WorldWideScience

Sample records for communication decision-making processes

  1. A communication model of shared decision making: accounting for cancer treatment decisions.

    Science.gov (United States)

    Siminoff, Laura A; Step, Mary M

    2005-07-01

    The authors present a communication model of shared decision making (CMSDM) that explicitly identifies the communication process as the vehicle for decision making in cancer treatment. In this view, decision making is necessarily a sociocommunicative process whereby people enter into a relationship, exchange information, establish preferences, and choose a course of action. The model derives from contemporary notions of behavioral decision making and ethical conceptions of the doctor-patient relationship. This article briefly reviews the theoretical approaches to decision making, notes deficiencies, and embeds a more socially based process into the dynamics of the physician-patient relationship, focusing on cancer treatment decisions. In the CMSDM, decisions depend on (a) antecedent factors that have potential to influence communication, (b) jointly constructed communication climate, and (c) treatment preferences established by the physician and the patient.

  2. Communicating climate information: travelling through the decision-making process

    International Nuclear Information System (INIS)

    Stoverinck, F.; Dubois, G.; Amelung, B.

    2013-01-01

    Climate change forces society to adapt. Adaptation strategies are preferably based on the best available climate information. Climate projections, however, often inform adaptation strategies after being interpreted once or several times. This process affects the original message put forward by climate scientists when presenting the basic climate projections, in particular regarding uncertainties. The nature of this effect and its implications for decision-making are as yet poorly understood. This paper explores the nature and consequences of a) the communication tools used by scientists and experts, and b)changes in the communicated information as it travels through the decision-making process. It does so by analysing the interpretative steps taken in a sample of 25 documents, pertaining to the field of public policies for climate change impact assessment and adaptation strategies. Five phases in the provisioning of climate information are distinguished: pre-existing knowledge (i.e. climate models and data), climate- change projection, impact assessment, adaptation strategy, and adaptation plan. Between the phases, climate information is summarized and synthesised in order to be passed on. The results show that in the sample information on uncertainty is under-represented: e.g. studies focus on only one scenario, and/or disregard probability distributions. In addition, visualization tools are often used ineffectively, leading to confusion and unintended interpretations. Several recommendations are presented. A better training of climatologists to communication issues, but also a training to climatology for decision makers are required, as well as more cautious and robust adaptation strategies, accounting for the uncertainty inherent to climate projections. (authors)

  3. Communicative processes and decision-making in relation to prostate cancer patients

    DEFF Research Database (Denmark)

    Løwe Netsey-Afedo, Mette Margrethe; Birkelund, Regner

    BACKGROUND: There are many benefits of involving patients in decision-making, including increased patient safety and improved health. Many patients with prostate cancer wish to be involved when making decisions in the course of their treatment. However, studies show that Patient Involvement and SDM...... of treatment, it is essential to involve patients' preferences, needs and desires when making decisions during the course of their disease. Furthermore, it is important that patients are adequately informed about treatment, side effects, and other specific issues important for the individual patient. The aim...... of this project is to examine the processes of communication between prostate cancer patients and health professionals related to decision-making in the course of the patient’s treatment. Organizational possibilities and constraints related to the involvement will also be examined. METHODS: Data will be collected...

  4. Communication barriers in the decision-making process : System Language and System Thinking

    NARCIS (Netherlands)

    Schinagl, S.; Paans, R.

    2017-01-01

    A major problem in the decision-making process is poor communication regarding threats and risks between information security experts and decision makers. By their nature, experts have a strong interest in operational details and limited insight into the purpose of the organization as they may not

  5. Why it is important to promote communication in the decision-making process

    International Nuclear Information System (INIS)

    Viktorsson, C.

    2001-01-01

    Opportunity, nightmare, integrity and public confidence are all well-known words for us working in the nuclear area. Dealing with the outside world involves all those elements. However, having an active communication component in the decision making process can reduce the risk of getting into a nightmare situation and at the same time it contributes to gaining public confidence. The nuclear regulatory authority needs confidence to achieve effectiveness. Investing in trust is, therefore, necessary but requires a well-defined strategy and working methods. Moreover, it requires patience, and a culture of openness and relaxed attitude towards media. Finally, my experience tells me that it requires training of staff and motivators that constantly remind us of the importance of promoting communication in the decision-making process. In this paper I am presenting some insights into how SKI (Swedish Nuclear Power Inspectorate) works when preparing decision and why we are doing it. (author)

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

    Science.gov (United States)

    Hicks, Karen Campbell

    2015-01-01

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

  7. Mothers' process of decision making for gastrostomy placement.

    Science.gov (United States)

    Brotherton, Ailsa; Abbott, Janice

    2012-05-01

    In this article we present the findings of an exploration of mothers' discourses on decision making for gastrostomy placement for their child. Exploring in-depth interviews of a purposive sample, we analyzed the mothers' discourses of the decision-making process to understand how their experiences of the process influenced their subsequent constructions of decision making. Mothers negotiated decision making by reflecting on their personal experiences of feeding their child, either orally or via a tube, and interwove their background experiences with the communications from members of the health care team until a decision was reached. Decision making was often fraught with difficulty, resulting in anxiety and guilt. Experiences of decision making ranged from perceived coercion to true choice, which encompasses a truly child-centered decision. The resulting impact of the decision-making process on the mothers was profound. We conclude with an exploration of the implications for clinical practice and describe how health care professionals can support mothers to ensure that decision-making processes for gastrostomy placement in children are significantly improved.

  8. Understanding Decision-Making, Communication Rules, and Communication Satisfaction as Culture: Implications for Organizational Effectiveness.

    Science.gov (United States)

    Shockley-Zalabak, Pamela

    A study of decision making processes and communication rules, in a corporate setting undergoing change as a result of organizational ineffectiveness, examined whether (1) decisions about formal communication reporting systems were linked to management assumptions about technical creativity/effectiveness, (2) assumptions about…

  9. Impact of Participation in Decision Making on Job Satisfaction: An Organizational Communication Perspective.

    Science.gov (United States)

    Xia, Ying; Zhang, Li; Zhao, Ning

    2016-09-20

    Participation in organizational decision-making has received considerable attention from scholars. Beyond the perspectives proposed in past studies, we offer a new account, based upon a communication perspective, to explain why and when participation in decision-making can influence job satisfaction. Drawing from social capital theory, we examine whether communication openness mediates the relationship between participation in decision-making and job satisfaction. We also investigate how information adequacy moderates this mediated process. Results from a sample of 184 employees in China showed that the four-factor model was the best fitting solution (CFI = .91, GFI = .90, RMSEA = .09). The analyses indicated that employees' participation in decision-making positively affected their job satisfaction (β = .32, p communication openness (direct effect became non-significant when communication openness was included: β = .06, n.s.). Results also found that decision-making information adequacy positively moderated the relationship between participation in decision-making and communication openness (β = .13, p communication and the free flow of information within organizations should be encouraged.

  10. Perception and communication of risk in decision making by persons with dementia.

    Science.gov (United States)

    Stevenson, Mabel; Savage, Beverley; Taylor, Brian J

    2017-01-01

    Communication of risks must involve people with dementia meaningfully to ensure informed and inclusive decision-making processes. This qualitative study explored concepts of risk from the perspective of persons with dementia and their experiences of communicating risk with family members and professionals. Data was analysed using grounded theory. Seventeen people in Northern Ireland with mild-moderate dementia who had recently made a decision about their daily life or care involving consideration of risks were interviewed between November 2015 and November 2016. A wide range of actual or feared risks were identified relating to: daily activities; hobbies and socialising; mental health and medicines; and risks to and from others. 'Risk' often held emotional rather than probability connotations. Constructive communications to address issues were presented. Problem-solving models of both active and passive decision-making about risks were evident. Effective risk communication in informed decision-making processes about health and social care is discussed.

  11. The impact of information and communication technology on decision making process in the big data era

    Directory of Open Access Journals (Sweden)

    Lukić Jelena

    2014-01-01

    Full Text Available The information necessary to make important decisions is held by many different hierarchical levels in organizations and management needs to find the answer on the question should the decisions be centralized and made by the top management or decentralized and made by the managers and employees of the lower-level units. This question becomes more important in the big data era which is characterized by volume, velocity, and variety of data. The aim of this paper is to analyze whether information and communication technology leads to centralization or decentralization tendencies in organizations and to give answer on the question what are the new challenges of decision making process in the big data era. The conclusion is that information and communication technology provides all organizational level with information that traditionally was used by only few levels, reducing internal coordination costs and enabling organizations to allow decision making across a higher range of hierarchical levels. But final decision of allocation of decision rights depends on knowledge of employees, especially in the big data era, where professionals with new knowledge and skills (known as data scientist became of tremendous importance.

  12. Family communication and decision making at the end of life: a literature review.

    Science.gov (United States)

    Wallace, Cara L

    2015-06-01

    Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research. Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest. The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life. Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

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

    Science.gov (United States)

    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.

  14. From the communication to participation in decision making

    International Nuclear Information System (INIS)

    Alonso, A.

    2004-01-01

    In the modern democratic societies there have appeared individuals and associations interested in and concerned with the risks proper to the use of ionising radiation and nuclear power. In the use of their democratic rights, they have requested and obtained from those responsible information on such activities and there has been established a fruitful communication process involving the interchange of facts and circumstances that is contributing to make the perceived risk more objective. At the moment, those societies are moving from information, through interactive communication, to participation in the decision.making processes with major social impacts or social sensitivity. This significant movement is analysed, as well as its causes and consequences. (Author)

  15. A conceptual model of the role of communication in surrogate decision making for hospitalized adults.

    Science.gov (United States)

    Torke, Alexia M; Petronio, Sandra; Sachs, Greg A; Helft, Paul R; Purnell, Christianna

    2012-04-01

    To build a conceptual model of the role of communication in decision making, based on literature from medicine, communication studies and medical ethics. We proposed a model and described each construct in detail. We review what is known about interpersonal and patient-physician communication, described literature about surrogate-clinician communication, and discussed implications for our developing model. The communication literature proposes two major elements of interpersonal communication: information processing and relationship building. These elements are composed of constructs such as information disclosure and emotional support that are likely to be relevant to decision making. We propose these elements of communication impact decision making, which in turn affects outcomes for both patients and surrogates. Decision making quality may also mediate the relationship between communication and outcomes. Although many elements of the model have been studied in relation to patient-clinician communication, there is limited data about surrogate decision making. There is evidence of high surrogate distress associated with decision making that may be alleviated by communication-focused interventions. More research is needed to test the relationships proposed in the model. Good communication with surrogates may improve both the quality of medical decisions and outcomes for the patient and surrogate. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Patients’ Perception of Patient–Provider Communication in Fertility Preservation Decision Making Among Young Women With Cancer

    Directory of Open Access Journals (Sweden)

    Aakrati Mathur

    2013-09-01

    Full Text Available Fertility preservation (FP for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to be directive when referring to the fertility clinic. Later in the process, they expect a supportive style of communication from providers. Patient-accessible language, supportive and reassuring styles of communication, and an existing relationship with providers may enhance well-being of the patients.

  17. How Are Distributed Groups Affected by an Imposed Structuring of their Decision-Making Process?

    DEFF Research Database (Denmark)

    Lundell, Anders Lorentz; Hertzum, Morten

    2011-01-01

    Groups often suffer from ineffective communication and decision making. This experimental study compares distributed groups solving a preference task with support from either a communication system or a system providing both communication and a structuring of the decision-making process. Results...... show that groups using the latter system spend more time solving the task, spend more of their time on solution analysis, spend less of their time on disorganized activity, and arrive at task solutions with less extreme preferences. Thus, the type of system affects the decision-making process as well...... as its outcome. Notably, the task solutions arrived at by the groups using the system that imposes a structuring of the decision-making process show limited correlation with the task solutions suggested by the system on the basis of the groups’ explicitly stated criteria. We find no differences in group...

  18. The decision-making process in public healthcare entities – identification of the decision-making process type

    Directory of Open Access Journals (Sweden)

    Szymaniec-Mlicka Karolina

    2017-05-01

    Full Text Available The decisions made in the organization determine its success, therefore, conducting studies in the scope of decision-making seems important both for theory and practice. The aim of the studies was to identify the type of decision-making process in public medical entities with the use of typology developed by P. Nutt. For this purpose we used qualitative methods. Interviews with 8 directors of hospitals were conducted and the reconstruction was made on the basis of the decision-making process, which enabled the assignment of the model of decision-making process to the organization. The research indicated that four organizations use the historical decision-making model, three organizations represent the model of generating solutions, and one organization uses the model of available solutions.

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

    Science.gov (United States)

    Müller-Staub, Maria

    2006-10-01

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

  20. [Evidence-based Risk and Benefit Communication for Shared Decision Making].

    Science.gov (United States)

    Nakayama, Takeo

    2018-01-01

     Evidence-based medicine (EBM) can be defined as "the integration of the best research evidence with clinical expertise and a patient's unique values and circumstances". However, even with the best research evidence, many uncertainties can make clinical decisions difficult. As the social requirement of respecting patient values and preferences has been increasingly recognized, shared decision making (SDM) and consensus development between patients and clinicians have attracted attention. SDM is a process by which patients and clinicians make decisions and arrive at a consensus through interactive conversations and communications. During the process of SDM, patients and clinicians share information with each other on the goals they hope to achieve and responsibilities in meeting those goals. From the clinician's standpoint, information regarding the benefits and risks of potential treatment options based on current evidence and professional experience is provided to patients. From the patient's standpoint, information on personal values, preferences, and social roles is provided to clinicians. SDM is a sort of "wisdom" in the context of making autonomous decisions in uncertain, difficult situations through interactions and cooperation between patients and clinicians. Joint development of EBM and SDM will help facilitate patient-clinician relationships and improve the quality of healthcare.

  1. Computational Psychometrics in Communication and Implications in Decision Making.

    Science.gov (United States)

    Cipresso, Pietro; Villani, Daniela; Repetto, Claudia; Bosone, Lucia; Balgera, Anna; Mauri, Maurizio; Villamira, Marco; Antonietti, Alessandro; Riva, Giuseppe

    2015-01-01

    Recent investigations emphasized the role of communication features on behavioral trust and reciprocity in economic decision making but no studies have been focused on the effect of communication on affective states in such a context. Thanks to advanced methods of computational psychometrics, in this study, affective states were deeply examined using simultaneous and synchronized recordings of gazes and psychophysiological signals in 28 female students during an investment game. Results showed that participants experienced different affective states according to the type of communication (personal versus impersonal). In particular, participants involved in personal communication felt more relaxed than participants involved in impersonal communication. Moreover, personal communication influenced reciprocity and participants' perceptions about trust and reciprocity. Findings were interpreted in the light of the Arousal/Valence Model and self-disclosure process.

  2. Evacuation decision-making: process and uncertainty

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-09-01

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

  3. Evacuation decision-making: process and uncertainty

    International Nuclear Information System (INIS)

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

    1985-09-01

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

  4. The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention.

    Science.gov (United States)

    Michelson, Kelly N; Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

    2016-12-01

    Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention.

  5. The Process and Impact of Stakeholder Engagement in Developing a Pediatric Intensive Care Unit Communication and Decision-Making Intervention

    Science.gov (United States)

    Frader, Joel; Sorce, Lauren; Clayman, Marla L; Persell, Stephen D; Fragen, Patricia; Ciolino, Jody D; Campbell, Laura C; Arenson, Melanie; Aniciete, Danica Y; Brown, Melanie L; Ali, Farah N; White, Douglas

    2016-01-01

    Stakeholder-developed interventions are needed to support pediatric intensive care unit (PICU) communication and decision-making. Few publications delineate methods and outcomes of stakeholder engagement in research. We describe the process and impact of stakeholder engagement on developing a PICU communication and decision-making support intervention. We also describe the resultant intervention. Stakeholders included parents of PICU patients, healthcare team members (HTMs), and research experts. Through a year-long iterative process, we involved 96 stakeholders in 25 meetings and 26 focus groups or interviews. Stakeholders adapted an adult navigator model by identifying core intervention elements and then determining how to operationalize those core elements in pediatrics. The stakeholder input led to PICU-specific refinements, such as supporting transitions after PICU discharge and including ancillary tools. The resultant intervention includes navigator involvement with parents and HTMs and navigator-guided use of ancillary tools. Subsequent research will test the feasibility and efficacy of our intervention. PMID:28725847

  6. Decision making and decision communications in elite rugby union referees: An inductive investigation

    OpenAIRE

    Cunningham, I; Mellick, M; Mascarenhas, Duncan R

    2012-01-01

    The application of law, combined with contextual judgment and communication have been shown to be essential skills of the elite sports official (Mascarenhas, Collins & Mortimer, 2005). Further, the behaviours that officials demonstrate to communicate decisions to sport participants have important implications for match outcomes and perceptions of fairness (Mellick et al., 2005; Simmons, 2010). The purpose of the present study was to explore the higher - order decision making and decision comm...

  7. Nonrational processes in ethical decision making.

    Science.gov (United States)

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

    2011-10-01

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

  8. Serotonin and decision making processes.

    Science.gov (United States)

    Homberg, Judith R

    2012-01-01

    Serotonin (5-HT) is an important player in decision making. Serotonergic antidepressant, anxiolytic and antipsychotic drugs are extensively used in the treatment of neuropsychiatric disorders characterized by impaired decision making, and exert both beneficial and harmful effects in patients. Detailed insight into the serotonergic mechanisms underlying decision making is needed to strengthen the first and weaken the latter. Although much remains to be done to achieve this, accumulating studies begin to deliver a coherent view. Thus, high central 5-HT levels are generally associated with improved reversal learning, improved attentional set shifting, decreased delay discounting, and increased response inhibition, but a failure to use outcome representations. Based on 5-HT's evolutionary role, I hypothesize that 5-HT integrates expected, or changes in, relevant sensory and emotional internal/external information, leading to vigilance behaviour affecting various decision making processes. 5-HT receptor subtypes play distinctive roles in decision making. 5-HT(2A) agonists and 5-HT2c antagonists decrease compulsivity, whereas 5-HT(2A) antagonists and 5-HT(2C) agonists decrease impulsivity. 5-HT(6) antagonists univocally affect decision making processes. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Jaenichen, Claudine

    2017-01-01

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

  10. PRAGMATIST MODEL OF DECISION-MAKING IN LAW: FROM THE INSTRUMENTAL MENTALISM TO THE COMMUNICATIVE INTERSUBJECTIVITY

    Directory of Open Access Journals (Sweden)

    Mário Cesar da Silva Andrade

    2015-12-01

    Full Text Available This paper aimed to evaluate the method of making rational decision derived from the philosophy of Kant as a foundation paradigma of public decisions and, more specifically, of legal decisions. Based on the communicative action theory of Jürgen Habermas, the question is  if  the  transcendental  model  of  decision-making  meets  the  democratic  demands. Methodologically, the qualitative research was based on doctrinal sources about the theme, promoting a legal and critical analysis. Habermas' communicative bias raises the hypothesis that Kant's transcendental method, which influenced so much the theory of justice and Law, entails the adoption of an objective posture by the decision maker, something incompatible with the need for broad participation and the intersubjectivity prescribed by democracy . It was concluded that the public decision-making process must overcome the transcendental, decisionistic  and  instrumental  models,  adopting  pragmatic  model,  which  is  more intersubjective and communicative, therefore more consistente with the participatory bias of democracy.

  11. 44 CFR 9.6 - Decision-making process.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making process. 9.6... HOMELAND SECURITY GENERAL FLOODPLAIN MANAGEMENT AND PROTECTION OF WETLANDS § 9.6 Decision-making process... protection decision-making process to be followed by the Agency in applying the Orders to its actions. While...

  12. Behavioural Decision Making and Suggestional Processes

    OpenAIRE

    Molz, Günter

    2001-01-01

    Common features between the domains of behavioural decision making and suggestional processes are discussed. These features are allocated in two aspects. First, behavioural decision making and suggestional processes are traditionally considered to provoke inadequate human behaviour. In this article arguments are put forward against this interpretation: Actions induced by non-rational decisions and / or by suggestional processes often have adaptive functions. Second, two common themat...

  13. 24 CFR 55.20 - Decision making process.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Decision making process. 55.20 Section 55.20 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development FLOODPLAIN MANAGEMENT Procedures for Making Determinations on Floodplain Management § 55.20 Decision making process. The decision making...

  14. Simulation Models of Human Decision-Making Processes

    Directory of Open Access Journals (Sweden)

    Nina RIZUN

    2014-10-01

    Full Text Available The main purpose of the paper is presentation of the new concept of human decision-making process modeling via using the analogy with Automatic Control Theory. From the author's point of view this concept allows to develop and improve the theory of decision-making in terms of the study and classification of specificity of the human intellectual processes in different conditions. It was proved that the main distinguishing feature between the Heuristic / Intuitive and Rational Decision-Making Models is the presence of so-called phenomenon of "enrichment" of the input information with human propensity, hobbies, tendencies, expectations, axioms and judgments, presumptions or bias and their justification. In order to obtain additional knowledge about the basic intellectual processes as well as the possibility of modeling the decision results in various parameters characterizing the decision-maker, the complex of the simulation models was developed. These models are based on the assumptions that:  basic intellectual processes of the Rational Decision-Making Model can be adequately simulated and identified by the transient processes of the proportional-integral-derivative controller; basic intellectual processes of the Bounded Rationality and Intuitive Models can be adequately simulated and identified by the transient processes of the nonlinear elements.The taxonomy of the most typical automatic control theory elements and their compliance with certain decision-making models with a point of view of decision-making process specificity and decision-maker behavior during a certain time of professional activity was obtained.

  15. Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation.

    Science.gov (United States)

    Hedberg, Berith; Malm, Dan; Karlsson, Jan-Erik; Årestedt, Kristofer; Broström, Anders

    2018-06-01

    Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making. The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms. A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale-Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data. Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication. Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.

  16. Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

    Science.gov (United States)

    Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

    2017-07-01

    Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

  17. Intra project team disagreement, conflict communications, and team performance in cross-functional new product teams: A decision-making quality perspective

    Directory of Open Access Journals (Sweden)

    Tsun Jin Chang

    2014-02-01

    Full Text Available This paper develops and examines a model of the antecedents and consequences of decision-making comprehensiveness during the new product development process. This model firstly suggests a concave relationship between intrateam task disagreement and decision-making comprehensiveness. It also conjectures that conflict communications influence the effectiveness of decision-making comprehensiveness on new product teams’ performance. An empirical test of the proposed framework involves a survey of 220 cross-functional new product teams. The findings show that an inverse U-shaped relationship exists between intrateam task disagreement and decision-making comprehensiveness. It also indicates that collaborative communication has a negative effect on innovativeness, whereas contentious communication adversely affects constraint adherence. However, decision-making comprehensiveness partially moderates the relationships between conflict communications and team performance. Some managerial and research implications of the findings were also discussed in this study.

  18. Tools for collaborative decision-making

    CERN Document Server

    Zaraté, Pascale

    2013-01-01

    Decision-making has evolved recently thanks to the introduction of information and communication technologies in many organizations, which has led to new kinds of decision-making processes, called "collaborative decision-making", at the organizational and cognitive levels. This book looks at the development of the decision-making process in organizations. Decision-aiding and its paradigm of problem solving are defined, showing how decision-makers now need to work in a cooperative way. Definitions of cooperation and associated concepts such as collaboration and coordination are given and a framework of cooperative decision support systems is presented, including intelligent DSS, cooperative knowledge-based systems, workflow, group support systems, collaborative engineering, integrating with a collaborative decision-making model in part or being part of global projects. Several models and experimental studies are also included showing that these new processes have to be supported by new types of tools, several ...

  19. Has patients' involvement in the decision-making process changed over time?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Dulmen, A.M. van; Haes, H.C.J.M. de; Visser, A.P.; Schellevis, F.G.; Bensing, J.M.

    2006-01-01

    Objective: To get insight into the changes over time of patients' involvement in the decision-making process, and into the factors contributing to patients' involvement and general practitioners' (GPs) communication related to the Medical Treatment Act (MTA) Issues: information about treatment,

  20. Has patients’ involvement in the decision-making process changed over time?

    NARCIS (Netherlands)

    Brink-Muinen, A. van den; Dulmen, S.M. van; Haes, H.C.J.M. de; Visser, A.P.; Schellevis, F.G.; Bensing, J.

    2006-01-01

    Objective To get insight into the changes over time of patients’ involvement in the decision-making process, and into the factors contributing to patients’ involvement and general practitioners’ (GPs) communication related to the Medical Treatment Act (MTA) issues: information about treatment,

  1. Cognitive processes in anesthesiology decision making.

    Science.gov (United States)

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

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

  2. Risk communication and decision-making in the prevention of invasive breast cancer.

    Science.gov (United States)

    Partridge, Ann H

    2017-08-01

    Risk communication surrounding the prevention of invasive breast cancer entails not only understanding of the disease, risks and opportunities for intervention. But it also requires understanding and implementation of optimal strategies for communication with patients who are making these decisions. In this article, available evidence for the issues surrounding risk communication and decision making in the prevention of invasive breast cancer are reviewed and strategies for improvement are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Decision making about pre-medication to children.

    Science.gov (United States)

    Proczkowska-Björklund, M; Runeson, I; Gustafsson, P A; Svedin, C G

    2008-11-01

    Inviting the child to participate in medical decisions regarding common medical procedures might influence the child's behaviour during the procedures. We wanted to study nurse decision-making communication regarding pre-medication before ear, nose and throat (ENT) surgery. In total, 102 children (3-6 years) signed for ENT surgery were video-filmed during the pre-medication process. The nurse decision-making communication was identified, transcribed and grouped in six main categories dependent on the level of participation (self-determination, compromise, negotiation, questioning, information, lack of communication). Associations between child factors (age, gender, verbal communication and non-verbal communication) and different nurse decision-making communication were studied. Associations between the decision-making communication and verbal hesitation and/or the child's compliance in taking pre-medication were also studied. Totally, information was the most frequently used category of decision making communication followed by negotiation and questioning. To the children showing signs of shyness, the nurse used more negotiation, questions and self-determination communication and less information. The nurse used more compromise, negotiation and gave less information to children with less compliance. No specific type of nurse decision-making communication was associated with verbal hesitation. The most important predictors for verbal hesitation were none or hesitant eye contact with nurse (OR = 4.5) and placement nearby or in parent's lap (OR = 4.7). Predictors for less compliance in taking pre-medication were verbal hesitation from the child (OR = 22.7) and children who did not give any verbal answer to nurse initial questions (OR = 5.5). Decision-making communication could not predict the child's compliance during pre-medication. Although negotiation, questioning and self-determination communication were associated with more unwillingness to take pre

  4. Decision-making in abnormal radiological situations

    International Nuclear Information System (INIS)

    Pretre, S.

    1998-01-01

    General problems associated with social impacts of radiology and decision making is discussed, as the main topics of the meeting. The problem of population is discussed living in areas contaminates with radioactive substances resulting from a major accident or from pest practices. This situation needs decision making process for initiating actions like relocation, resettlement or large-scale decontamination. The roles of various participants in this decision making process and in the communication with the public are considered. (R.P.)

  5. The RISAP-study: a complex intervention in risk communication and shared decision-making in general practice

    DEFF Research Database (Denmark)

    Kirkegaard, Pia; Edwards, Adrian G K; Hansen, Bo

    2010-01-01

    decision satisfaction (Provider Decision Process Assessment Instrument). The patients will receive a questionnaire at baseline and after 3 and 6 months. It includes questions about adherence to chosen treatment (Morisky Compliance Scale), self-rated health (SF-12), enablement (Patient Enablement Instrument...... training are needed. Aim:1) to systematically develop, describe and evaluate a complex intervention comprising a training programme for GPs in risk communication and shared decision-making, 2) to evaluate the effect of the training programme on real-life consultations between GPs and patients with high......), and risk communication and decision-making effectiveness (COMRADE Scale). Prescriptions, contacts to the health services, and cholesterol level will be drawn from the registers.In each group, 12 consultations will be observed and tape-recorded. The patients from these 24 consultations will be interviewed...

  6. Dual processing model of medical decision-making

    Science.gov (United States)

    2012-01-01

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

  7. Dual processing model of medical decision-making.

    Science.gov (United States)

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

    2012-09-03

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

  8. The decision-making process between rationality and emotions

    NARCIS (Netherlands)

    Alvino, Letizia; Franco, Massimo

    2017-01-01

    The decision-making process has been analyzed in several disciplines (economics, social sciences, humanities, etc.) with the aim of creating models to help decision-makers in strategy formulation. The Organizational theory takes into account both the decision-making process of individuals and groups

  9. Theoretical aspects of cellular decision-making and information-processing.

    Science.gov (United States)

    Kobayashi, Tetsuya J; Kamimura, Atsushi

    2012-01-01

    Microscopic biological processes have extraordinary complexity and variety at the sub-cellular, intra-cellular, and multi-cellular levels. In dealing with such complex phenomena, conceptual and theoretical frameworks are crucial, which enable us to understand seemingly different intra- and inter-cellular phenomena from unified viewpoints. Decision-making is one such concept that has attracted much attention recently. Since a number of cellular behavior can be regarded as processes to make specific actions in response to external stimuli, decision-making can cover and has been used to explain a broad range of different cellular phenomena [Balázsi et al. (Cell 144(6):910, 2011), Zeng et al. (Cell 141(4):682, 2010)]. Decision-making is also closely related to cellular information-processing because appropriate decisions cannot be made without exploiting the information that the external stimuli contain. Efficiency of information transduction and processing by intra-cellular networks determines the amount of information obtained, which in turn limits the efficiency of subsequent decision-making. Furthermore, information-processing itself can serve as another concept that is crucial for understanding of other biological processes than decision-making. In this work, we review recent theoretical developments on cellular decision-making and information-processing by focusing on the relation between these two concepts.

  10. Dual processing model of medical decision-making

    Directory of Open Access Journals (Sweden)

    Djulbegovic Benjamin

    2012-09-01

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

  11. Shared decision making in ante- & postnatal care – focus on communication skills training

    DEFF Research Database (Denmark)

    Nielsen, Annegrethe; Yding, Annika; Skovsted, Katrine Brander

    In recent years political focus has increasingly been on patient involvement in decisions in healthcare. One challenge in implementing the principles of shared decision making is to develop suitable communication practice in the clinical encounters between patients and healthcare providers....... A project where a group of midwives and nurses worked together in a serial of workshops training communication skills suitable for involving women in decisions in ante- and postnatal care was conducted in 2015. Communication skills training involved group analysis of videos of real consultations...... and a variety of roleplays and rehearsals of communication situations. Besides training communication skills the project aimed at documenting institutional practices obstructive to the purpose of sharing decisions....

  12. Dual processing model of medical decision-making

    OpenAIRE

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

    2012-01-01

    Abstract Background Dual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administe...

  13. Motivated information processing and group decision-making : Effects of process accountability on information processing and decision quality

    NARCIS (Netherlands)

    Scholten, Lotte; van Knippenberg, Daan; Nijstad, Bernard A.; De Dreu, Carsten K. W.

    Integrating dual-process models [Chaiken, S., & Trope, Y. (Eds.). (1999). Dual-process theories in social psychology. NewYork: Guilford Press] with work on information sharing and group decision-making [Stasser, G., & Titus, W. (1985). Pooling of unshared information in group decision making: biased

  14. "Doctor, Make My Decisions": Decision Control Preferences, Advance Care Planning, and Satisfaction With Communication Among Diverse Older Adults.

    Science.gov (United States)

    Chiu, Catherine; Feuz, Mariko A; McMahan, Ryan D; Miao, Yinghui; Sudore, Rebecca L

    2016-01-01

    Culturally diverse older adults may prefer varying control over medical decisions. Decision control preferences (DCPs) may profoundly affect advance care planning (ACP) and communication. To determine the DCPs of diverse, older adults and whether DCPs are associated with participant characteristics, ACP, and communication satisfaction. A total of 146 participants were recruited from clinics and senior centers in San Francisco. We assessed DCPs using the control preferences scale: doctor makes all decisions (low), shares with doctor (medium), makes own decisions (high). We assessed associations between DCPs and demographics; prior advance directives; ability to make in-the-moment goals of care decisions; self-efficacy, readiness, and prior asked questions; and satisfaction with patient-doctor communication (on a five-point Likert scale), using Chi-square and Kruskal-Wallis analysis of variance. Mean age was 71 ± 10 years, 53% were non-white, 47% completed an advance directive, and 70% made goals of care decisions. Of the sample, 18% had low DCPs, 33% medium, and 49% high. Older age was the only characteristic associated with DCPs (low: 75 ± 11 years, medium: 69 ± 10 years, high: 70 ± 9 years, P = 0.003). DCPs were not associated with ACP, in-the-moment decisions, or communication satisfaction. Readiness was the only question-asking behavior associated (low: 3.8 ± 1.2, medium: 4.1 ± 1.2, high: 4.3 ± 1.2, P = 0.05). Nearly one-fifth of diverse, older adults want doctors to make their medical decisions. Older age and lower readiness to ask questions were the only demographic variables significantly associated with low DCPs. Yet, older adults with low DCPs still engaged in ACP, asked questions, and reported communication satisfaction. Clinicians can encourage ACP and questions for all patients, but should assess DCPs to provide the desired amount of decision support. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All

  15. Making the Connection between Environmental Science and Decision Making

    Science.gov (United States)

    Woodhouse, C. A.; Crimmins, M.; Ferguson, D. B.; Garfin, G. M.; Scott, C. A.

    2011-12-01

    As society is confronted with population growth, limited resources, and the impacts of climate variability and change, it is vital that institutions of higher education promote the development of professionals who can work with decision-makers to incorporate scientific information into environmental planning and management. Skills for the communication of science are essential, but equally important is the ability to understand decision-making contexts and engage with resource managers and policy makers. It is increasingly being recognized that people who understand the linkages between science and decision making are crucial if science is to better support planning and policy. A new graduate-level seminar, "Making the Connection between Environmental Science and Decision Making," is a core course for a new post-baccalaureate certificate program, Connecting Environmental Science and Decision Making at the University of Arizona. The goal of the course is to provide students with a basic understanding of the dynamics between scientists and decision makers that result in scientific information being incorporated into environmental planning, policy, and management decisions. Through readings from the environmental and social sciences, policy, and planning literature, the course explores concepts including scientific information supply and demand, boundary organizations, co-production of knowledge, platforms for engagement, and knowledge networks. Visiting speakers help students understand some of the challenges of incorporating scientific information into planning and decision making within institutional and political contexts. The course also includes practical aspects of two-way communication via written, oral, and graphical presentations as well as through the interview process to facilitate the transfer of scientific information to decision makers as well as to broader audiences. We aspire to help students develop techniques that improve communication and

  16. Visual histories of decision processes for collaborative decision making

    OpenAIRE

    Kozlova, Karine

    2016-01-01

    Remembering, understanding and reconstructing past activities is a necessary part of any learning, sense-making or decision making process. It is also essential for any collaborative activity. This dissertation investigates the design and evaluation of systems to support decision remembering, understanding and reconstruction by groups and individuals. By conducting three qualitative case studies of small professional groups, we identify the critical activities where history functionality is n...

  17. Oncology residents' perspectives on communication skills and shared decision making.

    Science.gov (United States)

    Samant, Rajiv; Aivas, Inge; Bourque, Jean-Marc; Tucker, Tara

    2010-12-01

    Shared decision making (SDM) and effective communication are essential components of cancer care. Residents in oncology-related specialties were surveyed about communication skills and SDM. The response rate was 77% (17/22), and 93% stated that communication skills were very important for their specialty. Most (76%) thought their communication skills were adequate, but areas of difficulty included discussing end-of-life issues, giving hope when the prognosis was bleak and dealing with hostile patients. Only 58% of respondents had heard the term SDM, and 29% were aware of its meaning. More SDM and communication training are required for future oncology physicians.

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

    Science.gov (United States)

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

    2013-01-01

    Young women with cancer now face the complex decision about whether to undergo fertility preservation. Yet little is known about how these women process information involved in making this decision. The purpose of this article is to expand theoretical understanding of the decision-making process by examining aspects of information processing among young women diagnosed with cancer. Using a grounded theory approach, 27 women with cancer participated in individual, semistructured interviews. Data were coded and analyzed using constant-comparison techniques that were guided by 5 dimensions within the Contemplate phase of the decision-making process framework. In the first dimension, young women acquired information primarily from clinicians and Internet sources. Experiential information, often obtained from peers, occurred in the second dimension. Preferences and values were constructed in the third dimension as women acquired factual, moral, and ethical information. Women desired tailored, personalized information that was specific to their situation in the fourth dimension; however, women struggled with communicating these needs to clinicians. In the fifth dimension, women offered detailed descriptions of clinician behaviors that enhance or impede decisional debriefing. Better understanding of theoretical underpinnings surrounding women's information processes can facilitate decision support and improve clinical care.

  19. Complex Decision Making Theory and Practice

    CERN Document Server

    Qudrat-Ullah, Hassan; Spector, J Michael

    2007-01-01

    The increasingly complex environment of today's world, characterized by technological innovation and global communication, generates myriads of possible and actual interactions while limited physical and intellectual resources severely impinge on decision makers, be it in the public or private domains. At the core of the decision-making process is the need for quality information that allows the decision maker to better assess the impact of decisions in terms of outcomes, nonlinear feedback processes and time delays on the performance of the complex system invoked. This volume is a timely review on the principles underlying complex decision making, the handling of uncertainties in dynamic envrionments and of the various modeling approaches used. The book consists of five parts, each composed of several chapters: I: Complex Decision Making: Concepts, Theories and Empirical Evidence II: Tools and Techniques for Decision Making in Complex Environments and Systems III: System Dynamics and Agent-Based Modeling IV:...

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Science.gov (United States)

    Bright, Leslie Shay

    2010-01-01

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

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

    NARCIS (Netherlands)

    Zeiss, Ragna; van Egmond, S.

    2014-01-01

    This article studies the roles three science-based models play in Dutch policy and decision making processes. Key is the interaction between model construction and environment. Their political and scientific environments form contexts that shape the roles of models in policy decision making.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  5. Hospice decision making: diagnosis makes a difference.

    Science.gov (United States)

    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. The decision-making process between rationality and emotions

    OpenAIRE

    Alvino, Letizia; Franco, Massimo

    2017-01-01

    The decision-making process has been analyzed in several disciplines (economics, social sciences, humanities, etc.) with the aim of creating models to help decision-makers in strategy formulation. The Organizational theory takes into account both the decision-making process of individuals and groups of a company. Numerous models have been built, which include a wide range of psychological, environmental, hierarchical factors, all of which only account the notion of rationality. In time, such ...

  7. implications of decision making process on agricultural employees

    African Journals Online (AJOL)

    This study was designed to determine the implications of decision making process on employees' turnover in the Institute of ... Involvement in Decision Making and Agricultural Employees' Turnover in Ibadan, Nigeria 37 ..... Lack of motivation.

  8. Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

    Directory of Open Access Journals (Sweden)

    Dennis Drotar

    2010-03-01

    Full Text Available Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit collaborative decision making and can disrupt treatment adherence. However, models of provider-family communication that emphasize communication and shared goal-setting inform an anticipatory guidance model of collaborative decision-making that can enhance treatment adherence. Salient challenges and strategies involved in implementing collaborative decision-making in pediatric chronic illness care are described. Research is needed to: 1 describe the communication and decision-making process in the management of pediatric chronic illness; and 2 evaluate the impact of interventions that enhance collaborative decision-making on provider-family communication, illness management, and treatment adherence.Keywords: collaborative decision-making, shared decision-making, treatment adherence, pediatric chronic illness

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

    Science.gov (United States)

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

    2014-01-01

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

  10. Exploring the Reshoring and Insourcing Decision Making Process

    DEFF Research Database (Denmark)

    Bals, Lydia; Kirchoff, Jon F.; Foerstl, Kai

    2016-01-01

    The topics of reshoring and insourcing have recently become more widely discussed among operations management and international business scholars and managers, as some firms are revoking their offshoring and outsourcing decisions. This research focuses on and clarifies the decision making process...... organizational readiness in addition to decision drivers, improve coverage of the implementation stage and explore further contingency factors such as technological advancement as well as to focus on decision makers as the unit of analysis.......The topics of reshoring and insourcing have recently become more widely discussed among operations management and international business scholars and managers, as some firms are revoking their offshoring and outsourcing decisions. This research focuses on and clarifies the decision making processes...

  11. Markov decision processes: a tool for sequential decision making under uncertainty.

    Science.gov (United States)

    Alagoz, Oguzhan; Hsu, Heather; Schaefer, Andrew J; Roberts, Mark S

    2010-01-01

    We provide a tutorial on the construction and evaluation of Markov decision processes (MDPs), which are powerful analytical tools used for sequential decision making under uncertainty that have been widely used in many industrial and manufacturing applications but are underutilized in medical decision making (MDM). We demonstrate the use of an MDP to solve a sequential clinical treatment problem under uncertainty. Markov decision processes generalize standard Markov models in that a decision process is embedded in the model and multiple decisions are made over time. Furthermore, they have significant advantages over standard decision analysis. We compare MDPs to standard Markov-based simulation models by solving the problem of the optimal timing of living-donor liver transplantation using both methods. Both models result in the same optimal transplantation policy and the same total life expectancies for the same patient and living donor. The computation time for solving the MDP model is significantly smaller than that for solving the Markov model. We briefly describe the growing literature of MDPs applied to medical decisions.

  12. Decision making in matters of pollution in France

    International Nuclear Information System (INIS)

    Galle, Marion

    1989-01-01

    Decision making in matters of pollution, although taking place in a hierarchically determined institutional setting, can be interpreted as the result of a conflictual process between the different groups involved. 1. The statutory setting: coherence of laws and adaptability of norms; a hierarchical, pyramidal, formal structure; relative autonomy and flexibility of local decision making: possibility of developing local organizations for the control of pollution. 2. The conflictual process: Within the institutional setting, decision making is the result of interaction between: the state and the authorities, who make the rules and possess the formal power; industry, which has the economic power and is the arbiter of technical feasibility; the public, who are guardians of social values and judges of the acceptability of final decisions; the experts, who possess the scientific knowledge on which decisions are based. The relative weights of these different interests in decision making are linked with the existence of today's society of communication which increases the importance of communicators and especially the media. Conclusion: decision making in questions of environmental risk and pollution necessarily consists in taking into account all the interests involved in order to arrive at a solution acceptable to the public. The interests of society are not necessarily compatible with technical or scientific logic. (author)

  13. Modeling as a Decision-Making Process

    Science.gov (United States)

    Bleiler-Baxter, Sarah K.; Stephens, D. Christopher; Baxter, Wesley A.; Barlow, Angela T.

    2017-01-01

    The goal in this article is to support teachers in better understanding what it means to model with mathematics by focusing on three key decision-making processes: Simplification, Relationship Mapping, and Situation Analysis. The authors use the Theme Park task to help teachers develop a vision of how students engage in these three decision-making…

  14. Nonrational Processes in Ethical Decision Making

    Science.gov (United States)

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

    2011-01-01

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

  15. How Critical Thinking Shapes the Military Decision Making Process

    Science.gov (United States)

    2004-05-17

    emotional rebuttal. Conversely, people cannot make good rational decisions without at least a twinge of emotion attached to the decision . 2) Our minds... decision they make . If emotions overwhelm reason, then decisions should be postponed.27 Service biases are one of the strongest emotional bias. Any...FINAL 3. DATES COVERED (From - To) 4. TITLE AND SUBTITLE How Critical Thinking Shapes the Military Decision Making Process 5a. CONTRACT

  16. Development and utilization of complementary communication channels for treatment decision making and survivorship issues among cancer patients: The CIS Research Consortium Experience.

    Science.gov (United States)

    Fleisher, Linda; Wen, Kuang Yi; Miller, Suzanne M; Diefenbach, Michael; Stanton, Annette L; Ropka, Mary; Morra, Marion; Raich, Peter C

    2015-11-01

    Cancer patients and survivors are assuming active roles in decision-making and digital patient support tools are widely used to facilitate patient engagement. As part of Cancer Information Service Research Consortium's randomized controlled trials focused on the efficacy of eHealth interventions to promote informed treatment decision-making for newly diagnosed prostate and breast cancer patients, and post-treatment breast cancer, we conducted a rigorous process evaluation to examine the actual use of and perceived benefits of two complementary communication channels -- print and eHealth interventions. The three Virtual Cancer Information Service (V-CIS) interventions were developed through a rigorous developmental process, guided by self-regulatory theory, informed decision-making frameworks, and health communications best practices. Control arm participants received NCI print materials; experimental arm participants received the additional V-CIS patient support tool. Actual usage data from the web-based V-CIS was also obtained and reported. Print materials were highly used by all groups. About 60% of the experimental group reported using the V-CIS. Those who did use the V-CIS rated it highly on improvements in knowledge, patient-provider communication and decision-making. The findings show that how patients actually use eHealth interventions either singularly or within the context of other communication channels is complex. Integrating rigorous best practices and theoretical foundations is essential and multiple communication approaches should be considered to support patient preferences.

  17. Shared decision making observed in clinical practice: visual displays of communication sequence and patterns.

    Science.gov (United States)

    Elwyn, G; Edwards, A; Wensing, M; Hibbs, R; Wilkinson, C; Grol, R

    2001-05-01

    The aim of the study was to examine the communication strategies of general practitioners attempting to involve patients in treatment or management decisions. This empirical data was then compared with theoretical 'competences' derived for 'shared decision making'. The subjects were four general practitioners, who taped conducted consultations with the specific intent of involving patients in the decision-making process. The consultations were transcribed, coded into skill categorizations and presented as visual display using a specifically devised sequential banding The empirical data from these purposively selected consultation from clinicians who are experienced in shared decision making did not match suggested theoretical frameworks. The views of patients about treatment possibilities and their preferred role in decision making were not explored. The interactions were initiated by a problem-defining phase, statements of 'equipoise' consistently appeared and the portrayal of option information was often intermingled with opportunities to allow patients to question and reflect. A decision-making stage occurred consistently after approximately 80% of the total consultation duration and arrangements were consistently made for follow-up and review. Eight of the 10 consultations took more than 11 min - these specific consultations were characterized by significant proportions of time provided for information exchange and patient interaction. The results demonstrate that some theoretical competences are not distinguishable in practice and other stages, not previously described, such as the 'portrayal of equipoise', are observed. The suggested ideal of a shared decision-making interaction will either require more time than currently allocated, or alternative strategies to enable information exchange outside the consultation.

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

    Energy Technology Data Exchange (ETDEWEB)

    Khrennikova, Polina [School of Management, University of Leicester, University Road Leicester LE1 7RH (United Kingdom)

    2012-12-18

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

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

    Science.gov (United States)

    Khrennikova, Polina

    2012-12-01

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

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

    International Nuclear Information System (INIS)

    Khrennikova, Polina

    2012-01-01

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

  1. Supportive Care: Communication Strategies to Improve Cultural Competence in Shared Decision Making.

    Science.gov (United States)

    Brown, Edwina A; Bekker, Hilary L; Davison, Sara N; Koffman, Jonathan; Schell, Jane O

    2016-10-07

    Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations. Because health care beliefs of minority groups may follow their religion and country of origin, inevitable conflict can arise with decision making at the end of life. The principles of truth telling and patient autonomy are embedded in the framework of Anglo-American medical ethics. In contrast, in many parts of the world, the cultural norm is protection of the patient from the truth, decision making by the family, and a tradition of familial piety, where it is dishonorable not to do as much as possible for parents. The challenge for health care professionals is to understand how culture has enormous potential to influence patients' responses to medical issues, such as healing and suffering, as well as the physician-patient relationship. Our paper provides a framework of communication strategies that enhance crosscultural competency within nephrology teams. Shared decision making also enables clinicians to be culturally competent communicators by providing a model where clinicians and patients jointly consider best clinical evidence in light of a patient's specific health characteristics and values when choosing health care. The development of decision aids to include cultural awareness could avoid conflict proactively, more productively address it when it occurs, and enable decision making within the framework of the patient and family cultural beliefs. Copyright © 2016 by the American Society of Nephrology.

  2. Decision Making in Action

    Science.gov (United States)

    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

  3. On the Decision-Making Process in Music Education.

    Science.gov (United States)

    Jorgensen, Estelle R.

    1985-01-01

    Sketches a conceptual framework for the systematic description of decision-making processes in music education. Refers to existing formulations in education, management, marketing, and economics. Lists decision-making phases in music education, each exhibiting the characteristics of a social system. Offers a historical example of each phase. (AYC)

  4. Networks of Decision-Making and Communicating Agents: A New Methodology for Design and Evaluation of Organizational Strategies and Heterarchical Structures

    National Research Council Canada - National Science Library

    Levchuk, Georgiy M; Yu, Feili; Levchuk, Yuri; Pattipati, Krishna R

    2005-01-01

    In this paper, the authors explore the decomposition of organizational processes and decision-making, the coexistence of an organization's command and communication networks, and their effects on team performance...

  5. Decision Making and Ratio Processing in Patients with Mild Cognitive Impairment.

    Science.gov (United States)

    Pertl, Marie-Theres; Benke, Thomas; Zamarian, Laura; Delazer, Margarete

    2015-01-01

    Making advantageous decisions is important in everyday life. This study aimed at assessing how patients with mild cognitive impairment (MCI) make decisions under risk. Additionally, it investigated the relationship between decision making, ratio processing, basic numerical abilities, and executive functions. Patients with MCI (n = 22) were compared with healthy controls (n = 29) on a complex task of decision making under risk (Game of Dice Task-Double, GDT-D), on two tasks evaluating basic decision making under risk, on a task of ratio processing, and on several neuropsychological background tests. Patients performed significantly lower than controls on the GDT-D and on ratio processing, whereas groups performed comparably on basic decision tasks. Specifically, in the GDT-D, patients obtained lower net scores and lower mean expected values, which indicate a less advantageous performance relative to that of controls. Performance on the GDT-D correlated significantly with performance in basic decision tasks, ratio processing, and executive-function measures when the analysis was performed on the whole sample. Patients with MCI make sub-optimal decisions in complex risk situations, whereas they perform at the same level as healthy adults in simple decision situations. Ratio processing and executive functions have an impact on the decision-making performance of both patients and healthy older adults. In order to facilitate advantageous decisions in complex everyday situations, information should be presented in an easily comprehensible form and cognitive training programs for patients with MCI should focus--among other abilities--on executive functions and ratio processing.

  6. From the communication to participation in decision making; De la comunicacion a la participacion en la decisiones

    Energy Technology Data Exchange (ETDEWEB)

    Alonso, A. [Universidad Politecnica de Madrid (Spain)

    2004-07-01

    In the modern democratic societies there have appeared individuals and associations interested in and concerned with the risks proper to the use of ionising radiation and nuclear power. In the use of their democratic rights, they have requested and obtained from those responsible information on such activities and there has been established a fruitful communication process involving the interchange of facts and circumstances that is contributing to make the perceived risk more objective. At the moment, those societies are moving from information, through interactive communication, to participation in the decision.making processes with major social impacts or social sensitivity. This significant movement is analysed, as well as its causes and consequences. (Author)

  7. Decision Making in the Airplane

    Science.gov (United States)

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

    1995-01-01

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

  8. Decision Making Model for Business Process Outsourcing of Enterprise Content Management

    Directory of Open Access Journals (Sweden)

    Zhuojun Yi

    2013-03-01

    Full Text Available Business process outsourcing (BPO in enterprise content management (ECM is a growing though immature market. BPO in ECM focuses on pursuing market transactions in the process of managing all types of content being used in organizations. However, inadequate sourcing decisions lead to organizational sensitive content exposure, high transaction cost, poor outsourcer performance, low flexibility. ECM BPO in general is rarely discussed in the literature and no discussion was found on decision making strategies in ECM BPO. In this paper, we present a decision making model for ECM BPO that will fill the literature gap and guide industry practitioners with ECM sourcing decision making strategies. Our proposed decision making model includes two parts. Part one is an ECM functional framework that shows what functionality component or functionality combinations can be outsourced. Part two is a decision making model that provides guidance for decision making in ECM BPO. We apply the model in two case studies, and the results indicate that the model can guide the sourcing decision making process for organizations, and determine the factors when considering sourcing alternatives in ECM.

  9. Public participation in the decision making process in the nuclear field in Italy

    International Nuclear Information System (INIS)

    Pierantoni, F.

    1993-01-01

    In Italy, the decision making process to localize, construct and operate electronuclear power stations have been restructured and such a process today must follow the rules enacted by three laws: the Act of 2 August 1975 about the procedures for choosing the site; the Act of 8 July 1986 about the rules for the environmental impact evaluation, the so-called VIA which in italian means GO; the Act of 10 August 1988 which states that the construction of nuclear waste processing plants and nuclear waste storage plants must pass the Environment Impact Evaluation. In Italy there are three levels of Local government,'Regioni', 'Provincie' and 'Comuni', that are free to compete among themselves and with the Central government, so that it is very sticky to implement any decision. The Public Inquiry is a strongly innovative instrument. The Environmental Impact Evaluation procedure guarantees the transparency of the decision making process and supplies a real communication channel between the public opinion and the authorities. In the Public Inquiry any association, organization, union or group of people have the right to verify any part of the project under the Environmental Impact Evaluation and to express their consideration and observation on the subject

  10. Societal rationality; towards an understanding of decision making processes in society

    International Nuclear Information System (INIS)

    Wahlstroem, Bjoern

    2001-01-01

    In a search for new ways to structure decision making on complex and controversial issues it is necessary to build an understanding of why traditional decision making processes break down. One reason is connected to the issues themselves. They represent steps into the unknown and decisions should therefore be made with prudence. A second reason is connected to a track record according to which new technologies are seen as generating more problems than solutions. A third and more fundamental reason is connected to the decision making processes themselves and a need to find better ways to approach difficult questions in the society. One way to approach societal decision making processes is to investigate their hidden rationality in an attempt to understand causes of observed difficulties. The paper is based mainly on observations from the nuclear industry, but it builds also on controversies experienced in attempts to agree on global efforts towards sustainable approaches to development. It builds on an earlier paper, which discussed the basis of rationality both on an individual and a societal level. Research in societal decision making has to rely on a true multi-disciplinary approach. It is nor enough to understand the technical and scientific models by which outcomes are predicted, but it is also necessary to understand how people make sense of their environment and how they co-operate. Rationality is in this connection one of the key concepts, with an understanding that people always are rational in their own frame of action. The challenge in this connection is to understand how this subjective rationality is formed. Societal rationality has to do with the allocation of resources. There are decisions in which several conflicting views have to be considered. Spending time and resources ex ante may support a consensus ex post, but unfortunately there is no panacea for approaching difficult decisions. Decisions with an uncertain future have to be more robust than

  11. Societal rationality; towards an understanding of decision making processes in society

    Energy Technology Data Exchange (ETDEWEB)

    Wahlstroem, Bjoern [Technical Research Centre of Finland, Espoo (Finland)

    2001-07-01

    In a search for new ways to structure decision making on complex and controversial issues it is necessary to build an understanding of why traditional decision making processes break down. One reason is connected to the issues themselves. They represent steps into the unknown and decisions should therefore be made with prudence. A second reason is connected to a track record according to which new technologies are seen as generating more problems than solutions. A third and more fundamental reason is connected to the decision making processes themselves and a need to find better ways to approach difficult questions in the society. One way to approach societal decision making processes is to investigate their hidden rationality in an attempt to understand causes of observed difficulties. The paper is based mainly on observations from the nuclear industry, but it builds also on controversies experienced in attempts to agree on global efforts towards sustainable approaches to development. It builds on an earlier paper, which discussed the basis of rationality both on an individual and a societal level. Research in societal decision making has to rely on a true multi-disciplinary approach. It is nor enough to understand the technical and scientific models by which outcomes are predicted, but it is also necessary to understand how people make sense of their environment and how they co-operate. Rationality is in this connection one of the key concepts, with an understanding that people always are rational in their own frame of action. The challenge in this connection is to understand how this subjective rationality is formed. Societal rationality has to do with the allocation of resources. There are decisions in which several conflicting views have to be considered. Spending time and resources ex ante may support a consensus ex post, but unfortunately there is no panacea for approaching difficult decisions. Decisions with an uncertain future have to be more robust than

  12. Consumer recycling: An ethical decision-making process

    DEFF Research Database (Denmark)

    Culiberg, Barbara; Bajde, Domen

    2013-01-01

    Although recycling is often experienced as a moral dilemma, studies that systematically approach this issue from an ethical perspective are scarce. Moreover, previous studies have explored recycling by mainly using single ethical constructs, such as moral norms, values or obligations, rarely...... approaching it as an ethical decision-making process. Our study takes a more holistic approach and integrates the recycling literature with business ethics theory in order to develop a conceptual model of ethical decision making involved in recycling. The model is based on Jones' issue-contingent model...... using structural equation modelling. The results of our study confirmed the relationships between three key facets of ethical decision making: moral recognition, moral judgment and moral intention. Higher levels of moral recognition were found to lead to more positive moral judgments, which in turn...

  13. Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice.

    Science.gov (United States)

    Elwyn, G; Edwards, A; Hood, K; Robling, M; Atwell, C; Russell, I; Wensing, M; Grol, R

    2004-08-01

    A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on clinicians' ability to acquire skills and implement the competences of SDM or risk communication in consultations with patients. The aims of this study were to evaluate the effects of skill development workshops for SDM and the use of risk communication aids on the process of consultations. A cluster randomized trial with crossover was carried out with the participation of 20 recently qualified GPs in urban and rural general practices in Gwent, South Wales. A total of 747 patients with known atrial fibrillation, prostatism, menorrhagia or menopausal symptoms were invited to a consultation to review their condition or treatments. Half the consultations were randomly selected for audio-taping, of which 352 patients attended and were audio-taped successfully. After baseline, participating doctors were randomized to receive training in (i) SDM skills or (ii) the use of simple risk communication aids, using simulated patients. The alternative training was then provided for the final study phase. Patients were allocated randomly to a consultation during baseline or intervention 1 (SDM or risk communication aids) or intervention 2 phases. A randomly selected half of the consultations were audio-taped from each phase. Raters (independent, trained and blinded to study phase) assessed the audio-tapes using a validated scale to assess levels of patient involvement (OPTION: observing patient involvement), and to analyse the nature of risk information discussed. Clinicians completed questionnaires after each consultation, assessing perceived clinician-patient agreement and level of patient involvement in decisions. Multilevel modelling was carried out with the OPTION score as the dependent variable, and

  14. Use of PRA in Shuttle Decision Making Process

    Science.gov (United States)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

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

  15. Decision Accuracy in Computer-Mediated versus Face-to-Face Decision-Making Teams.

    Science.gov (United States)

    Hedlund; Ilgen; Hollenbeck

    1998-10-01

    Changes in the way organizations are structured and advances in communication technologies are two factors that have altered the conditions under which group decisions are made. Decisions are increasingly made by teams that have a hierarchical structure and whose members have different areas of expertise. In addition, many decisions are no longer made via strictly face-to-face interaction. The present study examines the effects of two modes of communication (face-to-face or computer-mediated) on the accuracy of teams' decisions. The teams are characterized by a hierarchical structure and their members differ in expertise consistent with the framework outlined in the Multilevel Theory of team decision making presented by Hollenbeck, Ilgen, Sego, Hedlund, Major, and Phillips (1995). Sixty-four four-person teams worked for 3 h on a computer simulation interacting either face-to-face (FtF) or over a computer network. The communication mode had mixed effects on team processes in that members of FtF teams were better informed and made recommendations that were more predictive of the correct team decision, but leaders of CM teams were better able to differentiate staff members on the quality of their decisions. Controlling for the negative impact of FtF communication on staff member differentiation increased the beneficial effect of the FtF mode on overall decision making accuracy. Copyright 1998 Academic Press.

  16. From science to decision-making: taking the risk to communicate on risks

    Science.gov (United States)

    Leroi, Eric

    2015-04-01

    Geoscientists and decision-makers have the same responsibility toward the society: reducing the damaging consequences induced by natural phenomena. They have to work together, geoscientists to improve the knowledge and decision-makers to take the "best" decision, both to design and implement balanced solutions, both to communicate. Feedback shows that if the collaboration between them has already improved, a lot has still to be done, especially in terms of communication; endless litany, geoscientists don't communicate in the right way! In a hyperspecialized technological and segmented society with sophisticated methods of communication, geoscientists don't use appropriate tools and terminology. It's true, and a lot of examples can be shown that highlight this! Risks is based on complex concepts, on notions that are poorly understood, even by scientists themselves, especially the concepts of probability and occurrence of phenomena. But the problem rest as well on the role and on the responsibility of the geoscientists. Risk management experts address geosciences and technology to identify problems and define protection, including prohibitive measures (such as not allowing building in hazardous areas). Policy makers and local planners want to know where to develop territories. On one hand the identification of problems, on the other hand the needs of solutions. Dialectic is not the same. When responsibility, money and image are the three main pillars of decision-making, long-term modeling and uncertainty, are the basic ones for geosciences. In our participative democracies people want to be actor of the development of their own territories; they want more freedom, more protection and less tax. Face to unrealistic political answers geoscientists have to explain and convince. It's not possible to gain on everything and some are going to loose. Shall geoscientists let decision-makers communicate on topics they hardly understand? No. Shall geoscientists communicate on

  17. Public involvement in the decision making process, Argentine experience

    International Nuclear Information System (INIS)

    Clein, D.

    1999-01-01

    In the frame of a young participative democracy the Comision Nacional de Energia Atomica (C.N.E.A.), technical and legal responsible for radioactive waste management, is developing a plan for the close out of tailings facilities from past mining and milling operations and the environmental restoration of nine different sites in six provinces all over the country. In the first site, Malargue Facility, different activities have been developed promoting public involvement in the decision making process. The lessons learned and the experience acquired have given the background for the systematization of public consultation in the ongoing and future stages of the plan. Malargue's experience in this field will be analyzed stressing on different aspects considered of importance for the design of a communicational strategy adapted to the characteristics of a society without experience in this field. The influence of public concern on conservative bias of technical decisions will be evaluated. (author)

  18. Age differences in dual information-processing modes: implications for cancer decision making.

    Science.gov (United States)

    Peters, Ellen; Diefenbach, Michael A; Hess, Thomas M; Västfjäll, Daniel

    2008-12-15

    Age differences in affective/experiential and deliberative processes have important theoretical implications for cancer decision making, as cancer is often a disease of older adulthood. The authors examined evidence for adult age differences in affective and deliberative information processes, reviewed the sparse evidence about age differences in decision making, and introduced how dual process theories and their findings might be applied to cancer decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age, particularly when decisions are unfamiliar and the information is numeric. However, age-related adaptive processes, including an increased focus on emotional goals and greater experience, can influence decision making and potentially offset age-related declines. A better understanding of the mechanisms that underlie cancer decision processes in our aging population should ultimately allow us to help older adults to better help themselves.

  19. Group decision-making: Factors that affect group effectiveness

    Directory of Open Access Journals (Sweden)

    Juliana Osmani

    2016-03-01

    Full Text Available Organizations are operating in a dynamic and turbulent environment. In these conditions, they have to make decisions for new problems or situations. Most of decisions are therefore non-programmed and unstructured, accompanied by risk and uncertainty. Moreover, the problems and situations are complex. All organizations are oriented towards group decisionmaking processes, as useful tools to cope with uncertainty and complexity. Apart from the necessity, companies are turning towards participatory processes also to benefit from the important advantages that these processes offer. Organizations have realized the importance of group decision-making processes to contribute to the creation of sustainable competitive advantages. Main objective of this paper is to show that group decision-making processes do not offer guarantee for good decisions, because the effectiveness of group is affected by many factors. So, the first thing done in this paper is discussing about the benefits and limitations that accompany the use of groups with decision-making purpose. Afterwards, we stop on the different factors that influence the group’s ability to make good decisions. The aim is to emphasize that regardless of the many advantages of groups, some factors as group size, type of communication within the group, leadership style, the norms, the differentiation of roles and statuses, cohesion and compliance degree should be the main elements to keep into consideration because they affect the effectiveness of group. In this regard, is discussed how such factors influence the quality of decision and then we try to draw some conclusions that can improve and make better and easier group decision-making processes.

  20. Housing decision making methods for initiation development phase process

    Science.gov (United States)

    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.

  1. Serotonin and decision making processes.

    NARCIS (Netherlands)

    Homberg, J.R.

    2012-01-01

    Serotonin (5-HT) is an important player in decision making. Serotonergic antidepressant, anxiolytic and antipsychotic drugs are extensively used in the treatment of neuropsychiatric disorders characterized by impaired decision making, and exert both beneficial and harmful effects in patients.

  2. Business making decisions

    Directory of Open Access Journals (Sweden)

    Enrique Benjamín Franklin Fincowsky

    2011-06-01

    Full Text Available People and organizations make better or get wrong as consequence of making decisions. Sometimes making decisions is just a trial and error process. Some others, decisions are good and the results profitable with a few of mistakes, most of the time because it’s considered the experience and the control of a specific field or the good intention of who makes them. Actually, all kinds of decisions bring learning. What is important is the intention, the attitude and the values considered in this process. People from different scenes face many facts and circumstances—almost always out of control—that affect the making decisions process. There is not a unique way to make decisions for all companies in many settings. The person who makes a decision should identify the problem, to solve it later using alternatives and solutions. Even though, follow all the steps it’s not easy as it seems. Looking back the conditions related to the decisions, we can mention the followings: uncertainty, risk and certainty. When people identify circumstances and facts, as well as its effects in a possible situation, they will make decisions with certainty. As long as the information decreases and it becomes ambiguous the risk becomes an important factor in the making decisions process because they are connected to probable objectives (clear or subjective (opinion judgment or intuition. To finish, uncertainty, involves people that make a decision with no or little information about circumstances or criteria with basis

  3. Influence of English proficiency on patient-provider communication and shared decision-making.

    Science.gov (United States)

    Paredes, Anghela Z; Idrees, Jay J; Beal, Eliza W; Chen, Qinyu; Cerier, Emily; Okunrintemi, Victor; Olsen, Griffin; Sun, Steven; Cloyd, Jordan M; Pawlik, Timothy M

    2018-06-01

    The number of patients in the United States (US) who speak a language other than English is increasing. We evaluated the impact of English proficiency on self-reported patient-provider communication and shared decision-making. The 2013-2014 Medical Expenditure Panel Survey database was utilized to identify respondents who spoke a language other than English. Patient-provider communication (PPC) and shared decision-making (SDM) scores from 4-12 were categorized as "poor" (4-7), "average" (8-11), and "optimal." The relationship between PPC, SDM, and English proficiency was analyzed. Among 13,880 respondents, most were white (n = 10,281, 75%), age 18-39 (n = 6,677, 48%), male (n = 7,275, 52%), middle income (n = 4,125, 30%), and born outside of the US (n = 9,125, 65%). English proficiency was rated as "very well" (n = 7,221, 52%), "well" (n = 2,378, 17%), "not well" (n = 2,820, 20%), or "not at all" (n = 1,463, 10%). On multivariable analysis, patients who rated their English as "well" (OR 1.73, 95% CI 1.37-2.18) or "not well" (OR 1.53, 95% CI 1.10-2.14) were more likely to report "poor" PPC (both P English proficiency as "not well" (OR 1.31, 95% CI 1.04-1.65, P = .02). Decreased English proficiency was associated with worse self-reported patient-provider communication and shared decision-making. Attention to patients' language needs is critical to patient satisfaction and improved perception of care. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Surgical Consultation as Social Process: Implications for Shared Decision Making.

    Science.gov (United States)

    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.

  5. Age Differences in Dual Information-Processing Modes: Implications for Cancer Decision Making

    Science.gov (United States)

    Peters, Ellen; Diefenbach, Michael A.; Hess, Thomas M.; Västfjäll, Daniel

    2008-01-01

    Age differences in affective/experiential and deliberative processes have important theoretical implications for cancer decision making as cancer is often a disease of older adulthood. We examine evidence for adult age differences in affective and deliberative information processes, review the sparse evidence about age differences in decision making and introduce how dual process theories and their findings might be applied to cancer decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age, particularly when decisions are unfamiliar and the information is numeric. However, age-related adaptive processes, including an increased focus on emotional goals and greater experience, can influence decision making and potentially offset age-related declines. A better understanding of the mechanisms that underlie cancer decision processes in our aging population should ultimately allow us to help older adults to better help themselves. PMID:19058148

  6. Decision Making

    Directory of Open Access Journals (Sweden)

    Pier Luigi Baldi

    2006-06-01

    Full Text Available This article points out some conditions which significantly exert an influence upon decision and compares decision making and problem solving as interconnected processes. Some strategies of decision making are also examined.

  7. Predicting IT Governance Performance : A Method for Model-Based Decision Making

    OpenAIRE

    Simonsson, Mårten

    2008-01-01

    Contemporary enterprises are largely dependent on Information Technology (IT), which makes decision making on IT matters important. There are numerous issues that confuse IT decision making, including contradictive business needs, financial constraints, lack of communication between business and IT stakeholders and difficulty in understanding the often heterogeneous and integrated IT systems. The discipline of IT governance aims at providing the decision making structures, processes, and rela...

  8. Analysis of Communication between Main Control Room Operators in Decision-making Process in Steam Generator Tube Rupture Accident

    International Nuclear Information System (INIS)

    Petkov, M.; Petkov, G.

    2006-01-01

    The paper presents an investigation results for Main Control Room operators' reliability by Performance Evaluation of Teamwork method, based on FSS-1000 training archives in KNPP in case of Steam Generator Tube Rupture accident. The advantages of operators' teamwork are shown: a) group decision-making vs. individual one: b) positive influence of crew initiated communication consisting of orders and reports that are required by instruction. (authors)

  9. Analysis of the decision-making process of nurse managers: a collective reflection.

    Science.gov (United States)

    Eduardo, Elizabete Araujo; Peres, Aida Maris; de Almeida, Maria de Lourdes; Roglio, Karina de Dea; Bernardino, Elizabeth

    2015-01-01

    to analyze the decision-making model adopted by nurses from the perspective of some decision-making process theories. qualitative approach, based on action research. Semi-structured questionnaires and seminars were conducted from April to June 2012 in order to understand the nature of decisions and the decision-making process of nine nurses in position of managers at a public hospital in Southern Brazil. Data were subjected to content analysis. data were classified in two categories: the current situation of decision-making, which showed a lack of systematization; the construction and collective decision-making, which emphasizes the need to develop a decision-making model. the decision-making model used by nurses is limited because it does not consider two important factors: the limits of human rationality, and the external and internal organizational environments that influence and determine right decisions.

  10. Granular computing and decision-making interactive and iterative approaches

    CERN Document Server

    Chen, Shyi-Ming

    2015-01-01

    This volume is devoted to interactive and iterative processes of decision-making– I2 Fuzzy Decision Making, in brief. Decision-making is inherently interactive. Fuzzy sets help realize human-machine communication in an efficient way by facilitating a two-way interaction in a friendly and transparent manner. Human-centric interaction is of paramount relevance as a leading guiding design principle of decision support systems.   The volume provides the reader with an updated and in-depth material on the conceptually appealing and practically sound methodology and practice of I2 Fuzzy Decision Making. The book engages a wealth of methods of fuzzy sets and Granular Computing, brings new concepts, architectures and practice of fuzzy decision-making providing the reader with various application studies.   The book is aimed at a broad audience of researchers and practitioners in numerous disciplines in which decision-making processes play a pivotal role and serve as a vehicle to produce solutions to existing prob...

  11. Safety assessment as basis for the decision making process

    International Nuclear Information System (INIS)

    Ilie, P.; Didita, L.; Danchiv, A.

    2005-01-01

    This paper deals with the safety assessment for a new near surface repository, particularly for the early stage of repository development using ISAM (Improvement of Safety Assessment Methodologies for Near Surface Disposal Facilities) safety assessment methodology. In this stage of the repository life cycle the main purpose of the safety assessment is to demonstrate that the plant is capable to be constructed and operated safely. The paper is based on development of the ASAM (Application of the Safety Assessment Methodologies for Near-Surface Disposal Facilities) Decision Support Subgroup of the Common Aspects Working Group. The implications of decision making for the application of the ISAM methodology on post-closure safety assessment are analysed. Some important elements of the decision-making process with impact on key components of the ISAM process are described. Following the development of Decision Support Subgroup of the ASAM Common Aspects Working Group the proposed change of ISAM methodology is analysed. This approach puts all activities in a decision context where the first iteration of the safety assessment is based on the existing state of knowledge and the initial engineering design. Confidence in the process is accomplished through the direct inclusion of all decision makers and stakeholders in the formulation of decisions, the definition of the state of knowledge, and decision making activities. The decision process is developed in context of undertaking assessments with little site-specific information, this situation is specifically for new planned repository. Limited site-specific information can result in a high degree of uncertainty, therefore it is important first of all to identify the sources of uncertainty arising from the limited nature of the site-specific information and then to apply appropriate approaches to manage the uncertainties and to determine whether the uncertainties are important to the overall safety of the disposal facility

  12. Theoretical Background for the Decision-Making Process Modelling under Controlled Intervention Conditions

    Directory of Open Access Journals (Sweden)

    Bakanauskienė Irena

    2017-12-01

    Full Text Available This article is intended to theoretically justify the decision-making process model for the cases, when active participation of investing entities in controlling the activities of an organisation and their results is noticeable. Based on scientific literature analysis, a concept of controlled conditions is formulated, and using a rational approach to the decision-making process, a model of the 11-steps decision-making process under controlled intervention is presented. Also, there have been unified conditions, describing the case of controlled interventions thus providing preconditions to ensure the adequacy of the proposed decision-making process model.

  13. Sexual picture processing interferes with decision-making under ambiguity.

    Science.gov (United States)

    Laier, Christian; Pawlikowski, Mirko; Brand, Matthias

    2014-04-01

    Many people watch sexually arousing material on the Internet in order to receive sexual arousal and gratification. When browsing for sexual stimuli, individuals have to make several decisions, all possibly leading to positive or negative consequences. Decision-making research has shown that decisions under ambiguity are influenced by consequences received following earlier decisions. Sexual arousal might interfere with the decision-making process and should therefore lead to disadvantageous decision-making in the long run. In the current study, 82 heterosexual, male participants watched sexual pictures, rated them with respect to sexual arousal, and were asked to indicate their current level of sexual arousal before and following the sexual picture presentation. Afterwards, subjects performed one of two modified versions of the Iowa Gambling Task in which sexual pictures were displayed on the advantageous and neutral pictures on the disadvantageous card decks or vice versa (n = 41/n = 41). Results demonstrated an increase of sexual arousal following the sexual picture presentation. Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.

  14. Mock Pages Are a Valid Construct for Assessment of Clinical Decision Making and Interprofessional Communication.

    Science.gov (United States)

    Boehler, Margaret L; Schwind, Cathy J; Markwell, Stephen J; Minter, Rebecca M

    2017-01-01

    Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills. Mock page cases (n = 16) were administered to 213 senior medical students from 12 medical schools participating in a national surgical resident preparatory curriculum in 2013 and 2014. Clinical decision making and interprofessional communication were measured by case-specific assessments evaluating these skills which have undergone rigorous standard-setting to determine pass/fail cut points. Students' performance improved in general for both communication and clinical decision making over the 4-week course. Cases have been identified that seem to be best suited for differentiating high- from low-performing students. Chest pain, pulmonary embolus, and mental status change cases posed the greatest difficulty for student learners. Simulated mock pages demonstrate an innovative technique for training students in both effective interprofessional communication and management of common postoperative conditions they will encounter as new surgical interns.

  15. The decision-making process during accidents or incidents in the operational nuclear area

    International Nuclear Information System (INIS)

    Martins, Maria da Penha Sanches; Vanni, Silvia Regina Vanni; Andrade, Delvonei Alves de

    2009-01-01

    This study reflects on one of the human behavior mediating factors that face nuclear facility operators during their decision-making process. It includes some mental processes used to determine the best course of action, based on intuitive and creative decisions, within a specific set of rational conditions which depend much more on perception about threats than on theoretical knowledge. A fast and efficient decision, in an unstable and ongoing changing scenario/environment, is extremely complex. The decision-making process goes beyond the purely rational level and many times is influenced by intuition. The importance of the decision-making process leads the study to also review human factors. The methodology used in this paper is based on cognitive aspects which are focused essentially on studies such as: decision process models, decision types and human rationality limits (time) versus individual decisions. Lastly, it makes assessments on how reason, emotion and being under stress relate to the decision-making process (author)

  16. The decision-making process during accidents or incidents in the operational nuclear area

    Energy Technology Data Exchange (ETDEWEB)

    Martins, Maria da Penha Sanches; Vanni, Silvia Regina Vanni [Centro Tecnologico da Marinha em Sao Paulo (CTMSP), SP (Brazil); Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)], email: penhamartins@yahoo.com.br, e-mail: sjcvanni@yahoo.com.br; Andrade, Delvonei Alves de [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)], e-mail: delvonei@ipen.br

    2009-07-01

    This study reflects on one of the human behavior mediating factors that face nuclear facility operators during their decision-making process. It includes some mental processes used to determine the best course of action, based on intuitive and creative decisions, within a specific set of rational conditions which depend much more on perception about threats than on theoretical knowledge. A fast and efficient decision, in an unstable and ongoing changing scenario/environment, is extremely complex. The decision-making process goes beyond the purely rational level and many times is influenced by intuition. The importance of the decision-making process leads the study to also review human factors. The methodology used in this paper is based on cognitive aspects which are focused essentially on studies such as: decision process models, decision types and human rationality limits (time) versus individual decisions. Lastly, it makes assessments on how reason, emotion and being under stress relate to the decision-making process (author)

  17. [The decision making process of ESRD families during the dialysis withdrawal period].

    Science.gov (United States)

    Lin, Tsai-Rung

    2011-08-01

    Hemodialysis is a financial burden to the state and families and the cause of much suffering in patients. It is a life prolonging therapy and death-delaying treatment. When the burdens of therapy substantially outweigh its benefits, withdrawal from dialysis is an appropriate option. However, considering the ethical and legal concerns of doing such is something families must face. There has been little research and little understanding of the process of decision-making within families in Taiwan. The process is full of conflicts, worries, guilt, shame, and lack of consensus. Effective communication with the medical team to resolve the conflict and describe the prognosis is necessary in order to reach a consensus and move toward palliative care. The article uses a case report and discusses the process. Finally, the author suggests an approach to making the situation better in the future.

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

    Science.gov (United States)

    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.

  19. The features of decision making process in international companies. Are companies in control of their own decisions?

    Directory of Open Access Journals (Sweden)

    Anastasia JELEVA

    2017-06-01

    Full Text Available The following article deals with the main causes of irrational decision making process in companies and with respective solutions to make decisions more rational and effective. With the aid of relevant literature, the ways managers, groups and leaders make decisions in reality will be clarified. Besides, the solutions to rational decisions examined through the perspective of managers, leaders and groups. Thus, the background of this article is the question “Are companies in control of their own decisions?” In addition, this paper includes relevant information about the features of decision making process, basic types of decisions, describes the most essential approach in management regarding to decision making and presents the top worst and best business decisions of all time.

  20. HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    Ali Soltani

    2011-06-01

    Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.

  1. HOSPITAL SITE SELECTION USING TWO-STAGE FUZZY MULTI-CRITERIA DECISION MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    Ali Soltani

    2011-01-01

    Full Text Available Site selection for sitting of urban activities/facilities is one of the crucial policy-related decisions taken by urban planners and policy makers. The process of site selection is inherently complicated. A careless site imposes exorbitant costs on city budget and damages the environment inevitably. Nowadays, multi-attributes decision making approaches are suggested to use to improve precision of decision making and reduce surplus side effects. Two well-known techniques, analytical hierarchal process and analytical network process are among multi-criteria decision making systems which can easily be consistent with both quantitative and qualitative criteria. These are also developed to be fuzzy analytical hierarchal process and fuzzy analytical network process systems which are capable of accommodating inherent uncertainty and vagueness in multi-criteria decision-making. This paper reports the process and results of a hospital site selection within the Region 5 of Shiraz metropolitan area, Iran using integrated fuzzy analytical network process systems with Geographic Information System (GIS. The weights of the alternatives were calculated using fuzzy analytical network process. Then a sensitivity analysis was conducted to measure the elasticity of a decision in regards to different criteria. This study contributes to planning practice by suggesting a more comprehensive decision making tool for site selection.

  2. Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness

    Science.gov (United States)

    Epstein, Ronald M.; Street, Richard L.

    2011-01-01

    In the context of serious illness, individuals usually rely on others to help them think and feel their way through difficult decisions. To help us to understand why, when, and how individuals involve trusted others in sharing information, deliberation, and decision making, we offer the concept of shared mind—ways in which new ideas and perspectives can emerge through the sharing of thoughts, feelings, perceptions, meanings, and intentions among 2 or more people. We consider how shared mind manifests in relationships and organizations in general, building on studies of collaborative cognition, attunement, and sensemaking. Then, we explore how shared mind might be promoted through communication, when appropriate, and the implications of shared mind for decision making and patient autonomy. Next, we consider a continuum of patient-centered approaches to patient-clinician interactions. At one end of the continuum, an interactional approach promotes knowing the patient as a person, tailoring information, constructing preferences, achieving consensus, and promoting relational autonomy. At the other end, a transactional approach focuses on knowledge about the patient, information-as-commodity, negotiation, consent, and individual autonomy. Finally, we propose that autonomy and decision making should consider not only the individual perspectives of patients, their families, and members of the health care team, but also the perspectives that emerge from the interactions among them. By drawing attention to shared mind, clinicians can observe in what ways they can promote it through bidirectional sharing of information and engaging in shared deliberation. PMID:21911765

  3. Understanding patient perceptions of shared decision making.

    Science.gov (United States)

    Shay, L Aubree; Lafata, Jennifer Elston

    2014-09-01

    This study aims to develop a conceptual model of patient-defined SDM, and understand what leads patients to label a specific, decision-making process as shared. Qualitative interviews were conducted with 23 primary care patients following a recent appointment. Patients were asked about the meaning of SDM and about specific decisions that they labeled as shared. Interviews were coded using qualitative content analysis. Patients' conceptual definition of SDM included four components of an interactive exchange prior to making the decision: both doctor and patient share information, both are open-minded and respectful, patient self-advocacy, and a personalized physician recommendation. Additionally, a long-term trusting relationship helps foster SDM. In contrast, when asked about a specific decision labeled as shared, patients described a range of interactions with the only commonality being that the two parties came to a mutually agreed-upon decision. There is no one-size-fits all process that leads patients to label a decision as shared. Rather, the outcome of "agreement" may be more important than the actual decision-making process for patients to label a decision as shared. Studies are needed to better understand how longitudinal communication between patient and physicians and patient self-advocacy behaviors affect patient perceptions of SDM. Published by Elsevier Ireland Ltd.

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

    Science.gov (United States)

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

    2013-06-01

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

  5. Contralateral prophylactic mastectomy: A qualitative approach to exploring the decision making process.

    Science.gov (United States)

    Greener, Judith R; Bass, Sarah Bauerle; Lepore, Stephen J

    2018-01-01

    The proportion of women with unilateral breast cancer and no familial or genetic risk factors who elect contralateral prophylactic mastectomy (CPM) has grown dramatically, even in the absence of clear data demonstrating improved outcomes. To further extend the literature that addresses treatment decision-making, qualitative interviews were conducted with eleven women who considered CPM. A social ecological model of breast cancer treatment decision-making provided the conceptual framework, and grounded theory was used to identify the cognitive, psychosocial, and emotional influences motivating treatment choice. This research identified five themes that give context to women's decision-making experience: (1) variability in physician communication, (2) immediacy of the decision, (3) meaning of being proactive about treatment, (4) meaning of risk, and (5) women's relationship with their breasts. The results suggest that greater emphasis should be placed on a more nuanced understanding of patients' emotional reaction to breast cancer and managing the decision-making environment.

  6. Joking or decision-making? Affective and instrumental behaviour in doctor-parent-child communication.

    NARCIS (Netherlands)

    Tates, K.; Meeuwesen, L.; Bensing, J.; Elbers, E.

    2002-01-01

    Advocating active child participation in medical encounters is in line with demands for shared decision-making and informed consent. The sparse literature on doctor-child communication, however, conceptualizes children as passive participants and depicts the stereotype of a 'joking' relationship,

  7. Risk-Based Decision Making for Deterioration Processes Using POMDP

    DEFF Research Database (Denmark)

    Nielsen, Jannie Sønderkær; Sørensen, John Dalsgaard

    2015-01-01

    This paper proposes a method for risk-based decision making for maintenance of deteriorating components, based on the partially observable Markov decision process (POMDP). Unlike most methods, the decision polices do not need to be stationary and can vary according to seasons and near the end...

  8. Access to augmentative and alternative communication: new technologies and clinical decision-making.

    Science.gov (United States)

    Fager, Susan; Bardach, Lisa; Russell, Susanne; Higginbotham, Jeff

    2012-01-01

    Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations.

  9. Joking or decision-making? Affective and instrumental behaviour in doctor-parent-child communication.

    OpenAIRE

    Tates, K.; Meeuwesen, L.; Bensing, J.; Elbers, E.

    2002-01-01

    Advocating active child participation in medical encounters is in line with demands for shared decision-making and informed consent. The sparse literature on doctor-child communication, however, conceptualizes children as passive participants and depicts the stereotype of a 'joking' relationship, which is limited mainly to affective behaviour. This descriptive study explores the nature of communication in the doctor-parent-child triad at the general practitioner's surgery. Video-taped observa...

  10. Characteristics of the postcounseling reproductive decision-making process: an explorative study.

    Science.gov (United States)

    Frets, P G; Verhage, F; Niermeijer, M F

    1991-09-01

    An in-depth, recorded interview of 30 couples 2-3 years after genetic counseling explored the characteristics of the postcounseling decision-making process, including the role of guilt feelings towards the proband. The study concerned couples with an affected child, sib, or spouse. Results were evaluated by 2 to 4 judges. In contrast to other studies, a generally unstructured decision-making process was found whereby guilt feelings played a significant role in more than half the couples. Guilt feelings were more predominant in couples with an affected sib than in those with an affected spouse. Lack of structure did not seem to complicate the decision-making process. Therefore, authors do not advocate promotion of structuring the decision-making process. Genetic counselors might focus on understanding counselees' feelings concerning the reproductive decision. Acceptance of apparently irrational considerations is particularly important, because these feelings indicate the influence of unconscious motives. Another important aspect of supporting counselees is to understand the role played by guilt feelings toward parents or an affected sib.

  11. Theoretical Background for the Decision-Making Process Modelling under Controlled Intervention Conditions

    OpenAIRE

    Bakanauskienė Irena; Baronienė Laura

    2017-01-01

    This article is intended to theoretically justify the decision-making process model for the cases, when active participation of investing entities in controlling the activities of an organisation and their results is noticeable. Based on scientific literature analysis, a concept of controlled conditions is formulated, and using a rational approach to the decision-making process, a model of the 11-steps decision-making process under controlled intervention is presented. Also, there have been u...

  12. Career Decision-Making Processes of Young Adults With First-Episode Psychosis.

    Science.gov (United States)

    Boychuk, Christa; Lysaght, Rosemary; Stuart, Heather

    2018-05-01

    The first episode of psychosis often emerges during young adulthood, when individuals are pursuing important educational and career goals that can become derailed because of the development of major impairments. Past research has neglected the developmental nature of employment and education decisions that young adults with first-episode psychosis make within the context of their lives. The purpose of this grounded theory study was to advance a model of the career decision-making processes of young adults with first-episode psychosis, and the influences that affect their career decision-making. The career decision-making of young adults with first-episode psychosis emerged as a multistaged, iterative process that unfolded over three phases of illness, and was affected by several internal and environmental influences. These findings suggest the phase of illness and career decision-making stage should be considered in future vocational programming for young adults with first-episode psychosis.

  13. Acceptability, acceptance and decision making

    International Nuclear Information System (INIS)

    Ackerschott, H.

    2002-01-01

    There is a fundamental difference between the acceptability of a civilizatory or societal risk and the acceptability of the decision-making process that leads to a civilizatory or societal risk. The analysis of individual risk decisions - regarding who, executes when which indisputably hazardous, unhealthy or dangerous behaviour under which circumstances - is not helpful in finding solutions for the political decisions at hand in Germany concerning nuclear energy in particular or energy in general. The debt for implementation of any technology, in the sense of making the technology a success in terms of broad acceptance and general utilisation, lies with the particular industry involved. Regardless of the technology, innovation research identifies the implementation phase as most critical to the success of any innovation. In this sense, nuclear technology is at best still an innovation, because the implementation has not yet been completed. Fear and opposition to innovation are ubiquitous. Even the economy - which is often described as 'rational' - is full of this resistance. Innovation has an impact on the pivotal point between stability, the presupposition for the successful execution of decisions already taken and instability, which includes insecurity, but is also necessary for the success of further development. By definition, innovations are beyond our sphere of experience; not at the level of reliability and trust yet to come. Yet they are evaluated via the simplifying heuristics for making decisions proven not only to be necessary and useful, but also accurate in the familiar. The 'settlement of the debt of implementation', the accompanying communication, the decision-making procedures concerning the regulation of averse effects of the technology, but also the tailoring of the new technology or service itself must be directed to appropriate target groups. But the group often aimed at in the nuclear debate, the group, which largely determines political

  14. Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research.

    Science.gov (United States)

    Land, Victoria; Parry, Ruth; Seymour, Jane

    2017-12-01

    Shared decision making (SDM) is generally treated as good practice in health-care interactions. Conversation analytic research has yielded detailed findings about decision making in health-care encounters. To map decision making communication practices relevant to health-care outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM. We searched nine electronic databases (last search November 2016) and our own and other academics' collections. Published conversation analyses (no restriction on publication dates) using recordings of health-care encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness-related decision making. We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively. Twenty-eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision-making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs' responses to patients' resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs' practices may constrain or encourage this participation. Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non-negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision's rationale). © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    Erol Akçay

    Full Text Available 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

  17. Assigning a volcano alert level: negotiating uncertainty, risk, and complexity in decision-making processes

    OpenAIRE

    Carina J Fearnley

    2013-01-01

    A volcano alert level system (VALS) is used to communicate warning information from scientists to civil authorities managing volcanic hazards. This paper provides the first evaluation of how the decision-making process behind the assignation of an alert level, using forecasts of volcanic behaviour, operates in practice . Using interviews conducted from 2007 to 2009 at five USGS-managed (US Geological Survey) volcano observatories (Alaska, Cascades, Hawaii, Long Valley, and Yellowstone), two k...

  18. Risk communication: Translating technically complex information to facilitate informed decision-making

    International Nuclear Information System (INIS)

    Sprecher, W.M.; Turner, E.

    1991-01-01

    Based on a review of risk communication and related literature, including policy material, this paper describes the newly revamped risk management program of the DOE's Office of Civilian Radioactive Waste Management (OCRWM), and some of the risk-related issues being confronted as the high-level waste management program moves forward. It also describes preliminary activities underway in which the OCRWM is developing strategies for risk communication. The authors offer a definition of risk management as comprised by the components of risk assessment and risk communication. The paper explores the discrepant views that experts and nonexperts have with respect to what constitutes a valid risk assessment model. By illustrating differences in the assessment of risk by experts and lay people, the paper demonstrates how these differences can create challenges in communicating risk and making decisions about risk. Finally, the paper discusses ways in which risk communication could be enhance, and elaborates on the OCRWM's commitment to improve its overall risk management efforts

  19. MANAGEMENT OF SELF-DEFENSE OF THE MUNICIPALITIES – PREPARATION FOR THE DECISION-MAKING PROCESS AT DISASTERS

    Directory of Open Access Journals (Sweden)

    Marianna Dobó

    2014-10-01

    Full Text Available The research, which was started in 2013 focuses on the decision-making process after vis-mayor situations (Dobó, 2013. Disaster Management in Hungary is a less known and researched area. However, over the last years natural problems had great impact on the decision making process of the local government (Csefkó, 1997. The disasters transformed the processes that had been working so far. The examination of the changed decisions became very important. Researches were carried out by the Disaster Management Department of National University of Public Service. One of the most important projects is the Critical infrastructure protection that could provide practical knowledge about the topic. The decision-making process after the crisis had not been analysed in previous studies. This research can be divided into several parts. First, there is exploration of the theoretical frameworks, laws and regulations. The decisions of the local government and the disaster management process can be presented by becoming familiar with the previous disasters. The most important stage will be the examination of the post-disaster period when the roles and the transformation of the players can be demonstrated. The methodology is complex. In the first phase, after consideration of the literature, the focus is on the changes of the law. The second stage contains media monitoring, document and map examination as well as interviews with the actors. In the third stage, the observation comes as a new method to the second phase: cooperative decision making process, crisis communication replacement, social reconciliation. The topic at any time is up to date due to the fact that while the preparedness for a crisis has become more urgent, the prediction of vis-mayor situations and consequently, the preparation is almost impossible. In this context, the decision-making process of 15 municipalities, which are now live every day of their flood, pour of the river-wall or red mud

  20. Health technology funding decision-making processes around the world: the same, yet different.

    Science.gov (United States)

    Stafinski, Tania; Menon, Devidas; Philippon, Donald J; McCabe, Christopher

    2011-06-01

    All healthcare systems routinely make resource allocation decisions that trade off potential health gains to different patient populations. However, when such trade-offs relate to the introduction of new, promising health technologies, perceived 'winners' and 'losers' are more apparent. In recent years, public scrutiny over such decisions has intensified, raising the need to better understand how they are currently made and how they might be improved. The objective of this paper is to critically review and compare current processes for making health technology funding decisions at the regional, state/provincial and national level in 20 countries. A comprehensive search for published, peer-reviewed and grey literature describing actual national, state/provincial and regional/institutional technology decision-making processes was conducted. Information was extracted by two independent reviewers and tabulated to facilitate qualitative comparative analyses. To identify strengths and weaknesses of processes identified, websites of corresponding organizations were searched for commissioned reviews/evaluations, which were subsequently analysed using standard qualitative methods. A total of 21 national, four provincial/state and six regional/institutional-level processes were found. Although information on each one varied, they could be grouped into four sequential categories: (i) identification of the decision problem; (ii) information inputs; (iii) elements of the decision-making process; and (iv) public accountability and decision implementation. While information requirements of all processes appeared substantial and decision-making factors comprehensive, the way in which they were utilized was often unclear, as were approaches used to incorporate social values or equity arguments into decisions. A comprehensive inventory of approaches to implementing the four main components of all technology funding decision-making processes was compiled, from which areas for future

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

    Science.gov (United States)

    Coroiu, A. M.

    2015-11-01

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

  2. Non-technical factors impacting on the decision making processes in environmental remediation. Influences on the decision making process such as cost, planned land use and public perception

    International Nuclear Information System (INIS)

    2002-04-01

    The IAEA attaches great importance to the dissemination of information that can assist Member States with the development, implementation, maintenance and continuous improvement of systems, programmes and activities that support the nuclear fuel cycle and nuclear applications, including the legacy of past practices and accidents. In response to this, the IAEA has initiated a comprehensive programme of work covering all aspects of environmental remediation: factors important for formulating a strategy for environmental remediation; site characterisation techniques and strategies; assessment of remediation technologies; assessment of technical options for cleanup of contaminated media; post-restoration compliance monitoring; assessment of the costs of remediation measures; remediation of low-level disperse radioactive contaminations in the environment. While this project mainly focus on technological aspects, non-technical factors will be influencing the decision making process in remediation decisively. Often their influence is only tacitly accepted and not explicitly acknowledged by the responsible decision makers. This makes it difficult to trace the decision making process in the event that it has to be revisited. The present publication attempts to make these factors explicit and to present methods to include them consciously into the decision making process

  3. The application of reduced-processing decision support systems to facilitate the acquisition of decision-making skills.

    Science.gov (United States)

    Perry, Nathan C; Wiggins, Mark W; Childs, Merilyn; Fogarty, Gerard

    2013-06-01

    The study was designed to examine whether the availability of reduced-processing decision support system interfaces could improve the decision making of inexperienced personnel in the context of Although research into reduced-processing decision support systems has demonstrated benefits in minimizing cognitive load, these benefits have not typically translated into direct improvements in decision accuracy because of the tendency for inexperienced personnel to focus on less-critical information. The authors investigated whether reduced-processing interfaces that direct users' attention toward the most critical cues for decision making can produce improvements in decision-making performance. Novice participants made incident command-related decisions in experimental conditions that differed according to the amount of information that was available within the interface, the level of control that they could exert over the presentation of information, and whether they had received decision training. The results revealed that despite receiving training, participants improved in decision accuracy only when they were provided with an interface that restricted information access to the most critical cues. It was concluded that an interface that restricts information access to only the most critical cues in the scenario can facilitate improvements in decision performance. Decision support system interfaces that encourage the processing of the most critical cues have the potential to improve the accuracy and timeliness of decisions made by inexperienced personnel.

  4. Caregiving decision making by older mothers and adult children: process and expected outcome.

    Science.gov (United States)

    Cicirelli, Victor G

    2006-06-01

    Dyadic caregiving decision making was studied in 30 mother-son and 29 mother-daughter pairs (mother's age=65-94 years) who responded to a vignette depicting a caregiving decision situation. The observed decision-making process of mother-child pairs was largely naturalistic, with few alternatives proposed and quick convergence to a decision followed by a postdecision justification; a degree of more rational decision making was seen in some pairs. Among significant findings, adult children, especially sons, dominated the decision process, doing more talking and introducing more alternatives than did their mothers, who played a more subordinate role. Mother-son pairs expected more negative outcomes and greater regrets regarding their decisions than mother-daughter pairs. Closeness of the parent-child relationship influenced the decision-making process, expected outcomes, and regrets. Copyright (c) 2006 APA, all rights reserved.

  5. Beyond dual-process models: A categorisation of processes underlying intuitive judgement and decision making

    NARCIS (Netherlands)

    Glöckner, A.; Witteman, C.L.M.

    2010-01-01

    Intuitive-automatic processes are crucial for making judgements and decisions. The fascinating complexity of these processes has attracted many decision researchers, prompting them to start investigating intuition empirically and to develop numerous models. Dual-process models assume a clear

  6. [Shared decision-making in medical practice--patient-centred communication skills].

    Science.gov (United States)

    van Staveren, Remke

    2011-01-01

    Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

  7. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    Science.gov (United States)

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

  8. Process of making decisions on loan currency: Influence of representativeness on information processing and coherence with consumption motives

    Directory of Open Access Journals (Sweden)

    Anđelković Dragan

    2016-01-01

    Full Text Available Rationality of decision maker is often reduced by heuristics and biases, and also by different types of external stimuli. In decision-making process individuals simplify phases of information selection and information processing by using heuristics, simple rules which are focused on one aspect of complex problem and ignore other aspects, and in that way 'speed up' decision-making process. This method of making decisions, although efficient in making simple decisions, can lead to mistakes in probability assessment and diminish rationality of decision maker. In that way it can influence drastically on transaction outcome for which decision is being made. The subject of this study is influence of representativeness heuristic on making financial decisions by individuals, and influence of consumption motives on stereotypical elements in information processing phase. Study was conducted by determining attitudes of respondents toward currencies, and then by conducting experiments with aim of analyzing method of making decisions on loan currency. Aim of study was determining whether and to what extent representativeness influence choice of currency in process of making loan decisions. Results of conducted behavioral experiments show that respondents, opposite to rational model, do not asses probability by processing available information and in accordance with their preferences, but by comparing decision objects with other objects which have same attributes, showing in that way moderate positive correlation between stereotypical attitudes and choice of loan currency. Experiments have shown that instrumental motive significantly influence representativeness heuristics, that is, individuals are prone to process information with diminished influence of stereotypical attitudes caused by external stimuli, in situations where there is no so called 'hedonistic decision-making'. Respondents have been making more efficient decisions if they had motive which does

  9. Strategic environmental assessment and the limits to rationality in decision making processes

    DEFF Research Database (Denmark)

    Kørnøv, Lone

    The paper focueses on the subject of rationality in decision making processes and the implications for the integration of SEA.......The paper focueses on the subject of rationality in decision making processes and the implications for the integration of SEA....

  10. What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment?

    Science.gov (United States)

    Jones, Georgina; Hughes, Jane; Mahmoodi, Neda; Smith, Emily; Skull, Jonathan; Ledger, William

    2017-07-01

    -provider communication); (ii) fear concerning the perceived risks associated with pursuing FP (delaying cancer treatment, aggravating a hormone positive cancer and consequences of a future pregnancy); (iii) non-referral from oncology (personal situation, having a hormone positive cancer, FP not a priority and transition between service issues); (iv) the dilemma (in survival mode, whether to prioritize one treatment over another); (v) personal situation (parity, relationship status) and (iv) costs (financial concerns). This review has found that a wide range of internal and external factors impact the FP decision-making process. Key external issues related to current service delivery such as the provision and timing of FP information, and lack of referral from oncology to the fertility clinic. However, internal issues such as women's fears concerning the perceived risks associated with pursuing FP also hindered decision-making but these 'risks' were typically overestimated and non-evidence based. These findings suggest that the implementation of a range of decision support interventions may be of benefit within the clinical care pathway of FP and cancer. Women would benefit from the provision of more evidence-based FP information, ideally received at cancer diagnosis, in advance of seeing a fertility specialist, for example through the implementation of patient decision aids. Healthcare professionals in both oncology and fertility services may also benefit from the implementation of training programmes and educational tools targeted at improving the communication skills needed to improve collaborative decision-making and deliver care that is patient-centred. Exploration of the current barriers, both intellectual and practical, that prevent some patients from accepting FP will help care providers to do better for their patients in the future. Finally, the extent to which a poorer prognosis and moral, ethical and religious beliefs influence the FP decision-making process also warrant

  11. Emergency management: Does it have a sufficiently comprehensive understanding of decision-making, process and context?

    International Nuclear Information System (INIS)

    Niculae, C.; French, S.; Carter, E.

    2004-01-01

    It is widely recognised in the social and management sciences that the effective support of decision-making requires a multidisciplinary perspective. This trend is also clear in nuclear emergency management (EM). However, communication between disciplines is not easy to maintain in EM contexts when the decision makers (DMs) are likely to be highly stressed. Such circumstances can lead them to revert to the instinctive patterns of perception of their core disciplines, making communication between disciplines difficult and, perhaps, obscuring complex interactions that have not been rehearsed in practice exercises. This paper explores decision making in EM and the nature of the socio-technical issues that will arise, suggesting that despite the lessons of past accidents the research EM community is still not taking a broad enough view of what future incidents may entail. (authors)

  12. Organizational decision making

    OpenAIRE

    Grandori, Anna

    2015-01-01

    Approved for public release; distribution is unlimited This thesis develops a heuristic approach to organizational decision-making by synthesizing the classical, neo-classical and contingency approaches to organization theory. The conceptual framework developed also integrates the rational and cybernetic approaches with cognitive processes underlying the decision-making process. The components of the approach address the role of environment in organizational decision-maki...

  13. Leadership of risk decision making in a complex, technology organization: The deliberative decision making model

    Science.gov (United States)

    Flaming, Susan C.

    2007-12-01

    The continuing saga of satellite technology development is as much a story of successful risk management as of innovative engineering. How do program leaders on complex, technology projects manage high stakes risks that threaten business success and satellite performance? This grounded theory study of risk decision making portrays decision leadership practices at one communication satellite company. Integrated product team (IPT) leaders of multi-million dollar programs were interviewed and observed to develop an extensive description of the leadership skills required to navigate organizational influences and drive challenging risk decisions to closure. Based on the study's findings the researcher proposes a new decision making model, Deliberative Decision Making, to describe the program leaders' cognitive and organizational leadership practices. This Deliberative Model extends the insights of prominent decision making models including the rational (or classical) and the naturalistic and qualifies claims made by bounded rationality theory. The Deliberative Model describes how leaders proactively engage resources to play a variety of decision leadership roles. The Model incorporates six distinct types of leadership decision activities, undertaken in varying sequence based on the challenges posed by specific risks. Novel features of the Deliberative Decision Model include: an inventory of leadership methods for managing task challenges, potential stakeholder bias and debates; four types of leadership meta-decisions that guide decision processes, and aligned organizational culture. Both supporting and constraining organizational influences were observed as leaders managed major risks, requiring active leadership on the most difficult decisions. Although the company's engineering culture emphasized the importance of data-based decisions, the uncertainties intrinsic to satellite risks required expert engineering judgment to be exercised throughout. An investigation into

  14. Using a group decision support system to make investment prioritisation decisions

    OpenAIRE

    Read, Martin; Gear, Tony; Minkes, Leonard; Irving, Ann

    2013-01-01

    This paper is concerned with how decision making groups involved in making investment prioritisation decisions involving funding of technology and science projects may be supported by a group decision support system (GDSS). While interested in decision outcomes, the primary focus of this paper is the role of a group support system as an aid to developing shared understanding within a group. The paper develops the conceptual framework of decision-making, communication and group support, and de...

  15. Categorization = Decision Making + Generalization

    Science.gov (United States)

    Seger, Carol A; Peterson, Erik J.

    2013-01-01

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

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

    Science.gov (United States)

    Cappon, Leen

    2016-01-01

    Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer.

    Science.gov (United States)

    Song, Lixin; Tyler, Christina; Clayton, Margaret F; Rodgiriguez-Rassi, Eleanor; Hill, Latorya; Bai, Jinbing; Pruthi, Raj; Bailey, Donald E

    2017-02-01

    To analyze the effects of a decision aid on improving patients' and family members' information giving and question asking during consultations for prostate cancer treatment decision-making. This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD-intervention targeted patient-only; TS-intervention targeted patients and family members; and control-a handout on staying healthy during treatment. We conducted content analysis using a researcher-developed communication coding system. Using SAS 9.3, we conducted Chi-square/Fisher's exact test to examine whether information giving and question asking among patients and family members varied by groups when discussing different content/topics. Compared with those in the TS and control groups, significantly higher percentages of participants in the TD group demonstrated information giving in discussing topics about diagnosis, treatment options, risks and benefits, and preferences; and engaged in question asking when discussing diagnosis, watchful waiting/active surveillance, risks and benefits, and preferences for treatment impacts. Information support and communication skills training for patients were effective in improving communication during treatment decision-making consultations. Providing information about prostate cancer and communication skills training empower patients and their family members. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Business intelligence and financial decision-making: a theoretical approach

    OpenAIRE

    Mary Julieth Murillo Junco; Gustavo Cáceres Castellanos

    2013-01-01

    This paper deals with a literature review about the origin, development and implementation of Business Intelligence focused directly to solving problems in the financial area of the different organizations. Wanted contextualize how it tools have been incorporated into the decision making processes of modern business. A feature of the way it makes decisions has to do with the rational use made of the information available, and it is in this field where information technology and communication ...

  19. The WIPP decision plan: Charting the course for openness in the decision making process

    International Nuclear Information System (INIS)

    Hagers, J.

    1992-01-01

    In June of 1989, the Secretary of Energy requested that a plan be developed that would clearly outline the prerequisites to opening the Waste Isolation Pilot Plant (WIPP). It was to provide the basis for a decision making process that was not only visible to the public, but one which included public participation. It must also be dynamic enough to effectively deal with the changing legislative, regulatory, and technical environments. Based on a recognized need for openness, the Secretary's Draft Decision Plan was developed. The plan charted the course for ultimately making the decision to declare WIPP ready to receive waste for the start of test phase operations. It outlined to critics and supporters alike the rigorous and thorough process by which the internal decisions were made. The plan identified all internal prerequisites to the decision; charted the review cycles, and targeted the completion dates. It also outlined the processes outside the control of the Department, institutional issues, such as legislative land withdrawal, issuance of permits, and designation of transportation routes

  20. The household decision making process in replacement of durable goods

    OpenAIRE

    Marell Molander, Agneta

    1998-01-01

    As durables are essential in many households, the level of ownership is high and, due to the high degree of penetration, a vast proportion of the current sales are replacement purchases. Even though a lot of research attention has been paid to decision making and decision processes many models are oriented towards non-durable goods and although a majority of purchases of many durable goods are replacements, few studies seem to make a distinction between a replacement purchase decision and a d...

  1. Ethical implications and decision making in care education process

    Directory of Open Access Journals (Sweden)

    Layse Kelle Silva

    2014-07-01

    Full Text Available Objective. To determine ethical implications for nursing practice at the point of decision making by nursing professors in practice area. Methodology. A qualitative method was adopted, with use of semistructured interviews with sixteen nursing professors who delivered care at a teaching hospital in Salvador, Bahia, from May to June 2011. The methodological reference used was the discourse of the collective subject (DCS by Lefévre and Lefévre. Results. In response to DCSs, the following subjects appeared: "Ethics is fundamental and of vital importance in the decision making process," "searching for knowledge and research to identify problems and solutions, including alternatives and support for decisions," and "to act in the best way." Conclusion. Professors who provide education about patient care also delivered care. They have the responsibility to consider the ethical implications of decision making because they stimulate fundamental reflection and could positively influence future nursing professionals.

  2. Multi-criteria decision making in product-driven process synthesis

    NARCIS (Netherlands)

    Ridder, de K.; Almeida-Rivera, C.; Bongers, P.M.M.; Bruin, S.; Flapper, S.D.P.; Braunschweig, B.; Joulia, X.

    2008-01-01

    Current efforts in the development of a Product-driven Process Synthesis methodology have been focusing on broadening the design scope to consumer preferences, product attributes, process variables and supply chain considerations. The methodology embraces a decision making activity to be performed

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

    International Nuclear Information System (INIS)

    Stern, Marc J.; Predmore, S. Andrew

    2011-01-01

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

  4. Business intelligence and financial decision-making: a theoretical approach

    Directory of Open Access Journals (Sweden)

    Mary Julieth Murillo Junco

    2013-01-01

    Full Text Available This paper deals with a literature review about the origin, development and implementation of Business Intelligence focused directly to solving problems in the financial area of the different organizations. Wanted contextualize how it tools have been incorporated into the decision making processes of modern business. A feature of the way it makes decisions has to do with the rational use made of the information available, and it is in this field where information technology and communication play a role today

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2008-01-01

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

  7. Distributed Decision Making and Control

    CERN Document Server

    Rantzer, Anders

    2012-01-01

    Distributed Decision Making and Control is a mathematical treatment of relevant problems in distributed control, decision and multiagent systems, The research reported was prompted by the recent rapid development in large-scale networked and embedded systems and communications. One of the main reasons for the growing complexity in such systems is the dynamics introduced by computation and communication delays. Reliability, predictability, and efficient utilization of processing power and network resources are central issues and the new theory and design methods presented here are needed to analyze and optimize the complex interactions that arise between controllers, plants and networks. The text also helps to meet requirements arising from industrial practice for a more systematic approach to the design of distributed control structures and corresponding information interfaces Theory for coordination of many different control units is closely related to economics and game theory network uses being dictated by...

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Supporting decision-making processes for evidence-based mental health promotion.

    Science.gov (United States)

    Jané-Llopis, Eva; Katschnig, Heinz; McDaid, David; Wahlbeck, Kristian

    2011-12-01

    The use of evidence is critical in guiding decision-making, but evidence from effect studies will be only one of a number of factors that will need to be taken into account in the decision-making processes. Equally important for policymakers will be the use of different types of evidence including implementation essentials and other decision-making principles such as social justice, political, ethical, equity issues, reflecting public attitudes and the level of resources available, rather than be based on health outcomes alone. This paper, aimed to support decision-makers, highlights the importance of commissioning high-quality evaluations, the key aspects to assess levels of evidence, the importance of supporting evidence-based implementation and what to look out for before, during and after implementation of mental health promotion and mental disorder prevention programmes.

  10. [The role of epidemiology in the process of decision-making].

    Science.gov (United States)

    Prost, A

    1997-01-01

    Epidemiology is the method of choice for quantifying and interpreting health phenomena, placing them into perspective to allow trend analysis and projections. It is a tool for analysis, evaluation and forecasting and is thus indispensable in the decision-making process. However, this comprehensive technique has its limitations since health is the result of complex interactions: individual requirements do not always correspond to the overall needs of the community; consideration has to be given to solidarity and the necessity for cost-sharing; and the decision process is strongly influenced by social, cultural, religious and political factors which defy quantification and, on occasion, any rational course of action. Each indicator only takes into account one aspect of the situation and the pertinent indicator should therefore be carefully selected. At the same time, any choice implicitly signifies value judgements-often unnoticed-which need to be balanced and validated in relation to the ethical values of the community in order to be of any assistance to decision-making. Decision-making is a qualitative political process which, although based on the quantitative analysis supplied by epidemiology, cannot be limited to it. Each approach enhance the other, but they should not be confused if freedom to act is to be preserved from being locked into some kind of mechanical process that is unacceptable both to man and to society.

  11. Information processing as a paradigm for decision making.

    Science.gov (United States)

    Oppenheimer, Daniel M; Kelso, Evan

    2015-01-03

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

  12. Factors Affecting Youth Voice in Decision-Making Processes within Youth Development Programs

    Directory of Open Access Journals (Sweden)

    Todd Tarifa

    2009-12-01

    Full Text Available Results of a study aimed at determining the factors affecting the level of inclusiveness of youth voice in the decision-making process of the 4-H youth development program are discussed in this paper. State and field level 4-H professionals identified potential factors which affect youth voice in the decision-making process. The information gathered was utilized to identify the degree to which youth voice was incorporated in the decision-making process, to better understand how to suit youth’s needs, identify promising practices, and diagnose barriers towards fostering youth voice within the 4-H youth development program. This feature article presents the findings of the study, and discusses potential ramifications and remedies.

  13. Children Involvement on Family Purchase Decision Making

    OpenAIRE

    Jostein, Revina Wintry

    2013-01-01

    Children take big involvement in family decision making process today. There are several factors that make this phenomenon happen, such as media influence. Currently, the development of information and communication technology is so fast, indirectly encourages all parties, including the children to be able to follow the changes. There are two main objectives that will be examined, related with all the stated problems at the previous section, which are to analyze which product category does ch...

  14. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection.

    Science.gov (United States)

    Dobler, Claudia C; Bosnic-Anticevich, Sinthia; Armour, Carol L

    2018-01-01

    The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds) and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk-benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

  15. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

    Directory of Open Access Journals (Sweden)

    Claudia C. Dobler

    2018-03-01

    Full Text Available The aim of the study was to explore the views of tuberculosis (TB physicians on treatment of latent TB infection (LTBI, focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explaining the concept of latency (in particular to patients from culturally and linguistically diverse backgrounds and providing guidance to patients while still framing treatment decisions as a choice. Tailored estimates of the risk of developing TB and the risk of developing an adverse effect from LTBI treatment were considered the most important information for decision making and discussion with patients. Physicians acknowledged that there is a significant amount of unwarranted treatment variation, which they attributed to the lack of evidence about the risk–benefit balance of LTBI treatment in certain scenarios and guidelines that refer to the need for case-by-case decision making in many instances. In order to successfully implement LTBI treatment at a clinical level, consideration should be given to research on how to best address communication challenges arising in clinical encounters.

  16. Advancing in the Career Decision-Making Process: The Role of Coping Strategies and Career Decision-Making Profiles

    Science.gov (United States)

    Perez, Maya; Gati, Itamar

    2017-01-01

    We tested the associations among the career decision-making difficulties, the career decision status, and either (a) the career decision-making profiles of 575 young adults, or (b) the coping strategies of 379 young adults. As hypothesized, a more advanced decision status was negatively associated with both career decision-making difficulties…

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

    Science.gov (United States)

    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. Achieving involvement: process outcomes from a cluster randomized trial of shared decision making skill development and use of risk communication aids in general practice.

    NARCIS (Netherlands)

    Elwyn, G.; Edwards, A.; Hood, K.; Robling, M.; Atwell, C.; Russell, I.; Wensing, M.J.P.; Grol, R.P.T.M.

    2004-01-01

    BACKGROUND: A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on

  19. Collective Decision Making as the Actualization of Decision Potential

    Directory of Open Access Journals (Sweden)

    Andrej Ule

    2009-12-01

    Full Text Available This paper presents some characteristics and dilemmas of collective decision making. Collective decision making could be presented as the process of successive crystallization of dominant alternatives under the influence of different decision contexts from primary given decision potentials. This process is presented as the many-phased process of the acting of contextually dependent “energizing factors” of the collective decision making on the “attractiveness matrix” of outcomes of collective decisions. The attractiveness matrix determines the attractiveness for each alternative of decision, and the most attractive alternative in the given situation presents the rational decision in the given situation. In the final phase of decision making holds a context which gets a simplified attractiveness matrix. It corresponds to the common decision for one of the alternatives.

  20. Information processing in decision-making systems.

    Science.gov (United States)

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

    2012-08-01

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

  1. A dynamic dual process model of risky decision making.

    Science.gov (United States)

    Diederich, Adele; Trueblood, Jennifer S

    2018-03-01

    Many phenomena in judgment and decision making are often attributed to the interaction of 2 systems of reasoning. Although these so-called dual process theories can explain many types of behavior, they are rarely formalized as mathematical or computational models. Rather, dual process models are typically verbal theories, which are difficult to conclusively evaluate or test. In the cases in which formal (i.e., mathematical) dual process models have been proposed, they have not been quantitatively fit to experimental data and are often silent when it comes to the timing of the 2 systems. In the current article, we present a dynamic dual process model framework of risky decision making that provides an account of the timing and interaction of the 2 systems and can explain both choice and response-time data. We outline several predictions of the model, including how changes in the timing of the 2 systems as well as time pressure can influence behavior. The framework also allows us to explore different assumptions about how preferences are constructed by the 2 systems as well as the dynamic interaction of the 2 systems. In particular, we examine 3 different possible functional forms of the 2 systems and 2 possible ways the systems can interact (simultaneously or serially). We compare these dual process models with 2 single process models using risky decision making data from Guo, Trueblood, and Diederich (2017). Using this data, we find that 1 of the dual process models significantly outperforms the other models in accounting for both choices and response times. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

    Science.gov (United States)

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

    2010-01-01

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

  3. Application of HTA research on policy decision-making.

    Science.gov (United States)

    Youngkong, Sitaporn

    2014-05-01

    This article provides an overview of the potential uses of health technology assessment (HTA) in health technology or health intervention-related policy decision-making. It summarises the role of HTA in policy planning, health system investment, price negotiation, development of clinical practice guidelines, and communication with health professionals. While the multifaceted nature of HTA means that some aspects of the data can result in conflicting conclusions, the comprehensive approach of HTA is still recommended. To help minimise the potential conflicts within HTA data, a multicriteria decision analysis (MCDA) approach is recommended as a way to assess a number of decision criteria simultaneously. A combination of HTA with MCDA allows policy decision-making to be undertaken in an empirically rigorous and rational way. This combination can be used to support policy decision-makers in Thailand and help them prioritise topics for assessment and make informed health benefit package coverage decisions. This approach enhances the legitimacy of policy decisions by increasing the transparency, systematic nature, and inclusiveness of the process.

  4. Expectations Do Not Alter Early Sensory Processing during Perceptual Decision-Making.

    Science.gov (United States)

    Rungratsameetaweemana, Nuttida; Itthipuripat, Sirawaj; Salazar, Annalisa; Serences, John T

    2018-06-13

    Two factors play important roles in shaping perception: the allocation of selective attention to behaviorally relevant sensory features, and prior expectations about regularities in the environment. Signal detection theory proposes distinct roles of attention and expectation on decision-making such that attention modulates early sensory processing, whereas expectation influences the selection and execution of motor responses. Challenging this classic framework, recent studies suggest that expectations about sensory regularities enhance the encoding and accumulation of sensory evidence during decision-making. However, it is possible, that these findings reflect well documented attentional modulations in visual cortex. Here, we tested this framework in a group of male and female human participants by examining how expectations about stimulus features (orientation and color) and expectations about motor responses impacted electroencephalography (EEG) markers of early sensory processing and the accumulation of sensory evidence during decision-making (the early visual negative potential and the centro-parietal positive potential, respectively). We first demonstrate that these markers are sensitive to changes in the amount of sensory evidence in the display. Then we show, counter to recent findings, that neither marker is modulated by either feature or motor expectations, despite a robust effect of expectations on behavior. Instead, violating expectations about likely sensory features and motor responses impacts posterior alpha and frontal theta oscillations, signals thought to index overall processing time and cognitive conflict. These findings are inconsistent with recent theoretical accounts and suggest instead that expectations primarily influence decisions by modulating post-perceptual stages of information processing. SIGNIFICANCE STATEMENT Expectations about likely features or motor responses play an important role in shaping behavior. Classic theoretical

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

    Science.gov (United States)

    Colakkadioglu, Oguzhan; Celik, D. Billur

    2016-01-01

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

  6. The consequences of introducing IT systems for decision-making processes in healthcare institutions

    Directory of Open Access Journals (Sweden)

    Marzena Furtak-Niczyporuk

    2017-03-01

      Aim: The aim of the study was the diagnosis of management decision-making in the therapeutic entity, for possible implementation tools in the form of an information system, which could accelerate and support the rational process of making those decisions. In addition, work was to evaluate the role of management decisions and the implications of the information system on the process of rational decision-making in the management entity therapeutic.   Material and Methods: The case study method allowed us to show the practical applications and benefits resulting from the application system to support rational decision-making management, in particular in terms of reducing costs and improving the organization of health services offered.   The results and conclusions: Presented system generates a database to support rational decision-making process in the field of management, minimize their costs while improving the organization of health services. Ability to use various functions of the system allows for multi-segment analysis, thanks to the specially chosen and condensed information, both in the form of text and graphics over any time horizon. Benefits of the implications of the system is the speed and efficiency of the whole process of treatment, as well as the reduction of administrative tasks of medical staff, which increases the time for the patient.

  7. Dispositional optimism, self-framing and medical decision-making.

    Science.gov (United States)

    Zhao, Xu; Huang, Chunlei; Li, Xuesong; Zhao, Xin; Peng, Jiaxi

    2015-03-01

    Self-framing is an important but underinvestigated area in risk communication and behavioural decision-making, especially in medical settings. The present study aimed to investigate the relationship among dispositional optimism, self-frame and decision-making. Participants (N = 500) responded to the Life Orientation Test-Revised and self-framing test of medical decision-making problem. The participants whose scores were higher than the middle value were regarded as highly optimistic individuals. The rest were regarded as low optimistic individuals. The results showed that compared to the high dispositional optimism group, participants from the low dispositional optimism group showed a greater tendency to use negative vocabulary to construct their self-frame, and tended to choose the radiation therapy with high treatment survival rate, but low 5-year survival rate. Based on the current findings, it can be concluded that self-framing effect still exists in medical situation and individual differences in dispositional optimism can influence the processing of information in a framed decision task, as well as risky decision-making. © 2014 International Union of Psychological Science.

  8. Information Technology for Agriculture: Using it tools to aid decision-making process in small properties

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Ferraz

    2017-07-01

    Full Text Available With the current scenario of agricultural competitiveness, the use of Information and Communication Technology (ICT tools has become increasingly common in the rural community, making life easier for farmers. The information obtained through Agroinformatics (Information Technology applied to agribusiness, serves as a basis for both decision-making, planning, and application of the best techniques and production processes. In Brazil, companies such as EMPRAPA (The Brazilian Agricultural Research Corporation work in the research and development of new technological tools, which seek to boost the agricultural production of small rural producers, reducing their costs and improving their results. But for this, it is necessary that the producers understand the concept of the importance in carrying out information collection in a correct way, because the information will be processed according to what is inserted in the systems. In this sense, this article aims to demonstrate through an explanatory research of qualitative nature and bibliographical character the importance of the use of ICT to support decision-making in the Brazilian rural sector. Also highlighting the benefits originated by the use of ICT in all stages of agricultural production and its accounting management, through examples of tools.

  9. Tactical decision making under stress (TADMUS) decision support system

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1996-01-01

    A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...

  10. Viewpoint: Decision-making in committees

    OpenAIRE

    Li Hao; Wing Suen

    2009-01-01

    This article reviews recent developments in the theory of committee decision-making. A committee consists of self-interested members who make a public decision by aggregating imperfect information dispersed among them according to a pre-specified decision rule. We focus on costly information acquisition, strategic information aggregation, and rules and processes that enhance the quality of the committee decision. Seeming inefficiencies of the committee decision-making process such as over-cau...

  11. Innovation and decision-making process in reverse logistics: a bibliometric analysis

    Directory of Open Access Journals (Sweden)

    Fernando Antonio Guimarães Tenório

    2014-05-01

    Full Text Available This work aimed to make a bibliometric analysis on empirical studies that focus on the reverse logistics process. Papers published in two major events of management and a production engineering were collected during the years 2007-2012. To perform the analysis assumptions were adopted as the concepts of innovation and decision-making. 43 articles were analyzed and it was found that, in most cases, organizations choose to deploy reverse logistics as a means to solving problems related to environmental laws and regulations and after its implementation, the decision-making process related to the network of companies that perform reverse logistics remains restricted to the adopter company, thus becoming a centralized decision-making process. It was also found that reverse logistics is, in most cases, an innovation in the supply chain, it provides a new way to manage and operate the return and recycling of waste products and generating competitive advantages in the form of increased net income and better picture of the organization to its partners and customers.

  12. Developing Holocaust Curricula: The Content Decision-Making Process

    Science.gov (United States)

    Lindquist, David H.

    2008-01-01

    The content decision-making process involved in developing Holocaust curricula is unusually complex and problematic. Educators must consider factors such as historical accuracy, selection of topics covered, potential teaching materials (such as textbooks and literary texts), and graphic materials (such as films and photographs) as they plan their…

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

    Science.gov (United States)

    Elwyn, Glyn; Miron-Shatz, Talya

    2010-06-01

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

  14. Decision Making in Action: Applying Research to Practice

    Science.gov (United States)

    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

  15. Implications of Decision Making Research for Decision Support and Displays

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1998-01-01

    To appear in J. A. Cannon-Bowers & E. Salas (Eds.), Decision Making Under Stress: Implications for Training and Simulation. A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes, and cognitive analysis was conducted of the decision making problems faced by Navy ...

  16. Parental explicit heuristics in decision-making for children with life-threatening illnesses.

    Science.gov (United States)

    Renjilian, Chris B; Womer, James W; Carroll, Karen W; Kang, Tammy I; Feudtner, Chris

    2013-02-01

    To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children's Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process.

  17. Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Oczkowski, Simon J; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-01-01

    Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25-4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43-2.59, pcare desired and care received by patients (RR 1.17, 95% CI 1.05-1.30, p = 0.004, low quality evidence, 2 RCTs). The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between

  18. Arriba-lib: association of an evidence-based electronic library of decision aids with communication and decision-making in patients and primary care physicians.

    Science.gov (United States)

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

    2012-03-01

    In shared decision-making, patients are empowered to actively ask questions and participate in decisions about their healthcare based on their preferences and values. Decision aids should help patients make informed choices among diagnostic or treatment options by delivering evidence-based information on options and outcomes; however, they have rarely been field tested, especially in the primary care context. We therefore evaluated associations between the use of an interactive, transactional and evidence-based library of decision aids (arriba-lib) and communication and decision-making in patients and physicians in the primary care context. Our electronic library of decision aids ('arriba-lib') includes evidence-based modules for cardiovascular prevention, diabetes, coronary heart disease, atrial fibrillation and depression. Twenty-nine primary care physicians recruited 192 patients. We used questionnaires to ask patients and physicians about their experiences with and attitudes towards the programme. Patients were interviewed via telephone 2 months after the consultation. Data were analysed by general estimation equations, cross tab analyses and by using effect sizes. Only a minority (8.9%) of the consultations were felt to be too long because physicians said consultations were unacceptably extended by arriba-lib. We found a negative association between the detailedness of the discussion of the clinical problem's definition and the age of the patients. Physicians discuss therapeutic options in less detail with patients who have a formal education of less than 8 years. Patients who were counselled by a physician with no experience in using a decision aid more often reported that they do not remember being counselled with the help of a decision aid or do not wish to be counselled again with a decision aid. Arriba-lib has positive associations to the decision-making process in patients and physicians. It can also be used with older age groups and patients with less

  19. Credible decision-making regarding the management of spent nuclear fuel -four key questions concerning the decision-making process

    Energy Technology Data Exchange (ETDEWEB)

    Kaaberger, T. [Swedish Society for Nature Conservation (Sweden)

    1995-12-01

    The author starts by questioning the need for an EIA, since he sees a common attitude that the EIA is a tool for getting the community to accept the implementation of decisions that have already been made, and not a rational, organized way of achieving a basis for decision-making. A question of decisive importance for the relevancy of an EIA is whether (or not) the decisions already have been made, and the author points at indications which he believes support this view. Finally, arguments for delegating the EIA process to an external body are given.

  20. Credible decision-making regarding the management of spent nuclear fuel -four key questions concerning the decision-making process

    International Nuclear Information System (INIS)

    Kaaberger, T.

    1995-01-01

    The author starts by questioning the need for an EIA, since he sees a common attitude that the EIA is a tool for getting the community to accept the implementation of decisions that have already been made, and not a rational, organized way of achieving a basis for decision-making. A question of decisive importance for the relevancy of an EIA is whether (or not) the decisions already have been made, and the author points at indications which he believes support this view. Finally, arguments for delegating the EIA process to an external body are given

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

    Science.gov (United States)

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

    2015-11-01

    When children come to the attention of the child welfare system, they become involved in a decision-making process in which decisions are made that have a significant effect on their future and well-being. The decision to remove children from their families is particularly complex; yet surprisingly little is understood about this decision-making process. This paper presents the results of a study to develop an instrument to explore, at the caseworker level, the context of the removal decision, with the objective of understanding the influence of the individual and organizational factors on this decision, drawing from the Decision Making Ecology as the underlying rationale for obtaining the measures. The instrument was based on the development of decision-making scales used in prior decision-making studies and administered to child protection caseworkers in several states. Analyses included reliability analyses, principal components analyses, and inter-correlations among the resulting scales. For one scale regarding removal decisions, a principal components analysis resulted in the extraction of two components, jointly identified as caseworkers' decision-making orientation, described as (1) an internal reference to decision-making and (2) an external reference to decision-making. Reliability analyses demonstrated acceptable to high internal consistency for 9 of the 11 scales. Full details of the reliability analyses, principal components analyses, and inter-correlations among the seven scales are discussed, along with implications for practice and the utility of this instrument to support the understanding of decision-making in child welfare. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Contingency Management and deliberative decision-making processes

    Directory of Open Access Journals (Sweden)

    Paul S. Regier

    2015-06-01

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

  3. Contingency Management and Deliberative Decision-Making Processes.

    Science.gov (United States)

    Regier, Paul S; Redish, A David

    2015-01-01

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

  4. A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation.

    Science.gov (United States)

    van der Krieke, Lian; Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

    2013-10-07

    Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions on perceived involvement in medical

  5. Decision-making process to shut down, refurbish/modify, or decommission research reactors

    International Nuclear Information System (INIS)

    Stover, R.L.; Murphie, W.E.

    1992-01-01

    Most US research reactors were built more than 20 years ago and some more than 40 years ago. Many have undergone refurbishments and modifications to update their safety systems and experimental capabilities. But changing safety bases, social concerns, and budget constraints have required research reactor operators to continually make decisions to shut down or refurbish/modify their facilities. These decisions involve potential replacement of reactor equipment that has reached its lifetime limits. Changes in philosophy and operation of the reactors are also factors to be considered. In this paper, each of the four factors involved in the decision-making process are discussed in detail. Then, several examples from DOE research reactors in the United States are discussed. Finally, some general conclusions are given to aid in the decision-making process

  6. Culinary Decision Making.

    Science.gov (United States)

    Curtis, Rob

    1987-01-01

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

  7. Communication and the financial decisions made by public authorities

    Directory of Open Access Journals (Sweden)

    Joanna M. Salachna

    2017-12-01

    Full Text Available The main purpose of this article is to assess an impact of communication between public authority and a society about financial decision-making by that authority. In this article authors consider “social communication” as a term referring to reliable information sharing about a process of public funds management. In that regard they see it as a mean of implementation of a principle of transparency, which is known in public finance science. The above mentioned purpose of the work is based on crucial problem: what are socio-political area effects (e.g. on financial decisions making or on an active citizenship of providing various information to citizens about a process of collecting and spending public funds. Authors claim that currently in Poland methodology of delivering such information might be inappropriate (incomprehensible from the social addressee’s perspective. This is due to the fact that it causes the process of public authority’s communicating with society is significantly distorted.

  8. [Clinical decision making: Fostering critical thinking in the nursing diagnostic process through case studies].

    Science.gov (United States)

    Müller-Staub, Maria; Stuker-Studer, Ursula

    2006-10-01

    Case studies, based on actual patients' situations, provide a method of clinical decision making to foster critical thinking in nurses. This paper describes the method and process of group case studies applied in continuous education settings. This method bases on Balints' case supervision and was further developed and combined with the nursing diagnostic process. A case study contains different phases: Pre-phase, selection phase, case delineation and case work. The case provider narratively tells the situation of a patient. This allows the group to analyze and cluster signs and symptoms, to state nursing diagnoses and to derive nursing interventions. Results of the case study are validated by applying the theoretical background and critical appraisal of the case provider. Learning effects of the case studies were evaluated by means of qualitative questionnaires and analyzed according to Mayring. Findings revealed the following categories: a) Patients' problems are perceived in a patient centred way, accurate nursing diagnoses are stated and effective nursing interventions implemented. b) Professional nursing tasks are more purposefully perceived and named more precise. c) Professional nursing relationship, communication and respectful behaviour with patients were perceived in differentiated ways. The theoretical framework is described in the paper "Clinical decision making and critical thinking in the nursing diagnostic process". (Müller-Staub, 2006).

  9. Whole mind and shared mind in clinical decision-making.

    Science.gov (United States)

    Epstein, Ronald Mark

    2013-02-01

    To review the theory, research evidence and ethical implications regarding "whole mind" and "shared mind" in clinical practice in the context of chronic and serious illnesses. Selective critical review of the intersection of classical and naturalistic decision-making theories, cognitive neuroscience, communication research and ethics as they apply to decision-making and autonomy. Decision-making involves analytic thinking as well as affect and intuition ("whole mind") and sharing cognitive and affective schemas of two or more individuals ("shared mind"). Social relationships can help processing of complex information that otherwise would overwhelm individuals' cognitive capacities. Medical decision-making research, teaching and practice should consider both analytic and non-analytic cognitive processes. Further, research should consider that decisions emerge not only from the individual perspectives of patients, their families and clinicians, but also the perspectives that emerge from the interactions among them. Social interactions have the potential to enhance individual autonomy, as well as to promote relational autonomy based on shared frames of reference. Shared mind has the potential to result in wiser decisions, greater autonomy and self-determination; yet, clinicians and patients should be vigilant for the potential of hierarchical relationships to foster coercion or silencing of the patient's voice. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. Reducing ongoing product design decision-making bias

    NARCIS (Netherlands)

    Antioco, M.; Moenaert, R.K.; Lindgreen, A.

    2008-01-01

    The objective of this exploratory study is to add to our understanding of ongoing product design decision-making to reduce eventual decision-making bias. Six research questions are formulated with the aim to establish if and how functional membership and informal patterns of communication within an

  11. Using the Situated Clinical Decision-Making framework to guide analysis of nurses' clinical decision-making.

    Science.gov (United States)

    Gillespie, Mary

    2010-11-01

    Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. The participation of the German Länder in the EU decision-making process

    Directory of Open Access Journals (Sweden)

    Carlo Panara

    2012-09-01

    Full Text Available This article sketches out the main features of the German system of regional participation in the EU decision-making process with the aim of identifying the key strengths and weaknesses of that system. The author will be examining whether the model currently in place allows for a sufficiently rapid and effective response to the EU decision-making process, and whether there is a sufficiently balanced representation of regional and federal interests at the EU level. The article will also contain a proposal as to how the German model of regional participation in the EU decision-making process could be further improved.

  13. People, Process, and Policy: Case Studies in National Security Advising, the National Security Council, and Presidential Decision Making

    Science.gov (United States)

    2017-06-01

    confirmation of Lake’s concerns with the administration’s public relations failures, David Gergen, the president’s communications advisor, increased... Public Affairs: 389-395. 75 these positions, he did not openly object too them during the campaign. Additionally, as this case study shows, he...PEOPLE, PROCESS, AND POLICY: CASE STUDIES IN NATIONAL SECURITY ADVISING, THE NATIONAL SECURITY COUNCIL, AND PRESIDENTIAL DECISION MAKING

  14. A design process for using normative models in shared decision making: a case study in the context of prenatal testing.

    Science.gov (United States)

    Rapaport, Sivan; Leshno, Moshe; Fink, Lior

    2014-12-01

    Shared decision making (SDM) encourages the patient to play a more active role in the process of medical consultation and its primary objective is to find the best treatment for a specific patient. Recent findings, however, show that patient preferences cannot be easily or accurately judged on the basis of communicative exchange during routine office visits, even for patients who seek to expand their role in medical decision making (MDM). The objective of this study is to improve the quality of patient-physician communication by developing a novel design process for SDM and then demonstrating, through a case study, the applicability of this process in enabling the use of a normative model for a specific medical situation. Our design process goes through the following stages: definition of medical situation and decision problem, development/identification of normative model, adaptation of normative model, empirical analysis and development of decision support systems (DSS) tools that facilitate the SDM process in the specific medical situation. This study demonstrates the applicability of the process through the implementation of the general normative theory of MDM under uncertainty for the medical-financial dilemma of choosing a physician to perform amniocentesis. The use of normative models in SDM raises several issues, such as the goal of the normative model, the relation between the goals of prediction and recommendation, and the general question of whether it is valid to use a normative model for people who do not behave according to the model's assumptions. © 2012 John Wiley & Sons Ltd.

  15. Exploring decision-making for environmental health services: perspectives from four cities.

    Science.gov (United States)

    Hunt, C; Lewin, S

    2000-01-01

    Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

  16. Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication : an Agenda for Science and Practice

    OpenAIRE

    Betsch, Cornelia; Böhm, Robert; Airhihenbuwa, Collins O.; Butler, Robb; Chapman, Gretchen B.; Haase, Niels; Herrmann, Benedikt; Igarashi, Tasuku; Kitayama, Shinobu; Korn, Lars; Nurm, Ülla-Karin; Rohrmann, Bernd; Rothman, Alexander J.; Shavitt, Sharon; Updegraff, John A.

    2016-01-01

    This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making ...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    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.

  19. Human factors influencing decision making

    OpenAIRE

    Jacobs, Patricia A.

    1998-01-01

    This report supplies references and comments on literature that identifies human factors influencing decision making, particularly military decision making. The literature has been classified as follows (the classes are not mutually exclusive): features of human information processing; decision making models which are not mathematical models but rather are descriptive; non- personality factors influencing decision making; national characteristics influencing decision makin...

  20. The role of public communication in decision making for waste management infrastructure.

    Science.gov (United States)

    Kirkman, Richard; Voulvoulis, Nikolaos

    2017-12-01

    Modern waste management provision seeks to meet challenging objectives and strategies while reflecting community aspirations and ensuring cost-effective compliance with statutory obligations. Its social acceptability, which affects both what systems (infrastructure) can be put in place and to what extent their implementation will be successful, is a multi-dimensional phenomenon, often not well understood. In light of the growing evidence that decisions to build new infrastructure are often contested by the public, there is a clear need to understand the role of scientific evidence in public perception, particularly as environmental infrastructure delivery is often objected to by the public on environmental grounds. In this paper the need for waste management infrastructure is reviewed, and the way its delivery in the UK has evolved is used as an example of the role of public perception in the planning and delivery of waste facilities. Findings demonstrate the vital role of public communication in waste management infrastructure delivery. Public perception must be taken into account early in the decision making process, with the public informed and engaged from the start. There is a pressing need for people not simply to accept but to understand and appreciate the need for infrastructure, the nature of infrastructure investments and development, the costs and the benefits involved, and the technological aspects. Scientific evidence and literacy have a critical role to play, facilitating public engagement in a process that empowers people, allowing them to define and handle challenges and influence decisions that will impact their lives. Problem ownership, and an increased probability of any solutions proposed being selected and implemented successfully are potential benefits of such approach. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Bangkok's mass rapid transit system's commuter decision-making process in using integrated smartcards

    Directory of Open Access Journals (Sweden)

    Peerakan Kaewwongwattana

    2016-05-01

    Full Text Available This paper studied the decision-making process to use an integrated smartcard ticketing system by Bangkok metropolitan transit commuters. A second-order Confirmatory Factor Analysis using LISREL 9.10 was undertaken on Bangkok commuter's decision-making process on the use of an integrated smartcard system. The sample consisted of 300 Bangkok commuters obtained by accidental sampling using questionnaires with a 5-point Likert scale. The tools in the research questionnaires used scale estimation that achieved a confidence value of 0.84. The research instruments used rating scales measuring information search, alternative choices, and use decision on the 15 variables in the decision-making process which had factor loadings between 0.49 and 0.89 weight elements when sorted in descending order and overall had a high level. Use decision, alternative choices and information search had a factor of 0.89, 0.65 and 0.49, respectively. There was a good fit of the decision-making model to the empirical data (chi-square = 34.55, probability (p = 0.94, df = 49, RMSEA = 0.00, GFI = 0.98, AGFI = 0.96, SRMR = 0.04.

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

    Science.gov (United States)

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

    2017-08-09

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

  3. Using the ACT-R architecture to specify 39 quantitative process models of decision making

    Directory of Open Access Journals (Sweden)

    Julian N. Marewski

    2011-08-01

    Full Text Available Hypotheses about decision processes are often formulated qualitatively and remain silent about the interplay of decision, memorial, and other cognitive processes. At the same time, existing decision models are specified at varying levels of detail, making it difficult to compare them. We provide a methodological primer on how detailed cognitive architectures such as ACT-R allow remedying these problems. To make our point, we address a controversy, namely, whether noncompensatory or compensatory processes better describe how people make decisions from the accessibility of memories. We specify 39 models of accessibility-based decision processes in ACT-R, including the noncompensatory recognition heuristic and various other popular noncompensatory and compensatory decision models. Additionally, to illustrate how such models can be tested, we conduct a model comparison, fitting the models to one experiment and letting them generalize to another. Behavioral data are best accounted for by race models. These race models embody the noncompensatory recognition heuristic and compensatory models as a race between competing processes, dissolving the dichotomy between existing decision models.

  4. Family decision-making during food buying

    DEFF Research Database (Denmark)

    Nørgaard, Maria Kümpel

    Decision-making during food buying is a joint family activity involving both parents and children. Children manage to achieve a high degree of influence on many decisions, among other things, because they participate actively and help out doing various tasks. These decisions may turn out...... to be a choice of unhealthy food. Many decisions are made at the supermarket or other food shops, and food packaging is often used in the comparison of food products. Only rarely do families use nutritional information on food labels due to several problems in the understanding of these labels; this may result...... in difficulties in distinguishing among healthy and unhealthy food. Both parents and children being active in the decision process may lead to conflicts due to gaps in preference such as between healthy and unhealthy food. Families solve these conflicts via open communication patterns and a use of various...

  5. A qualitative study on community pharmacists' decision-making process when making a diagnosis.

    Science.gov (United States)

    Sinopoulou, Vassiliki; Summerfield, Paul; Rutter, Paul

    2017-12-01

    Self-care policies are increasingly directing patients to seek advice from community pharmacists. This means pharmacists need to have sound diagnostic decision-making skills to enable them to recognise a variety of conditions. The aim of this study was to investigate the process by which pharmacists manage patient signs and symptoms and to explore their use of decision-making for diagnostic purposes. Data were collected through semi-structured, face-to-face interviews with community pharmacists working in England, between August 2013 and November 2014. Pharmacists were asked to share their experiences on how they performed patient consultations, and more specifically how they would approach a hypothetical headache scenario. As part of the interview, their sources of knowledge and experience were also explored. Framework analysis was used to identify themes and subthemes. Eight interviews were conducted with pharmacists who had a wide range of working practice, from 1 year through to 40 years of experience. The pharmacists' main motivations during consultations were product selection and risk minimisation. Their questioning approach and decision-making relied heavily on mnemonic methods. This led to poor quality information gathering-although pharmacists acknowledged they needed to "delve deeper" but were often unable to articulate how or why. Some pharmacists exhibited elements of clinical reasoning in their consultations, but this seemed, mostly, to be unconscious and subsequently applied inappropriately. Overall, pharmacists exhibited poor decision-making ability, and often decisions were based on personal belief and experiences rather than evidence. Community pharmacists relied heavily on mnemonic methods to manage patients' signs and symptoms with diagnosis-based decision-making being seldom employed. These findings suggest practicing pharmacists should receive more diagnostic training. © 2017 John Wiley & Sons, Ltd.

  6. From Forecasters to the General Public: A Communication Tool to Understand Decision-making Challenges in Weather-related Early Warning Systems

    Science.gov (United States)

    Terti, G.; Ruin, I.; Kalas, M.; Lorini, V.; Sabbatini, T.; i Alonso, A. C.

    2017-12-01

    New technologies are currently adopted worldwide to improve weather forecasts and communication of the corresponding warnings to the end-users. "EnhANcing emergency management and response to extreme WeatHER and climate Events" (ANYWHERE) project is an innovating action that aims at developing and implementing a European decision-support platform for weather-related risks integrating cutting-edge forecasting technology. The initiative is built in a collaborative manner where researchers, developers, potential users and other stakeholders meet frequently to define needs, capabilities and challenges. In this study, we propose a role-playing game to test the added value of the ANYWHERE platform on i) the decision-making process and the choice of warning levels under uncertainty, ii) the management of the official emergency response and iii) the crisis communication and triggering of protective actions at different levels of the warning system (from hazard detection to citizen response). The designed game serves as an interactive communication tool. Here, flood and flash flood focused simulations seek to enhance participant's understanding of the complexities and challenges embedded in various levels of the decision-making process under the threat of weather disasters (e.g., forecasting/warnings, official emergency actions, self-protection). Also, we facilitate collaboration and coordination between the participants who belong to different national or local agencies/authorities across Europe. The game is first applied and tested in ANYWHERE's workshop in Helsinki (September, 2017) where about 30-50 people, including researchers, forecasters, civil protection and representatives of related companies, are anticipated to play the simulation. The main idea is to provide to the players a virtual case study that well represents realistic uncertainties and dilemmas embedded in the real-time forecasting-warning processes. At the final debriefing step the participants are

  7. Rule-based decision making model

    International Nuclear Information System (INIS)

    Sirola, Miki

    1998-01-01

    A rule-based decision making model is designed in G2 environment. A theoretical and methodological frame for the model is composed and motivated. The rule-based decision making model is based on object-oriented modelling, knowledge engineering and decision theory. The idea of safety objective tree is utilized. Advanced rule-based methodologies are applied. A general decision making model 'decision element' is constructed. The strategy planning of the decision element is based on e.g. value theory and utility theory. A hypothetical process model is built to give input data for the decision element. The basic principle of the object model in decision making is division in tasks. Probability models are used in characterizing component availabilities. Bayes' theorem is used to recalculate the probability figures when new information is got. The model includes simple learning features to save the solution path. A decision analytic interpretation is given to the decision making process. (author)

  8. Breaking the sound barrier: exploring parents' decision-making process of cochlear implants for their children.

    Science.gov (United States)

    Chang, Pamara F

    2017-08-01

    To understand the dynamic experiences of parents undergoing the decision-making process regarding cochlear implants for their child(ren). Thirty-three parents of d/Deaf children participated in semi-structured interviews. Interviews were digitally recorded, transcribed, and coded using iterative and thematic coding. The results from this study reveal four salient topics related to parents' decision-making process regarding cochlear implantation: 1) factors parents considered when making the decision to get the cochlear implant for their child (e.g., desire to acculturate child into one community), 2) the extent to which parents' communities influence their decision-making (e.g., norms), 3) information sources parents seek and value when decision-making (e.g., parents value other parent's experiences the most compared to medical or online sources), and 4) personal experiences with stigma affecting their decision to not get the cochlear implant for their child. This study provides insights into values and perspectives that can be utilized to improve informed decision-making, when making risky medical decisions with long-term implications. With thorough information provisions, delineation of addressing parents' concerns and encompassing all aspects of the decision (i.e., medical, social and cultural), health professional teams could reduce the uncertainty and anxiety for parents in this decision-making process for cochlear implantation. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Participation in decision-making process, incentives and training as ...

    African Journals Online (AJOL)

    Participation in decision-making process, incentives and training as predictors of organizational commitment among industrial workers. ... African Journal for the Psychological Study of Social Issues ... Results indicated that the three motivational factors jointly and significantly predicted organizational commitment. Also, each ...

  10. THE CONTRIBUTION OF PHILOSOPHY AND PSYCHOLOGY IN THE ETHICAL DECISION MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    DANIELA LIVIA DOLTU

    2010-11-01

    Full Text Available This article aims to explore the relationship between morality and organizational culture with reference to the process of ethical decision making and to the cooperation between philosopher and psychologist for the improvement of ethical climate within a public institution. Firstly, we introduce the notion of organizational culture emphasizing the importance of moral values and their role in building a true ethical climate. Secondly, we focus on the study of ethical decision making. The process is examined from the perspective of the interaction between human personality and different elements of organizational culture. Philosophy and psychology differently approach this problem. Our intention is to bridge the gap between the two perspectives, by demonstrating their belonging to the same continuum as well as the need for knowledge from both fields in order to have a complete overview of its internal mechanisms. Deontological and utilitarian theories fail to explain by themselves the decision making process and so psychology does: moral development theories, the leadership type, and emotions have on their basis a personal moral philosophy. We will also consider the influence of social groups on individual decision making.

  11. Patient participation in decision-making about cardiovascular preventive drugs - resistance as agency.

    Science.gov (United States)

    Hultberg, Josabeth; Rudebeck, Carl Edvard

    2017-09-01

    The aim of the study was to describe and explore patient agency through resistance in decision-making about cardiovascular preventive drugs in primary care. Six general practitioners from the southeast of Sweden audiorecorded 80 consultations. From these, 28 consultations with proposals from GPs for cardiovascular preventive drug treatments were chosen for theme-oriented discourse analysis. The study shows how patients participate in decision-making about cardiovascular preventive drug treatments through resistance in response to treatment proposals. Passive modes of resistance were withheld responses and minimal unmarked acknowledgements. Active modes were to ask questions, contest the address of an inclusive we, present an identity as a non-drugtaker, disclose non-adherence to drug treatments, and to present counterproposals. The active forms were also found in anticipation to treatment proposals from the GPs. Patients and GPs sometimes displayed mutual renouncement of responsibility for decision-making. The decision-making process appeared to expand both beyond a particular phase in the consultations and beyond the single consultation. The recognition of active and passive resistance from patients as one way of exerting agency may prove valuable when working for patient participation in clinical practice, education and research about patient-doctor communication about cardiovascular preventive medication. We propose particular attentiveness to patient agency through anticipatory resistance, patients' disclosures of non-adherence and presentations of themselves as non-drugtakers. The expansion of the decision-making process beyond single encounters points to the importance of continuity of care. KEY POINTS Guidelines recommend shared decision-making about cardiovascular preventive treatment. We need an understanding of how this is accomplished in actual consultations.This paper describes how patient agency in decision-making is displayed through different forms

  12. Shared decision-making.

    Science.gov (United States)

    Godolphin, William

    2009-01-01

    Shared decision-making has been called the crux of patient-centred care and identified as a key part of change for improved quality and safety in healthcare. However, it rarely happens, is hard to do and is not taught - for many reasons. Talking with patients about options is not embedded in the attitudes or communication skills training of most healthcare professionals. Information tools such as patient decision aids, personal health records and the Internet will help to shift this state, as will policy that drives patient and public involvement in healthcare delivery and training.

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

    Science.gov (United States)

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

    2015-02-15

    Prefrontal cortex plays a vital role in the theory of mind (ToM) and decision making, as shown in functional brain imaging and lesion studies. Considering the primary neuropathology of Parkinson's disease (PD) involving the frontal lobe system, patients with PD are expected to exhibit deficits in ToM and social decision making. The aim of this study was to investigate affective ToM and decision making in patients with PD and healthy controls (HC) in a task assessing affective ToM (Reading the Mind in the Eyes, RME) and two decision-making tasks (Iowa Gambling Task, IGT; Game of Dice Task, GDT). Consistent with previous findings, patients with PD were impaired in the affective ToM task, and when making decisions under ambiguity and in risk situations. The score of emotion recognition in the RME task was negatively correlated with the severity of the disease and positively correlated with the total number of advantageous cards chosen in the IGT. However, the final capital in the GDT was correlated with memory impairment. The present study implies that affective ToM and decision making under ambiguity may share similar neural mechanisms, while decision making under ambiguity and decision making under risk may involve processing within different neural networks. Copyright © 2014 Elsevier B.V. All rights reserved.

  14. Importance of information for tourist service users in travel decision making

    Directory of Open Access Journals (Sweden)

    Đorđević Aleksandar

    2013-01-01

    Full Text Available In modern conditions of operation, the provision of right information to customers is one of the key factors of marketing communication success. When making the decision on the selection of travel, customers in tourism (tourists have the need for greater number of different information compared to the selection of other products and services. The need for more information is conditioned by the specificity of travel as a product. The tourists gather different information in the travel decision-making process on destinations, activities at destinations, hotels and services they offer, travel programs, etc. Likewise, the information on the brand and image of tourist destination they are travelling to and the brand of tourist service provider (hotel, tour-operator, travel agency, etc. are also relevant. Brands present a kind of quality guarantee and reduce the need for additional information. The aim of this paper is to determine the significance of different information for various segments of customers in tourism on the basis of empirical research. The paper will test whether various tourist segments, towards which the different communication strategies focused on travel promotion would be formulated, can be identified based on the type of information the tourists gather in the decision-making process. The paper will also consider whether the segmentation of the tourism market, based on the relevance of different information in the decision-making process of tourists, is more efficient compared to the segmentation based on the traditional criteria.

  15. Deploying Affect-Inspired Mechanisms to Enhance Agent Decision-Making and Communication

    OpenAIRE

    Antos, Dimitrios

    2012-01-01

    Computer agents are required to make appropriate decisions quickly and efficiently. As the environments in which they act become increasingly complex, efficient decision-making becomes significantly more challenging. This thesis examines the positive ways in which human emotions influence people’s ability to make good decisions in complex, uncertain contexts, and develops computational analogues of these beneficial functions, demonstrating their usefulness in agent decision-making and communi...

  16. Examination of Children Decision Making Using Clues during the Logical Reasoning Process

    Science.gov (United States)

    Çelik, Meryem

    2017-01-01

    Logical reasoning is the process of thinking about a problem and finding the most effective solution. Children's decision-making skills are part of their cognitive development and are also indicative. The purpose of this study was to examine children's decision-making skills using clues in logical reasoning based on various variables. The study…

  17. Some applications of fuzzy sets and the analytical hierarchy process to decision making

    OpenAIRE

    Castro, Alberto Rosas

    1984-01-01

    Approved for public release; distribution unlimited This thesis examines the use of fuzzy set theory and the analytic hierarchy process in decision making. It begins by reviewing the insight of psychologists, social scientists and computer scientists to the decision making process. The Operations Research- Systems Analysis approach is discussed followed by a presentation of the basis of fuzzy set theory and the analytic hierarchy process. Two applications of these meth...

  18. Neural substrates of decision-making.

    Science.gov (United States)

    Broche-Pérez, Y; Herrera Jiménez, L F; Omar-Martínez, E

    2016-06-01

    Decision-making is the process of selecting a course of action from among 2 or more alternatives by considering the potential outcomes of selecting each option and estimating its consequences in the short, medium and long term. The prefrontal cortex (PFC) has traditionally been considered the key neural structure in decision-making process. However, new studies support the hypothesis that describes a complex neural network including both cortical and subcortical structures. The aim of this review is to summarise evidence on the anatomical structures underlying the decision-making process, considering new findings that support the existence of a complex neural network that gives rise to this complex neuropsychological process. Current evidence shows that the cortical structures involved in decision-making include the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and dorsolateral prefrontal cortex (DLPFC). This process is assisted by subcortical structures including the amygdala, thalamus, and cerebellum. Findings to date show that both cortical and subcortical brain regions contribute to the decision-making process. The neural basis of decision-making is a complex neural network of cortico-cortical and cortico-subcortical connections which includes subareas of the PFC, limbic structures, and the cerebellum. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  19. Cancer Counseling of Low-Income Limited English Proficient Latina Women Using Medical Interpreters: Implications for Shared Decision-Making.

    Science.gov (United States)

    Kamara, Daniella; Weil, Jon; Youngblom, Janey; Guerra, Claudia; Joseph, Galen

    2018-02-01

    In cancer genetic counseling (CGC), communication across language and culture challenges the model of practice based on shared decision-making. To date, little research has examined the decision-making process of low-income, limited English proficiency (LEP) patients in CGC. This study identified communication patterns in CGC sessions with this population and assessed how these patterns facilitate or inhibit the decision-making process during the sessions. We analyzed 24 audio recordings of CGC sessions conducted in Spanish via telephone interpreters at two public hospitals. Patients were referred for risk of hereditary breast and ovarian cancer; all were offered genetic testing. Audio files were coded by two bilingual English-Spanish researchers and analyzed using conventional content analysis through an iterative process. The 24 sessions included 13 patients, 6 counselors, and 18 interpreters. Qualitative data analyses identified three key domains - Challenges Posed by Hypothetical Explanations, Misinterpretation by the Medical Interpreter, and Communication Facilitators - that reflect communication patterns and their impact on the counselor's ability to facilitate shared decision-making. Overall, we found an absence of patient participation in the decision-making process. Our data suggest that when counseling LEP Latina patients via medical interpreter, prioritizing information with direct utility for the patient and organizing information into short- and long-term goals may reduce information overload and improve comprehension for patient and interpreter. Further research is needed to test the proposed counseling strategies with this population and to assess how applicable our findings are to other populations.

  20. THE FEATURES OF THE PROCESS OF MANAGERIAL DECISION-MAKING IN THE ENTERPRISE

    Directory of Open Access Journals (Sweden)

    E. V. Romanovskaya

    2015-01-01

    Full Text Available The article discusses issues related to the development and acceptance of administrative decisions in the enterprise. The large number of publications in the field of research of the process of managerial decision-making demonstrates its relevance for effective management of the enterprise. The article presents the author's approach to the disclosure of the nature and concepts of the term «management decision», a substantive analysis of the main elements of the theoretical aspect of managerial decision-making. The increased competition associated with market liberalization and globalization of world economy, requires from senior management of an effective control system. The authors revised classification criteria and allocated them accordingly the kinds of management decisions; identifies the main stages of development and adoption of management decisions. The article is devoted to finding new ways of making decisions to improve the efficiency of enterprise management. It is noted that for optimal decision making, it is required to calculate the impact of its implementation on the value of the enterprise as a whole or the size of its economic effect.

  1. Simulation based decision support for strategic communication and marketing management concerning the consumer introduction of smart energy meters

    Directory of Open Access Journals (Sweden)

    Jeroen STRAGIER

    2013-07-01

    Full Text Available Communication and marketing professionals make strategic decisions in highly complex and dynamic contexts. These decisions are highly uncertain on the outcome and process level when, for example, consumer behaviour is at stake. Decision support systems can provide insights in these levels of uncertainty and the professional process of decision making. However, literature describing decision support tools for strategic communication and marketing management that provide clear insights in uncertainty levels is lacking. This study therefore aims at developing a consumer behaviour simulation module as an important element of such a future decision support tool. The consumer behaviour simulation we propose in this paper is based on data collected from a survey among 386 households with which a behavioural change model was calibrated. We show how various decision scenarios for strategic communication and marketing challenges can be explored and how such a simulation based decision support system can facilitate strategic communication and marketing management concerning the introduction of a smart energy meter.

  2. Environmental Decision Analysis: Meeting the Challenges of Making Good Decisions at CALFED

    Directory of Open Access Journals (Sweden)

    Claire D Tomkins

    2006-09-01

    Full Text Available We present a methodology to support decision making at CALFED based on the principles of decision analysis, an analytical approach to decision making designed to handle complex decisions involving both uncertainty and multiple dimensions of value. The impetus for such an approach is a recognized need to enhance communication between scientists and management and between program elements within CALFED. In addition, the environmental decision analysis framework supports both the explicit representation of uncertainty in the decision problem and communication about risk, important elements of most environmental management decisions. The decision analysis cycle consists of four phases: 1 formulate, 2 evaluate, 3 appraise, and 4 decide. In phase one, we identify the objectives and also the alternatives, or possible actions. To facilitate inter-comparison between proposed actions, we recommend formulation of a set of common metrics for CALFED. In our pilot study, we introduced common metrics for salinity, winter-run Chinook salmon survival, and habitat health. The second phase focuses on quantifying possible impacts on the set of metrics, drawing on existing data, model runs, and expert opinions. For the evaluation phase, we employ tools such as decision trees to assess the system-wide impacts of a given action. In the final phase, tools such as expected cost-benefit analysis, value contribution diagrams, and 3-D tradeoff plots aid communication between various stakeholders, scientists, and managers. While decision analysis provides a spectrum of decision support tools, we emphasize that it does not dictate a solution but rather enhances communication about tradeoffs associated with different actions.

  3. Factors affecting long-term-care residents' decision-making processes as they formulate advance directives.

    Science.gov (United States)

    Lambert, Heather C; McColl, Mary Ann; Gilbert, Julie; Wong, Jiahui; Murray, Gale; Shortt, Samuel E D

    2005-10-01

    The purpose of this study was to describe factors contributing to the decision-making processes of elderly persons as they formulate advance directives in long-term care. This study was qualitative, based on grounded theory. Recruitment was purposive and continued until saturation was reached. Nine residents of a long-term-care facility were interviewed by use of a semistructured format. Open and axial coding of interview transcripts were carried out and the factors contributing to the decision process were defined. Elders based their decisions primarily on information gathered from personal experiences with death and illness. They obtained very little information from professionals or the media. Major factors considered by elders as they weighed information included spiritual, emotional, and social considerations. The factors considered during the decision-making process were oriented more toward the individual's experiences and less on contributions from objective sources than anticipated. Decision making for advance directives is a highly personalized process. The approach of health professionals when assisting with end-of-life decision making should be planned with these contributing factors in mind, so that the services offered to the individuals in this population best meet their needs.

  4. Involvement of Family Members and Professionals in Older Women's Post-Fall Decision Making.

    Science.gov (United States)

    Bergeron, Caroline D; Hilfinger Messias, DeAnne K; Friedman, Daniela B; Spencer, S Melinda; Miller, Susan C

    2018-03-01

    This exploratory, descriptive study examined involvement of family members and professionals in older women's post-fall decision making. We conducted semistructured interviews with 17 older women who had recently fallen and 11 individuals these women identified as being engaged in their post-fall decision-making processes. Qualitative data analysis involved open and axial coding and development of themes. After experiencing a fall, these older women's openness to others' opinions and advice; their assessments of types and credibility of potential information sources; and the communication practices they established with these sources influenced how they accessed, accepted, or rejected information from family members and professionals. Increased awareness of the involvement of others in post-fall decision making could enhance communication with older women who fall. Developing and implementing practical strategies to help family members and professionals initiate and engage in conversations about falls and their consequences could lead to more open decision making and improved post-fall quality of life among older women.

  5. Assessing the preconditions for communication influence on decision making: the North American Quitline Consortium.

    Science.gov (United States)

    Bonito, Joseph A; Ruppel, Erin K; Saul, Jessie E; Leischow, Scott J

    2013-01-01

    The network of North American quitlines is a loose confederation of telephone-based smoking cessation professionals, including smoking cessation counseling providers, funders, researcher and policy advocates. Each quitline has some leeway in the types of services it provides, and the purpose of this article is to identify factors that explain such choices. Representatives from quitline organizations responded to a survey regarding the importance of several items that were hypothesized to influence general intentions to adopt and implement new cessation methods. Results indicate that internal (to the quitline) constraints are positively associated with consensus processes and that implementation of practices in general was more likely if consensus processes were used. Unilateral decision making (one person within an organization makes decisions for the quitline on his/her own) was unrelated to either internal or external constraints and was negatively associated with adoption of quitline practices. Discussion focuses on factors that influence consensus decision-making processes beyond those investigated in the article.

  6. Preferences for political decision-making processes and issue publics

    NARCIS (Netherlands)

    Wojcieszak, M.

    2014-01-01

    Research on public attitudes toward political decision-making has typically focused on politics in general. This study attends to issue-level as well as individual-level factors that can explain political process preferences. First, drawing on the classic distinction between easy and hard political

  7. The analytic hierarchy process as a support for decision making

    Directory of Open Access Journals (Sweden)

    Filipović Milanka

    2007-01-01

    Full Text Available The first part of this text deals with a convention site selection as one of the most lucrative areas in the tourism industry. The second part gives a further description of a method for decision making - the analytic hierarchy process. The basic characteristics: hierarchy constructions and pair wise comparison on the given level of the hierarchy are allured. The third part offers an example of application. This example is solved using the Super - Decision software, which is developed as a computer support for the analytic hierarchy process. This indicates that the AHP approach is a useful tool to help support a decision of convention site selection. .

  8. Selective exposure to information: how different modes of decision making affect subsequent confirmatory information processing.

    Science.gov (United States)

    Fischer, Peter; Fischer, Julia; Weisweiler, Silke; Frey, Dieter

    2010-12-01

    We investigated whether different modes of decision making (deliberate, intuitive, distracted) affect subsequent confirmatory processing of decision-consistent and inconsistent information. Participants showed higher levels of confirmatory information processing when they made a deliberate or an intuitive decision versus a decision under distraction (Studies 1 and 2). As soon as participants have a cognitive (i.e., deliberate cognitive analysis) or affective (i.e., intuitive and gut feeling) reason for their decision, the subjective confidence in the validity of their decision increases, which results in increased levels of confirmatory information processing (Study 2). In contrast, when participants are distracted during decision making, they are less certain about the validity of their decision and thus are subsequently more balanced in the processing of decision-relevant information.

  9. Conceptual Frameworks for the Workplace Change Adoption Process: Elements Integration from Decision Making and Learning Cycle Process.

    Science.gov (United States)

    Radin Umar, Radin Zaid; Sommerich, Carolyn M; Lavender, Steve A; Sanders, Elizabeth; Evans, Kevin D

    2018-05-14

    Sound workplace ergonomics and safety-related interventions may be resisted by employees, and this may be detrimental to multiple stakeholders. Understanding fundamental aspects of decision making, behavioral change, and learning cycles may provide insights into pathways influencing employees' acceptance of interventions. This manuscript reviews published literature on thinking processes and other topics relevant to decision making and incorporates the findings into two new conceptual frameworks of the workplace change adoption process. Such frameworks are useful for thinking about adoption in different ways and testing changes to traditional intervention implementation processes. Moving forward, it is recommended that future research focuses on systematic exploration of implementation process activities that integrate principles from the research literature on sensemaking, decision making, and learning processes. Such exploration may provide the groundwork for development of specific implementation strategies that are theoretically grounded and provide a revised understanding of how successful intervention adoption processes work.

  10. Shared Decision Making in ICUs: An American College of Critical Care Medicine and American Thoracic Society Policy Statement.

    Science.gov (United States)

    Kon, Alexander A; Davidson, Judy E; Morrison, Wynne; Danis, Marion; White, Douglas B

    2016-01-01

    Shared decision making is endorsed by critical care organizations; however, there remains confusion about what shared decision making is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define shared decision making, recommend when shared decision making should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. The American College of Critical Care Medicine and American Thoracic Society Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of American College of Critical Care Medicine and American Thoracic Society were included in the statement. Six recommendations were endorsed: 1) DEFINITION: Shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient's values, goals, and preferences. 2) Clinicians should engage in a shared decision making process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their "default" approach a shared decision making process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable, including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making

  11. Linking Effective Project Management to Business Strategy in Oil and Gas Industry through Decision-making Processes

    Science.gov (United States)

    Adeleke, Adeyinka

    The construction project in the oil and gas industry covers the entire spectrum of hydrocarbon production from the wellhead (upstream) to downstream facilities. In each of these establishments, the activities in a construction project include: consulting, studies, front-end engineering, detail engineering, procurement, program management, construction, installation, commissioning and start-up. Efficient management of each of the activities involved in construction projects is one of the driving forces for the successful completion of the project. Optimizing the crucial factors in project management during each phase of a project in an oil and gas industry can assist managers to maximize the use of available resources and drive the project to successful conclusions. One of these factors is the decision-making process in the construction project. Current research effort investigated the relationship between decision-making processes and business strategy in oil and gas industry using employee surveys. I recruited employees of different races, age group, genders, and years of experience in order understand their influence on the implementation of the decision-making process in oil and gas industry through a quantitative survey. Decision-making was assessed using five decision measures: (a) rational, (b) intuitive, (c) dependent, (d) avoidant, and (e) spontaneous. The findings indicated gender, age, years of work experience and job titles as primary variables with a negative relationship with decision-making approach for employees working in a major oil and gas industry. The study results revealed that the two most likely decision-making methods in oil and gas industry include: making a decision in a logical and systematic way and seek assistance from others when making a decision. Additionally, the two leading management approaches to decision-making in the oil and gas industry include: decision analysis is part of organization culture and management is committed to

  12. Transparency in decision-making processes governing hazardous activities

    DEFF Research Database (Denmark)

    Rasmussen, B.; Jensen, K.K.; Sandøe, P.

    2007-01-01

    Transparent decisions are decisions in which the decision maker clearly presents to others the normative and factual premises behind the conclusions and explains the reasoning leading from these premises to the conclusion. Transparency thus involves uncovering, describing, documenting...... and communicating all the argumentative steps in the line of reasoning. It also involves acknowledging the weighting of any evidence drawn upon in reaching the final decision. It is recommended that each decision should be accompanied by an audit trail describing the premises justifying it. Uncertainties should...

  13. Increasing a large petrochemical company efficiency by improvement of decision making process

    OpenAIRE

    Kirin Snežana D.; Nešić Lela G.

    2010-01-01

    The paper shows the results of a research conducted in a large petrochemical company, in a state under transition, with the aim to "shed light" on the decision making process from the aspect of personal characteristics of the employees, in order to use the results to improve decision making process and increase company efficiency. The research was conducted by a survey, i.e. by filling out a questionnaire specially made for this purpose, in real conditions, during working hours. The sample of...

  14. CapDEM TDP - DND Capability Decision-Making Process: the As-Is

    National Research Council Canada - National Science Library

    Harvey, Gaetane; Leclerc, Jocelyn; Dussault, Genevieve

    2005-01-01

    The purpose of this document is to describe the current DND/CF Acquisition process as well as the associated decision-making process in order to provide the project team with a common understanding...

  15. Decision making and cancer.

    Science.gov (United States)

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

    2015-01-01

    We review decision making along the cancer continuum in the contemporary context of informed and shared decision making in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cognition, emotion, and their interaction are described, including classical psychophysical approaches, dual-process approaches that focus on conflicts between emotion versus cognition (or reason), and modern integrative approaches such as fuzzy-trace theory. In contrast to the earlier emphasis on rote use of numerical detail, modern approaches emphasize understanding the bottom-line gist of options (which encompasses emotion and other influences on meaning) and retrieving relevant social and moral values to apply to those gist representations. Finally, research on interventions to support better decision making in clinical settings is reviewed, drawing out implications for future research on decision making and cancer. PsycINFO Database Record (c) 2015 APA, all rights reserved.

  16. Decision making biases in the communication of earthquake risk

    Science.gov (United States)

    Welsh, M. B.; Steacy, S.; Begg, S. H.; Navarro, D. J.

    2015-12-01

    L'Aquila, with 6 scientists convicted of manslaughter, shocked the scientific community, leading to urgent re-appraisal of communication methods for low-probability, high-impact events. Before the trial, a commission investigating the earthquake recommended risk assessment be formalised via operational earthquake forecasts and that social scientists be enlisted to assist in developing communication strategies. Psychological research has identified numerous decision biases relevant to this, including hindsight bias, where people (after the fact) overestimate an event's predictability. This affects experts as well as naïve participants as it relates to their ability to construct a plausible causal story rather than the likelihood of the event. Another problem is availability, which causes overestimation of the likelihood of observed rare events due to their greater noteworthiness. This, however, is complicated by the 'description-experience' gap, whereby people underestimate probabilities for events they have not experienced. That is, people who have experienced strong earthquakes judge them more likely while those who have not judge them less likely - relative to actual probabilities. Finally, format changes alter people's decisions. That is people treat '1 in 10,000' as different from 0.01% despite their mathematical equivalence. Such effects fall under the broad term framing, which describes how different framings of the same event alter decisions. In particular, people's attitude to risk depends significantly on how scenarios are described. We examine the effect of biases on the communication of change in risk. South Australian participants gave responses to scenarios describing familiar (bushfire) or unfamiliar (earthquake) risks. While bushfires are rare in specific locations, significant fire events occur each year and are extensively covered. By comparison, our study location (Adelaide) last had a M5 quake in 1954. Preliminary results suggest the description

  17. Factors influencing the surgical decision for the treatment of degenerative lumbar stenosis in a preference-based shared decision-making process.

    Science.gov (United States)

    Kim, Ho-Joong; Park, Jae-Young; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Yeom, Jin S

    2015-02-01

    In a preference-based shared decision-making system, several subjective and/or objective factors such as pain severity, degree of disability, and the radiological severity of canal stenosis may influence the final surgical decision for the treatment of lumbar spinal stenosis (LSS). However, our understanding of the shared decision-making process and the significance of each factor remain primitive. In the present study, we aimed to investigate which factors influence the surgical decision for the treatment of LSS when using a preference-based, shared decision-making process. We included 555 patients, aged 45-80 years, who used a preference-based shared decision-making process and were treated conservatively or surgically for chronic leg and/or back pain caused by LSS from April 2012 to December 2012. Univariate and multivariable-adjusted logistic regression analyses were used to assess the association of surgical decision making with age, sex, body mass index, symptom duration, radiologic stenotic grade, Oswestry Disability Index (ODI), visual analog scale (VAS) scores for back and leg pain, Short Form-36 (SF-36) subscales, and motor weakness. In univariate analysis, the following variables were associated with a higher odds of a surgical decision for LSS: male sex; the VAS score for leg pain; ODI; morphological stenotic grades B, C, and D; motor weakness; and the physical function, physical role, bodily pain, social function, and emotional role of the SF-36 subscales. Multivariate analysis revealed that male sex, ODI, morphological stenotic grades C and D, and motor weakness were significantly associated with a higher possibility of a surgical decision. Motor weakness, male sex, morphological stenotic grade, and the amount of disability are critical factors leading to a surgical decision for LSS when using a preference-based shared decision-making process.

  18. Toward a Model of Human Information Processing for Decision-Making and Skill Acquisition in Laparoscopic Colorectal Surgery.

    Science.gov (United States)

    White, Eoin J; McMahon, Muireann; Walsh, Michael T; Coffey, J Calvin; O Sullivan, Leonard

    To create a human information-processing model for laparoscopic surgery based on already established literature and primary research to enhance laparoscopic surgical education in this context. We reviewed the literature for information-processing models most relevant to laparoscopic surgery. Our review highlighted the necessity for a model that accounts for dynamic environments, perception, allocation of attention resources between the actions of both hands of an operator, and skill acquisition and retention. The results of the literature review were augmented through intraoperative observations of 7 colorectal surgical procedures, supported by laparoscopic video analysis of 12 colorectal procedures. The Wickens human information-processing model was selected as the most relevant theoretical model to which we make adaptions for this specific application. We expanded the perception subsystem of the model to involve all aspects of perception during laparoscopic surgery. We extended the decision-making system to include dynamic decision-making to account for case/patient-specific and surgeon-specific deviations. The response subsystem now includes dual-task performance and nontechnical skills, such as intraoperative communication. The memory subsystem is expanded to include skill acquisition and retention. Surgical decision-making during laparoscopic surgery is the result of a highly complex series of processes influenced not only by the operator's knowledge, but also patient anatomy and interaction with the surgical team. Newer developments in simulation-based education must focus on the theoretically supported elements and events that underpin skill acquisition and affect the cognitive abilities of novice surgeons. The proposed human information-processing model builds on established literature regarding information processing, accounting for a dynamic environment of laparoscopic surgery. This revised model may be used as a foundation for a model describing robotic

  19. [Interoception and decision-making].

    Science.gov (United States)

    Ohira, Hideki

    2015-02-01

    We sometimes make decisions relying not necessarily on deliberative thoughts but on intuitive and emotional processes in uncertain situations. The somatic marker hypothesis proposed by Damasio argued that interoception, which means bodily responses such as sympathetic activity, can be represented in the insula and anterior cingulate cortex and can play critical roles in decision-making. Though this hypothesis has been criticized in its theoretical and empirical aspects, recent studies are expanding the hypothesis to elucidate multiple bodily responses including autonomic, endocrine, and immune activities that affect decision-making. In addition, cumulative findings suggest that the anterior insula where the inner model of interoception is represented can act as an interface between the brain and body in decision-making. This article aims to survey recent findings on the brain-body interplays underlying decision-making, and to propose hypotheses on the significance of the body in decision-making.

  20. Challenges to fair decision-making processes in the context of health care services

    DEFF Research Database (Denmark)

    Shayo, Elizabeth H.; Norheim, Ole F.; Mboera, Leonard E. G.

    2012-01-01

    challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. METHODS: The study was carried out in the Mbarali District......ABSTRACT: BACKGROUND: Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people's needs. In Tanzania, the policy of decentralization and the health sector reform place......: The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether...

  1. The application of the heuristic-systematic processing model to treatment decision making about prostate cancer.

    Science.gov (United States)

    Steginga, Suzanne K; Occhipinti, Stefano

    2004-01-01

    The study investigated the utility of the Heuristic-Systematic Processing Model as a framework for the investigation of patient decision making. A total of 111 men recently diagnosed with localized prostate cancer were assessed using Verbal Protocol Analysis and self-report measures. Study variables included men's use of nonsystematic and systematic information processing, desire for involvement in decision making, and the individual differences of health locus of control, tolerance of ambiguity, and decision-related uncertainty. Most men (68%) preferred that decision making be shared equally between them and their doctor. Men's use of the expert opinion heuristic was related to men's verbal reports of decisional uncertainty and having a positive orientation to their doctor and medical care; a desire for greater involvement in decision making was predicted by a high internal locus of health control. Trends were observed for systematic information processing to increase when the heuristic strategy used was negatively affect laden and when men were uncertain about the probabilities for cure and side effects. There was a trend for decreased systematic processing when the expert opinion heuristic was used. Findings were consistent with the Heuristic-Systematic Processing Model and suggest that this model has utility for future research in applied decision making about health.

  2. Moral and Ethical Decision Making: Literature Review

    Science.gov (United States)

    2005-08-08

    exploration and elaboration of both rational and intuitive decision making processes. In addition, emotions may also play an important role in...More specifically, it suggests that both rational and intuitive decision making processes are likely to play an important role in ethical decision ...and military literature related to ethical decision making more generally. Specifically, it suggests that both rational and intuitive decision making

  3. Mapping Perceptions of Lupus Medication Decision-Making Facilitators: The Importance of Patient Context.

    Science.gov (United States)

    Qu, Haiyan; Shewchuk, Richard M; Alarcón, Graciela; Fraenkel, Liana; Leong, Amye; Dall'Era, Maria; Yazdany, Jinoos; Singh, Jasvinder A

    2016-12-01

    Numerous factors can impede or facilitate patients' medication decision-making and adherence to physicians' recommendations. Little is known about how patients and physicians jointly view issues that affect the decision-making process. Our objective was to derive an empirical framework of patient-identified facilitators to lupus medication decision-making from key stakeholders (including 15 physicians, 5 patients/patient advocates, and 8 medical professionals) using a patient-centered cognitive mapping approach. We used nominal group patient panels to identify facilitators to lupus treatment decision-making. Stakeholders independently sorted the identified facilitators (n = 98) based on their similarities and rated the importance of each facilitator in patient decision-making. Data were analyzed using multidimensional scaling and hierarchical cluster analysis. A cognitive map was derived that represents an empirical framework of facilitators for lupus treatment decisions from multiple stakeholders' perspectives. The facilitator clusters were 1) hope for a normal/healthy life, 2) understand benefits and effectiveness of taking medications, 3) desire to minimize side effects, 4) medication-related data, 5) medication effectiveness for "me," 6) family focus, 7) confidence in physician, 8) medication research, 9) reassurance about medication, and 10) medication economics. Consideration of how different stakeholders perceive the relative importance of lupus medication decision-making clusters is an important step toward improving patient-physician communication and effective shared decision-making. The empirically derived framework of medication decision-making facilitators can be used as a guide to develop a lupus decision aid that focuses on improving physician-patient communication. © 2016, American College of Rheumatology.

  4. The Military Decision-Making Process (MDMP): A Prototype Training Product

    National Research Council Canada - National Science Library

    Wampler, Richard

    1998-01-01

    ...): A Prototype Training Product. The MDMP product is a computer-based, stand alone training support package to assist individuals and staffs of light infantry brigades in learning to participate in the military decision-making process...

  5. Communicating Ecological Indicators to Decision Makers and the Public

    Directory of Open Access Journals (Sweden)

    Andrew Schiller

    2001-06-01

    Full Text Available Ecological assessments and monitoring programs often rely on indicators to evaluate environmental conditions. Such indicators are frequently developed by scientists, expressed in technical language, and target aspects of the environment that scientists consider useful. Yet setting environmental policy priorities and making environmental decisions requires both effective communication of environmental information to decision makers and consideration of what members of the public value about ecosystems. However, the complexity of ecological issues, and the ways in which they are often communicated, make it difficult for these parties to fully engage such a dialogue. This paper describes our efforts to develop a process for translating the indicators of regional ecological condition used by the U.S. Environmental Protection Agency into common language for communication with public and decision-making audiences. A series of small-group sessions revealed that people did not want to know what these indicators measured, or how measurements were performed. Rather, respondents wanted to know what such measurements can tell them about environmental conditions. Most positively received were descriptions of the kinds of information that various combinations of indicators provide about broad ecological conditions. Descriptions that respondents found most appealing contained general reference to both the set of indicators from which the information was drawn and aspects of the environment valued by society to which the information could be applied. These findings can assist with future efforts to communicate scientific information to nontechnical audiences, and to represent societal values in ecological programs by improving scientist-public communication.

  6. 44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT..., App. A Appendix A to Part 9—Decision-making Process for E.O. 11988 EC02FE91.074 ...

  7. [The Decision-Making Processes in Taiwanese Women With Repeat Caesarean Deliveries].

    Science.gov (United States)

    Chen, Shu-Wen

    2016-10-01

    Repeat caesarean delivery (RCD) ranks as the top reason for the high caesarean rates in Taiwan. More than 90% of Taiwanese women who have had a previous caesarean delivery chose RCD following their next pregnancy. To explore the decision-making processes regarding RCD in Taiwanese women. A qualitative approach with grounded theory was used to conduct this research. Participants were recruited from a private medical centre in northern Taiwan. Methods of data collection include in-depth interviews, observation, and field notes. Constant comparative analytical techniques were employed for data analysis. A total of 16 women chose RCD. Ensuring the well-being of mother and fetus was the core theme. Women's decisions were influenced by both internal factors (previous negative experience of birth, concern about uterine rupture, fixing the scar of previous caesarean and current pregnancy situation) and external factors (obstetrician's recommendation, the experience of female significant others, an inaccurate information from internet and the unconditional financial coverage from Health National Insurance). Decision-making processes involved searching information regarding mode of birth, evaluating vaginal birth risk, trusting obstetricians' professional judgment, and a lack of progress during the course of labour. The well-being of mother and fetus is the major concern affecting mothers' decisions regarding RCD. The majority of Taiwanese women participate passively in the decision-making process regarding their options for mode of birth. In the present study, women choices were primarily guided by reducing the risk of uterine rupture. Hospitals should reduce unnecessary induction interventions. Obstetricians should inform women of the risks and benefits of various birth modes. The government could establish a website that provides a clear explanation of the criteria for the government to financially cover the costs of RCD in order to assist women to make optimal birth

  8. Decision-Oriented Health Technology Assessment: One Step Forward in Supporting the Decision-Making Process in Hospitals.

    Science.gov (United States)

    Ritrovato, Matteo; Faggiano, Francesco C; Tedesco, Giorgia; Derrico, Pietro

    2015-06-01

    This article outlines the Decision-Oriented Health Technology Assessment: a new implementation of the European network for Health Technology Assessment Core Model, integrating the multicriteria decision-making analysis by using the analytic hierarchy process to introduce a standardized methodological approach as a valued and shared tool to support health care decision making within a hospital. Following the Core Model as guidance (European network for Health Technology Assessment. HTA core model for medical and surgical interventions. Available from: http://www.eunethta.eu/outputs/hta-core-model-medical-and-surgical-interventions-10r. [Accessed May 27, 2014]), it is possible to apply the analytic hierarchy process to break down a problem into its constituent parts and identify priorities (i.e., assigning a weight to each part) in a hierarchical structure. Thus, it quantitatively compares the importance of multiple criteria in assessing health technologies and how the alternative technologies perform in satisfying these criteria. The verbal ratings are translated into a quantitative form by using the Saaty scale (Saaty TL. Decision making with the analytic hierarchy process. Int J Serv Sci 2008;1:83-98). An eigenvectors analysis is used for deriving the weights' systems (i.e., local and global weights' system) that reflect the importance assigned to the criteria and the priorities related to the performance of the alternative technologies. Compared with the Core Model, this methodological approach supplies a more timely as well as contextualized evidence for a specific technology, making it possible to obtain data that are more relevant and easier to interpret, and therefore more useful for decision makers to make investment choices with greater awareness. We reached the conclusion that although there may be scope for improvement, this implementation is a step forward toward the goal of building a "solid bridge" between the scientific evidence and the final decision

  9. Emotions in Risk Assessment and Decision Making Processes During Craft Practice

    Directory of Open Access Journals (Sweden)

    Camilla Groth

    2015-12-01

    Full Text Available Traditionally subjective experiences and emotions have been overlooked in the practice of scientific research. In the field of design and craft research too, feelings and emotions have been considered as interfering with the rigour of research. However, as a result of findings in neuroscience, a new understanding has emerged, providing emotions a central role in risk assessment and decision making processes. This has implications also for how we understand craft practice. In this practice-led research, a craft practitioner analysed five video-recordings of herself while throwing clay blindfolded. The researcher-practitioner specifically studied critical incidents in the throwing process and made a detailed analysis of how sensory experiences and emotions guided her in risk assessment, decision making, and problem solving during the clay-throwing sessions. She found that her tactile experience gave her important clues on the condition of the material and its consequent possibilities at different stages. These experiences in turn affected her emotions in either positive or negative ways, affecting her risk assessment, decision making, and problem solving activities. This research has shown that sensory experiences and emotions influence the craft making process and are thus important elements in the expertise of the craftsperson. The role of such emotions remains to be studied further in the expertise of researchers in general.

  10. Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

    Science.gov (United States)

    Slosky, Laura E.; Burke, Natasha L.; Siminoff, Laura A.

    2014-01-01

    Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT). Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview. Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment. Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population. PMID:25161672

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

    Science.gov (United States)

    Skanavis, Constantina; Sakellari, Maria

    2012-01-01

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

  12. Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making.

    Science.gov (United States)

    Peters, Ellen; Hess, Thomas M; Västfjäll, Daniel; Auman, Corinne

    2007-03-01

    Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory (Kahneman & Tversky, 1979) and how prospect theory and theories regarding age differences in information processing can inform one another. © 2007 Association for Psychological Science.

  13. Key stakeholders' perceptions of the acceptability and usefulness of a tablet-based tool to improve communication and shared decision making in ICUs.

    Science.gov (United States)

    Ernecoff, Natalie C; Witteman, Holly O; Chon, Kristen; Chen, Yanquan Iris; Buddadhumaruk, Praewpannarai; Chiarchiaro, Jared; Shotsberger, Kaitlin J; Shields, Anne-Marie; Myers, Brad A; Hough, Catherine L; Carson, Shannon S; Lo, Bernard; Matthay, Michael A; Anderson, Wendy G; Peterson, Michael W; Steingrub, Jay S; Arnold, Robert M; White, Douglas B

    2016-06-01

    broad support among stakeholders for the use of a tablet-based tool to improve communication and shared decision making in ICUs. Eliciting the perspectives of key stakeholders early in the design process yielded important insights to create a tool tailored to the needs of surrogates and care providers in ICUs. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Judgment and decision making.

    Science.gov (United States)

    Fischhoff, Baruch

    2010-09-01

    The study of judgment and decision making entails three interrelated forms of research: (1) normative analysis, identifying the best courses of action, given decision makers' values; (2) descriptive studies, examining actual behavior in terms comparable to the normative analyses; and (3) prescriptive interventions, helping individuals to make better choices, bridging the gap between the normative ideal and the descriptive reality. The research is grounded in analytical foundations shared by economics, psychology, philosophy, and management science. Those foundations provide a framework for accommodating affective and social factors that shape and complement the cognitive processes of decision making. The decision sciences have grown through applications requiring collaboration with subject matter experts, familiar with the substance of the choices and the opportunities for interventions. Over the past half century, the field has shifted its emphasis from predicting choices, which can be successful without theoretical insight, to understanding the processes shaping them. Those processes are often revealed through biases that suggest non-normative processes. The practical importance of these biases depends on the sensitivity of specific decisions and the support that individuals have in making them. As a result, the field offers no simple summary of individuals' competence as decision makers, but a suite of theories and methods suited to capturing these sensitivities. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

  15. The Self in Decision Making and Decision Implementation.

    Science.gov (United States)

    Beach, Lee Roy; Mitchell, Terence R.

    Since the early 1950's the principal prescriptive model in the psychological study of decision making has been maximization of Subjective Expected Utility (SEU). This SEU maximization has come to be regarded as a description of how people go about making decisions. However, while observed decision processes sometimes resemble the SEU model,…

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

    Science.gov (United States)

    Papageorgiou, Spiros

    2010-01-01

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

  17. GROUPS DECISION MAKING WITHIN THE ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Anca Stan

    2008-12-01

    Full Text Available In a highly global market, organizations that have the ability to analyze and rapidly respond to the constantly changing marketplace will have the greatest chance of remaining competitive and profitable. Group decision making is the process of arriving at a judgment based upon the feedback of multiple individuals. Due to the importance of the group decision making process, decision making models can be used to establish a systematic means of developing effective group decision making. Once a decision has been made, the members of the group should be willing to accept it and support its implementations.

  18. A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

    Science.gov (United States)

    Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

    2013-01-01

    Background Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. Objective This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. Methods The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions

  19. The Production of Green Identities in Garbage Can Decision-making Processes

    DEFF Research Database (Denmark)

    Backer, Lise

    of organisational identities to the model. Within the scientific field of business and the environment the article contributes to a new understanding of the relationship between decision-making, green organisational identities and the process of social construction of business opportunities. This relationship can...... the decision has happened. Thus, in the process of accounting for their decision the corporations are not just accounting for a particular decision, but also in a general sense contributing to socially constructing anew what can be considered a business opportunity - also for other corporations....... In this process of socially constructing new business opportunities the corporations are drawing on cultural sources not just from the field of rhetoric of economics, but also from other cultural sources within the business sector and the society as such....

  20. Multicriteria decision analysis: Overview and implications for environmental decision making

    Science.gov (United States)

    Hermans, Caroline M.; Erickson, Jon D.; Erickson, Jon D.; Messner, Frank; Ring, Irene

    2007-01-01

    Environmental decision making involving multiple stakeholders can benefit from the use of a formal process to structure stakeholder interactions, leading to more successful outcomes than traditional discursive decision processes. There are many tools available to handle complex decision making. Here we illustrate the use of a multicriteria decision analysis (MCDA) outranking tool (PROMETHEE) to facilitate decision making at the watershed scale, involving multiple stakeholders, multiple criteria, and multiple objectives. We compare various MCDA methods and their theoretical underpinnings, examining methods that most realistically model complex decision problems in ways that are understandable and transparent to stakeholders.

  1. Psychometrics of shared decision making and communication as patient centered measures for two language groups.

    Science.gov (United States)

    Alvarez, Kiara; Wang, Ye; Alegria, Margarita; Ault-Brutus, Andrea; Ramanayake, Natasha; Yeh, Yi-Hui; Jeffries, Julia R; Shrout, Patrick E

    2016-09-01

    Shared decision making (SDM) and effective patient-provider communication are key and interrelated elements of patient-centered care that impact health and behavioral health outcomes. Measurement of SDM and communication from the patient's perspective is necessary in order to ensure that health care systems and individual providers are responsive to patient views. However, there is a void of research addressing the psychometric properties of these measures with diverse patients, including non-English speakers, and in the context of behavioral health encounters. This study evaluated the psychometric properties of 2 patient-centered outcome measures, the Shared Decision-Making Questionnaire-9 (SDM-Q) and the Kim Alliance Scale-Communication subscale (KAS-CM), in a sample of 239 English and Spanish-speaking behavioral health patients. One dominant factor was found for each scale and this structure was used to examine whether there was measurement invariance across the 2 language groups. One SDM-Q item was inconsistent with the configural invariance comparison and was removed. The remaining SDM-Q items exhibited strong invariance, meaning that item loadings and item means were similar across the 2 groups. The KAS-CM items had limited variability, with most respondents indicating high communication levels, and the invariance analysis was done on binary versions of the items. These had metric invariance (loadings the same over groups) but several items violated the strong invariance test. In both groups, the SDM-Q had high internal consistency, whereas the KAS-CM was only adequate. These findings help interpret results for individual patients, taking into account cultural and linguistic differences in how patients perceive SDM and patient-provider communication. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Using the ACT-R architecture to specify 39 quantitative process models of decision making

    NARCIS (Netherlands)

    Marewski, Julian N.; Mehlhorn, Katja

    Hypotheses about decision processes are often formulated qualitatively and remain silent about the interplay of decision, memorial, and other cognitive processes. At the same time, existing decision models are specified at varying levels of detail, making it difficult to compare them. We provide a

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

    Science.gov (United States)

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

    2013-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Czamanski-Cohen, Johanna

    2012-01-01

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

  6. Supporting Communication and Decision Making in Finnish Intensive Care with Language Technology

    Directory of Open Access Journals (Sweden)

    Hanna J. Suominen

    2010-01-01

    Full Text Available A fluent flow of health information is critical for health communication and decision making. However, the flow is fragmented by the large amount of textual records and their specific jargon. This creates risks for both patient safety and cost-effective health services. Language technology for the automated processing of textual health records is emerging. In this paper, we describe method development for building topical overviews in Finnish intensive care. Our topical search methods are based on supervised multi-label classification and regression, as well as supervised and unsupervised multi-class classification. Our linguistic analysis methods are based on rule-based and statistical parsing, as well as tailoring of a commercial morphological analyser. According to our experimental results, the supervised methods generalise for multiple topics and human annotators, and the unsupervised method enables an ad hoc information search. Tailored linguistic analysis improves performance in the experiments and, in addition, improves text comprehensibility for health professionals and laypeople. In conclusion, the performance of our methods is promising for real-life applications.

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

    Science.gov (United States)

    Gkigkitzis, Ioannis

    2013-01-01

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

  8. Treatment decision-making processes in the systemic treatment of ovarian cancer: review of the scientific evidence.

    Science.gov (United States)

    Luketina, Hrvoje; Fotopoulou, Christina; Luketina, Ruzica-Rosalia; Pilger, Adak; Sehouli, Jalid

    2012-09-01

    The systemic treatment of epithelial ovarian cancer (OC) is one of the cornerstones in the multimodal management of advanced OC in both primary and recurrent stages of this disease. In most situations various treatment options are available but only few data exists about the treatment decision-making process. Therefore, we conducted a review of the current literature regarding the decision-making process concerning the systemic therapy in patients with advanced ovarian cancer. The electronic database MEDLINE (PubMed) was systematically reviewed for studies that evaluate the treatment decision-making processes in patients with advanced OC. The PubMed database was searched in detail for all titles and abstracts of potentially relevant studies published between 1995 and 2011. An initial search identified 15 potentially relevant studies, but only seven met all inclusion criteria. Factors that influence treatment decisions in patients with OC include not only rational arguments and medical reasons, but also individual attitudes, fears, existential questions, various projections resulting from the physician patient relationship and the social environment. The physician's personal experience with OC treatment seems to be an important factor, followed by previous personal experience with medical issues, and the fear of side-effects and future metastases. Family and self-support organisations also seem to play a significant role in the treatment decision-making process. This review underlines the need for more research activities to explore the treatment decision-making process to enable the best individual support for patients in treatment decision-making. It is a challenge for clinicians to determine the individual information needs of women with OC and to involve them during the decision-making process to the extent they wish.

  9. An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making.

    Science.gov (United States)

    Jelihovschi, Ana P G; Cardoso, Ricardo L; Linhares, Alexandre

    2017-01-01

    Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making.

  10. Modelling decision-making by pilots

    Science.gov (United States)

    Patrick, Nicholas J. M.

    1993-01-01

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

  11. Agent-Based Modeling of Consumer Decision making Process Based on Power Distance and Personality

    NARCIS (Netherlands)

    Roozmand, O.; Ghasem-Aghaee, N.; Hofstede, G.J.; Nematbakhsh, M.A.; Baraani, A.; Verwaart, T.

    2011-01-01

    Simulating consumer decision making processes involves different disciplines such as: sociology, social psychology, marketing, and computer science. In this paper, we propose an agent-based conceptual and computational model of consumer decision-making based on culture, personality and human needs.

  12. The Impact of Shared Decision-making Interventions on Prostate Cancer Treatment Decision-making

    Science.gov (United States)

    Angie Fagerlin, PhD, is a Professor and Chair in the Department of Population Health Sciences at the University of Utah and a Research Scientist at the Salt Lake City VA. She is the current President of the Society of Medical Decision Making. Dr. Fagerlin’s training is in experimental psychology, primarily in the areas of cognitive and social psychology.  Her research focuses on testing methods for communicating medical data to patients and providers (e.g., the risks and benefits of cancer treatment) and the development and testing of decision support interventions.  Her recent work is testing the impact of patient decision aids on patient-physician communication.  Additionally, she is testing multiple methods for communicating about genetic testing and infectious diseases (e.g., the Zika virus, Ebola, influenza).  Her research has been funded by NCI, NIH, VA, PCORI, and the European Union. If you are a person with a disability and require an assistive device, services or other reasonable accommodations to participate in this activity, please contact the Cancer Prevention Fellowship Program at (240) 276-5626 at least one week in advance of the lecture date to discuss your accommodation needs.

  13. Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication: An Agenda for Science and Practice.

    Science.gov (United States)

    Betsch, Cornelia; Böhm, Robert; Airhihenbuwa, Collins O; Butler, Robb; Chapman, Gretchen B; Haase, Niels; Herrmann, Benedikt; Igarashi, Tasuku; Kitayama, Shinobu; Korn, Lars; Nurm, Ülla-Karin; Rohrmann, Bernd; Rothman, Alexander J; Shavitt, Sharon; Updegraff, John A; Uskul, Ayse K

    2016-10-01

    This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research. © The Author(s) 2015.

  14. [Cognitive errors in diagnostic decision making].

    Science.gov (United States)

    Gäbler, Martin

    2017-10-01

    Approximately 10-15% of our diagnostic decisions are faulty and may lead to unfavorable and dangerous outcomes, which could be avoided. These diagnostic errors are mainly caused by cognitive biases in the diagnostic reasoning process.Our medical diagnostic decision-making is based on intuitive "System 1" and analytical "System 2" diagnostic decision-making and can be deviated by unconscious cognitive biases.These deviations can be positively influenced on a systemic and an individual level. For the individual, metacognition (internal withdrawal from the decision-making process) and debiasing strategies, such as verification, falsification and rule out worst-case scenarios, can lead to improved diagnostic decisions making.

  15. Age Differences in Information Use While Making Decisions: Resource Limitations or Processing Differences?

    Science.gov (United States)

    Jacobs-Lawson, Joy M; Schumacher, Mitzi M; Wackerbarth, Sarah B

    2016-09-20

    Recent research on the decision-making abilities of older adults has shown that they use less information than young adults. One explanation ascribes this age difference to reductions in cognitive abilities with age. The article includes three experimental studies that focused on determining the conditions in which older and young adults would display dissimilar information processing characteristics. Findings from Studies 1 and 2 demonstrated that older adults are not necessarily at greater disadvantage than young adults in decision contexts that demand more information processing resources. Findings from Study 3 indicated that older adults when faced with decisions that require greater processing are likely to use a strategy that reduces the amount of information needed, whereas younger adults rely on strategies that utilize more resources. Combined the findings indicate that older adults change their decision-making strategies based on the context and information provided. Furthermore, support is provided for processing difference. © The Author(s) 2016.

  16. Modeling Human Elements of Decision-Making

    Science.gov (United States)

    2002-06-01

    include factors such as personality, emotion , and level of expertise, which vary from individual to individual. The process of decision - making during... rational choice theories such as utility theory, to more descriptive psychological models that focus more on the process of decision - making ...descriptive nature, they provide a more realistic representation of human decision - making than the rationally based models. However these models do

  17. How social cognition can inform social decision making

    Science.gov (United States)

    Lee, Victoria K.; Harris, Lasana T.

    2013-01-01

    Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures—while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context—and examine the benefits of integrating social psychological theory with behavioral economic theory. PMID:24399928

  18. How social cognition can inform social decision making.

    Science.gov (United States)

    Lee, Victoria K; Harris, Lasana T

    2013-12-25

    Social decision-making is often complex, requiring the decision-maker to make inferences of others' mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision-making involving social and non-social stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social vs. non-social contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g., mental state inferences, impression formation, spontaneous trait inferences) that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex (MPFC), superior temporal sulcus (STS), temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures-while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context-and examine the benefits of integrating social psychological theory with behavioral economic theory.

  19. How Social Cognition Can Inform Social Decision Making

    Directory of Open Access Journals (Sweden)

    Victoria eLee

    2013-12-01

    Full Text Available Social decision-making is often complex, requiring the decision-maker to make inferences of others’ mental states in addition to engaging traditional decision-making processes like valuation and reward processing. A growing body of research in neuroeconomics has examined decision- making involving social and nonsocial stimuli to explore activity in brain regions such as the striatum and prefrontal cortex, largely ignoring the power of the social context. Perhaps more complex processes may influence decision-making in social versus nonsocial contexts. Years of social psychology and social neuroscience research have documented a multitude of processes (e.g. mental state inferences, impression formation, spontaneous trait inferences that occur upon viewing another person. These processes rely on a network of brain regions including medial prefrontal cortex, superior temporal sulcus, temporal parietal junction, and precuneus among others. Undoubtedly, these social cognition processes affect social decision-making since mental state inferences occur spontaneously and automatically. Few studies have looked at how these social inference processes affect decision-making in a social context despite the capability of these inferences to serve as predictions that can guide future decision-making. Here we review and integrate the person perception and decision-making literatures to understand how social cognition can inform the study of social decision-making in a way that is consistent with both literatures. We identify gaps in both literatures—while behavioral economics largely ignores social processes that spontaneously occur upon viewing another person, social psychology has largely failed to talk about the implications of social cognition processes in an economic decision-making context—and examine the benefits of integrating social psychological theory with behavioral economic theory.

  20. Multiple Attribute Decision Making Based Relay Vehicle Selection for Electric Vehicle Communication

    Directory of Open Access Journals (Sweden)

    Zhao Qiang

    2015-01-01

    Full Text Available Large-scale electric vehicle integration into power grid and charging randomly will cause serious impacts on the normal operation of power grid. Therefore, it is necessary to control the charging behavior of electric vehicle, while information transmission for electric vehicle is significant. Due to the highly mobile characteristics of vehicle, transferring information to power grid directly might be inaccessible. Relay vehicle (RV can be used for supporting multi-hop connection between SV and power grid. This paper proposes a multiple attribute decision making (MADM-based RV selection algorithm, which considers multiple attribute, including data transfer rate, delay, route duration. It takes the characteristics of electric vehicle communication into account, which can provide protection for the communication services of electric vehicle charging and discharging. Numerical results demonstrate that compared to previous algorithm, the proposed algorithm offer better performance in terms of throughput, transmission delay.

  1. Decision Making in Adults with ADHD

    Science.gov (United States)

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

    2012-01-01

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

  2. Decision making about Pap test use among Korean immigrant women: A qualitative study.

    Science.gov (United States)

    Kim, Kyounghae; Kim, Soohyun; Gallo, Joseph J; Nolan, Marie T; Han, Hae-Ra

    2017-08-01

    Understanding how individuals make decisions about Pap tests concerning their personal values helps health-care providers offer tailored approaches to guide patients' decision making. Yet research has largely ignored decision making about Pap tests among immigrant women who experience increased risk of cervical cancer. To explore decision making about Pap tests among Korean immigrant women. We conducted a qualitative descriptive study using 32 semi-structured, in-depth interviews with Korean immigrant women residing in a north-eastern metropolitan area. Data were audio-recorded, transcribed verbatim and analysed using inductive coding. Although most women with positive decisions made their own decisions, some women deferred to their providers, and others made decisions in collaboration with their providers and significant others. While women making positive decisions tended to consider both barriers to and facilitators of having Pap tests, women making negative decisions predominantly discussed the barriers to having Pap tests, such as modesty and differences between the South Korean and US health-care systems. The women's reflections on their decisions differed regarding their Pap test decisions. Women's desired roles in the decision-making process and reflection on their decision outcome appeared to vary, although most participants with positive decisions made their own decisions and were satisfied with their decisions. Future research should conduct longitudinal, quantitative studies to test our findings regarding decision-making processes and outcomes about Pap tests. The findings should be incorporated into cervical cancer screening practices to fulfil the unmet needs of immigrant women in patient-provider communication and to facilitate women's decision making about Pap tests. © 2016 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  3. Human Errors in Decision Making

    OpenAIRE

    Mohamad, Shahriari; Aliandrina, Dessy; Feng, Yan

    2005-01-01

    The aim of this paper was to identify human errors in decision making process. The study was focused on a research question such as: what could be the human error as a potential of decision failure in evaluation of the alternatives in the process of decision making. Two case studies were selected from the literature and analyzed to find the human errors contribute to decision fail. Then the analysis of human errors was linked with mental models in evaluation of alternative step. The results o...

  4. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    Science.gov (United States)

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95

  5. Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2012-01-01

    of the interaction between a corporation and its stakeholders. Methodology/approach: This paper offers a theoretical 'Organic Stakeholder Model' based on decision making theory, risk assessment and adaption to a rapidly changing world combined with appropriate stakeholder theory for ethical purposes in decision...... applicable): The Model is based on case studies, but the limited scope of the length of the paper did not leave room to show the empirical evidence, but only the theoretical study. Originality / value of a paper: The model offers a new way of combining risk management with ethical decision-making processes...... by the inclusion of multiple stakeholders. The conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk management models does – for the sake of the wider social responsibilities of the businesses...

  6. Patient decision-making: medical ethics and mediation.

    OpenAIRE

    Craig, Y J

    1996-01-01

    A review of medical ethics literature relating to the importance of the participation of patients in decision-making introduces the role of rights-based mediation as a voluntary process now being developed innovatively in America. This is discussed in relation to the theory of communicative ethics and moral personhood. References are then made to the work of medical ethics committees and the role of mediation within these. Finally it is suggested that mediation is part of an eirenic ethic alr...

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

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

    2015-01-01

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

  9. Decision Making under Uncertainty: A Neural Model based on Partially Observable Markov Decision Processes

    Directory of Open Access Journals (Sweden)

    Rajesh P N Rao

    2010-11-01

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

  10. Dementia, Decision Making, and Capacity.

    Science.gov (United States)

    Darby, R Ryan; Dickerson, Bradford C

    After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.

  11. THE MAKING OF DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Leonardo Yuji Tamura

    2016-04-01

    Full Text Available Quantum Electronics was a Brazilian startup in the 1990's that was acquired by an American equity fund in 2012. They are currently the largest manufacturer of vehicle tracking and infotainment systems. The company was founded by three college friends, who are currently executives at the company: Camilo Santos, Pedro Barbosa and Luana Correa. Edward Hutter was sent by the equity fund to take over the company’s finances, but is having trouble making organizational decisions with his colleagues. As a consultant, I was called to help them improve their decision making process and project prioritization. I adapted and deployed our firm's methodology, but, in the end, its adequacy is shown to be very much in question. The author of this case study intends to explore how actual organizational decisions rely on different decision models and their assumptions, .as well as demonstrate that a decision model is neither absolutely good nor bad as its quality is context dependent.

  12. A Make-or-buy Decision Process for Outsourcing

    OpenAIRE

    Bajec, Patricija; Jakomin, Igor

    2010-01-01

    Should firms perform logistics services on their own or should they buy them from a logistics provider? Today’s global competition forces companies to re-evaluate their existing processes, technologies and services in order to focuse on strategic activities. Outsourcing is now increasingly used as a competitive weapon in today’s economy. External parties can often do job quicker, cheaper and better. This has resulted in an increasing awareness of the importance of the make-or-buy decision, th...

  13. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    Science.gov (United States)

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  14. Command Decision-Making: Experience Counts

    National Research Council Canada - National Science Library

    Wolgast, Kelly A

    2005-01-01

    Decision-making is the mainstay of military leadership and command. Due to the changed nature of the current military environment, military commanders can no longer rely solely on the traditional Military Decision-making Process (MDMP...

  15. The impact of mass media health communication on health decision-making and medical advice-seeking behavior of u.s. Hispanic population.

    Science.gov (United States)

    De Jesus, Maria

    2013-01-01

    Mass media health communication has enormous potential to drastically alter how health-related information is disseminated and obtained by different populations. However, there is little evidence regarding the influence of media channels on health decision-making and medical advice-seeking behaviors among the Hispanic population. The Pew 2007 Hispanic Healthcare Survey was used to test the hypothesis that the amount of mass media health communication (i.e., quantity of media-based health information received) is more likely to influence Hispanic adults' health decision-making and medical advice-seeking behavior compared to health literacy and language proficiency variables. Results indicated that quantity of media-based health information is positively associated with health decision-making and medical advice-seeking behavior above and beyond the influence of health literacy and English and Spanish language proficiency. In a context where physician-patient dynamics are increasingly shifting from a passive patient role model to a more active patient role model, media-based health information can serve as an influential cue to action, prompting Hispanic individuals to make certain health-related decisions and to seek more health advice and information from a health provider. Study implications are discussed.

  16. Research in Brief: Shared Decision Making Enhances Instructional Leadership.

    Science.gov (United States)

    Lindle, Joan Clark

    1992-01-01

    A study of three middle school principals about their instructional leadership activities before and after the establishment of shared decision making revealed an enhancement of leadership. The nature of the middle school teacher's role demands participative leadership and communication and decision making revolved around instructional issues.…

  17. An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making

    Directory of Open Access Journals (Sweden)

    Ana P. G. Jelihovschi

    2018-01-01

    Full Text Available Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11 and the performance based Cognitive Reflection Test (CRT. Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper. These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making.

  18. An Analysis of the Associations among Cognitive Impulsiveness, Reasoning Process, and Rational Decision Making

    Science.gov (United States)

    Jelihovschi, Ana P. G.; Cardoso, Ricardo L.; Linhares, Alexandre

    2018-01-01

    Impulsivity may lead to several unfortunate consequences and maladaptive behaviors for both clinical and nonclinical people. It has a key role in many forms of psychopathology. Although literature has discussed the negative impact of impulsivity, few have emphasized the relationship between cognitive impulsiveness and decision making. The aim of this study is to investigate the effects of cognitive impulsiveness on decision making and explore the strategies used by participants to solve problems. For this purpose, we apply two measures of impulsivity: the self-report Barratt Impulsiveness Scale (BIS-11) and the performance based Cognitive Reflection Test (CRT). Moreover, we evaluate participants' reasoning processes employed to answer CRT questions based on the calculation expressions, data organization, and erasures they made while answering the CRT (note that we utilized the instruments using pen and paper). These reasoning processes are related to the role of executive functions in decision making, and its relationship with impulsiveness. The sample consists of 191 adults, who were either professionals or undergraduate students from the fields of business, management, or accounting. The results show that cognitive impulsiveness may negatively affect decision making, and that those who presented the calculation to answer the CRT questions made better decisions. Moreover, there was no difference in the strategies used by impulsive vs. nonimpulsive participants during decision making. Finally, people who inhibited their immediate answers to CRT questions performed better during decision making. PMID:29375440

  19. Affective Decision Making and the Ellsberg Paradox

    OpenAIRE

    Anat Bracha; Donald J. Brown

    2008-01-01

    Affective decision-making is a strategic model of choice under risk and uncertainty where we posit two cognitive processes -- the "rational" and the "emotional" process. Observed choice is the result of equilibrium in this intrapersonal game. As an example, we present applications of affective decision-making in insurance markets, where the risk perceptions of consumers are endogenous. We derive the axiomatic foundation of affective decision making, and show that affective decision making is ...

  20. Children's Decision-Making Involvement About Research Participation: Associations With Perceived Fairness and Self-Efficacy.

    Science.gov (United States)

    Miller, Victoria A; Feudtner, Chris; Jawad, Abbas F

    2017-04-01

    The primary objective of this study was to examine the associations of children's involvement in decisions about research participation with their perceptions of the decision-making process and self-efficacy. Participants were children (ages 8-17) who enrolled in research studies in the prior 2 months. Children completed a questionnaire that yielded three decision-making involvement subscales: Researcher Engages Child, Researcher Supports Autonomy, and Child Participates. Children reported on fairness of the decision-making process and health-related decision self-efficacy. After adjusting for age, higher scores on Researcher Engages Child were associated with greater self-efficacy, and higher scores on Researcher Supports Autonomy were associated with greater perceived fairness. These data underscore the potential importance of researcher-child interactions about research participation when assent is sought, including proactively involving children in the decision by asking for their opinions and communicating their central role in the decision, which are likely to be more meaningful to children than receiving information or signing a form.

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

    Science.gov (United States)

    Lin, Chin-Feng; Wang, Hui-Fang

    2008-12-01

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

  2. Clinical intuition in the nursing process and decision-making-A mixed-studies review.

    Science.gov (United States)

    Melin-Johansson, Christina; Palmqvist, Rebecca; Rönnberg, Linda

    2017-12-01

    To review what is characteristic of registered nurses' intuition in clinical settings, in relationships and in the nursing process. Intuition is a controversial concept and nurses believe that there are difficulties in how they should explain their nursing actions or decisions based on intuition. Much of the evidence from the body of research indicates that nurses value their intuition in a variety of clinical settings. More information on how nurses integrate intuition as a core element in daily clinical work would contribute to an improved understanding on how they go about this. Intuition deserves a place in evidence-based activities, where intuition is an important component associated with the nursing process. An integrative review strengthened with a mixed-studies review. Literature searches were conducted in the databases CINAHL, PubMed and PsycINFO, and literature published 1985-2016 were included. The findings in the studies were analysed with content analysis, and the synthesis process entailed a reasoning between the authors. After a quality assessment, 16 studies were included. The analysis and synthesis resulted in three categories. The characteristics of intuition in the nurse's daily clinical activities include application, assertiveness and experiences; in the relationships with patients' intuition include unique connections, mental and bodily responses, and personal qualities; and in the nursing process include support and guidance, component and clues in decision-making, and validating decisions. Intuition is more than simply a "gut feeling," and it is a process based on knowledge and care experience and has a place beside research-based evidence. Nurses integrate both analysis and synthesis of intuition alongside objective data when making decisions. They should rely on their intuition and use this knowledge in clinical practice as a support in decision-making, which increases the quality and safety of patient care. We find that intuition plays a

  3. Making better decisions in uncertain times (Invited)

    Science.gov (United States)

    St John, C.

    2013-12-01

    Scientific information about climate change and other human impacts on the environment are increasingly available and sought after (often in the form of probabilistic forecasts or technical information related to engineering solutions). However, it is increasingly apparent that there are barriers to the use of this information by decision makers - either from its lack of application altogether, its usability for people without scientific backgrounds, or its ability to inform sound decisions and widespread behavior change. While the argument has been made that an information deficit is to blame, we argue that there is also a motivation deficit contributing to a lack of understanding of information about climate change impacts and solutions. Utilizing insight from over thirty years of research in social and cognitive psychology, in addition to other social sciences, the Center for Research on Environmental Decisions (CRED) seeks to understand how people make environmental decisions under conditions of uncertainty, and how these decisions can be improved. This presentation will focus specifically on recent research that has come forth since the 2009 publication of CRED's popular guide 'The Psychology of Climate Change Communication: A Guide for Scientists, Journalists, Educators, Political Aides, and the Interested Public.' Utilizing case studies from real world examples, this talk will explore how decision making can be improved through a better understanding of how people perceive and process uncertainty and risk. It will explore techniques such as choice architecture and 'nudging' behavior change, how social goals and group participation affect decision making, and how framing of environmental information influences mitigative behavior.

  4. Decision-Making Processes in Texas School Districts That Arm Personnel

    Science.gov (United States)

    Domain, Melinda Willoughby

    2014-01-01

    This qualitative phenomenological study employed narrative inquiry to describe the decision-making processes that Texas school districts followed in enacting firearms policies that allow school employees to carry concealed weapons on district property. Exploration of the lived experiences of eight Texas superintendents in such schools contributed…

  5. Difficult decisions: A qualitative exploration of the statistical decision making process from the perspectives of psychology students and academics

    Directory of Open Access Journals (Sweden)

    Peter James Allen

    2016-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  7. PROCESSING THE INFORMATION CONTENT ON THE BASIS OF FUZZY NEURAL MODEL OF DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Nina V. Komleva

    2013-01-01

    Full Text Available The article is devoted to the issues of mathematical modeling of the decision-making process of information content processing based on the fuzzy neural network TSK. Integral rating assessment of the content, which is necessary for taking a decision about its further usage, is made depended on varying characteristics. Mechanism for building individual trajectory and forming individual competence is provided to make the intellectual content search.

  8. Physician Perspectives on Decision Making for Treatment of Pediatric Sleep-Disordered Breathing.

    Science.gov (United States)

    Boss, Emily F; Links, Anne R; Saxton, Ron; Cheng, Tina L; Beach, Mary Catherine

    2017-10-01

    Sleep-disordered breathing (SDB) is prevalent in children and most commonly treated by surgery with adenotonsillectomy. We aimed to learn physician perspectives of social and communication factors that influence decision making for treatment of pediatric SDB. Purposive sampling identified 10 physician key informants across disciplines and practice settings, who participated in semistructured interviews regarding SDB care experiences and communication with parents. Interviews were analyzed using directed qualitative content analysis. Physicians provided a variety of perspectives on decision making for treatment that fell into 3 overarching themes: approach to surgery and alternatives, communication and decision making with families, and sociocultural factors/barriers to care. Perspectives were moderately heterogeneous, suggesting that individual social and relational elements may significantly influence how physicians refer patients and recommend treatment, and how parents choose surgery for this prevalent condition. These findings will inform development of culturally competent communication strategies and support tools to enhance shared decision making for physicians treating children with SDB.

  9. A Multi-layer Dynamic Model for Coordination Based Group Decision Making in Water Resource Allocation and Scheduling

    Science.gov (United States)

    Huang, Wei; Zhang, Xingnan; Li, Chenming; Wang, Jianying

    Management of group decision-making is an important issue in water source management development. In order to overcome the defects in lacking of effective communication and cooperation in the existing decision-making models, this paper proposes a multi-layer dynamic model for coordination in water resource allocation and scheduling based group decision making. By introducing the scheme-recognized cooperative satisfaction index and scheme-adjusted rationality index, the proposed model can solve the problem of poor convergence of multi-round decision-making process in water resource allocation and scheduling. Furthermore, the problem about coordination of limited resources-based group decision-making process can be solved based on the effectiveness of distance-based group of conflict resolution. The simulation results show that the proposed model has better convergence than the existing models.

  10. Seasonality in communication and collective decision-making in ants.

    Science.gov (United States)

    Stroeymeyt, N; Jordan, C; Mayer, G; Hovsepian, S; Giurfa, M; Franks, N R

    2014-04-07

    The ability of animals to adjust their behaviour according to seasonal changes in their ecology is crucial for their fitness. Eusocial insects display strong collective behavioural seasonality, yet the mechanisms underlying such changes are poorly understood. We show that nest preference by emigrating Temnothorax albipennis ant colonies is influenced by a season-specific modulatory pheromone that may help tune decision-making according to seasonal constraints. The modulatory pheromone triggers aversion towards low-quality nests and enhances colony cohesion in summer and autumn, but not after overwintering-in agreement with reports that field colonies split in spring and reunite in summer. Interestingly, we show that the pheromone acts by downgrading the perceived value of marked nests by informed and naive individuals. This contrasts with theories of collective intelligence, stating that accurate collective decision-making requires independent evaluation of options by individuals. The violation of independence highlighted here was accordingly shown to increase error rate during emigrations. However, this is counterbalanced by enhanced cohesion and the transmission of valuable information through the colony. Our results support recent claims that optimal decisions are not necessarily those that maximize accuracy. Other criteria-such as cohesion or reward rate-may be more relevant in animal decision-making.

  11. Psychiatric service staff perceptions of implementing a shared decision-making tool: a process evaluation study.

    Science.gov (United States)

    Schön, Ulla-Karin; Grim, Katarina; Wallin, Lars; Rosenberg, David; Svedberg, Petra

    2018-12-01

    Shared decision making, SDM, in psychiatric services, supports users to experience a greater sense of involvement in treatment, self-efficacy, autonomy and reduced coercion. Decision tools adapted to the needs of users have the potential to support SDM and restructure how users and staff work together to arrive at shared decisions. The aim of this study was to describe and analyse the implementation process of an SDM intervention for users of psychiatric services in Sweden. The implementation was studied through a process evaluation utilizing both quantitative and qualitative methods. In designing the process evaluation for the intervention, three evaluation components were emphasized: contextual factors, implementation issues and mechanisms of impact. The study addresses critical implementation issues related to decision-making authority, the perceived decision-making ability of users and the readiness of the service to increase influence and participation. It also emphasizes the importance of facilitation, as well as suggesting contextual adaptations that may be relevant for the local organizations. The results indicate that staff perceived the decision support tool as user-friendly and useful in supporting participation in decision-making, and suggest that such concrete supports to participation can be a factor in implementation if adequate attention is paid to organizational contexts and structures.

  12. New vaccine adoption: qualitative study of national decision-making processes in seven low- and middle-income countries.

    Science.gov (United States)

    Burchett, H E D; Mounier-Jack, S; Griffiths, U K; Biellik, R; Ongolo-Zogo, P; Chavez, E; Sarma, H; Uddin, J; Konate, M; Kitaw, Y; Molla, M; Wakasiaka, S; Gilson, L; Mills, A

    2012-05-01

    As more new and improved vaccines become available, decisions on which to adopt into routine programmes become more frequent and complex. This qualitative study aimed to explore processes of national decision-making around new vaccine adoption and to understand the factors affecting these decisions. Ninety-five key informant interviews were conducted in seven low- and middle-income countries: Bangladesh, Cameroon, Ethiopia, Guatemala, Kenya, Mali and South Africa. Framework analysis was used to explore issues both within and between countries. The underlying driver for adoption decisions in GAVI-eligible countries was the desire to seize GAVI windows of opportunity for funding. By contrast, in South Africa and Guatemala, non-GAVI-eligible countries, the decision-making process was more rooted in internal and political dynamics. Decisions to adopt new vaccines are, by nature, political. The main drivers influencing decisions were the availability of funding, political prioritization of vaccination or the vaccine-preventable disease and the burden of disease. Other factors, such as financial sustainability and feasibility of introduction, were not as influential. Although GAVI procedures have established more formality in decision-making, they did not always result in consideration of all relevant factors. As familiarity with GAVI procedures increased, questioning by decision-makers about whether a country should apply for funding appeared to have diminished. This is one of the first studies to empirically investigate national processes of new vaccine adoption decision-making using rigorous methods. Our findings show that previous decision-making frameworks (developed to guide or study national decision-making) bore little resemblance to real-life decisions, which were dominated by domestic politics. Understanding the realities of vaccine policy decision-making is critical for developing strategies to encourage improved evidence-informed decision-making about new

  13. Communication and decision-making in mental health: A systematic review focusing on Bipolar disorder.

    Science.gov (United States)

    Fisher, Alana; Manicavasagar, Vijaya; Kiln, Felicity; Juraskova, Ilona

    2016-07-01

    To systematically review studies of communication and decision-making in mental health-based samples including BP patients. Qualitative systematic review of studies using PsychINFO, MEDLINE, SCOPUS, CINAHL, and EMBASE (January 2000-March 2015). One author assessed study eligibility, verified by two co-authors. Data were independently extracted by two authors, and cross-checked by another co-author. Two independent raters assessed eligible studies using a validated quality appraisal. Of 519 articles retrieved, 13 studies were included (i.e., 10 quantitative/1 qualitative/1 mixed-methods). All were cross-sectional; twelve were rated good/strong quality (>70%). Four inter-related themes emerged: patient characteristics and patient preferences, quality of patient-clinician interactions, and influence of SDM/patient-centred approach on patient outcomes. Overall BP patients, like others, have unmet decision-making needs, and desire greater involvement. Clinician consultation behaviour influenced patient involvement; interpersonal aspects (e.g., empathy, listening well) fostered therapeutic relationships and positive patient outcomes, including: improved treatment adherence, patient satisfaction with care, and reduced suicidal ideation. This review reveals a paucity of studies reporting bipolar-specific findings. To inform targeted BP interventions, greater elucidation of unmet decision-making needs is needed. Eliciting patient preferences and developing a collaborative therapeutic alliance may be particularly important in BP, promoting improved patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Improving accountability in vaccine decision-making.

    Science.gov (United States)

    Timmis, James Kenneth; Black, Steven; Rappuoli, Rino

    2017-11-01

    Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically. Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.

  15. Web-based cancer communication and decision making systems: connecting patients, caregivers, and clinicians for improved health outcomes.

    Science.gov (United States)

    DuBenske, Lori L; Gustafson, David H; Shaw, Bret R; Cleary, James F

    2010-01-01

    Over the cancer disease trajectory, from diagnosis and treatment to remission or end of life, patients and their families face difficult decisions. The provision of information and support when most relevant can optimize cancer decision making and coping. An interactive health communication system (IHCS) offers the potential to bridge the communication gaps that occur among patients, family, and clinicians and to empower each to actively engage in cancer care and shared decision making. This is a report of the authors' experience (with a discussion of relevant literature) in developing and testing a Web-based IHCS-the Comprehensive Health Enhancement Support System (CHESS)-for patients with advanced lung cancer and their family caregivers. CHESS provides information, communication, and coaching resources as well as a symptom tracking system that reports health status to the clinical team. Development of an IHCS includes a needs assessment of the target audience and applied theory informed by continued stakeholder involvement in early testing. Critical issues of IHCS implementation include 1) need for interventions that accommodate a variety of format preferences and technology comfort ranges; 2) IHCS user training, 3) clinician investment in IHCS promotion, and 4) IHCS integration with existing medical systems. In creating such comprehensive systems, development strategies need to be grounded in population needs with appropriate use of technology that serves the target users, including the patient/family, clinical team, and health care organization. Implementation strategies should address timing, personnel, and environmental factors to facilitate continued use and benefit from IHCS.

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

    Science.gov (United States)

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

    Science.gov (United States)

    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.

  18. Electroencephalogy (EEG) Feedback in Decision-Making

    Science.gov (United States)

    2015-08-26

    Electroencephalogy ( EEG ) Feedback In Decision- Making The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful...feedback when training rapid decision-making. More specifically, EEG will allow us to provide online feedback about the neural decision processes...Electroencephalogy ( EEG ) Feedback In Decision-Making Report Title The goal of this project is to investigate whether Electroencephalogy ( EEG ) can provide useful

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

    Science.gov (United States)

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

    2012-05-01

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

  20. Social processes used by African American women in making decisions about mammography screening.

    Science.gov (United States)

    Fowler, Barbara Ann

    2006-01-01

    To describe the social processes used by African American (AA) women ages > or = 50 years in making decisions about mammography screening. Grounded theory methodology. Tape-recorded interviews with a researcher-designed, semi-structured interview guide with an initial and theoretical sample of 30 AA women ages 52 to 71 of diverse socioeconomic status. Interviews occurred in various settings such as the church rectory, women's homes, and work settings. Extensive written field notes and tapes were transcribed verbatim immediately after the interviews by an experienced transcriptionist. The women's decisions about mammography screening were associated with five social processes: (a) acknowledging prior experiences with healthcare providers and systems; (b) reporting fears and fatalistic beliefs of breast cancer and related treatment; (c) valuing the opinions of significant others; (d) relying on religious beliefs and supports; and (e) caregiving responsibilities of significant others. The processes were further differentiated by three distinct decision-making styles: taking charge, enduring, and protesting. Each of the social processes was reported equally and emphasized by the diverse sample of AA women in decisions related to mammography screening. Mammography screening decisions were heavily influenced by caregiving responsibilities. Further research is needed to explain and understand this social process on the health and well-being of AA women over time.

  1. Communicating Uncertainty in Volcanic Ash Forecasts: Decision-Making and Information Preferences

    Science.gov (United States)

    Mulder, Kelsey; Black, Alison; Charlton-Perez, Andrew; McCloy, Rachel; Lickiss, Matthew

    2016-04-01

    The Robust Assessment and Communication of Environmental Risk (RACER) consortium, an interdisciplinary research team focusing on communication of uncertainty with respect to natural hazards, hosted a Volcanic Ash Workshop to discuss issues related to volcanic ash forecasting, especially forecast uncertainty. Part of the workshop was a decision game in which participants including forecasters, academics, and members of the Aviation Industry were given hypothetical volcanic ash concentration forecasts and asked whether they would approve a given flight path. The uncertainty information was presented in different formats including hazard maps, line graphs, and percent probabilities. Results from the decision game will be presented with a focus on information preferences, understanding of the forecasts, and whether different formats of the same volcanic ash forecast resulted in different flight decisions. Implications of this research will help the design and presentation of volcanic ash plume decision tools and can also help advise design of other natural hazard information.

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Women's decision-making processes and the influences on their mode of birth following a previous caesarean section in Taiwan: a qualitative study.

    Science.gov (United States)

    Chen, Shu-Wen; Hutchinson, Alison M; Nagle, Cate; Bucknall, Tracey K

    2018-01-17

    Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation. Stage II involved interviews with pregnant women at 35-37 weeks' gestation. Stage III consisted of interviews with the same women who were interviewed postnatally, 1 month after birth. The research was conducted in a private medical centre in northern Taiwan. Using a purposive sampling, 21 women and 9 obstetricians were recruited. Data collection involved in-depth interviews, observation and field notes. Constant comparative analysis was employed for data analysis. Ensuring the safety of mother and baby was the focus of women's decisions. Women's decisions-making influences included previous birth experience, concern about the risks of vaginal birth, evaluation of mode of birth, current pregnancy situation, information resources and health insurance. In communicating with obstetricians, some women complied with obstetricians' recommendations for repeat caesarean section (RCS) without being informed of alternatives. Others used four step decision-making processes that included searching for information, listening to obstetricians' professional judgement, evaluating alternatives, and making a decision regarding mode of birth. After birth, women reflected on their decisions in three aspects: reflection on birth choices; reflection on factors influencing decisions; and reflection on outcomes of decisions. The health and wellbeing of mother and baby were the major concerns for women. In response to the decision-making influences, women's interactions with obstetricians regarding birth choices

  4. Using Option Grids: steps toward shared decision-making for neonatal circumcision.

    Science.gov (United States)

    Fay, Mary; Grande, Stuart W; Donnelly, Kyla; Elwyn, Glyn

    2016-02-01

    To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    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. Altered communicative decisions following ventromedial prefrontal lesions.

    Science.gov (United States)

    Stolk, Arjen; D'Imperio, Daniela; di Pellegrino, Giuseppe; Toni, Ivan

    2015-06-01

    Damage to the human ventromedial prefrontal cortex (vmPFC) leads to profound changes in everyday social interactions [1, 2]. Yet, in the lab, vmPFC patients show surprising proficiency in reasoning about other agents [3-8]. These conflicting observations suggest that what vmPFC patients lack in everyday social interactions might be the ability to guide their decisions with knowledge about a social partner [9-13], despite preserved access to that knowledge [2, 14]. Quantification of socially relevant decisions during live interaction with different partners offers the possibility of testing this hypothesis. Eight patients with vmPFC damage, eight patients with brain damage elsewhere, and 15 healthy participants were asked to communicate non-verbally with two different addressees, an adult or a child, in an experimentally controlled interactive setting [15, 16]. In reality, a confederate blindly performed the role of both adult and child addressee, with matched performance and response times, such that the two addressees differed only in terms of the communicator's beliefs. Patients with vmPFC damage were able-and motivated-to generate communicatively effective behaviors. However, unlike patient and healthy controls, vmPFC patients failed to adjust their communicative decisions to the presumed abilities of their addressee. These findings indicate that the human vmPFC is necessarily involved in social interactions, insofar as those interactions need to be tailored toward knowledge about a social partner. In this perspective, the known contribution of this region to disparate domains like value-based decision-making [17-19], schema-based memory-processing [20-22], and person-specific mentalizing [11-13] might be instances of decisions based on contingently updated conceptual knowledge. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Schiebener, Johannes; Brand, Matthias

    2015-06-01

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

  8. Understanding and improving communication and decision-making in palliative care for Turkish and Moroccan immigrants: a multiperspective study

    NARCIS (Netherlands)

    de Graaff, F.M.; Francke, A.L.; van den Muijsenbergh, M.E.T.C.; van der Geest, S.

    2012-01-01

    Objective. The aim of this study is to explore how communication and decision-making in palliative care among Turkish and Moroccan patients is influenced by different styles of care management between Turkish and Moroccan families and Dutch professional care providers. Problems as well as solutions

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

    Science.gov (United States)

    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.

  10. Evidence-based surgery: Dissemination, communication, decision aids

    NARCIS (Netherlands)

    Knops, A.M.

    2013-01-01

    Surgeons are expected to make treatment decisions that are based on the best available evidence. Moreover, they are called to recognise that important decisions should also be shared with patients. While dissemination of evidence-based surgery and communication of evidence to patients have been

  11. Logics of pre-merger decision-making processes: the case of Karolinska University Hospital.

    Science.gov (United States)

    Choi, Soki; Brommels, Mats

    2009-01-01

    The purpose of this paper is to examine how and why a decision to merge two university hospitals in a public context might occur by using an in-depth case study of the pre-merger process of Karolinska University Hospital. Based on extensive document analysis and 35 key informant interviews the paper reconstructed the pre-merger process, searched for empirical patterns, and interpreted those by applying neo-institutional theory. Spanning nearly a decade, the pre-merger process goes from idea generation through transition to decision, and took place on two arenas, political, and scientific. Both research excellence and economic efficiency are stated merger motives. By applying a neo-institutional perspective, the paper finds that the two initial phases are driven by decision rationality, which is typical for political organizations and that the final phase demonstrated action rationality, which is typical for private firms. Critical factors behind this radical change of decision logic are means convergence, uniting key stakeholder groups, and an economic and political crisis, triggering critical incidents, which ultimately legitimized the formal decision. It is evident from the paper that merger decisions in the public sector might not necessarily result from stated and/or economic drivers only. This paper suggests that a change of decision logic from decision to action rationality might promote effective decision making on large and complex issues in a public context. This is the first systematic in-depth study of a university hospital merger employing a decision-making perspective.

  12. Drone swarm with free-space optical communication to detect and make deep decisions about physical problems for area surveillance

    Science.gov (United States)

    Mazher, Wamidh Jalil; Ibrahim, Hadeel T.; Ucan, Osman N.; Bayat, Oguz

    2018-03-01

    This paper aims to design a drone swarm network by employing free-space optical (FSO) communication for detecting and deep decision making of topological problems (e.g., oil pipeline leak), where deep decision making requires the highest image resolution. Drones have been widely used for monitoring and detecting problems in industrial applications during which the drone sends images from the on-air camera video stream using radio frequency (RF) signals. To obtain higher-resolution images, higher bandwidth (BW) is required. The current study proposed the use of the FSO communication system to facilitate higher BW for higher image resolution. Moreover, the number of drones required to survey a large physical area exceeded the capabilities of RF technologies. Our configuration of the drones is V-shaped swarm with one leading drone called mother drone (DM). The optical decode-and-forward (DF) technique is used to send the optical payloads of all drones in V-shaped swarm to the single ground station through DM. Furthermore, it is found that the transmitted optical power (Pt) is required for each drone based on the threshold outage probability of FSO link failure among the onboard optical-DF drones. The bit error rate of optical payload is calculated based on optical-DF onboard processing. Finally, the number of drones required for different image resolutions based on the size of the considered topological area is optimized.

  13. Lone ranger decision making versus consensus decision making: Descriptive analysis

    OpenAIRE

    Maite Sara Mashego

    2015-01-01

    Consensus decision making, concerns group members make decisions together with the requirement of reaching a consensus that is all members abiding by the decision outcome. Lone ranging worked for sometime in a autocratic environment. Researchers are now pointing to consensus decision-making in organizations bringing dividend to many organizations. This article used a descriptive analysis to compare the goodness of consensus decision making and making lone ranging decision management. This art...

  14. Improving family satisfaction and participation in decision making in an intensive care unit.

    Science.gov (United States)

    Huffines, Meredith; Johnson, Karen L; Smitz Naranjo, Linda L; Lissauer, Matthew E; Fishel, Marmie Ann-Michelle; D'Angelo Howes, Susan M; Pannullo, Diane; Ralls, Mindy; Smith, Ruth

    2013-10-01

    Background Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together. Objectives To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families. Methods A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm. Results Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation. Conclusions Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together.

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

    Science.gov (United States)

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

    2014-01-01

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

  16. Benefit-risk trade-offs in retrospect: how major stakeholders perceive the decision-making process in the Barents Sea oil field development

    DEFF Research Database (Denmark)

    Renn, Ortwin; Grieger, Khara Deanne; Øien, Knut

    2013-01-01

    review of the decision-making process seen through the lenses of the major stakeholders involved in this process. The research design used qualitative methods of empirical research including stakeholder interviews during a five-day period in 2011 in Northern Norway. Results showed that the siting process...... additional benefits to the communities which would then be fairly distributed among the beneficiaries have been disappointed. We review the reasons behind these results as well as formulate recommendations regarding potential improvements to the risk-benefit communication process in addition to future siting...

  17. Using Decision Trees to Characterize Verbal Communication During Change and Stuck Episodes in the Therapeutic Process

    Directory of Open Access Journals (Sweden)

    Víctor Hugo eMasías

    2015-04-01

    Full Text Available Methods are needed for creating models to characterize verbal communication between therapists and their patients that are suitable for teaching purposes without losing analytical potential. A technique meeting these twin requirements is proposed that uses decision trees to identify both change and stuck episodes in therapist-patient communication. Three decision tree algorithms (C4.5, NBtree, and REPtree are applied to the problem of characterizing verbal responses into change and stuck episodes in the therapeutic process. The data for the problem is derived from a corpus of 8 successful individual therapy sessions with 1,760 speaking turns in a psychodynamic context. The decision tree model that performed best was generated by the C4.5 algorithm. It delivered 15 rules characterizing the verbal communication in the two types of episodes. Decision trees are a promising technique for analyzing verbal communication during significant therapy events and have much potential for use in teaching practice on changes in therapeutic communication. The development of pedagogical methods using decision trees can support the transmission of academic knowledge to therapeutic practice.

  18. Using decision trees to characterize verbal communication during change and stuck episodes in the therapeutic process.

    Science.gov (United States)

    Masías, Víctor H; Krause, Mariane; Valdés, Nelson; Pérez, J C; Laengle, Sigifredo

    2015-01-01

    Methods are needed for creating models to characterize verbal communication between therapists and their patients that are suitable for teaching purposes without losing analytical potential. A technique meeting these twin requirements is proposed that uses decision trees to identify both change and stuck episodes in therapist-patient communication. Three decision tree algorithms (C4.5, NBTree, and REPTree) are applied to the problem of characterizing verbal responses into change and stuck episodes in the therapeutic process. The data for the problem is derived from a corpus of 8 successful individual therapy sessions with 1760 speaking turns in a psychodynamic context. The decision tree model that performed best was generated by the C4.5 algorithm. It delivered 15 rules characterizing the verbal communication in the two types of episodes. Decision trees are a promising technique for analyzing verbal communication during significant therapy events and have much potential for use in teaching practice on changes in therapeutic communication. The development of pedagogical methods using decision trees can support the transmission of academic knowledge to therapeutic practice.

  19. Influences on Decision Making Identified by Parents of Children Receiving Pediatric Palliative Care.

    Science.gov (United States)

    Carroll, Karen W; Mollen, Cynthia J; Aldridge, Sarah; Hexem, Kari R; Feudtner, Chris

    2012-01-01

    Parental decision making is a critical component in the provision of palliative and end-of-life care, yet factors that parents perceive as influencing this process, when they are making decisions for their children, have not been well characterized. As part of a mixed-methods cohort study, we interviewed 73 parents of 50 pediatric patients who were referred to the hospital's pediatric palliative care service. The semistructured interviews focused on "decision making for your child"; the interviews were recorded and transcribed. A random sample (n = 13) was first coded and analyzed for core themes, and these themes were then cross-validated with a second random sample (n = 3) of interviews. Four dominant interrelated themes permeated parents' discussions about the decisions they were making for their children and the process of decision making. First, Orientation and Direction (including the subthemes of Goals and Hopes, Spirituality and Meaning, and Purposeful Effort) connotes the parents' effort to establish and clarify the broad context of decision making. Second, Defining What Is Good for the Child (including the subthemes of Quality of Life and Suffering, and Normalcy and Normalization) conveys how the parents posed questions and pondered what decisions would be in the child's best interests. Third, the entwined theme of Relationships, Communication, and Support reflects how parents reported the social and interactive nature of decision making. Fourth, the theme of Feelings and Personal Accountability focuses inward as parents report efforts to deal with their emotional responses and self-judgments. Parents report grappling with several influences upon their decision-making processes that extend well beyond the standard discussions of medical information exchanges and the evaluation of risks and benefits. Decision support for these parents should account for these diverse influences.

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

    Science.gov (United States)

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

    2016-07-01

    When making a decision, humans consider two types of information: information they have acquired through their prior experience of the world, and further information they gather to support the decision in question. Here, we present evidence that data from search engines such as Google can help us model both sources of information. We show that statistics from search engines on the frequency of content on the Internet can help us estimate the statistical structure of prior experience; and, specifically, we outline how such statistics can inform psychological theories concerning the valuation of human lives, or choices involving delayed outcomes. Turning to information gathering, we show that search query data might help measure human information gathering, and it may predict subsequent decisions. Such data enable us to compare information gathered across nations, where analyses suggest, for example, a greater focus on the future in countries with a higher per capita GDP. We conclude that search engine data constitute a valuable new resource for cognitive scientists, offering a fascinating new tool for understanding the human decision-making process. Copyright © 2016 The Authors. Topics in Cognitive Science published by Wiley Periodicals, Inc. on behalf of Cognitive Science Society.

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

    Science.gov (United States)

    Ruohonen, Toni; Ennejmy, Mohammed

    2013-01-01

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

  2. Consensual decision-making model based on game theory for LNG processes

    International Nuclear Information System (INIS)

    Castillo, Luis; Dorao, Carlos A.

    2012-01-01

    Highlights: ► A Decision Making (DM) approach for LNG projects based on game theory is presented. ► DM framework was tested with two different cases, using analytical models and a simple LNG process. ► The problems were solved by using a Genetic Algorithm (GA) binary coding and Nash-GA. ► Integrated models from the design and optimization of the process could result in more realistic outcome. ► The major challenge in such a framework is related to the uncertainties in the market models. - Abstract: Decision-Making (DM) in LNG projects is a quite complex process due to the number of actors, approval phases, large investments and capital return in the long time. Furthermore, due to the very high investment of a LNG project, a detailed and efficient DM process is required in order to minimize risks. In this work a Decision-Making (DM) approach for LNG projects is presented. The approach is based on a consensus algorithm to address the consensus output over a common value using cost functions within a framework based on game theory. The DM framework was tested with two different cases. The first case was used for evaluating the performance of the framework with analytical models, while the second case corresponds to a simple LNG process. The problems were solved by using a Genetic Algorithm (GA) binary coding and Nash-GA. The results of the DM framework in the LNG project indicate that considering an integrated DM model and including the markets role from the design and optimization of the process more realistic outcome could be obtained. However, the major challenge in such a framework is related to the uncertainties in the market models.

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

    Science.gov (United States)

    Hulton, Linda J.

    2001-10-03

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

  4. Evaluation of End-Products in Architecture Design Process: A Fuzzy Decision-Making Model

    Directory of Open Access Journals (Sweden)

    Serkan PALABIYIK

    2012-06-01

    Full Text Available This paper presents a study on the development of a fuzzy multi-criteria decision-making model for the evaluation of end products of the architectural design process. Potentials of the developed model were investigated within the scope of architectural design education, specifically an international design studio titled “Design for Disassembly and Reuse: Design & Building Multipurpose Transformable Pavilions.” The studio work followed a design process that integrated systematic and heuristic thinking. The design objectives and assessment criteria were clearly set out at the beginning of the process by the studio coordinator with the aim of narrowing the design space and increasing awareness of the consequences of design decisions. At the end of the design process, designs produced in the studio were evaluated using the developed model to support decision making. The model facilitated the identification of positive and negative aspects of the designs and selection of the design alternative that best met the studio objectives set at the beginning.

  5. ED Triage Decision-Making With Mental Health Presentations: A "Think Aloud" Study.

    Science.gov (United States)

    Clarke, Diana E; Boyce-Gaudreau, Krystal; Sanderson, Ana; Baker, John A

    2015-11-01

    Triage is the process whereby persons presenting to the emergency department are quickly assessed by a nurse and their need for care and service is prioritized. Research examining the care of persons presenting to emergency departments with psychiatric and mental health problems has shown that triage has often been cited as the most problematic aspect of the encounter. Three questions guided this investigation: Where do the decisions that triage nurses make fall on the intuitive versus analytic dimensions of decision making for mental health presentations in the emergency department, and does this differ according to comfort or familiarity with the type of mental health/illness presentation? How do "decision aids" (i.e., structured triage scales) help in the decision-making process? To what extent do other factors, such as attitudes, influence triage nurses' decision making? Eleven triage nurses participating in this study were asked to talk out loud about the reasoning process they would engage in while triaging patients in 5 scenarios based on mental health presentations to the emergency department. Themes emerging from the data were tweaking the results (including the use of intuition and early judgments) to arrive at the desired triage score; consideration of the current ED environment; managing uncertainty and risk (including the consideration of physical reasons for presentation); and confidence in communicating with patients in distress and managing their own emotive reactions to the scenario. Findings support the preference for using the intuitive mode of decision making with only tacit reliance on the decision aid. Copyright © 2015 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  6. Motivators That Intervene in the Decision Making Process in Tourism

    Directory of Open Access Journals (Sweden)

    Alexandra VINEREAN

    2014-10-01

    Full Text Available Being part of the tourism industries involves many researches and analyses in different periods of time, regarding different segments of consumers. Therefore, it is important to be aware of all the factors and motivators that influence a tourist to purchase a particular tourism services. These complex variables are crucial for the final purchase decision of an offer with emotional value for customers. This paper presents the principals motivators which intervene in the decision making process that should be acknowledged by marketers in order to provide the ideal tourism package.

  7. International Patients' Travel Decision Making Process- A Conceptual Framework.

    Science.gov (United States)

    Khan, Mohammad Jamal; Chelliah, Shankar; Haron, Mahmod Sabri

    2016-02-01

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

  8. The Use of the Evidence from the Behavioral Sciences in the Organizational Decision-Making Process

    Directory of Open Access Journals (Sweden)

    Bogdan MÎNJINĂ

    2015-09-01

    Full Text Available The important managerial decision-making and the development of policies, strategies, internal normative acts and procedures must be solid grounded for efficient achieving of their objectives. To this end, the evidence-based approach uses various types of evidence, a leading role having those scientific, and the critical thinking. The evidence from behavioral sciences is especially important when the decisions objectives involve behavioral elements. They also help to ensure the rationality of any decision-making process. The concern for the use of behavioral sciences research in the decision-making preceded the occurrence of evidence-based approach. The increased knowledge fund of organizations, the access to the best practices and to the relevant scientific research findings represent only the initial stages of the evidence-based approach implementation and functioning. The ensuring of their effective use calls for special skills training among staff, the creation of tools and organizational mechanisms and of a facilitating organizational culture. This paper argues the need to integrate two approaches that promote the decision-making based on scientific evidence, the evidence-based approach and the use of behavioral and social sciences in the decision-making, to potentiate the contribution of the behavioral sciences to the increasing of the decision-making efficiency. The efforts made in this paper had overall objective to prepare and facilitate the use of research evidence provided by behavioral sciences in the organizational decision-making process by presenting the main concepts and knowledge in the field and by proposing an outline procedure specifically developed.

  9. Do Teachers Make Decisions Like Firefighters? Applying Naturalistic Decision-Making Methods to Teachers' In-Class Decision Making in Mathematics

    Science.gov (United States)

    Jazby, Dan

    2014-01-01

    Research into human decision making (DM) processes from outside of education paint a different picture of DM than current DM models in education. This pilot study assesses the use of critical decision method (CDM)--developed from observations of firefighters' DM -- in the context of primary mathematics teachers' in-class DM. Preliminary results…

  10. Communication and US-Somali Immigrant Human Papillomavirus (HPV) Vaccine Decision-Making.

    Science.gov (United States)

    Dailey, Phokeng M; Krieger, Janice L

    2017-09-01

    The current study uses a multiple goal theoretical perspective to explore how Somali immigrant families living in Ohio, USA, make decisions regarding whether to vaccinate their children against human papillomavirus (HPV)-a leading cause of cervical cancer. A focus was placed on the communication goals of parents in HPV vaccine discussions with their child and health care provider. Semi-structured interviews were audiotaped, transcribed, and analyzed using a grounded theory approach. Key themes are the implications of the vaccine for early sexual activity, confusion between HPV and HIV (human immunodeficiency virus), the perception that the HPV vaccine is unnecessary, uncertainty about the vaccine's efficacy and side effects, avoidance of parent-child communication about the vaccine, and a preference for framing the vaccine as a health promotion behavior. Framing the threat of HPV in the context of initiation of sexual activity, uncertainty regarding vaccine efficacy, and anticipated regret account for the inconsistency in HPV vaccine uptake among Somali parents. Clinicians should consider talking about HPV as a distal versus an immediate threat and HPV vaccine uptake as a health-promotion behavior rather than a sexually transmitted infection prevention behavior.

  11. Role of affect in decision making.

    Science.gov (United States)

    Bandyopadhyay, Debarati; Pammi, V S Chandrasekhar; Srinivasan, Narayanan

    2013-01-01

    Emotion plays a major role in influencing our everyday cognitive and behavioral functions, including decision making. We introduce different ways in which emotions are characterized in terms of the way they influence or elicited by decision making. This chapter discusses different theories that have been proposed to explain the role of emotions in judgment and decision making. We also discuss incidental emotional influences, both long-duration influences like mood and short-duration influences by emotional context present prior to or during decision making. We present and discuss results from a study with emotional pictures presented prior to decision making and how that influences both decision processes and postdecision experience as a function of uncertainty. We conclude with a summary of the work on emotions and decision making in the context of decision-making theories and our work on incidental emotions. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Making effective links to decision-making: Key challenges for health impact assessment

    International Nuclear Information System (INIS)

    Elliott, Eva; Francis, Sarah

    2005-01-01

    This paper draws on an exploratory research study to examine the effectiveness of health impact assessments in Wales. Through the review of five case study health impact assessments the research identified a number of benefits of the process in terms of skills and knowledge development amongst participants. The indirect contributions to decision-making were also evident including the way in which health impact assessment provided useful insights into the local community's perspective and raised awareness about the wider determinants of health. The process was also useful in establishing a dialogue between different stakeholders, which indirectly assisted decision-making and implementation. The direct links between health impact assessment and decision-making were more difficult to trace and this paper puts forward a number of suggestions for making those links more transparent. Suggestions include integrating decision-makers and clarifying the intended links to decision-making at the start of the health impact assessment process. Mainstreaming health impact assessment so that it is triggered as a routine part of all decision-making would help ensure it stands the best chance of informing decisions

  13. [Shared decision-making and communication theory: grounding the tango].

    Science.gov (United States)

    Kasper, Jürgen; Légaré, France; Scheibler, Fülöp; Geiger, Friedemann

    2010-01-01

    Shared decision-making (SDM) has the potential to overcome outdated social role models in the health care system. The concept, however, adheres to archaic epistemological assumptions as can be inferred from the rudimentary stage of the measurement methods used and from the information monopoly that the physician still holds in this concept. Advantages of an up-to-date model of knowledge for understanding and operationalising SDM are outlined. To this purpose, essential definitions of the concept are reflected in terms of epistemology. Accordingly, information emerges through a process of social construction. Likewise, interpersonal relations do not represent a static condition; rather, they develop anew with each interaction. Therefore, constructs suitable to focus on dyadic interaction processes can be used as indicators of sharing in SDM. Theories and methods of the interpersonal paradigm are advocated. Copyright © 2010. Published by Elsevier GmbH.

  14. Decision making in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Labudda, Kirsten; Frigge, Kristina; Horstmann, Simone; Aengenendt, Joerg; Woermann, Friedrich G; Ebner, Alois; Markowitsch, Hans J; Brand, Matthias

    2009-01-01

    The mesiotemporal lobe is involved in decision making processes because bilateral amygdala damage can cause impairments in decision making that is mainly based on the processing of emotional feedback. In addition to executive functions, previous studies have suggested the involvement of feedback processing in decision making under risk when explicit information about consequences and their probabilities is provided. In the current study, we investigated whether unilateral mesiotemporal damage, comprising of the hippocampus and/or the amygdala, results in alterations of both kinds of decision making. For this purpose, we preoperatively examined 20 patients with refractory unilateral mesiotemporal lobe epilepsy (TLE) and a comparison group (CG) of 20 healthy volunteers with the Iowa Gambling Task to assess decision making based on feedback processing, the Game of Dice Task to assess decision making under risk, and with a neuropsychological test battery. Results indicate that TLE patients performed normally in decision making under risk, but can exhibit disturbances in decision making on the Iowa Gambling Task. A subgroup analysis revealed that those patients with a preference for the disadvantageous alternatives performed worse on executive subcomponents and had seizure onset at an earlier age in comparison to the patient subgroup without disadvantageous decision making. Furthermore, disadvantageous decision making can emerge in patients with selective hippocampal sclerosis not extended to the amygdala. Thus, our results demonstrate for the first time that presurgical patients with TLE can have selective reductions in decision making and that these deficits can result from hippocampal lesions without structural amygdala abnormalities.

  15. A qualitative study of women's decision-making at the end of IVF treatment.

    Science.gov (United States)

    Peddie, V L; van Teijlingen, E; Bhattacharya, S

    2005-07-01

    The decision not to pursue further in vitro fertilization (IVF) after one or more unsuccessful attempts is an important and often difficult one for couples. Relatively little is known about the woman's perception of this decision-making process. The aim of this study was to examine patients' perspectives of decision-making, including circumstances influencing it and satisfaction with the decision-making process. Semi-structured interviews were conducted with a purposive sample of 25 women who had decided to end treatment after unsuccessful IVF treatment. Interviews were tape-recorded and transcribed by means of thematic analysis using the open coding technique. Women experienced difficulty in accepting that their infertility would remain unresolved. Many felt that they had started with unrealistic expectations of treatment success and felt vulnerable to the pressures of both the media and society. Although the decision to end treatment was difficult, it offered many women a way out of the emotional distress caused by IVF; however, the process of decision-making created a sense of 'confrontation' for the women in which they had to address issues they had previously avoided. Adoptive parents perceived less societal pressure than those who remained childless. Efforts to improve the psychological preparation of couples who decide to end IVF treatment should be directed towards examination of the existing system of consultation, which has certain limitations in terms of the quality of communication and the provision of post-treatment support. Further efforts to develop strategies, which facilitate the decision-making process, should be considered.

  16. Cochlear Implant: the complexity involved in the decision making process by the family.

    Science.gov (United States)

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

    2014-01-01

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

  17. Decision making in midwifery: rationality and intuition.

    Science.gov (United States)

    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.

  18. A meaning for transparency in decision processes

    Energy Technology Data Exchange (ETDEWEB)

    Wene, C.O. [Chalmers Univ. of Technology, Goeteborg (Sweden). Energy System Technology; Espejo, R. [Univ. of Lincolnshire and Humberside, Lincoln (United Kingdom). Lincoln School of Management

    1999-12-01

    In this paper we discuss transparency in decision processes. We argue that transparency requires fostering, producing and maintaining distributed dialogues and communications between all those affected by (the stakeholders) and those producing these decisions (the decision makers and the actors/experts). The issues raised in these dialogues will not only refer to questions of technical efficiency, but also to what is right and fair and what is considered to be good in society. Social policies, particularly those of wide social significance, are in one form or another the outcome of multiple meaning creation processes, reflecting their multiple spheres of influence, from the local to the global, from the disciplinary to the multi- and transdisciplinary. Each of these processes requires transparency. This paper is focused on the structural requirements to make these dialogues and communications effective at all levels, taking into account the need for technical explanation, proof of authenticity and legitimacy of actions. Moreover it is concerned with the alignment of these meanings creation processes in order to increase the chances of having not only a distributed but also a coherent overall decision process. Our emphasis is in defining forms of interaction among stakeholders in order to ground the debate of the policy throughout the organisation, beyond senior levels of management. The aim is increasing the demands on those responsible for policy implementation, stretching them so that they offer the best of themselves. We argue that this is the basis for a structural mechanism for transparency. The outcome of this paper is a conceptual framework to study issues of transparency in policy making which is illustrated with reference to nuclear waste management in Sweden.

  19. A meaning for transparency in decision processes

    International Nuclear Information System (INIS)

    Wene, C.O.; Espejo, R.

    1999-01-01

    In this paper we discuss transparency in decision processes. We argue that transparency requires fostering, producing and maintaining distributed dialogues and communications between all those affected by (the stakeholders) and those producing these decisions (the decision makers and the actors/experts). The issues raised in these dialogues will not only refer to questions of technical efficiency, but also to what is right and fair and what is considered to be good in society. Social policies, particularly those of wide social significance, are in one form or another the outcome of multiple meaning creation processes, reflecting their multiple spheres of influence, from the local to the global, from the disciplinary to the multi- and transdisciplinary. Each of these processes requires transparency. This paper is focused on the structural requirements to make these dialogues and communications effective at all levels, taking into account the need for technical explanation, proof of authenticity and legitimacy of actions. Moreover it is concerned with the alignment of these meanings creation processes in order to increase the chances of having not only a distributed but also a coherent overall decision process. Our emphasis is in defining forms of interaction among stakeholders in order to ground the debate of the policy throughout the organisation, beyond senior levels of management. The aim is increasing the demands on those responsible for policy implementation, stretching them so that they offer the best of themselves. We argue that this is the basis for a structural mechanism for transparency. The outcome of this paper is a conceptual framework to study issues of transparency in policy making which is illustrated with reference to nuclear waste management in Sweden

  20. Shared Decision Making and Effective Physician-Patient Communication: The Quintessence of Patient-Centered Care

    Directory of Open Access Journals (Sweden)

    Huy Ming Lim

    2015-03-01

    Full Text Available The Institute of Medicine’s (IOM 2001 landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, identified patient-centeredness as one of the fundamental attributes of quality health care, alongside safety, effectiveness, timeliness, efficiency, and equity. The IOM defined patient-centeredness as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” This concept of patient-centered care represents a paradigm shift from the traditional disease-oriented and physician-centered care, grounding health care in the subjective experience of illness and the needs and preferences of individual patients rather than the evaluation and treatment of diseases which emphasizes on leveraging clinical expertise and evidence derived from population-based studies. Regrettably, despite the ubiquitous talk about patient-centered care in modern health care, shared decision-making and effective physician-patient communication—the two cruxes of patient-centered care—are yet to become the norms. Strategies to promote and enhance shared decision-making and effective communication between clinicians and patients should be rigorously implemented to establish a health care system that truly values patients as individuals and turn the rhetoric of patient-centered care into reality.

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

    Science.gov (United States)

    Lamp, Sandra A.

    2012-01-01

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

  2. Reasoning in explanation-based decision making.

    Science.gov (United States)

    Pennington, N; Hastie, R

    1993-01-01

    A general theory of explanation-based decision making is outlined and the multiple roles of inference processes in the theory are indicated. A typology of formal and informal inference forms, originally proposed by Collins (1978a, 1978b), is introduced as an appropriate framework to represent inferences that occur in the overarching explanation-based process. Results from the analysis of verbal reports of decision processes are presented to demonstrate the centrality and systematic character of reasoning in a representative legal decision-making task.

  3. Intergroup conflict and rational decision making.

    Science.gov (United States)

    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.

  4. Intergroup Conflict and Rational Decision Making

    Science.gov (United States)

    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

  5. Intergroup conflict and rational decision making.

    Directory of Open Access Journals (Sweden)

    Vicente Martínez-Tur

    Full Text Available 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.

  6. Analysis of Decision Making Process in Moneyball: The Art of Winning an Unfair Game

    Directory of Open Access Journals (Sweden)

    Mochamad Sandy Triady

    2015-03-01

    Full Text Available Billy Beanes’s success in using data-driven decision making in baseball industry is wonderfully written by Michael Lewis in Moneyball. As a general manager in baseball team that were in the bottom position of the league from the financial side to acquire the players, Beane, along with his partner, explored the use of data in choosing the team’s player. They figured out how to determine the worth of every player.The process was not smooth, due to the condition of baseball industry that was not common with using advanced statistic in acquiring   players. Many teams still use the old paradigm that rely on experts’ judgments, intuition, or experience in decision making process. Moneyball approached that using data-driven decision making gave excellent result for Beane’s team. The team won 20 gamessequently in the 2002 season and also spent the lowest cost per win than other teams.This paper attempts to review the principles of Moneyball – The Art of Winning an Unfair Game as a process of decision making and gives what we can learn from the story in order to win the games, the unfair games.

  7. Influence of portofolio management in decision-making

    Directory of Open Access Journals (Sweden)

    Rolney Baptestone

    2018-05-01

    Full Text Available This research aims to demonstrate how portfolio management influences the decision-making process in the projects of a financial organization. And to achieve this goal was used the single case study method. In order to reach this goal, the study began by means of bibliometric research on the subject of portfolio management and subsequent bibliographic research on the theme, decision making. Next, the relationships between portfolio management and decision making were studied. The results of the data collected confirmed the relationship between "the use of the project identification process in portfolio management to influence decision making" in order to add value to the business. It is also possible to demonstrate moderately that "the use of criteria for project selection influences the consequences of decision making", helping in the strategic management of the organization. One of the academic contributions was to note a migration of the portfolio management process, such as a tool that only controls the projects that will compose the portfolio of an organization, for a process that aims at a direct alignment with the strategic management of the organization. Regarding the practical implications, it was verified the importance of portfolio analysis for decision making, to the detriment of the evaluation of only one project. Taking into account the profitability and the return on investment of the projects, as the most important aspects for a decision making.

  8. Make or buy decision considering uncertainty based on fuzzy logic using simulation and multiple criteria decision making

    Directory of Open Access Journals (Sweden)

    Ali Mohtashami

    2013-01-01

    Full Text Available Decision making on making/buying problem has always been a challenge to decision makers. In this paper a methodology has been proposed to resolve this challenge. This methodology is capable of evaluating making/buying decision making under uncertainty. For uncertainty, the fuzzy logic and simulation approaches have been used. The proposed methodology can be applied to parts with multi stage manufacturing processes and different suppliers. Therefore this methodology provides a scale for decision making from full outsourcing to full manufacturing and with selecting appropriate supplier.

  9. Challenges in shared decision making in advanced cancer care: a qualitative longitudinal observational and interview study.

    Science.gov (United States)

    Brom, Linda; De Snoo-Trimp, Janine C; Onwuteaka-Philipsen, Bregje D; Widdershoven, Guy A M; Stiggelbout, Anne M; Pasman, H Roeline W

    2017-02-01

    Patients' preferences and expectations should be taken into account in treatment decision making in the last phase of life. Shared decision making (SDM) is regarded as a way to give the patient a central role in decision making. Little is known about how SDM is used in clinical practice in advanced cancer care. To examine whether and how the steps of SDM can be recognized in decision making about second- and third-line chemotherapy. Fourteen advanced cancer patients were followed over time using face-to-face in-depth interviews and observations of the patients' out-clinic visits. Interviews and outpatient clinic visits in which treatment options were discussed or decisions made were transcribed verbatim and analysed using open coding. Patients were satisfied with the decision-making process, but the steps of SDM were barely seen in daily practice. The creation of awareness about available treatment options by physicians was limited and not discussed in an equal way. Patients' wishes and concerns were not explicitly assessed, which led to different expectations about improved survival from subsequent lines of chemotherapy. To reach SDM in daily practice, physicians should create awareness of all treatment options, including forgoing treatment, and communicate the risk of benefit and harm. Open and honest communication is needed in which patients' expectations and concerns are discussed. Through this, the difficult process of decision making in the last phase of life can be facilitated and the focus on the best care for the specific patient is strengthened. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  10. Optimising Transport Decision Making using Customised Decision Models and Decision Conferences

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn

    The subject of this Ph.D. thesis entitled “Optimising Transport Decision Making using Customised Decision Models and Decision Conferences” is multi-criteria decision analysis (MCDA) and decision support in the context of transport infrastructure assessments. Despite the fact that large amounts...... is concerned with the insufficiency of conventional cost-benefit analysis (CBA), and proposes the use of MCDA as a supplementing tool in order to also capture impacts of a more strategic character in the appraisals and hence make more use of the often large efforts put in the preliminary examinations. MCDA...... and rail to bike transport projects. Two major concerns have been to propose an examination process that can be used in situations where complex decision problems need to be addressed by experts as well as non-experts in decision making, and to identify appropriate assessment techniques to be used...

  11. Helping farmers face the increasing complexity of decision-making for crop protection

    Directory of Open Access Journals (Sweden)

    Vittorio ROSSI

    2013-01-01

    Full Text Available The European Community Directive 128/2009 on the Sustainable Use of Pesticides establishes a strategy for the use of plant protection products (PPPs in the European Community so as to reduce risks to human health and the environment. Integrated Pest Management (IPM is a key component of this strategy, which will become mandatory in 2014. IPM is based on dynamic processes and requires decision-making at strategic, tactical, and operational levels. Relative to decision makers in conventional agricultural systems, decision makers in IPM systems require more knowledge and must deal with greater complexity. Different tools have been developed for supporting decision-making in plant disease control and include warning services, on-site devices, and decision support systems (DSSs. These decision-support tools operate at different spatial and time scales, are provided to users both by public and private sources, focus on different communication modes, and can support multiple options for delivering information to farmers. Characteristics, weaknesses, and strengths of these tools are described in this review. Also described are recently developed DSSs, which are characterised by: i holistic treatment of crop management problems (including pests, diseases, fertilisation, canopy management and irrigation; ii conversion of complex decision processes into simple and easy-to-understand ‘decision supports’; iii easy and rapid access through the Internet; and iv two-way communication between users and providers that make it possible to consider context-specific information. These DSSs are easy-to-use tools that perform complex tasks efficiently and effectively. The delivery of these DSSs via the Internet increases user accessibility, allows the DSSs to be updated easily and continuously (so that new knowledge can be rapidly and efficiently provided to farmers, and allows users to maintain close contact with providers.

  12. Ethical aspect price decision making

    Directory of Open Access Journals (Sweden)

    Grubor Aleksandar

    2007-01-01

    Full Text Available Price decision making in a marketing program framework creatings is a complicated and delicated part of marketing management, especially to keep in sight culminating of mass external factors. In a market economies price policy as a marketing mix instrument rarely is regulated by the law, which opening the ethical aspect questions of price decision making process. The ethics in the price decision making means consideration of the inner law of the individual (marketing managers and/or consumers, whose irreverence does not entail any juridical sanctions, rather its application is sanctioned by the self - awareness. The acception and stability of the ethical aspect price decision making are determined by the characteristic of selected marketing environment.

  13. Making ethical choices: a comprehensive decision-making model for Canadian psychologists.

    Science.gov (United States)

    Hadjistavropoulos, T; Malloy, D C

    2000-05-01

    This paper proposes a theoretical augmentation of the seven-step decision-making model outlined in the Canadian Code of Ethics for Psychologists. We propose that teleological, deontological, and existential ethical perspectives should be taken into account in the decision-making process. We also consider the influence of individual, issue-specific, significant-other, situational, and external factors on ethical decision-making. This theoretical analysis demonstrates the richness and complexity of ethical decision-making.

  14. A mapping of design decision-making

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2004-01-01

    In this paper we present the decision score, which is a model of decision-making seen in the engineering designer's perspective of the design process dynamics, where a decision has multiple objects and where it is based on earlier decisions, prediction of consequences and design process progressi...

  15. Making sense of adolescent decision-making: challenge and reality.

    Science.gov (United States)

    Unguru, Yoram

    2011-08-01

    Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.

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

    Science.gov (United States)

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

    2013-06-01

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

  17. Psychopharmacology decision-making among pregnant and postpartum women and health providers: informing compassionate and collaborative care women's health.

    Science.gov (United States)

    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.

  18. Decision-making, somatic markers and emotion processing in opiate users.

    Science.gov (United States)

    Biernacki, Kathryn; Terrett, Gill; McLennan, Skye N; Labuschagne, Izelle; Morton, Phoebe; Rendell, Peter G

    2018-01-01

    Opiate use is associated with deficits in decision-making. A possible explanation for these deficits is provided by the somatic marker hypothesis, which suggests that substance users may experience abnormal emotional responses during decision-making involving reward and punishment. This in turn may interfere with the brief physiological arousal, i.e. somatic markers that normally occur in anticipation of risky decisions. To date, the applicability of the somatic marker hypothesis to explain decision-making deficits has not been investigated in opiate users. This study assessed whether decision-making deficits in opiate users were related to abnormal emotional responses and reduced somatic markers. Opiate users enrolled in an opiate substitute treatment program (n = 28) and healthy controls (n = 32) completed the Iowa Gambling Task (IGT) while their skin conductance responses (SCRs) were recorded. Participants' emotional responses to emotion-eliciting videos were also recorded using SCRs and subjective ratings. Opiate users displayed poorer decision-making on the IGT than did controls. However, there were no differences between the groups in SCRs; both groups displayed stronger SCRs following punishment than following reward, and both groups displayed stronger anticipatory SCRs prior to disadvantageous decisions than advantageous decisions. There were no group differences in objective or subjective measures of emotional responses to the videos. The results suggest that deficits in emotional responsiveness are not apparent in opiate users who are receiving pharmacological treatment. Thus, the somatic marker hypothesis does not provide a good explanation for the decision-making deficits in this group.

  19. Stepwise decision making for the long-term management of radioactive waste

    International Nuclear Information System (INIS)

    Pescatore, C.; Vari, A.

    2005-01-01

    The context of long-term radioactive waste management is being shaped by changes in modern society. Values such as health, environmental protection and safety are increasingly important, as are trends towards improved forms of participatory democracy that demand new forms of risk governance in dealing with hazardous activities. These changes in turn necessitate new forms of dialogue and decision-making processes that include a large number of stakeholders. The new dynamic of dialogue and decision-making process has been characterised as a shift from a more traditional 'decide, announce and defend' model, focused on technical assurance, to one of 'engage, interact and cooperate', for which both technical assurance and quality of the process are of comparable importance to a constructive outcome. Consequently, the scientific and engineering aspects of waste management safety are no longer of exclusive importance. Organisational ability to communicate and to adapt to the new context has emerged as a critical contributor to public confidence. In the new decision-making context it is clear that (a) any significant decisions regarding the long-term management of radioactive waste will be accompanied by a comprehensive public review with involvement of a diverse range of stakeholders; (b) the public, and especially the local public, are not willing to commit irreversibly to technical choices on which they have insufficient familiarity and understanding; and (c) any management options will take decades to be developed and implemented, which will involve stakeholders who have not yet been born. Thus, a 'decision' no longer means opting for, in one go and for all time, a complete package solution. Instead, a decision is one step in an overall, cautious process of examining and making choices that preserve the safety and well-being of the present generation and the coming ones while not needlessly depriving the latter of their right of choice. Consideration is thus

  20. Shared Decision Making in Intensive Care Units: An American College of Critical Care Medicine and American Thoracic Society Policy Statement

    Science.gov (United States)

    Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.

    2015-01-01

    Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value

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

    OpenAIRE

    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 funct...

  2. Instructional decision making of high school science teachers

    Science.gov (United States)

    Carver, Jeffrey S.

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

  3. Integrating Click-Through and Eye-Tracking Logs for Decision-Making Process Mining

    Directory of Open Access Journals (Sweden)

    Razvan PETRUSEL

    2014-01-01

    Full Text Available In current software every click of the users is logged, therefore a wealth of click-through information exists. Besides, recent technologies have made eye-tracking affordable and an alternative to other human-computer interaction means (e.g. mouse, touchscreens. A big challenge is to make sense of all this data and convert it into useful information. This paper introduces a possible solution placed in the context of decision-making processes. We show how the decision maker's activity can be traced using two means: mouse tracing (i.e. clicks and eye-tracking (i.e. eye fixations. Then, we discuss a mining approach, based on the log, which extracts a Decision Data Model (DDM. We use the DDM to determine, post-hoc, which decision strategy was employed. The paper concludes with a validation based on a controlled experiment.

  4. Constructions of accountability in child protection workers decision-making processes

    DEFF Research Database (Denmark)

    Schrøder, Ida Marie

    2014-01-01

    collected from three Danish local governments and consists of 24 qualitative interviews with child protection workers, leaders and economic consultants, 12 observations of team meetings and a quantitative survey of 150 cases. The study ends summer 2014 and the results of the research will be utilized...... construction of accountability as relational effects of these new forms of accounting practice. The paper draws on the preliminary results from a 2 ½ year mixed method study of how budgeting and accounting practice influences the processes of decision-making in child protection work. The data has been...... systems – such as setting standards or deciding on the delegation of decision-making authority. Using Actor-network theory as a methodological and analytical approach, it furthermore becomes clear how the types of accountability are enacted as effects, not only by the technologies offered to support...

  5. Shared decision making and medication management in the recovery process.

    Science.gov (United States)

    Deegan, Patricia E; Drake, Robert E

    2006-11-01

    Mental health professionals commonly conceptualize medication management for people with severe mental illness in terms of strategies to increase compliance or adherence. The authors argue that compliance is an inadequate construct because it fails to capture the dynamic complexity of autonomous clients who must navigate decisional conflicts in learning to manage disorders over the course of years or decades. Compliance is rooted in medical paternalism and is at odds with principles of person-centered care and evidence-based medicine. Using medication is an active process that involves complex decision making and a chance to work through decisional conflicts. It requires a partnership between two experts: the client and the practitioner. Shared decision making provides a model for them to assess a treatment's advantages and disadvantages within the context of recovering a life after a diagnosis of a major mental disorder.

  6. Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

    Science.gov (United States)

    McGlinchey, Mark P; Davenport, Sally

    2015-01-01

    The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and

  7. Physicians' perspectives on communication and decision making in clinical encounters for treatment of latent tuberculosis infection

    OpenAIRE

    Claudia C. Dobler; Sinthia Bosnic-Anticevich; Carol L. Armour

    2018-01-01

    The aim of the study was to explore the views of tuberculosis (TB) physicians on treatment of latent TB infection (LTBI), focusing on decision making and communication in clinical practice. 20 Australian TB physicians participated in a semistructured interview in person or over the telephone. Interviews were recorded, transcribed and analysed thematically. The study identified challenges that physicians face when discussing treatment for LTBI with patients. These included difficulties explain...

  8. Simulation based decision support for strategic communication and marketing management concerning the consumer introduction of smart energy meters

    NARCIS (Netherlands)

    Van der Sanden, M.C.A.; Van Dam, K.H.; Stragier, J.; Kobus, C.B.A.

    2013-01-01

    Communication and marketing professionals make strategic decisions in highly complex and dynamic contexts. These decisions are highly uncertain on the outcome and process level when, for example, consumer behaviour is at stake. Decision support systems can provide insights in these levels of

  9. Sharing and Communicating Intuition in Organizational Decision Making

    DEFF Research Database (Denmark)

    Constantiou, Ioanna; Shollo, Arisa; Vendelø, Morten Thanning

    Research on intuition as part of decision making is well established in the fields of management and organization studies. There has been a large number of important theoretical works as well as empirical studies focusing on senior managers’ or executives’ intuition. While such studies are evidence...

  10. Cochlear Implant: the complexity involved in the decision making process by the family

    Directory of Open Access Journals (Sweden)

    Sheila de Souza Vieira

    2014-06-01

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

  11. A Relational Approach to the Acquisition Decision-Making Process in the Military Organization

    Directory of Open Access Journals (Sweden)

    Gheorghe Minculete

    2016-06-01

    Full Text Available The market relations of military organizations focus on the acquisition of material goods and/or services. Nonetheless, the importance of the decisions related to the supply process is sometimes minimized. This attitude is so harmful for the effi cacy and effi ciency of the activities conducted by the military structure that at times it can have a negative impact on the management staff too. Problems may occur because the acquisition process must unfold performance-oriented; its main objective is the purchasing of material goods and/or services meant to ensure the smooth operation of the activities of the military organization. In case this cannot be achieved, it is highly probable that the mission of the organization itself is compromised. The present article explores the constitutive elements of the acquisition decision-making situation, certainty, uncertainty and risk connected to the purchasing mechanism, as well as the stages of the acquisition decision-making process

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

    Science.gov (United States)

    Reyna, Valerie F; Brainerd, Charles J

    2011-09-01

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

  13. Deliberation versus automaticity in decision making: Which presentation format features facilitate automatic decision making?

    Directory of Open Access Journals (Sweden)

    Anke Soellner

    2013-05-01

    Full Text Available The idea of automatic decision making approximating normatively optimal decisions without necessitating much cognitive effort is intriguing. Whereas recent findings support the notion that such fast, automatic processes explain empirical data well, little is known about the conditions under which such processes are selected rather than more deliberate stepwise strategies. We investigate the role of the format of information presentation, focusing explicitly on the ease of information acquisition and its influence on information integration processes. In a probabilistic inference task, the standard matrix employed in prior research was contrasted with a newly created map presentation format and additional variations of both presentation formats. Across three experiments, a robust presentation format effect emerged: Automatic decision making was more prevalent in the matrix (with high information accessibility, whereas sequential decision strategies prevailed when the presentation format demanded more information acquisition effort. Further scrutiny of the effect showed that it is not driven by the presentation format as such, but rather by the extent of information search induced by a format. Thus, if information is accessible with minimal need for information search, information integration is likely to proceed in a perception-like, holistic manner. In turn, a moderate demand for information search decreases the likelihood of behavior consistent with the assumptions of automatic decision making.

  14. Entrepreneurs` Cognitive and Decision Making Styles

    Directory of Open Access Journals (Sweden)

    Mahmoud Motvaseli

    2015-12-01

    Full Text Available The main purpose of this study is to explore the relation between decision-making styles which are measured by the General decision-making style (GDMS test and information processing styles which are often termed cognitive styles and are, in this study, measured by Cognitive Style Inventory. The authors directed a survey research on 162 Iranian students. Structural equation modeling techniques were used to measure the impact of cognitive styles on decision-making styles. The authors found that cognitive styles have a positive impact on decision-making styles. In spite of the abundant research on factors that affect decision-making styles, few researches have tested the relationship between cognitive styles and decision-making styles. This study examines the impact of cognitive styles on decision-making styles in Iran. This study, like most research paper studies, cannot easily be generalized. Furthermore, the results of this study could be affected by economic conditions.

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

    Directory of Open Access Journals (Sweden)

    Shahar eAyal

    2015-07-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  18. A spiral model of musical decision-making.

    Science.gov (United States)

    Bangert, Daniel; Schubert, Emery; Fabian, Dorottya

    2014-01-01

    This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1) and deliberate (Type 2) decision-making processes changes with increasing expertise and conceptualizes this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning toward greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural), increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion toward the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans' (2011) Intervention Model of dual-process theories, Cognitive Continuum Theory Hammond et al. (1987), Hammond (2007), Baylor's (2001) U-shaped model for the development of intuition by level of expertise. By theorizing how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally.

  19. A spiral model of musical decision-making

    Directory of Open Access Journals (Sweden)

    Daniel eBangert

    2014-04-01

    Full Text Available This paper describes a model of how musicians make decisions about performing notated music. The model builds on psychological theories of decision-making and was developed from empirical studies of Western art music performance that aimed to identify intuitive and deliberate processes of decision-making, a distinction consistent with dual-process theories of cognition. The model proposes that the proportion of intuitive (Type 1 and deliberate (Type 2 decision-making processes changes with increasing expertise and conceptualises this change as movement along a continually narrowing upward spiral where the primary axis signifies principal decision-making type and the vertical axis marks level of expertise. The model is intended to have implications for the development of expertise as described in two main phases. The first is movement from a primarily intuitive approach in the early stages of learning towards greater deliberation as analytical techniques are applied during practice. The second phase occurs as deliberate decisions gradually become automatic (procedural, increasing the role of intuitive processes. As a performer examines more issues or reconsiders decisions, the spiral motion towards the deliberate side and back to the intuitive is repeated indefinitely. With increasing expertise, the spiral tightens to signify greater control over decision type selection. The model draws on existing theories, particularly Evans’ (2011 Intervention Model of dual-process theories, Cognitive Continuum Theory (Hammond et al., 1987; Hammond, 2007, and Baylor’s (2001 U-shaped model for the development of intuition by level of expertise. By theorising how musical decision-making operates over time and with increasing expertise, this model could be used as a framework for future research in music performance studies and performance science more generally.

  20. Utilisation of Cost Type Information in Decision Making Process Approaches on Public Establishments

    OpenAIRE

    Mihai (Andreescu) Gabriela; Ionescu (Eftene) Nicoleta; Uta Tatiana

    2011-01-01

    Managerial decisions and decision making process stand for the key issues of each entity around which all activities of financial information collection, processing, review, construing, summarizing, and not only, gravitate within every organisation. Moreover, costs (calculation, review and optimization of such) are important as the whole activity of an organisation reflects itself in costs, respectively based on information concerning costs based on which managers may decide on purchasing, pr...

  1. A New Interlink Decision Making Index for Making Multi-criteria Decision

    Directory of Open Access Journals (Sweden)

    Eric Hu

    2012-11-01

    Full Text Available Multi-criteria decisions usually require measurement or evaluation of performance in different units and their mix by application of weighting factors. This approach lads to potential manipulation of the results as a direct consequence of the applied weightings. In this paper a mechanism that is the brain child of the authors, has been proposed to overcome this problem. It is known as the Interlink Decision Making Index (IDMI and has all the desired features: simple, interlink (all criteria and automatically guaranteed dominant influence of critical criteria (i.e. no human weighting needed. The IDMI is capable of reflecting the total merits of a particular option once the normal decision making criteria and (up to two critical criteria have been chosen. Then, without arbitrarily weighting criteria, comparison and selection of the best possible option can be made. Simple software has been developed to do this numerical transfer and graphic presentation. Two hypothetical examples are presented in the paper to demonstrate the application of the IDMI concept and its advantages over the traditional "tabular and weightingmethod" in the decision making process

  2. Fundamental issues of rationalization in corporate decision-making

    OpenAIRE

    Marek Jacek Stankiewicz

    2010-01-01

    The paper deals with the problems of the improvement of the decision-making process that is composed of two sub-systems: preparations for making a decision and taking it. Based on the multi-aspect characteristics of the essence and conditions of the decision-making process a referential model of decision-making has been proposed. The model assumes the existence of two principles that apparently may seem contradictory – the principle of rationality and the principle of creative uniqueness. Dec...

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Market Segmentation in the Decision Making Process in Tourism

    Directory of Open Access Journals (Sweden)

    Alexandra VINEREAN

    2014-07-01

    Full Text Available In this paper, I examine the responses of 154 tourists in relation to their predisposition to purchase and the patterns and habits that are usually decisive in the decision making process regarding tourism services or products. For this research, I conducted a selective direct research, whose purpose was to obtain a segmentation of consumers who purchase tourism services based on specific dimensions of behavior. This research also implied studying the behavior of current and potential customers who purchase travel services depending on several variables for establishing different consumption habits. Thus, to establish a more detailed image of the tourists who participated in this direct and selective research, the analysis involved a factor analysis and a cluster analysis.

  5. Rationality and Emotions in Decision Making

    OpenAIRE

    Olga Markic

    2009-01-01

    Decision making is traditionally viewed as a rational process where reason calculates the best way to achieve the goal. Investigations from different areas of cognitive science have shown that human decisions and actions are much more influenced by intuition and emotional responses then it was previously thought. In this paper I examine the role of emotion in decision making, particularly Damasio’s hypothesis of somatic markers and Green’s dual process theory of moral judgment. I conclude the...

  6. Decision boxes for clinicians to support evidence-based practice and shared decision making: the user experience

    Directory of Open Access Journals (Sweden)

    Giguere Anik

    2012-08-01

    Full Text Available Abstract Background This project engages patients and physicians in the development of Decision Boxes, short clinical topic summaries covering medical questions that have no single best answer. Decision Boxes aim to prepare the clinician to communicate the risks and benefits of the available options to the patient so they can make an informed decision together. Methods Seven researchers (including four practicing family physicians selected 10 clinical topics relevant to primary care practice through a Delphi survey. We then developed two one-page prototypes on two of these topics: prostate cancer screening with the prostate-specific antigen test, and prenatal screening for trisomy 21 with the serum integrated test. We presented the prototypes to purposeful samples of family physicians distributed in two focus groups, and patients distributed in four focus groups. We used the User Experience Honeycomb to explore barriers and facilitators to the communication design used in Decision Boxes. All discussions were transcribed, and three researchers proceeded to thematic content analysis of the transcriptions. The coding scheme was first developed from the Honeycomb’s seven themes (valuable, usable, credible, useful, desirable, accessible, and findable, and included new themes suggested by the data. Prototypes were modified in light of our findings. Results Three rounds were necessary for a majority of researchers to select 10 clinical topics. Fifteen physicians and 33 patients participated in the focus groups. Following analyses, three sections were added to the Decision Boxes: introduction, patient counseling, and references. The information was spread to two pages to try to make the Decision Boxes less busy and improve users’ first impression. To try to improve credibility, we gave more visibility to the research institutions involved in development. A statement on the boxes’ purpose and a flow chart representing the shared decision-making

  7. The Role of Intuition and Creativity in Decision Making

    OpenAIRE

    Wierzbicki, A.P.

    1992-01-01

    The paper starts with a reflection on various perceptions of rationality in decision making; by concentrating on so-called deliberative decision making and examining its analogy to cognitive processes, a case for including intuitive decisions into the concept of rational decision making is made. The role of "Gestalt" images and basic concepts in perceiving reality is stressed. Intuitive decision making is operationally defined and various phases of intuitive decision processes are examined. S...

  8. Decision Making Based On Management Information System and Decision Support System

    Directory of Open Access Journals (Sweden)

    Şükrü Ada

    2015-04-01

    Full Text Available Information hasbecome an essentialresource for managing modern organizations. This is so because today’sbusiness environment is volatile, dynamic, turbulent and necessitates the burgeoning demand for accurate, relevant, complete,timely and economical information needed to drive the decision-making process in order to accentuate organizational abilities to manage opportunities and threat. MIS work on online mode with an average processing speed. Generally, it is used by low level management. Decision support system are powerful tool that assist corporate executives, administrators and other senior officials in making decision regarding the problem. Management Information Systems is a useful tool that provided organized and summarized information in a proper time to decision makers and enable making accurate decision for managers in organizations. This paper will discuss the concept, characteristics, types of MIS, the MIS model, and in particular it will highlight the impact and role of MIS on decision making.

  9. Considering Risk and Resilience in Decision-Making

    Science.gov (United States)

    Torres-Pomales, Wilfredo

    2015-01-01

    This paper examines the concepts of decision-making, risk analysis, uncertainty and resilience analysis. The relation between risk, vulnerability, and resilience is analyzed. The paper describes how complexity, uncertainty, and ambiguity are the most critical factors in the definition of the approach and criteria for decision-making. Uncertainty in its various forms is what limits our ability to offer definitive answers to questions about the outcomes of alternatives in a decision-making process. It is shown that, although resilience-informed decision-making would seem fundamentally different from risk-informed decision-making, this is not the case as resilience-analysis can be easily incorporated within existing analytic-deliberative decision-making frameworks.

  10. The amygdala and decision-making.

    Science.gov (United States)

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

    2011-03-01

    Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  11. THE STRUCTURAL SPECIFICITIES OF THE US CONGRESS’ WHICH INFLUENCE THE POLICY DECISION-MAKING PROCESS

    Directory of Open Access Journals (Sweden)

    O A. Frolova

    2014-04-01

    Full Text Available The U.S. Congress plays an important role in the decision-making process at the system of American political management. First of all, it applies to formulation and coordination of different interests through the law passing process. The article examines the Congress’ structure and the different aspects of its functioning. Those aspects often play a key role in lawmaking process and later affect the forming of the US political vector. The author comes to conclusion that the existing system of subcommittees doesn’t allow the U.S. Legislature to consider many bills completely and that fact negatively impacts on political decision-making process.Purchase on Elibrary.ru > Buy now

  12. The decision-making threshold and the factors that affect it: A qualitative study of patients' decision-making in knee replacement surgery.

    Science.gov (United States)

    Barlow, T; Scott, P; Thomson, L; Griffin, D; Realpe, A

    2018-03-01

    Osteoarthritis is a significant cause of burden to the ageing population and knee replacement is a common operation for treatment of end-stage disease. We aimed to explore these factors to help understand patients' decision-making, which is critical in informing patient-centred care. These can be used to enhance decision-making and dialogue between clinicians and patients, allowing a more informed choice. The study consisted of two focus groups, in a patient cohort after total knee replacement followed by more in-depth interviews to further test and explore themes from the focus groups, in patients in either the deliberation stage or the decision-making stage. Using qualitative research methods (iterative thematic analysis) reviewing decision-making and deliberation phases of making informed choices we found nine key themes that emerged from the study groups. An awareness of the deliberation phase, the factors that influence it, the stress associated with it, preferred models of care, and the influence of the decision-making threshold will aid useful communication between doctors and patients. Copyright © 2017 John Wiley & Sons, Ltd.

  13. How do small groups make decisions?

    OpenAIRE

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

    2017-01-01

    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 e...

  14. Decision-making impairments in Parkinson's disease as a by-product of defective cost-benefit analysis and feedback processing.

    Science.gov (United States)

    Ryterska, Agata; Jahanshahi, Marjan; Osman, Magda

    2014-01-01

    Studies examining decision-making in people with Parkinson's disease (PD) show impaired performance on a variety of tasks. However, there are also demonstrations that patients with PD can make optimal decisions just like healthy age-matched controls. We propose that the reason for these mixed findings is that PD does not produce a generalized impairment of decision-making, but rather affects sub-components of this process. In this review we evaluate this hypothesis by considering the empirical evidence examining decision-making in PD. We suggest that of the various stages of the decision-making process, the most affected in PD are (1) the cost-benefit analysis stage and (2) the outcome evaluation stage. We consider the implications of this proposal for research in this area.

  15. Optimizing Negotiation Conflict in the Cloud Service Negotiation Framework Using Probabilistic Decision Making Model.

    Science.gov (United States)

    Rajavel, Rajkumar; Thangarathinam, Mala

    2015-01-01

    Optimization of negotiation conflict in the cloud service negotiation framework is identified as one of the major challenging issues. This negotiation conflict occurs during the bilateral negotiation process between the participants due to the misperception, aggressive behavior, and uncertain preferences and goals about their opponents. Existing research work focuses on the prerequest context of negotiation conflict optimization by grouping similar negotiation pairs using distance, binary, context-dependent, and fuzzy similarity approaches. For some extent, these approaches can maximize the success rate and minimize the communication overhead among the participants. To further optimize the success rate and communication overhead, the proposed research work introduces a novel probabilistic decision making model for optimizing the negotiation conflict in the long-term negotiation context. This decision model formulates the problem of managing different types of negotiation conflict that occurs during negotiation process as a multistage Markov decision problem. At each stage of negotiation process, the proposed decision model generates the heuristic decision based on the past negotiation state information without causing any break-off among the participants. In addition, this heuristic decision using the stochastic decision tree scenario can maximize the revenue among the participants available in the cloud service negotiation framework.

  16. Capturing a Commander's decision making style

    Science.gov (United States)

    Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

    2017-05-01

    A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

  17. Decision-Making Processes in the Workplace: How Exhaustion, Lack of Resources and Job Demands Impair Them and Affect Performance.

    Science.gov (United States)

    Ceschi, Andrea; Demerouti, Evangelia; Sartori, Riccardo; Weller, Joshua

    2017-01-01

    The present study aims to connect more the I/O and the decision-making psychological domains, by showing how some common components across jobs interfere with decision-making and affecting performance. Two distinct constructs that can contribute to positive workplace performance have been considered: decision-making competency (DMCy) and decision environment management (DEM). Both factors are presumed to involve self-regulatory mechanisms connected to decision processes by influencing performance in relation to work environment conditions. In the framework of the job demands-resources (JD-R) model, the present study tested how such components as job demands, job resources and exhaustion can moderate decision-making processes and performance, where high resources are advantageous for decision-making processes and performance at work, while the same effect happens with low job demands and/or low exhaustion. In line with the formulated hypotheses, results confirm the relations between both the decision-making competences, performance (i.e., in-role and extra-role) and moderators considered. In particular, employees with low levels of DMCy show to be more sensitive to job demands toward in-role performance, whereas high DEM levels increase the sensitivity of employees toward job resources and exhaustion in relation to extra-role performance. These findings indicate that decision-making processes, as well as work environment conditions, are jointly related to employee functioning.

  18. Decision-Making Processes in the Workplace: How Exhaustion, Lack of Resources and Job Demands Impair Them and Affect Performance

    Directory of Open Access Journals (Sweden)

    Andrea Ceschi

    2017-05-01

    Full Text Available The present study aims to connect more the I/O and the decision-making psychological domains, by showing how some common components across jobs interfere with decision-making and affecting performance. Two distinct constructs that can contribute to positive workplace performance have been considered: decision-making competency (DMCy and decision environment management (DEM. Both factors are presumed to involve self-regulatory mechanisms connected to decision processes by influencing performance in relation to work environment conditions. In the framework of the job demands-resources (JD-R model, the present study tested how such components as job demands, job resources and exhaustion can moderate decision-making processes and performance, where high resources are advantageous for decision-making processes and performance at work, while the same effect happens with low job demands and/or low exhaustion. In line with the formulated hypotheses, results confirm the relations between both the decision-making competences, performance (i.e., in-role and extra-role and moderators considered. In particular, employees with low levels of DMCy show to be more sensitive to job demands toward in-role performance, whereas high DEM levels increase the sensitivity of employees toward job resources and exhaustion in relation to extra-role performance. These findings indicate that decision-making processes, as well as work environment conditions, are jointly related to employee functioning.

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

    Science.gov (United States)

    Liberatore, Matthew J.; Nydick, Robert L.

    1997-01-01

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

  20. Proposal for an integrated risk informed decision making process for German regulators

    International Nuclear Information System (INIS)

    Einarsson, Svante; Wielenberg, Andreas

    2013-01-01

    Regulatory decisions for German nuclear power plants (NPP) have traditionally been based on deterministic safety analyses. However, the IRRS-Mission of IAEA in 2008 proposed, among others, in 'Suggestion 25' to develop a national policy 'on the use of risk insights in the regulatory framework and decision making'. Consequently, the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) launched a project with the goal of developing a proposal for a uniform federal approach on using risk information in decision making. To this end, the state of the application of probabilistic and risk informed methods has been investigated both on an international and a national level. On the international level, the concept of Integrated Risk Informed Decision Making (IRIDM) has been defined in INSAG-25. It is a structured process, in which all knowledge and requirements relevant to the issue in question are to be considered in a decision. Such knowledge and other requirements are e.g. deterministic and probabilistic safety analyses, regulatory requirements and other applicable findings (including cost-benefit analyses). The IRIDM concept according to INSAG-25 is the cornerstone of the proposal for a uniform federal German approach for IRIDM in the regulatory framework for nuclear installations in Germany. (orig.)

  1. When Family Considerations Influence Work Decisions: Decision-Making Processes

    Science.gov (United States)

    Powell, Gary N.; Greenhaus, Jeffrey H.

    2012-01-01

    The work-family literature has provided an abundance of evidence that various family factors are linked to various work decisions, suggesting that the "family-relatedness" of work decisions is a prevalent phenomenon (Greenhaus & Powell, 2012). However, the cognitive processes by which such linkages occur have received little attention. We offer a…

  2. Clinical decision making: how surgeons do it.

    Science.gov (United States)

    Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

    2013-06-01

    Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  3. HTA and decision-making processes in Central, Eastern and South Eastern Europe: Results from a survey.

    Science.gov (United States)

    García-Mochón, Leticia; Espín Balbino, Jaime; Olry de Labry Lima, Antonio; Caro Martinez, Araceli; Martin Ruiz, Eva; Pérez Velasco, Román

    2017-03-31

    To gain knowledge and insights on health technology assessment (HTA) and decision-making processes in Central, Eastern and South Eastern Europe (CESEE) countries. A cross-sectional study was performed. Based on the literature, a questionnaire was developed in a multi-stage process. The questionnaire was arranged according to 5 broad domains: (i) introduction/country settings; (ii) use of HTA in the country; (iii) decision-making process; (iv) implementation of decisions; and (v) HTA and decision-making: future challenges. Potential survey respondents were identified through literature review-with a total of 118 contacts from the 24 CESEE countries. From March to July 2014, the survey was administered via e-mail. A total of 22 questionnaires were received generating an 18.6% response rate, including 4 responses indicating that their institutions had no involvement in HTA. Most of the CESEE countries have entities under government mandates with advisory functions and different responsibilities for decision-making, but mainly in charge of the reimbursement and pricing of medicines. Other areas where discrepancies across countries were found include criteria for selecting technologies to be assessed, stakeholder involvement, evidence requirements, use of economic evaluation, and timeliness of HTA. A number of CESEE countries have created formal decision-making processes for which HTA is used. However, there is a high level of heterogeneity related to the degree of development of HTA structures, and the methods and processes followed. Further studies focusing on the countries from which information is scarcer and on the HTA of health technologies other than medicines are warranted. Reviews/comparative analyses. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Is Shared Decision Making for End-of-Life Decisions Associated With Better Outcomes as Compared to Other Forms of Decision Making? A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Negin Hajizadeh MD, MPH

    2016-07-01

    Full Text Available Background: Whether shared decision making (SDM has been evaluated for end-of-life (EOL decisions as compared to other forms of decision making has not been studied. Purpose: To summarize the evidence on SDM being associated with better outcomes for EOL decision making, as compared to other forms of decision making. Data Sources: PubMed, Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and CINAHL databases were searched through April 2014. Study Selection: Studies were selected that evaluated SDM, compared to any other decision making style, for an EOL decision. Data Extraction: Components of SDM tested, comparators to SDM, EOL decision being assessed, and outcomes measured. Data Synthesis: Seven studies met the inclusion criteria (three experimental and four observational studies. Results were analyzed using narrative synthesis. All three experimental studies compared SDM interventions to usual care. The four observational studies compared SDM to doctor-controlled decision making, or reported the correlation between level of SDM and outcomes. Components of SDM specified in each study differed widely, but the component most frequently included was presenting information on the risks/benefits of treatment choices (five of seven studies. The outcome most frequently measured was communication, although with different measurement tools. Other outcomes included decisional conflict, trust, satisfaction, and “quality of dying.” Limitations: We could not analyze the strength of evidence for a given outcome due to heterogeneity in the outcomes reported and measurement tools. Conclusions: There is insufficient evidence supporting SDM being associated with improved outcomes for EOL decisions as opposed to other forms of decision making. Future studies should describe which components of SDM are being tested, outline the comparator decision making style, and use validated tools to measure outcomes.

  5. A grounded typology of vacation decision-making

    NARCIS (Netherlands)

    Decrop, A.; Snelders, H.M.J.J.

    2005-01-01

    This paper presents a typology of vacationers based on decision-making variables and processes. Employing a naturalistic perspective, the (summer) vacation decision-making process of 25 Belgian households was followed for a year. In-depth interview and observation data were analyzed and interpreted

  6. Medical decision making

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Vries, M. de; Scherer, L.; Keren, G.; Wu, G.

    2016-01-01

    This chapter presents an overview of the field of medical decision making. It distinguishes the levels of decision making seen in health-care practice and shows how research in judgment and decision making support or improve decision making. Most of the research has been done at the micro level,

  7. Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.

    Science.gov (United States)

    Wunderlich, Tracy; Cooper, Gregory; Divine, George; Flocke, Susan; Oja-Tebbe, Nancy; Stange, Kurt; Lafata, Jennifer Elston

    2010-09-01

    To compare patient-reported and observer-rated shared decision making (SDM) use for colorectal cancer (CRC) screening and evaluate patient, physician and patient-reported relational communication factors associated with patient-reported use of shared CRC screening decisions. Study physicians are salaried primary care providers. Patients are insured, aged 50-80 and due for CRC screening. Audio-recordings from 363 primary care visits were observer-coded for elements of SDM. A post-visit patient survey assessed patient-reported decision-making processes and relational communication during visit. Association of patient-reported SDM with observer-rated elements of SDM, as well as patient, physician and relational communication factors were evaluated using generalized estimating equations. 70% of patients preferred SDM for preventive health decisions, 47% of patients reported use of a SDM process, and only one of the screening discussions included all four elements of SDM per observer ratings. Patient report of SDM use was not associated with observer-rated elements of SDM, but was significantly associated with female physician gender and patient-reported relational communication. Inconsistencies exist between patient reports and observer ratings of SDM for CRC screening. Future studies are needed to understand whether SDM that is patient-reported, observer-rated or both are associated with informed and value-concordant CRC screening decisions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Claire A Hales

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

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

    Science.gov (United States)

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

    2016-01-01

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

  10. Termination of pregnancy following a prenatal diagnosis of Down syndrome: A qualitative study of the decision-making process of pregnant couples.

    Science.gov (United States)

    Lou, Stina; Carstensen, Kathrine; Petersen, Olav Bjørn; Nielsen, Camilla Palmhøj; Hvidman, Lone; Lanther, Maja Retpen; Vogel, Ida

    2018-05-23

    In Denmark, first trimester screening has a very high uptake (>90%). If Down syndrome is diagnosed, termination rates are high (>95%). The aim of this study was to investigate the timing of the decision to terminate pregnancy following a diagnosis of Down syndrome and the factors influencing this decision. Semi-structured, qualitative interview study with 21 couples who had received a prenatal diagnosis of Down syndrome and decided to terminate the pregnancy. Participants were recruited from obstetric departments between February 2016 and July 2017. Data were analyzed using thematic analysis. Five themes were identified: "initial decision-making", "consolidating the decision", "reasons and concerns shaping the termination of pregnancy decision", "the right decision is also burdensome", and "perceived influences in decision-making". For most couples, the initial decision to terminate pregnancy was made before or during the diagnostic process, but it was re-addressed and consolidated following the actual diagnosis. Imagining a family future with a severely affected Down syndrome child was the main factor influencing the termination of pregnancy decision. The decision was articulated as "right" but also as existentially burdensome for some, due to fear of regret and concern about ending a potential life. The decision to terminate pregnancy was considered a private matter between the couple, but was refined through interactions with clinicians and social networks. All couples made an initial decision prior to receiving the Down syndrome diagnosis. Knowledge of the couple's initial decision may facilitate patient-centered communication during and after the diagnostic process. Couples may benefit from counseling to deal with grief and existential concerns. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

  11. Medical decision-making in children and adolescents: developmental and neuroscientific aspects.

    Science.gov (United States)

    Grootens-Wiegers, Petronella; Hein, Irma M; van den Broek, Jos M; de Vries, Martine C

    2017-05-08

    Various international laws and guidelines stress the importance of respecting the developing autonomy of children and involving minors in decision-making regarding treatment and research participation. However, no universal agreement exists as to at what age minors should be deemed decision-making competent. Minors of the same age may show different levels of maturity. In addition, patients deemed rational conversation-partners as a child can suddenly become noncompliant as an adolescent. Age, context and development all play a role in decision-making competence. In this article we adopt a perspective on competence that specifically focuses on the impact of brain development on the child's decision-making process. We believe that the discussion on decision-making competence of minors can greatly benefit from a multidisciplinary approach. We adopted such an approach in order to contribute to the understanding on how to deal with children in decision-making situations. Evidence emerging from neuroscience research concerning the developing brain structures in minors is combined with insights from various other fields, such as psychology, decision-making science and ethics. Four capacities have been described that are required for (medical) decision-making: (1) communicating a choice; (2) understanding; (3) reasoning; and (4) appreciation. Each capacity is related to a number of specific skills and abilities that need to be sufficiently developed to support the capacity. Based on this approach it can be concluded that at the age of 12 children can have the capacity to be decision-making competent. However, this age coincides with the onset of adolescence. Early development of the brain's reward system combined with late development of the control system diminishes decision-making competence in adolescents in specific contexts. We conclude that even adolescents possessing capacities required for decision-making, may need support of facilitating environmental factors

  12. Enhancing shared decision making through assessment of patient-clinician concordance on decision quality

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Selby, Warwick; Salkeld, Glenn

    to quantify, document, and suggest how future dyadic decisions can be enhanced by criterion prioritisation. Associations between patient’s MDQ-W before, and MDQ-R after consultation with their clinician were analysed along with patient scores from the Satisfaction With Decision (SWD) instrument. Results...... and clinician using the dually-personalised decomposable MyDecisionQuality (MDQ) instrument. This has the potential to guide future work on optimising dyad-specific patient-clinician communication for shared decision making and informed consent....

  13. The Role of Dysfunctional Myths in a Decision-Making Process under Bounded Rationality: A Complex Dynamical Systems Perspective.

    Science.gov (United States)

    Stamovlasis, Dimitrios; Vaiopoulou, Julie

    2017-07-01

    The present study examines the factors influencing a decision-making process, with specific focus on the role of dysfunctional myths (DM). DM are thoughts or beliefs that are rather irrational, however influential to people's decisions. In this paper a decision-making process regarding the career choice of university students majoring in natural sciences and education (N=496) is examined by analyzing survey data taken via Career Decision Making Difficulties Questionnaire (CDDQ). The difficulty of making the choice and the certainty about one's decision were the state variables, while the independent variables were factors related to the lack of information or knowledge needed, which actually reflect a bounded rationality. Cusp catastrophe analysis, based on both least squares and maximum likelihood procedures, showed that the nonlinear models predicting the two state variables were superior to linear alternatives. Factors related to lack of knowledge about the steps involved in the process of career decision-making, lack of information about the various occupations, lack of information about self and lack of motivation acted as asymmetry, while dysfunctional myths acted as bifurcation factor for both state variables. The catastrophe model, grounded in empirical data, revealed a unique role for DM and a better interpretation within the context of complexity and the notion of bounded rationality. The analysis opens the nonlinear dynamical systems (NDS) perspective in studying decision-making processes. Theoretical and practical implications are discussed.

  14. An analysis of medical decision making

    International Nuclear Information System (INIS)

    Lusted, L.B.

    1977-01-01

    Medical decision-making studies continue to focus on two questions: How do physicians make decisions and how should physicians make decisions. Researchers pursuing the first question emphasize human cognitive processes and the programming of symbol systems to model the observed human behaviour. Those researchers concentrating on the second question assume that there is a standard of performance against which physicians' decisions can be judged, and to help the physician improve his performance an array of tools is proposed. These tools include decision trees, Bayesian analysis, decision matrices, receiver operating characteristic (ROC) analysis, and cost-benefit considerations including utility measures. Both questions must be answered in an ethical context where ethics and decision analysis are intertwined. (author)

  15. Decision-making in nursing practice: An integrative literature review.

    Science.gov (United States)

    Nibbelink, Christine W; Brewer, Barbara B

    2018-03-01

    To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient

  16. A Review of Multi-Criteria Decision-Making Methods Applied to the Sustainable Bridge Design

    Directory of Open Access Journals (Sweden)

    Vicent Penadés-Plà

    2016-12-01

    Full Text Available The construction of bridges has been necessary for societies since ancient times, when the communication between and within towns, cities or communities was established. Until recently, the economic factor has been the only one considered in the decision-making of any type of construction process for bridges. However, nowadays, the objective should not be just the construction of bridges, but of sustainable bridges. Economic, social and environmental factors, which form the three pillars of sustainability, have been recently added. These three factors usually have conflicting perspectives. The decision-making process allows the conversion of a judgment into a rational procedure to reach a compromise solution. The aim of this paper is to review different methods and sustainable criteria used for decision-making at each life-cycle phase of a bridge, from design to recycling or demolition. This paper examines 77 journal articles for which different methods have been used. The most used methods are briefly described. In addition, a statistical study was carried out on the Multiple Attribute Decision-making papers reviewed.

  17. Reasons for family involvement in elective surgical decision-making in Taiwan: a qualitative study.

    Science.gov (United States)

    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. Mechanisms of public participation in the decision-making process

    International Nuclear Information System (INIS)

    Corner, J.

    1993-01-01

    Public inquiries, hearings, referenda and government reviews are among a number of commonly mechanisms through which the public in the relevant OECD countries participate in the decision-making process in respect of nuclear power and its development. The scope, application and effectiveness of these procedures appear to vary from country to country; differences which may result from styles of government, history, national interest and other factors. We listen to each OECD member in turn, explaining how is the situation in his country

  19. Legality, legitimacy and formal and informal decision-making processes: when does a decision become legitimate?

    International Nuclear Information System (INIS)

    Zwetkoff, C.

    2004-01-01

    A few words on the purpose of this paper are given by way of introduction. A brief analysis will be made of the relationship between legality and legitimacy in relation to decision-making processes and within the context of the policies concerning the public management of technological risks. The aim is to raise questions and outline some reflections based on the theory of the state, from the perspective of the conditions of the institutionalization of power. I shall first clarify a few conceptual points. The notion of legality refers to the notion of compliance with legal standards, that is to say, with the law. Is the decision made by a person empowered by law so do to (legal competence)? Is it taken in compliance with legal procedure? And are the effects implicitly in keeping with the spirit of the law? The legitimacy of the power of those who govern, or the legitimacy of their decisions, is not determined solely by legal standards but rather, is a matter of individual and social representation or view. As Hobbes says, in essence, to govern is to convince: to convince people of the rightfulness of the source of the power of those who govern and of the action or public policies that they formulate. The paper is organised around three propositions: 1. The role of the legitimacy or social acceptability of public policies has always been an element of the way all political systems function. This role, however, occupies an increasingly important place on the political agenda in a societal decision-making context that has undergone irreversible changes. 2. Although the essence of the social legitimacy of public policies remains the same, the conditions, mechanisms and criteria evolve. 3. The critical centrality of social legitimacy, together with the evolution of the criteria for legitimate decision, today modify the decision-making mechanisms that were established in response to the requirements of classical democracy. We observe a political organisation i n the

  20. Comparing perceptual and preferential decision making.

    Science.gov (United States)

    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.

  1. Public Marketing: An Alternative Policy Decision-Making Idea for Small Cities. Community Development Research Series.

    Science.gov (United States)

    Meyers, James; And Others

    The concept of public marketing presents a strategy for the systems approach to community development that would facilitate the community decision making process via improved communication. Basic aspects of the social marketing process include: (1) product policy; (2) channels of distribution; (3) pricing (perceived price vs quality and quantity…

  2. Effects of stochastic interest rates in decision making under risk: A Markov decision process model for forest management

    Science.gov (United States)

    Mo Zhou; Joseph Buongiorno

    2011-01-01

    Most economic studies of forest decision making under risk assume a fixed interest rate. This paper investigated some implications of this stochastic nature of interest rates. Markov decision process (MDP) models, used previously to integrate stochastic stand growth and prices, can be extended to include variable interest rates as well. This method was applied to...

  3. The Effects of Decision-Making Style on Openness and Satisfaction within Japanese Organizations.

    Science.gov (United States)

    Stewart, Lea P.; And Others

    1986-01-01

    Examines the influence of decision-making style on communication openness and satisfaction in Japanese organizations. Results of a survey indicated that Japanese employees preferred persuasive or consultative managerial decision-making styles and were more satisfied when their preferred decision-making style and the style of their manager were…

  4. Shared decision-making in neonatology: an utopia or an attainable goal?

    Science.gov (United States)

    D'Aloja, Ernesto; Floris, Laura; Muller, Mima; Birocchi, Francesca; Fanos, Vassilios; Paribello, Francesco; Demontis, Roberto

    2010-10-01

    Medical decision making is sometimes considered as a relatively simple process in which a decision may be made by the physician, by the patient, or by both patient and physician working together. There are three main models of decision making--paternalism, patient informed choice, and shared decision-making (SDM), having each one of these drawbacks and limitations. Historically, the most adopted one was the paternalism (strongly 'Doctor knows best'), where the professional made the decision based on what he/she considered to be as the patient's best interest, not necessarily contemplating patient's will and wishes. Currently, at the antipodes, the patient informed choice, where the patient makes his/her decision based on information received from the physician with no possible interference of professional's own preferences, seems to be the preferred relationship standard. SDM represents an intermediate approach between the two above-mentioned opposite models, being a medical process that involves actively the doctor and the patient who both bring their own facts and preferences to reach an agreement on the decision on if, when and how to treat a disease. This model, being characterized by elements pertaining to both the others, is gaining popularity in several medical and surgical scenarios whenever a competent patient is able to actively participate into the decisional process. On this basis can this model be implemented also in a Neonatology Intensive Care Unit where little patients are--by nature--incompetent, being the diagnostic/therapeutic choices taken by parents? We focused on this complex item considering four possible different scenarios and it seems to us that it could be possible to introduce such an approach, providing that parents' empowerment, a good physician's communication skill and consideration of all cultural, religious, economic, and ethic values of every single actor have been fairly taken into account.

  5. Parent Communication Prompt to Increase Shared Decision-Making: A New Intervention Approach

    Directory of Open Access Journals (Sweden)

    Lauren M. Hubner

    2018-03-01

    Full Text Available ObjectiveShared decision-making (SDM is the process by which patients, clinicians, and in pediatrics, parents/caregivers, discuss treatment options, communicate available evidence for or against the different options, share preferences and values, and eventually arrive at a joint decision. This study evaluates the use of a novel, universally applicable, SDM intervention, provided to parents, intended to promote engagement and participation with their child’s clinician.MethodsTwo-arm randomized controlled trial comparing the impact of a SDM-focused intervention prompt to a neutral comparison prompt on perception of SDM participation. Participants included English-speaking parents of children (0–17 years attending one Developmental-Behavioral Pediatric (DBP clinic and their child’s clinician. Prior to visit start, parents received either the intervention prompt encouraging engagement with the clinician in decision-making, or the comparison prompt reminding them to request a school/work excuse note if needed. After the visit, SDM was assessed by both parents and DBP clinicians. SDM was scored as present if the respondent answered “strongly agree” to all SDM-related items. Logistic regression tested effects of visit, child, parent, clinician characteristics, and intervention group status on parent-reported SDM. Cohen’s kappa assessed alignment between parent and clinician perceptions of SDM.ResultsOf 88 parents screened, 50 (61% met eligibility criteria and agreed to participate (intervention n = 26; comparison n = 24. Eligible participants (parents and clinicians for analysis completed the surveys with no missing data. Overall, SDM was present in 76% of parents and 34% of clinicians. With high rates of parent-reported SDM in both intervention and comparison groups, no main intervention effect was detected. Compared to the comparison group, there was greater alignment between parent and clinician perception of SDM in the

  6. Fostering climate dialogue by introducing students to uncertainty in