolled 99 patients, minimum age 65 years, at a tertiary hand specialty practice between March and June 2015. All patients completed the Control Preferences Scale, a validated system that distinguishes among patient preferences for patient-directed, collaborative, or physician-directed decision making. Bivariate and logistic regression analyses assessed associations among demographic data; clinic encounter variables such as familiarity with provider, trauma, diagnosis, and treatment decision; and the primary outcome of Control Preferences Scale preferences. A total of 81% of patients analyzed preferred a more patient-directed role in decision making; 46% of the total cohort cited a collaborative approach as their most preferred treatment approach. Sixty-seven percent cited the most physician-directed approach as their least preferred model of decision making. In addition, 49% reported that spending more time with their physician to address questions and explain the diagnosis would be most useful when making a health care decision and 73% preferred additional written informational material. Familiarity with the provider was associated with being more likely to prefer a collaborative approach. Older adult patients with symptomatic upper-extremity conditions desire more patient-directed roles in treatment decision making. Given the limited amount of reliable information obtained independently outside the office visit, our data suggest that written decision aids offer an approach to shared decision making that is most consistent with the preferences of the older orthopedic patient. This study quantifies older adults' desire to participate in decision making when choosing among treatments for hand conditions. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Response time distributions in rapid chess: a large-scale decision making experiment.

    PubMed

    Sigman, Mariano; Etchemendy, Pablo; Slezak, Diego Fernández; Cecchi, Guillermo A

    2010-01-01

    Rapid chess provides an unparalleled laboratory to understand decision making in a natural environment. In a chess game, players choose consecutively around 40 moves in a finite time budget. The goodness of each choice can be determined quantitatively since current chess algorithms estimate precisely the value of a position. Web-based chess produces vast amounts of data, millions of decisions per day, incommensurable with traditional psychological experiments. We generated a database of response times (RTs) and position value in rapid chess games. We measured robust emergent statistical observables: (1) RT distributions are long-tailed and show qualitatively distinct forms at different stages of the game, (2) RT of successive moves are highly correlated both for intra- and inter-player moves. These findings have theoretical implications since they deny two basic assumptions of sequential decision making algorithms: RTs are not stationary and can not be generated by a state-function. Our results also have practical implications. First, we characterized the capacity of blunders and score fluctuations to predict a player strength, which is yet an open problem in chess softwares. Second, we show that the winning likelihood can be reliably estimated from a weighted combination of remaining times and position evaluation.

  2. Forecasted economic change and the self-fulfilling prophecy in economic decision-making

    PubMed Central

    2017-01-01

    This study addresses the self-fulfilling prophecy effect, in the domain of economic decision-making. We present experimental data in support of the hypothesis that speculative forecasts of economic change can impact individuals’ economic decision behavior, prior to any realized changes. In a within-subjects experiment, participants (N = 40) played 180 trials in a Balloon Analogue Risk Talk (BART) in which they could make actual profit. Simple messages about possible (positive and negative) changes in outcome probabilities of future trials had significant effects on measures of risk taking (number of inflations) and actual profits in the game. These effects were enduring, even though no systematic changes in actual outcome probabilities took place following any of the messages. Risk taking also found to be reflected in reaction times revealing increasing reaction times with riskier decisions. Positive and negative economic forecasts affected reaction times slopes differently, with negative forecasts resulting in increased reaction time slopes as a function of risk. These findings suggest that forecasted positive or negative economic change can bias people’s mental model of the economy and reduce or stimulate risk taking. Possible implications for media-fulfilling prophecies in the domain of the economy are considered. PMID:28334031

  3. Response Time Distributions in Rapid Chess: A Large-Scale Decision Making Experiment

    PubMed Central

    Sigman, Mariano; Etchemendy, Pablo; Slezak, Diego Fernández; Cecchi, Guillermo A.

    2010-01-01

    Rapid chess provides an unparalleled laboratory to understand decision making in a natural environment. In a chess game, players choose consecutively around 40 moves in a finite time budget. The goodness of each choice can be determined quantitatively since current chess algorithms estimate precisely the value of a position. Web-based chess produces vast amounts of data, millions of decisions per day, incommensurable with traditional psychological experiments. We generated a database of response times (RTs) and position value in rapid chess games. We measured robust emergent statistical observables: (1) RT distributions are long-tailed and show qualitatively distinct forms at different stages of the game, (2) RT of successive moves are highly correlated both for intra- and inter-player moves. These findings have theoretical implications since they deny two basic assumptions of sequential decision making algorithms: RTs are not stationary and can not be generated by a state-function. Our results also have practical implications. First, we characterized the capacity of blunders and score fluctuations to predict a player strength, which is yet an open problem in chess softwares. Second, we show that the winning likelihood can be reliably estimated from a weighted combination of remaining times and position evaluation. PMID:21031032

  4. Many faces of rationality: Implications of the great rationality debate for clinical decision-making.

    PubMed

    Djulbegovic, Benjamin; Elqayam, Shira

    2017-10-01

    Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models. Rationality is typically classified under umbrella of normative (addressing the question how people "should" or "ought to" make their decisions) and descriptive theories of decision-making (which portray how people actually make their decisions). Normative theories of rational thought of relevance to medicine include epistemic theories that direct practice of evidence-based medicine and expected utility theory, which provides the basis for widely used clinical decision analyses. Descriptive theories of rationality of direct relevance to medical decision-making include bounded rationality, argumentative theory of reasoning, adaptive rationality, dual processing model of rationality, regret-based rationality, pragmatic/substantive rationality, and meta-rationality. For the first time, we provide a review of wide range of theories and models of rationality. We showed that what is "rational" behaviour under one rationality theory may be irrational under the other theory. We also showed that context is of paramount importance to rationality and that no one model of rationality can possibly fit all contexts. We suggest that in context-poor situations, such as policy decision-making, normative theories based on expected utility informed by best research evidence may provide the optimal approach to medical decision-making, whereas in the context-rich circumstances other types of rationality, informed by human cognitive architecture and driven by intuition and emotions such as the aim to minimize regret, may provide better solution to the problem at hand. The choice of theory under which we operate is important as it determines both policy and our individual decision-making. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

  5. An integrated theory of attention and decision making in visual signal detection.

    PubMed

    Smith, Philip L; Ratcliff, Roger

    2009-04-01

    The simplest attentional task, detecting a cued stimulus in an otherwise empty visual field, produces complex patterns of performance. Attentional cues interact with backward masks and with spatial uncertainty, and there is a dissociation in the effects of these variables on accuracy and on response time. A computational theory of performance in this task is described. The theory links visual encoding, masking, spatial attention, visual short-term memory (VSTM), and perceptual decision making in an integrated dynamic framework. The theory assumes that decisions are made by a diffusion process driven by a neurally plausible, shunting VSTM. The VSTM trace encodes the transient outputs of early visual filters in a durable form that is preserved for the time needed to make a decision. Attention increases the efficiency of VSTM encoding, either by increasing the rate of trace formation or by reducing the delay before trace formation begins. The theory provides a detailed, quantitative account of attentional effects in spatial cuing tasks at the level of response accuracy and the response time distributions. (c) 2009 APA, all rights reserved

  6. The use of control charts by laypeople and hospital decision-makers for guiding decision making.

    PubMed

    Schmidtke, K A; Watson, D G; Vlaev, I

    2017-07-01

    Graphs presenting healthcare data are increasingly available to support laypeople and hospital staff's decision making. When making these decisions, hospital staff should consider the role of chance-that is, random variation. Given random variation, decision-makers must distinguish signals (sometimes called special-cause data) from noise (common-cause data). Unfortunately, many graphs do not facilitate the statistical reasoning necessary to make such distinctions. Control charts are a less commonly used type of graph that support statistical thinking by including reference lines that separate data more likely to be signals from those more likely to be noise. The current work demonstrates for whom (laypeople and hospital staff) and when (treatment and investigative decisions) control charts strengthen data-driven decision making. We present two experiments that compare people's use of control and non-control charts to make decisions between hospitals (funnel charts vs. league tables) and to monitor changes across time (run charts with control lines vs. run charts without control lines). As expected, participants more accurately identified the outlying data using a control chart than using a non-control chart, but their ability to then apply that information to more complicated questions (e.g., where should I go for treatment?, and should I investigate?) was limited. The discussion highlights some common concerns about using control charts in hospital settings.

  7. Risk-Sensitive Decision-Making Deficit in Adolescent Suicide Attempters

    PubMed Central

    Ackerman, John P; McBee-Strayer, Sandy M; Mendoza, Kristen; Stevens, Jack; Sheftall, Arielle H; Campo, John V

    2015-01-01

    Abstract Objective: Suicide among adolescents is a major public health problem. Decision-making deficits may play an important role in vulnerability to suicidal behavior, but few studies have examined decision-making performance in youth at risk for suicide. In this study, we seek to extend recent findings that adolescent suicide attempters process risk evaluations differently than adolescents who have not attempted suicide. Methods: We assessed decision-making in 14 adolescent suicide attempters and 14 non-attempter comparison subjects, ages 15–19, using the Cambridge Gambling Task (CGT). Each participant was also administered a diagnostic interview (Mini-International Neuropsychiatric Interview [MINI]), structured suicide severity measures, and a brief intelligence quotient (IQ) measure. Results: After controlling for gender and IQ differences, suicide attempters displayed an elevated risk-taking propensity on the CGT relative to comparison subjects, such that they were more willing to take a large risk with their bank of points, a decision-making style that proves disadvantageous over time. No group differences in the latency or accuracy of decision-making were observed. Conclusions: Adolescents with a history of suicide attempt display increased risk-taking and greater difficulty predicting probable outcomes on the CGT. Such deficits have been associated with dysfunction in the orbitofrontal prefrontal cortex, which supports other studies implicating impaired decision-making among individuals with a history of suicide attempt. PMID:25265242

  8. The use of logistic regression to enhance risk assessment and decision making by mental health administrators.

    PubMed

    Menditto, Anthony A; Linhorst, Donald M; Coleman, James C; Beck, Niels C

    2006-04-01

    Development of policies and procedures to contend with the risks presented by elopement, aggression, and suicidal behaviors are long-standing challenges for mental health administrators. Guidance in making such judgments can be obtained through the use of a multivariate statistical technique known as logistic regression. This procedure can be used to develop a predictive equation that is mathematically formulated to use the best combination of predictors, rather than considering just one factor at a time. This paper presents an overview of logistic regression and its utility in mental health administrative decision making. A case example of its application is presented using data on elopements from Missouri's long-term state psychiatric hospitals. Ultimately, the use of statistical prediction analyses tempered with differential qualitative weighting of classification errors can augment decision-making processes in a manner that provides guidance and flexibility while wrestling with the complex problem of risk assessment and decision making.

  9. Toward Optimal Decision Making among Vulnerable Patients Referred for Cardiac Surgery: A Qualitative Analysis of Patient and Provider Perspectives.

    PubMed

    Gainer, Ryan A; Curran, Janet; Buth, Karen J; David, Jennie G; Légaré, Jean-Francois; Hirsch, Gregory M

    2017-07-01

    Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population. Focus groups were held with both providers and former patients. Three focus groups were convened for Coronary Artery Bypass Graft (CABG), Valve, or CABG +Valve patients ≥ 70 y old (2-y post-op, ≤ 8-wk post-op, complicated post-op course) (n = 15). Three focus groups were convened for Intermediate Medical Care Unit (IMCU) nurses, Intensive Care Unit (ICU) nurses, surgeons, anesthesiologists and cardiac intensivists (n = 20). We used a semi-structured interview format to ask questions surrounding the informed consent process. Transcribed audio data was analyzed to develop consistent and comprehensive themes. We identified 5 main themes that influence the decision making process: educational barriers, educational facilitators, patient autonomy and perceived autonomy, patient and family expectations of care, and decision making advocates. All themes were influenced by time constraints experienced in the current consent process. Patient groups expressed a desire to receive information earlier in their care to allow time to identify personal values and preferences in developing plans for treatment. Both groups strongly supported a formal approach for shared decision making with a decisional coach to provide information and facilitate communication with the care team. Identifying the barriers and facilitators to patient and caretaker engagement in decision making is a key step in the development of a structured, patient-centered SDM approach. Intervention early in the decision process, the use of individualized decision aids that employ graphic risk presentations, and a dedicated decisional coach were identified by patients and providers as approaches with a high potential for success. The impact of such a formalized shared decision making process in cardiac surgery on decisional quality will need to be formally assessed. Given the trend toward older and frail patients referred for complex cardiac procedures, the need for an effective shared decision making process is compelling.

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

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  11. Space and Power in the Ivory Tower: Effective Space Management and Decision Making

    ERIC Educational Resources Information Center

    Blanchette, Sandra

    2012-01-01

    At a time when there are enormous economic pressures on campuses to use resources effectively, space being one of these resources, the academic culture of shared governance, with its fragmented roles for decision making, presents additional challenges. These roles are fragmented due to independent faculty and administrative action. They are…

  12. Implementing Data-Informed Decision Making in Schools: Teacher Access, Supports and Use

    ERIC Educational Resources Information Center

    Means, Barbara; Padilla, Christine; DeBarger, Angela; Bakia, Marianne

    2009-01-01

    Implementation of the No Child Left Behind (NCLB) legislation has been accompanied by demand for data systems capable of providing a longitudinal record of each student's educational experiences and performance over time. The national Study of Education Data Systems and Decision Making is examining both the implementation of student data systems…

  13. Psychotropic Medication Management in a Residential Group Care Program

    ERIC Educational Resources Information Center

    Spellman, Douglas F.; Griffith, Annette K.; Huefner, Jonathan C.; Wise, Neil, III; McElderry, Ellen; Leslie, Laurel K.

    2010-01-01

    This article presents a psychotropic medication management approach that is used within a residential care program. The approach is used to assess medications at youths' times of entry and to facilitate decision making during care. Data from a typical case study have indicated that by making medication management decisions slowly, systematically,…

  14. 29 CFR 2570.43 - Notification of interested persons by applicant.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... hearing on the exemption before making its final decision, you will be notified of the time and place of...., Washington, DC 20210, ATTENTION: Application No. ___. 4 3 The applicant will fill in the room number of the... regarding the application. The Department will make no final decision on the proposed exemption until it...

  15. A Qualitative Analysis of Parental Decision-Making in Regards to Homeschooling

    ERIC Educational Resources Information Center

    Campbell, Pamela Lou Rogers

    2012-01-01

    Researchers have spent a relatively small amount of time focusing on homeschooling. The few studies which have been completed regarding homeschooling have skirted the question of the decision-making process taken by parents as they choose to begin or discontinue homeschooling. The void in the academic knowledge regarding this growing trend in…

  16. The Role of Research and Analysis in Resource Allocation Decisions

    ERIC Educational Resources Information Center

    Lea, Dennis; Polster, Patty Poppe

    2011-01-01

    In a time of diminishing resources and increased accountability, it is important for school leaders to make the most of every dollar they spend. One approach to ensuring responsible resource allocation is to closely examine the organizational culture surrounding decision making and provide a structure and process to incorporate research and data…

  17. Balancing Data, Time, and Expectations: The Complex Decision-­Making Environment of Enrollment Management

    ERIC Educational Resources Information Center

    Johnson, Adam W.

    2016-01-01

    As a growing entity within higher education organizational structures, enrollment managers (EMs) are primarily tasked with projecting, recruiting, and retaining the student population of their campuses. Enrollment managers are expected by institutional presidents as well as through industry standards to make data-driven planning decisions to reach…

  18. 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…

  19. Balancing Data, Time, and Expectations: The Complex Decision-Making Environment of Enrollment Management

    ERIC Educational Resources Information Center

    Johnson, Adam W.

    2013-01-01

    As a growing entity within higher education organizational structures, enrollment managers (EMs) are primarily tasked with projecting, recruiting, and retaining the student population of their campuses. Enrollment managers are expected by institutional presidents as well as through industry standards to make data-driven planning decisions to reach…

  20. 77 FR 71871 - Information Collection Available for Public Comments and Recommendations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-04

    ... availability, location, and specifications of U.S.-flag vessels for the purpose of making vessel availability... Administrator to make a timely and informed decision on the availability of coastwise qualified vessels in support of a request from the Department of Homeland Security prior to the final decision on granting a...

  1. Power and Flow Experience in Time-Intensive Business Simulation Game

    ERIC Educational Resources Information Center

    Kiili, Kristian; Lainema, Timo

    2010-01-01

    Power is an influential component of social interaction and there are reasons for thinking that it may have important effects both on decision-making and psychological and interpersonal processes. The aim of this paper was to study the relations between the feeling of power, decision-making and flow experience in a collaborative business…

  2. A Dynamic Model for Decision Making During Memory Retrieval

    DTIC Science & Technology

    2015-10-26

    quantum probability decision making. 15. SUBJECT TERMS...making  can  be  interpreted  in  terms  of  humans  knowledge  of  probability  being   rooted  in   quantum  probability...over  brief  periods  of  time  so  that  the  changes  are  not  perceived   consciously ,  the   effects  seen

  3. Optimal decision-making in mammals: insights from a robot study of rodent texture discrimination

    PubMed Central

    Lepora, Nathan F.; Fox, Charles W.; Evans, Mathew H.; Diamond, Mathew E.; Gurney, Kevin; Prescott, Tony J.

    2012-01-01

    Texture perception is studied here in a physical model of the rat whisker system consisting of a robot equipped with a biomimetic vibrissal sensor. Investigations of whisker motion in rodents have led to several explanations for texture discrimination, such as resonance or stick-slips. Meanwhile, electrophysiological studies of decision-making in monkeys have suggested a neural mechanism of evidence accumulation to threshold for competing percepts, described by a probabilistic model of Bayesian sequential analysis. For our robot whisker data, we find that variable reaction-time decision-making with sequential analysis performs better than the fixed response-time maximum-likelihood estimation. These probabilistic classifiers also use whatever available features of the whisker signals aid the discrimination, giving improved performance over a single-feature strategy, such as matching the peak power spectra of whisker vibrations. These results cast new light on how the various proposals for texture discrimination in rodents depend on the whisker contact mechanics and suggest the possibility of a common account of decision-making across mammalian species. PMID:22279155

  4. Beneficent Persuasion: Techniques and Ethical Guidelines to Improve Patients’ Decisions

    PubMed Central

    Swindell, J. S.; McGuire, Amy L.; Halpern, Scott D.

    2010-01-01

    Physicians frequently encounter patients who make decisions that contravene their long-term goals. Behavioral economists have shown that irrationalities and self-thwarting tendencies pervade human decision making, and they have identified a number of specific heuristics (rules of thumb) and biases that help explain why patients sometimes make such counterproductive decisions. In this essay, we use clinical examples to describe the many ways in which these heuristics and biases influence patients’ decisions. We argue that physicians should develop their understanding of these potentially counterproductive decisional biases and, in many cases, use this knowledge to rebias their patients in ways that promote patients’ health or other values. Using knowledge of decision-making psychology to persuade patients to engage in healthy behaviors or to make treatment decisions that foster their long-term goals is ethically justified by physicians’ duties to promote their patients’ interests and will often enhance, rather than limit, their patients’ autonomy. We describe techniques that physicians may use to frame health decisions to patients in ways that are more likely to motivate patients to make choices that are less biased and more conducive to their long-term goals. Marketers have been using these methods for decades to get patients to engage in unhealthy behaviors; employers and policy makers are beginning to consider the use of similar approaches to influence healthy choices. It is time for clinicians also to make use of behavioral psychology in their interactions with patients. PMID:20458111

  5. Emotional Components of Unethical Decisions: An Exploratory Study

    ERIC Educational Resources Information Center

    Priesmeyer, H. Richard

    2011-01-01

    The role of emotions in decision-making has been explored by others and has revealed that both "immediate emotions", those present at the time of the decision, and "expected emotions", those expected to result from a decision, effect which alternative will be chosen (Lowenstein, 2001). The significance of emotions in behavior…

  6. Auditory attention and multiattribute decision-making during a 33 h sleep-deprivation period: mean performance and between-subject dispersions.

    PubMed

    Linde, L; Edland, A; Bergström, M

    1999-05-01

    One purpose of this study was to compare attention in the evening (22:00 h), in the late night (04:00 h), in the morning (10:00 h) and in the afternoon (16:00 h) during a period of complete wakefulness beginning at 08:00 h with a mean daytime performance without sleep deprivation. Another purpose was to investigate sleep deprivation effects on a multi-attribute decision-making task with and without time pressure. Twelve sleep-deprived male students were compared with 12 male non-sleep-deprived students. Both groups were tested five times with an auditory attention and a symbol coding task. Significant declines (p < 0.05) in mean level of performance on the auditory attention task were found at 04:00, 10:00 and 16:00 h for subjects forced to the vigil. However, the effect of the sleep deprivation manifested itself even more in increased between-subject dispersions. There were no differences between time pressure and no time pressure on the decision-making task and no significant differences between sleep-deprived and non-sleep-deprived subjects in decision strategies. In fact, the pattern of decision strategies among the sleep-deprived subject was more similar to a pattern of decision strategies typical for non-stressful conditions than the pattern of decision strategies among the non-sleep-deprived subjects. This result may have been due to the fact that the sleep loss acted as a dearouser. Here too, however, the variances differed significantly among sleep-deprived and non-sleep-deprived subjects, indicating that the sleep-deprived subjects were more variable in their decision strategy pattern than the control group.

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

    PubMed

    Özveren, Bora

    2016-04-01

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

  8. Translational Cognition for Decision Support in Critical Care Environments: A Review

    PubMed Central

    Patel, Vimla L.; Zhang, Jiajie; Yoskowitz, Nicole A.; Green, Robert; Sayan, Osman R.

    2008-01-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers. PMID:18343731

  9. Translational cognition for decision support in critical care environments: a review.

    PubMed

    Patel, Vimla L; Zhang, Jiajie; Yoskowitz, Nicole A; Green, Robert; Sayan, Osman R

    2008-06-01

    The dynamic and distributed work environment in critical care requires a high level of collaboration among clinical team members and a sophisticated task coordination system to deliver safe, timely and effective care. A complex cognitive system underlies the decision-making process in such cooperative workplaces. This methodological review paper addresses the issues of translating cognitive research to clinical practice with a specific focus on decision-making in critical care, and the role of information and communication technology to aid in such decisions. Examples are drawn from studies of critical care in our own research laboratories. Critical care, in this paper, includes both intensive (inpatient) and emergency (outpatient) care. We define translational cognition as the research on basic and applied cognitive issues that contribute to our understanding of how information is stored, retrieved and used for problem-solving and decision-making. The methods and findings are discussed in the context of constraints on decision-making in real-world complex environments and implications for supporting the design and evaluation of decision support tools for critical care health providers.

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

    PubMed

    Albantakis, Larissa; Deco, Gustavo

    2011-06-01

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

  11. Integration of Dynamic Models in Range Operations

    NASA Technical Reports Server (NTRS)

    Bardina, Jorge; Thirumalainambi, Rajkumar

    2004-01-01

    This work addresses the various model interactions in real-time to make an efficient internet based decision making tool for Shuttle launch. The decision making tool depends on the launch commit criteria coupled with physical models. Dynamic interaction between a wide variety of simulation applications and techniques, embedded algorithms, and data visualizations are needed to exploit the full potential of modeling and simulation. This paper also discusses in depth details of web based 3-D graphics and applications to range safety. The advantages of this dynamic model integration are secure accessibility and distribution of real time information to other NASA centers.

  12. Managing Costs, Managing Benefits: Employer Decisions in Local Health Care Markets

    PubMed Central

    Christianson, Jon B; Trude, Sally

    2003-01-01

    Objectives To better understand employer health benefit decision making, how employer health benefits strategies evolve over time, and the impact of employer decisions on local health care systems. Data Sources/Study Setting. Data were collected as part of the Community Tracking Study (CTS), a longitudinal analysis of health system change in 12 randomly selected communities. Study Design This is an observational study with data collection over a six-year period. Data Collection/Extraction Methods The study used semistructured interviews with local respondents, combined with monitoring of local media, to track changes in health care systems over time and their impact on community residents. Interviewing began in 1996 and was carried out at two-year intervals, with a total of approximately 2,200 interviews. The interviews provided a variety of perspectives on employer decision making concerning health benefits; these perspectives were triangulated to reach conclusions. Principal Findings The tight labor market during the study period was the dominant consideration in employer decision making regarding health benefits. Employers, in managing employee compensation, made independent decisions in pursuit of individual goals, but these decisions were shaped by similar labor market conditions. As a result, within and across our study sites, employer decisions in aggregate had an important impact on local health care systems, although employers' more highly visible public efforts to bring about health system change often met with disappointing results. Conclusions General economic conditions in the 1990s had an important impact on the configuration of local health systems through their effect on employer decision making regarding health benefits offered to employees, and the responses of health plans and providers to those decisions. PMID:12650371

  13. An Integrated Web-based Decision Support System in Disaster Risk Management

    NASA Astrophysics Data System (ADS)

    Aye, Z. C.; Jaboyedoff, M.; Derron, M. H.

    2012-04-01

    Nowadays, web based decision support systems (DSS) play an essential role in disaster risk management because of their supporting abilities which help the decision makers to improve their performances and make better decisions without needing to solve complex problems while reducing human resources and time. Since the decision making process is one of the main factors which highly influence the damages and losses of society, it is extremely important to make right decisions at right time by combining available risk information with advanced web technology of Geographic Information System (GIS) and Decision Support System (DSS). This paper presents an integrated web-based decision support system (DSS) of how to use risk information in risk management efficiently and effectively while highlighting the importance of a decision support system in the field of risk reduction. Beyond the conventional systems, it provides the users to define their own strategies starting from risk identification to the risk reduction, which leads to an integrated approach in risk management. In addition, it also considers the complexity of changing environment from different perspectives and sectors with diverse stakeholders' involvement in the development process. The aim of this platform is to contribute a part towards the natural hazards and geosciences society by developing an open-source web platform where the users can analyze risk profiles and make decisions by performing cost benefit analysis, Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) with the support of others tools and resources provided. There are different access rights to the system depending on the user profiles and their responsibilities. The system is still under development and the current version provides maps viewing, basic GIS functionality, assessment of important infrastructures (e.g. bridge, hospital, etc.) affected by landslides and visualization of the impact-probability matrix in terms of socio-economic dimension.

  14. A study protocol of the effectiveness of PEGASUS: a multi-centred study comparing an intervention to promote shared decision making about breast reconstruction with treatment as usual.

    PubMed

    Harcourt, Diana; Paraskeva, Nicole; White, Paul; Powell, Jane; Clarke, Alex

    2017-10-02

    Increasingly, women elect breast reconstruction after mastectomy. However, their expectations of surgery are often not met, and dissatisfaction with outcome and ongoing psychosocial concerns and distress are common. We developed a patient-centered intervention, PEGASUS:(Patients' Expectations and Goals: Assisting Shared Understanding of Surgery) which supports shared decision making by helping women clarify their own, individual goals about reconstruction so that they can discuss these with their surgeon. Our acceptability/feasibility work has shown it is well received by patients and health professionals alike. We now need to establish whether PEGASUS improves patients' experiences of breast reconstruction decision making and outcomes. The purpose of this study is, therefore, to examine the effectiveness of PEGASUS, an intervention designed to support shared decision making about breast reconstruction. A multi-centered sequential study will compare the impact of PEGASUS with usual care, in terms of patient reported outcomes (self-reported satisfaction with the outcome of surgery, involvement in decision making and in the consultation) and health economics. Initially we will collect data from our comparison (usual care) group (90 women) who will complete standardized measures (Breast-Q, EQ5D -5 L and ICECAP- A) at the time of decision making, 3, 6 and 12 months after surgery. Health professionals will then be trained to use PEGASUS, which will be delivered to the intervention group (another 90 women completing the same measures at the time of decision making, and 3, 6 and 12 months after surgery). Health professionals and a purposefully selected sample of participants will be interviewed about whether their expectations of reconstruction were met, and their experiences of PEGASUS (if appropriate). PEGASUS may have the potential to provide health professionals with an easily accessible tool aiming to support shared decision making and improve patients' satisfaction with breast reconstruction. Results of this study will be available at the end of 2019. ISRCTN 18000391 (DOI 10.1186/ISRCTN18000391) 27/01/2016.

  15. Development of a decision support system for tsunami evacuation: application to the Jiyang District of Sanya city in China

    NASA Astrophysics Data System (ADS)

    Hou, Jingming; Yuan, Ye; Wang, Peitao; Ren, Zhiyuan; Li, Xiaojuan

    2017-03-01

    Major tsunami disasters often cause great damage in the first few hours following an earthquake. The possible severity of such events requires preparations to prevent tsunami disasters or mitigate them. This paper is an attempt to develop a decision support system for rapid tsunami evacuation for local decision makers. Based on the numerical results database of tsunami disasters, this system can quickly obtain the tsunami inundation and travel time. Because numerical models are calculated in advance, this system can reduce decision-making time. Population distribution, as a vulnerability factor, was analyzed to identify areas of high risk for tsunami disasters. Combined with spatial data, this system can comprehensively analyze the dynamic and static evacuation process and identify problems that negatively impact evacuation, thus supporting the decision-making for tsunami evacuation in high-risk areas. When an earthquake and tsunami occur, this system can rapidly obtain the tsunami inundation and travel time and provide information to assist with tsunami evacuation operations.

  16. Patient and physician views of shared decision making in cancer.

    PubMed

    Tamirisa, Nina P; Goodwin, James S; Kandalam, Arti; Linder, Suzanne K; Weller, Susan; Turrubiate, Stella; Silva, Colleen; Riall, Taylor S

    2017-12-01

    Engaging patients in shared decision making involves patient knowledge of treatment options and physician elicitation of patient preferences. Our aim was to explore patient and physician perceptions of shared decision making in clinical encounters for cancer care. Patients and physicians were asked open-ended questions regarding their perceptions of shared decision making throughout their cancer care. Transcripts of interviews were coded and analysed for shared decision-making themes. At an academic medical centre, 20 cancer patients with a range of cancer diagnoses, stages of cancer and time from diagnosis, and eight physicians involved in cancer care were individually interviewed. Most physicians reported providing patients with written information. However, most patients reported that written information was too detailed and felt that the physicians did not assess the level of information they wished to receive. Most patients wanted to play an active role in the treatment decision, but also wanted the physician's recommendation, such as what their physician would choose for him/herself or a family member in a similar situation. While physicians stated that they incorporated patient autonomy in decision making, most provided data without making treatment recommendations in the format preferred by most patients. We identified several communication gaps in cancer care. While patients want to be involved in the decision-making process, they also want physicians to provide evidence-based recommendations in the context of their individual preferences. However, physicians often are reluctant to provide a recommendation that will bias the patient. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  17. [Decision making and executive function in severe traumatic brain injured patients: validation of a decision-making task and correlated features].

    PubMed

    Wiederkehr, S; Barat, M; Dehail, P; de Sèze, M; Lozes-Boudillon, S; Giroire, J-M

    2005-02-01

    At the chronic stage, severe traumatic brain injured (TBI) patients experience difficulty in making decisions. Several studies have demonstrated the involvement of the prefrontal cortex, in particular the orbitofrontal region, in decision-making. The aim of the present study was to validate a decision-making task in this population and to ascertain whether the components of their dysexecutive syndrome may affect their decision-making and lead to difficulties for social rehabilitation. Fifteen TBI patients and 15 controlled subjects matched for age, sex and years of education were assessed by a battery of executive tests (GREFEX) and by the gambling task (GT). The TBI subjects performed significantly worse than the controlled group in five out of six GREFEX tests. The TBI choices are significantly more disadvantageous than the choices of the control group when considering the three last blocks of 20 cards of the GT. The GT total score correlated significantly with execution time of the Stroop interference condition and the Trail Making Task B, as well as with the two measures (correct sequence span and number of crossed boxes) of the double condition of Baddeley's task. We postulate that executive functioning (supervisory attentional system) influence performance in the gambling task through mechanisms of inhibitory control, divided attention and working memory. Thus, this task seems to be determined by multiple factors; the process of decision-making may depend on frontal integrity.

  18. Future fertility for individuals with differences of sex development: Parent attitudes and perspectives about decision-making.

    PubMed

    Johnson, Emilie K; Rosoklija, Ilina; Shurba, Angela; D'Oro, Anthony; Gordon, Elisa J; Chen, Diane; Finlayson, Courtney; Holl, Jane L

    2017-08-01

    Children, adolescents, and young adults (children/youth) with differences/disorders of sex development (DSD) face challenges related to future fertility; this may be due to variations in gonadal development, and, for some, gonadectomy performed to reduce the risk of malignancy. Childhood may be the only time for preservation of biological fertility potential for children/youth who undergo gonadectomy or have early gonadal failure. Fertility-related decision-making for these patients is particularly complicated, due to the need for parental proxy decision-making, potential discordance between gender identity and gonadal type, and uncertain future assisted reproductive technologies. This study aimed to assess: (1) attitudes regarding future fertility, and (2) healthcare needs for fertility-related decision-making among parents of children/youth with DSD. Semi-structured qualitative interviews about future fertility were conducted with parents of children/youth with DSD. Parents who had never discussed fertility with a healthcare provider were excluded. Grounded theory methodology was used to identify emergent themes and patterns. Demographics and clinical characteristics were assessed via survey and medical chart review. Nineteen parents were interviewed (participation rate: 60%, 14 mothers/5 fathers, median patient age at diagnosis 6 months (range 0-192), eight DSD diagnoses). The most common emergent themes are summarized in the Summary Table. Most parents identified fertility as a key concern, both at time of diagnosis and throughout development. Parents expressed difficulty with timing of disclosure about potential infertility to their children. Multiple preferences related to medical decision-making about future fertility and fertility preservation were expressed, including: a desire for step-by-step decision-making, and use of medically vetted information and research to guide decisions. This qualitative study provided new information about the perspectives of parents of children/youth with DSD regarding future fertility. Previous studies have suggested that the possibility of biological parenthood is important to many individuals with DSD. This study provided an in-depth parental perspective. This is important because many decisions that affect future fertility are made in childhood, and require parents to make decisions on behalf of their children. The study sample was limited in its geographic diversity. Strengths of the study included diversity in age of the child/youth, ethnic backgrounds, and the DSD diagnoses that were represented. Future fertility was a concern for many parents of children/youth with DSD. Parents expressed multiple priorities and preferences related to making difficult fertility-related medical decisions for their children. Many of the study findings could be incorporated into future best practices for discussions about fertility with families of children/youth with DSD. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  19. The contingency of patient preferences for involvement in health decision making.

    PubMed

    Ryan, John; Sysko, James

    2007-01-01

    Studies indicate that better patient compliance and higher patient satisfaction result when agreement exists between the physician and the patient regarding the medical problem and its treatment. This study will extend previous work by investigating (1) under what conditions patients prefer to be actively involved in their treatment decisions, (2) the underlying theoretical reasons that may account for patient decision-making preferences, and (3) what medical decision-making model can guide physicians and medical policy makers when adapting their medical decision-making styles. A total of 2,765 individuals were surveyed by the National Opinion Research Center as part of the 2002 General Social Survey (GSS). This survey included a one-time topical module on "Doctors and Patients," which incorporated questions on patient preferences concerning the physician-patient relationship. Demographic information (e.g., age, education, and sex) was analyzed against patient preferences for medical decision making. Results support patient preferences for participatory medical decision making, and this is especially true for younger, more educated, and female patients. Common prudence would suggest that the best way to determine a patient's preference for participating in medical decision making is to simply ask them. However, the very asking of this straightforward question is based on the assumption that patients do wish to be actively involved. Results of this study support such an assumption. In the absence of all other knowledge, the results of this national survey support the health care practitioner's belief that U.S. patients, in general, have a preference for being actively involved in medical decision making and that this preference is truer for younger, female, and more educated patients.

  20. Current understanding of decision-making in adolescents with cancer: A narrative systematic review

    PubMed Central

    Day, Emma; Jones, Louise; Langner, Richard; Bluebond-Langner, Myra

    2016-01-01

    Background: Policy guidance and bioethical literature urge the involvement of adolescents in decisions about their healthcare. It is uncertain how roles and expectations of adolescents, parents and healthcare professionals influence decision-making and to what extent this is considered in guidance. Aims: To identify recent empirical research on decision-making regarding care and treatment in adolescent cancer: (1) to synthesise evidence to define the role of adolescents, parents and healthcare professionals in the decision-making process and (2) to identify gaps in research. Design: A narrative systematic review of qualitative, quantitative and mixed-methods research. We adopted a textual approach to synthesis, using a theoretical framework of interactionism to interpret findings. Data Sources: The databases MEDLINE, PsycINFO, SCOPUS, EMBASE and CINHAL were searched from 2001 through May 2015 for publications on decision-making for adolescents (13–19 years) with cancer. Results: Twenty-eight articles were identified. Adolescents and parents initially find it difficult to participate in decision-making due to a lack of options in the face of protocol-driven care. Parent and adolescent preferences for information and response to loss of control vary between individuals and over time. No studies indicate parental or adolescent preference for a high degree of independence in decision-making. Conclusion: Striving to make parents and adolescents fully informed or urge them towards more independence than they prefer may add to distress and confusion. This may interfere with their ability to participate in their preferred way in decisions about care and treatment. Future research should include analysis of on-ground interactions among parents, adolescents and clinicians across the trajectory. PMID:27160700

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