Erickson Lonny J
Full Text Available Abstract Background Healthcare decisionmaking is a complex process relying on disparate types of evidence and value judgments. Our objectives for this study were to develop a practical framework to facilitate decisionmaking in terms of supporting the deliberative process, providing access to evidence, and enhancing the communication of decisions. Methods Extensive analyses of the literature and of documented decisionmaking processes around the globe were performed to explore what steps are currently used to make decisions with respect to context (from evidence generation to communication of decision and thought process (conceptual components of decisions. Needs and methodologies available to support decisionmaking were identified to lay the groundwork for the EVIDEM framework. Results A framework was developed consisting of seven modules that can evolve over the life cycle of a healthcare intervention. Components of decision that could be quantified, i.e., intrinsic value of a healthcare intervention and quality of evidence available, were organized into matrices. A multicriteria decision analysis (MCDA Value Matrix (VM was developed to include the 15 quantifiable components that are currently considered in decisionmaking. A methodology to synthesize the evidence needed for each component of the VM was developed including electronic access to full text source documents. A Quality Matrix was designed to quantify three criteria of quality for the 12 types of evidence usually required by decisionmakers. An integrated system was developed to optimize data analysis, synthesis and validation by experts, compatible with a collaborative structure. Conclusion The EVIDEM framework promotes transparent and efficient healthcare decisionmaking through systematic assessment and dissemination of the evidence and values on which decisions are based. It provides a collaborative framework that could connect all stakeholders and serve the healthcare community at
Objectives To test and further develop a healthcare policy and clinical decision support framework using growth hormone (GH) for Turner syndrome (TS) as a complex case study. Methods The EVIDEM framework was further developed to complement the multicriteria decision analysis (MCDA) Value Matrix, that includes 15 quantifiable components of decision clustered in four domains (quality of evidence, disease, intervention and economics), with a qualitative tool including six ethical and health system-related components of decision. An extensive review of the literature was performed to develop a health technology assessment report (HTA) tailored to each component of decision, and content was validated by experts. A panel of representative stakeholders then estimated the MCDA value of GH for TS in Canada by assigning weights and scores to each MCDA component of decision and then considered the impact of non-quantifiable components of decision. Results Applying the framework revealed significant data gaps and the importance of aligning research questions with data needs to truly inform decision. Panelists estimated the value of GH for TS at 41% of maximum value on the MCDA scale, with good agreement at the individual level (retest value 40%; ICC: 0.687) and large variation across panelists. Main contributors to this panel specific value were "Improvement of efficacy", "Disease severity" and "Quality of evidence". Ethical considerations on utility, efficiency and fairness as well as potential misuse of GH had mixed effects on the perceived value of the treatment. Conclusions This framework is proposed as a pragmatic step beyond the current cost-effectiveness model, combining HTA, MCDA, values and ethics. It supports systematic consideration of all components of decision and available evidence for greater transparency. Further testing and validation is needed to build up MCDA approaches combined with pragmatic HTA in healthcare decisionmaking. PMID:20377888
Goetghebeur, Mireille M; Wagner, Monika; Khoury, Hanane; Rindress, Donna; Grégoire, Jean-Pierre; Deal, Cheri
To test and further develop a healthcare policy and clinical decision support framework using growth hormone (GH) for Turner syndrome (TS) as a complex case study. The EVIDEM framework was further developed to complement the multicriteria decision analysis (MCDA) Value Matrix, that includes 15 quantifiable components of decision clustered in four domains (quality of evidence, disease, intervention and economics), with a qualitative tool including six ethical and health system-related components of decision. An extensive review of the literature was performed to develop a health technology assessment report (HTA) tailored to each component of decision, and content was validated by experts. A panel of representative stakeholders then estimated the MCDA value of GH for TS in Canada by assigning weights and scores to each MCDA component of decision and then considered the impact of non-quantifiable components of decision. Applying the framework revealed significant data gaps and the importance of aligning research questions with data needs to truly inform decision. Panelists estimated the value of GH for TS at 41% of maximum value on the MCDA scale, with good agreement at the individual level (retest value 40%; ICC: 0.687) and large variation across panelists. Main contributors to this panel specific value were "Improvement of efficacy", "Disease severity" and "Quality of evidence". Ethical considerations on utility, efficiency and fairness as well as potential misuse of GH had mixed effects on the perceived value of the treatment. This framework is proposed as a pragmatic step beyond the current cost-effectiveness model, combining HTA, MCDA, values and ethics. It supports systematic consideration of all components of decision and available evidence for greater transparency. Further testing and validation is needed to build up MCDA approaches combined with pragmatic HTA in healthcare decision-making.
Full Text Available Abstract Objectives To test and further develop a healthcare policy and clinical decision support framework using growth hormone (GH for Turner syndrome (TS as a complex case study. Methods The EVIDEM framework was further developed to complement the multicriteria decision analysis (MCDA Value Matrix, that includes 15 quantifiable components of decision clustered in four domains (quality of evidence, disease, intervention and economics, with a qualitative tool including six ethical and health system-related components of decision. An extensive review of the literature was performed to develop a health technology assessment report (HTA tailored to each component of decision, and content was validated by experts. A panel of representative stakeholders then estimated the MCDA value of GH for TS in Canada by assigning weights and scores to each MCDA component of decision and then considered the impact of non-quantifiable components of decision. Results Applying the framework revealed significant data gaps and the importance of aligning research questions with data needs to truly inform decision. Panelists estimated the value of GH for TS at 41% of maximum value on the MCDA scale, with good agreement at the individual level (retest value 40%; ICC: 0.687 and large variation across panelists. Main contributors to this panel specific value were "Improvement of efficacy", "Disease severity" and "Quality of evidence". Ethical considerations on utility, efficiency and fairness as well as potential misuse of GH had mixed effects on the perceived value of the treatment. Conclusions This framework is proposed as a pragmatic step beyond the current cost-effectiveness model, combining HTA, MCDA, values and ethics. It supports systematic consideration of all components of decision and available evidence for greater transparency. Further testing and validation is needed to build up MCDA approaches combined with pragmatic HTA in healthcare decisionmaking.
Wagner, Monika; Khoury, Hanane; Willet, Jacob; Rindress, Donna; Goetghebeur, Mireille
The multiplicity of issues, including uncertainty and ethical dilemmas, and policies involved in appraising interventions for rare diseases suggests that multicriteria decision analysis (MCDA) based on a holistic definition of value is uniquely suited for this purpose. The objective of this study was to analyze and further develop a comprehensive MCDA framework (EVIDEM) to address rare disease issues and policies, while maintaining its applicability across disease areas. Specific issues and policies for rare diseases were identified through literature review. Ethical and methodological foundations of the EVIDEM framework v3.0 were systematically analyzed from the perspective of these issues, and policies and modifications of the framework were performed accordingly to ensure their integration. Analysis showed that the framework integrates ethical dilemmas and issues inherent to appraising interventions for rare diseases but required further integration of specific aspects. Modification thus included the addition of subcriteria to further differentiate disease severity, disease-specific treatment outcomes, and economic consequences of interventions for rare diseases. Scoring scales were further developed to include negative scales for all comparative criteria. A methodology was established to incorporate context-specific population priorities and policies, such as those for rare diseases, into the quantitative part of the framework. This design allows making more explicit trade-offs between competing ethical positions of fairness (prioritization of those who are worst off), the goal of benefiting as many people as possible, the imperative to help, and wise use of knowledge and resources. It also allows addressing variability in institutional policies regarding prioritization of specific disease areas, in addition to existing uncertainty analysis available from EVIDEM. The adapted framework measures value in its widest sense, while being responsive to rare disease
Goetghebeur, Mireille M; Wagner, Monika; Khoury, Hanane; Levitt, Randy J; Erickson, Lonny J; Rindress, Donna
Health care decision making is complex and requires efficient and explicit processes to ensure transparency and consistency of factors considered. To pilot an adaptable decision-making framework incorporating multicriteria decision analysis (MCDA) in health technology assessment (HTA) with a pan-Canadian group of policy and clinical decision makers and researchers appraising 10 medicines covering 6 therapeutic areas. An appraisal group was convened and participants were asked to express their individual perspectives, independently of the medicines, by assigning weights to each criterion of the MCDA core model: disease severity, size of population, current practice and unmet needs, intervention outcomes (efficacy, safety, patient reported), type of health benefit, economics, and quality of evidence. Participants then assigned performance scores for each medicine using available evidence synthesized in a "by-criterion" HTA report covering each of the MCDA CORE model criteria. MCDA estimates of perceived value were calculated by combining normalized weights and scores. Feedback on the approach was collected through structured discussion. Relative weights on criteria varied widely, reflecting the diverse perspectives of participants. Scores for each criterion provided a performance measure, highlighting strengths and weaknesses of each medicine. MCDA estimates of perceived value ranged from 0.42 to 0.64 across medicines, providing comprehensive measures incorporating a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format of the multiple elements guiding decision, including criteria and values (MCDA core model) and evidence (HTA "by-criterion" report). This proof-of-concept study demonstrated the usefulness of incorporating MCDA in HTA to support transparent and systematic appraisal of health care interventions. Further research is needed to advance MCDA-based approaches to
Gilabert-Perramon, Antoni; Torrent-Farnell, Josep; Catalan, Arancha; Prat, Alba; Fontanet, Manel; Puig-Peiró, Ruth; Merino-Montero, Sandra; Khoury, Hanane; Goetghebeur, Mireille M; Badia, Xavier
The aim of this study was to adapt and assess the value of a Multi-Criteria Decision Analysis (MCDA) framework (EVIDEM) for the evaluation of Orphan drugs in Catalonia (Catalan Health Service). The standard evaluation and decision-making procedures of CatSalut were compared with the EVIDEM methodology and contents. The EVIDEM framework was adapted to the Catalan context, focusing on the evaluation of Orphan drugs (PASFTAC program), during a Workshop with sixteen PASFTAC members. The criteria weighting was done using two different techniques (nonhierarchical and hierarchical). Reliability was assessed by re-test. The EVIDEM framework and methodology was found useful and feasible for Orphan drugs evaluation and decision making in Catalonia. All the criteria considered for the development of the CatSalut Technical Reports and decision making were considered in the framework. Nevertheless, the framework could improve the reporting of some of these criteria (i.e., "unmet needs" or "nonmedical costs"). Some Contextual criteria were removed (i.e., "Mandate and scope of healthcare system", "Environmental impact") or adapted ("population priorities and access") for CatSalut purposes. Independently of the weighting technique considered, the most important evaluation criteria identified for orphan drugs were: "disease severity", "unmet needs" and "comparative effectiveness", while the "size of the population" had the lowest relevance for decision making. Test-retest analysis showed weight consistency among techniques, supporting reliability overtime. MCDA (EVIDEM framework) could be a useful tool to complement the current evaluation methods of CatSalut, contributing to standardization and pragmatism, providing a method to tackle ethical dilemmas and facilitating discussions related to decision making.
This contribution describes the implementation of the conditional-value-at-risk (CVaR) metric to create a general multi-stakeholder decision-making framework. It is observed that stakeholder dissatisfactions (distance to their individual ideal solutions) can be interpreted as random variables. We thus shape the dissatisfaction distribution and find an optimal compromise solution by solving a CVaR minimization problem parameterized in the probability level. This enables us to generalize multi-stakeholder settings previously proposed in the literature that minimizes average and worst-case dissatisfactions. We use the concept of the CVaR norm to give a geometric interpretation to this problem and use the properties of this norm to prove that the CVaR minimization problem yields Pareto optimal solutions for any choice of the probability level. We discuss a broad range of potential applications of the framework. We demonstrate the framework in a bio-waste processing facility location case study, where we seek compromise solutions (facility locations) that balance stakeholder priorities on transportation, safety, water quality, and capital costs. This conference presentation abstract explains a new decision-making framework that computes compromise solution alternatives (reach consensus) by mitigating dissatisfactions among stakeholders as needed for SHC Decision Science and Support Tools project.
Wright, Stuart Anthony Lewis
The paper focuses on the decision-making process in the EU Water Framework Directive (WFD). The WFD is an important piece of legislation, which will decide the quality of the EU aquatic environment for the foreseeable future. The main environmental goal of the Directive is good ecological status...... draws attention to a potential development path, which the DCA process could take, based on an important guidance document on economics in the WFD (WATECO) and the AquaMoney project, a large neoclassical project established to produce guidelines for member states as to how to conduct DCA, essentially...... based on economic valuation methodologies, specifically contingent valuation and benefit transfer. The paper is critical of this potential approach based on a theoretical discussion, which concludes that deliberative approaches to decision-making appear to be more appropriate as they better fit...
Hanine, Mohamed; Boutkhoum, Omar; Tikniouine, Abdessadek; Agouti, Tarik
Fuzzy multi-criteria group decision making (FMCGDM) process is usually used when a group of decision-makers faces imprecise data or linguistic variables to solve the problems. However, this process contains many methods that require many time-consuming calculations depending on the number of criteria, alternatives and decision-makers in order to reach the optimal solution. In this study, a web-based FMCGDM framework that offers decision-makers a fast and reliable response service is proposed. The proposed framework includes commonly used tools for multi-criteria decision-making problems such as fuzzy Delphi, fuzzy AHP and fuzzy TOPSIS methods. The integration of these methods enables taking advantages of the strengths and complements each method's weakness. Finally, a case study of location selection for landfill waste in Morocco is performed to demonstrate how this framework can facilitate decision-making process. The results demonstrate that the proposed framework can successfully accomplish the goal of this study.
In support of the Environmentally Preferable Purchasing Program of the US EPA, the Systems Analysis Branch has developed a decision-making tool based on life cycle assessment. This tool, the Framework for Responsible Environmental Decision-making or FRED streamlines LCA by choosi...
Entwistle, Vikki A; Watt, Ian S
To consider the conceptualisation of patient involvement in treatment decision-making. Conceptual review. Current models and measures of patient involvement in treatment decision-making tend to focus on communication within consultations and/or on the patient's use of information to consider the selection of one treatment option from a well-defined set. These narrowly focused models and measures may obscure the relevance of patient involvement in decision-making for some health care contexts and limit investigations of the relationships between patient involvement in decision-making and health care outcomes. We outline a broader conceptual framework that reflects more of the complexity of the concept of involvement. It acknowledges that patients can be involved not only because of what they say and do to influence a decision, but also by virtue of what they think and feel about their roles, efforts and contributions to decision-making and their relationships with their clinicians. The framework encompasses the full range of activities associated with decision-making. The proposed conceptual framework may broaden the relevance of patient involvement in decision-making and encourage a more comprehensive characterisation that may facilitate more sophisticated investigations of the relationships between patient involvement in decision-making and health care outcomes. Clinicians who aspire to facilitate patient involvement in decision-making need to look beyond the way they discuss health care options with patients. They should also consider how they might enable patients to engage in the full range of decision-making activities and to develop a positive sense of involvement in these activities and with their clinicians.
Miot, Jacqui; Wagner, Monika; Khoury, Hanane; Rindress, Donna; Goetghebeur, Mireille M
Systematic and transparent approaches to priority setting are needed, particularly in low-resource settings, to produce decisions that are sound and acceptable to stakeholders. The EVIDEM framework brings together Health Technology Assessment (HTA) and multi-criteria decision analysis (MCDA) by proposing a comprehensive set of decision criteria together with standardized processes to support decisionmaking. The objective of the study was to field test the framework for decisionmaking on a screening test by a private health plan in South Africa. Liquid-based cytology (LBC) for cervical cancer screening was selected by the health plan for this field test. An HTA report structured by decision criterion (14 criteria organized in the MCDA matrix and 4 contextual criteria) was produced based on a literature review and input from the health plan. During workshop sessions, committee members 1) weighted each MCDA decision criterion to express their individual perspectives, and 2) to appraise LBC, assigned scores to each MCDA criterion on the basis of the by-criterion HTA report.Committee members then considered the potential impacts of four contextual criteria on the use of LBC in the context of their health plan. Feedback on the framework and process was collected through discussion and from a questionnaire. For 9 of the MCDA matrix decision criteria, 89% or more of committee members thought they should always be considered in decisionmaking. Greatest weights were given to the criteria "Budget impact", "Cost-effectiveness" and "Completeness and consistency of reporting evidence". When appraising LBC for cervical cancer screening, the committee assigned the highest scores to "Relevance and validity of evidence" and "Disease severity". Combination of weights and scores yielded a mean MCDA value estimate of 46% (SD 7%) of the potential maximum value. Overall, the committee felt the framework brought greater clarity to the decisionmaking process and was easily adaptable to
Chaudry, Ajay; Henly, Julia; Meyers, Marcia
This working paper is one in a series of projects initiated by the Administration for Children and Families (ACF) to improve knowledge for child care researchers and policy makers about parental child care decision making. In this paper, the authors identify three distinct conceptual frameworks for understanding child care decisions--a rational…
Hsiao, L.; Vorst, van der J.G.A.J.; Kemp, R.G.M.; Omta, S.W.F.
Purpose – The purpose of this paper is to present a decision-making framework for outsourcing levels of logistics activities. These are: execution level of basic activities (such as transportation, warehousing); value-added activities; planning and control level of activities (such as transportation
This contribution describes the implementation of the conditional-value-at-risk (CVaR) metric to create a general multi-stakeholder decision-making framework. It is observed that stakeholder dissatisfactions (distance to their individual ideal solutions) can be interpreted as ran...
We propose a decision-making framework to compute compromise solutions that balance conflicting priorities of multiple stakeholders on multiple objectives. In our setting, we shape the stakeholder dis-satisfaction distribution by solving a conditional-value-at-risk (CVaR) minimiz...
Hargrave, C.; Moores, M.; Deegan, T.; Gibbs, A.; Poulsen, M.; Harden, F.; Mengersen, K.
A decision-making framework for image-guided radiotherapy (IGRT) is being developed using a Bayesian Network (BN) to graphically describe, and probabilistically quantify, the many interacting factors that are involved in this complex clinical process. Outputs of the BN will provide decision-support for radiation therapists to assist them to make correct inferences relating to the likelihood of treatment delivery accuracy for a given image-guided set-up correction. The framework is being developed as a dynamic object-oriented BN, allowing for complex modelling with specific subregions, as well as representation of the sequential decision-making and belief updating associated with IGRT. A prototype graphic structure for the BN was developed by analysing IGRT practices at a local radiotherapy department and incorporating results obtained from a literature review. Clinical stakeholders reviewed the BN to validate its structure. The BN consists of a sub-network for evaluating the accuracy of IGRT practices and technology. The directed acyclic graph (DAG) contains nodes and directional arcs representing the causal relationship between the many interacting factors such as tumour site and its associated critical organs, technology and technique, and inter-user variability. The BN was extended to support on-line and off-line decision-making with respect to treatment plan compliance. Following conceptualisation of the framework, the BN will be quantified. It is anticipated that the finalised decision-making framework will provide a foundation to develop better decision-support strategies and automated correction algorithms for IGRT.
Thompson, Alison K; Faith, Karen; Gibson, Jennifer L; Upshur, Ross E G
Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.
Gibson Jennifer L
Full Text Available Abstract Background Planning for the next pandemic influenza outbreak is underway in hospitals across the world. The global SARS experience has taught us that ethical frameworks to guide decision-making may help to reduce collateral damage and increase trust and solidarity within and between health care organisations. Good pandemic planning requires reflection on values because science alone cannot tell us how to prepare for a public health crisis. Discussion In this paper, we present an ethical framework for pandemic influenza planning. The ethical framework was developed with expertise from clinical, organisational and public health ethics and validated through a stakeholder engagement process. The ethical framework includes both substantive and procedural elements for ethical pandemic influenza planning. The incorporation of ethics into pandemic planning can be helped by senior hospital administrators sponsoring its use, by having stakeholders vet the framework, and by designing or identifying decision review processes. We discuss the merits and limits of an applied ethical framework for hospital decision-making, as well as the robustness of the framework. Summary The need for reflection on the ethical issues raised by the spectre of a pandemic influenza outbreak is great. Our efforts to address the normative aspects of pandemic planning in hospitals have generated interest from other hospitals and from the governmental sector. The framework will require re-evaluation and refinement and we hope that this paper will generate feedback on how to make it even more robust.
Watson, Erin R; Foster-Fishman, Pennie G
Many community decision-making bodies encounter challenges in creating conditions where stakeholders from disadvantaged populations can authentically participate in ways that give them actual influence over decisions affecting their lives (Foster-Fishman et al., Lessons for the journey: Strategies and suggestions for guiding planning, governance, and sustainability in comprehensive community initiatives. W.K. Kellogg Foundation, Battle Creek, MI, 2004). These challenges are often rooted in asymmetrical power dynamics operating within the settings (Prilleltensky, J Commun Psychol 36:116-136, 2008). In response, this paper presents the Exchange Boundary Framework, a new approach for understanding and promoting authentic, empowered participation within collaborative decision-making settings. The framework expands upon theories currently used in the field of community psychology by focusing on the underlying processes through which power operates in relationships and examining the evolution of power dynamics over time. By integrating concepts from social exchange theory (Emerson, Am Soc Rev 27:31-41, 1962) and social boundaries theory (Hayward, Polity 31(1):1-22, 1998), the framework situates power within parallel processes of resources exchange and social regulation. The framework can be used to understand the conditions leading to power asymmetries within collaborative decisionmaking processes, and guide efforts to promote more equitable and authentic participation by all stakeholders within these settings. In this paper we describe the Exchange Boundary Framework, apply it to three distinct case studies, and discuss key considerations for its application within collaborative community settings.
Full Text Available Abstract Background Scientists striving to unlock mysteries within complex biological systems face myriad barriers in effectively integrating available information to enhance their understanding. While experimental techniques and available data sources are rapidly evolving, useful information is dispersed across a variety of sources, and sources of the same information often do not use the same format or nomenclature. To harness these expanding resources, scientists need tools that bridge nomenclature differences and allow them to integrate, organize, and evaluate the quality of information without extensive computation. Results Sidekick, a genomic data driven analysis and decision making framework, is a web-based tool that provides a user-friendly intuitive solution to the problem of information inaccessibility. Sidekick enables scientists without training in computation and data management to pursue answers to research questions like "What are the mechanisms for disease X" or "Does the set of genes associated with disease X also influence other diseases." Sidekick enables the process of combining heterogeneous data, finding and maintaining the most up-to-date data, evaluating data sources, quantifying confidence in results based on evidence, and managing the multi-step research tasks needed to answer these questions. We demonstrate Sidekick's effectiveness by showing how to accomplish a complex published analysis in a fraction of the original time with no computational effort using Sidekick. Conclusions Sidekick is an easy-to-use web-based tool that organizes and facilitates complex genomic research, allowing scientists to explore genomic relationships and formulate hypotheses without computational effort. Possible analysis steps include gene list discovery, gene-pair list discovery, various enrichments for both types of lists, and convenient list manipulation. Further, Sidekick's ability to characterize pairs of genes offers new ways to
Morgan, Rebecca L; Kelley, Leah; Guyatt, Gordon H; Johnson, Ana; Lavis, John N
To guide decision-making about whether or not to pay for a new healthcare intervention, a number of existing frameworks systematically weigh scientific evidence, cost, and social and ethical values. Each framework has strengths and limitations. This study aims to review and summarize available frameworks and generate an integrated framework, if and where applicable, highlighting particular issues faced with expensive but effective and desirable healthcare interventions. We conducted a critical interpretive synthesis to inform decision-making about healthcare interventions. We updated prior systematic reviews on decision-making frameworks through 2015. Purposive sampling identified relevant constructs and considerations to facilitate decision-making. Of 2,980 references, we purposively sampled 19 frameworks. The new framework, which built on the GRADE Evidence to Decision framework, included burden of disease, benefits and harms, values and preferences, resource use, equity, acceptability, and feasibility. Modifications to the Evidence to Decision framework included adding limitations of alternative technologies considerations in use (expanding benefits and harms) and broadening acceptability and feasibility constructs to include political and health system factors. No modifications appeared necessary to address the situation of effective but expensive and desirable interventions. Guideline developers, health technology assessment producers, and decision-makers can use our integrated framework to inform decision-making about healthcare interventions. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Systematic approaches to making decisions in the public sector are becoming very common. Most often, these approaches concern expert decision models. The expansion of the idea of the development of e-participation and e-democracy was influenced by the development of technology. All stakeholders are supposed to participate in decision making, so this brings a new feature to the decision-making process, in which amateurs and non-specialists are participating decision making instead of experts. To be able to understand the needs and wishes of stakeholders, it is not enough to vote for alternatives - it is important to participate in solution-finding and to express opinions about the important elements of these matters. The solution presented in this paper concerns fuzzy decision-making framework. This framework combines the advantages of the introduction of the decision-making problem in a tree structure and the possibilities offered by the flexibility of the fuzzy approach. The possibilities of implementation of the framework in practice are introduced by case studies of investment projects appraisal in a community and assessment of efficiency and effectiveness of public institutions.
Clarinval, Caroline; Biller-Andorno, Nikola
Introduction: This paper aims to raise awareness regarding ethical issues in the context of humanitarian action, and to offer a framework for systematically and effectively addressing such issues. Methods: Several cases highlight ethical issues that humanitarian aid workers are confronted with at different levels over the course of their deployments. The first case discusses a situation at a macro-level concerning decisions being made at the headquarters of a humanitarian organization. The second case looks at meso-level issues that need to be solved at a country or regional level. The third case proposes an ethical dilemma at the micro-level of the individual patient-provider relationship. Discussion: These real-life cases have been selected to illustrate the ethical dimension of conflicts within the context of humanitarian action that might remain unrecognized in everyday practice. In addition, we propose an ethical framework to assist humanitarian aid workers in their decision-making process. The framework draws on the principles and values that guide humanitarian action and public health ethics more generally. Beyond identifying substantive core values, the framework also includes a ten-step process modelled on tools used in the clinical setting that promotes a transparent and clear decision-making process and improves the monitoring and evaluation of aid interventions. Finally, we recommend organizational measures to implement the framework effectively. Conclusion: This paper uses a combination of public health/clinical ethics concepts and practices and applies them to the decision-making challenges encountered in relief operations in the humanitarian aid context. PMID:24987575
Martínez de Anguita, Pablo; Alonso, Enrique; Martín, María Angeles
This article develops a decision-making framework for environmental management that integrates technical, economic, political and legal, and ethical decision levels. It attempts to show how these decision levels can be ordained, integrated and interconnected and postulates a hierarchic concentric sphere system that proposes an environmental management model for long-term solutions. This model can be used as a check list for environmental management decision-making and also as a guide for environmental conflict resolution where environmental problems necessitate several levels of decision making. It integrates various environmental ethical positions and evaluates political decisions into a comprehensive, broadly applicable multidisciplinary approach. The objective of this decision-making model is to interconnect into a simplified sequence different levels of environmental management processes in order to account for sustainability, efficacy, efficiency and the acceptability of environmental management processes in the long term. This is done by observing when an environmental problem needs to be solved within a certain sphere of solutions and when it requires wider frameworks, how these can be established and how this process proves that solidarity is the widest and most reasonable sphere.
Levac, Danielle E; Galvin, Jane
Multiple virtual reality (VR) systems are used to improve motor function in children and youth with neurological impairments. Galvin and Levac developed a classification framework to facilitate clinical decision-making about VR system use. This paper applies the classification framework to identify its strengths and limitations. The classification framework is applied to three case studies where therapists may consider using VR with children involved in paediatric rehabilitation programmes. The classification framework identified VR systems that met each child's individual needs. The relevance of each category to clinical decision-making varied depending on each child's goals. Categories requiring further development and suggestions for additional categories are discussed. The classification framework facilitates child-centred decision-making about the use of VR as a therapeutic intervention. It has shown initial utility but requires further validation with clinicians working in a variety of clinical settings and with a range of client populations.
Nicolini, Marie; Vandenberghe, Joris; Gastmans, Chris
In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision-making in CCC. Also, the medico-legal framework underlying CCC use sometimes appears to foster the use of reductionist clinical evaluation. Layered on top of these issues is how stakeholders view coercion. There is a discrepancy between clinicians' and patients' perception of coercion, which leads to clinician-patient differences on whether CCC is necessary. Moreover, the way in which the evaluation is typically carried out influences patients' perception of coercion and subsequently their motivation for participating fully in treatment. In this article, we explore the value of care ethics, often applied to care practices such as nursing, when applied to more procedural medical practices, such as decision-making regarding CCC. The care-ethical approach views decision-making as part of a dynamic care process, within which the lived experience, interpretative dialogue and promotion of dignity are core features. Embracing this new framework means a paradigm shift in when the therapeutic relationship begins, namely, investing in it occurs while conducting an evaluation for a possible CCC procedure. Unlike in current typical evaluations, early cultivation of the therapeutic relationship enables the patient to participate in the definition of his needs, reduces perceived coercion and negative emotions and enhances treatment motivation. Finally, implications of this
Full Text Available Abstract Background Colorectal cancer is the third leading cause of death from cancer worldwide with over 900,000 diagnoses and 639,000 deaths each year. Although shared decision making is broadly advocated as a mechanism by which to achieve patient-centred care, there has been little investigation of patient and physician shared decision-making preferences and practices or the outcomes associated with shared decision making in the context of colorectal cancer. Aim The aim of this study is to determine patient and physician attitudes towards the use of shared decision making in the setting of colorectal cancer. Methods Standard principles of qualitative research will be used to sample and interview 20 colorectal cancer patients in each of three tertiary care hospitals (n = 60 and 15 surgeons, radiation oncologists, and medical oncologists (n = 45 affiliated with cancer centres. The interview questions will be guided by a conceptual framework defining patient and physician factors that influence the shared decision-making process and associated outcomes in the setting of colorectal cancer. An inductive, grounded approach will be used by two investigators to independently analyze the interview transcripts. These investigators will meet to compare and achieve consensus on themes that will be tabulated to compare barriers, enablers, and outcomes of shared decision making by patient, physician, and contextual factors. Discussion This study is the first to examine both patient and physician perspectives on the use of shared decision making for colorectal cancer in North America or elsewhere. It will provide a framework that can be used to describe the shared decision-making process and its outcomes, and evaluate strategies to facilitate this process for patients with colorectal cancer.
Fry, Margaret; Stainton, Colleen
The role of the triage nurse has emerged in response to growing community demand for a more accessible and efficient emergency department (ED) service. The focus of triage research has been on measuring outcomes and improving the delivery of emergency care. This has meant that the context of care, and triage processes and practices have remained concealed. Thus, little evidence about the role and ways to prepare nurses for this role is available. The aim of this study was to provide insight and understanding needed to educate and support the triage nursing role in Australian EDs. A 12-month ethnographic study of triage nursing practice was conducted in Sydney metropolitan EDs. Data were then collected from participant observation in four EDs and interviews with 10 triage nurses. Analysis used standard content and thematic analysis techniques. Findings reveal that notions of timeliness, efficiency and equity are embedded in a culture of ED care. This sustains a particular cadence of care to which triage nurses are culturally oriented. Triage nurses maintain, negotiate and restore this cadence of emergency care by using gatekeeping, timekeeping and decision-making processes. The comprehensive study of triage nursing has led to the development of an educational framework based on the processes of gatekeeping, timekeeping and decision-making.
Yang, Yueran; Guyll, Max; Madon, Stephanie
This article presents a new model of confessions referred to as the interrogation decision-making model. This model provides a theoretical umbrella with which to understand and analyze suspects' decisions to deny or confess guilt in the context of a custodial interrogation. The model draws upon expected utility theory to propose a mathematical account of the psychological mechanisms that not only underlie suspects' decisions to deny or confess guilt at any specific point during an interrogation, but also how confession decisions can change over time. Findings from the extant literature pertaining to confessions are considered to demonstrate how the model offers a comprehensive and integrative framework for organizing a range of effects within a limited set of model parameters. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Cohen, Robert A.
Frail elderly patients with advanced kidney disease experience many of the burdens associated with dialysis. Although these patients constitute the fastest-growing population starting dialysis, they often suffer loss of functional status, impaired quality of life, and increased mortality after dialysis initiation. Nephrology clinicians face the challenges of helping patients decide if the potential benefits of dialysis outweigh the risks and preparing such patients for future setbacks. A communication framework for dialysis decision-making that aligns treatment choices with patient goals and values is presented. The role of uncertainty is highlighted, and the concept of a goal-directed care plan is introduced. This plan incorporates a time-limited trial that promotes frequent opportunities for reassessment. Using the communication skills presented, the clinician can prepare and guide patients for the dialysis trajectory as it unfolds. PMID:24970868
King, Russel J.
This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.
Manap, Norpadzlihatun; Voulvoulis, Nikolaos
The aim of this study was to develop a risk-based decision-making framework for the selection of sediment dredging option. Descriptions using case studies of the newly integrated, holistic and staged framework were followed. The first stage utilized the historical dredging monitoring data and the contamination level in media data into Ecological Risk Assessment phases, which have been altered for benefits in cost, time and simplicity. How Multi-Criteria Decision Analysis (MCDA) can be used to analyze and prioritize dredging areas based on environmental, socio-economic and managerial criteria was described for the next stage. The results from MCDA will be integrated into Ecological Risk Assessment to characterize the degree of contamination in the prioritized areas. The last stage was later described using these findings and analyzed using MCDA, in order to identify the best sediment dredging option, accounting for the economic, environmental and technical aspects of dredging, which is beneficial for dredging and sediment management industries. Copyright © 2014 Elsevier B.V. All rights reserved.
Kraak, Vivica I; Story, Mary
To address obesity and diet-related chronic diseases in the United States, organizations such as the Robert Wood Johnson Foundation and the Institute of Medicine have encouraged the use of voluntary engagement strategies among stakeholders. By using public-private partnerships as well as networks, alliances, and coalitions, voluntary engagement can translate evidence-informed dietary recommendations into effective policies and actions and into innovative products and services. We offer six guiding principles and a decision-making framework that stakeholders can use to ensure that partnerships are accountable and effective in their pursuit of health-related goals. We apply the principles and framework to four national partnerships of US food, beverage, and food retail industry stakeholders working to prevent child obesity and to promote healthy food environments through product reformulation and healthy food retail incentives. We conclude that partnerships should be evaluated for their synergy, accountability, and effectiveness at achieving the partners' objectives. Independent evaluations will help build credibility and public trust in the capacity of voluntary engagement strategies to promote healthy food environments and positively influence public health. Project HOPE—The People-to-People Health Foundation, Inc.
Wilcock, Jane; Iliffe, Steve; Griffin, Mark; Jain, Priya; Thuné-Boyle, Ingela; Lefford, Frances; Rapp, David
Early diagnosis of dementia is important because this allows those with dementia and their families to engage support and plan ahead. However, dementia remains underdetected and suboptimally managed in general practice. Our objective was to test the effect of a workplace-based tailored educational intervention developed for general practice on the clinical management of people with dementia. The tailored educational intervention was tested in an unblinded cluster randomized controlled trial with a pre/post-intervention design, with two arms: usual/normal care control versus educational intervention. The primary outcome measure was an increase in the proportion of patients with dementia who received at least two documented dementia-specific management reviews per year. Case identification was a secondary outcome measure. 23 practices in South-East England participated. A total of 1,072 patients with dementia (intervention: 512, control: 560) had information in their medical records showing the number of reviews within 12 months (or a proportion of) before intervention or randomization and within 12 months (or a proportion of) after. The mean total number of dementia management reviews after the educational intervention for people with dementia was 0.89 (SD 1.09; minimum 0; median 1; maximum 8) compared with 0.89 (SD 0.92; minimum 0; median 1; maximum 4) before intervention. In the control group prior to randomization the mean total number of dementia management reviews was 1.66 (SD 1.87; minimum 0; median 1; maximum 12) and in the period after randomization it was 1.56 (SD 1.79; minimum 0; median 1; maximum 11). Case detection rates were unaffected. The estimated incidence rate ratio for intervention versus control group was 1.03 (P = 0.927, 95% CI 0.57 to 1.86). The trial was timely, coinciding with financial incentives for dementia management in general practice (through the Quality Outcomes Framework); legal imperatives (in the form of the Mental Capacity Act
Fooladivanda, Aida; Shokouhi, Shahriar B; Ahmadinejad, Nasrin
Breast-region segmentation is an important step for density estimation and Computer-Aided Diagnosis (CAD) systems in Magnetic Resonance Imaging (MRI). Detection of breast-chest wall boundary is often a difficult task due to similarity between gray-level values of fibroglandular tissue and pectoral muscle. This paper proposes a robust breast-region segmentation method which is applicable for both complex cases with fibroglandular tissue connected to the pectoral muscle, and simple cases with high contrast boundaries. We present a decision-making framework based on geometric features and support vector machine (SVM) to classify breasts in two main groups, complex and simple. For complex cases, breast segmentation is done using a combination of intensity-based and atlas-based techniques; however, only intensity-based operation is employed for simple cases. A novel atlas-based method, that is called localized-atlas, accomplishes the processes of atlas construction and registration based on the region of interest (ROI). Atlas-based segmentation is performed by relying on the chest wall template. Our approach is validated using a dataset of 210 cases. Based on similarity between automatic and manual segmentation results, the proposed method achieves Dice similarity coefficient, Jaccard coefficient, total overlap, false negative, and false positive values of 96.3, 92.9, 97.4, 2.61 and 4.77%, respectively. The localization error of the breast-chest wall boundary is 1.97 mm, in terms of averaged deviation distance. The achieved results prove that the suggested framework performs the breast segmentation with negligible errors and efficient computational time for different breasts from the viewpoints of size, shape, and density pattern.
Ruohonen, Toni; Ennejmy, Mohammed
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.
Khefacha, I.; Belkacem, L.
This study investigates how decisions are made in Tunisian public higher education establishments. Some factors are identified as having a potentially significant impact on the odds that the decision-making process follows the characteristics of one of the most well known decision-making models: collegial, political, bureaucratic or anarchical…
This study examines strategic decision-making at the college level in relation to seven theoretical frames. Strategic decisions are those made by top executives, have wide-ranging influence throughout the organization, affect the long-term future of the organization, and are connected to the external environment. The seven decision-making frames…
Smith, David R.; McGowan, Conor P.; Daily, Jonathan P.; Nichols, James D.; Sweka, John A.; Lyons, James E.
Application of adaptive management to complex natural resource systems requires careful evaluation to ensure that the process leads to improved decision-making. As part of that evaluation, adaptive policies can be compared with alternative nonadaptive management scenarios. Also, the value of reducing structural (ecological) uncertainty to achieving management objectives can be quantified.A multispecies adaptive management framework was recently adopted by the Atlantic States Marine Fisheries Commission for sustainable harvest of Delaware Bay horseshoe crabs Limulus polyphemus, while maintaining adequate stopover habitat for migrating red knots Calidris canutus rufa, the focal shorebird species. The predictive model set encompassed the structural uncertainty in the relationships between horseshoe crab spawning, red knot weight gain and red knot vital rates. Stochastic dynamic programming was used to generate a state-dependent strategy for harvest decisions given that uncertainty. In this paper, we employed a management strategy evaluation approach to evaluate the performance of this adaptive management framework. Active adaptive management was used by including model weights as state variables in the optimization and reducing structural uncertainty by model weight updating.We found that the value of information for reducing structural uncertainty is expected to be low, because the uncertainty does not appear to impede effective management. Harvest policy responded to abundance levels of both species regardless of uncertainty in the specific relationship that generated those abundances. Thus, the expected horseshoe crab harvest and red knot abundance were similar when the population generating model was uncertain or known, and harvest policy was robust to structural uncertainty as specified.Synthesis and applications. The combination of management strategy evaluation with state-dependent strategies from stochastic dynamic programming was an informative approach to
van Til, Janine Astrid; Groothuis-Oudshoorn, Catharina Gerarda Maria; Lieferink, Marijke; Dolan, James; Goetghebeur, Mireille
Background There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare
Garnett, Kenisha; Cooper, Tim; Longhurst, Philip; Jude, Simon; Tyrrel, Sean
The technical expertise that politicians relied on in the past to produce cost-effective and environmentally sound solutions no longer provides sufficient justification to approve waste facilities. Local authorities need to find more effective ways to involve stakeholders and communities in decision-making since public acceptance of municipal waste facilities is integral to delivering effective waste strategies. This paper presents findings from a research project that explored attitudes towards greater levels of public involvement in UK waste management decision-making. The study addressed questions of perception, interests, the decision context, the means of engagement and the necessary resources and capacity for adopting a participatory decision process. Adopting a mixed methods approach, the research produced an empirical framework for negotiating the mode and level of public involvement in waste management decision-making. The framework captures and builds on theories of public involvement and the experiences of practitioners, and offers guidance for integrating analysis and deliberation with public groups in different waste management decision contexts. Principles in the framework operate on the premise that the decision about 'more' and 'better' forms of public involvement can be negotiated, based on the nature of the waste problem and wider social context of decision-making. The collection of opinions from the wide range of stakeholders involved in the study has produced new insights for the design of public engagement processes that are context-dependent and 'fit-for-purpose'; these suggest a need for greater inclusivity in the case of contentious technologies and high levels of uncertainty regarding decision outcomes. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Stockall, Nancy; Dennis, Lindsay R.
This article presents a seven-step framework for decision making to solve ethical issues in special education. The authors developed the framework from the existing literature and theoretical frameworks of justice, critique, care, and professionalism. The authors briefly discuss each theoretical framework and then describe the decision-making…
The sport medicine clinician is faced with return-to-play (RTP) decisions for every patient who wants to return to activity. The complex interaction of factors related to history, physical examination, testing, activity and baseline characteristics can make RTP decision-making challenging. Further, when reasoning is not explicit, unnecessary conflict can arise among clinicians themselves, or among clinicians and patients. This conflict can have negative health consequences for the patient. In 2010, a transparent framework for RTP decisions was proposed. However, some have identified limitations to the framework and found difficulties in its implementation. This paper presents a revised framework that addresses the limitations, and provides concrete examples of how to apply it in simple and complex cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Catacutan, Maria Rosario G.; de Guzman, Allan B.
Ethical decision-making in school administration has received considerable attention in educational leadership literature. However, most research has focused on principals working in secondary school settings while studies that explore ethical reasoning processes of academic deans have been significantly few. This qualitative study aims to…
McCready, John W.
The purpose of this study was to examine use of decision-making tools and feedback in strategic planning in order to develop a rigorous process that would promote the efficiency of strategic planning for acquisitions in the United States Coast Guard (USCG). Strategic planning is critical to agencies such as the USCG in order to be effective…
Ghavami, Seyed Morsal; Taleai, Mohammad
Most spatial problems are multi-actor, multi-issue and multi-phase in nature. In addition to their intrinsic complexity, spatial problems usually involve groups of actors from different organizational and cognitive backgrounds, all of whom participate in a social structure to resolve or reduce the complexity of a given problem. Hence, it is important to study and evaluate what different aspects influence the spatial problem resolution process. Recently, multi-agent systems consisting of groups of separate agent entities all interacting with each other have been put forward as appropriate tools to use to study and resolve such problems. In this study, then in order to generate a better level of understanding regarding the spatial problem group decision-making process, a conceptual multi-agent-based framework is used that represents and specifies all the necessary concepts and entities needed to aid group decision making, based on a simulation of the group decision-making process as well as the relationships that exist among the different concepts involved. The study uses five main influencing entities as concepts in the simulation process: spatial influence, individual-level influence, group-level influence, negotiation influence and group performance measures. Further, it explains the relationship among different concepts in a descriptive rather than explanatory manner. To illustrate the proposed framework, the approval process for an urban land use master plan in Zanjan—a provincial capital in Iran—is simulated using MAS, the results highlighting the effectiveness of applying an MAS-based framework when wishing to study the group decision-making process used to resolve spatial problems.
Landsiedel, Robert; Ma-Hock, Lan; Wiench, Karin; Wohlleben, Wendel; Ursula G. Sauer
As presented at the 2016 TechConnect World Innovation Conference on 22?25 May 2016 in Washington DC, USA, the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) ?Nano Task Force? proposes a Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) consisting of three tiers to assign nanomaterials to four main groups with possible further subgrouping to refine specific information needs. The DF4nanoGrouping covers all relevant aspects of a na...
Full Text Available Abstract Background We have developed a framework for translating existing sources of synthesized and quality-assessed evidence, primarily systematic reviews, into actionable messages in the form of short accessible briefings. The service aims to address real-life problems in response to requests from decision-makers. Development of the framework was based on a scoping review of existing resources and our initial experience with two briefing topics, including models of service provision for young people with eating disorders. We also drew on previous experience in dissemination research and practice. Where appropriate, we made use of the SUPporting POlicy relevant Reviews and Trials (SUPPORT tools for evidence-informed policymaking. Findings To produce a product that it is fit for this purpose it has been necessary to go beyond a traditional summary of the available evidence relating to effectiveness. Briefings have, therefore, included consideration of cost effectiveness, local applicability, implications relating to local service delivery, budgets, implementation and equity. Our first evidence briefings produced under this framework cover diagnostic endoscopy by specialist nurses and integrated care pathways in mental healthcare settings. Conclusions The framework will enable researchers to present and contextualize evidence from systematic reviews and other sources of synthesized and quality-assessed evidence. The approach is designed to address the wide range of questions of interest to decision-makers, especially those commissioning services or managing service delivery and organization in primary or secondary care. Evaluation of the use and usefulness of the evidence briefings we produce is an integral part of the framework and will help to fill a gap in the literature.
Laidsaar-Powell, Rebekah; Butow, Phyllis; Charles, Cathy; Gafni, Amiram; Entwistle, Vikki; Epstein, Ronald; Juraskova, Ilona
Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM. Copyright © 2017 Elsevier B.V. All rights reserved.
Iliffe, Steve; Wilcock, Jane; Griffin, Mark; Jain, Priya; Thuné-Boyle, Ingela; Koch, Tamar; Lefford, Frances
The National Dementia Strategy seeks to enhance general practitioners' diagnostic and management skills in dementia. Early diagnosis in dementia within primary care is important as this allows those with dementia and their family care networks to engage with support services and plan for the future. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice. An earlier unblinded, cluster randomised controlled study tested the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. In this original trial, a computer decision support system and practice-based educational workshops were effective in improving rates of detecting dementia although not in changing clinical management. The challenge therefore is to find methods of changing clinical management. Our aim in this new trial is to test a customised educational intervention developed for general practice, promoting both earlier diagnosis and concordance with management guidelines. The customised educational intervention combines practice-based workshops and electronic support material. Its effectiveness will be tested in an unblinded cluster randomised controlled trial with a pre-post intervention design, with two arms; normal care versus the educational intervention. Twenty primary care practices have been recruited with the aim of gaining 200 patient participants. We will examine whether the intervention is effective, pragmatic and feasible within the primary care setting. Our primary outcome measure is an increase in the proportion of patients with dementia who receive at least two dementia-specific management reviews per year. We will also examine important secondary outcomes such as practice concordance with management guidelines and benefits to patients and carers in terms of quality of life and carer strain. The EVIDEM-ED trial builds on the earlier study but the intervention is different in
Chung, Jane; Reeder, Blaine; Lazar, Amanda; Joe, Jonathan; Demiris, George; Thompson, Hilaire J
Sensor technologies are designed to assist independent living of older adults. However, it is often difficult for older adults to make an informed decision about adopting sensor technologies. To explore Bruce's framework of informed decision making (IDM) for in-home use of sensor technologies in community-dwelling elders. The IDM framework guided development of a semi-structured interview. A theory-driven coding approach was used for analysis. Participants supported most of the elements of the framework, but not all aspects of each element were addressed. Perceived usefulness of technologies was identified as an area for framework extension. This paper provides useful information for health care professionals to consider how to enhance IDM of older adults regarding the use of sensor technologies. The results also illuminate elements of the IDM framework that may be critical to facilitating independent living for older adults.
Ricci, Paolo F; Cox, Louis A; MacDonald, Thomas R
Fundamental principles of precaution are legal maxims that ask for preventive actions, perhaps as contingent interim measures while relevant information about causality and harm remains unavailable, to minimize the societal impact of potentially severe or irreversible outcomes. Such principles do not explain how to make choices or how to identify what is protective when incomplete and inconsistent scientific evidence of causation characterizes the potential hazards. Rather, they entrust lower jurisdictions, such as agencies or authorities, to make current decisions while recognizing that future information can contradict the scientific basis that supported the initial decision. After reviewing and synthesizing national and international legal aspects of precautionary principles, this paper addresses the key question: How can society manage potentially severe, irreversible or serious environmental outcomes when variability, uncertainty, and limited causal knowledge characterize their decision-making? A decision-analytic solution is outlined that focuses on risky decisions and accounts for prior states of information and scientific beliefs that can be updated as subsequent information becomes available. As a practical and established approach to causal reasoning and decision-making under risk, inherent to precautionary decision-making, these (Bayesian) methods help decision-makers and stakeholders because they formally account for probabilistic outcomes, new information, and are consistent and replicable. Rational choice of an action from among various alternatives--defined as a choice that makes preferred consequences more likely--requires accounting for costs, benefits and the change in risks associated with each candidate action. Decisions under any form of the precautionary principle reviewed must account for the contingent nature of scientific information, creating a link to the decision-analytic principle of expected value of information (VOI), to show the
Kennedy, Catriona; O'Reilly, Pauline; Fealy, Gerard; Casey, Mary; Brady, Anne-Marie; McNamara, Martin; Prizeman, Geraldine; Rohde, Daniela; Hegarty, Josephine
To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Discussion paper. Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decision-making provides a very public statement about the status of nursing in a given jurisdiction. © 2015 John Wiley & Sons Ltd.
Full Text Available Background Sensor technologies are designed to assist independent living of older adults. However, it is often difficult for older adults to make an informed decision about adopting sensor technologies.Objective To explore Bruce’s framework of informed decision making (IDM for in-home use of sensor technologies in community-dwelling elders.Method The IDM framework guided development of a semi-structured interview. A theory-driven coding approach was used for analysis.Results Participants supported most of the elements of the framework, but not all aspects of each element were addressed. Perceived usefulness of technologies was identified as an area for framework extension.Conclusion This paper provides useful information for health care professionals to consider how to enhance IDM of older adults regarding the use of sensor technologies. The results also illuminate elements of the IDM framework that may be critical to facilitating independent living for older adults.
Bennett, Casey C.; Hauser, Kris
In the modern healthcare system, rapidly expanding costs/complexity, the growing myriad of treatment options, and exploding information streams that often do not effectively reach the front lines hinder the ability to choose optimal treatment decisions over time. The goal in this paper is to develop a general purpose (non-disease-specific) computational/artificial intelligence (AI) framework to address these challenges. This serves two potential functions: 1) a simulation environment for expl...
Bennett, Casey C; Hauser, Kris
In the modern healthcare system, rapidly expanding costs/complexity, the growing myriad of treatment options, and exploding information streams that often do not effectively reach the front lines hinder the ability to choose optimal treatment decisions over time. The goal in this paper is to develop a general purpose (non-disease-specific) computational/artificial intelligence (AI) framework to address these challenges. This framework serves two potential functions: (1) a simulation environment for exploring various healthcare policies, payment methodologies, etc., and (2) the basis for clinical artificial intelligence - an AI that can "think like a doctor". This approach combines Markov decision processes and dynamic decision networks to learn from clinical data and develop complex plans via simulation of alternative sequential decision paths while capturing the sometimes conflicting, sometimes synergistic interactions of various components in the healthcare system. It can operate in partially observable environments (in the case of missing observations or data) by maintaining belief states about patient health status and functions as an online agent that plans and re-plans as actions are performed and new observations are obtained. This framework was evaluated using real patient data from an electronic health record. The results demonstrate the feasibility of this approach; such an AI framework easily outperforms the current treatment-as-usual (TAU) case-rate/fee-for-service models of healthcare. The cost per unit of outcome change (CPUC) was $189 vs. $497 for AI vs. TAU (where lower is considered optimal) - while at the same time the AI approach could obtain a 30-35% increase in patient outcomes. Tweaking certain AI model parameters could further enhance this advantage, obtaining approximately 50% more improvement (outcome change) for roughly half the costs. Given careful design and problem formulation, an AI simulation framework can approximate optimal
Full Text Available Abstract Background The National Dementia Strategy seeks to enhance general practitioners' diagnostic and management skills in dementia. Early diagnosis in dementia within primary care is important as this allows those with dementia and their family care networks to engage with support services and plan for the future. There is, however, evidence that dementia remains under-detected and sub-optimally managed in general practice. An earlier unblinded, cluster randomised controlled study tested the effectiveness of educational interventions in improving detection rates and management of dementia in primary care. In this original trial, a computer decision support system and practice-based educational workshops were effective in improving rates of detecting dementia although not in changing clinical management. The challenge therefore is to find methods of changing clinical management. Our aim in this new trial is to test a customised educational intervention developed for general practice, promoting both earlier diagnosis and concordance with management guidelines. Design/Method The customised educational intervention combines practice-based workshops and electronic support material. Its effectiveness will be tested in an unblinded cluster randomised controlled trial with a pre-post intervention design, with two arms; normal care versus the educational intervention. Twenty primary care practices have been recruited with the aim of gaining 200 patient participants. We will examine whether the intervention is effective, pragmatic and feasible within the primary care setting. Our primary outcome measure is an increase in the proportion of patients with dementia who receive at least two dementia-specific management reviews per year. We will also examine important secondary outcomes such as practice concordance with management guidelines and benefits to patients and carers in terms of quality of life and carer strain. Discussion The EVIDEM-ED trial
Hoover, Mark D; Myers, David S; Cash, Leigh J; Guilmette, Raymond A; Kreyling, Wolfgang G; Oberdörster, Günter; Smith, Rachel; Cassata, James R; Boecker, Bruce B; Grissom, Michael P
The National Council on Radiation Protection and Measurements (NCRP) established NCRP Scientific Committee 2-6 to develop a report on the current state of knowledge and guidance for radiation safety programs involved with nanotechnology. Nanotechnology is the understanding and control of matter at the nanoscale, at dimensions between ∼1 and 100 nm, where unique phenomena enable novel applications. While the full report is in preparation, this paper presents and applies an informatics-based decision-making framework and process through which the radiation protection community can anticipate that nano-enabled applications, processes, nanomaterials, and nanoparticles are likely to become present or are already present in radiation-related activities; recognize specific situations where environmental and worker safety, health, well-being, and productivity may be affected by nano-related activities; evaluate how radiation protection practices may need to be altered to improve protection; control information, interpretations, assumptions, and conclusions to implement scientifically sound decisions and actions; and confirm that desired protection outcomes have been achieved. This generally applicable framework and supporting process can be continuously applied to achieve health and safety at the convergence of nanotechnology and radiation-related activities.
Fabiano, B; Currò, F; Palazzi, E; Pastorino, R
The risk from dangerous goods transport by road and strategies for selecting road load/routes are faced in this paper, by developing an original site-oriented framework of general applicability at local level. A realistic evaluation of the frequency must take into account on one side inherent factors (e.g. tunnels, rail bridges, bend radii, slope, characteristics of neighborhood, etc.) on the other side factors correlated to the traffic conditions (e.g. dangerous goods trucks, etc.). Field data were collected on the selected highway, by systematic investigation, providing input data for a database reporting tendencies and intrinsic parameter/site-oriented statistics. The developed technique was applied to a pilot area, considering both the individual risk and societal risk and making reference to flammable and explosive scenarios. In this way, a risk assessment, sensitive to route features and population exposed, is proposed, so that the overall uncertainties in risk analysis can be lowered.
Fleming, Stephen M; Daw, Nathaniel D
People are often aware of their mistakes, and report levels of confidence in their choices that correlate with objective performance. These metacognitive assessments of decision quality are important for the guidance of behavior, particularly when external feedback is absent or sporadic. However, a computational framework that accounts for both confidence and error detection is lacking. In addition, accounts of dissociations between performance and metacognition have often relied on ad hoc assumptions, precluding a unified account of intact and impaired self-evaluation. Here we present a general Bayesian framework in which self-evaluation is cast as a "second-order" inference on a coupled but distinct decision system, computationally equivalent to inferring the performance of another actor. Second-order computation may ensue whenever there is a separation between internal states supporting decisions and confidence estimates over space and/or time. We contrast second-order computation against simpler first-order models in which the same internal state supports both decisions and confidence estimates. Through simulations we show that second-order computation provides a unified account of different types of self-evaluation often considered in separate literatures, such as confidence and error detection, and generates novel predictions about the contribution of one's own actions to metacognitive judgments. In addition, the model provides insight into why subjects' metacognition may sometimes be better or worse than task performance. We suggest that second-order computation may underpin self-evaluative judgments across a range of domains. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Abramoff, Rose; Harden, Jennifer; Georgiou, Katerina; Tang, Jinyun; Torn, Margaret; Riley, William
In order to plan for responsible soil carbon (C) management, it is important to know how site factors will affect C stabilization. For example, is mineral-associated C vulnerable to climate change, and how do management practices that modify plant inputs affect mineral-associated C? We applied a soil organic carbon (SOC) decomposition model that represents microbial physiology and mineral sorption. The model was able to reproduce large spatial gradients in SOC stocks; model predictions of SOC were highly correlated with SOC observations across an 4000 km transect (R2 > 0.9). We also used a Random Forest algorithm to compare our model predictions with transect data. We applied this model to explore expected changes to SOC across a range of mineral surface properties, mean annual temperature (MAT), and plant input rates. We found that SOC generally increased after plant amendments. Furthermore, the type of amendment (i.e., high vs. low lignin content), soil mineralogy, and climate all affected the sign and magnitude of SOC change over time. In particular, cold sites with low mineral surface availability were most vulnerable to SOC loss, and may benefit most from plant amendments. At all sites, mineral surface saturation reduced the SOC pool's sensitivity to changes in plant inputs. Saturated soils lost a smaller fraction of initial mineral-associated C following warming. We encourage the use of soil carbon models as frameworks to evaluate how particular sites may respond to changes in management and/or climate.
Arts, Josje H E; Hadi, Mackenzie; Irfan, Muhammad-Adeel; Keene, Athena M; Kreiling, Reinhard; Lyon, Delina; Maier, Monika; Michel, Karin; Petry, Thomas; Sauer, Ursula G; Warheit, David; Wiench, Karin; Wohlleben, Wendel; Landsiedel, Robert
The European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) 'Nano Task Force' proposes a Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) that consists of 3 tiers to assign nanomaterials to 4 main groups, to perform sub-grouping within the main groups and to determine and refine specific information needs. The DF4nanoGrouping covers all relevant aspects of a nanomaterial's life cycle and biological pathways, i.e. intrinsic material and system-dependent properties, biopersistence, uptake and biodistribution, cellular and apical toxic effects. Use (including manufacture), release and route of exposure are applied as 'qualifiers' within the DF4nanoGrouping to determine if, e.g. nanomaterials cannot be released from a product matrix, which may justify the waiving of testing. The four main groups encompass (1) soluble nanomaterials, (2) biopersistent high aspect ratio nanomaterials, (3) passive nanomaterials, and (4) active nanomaterials. The DF4nanoGrouping aims to group nanomaterials by their specific mode-of-action that results in an apical toxic effect. This is eventually directed by a nanomaterial's intrinsic properties. However, since the exact correlation of intrinsic material properties and apical toxic effect is not yet established, the DF4nanoGrouping uses the 'functionality' of nanomaterials for grouping rather than relying on intrinsic material properties alone. Such functionalities include system-dependent material properties (such as dissolution rate in biologically relevant media), bio-physical interactions, in vitro effects and release and exposure. The DF4nanoGrouping is a hazard and risk assessment tool that applies modern toxicology and contributes to the sustainable development of nanotechnological products. It ensures that no studies are performed that do not provide crucial data and therefore saves animals and resources. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights
Landsiedel, Robert; Ma-Hock, Lan; Wiench, Karin; Wohlleben, Wendel; Sauer, Ursula G.
As presented at the 2016 TechConnect World Innovation Conference on 22-25 May 2016 in Washington DC, USA, the European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) `Nano Task Force' proposes a Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) consisting of three tiers to assign nanomaterials to four main groups with possible further subgrouping to refine specific information needs. The DF4nanoGrouping covers all relevant aspects of a nanomaterial's life cycle and biological pathways: intrinsic material properties and system-dependent properties (that depend upon the nanomaterial's respective surroundings), biopersistence, uptake and biodistribution, and cellular and apical toxic effects. Use, release, and exposure route may be applied as `qualifiers' to determine if, e.g., nanomaterials cannot be released from products, which may justify waiving of testing. The four main groups encompass (1) soluble, (2) biopersistent high aspect ratio, (3) passive, and (4) active nanomaterials. The DF4nanoGrouping foresees a stepwise evaluation of nanomaterial properties and effects with increasing biological complexity. In case studies covering carbonaceous nanomaterials, metal oxide, and metal sulfate nanomaterials, amorphous silica and organic pigments (all nanomaterials having primary particle sizes below 100 nm), the usefulness of the DF4nanoGrouping for nanomaterial hazard assessment was confirmed. The DF4nanoGrouping facilitates grouping and targeted testing of nanomaterials. It ensures that sufficient data for the risk assessment of a nanomaterial are available, and it fosters the use of non-animal methods. No studies are performed that do not provide crucial data. Thereby, the DF4nanoGrouping serves to save both animals and resources.
Voglmayr, Elisabeth; Widder, Joachim
By means of a case report on a 44-year-old female patient, we show how, with changing personnel and places of care, decisions as well as the kind of decision-making during illness influence the quality of care. The patient was receiving immunosuppressive therapy after kidney transplantation and then suffered from a carcinomatous ovary. At first she refused postoperative chemotherapy, but then returned with a very advanced state of metastatic growth. The lack of continuity, a missing overall interdisciplinary concept of medical case, as well as the failure to document decision processes and the patient's attitude to life and suffering made it difficult for the caring team to accompany her in the last weeks of life. A possible solution to such a complex problem will be the introduction of ethical case deliberation.
Peirson, William; Davey, Erica; Jones, Alan; Hadwen, Wade; Bishop, Keith; Beger, Maria; Capon, Samantha; Fairweather, Peter; Creese, Bob; Smith, Timothy F; Gray, Leigh; Tomlinson, Rodger
Ongoing coastal development and the prospect of severe climate change impacts present pressing estuary management and governance challenges. Robust approaches must recognise the intertwined social and ecological vulnerabilities of estuaries. Here, a new governance and management framework is proposed that recognises the integrated social-ecological systems of estuaries so as to permit transformative adaptation to climate change within these systems. The framework lists stakeholders and identifies estuarine uses and values. Goals are categorised that are specific to ecosystems, private property, public infrastructure, and human communities. Systematic adaptation management strategies are proposed with conceptual examples and associated governance approaches. Contrasting case studies are used to illustrate the practical application of these ideas. The framework will assist estuary managers worldwide to achieve their goals, minimise maladaptative responses, better identify competing interests, reduce stakeholder conflict and exploit opportunities for appropriate ecosystem restoration and sustainable development. Copyright © 2015 Elsevier Ltd. All rights reserved.
Jane, Nancy Yesudhas; Nehemiah, Khanna Harichandran; Arputharaj, Kannan
Clinical time-series data acquired from electronic health records (EHR) are liable to temporal complexities such as irregular observations, missing values and time constrained attributes that make the knowledge discovery process challenging. This paper presents a temporal rough set induced neuro-fuzzy (TRiNF) mining framework that handles these complexities and builds an effective clinical decision-making system. TRiNF provides two functionalities namely temporal data acquisition (TDA) and temporal classification. In TDA, a time-series forecasting model is constructed by adopting an improved double exponential smoothing method. The forecasting model is used in missing value imputation and temporal pattern extraction. The relevant attributes are selected using a temporal pattern based rough set approach. In temporal classification, a classification model is built with the selected attributes using a temporal pattern induced neuro-fuzzy classifier. For experimentation, this work uses two clinical time series dataset of hepatitis and thrombosis patients. The experimental result shows that with the proposed TRiNF framework, there is a significant reduction in the error rate, thereby obtaining the classification accuracy on an average of 92.59% for hepatitis and 91.69% for thrombosis dataset. The obtained classification results prove the efficiency of the proposed framework in terms of its improved classification accuracy.
Fourie, Cornelius Jacobus
Full Text Available In this paper, a life cycle costing (LCC framework for effective maintenance management is investigated and developed for use in a railway rolling stock environment. The framework consists of combining typical mission-critical components together with their failure and maintenance history. All costs related to the operation and maintenance of these components throughout their life cycle are also determined. The next step involves considering different scenarios under which the components can be used in relation to operations, maintenance, and replacements. The decision about which scenario to take is based on the one with the most favourable net present value after life cycle costing is performed over a specified period of time. A typical railway rolling-stock maintenance organisation in South Africa was used to highlight the practical implications of such a framework and how the company could make informed and appropriate decisions. The conclusion of this study is that such a framework is useful, and that it can be used as a basis for estimating LCC across a spectrum of critical assets found in the rolling stock environment.
Full Text Available The Cynefin scheme is a concept of knowledge management, originally devised to support decision making in management, but more generally applicable to situations, in which complexity challenges the quality of insight, prediction, and decision. Despite the fact that life itself, and especially the brain and its diseases, are complex to the extent that complexity could be considered their cardinal feature, complex problems in biomedicine are often treated as if they were actually not more than the complicated sum of solvable sub-problems. Because of the emergent properties of complex contexts this is not correct. With a set of clear criteria Cynefin helps to set apart complex problems from “simple/obvious,” “complicated,” “chaotic,” and “disordered” contexts in order to avoid misinterpreting the relevant causality structures. The distinction comes with the insight, which specific kind of knowledge is possible in each of these categories and what are the consequences for resulting decisions and actions. From student's theses over the publication and grant writing process to research politics, misinterpretation of complexity can have problematic or even dangerous consequences, especially in clinical contexts. Conceptualization of problems within a straightforward reference language like Cynefin improves clarity and stringency within projects and facilitates communication and decision-making about them.
Mendoza P. Sara
Full Text Available Objetivo: Realizar un análisis del Modelo de Toma de Decisiones en Salud de Ottawa, planteado por la enfermera canadiense Annette M. O’Connors, como una estrategia para resolver conflictos decisionales en salud. Se plantea su utilidad en la intervención que hace enfermería en la comunidad y la familia. Se concluye que el conflicto decisional surge frente a la toma de decisiones y los profesionales de la salud deben adoptar un rol protagónico en él, desarrollando habilidades para apoyar a sus pacientes o usuarios en los conflictos que deben enfrentar, teniendo el Modelo de toma de decisiones de Ottawa como un referencial útil para ayudarles, especialmente a las mujeres, a asumir un rol más activo en las decisiones que afectan su propia salud.This article analyses the Ottawa Decision-support Framework proponed by the Canadian nurse Annette M. O´Connors to help strategic decision-making in Health and its usefulness in the nurses´intervention in the family and the community. When conflicting opinions have to be considered before making a decision, the nursing professionals should assume a protagonist part. Therefore they have to develop abilities to support their patients when they face conflicts. The Ottawa Decision Support Framework is a very useful reference to help people, especially women, when they should assume a more active part in decisions that affect their health.
Full Text Available A fundamental concern for the investor community is to identify techniques which would allow them to evaluate and highlight the most probable financial risks that could affect the value of their asset portfolio. Traditional techniques primarily focus on estimating certain conventional social-economic factors and many fail to cover an array of climate change risks. A limited number of institutional documents present, to a somewhat limited extent, some general-defined types of business climate change risks, which are deemed most likely to influence the value of an investors’ portfolio. However, it is crucial that stakeholders of businesses and scholars consider a wider range of information so as to assist investors in their decision making. This paper aims at establishing a new framework to operationalize and quantify an array of business climate change risks to provide more comprehensive and tangible information on non-traditional risks. This framework relies on the benchmarking – scoring systems and Global Reporting Initiative (GRI guidelines, and is applied to various Greek businesses that are certified by Environmental Management and Audit Scheme (EMAS.
Radaelli, Giovanni; Lettieri, Emanuele; Masella, Cristina; Merlino, Luca; Strada, Alberto; Tringali, Michele
This study describes the health technology assessment (HTA) framework introduced by Regione Lombardia to regulate the introduction of new technologies. The study outlines the process and dimensions adopted to prioritize, assess and appraise the requests of new technologies. The HTA framework incorporates and adapts elements from the EUnetHTA Core Model and the EVIDEM framework. It includes dimensions, topics, and issues provided by EUnetHTA Core Model to collect data and process the assessment. Decision making is instead supported by the criteria and Multi-Criteria Decision Analysis technique from the EVIDEM consortium. The HTA framework moves along three process stages: (i) prioritization of requests, (ii) assessment of prioritized technology, (iii) appraisal of technology in support of decision making. Requests received by Regione Lombardia are first prioritized according to their relevance along eight dimensions (e.g., costs, efficiency and efficacy, organizational impact, safety). Evidence about the impacts of the prioritized technologies is then collected following the issues and topics provided by EUnetHTA Core Model. Finally, the Multi-Criteria Decision Analysis technique is used to appraise the novel technology and support Regione Lombardia decision making. The VTS (Valutazione delle Tecnologie Sanitarie) framework has been successfully implemented at the end of 2011. From its inception, twenty-six technologies have been processed.
Shortridge, Julie E; Guikema, Seth D
There is increasing concern over deep uncertainty in the risk analysis field as probabilistic models of uncertainty cannot always be confidently determined or agreed upon for many of our most pressing contemporary risk challenges. This is particularly true in the climate change adaptation field, and has prompted the development of a number of frameworks aiming to characterize system vulnerabilities and identify robust alternatives. One such methodology is robust decision making (RDM), which uses simulation models to assess how strategies perform over many plausible conditions and then identifies and characterizes those where the strategy fails in a process termed scenario discovery. While many of the problems to which RDM has been applied are characterized by multiple objectives, research to date has provided little insight into how treatment of multiple criteria impacts the failure scenarios identified. In this research, we compare different methods for incorporating multiple objectives into the scenario discovery process to evaluate how they impact the resulting failure scenarios. We use the Lake Tana basin in Ethiopia as a case study, where climatic and environmental uncertainties could impact multiple planned water infrastructure projects, and find that failure scenarios may vary depending on the method used to aggregate multiple criteria. Common methods used to convert multiple attributes into a single utility score can obscure connections between failure scenarios and system performance, limiting the information provided to support decision making. Applying scenario discovery over each performance metric separately provides more nuanced information regarding the relative sensitivity of the objectives to different uncertain parameters, leading to clearer insights on measures that could be taken to improve system robustness and areas where additional research might prove useful. © 2016 Society for Risk Analysis.
Angarita, H.; Craven, J.; Caggiano, F.; Corzo, G.
An Integrated approach involving extensive stakeholder dialogue is widely advocated in sustainable water management. However, it requires a social learning process in which scientist and stakeholders become aware of the relationship between their own frames of reference and those of others, differences can be dealt with constructively, and shared ideas can be used to facilitate cooperation. Key obstacles in this process are heritage systems, attitudes and processes, factually wrong, incomplete or unshared mental models, and lack of science-policy dialogue (Pahl-Wostl et al., 2005) To overcome these barriers, a space is required which is free of heritage systems, where mental models can be safely and easily compared and corrected, and where scientists and policy-makers can come together. A "serious game" can serve as such a space - Serious games are games or simulations used to achieve an organizational or educational goal, and such games have already been used to facilitate stakeholder cooperation in the water management sector (Rusca et al., 2005). As well as bringing stakeholders together, they can be an accessible interface between scientific models and non-experts. Here we present SimBasin, a multiplayer serious game framework and development engine. The engine allows to easily create a simulated multiplayer basin management game using WEAP water resources modelling software (SEI, 1992-2015), to facilitate the communication of the complex, long term and wide range relationships between hydrologic, climate, and human systems present in river basins, and enable dialogue between policy-makers and scientists. Different games have been created using the Sim-Basin engine and used in various contexts. Here are discussed experiences with stakeholders at a national forum in Bogotá, flood risk management agencies in the lower Magdalena River Basin in Colombia and with water professionals in Bangkok. The experience shows that the game is a useful tool for enabling
Aldashev, Gani; Kirchsteiger, Georg; Sebald, Alexander Christopher
It is a persistent finding in psychology and experimental economics that people's behavior is not only shaped by outcomes but also by decision-making procedures. In this paper we develop a general framework capable of modelling these procedural concerns. Within the context of psychological games we...
Dunger, Christine; Schnell, Martin W; Bausewein, Claudia
Decision-making (DM) in healthcare can be understood as an interactive process addressing decision makers' reasoning as well as their visible behaviour after the decision is made. Other key elements of DM are ethical aspects and the role as well as the treatment options of the examined professions. Nurses' DM to choose interventions in situations of severe breathlessness is such interactions. They are also ethically relevant regarding the vulnerability of affected patients and possible restrictions or treatment options. The study aims to explore which factors influence nurses' DM to use nursing interventions in situations where patients suffer from severe breathlessness. Qualitative study including nurses in German hospital wards and hospices. A triangulation of different methods of data collection-participant observation and qualitative expert interviews-and analysis merge in a reflexive grounded theory approach which integrates Goffman's framework analysis. It allows an analysis of nurses' self-statements about DM, their behaviour in relevant clinical situations and its influences. Data collection and analysis will be examined simultaneously. Informed consent will be gained from all participants and the institutional stakeholders. Ongoing consent has to be ensured since observations will take place in healthcare institutions and many patients will be highly vulnerable. The study has been evaluated and approved by the Witten/Herdecke University Ethics Committee, Witten, Germany. Results of the study will be published at congresses and in journal papers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Brooks, Alan; Ba-Nguz, Antoinette
Traditionally it has taken years or decades for new public health interventions targeting diseases found in developing countries to be accessible to those most in need. One reason for the delay has been insufficient anticipation of the eventual processes and evidence required for decision making by countries. This paper describes research into the anticipated processes and data needed to inform decision making on malaria vaccines, the most advanced of which is still in phase 3 trials. From 2006 to 2008, a series of country consultations in Africa led to the development of a guide to assist countries in preparing their malaria vaccine decision-making frameworks. The guide builds upon the World Health Organization’s Vaccine Introduction Guidelines. It identifies the processes and data for decisions, when they would be needed relative to the development timelines of the intervention, and where they will come from. Policy development will be supported by data (e.g. malaria disease burden; roles of other malaria interventions; malaria vaccine impact; economic and financial issues; malaria vaccine efficacy, quality and safety) as will implementation decisions (e.g. programmatic issues and socio-cultural environment). This generic guide can now be applied to any future malaria vaccine. The paper discusses the opportunities and challenges to early planning for country decision-making—from the potential for timely, evidence-informed decisions to the risks of over-promising around an intervention still under development. Careful and well-structured planning by countries is an important way to ensure that new interventions do not remain unused for years or decades after they become available. PMID:22513733
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 ...
This research addresses a management of end-of-life (EOL) electronic products within the boundary of Environmentally Benign Manufacturing (EBM). For the comprehensive evaluation of EOL electronic products, existing recycling programs, the roles of each stakeholder in e-waste recycling, and technologies are identified. The results show that to increase the recycling rate a steady supply of collected materials is needed, as well as effective sorting techniques, proper incorporation of Design for the Environment in early product design, and valued secondary markets for recycled goods. Technical cost modeling (TCM) results provide guidance to the recycling industry on how to maximize revenue and ensure the robust economic viability of e-waste Materials Recycling Facilities. Revenue sources with higher profit-efficiency ratios are an example. Also, process automation is demonstrated to be a major hurdle to overcome because of the high labor cost in the recycling industry combined with the randomness factor associated with the input stream. The results of the materials flow analysis (MFA) indicate that the pattern of outflow and the amount do not simply depend on the inflow pattern and amount. Also, the behavior of consumers, especially of the first user, is the most critical factor that determines the outflow of personal computer systems at the EOL stage. The combination of TCM and MFA provide a tool for estimating the infrastructure needed to treat future e-waste, such as the number of treatment facilities and the total capital investment needed. Laws that are designed to minimize the generation of toxic waste and the use of toxic substances in the U.S. and Europe are reviewed. And electronic and electrical industries in California and Massachusetts are analyzed in terms of the generation of toxic waste, the size of these industries. The results of the Analytic Hierarchy Process decision-making study indicate that the current toxic waste treatment methods practiced in
Mahmoodi, Neda; Sargeant, Sally
This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making. Studying breast cancer patients' subjective experiences of adjuvant treatment decision-making provides a broader perspective on patient participatory role preferences and doctor-patient power dynamics within shared decision-making for breast cancer.
van Til, Janine; Groothuis-Oudshoorn, Catharina; Lieferink, Marijke; Dolan, James; Goetghebeur, Mireille
There is an increased interest in the use of multi-criteria decision analysis (MCDA) to support regulatory and reimbursement decision making. The EVIDEM framework was developed to provide pragmatic multi-criteria decision support in health care, to estimate the value of healthcare interventions, and to aid in priority-setting. The objectives of this study were to test 1) the influence of different weighting techniques on the overall outcome of an MCDA exercise, 2) the discriminative power in weighting different criteria of such techniques, and 3) whether different techniques result in similar weights in weighting the criteria set proposed by the EVIDEM framework. A sample of 60 Dutch and Canadian students participated in the study. Each student used an online survey to provide weights for 14 criteria with two different techniques: a five-point rating scale and one of the following techniques selected randomly: ranking, point allocation, pairwise comparison and best worst scaling. The results of this study indicate that there is no effect of differences in weights on value estimates at the group level. On an individual level, considerable differences in criteria weights and rank order occur as a result of the weight elicitation method used, and the ability of different techniques to discriminate in criteria importance. Of the five techniques tested, the pair-wise comparison of criteria has the highest ability to discriminate in weights when fourteen criteria are compared. When weights are intended to support group decisions, the choice of elicitation technique has negligible impact on criteria weights and the overall value of an innovation. However, when weights are used to support individual decisions, the choice of elicitation technique influences outcome and studies that use dissimilar techniques cannot be easily compared. Weight elicitation through pairwise comparison of criteria is preferred when taking into account its superior ability to discriminate between
Cooper, R J; Bissell, P; Wingfield, J
Increasing interest in empirical ethics has enhanced understanding of healthcare professionals' ethical problems and attendant decision-making. A four-stage decision-making model involving ethical attention, reasoning, intention and action offers further insights into how more than reasoning alone may contribute to decision-making. To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an under-researched professional group. 23 purposively sampled UK community pharmacists were asked, in semi-structured interviews, to describe ethical problems in their work and how they were resolved. Framework analysis of transcribed interviews utilised the four decision-making stages, together with constant comparative methods and deviant-case analysis. Pharmacists were often inattentive and constructed problems in legal terms. Ethical reasoning was limited, but examples of appeals to consequences, the golden rule, religious faith and common-sense experience emerged. Ethical intention was compromised by frequent concern about legal prosecution. Ethical inaction was common, typified by pharmacists' failure to report healthcare professionals' bad practices, and ethical passivity emerged to describe these negative examples of the four decision-making stages. Pharmacists occasionally described more ethically active decision-making, but this often involved ethical uncertainty. The four decision-making stages are a useful tool in considering how healthcare professionals try to resolve ethical problems in practice. They reveal processes often ignored in normative theories, and their recognition and the emergence of ethical passivity indicates the complexity of decision-making in practice. Ethical passivity may be deleterious to patients' welfare, and concerns emerge about improving pharmacists' ethical training and promoting ethical awareness and responsibility.
Chang, Luke J; Sanfey, Alan G
Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.
and Asa P. Smith (eds.), Image and Reality in World Politics, Columbia University Press, New York, 1967. Festinger , Leon , A Theo of Cognitive...University, 1956. Trotsky, Leon , "The Revolution Betrayed," in Samuel Hendel (ed.), The Soviet Crucible: The Soviet Government in Theory and Practice, D. Van
Full Text Available Abstract Background Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. Methods Thirty-six participants met for two days. Results Participants suggested ways to improve an environmental scan that had inventoried 53 shared decision-making training programs from 14 countries. Their proposed research agenda included reaching an international consensus on shared decision-making competencies and creating a framework for accrediting continuing professional development initiatives in shared decision-making. Conclusions Variability in shared decision-making training programs showcases the need for quality assurance frameworks.
Nibbelink, Christine W; Brewer, Barbara B
Identify and summarize 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. 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 leading 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; organization 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. 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 NDM as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient outcomes. This article is protected by
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.
Cristina C B Cavalcante
Full Text Available History matching is the process of modifying the uncertain attributes of a reservoir model to reproduce the real reservoir performance. It is a classical reservoir engineering problem and plays an important role in reservoir management since the resulting models are used to support decisions in other tasks such as economic analysis and production strategy. This work introduces a dynamic decision-making optimization framework for history matching problems in which new models are generated based on, and guided by, the dynamic analysis of the data of available solutions. The optimization framework follows a 'learning-from-data' approach, and includes two optimizer components that use machine learning techniques, such as unsupervised learning and statistical analysis, to uncover patterns of input attributes that lead to good output responses. These patterns are used to support the decision-making process while generating new, and better, history matched solutions. The proposed framework is applied to a benchmark model (UNISIM-I-H based on the Namorado field in Brazil. Results show the potential the dynamic decision-making optimization framework has for improving the quality of history matching solutions using a substantial smaller number of simulations when compared with a previous work on the same benchmark.
Pamela J. Jakes; Thomas E. Fish
Public land managers are searching for frameworks for organizing and displaying social information that will make it useful in forest management and decisionmaking. On the Chequamegon-Nicolet National Forests in Wisconsin, managers and researchers have used the concept of functional communities to develop such a framework. Functional communities define geographic areas...
ASPECTS OF ORGANIZATION THEORY ARE REVIEWED ANALYTICALLY TO DEVELOP THE IMPLICATIONS OF THREE MAJOR HYPOTHESES DEFINING THE RELATIONSHIP OF BUREAUS AND BUREAUCRATIC OFFICIALS TO THE DECISIONMAKING PROCESS IN A REALISTIC WORLD WHERE INFORMATION IS COSTLY AND UNCERTAINTY IS AN IMPORTANT FACTOR IN MAKING DECISIONS--(1) BUREAUCRATIC OFFICIALS SEEK TO…
Meer, van Floor; Charbonnier, Lisette; Smeets, Paul A.M.
Food decisions determine energy intake. Since overconsumption is the main driver of obesity, the effects of weight status on food decision-making are of increasing interest. An additional factor of interest is age, given the rise in childhood obesity, weight gain with aging, and the increased
Gutierrez-Alcaraz, G. [Programa de Graduados e Investigacion en Ingenieria Electrica. Departamento de Ingenieria Electrica y Electronica, Instituto Tecnologico de Morelia. Av. Tecnologico 1500, Col. Lomas de Santiaguito 58120. Morelia, Mich. (Mexico); Sheble, Gerald B. [INESC Porto, Faculdade de Engenharia, Universidade do Porto, Campus da FEUP, Rua Dr. Roberto Frias, 4200-465 Porto (Portugal)
This paper proposes four decision-making procedures to be employed by electric generating companies as part of their bidding strategies when competing in an oligopolistic market: naive, forward, adaptive, and moving average expectations. Decision-making is formulated in a dynamic framework by using linear control theory. The results reveal that interactions among all GENCOs affect market dynamics. Several numerical examples are reported, and conclusions are presented. (author)
A framework using concepts from systems theory, theories of power, and the garbage can model of decision-making was developed for the purpose of teaching aspiring school administrators to analyze situations using a political lens. The framework is demonstrated in an analysis of the process that led to Ohio's establishing a school facilities…
Hartley, Catherine A.; Phelps, Elizabeth A.
While the everyday decision-making of clinically anxious individuals is clearly influenced by their excessive fear and worry, the relationship between anxiety and decision-making remains relatively unexplored in neuroeconomic studies. In this review, we attempt to explore the role of anxiety in decision-making using a neuroeconomic approach. We first review the neural systems mediating fear and anxiety, which overlap with a network of brain regions implicated in studies of economic decision-m...
Schwenk-Ferrero, A.; Andrianov, A.
The paper proposes a multicriteria decision analysis (MCDA) framework for a comparative evaluation of nuclear waste management strategies taking into account different local perspectives (expert and stakeholder opinions). Of note, a novel approach is taken using a multiple-criteria formulation that is methodologically adapted to tackle various conflicting criteria and a large number of expert/stakeholder groups involved in the decision-making process. The purpose is to develop a framework and...
Full Text Available An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the well-studied stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.
Kert, Serhat Bahadir; Uz, Cigdem; Gecu, Zeynep
This study examined the effectiveness of an electronic performance support system (EPSS) on computer ethics education and the ethical decision-making processes. There were five different phases to this ten month study: (1) Writing computer ethics scenarios, (2) Designing a decision-making framework (3) Developing EPSS software (4) Using EPSS in a…
Reuman, David A.; And Others
Conceptualizing classroom decision-making within the framework of person-environment fit, it is hypothesized that students will report fewer decision-making opportunities than they think they should have in math classrooms, and that congruence on these "can decide" and "should decide" dimensions will be positively related to…
Jackson, Simon A.; Kleitman, Sabina
Decision-making is a complex process that is largely studied from an experimental perspective or in specific organizational contexts. As such, no generalizable framework exists with which to study decision-making from an individual differences perspective for predictive/selection purposes. By generalising a context-specific decision model proposed…
This study was aimed at discovering what elite coaches perceive to be the critical characteristics of decision-making that distinguish expert players from novices in basketball. A qualitative method of inquiry (the long interview) was followed. The data were gathered during interviews with five elite coaches. A framework to ...
Provides a theoretical overview of decision-making models which are applicable to libraries; presents a framework for comparing the rational, political bargaining, and garbage can models; describes a case study that applied the models to a decision regarding an academic library governance system; and discusses strategies for library managers for…
a manager is being influenced by deputies. This paper argues that these problems can be analyzed as decision-making in a hierarchy using a common-agency framework. The main result is that even when the influential parties act simultaneously and the strategy sets are discrete, solutions to such decision...
By means of a panel discussion and extensive audience interaction, explore the current challenges and progress to date in applying risk considerations to decisionmaking related to low-level waste. This topic is especially timely because of the proposed legislation pertaining to risk-based decisionmaking and because of the increased emphasis placed on radiological performance assessments of low-level waste disposal.
Hartley, Catherine A; Phelps, Elizabeth A
Although the everyday decision-making of clinically anxious individuals is clearly influenced by their excessive fear and worry, the relationship between anxiety and decision-making remains relatively unexplored in neuroeconomic studies. In this review, we attempt to explore the role of anxiety in decision-making with a neuroeconomic approach. We first review the neural systems mediating fear and anxiety, which overlap with a network of brain regions implicated in studies of economic decision-making. We then discuss the potential influence of cognitive biases associated with anxiety upon economic choice, focusing on a set of decision-making biases involving choice in the face of potential aversive outcomes. We propose that the neural circuitry supporting fear learning and regulation may mediate the influence of anxiety upon choice and suggest that techniques for altering fear and anxiety may also change decisions. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Czaczkes, Tomer J; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen
Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
de Jong, Gjalt; Van Vo, Dut; Marek, Philipp
We studied an underrepresented area in the international business (IB) literature: the effect of country context distance on the distribution of decision-making autonomy across headquarters and foreign affiliates. Foreign affiliates directly contribute to the competitive advantages of multinational...... enterprises, highlighting the importance of such intra-firm collaboration. The division of decision-making autonomy is a core issue in the management of headquarters–subsidiary relationships. The main contribution of our paper is that we confront two valid theoretical frameworks – business network theory...
B. Wierenga (Berend)
textabstractWhile a whole range of factors influences the outcomes of a marketing policy, it is managerial decision-making that can really make a difference. A clearer understanding of how marketers make decisions should therefore improve their quality.
Zafeiris, Anna; Koman, Zsombor; Mones, Enys; Vicsek, Tamás
An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem - but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present empirical results obtained by using a large-scale database of citations being in good agreement with the above theory. The framework we have developed can easily be adapted to a variety of realistic situations since taking into account the weights of the sub-problems, the opinions or the relations of the group is straightforward. Consequently, our method can be used in several contexts, especially when the optimal composition of a group of decision-makers is designed.
Culbreth, Adam J; Westbrook, Andrew; Daw, Nathaniel D; Botvinick, Matthew; Barch, Deanna M
Individuals with schizophrenia have a diminished ability to use reward history to adaptively guide behavior. However, tasks traditionally used to assess such deficits often rely on multiple cognitive and neural processes, leaving etiology unresolved. In the current study, we adopted recent computational formalisms of reinforcement learning to distinguish between model-based and model-free decision-making in hopes of specifying mechanisms associated with reinforcement-learning dysfunction in schizophrenia. Under this framework, decision-making is model-free to the extent that it relies solely on prior reward history, and model-based if it relies on prospective information such as motivational state, future consequences, and the likelihood of obtaining various outcomes. Model-based and model-free decision-making was assessed in 33 schizophrenia patients and 30 controls using a 2-stage 2-alternative forced choice task previously demonstrated to discern individual differences in reliance on the 2 forms of reinforcement-learning. We show that, compared with controls, schizophrenia patients demonstrate decreased reliance on model-based decision-making. Further, parameter estimates of model-based behavior correlate positively with IQ and working memory measures, suggesting that model-based deficits seen in schizophrenia may be partially explained by higher-order cognitive deficits. These findings demonstrate specific reinforcement-learning and decision-making deficits and thereby provide valuable insights for understanding disordered behavior in schizophrenia. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Martínez-Martínez, Ismael; Sánchez-Burillo, Eduardo
Recent experiments report violations of the classical law of total probability and incompatibility of certain mental representations when humans process and react to information. Evidence shows promise of a more general quantum theory providing a better explanation of the dynamics and structure of real decision-making processes than classical probability theory. Inspired by this, we show how the behavioral choice-probabilities can arise as the unique stationary distribution of quantum stochastic walkers on the classical network defined from Luce’s response probabilities. This work is relevant because (i) we provide a very general framework integrating the positive characteristics of both quantum and classical approaches previously in confrontation, and (ii) we define a cognitive network which can be used to bring other connectivist approaches to decision-making into the quantum stochastic realm. We model the decision-maker as an open system in contact with her surrounding environment, and the time-length of the decision-making process reveals to be also a measure of the process’ degree of interplay between the unitary and irreversible dynamics. Implementing quantum coherence on classical networks may be a door to better integrate human-like reasoning biases in stochastic models for decision-making.
Decision-making under risk has been variably characterized and examined in many different disciplines. However, interdisciplinary integration has not been forthcoming. Classic theories of decision-making have not been amply revised in light of greater empirical data on actual patterns of decision-making behavior. Furthermore, the meta-theoretical framework of evolution by natural selection has been largely ignored in theories of decision-making under risk in the human behavioral sciences. In this review, I critically examine four of the most influential theories of decision-making from economics, psychology, and biology: expected utility theory, prospect theory, risk-sensitivity theory, and heuristic approaches. I focus especially on risk-sensitivity theory, which offers a framework for understanding decision-making under risk that explicitly involves evolutionary considerations. I also review robust empirical evidence for individual differences and environmental/situational factors that predict actual risky decision-making that any general theory must account for. Finally, I offer steps toward integrating various theoretical perspectives and empirical findings on risky decision-making. © 2014 by the Society for Personality and Social Psychology, Inc.
Paulus, Martin P; Yu, Angela J
Emotion processing and decision-making are integral aspects of daily life. However, our understanding of the interaction between these constructs is limited. In this review, we summarize theoretical approaches that link emotion and decision-making, and focus on research with anxious or depressed individuals to show how emotions can interfere with decision-making. We integrate the emotional framework based on valence and arousal with a Bayesian approach to decision-making in terms of probability and value processing. We discuss how studies of individuals with emotional dysfunctions provide evidence that alterations of decision-making can be viewed in terms of altered probability and value computation. We argue that the probabilistic representation of belief states in the context of partially observable Markov decision processes provides a useful approach to examine alterations in probability and value representation in individuals with anxiety and depression, and outline the broader implications of this approach. Copyright © 2012. Published by Elsevier Ltd.
Andrea Ceschi; Evangelia Demerouti; Riccardo Sartori; Joshua Weller
.... 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...
Fraher, Amy; Grint, Keith
This article expands organization theory about Wicked, Tame, and Critical problems and their associated decision-making styles, Leadership, Management, and Command, by offering a framework that spans across all three which we call ‘Agonistic Governance’: an approach to decision-making that is premised on the acceptance that complexity generates paradoxes and contradictions and, to be successful, organizational actors must have the agency to positively embrace these, rather than try to elimina...
Wolgast, Kelly A
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...
Full Text Available The article shows the stages of development of the theory and practice of decision-making. Emphasis is placed on the contemporary culture of decision-making. At the base of the current trends is the transition from intuition and experience in decision-making to analytics. Modern business intelligence means the development of the culture of work with big data.
The article shows the stages of development of the theory and practice of decision-making. Emphasis is placed on the contemporary culture of decision-making. At the base of the current trends is the transition from intuition and experience in decision-making to analytics. Modern business intelligence means the development of the culture of work with big data.
Decision-making during pregnancy can be ethically complex. This paper offers a framework for maternal decision-making and clinical counseling that can be used to approach such decisions in a systematic way. Three fundamental questions are addressed: (1) Who should make decisions? (2) How should decisions be made? and (3) What is the role of the clinician? The proposed framework emphasizes the decisional authority of the pregnant woman. It draws ethical support from the concept of a good parent and the requirements of parental obligations. It also describes appropriate counseling methods for clinicians in light of those parental obligations. Finally, the paper addresses how cultural differences may shape the framework's guidance of maternal decision-making during pregnancy. Copyright © 2017. Published by Elsevier Ltd.
Weeks, Laura; Balneaves, Lynda G; Paterson, Charlotte; Verhoef, Marja
Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decision-making by patients with cancer within the context of treatment, survivorship, and palliation. We also aimed to summarize emergent concepts within a preliminary conceptual framework. We conducted an integrative literature review, searching 12 electronic databases for articles published in English that described studies of the process, context, or outcomes of CAM-related decision-making. We summarized descriptive data using frequencies and used a descriptive constant comparative method to analyze statements about original qualitative results, with the goal of identifying distinct concepts pertaining to CAM-related decision-making by patients with cancer and the relationships among these concepts. Of 425 articles initially identified, 35 met our inclusion criteria. Seven unique concepts related to CAM and cancer decision-making emerged: decision-making phases, information-seeking and evaluation, decision-making roles, beliefs, contextual factors, decision-making outcomes, and the relationship between CAM and conventional medical decision-making. CAM decision-making begins with the diagnosis of cancer and encompasses 3 distinct phases (early, mid, and late), each marked by unique aims for CAM treatment and distinct patterns of information-seeking and evaluation. Phase transitions correspond to changes in health status or other milestones within the cancer trajectory. An emergent conceptual framework illustrating relationships among the 7 central concepts is presented. CAM-related decision-making by patients with cancer occurs as a nonlinear, complex
A decision framework was developed for context-sensitive planning within the roadside ROW in : Michigan. This framework provides a roadside suitability assessment model that may be used to : support integrated decision-making and policy level conside...
Bangert, Daniel; Schubert, Emery; Fabian, Dorottya
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.
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.
This report presents a three-tiered framework to integrate data, information, and decision-making in highway projects. The study uses the Jurans Triple Role concept and context graph to illustrate the relationship between data, information, and de...
Full Text Available The paper proposes a multicriteria decision analysis (MCDA framework for a comparative evaluation of nuclear waste management strategies taking into account different local perspectives (expert and stakeholder opinions. Of note, a novel approach is taken using a multiple-criteria formulation that is methodologically adapted to tackle various conflicting criteria and a large number of expert/stakeholder groups involved in the decision-making process. The purpose is to develop a framework and to show its application to qualitative comparison and ranking of options in a hypothetical case of three waste management alternatives: interim storage at and/or away from the reactor site for the next 100 years, interim decay storage followed in midterm by disposal in a national repository, and disposal in a multinational repository. Additionally, major aspects of a decision-making aid are identified and discussed in separate paper sections dedicated to application context, decision supporting process, in particular problem structuring, objective hierarchy, performance evaluation modeling, sensitivity/robustness analyses, and interpretation of results (practical impact. The aim of the paper is to demonstrate the application of the MCDA framework developed to a generic hypothetical case and indicate how MCDA could support a decision on nuclear waste management policies in a “small” newcomer country embarking on nuclear technology in the future.
Greenstein, J. S.; Rouse, W. B.
It is proposed that human decisionmaking performance in multiple process monitoring situations can be modeled in terms of the detection of process related events and the allocation of attention among processes once events are felt to have occurred. An elementary pattern recognition technique, discriminant analysis, is used to generate estimates of event occurrence probability. A queueing theory framework is then utilized to incorporate these probabilities as well as other task characteristics into the solution of the attention allocation problem. The performance of the model is compared with that of subjects in two experiments.
a manager is being influenced by deputies. This paper argues that these problems can be analyzed as decision-making in a hierarchy using a common-agency framework. The main result is that even when the influential parties act simultaneously and the strategy sets are discrete, solutions to such decision......A characteristic set of decision problems is given when an authority has to choose between a finite number of alternatives and is being influenced by a number of parties. For instance, the location of a firm when local authorities are competing for being the host, various types of lobbyism, or when...... problems as pure-strategy equilibria exist....
Astbury, Ruth; Shepherd, Ashley; Cheyne, Helen
To explore the processes that support shared decision-making when health visitors and parents are creating plans to improve the well-being of babies and children. Worldwide, there is a focus on promoting children's well-being to enhance the population health. Within the United Kingdom, health visitors have a key responsibility for working in partnership with parents to support this agenda. Despite evidence that the application of 'shared decision-making' frameworks can increase patient participation, improve patient satisfaction and improve health outcomes, there is limited research linking shared decision-making with health visitor practice. A qualitative, descriptive study. The study was undertaken in two phases: in Phase 1, data were collected by audio recording two health visitor-parent decision-making conversations, in the absence of the researcher, where decisions around planning for a baby or child were being made as part of usual care, and then the participants' experiences were sought through individual questionnaires. In Phase 2, semistructured interviews were conducted with nine health visitors and nine parents in relation to their recent experiences of planning care. Evidence of supportive processes included having a shared understanding around the issue needing to be addressed; being able to identify interventions that were accessible for the family; engaging in decision-making through deep, meaningful conversations using sensitive and responsive approaches; and establishing positive relationships between health visitors and parents, significant others within the family and other professionals. Despite evidence of strong, trusting relationships between parents and health visitors, there were times when shared decision-making was unable to take place due to the absence of supportive processes. Health visitors are aware that planning interventions with parents can be complex. These findings indicate the value of using a shared decision-making framework
Zavadskas, Edmundas Kazimieras; Govindan, K.; Antucheviciene, Jurgita
Formal decision-making methods can be used to help improve the overall sustainability of industries and organisations. Recently, there has been a great proliferation of works aggregating sustainability criteria by using diverse multiple criteria decision-making (MCDM) techniques. A number of review...... the advantages of hybrid approaches over individual methods, and we conclude that they can assist decision-makers in handling information such as stakeholders' preferences, interconnected or contradictory criteria, and uncertain environments. The main contribution of this work is identifying hybrid approaches...... as improvements for decision-making related to sustainability issues, while also promoting future application of the approaches....
..., this article offers material on some important issues - in the context of forensic psychology - such as ethical decision-making and principles, professional ethics, the regulation of psychology...
This dissertation presents an evaluation of the democratic qualities of decision-making processes for large transport infrastructure projects in two Scandinavian countries: Denmark and Sweden. The study uncovers criteria from aggregative and deliberative theories of democracy to create a qualitat......This dissertation presents an evaluation of the democratic qualities of decision-making processes for large transport infrastructure projects in two Scandinavian countries: Denmark and Sweden. The study uncovers criteria from aggregative and deliberative theories of democracy to create...... concerns into those decisions. Four central normative areas define the framework created for this evaluation: a) fulfilment of procedural obligations during the process; b) development of public debate; c) influence achieved or attempted during the decision-making process; d) existence and reproduction...... of institutional arrangements for expression of political will. The opportunities that non-state actors have to bring into question specific decisions of the state are analysed through the concept of institutional space. Different kinds of data are used; interviews with key actors, analysis of documents...
Cherkowski, Sabre; Walker, Keith D.; Kutsyuruba, Benjamin
This descriptive study provides a rich portrait of moral agency and ethical decision-making processes among a sample of Canadian school principals. Using an ethical responsibility framework linking moral agency and transformational leadership, the researchers found that (1) modeling moral agency is important for encouraging others to engage their…
H. Dean Claxton; Giuseppe Rensi
An analytical procedure to help management decision-making in planning government research is described. The objectives, activities, and restrictions of a government research organization are modeled in a consistent analytical framework. Theory and methodology is drawn from economics and mathe-matical programing. The major analytical aspects distinguishing research...
Briscoe, Felecia M.
Using a critical postmodern framework, this article analyzes the relationship of the decision-making processes of anarchism and neoliberalism to that of deep democracy. Anarchist processes are found to share common core principals with deep democracy; but neoliberal processes are found to be antithetical to deep democracy. To increase the joy in…
experiments and directly compare normalized value coding and existing economic choice models (e.g. the multinomial logit model ). Importantly, this...existing economic choice models (e.g. the multinomial logit model ). Importantly, this theoretical framework provides a means to estimate normalization...1) characterize the effect of normalization in value circuits using computational models of decision-making, 2) examine whether human decision
McGinnis, J. Randy; And Others
The purpose of this study was to describe and interpret teacher decision-making with ethnically diverse students. A new paradigmatic theoretical framework formed through the confluence of constructivism, multiculturalism, the teacher-as-decision-maker, and semiology guided the research. The research site was a suburban middle school located in the…
Kelly, B D
Ireland's Assisted Decision-Making (Capacity) Bill (2013) aims to reform the law relating to persons who require assistance exercising their decision-making capacity. When finalised, the Bill will replace Ireland's outdated Ward of Court system which has an all-or-nothing approach to capacity; does not adequately define capacity; is poorly responsive to change; makes unwieldy provision for appointing decision-makers; and has insufficient provision for review. To explore the content and implications of the Assisted Decision-Making (Capacity) Bill. Review of the content of the Assisted Decision-Making (Capacity) Bill and related literature. The new Bill includes a presumption of capacity and defines lack of capacity. All interventions must minimise restriction of rights and freedom, and have due regard for "dignity, bodily integrity, privacy and autonomy". The Bill proposes legal frameworks for "assisted decision-making" (where an individual voluntarily appoints someone to assist with specific decisions relating to personal welfare or property and affairs, by, among other measures, assisting the individual to communicate his or her "will and preferences"); "co-decision-making" (where the Circuit Court declares the individual's capacity is reduced but he or she can make specific decisions with a co-decision-maker to share authority); "decision-making representatives" (substitute decision-making); "enduring power of attorney"; and "informal decision-making on personal welfare matters" (without apparent oversight). These measures, if implemented, will shift Ireland's capacity laws away from an approach based on "best interests" to one based on "will and preferences", and increase compliance with the United Nations' Convention on the Rights of Persons with Disabilities.
Full Text Available (INTJ) on the Myers-Briggs personality type indicators, and who then proceeded to explain their decision-making behaviour in the light of this. The Recognition-Primed Decision Model was supported in the sense that decision-making was seen by DM2, DM3...
Kamari, Aliakbar; Corrao, Rossella; Kirkegaard, Poul Henning
An overview of recent research related to building renovation has revealed that efforts to date do not address sustainability issues comprehensively. The question then arises in regard to the holistic sustainability objectives within building renovation context. In order to deal with this question...... sustainability objectives have been collected and structured, and subsequently verified using a Delphi study. A sustainability framework was developed in cooperation with University of Palermo and Aarhus University to audit, develop and assess building renovation performance, and support decision-making during...... the project’s lifecycle. The paper represents the results of research aiming at addressing sustainability of the entire renovation effort including new categories, criteria, and indicators. The developed framework can be applied during different project stages and to assist in the consideration...
Full Text Available Traditional theories of decision-making assume that utilities are based on the intrinsic value of outcomes; in turn, these values depend on associations between expected outcomes and the current motivational state of the decision-maker. This view disregards the fact that humans (and possibly other animals have prospection abilities, which permit anticipating future mental processes and motivational and emotional states. For instance, we can evaluate future outcomes in light of the motivational state we expect to have when the outcome is collected, not (only when we make a decision. Consequently, we can plan for the future and choose to store food to be consumed when we expect to be hungrier, not immediately. Furthermore, similarly to any expected outcome, we can assign a a value to our anticipated mental processes and emotions. It has been reported that (in some circumstances human subjects prefer to receive an unavoidable punishment immediately, probably because they are anticipating the dread associated with the time spent waiting for the punishment. This article offers a formal framework to guide neuroeconomic research on how prospection affects decision-making. The model has two characteristics. First, it uses model-based Bayesian inference to describe anticipation of cognitive and motivational processes. Second, the utility maximization process considers these anticipations in two ways: to evaluate outcomes (e.g., the pleasure of eating a pie is evaluated differently at the beginning of a dinner, when one is hungry, and at the end of the dinner, when one is satiated, and as outcomes having a value themselves (e.g., the case of dread as a cost of waiting for punishment. By explicitly accounting for the relationship between prospection and value, our model provides a framework to reconcile the utility-maximization approach with psychological phenomena such as planning for the future and dread.
The thesis presents one of the four most popular PHP web frameworks: Laravel, Symfony, CodeIgniter and CakePHP. These frameworks are compared with each other according to the four criteria, which can help with the selection of a framework. These criteria are size of the community, quality of official support, comprehensibility of framework’s documentation and implementation of functionalities in individual frameworks, which are automatic code generation, routing, object-relational mapping and...
This thesis deals with an interesting Czech PHP framework called Nette. The first part of the thesis introduces the reader to general ideas, design patterns used in Nette and also describes the main properties of the framework. Goal of the second part is focused on real-life application demonstration of the framework while developing a web application. This thesis is not an instructional material, but helps to explain the main advantages of the framework and can thus offer a more detailed des...
Jensen, Andreas Schmidt; Dignum, Virginia; Villadsen, Jørgen
This short paper introduces and summarizes the AORTA reasoning framework that can be integrated into BDI-agents to enable organizational decision-making. This work has recently been published in the Journal of Autonomous Agents and Multi-Agent Systems (JAAMAS), as ....
Moore, Bethany; Bone, Eric A
The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.
Webb, Colleen T; Ferrari, Matthew; Lindström, Tom; Carpenter, Tim; Dürr, Salome; Garner, Graeme; Jewell, Chris; Stevenson, Mark; Ward, Michael P; Werkman, Marleen; Backer, Jantien; Tildesley, Michael
Epidemiological models in animal health are commonly used as decision-support tools to understand the impact of various control actions on infection spread in susceptible populations. Different models contain different assumptions and parameterizations, and policy decisions might be improved by considering outputs from multiple models. However, a transparent decision-support framework to integrate outputs from multiple models is nascent in epidemiology. Ensemble modelling and structured decision-making integrate the outputs of multiple models, compare policy actions and support policy decision-making. We briefly review the epidemiological application of ensemble modelling and structured decision-making and illustrate the potential of these methods using foot and mouth disease (FMD) models. In case study one, we apply structured decision-making to compare five possible control actions across three FMD models and show which control actions and outbreak costs are robustly supported and which are impacted by model uncertainty. In case study two, we develop a methodology for weighting the outputs of different models and show how different weighting schemes may impact the choice of control action. Using these case studies, we broadly illustrate the potential of ensemble modelling and structured decision-making in epidemiology to provide better information for decision-making and outline necessary development of these methods for their further application. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.
Full Text Available Supported decision-making is at the forefront of modern disability research. This is due to Article 12 of the Convention on the Rights of Persons with Disabilities (CRPD, which creates a state obligation to provide support for the exercise of legal capacity. This turned the practice of supported decision-making into a human rights imperative. Government and funding agencies are increasingly focusing their attention on the area. Researchers are similarly increasing their interest in the field. The impending danger is that the rush of interest in the area will overshadow the original intention of supported decision-making: to ensure that people with cognitive disability are provided with the freedom and the tools to participate as equal citizens and for every individual to be free to direct their own life. This article explores the theoretical foundations of supported decision-making and the evolution of supported decision-making research. It explains the research that is emerging in leading jurisdictions, the United States and Australia, and its potential to transform disability services and laws related to decision-making. Finally, it identifies areas of concern in the direction of such research and provides recommendations for ensuring that supported decision-making remains protective of the rights, will and preferences of people with cognitive disability.
Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Belles, Randy [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Denning, Richard S. [Self Employed
Decision-making is the process of identifying decision alternatives, assessing those alternatives based on predefined metrics, selecting an alternative (i.e., making a decision), and then implementing that alternative. The generation of decisions requires a structured, coherent process, or a decision-making process. The overall objective for this work is that the generalized framework is adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision-making modules that can perform a given set of tasks rationally, consistently, and reliably. Risk-informed decision-making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The probabilistic portion of the decision-making engine of the supervisory control system is based on the control actions associated with an ALMR PRISM. Newly incorporated into the probabilistic models are the prognostic/diagnostic models developed by Pacific Northwest National Laboratory. These allow decisions to incorporate the health of components into the decision–making process. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic portion of the decision-making engine uses thermal-hydraulic modeling and components for an advanced liquid-metal reactor Power Reactor Inherently Safe Module. The deterministic multi
Thanh Tien Nguyen
Full Text Available Although the question of what to teach and how to teach has received much attention from the literature, little was known about the way in which academics in teaching groups make decision on what and how to teach. This paper reports an analysis of variations in the decision-making approach to tertiary teaching through academics’ practices of designing course syllabuses, teaching, and assessing student learning. The study was conducted in three Faculties of business administration of three Higher Education Institutions (HEIs in Vietnam and three different patterns of decision-making approach to tertiary teaching, namely as (i the Given Framework, (ii the Closed Framework, and (iii the Open Framework, were found.
Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona
Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.
Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica
Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth. To increase understanding of decision-making in complex home-like birth settings by exploring midwives' and women's perspectives and to develop a dynamic model integrating participatory processes for making shared decisions. The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births. The central phenomenon that arose from the data was "defining/redefining decision as a joint commitment to healthy childbirth". The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife's decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman's decision, making an informed decision or taking the necessary decision. To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Schovsbo, Jens Hemmingsen; Petersen, Clement Salung
of its institutional design, the UPC will be biased towards technology based values. Therefore, there is a risk that non-technical values and interests will be either overlooked or underdeveloped in UPC decision-making which is likely to jeopardize public trust and legitimacy of its decisions. This paper...... analyses how these blind spots can be covered in patent litigation before the UPC within the current legislative framework. The paper focuses on the role of UPC judges as case-managers and decision-makers, on the potential role of third party interveners, and addresses the key role of the parties...
Lowery, David; Cerga-Pashoja, Arlinda; Iliffe, Steve; Thuné-Boyle, Ingela; Griffin, Mark; Lee, James; Bailey, Alex; Bhattacharya, Rahul; Warner, James
The objective of this study is to evaluate the effectiveness of a simple dyadic (person with dementia and their main carer) exercise regimen as a therapy for the behavioural and psychological symptoms of dementia. A two arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored walking regimen designed to become progressively intensive and last between 20-30 min, at least five times per week).Community-dwelling individuals with ICD-10 confirmed dementia with the following: clinically significant behavioural and psychological symptoms, a carer willing and able to co-participate in the exercise regimen, and no physical conditions or symptoms that would preclude exercise participation were invited by mental health or primary care services into the study. One hundred and thirty-one dyads were recruited to this study. There was no significant difference in Behavioural and Psychological Symptoms as measured by the Neuropsychiatric Inventory at week 12 between the group receiving the dyadic exercise regimen and those that did not (adjusted difference in means (intervention minus control) = -1.53, p = 0.6, 95% CI [-7.37, 4.32]). There was a significant between-group difference in caregiver's burden as measured by the Zarit Caregiver Burden Inventory at week 12 (OR = 0.18, p = 0.01, CI [0.05, 0.69]) favouring the exercise group. This study found that regular simple exercise does not appear to improve the behavioural and psychological symptoms of dementia, but did seem to attenuate caregiver burden. Further study to improve exercise uptake are needed. Copyright © 2013 John Wiley & Sons, Ltd.
Iliffe, Steve; Koch, Tamar; Jain, Priya; Lefford, Frances; Wong, Geoffrey; Warner, Alex; Wilcock, Jane
Dementia syndromes are under-diagnosed and under-treated in primary care. Earlier recognition of and response to dementia syndrome is likely to enhance the quality of life of people with dementia, but general practitioners consistently report limited skills and confidence in diagnosis and management of this condition. Changing clinical practice is difficult, and the challenge for those seeking change it is to find ways of working with the grain of professional knowledge and practice. Assessment of educational needs in a practice has the potential to accommodate variations in individual understanding and competence, learning preferences and skill mix. Educational prescriptions identify questions that need to be answered in order to address a clinical problem. This paper reports the development of an educational needs assessment tool to guide tailored educational interventions designed to enhance early diagnosis and management of dementia in primary care, in the Evidence Based Interventions in Dementia in the Community - Early Diagnosis trial. A multidisciplinary team, including a lay researcher, used an iterative technology development approach to create an educational needs assessment tool, from which educational prescriptions could be written. Workplace learning was tailored to each practice using the educational prescription, and the method was field-tested in five pilot practices. The educational prescriptions appeared acceptable and useful in volunteer practices. The time commitment (no more than four hours, spread out at the practice's discretion) appeared manageable. The pilot group of practices prioritised diagnosis, assessment of carers' needs, quality markers for dementia care in general practice, and the implications of the Mental Capacity Act (2005) for their clinical practice. The content of the educational needs assessment tool seemed to be comprehensive, in that no new topics were identified by practices in the field trial. The educational needs assessment tool took into account practitioners' knowledge of the local health and social care systems, reflected the complexity of the diagnostic and care processes for people with dementia, and acknowledged the complexity of the disease process itself.
Full Text Available Abstract Background Dementia syndromes are under-diagnosed and under-treated in primary care. Earlier recognition of and response to dementia syndrome is likely to enhance the quality of life of people with dementia, but general practitioners consistently report limited skills and confidence in diagnosis and management of this condition. Changing clinical practice is difficult, and the challenge for those seeking change it is to find ways of working with the grain of professional knowledge and practice. Assessment of educational needs in a practice has the potential to accommodate variations in individual understanding and competence, learning preferences and skill mix. Educational prescriptions identify questions that need to be answered in order to address a clinical problem. This paper reports the development of an educational needs assessment tool to guide tailored educational interventions designed to enhance early diagnosis and management of dementia in primary care, in the Evidence Based Interventions in Dementia in the Community – Early Diagnosis trial. Methods A multidisciplinary team, including a lay researcher, used an iterative technology development approach to create an educational needs assessment tool, from which educational prescriptions could be written. Workplace learning was tailored to each practice using the educational prescription, and the method was field-tested in five pilot practices. Results The educational prescriptions appeared acceptable and useful in volunteer practices. The time commitment (no more than four hours, spread out at the practice’s discretion appeared manageable. The pilot group of practices prioritised diagnosis, assessment of carers’ needs, quality markers for dementia care in general practice, and the implications of the Mental Capacity Act (2005 for their clinical practice. The content of the educational needs assessment tool seemed to be comprehensive, in that no new topics were identified by practices in the field trial. Conclusions The educational needs assessment tool took into account practitioners’ knowledge of the local health and social care systems, reflected the complexity of the diagnostic and care processes for people with dementia, and acknowledged the complexity of the disease process itself.
Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt
This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...
Pristed Nielsen, Helene
Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand......Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand...
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
Nesbitt, P.; Kennedy, Q.; Alt, JK; Fricker, RD; Whitaker, L.; Yang, J.; Appleget, JA; Huston, J.; Patton, S
Approved for public release; distribution is unlimited. This research aims to gain insight into optimal wargaming decision-making mechanisms using neurophysiological measures by investigating whether brain activation and visual scan patterns predict attention, perception, and/or decision-making errors through human-in-the-loop wargaming simulation experiments. We investigate whether brain activity and visual scan patterns can explain optimal wargaming decision making and its devel...
Broche-Pérez, Y; Herrera Jiménez, L F; Omar-Martínez, E
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.
Gudmundsson, Henrik; Hall, Ralph P.; Marsden, Greg
This textbook provides an introduction to the concept of sustainability in the context of transportation planning, management, and decision-making. The book is divided into two parts. In the first part, indicators and frameworks for measuring sustainable development in the transportation sector...... are developed. In the second, the authors analyze actual planning and decision-making in transportation agencies in a variety of governance settings. This analysis of real-world case studies demonstrates the benefits and limitations of current approaches to sustainable development in transportation. The book...
Search and Classification Using Multiple Autonomous Vehicles provides a comprehensive study of decision-making strategies for domain search and object classification using multiple autonomous vehicles (MAV) under both deterministic and probabilistic frameworks. It serves as a first discussion of the problem of effective resource allocation using MAV with sensing limitations, i.e., for search and classification missions over large-scale domains, or when there are far more objects to be found and classified than there are autonomous vehicles available. Under such scenarios, search and classification compete for limited sensing resources. This is because search requires vehicle mobility while classification restricts the vehicles to the vicinity of any objects found. The authors develop decision-making strategies to choose between these competing tasks and vehicle-motion-control laws to achieve the proposed management scheme. Deterministic Lyapunov-based, probabilistic Bayesian-based, and risk-based decision-mak...
... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making... § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all relevant... to being prepared at the earliest point in the decision-making process, shall accompany the relevant...
Pedersen, Jens Myrup; Knudsen, Thomas Phillip; Madsen, Ole Brun
An evaluation framework for large-scale network structures is presented, which facilitates evaluations and comparisons of different physical network structures. A number of quantitative and qualitative parameters are presented, and their importance to networks discussed. Choosing a network...... is closed by an example of how the framework can be used. The framework supports network planners in decision-making and researchers in evaluation and development of network structures....
A solid understanding of human decision-making is essential to analyze the complexity of coupled human and natural systems (CHANS) and inform policies to promote resilience in the face of environmental change. Human decisions drive and/or mediate the interactions and feedbacks, and contribute to the heterogeneity and non-linearity that characterize CHANS. However, human decision-making is usually over-simplistically modeled, whereby human agents are represented deterministically either as dumb or clairvoyant decision-makers. Decision-making models fall short in the integration of both environmental and human behavioral drivers, and concerning the latter, tend to focus on only one category, e.g. economic, cultural, or psychological. Furthermore, these models render a linear decision-making process and therefore fail to account for the recursive co-evolutionary dynamics in CHANS. As a result, these models constitute only a weak basis for policy-making. There is therefore scope and an urgent need for better approaches to human decision-making, to produce the knowledge that can inform vulnerability reduction policies in the face of environmental change. This presentation synthesizes the current state-of-the-art of modelling human decision-making in CHANS, with particular reference to agricultural systems, and delineates how the above mentioned shortcomings can be overcome. Through examples from research on pesticide use and adaptation to climate change, both based on the integrative agent-centered framework (Feola and Binder, 2010), the approach for an improved understanding of human agents in CHANS are illustrated. This entails: integrative approach, focus on behavioral dynamics more than states, feedbacks between individual and system levels, and openness to heterogeneity.
Mabel, Hilary; Rose, Susannah L; Kodish, Eric
Decisions about continuing or terminating a pregnancy touch on profound, individualized questions about bodily integrity, reproductive autonomy, deeply held values regarding one's capacity for parenthood, and, in the case of a high-risk pregnancy, the risks one is willing to take to have a baby. So far as possible, reproductive decisions are made between a patient, in some cases her partner, and her medical provider. However, this standard framework cannot be applied if the patient lacks decision-making capacity. In this essay, we discuss one such case that came before our clinical ethics team. We describe the challenges of respecting a patient's reproductive preferences when the patient cannot share what those preferences are, and we argue that decisions regarding reproductive health care should not be treated with exceptionalism. Rather, they should proceed under the normal processes of surrogate decision-making, including the application of substituted judgment. This approach enables us to take the patient's values into account when considering the questions implicated in reproductive health care, just as we do for other kinds of health care decisions in which a patient's deeply held values are salient. © 2017 The Hastings Center.
Cetiner, Sacit M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Flanagan, George F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Fugate, David L. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Kisner, Roger A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
This technical report was generated as a product of the Supervisory Control for Multi-Modular Small Modular Reactor (SMR) Plants project within the Instrumentation, Control and Human-Machine Interface technology area under the Advanced Small Modular Reactor (AdvSMR) Research and Development Program of the US Department of Energy. The report documents the definition of strategies, functional elements, and the structural architecture of a supervisory control system for multi-modular AdvSMR plants. This research activity advances the state of the art by incorporating real-time, probabilistic-based decision-making into the supervisory control system architectural layers through the introduction of a tiered-plant system approach. The report provides background information on the state of the art of automated decision-making, including the description of existing methodologies. It then presents a description of a generalized decision-making framework, upon which the supervisory control decision-making algorithm is based. The probabilistic portion of automated decision-making is demonstrated through a simple hydraulic loop example.
Ceschi, Andrea; Demerouti, Evangelia; Sartori, Riccardo; Weller, Joshua
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. PMID:28529491
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.
Ceschi, Andrea; Demerouti, Evangelia; Sartori, Riccardo; Weller, Joshua
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.
Wade, Katherine; Melamed, Irene; Goldhagen, Jeffrey
This analysis adopts a child rights approach-based on the principles, standards, and norms of child rights and the U.N. Convention on the Rights of the Child (CRC)-to explore how decisions could be made with regard to treatment of a severely impaired infant (Baby G). While a child rights approach does not provide neat answers to ethically complex issues, it does provide a framework for decision-making in which the infant is viewed as an independent rights-holder. The state has obligations to develop the capacity of those who make decisions for infants in such situations to meet their obligations to respect, protect, and fulfill their rights as delineated in the CRC. Furthermore, a child rights approach requires procedural clarity and transparency in decision-making processes. As all rights in the CRC are interdependent and indivisible, all must be considered in the process of ethical decision-making, and the reasons for decisions must be delineated by reference to how these rights were considered. It is also important that decisions that are made in this context be monitored and reviewed to ensure consistency. A rights-based framework ensures decision-making is child-centered and that there are transparent criteria and legitimate procedures for making decisions regarding the child's most basic human right: the right to life, survival, and development.
Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John
Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.
Vetter, Donald P.; And Others
This unit on decision-making and discussion skills is the second of five units in a ninth grade social studies course (course described in SO 010 891). There are two major objectives: (1) given a problem, the student will make value judgments using decision-making skills; and (2) using proper discussion techniques, the student will analyze a…
G.R. Teisman (Geert)
textabstractThis article elaborates on the question how complex decision-making can be analysed. Three conceptual models are compared: the phase model, the stream model and the rounds model. Each model is based on specific assumptions about what decision-making is and how it should be analysed. The
Full Text Available The management models pursued in logistics terminals determine their performance to a great extent. Terminals managed by public actors usually incorporate more social criteria into their decision-making processes. In addition, private management focuses on economic viability of the initiative. Decision-making is a complex process regardless the structure of management or the decision models useddue to the fact that a wide range of diverse criteria are embedded into this process. The objective of this paper it to determine a prioritization of a set of alternative options for investment projects which were suggested by port executives taking into account criteria and evaluation that have already validated by them. In order to perform the analysis a multi-criteria decision-making model was used: the Analytic Hierachy Process. The outcomes support a low-biased and efficient strategic planning through a balanced decision-making framework.
Matusek, Jill Anne; Wright, Margaret O'Dougherty
Ethical dilemmas frequently arise in the treatment of clients with eating disorders, and clinicians regularly encounter an array of ethical challenges related to whether or not overt and covert coercive tactics should be implemented. In this paper, the authors provide an overview of perplexing ethical questions relevant to medical, nutritional and psychological treatment of clients with eating disorders including imposed treatment, enforced feeding, the duty to protect minors and adults, the determination of competence and capacity among medically comprised clients, and the effectiveness of coercive treatment for clients with eating disorders. The processes of ethical decision-making in terms of ethical principles, professional codes of conduct, the existing empirical literature and the use of a decision-making framework are explored. Taking a collaborative and client-sensitive approach, the authors outline and apply an integrative ethical decision-making model to facilitate clinicians' decision-making process. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.
S. P. Giles
Full Text Available Ethical decision-making presupposes the possession of a free will. Central to a discussion on reformed ethics is the question of the bounds of freedom of the will. The reformed tradition, along with the wider Christian tradition, affirms that the will is not free in the Pelagian sense of being absolutely free, but is constrained by the effects of humanity’s fall from original righteousness. This ariticle considers the nature and extent to which the will is considered free, or no longer free at all. The question posed here, within the reformed theoretic ethical framework, is whether the will is so vitiated that a person is in- capable of any effective choice of action or inaction in the face of any moral dilemma, or does fallen humanity still possess some ability to make a free choice, albeit under conditions of impaired freedom of the will?
The volume delivers a wealth of effective methods to deal with various types of uncertainty inherently existing in human-centric decision problems. It elaborates on comprehensive decision frameworks to handle different decision scenarios, which help use effectively the explicit and tacit knowledge and intuition, model perceptions and preferences in a more human-oriented style. The book presents original approaches and delivers new results on fundamentals and applications related to human-centered decision making approaches to business, economics and social systems. Individual chapters cover multi-criteria (multiattribute) decision making, decision making with prospect theory, decision making with incomplete probabilistic information, granular models of decision making and decision making realized with the use of non-additive measures. New emerging decision theories being presented as along with a wide spectrum of ongoing research make the book valuable to all interested in the field of advanced decision-mak...
Full Text Available Abstraction and hierarchical information-processing are hallmarks of human and animal intelligence underlying the unrivaled flexibility of behavior in biological systems. Achieving such a flexibility in artificial systems is challenging, even with more and more computational power. Here we investigate the hypothesis that abstraction and hierarchical information-processing might in fact be the consequence of limitations in information-processing power. In particular, we study an information-theoretic framework of bounded rational decision-making that trades off utility maximization against information-processing costs. We apply the basic principle of this framework to perception-action systems with multiple information-processing nodes and derive bounded optimal solutions. We show how the formation of abstractions and decision-making hierarchies depends on information-processing costs. We illustrate the theoretical ideas with example simulations and conclude by formalizing a mathematically unifying optimization principle that could potentially be extended to more complex systems.
Full Text Available The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to malpractice suits, this article offers material on some important issues – in the context of forensic psychology – such as ethical decision-making and principles, professional ethics, the regulation of psychology as a profession, the Ethical Code of Professional Conduct to which a psychologist should adhere, ethical aspects and issues pertaining to forensic psychology in general, some ethical issues pertaining to child forensic psychology, summary guidelines for ethical decision-making and some steps to follow to ensure sound ethical decisionmaking.
The author proposes a new model for the assessment of decision-making capacity based on the principles of narrative medicine. The narrative method proposed by the author addresses the hidden power realtionships implicit in the current model of capacity assessment. Sample cases are reviewed using the traditional model in comparison with the narrative model. Narrative medicine provides an effective model for the assessment of decision-making capacity. Deficiencies in the traditional model capacity assessment can be effectively addressed using narrative strategies. © 2015 John Wiley & Sons, Ltd.
Indhraratana, Apinya; Kaemkate, Wannee
The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…
Nielsen, Jeppe; Andersen, Kim Normann; Danziger, James N.
Whereas digital technologies are often depicted as being capable of disrupting long-standing power structures and facilitating new governance mechanisms, the power reinforcement framework suggests that information and communications technologies tend to strengthen existing power arrangements within...... public organizations. This article revisits the 30-yearold power reinforcement framework by means of an empirical analysis on the use of mobile technology in a large-scale programme in Danish public sector home care. It explores whether and to what extent administrative management has controlled decision......-making and gained most benefits from mobile technology use, relative to the effects of the technology on the street-level workers who deliver services. Current mobile technology-in-use might be less likely to be power reinforcing because it is far more decentralized and individualized than the mainly expert...
Diaby, Vakaramoko; Goeree, Ron
In recent years, the quest for more comprehensiveness, structure and transparency in reimbursement decision-making in healthcare has prompted the research into alternative decision-making frameworks. In this environment, multi-criteria decision analysis (MCDA) is arising as a valuable tool to support healthcare decision-making. In this paper, we present the main MCDA decision support methods (elementary methods, value-based measurement models, goal programming models and outranking models) using a case study approach. For each family of methods, an example of how an MCDA model would operate in a real decision-making context is presented from a critical perspective, highlighting the parameters setting, the selection of the appropriate evaluation model as well as the role of sensitivity and robustness analyses. This study aims to provide a step-by-step guide on how to use MCDA methods for reimbursement decision-making in healthcare.
Chang, L.J.; Sanfey, A.G.
PURPOSE: Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels
This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…
Hansen, Claus Thorp; Andreasen, Mogens Myrup
. The model is based on four observations: the engineering designers do not see a neat string of distinct and explicitly made decisions, there are several decision-makers during design, a design decision is not made at a distinct moment in time, and the decision object is evolving in time and changing...
Rilling, J.K.; Sanfey, A.G.
Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory
Medicine is incorporating genetic services into all avenues of health-care, ranging from the rarest to the most common diseases. Cognitive theories of decision-making still dominate professionals' understanding of patient decision-making about how to use genetic information and whether to have testing. I discovered a conceptual model of decision-making while carrying out a phenomenological-hermeneutic descriptive study of a convenience sample of 12 couples who were interviewed while deciding whether to undergo prenatal genetic testing. Thirty-two interviews were conducted with 12 men and 12 women separately. Interviews were transcribed verbatim and all data were analyzed using three levels of coding that were sorted into 30 categories and then abstracted into three emergent meta-themes that described men's and women's attempts to make sense and find meaning in how to best use prenatal genetic technology. Their descriptions of how they thought about, communicated, and coped with their decision were so detailed it was possible to discern nine different types of thinking they engaged in while deciding to accept or decline testing. They believed that decision-making is a process of working through your own personal style of thinking. This might include only one or any combination of the following types of thinking: analytical, ethical, moral, reflective, practical, hypothetical, judgmental, scary, and second sight, as described in detail by these 12 couples.
Bleiler-Baxter, Sarah K.; Stephens, D. Christopher; Baxter, Wesley A.; Barlow, Angela T.
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…
This paper suggests an innovative idea of using the "technology fair" as a means for promoting pre-service teachers (university students) decision-making skills. The purpose of the study was to investigate the influence of a procedure of working with primary school children to complete and present a technology fair project, on the decision-making…
The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…
Leliveld, Marijke Christina
This dissertation sheds more light on ethics in economic decision-making. Over the course of nine experiments, I studied (a) when people adhere to ethical standards like the do-no-harm principle, and (b) how people respond to situations in which ethical standards are violated by studying not only
Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.
Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…
Sohl, Terry L; Claggett, Peter R
The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results. Published by Elsevier Ltd.
Sohl, Terry L.; Claggett, Peter R.
The last decade has seen a remarkable increase in the number of modeling tools available to examine future land-use and land-cover (LULC) change. Integrated modeling frameworks, agent-based models, cellular automata approaches, and other modeling techniques have substantially improved the representation of complex LULC systems, with each method using a different strategy to address complexity. However, despite the development of new and better modeling tools, the use of these tools is limited for actual planning, decision-making, or policy-making purposes. LULC modelers have become very adept at creating tools for modeling LULC change, but complicated models and lack of transparency limit their utility for decision-makers. The complicated nature of many LULC models also makes it impractical or even impossible to perform a rigorous analysis of modeling uncertainty. This paper provides a review of land-cover modeling approaches and the issues causes by the complicated nature of models, and provides suggestions to facilitate the increased use of LULC models by decision-makers and other stakeholders. The utility of LULC models themselves can be improved by 1) providing model code and documentation, 2) through the use of scenario frameworks to frame overall uncertainties, 3) improving methods for generalizing key LULC processes most important to stakeholders, and 4) adopting more rigorous standards for validating models and quantifying uncertainty. Communication with decision-makers and other stakeholders can be improved by increasing stakeholder participation in all stages of the modeling process, increasing the transparency of model structure and uncertainties, and developing user-friendly decision-support systems to bridge the link between LULC science and policy. By considering these options, LULC science will be better positioned to support decision-makers and increase real-world application of LULC modeling results.
Jefford, Elaine; Jomeen, Julie; Martin, Colin R
The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general
Daemers, Darie O A; van Limbeek, Evelien B M; Wijnen, Hennie A A; Nieuwenhuijze, Marianne J; de Vries, Raymond G
Although midwives make clinical decisions that have an impact on the health and well-being of mothers and babies, little is known about how they make those decisions. Wide variation in intrapartum decisions to refer women to obstetrician-led care suggests that midwives' decisions are based on more than the evidence based medicine (EBM) model - i.e. clinical evidence, midwife's expertise, and woman's values - alone. With this study we aimed to explore the factors that influence clinical decision-making of midwives who work independently. We used a qualitative approach, conducting in-depth interviews with a purposive sample of 11 Dutch primary care midwives. Data collection took place between May and September 2015. The interviews were semi-structured, using written vignettes to solicit midwives' clinical decision-making processes (Think Aloud method). We performed thematic analysis on the transcripts. We identified five themes that influenced clinical decision-making: the pregnant woman as a whole person, sources of knowledge, the midwife as a whole person, the collaboration between maternity care professionals, and the organisation of care. Regarding the midwife, her decisions were shaped not only by her experience, intuition, and personal circumstances, but also by her attitudes about physiology, woman-centredness, shared decision-making, and collaboration with other professionals. The nature of the local collaboration between maternity care professionals and locally-developed protocols dominated midwives' clinical decision-making. When midwives and obstetricians had different philosophies of care and different practice styles, their collaborative efforts were challenged. Midwives' clinical decision-making is a more varied and complex process than the EBM framework suggests. If midwives are to succeed in their role as promoters and protectors of physiological pregnancy and birth, they need to understand how clinical decisions in a multidisciplinary context are
Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul
To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.
Reasons, methods used and decision-making for pregnancy termination among ... was influenced by socio-economic, educational and personal considerations. ... Conclusion: Relationship issues influence the decision-making process for ...
Lin, Yanxia; Myall, Michelle; Jarrett, Nikki
To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.
Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona
This study qualitatively explored clinicians' views and experiences of treatment decision-making in BPII. Semi-structured interviews were conducted with 20 practising clinicians (n = 10 clinical psychologists, n = 6 GPs, n = 4 psychiatrists) with experience in treating adult outpatients with BPII. Interviews were audiotaped, transcribed verbatim and thematically analysed using framework methods. Professional experience, and preferences for patient involvement in decision-making were also assessed. Qualitative analyses yielded four inter-related themes: (1) (non-)acceptance of diagnosis and treatment; (2) types of decisions; (3) treatment uncertainty and balancing act; and (4) decision-making in consultations. Clinician preferences for treatment, professional experience, and self-reported preferences for patient/family involvement seemed to influence decision-making. This study is the first to explore clinician views and experiences of treatment decision-making in BPII. Findings demonstrate how clinician-related factors may shape treatment decision-making, and suggest potential problems such as patient perceptions of lower-than-preferred involvement.
Nielsen, Mogens; Krukow, Karl Kristian; Sassone, Vladimiro
, the two types of systems are fundamentally making decisions based on information about the past behaviour of an entity. A logical policy-centric framework for such behaviour-based decision-making is presented. In the framework, principals specify policies which state precise requirements on the past......Reputation systems are meta systems that record, aggregate and distribute information about principals' behaviour in distributed applications. Similarly, history-based access control systems make decisions based on programs' past security-sensitive actions. While the applications are distinct...
Kaplan, Raphael; Schuck, Nicolas W; Doeller, Christian F
A growing body of work is investigating the use of mental maps during decision-making. Here we discuss how decision-making organizes experiences according to an internal model of the current task, thereby structuring memory. Likewise, we consider how the structure of mental maps contributes to decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.
Smith, Mitchell R.; Zeuwts, Linus; Lenoir, Matthieu; Hens, Nathalie; De Jong, Laura M. S.; Coutts, Aaron J.
This study aimed to investigate the impact of mental fatigue on soccer-specific decision-making. Twelve well-trained male soccer players performed a soccer-specific decision-making task on two occasions, separated by at least 72 h. The decision-making task was preceded in a randomised order by 30
Alvino, Letizia; Franco, Massimo
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
Individual consumers are subject to different influences on how they make decisions and what decision-making style they use. Consumer decision-making styles are a mental orientation that characterises a consumer's approach to making choices. The main purpose of the study is to explore the decision-making styles of ...
... 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...
O'Connor, Donna; Larkin, Paul; Williams, A. Mark
Background: Decision-making is a key component of performance in sport. However, there has been minimal investigation of how coaches may adapt practice sessions to specifically develop decision-making. Purpose: The aim in this exploratory study was to investigate the pedagogical approaches coaches use to develop decision-making in soccer. Method:…
Pier Luigi Baldi
Full Text Available A brief survey of key literature on emotions and decision-making introduces an empirical study of a group of university students exploring the effects of decision-making complexity on error risk. The results clearly show that decision-making under stress in the experimental group produces significantly more errors than in the stress-free control group.
Quality clinical decision-making in nursing is the essence of quality nursing care delivery. The purpose of this article is to conceptualise a system for quality clinical decision-making in nursing. A system for quality clinical decisionmaking in nursing was conceptualised based on a review of the literature pertaining to clinical ...
Pollard, S; Bansback, N; FitzGerld, J M; Bryan, S
A shared approach to decision-making framework has been suggested for chronic disease management especially where multiple treatment options exist. Shared decision-making (SDM) requires that both physician and patients are actively engaged in the decision-making process, including information exchange; expressing treatment preferences; as well as agreement over the final treatment decision. Although SDM appears well supported by patients, practitioners and policymakers alike, the current challenge is to determine how best to make SDM a reality in everyday clinical practice. Within the context of asthma, adherence rates are poor and are linked to outcomes such as reduced asthma control, increased symptoms, healthcare expenditures, and lower patient quality of life. It has been suggested that SDM can improve treatment adherence and that ignoring patients' personal goals and preferences may result in reduced rates of adherence. Furthermore, understanding predictors of poor treatment adherence is a necessary step toward developing effective strategies to improve the patient-reported and clinically important outcomes. Here, we describe why a shared approach to treatment decision-making for asthma has the potential to be an effective tool for improving adherence, with associated clinical and patient-related outcomes. In addition, we explore insights into the reasons why SDM has not been implemented into routine clinical practice. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Woodhouse, Kristina Demas; Tremont, Katie; Vachani, Anil; Schapira, Marilyn M; Vapiwala, Neha; Simone, Charles B; Berman, Abigail T
Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.
Samsi, Kritika; Manthorpe, Jill
Exercising choice and control over decisions is central to quality of life. The Mental Capacity Act 2005 (England and Wales) provides a legal framework to safeguard the rights of people with dementia to make their own decisions for as long as possible. The impact of this on long-term planning has been investigated; everyday decision-making in people's own homes remains unexplored. Using a phenomenological approach, we interviewed 12 dyads (one person with dementia + one carer) four times over one year to ascertain experience of decision-making, how decisions were negotiated, and how dynamics changed. Qualitative interviews were conducted in people's own homes, and thematic analysis was applied to transcripts. Respecting autonomy, decision-specificity and best interests underlay most everyday decisions in this sample. Over time, dyads transitioned from supported decision-making, where person with dementia and carer made decisions together, to substituted decision-making, where carers took over much decision-making. Points along this continuum represented carers' active involvement in retaining their relative's engagement through providing cues, reducing options, using retrospective information, and using the best interests principle. Long-term spouse carers seemed most equipped to make substitute decisions for their spouses; adult children and friend carers struggled with this. Carers may gradually take on decision-making for people with dementia. This can bring with it added stresses, such as determining their relative's decision-making capacity and weighing up what is in their best interests. Practitioners and support services should provide timely advice to carers and people with dementia around everyday decision-making, and be mindful how abilities may change.
García-Altés, Anna; Argimon, Josep M
Improving the quality and transparency of governmental healthcare decision-making has an impact on the health of the population through policies, organisational management and clinical practice. Moreover, the comparison between healthcare centres and the transparent feedback of results to professionals and to the wider public contribute directly to improved results. The "Results Centre" of the Catalan healthcare system measures and disseminates the results achieved by the different healthcare centres in order to facilitate a shared decision-making process, thereby enhancing the quality of healthcare provided to the population of Catalonia (Spain). This is a pioneering initiative in Spain and is aligned with the most advanced countries in terms of policies of transparency and accountability. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.
Michael Christensen; Thorbjørn Knudsen
Starting from the premise that individuals within an organization are fallible, this paper advances the study of relationships between the organization's decision-making structure and its performance. We offer a general treatment that allows one to analyze the full range of organizational architectures between extreme centralized and decentralized forms (often referred to as hierarchies and polyarchies). Our approach furthermore allows designers to examine the change in the overall reliabilit...
Weller, Joshua A.; Fisher, Philip A.
Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to these behaviors. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as...
Ko, C-H; Wang, P-W; Liu, T-L; Chen, C-S; Yen, C-F; Yen, J-Y
Persistent gaming, despite acknowledgment of its negative consequences, is a major criterion for individuals with Internet gaming disorder (IGD). This study evaluated the adaptive decision-making, risky decision, and decision-making style of individuals with IGD. We recruited 87 individuals with IGD and 87 without IGD (matched controls). All participants underwent an interview based on the Diagnostic and Statistical Manual of Mental Disorders (5th Edition) diagnostic criteria for IGD and completed an adaptive decision-making task; the Preference for Intuition and Deliberation Scale, Chen Internet Addiction Scale, and Barratt Impulsivity Scale were also assessed on the basis of the information from the diagnostic interviews. The results demonstrated that the participants in both groups tend to make more risky choices in advantage trials where their expected value (EV) was more favorable than those of the riskless choice. The tendency to make a risky choice in advantage trials was stronger among IGD group than that among controls. Participants of both groups made more risky choices in the loss domain, a risky option to loss more versus sure loss option, than they did in the gain domain, a risky option to gain more versus sure gain. Furthermore, the participants with IGD made more risky choices in the gain domain than did the controls. Participants with IGD showed higher and lower preferences for intuitive and deliberative decision-making styles, respectively, than controls and their preferences for intuition and deliberation were positively and negatively associated with IGD severity, respectively. These results suggested that individuals with IGD have elevated EV sensitivity for decision-making. However, they demonstrated risky preferences in the gain domain and preferred an intuitive rather than deliberative decision-making style. This might explain why they continue Internet gaming despite negative consequences. Thus, therapists should focus more on decision-making
Naudé, Jérémie; Dongelmans, Malou; Faure, Philippe
Addiction to nicotine is characterized by impulses, urges and lack of self-control towards cigarettes. A key element in the process of addiction is the development of habits oriented towards nicotine consumption that surpass flexible systems as a consequence of a gradual adaptation to chronic drug exposure. However, the long-term effects of nicotine on brain circuits also induce wide changes in decision-making processes, affecting behaviors unrelated to cigarettes. This review aims at providing an update on the implications of nicotine on general decision-making processes, with an emphasis on impulsivity and risk-taking. As impulsivity is a rather ambiguous behavioral trait, we build on economic and normative theories to better characterize these nicotine-induced alterations in decision-making. Nonetheless, experimental data are sparse and often contradictory. We will discuss how the latest findings on the neurobiological basis of choice behavior may help disentangling these issues. We focus on the role of nicotine acetylcholine receptors and their different subunits, and on the spatio-temporal dynamics (i.e. diversity of the neural circuits, short- and long-term effects) of both endogenous acetylcholine and nicotine action. Finally, we try to link these neurobiological results with neuro-computational models of attention, valuation and action, and of the role of acetylcholine in these decision processes. This article is part of the Special Issue entitled 'The Nicotinic Acetylcholine Receptor: From Molecular Biology to Cognition'. Copyright © 2014 Elsevier Ltd. All rights reserved.
Sax, Joanna K
Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.
Perez, Maya; Gati, Itamar
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…
... identify specific decision-making domain typologies as a mechanism to maximise the effectiveness of leadership responses to both opportunities and challenges that emerge during interventions. In this instance the Cynefin framework was used to: (1) provide an indication to the project managers whether the early stages ...
Objectives Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. Methods This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. Results It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. Conclusions To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions. PMID:26618028
Technological advances using telemedicine and telehealth are growing in healthcare fields, but the evaluation framework for them is inconsistent and limited. This paper suggests a comprehensive evaluation framework for telemedicine system implementation and will support related stakeholders' decision-making by promoting general understanding, and resolving arguments and controversies. This study focused on developing a comprehensive evaluation framework by summarizing themes across the range of evaluation techniques and organized foundational evaluation frameworks generally applicable through studies and cases of diverse telemedicine. Evaluation factors related to aspects of information technology; the evaluation of satisfaction of service providers and consumers, cost, quality, and information security are organized using the fishbone diagram. It was not easy to develop a monitoring and evaluation framework for telemedicine since evaluation frameworks for telemedicine are very complex with many potential inputs, activities, outputs, outcomes, and stakeholders. A conceptual framework was developed that incorporates the key dimensions that need to be considered in the evaluation of telehealth implementation for a formal structured approach to the evaluation of a service. The suggested framework consists of six major dimensions and the subsequent branches for each dimension. To implement telemedicine and telehealth services, stakeholders should make decisions based on sufficient evidence in quality and safety measured by the comprehensive evaluation framework. Further work would be valuable in applying more comprehensive evaluations to verify and improve the comprehensive framework across a variety of contexts with more factors and participant group dimensions.
Maloney, Mary Alison; Schwartz, Lisa; O'Reilly, Daria; Levine, Mitchel
Value assessments of marketed drug technologies have been developed through disinvestment frameworks. Components of these frameworks are varied and implementation challenges are prevalent. The objective of this systematic literature review was to describe disinvestment framework process components for drugs and to report on framework components, challenges, and solutions. A systematic literature search was conducted using the terms: reassessment, reallocation, reinvestment, disinvestment, delist, decommission or obsolescence in MEDLINE, EMBASE, NLM PubMed, the Cochrane Library, and CINAHL from January 1, 2000, until November 14, 2015. Additional citations were identified through a gray literature search of Health Technology Assessment international (HTAi) and the International Network of Agencies for Health Technology Assessment (INAHTA) member Web sites and from bibliographies of full-text reviewed manuscripts. Sixty-three articles underwent full text review and forty were included in the qualitative analysis. Framework components including disinvestment terms and definitions, identification and prioritization criteria and methods, assessment processes, stakeholders and dissemination strategies, challenges, and solutions were compiled. This review finds that stakeholders lack the political, administrative, and clinical will to support disinvestment and that there is not one disinvestment framework that is considered best practice. Drug technology disinvestment components and processes vary and challenges are numerous. Future research should focus on lessening value assessment challenges. This could include adopting more neutral framework terminology, setting fixed reassessment timelines, conducting therapeutic reviews, and modifying current qualitative decision-making assessment frameworks.
The aim of the thesis is to introduce reader to the Spring framework and describe it as a convenient tool for rapid application development and launching projects. It is necessary to grab the Spring issue in a broader context. That's why thesis is trying to note all the relevant technologies that are closely related to Spring, or which is Spring based on. The first step to understanding Spring is a basic knowledge of Java EE. Thesis presents the architecture of Java EE while arguing its flaws...
Olhoff, Anne; Olsen, Karen Holm
Energy systems are significantly vulnerable to current climate variability and extreme events. As climate change becomes more pronounced, the risks and vulnerabilities will be exacerbated. To date, energy sector adaptation issues have received very limited attention. In this paper, a climate risk...... management framework is used as the basis for identifying key challenges and opportunities to enhance the integration of climate change adaptation in energy planning and decision-making. Given its importance for raising awareness and for stimulating action by planners and decision-makers, emphasis is placed...... barriers to integration of climate risks and adaptive responses in energy planning and decision making. Both detailed assessments of the costs and benefits of integrating adaptation measures and rougher ‘order of magnitude’ estimates would enhance awareness raising and momentum for action....
Sabre Lynn Cherkowski
Full Text Available This descriptive study provides a rich portrait of moral agency and ethical decision-making processes among a sample of Canadian school principals. Using an ethical responsibility framework linking moral agency and transformational leadership, the researchers found that 1 modeling moral agency is important for encouraging others to engage their own moral agency in the best interests of all children; 2 despite efforts to engage in collaborative decision-making, principals are often faced with the reality that they are the ones to absorb the cost of decisions; and 3 moral agents need to become wide-awake to the ethical issues and challenges that permeate their day-to-day work lives.
Tuckett, David; Nikolic, Milena
We propose conviction narrative theory (CNT) to broaden decision-making theory in order to better understand and analyse how subjectively means–end rational actors cope in contexts in which the traditional assumptions in decision-making models fail to hold. Conviction narratives enable actors to draw on their beliefs, causal models, and rules of thumb to identify opportunities worth acting on, to simulate the future outcome of their actions, and to feel sufficiently convinced to act. The framework focuses on how narrative and emotion combine to allow actors to deliberate and to select actions that they think will produce the outcomes they desire. It specifies connections between particular emotions and deliberative thought, hypothesising that approach and avoidance emotions evoked during narrative simulation play a crucial role. Two mental states, Divided and Integrated, in which narratives can be formed or updated, are introduced and used to explain some familiar problems that traditional models cannot. PMID:28804217
Gudmundsson, Henrik; Harmer, Clare; Hewitt, Alison
these three tasks SUNRA will produce a framework for NRA’s, with each WP delivering one part of the framework. These frameworks will then go on to be trialled with several NRAs, before being widely disseminated. Purpose and content The purpose of this report is to describe the development of SUNRA Framework...... Part 1 “Sustainability Definitions for NRAs”. The objective of this part of the framework is to support NRAs in developing and implementing definitions of sustainability. The present report contains the foundations for the framework, including: •The methodology adopted in the process of developing...... to measure sustainable development at a strategic level and integrate sustainable development decision-making into key intervention points (WP2). 3.Developing a sustainability rating system framework that will enable NRAs to improve performance within the context of building and managing roads (WP3). Through...
Ram, B. [Energetics, Inc., Columbia, MD (United States)
Assessing the potential environmental and human effects of deploying renewable wind energy requires a new way of evaluating potential environmental and human impacts. This paper explores an integrated risk framework for renewable wind energy siting decisionmaking.
Liu, Kevin F R
While pursuing economic development, countries around the world have become aware of the importance of environmental sustainability; therefore, the evaluation of environmental sustainability has become a significant issue. Traditionally, multiple-criteria decision-making (MCDM) was widely used as a way of evaluating environmental sustainability, Recently, several researchers have attempted to implement this evaluation with fuzzy logic since they recognized the assessment of environmental sustainability as a subjective judgment Intuition. This paper outlines a new evaluation-framework of environmental sustainability, which integrates fuzzy logic into MCDM. This evaluation-framework consists of 36 structured and 5 unstructured decision-points, wherein MCDM is used to handle the former and fuzzy logic serves for the latter, With the integrated evaluation-framework, the evaluations of environmental sustainability in 146 countries are calculated, ranked and clustered, and the evaluation results are very helpful to these countries, as they identify their obstacles towards environmental sustainability.
Full Text Available Abstract Background Multidisciplinary guideline development groups (GDGs have considerable influence on UK healthcare policy and practice, but previous research suggests that research evidence is a variable influence on GDG recommendations. The Evidence into Recommendations (EiR study has been set up to document social-psychological influences on GDG decision-making. In this paper we aim to evaluate the relevance of existing qualitative methodologies to the EiR study, and to develop a method best-suited to capturing influences on GDG decision-making. Methods A research team comprised of three postdoctoral research fellows and a multidisciplinary steering group assessed the utility of extant qualitative methodologies for coding verbatim GDG meeting transcripts and semi-structured interviews with GDG members. A unique configuration of techniques was developed to permit data reduction and analysis. Results Our method incorporates techniques from thematic analysis, grounded theory analysis, content analysis, and framework analysis. Thematic analysis of individual interviews conducted with group members at the start and end of the GDG process defines discrete problem areas to guide data extraction from GDG meeting transcripts. Data excerpts are coded both inductively and deductively, using concepts taken from theories of decision-making, social influence and group processes. These codes inform a framework analysis to describe and explain incidents within GDG meetings. We illustrate the application of the method by discussing some preliminary findings of a study of a National Institute for Health and Clinical Excellence (NICE acute physical health GDG. Conclusion This method is currently being applied to study the meetings of three of NICE GDGs. These cover topics in acute physical health, mental health and public health, and comprise a total of 45 full-day meetings. The method offers potential for application to other health care and decision-making
Christoph W Korn
Full Text Available Living organisms need to maintain energetic homeostasis. For many species, this implies taking actions with delayed consequences. For example, humans may have to decide between foraging for high-calorie but hard-to-get, and low-calorie but easy-to-get food, under threat of starvation. Homeostatic principles prescribe decisions that maximize the probability of sustaining appropriate energy levels across the entire foraging trajectory. Here, predictions from biological principles contrast with predictions from economic decision-making models based on maximizing the utility of the endpoint outcome of a choice. To empirically arbitrate between the predictions of biological and economic models for individual human decision-making, we devised a virtual foraging task in which players chose repeatedly between two foraging environments, lost energy by the passage of time, and gained energy probabilistically according to the statistics of the environment they chose. Reaching zero energy was framed as starvation. We used the mathematics of random walks to derive endpoint outcome distributions of the choices. This also furnished equivalent lotteries, presented in a purely economic, casino-like frame, in which starvation corresponded to winning nothing. Bayesian model comparison showed that--in both the foraging and the casino frames--participants' choices depended jointly on the probability of starvation and the expected endpoint value of the outcome, but could not be explained by economic models based on combinations of statistical moments or on rank-dependent utility. This implies that under precisely defined constraints biological principles are better suited to explain human decision-making than economic models based on endpoint utility maximization.
Purpose: The purpose of this paper is to question the appropriateness of a proposal for a new European Qualifications Framework. The framework has three perspectives: historical; analytical; and national. Design/methodology/approach: The approaches are diverse since the first insists on the institutional and decision-making processes at European…
Sijtsma, F.J.; Heide, van der C.M.; Hinsberg, van A.
In this paper we focus on how to achieve better decision support when decision-makers use the ecosystem services (ESS) framework to broaden their evaluations. We contribute to the debate on valuation of ecosystem services by inquiring into how the ESS framework relates to the judgement and
Cells can cope with unpredictable environmental conditions by differentiating into appropriate states. In this talk, I will present our recent attempts to understand the role of genetic circuits in regulating the underlying process of cellular decision-making. Specifically, we are interested in how interactions within and across genetic circuits enable cells to choose among alternative fates. To address this question my laboratory is employing systems and synthetic biology approaches. Our ultimate goal is to uncover possible evolutionary pressures that may have selected for specific gene circuit architectures, dynamics and noise properties.
Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner
Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be
Odame, Augustina Yaa Oye
This dissertation is made up of three separate studies under the unifying theme of “Water Decision-Making under Uncertainty.” The first study analyzed a farmer’s decision to invest in a more efficient irrigation system given uncertainty about future water supplies and his post-investment efficiency. It found the price at which farmers would no longer produce to be a bigger consideration in irrigation investment than previously thought. It also found support for a careful identification and co...
Lyles, Garry; Flores, Tim; Hundley, Jason; Monk, Timothy; Feldman,Stuart
The Space Shuttle program has ended and elements of the Constellation Program have either been cancelled or transitioned to new NASA exploration endeavors. The National Aeronautics and Space Administration (NASA) has worked diligently to select an optimum configuration for the Space Launch System (SLS), a heavy lift vehicle that will provide the foundation for future beyond low earth orbit (LEO) large-scale missions for the next several decades. From Fall 2010 until Spring 2011, an SLS decision-making framework was formulated, tested, fully documented, and applied to multiple SLS vehicle concepts at NASA from previous exploration architecture studies. This was a multistep process that involved performing figure of merit (FOM)-based assessments, creating Pass/Fail gates based on draft threshold requirements, performing a margin-based assessment with supporting statistical analyses, and performing sensitivity analysis on each. This paper focuses on the various steps and methods of this process (rather than specific data) that allowed for competing concepts to be compared across a variety of launch vehicle metrics in support of the successful completion of the SLS Mission Concept Review (MCR) milestone.
Across the tropics, rural farmers and livestock keepers use mobility as an adaptive livelihood strategy. Continued migration to and within frontier areas is widely viewed as a driver of environmental decline and biodiversity loss. Recent scholarship advances our understanding of migration decision-making in the context of changing climate and environments, and in doing so it highlights the variation in migration responses to primarily economic and environmental factors. Building on these insights, this letter investigates past and future migration decisions in a frontier landscape of Tanzania, East Africa. Combining field observations and household data within a multilevel modeling framework, the letter analyzes the explicit importance of social factors relative to economic and environmental factors in driving decisions to migrate or remain. Results indeed suggest that local community ties and non-local social networks drive both immobility and anticipated migration, respectively. In addition, positive interactions with local protected natural resource areas promote longer-term residence. Findings shed new light on how frontier areas transition to human dominated landscapes. This highlights critical links between migration behavior and the conservation of biodiversity and management of natural resources, as well as how migrants evolve to become integrated into communities.
Anahita A. Jami
Full Text Available A wider use of renewable energy is emerging as a viable solution to meet the increasing demand for global energy while contributing to the reduction of greenhouse gas emissions. However, current literature on renewable energy, particularly on wind power, highlights the social barriers and public opposition to renewable energy investment. One solution to overcome the public opposition, which is recommended by scholars, is to deploy a collaborative approach. Relatively little research has specifically focused on the role of effective communication and the use of a knowledge-broker in collaborative decision-making. This study attempts to fill this gap through the proposition of a participatory framework that highlights the role of the knowledge-broker in a wind project decision-making process. In this paper, five illustrative wind projects in Ontario are used to highlight the current situation with public participation and to address how the proposed framework could have improved the process. Based on the recommended collaborative framework, perception must shift from the dominant view of the public as “a risk to be managed” towards “a resource that can be tapped”. The developers need to improve sharing what they know and foster co-learning around questions and concerns.
Geessink, Noralie H; Schoon, Yvonne; van Herk, Hanneke C P; van Goor, Harry; Olde Rikkert, Marcel G M
To identify key elements of optimal treatment decision-making for surgeons and older patients with colorectal (CRC) or pancreatic cancer (PC). Six focus groups with different participants were performed: three with older CRC/PC patients and relatives, and three with physicians. Supplementary in-depth interviews were conducted in another seven patients. Framework analysis was used to identify key elements in decision-making. 23 physicians, 22 patients and 14 relatives participated. Three interacting components were revealed: preconditions, content and facilitators of decision-making. To provide optimal information about treatments' impact on an older patient's daily life, physicians should obtain an overall picture and take into account patients' frailty. Depending on patients' preferences and capacities, dividing decision-making into more sessions will be helpful and simultaneously emphasize patients' own responsibility. GPs may have a valuable contribution because of their background knowledge and supportive role. Stakeholders identified several crucial elements in the complex surgical decision-making of older CRC/PC patients. Structured qualitative research may also be of great help in optimizing other treatment directed decision-making processes. Surgeons should be trained in examining preconditions and useful facilitators in decision-making in older CRC/PC patients to optimize its content and to improve the quality of shared care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Walker, Paul; Lovat, Terry
This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.
Weller, Joshua A; Fisher, Philip A
Although maltreated children involved with child welfare services are known to exhibit elevated levels of health-risking behaviors, little is known about their decision-making processes leading to such tendencies. Research findings suggest that maltreated children exhibit developmental delays in neurocognitive and emotional regulation systems that could adversely impact their abilities to make decisions under conditions of risk. Whereas prior researchers have examined risky decision making as a global construct, maltreated children's decision making was examined in two contexts in the present study: potential gains and potential losses. Comparing maltreated children (n = 25) and a nonmaltreated community group (n = 112), it was found that the maltreated children showed decision-making impairments for both domains: This impairment was especially prominent in the loss domain. The maltreated children took excessive risks and were insensitive to changes in expected value. Follow-up analyses revealed that these differences were primarily associated with insensitivity to changes in outcome magnitude for the risky option. Finally, response latency analyses indicated that the maltreated children were slower to make choices, reinforcing underlying differences in decision processes between groups. These results have implications for basic and translational science.
Lettice, Fiona; Durowoju, Olatunde
Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management. Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...
Jespersen, Kristina Risom
of gate decision-making and information sources was developed across five generic stages (idea, concept, design, test, and commercialization). Our data was generated with a participatory agent-based simulation of NPD gate decision-points in the development process. The sample consists of 134 managers from......The purpose of this study is to examine how the exploration/exploitation continuum is applied by decision-makers in new product gate decision-making. Specifically, we analyze at gate decision-points how the evaluation of a new product project is affected by the information source exploitation....../exploration search behavior of decision-makers. In addition, overexploitation and overexploration in new product development decision-making is investigated through mediating effects of perceived information usefulness and applied performance criteria by decision-makers at gates. To this end a conceptual model...
Grffith, Richard; Tengnah, Cassam
Shared decision-making lies at the heart of the Government's reforms of the NHS in England. The slogan, 'No decision about me without me', underpins shared decision-making that sees patients as active participants in their treatment decisions. In this article, Richard Griffith and Cassam Tengnah argue that for 'no decision about me, without me' to be a reality, district nurses must guard against paternalistic decision-making that excludes the views and wishes of their patients.
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the...
The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems. © 2015 The Canadian College of Health Leaders.
Lee, Bo Ra
Although a substantial literature is developing regarding the effects of stress on decision-making (cf. Mather & Lighthall, 2012), the literature on stress and social decision-making is still in the beginning stage. The present research extends this new literature by examining the mediating and moderating factors of the effect of stress on social decision-making. Furthermore, a novel aspect of the research is its effort to connect the information-processing and functional perspectives, with r...
Clift, Roland; Sim, Sarah; King, Henry
scales; (2) setting 'distance from boundary' measures that can be applied at different scales; (3) development of global, preferably open-source, databases and models; and (4) advancing understanding of the interactions between the different PBs. Addressing the scientific and technical challenges......The Planetary Boundaries (PB) framework represents a significant advance in specifying the ecological constraints on human development. However, to enable decision-makers in business and public policy to respect these constraints in strategic planning, the PB framework needs to be developed...... to generate practical tools. With this objective in mind, we analyse the recent literature and highlight three major scientific and technical challenges in operationalizing the PB approach in decision-making: first, identification of thresholds or boundaries with associated metrics for different geographical...
Full Text Available Decision making in engineering design problems is challenging because they have multiple and conflicting criteria and complex correlation between design parameters. This study proposes a decision-making support methodology named design mode analysis, which consists of data clustering and principal component analysis (PCA. A design mode is indicated by the eigenvector obtained by PCA and reveals the dominant design parameters in a given dataset. The proposed method is a general framework to obtain the design modes from high-dimensional and large datasets. The effectiveness of the proposed method is verified on the conceptual design problem of the hybrid rocket engine.
Detailed summaries of two NASA-funded research projects are provided. The first project was an ecological task analysis of the Star Cruiser model. Star Cruiser is a psychological model designed to test a subject's level of cognitive activity. Ecological task analysis is used as a framework to predict the types of cognitive activity required to achieve productive behavior and to suggest how interfaces can be manipulated to alleviate certain types of cognitive demands. The second project is presented in the form of a thesis for the Masters Degree. The thesis discusses the modeling of decision-making through the use of neural network and genetic-algorithm machine learning technologies.
The current paradigm of building design is evolving rapidly and building developers are beginning to dopt sustainable building practices across Canada. Attaining a sustainable built environment is challenged by the complexity of decision-making and stakeholders need to examine a large number of sustainability metrics to support a 'good decision'. Each sustainable building development has a design path unique to the values of the building stakeholders.This project outlines a framework that as...
Burchett, HE; Mounier-Jack, S; Griffiths, UK; Biellik, R; Ongolo-Zogo, P; Chavez, E.; Sarma, H; Uddin, J; Konate, M.; Kitaw, Y; Molla, M.; Wakasiaka, S; Gilson, L.; Mills, A
: 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 use...
Raine, Tina R.; Gard, Jennifer C.; Boyer, Cherrie B.; Haider, Sadia; Brown, Beth A.; Hernandez, F. Antonio Ramirez; Harper, Cynthia C.
Much attention has been focused on efforts to reduce unintended pregnancy by improving contraceptive use among high-risk women; however, there is limited information to guide interventions to engage young men in contraceptive decision-making. We conducted focus groups of young men, ages 19–26, from diverse racial backgrounds from low-income communities in the San Francisco Bay Area to examine social norms about sexual relationships and how they impact on contraceptive use. The data were analysed using content analysis. A range of relationships were described, however casual relationships predominated. While young men expressed strong desires to avoid pregnancy in casual relationships, the unpredictable nature of relationships, together with low communication and regard for the women involved, made stressing consistent contraceptive use among partners unlikely. The themes expressed by these young men about sex and behaviour in different relationships illustrate a spectrum of decision-making dilemmas and illustrate the inherent difficulty in fully engaging young men in contraceptive decision-making. A strategy is needed to address relationship values, dynamics, and condom use beyond STI prevention frameworks, and young women’s ability to make appropriate contraceptive choices in light of the inherent difficulties and uncertainty associated with casual relationships. PMID:20169479
Full Text Available Autonomous vehicles need to perform social accepted behaviors in complex urban scenarios including human-driven vehicles with uncertain intentions. This leads to many difficult decision-making problems, such as deciding a lane change maneuver and generating policies to pass through intersections. In this paper, we propose an intention-aware decision-making algorithm to solve this challenging problem in an uncontrolled intersection scenario. In order to consider uncertain intentions, we first develop a continuous hidden Markov model to predict both the high-level motion intention (e.g., turn right, turn left, and go straight and the low level interaction intentions (e.g., yield status for related vehicles. Then a partially observable Markov decision process (POMDP is built to model the general decision-making framework. Due to the difficulty in solving POMDP, we use proper assumptions and approximations to simplify this problem. A human-like policy generation mechanism is used to generate the possible candidates. Human-driven vehicles’ future motion model is proposed to be applied in state transition process and the intention is updated during each prediction time step. The reward function, which considers the driving safety, traffic laws, time efficiency, and so forth, is designed to calculate the optimal policy. Finally, our method is evaluated in simulation with PreScan software and a driving simulator. The experiments show that our method could lead autonomous vehicle to pass through uncontrolled intersections safely and efficiently.
Alfonso, L.; Mukolwe, M. M.; Di Baldassarre, G.
Floods are one of the most frequent and disruptive natural hazards that affect man. Annually, significant flood damage is documented worldwide. Flood mapping is a common preimpact flood hazard mitigation measure, for which advanced methods and tools (such as flood inundation models) are used to estimate potential flood extent maps that are used in spatial planning. However, these tools are affected, largely to an unknown degree, by both epistemic and aleatory uncertainty. Over the past few years, advances in uncertainty analysis with respect to flood inundation modeling show that it is appropriate to adopt Probabilistic Flood Maps (PFM) to account for uncertainty. However, the following question arises; how can probabilistic flood hazard information be incorporated into spatial planning? Thus, a consistent framework to incorporate PFMs into the decision-making is required. In this paper, a novel methodology based on Decision-Making under Uncertainty theories, in particular Value of Information (VOI) is proposed. Specifically, the methodology entails the use of a PFM to generate a VOI map, which highlights floodplain locations where additional information is valuable with respect to available floodplain management actions and their potential consequences. The methodology is illustrated with a simplified example and also applied to a real case study in the South of France, where a VOI map is analyzed on the basis of historical land use change decisions over a period of 26 years. Results show that uncertain flood hazard information encapsulated in PFMs can aid decision-making in floodplain planning.
Amorin-Woods Lyndon G
Full Text Available Abstract Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.
Dunn, M. C.; Clare, I. C. H.; Holland, A. J.
Background: In England and Wales, the "Mental Capacity Act 2005" (MCA) provides a new legal framework to regulate substitute decision-making relating to the welfare of adults who lack the capacity to make one or more autonomous decisions about their care and support. Any substitute decision made on behalf of an adult lacking capacity…
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...
Cetiner, Sacit M [ORNL; Kisner, Roger A [ORNL; Muhlheim, Michael David [ORNL; Fugate, David L [ORNL
Decision-making is the process of identifying and choosing alternatives where each alternative offers a different approach or path to move from a given state or condition to a desired state or condition. The generation of consistent decisions requires that a structured, coherent process be defined, immediately leading to a decision-making framework. The overall objective of the generalized framework is for it to be adopted into an autonomous decision-making framework and tailored to specific requirements for various applications. In this context, automation is the use of computing resources to make decisions and implement a structured decision-making process with limited or no human intervention. The overriding goal of automation is to replace or supplement human decision makers with reconfigurable decision- making modules that can perform a given set of tasks reliably. Risk-informed decision making requires a probabilistic assessment of the likelihood of success given the status of the plant/systems and component health, and a deterministic assessment between plant operating parameters and reactor protection parameters to prevent unnecessary trips and challenges to plant safety systems. The implementation of the probabilistic portion of the decision-making engine of the proposed supervisory control system was detailed in previous milestone reports. Once the control options are identified and ranked based on the likelihood of success, the supervisory control system transmits the options to the deterministic portion of the platform. The deterministic multi-attribute decision-making framework uses variable sensor data (e.g., outlet temperature) and calculates where it is within the challenge state, its trajectory, and margin within the controllable domain using utility functions to evaluate current and projected plant state space for different control decisions. Metrics to be evaluated include stability, cost, time to complete (action), power level, etc. The
Full Text Available In this paper we present Zend Architecture, which is an open source technology for developing web applications and services, based on object-oriented components, and the Model-View-Controller architectural pattern, also known as MVC, which is the fundament of this architecture. The MVC presentation emphasises its main characteristics, such as facilitating the components reuse by dividing the application into distinct interconnected modules, tasks distribution in the process of developing an application, the MVC life cycle and also the essential features of the components in which it separates the application: model, view, controller. The controller coordinates the models and views and it’s responsible with manipulating the user events through the corresponding actions. The model contains application rules, respectively the scripts that implement the database manipulation. The third component, the view represents the controllers interface with the user or the way it displays the response to the event triggered by the user. Another aspect treated in this paper consists in highlighting the Zend architecture advantages and disadvantages. Among the framework advantages, we can enumerate good code organization, due to its delimitation into three sections, presentation, logic and data access, and dividing the code into components, which facilitates the code reuse and testing. Other advantages are the open-source license and the support for multiple database systems. The main disadvantages are represented by its size and complexity, that makes it hard to understand for a beginner programmer, the resources it needs etc. The last section of the paper presents a comparison between Zend and other PHP architectures, like Symphony, CakePHP and CodeIgniter, which includes their essential features and points out their similarities and differences, based on the unique functions that set them apart from others. The main thing that distinguishes ZF from the
Lin Jennifer S
Full Text Available Abstract The development of genomic tests is one of the most significant technological advances in medical testing in recent decades. As these tests become increasingly available, so does the need for a pragmatic framework to evaluate the evidence base and evidence gaps in order to facilitate informed decision-making. In this article we describe such a framework that can provide a common language and benchmarks for different stakeholders of genomic testing. Each stakeholder can use this framework to specify their respective thresholds for decision-making, depending on their perspective and particular needs. This framework is applicable across a broad range of test applications and can be helpful in the application and communication of a regulatory science for genomic testing. Our framework builds upon existing work and incorporates principles familiar to researchers involved in medical testing (both diagnostic and prognostic generally, as well as those involved in genomic testing. This framework is organized around six phases in the development of genomic tests beginning with marker identification and ending with population impact, and highlights the important knowledge gaps that need to be filled in establishing the clinical relevance of a test. Our framework focuses on the clinical appropriateness of the four main dimensions of test research questions (population/setting, intervention/index test, comparators/reference test, and outcomes rather than prescribing a hierarchy of study designs that should be used to address each phase.
Antioco, M.; Moenaert, R.K.; Lindgreen, A.
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
Robson, Maggie; Cook, Peter; Hunt, Kathy; Alred, Geof; Robson, Dave
Explores the process of ethical decision-making in counseling research and examines to what extent decision-making is based on intuitive thinking. Reviews and considers several models of ethical problem solving. Argues that ethical decisions are reached through intuition, informed by ethical principles, codes of practice, and reference to the laws…
Bronner, F.; de Hoog, R.
In the last 20 years changes have taken place which have altered the decision-making process in families—family democracy is clearly in the ascendant. The family has evolved into what business research calls a decision-making unit. This general trend probably also has consequences for holiday
This paper is a brief description of a conference presentation consisting of a 2.5-hour clinic session on decision-making. A motion picture, "The Making of a Decision," followed by a lively discussion, was used to illustrate the strenghts and weaknesses of administrators in their decision-making process. Presented in the film are three…
AJRH Managing Editor
Women's decision-making autonomy score was obtained from 5 questions on who has the final say .... Most women (63.3%) had high levels of household decision-making index (score >3) while the minority (12.2%) had low autonomy level. (score <2) (Figure1). It was found ..... women living in rural areas in credit programs.
Le Berre, A-P; Rauchs, G; La Joie, R; Mézenge, F; Boudehent, C; Vabret, F; Segobin, S; Viader, F; Allain, P; Eustache, F; Pitel, A-L; Beaunieux, H
Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (Palcoholism may result from impairment of both emotional and cognitive networks. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
student samples. Radder et al. (2006) investigated the decision-making styles of students when purchasing clothing in the South. African context; and these authors suggested that further South African .... decision-making style of local and international students studying at .... no adjustments were carried out. No incentives.
James, Constance R.; Smith, J. Goosby
This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…
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.
Full Text Available Abstract Background Shared decision-making has been advocated; however there are relatively few studies on physician preferences for, and experiences of, different styles of clinical decision-making as most research has focused on patient preferences and experiences. The objectives of this study were to determine 1 physician preferences for different styles of clinical decision-making; 2 styles of clinical decision-making physicians perceive themselves as practicing; and 3 the congruence between preferred and perceived style. In addition we sought to determine physician perceptions of the availability of time in visits, and their role in encouraging patients to look for health information. Methods Cross-sectional survey of a nationally representative sample of U.S. physicians. Results 1,050 (53% response rate physicians responded to the survey. Of these, 780 (75% preferred to share decision-making with their patients, 142 (14% preferred paternalism, and 118 (11% preferred consumerism. 87% of physicians perceived themselves as practicing their preferred style. Physicians who preferred their patients to play an active role in decision-making were more likely to report encouraging patients to look for information, and to report having enough time in visits. Conclusion Physicians tend to perceive themselves as practicing their preferred role in clinical decision-making. The direction of the association cannot be inferred from these data; however, we suggest that interventions aimed at promoting shared decision-making need to target physicians as well as patients.
Suchman, J. Richard; DiSario, Martha R.
An instructional system is presented for building the competencies of adult basic education students in making consumer decisions, and offers a guide to teachers who wish to design their own decision-making problems for students. The first four chapters provide a brief introduction, discuss the rational consumer decision-making process and the…
The significance of participatory decision-making has received world wide acclamation by management scholars. This study, therefore, focused on the nature of participation, pattern of participation and the appropriateness or otherwise of rational participatory decision--making processes in polytechnics in northern Nigeria.
Significant variation was found in personal decision-making styles. However, some central themes emerged, such as the importance of sensitivity to the decision-making context, attention to the presentation of information, and the use of intuition. In terms of the use of decision support technology, the use of self-help tools, ...
Ganske, Kathryn H.; Ashby, Jeffrey S.
This study investigated the relationship between perfectionism and career decision-making self-efficacy. Participants completed the Almost Perfect Scale-Revised (R. B. Slaney, K. G. Rice, M. Mobley, J. Trippi, & J. S. Ashby, 2001) and the Career Decision-Making Self-Efficacy-Short Form (N. E. Betz, K. L. Klein, & K. M. Taylor, 1996). Adaptive…
This study investigates the relationships among participation in decision-making process, incentives, training and organizational commitment among some industrial workers. Measures on participation in decision-making, incentives, training and organizational commitment were employed to collect data from the workers in ...
Wout, M. van 't; Kahn, R.S.; Sanfey, A.G.; Aleman, A.
The emerging field of neuroeconomics has provided evidence that emotional as well as cognitive processes may contribute to economic decision-making. Indeed, activation of the anterior insula, a brain area involved in emotional processing, has been shown to predict decision-making in the Ultimatum
van't Wout, M; Kahn, RS; Sanfey, AG; Aleman, A
The emerging field of neuroeconomics has provided evidence that emotional as well as cognitive processes may contribute to economic decision-making. Indeed, activation of the anterior insula, a brain area involved in emotional processing, has been shown to predict decision-making in the Ultimatum
Geelhoed, Willem; Zimmermann, Frank
Dutch criminal law does not provide for criminal liability for a political decision-maker who decides to build a bridge, if thereafter the project runs out of control or the bridge appears not to justify the funds spent on the project. This is most probably even the case if the decision-maker knew
Kreitler, Crystal M.; Dansereau, Donald F.; Barth, Timothy M.; Ito, Sachiyo
Previous studies have demonstrated that many college students, specifically those high on extraversion are prone to risky and sometimes unethical decision-making. The present study examined the impact of a decision-making "tool" that incorporated the use of standard ethical perspectives on students' attitudes and intentions. This "fill in the…
Sanfey, A.G.; Hastie, R.; Colvin, M.K.; Grafman, J.
Poor social judgment and decision-making abilities have often been attributed to people who have suffered injury to the ventromedial prefrontal cortex (VMPFC). However, few laboratory tests of decision-making have been conducted on these patients. The exception to this is the Iowa Gambling Task
Ahmed, S.; Hansen, Claus Thorp
This paper describes research that combines the generic decision-making model of Hansen, together with design strategies employed by experienced engineering designers. The relationship between the six decision-making sub-activities and the eight design strategies are examined. By combining...
McGrady, Meghan E; Brown, Gabriella A; Pai, Ahna L H
Nearly half of all adolescents and young adults (AYAs) with cancer struggle to adhere to oral chemotherapy or antibiotic prophylactic medication included in treatment protocols. The mechanisms that drive non-adherence remain unknown, leaving health care providers with few strategies to improve adherence among their patients. The purpose of this study was to use qualitative methods to investigate the mechanisms that drive the daily adherence decision-making process among AYAs with cancer. Twelve AYAs (ages 15-31) with cancer who had a current medication regimen that included oral chemotherapy or antibiotic prophylactic medication participated in this study. Adolescents and young adults completed a semi-structured interview and a card sorting task to elucidate the themes that impact adherence decision-making. Interviews were transcribed verbatim and coded twice by two independent raters to identify key themes and develop an overarching theoretical framework. Adolescents and young adults with cancer described adherence decision-making as a complex, multi-dimensional process influenced by personal goals and values, knowledge, skills, and environmental and social factors. Themes were generally consistent across medication regimens but differed with age, with older AYAs discussing long-term impacts and receiving physical support from their caregivers more than younger AYAs. The mechanisms that drive daily adherence decision-making among AYAs with cancer are consistent with those described in empirically-supported models of adherence among adults with other chronic medical conditions. These mechanisms offer several modifiable targets for health care providers striving to improve adherence among this vulnerable population. Copyright © 2015 Elsevier Ltd. All rights reserved.
Agger Nielsen, Jeppe; Pedersen, Keld
IT project portfolio management (IT PPM) has evolved into a significant area of research interest, but we know little about IT PPM practices in public sector organizations. Therefore this article investigates decision-making processes in the IT PPM practices of local governments, and discusses how...... these practices match the normative advice proposed by the IT PPMliterature.We rely on decision-making theories togetherwith case-studies of four Danish local governments.We find that politics, intuition and coincidence play a crucial role in IT PPM decisionmaking, while technical rationality (as proposed...... that implementing textbook-IT PPM is difficult because it relies on decision-making ideals that are incompatiblewith organizational contexts and individual behavior in these organizations. Instead of radically changing decision-making styles, the organizations might be better off improving IT PPM practice within...
Hsieh, Linda; Elbanna, Said; Narooz, Rose
ad hoc internationalization, credit check, distribution adaptation, and decision team size) and their influence on the extent of procedural rationality in SME internationalization decision-making process. The findings from a sample of 176 export-active SMEs show that decision-makers tend to follow......This paper contributes to the growing body of empirical work on how SME decision-makers decide to internationalize in two ways: first, it responds to recent calls for incorporating strategic decision-making literature into understanding SME internationalization decisions. Second, it provides...... a more rational decision-making procedure when they perceive a high level of international risk. The evidence also suggest that internationalization performance, planned internationalization, credit check, and decision team size are positively related to procedural rationality....
Al-Hamdan, Zaid M; Bawadi, Hala A; Redman, Richard W; Al-Nawafleh, Ahmad H
Nurses in any organizational context are members of a team and cannot work independently. Teamwork requires making decisions frequently, and these decisions affect team performance on a regular basis. Ultimately, the team shapes the quality of patient care. This study examines nurse decision-making related to patient care, self-management and the work environment. Qualitative descriptive design was used to collect data. Eighteen staff nurses participated in semi-structured interviews to explore the perception of Jordanian staff nurses regarding their participation in decision-making. Variation in decision-making involvement was found to exist across unit types and from hospital to hospital. In general, the participants were not satisfied with their level of decision-making involvement and believed that they could participate more. The results have implications for nurse managers in facilitating the engagement of staff nurses in decision-making and creating an organizational culture to facilitate this engagement. Copyright © 2015 Elsevier Inc. All rights reserved.
Williams, I; McIver, S; Moore, D; Bryan, S
approach to consideration of clinical effectiveness and cost-effectiveness information. Some interviewees considered the key role of a cost-effectiveness analysis to be the provision of a framework for decision-making. Interviewees indicated that NICE makes use of some form of cost-effectiveness threshold but expressed concern about its basis and its use in decision-making. Frustrations with the appraisal process were expressed in terms of the scope of the policy question being addressed. Committee members raised concerns about lack of understanding of the economic analysis but felt that a single measure of benefit, e.g. the quality-adjusted life-year, was useful in allowing comparison of disparate health interventions and in providing a benchmark for later decisions. The importance of ensuring that committee members understood the limitations of the analysis was highlighted for model-based analyses. This study suggests that research is needed into structures, processes and mechanisms by which technology coverage decisions can and should be made in healthcare. Further development of 'resource centres' may be useful to provide independent published analyses in order to support local decision-makers. Improved methods of economic analyses and of their presentation, which take account of the concerns of their users, are needed. Finally, the findings point to the need for further assessment of the feasibility and value of a formal process of clarification of the objectives that we seek from investments in healthcare.
Full Text Available Investigation into the neural and computational bases of decision-making has proceeded in two parallel but distinct streams. Perceptual decision making (PDM is concerned with how observers detect, discriminate and categorise noisy sensory information. Economic decision making (EDM explores how options are selected on the basis of their reinforcement history. Traditionally, the subfields of PDM and EDM have employed different paradigms, proposed different mechanistic models, explored different brain regions, disagreed about whether decisions approach optimality. Nevertheless, we argue that there is a common framework for understanding decisions made in both domains, under which an agent has to combine sensory information (what is the stimulus with value information (what is it worth. We review computational models of the decision process typically used in PDM, based around the idea that decisions involve a serial integration of evidence, and assess their applicability to decisions between good and gambles. Subsequently, we consider the contribution of three key brain regions – the parietal cortex, the basal ganglia, and the orbitofrontal cortex – to perceptual and economic decision-making, with a focus on the mechanisms by which sensory and reward information are integrated during choice. We find that although the parietal cortex is often implicated in the integration of sensory evidence, there is evidence for its role in encoding the expected value of a decision. Similarly, although much research has emphasised the role of the striatum and orbitofrontal cortex in value-guided choices, they may play an important role in categorisation of perceptual information. In conclusion, we consider how findings from the two fields might be brought together, in order to move towards a general framework for understanding decision-making in humans and other primates.
Madani, Amin; Watanabe, Yusuke; Feldman, Liane S; Vassiliou, Melina C; Barkun, Jeffrey S; Fried, Gerald M; Aggarwal, Rajesh
Bile duct injuries from laparoscopic cholecystectomy remain a significant source of morbidity and are often the result of intraoperative errors in perception, judgment, and decision-making. This qualitative study aimed to define and characterize higher-order cognitive competencies required to safely perform a laparoscopic cholecystectomy. Hierarchical and cognitive task analyses for establishing a critical view of safety during laparoscopic cholecystectomy were performed using qualitative methods to map the thoughts and practices that characterize expert performance. Experts with more than 5 years of experience, and who have performed at least 100 laparoscopic cholecystectomies, participated in semi-structured interviews and field observations. Verbal data were transcribed verbatim, supplemented with content from published literature, coded, thematically analyzed using grounded-theory by 2 independent reviewers, and synthesized into a list of items. A conceptual framework was created based on 10 interviews with experts, 9 procedures, and 18 literary sources. Experts included 6 minimally invasive surgeons, 2 hepato-pancreatico-biliary surgeons, and 2 acute care general surgeons (median years in practice, 11 [range 8 to 14]). One hundred eight cognitive elements (35 [32%] related to situation awareness, 47 [44%] involving decision-making, and 26 [24%] action-oriented subtasks) and 75 potential errors were identified and categorized into 6 general themes and 14 procedural tasks. Of the 75 potential errors, root causes were mapped to errors in situation awareness (24 [32%]), decision-making (49 [65%]), or either one (61 [81%]). This study defines the competencies that are essential to establishing a critical view of safety and avoiding bile duct injuries during laparoscopic cholecystectomy. This framework may serve as the basis for instructional design, assessment tools, and quality-control metrics to prevent injuries and promote a culture of patient safety. Copyright
Dunn, Michael C.; Clare, Isabel C. H.; Holland, Anthony J.
In the UK, current policies and services for people with mental disorders, including those with intellectual disabilities (ID), presume that these men and women can, do, and should, make decisions for themselves. The new Mental Capacity Act (England and Wales) 2005 (MCA) sets this presumption into statute, and codifies how decisions relating to health and welfare should be made for those adults judged unable to make one or more such decisions autonomously. The MCA uses a procedural checklist to guide this process of substitute decision-making. The personal experiences of providing direct support to seven men and women with ID living in residential care, however, showed that substitute decision-making took two forms, depending on the type of decision to be made. The first process, ‘strategic substitute decision-making’, paralleled the MCA’s legal and ethical framework, whilst the second process, ‘relational substitute decision-making’, was markedly different from these statutory procedures. In this setting, ‘relational substitute decision-making’ underpinned everyday personal and social interventions connected with residents’ daily living, and was situated within a framework of interpersonal and interdependent care relationships. The implications of these findings for residential services and the implementation of the MCA are discussed. PMID:18240026
Møller, Lea Ravnkilde; Drews, Martin; Larsen, Morten Andreas Dahl
Climate change causes transformations to the conditions of existing agricultural practices appointing farmers to continuously evaluate their agricultural strategies, e.g., towards optimising revenue. In this light, this paper presents a framework for applying Bayesian updating to simulate decision-making, reaction patterns and updating of beliefs among farmers in a developing country, when faced with the complexity of adapting agricultural systems to climate change. We apply the approach to a case study from Ghana, where farmers seek to decide on the most profitable of three agricultural systems (dryland crops, irrigated crops and livestock) by a continuous updating of beliefs relative to realised trajectories of climate (change), represented by projections of temperature and precipitation. The climate data is based on combinations of output from three global/regional climate model combinations and two future scenarios (RCP4.5 and RCP8.5) representing moderate and unsubstantial greenhouse gas reduction policies, respectively. The results indicate that the climate scenario (input) holds a significant influence on the development of beliefs, net revenues and thereby optimal farming practices. Further, despite uncertainties in the underlying net revenue functions, the study shows that when the beliefs of the farmer (decision-maker) opposes the development of the realised climate, the Bayesian methodology allows for simulating an adjustment of such beliefs, when improved information becomes available. The framework can, therefore, help facilitating the optimal choice between agricultural systems considering the influence of climate change.
Colakkadioglu, Oguzhan; Celik, D. Billur
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…
Maria Villar; Theresa Kushner
.... This simple framework, modeled after Abraham Maslow's hierarchy of human needs, helps organizations map and grow their data strategy and can be a useful decision-making tool to prevent enterprise...
Osamor, Pauline E; Grady, Christine
Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making. We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples' joint decision-making, and the ethics of couples' joint decision-making. We believe that the extent to which couples' joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples' joint decision-making about a woman's own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman's autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples' joint decision-making should be viewed as consistent with the principle of respect for the woman's autonomy. At the other end of the spectrum are decisions made by the man without the woman's input, representing domination of one partner by the other. We recommend viewing the dynamics of couples' joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples' joint decision-making should not be taken at face value but should be assessed against
Full Text Available Two procedures were adopted to assess decision-making styles in the workplace: (a the administration of traditional standardized self-report questionnaires and (b open-ended questions about the way respondents would take decisions in a critical business case. Seventy-four adults were given two questionnaires: the Preference for Intuition and Deliberation, which assesses “deliberative” or “intuitive” decision style, and the Style of Learning and Thinking, which assesses thinking styles as “left” (namely, analytical-systematic or “right” (that is, global-intuitive. Participants were also presented with a business case that involved taking a decision. Responses to the business case were used to classify approaches to decision making as “analytical-systematic” or “global-intuitive.” Results showed that the questionnaires correlated consistently with scores from the business case, thus supporting the notion that the assessment of decision style through self-report questionnaires is reliable and valid.
Filip, Florin Gheorghe; Ciurea, Cristian
This is a book about how management and control decisions are made by persons who collaborate and possibly use the support of an information system. The decision is the result of human conscious activities aiming at choosing a course of action for attaining a certain objective (or a set of objectives). The act of collaboration implies that several entities who work together and share responsibilities to jointly plan, implement and evaluate a program of activities to achieve the common goals. The book is intended to present a balanced view of the domain to include both well-established concepts and a selection of new results in the domains of methods and key technologies. It is meant to answer several questions, such as: a) “How are evolving the business models towards the ever more collaborative schemes?”; b) “What is the role of the decision-maker in the new context?” c) “What are the basic attributes and trends in the domain of decision-supporting information systems?”; d) “Which are the basic...
Cassey, Peter; Heathcote, Andrew; Brown, Scott D
Speed-accuracy tradeoff (SAT) is an adaptive process balancing urgency and caution when making decisions. Computational cognitive theories, known as "evidence accumulation models", have explained SATs via a manipulation of the amount of evidence necessary to trigger response selection. New light has been shed on these processes by single-cell recordings from monkeys who were adjusting their SAT settings. Those data have been interpreted as inconsistent with existing evidence accumulation theories, prompting the addition of new mechanisms to the models. We show that this interpretation was wrong, by demonstrating that the neural spiking data, and the behavioural data are consistent with existing evidence accumulation theories, without positing additional mechanisms. Our approach succeeds by using the neural data to provide constraints on the cognitive model. Open questions remain about the locus of the link between certain elements of the cognitive models and the neurophysiology, and about the relationship between activity in cortical neurons identified with decision-making vs. activity in downstream areas more closely linked with motor effectors.
Full Text Available Speed-accuracy tradeoff (SAT is an adaptive process balancing urgency and caution when making decisions. Computational cognitive theories, known as "evidence accumulation models", have explained SATs via a manipulation of the amount of evidence necessary to trigger response selection. New light has been shed on these processes by single-cell recordings from monkeys who were adjusting their SAT settings. Those data have been interpreted as inconsistent with existing evidence accumulation theories, prompting the addition of new mechanisms to the models. We show that this interpretation was wrong, by demonstrating that the neural spiking data, and the behavioural data are consistent with existing evidence accumulation theories, without positing additional mechanisms. Our approach succeeds by using the neural data to provide constraints on the cognitive model. Open questions remain about the locus of the link between certain elements of the cognitive models and the neurophysiology, and about the relationship between activity in cortical neurons identified with decision-making vs. activity in downstream areas more closely linked with motor effectors.
Zafeiris, Anna; Mones, Enys; Vicsek, Tamás
An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem -- but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present emp...
Full Text Available The ubiquitous and intense nature of stress responses necessitate that we understand how they affect decision-making. Despite a number of studies examining risky decision-making under stress, it is as yet unclear whether and in what way stress alters the underlying processes that shape our choices. This is in part because previous studies have not separated and quantified dissociable valuation and decision-making processes that can affect choices of risky options, including risk attitudes, loss aversion, and choice consistency, among others. Here, in a large, fully-crossed two-day within-subjects design, we examined how acute stress alters risky decision-making. On each day, 120 participants completed either the cold pressor test or a control manipulation with equal probability, followed by a risky decision-making task. Stress responses were assessed with salivary cortisol. We fit an econometric model to choices that dissociated risk attitudes, loss aversion, and choice consistency using hierarchical Bayesian techniques to both pool data and allow heterogeneity in decision-making. Acute stress was found to have no effect on risk attitudes, loss aversion, or choice consistency, though participants did become more loss averse and more consistent on the second day relative to the first. In the context of an inconsistent previous literature on risk and acute stress, our findings provide strong and specific evidence that acute stress does not affect risk attitudes, loss aversion, or consistency in risky monetary decision-making.
Sokol-Hessner, Peter; Raio, Candace M; Gottesman, Sarah P; Lackovic, Sandra F; Phelps, Elizabeth A
The ubiquitous and intense nature of stress responses necessitate that we understand how they affect decision-making. Despite a number of studies examining risky decision-making under stress, it is as yet unclear whether and in what way stress alters the underlying processes that shape our choices. This is in part because previous studies have not separated and quantified dissociable valuation and decision-making processes that can affect choices of risky options, including risk attitudes, loss aversion, and choice consistency, among others. Here, in a large, fully-crossed two-day within-subjects design, we examined how acute stress alters risky decision-making. On each day, 120 participants completed either the cold pressor test or a control manipulation with equal probability, followed by a risky decision-making task. Stress responses were assessed with salivary cortisol. We fit an econometric model to choices that dissociated risk attitudes, loss aversion, and choice consistency using hierarchical Bayesian techniques to both pool data and allow heterogeneity in decision-making. Acute stress was found to have no effect on risk attitudes, loss aversion, or choice consistency, though participants did become more loss averse and more consistent on the second day relative to the first. In the context of an inconsistent previous literature on risk and acute stress, our findings provide strong and specific evidence that acute stress does not affect risk attitudes, loss aversion, or consistency in risky monetary decision-making.
Chu, Tianshu; Wang, Jie; Chen, Jiayu
This paper presents an adaptive online learning (OL) framework for supporting clinical breast cancer (BC) diagnosis. Unlike traditional data mining, which trains a particular model from a fixed set of medical data, our framework offers robust OL models that can be updated adaptively according to new data sequences and newly discovered features. As a result, our framework can naturally learn to perform BC diagnosis using experts' opinions on sequential patient cases with cumulative clinical measurements. The framework integrates both supervised learning (SL) models for BC risk assessment and reinforcement learning (RL) models for decision-making of clinical measurements. In other words, online SL and RL interact with one another, and under a doctor's supervision, push the patient's diagnosis further. Furthermore, our framework can quickly update relevant model parameters based on current diagnosis information during the training process. Additionally, it can build flexible fitted models by integrating different model structures and plugging in the corresponding parameters during the prediction (or decision-making) process. Even when the feature space is extended, it can initialize the corresponding parameters and extend the existing model structure without loss of the cumulative knowledge. We evaluate the OL framework on real datasets from BCSC and WBC, and demonstrate that our SL models achieve accurate BC risk assessment from sequential data and incremental features. We also verify that the well-trained RL models provide promising measurement suggestions.
within the 4D/RCS context. Lexicons, Taxonomies and Ontologies One technique for knowledge representation is to progress from a lexicon (a domain...on its way to achieving its vision to become “the world’s largest and most complete general knowledge base and commonsense reasoning engine.” Another...of the 2004 AAAI Spring Symposium Series on Knowledge Representation and Ontology for Autonomous Systems, Palo Alto, CA, 67-78. Barbera, A., Messina
Munteanu Stolojanu Victoria-Ileana
Full Text Available Management by objectives framwork- a management system based on strict targets to determine the executors, who participate directly in establishing their close correlation and that rewards and sanctions to achieve the predetermined objectives. The main goal of the article is represented by the goals as management elements but also as the nervous system of the managerial actions. The presence of the functional deviationism in organizations, the need of reconsidering the functional deviationism in organizations, the need of reconsidering the strategic planning, all these lead under economic and financial crisis to the need of elaborating a tool which should the manager find an optimum combination between the limited resources and carryng out the objectives with a minimum cost.
van der Zee, D.J.; van der Vorst, J.G.A.J.
Owing to its inherent modeling flexibility, simulation is often regarded as the proper means for supporting decision making on supply chain design. The ultimate success of supply chain simulation, however, is determined by a combination of the analyst's skills, the chain members' involvement, and
Full Text Available Sustainability is probably the ultimate goal of any entrepreneur when initiating or developing a business. As it involves competitiveness, companies aim to produce differentiated economic offerings by reusing and sharing processes, components, information and knowledge ‒ many times from different domains. However, to be effective, this should be envisaged already when developing the entrepreneurial plan or when assessing the opportunity of extending the business – therefore the need for planning / implementing / integrating several business lines (from various domains. As many of them may look attractive, an effective decision of starting one business line or another should be supported by some tool that allows a systematic assessment of the opportunity of implementing them. This paper proposes an algorithm that supports entrepreneurs in this respect. The opportunity of developing new business lines is assessed by estimating the mutual impact between them and existing business lines, their impact on organizational performance, and additional indicators such as financial effort, the estimated return on investment, technical and organizational difficulty, risk level or domain financing opportunities. An application example is presented in which an SME in an interdisciplinary domain (covering IT and life-sciences assesses the opportunity of opening two new business lines.
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the number of options in a decision problem increases the number of heuristics brought to the task. This challenges the choice overload view that people give up when confronted with too much choice. PMID:22408282
Besedeš, Tibor; Deck, Cary; Sarangi, Sudipta; Shor, Mikhael
Using paper and pencil experiments administered in senior centers, we examine decision-making performance in multi-attribute decision problems. We differentiate the effects of declining cognitive performance and changing cognitive process on decision-making performance of seniors as they age. We find a significant decline in performance with age due to reduced reliance on common heuristics and increased decision-making randomness among our oldest subjects. However, we find that increasing the number of options in a decision problem increases the number of heuristics brought to the task. This challenges the choice overload view that people give up when confronted with too much choice.
Fraser, Michael; Elgamal, Ahmed; Conte, Joel P.; Masri, Sami; Fountain, Tony; Gupta, Amarnath; Trivedi, Mohan; El Zarki, Magda
Internet technologies are increasingly facilitating real-time monitoring of Bridges and Highways. The advances in wireless communications for instance, are allowing practical deployments for large extended systems. Sensor data, including video signals, can be used for long-term condition assessment, traffic-load regulation, emergency response, and seismic safety applications. Computer-based automated signal-analysis algorithms routinely process the incoming data and determine anomalies based on pre-defined response thresholds and more involved signal analysis techniques. Upon authentication, appropriate action may be authorized for maintenance, early warning, and/or emergency response. In such a strategy, data from thousands of sensors can be analyzed with near real-time and long-term assessment and decision-making implications. Addressing the above, a flexible and scalable (e.g., for an entire Highway system, or portfolio of Networked Civil Infrastructure) software architecture/framework is being developed and implemented. This framework will network and integrate real-time heterogeneous sensor data, database and archiving systems, computer vision, data analysis and interpretation, physics-based numerical simulation of complex structural systems, visualization, reliability & risk analysis, and rational statistical decision-making procedures. Thus, within this framework, data is converted into information, information into knowledge, and knowledge into decision at the end of the pipeline. Such a decision-support system contributes to the vitality of our economy, as rehabilitation, renewal, replacement, and/or maintenance of this infrastructure are estimated to require expenditures in the Trillion-dollar range nationwide, including issues of Homeland security and natural disaster mitigation. A pilot website (http://bridge.ucsd.edu/compositedeck.html) currently depicts some basic elements of the envisioned integrated health monitoring analysis framework.
Gwenan M. Knight
Full Text Available The dominant approach to decision-making in public health policy for infectious diseases relies heavily on expert opinion, which often applies empirical evidence to policy questions in a manner that is neither systematic nor transparent. Although systematic reviews are frequently commissioned to inform specific components of policy (such as efficacy, the same process is rarely applied to the full decision-making process. Mathematical models provide a mechanism through which empirical evidence can be methodically and transparently integrated to address such questions. However, such models are often considered difficult to interpret. In addition, models provide estimates that need to be iteratively re-evaluated as new data or considerations arise. Using the case study of a novel diagnostic for tuberculosis, a framework for improved collaboration between public health decision-makers and mathematical modellers that could lead to more transparent and evidence-driven policy decisions for infectious diseases in the future is proposed. The framework proposes that policymakers should establish long-term collaborations with modellers to address key questions, and that modellers should strive to provide clear explanations of the uncertainty of model structure and outputs. Doing so will improve the applicability of models and clarify their limitations when used to inform real-world public health policy decisions.
Chai, Junyi; Liu, James N. K.
The study proposes a framework of ONTOlogy-based Group Decision Support System (ONTOGDSS) for decision process which exhibits the complex structure of decision-problem and decision-group. It is capable of reducing the complexity of problem structure and group relations. The system allows decision makers to participate in group decision-making through the web environment, via the ontology relation. It facilitates the management of decision process as a whole, from criteria generation, alternat...
Díaz, Sandra; Demissew, Sebsebe; Carabias, Julia
, including indigenous and local knowledge. Because the focus on co-construction of integrative knowledge is shared by an increasing number of initiatives worldwide, this framework should be useful beyond IPBES, for the wider research and knowledge-policy communities working on the links between nature...... and people, such as natural, social and engineering scientists, policy-makers at different levels, and decision-makers in different sectors of society....
Typically environmental management problems require analysis of large and complex data sets originating from concurrent data streams with different data collection frequencies and pedigree. These big data sets require on-the-fly integration into a series of models with different complexity for various types of model analyses where the data are applied as soft and hard model constraints. This is needed to provide fast iterative model analyses based on the latest available data to guide decision-making. Furthermore, the data and model are associated with uncertainties. The uncertainties are probabilistic (e.g. measurement errors) and non-probabilistic (unknowns, e.g. alternative conceptual models characterizing site conditions). To address all of these issues, we have developed an integrated framework for real-time data and model analyses for environmental decision-making called ZEM. The framework allows for seamless and on-the-fly integration of data and modeling results for robust and scientifically-defensible decision-making applying advanced decision analyses tools such as Bayesian- Information-Gap Decision Theory (BIG-DT). The framework also includes advanced methods for optimization that are capable of dealing with a large number of unknown model parameters, and surrogate (reduced order) modeling capabilities based on support vector regression techniques. The framework is coded in Julia, a state-of-the-art high-performance programing language (http://julialang.org). The ZEM framework is open-source and can be applied to any environmental management site. The framework will be open-source and released under GPL V3 license.
Radio resource management becomes an important aspect of the current wireless networks because of spectrum scarcity and applications heterogeneity. Cognitive radio is a potential candidate for resource management because of its capability to satisfy the growing wireless demand and improve network efficiency. Decision-making is the main function of the radio resources management process as it determines the radio parameters that control the use of these resources. In this paper, we propose an adaptive decision-making scheme (ADMS) for radio resources management of different types of network applications including: power consuming, emergency, multimedia, and spectrum sharing. ADMS exploits genetic algorithm (GA) as an optimization tool for decision-making. It consists of the several objective functions for the decision-making process such as minimizing power consumption, packet error rate (PER), delay, and interference. On the other hand, maximizing throughput and spectral efficiency. Simulation results and test bed evaluation demonstrate ADMS functionality and efficiency.
... Editors David C. Spencer, MD Steven Karceski, MD Stroke, tPA, and physician decision-making Dominic Hovsepian, BS ... for oxygen, it is called ischemia or a stroke. The area of brain where the stroke occurs ...
This book provides an overview of intelligent decision-making techniques and discusses their application in production and retail operations. Manufacturing and retail enterprises have stringent standards for using advanced and reliable techniques to improve decision-making processes, since these processes have significant effects on the performance of relevant operations and the entire supply chain. In recent years, researchers have been increasingly focusing attention on using intelligent techniques to solve various decision-making problems. The opening chapters provide an introduction to several commonly used intelligent techniques, such as genetic algorithm, harmony search, neural network and extreme learning machine. The book then explores the use of these techniques for handling various production and retail decision-making problems, such as production planning and scheduling, assembly line balancing, and sales forecasting.
The aim of the paper is to present a heuristic method for decision-making regarding an NP-hard scheduling problem with limitations related to tasks and the resources dependent on the current state of the process...
Hansen, Claus Thorp; Andreasen, Mogens Myrup
stakeholders have to be reflected in the product design specifications, and decision-making during the design process becomes both a search for the best design solution and a navigation towards a feasible and efficient process. Thus, the decisions made during the design process have a critical impact both...... on the design solution obtained, but also on the design process in itself. In this paper we will propose a model of these interrelated decision activities, we will outline a mindset for decision-making, and we will discuss decision-making methodologies found in literature and current approaches seen in practice......In the situation where an industrial company launches a new product to the consumer market, based upon more or less new invented solutions, the evaluation and decision-making activities during design become rather complex. The engineering designer or design team has: · to target the customer’s need...
... a critical approach. ISSN 0378-5254 Journal of Family Ecology and Consumer Sciences, Vol 29, 2001. 82 ..... ties during consumer decision-making rather than preparedness before .... tant and that many of these models have a strong or.
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.
M. Stallen (Mirre)
textabstractThis thesis explores how social context influences the neurobiological processes underlying decision-making. To this end, this research takes an interdisciplinary approach, combining methods and insights from Psychology, Marketing, Economics, and Neuroscience. In particular, behavioural
Nies, Yong Hui; Islahudin, Farida; Chong, Wei Wen; Abdullah, Norlia; Ismail, Fuad; Ahmad Bustamam, Ros Suzanna; Wong, Yoke Fui; Saladina, J J; Mohamed Shah, Noraida
This study investigated breast cancer patients' involvement level in the treatment decision-making process and the concordance between patients' and physician's perspectives in decision-making. A cross-sectional study was conducted involving physicians and newly diagnosed breast cancer patients from three public/teaching hospitals in Malaysia. The Control Preference Scale (CPS) was administered to patients and physicians, and the Krantz Health Opinion Survey (KHOS) was completed by the patients alone. Binary logistic regression was used to determine the association between sociodemographic characteristics, the patients' involvement in treatment decision-making, and patients' preference for behavioral involvement and information related to their disease. The majority of patients preferred to share decision-making with their physicians (47.5%), while the second largest group preferred being passive (42.6%) and a small number preferred being active (9.8%). However, the physicians perceived that the majority of patients preferred active decision-making (56.9%), followed by those who desired shared decision-making (32.8%), and those who preferred passive decision-making (10.3%). The overall concordance was 26.5% (54 of 204 patient-physician dyads). The median of preference for information score and behavioral involvement score was 4 (interquartile range [IQR] =3-5) and 2 (IQR =2-3), respectively. In univariate analysis, the ethnicity and educational qualification of patients were significantly associated with the patients' preferred role in the process of treatment decision-making and the patients' preference for information seeking (p>0.05). However, only educational qualification (p=0.004) was significantly associated with patients' preference for information seeking in multivariate analysis. Physicians failed to understand patients' perspectives and preferences in treatment decision-making. The concordance between physicians' perception and patients' perception was
Zafeiris, Anna; Koman, Zsombor; Mones, Enys
for finding the optimal distribution of the group membersâ€™ competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach...... requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present empirical results obtained by using a large-scale database of citations being in good agreement with the above theory. The framework we have developed can easily be adapted to a variety...
Full Text Available Introduction Since Occupy Wall Street finally started getting mainstream media coverage, the idea of consensus decision-making seems to have permeated our American psyche. For me, it was waking up to a story on NPR’s Morning Edition that I couldn’t shake. The story featured a discussion of the group meetings and decision-making process occurring in Zuccotti [...
G. J. Rossouw
Business Ethics is a truly interdisciplinary field of study. The specific issue of moral decision-making within the field of business ethics testifies to this. Recently some have made important contributions in this regard - contributions in which they emphasised that moral theory is not sufficient for moral decision-making. What is needed besides moral theory is problem-solving ability. In this article the same point is argued, but from a philosophical perspective. It is further indicated th...
Rebecca LeFebvre; Volker Franke
Does culture matter in decision-making? Existing literature largely assumes that the cognitive processes that inform decision-making are universally applicable, while only very few studies indicate that cultural norms and values shape cognitive processes. Using survey based quasi-experimental design, this research shows that subjects with higher levels of individualism tend to be more rational in their decision processing, while those with higher levels of collectivism tend to be more depende...
E. Martínez Bernabé; G. Paluzie-Ávila; S. Terre Ohme; D. Ruiz Poza; M. A. Parada Aradilla; J. González Martínez; R. Albertí Valmaña; M. Castellvi Gordo
Introduction: Support systems in clinical decision-making use individual characteristicsof the patient to generate recommendations to the clinician. Objective: To assess the impact of a tool for adjusting drug dosing in renal failure asa support system in clinical decision-making regarding the level of acceptance of theinterventions as well as the time invested by the pharmacist. Method: Non-randomized, prospective and hospital interventional study comparingpre- and post-implementation ...
Murty, Vishnu; FeldmanHall, Oriel; Hunter, Lindsay E.; Phelps, Elizabeth A.; Davachi, Lila
Prior research illustrates that memory can guide value-based decision-making. For example, previous work has implicated both working memory and procedural memory (i.e., reinforcement learning) in guiding choice. However, other types of memories, such as episodic memory, may also influence decision-making. Here we test the role for episodic memory—specifically item versus associative memory—in supporting value-based choice. Participants completed a task where they first learned the value assoc...
Full Text Available We present a dynamical systems analysis of a decision-making mechanism inspired by collective choice in house-hunting honeybee swarms, revealing the crucial role of cross-inhibitory 'stop-signalling' in improving the decision-making capabilities. We show that strength of cross-inhibition is a decision-parameter influencing how decisions depend both on the difference in value and on the mean value of the alternatives; this is in contrast to many previous mechanistic models of decision-making, which are typically sensitive to decision accuracy rather than the value of the option chosen. The strength of cross-inhibition determines when deadlock over similarly valued alternatives is maintained or broken, as a function of the mean value; thus, changes in cross-inhibition strength allow adaptive time-dependent decision-making strategies. Cross-inhibition also tunes the minimum difference between alternatives required for reliable discrimination, in a manner similar to Weber's law of just-noticeable difference. Finally, cross-inhibition tunes the speed-accuracy trade-off realised when differences in the values of the alternatives are sufficiently large to matter. We propose that the model, and the significant role of the values of the alternatives, may describe other decision-making systems, including intracellular regulatory circuits, and simple neural circuits, and may provide guidance in the design of decision-making algorithms for artificial systems, particularly those functioning without centralised control.
Fox, John; Cooper, Richard P.; Glasspool, David W.
Decision-making behavior is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI, and other technical disciplines. However the conceptualization of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision-maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision-making with respect to other high-level cognitive capabilities like problem solving, planning, and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuropsychology, artificial intelligence, and decision engineering. PMID:23565100
Murty, Vishnu P; FeldmanHall, Oriel; Hunter, Lindsay E; Phelps, Elizabeth A; Davachi, Lila
Prior research illustrates that memory can guide value-based decision-making. For example, previous work has implicated both working memory and procedural memory (i.e., reinforcement learning) in guiding choice. However, other types of memories, such as episodic memory, may also influence decision-making. Here we test the role for episodic memory-specifically item versus associative memory-in supporting value-based choice. Participants completed a task where they first learned the value associated with trial unique lotteries. After a short delay, they completed a decision-making task where they could choose to reengage with previously encountered lotteries, or new never before seen lotteries. Finally, participants completed a surprise memory test for the lotteries and their associated values. Results indicate that participants chose to reengage more often with lotteries that resulted in high versus low rewards. Critically, participants not only formed detailed, associative memories for the reward values coupled with individual lotteries, but also exhibited adaptive decision-making only when they had intact associative memory. We further found that the relationship between adaptive choice and associative memory generalized to more complex, ecologically valid choice behavior, such as social decision-making. However, individuals more strongly encode experiences of social violations-such as being treated unfairly, suggesting a bias for how individuals form associative memories within social contexts. Together, these findings provide an important integration of episodic memory and decision-making literatures to better understand key mechanisms supporting adaptive behavior. (c) 2016 APA, all rights reserved).
Full Text Available In order to regulate natural processes and control the scale of human activities, sustainability assessment needs to be integrated into urban planning. In this context, indicator-based sustainability assessment tools are fundamental instruments that provide information to support policy and decision-making. Indicators are necessary to monitor the implementation of the policies and provide feedback needed to accomplish the desirable state of sustainable urban development. This paper aims to explore the role of indicator-based sustainability assessment in policy and the decision-making process. Therefore, it reviews the identified sustainable development indicator initiatives and addresses the research gaps in the literature for future improvement of sustainability assessment frameworks. It concludes with a discussion that the major problem in sustainability assessment lies in the gathering of reliable and accessible data.
Ren, Jingzheng; Manzardo, Alessandro; Mazzi, Anna
Purpose The study objectives are two-fold: (i) combining the life cycle sustainability assessment (LCSA) framework and the multi-criteria decision-making (MCDM) methodology for sustainability assessment; (ii) determining the most sustainable scenario for bioethanol production in China according...... is to test the combination of a MCDM methodology and LCSA for sustainability decision-making by studying three alternative pathways for bioethanol production in China. The proposed method feasibly enables the decision-makers/stakeholders to find the most sustainable scenario to achieve their objectives among......’s proposed method investigates an illustrative case about three alternative bioethanol production scenarios (wheat-based, corn-based and cassava-based): the prior sequence (based on the sustainability performances) in descending order is cassava-based, corn-based and wheat-based. The proposed methodology...
D'Amico, Francesco; Rehill, Amritpal; Knapp, Martin; Lowery, David; Cerga-Pashoja, Arlinda; Griffin, Mark; Iliffe, Steve; Warner, James
Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains. Copyright © 2015 John Wiley & Sons, Ltd.
Full Text Available Georgi Iskrov, Rumen Stefanov Department of Social Medicine and Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria Abstract: This study aims to explore the current rationale of post-marketing access to orphan drugs. As access to orphan medicinal products depends on assessment and appraisal by health authorities, this article is focused on health technology assessment (HTA and reimbursement decision-making considerations for orphan drugs. A critical analysis may identify important factors that could predetermine the combined outcomes of these two processes. Following this objective, an analytical framework was developed, comprising three overlaying issues: to outline what is currently done and what needs to be done in the field of HTA of orphan drugs, to synthesize important variables relevant to the reimbursement decision-making about orphan drugs, and to unveil relationships between theory and practice. Methods for economic evaluation, cost-effectiveness threshold, budget impact, uncertainty of evidence, criteria in reimbursement decision-making, and HTA research agenda are all explored and discussed from an orphan drug perspective. Reimbursement decision-making for orphan drugs is a debate of policy priorities, health system specifics, and societal attitudes. Health authorities need to pursue a multidisciplinary analysis on a range of criteria, ensuring an explicit understanding of the trade-offs for decisions related to eligibility for reimbursement. The only reasonable way to accept a higher valuation of orphan drug benefits is if these are demonstrated empirically. Rarity means that the quality of orphan drug evidence is not the same as for conventional therapies. Closing this gap is another crucial point for the timely access to these products. The generation of evidence goes far beyond pre-market authorization trials and requires transnational cooperation and coordination. Early constructive dialogue among orphan drug
Waldron, Nicholas; Johnson, Claire E; Saul, Peter; Waldron, Heidi; Chong, Jeffrey C; Hill, Anne-Marie; Hayes, Barbara
Advance cardiopulmonary resuscitation (CPR) decision-making and escalation of care discussions are variable in routine clinical practice. We aimed to explore physician barriers to advance CPR decision-making in an inpatient hospital setting and develop a pragmatic intervention to support clinicians to undertake and document routine advance care planning discussions. Two focus groups, which involved eight consultants and ten junior doctors, were conducted following a review of the current literature. A subsequent iterative consensus process developed two intervention elements: (i) an updated 'Goals of Patient Care' (GOPC) form and process; (ii) an education video and resources for teaching advance CPR decision-making and communication. A multidisciplinary group of health professionals and policy-makers with experience in systems development, education and research provided critical feedback. Three key themes emerged from the focus groups and the literature, which identified a structure for the intervention: (i) knowing what to say; (ii) knowing how to say it; (iii) wanting to say it. The themes informed the development of a video to provide education about advance CPR decision-making framework, improving communication and contextualising relevant clinical issues. Critical feedback assisted in refining the video and further guided development and evolution of a medical GOPC approach to discussing and recording medical treatment and advance care plans. Through an iterative process of consultation and review, video-based education and an expanded GOPC form and approach were developed to address physician and systemic barriers to advance CPR decision-making and documentation. Implementation and evaluation across hospital settings is required to examine utility and determine effect on quality of care.
There is a tendency for physicians to approach ethical problems in a manner similar to that in which they approach medical problems. Instead of disease categories (such as congestive heart failure or diarrhea), the physician substitutes moral quandaries (such as euthanasia or abortion). The goal is to learn what the "right" rules are for this particular problem at this particular moment. Although this method has important practical and instructive value, it can produce an empirical attitude toward ethics akin to that found in students who strive to learn medicine solely by algorithms. Using theoretical models as a center for discussion, this article has attempted to approach medical ethics as a decision-making process derived from the physician-patient relationship model in use. What is the type of physician-patient relationship that forms the soundest base for making ethical decisions? It must be realized that the contractual relationship cannot be ignored, for in our consumer-oriented society it will surely remain as a protection for the patient against the incompetent or immoral physician. It should not become the sole guide of physician behavior, however, lest we be satisfied with mediocre behavior as the maximal standard. Likewise, although technical competence is required for one to make the right and good decision, it is insufficient alone as a guide for moral behavior. Given the medically correct facts, a multitude of responses are available which necessitate a moral choice. Physicians need a guiding principle that goes beyond any aesthetic code of behavior, or protection of self-interest, and which enables them to deal with all the unexpected ethical questions faced in providing care to patients. Moral principles such as truth-telling, promise-keeping, and protecting the patient when he is vulnerable, help the physician to act in a moral manner, but lack the encompassing nature of the covenantal promise. The covenantal model includes a donative element
Dunn, Jennifer A; Hay-Smith, E Jean; Keeling, Sally; Sinnott, K Anne
To quantify time from spinal cord injury to upper limb reconstructive surgery for individuals with tetraplegia; to explore influences on decision-making about surgery for persons with long-standing (>10y) tetraplegia; and to determine the applicability of our previously developed conceptual framework that described the decision-making processes for people with tetraplegia of tetraplegia for >10 years. Not applicable. An audit of time frames between injury, assessment, and surgery for people with tetraplegia was undertaken. Interviews of people with tetraplegia were analyzed using constructivist grounded theory. Sixty-two percent of people with tetraplegia assessed for surgery had upper limb reconstructive surgery. Most were assessed within the first 3 years of spinal cord injury. Over half had surgery within 4 years after injury; however, 20% waited >10 years. Changes in prioritized activities, and the identification of tasks possible with surgery, were influential in the decision-making process. Participants were aware of surgery, but required a reoffer from health professionals before proceeding. The influence of peers was prominent in reinforcing the improvement in prioritized activities possible after surgery. Findings confirmed that the previously developed conceptual framework for decision-making about upper limb reconstructive surgery was applicable for people with tetraplegia of >10 years. Similarities were seen in the influence of goals and priorities (although the nature of these might change) and information from peers (although this influence was greater for those injured longer). Repeat offers for surgery were required to allow for changes in circumstances over time. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
We examine the main theoretical models of decision making under stress and the effects of decision stress on decision making process to provide a deeper understanding of the decision making phenomenon. The literature review reveals that stress can have an impact on each stage of the decision-making process. The review also finds that decision makers could enhance their decision-making performance and prevent potential decision failures by means of adapting certain coping strategies.
Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products. This paper presents a conceptual framework for including near-field exposures into Life Cycle Assessment using advanced human exposure modeling and high-throughput tools
Public health, prevention, health education and health promotion are inseparable from the concepts of information and communication. Information should respond as much as possible to the needs of professionals, decision-makers, and consumers who are more and more concerned and conscious of its importance in light of "information overload", various dissemination channels and the multiplicity of its sources. There are numerous issues at stake ranging from comprehension, to the validation of health information, health education, health promotion, prevention, decision-making, as well as issues related to knowledge and power. Irrespective of the type of choice to be made, the need for information, knowledge, and know-how is inseparable from that of other tools or regulatory measures required for decision-making. Information is the same as competence, epidemiological and population data, health data, scientific opinion, and expert conferences--all are needed to assist in decision-making. Based on the principle of precaution, information must increasingly take into account the rejection of a society which often reasons on the basis of a presumption of zero-risk, in an idealistic manner, and which also excludes the possibility of new risks. The consumer positions himself as the regulator of decisions, specifically those with regard to the notion of acceptable level of risk. All of the actors involved in the health system are or become at one moment or another public health decision-makers. Their decision might be based either on an analytical approach, or on an intuitive approach. Although the act of decision-making is the least visible part of public health policy, it is certainly the driving force. This process should integrate the perspective of all of the relevant players, including consumers, who are currently situated more and more frequently at the heart of the health system. Public health decision-making is conducted as a function of political, strategic and
Muhar, Andreas; Raymond, Christopher M.; van den Born, Riyan J.G.
of existing social-cultural concepts, frameworks and associated research methods. Particular emphasis is given to the context-sensitivity of social-cultural concepts in decision-making. These aspects are translated into a conceptual model aiming not to replace but to expand and enhance existing frameworks....... Integrating this model into existing frameworks provides a tool for the exploration of how social-cultural concepts of nature interact with existing contexts to influence governance of social-ecological systems....
Theuns F.J. Oosthuizen
Full Text Available A lack of optimum selection and application of decision-making techniques, in conjunction with suitable decision-making practice and perception of employees in a transport work environment demands attention to improve overall performance. Although multiple decision-making techniques exist, five prevalent techniques were considered in this article, namely the Kepner-Tregoe, Delphi, stepladder, nominal group and brainstorming techniques. A descriptive research design was followed, using an empirical survey which was conducted among 210 workers employed in a transport work environment and studying in the field of transport management. The purpose was to establish to what extent the five decision-making techniques are used in their work environment and furthermore how the decision-making practice of using gut-feel and/or a step-by-step decision-making process and their perception of their decision-making success relate. The research confirmed that the use of decision-making techniques is correlated to perceived decision-making success. Furthermore, the Kepner-Tregoe, stepladder, Delphi and brainstorming techniques are associated with a step-by-step decision-making process. No significant association was confirmed between the use of gut-feel and decision-making techniques. Brainstorming was found to be the technique most frequently used by transport employees; however, it has limitations as a comprehensive decision-making technique. Employees working in a transport work environment need training in order to select and use the four comprehensive decision-making techniques.
If an eruption sequence is protracted and episodic, continuing for many months, or even a number of years, it can be very difficult for authorities to decide when an evacuated population might be allowed to return. A precautionary approach may be appropriate as a general principle, especially if the societal implications are deemed to be manageable. However, where the livelihoods of the evacuees are critically at stake, such as with farmers, and the economic costs of continuing evacuation are high, a risk-informed approach to supporting decision-making might be warranted. Such an approach has been developed, based on concepts drawn from cost-benefit analysis. On any given day during an extended volcanic crisis, a decision-maker may wish to consider whether to allow then for the return of evacuees. A delay of a decision by one day will increase the evacuation cost by one day's worth of accommodation and economic disruption. On the other hand, there is a small chance that there might be an onset to another eruption on this given day, so there would be a safety benefit in the delay. The task of quantifying this safety benefit requires a coherent synthesis of all the volcano monitoring data time series, together with an assessment of the medium and long-term historical and geological data, so that the probability of each of the alternative eruptive scenarios can be scientifically estimated. Bayesian belief networks provide a convenient framework for this synthesis. For each scenario, the potential casualty implications for returned evacuees need to be assessed. The application of this end of eruption methodology is illustrated and compared with the equivalent decision-making procedure at the start of an eruption.
Hepler, Teri J.; Feltz, Deborah L.
The purpose of this study was to examine the relationship between decision-making self-efficacy and decision-making performance in sport. Undergraduate students (N = 78) performed 10 trials of a decision-making task in baseball. Self-efficacy was measured before performing each trial. Decision-making performance was assessed by decision speed and…
Get a thorough introduction to ADO.NET Entity Framework 4 -- Microsoft's core framework for modeling and interacting with data in .NET applications. The second edition of this acclaimed guide provides a hands-on tour of the framework latest version in Visual Studio 2010 and .NET Framework 4. Not only will you learn how to use EF4 in a variety of applications, you'll also gain a deep understanding of its architecture and APIs. Written by Julia Lerman, the leading independent authority on the framework, Programming Entity Framework covers it all -- from the Entity Data Model and Object Service
Gillespie, Mary; Shackell, Eileen
In nursing education, physiological concepts are typically presented within a body 'systems' framework yet learners are often challenged to apply this knowledge in the holistic and functional manner needed for effective clinical decision-making and safe patient care. A nursing faculty addressed this learning challenge by developing an advanced organizer as a conceptual and integrative learning tool to support learners in diverse learning environments and practice settings. A mixed methods research study was conducted that explored the effectiveness of the Oxygen Supply and Demand Framework as a learning tool in undergraduate nursing education. A pretest/post-test assessment and reflective journal were used to gather data. Findings indicated the Oxygen Supply and Demand Framework guided the development of pattern recognition and thinking processes and supported knowledge development, knowledge application and clinical decision-making. The Oxygen Supply and Demand Framework supports undergraduate students learning to provide safe and effective nursing care. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Although poor decision-making is a hallmark of psychiatric conditions such as attention deficit/hyperactivity disorder, pathological gambling or substance abuse, a fraction of healthy individuals exhibit similar poor decision-making performances in everyday life and specific laboratory tasks such as the Iowa Gambling Task. These particular individuals may provide information on risk factors or common endophenotypes of these mental disorders. In a rodent version of the Iowa gambling task--the Rat Gambling Task (RGT, we identified a population of poor decision makers, and assessed how these rats scored for several behavioral traits relevant to executive disorders: risk taking, reward seeking, behavioral inflexibility, and several aspects of impulsivity. First, we found that poor decision-making could not be well predicted by single behavioral and cognitive characteristics when considered separately. By contrast, a combination of independent traits in the same individual, namely risk taking, reward seeking, behavioral inflexibility, as well as motor impulsivity, was highly predictive of poor decision-making. Second, using a reinforcement-learning model of the RGT, we confirmed that only the combination of extreme scores on these traits could induce maladaptive decision-making. Third, the model suggested that a combination of these behavioral traits results in an inaccurate representation of rewards and penalties and inefficient learning of the environment. Poor decision-making appears as a consequence of the over-valuation of high-reward-high-risk options in the task. Such a specific psychological profile could greatly impair clinically healthy individuals in decision-making tasks and may predispose to mental disorders with similar symptoms.
Lovell, Sarah; Walker, Robert J; Schollum, John B W; Marshall, Mark R; McNoe, Bronwen M; Derrett, Sarah
Background Issues related to renal replacement therapy in elderly people with end stage kidney disease (ESKD) are complex. There is inadequate empirical data related to: decision-making by older populations, treatment experiences, implications of dialysis treatment and treatment modality on quality of life, and how these link to expectations of ageing. Study population Participants for this study were selected from a larger quantitative study of dialysis and predialysis patients aged 65 years or older recruited from three nephrology services across New Zealand. All participants had reached chronic kidney disease (CKD) stage 5 and had undergone dialysis education but had not started dialysis or recently started dialysis within the past 6 months. Methodology Serial qualitative interviews were undertaken to explore the decision-making processes and subsequent treatment experiences of patients with ESKD. Analytical approach: A framework method guided the iterative process of analysis. Decision-making codes were generated within NVivo software and then compared with the body of the interviews. Results Interviews were undertaken with 17 participants. We observed that decision-making was often a fluid process, rather than occurring at a single point in time, and was heavily influenced by perceptions of oneself as becoming old, social circumstances, life events and health status. Limitations This study focuses on participants' experiences of decision-making about treatment and does not include perspectives of their nephrologists or other members of the nephrology team. Conclusions Older patients often delay dialysis as an act of self-efficacy. They often do not commit to a dialysis decision following predialysis education. Delaying decision-making and initiating dialysis were common. This was not seen by participants as a final decision about therapy. Predialysis care and education should be different for older patients, who will delay decision-making until the time of
Sahul Hameed, Ruzanna; Thiruchelvam, Sivadass; Nasharuddin Mustapha, Kamal; Che Muda, Zakaria; Mat Husin, Norhayati; Ezanee Rusli, Mohd; Yong, Lee Choon; Ghazali, Azrul; Itam, Zarina; Hakimie, Hazlinda; Beddu, Salmia; Liyana Mohd Kamal, Nur
This paper proposes a conceptual framework to compare criteria/factor that influence the supplier selection. A mixed methods approach comprising qualitative and quantitative survey will be used. The study intend to identify and define the metrics that key stakeholders at Public Works Department (PWD) believed should be used for supplier. The outcomes would foresee the possible initiatives to bring procurement in PWD to a strategic level. The results will provide a deeper understanding of drivers for supplier’s selection in the construction industry. The obtained output will benefit many parties involved in the supplier selection decision-making. The findings provides useful information and greater understanding of the perceptions that PWD executives hold regarding supplier selection and the extent to which these perceptions are consistent with findings from prior studies. The findings from this paper can be utilized as input for policy makers to outline any changes in the current procurement code of practice in order to enhance the degree of transparency and integrity in decision-making.
In recent years, various authors have proposed that the concept of equipoise be abandoned since it conflates the practice of clinical care with clinical research. At the same time, the equipoise opponents acknowledge the necessity of clinical research if there are unresolved uncertainties about the effects of proposed healthcare interventions. Since equipoise represents just one measure of uncertainty, proposals to abandon equipoise while maintaining a requirement for addressing uncertainties are contradictory and ultimately not valid. As acknowledgment and articulation of uncertainties represent key scientific and moral requirements for human experimentation, the concept of equipoise remains the most useful framework to link the theory of human experimentation with the theory of rational choice. In this paper, I show how uncertainty (equipoise) is at the intersection between epistemology, decision-making and ethics of clinical research. In particular, I show how our formulation of responses to uncertainties of hoped-for benefits and unknown harms of testing is a function of the way humans cognitively process information. This approach is based on the view that considerations of ethics and rationality cannot be separated. I analyze the response to uncertainties as it relates to the dual-processing theory, which postulates that rational approach to (clinical research) decision-making depends both on analytical, deliberative processes embodied in scientific method (system II) and “good” human intuition (system I). Ultimately, our choices can only become wiser if we understand a close and intertwined relationship between irreducible uncertainty, inevitable errors, and unavoidable injustice. PMID:21817885
Cassey, Peter J; Gaut, Garren; Steyvers, Mark; Brown, Scott D
Theory development in both psychology and neuroscience can benefit by consideration of both behavioral and neural data sets. However, the development of appropriate methods for linking these data sets is a difficult statistical and conceptual problem. Over the past decades, different linking approaches have been employed in the study of perceptual decision-making, beginning with rudimentary linking of the data sets at a qualitative, structural level, culminating in sophisticated statistical approaches with quantitative links. We outline a new approach, in which a single model is developed that jointly addresses neural and behavioral data. This approach allows for specification and testing of quantitative links between neural and behavioral aspects of the model. Estimating the model in a Bayesian framework allows both data sets to equally inform the estimation of all model parameters. The use of a hierarchical model architecture allows for a model, which accounts for and measures the variability between neurons. We demonstrate the approach by re-analysis of a classic data set containing behavioral recordings of decision-making with accompanying single-cell neural recordings. The joint model is able to capture most aspects of both data sets, and also supports the analysis of interesting questions about prediction, including predicting the times at which responses are made, and the corresponding neural firing rates.
Owen, Megan A; Swaisgood, Ronald R; Blumstein, Daniel T
Survival and successful reproduction require animals to make critical decisions amidst a naturally dynamic environmental and social background (i.e. "context"). However, human activities have pervasively, and rapidly, extended contextual variation into evolutionarily novel territory, potentially rendering evolved animal decision-making mechanisms and strategies maladaptive. We suggest that explicitly focusing on animal decision-making (ADM), by integrating and applying findings from studies of sensory ecology, cognitive psychology, behavioral economics and eco-evolutionary strategies, may enhance our understanding of, and our ability to predict how, human-driven changes in the environment and population demography will influence animal populations. Fundamentally, the decisions animals make involve evolved mechanisms, and behaviors emerge from the combined action of sensory integration, cognitive mechanisms and strategic rules of thumb, and any of these processes may have a disproportionate influence on behavior. Although there is extensive literature exploring ADM, it generally reflects a canalized, discipline-specific approach that lacks a unified conceptual framework. As a result, there has been limited application of ADM theory and research findings into predictive models that can enhance management outcomes, even though it is likely that the relative resilience of species to rapid environmental change is fundamentally a result of how ADM is linked to contextual variation. Here, we focus on how context influences ADM, and highlight ideas and results that may be most applicable to conservation biology. © 2016 International Society of Zoological Sciences, Institute of Zoology/Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.
Goeree, Ron; Diaby, Vakaramoko
In a climate of escalating demands for new health care services and significant constraints on new resources, the disciplines of health economics and health technology assessment (HTA) have increasingly been turned to as explicit evidence-based frameworks to help make tough health care access and reimbursement decisions. Health economics is the discipline of economics concerned with the efficient allocation of health care resources, essentially trying to maximize health benefits to society contingent upon available resources. HTA is a broader field drawing upon several disciplines, but which relies heavily upon the tools of health economics and economic evaluation. Traditionally, health economics and economic evaluation have been widely used at the political (macro) and local (meso) decision-making levels, and have progressively had an important role even at informing individual clinical decisions (micro level). The aim of this paper is to introduce readers to health economics and discuss its relevance to frontline clinicians. Particularly, the content of the paper will facilitate clinicians' understanding of the link between economics and their medical practice, and how clinical decision-making reflects on health care resource allocation. Copyright © 2013 Elsevier Ltd. All rights reserved.
Potter, Beth K; Etchegary, Holly; Nicholls, Stuart G; Wilson, Brenda J; Craigie, Samantha M; Araia, Makda H
A challenge in designing effective education for parents about newborn screening (NBS) has been uncertainty about appropriate content. Arguing that the goals of education may be usefully tied to parental decision-making, we sought to: (1) explore how different ways of implementing NBS differ in their approaches to parental engagement in decision-making; (2) map the potential goals of education onto these "implementation models"; and (3) consider the content that may be needed to support these goals. The resulting conceptual framework supports the availability of comprehensive information about NBS for parents, irrespective of the model of implementation. This is largely because we argue that meeting parental expectations and preferences for communication is an important goal regardless of whether or notparents are actively involved in making a decision. Our analysis supports a flexible approach, in which some educational messages are emphasized as important for all parents to understand while others are made available depending on parents' preferences. We have begun to define the content of NBS education for parents needed to support specific goals. Further research and discussion is important to determine the most appropriate strategies for delivering the tailored approach to education that emerged from our analysis.
Resource and experiential impacts associated with visitation to wilderness and other similar backcountry settings have long been addressed by land managers under the context of “carrying capacity” decisionmaking. Determining a maximum level of allowable use, below which high-quality resource and experiential conditions would be sustained, was an early focus in the 1960s and 1970s. However, decades of recreation ecology research have shown that the severity and areal extent of visitor impact problems are influenced by an interrelated array of use-related, environmental, and managerial factors. This complexity, with similar findings from social science research, prompted scientists and managers to develop more comprehensive carrying capacity frameworks, including a new Visitor Use Management framework. These frameworks rely on a diverse array of management strategies and actions, often termed a “management toolbox,” for resolving visitor impact problems. This article reviews the most recent and relevant recreation ecology studies that have been applied in wildland settings to avoid or minimize resource impacts. The key findings and their management implications are highlighted to support the professional management of common trail, recreation site, and wildlife impact problems. These studies illustrate the need to select from a more diverse array of impact management strategies and actions based on an evaluation of problems to identify the most influential factors that can be manipulated.
Afsarmanesh, H.; Camarinha-Matos, L.M.; Camarinha-Matos, L.M.; Afsarmanesh, H.
A framework is defined for ARCON reference modeling, introducing multiple modeling perspectives of: Environment characteristics, life cycle stages, and modeling intents. This novel modeling framework takes into account contributions from previous related works, mainly on enterprise modeling, and
Decision-making refers to assessing costs and benefits of competing actions, with either a known outcome or an uncertain result. Decision-making depends on several abilities, such as behavioural flexibility and inhibiting risky responses. Several factors affect decision-making, causing differences in the outcome of decision-making processes. The overall aim was to improve our understanding of effects of stress and gender on decision-making, in rodents and in humans. First, impulsive decision-...
Venture capital investment decision-making is the most important issue in venture capital investment selection. There are higher uncertainty and complexity in venture capital investment decision-making process. This paper analysis these uncertain risk in venture capital investment decision-making base the previous studies. Attributed the venture capital candidate firms' select to fuzzy optimal decision-making. Build a risk-weight fuzzy optimal return model to avoid the decision-making risk. Get the optimal solution set.
This set of tutorials provides an overview of incorporating systems thinking into decision-making, an introduction to the DPSIR framework as one approach that can assist in the decision analysis process, and an overview of DPSIR tools, including concept mapping and keyword lists,...
Maluka, Stephen; Kamuzora, Peter; Sebastián, Miguel San
In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania...
Gogate, Nivedita G.; Kalbar, Pradip; Raval, Pratap M.
This paper addresses the problem of selecting the most sustainable stormwater management alternative in developing countries in a dense urban context. Firstly, suitable Low Impact Development (LID) stormwater management measures for dense urban areas in developing countries were identified based...... on critical review of literature. Alternatives have been formulated as varying percentages (degree of adoption) of these suitable measures to manage the stormwater sustainably. Further, a novel decision-making framework is developed which generates the hierarchy for selection of the most sustainable...... stormwater management alternative. Four main criteria (technical, economic, environmental and social) comprising three quantitative and eight qualitative indicators have been used for evaluating seven alternatives. The regional and local societal priorities are captured through criteria...
Allio, Lorenzo; Ballantine, Bruce; Meads, Richard
Used well, science provides effective ways of identifying potential risks, protecting citizens, and using resources wisely. It enables government decisions to be based on evidence and provides a foundation for a rule-based framework that supports global trade. To ensure that the best available science becomes a key input in the decisions made by EU institutions, this abridged version of a working paper produced for the European Policy Centre, a leading, independent think tank, considers how science is currently used in the policy and decision-making processes of the EU, what the limitations of scientific evidence are, and how a risk assessment process based on scientific 'good practices' can be advantageous. Finally, the paper makes recommendations on how to improve the use of science by EU institutions.
Marchamalo, M. [Research Group: Hydrobiology, Universidad Politecnica de Madrid, Madrid (Spain); Romero, C. [Research Group: Economics for a Sustainable Environment, Universidad Politecnica de Madrid, Madrid (Spain)
The economic, social and environmental implications of electricity generation for land use planning are a significant and complex problem in many countries. One reason for this complexity is the existence of several stakeholders with very different views or perceptions of the different criteria underlying the decision-making process. Therefore, the aggregation of individual stakeholder preferences into a single collective preference is a crucial problem. In this paper, this type of problem is addressed with the help of a methodology based upon the definition of a consensus within a distance-based framework. The methodology is applied to a case study in Costa Rica at two levels: at a national level and at a river basin level. The River Birris was chosen because the conflict of interests between agricultural production and electricity generation are especially significant in this basin. (author)
To present the philosophical framework of feminist poststructuralism, discuss its use as an innovative research approach and its implications for nursing knowledge development and practice. This perspective examines the construction of meaning, power relationships, and the importance of language as it affects contemporary healthcare decisions. It seeks to identify and expose biases that marginalize the healthcare needs of women and contribute to healthcare disparities for this population. Additionally, a feminist poststructuralist perspective seeks to develop new knowledge for understanding gender differences. A feminist poststructuralist perspective represents an alternative paradigm for studying the phenomenon of clinical decision-making. An empirical application example of a feminist poststructuralist perspective is provided. This exemplar investigated emergency department registered nurses' triage decisions for men and women with symptoms suggestive of coronary heart disease.
Møller, Lea Ravnkilde; Drews, Martin; Larsen, Morten Andreas Dahl
crops, irrigated crops and livestock) by a continuous updating of beliefs relative to realised trajectories of climate (change), represented by projections of temperature and precipitation. The climate data is based on combinations of output from three global/regional climate model combinations and two......Climate change causes transformations to the conditions of existing agricultural practices appointing farmers to continuously evaluate their agricultural strategies, e.g., towards optimising revenue. In this light, this paper presents a framework for applying Bayesian updating to simulate decision......-making, reaction patterns and updating of beliefs among farmers in a developing country, when faced with the complexity of adapting agricultural systems to climate change. We apply the approach to a case study from Ghana, where farmers seek to decide on the most profitable of three agricultural systems (dryland...
Ngadimon, I W; Islahudin, F; Mohamed Shah, N; Md Hatah, E; Makmor-Bakry, M
Background Shared decision-making is vital in achieving desired drug therapy goals, especially with antibiotics, in view of the potential long-term reduction in drug resistance. However, shared decision-making is rarely practiced with adolescent patients. Objectives The aim of the study was to identify the effect antibiotic education has on willingness to engage in shared decision-making among adolescents in Malaysia. Setting Participants from secondary schools in Malaysia were enrolled with ethical approval. Method The adolescents answered a validated questionnaire, which included demographics, antibiotic knowledge, attitude towards antibiotic use, and the Control Preference Scale, which measures willingness to engage in shared decision-making. Afterwards, antibiotic education was delivered to participating students. Main outcome measure Knowledge about and attitude toward antibiotics were investigated. Results A total of 510 adolescents participated in the study. Knowledge of antibiotics significantly increased post education (pre 3.2 ± 1.8 vs. post 6.8 ± 2.1, p education (χ = 36.9, df = 2, p education improves knowledge, attitude, and willingness to engage in shared decision-making among adolescents. Antibiotic education can therefore be introduced as a strategy to reduce inappropriate antibiotic use.
Lee, Shiu-Yu C Katie
The decision-making process that is used by cancer patients to determine their treatment has become more multi-foci, difficult and complicated in recent years. This has in part been attributed to the increasing incidence rate of cancer in Taiwan and the rapid development of medical technologies and treatment modalities. Oncology nurses must assist patients and family to make informed and value-based treatment decisions. Decision-making is an information process that involves appraising one's own expectation and values based on his/her knowledge on cancer and treatment options. Because cancer treatment involves risks and uncertainties, and impacts quality of life, the treatment decision-making for cancer is often stressful, or even conflicting. This paper discusses the decision-making behaviors of cancer patients and the decisional conflict, participation, and informational needs that are involved in cancer treatment. The trend toward shared decision-making and decisional support will be also explored in order to facilitate the future development of appropriate clinical interventions and research.
de Barros Barbosa, Ciro; de barros Barbosa, C.; Ferreira Pires, Luis; Pires, L.F.; van Sinderen, Marten J.
This paper reports on the development of a catalogue of frameworks for protocol implementation. Frameworks are software structures developed for a specific application domain, which can be re-used in the implementation of various different concrete systems in this domain. By using frameworks we aim
Zolfagharipoor, Mohammad Amin; Ahmadi, Azadeh
The objective of this paper is to provide an efficient framework for effluent trading in river systems. The proposed framework consists of two pessimistic and optimistic decision-making models to increase the executability of river water quality trading programs. The models used for this purpose are (1) stochastic fallback bargaining (SFB) to reach an agreement among wastewater dischargers and (2) stochastic multi-criteria decision-making (SMCDM) to determine the optimal treatment strategy. The Monte-Carlo simulation method is used to incorporate the uncertainty into analysis. This uncertainty arises from stochastic nature and the errors in the calculation of wastewater treatment costs. The results of river water quality simulation model are used as the inputs of models. The proposed models are used in a case study on the Zarjoub River in northern Iran to determine the best solution for the pollution load allocation. The best treatment alternatives selected by each model are imported, as the initial pollution discharge permits, into an optimization model developed for trading of pollution discharge permits among pollutant sources. The results show that the SFB-based water pollution trading approach reduces the costs by US$ 14,834 while providing a relative consensus among pollutant sources. Meanwhile, the SMCDM-based water pollution trading approach reduces the costs by US$ 218,852, but it is less acceptable by pollutant sources. Therefore, it appears that giving due attention to stability, or in other words acceptability of pollution trading programs for all pollutant sources, is an essential element of their success.
Full Text Available In perceptual decision-making, ideal decision-makers should bias their choices toward alternatives associated with larger rewards, and the extent of the bias should decrease as stimulus sensitivity increases. When responses must be made at different times after stimulus onset, stimulus sensitivity grows with time from zero to a final asymptotic level. Are decision makers able to produce responses that are more biased if they are made soon after stimulus onset, but less biased if they are made after more evidence has been accumulated? If so, how close to optimal can they come in doing this, and how might their performance be achieved mechanistically? We report an experiment in which the payoff for each alternative is indicated before stimulus onset. Processing time is controlled by a "go" cue occurring at different times post stimulus onset, requiring a response within msec. Reward bias does start high when processing time is short and decreases as sensitivity increases, leveling off at a non-zero value. However, the degree of bias is sub-optimal for shorter processing times. We present a mechanistic account of participants' performance within the framework of the leaky competing accumulator model , in which accumulators for each alternative accumulate noisy information subject to leakage and mutual inhibition. The leveling off of accuracy is attributed to mutual inhibition between the accumulators, allowing the accumulator that gathers the most evidence early in a trial to suppress the alternative. Three ways reward might affect decision making in this framework are considered. One of the three, in which reward affects the starting point of the evidence accumulation process, is consistent with the qualitative pattern of the observed reward bias effect, while the other two are not. Incorporating this assumption into the leaky competing accumulator model, we are able to provide close quantitative fits to individual participant data.
Murray, John D; Jaramillo, Jorge; Wang, Xiao-Jing
Working memory (WM) and decision-making (DM) are fundamental cognitive functions involving a distributed interacting network of brain areas, with the posterior parietal cortex (PPC) and prefrontal cortex (PFC) at the core. However, the shared and distinct roles of these areas and the nature of their coordination in cognitive function remain poorly understood. Biophysically based computational models of cortical circuits have provided insights into the mechanisms supporting these functions, yet they have primarily focused on the local microcircuit level, raising questions about the principles for distributed cognitive computation in multiregional networks. To examine these issues, we developed a distributed circuit model of two reciprocally interacting modules representing PPC and PFC circuits. The circuit architecture includes hierarchical differences in local recurrent structure and implements reciprocal long-range projections. This parsimonious model captures a range of behavioral and neuronal features of frontoparietal circuits across multiple WM and DM paradigms. In the context of WM, both areas exhibit persistent activity, but, in response to intervening distractors, PPC transiently encodes distractors while PFC filters distractors and supports WM robustness. With regard to DM, the PPC module generates graded representations of accumulated evidence supporting target selection, while the PFC module generates more categorical responses related to action or choice. These findings suggest computational principles for distributed, hierarchical processing in cortex during cognitive function and provide a framework for extension to multiregional models.SIGNIFICANCE STATEMENT Working memory and decision-making are fundamental "building blocks" of cognition, and deficits in these functions are associated with neuropsychiatric disorders such as schizophrenia. These cognitive functions engage distributed networks with prefrontal cortex (PFC) and posterior parietal cortex
Programming Entity Framework is a thorough introduction to Microsoft's new core framework for modeling and interacting with data in .NET applications. This highly-acclaimed book not only gives experienced developers a hands-on tour of the Entity Framework and explains its use in a variety of applications, it also provides a deep understanding of its architecture and APIs -- knowledge that will be extremely valuable as you shift to the Entity Framework version in .NET Framework 4.0 and Visual Studio 2010. From the Entity Data Model (EDM) and Object Services to EntityClient and the Metadata Work
Glasdam, Stinne; Oeye, Christine; Thrysøe, Lars
This article focuses on patients’ participation in decision-making in meetings with healthcare professionals in a healthcare system which appeared to be governed in a neoliberal manner. Drawing on two constructed empirical cases, this article analyses and discusses the clinical practice around...... is going to happen in his life. Both professionals and patients have an underlying, tacit preconception that every medical treatment is better than no treatment. Patients do not always want to be a ‘customer’ in the healthcare system; they want to be a patient, consulting an expert for help and advice......, which creates resistance to the some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal frame and medical logic. The decision-making competence in relation to the choice of treatment is placed away...
Full Text Available The aim of this study is to examine the self-esteem in decision making and decision-making styles of orienteering athletes in terms of different variables. 157 male and 43 female orienteering athletes, making a total of 200 athletes that joined the 3rd Level of Turkey Championship in 2015 have participated in this study which is in a survey model. The data collection tools were the Melbourne Decision-making. Quastionnaire I-II and the Personal Information Form which were adapted into Turkish by Deniz (2004. In the data analysis, descriptive statics, anova, t test and Tukey test have been utilized. There is a significant difference between athletes’ marital status, age groups, experiences in orienteering sports and self-esteem in decision making, decision making styles (p<0.05. According to the research results, it has been determined that married orienteering athletes prefer both self-esteem in decision making and vigilance decision-making style more often than the single athletes that mostly prefer procrastination decision-making style. Also, it has been found out that as the athletes’ age and experiences in sports increase, selfesteem and decision-making styles are affected more positively as well.
Flouri, Eirini; Ioakeimidi, Sofia; Midouhas, Emily; Ploubidis, George B
There is much research to suggest that maternal psychological distress is associated with many adverse outcomes in children. This study examined, for the first time, if it is related to children's affective decision-making. Using data from 12,080 families of the Millennium Cohort Study, we modelled the effect of trajectories of maternal psychological distress in early-to-middle childhood (3-11 years) on child affective decision-making, measured with a gambling task at age 11. Latent class analysis showed four longitudinal types of maternal psychological distress (chronically high, consistently low, moderate-accelerating and moderate-decelerating). Maternal distress typology predicted decision-making but only in girls. Specifically, compared to girls growing up in families with never-distressed mothers, those exposed to chronically high maternal psychological distress showed more risk-taking, bet more and exhibited poorer risk-adjustment, even after correction for confounding. Most of these effects on girls' decision-making were not robust to additional controls for concurrent internalising and externalising problems, but chronically high maternal psychological distress was associated positively with risk-taking even after this adjustment. Importantly, this association was similar for those who had reached puberty and those who had not. Given the study design, causality cannot be inferred. Therefore, we cannot propose that treating chronic maternal psychological distress will reduce decision-making pathology in young females. Our study suggests that young daughters of chronically distressed mothers tend to be particularly reckless decision-makers. Copyright © 2017. Published by Elsevier B.V.
Aupperle, Robin L; Melrose, Andrew J; Francisco, Alex; Paulus, Martin P; Stein, Murray B
Animal approach-avoidance conflict paradigms have been used extensively to operationalize anxiety, quantify the effects of anxiolytic agents, and probe the neural basis of fear and anxiety. Results from human neuroimaging studies support that a frontal-striatal-amygdala neural circuitry is important for approach-avoidance learning. However, the neural basis of decision-making is much less clear in this context. Thus, we combined a recently developed human approach-avoidance paradigm with functional magnetic resonance imaging (fMRI) to identify neural substrates underlying approach-avoidance conflict decision-making. Fifteen healthy adults completed the approach-avoidance conflict (AAC) paradigm during fMRI. Analyses of variance were used to compare conflict to nonconflict (avoid-threat and approach-reward) conditions and to compare level of reward points offered during the decision phase. Trial-by-trial amplitude modulation analyses were used to delineate brain areas underlying decision-making in the context of approach/avoidance behavior. Conflict trials as compared to the nonconflict trials elicited greater activation within bilateral anterior cingulate cortex, anterior insula, and caudate, as well as right dorsolateral prefrontal cortex (PFC). Right caudate and lateral PFC activation was modulated by level of reward offered. Individuals who showed greater caudate activation exhibited less approach behavior. On a trial-by-trial basis, greater right lateral PFC activation related to less approach behavior. Taken together, results suggest that the degree of activation within prefrontal-striatal-insula circuitry determines the degree of approach versus avoidance decision-making. Moreover, the degree of caudate and lateral PFC activation related to individual differences in approach-avoidance decision-making. Therefore, the approach-avoidance conflict paradigm is ideally suited to probe anxiety-related processing differences during approach-avoidance decision-making
Full Text Available In an intense competition in the global market, organisations seek to take advantage of all their internal and external potentials, advantages, and resources. It has been found that, in addition to competitive products and services, a good business also requires an effective management of business processes, which is the discipline of the business process management (BPM. The introduction of the BPM in the organisation requires a thoughtful selection of an appropriate methodological approach, since the latter will formalize activities, products, applications and other efforts of the organisation in this field. Despite many technology-driven solutions of software companies, recommendations of consulting companies, techniques, good practices and tools, the decision on what methodology to choose is anything but simple. The aim of this article is to simplify the adoption of such decisions by building a framework for the evaluation of BPM methodologies according to a qualitative multi-attribute decision-making method. The framework defines a hierarchical decision-making model, formalizes the decision-making process and thus contributes significantly to an independent, credible final decision that is the most appropriate for a specific organisation.
Payne, Lesle Karns
The author in this article presents a theory of decision-making in nursing, specifically a middle-range theory of intuitive decision-making in nursing created through the synthesis of Patricia Benner's model of skill acquisition in nursing and Damasio's somatic marker hypothesis. The author proposes that Damasio's somatic state is equivalent to what Benner has identified as intuition. When a nurse is faced with a decision, intuition, if developed, is a somatic state that creates a measurable physiological biasing signal (skin conductive response) that helps in making an advantageous decision. Research, educational, clinical and theoretical implications are discussed. © The Author(s) 2015.
Full Text Available Working capital is crucial to determine the short-term financial position of a given company. Significant changes in working capital provide important information to the stakeholders. Working capital analysis is one of the methods of credit rating and it can also help to better understand the business cycle of a given company. One of the key elements of working capital management is liquidity management, that is, to maintain a company’s ability to pay continuously, because in the short-term, it ensures the company to stay afloat, and justifies its progress on the long-term. Decision makers are in need of such indicators and interrelations that can help precisely assessing the real situation and recognise problems of funding in time. Achieving this goal is a very complex task because the use of several indicators and perspectives are necessary to measure liquidity. For this, companies have to develop management and organizational structures that provide an adequate framework to measure and follow up liquidity. To facilitate this, the study draws attention to interrelations that anticipate the actual liquidity position of a company more precisely. Generally, liquidity indicators are being used to measure a company’s ability to pay, but those do not sufficiently take into account for how long different components are tied up during the operation. Adjusted liquidity indicators can be calculated to solve these problems as these include the time an asset is in the operating cycle in the case of current assets and short-term liabilities. At the same time, these days the continuous monitoring and analysis of operational data has become essential, too. The database which has been created as a result of the annual financial statement reporting obligation that was introduced by the Act C in 2000 can be used to analyse company data on a yearly basis. However, in case we would like to examine the changes of these indicators continuously during the
Devnani, Rohit; Slaven, James E; Bosslet, Gabriel T; Montz, Kianna; Inger, Lev; Burke, Emily S; Torke, Alexia M
Many hospitalized adults do not have the capacity to make their own health care decisions and thus require a surrogate decision-maker. While the ethical standard suggests that decisions should focus on a patient's preferences, our study explores the principles that surrogates consider most important when making decisions for older hospitalized patients. We sought to determine how frequently surrogate decision-makers prioritized patient preferences in decision-making and what factors may predict their doing so. We performed a secondary data analysis of a study conducted at three local hospitals that surveyed surrogate decision-makers for hospitalized patients 65 years of age and older. Surrogates rated the importance of 16 decision-making principles and selected the one that was most important. We divided the surrogates into two groups: those who prioritized patient preferences and those who prioritized patient well-being. We analyzed the two groups for differences in knowledge of patient preferences, presence of advance directives, and psychological outcomes. A total of 362 surrogates rated an average of six principles as being extremely important in decision-making; 77.8% of surrogates selected a patient well-being principle as the most important, whereas only 21.1% selected a patient preferences principle. Advance directives were more common to the patient preferences group than the patient well-being group (61.3% vs. 44.9%; 95% CI: 1.01-3.18; p = 0.04), whereas having conversations with the patient about their health care preferences was not a significant predictor of surrogate group identity (81.3% vs. 67.4%; 95% CI: 0.39-1.14; p = 0.14). We found no differences between the two groups regarding surrogate anxiety, depression, or decisional conflict. While surrogates considered many factors, they focused more often on patient well-being than on patient preferences, in contravention of our current ethical framework. Surrogates more commonly prioritized
Jull, Janet; Stacey, Dawn; Giles, Audrey; Boyer, Yvonne
Little is known about shared decision-making (SDM) with Métis, First Nations and Inuit women ("Aboriginal women"). SDM is a collaborative process that engages health care professional(s) and the client in making health decisions and is fundamental for informed consent and patient-centred care. The objective of this study is to explore Aboriginal women's health and social decision-making needs and to engage Aboriginal women in culturally adapting an SDM approach. Using participatory research principles and guided by a postcolonial theoretical lens, the proposed mixed methods research will involve three phases. Phase I is an international systematic review of the effectiveness of interventions for Aboriginal peoples' health decision-making. Developed following dialogue with key stakeholders, proposed methods are guided by the Cochrane handbook and include a comprehensive search, screening by two independent researchers, and synthesis of findings. Phases II and III will be conducted in collaboration with Minwaashin Lodge and engage an urban Aboriginal community of women in an interpretive descriptive qualitative study. In Phase II, 10 to 13 Aboriginal women will be interviewed to explore their health/social decision-making experiences. The interview guide is based on the Ottawa Decision Support Framework and previous decisional needs assessments, and as appropriate may be adapted to findings from the systematic review. Digitally-recorded interviews will be transcribed verbatim and analyzed inductively to identify participant decision-making approaches and needs when making health/social decisions. In Phase III, there will be cultural adaptation of an SDM facilitation tool, the Ottawa Personal Decision Guide, by two focus groups consisting of five to seven Aboriginal women. The culturally adapted guide will undergo usability testing through individual interviews with five to six women who are about to make a health/social decision. Focus groups and individual
Full Text Available Abstract Background Little is known about shared decision-making (SDM with Métis, First Nations and Inuit women (“Aboriginal women”. SDM is a collaborative process that engages health care professional(s and the client in making health decisions and is fundamental for informed consent and patient-centred care. The objective of this study is to explore Aboriginal women’s health and social decision-making needs and to engage Aboriginal women in culturally adapting an SDM approach. Methods Using participatory research principles and guided by a postcolonial theoretical lens, the proposed mixed methods research will involve three phases. Phase I is an international systematic review of the effectiveness of interventions for Aboriginal peoples’ health decision-making. Developed following dialogue with key stakeholders, proposed methods are guided by the Cochrane handbook and include a comprehensive search, screening by two independent researchers, and synthesis of findings. Phases II and III will be conducted in collaboration with Minwaashin Lodge and engage an urban Aboriginal community of women in an interpretive descriptive qualitative study. In Phase II, 10 to 13 Aboriginal women will be interviewed to explore their health/social decision-making experiences. The interview guide is based on the Ottawa Decision Support Framework and previous decisional needs assessments, and as appropriate may be adapted to findings from the systematic review. Digitally-recorded interviews will be transcribed verbatim and analyzed inductively to identify participant decision-making approaches and needs when making health/social decisions. In Phase III, there will be cultural adaptation of an SDM facilitation tool, the Ottawa Personal Decision Guide, by two focus groups consisting of five to seven Aboriginal women. The culturally adapted guide will undergo usability testing through individual interviews with five to six women who are about to make a health
Russell, Robin E.; Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan H. Campbell
The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.
Wright, Stuart Anthony Lewis; Fritsch, Oliver
of involvement. The article discusses the appropriateness of actively involving the public during the two aforementioned decision-making stages and suggests concrete ways in which active involvement may be operationalised. We conclude that member states should not implement a minimum form of participation......We identify two key stages in the river basin planning process under the Water Framework Directive: the selection of instruments for a programme of measures to achieve the environmental targets, and disproportionate cost analysis to determine whether selected measures involve high costs. Some EU...... of actively involving non-state actors, which can be summarised as increasing the effectiveness of policy and improving its implementation. Criticising the emerging economic decision-making approach, we argue that economic analyses could result in a missed opportunity to capitalise on the potential benefits...
Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard
In this paper we argue that introducing object-oriented frameworks as subject already in the CS1 curriculum is important if we are to train the programmers of tomorrow to become just as much software reusers as software producers. We present a simple, graphical, framework that we have successfully...... used to introduce the principles of object-oriented frameworks to students at the introductory programming level. Our framework, while simple, introduces central abstractions such as inversion of control, event-driven programming, and variability points/hot-spots. This has provided a good starting...... point for introducing graphical user interface frameworks such as Java Swing and AWT as the students are not overwhelmed by all the details of such frameworks right away but given a conceptual road-map and practical experience that allow them to cope with the complexity....
Full Text Available . Introduction: Decision-making when facing a pediatric cancer treatment deserves a spotlight due to the amount of decisions that parents must deal with during this process, which may often generate emotional stress, doubts, uncertainties and anxieties. Thus, assessing how the health team influences the decision of parents is an important factor to evaluate how much autonomy they have to be able to choose on the numerous possibilities resulting from the treatment. Objective: To evaluate parents’ decision-making process in oncologic pediatric treatments and to analyze the perception of coercion, the level of moral-psychological development and other difficulties. Method: 10 participants were selected by convenience to conduct individual semi-structured interviews, applying the Scale of Perception of Coercion in Assistance and the Moral-Psychological Development Scale. Results: Nine mothers and one father were interviewed (n = 10, with an average age of 33.1 years. Six categories were identified from the analysis of content originated from the central theme. There was no perception of coercion by parents and all have shown psychological and moral levels suitable for decision-making. Conclusion: It was observed that, in spite of emotional difficulties, parents have proved able to decide on issues related to the treatment of their children, having enough autonomy for decision-making.
price or —trusted“ brand name) (Solomon, 1996:287). The so-called —rational“ consumer became the subject .... though brand decision-making represents a fair amount of deliberation during consumer decision- making ..... consumption that relate to the multisensory images, fantasies and emotive aspects of product usage.
The aim of this paper is to show the limitations of rational decision-making models as applied to child spacing and more specifically to the use of modern methods of contraception. In the light of factors known to influence low uptake of child spacing services in other African countries, suggestions are made to explain the ...
Cryer, Rodger E.; And Others
The School Personnel Utilization Project developed a series of modules to assist school personnel in building the necessary skills for the development of organizational change strategies and collaborative, collegial, educational problem solving capabilities. This specific module is on the concept of shared decision-making and its application to…
Conversely, no significant difference was found in leadership effectiveness between decision-making in public and private universities. The study finally reveals that there is a significant relationship between the management-student relationship and teaching effectiveness. The results therefore show that, for leadership and ...
even in the absence of psychological effects. In particular, the question may be addressed: with how high an error rate may the aid operate and still...Rationality," Ajiiigm 0 Vl1, No.6, pp. 703-709.  Levis, A.H. arid K.L. Boettcher (1983j). "Decisionmaking Organizacions with Acyclical Informafion
Communication and decision-making about reproductive health issues within couples in Kwara State, Nigeria. ... Tropical Journal of Obstetrics and Gynaecology ... higher education, Christianity, and approval of couples' use of family planning methods for males were predictive of spousal communication on these issues.
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
Hewitt, Chris D.; Stone, Roger C.; Tait, Andrew B.
To enable society to better manage the risks and opportunities arising from changes in climate, engagement between the users and the providers of climate information needs to be much more effective and should better link climate information with decision-making.
Barnard-Brak, Lucy; Stevens, Tara; Robinson, Eric; Holt, Ann
The current study examined the diagnostic decision-making of school psychologists as a function of a student's disability and academic performance with three research questions using a randomly-selected sample of school psychologists from the state of Texas. Results from the first research question indicated that school psychologists significantly…
Full Text Available From ants to humans, the timing of many animal behaviors comes in bursts of activity separated by long periods of inactivity. Recently, mathematical modeling has shown that simple algorithms of priority-driven behavioral choice can result in bursty behavior. To experimentally test this link between decision-making circuitry and bursty dynamics, we have turned to Drosophila melanogaster. We have found that the statistics of intervals between activity periods in endogenous activity-rest switches of wild-type Drosophila are very well described by the Weibull distribution, a common distribution of bursty dynamics in complex systems. The bursty dynamics of wild-type Drosophila walking activity are shown to be determined by this inter-event distribution alone and not by memory effects, thus resembling human dynamics. Further, using mutant flies that disrupt dopaminergic signaling or the mushroom body, circuitry implicated in decision-making, we show that the degree of behavioral burstiness can be modified. These results are thus consistent with the proposed link between decision-making circuitry and bursty dynamics, and highlight the importance of using simple experimental systems to test general theoretical models of behavior. The findings further suggest that analysis of bursts could prove useful for the study and evaluation of decision-making circuitry.
Full Text Available Adolescents often make risky and impulsive decisions. Such behavior has led to the common assumption that a dysfunction in risk-related decision-making peaks during this age. Differences in how risk has been defined across studies, however, make it difficult to draw conclusions about developmental changes in risky decision-making. Here, we developed a non-symbolic economic decision-making task that can be used across a wide age span and that uses coefficient of variation (CV in reward as an index of risk. We found that young children showed the strongest preference for risky compared to sure bet options of equal expected value, adolescents were intermediate in their risk preference, and young adults showed the strongest risk aversion. Furthermore, children’s preference for the risky option increased for larger CVs, while adolescents and young adults showed the opposite pattern, favoring the sure bet more often as CV increased. Finally, when faced with two gambles in a risk-return tradeoff, all three age groups exhibited a greater preference for the option with the lower risk and return as the disparity in risk between the two options increased. These findings demonstrate clear age-related differences in economic risk preferences that vary with choice set and risk. Importantly, adolescence appears to represent an intermediate decision-making phenotype along the transition from childhood to adulthood, rather than an age of heightened preference for economic risk.
The purposes of this study are (1) to adapt the Career Decision-Making Difficulties Questionnaire (CDDQ) to Turkish high school students and (2) to examine gender differences, grade differences, and differences between "decided" and "undecided" students. The sample consisted of 2509 adolescent students. The results showed that…
Ubbink, Dirk T.; Santema, Trientje B.; Lapid, Oren
Shared decision-making (SDM) invokes the bidirectional communication between physicians and patients required to involve the patient's preference in the eventual treatment choice. This paper will explain what SDM is, why it is important, and how it is performed in clinical practice. It is an
Shaw, Chloe; Stokoe, Elizabeth; Gallagher, Katie; Aladangady, Narendra; Marlow, Neil
The article analyses the decision-making process between doctors and parents of babies in neonatal intensive care. In particular, it focuses on cases in which the decision concerns the redirection of care from full intensive care to palliative care at the end of life. Thirty one families were recruited from a neonatal intensive care unit in England and their formal interactions with the doctor recorded. The conversations were transcribed and analysed using conversation analysis. Analysis focused on sequences in which decisions about the redirection of care were initiated and progressed. Two distinct communicative approaches to decision-making were used by doctors: 'making recommendations' and 'providing options'. Different trajectories for parental involvement in decision-making were afforded by each design, as well as differences in terms of the alignments, or conflicts, between doctors and parents. 'Making recommendations' led to misalignment and reduced opportunities for questions and collaboration; 'providing options' led to an aligned approach with opportunities for questions and fuller participation in the decision-making process. The findings are discussed in the context of clinical uncertainty, moral responsibility and the implications for medical communication training and guidance. A Virtual Abstract of this paper can be accessed at: https://www.youtube.com/watch?v=MyuymxDNupk&feature=youtu.be. © 2016 Foundation for the Sociology of Health & Illness.
Full Text Available Decision-making behaviour is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI and other technical disciplines. However the conceptualisation of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision making with respect to other high-level cognitive capabilities like problem-solving, planning and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuro-psychology, artificial intelligence, and decision engineering.
the cosine similarity measure is often used in information retrieval, citation analysis, and automatic classification. However, it scarcely deals with trapezoidal fuzzy information and multicriteria decision-making problems. For this purpose, a cosine similarity measure between trapezoidal fuzzy numbers is proposed based on ...
... the Doctors' clinical decision-making despite its huge limitations enumerated by the Doctors. Recommendations were made towards a balanced collection development of both print and non-print materials, aggressive re-sensitization and reorientation to the use of handheld digital devices for evidence-based medicine.
Navas, Juan F.; Vilar-López, Raquel; Perales, José C.; Steward, Trevor; Fernández-Aranda, Fernando; Verdejo-García, Antonio
Background The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions). The aims of this study were:  to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight;  to examine the associations between body mass index (BMI) and decision-making, and the degree to which these associations are modulated by reward sensitivity. Methods Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT) and decision-making under ambiguity via the Iowa Gambling Task (IGT). Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ). Results Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance), independently of reward sensitivity. Conclusions Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices. PMID:27257888
Huebner, E. Scott; And Others
Findings regarding the influence of four potential sources of bias (sex, socioeconimic status, race, physical attractiveness) upon decision-making stages of the assessment process are selectively reviewed. It is concluded that, though further research is needed, convincing evidence of bias in later stages of decision making has yet to be…
Jan 1, 2009 ... This short and accessible book is essential reading for anyone interested in … the importance of synergy between researchers and decision-makers in Africa and how this can contribute to development. It highlights the key constraints why research is not used in policy development but also presents ...
French, Jennifer A.
One-hundred and eleven graduate students enrolled in a clinical psychology training program (PsyD) participated in a research study that examined the ethical decision-making processes and factors that have been proposed to influence behavior (Smith, McGuire, Abbott, & Blau, 1991). Using a two-part questionnaire, data regarding the ethical…
Eijdenberg, E.L.; Masurel, E.; Paas, L.J.
This paper aims to investigate the effect of decision-making, in terms of the effectuation and causation orientation of small business owners, on the growth of their small businesses in an uncertain environment: Burundi. On the basis of primary data from a pre-study of 29 expert interviews, a
Lumpkin, Angela; Franco, Dan; Multon, Karen; Achen, Rebecca M.
Grounded in a social cognitive theoretical perspective, this study explores the career decision-making self-efficacy (CDSE) and vocational identity development process for college students interested or majoring in sport management. While a popular undergraduate major, little research has investigated the specific factors that influence different…
Purpose: The purpose of this paper is to examine the decision-making process of students who decided to study for a foundation degree. Design/methodology/approach: The research involved interviewing 30 students who were on, or had recently completed, a business-related foundation degree. Findings: This study found that students were not adopting a…
Zhao, Xu; Huang, Chunlei; Li, Xuesong; Zhao, Xin; Peng, Jiaxi
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.
Uspanov, Zholdybai T.; Turabayeva, Dana S.
The article considers the psychological peculiarities of judge professional activity and decision-making, judge's mental set and requirements to ethical and moral requirements and quality. Moreover, this work offers original job analysis and competency model of judge professional activity. The authors have studied the problems concerning the…
Is there a need for a paradigm shift? The paper will provide recommendations on how reform of the multilateral decision-making structures should focus on promoting the interests of developing countries that have historically been marginalised. Developing countries, like those making up BRICS, stand ready to contribute to ...
... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Decisionmakers, notifications, and additional information. 59.4 Section 59.4 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) GRANTS TO STATES FOR CONSTRUCTION OR ACQUISITION OF STATE HOMES § 59...
Lee, Michael D.; Paradowski, Michael J.
We consider group decision-making on an optimal stopping problem, for which large and stable individual differences have previously been established. In the problem, people are presented with a sequence of five random numbers between 0 and 100, one at a time, and are required to choose the maximum of the sequence, without being allowed to return…
His current area of research includes Multi-criteria Decision-Making, Soft Computing, Robotics and Automation, Intelligent Control, Pattern. Recognitions, Fault Diagnosis, and Mechanical Design. He has published more than ninety papers in journals. He has written few books related to his research work. He has finished a ...
Wind, H.G.; Pouwels, I.H.M.; Pouwels, I.H.M.; Witter, V.J.
Traditionally, decision-making by water authorities in the Netherlands is largely based on intuition. Their tasks were, after all, relatively few and straight-forward. The growing number of tasks, together with the new integrated approach on water management issues, however, induces water
Hill, Katherine A; Dasari, Mohini; Littleton, Eliza B; Hamad, Giselle G
Cognitive skills such as decision-making are critical to developing operative autonomy. We explored resident decision-making using a recollection of specific examples, from the attending surgeon and resident, after laparoscopic cholecystectomy. In a separate semi-structured interview, the attending and resident both answered five questions, regarding the resident's operative roles and decisions, ways the attending helped, times when the attending operated, and the effect of the relationship between attending and resident. Themes were extracted using inductive methods. Thirty interviews were completed after 15 cases. Facilitators of decision-making included dialogue, safe struggle, and appreciation for retraction. Aberrant case characteristics, anatomic uncertainties, and time pressures provided barriers. Attending-resident mismatches included descriptions of transitioning control to the attending. Reciprocal dialogue, including concept-driven feedback, is helpful during intraoperative teaching. Unanticipated findings impede resident decision-making, and we describe differences in understanding transfers of operative control. Given these factors, we suggest that pre-operative discussions may be beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.
Objective: To explore the methods, reasons and decision-making process for termination of pregnancy among adolescents and older women, in Mulago hospital, Kampala, Uganda. Design: Comparative study. Subjects: Nine hundred and forty two women seeking postabortion care, of which 333 had induced abortion (of ...
By combining the models and tasks of Game Theory with modern psychological and neuroscientific methods, the neuroeconomic approach to the study of social decision-making has the potential to extend our knowledge of brain mechanisms involved in social decisions and to advance theoretical models of
Johnson, Theresa L.
High-stakes standardized tests in reading and limited instructional time are two powerful disincentives for teaching economics in the elementary classroom. In this article, integrating instruction in poetry and economic decision-making is presented as one way to maximize the use of scarce instructional time. Following a brief introduction to the…
Fleurke, F.; Willemse, R.
In studies on central-local relations it is common to assess local autonomy in a deductive way. The extent of local autonomy is determined by measuring the central legal and financial competence, after which the remaining room for local decision-making is determined. The outcome of this indirect
Empowering Health Care Decision-makers to Achieve Regional Needs for Tobacco Control in Latin America ... This project builds on earlier work on the development and validation of an economic model to estimate the social, economic, and health burden of tobacco, together with the expected impact of tax increases in ...
van der Salm, Sandra M. A.; van Rootselaar, Anne-Fleur; Cath, Danielle C.; de Haan, Rob J.; Koelman, Johannes H. T. M.; Tijssen, Marina A. J.
Objective: Functional or psychogenic movement disorders (FMD) present a diagnostic challenge. To diagnose FMD, clinicians must have experience with signs typical of FMD and distinguishing features from other hyperkinetic disorders. The aim of this study was to clarify the decision-making process of
Bruck, D; Pisani, D L
Sleep inertia, the performance impairment that occurs immediately after awakening, has not been studied previously in relation to decision-making performance. Twelve subjects were monitored in the sleep laboratory for one night and twice awoken by a fire alarm (slow wave sleep, SWS and REM sleep). Decision making was measured over 10 3-min trials using the 'Fire Chief' computer task under conditions of baseline. SWS and REM arousal. The most important finding was that sleep inertia reduces decision-making performance for at least 30 min with the greatest impairments (in terms of both performance and subjective ratings) being found within 3 min after abrupt nocturnal awakening. Decision-making performance was as little as 51% of optimum (i.e. baseline) during these first few minutes. However, after 30 min. performance may still be as much as 20% below optimum. The initial effects of sleep inertia during the first 9 min are significantly greater after SWS arousal than after REM arousal, but this difference is not sustained. Decision-making performance after REM arousal showed more variability than after SWS arousal. Subjects reported being significantly sleepier and less clear-headed following both SWS and REM awakenings compared with baseline and this was sustained across the full 30 min. In order to generalize this finding to real-life situations, further research is required on the effects of continuous noise, emotional arousal and physical activity on the severity and duration of sleep inertia.
Gail Blatternberger; William F. Hyde; Thomas J. Mills
In the past, decisionmaking in wildland fire management generally has not included a full consideration of the risk and uncertainty that is inherent in evaluating alternatives. Fire management policies in some Federal land management agencies now require risk evaluation. The model for estimating the economic efficiency of fire program alternatives is the minimization...
Lindquist, David H.
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…
Apr 19, 2011 ... responsibility of school leaders, and the way and manner in which they carry .... Does the level of participation in decision-making by students and teachers influence their attitude to school work? 4. Does the level of participation in .... about the best leadership styles for achieving optimal followership and.
This study investigated students' and teachers' participation in decisionmaking in secondary schools and the consequent impact on their attitude to school work and school internal discipline in Nigeria. This was necessitated by the observed frequent breakdown of law and order in secondary schools alleged to be related to ...
Juan F Navas
Full Text Available The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions. The aims of this study were:  to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight;  to examine the associations between body mass index (BMI and decision-making, and the degree to which these associations are modulated by reward sensitivity.Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT and decision-making under ambiguity via the Iowa Gambling Task (IGT. Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ.Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance, independently of reward sensitivity.Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices.
van Meer, Floor|info:eu-repo/dai/nl/375286829; Charbonnier, Lisette|info:eu-repo/dai/nl/41364118X; Smeets, Paul A M|info:eu-repo/dai/nl/304817740
Food decisions determine energy intake. Since overconsumption is the main driver of obesity, the effects of weight status on food decision-making are of increasing interest. An additional factor of interest is age, given the rise in childhood obesity, weight gain with aging, and the increased chance
Felipe-Lucia, María R; Comín, Francisco A; Escalera-Reyes, Javier
Methods to assess ecosystem services using ecological or economic approaches are considerably better defined than methods for the social approach. To identify why the social approach remains unclear, we reviewed current trends in the literature. We found two main reasons: (i) the cultural ecosystem services are usually used to represent the whole social approach, and (ii) the economic valuation based on social preferences is typically included in the social approach. Next, we proposed a framework for the social valuation of ecosystem services that provides alternatives to economics methods, enables comparison across studies, and supports decision-making in land planning and management. The framework includes the agreements emerged from the review, such as considering spatial-temporal flows, including stakeholders from all social ranges, and using two complementary methods to value ecosystem services. Finally, we provided practical recommendations learned from the application of the proposed framework in a case study.
Laue, Johanna; Melbye, Hasse; Halvorsen, Peder A; Andreeva, Elena A; Godycki-Cwirko, Maciek; Wollny, Anja; Francis, Nick A; Spigt, Mark; Kung, Kenny; Risør, Mette Bech
To explore the decision-making of general practitioners (GPs) concerning treatment with antibiotics and/or oral corticosteroids and hospitalization for COPD patients with exacerbations. Thematic analysis of seven focus groups with 53 GPs from urban and rural areas in Norway, Germany, Wales, Poland, Russia, the Netherlands, and Hong Kong. Four main themes were identified. 1) Dealing with medical uncertainty: the GPs aimed to make clear medical decisions and avoid unnecessary prescriptions and hospitalizations, yet this was challenged by uncertainty regarding the severity of the exacerbations and concerns about overlooking comorbidities. 2) Knowing the patient: contextual knowledge about the individual patient provided a supplementary framework to biomedical knowledge, allowing for more differentiated decision-making. 3) Balancing the patients' perspective: the GPs considered patients' experiential knowledge about their own body and illness as valuable in assisting their decision-making, yet felt that dealing with disagreements between their own and their patients' perceptions concerning the need for treatment or hospitalization could be difficult. 4) Outpatient support and collaboration: both formal and informal caregivers and organizational aspects of the health systems influenced the decision-making, particularly in terms of mitigating potentially severe consequences of "wrong decisions" and concerning the negotiation of responsibilities. Fear of overlooking severe comorbidity and of further deteriorating symptoms emerged as a main driver of GPs' management decisions. GPs consider a holistic understanding of illness and the patients' own judgment crucial to making reasonable decisions under medical uncertainty. Moreover, GPs' decisions depend on the availability and reliability of other formal and informal carers, and the health care systems' organizational and cultural code of conduct. Strengthening the collaboration between GPs, other outpatient care facilities
Greenwalt, R; Hibbard, W; Raber, E; Carlsen, T; Folks, K; MacQueen, D; Mancieri, S; Bunt, T; Richards, J; Hirabayashi-Dethier, J
The IBRD Operational Decision Framework in this document is an expansion of an emerging general risk management framework under development by an interagency working group. It provides the level of detail necessary to develop a general Consequence Management Guidance Document for biological contamination remediation and restoration. It is the intent of this document to support both wide area and individual site remediation and restoration activities. This product was initiated as a portion of the IBRD Task 1 Systems Analysis to aid in identification of wide area remediation and restoration shortcomings and gaps. The draft interagency general risk management framework was used as the basis for the analysis. The initial Task 1 analysis document expanded the draft interagency framework to a higher level of resolution, building on both the logic structure and the accompanying text explanations. It was then employed in a qualitative manner to identify responsible agencies, data requirements, tool requirements, and current capabilities for each decision and task. This resulted in identifying shortcomings and gaps needing resolution. Several meetings of a joint LLNL/SNL working group reviewed and approved the initial content of this analysis. At the conclusion of Task 1, work continued on the expanded framework to generate this Operational Decision Framework which is consistent with the existing interagency general risk management framework. A large LLNL task group met repeatedly over a three-month period to develop the expanded framework, coordinate the framework with the biological remediation checklist, and synchronize the logic with the Consequence Management Plan table of contents. The expanded framework was briefed at a large table top exercise reviewing the interagency risk management framework. This exercise had representation from major US metropolitan areas as well as national agencies. This product received positive comments from the participants. Upon
This paper is about Java object relational frameworks and related processes. The goal of this work consists of showing design patterns for ORM, introducing Java ORM standards along with the main implementations, finding criteria for comparison of ORM frameworks and showing working ORM example in a case study. This paper has the following structure: The first part of this paper discusses main ORM design patters, approaches to ORM and performance related features of Java ORM frameworks. Next pa...
The topic of this bachelor thesis is the web application framework Spring MVC which is an integral part of the Spring platform. That means it offers many options of adjustment and support of other significant technologies. The aim is to introduce basic principles of this framework on a theoretical level and subsequently examine them on a real example of application. The thesis is divided into three main parts. The first part is focused on Spring framework in general to introduce basic princip...
DAHLGREN DIVISION NAVAL SURFACE WARFARE CENTER Dahlgren, Virginia 22448-5100 NSWCDD/MP-17/300 JT BACHMAN LEADERSHIP FRAMEWORK...REPORT TYPE Miscellaneous Publication 3. DATES COVERED (From - To) 27 Sept 2016 – 08 June 2017 4. TITLE AND SUBTITLE JT BACHMAN LEADERSHIP FRAMEWORK...distribution is unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT This document describes the leadership framework of a civil servant following
Djulbegovic, Benjamin; Hozo, Iztok; Beckstead, Jason; Tsalatsanis, Athanasios; Pauker, Stephen G
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
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
Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard
In this paper we argue that introducing object-oriented frameworks as subject already in the CS1 curriculum is important if we are to train the programmers of tomorrow to become just as much software reusers as software producers. We present a simple, graphical, framework that we have successfull...... point for introducing graphical user interface frameworks such as Java Swing and AWT as the students are not overwhelmed by all the details of such frameworks right away but given a conceptual road-map and practical experience that allow them to cope with the complexity....
Hansen, Zaza Nadja Lee; Ahmed-Kristensen, Saeema
This paper investigates the implications for management and engineering functions and strategies when the product development process is globalised. Five case studies of Danish multinational corporations were conducted. The findings showed that offshoring engineering presented companies...... of the organisation. The Global Decision-Making (GDM) framework described here is a decision-making framework for engineering offshoring decisions for product development activities. The framework proposes that risks in engineering offshoring can be reduced by connecting engineering operations to strategic management...... with challenges to both management and engineering. These challenges are addressed by management at the operational level. However, this resulted in both positive and negative impacts. We propose this is because there is a decoupling between global engineering operations and the strategic level...
Worthy, Darrell A; Byrne, Kaileigh A; Fields, Sherecce
In two experiments we examined the role of emotion, specifically worry, anxiety, and mood, on prospection during decision-making. Worry is a particularly relevant emotion to study in the context of prospection because high levels of worry may make individuals more aversive toward the uncertainty associated with the prospect of obtaining future improvements in rewards or states. Thus, high levels of worry might lead to reduced prospection during decision-making and enhance preference for immediate over delayed rewards. In Experiment 1 participants performed a two-choice dynamic decision-making task where they were required to choose between one option (the decreasing option) which provided larger immediate rewards but declines in future states, and another option (the increasing option) which provided smaller immediate rewards but improvements in future states, making it the optimal choice. High levels of worry were associated with poorer performance in the task. Additionally, fits of a sophisticated reinforcement-learning model that incorporated both reward-based and state-based information suggested that individuals reporting high levels of worry gave greater weight to the immediate rewards they would receive on each trial than to the degree to which each action would lead to improvements in their future state. In Experiment 2 we found that high levels of worry were associated with greater delay discounting using a standard delay discounting task. Combined, the results suggest that high levels of worry are associated with reduced prospection during decision-making. We attribute these results to high worriers' aversion toward the greater uncertainty associated with attempting to improve future rewards than to maximize immediate reward. These results have implications for researchers interested in the effects of emotion on cognition, and suggest that emotion strongly affects the focus on temporal outcomes during decision-making.
Song, Mi-Kyung; Lin, Feng-Chang; Gilet, Constance A; Arnold, Robert M; Bridgman, Jessica C; Ward, Sandra E
Careful patient-clinician shared decision-making about dialysis initiation has been promoted, but few studies have addressed patient perspectives on the extent of information provided and how decisions to start dialysis are made. Ninety-nine maintenance dialysis patients recruited from 15 outpatient dialysis centers in North Carolina completed semistructured interviews on information provision and communication about the initiation of dialysis. These data were examined with content analysis. In addition, informed decision-making (IDM) scores were created by summing patient responses (yes/no) to 10 questions about the decision-making. The mean IDM score was 4.4 (of 10; SD = 2.0); 67% scored 5 or lower. Age at the time of decision-making (r = -0.27, P = 0.006), years of education (r = 0.24, P = 0.02) and presence of a warning about progressing to end-stage kidney disease (t = 2.9, P = 0.005) were significantly associated with IDM scores. Nearly 70% said that the risks and burdens of dialysis were not mentioned at all, and only one patient recalled that the doctor offered the option of not starting dialysis. While a majority (67%) said that they felt they had no choice about starting dialysis (because the alternative would be death) or about dialysis modality, only 21.2% said that they had felt rushed to make a decision. About one-third of the patients perceived that the decision to start dialysis and modality was already made by the doctor. A majority of patients felt unprepared and ill-informed about the initiation of dialysis. Improving the extent of IDM about dialysis may optimize patient preparation prior to starting treatment and their perceptions about the decision-making process.
Full Text Available There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined--and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and women's mobility. Two measures were created for each dimension, and for the overall empowerment: women's independent decisions, and those taken jointly by couples. Contraceptive use was categorized as either female-only or couple methods on the basis of whether a method requires the awareness of, or some support and cooperation from, the husband. Multinomial regression was used, by means of Odds Ratios (OR, to assess associations between empowerment dimensions and female-only and couple contraceptive methods.Overall, women tend to get higher decision-making power with increased age, higher literacy, a greater number of children, or being in a household that has superior socio-economic status. The measures for couples' decision-making for overall empowerment and for each dimension of it showed positive associations with couple methods as well as with female-only methods. The only exception was the measure of economic empowerment, which was associated only with the couple method.Couples' joint decision-making is a stronger determinant of the use of contraceptive methods than women-only decision-making. This is the case over and above the contribution of women's socio-demographic and economic statuses. Effort needs to be made to educate women and their husbands
Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Sheikh, Muhammad Ishaque; Abbas, Ghazunfer; Temmerman, Marleen; Avan, Bilal Iqbal
Introduction There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined - and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach. Methods We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15–49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and women's mobility. Two measures were created for each dimension, and for the overall empowerment: women's independent decisions, and those taken jointly by couples. Contraceptive use was categorized as either female-only or couple methods on the basis of whether a method requires the awareness of, or some support and cooperation from, the husband. Multinomial regression was used, by means of Odds Ratios (OR), to assess associations between empowerment dimensions and female-only and couple contraceptive methods. Results Overall, women tend to get higher decision-making power with increased age, higher literacy, a greater number of children, or being in a household that has superior socio-economic status. The measures for couples' decision-making for overall empowerment and for each dimension of it showed positive associations with couple methods as well as with female-only methods. The only exception was the measure of economic empowerment, which was associated only with the couple method. Conclusion Couples' joint decision-making is a stronger determinant of the use of contraceptive methods than women-only decision-making. This is the case over and above the contribution of women's socio-demographic and economic statuses. Effort needs to be made to educate
Hameed, Waqas; Azmat, Syed Khurram; Ali, Moazzam; Sheikh, Muhammad Ishaque; Abbas, Ghazunfer; Temmerman, Marleen; Avan, Bilal Iqbal
There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined--and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach. We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and women's mobility. Two measures were created for each dimension, and for the overall empowerment: women's independent decisions, and those taken jointly by couples. Contraceptive use was categorized as either female-only or couple methods on the basis of whether a method requires the awareness of, or some support and cooperation from, the husband. Multinomial regression was used, by means of Odds Ratios (OR), to assess associations between empowerment dimensions and female-only and couple contraceptive methods. Overall, women tend to get higher decision-making power with increased age, higher literacy, a greater number of children, or being in a household that has superior socio-economic status. The measures for couples' decision-making for overall empowerment and for each dimension of it showed positive associations with couple methods as well as with female-only methods. The only exception was the measure of economic empowerment, which was associated only with the couple method. Couples' joint decision-making is a stronger determinant of the use of contraceptive methods than women-only decision-making. This is the case over and above the contribution of women's socio-demographic and economic statuses. Effort needs to be made to educate women and their husbands equally, with
Kadmon, Ilana; Noy, Sigal; Billig, Allan; Tzur, Tomer
To address decision-making styles among breast cancer survivors considering breast reconstruction. . A primary analysis of a cross-sectional sample among survivors who chose to have breast reconstruction to examine correlations among patient age, decision-making style, and the level of involvement of decision making. . Hadassah Medical Center in Jerusalem, Israel. . 70 women who had undergone breast reconstruction surgery in the past five years. . Participants completed decision-making style and demographic questionnaires and an assessment of their level of involvement in the decision-making process. . Level of involvement in decision making, decision-making model between provider and patient, and decision-making styles were examined. . No correlation was found between four main decision-making styles and patient age or the extent of patient decision-making involvement and age. A statistically significant correlation was found between the level of involvement in decision making and the decision-making style of the patient. . Nurses should assess patient decision-making styles to ensure maximum patient involvement in the decision-making process based on personal desires regardless of age. . Nurses working in breast cancer care must address the decision-making process of patients diagnosed with breast cancer, including the choice to undergo breast reconstruction after mastectomy. Nurses should understand the complex factors that influence a woman's decision-making style to best help with the decision.
Soltani, Atousa; Hewage, Kasun; Reza, Bahareh; Sadiq, Rehan
Municipal Solid Waste Management (MSWM) is a complicated process that involves multiple environmental and socio-economic criteria. Decision-makers look for decision support frameworks that can guide in defining alternatives, relevant criteria and their weights, and finding a suitable solution. In addition, decision-making in MSWM problems such as finding proper waste treatment locations or strategies often requires multiple stakeholders such as government, municipalities, industries, experts, and/or general public to get involved. Multi-criteria Decision Analysis (MCDA) is the most popular framework employed in previous studies on MSWM; MCDA methods help multiple stakeholders evaluate the often conflicting criteria, communicate their different preferences, and rank or prioritize MSWM strategies to finally agree on some elements of these strategies and make an applicable decision. This paper reviews and brings together research on the application of MCDA for solving MSWM problems with more focus on the studies that have considered multiple stakeholders and offers solutions for such problems. Results of this study show that AHP is the most common approach in consideration of multiple stakeholders and experts and governments/municipalities are the most common participants in these studies. Copyright © 2014 Elsevier Ltd. All rights reserved.
Greening, L.A. [Oso Energy and Environmental Economics, Los Alamos, NM (United States); Bernow, S. [Tellus Institute Inc., Boston, MA (United States)
Conventional economic modeling tools that depend upon one criterion to select among possible alternatives for inclusion in an energy or environmental policy have limitations. Formulation of both sets of policies involves large numbers of stakeholders with differing views and preferences. Those views and preferences cannot always be determined in advance or with certainty since many of the attributes of these policy alternatives are non-market valued. The use of multi-criteria decision-making (MCDM) methods in an integrated assessment (IA) framework offers a far better alternative to cost/benefit and similar methods. To facilitate understanding of MCDM methods, we offer a typology for this broad class o models, suggest some of the types of problems that may be analyzed with these methods, and recommend the implementation of several MCDM methods in currently evolving IA frameworks. Depending upon the choice of method from this family of methods, a wide range of attributes associated with multi-pollutant reduction and energy system development strategies, and a diversity of stakeholder preferences may be incorporated into the analysis. The resulting policy space can then provide a basis for comparison and selection of policy alternatives in a political or negotiated process. (author)
Kim, Hae Won; Kang, Jee In; Namkoong, Kee; Jhung, Kyungun; Ha, Ra Yeon; Kim, Se Joo
Deficits in decision-making have been suggested as a key concept in understanding the symptoms of obsessive-compulsive disorder (OCD). However, evidence in the extant literature remains inconclusive on whether patients with OCD show inferior performance on laboratory decision-making tasks. The aims of the present study were therefore to (1) assess decision-making under ambiguity and under risk in patients with OCD and (2) study the influence of neuropsychological and clinical variables on decision-making in OCD. The sample consisted of 65 patients with OCD and 58 controls. The Iowa gambling task (IGT) and the game of dice task (GDT) were used to examine decision-making under ambiguity and decision-making under risk, respectively. In addition, reversal learning and executive function were assessed in terms of their relationship with decision-making tasks. Patients with OCD showed impairment in the IGT, but not in the GDT. Reversal learning was neither impaired nor correlated with IGT performance. Among the clinical variables, illness severity and depression were associated with IGT scores. Executive function was impaired, but no significant relationship was found between executive function and GDT performance in OCD patients. Almost all OCD patients were on medication when they performed decision-making tasks. Patients with OCD are impaired in decision-making under ambiguity, but not under risk. These findings demonstrate that decision-making processes are dissociated in OCD. Copyright © 2015 Elsevier B.V. All rights reserved.
Gulbrandsen, P.; Clayman, M.L.; Beach, M.C.; Han, P.K.; Boss, E.F.; Ofstad, E.H.; Elwyn, G.
OBJECTIVE: We describe the different ways in which illness represents an existential problem, and its implications for shared decision-making. METHODS: We explore core concepts of shared decision-making in medical encounters (uncertainty, vulnerability, dependency, autonomy, power, trust,
... Issue Past Issues Feature: Senior Living Caregiving and Decision-Making For Seniors: How You Can Help Past Issues / ... key resources and suggestions for effective care and decision-making for seniors. —The Editors To Find Out More ...
Dahm, Philipp; Oxman, Andrew D; Djulbegovic, Benjamin; Guyatt, Gordon H; Murad, M Hassan; Amato, Laura; Parmelli, Elena; Davoli, Marina; Morgan, Rebecca L; Mustafa, Reem A; Sultan, Shahnaz; Falck-Ytter, Yngve; Akl, Elie A; Schünemann, Holger J
Coverage decisions are complex and require the consideration of many factors. A well-defined, transparent process could improve decision-making and facilitate decision-maker accountability. We surveyed key US-based stakeholders regarding their current approaches for coverage decisions. Then, we held a workshop to test an evidence-to-decision (EtD) framework for coverage based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. A total of 42 individuals (including 19 US stakeholders as well as international health policymakers and GRADE working group members) attended the workshop. Of the 19 stakeholders, 14 (74%) completed the survey before the workshop. Almost all of their organizations (13 of 14; 93%) used systematic reviews for coverage decision-making; few (2 of 14; 14%) developed their own evidence synthesis; a majority (9 of 14; 64%) rated the certainty of evidence (using various systems); almost all (13 of 14; 93%) denied formal consideration of resource use; and half (7 of 14; 50%) reported explicit criteria for decision-making. At the workshop, stakeholders successfully applied the EtD framework to four case studies and provided narrative feedback, which centered on contextual factors affecting coverage decisions in the United States, the need for reliable data on subgroups of patients, and the challenge of decision-making without formal consideration of resource use. Stakeholders successfully applied the EtD framework to four case studies and highlighted contextual factors affecting coverage decisions and affirmed its value. Their input informed the further development of a revised EtD framework, now publicly available (http://gradepro.org/). Published by Elsevier Inc.
Søndergaard, Dorte Marie
This paper introduces the research and new conceptual framework developed by eXbus: Exploring Bullying in Schools from 2007-2012.......This paper introduces the research and new conceptual framework developed by eXbus: Exploring Bullying in Schools from 2007-2012....
Laursen, Karl Kaas; Pedersen, M. F.; Bendtsen, Jan Dimon
The goal of the Sophy framework (Simulation, Observation and Planning in Hybrid Systems) is to implement a multi-level framework for description, simulation, observation, fault detection and recovery, diagnosis and autonomous planning in distributed embedded hybrid systems. A Java-based distribut...
Laursen, Karl Kaas; Pedersen, Martin Fejrskov; Bendtsen, Jan Dimon
The goal of the Sophy framework (Simulation, Observation and Planning in Hybrid Systems) is to implement a multi-level framework for description, simulation, observation, fault detection and recovery, diagnosis and autonomous planning in distributed embedded hybrid systems. A Java-based distribut...
Gagliardi, R.; Mauri, M.; Polzonetti, A.
This presentation illustrates the framework of processing performance of the faculty of the University of Camerino. The evaluation criteria are explained and the technological structure that allows automatic performance assessment available online anywhere and anytime. The designed framework is usually applied to the performance evaluation of…
Apurv, T.; Cai, X.
Drought is one of the most expensive natural disasters as it affects many sectors of the economy. The threat posed by droughts is expected to further increase due to increasing water demands fuelled by increasing population and also due to climate change in many regions. Management of the increasing drought risk requires shift from traditional crisis management approaches to long term strategic planning for reduction of drought risk. This study proposes a framework for management of long term drought risk. The framework uses the system based approach proposed by Tsakiris et al. (2013), in which a watershed is considered as a system and different water sources in the watershed (like groundwater, reservoirs, streams etc.) are considered as subsystems associated with certain water requirements of different sectors. Droughts are defined separately for each subsystem considering water availability and requirement. The percentile based drought indicator framework proposed by Steinemann et al. (2015) is used for defining drought for each subsystem, allowing the selection of thresholds, variables of interest, and time scale which are most relevant for stakeholders dependent on a particular subsystem. Future drought risk under different drought management strategies are assessed using hydrologic models that model both hydrologic and human components of a watershed. The robustness of a management strategy is assessed by simulating system response across a wide range of stochastically generated future climate scenarios. The framework is useful for operational drought management as it allows direct management of drought risks with consideration of different water sources and water users. Steinemann, A., Iacobellis, S.F., Cayan, D.R., (2015) "Developing and evaluating drought indicators for decision-making" J. Hydrometeor. 16 (4), 1793-1803 Tsakiris, G, Nalbantis, I, Vangelis, H, Verbeiren, B, Huysmans, M, Tychon, B, Jacquemin, I, Canters, F, Vanderhaegen, S, Engelen, G
Nieuwenhuijze, M.J.; Korstjens, I.; De Jonge, A.; de Vries, R; Lagro-Janssen, A.
BACKGROUND: For most women, participation in decision-making during maternity care has a positive impact on their childbirth experiences. Shared decision-making (SDM) is widely advocated as a way to support people in their healthcare choices. The aim of this study was to identify quality criteria and professional competencies for applying shared decision-making in maternity care. We focused on decision-making in everyday maternity care practice for healthy women. METHODS: An international thr...
Clark, L; Dombrovski, AY; Siegle, GJ; Butters, MA; Shollenberger, CL; Sahakian, BJ; Szanto, K
Suicidal behavior is a potentially lethal complication of late-life depression. In younger adults, suicide has been linked to abnormal decision-making ability. Given that there are substantial age-related decreases in decision-making ability, and that older adults experience environmental stressors that require effective decision-making, we reasoned that impaired decision-making may be particularly relevant to suicidal behavior in the elderly. We thus compared performance on a probabilistic d...
Hadjistavropoulos, T; Malloy, D C
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.
Decision-making refers to assessing costs and benefits of competing actions, with either a known outcome or an uncertain result. Decision-making depends on several abilities, such as behavioural flexibility and inhibiting risky responses. Several factors affect decision-making, causing differences
Guillaume, Sebastien; Jollant, Fabrice; Jaussent, Isabelle; Lawrence, Natalia; Malafosse, Alain; Courtet, Philippe
In 1994, it was proposed that decision-making requires emotion-related signals, known as somatic markers. In contrast, some authors argued that conscious knowledge of contingencies is sufficient for advantageous decision-making. We aimed to investigate the respective roles of somatic markers and explicit knowledge in decision-making. Thirty…
Cao, Ming; Stewart, Andrew; Leonard, Naomi Ehrich
Leveraging research by psychologists on human decision-making, we present a human-robot decision-making problem associated with a complex task and study the corresponding joint decision-making dynamics. The collaborative task is designed so that the human makes decisions just as human subjects make
Is life about choice or is life about meaning? Sensemaking and decision-making represent rather different perspectives on different types of human activities, but the governance of wicked problems poses serious challenges for both sensemaking and decision-making. Decision-making is very much
Hepler, Teri J.; Feltz, Deborah L.
Can taking the first (TTF) option in decision-making lead to the best decisions in sports contexts? And, is one's decision-making self-efficacy in that context linked to TTF decisions? The purpose of this study was to examine the role of the TTF heuristic and self-efficacy in decision-making on a simulated sports task. Undergraduate and graduate…
Govan, George V.; Patrick, Sondra; Yen, Cherng-Jyn
This study examined how high school seniors construct decision-making strategies for choosing a college to attend. To comprehend their decision-making strategies, we chose to examine this process through the theoretical lens of bounded rationality, which brings to light the complexity in constructing a college choice decision-making strategy…
Bartelink, Cora; van Yperen, Tom A.; ten Berge, Ingrid J.
Assessment and decision-making in child maltreatment cases is difficult. Practitioners face many uncertainties and obstacles during their assessment and decision-making process. Research exhibits shortcomings in this decision-making process. The purpose of this literature review is to identify and
Sidiropoulou-Dimakakou, Despina; Mylonas, Kostas; Argyropoulou, Katerina; Drosos, Nikos
The present study aims at investigating career decision-making process of 6th grade students with the use of the Childhood Career Decision-Making Questionnaire (CCDMQ). CCDMQ offers scores for the following three decision-making dimensions: (a) "Concerns/fears regarding career future", (b) "Investment ?n decision-making…
Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne
Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on…
Ceschi, Andrea; Costantini, Arianna; Phillips, Susan D.; Sartori, Riccardo
Purpose: This paper aims to link findings from laboratory-based decision-making research and decision-making competence (DMC) aspects that may be central for career-related decision-making processes. Past research has identified individual differences in rational responses in decision situations, which the authors refer to as DMC. Although there…
... considered in Agency decision-making. 408.5 Section 408.5 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED... Procedures § 408.5 Ensuring environmental documents are actually considered in Agency decision-making... environmental documents in agency decision-making. To implement these requirements, Eximbank officials will: (a...
Meriläinen, Matti; Puhakka, Helena; Sinkkonen, Hanna-Maija
The aim of this research was to clarify the characteristics of Finnish upper secondary school students as vocational decision-makers. The focus was especially on what skills and competences were related to decision-making at different phases of the decision-making process. Altogether, 216 upper secondary school students filled in the…
Espin, Christine A.; Wayman, Miya Miura; Deno, Stanley L.; McMaster, Kristen L.; de Rooij, Mark
In this special issue, we explore the decision-making aspect of "data-based decision-making". The articles in the issue address a wide range of research questions, designs, methods, and analyses, but all focus on data-based decision-making for students with learning difficulties. In this first article, we introduce the topic of…
Dauer, Jenny M.; Lute, Michelle L.; Straka, Olivia
We propose two contrasting types of student decision-making based on social and cognitive psychology models of separate mental processes for problem solving. Informal decision-making uses intuitive reasoning and is subject to cognitive biases, whereas formal decision-making uses effortful, logical reasoning. We explored indicators of students'…
Light, Richard L.; Harvey, Stephen; Mouchet, Alain
This article draws on Game Sense pedagogy and complex learning theory (CLT) to make suggestions for improving decision-making ability in team sports by adopting a holistic approach to coaching with a focus on decision-making "at-action". It emphasizes the complexity of decision-making and the need to focus on the game as a whole entity,…
Calhoun, Patrick Wayne
Little is known about the decision-making styles of active-duty police officers or what the consequences of not understanding those decision-making styles may be. The purpose of the study was to describe the demographics and decision-making profiles of active-duty police officers, as well as any relationships that may exist among these variables,…
Carr, Susan M
Clinical reasoning is employed to develop solutions to health needs. The impact of the clinical environment on the organization of knowledge-guiding practice has received limited attention. This gap in the clinical landscape restricts the sharing of decision-making processes. Focusing on the community, and specifically the patient's home as a context for nursing, this paper describes the creation of a collective conceptual map for a group of community nurses. There is a twofold aim of exploring the process of exposing and articulating the clinical framework and enhancing and sharing understanding of the clinical paradigm in this context. An interpretive research approach was utilized. Hermeneutic phenomenology guided the level of meaning accessed and constructivism was used to build an educational picture. Multiple methods including focus groups, observation and narrative recordings were utilized to collect and analyse research data. All nurses may engage with the same concepts--health, need, care and partnerships--but organized into particular frames by the guiding practice philosophy and service organization. A four-stage framework for understanding clinical reasoning in the community setting is presented. This acknowledges the multi-faceted nature of health, the lived experience of health deficits, and is located in a participation and negotiated model of care. Practice examples are presented to expose the construction of need and response which often occurs in a triadic decision-making process. Environment of care has significant implications on need identification and response. Mechanisms to enhance the sharing of clinical reasoning and decision-making transparency are essential to aid inter- and intra-professional communication. Presentation of a clinical reasoning framework exposes the breath of 'signals' encountered in practice and the range of knowledge employed in understanding and responding to patient need. Copyright 2004 Blackwell Publishing Ltd
Servant, Mathieu; White, Corey; Montagnini, Anna; Burle, Borís
A current challenge for decision-making research is in extending models of simple decisions to more complex and ecological choice situations. Conflict tasks (e.g., Simon, Stroop, Eriksen flanker) have been the focus of much interest, because they provide a decision-making context representative of everyday life experiences. Modeling efforts have led to an elaborated drift diffusion model for conflict tasks (DMC), which implements a superimposition of automatic and controlled decision activations. The DMC has proven to capture the diversity of behavioral conflict effects across various task contexts. This study combined DMC predictions with EEG and EMG measurements to test a set of linking propositions that specify the relationship between theoretical decision-making mechanisms involved in the Simon task and brain activity. Our results are consistent with a representation of the superimposed decision variable in the primary motor cortices. The decision variable was also observed in the EMG activity of response agonist muscles. These findings provide new insight into the neurophysiology of human decision-making. In return, they provide support for the DMC model framework.
Davis, Selena; Roudsari, Abdul; Raworth, Rebecca; Courtney, Karen L; MacKay, Lee
This scoping review aims to determine the size and scope of the published literature on shared decision-making (SDM) using personal health record (PHR) technology and to map the literature in terms of system design and outcomes. Literature from Medline, Google Scholar, Cumulative Index to Nursing and Allied Health Literature, Engineering Village, and Web of Science (2005-2015) using the search terms "personal health records," "shared decision making," "patient-provider communication," "decision aid," and "decision support" was included. Articles ( n = 38) addressed the efficacy or effectiveness of PHRs for SDM in engaging patients in self-care and decision-making or ways patients can be supported in SDM via PHR. Analysis resulted in an integrated SDM-PHR conceptual framework. An increased interest in SDM via PHR is apparent, with 55% of articles published within last 3 years. Sixty percent of the literature originates from the United States. Twenty-six articles address a particular clinical condition, with 10 focused on diabetes, and one-third offer empirical evidence of patient outcomes. The tethered and standalone PHR architectural types were most studied, while the interconnected PHR type was the focus of more recently published methodological approaches and discussion articles. The study reveals a scarcity of rigorous research on SDM via PHR. Research has focused on one or a few of the SDM elements and not on the intended complete process. Just as PHR technology designed on an interconnected architecture has the potential to facilitate SDM, integrating the SDM process into PHR technology has the potential to drive PHR value.
Melo, Juliana; Peters, Marissa; Teal, Stephanie; Guiahi, Maryam
To evaluate influences on adolescent and young women's contraceptive decision-making processes. We conducted 21 individual interviews with women who presented to an adolescent-focused Title X family planning clinic seeking a new contraceptive method. Data were collected using a semi-structured interview guide, audio-taped and transcribed. Three researchers independently coded the transcripts using grounded theory; codes were organized into overarching themes and discrepancies were resolved. After identification of themes, we organized the conceptual framework of the decision-making process using the transtheoretical model of behavior change in which participants move through 4 stages: (1) contemplation, (2) preparation, (3) action, and (4) maintenance. When contemplating contraception, most of our participants were highly motivated to avoid pregnancy. During preparation, participants gathered information related to their contraceptive concerns. Participants cited peers as primary informants and healthcare providers as experts in the field. Participants integrated information received with their personal concerns about contraception initiation; the most common concerns were effectiveness, method duration, convenience, and side effects. When participants acted on choosing a contraceptive method they described how it fit their individual needs. They considered their contraceptive experiences unique and not necessarily applicable to others. During maintenance, they acted as informants for other peers, but most commonly expressed that each individual must choose "the best method for her." When adolescent and young women select a contraceptive method they balance the benefits and risks of available methods portrayed by peers and provider in the context of their personal concerns. Peer influence appeared to be greatest when participants shared contraceptive concerns and goals. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by
Dewar, Sandra R; Pieters, Huibrie C
Clear evidence supports the benefits of surgery over medical therapy for patients with refractory focal epilepsy. Surgical procedures meet the needs of fewer than 2% of those eligible. Referral to a tertiary epilepsy center early in the course of disease is recommended; however, patients live with disabling and life-threatening seizures for an average of 22years before considering surgical treatment. Reasons for this treatment gap are unclear. A critical analysis of the literature addressing perceptions of surgical treatment for epilepsy is placed in the context of a brief history and current treatment guidelines. Common conceptual themes shaping perceptions of epilepsy surgery are identified. Data sources used for this study were PubMed-MEDLINE and PsycINFO from 2003 to December 2013; hand searches of reference lists. Nine papers that addressed patient perceptions of surgery for epilepsy and three papers addressing physician attitudes were reviewed. Treatment misperceptions held by both patients and physicians lead to undertreatment and serious health consequences. Fear of surgery, ignorance of treatment options, and tolerance of symptoms emerge as a triad of responses central to weighing treatment risks and benefits and, ultimately, to influencing treatment decision-making. Our novel explanatory framework serves to illustrate and explain relationships among contributory factors. Comparisons across studies are limited by the heterogeneity of study populations and by the fact that no instrument has been developed to consistently measure disability in refractory focal epilepsy. Exploring the components of decision-making for the management of refractory focal epilepsy from the patient's perspective presents a new angle on a serious contemporary challenge in epilepsy care and may lead to explanation as to why there is reluctance to embrace a safe and effective treatment. Copyright © 2014 Elsevier Inc. All rights reserved.
Ling, Dong-Lan; Yu, Hong-Jing; Guo, Hui-Ling
Truth-telling toward terminally ill patients is a challenging ethical issue in healthcare practice. However, there are no existing ethical guidelines or frameworks provided for Chinese nurses in relation to decision-making on truth-telling of terminal illness and the role of nurses thus is not explicit when encountering this issue. The intention of this paper is to provide ethical guidelines or strategies with regards to decision-making on truth-telling of terminal illness for Chinese nurses. This paper initially present a case scenario and then critically discuss the ethical issue in association with ethical principles and philosophical theories. Instead of focusing on attitudes toward truth disclosure, it aims to provide strategies regarding this issue for nurses. It highlights and discusses some of the relevant ethical assumptions around the perceived role of nurses in healthcare settings by focusing on nursing ethical virtues, nursing codes of ethics, and philosophical perspectives. And Confucian culture is discussed to explicate that deontology does not consider family-oriented care in China. Treating each family individually to explore the family's beliefs and values on this issue is essential in healthcare practice and nurses should tailor their own approach to individual needs regarding truth-telling in different situations. Moreover, the Chinese Code of Ethics should be modified to be more specific and applicable. Finally, a narrative ethics approach should be applied and teamwork between nurses, physicians and families should be established to support cancer patients and to ensure their autonomy and hope. Ethical considerations: This paper was approved by the Ethics Committee of The Second Affiliated Hospital of Guangzhou Medical University. The authors have obtained consent to use the case study and it has been anonymised to preserve the patient's confidentiality.
Karimi, Sahar; Papamichail, K. Nadia; Holland, C.P.
This paper provides an empirical typology of online decision-making purchasing behaviour. The study explores how the online purchase process is affected by individual decision-making style and knowledge of product. Drawing from the decision analysis and consumer behaviour literatures, we present a typology of online purchase decision-making behaviour and introduce four archetypes of online consumers. A number of experiments have been conducted in two online settings: retail banking and mobile...
The present research contributes to a limited researched area in consumer research. Little is known about how culture influence emotions in consumer decision-making. It is revealed that culture shapes how consumers ideally want to feel, and that this in turn influences preferences and choice, which...... Danes as other Western cultures prefer high arousal positive emotions over low arousal positive emotions, but it is also revealed that it could be crucial when studying the influence of culture on emotions in decision-making to distinguish between more than high and low arousal positive and negative...... is guided by anticipated emotions. Empirical results confirm that some emotions are preferred more than others and that studying discrete emotions may be important when trying to understand how other cultural dimensions than the traditionally studied influence emotions. It is confirmed that indeed also...
Full Text Available Does culture matter in decision-making? Existing literature largely assumes that the cognitive processes that inform decision-making are universally applicable, while only very few studies indicate that cultural norms and values shape cognitive processes. Using survey based quasi-experimental design, this research shows that subjects with higher levels of individualism tend to be more rational in their decision processing, while those with higher levels of collectivism tend to be more dependent and less likely to betray the interests of members of more central ingroups in favor of less central ingroups. Furthermore, the results indicate that in conflict settings that seem familiar, individuals are more likely to compromise in order to achieve peace.
Macquet, A C; Fleurance, P
This paper reports on a study of naturalistic decision-making in expert badminton players. These decisions are frequently taken under time-pressured conditions, yet normally lead to successful performance. Two male badminton teams participated in this study. Self-confrontation interviews were used to collect data. Inductive data analysis revealed three types of intentions during a rally: to maintain the rally; to take the advantage; and to finish the point. It also revealed eight types of decision taken in this situation: to ensure an action; to observe the opponent's response to an action; to realize a limited choice; to influence the opponent's decision; to put pressure on an opponent; to surprise the opponent; to reproduce an efficient action; and to play wide. A frequent decision was to put pressure on the opponent. Different information and knowledge was linked to specific decisions. The results are discussed in relation to research that has considered naturalistic decision-making.
Full Text Available Business Ethics is a truly interdisciplinary field of study. The specific issue of moral decision-making within the field of business ethics testifies to this. Recently some have made important contributions in this regard - contributions in which they emphasised that moral theory is not sufficient for moral decision-making. What is needed besides moral theory is problem-solving ability. In this article the same point is argued, but from a philosophical perspective. It is further indicated that problem-solving ability entails more than merely a strategy fo r making moral decisions. It should also include the development of the thinking skills which are demanded by the strategy chosen fo r problem resolution.
Dobrajska, Magdalena; Billinger, Stephan; Becker, Markus C.
takes place in response to changes in decision characteristics, including decision complexity, decision importance, CEO proximity, and the degree to which a decision is routine. We show various manifestations of the substitution mechanism and discuss implications for strategic decision-making.......Strategic decisions are often made by multiple organizational members who form decision-making structures specialized for a given strategic decision. We study a series of strategic decisions in a business unit of a global Fortune 500 firm, identifying for each decision the hierarchical...... and departmental positions of all participating organizational members. We find that firms substitute between different structural components in decision-making structures to combine hierarchical authority with cross-departmental coordination and redundant knowledge. This substitution between structural components...
Kidholm, Kristian; Ølholm, Anne Mette; Birk-Olsen, Mette
. The hospital managers identified the clinical, economic, safety and organizational aspects of new treatments as being the most relevant for decision-making. With regard to economic aspects, the hospital managers typically had a narrower focus on budget impact and reimbursement. In addition to the information......Assessments of new health technologies in Europe are often made at the hospital level. However, the guidelines for health technology assessment (HTA), e.g. the EUnetHTA Core Model, are produced by national HTA organizations and focus on decision-making at the national level. This paper describes...... the results of an interview study with European hospital managers about their need for information when deciding about investments in new treatments. The study is part of the AdHopHTA project. Face-to-face, structured interviews were conducted with 53 hospital managers from nine European countries...
Full Text Available Stimulated by the expressed managers’ need for some completed methods for environmental management in enterprises, we present the method for environmentally oriented business decision-making. It is based on simulations where optimization models of business processes are used as scenarios. The possibilities for an integrated approach to environmental protection are introduced and – decomposed according to the type of the considered element by using zero-one variables – included in the optimization models. The method is completed for multicriteria decision-making where in the simulations obtained optimal values are included. In a real-life case where the Analytic Hierarchy Process technique is used to evaluate environmentally oriented business processes, special attention is given to criteria and weights: we consider preferences and survey findings on the environmental impact of business processes in the enterprise, survey findings on environmental management in the processing industry, and ecobalances.
Yan, Xiangbin; Dai, Shiliang
Previous research on online consumer behavior has mostly been confined to the perceived risk which is used to explain those barriers for purchasing online. However, perceived benefit is another important factor which influences consumers’ decision when shopping online. As a result, an integrated consumer online shopping decision-making model is developed which contains three elements—Consumer, Product, and Web Site. This model proposed relative factors which influence the consumers’ intention during the online shopping progress, and divided them into two different dimensions—mentally level and material level. We tested those factors with surveys, from both online volunteers and offline paper surveys with more than 200 samples. With the help of SEM, the experimental results show that the proposed model and method can be used to analyze consumer’s online shopping decision-making process effectively.
This book offers a comprehensive reference guide to fuzzy statistics and fuzzy decision-making techniques. It provides readers with all the necessary tools for making statistical inference in the case of incomplete information or insufficient data, where classical statistics cannot be applied. The respective chapters, written by prominent researchers, explain a wealth of both basic and advanced concepts including: fuzzy probability distributions, fuzzy frequency distributions, fuzzy Bayesian inference, fuzzy mean, mode and median, fuzzy dispersion, fuzzy p-value, and many others. To foster a better understanding, all the chapters include relevant numerical examples or case studies. Taken together, they form an excellent reference guide for researchers, lecturers and postgraduate students pursuing research on fuzzy statistics. Moreover, by extending all the main aspects of classical statistical decision-making to its fuzzy counterpart, the book presents a dynamic snapshot of the field that is expected to stimu...
Purpose The importance of shared mental models in teamwork has been explored in a diverse array of artificial work groups. This study extends such research to explore the role of mental models in the strategic decision-making of a real-world senior management group. Design/Methodology Data were collected from an intact group of senior healthcare executives (N=13) through semi-structured interviews, meeting observations and internal document analysis. Participants responded to intervi...
Bastons, Miquel; Armengou, Jaume
There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.