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.
Full Text Available Abstract Background Consistent healthcare decisionmaking requires systematic consideration of decision criteria and evidence available to inform them. This can be tackled by combining multicriteria decision analysis (MCDA and Health Technology Assessment (HTA. The objective of this study was to field-test a decision support framework (EVIDEM, explore its utility to a drug advisory committee and test its reliability over time. Methods Tramadol for chronic non-cancer pain was selected by the health plan as a case study relevant to their context. Based on extensive literature review, a by-criterion HTA report was developed to provide synthesized evidence for each criterion of the framework (14 criteria for the MCDA Core Model and 6 qualitative criteria for the Contextual Tool. During workshop sessions, committee members tested the framework in three steps by assigning: 1 weights to each criterion of the MCDA Core Model representing individual perspective; 2 scores for tramadol for each criterion of the MCDA Core Model using synthesized data; and 3 qualitative impacts of criteria of the Contextual Tool on the appraisal. Utility and reliability of the approach were explored through discussion, survey and test-retest. Agreement between test and retest data was analyzed by calculating intra-rater correlation coefficients (ICCs for weights, scores and MCDA value estimates. Results The framework was found useful by the drug advisory committee in supporting systematic consideration of a broad range of criteria to promote a consistent approach to appraising healthcare interventions. Directly integrated in the framework as a "by-criterion" HTA report, synthesized evidence for each criterion facilitated its consideration, although this was sometimes limited by lack of relevant data. Test-retest analysis showed fair to good consistency of weights, scores and MCDA value estimates at the individual level (ICC ranging from 0.676 to 0.698, thus lending some
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
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.
Most local agencies in Iowa currently make their pavement treatment decisions based on their limited experience due primarily to : lack of a systematic decision-making framework and a decision-aid tool. The lack of objective condition assessment data...
Chinchilla, Nuria; Moragas, Maruja; Kim, Sowon
We introduce motivation theory as a way of understanding the decision-making process in the work and family context. We use core concepts from motivation theory - extrinsic, intrinsic and prosocial motivation - and link them to motivational learning to build our framework. We then propose a framework illustrating motivational factors that influence work-family decision-making and offer propositions focusing on the motivational consequences for individuals which will impact their future decisi...
Nurses' clinical decision-making is a complex process that holds potential to influence the quality of care provided and patient outcomes. The evolution of nurses' decision-making that occurs with experience has been well documented. In addition, literature includes numerous strategies and approaches purported to support development of nurses' clinical decision-making. There has been, however, significantly less attention given to the process of assessing nurses' clinical decision-making and novice clinical educators are often challenged with knowing how to best support nurses and nursing students in developing their clinical decision-making capacity. The Situated Clinical Decision-Making framework is presented for use by clinical educators: it provides a structured approach to analyzing nursing students' and novice nurses' decision-making in clinical nursing practice, assists educators in identifying specific issues within nurses' clinical decision-making, and guides selection of relevant strategies to support development of clinical decision-making. A series of questions is offered as a guide for clinical educators when assessing nurses' clinical decision-making. The discussion presents key considerations related to analysis of various decision-making components, including common sources of challenge and errors that may occur within nurses' clinical decision-making. An exemplar illustrates use of the framework and guiding questions. Implications of this approach for selection of strategies that support development of clinical decision-making are highlighted. Copyright © 2010 Elsevier Ltd. All rights reserved.
Maes, Marc A.; Faber, Michael H.
A rational decision-making process does not exclude the possibility of decision makers expressing different preferences and disagreeing regarding the effects of consequences and optimal course of actions. This point of view is explored in depth in this paper. A framework is developed that includes several decision makers (instead of just one) and allows for the variability of preferences among these decision makers. The information provided by the varying opinions of decision makers can be used to optimize our own decision-making. To achieve this, likelihood functions are developed for stated preferences among both discrete and continuous alternatives, and stated preference rankings of alternatives. Two applications are pursued: the optimization of the lifecycle utility of a structural system subject to consequences of failure proportional to the intensity of hazards exceeding a variable threshold, and to follow-up consequences. Also, the problem of tight decisions or close calls is investigated in order to explore the efficiency of a Bayesian approach using stated preferences and stated rankings
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...
Wright, Stuart Anthony Lewis
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...... the nature of environmental problems. The second part of the paper is an analysis of the decision-making process in the WFD. The WFD both introduces economic methodologies and public participation for river basin management. The paper concludes that the use of neoclassical methods, such as contingent...
Cohen, Elena P.
Provides a framework for understanding the cultural, social, political, and economic factors that affect decision making when working with ethnically and racially diverse families in the child welfare system. Describes external factors affecting the decision- making process, including community environment, agency structure, and family…
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…
A ‘multiple perspective’ framework for the grouping of nanomaterials Robert Landsiedel presenting the results of the ECETOC Nano Task Force (Josje H.E. Arts a, Mackenzie Hadi b, Athena M. Keene c, Reinhard Kreiling d, Delina Lyon e, Monika Maier f, Karin Michel g, Thomas Petry h, Ursula G. Sauer i, David Warheit j, Karin Wiench k, Robert Landsiedel k) a AkzoNobel, Technology and Engineering, Arnhem, Netherlands b Shell Health, Shell International B.V., The Hague, Netherlands...
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...
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...
Kim, Beom Seock
The utility and the nuclear research institutes in Korea have conduct research for improving inefficient requirements in technical specifications using the results of probability risk assessments and information associated with risk. However, the guidance for reviewing the improved technical specifications has not been developed. Thus, the objective of this study is to develop a decision-making framework for investigating and reviewing the documents associated with the changes of technical specifications. This work has been done for helping the regulation agency to review the improved technical specifications as well as to make decisions whether the remedy is accepted or not. The contents of this study include: 1. Surveys on Technical Specification regulations in foreign countries as well as those in Korea 2. Surveys on the state- of- the- art methodology for Risk Informed Technical Specifications and their uses in Korea 3. Development of a decision-making framework in both the licensee and the regulation agency position 4. Development and applications of a decision-making framework using Influence Diagrams. The decision-making framework for RITS using Influence Diagrams are developed and applied to an example problem in this study. This work might contribute to developing the risk informed regulation guidance for improving the quality of the current technical specifications
Hargrave, C; Deegan, T; Gibbs, A; Poulsen, M; Moores, 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.
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.
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
Liefbroer, A.C.; Klobas, J.E.; Philipov, D.; Azjen, I.; Philipov, D.; Liefbroer, A.C.; Klobas, J.E.
This chapter lays the theoretical and methodological foundation for the book, Reproductive decision-making in a macro-micro perspective. It introduces the issues addressed in the book and the European Commission Seventh Framework funded collaborative research project, REPRO, on which it is based. A
Kotalik, Jaro; Covino, Cathy; Doucette, Nadine; Henderson, Steve; Langlois, Michelle; McDaid, Karen; Pedri, Louisa M
The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework. The resultant framework consists of a set of questions for each of the MVVs. Users of the framework are expected to identify two or more possible decisions to address the issue at hand and then, by applying the provided sequence of questions to each, examine these options and determine the overall ethically preferable decision. The construction of such a framework requires the creative involvement of the institution's staff. Thus the development of the framework can represent a training process in ethical decision-making as well as advance the ethical atmosphere of the institution. This novel approach has the advantage of placing the MVVs on active duty, at the centre of ethical decision-making, and lifts it from its otherwise relative obscurity in most institutions.
Sirvent, N; Bérard, E
One aim of the law promulgated in France on March 4, 2002 concerning patients' rights and the quality of the health care system was to reconsider the bases of the physician-patient relationship. The new legal framework recommends establishment of a true dialogue between the two protagonists, and it assigns decisional priority to the patient rather than to the physician or third parties. In the case of minors, the principle of parental authority requires that the physician consults the holders of this authority before making any medical decision. However, the law of March 4, 2002 also reinforced the participation of minors in medical decisions concerning them. The lawmaker explicitly envisaged the possibility of overruling the principle of parental authority. This new "balance of power" obliges the physician to inform the minor of his or her medical condition in a manner appropriate to the child's degree of maturity. The minor may even put forward the principle of medical secrecy to prevent the sharing of information with his or her parents. This new "autonomy" of minors gives rise to at least two reservations: i) the difficulty involved in assessment of a minor's degree of discernment; ii) the minor's vulnerability with respect to his or her entourage. Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.
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.
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
Piegorsch, Karen M; Watkins, Ken W; Piegorsch, Walter W; Reininger, Belinda; Corwin, Sara J; Valois, Robert F
Ergonomists play an important role in preventing and controlling work-related injuries and illnesses, yet little is known about the decision-making processes that lead to their recommendations. This study (1) generated a data-grounded conceptual framework, based on schema theory, for ergonomic decision-making by experienced practitioners in the USA and (2) assessed the adequacy of that framework for describing the decision-making of ergonomics practitioners from backgrounds in industrial engineering (IE) and physical therapy (PT). A combination of qualitative and quantitative analyses, within and across 54 decision-making situations derived from in-depth interviews with 21 practitioners, indicated that a single framework adequately describes the decision-making of experienced practitioners from these backgrounds. Results indicate that demands of the practitioner environment and practitioner factors such as personality more strongly influence the decision-making of experienced ergonomics practitioners than does practitioner background in IE or PT.
Xue, Jie; Gui, Dongwei; Zhao, Ying; Lei, Jiaqiang; Zeng, Fanjiang; Feng, Xinlong; Mao, Donglei; Shareef, Muhammad
The competition for water resources between agricultural and natural oasis ecosystems has become an increasingly serious problem in oasis areas worldwide. Recently, the intensive extension of oasis farmland has led to excessive exploitation of water discharge, and consequently has resulted in a lack of water supply in natural oasis. To coordinate the conflicts, this paper provides a decision-making framework for modeling environmental flows in oasis areas using Bayesian networks (BNs). Three components are included in the framework: (1) assessment of agricultural economic loss due to meeting environmental flow requirements; (2) decision-making analysis using BNs; and (3) environmental flow decision-making under different water management scenarios. The decision-making criterion is determined based on intersection point analysis between the probability of large-level total agro-economic loss and the ratio of total to maximum agro-economic output by satisfying environmental flows. An application in the Qira oasis area of the Tarim Basin, Northwest China indicates that BNs can model environmental flow decision-making associated with agricultural economic loss effectively, as a powerful tool to coordinate water-use conflicts. In the case study, the environmental flow requirement is determined as 50.24%, 49.71% and 48.73% of the natural river flow in wet, normal and dry years, respectively. Without further agricultural economic loss, 1.93%, 0.66% and 0.43% of more river discharge can be allocated to eco-environmental water demands under the combined strategy in wet, normal and dry years, respectively. This work provides a valuable reference for environmental flow decision-making in any oasis area worldwide.
Pinchevsky, Gillian M
This study fills a gap in the literature by exploring the utility of contemporary courtroom theoretical frameworks-uncertainty avoidance, causal attribution, and focal concerns-for explaining decision-making in specialized domestic violence courts. Using data from two specialized domestic violence courts, this study explores the predictors of prosecutorial and judicial decision-making and the extent to which these factors are congruent with theoretical frameworks often used in studies of court processing. Findings suggest that these theoretical frameworks only partially help explain decision-making in the courts under study. A discussion of the findings and implications for future research is provided. © The Author(s) 2016.
Grill, Kalle; Dawson, Angus
A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim's and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health.
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
Davidson, Gavin; Brophy, Lisa; Campbell, Jim; Farrell, Susan J; Gooding, Piers; O'Brien, Ann-Marie
There have been important recent developments in law, research, policy and practice relating to supporting people with decision-making impairments, in particular when a person's wishes and preferences are unclear or inaccessible. A driver in this respect is the United Nations Convention on the Rights of Persons with Disabilities (CRPD); the implications of the CRPD for policy and professional practices are currently debated. This article reviews and compares four legal frameworks for supported and substitute decision-making for people whose decision-making ability is impaired. In particular, it explores how these frameworks may apply to people with mental health problems. The four jurisdictions are: Ontario, Canada; Victoria, Australia; England and Wales, United Kingdom (UK); and Northern Ireland, UK. Comparisons and contrasts are made in the key areas of: the legal framework for supported and substitute decision-making; the criteria for intervention; the assessment process; the safeguards; and issues in practice. Thus Ontario has developed a relatively comprehensive, progressive and influential legal framework over the past 30 years but there remain concerns about the standardisation of decision-making ability assessments and how the laws work together. In Australia, the Victorian Law Reform Commission (2012) has recommended that the six different types of substitute decision-making under the three laws in that jurisdiction, need to be simplified, and integrated into a spectrum that includes supported decision-making. In England and Wales the Mental Capacity Act 2005 has a complex interface with mental health law. In Northern Ireland it is proposed to introduce a new Mental Capacity (Health, Welfare and Finance) Bill that will provide a unified structure for all substitute decision-making. The discussion will consider the key strengths and limitations of the approaches in each jurisdiction and identify possible ways that further progress can be made in law, policy
Mahmoud, M.; Liu, Yajing; Hartmann, H.; Stewart, S.; Wagener, T.; Semmens, D.; Stewart, R.; Gupta, H.; Dominguez, D.; Dominguez, F.; Hulse, D.; Letcher, R.; Rashleigh, Brenda; Smith, C.; Street, R.; Ticehurst, J.; Twery, M.; van, Delden H.; Waldick, R.; White, D.; Winter, L.
Scenarios are possible future states of the world that represent alternative plausible conditions under different assumptions. Often, scenarios are developed in a context relevant to stakeholders involved in their applications since the evaluation of scenario outcomes and implications can enhance decision-making activities. This paper reviews the state-of-the-art of scenario development and proposes a formal approach to scenario development in environmental decision-making. The discussion of current issues in scenario studies includes advantages and obstacles in utilizing a formal scenario development framework, and the different forms of uncertainty inherent in scenario development, as well as how they should be treated. An appendix for common scenario terminology has been attached for clarity. Major recommendations for future research in this area include proper consideration of uncertainty in scenario studies in particular in relation to stakeholder relevant information, construction of scenarios that are more diverse in nature, and sharing of information and resources among the scenario development research community. ?? 2008 Elsevier Ltd.
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).
Manson, Helen M
Ethical analysis frameworks can help to identify the ethical dimensions to clinical care and provide a method for justifying clinical decisions. Published frameworks, however, have some limitations to easy, practical use. The aim was to identify a comprehensive yet easy-to-use framework that clarifies ethical decision-making, suitable for use by medical learners and clinical educators. A literature search identified published frameworks that define the components of ethical clinical decision-making. On this basis, a new framework, the 'CoRE-Values Compass and Grid' was constructed. This was formally evaluated during a medical school interprofessional teaching session. For 88% of 228 medical and nursing students, the new framework was easy to understand; 85% reported it as easy to use. The framework improved awareness of the ethical dimensions to a clinical scenario for 97% of students and the ability to systematically identify ethical aspects for 83%. Students and instructors reported that the framework helped to link ethics theory with clinical practice. The framework was described as a useful educational tool by 85% of students and 95% of instructors. The 'CoRE-Values Compass and Grid' is a new framework, shown to aid the systematic identification and consideration of ethical aspects to clinical cases.
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
The National Transportation System (NTS) is undoubtedly a complex system-of-systems---a collection of diverse 'things' that evolve over time, organized at multiple levels, to achieve a range of possibly conflicting objectives, and never quite behaving as planned. The purpose of this research is to develop a virtual transportation architecture for the ultimate goal of formulating an integrated decision-making framework. The foundational endeavor begins with creating an abstraction of the NTS with the belief that a holistic frame of reference is required to properly study such a multi-disciplinary, trans-domain system. The culmination of the effort produces the Transportation Architecture Field (TAF) as a mental model of the NTS, in which the relationships between four basic entity groups are identified and articulated. This entity-centric abstraction framework underpins the construction of a virtual NTS couched in the form of an agent-based model. The transportation consumers and the service providers are identified as adaptive agents that apply a set of preprogrammed behavioral rules to achieve their respective goals. The transportation infrastructure and multitude of exogenous entities (disruptors and drivers) in the whole system can also be represented without resorting to an extremely complicated structure. The outcome is a flexible, scalable, computational model that allows for examination of numerous scenarios which involve the cascade of interrelated effects of aviation technology, infrastructure, and socioeconomic changes throughout the entire system.
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.
Azadeh, Ali; Zarrin, Mansour; Hamid, Mehdi
Road accidents can be caused by different factors such as human factors. Quality of the decision-making process of drivers could have a considerable impact on preventing disasters. The main objective of this study is the analysis of factors affecting road accidents by considering the severity of accidents and decision-making styles of drivers. To this end, a novel framework is proposed based on data envelopment analysis (DEA) and statistical methods (SMs) to assess the factors affecting road accidents. In this study, for the first time, dominant decision-making styles of drivers with respect to severity of injuries are identified. To show the applicability of the proposed framework, this research employs actual data of more than 500 samples in Tehran, Iran. The empirical results indicate that the flexible decision style is the dominant style for both minor and severe levels of accident injuries. Copyright © 2015 Elsevier Ltd. All rights reserved.
The protection of process plants from external events is mandatory in the Seveso Directive. Among these events figures the possibility of inundation of a plant, which may cause a hazard by disabling technical components and obviating operator interventions. A methodological framework for dealing with hazards from potential flooding events is presented. It combines an extension of the fault tree method with generic properties of flooding events in rivers and of dikes, which should be adapted to site-specific characteristics in a concrete case. Thus, a rational basis for deciding whether upgrading is required or not and which of the components should be upgraded is provided. Both the deterministic and the probabilistic approaches are compared. Preference is given to the probabilistic one. The conclusions drawn naturally depend on the scope and detail of the model calculations and the decision criterion adopted. The latter has to be supplied from outside the analysis, e.g. by the analyst himself, the plant operator or the competent authority. It turns out that decision-making is only viable if the boundary conditions for both the procedure of analysis and the decision criterion are clear.
Godoy, David R.; Pascual, Rodrigo; Knights, Peter
Maintenance outsourcing is a strategic driver for asset intensive industries pursuing to enhance supply chain performance. Spare parts management plays a relevant role in this premise since its significant impact on equipment availability, and hence on business success. Designing critical spares policies might therefore seriously affect maintenance contracts profitability, yet service receivers and external providers traditionally attempt to benefit separately. To coordinate both chain parties, we investigated whether the spare components pool should be managed in-house or contracted out. This paper provides a decision-making framework to efficiently integrate contractual conditions with critical spares stockholding. Using an imperfect maintenance strategy over a finite horizon, the scheme maximizes chain returns whilst evaluating the impact of an additional part to stock. As result, an original joint value – preventive interval and stock level – sets the optimal agreement to profitably allocate the components pool within the service contract. Subsidization bonuses on preventive interventions and pooling costs are also estimated to induce the service provider to adjust its policy when needed. The proposed contractual conditions motivate stakeholders to continuously improve maintenance performance and supply practices, thus obtaining higher joint benefits
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.
Eling, K.; Griffin, A.; Langerak, F.
The goal of decision-making during the execution of the fuzzy front end (FFE) is to develop a creative new product concept. Although intuitive decision-making has been found to increase new product creativity, the theoretical knowledge base as to why and under which conditions intuition use during
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
Han-hui LIU; Yan-yan AN; Hui-min LI; Zhen WEI; Xing-ting ZHU; Hui-jie LI
Background Humans often display irrational choice and decision-making due to the frame effect. However, it is unclear whether this irrational choice and decision-making will increase during the aging process. Methods The present research explored development and aging of risky-seeking and rational decision-making with 232 younger adults and 120 older adults. The experiment was a 2 (Age:younger adult and old adult) × 2 (Frame: positive and negative) × 2 (Relevance: lower level and higher level...
Dragičević-Radičević, Tatjana; Mitrović, Ranka; Mikuljević, Milica
For the purpose of effective and efficient decision-making participation of employees in decision-making on important influences raise employee motivation, encouraging the creative potential of people and overall, improve the quality of decisions, and thus on the overall organizational performance. In order to meet this requirement that employees must have the relevant information regarding the status and position of the company they work for and that they know the proper usage. That's why pa...
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.
Full Text Available Background Humans often display irrational choice and decision-making due to the frame effect. However, it is unclear whether this irrational choice and decision-making will increase during the aging process. Methods The present research explored development and aging of risky-seeking and rational decision-making with 232 younger adults and 120 older adults. The experiment was a 2 (Age:younger adult and old adult × 2 (Frame: positive and negative × 2 (Relevance: lower level and higher level, with the risky probability as a control variable and the decision-making scores as dependent variables. Results The results revealed that older adults demonstrated much more irrational decision-making (framing effect. In the detail, the risky decision-making score of the older adults in the positive framing was 5.13 ± 2.12, and 6.55 ± 1.05 in the negative framing [F (1, 118 = 21.470, P = 0.000; η2 = 0.156], while the risky decision-making score of the younger adults in the positive framing was 3.18 ± 2.49, and 5.00 ± 2.41 in the negative framing [F (1, 230 = 31.260, P = 0.000; η 2 = 0.121]. Meanwhile, the older adults showed risk seeking for the life-death scenario [F (1, 350 = 4.820, P = 0.029]. Conclusions These results suggested that the hypofunction in orbital and medial prefrontal cortex and amygdale in older adults might be the underlying mechanisms. Furthermore, the susceptibility to expected value (EV of the older adults might decrease although their scores in risky probability understanding were not significantly different from the younger adults. doi: 10.3969/j.issn.1672-6731.2014.03.008
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…
Liefbroer, A.C.; Klobas, J.; Philipov, D.; Ajzen, I.; Philipov, D.; Liefbroer, A.C.; Klobas, J.E.
This book provides new insights into the significant gap that currently exists between desired and actual fertility in Europe. It examines how people make decisions about having children and demonstrates how the macro-level environment affects micro-level decision-making. Written by an international
Full Text Available T-enabled objects. This implies taking into account multi-objective goals in the collection process while dealing with complexities such as data loss during IoT based data collection. Understanding current decision-making algorithms highlights the deeper insight...
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.
Van den Bulcke, Bo; Piers, Ruth; Jensen, Hanne Irene; Malmgren, Johan; Metaxa, Victoria; Reyners, Anna K; Darmon, Michael; Rusinova, Katerina; Talmor, Daniel; Meert, Anne-Pascale; Cancelliere, Laura; Zubek, Làszló; Maia, Paolo; Michalsen, Andrej; Decruyenaere, Johan; Kompanje, Erwin J O; Azoulay, Elie; Meganck, Reitske; Van de Sompel, Ariëlla; Vansteelandt, Stijn; Vlerick, Peter; Vanheule, Stijn; Benoit, Dominique D
Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates. Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups. Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team; active involvement of nurses in end-of-life care and decision-making; active decision-making by physicians; and practice and culture of ethical awareness. Measurement invariance of the EDMCQ across occupational groups was shown, reflecting that nurses and physicians interpret the EDMCQ items in a similar manner. The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians' behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU
A structured framework and tool that can reflect local requirements, : practices, and operational conditions would greatly assist local : agencies in making consistent and defensible pavement treatment : selection decisions.
Full Text Available Stormwater drainage systems in urban areas located in arid environmental regions generally consist of storm-sewer networks and man-made ponds for the collection and disposal of runoff, respectively. Due to expansion in cities’ boundaries as a result of population growth, the capacity of existing drainage systems has been exhausted. Therefore, such systems overflow even during the smaller (than the design return period floods. At the same time, changing rainfall patterns and flash floods due to climate change are other phenomena that need appropriate attention. Consequently, the municipalities in arid environmental regions are facing challenges for effective decision-making concerning (i improvement needs for drainage networks for safe collection of stormwater, (ii selection of most feasible locations for additional ponds, and (iii evaluation of other suitable options, such as micro-tunneling. In this research, a framework has been developed to evaluate different stormwater drainage options for urban areas of arid regions. Rainfall-runoff modeling was performed with the help of Hydrological-Engineering-Centre, Hydrological-Modelling-System (HEC-HMS. To evaluate the efficacy of each option for handling a given design flood, hydraulic-modeling was performed using SewerGEMS. Meteorological and topographical data was gathered from the Municipality of Buraydah and processed to generate different inputs required for hydraulic modeling. Finally, multicriteria decision-making (MCDM was performed to evaluate all the options on the basis of four sustainability criteria, i.e., flood risk, economic viability, environmental impacts, and technical constraints. Criteria weights were established through group decision-making using the Analytic Hierarchy Process (AHP. Preference-Ranking-Organization-Method for Enrichment-Evaluation (PROMETHEE II was used for final ranking of stormwater drainage options. The proposed framework has been implemented on a case of
Malekpour, Shirin; Langeveld, Jeroen; Letema, Sammy; Clemens, François; van Lier, Jules B
This paper introduces the probabilistic evaluation framework, to enable transparent and objective decision-making in technology selection for sanitation solutions in low-income countries. The probabilistic framework recognizes the often poor quality of the available data for evaluations. Within this framework, the evaluations will be done based on the probabilities that the expected outcomes occur in practice, considering the uncertainties in evaluation parameters. Consequently, the outcome of evaluations will not be single point estimates; but there exists a range of possible outcomes. A first trial application of this framework for evaluation of sanitation options in the Nyalenda settlement in Kisumu, Kenya, showed how the range of values that an evaluation parameter may obtain in practice would influence the evaluation outcomes. In addition, as the probabilistic evaluation requires various site-specific data, sensitivity analysis was performed to determine the influence of each data set quality on the evaluation outcomes. Based on that, data collection activities could be (re)directed, in a trade-off between the required investments in those activities and the resolution of the decisions that are to be made. Copyright © 2013 Elsevier Ltd. All rights reserved.
The role of decision-making in learning performance has been an occasional topic in the research literature in science education, but rarely has it been a central issue in the field. Nonetheless, recent studies regarding the topic in several fields other than education, such as cognitive neuroscience and social choice theory, indicate the fundamental importance(s) of the topic. This study focuses on a possible role of decision-making in science learning. Initially the study was designed to probe the decision-making ability of elementary school children with a modified version of the Iowa Gambling Task (IGT). The experiment involved six Montessori 3rd and 4th grade students as the experimental group and eight public school 3rd and 4th grade students as the control group. The result of the modified IGT revealed a tendency in choice trajectories favoring children at the Montessori school. However, the probabilistic value went below the statistically significant level set by the U test. A further study focused on the impact of better decision-making ability revealed in the first experiment on performances with a science learning module that emphasized collective reasoning. The instruction was based on a set of worksheets with multiple choices on which students were asked to make predictions with and to provide supportive arguments regarding outcomes of experiments introduced in the worksheet. Then the whole class was involved with a real experiment to see which choice was correct. The findings in the study indicated that the Montessori students often obtained higher scores than non-Montessori students in making decision with a tendency of consistency in terms of their choices of the alternatives on the worksheets. The findings of the experiments were supported by a correlational analysis that was performed at the end of study. Although no statistically significant correlations were found, there was a tendency for positively associative shifts between the scores of the
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
Roth, N; Ciffroy, P
Considerable efforts have been invested so far to evaluate and rank the quality and relevance of (eco)toxicity data for their use in regulatory risk assessment to assess chemical hazards. Many frameworks have been developed to improve robustness and transparency in the evaluation of reliability and relevance of individual tests, but these frameworks typically focus on either environmental risk assessment (ERA) or human health risk assessment (HHRA), and there is little cross talk between them. There is a need to develop a common approach that would support a more consistent, transparent and robust evaluation and weighting of the evidence across ERA and HHRA. This paper explores the applicability of existing Data Quality Assessment (DQA) frameworks for integrating environmental toxicity hazard data into human health assessments and vice versa. We performed a comparative analysis of the strengths and weaknesses of eleven frameworks for evaluating reliability and/or relevance of toxicity and ecotoxicity hazard data. We found that a frequent shortcoming is the lack of a clear separation between reliability and relevance criteria. A further gaps and needs analysis revealed that none of the reviewed frameworks satisfy the needs of a common eco-human DQA system. Based on our analysis, some key characteristics, perspectives and recommendations are identified and discussed for building a common DQA system as part of a future integrated eco-human decision-making framework. This work lays the basis for developing a common DQA system to support the further development and promotion of Integrated Risk Assessment. Copyright © 2016 Elsevier Ltd. All rights reserved.
Horita, Flávio E.A.; Albuquerque, João Porto de; Marchezini, Victor; Mendiondo, Eduardo M.
With the emergence of big data and new data sources, a challenge posed to today's organizations consists of identifying how to align their decision-making and organizational processes to data that could help them make better-informed decisions. This paper presents a study in the context of disaster management in Brazil that applies oDMN +, a framework that connects decision-making with data sources through an extended modeling notation and a modeling process. The study results revealed that t...
Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M
This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.
Norrie, S.J.; Fang, L. [Ryerson Polytechnic Univ., Toronto, ON (Canada). Environmental Applied Science and Management Graduate Program
This paper proposed a framework for the consideration of multiple objectives in the long-term planning of electricity generation systems. The framework was comprised of 3 components: (1) information based on life-cycle inventories of electricity generation technologies; (2) a set of alternative scenarios to be evaluated and ranked using the framework; and (3) stakeholder values for decision objectives. Scenarios were developed to represent a set of future conditions, and values were derived through the use of questionnaires. Planning for electricity generation in Ontario was selected as a test case for the DM framework. Three scenarios were presented: (1) a business as usual scenario characterized by large, central power plants; (2) a mix of central power plants, distributed generation, and advanced conventional fuel technologies; and (3) small-scale distributed and renewable energy sources and aggressive demand-side management. The life-cycle based information from the scenario evaluation was used to estimate the performance of each scenario on the established decision criteria. Results showed that scenario 3 was the closest to achieving the fundamental objectives according to the decision criteria. It was concluded that the DM framework showed that the use of holistic environmental information and preferential information for multiple objectives can be integrated into a framework that openly and consistently evaluates a set of alternative scenarios. 31 refs., 7 tabs., 4 figs.
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.
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.
Chambers, Duncan; Wilson, Paul
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. 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. 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.
Full Text Available This paper investigates interactions between game theoretical strategies and social relationships in real-time decision-making and rewarding environments. We propose an experimental framework based on techniques of web-based multiplayer online games for this purpose. In our framework, multiple human players, represented as particles in a two-dimensional space of social interactions, can modify their positions and game strategies for the prisoner's dilemma in real time, and receive benefit or cost emerging from both game theoretical and social relationships with neighboring players. We report on experiments with human participants in different conditions of the payoff matrix, which reflects game structures, and the speed of each player, which reflects the ability to change her social relationship. We show that cooperative relationships emerge in real human groups regardless of experimental settings, and show their basic behavioral patterns. We further discuss relationships between behavioral characters of participants in the experiments and their psychological characters to see how their personalities can be reflected in their behavior in such a game theoretical framework, and show that a few psychological characters of participants might reflect their behavioral characters at least in part, but there were variations in these relationships between experimental groups.
Rangel, Erica Cavalcanti; Pereira, Andre; Cavalcante, Tania Maria; Oliveira, Egléubia Andrade; Silva, Vera Luiza da Costa E
Tobacco consumption is a leading cause of various types of cancer and other tobacco-related diseases. In 2003, the World Health Assembly adopted the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), which aims to protect citizens from the health, social, environmental, and economic consequences of tobacco consumption and exposure to tobacco smoke. The Convention was to be ratified by the Member States of the WHO; in Brazil's case, ratification involved the National Congress, which held public hearings in the country's leading tobacco growing communities (municipalities). The current study analyzes this decision-making process according to the different interests, positions, and stakeholders. In methodological terms, this is a qualitative study based on document research, drawing primarily on the shorthand notes from the public hearings. We analyze the interests and arguments for and against ratification. The article shows that although preceded by intense debates, the final decision in favor of ratification was made by a limited group of government stakeholders, characterizing a decision-making process similar to a funnel.
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
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.
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.
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
Gin-Rong Liu Peiwen Lu
Full Text Available We live in challenging times with a heightened sense of uncertainty and unpredictability. Climate change, with its impact on disruptive events as well as gradual trends, has been addressed in scientific studies and become increasingly important in policymaking. This rises up a great need on scientific integration and knowledge transformation. The Taiwan Integrated Research Programme on Climate Change Adaptation Technology (TaiCCAT is formed under this concern. Directing by the Ministry of Science and Technology (MOST, it carries a strong intention to explore and to conduct adequate knowledge of climate change and adaptation strategies for decision-making supports. The TaiCCAT highly recommends the approach of cross-disciplinary collaboration from environmental studies to adaptation governance. The result can therefore be more contributive to reflect the complexity of the changing world.
Esteves, L. S.; Foord, J.; Draux, H.
A strong and evidence-based environmental legislation contributes to reduce the generalised degradation of natural and semi-natural environments. However, the wide range of coastal settings and the complexity of interactions between physical, biological and socio-economic factors prevent the development of very specific guidelines at national and regional levels. Often coastal management decisions are taken locally as local governments are better placed to engage with local community. However, they can also be more influenced by stronger local sectors and suffer from lack of expertise, experience and funding. Significant conflicts might arise between sectoral interests, especially in multi-functional coastal areas. Reaching a consensus on which function is more important is a difficult task. Here a methodological framework is suggested to support decision-making in (1) the identification of priority objectives (e.g. which function should be preserved; how much loss is acceptable etc.); (2) the selection of measurable indicators to assess environmental damage (e.g. loss of habitats, services etc.) and (3) assessment of habitat/service compensation. Amongst the initial decisions, it is necessary to (a) determine at which scales (temporal and spatial) the objectives will be defined and (b) the sensitivity of each step to conflicts between experts' opinion (what is scientifically more adequate) and local needs (what the local community expects). The framework is applied to address conflicts identified in the management of Farlington Marshes (Langstone Harbour, Portsmouth, southern England) between habitat conservation, management of flood risk and provision of recreational grounds/green areas. Langstone Harbour is a designated conservation area of national, European and international importance. The North Solent Shoreline Management Plan (2011) indicates that 'hold-the-line' is the most adequate approach to be implemented along most of Langstone Harbour's shoreline in
Callon, Wynne; Beach, Mary Catherine; Links, Anne R; Wasserman, Carly; Boss, Emily F
We aimed to develop a comprehensive, descriptive framework to measure shared decision making (SDM) in clinical encounters. We combined a top-down (theoretical) approach with a bottom-up approach based on audio-recorded dialogue to identify all communication processes related to decision making. We coded 55 pediatric otolaryngology visits using the framework and report interrater reliability. We identified 14 clinician behaviors and 5 patient behaviors that have not been previously described, and developed a new SDM framework that is descriptive (what does happen) rather than normative (what should happen). Through the bottom-up approach we identified three broad domains not present in other SDM frameworks: socioemotional support, understandability of clinician dialogue, and recommendation-giving. We also specify the ways in which decision-making roles are assumed implicitly rather than discussed explicitly. Interrater reliability was >75% for 92% of the coded behaviors. This SDM framework allows for a more expansive understanding and analysis of how decision making takes place in clinical encounters, including new domains and behaviors not present in existing measures. We hope that this new framework will bring attention to a broader conception of SDM and allow researchers to further explore the new domains and behaviors identified. Copyright © 2018. Published by Elsevier B.V.
Background Research-informed fetal monitoring guidelines recommend intermittent auscultation (IA) for fetal heart monitoring for low-risk women. However, the use of cardiotocography (CTG) continues to dominate many institutional maternity settings. Methods A mixed methods intervention study with before and after measurement was undertaken in one secondary level health service to facilitate the implementation of an initiative to encourage the use of IA. The intervention initiative was a decision-making framework called Intelligent Structured Intermittent Auscultation (ISIA) introduced through an education session. Results Following the intervention, medical records review revealed an increase in the use of IA during labour represented by a relative change of 12%, with improved documentation of clinical findings from assessments, and a significant reduction in the risk of receiving an admission CTG (RR 0.75, 95% CI, 0.60 – 0.95, p = 0.016). Conclusion The ISIA informed decision-making framework transformed the practice of IA and provided a mechanism for knowledge translation that enabled midwives to implement evidence-based fetal heart monitoring for low risk women. PMID:24884597
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.
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.
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
Edwards, Ian; Delany, Clare M; Townsend, Anne F; Swisher, Laura Lee
This is the second of 2 companion articles in this issue. The first article explored the clinical and ethical implications of new emphases in physical therapy codes of conduct reflecting the growing evidence regarding the importance of social determinants of health, epidemiological trends for health service delivery, and the enhanced participation of physical therapists in shaping health care reform in a number of international contexts. The first article was theoretically oriented and proposed that a re-thinking of ethical frameworks expressed in codes of ethics could both inform and underpin practical strategies for working in primary health care. A review of the ethical principle of "justice," which, arguably, remains the least consensually understood and developed principle in the ethics literature of physical therapy, was provided, and a more recent perspective-the capability approach to justice-was discussed. The current article proposes a clinical and ethical decision-making framework, the ethical reasoning bridge (ER bridge), which can be used to assist physical therapy practitioners to: (1) understand and implement the capability approach to justice at a clinical level; (2) reflect on and evaluate both the fairness and influence of beliefs, perspectives, and context affecting health and disability through a process of "wide reflective equilibrium" and assist patients to do this as well; and (3) nurture the development of moral agency, in partnership with patients, through a transformative learning process manifest in a mutual "crossing" and "re-crossing" of the ER bridge. It is proposed that the development and exercise of moral agency represent an enacted justice that is the result of a shared reasoning and learning experience on the part of both therapists and patients.
Kaizer, Franceen; Spiridigliozzi, Anna-Maria; Hunt, Matthew R
To address the risks of aspiration pneumonia, patients with dysphagia may be prescribed a modified diet. The goal of diet modification is to decrease the risk of patients aspirating food due to their diminished swallowing reflex. Some patients may not accept diet modification or may not adhere to the treatments identified by the interdisciplinary team. Such scenarios may result in important moral uncertainty and concern for clinicians. As a result of several ethics consultations related to this issue, a working group of the Clinical Ethics Committee at the Jewish Rehabilitation Hospital in Laval, Quebec, Canada, developed a framework for responding to situations when patients do not adhere to recommended diet modification. The goal of this tool is to facilitate discussion and collaboration between clinicians and patients, to clarify assumed versus real risk, and to promote shared decision-making in dysphagia care. In this article we examine the clinical context of diet modification for patients with dysphagia in rehabilitation hospitals, explore ethical aspects of this topic, present the clinical algorithm, and discuss our experience with developing and piloting this tool.
recherche fait ressortir plusieurs facteurs liés au besoin de procéder à la résolution inter-organisationnelle des problèmes pendant toute la durée de...l’événement, et plus particulièrement pendant les phases de préparation et de planification afin de mettre en place ii DRDC CSS CR 2011-33 le...the problem using flexible interpretive frameworks. Collaboration is represented below as a bridge that is made up of organizations that support
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
Bossaerts, Peter; Murawski, Carsten
The rationality principle postulates that decision-makers always choose the best action available to them. It underlies most modern theories of decision-making. The principle does not take into account the difficulty of finding the best option. Here, we propose that computational complexity theory (CCT) provides a framework for defining and quantifying the difficulty of decisions. We review evidence showing that human decision-making is affected by computational complexity. Building on this evidence, we argue that most models of decision-making, and metacognition, are intractable from a computational perspective. To be plausible, future theories of decision-making will need to take into account both the resources required for implementing the computations implied by the theory, and the resource constraints imposed on the decision-maker by biology. Copyright © 2017 Elsevier Ltd. All rights reserved.
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 ...
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.
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.
Jorgensen, Estelle R.
Sketches a conceptual framework for the systematic description of decision-making processes in music education. Refers to existing formulations in education, management, marketing, and economics. Lists decision-making phases in music education, each exhibiting the characteristics of a social system. Offers a historical example of each phase. (AYC)
Nibbelink, Christine W; Brewer, Barbara B
To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient
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.
Gutierrez-Alcaraz, G.; Sheble, Gerald B.
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)
de Jong, Gjalt; Van Vo, Dut; Marek, Philipp
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......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...... approach to the study of subsidiary decision-making autonomy...
Shared decision-making has been called the crux of patient-centred care and identified as a key part of change for improved quality and safety in healthcare. However, it rarely happens, is hard to do and is not taught - for many reasons. Talking with patients about options is not embedded in the attitudes or communication skills training of most healthcare professionals. Information tools such as patient decision aids, personal health records and the Internet will help to shift this state, as will policy that drives patient and public involvement in healthcare delivery and training.
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…
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 ...
Despite the growing interest of the language testing community in standard setting, primarily due to the use of the Common European Framework of Reference (CEFR-Council of Europe, 2001), the participants' decision-making process in the CEFR standard setting context remains unexplored. This study attempts to fill in this gap by analyzing these…
Shenoy, Pradeep; Yu, Angela J
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 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.
Shenoy, Pradeep; Yu, Angela J.
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 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. PMID:21647306
Karban, Richard; Orrock, John L
Recently plant biologists have documented that plants, like animals, engage in many activities that can be considered as behaviors, although plant biologists currently lack a conceptual framework to understand these processes. Borrowing the well-established framework developed by psychologists, we propose that plant behaviors can be constructively modeled by identifying four distinct components: 1) a cue or stimulus that provides information, 2) a judgment whereby the plant perceives and processes this informative cue, 3) a decision whereby the plant chooses among several options based on their relative costs and benefits, and 4) action. Judgment for plants can be determined empirically by monitoring signaling associated with electrical, calcium, or hormonal fluxes. Decision-making can be evaluated empirically by monitoring gene expression or differential allocation of resources. We provide examples of the utility of this judgment and decision-making framework by considering cases in which plants either successfully or unsuccessfully induced resistance against attacking herbivores. Separating judgment from decision-making suggests new analytical paradigms (i.e., Bayesian methods for judgment and economic utility models for decision-making). Following this framework, we propose an experimental approach to plant behavior that explicitly manipulates the stimuli provided to plants, uses plants that vary in sensory abilities, and examines how environmental context affects plant responses. The concepts and approaches that follow from the judgment and decision-making framework can shape how we study and understand plant-herbivore interactions, biological invasions, plant responses to climate change, and the susceptibility of plants to evolutionary traps. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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.
We sometimes make decisions relying not necessarily on deliberative thoughts but on intuitive and emotional processes in uncertain situations. The somatic marker hypothesis proposed by Damasio argued that interoception, which means bodily responses such as sympathetic activity, can be represented in the insula and anterior cingulate cortex and can play critical roles in decision-making. Though this hypothesis has been criticized in its theoretical and empirical aspects, recent studies are expanding the hypothesis to elucidate multiple bodily responses including autonomic, endocrine, and immune activities that affect decision-making. In addition, cumulative findings suggest that the anterior insula where the inner model of interoception is represented can act as an interface between the brain and body in decision-making. This article aims to survey recent findings on the brain-body interplays underlying decision-making, and to propose hypotheses on the significance of the body in decision-making.
Sterzer, Philipp; Voss, Martin; Schlagenhauf, Florian; Heinz, Andreas
Dysfunctional decision-making has been implicated in the positive and negative symptoms of schizophrenia. Decision-making can be conceptualized within the framework of hierarchical predictive coding as the result of a Bayesian inference process that uses prior beliefs to infer states of the world. According to this idea, prior beliefs encoded at higher levels in the brain are fed back as predictive signals to lower levels. Whenever these predictions are violated by the incoming sensory data, a prediction error is generated and fed forward to update beliefs encoded at higher levels. Well-documented impairments in cognitive decision-making support the view that these neural inference mechanisms are altered in schizophrenia. There is also extensive evidence relating the symptoms of schizophrenia to aberrant signaling of prediction errors, especially in the domain of reward and value-based decision-making. Moreover, the idea of altered predictive coding is supported by evidence for impaired low-level sensory mechanisms and motor processes. We review behavioral and neural findings from these research areas and provide an integrated view suggesting that schizophrenia may be related to a pervasive alteration in predictive coding at multiple hierarchical levels, including cognitive and value-based decision-making processes as well as sensory and motor systems. We relate these findings to decision-making processes and propose that varying degrees of impairment in the implicated brain areas contribute to the variety of psychotic experiences. Copyright © 2018 Elsevier Inc. All rights reserved.
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.
Risk assessment and analysis is connected to the policy framework used in decision-making on issues concerning technological risk. A review of the problems created by different views concerning the fundamental structure of risk concepts is used as a way to describe the structure of risk assessment studies as used in decision-making. The fundamental difference between judgments based on assessments and on perceptions is analyzed in order to explain the dynamics of the decision making process. A proposed effort to study the energy sector as a dynamic endless game implementing a mixed strategy is suggested. (author)
Rycroft-Malone, Jo; Fontenla, Marina; Seers, Kate; Bick, Debra
To explore how protocol-based care affects clinical decision-making. In the context of evidence-based practice, protocol-based care is a mechanism for facilitating the standardisation of care and streamlining decision-making through rationalising the information with which to make judgements and ultimately decisions. However, whether protocol-based care does, in the reality of practice, standardise decision-making is unknown. This paper reports on a study that explored the impact of protocol-based care on nurses' decision-making. Theoretically informed by realistic evaluation and the promoting action on research implementation in health services framework, a case study design using ethnographic methods was used. Two sites were purposively sampled; a diabetic and endocrine unit and a cardiac medical unit. Within each site, data collection included observation, postobservation semi-structured interviews with staff and patients, field notes, feedback sessions and document review. Data were inductively and thematically analysed. Decisions made by nurses in both sites were varied according to many different and interacting factors. While several standardised care approaches were available for use, in reality, a variety of information sources informed decision-making. The primary approach to knowledge exchange and acquisition was person-to-person; decision-making was a social activity. Rarely were standardised care approaches obviously referred to; nurses described following a mental flowchart, not necessarily linked to a particular guideline or protocol. When standardised care approaches were used, it was reported that they were used flexibly and particularised. While the logic of protocol-based care is algorithmic, in the reality of clinical practice, other sources of information supported nurses' decision-making process. This has significant implications for the political goal of standardisation. The successful implementation and judicious use of tools such as
Hansen, Zaza Nadja Lee; Ahmed-Kristensen, Saeema
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...
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.
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.
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.
Yacoubian, Hagop A.
Scientifically literate citizens must be able to engage in making decisions on science-based social issues. In this paper, I start by showing examples of science curricula and policy documents that capitalise the importance of engaging future citizens in decision-making processes whether at the personal or at the societal levels. I elucidate the ideological underpinnings behind a number of the statements within those documents that have defined the trajectory of scientific literacy and have shaped what ought to be considered as personal and societal benefits. I argue that science curricula and policy documents can truly endorse scientific literacy when they embed principles of democratic education at their core. The latter entails fostering learning experiences where some of the underlying assumptions and political ideologies are brought to the conscious level and future citizens encouraged to reflect upon them critically and explicitly. Such a proposal empowers the future citizens to engage in critical deliberation on science-based social issues without taking the underlying status quo for granted. I end up the paper by situating the preparation of scientifically literate citizens within a framework of democratic education, discuss conditions through which a curriculum for scientific literacy can serve democratic decision-making processes, and provide modest recommendations.
Tower, Marion; Chaboyer, Wendy; Green, Quentine; Dyer, Kirsten; Wallis, Marianne
To examine registered nurses' decision-making when documenting care in patients' progress notes. What constitutes effective nursing documentation is supported by available guidelines. However, ineffective documentation continues to be cited as a major cause of adverse events for patients. Decision-making in clinical practice is a complex process. To make an effective decision, the decision-maker must be situationally aware. The concept of situation awareness and its implications for making safe decisions has been examined extensively in air safety and more recently is being applied to health. The study was situated in a naturalistic paradigm. Purposive sampling was used to recruit 17 registered nurses who used think-aloud research methods when making decisions about documenting information in patients' progress notes. Follow-up interviews were conducted to validate interpretations. Data were analysed systematically for evidence of cues that demonstrated situation awareness as nurses made decisions about documentation. Three distinct decision-making scenarios were illuminated from the analysis: the newly admitted patient, the patient whose condition was as expected and the discharging patient. Nurses used mental models for decision-making in documenting in progress notes, and the cues nurses used to direct their assessment of patients' needs demonstrated situation awareness at different levels. Nurses demonstrate situation awareness at different levels in their decision-making processes. While situation awareness is important, it is also important to use an appropriate decision-making framework. Cognitive continuum theory is suggested as a decision-making model that could support situation awareness when nurses made decisions about documenting patient care. Because nurses are key decision-makers, it is imperative that effective decisions are made that translate into safe clinical care. Including situation awareness training, combined with employing cognitive
SM Turpin; MA Marais
This paper compares a number of theoretical models of decision-making with the way in which senior managers make decisions in practice. Six prominent decision-makers were interviewed about their own decision-making style, as well as their use of decision support technology. 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, ...
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...... concludes with a discussion on how to make sustainability count in transportation decision-making and practice....
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.
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 to the link between emotion and decision-making, and focus on research with anxious or depressed individuals that reveals 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 then 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. PMID:22898207
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...
Anwar, Ibrahim A.
This study was carried out in the context of participation in decision-making in the Barzan sub-district in the Kurdistan region of Iraq. It focused on women’s participation in decision-making from the perspective of gender and development. Democratic governance and decentralisation served as the main theoretical framework and pre-condition for analyzing participation. Though the Kurdistan region has been moving towards democracy, decentralisation and participatory governance since 1992, ther...
This paper proposes a conceptual model for ethical business decision-making. The purpose of this model is to explore the ethical implications of personal relationship in business exchanges. Firstly, this paper introduces personal relationship in business exchanges. Secondly, three normative theories of ethics that are relevant to the business environment are presented. Thirdly, a literature study on the existing models and frameworks for ethical business decision-making is pres...
Presented is an outline of a college course, "Education in American Society," that focused on teaching students rational decision-making skills while examining current issues in American Education. The outline is followed by student comments, reactions, and evaluations of the course. (JMD)
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 .......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 ....
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...
Cooper, R.J.; Bissell, P.; Wingfield, J.
Background: 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.\\ud \\ud Aims: To explore how the four-stage model can increase understanding of decision-making in healthcare and describe the decision-making of an und...
Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah
challenges. In the long-term, shared decision-making might lead to changes in resource utilization, perhaps to reductions in cost, and to modification of workforce composition. Despite the gradual shift to value-based payment, some organizations, motivated by continued income derived from achieving high volumes of procedures and contacts, will see this as a negative consequence. We suggest that a broader conceptualization and measurement of shared decision-making would provide a more substantive evidence base to guide implementation. We outline a framework which illustrates a hypothesized set of proximal, distal, and distant consequences that might occur if collaboration and deliberation could be achieved routinely, proposing that well-informed preference-based patient decisions might lead to safer, more cost-effective healthcare, which in turn might result in reduced utilization rates and improved health outcomes.
Miller, R A
The three decisionmaking aids described by the authors attack the generic problem of "see no evil, hear no evil, speak no evil"--improving the detection, diagnosis, and therapy of psychiatric disorders in the primary care setting. The three systems represent interventions at different steps in the process of providing appropriate care to psychiatric patients. The DSPW system of Robins and Marcus offers the potential of increasing the recognition of psychiatric disease in the physician's office. Politser's IDS program is representative of the sort of sophisticated microcomputer-based decisionmaking support tools that will become available to physicians in the not-too-distant future. Erdman's study of the impact of explanation capabilities on the acceptability of therapy recommending systems points out the need for careful scientific evaluations of features added to diagnostic and therapeutic systems.
Qu, Haiyan; Shewchuk, Richard M; Alarcón, Graciela; Fraenkel, Liana; Leong, Amye; Dall'Era, Maria; Yazdany, Jinoos; Singh, Jasvinder A
Numerous factors can impede or facilitate patients' medication decision-making and adherence to physicians' recommendations. Little is known about how patients and physicians jointly view issues that affect the decision-making process. Our objective was to derive an empirical framework of patient-identified facilitators to lupus medication decision-making from key stakeholders (including 15 physicians, 5 patients/patient advocates, and 8 medical professionals) using a patient-centered cognitive mapping approach. We used nominal group patient panels to identify facilitators to lupus treatment decision-making. Stakeholders independently sorted the identified facilitators (n = 98) based on their similarities and rated the importance of each facilitator in patient decision-making. Data were analyzed using multidimensional scaling and hierarchical cluster analysis. A cognitive map was derived that represents an empirical framework of facilitators for lupus treatment decisions from multiple stakeholders' perspectives. The facilitator clusters were 1) hope for a normal/healthy life, 2) understand benefits and effectiveness of taking medications, 3) desire to minimize side effects, 4) medication-related data, 5) medication effectiveness for "me," 6) family focus, 7) confidence in physician, 8) medication research, 9) reassurance about medication, and 10) medication economics. Consideration of how different stakeholders perceive the relative importance of lupus medication decision-making clusters is an important step toward improving patient-physician communication and effective shared decision-making. The empirically derived framework of medication decision-making facilitators can be used as a guide to develop a lupus decision aid that focuses on improving physician-patient communication. © 2016, American College of Rheumatology.
R F&aauml;re; S Grosskopf; D Margaritis
In this note we extend the standard DEA paradigm to address the question of how one can price DMUs (decision-making units). To do this we use an adjoint transformation to the technology generated by these DMUs which links to traditional linear programming theory of the firm and is similar to pricing portfolios in financial markets. We also provide a numerical example illustrating the practicality of the proposed method.
Full Text Available This paper compares a number of theoretical models of decision-making with the way in which senior managers make decisions in practice. Six prominent decision-makers were interviewed about their own decision-making style, as well as their use of decision support technology. 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, such as office software, was clearly favoured.
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...
Svec, Joseph; Andic, Tanja
Using the continuous Demographic and Health Surveys (2005-2012) for Peru, we employ multinomial logistic regression estimates to assess risk for intimate partner violence (IPV). Using empowerment and gender frameworks for IPV, we find that women making more household decisions jointly are less likely to experience physical violence. We also find that education is negatively associated with IPV, unless a woman's attainment exceeds her partner's. Although women earning more than their partners are more likely to experience violence, joint decision-makers have a lower risk of moderate physical violence even when their status exceeds that of a male partner. By adding measures for relationship dynamics, we highlight the ways decision-making within the household contributes to violence risk for women. While deviating from male-breadwinning norms can result in violence, risk factors are conditioned on the nature of cooperation within a partnership. Our findings suggest that shared power within the household reduces IPV risk.
When an environmental contamination occurs in a wide area, it is necessary to estimate the future influence by emergent environmental monitoring and rapidly take measures for it. This study aimed to support an emergency decision-making by constructing practical schemes with regards to the following three items in the dose limitation system recommended by ICRP; validity of intervention actions, optimization of protection and dose limitation. A framework of decision-making process was constructed to make clear the corresponding responsibility and the principle of intervention, to introduce stochastic techniques for estimating the environmental radiation shift and to reduce the social burden for the contamination. The results obtained by using this method were variable depending on the characteristics of subjects and regions applied. Therefore, it is needed to select an appropriate evaluation model and specific parameters suitable for the respective cases. (M.N.)
Adida, M; Maurel, M; Kaladjian, A; Fakra, E; Lazerges, P; Da Fonseca, D; Belzeaux, R; Cermolacce, M; Azorin, J-M
Abnormalities involving the prefrontal cortex (PFC) have long been postulated to underpin the pathophysiology of schizophrenia. Investigations of PFC integrity have focused mainly on the dorsolateral PFC (DLPFC) and abnormalities in this region have been extensively documented. However, defects in schizophrenia may extend to other prefrontal regions, including the ventromedial PFC (VMPFC), and evidence of VMPFC abnormalities comes from neuropathological, structural and functional studies. Patients with acquired brain injury to the VMPFC display profound disruption of social behaviour and poor judgment in their personal lives. The Iowa Gambling Task (IGT) was developed to assess decision-making in these neurological cases : it presents a series of 100 choices from four card decks that differ in the distribution of rewarding and punishing outcomes. Whilst healthy volunteers gradually develop a preference for the two "safe" decks over the course of the task, patients with VMPFC lesions maintain a preference for the two "risky" decks which are associated with high reinforcement in the short term, but significant long-term debt. Interestingly, damage to VMPFC may cause both poor performance on the IGT and lack of insight concerning the acquired personality modification. Recently, our group reported a trait-related decisionmaking impairment in the three phases of bipolar disorder. In a PET study, VMPFC dysfunction was shown in bipolar manic patients impaired on a decision-making task and an association between decision-making cognition and lack of insight was described in mania. A quantitative association between grey matter volume of VMPFC and memory impairment was previously reported in schizophrenia. Research suggests that lack of insight is a prevalent feature in schizophrenia patients, like auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. Because schizophrenia is associated with significant social or occupational
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.
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.
O'Donnell, E.P.; Raney, T.J.
This paper outlines a proposed approach to backfit decision-making which utilizes quantitative risk assessment techniques, benefit-cost methodology and decision criteria. In general terms, it is structured to provide an objective framework for decision-making aimed at ensuring a positive return on backfit investment while allowing for inclusion of subjective value judgments by the decision-maker. The distributions of the independent variables are combined to arrive at an overall probability distribution for the benefit-cost ratio. In this way, the decision-maker can explicitly establish the probability or level of confidence that a particular backfit will yield benefits in excess of cost. An example is presented demonstrating the application of methodology to a specific plant backfit. (orig.)
Ogawa, Asao; Kondo, Kyoko; Takei, Hiroyuki; Fujisawa, Daisuke; Ohe, Yuichiro; Akechi, Tatsuo
The objective of this study was to assess decision-making capacity in patients newly diagnosed with lung cancer, clinical factors associated with impaired capacity, and physicians' perceptions of patients' decision-making capacity. We recruited 122 patients newly diagnosed with lung cancer. One hundred fourteen completed the assessment. All patients were receiving a combination of treatments (e.g., chemotherapy, chemo-radiotherapy, or targeted therapy). Decision-making capacity was assessed using the MacArthur Competence Tool for Treatment. Cognitive impairment, depressive symptoms, and frailty were also evaluated. Physicians' perceptions were compared with the ascertainments. Twenty-seven (24%, 95% confidence interval [CI], 16-31) patients were judged to have incapacity. Clinical teams had difficulty in judging six (22.2%) patients for incapacity. Logistic regression identified frailty (odds ratio, 3.51; 95% CI, 1.13-10.8) and cognitive impairment (odds ratio, 5.45; 95% CI, 1.26-23.6) as the factors associated with decision-making incapacity. Brain metastasis, emphysema, and depression were not associated with decision-making incapacity. A substantial proportion of patients diagnosed with lung cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision-making frameworks to act in the best interest of patients. Decision-making capacity is the cornerstone of clinical practice. A substantial proportion of patients with cancer show impairments in their capacity to make a medical decision. Assessment of cognitive impairment and frailty may provide appropriate decision-making frameworks to act in the best interest of patients. © AlphaMed Press 2017.
Full Text Available The aim of this study is to construct an unmanned ship swarms monitoring model to improve autonomous decision-making efficiency and safety performance of unmanned ship navigation. A framework is proposed to determine the relationship between on-board decision-making and shore side monitoring, the process of ship data detection, tracking, analysis and loss, and the application of decision-making algorithm, to discuss the different risk responses of specific unmanned ship types under various latent hazard environments, particularly in terms of precise conversion timing in switching over to remote control and full manual monitoring, to ensure safe navigation when the capability of automatic risk response inadequate. This frame-work makes it easier to train data and the adjustment for machine learning based on Bayesian risk prediction. It can be concluded that the automation level can be increased and the workload of shore-based seafarers can be reduced easily.
Rosoff, Philip M
As medical technology continues to improve, more people will live longer lives with multiple chronic illnesses with increasing cumulative debilitation, including cognitive dysfunction. Combined with the aging of society in most developed countries, an ever-growing number of patients will require surrogate decision-makers. While advance care planning by patients still capable of expressing their preferences about medical interventions and end-of-life care can improve the quality and accuracy of surrogate decisions, this is often not the case, not infrequently leading to demands for ineffective, inappropriate and prolonged interventions. In 1980 LaFollette called for the licensing of prospective parents, basing his argument on the harm they can do to vulnerable people (children). In this paper, I apply his arguments to surrogate decision-makers for cognitively incapacitated patients, rhetorically suggesting that we require potential surrogates to qualify for this position by demonstrating their ability to make reasonable and rational decisions for others. I employ this theoretical approach to argue that the loose criteria by which we authorize surrogates' generally unchallenged power should be reconsidered.
Patrick, Nicholas J. M.
Our scientific goal is to understand the process of human decision-making. Specifically, a model of human decision-making in piloting modern commercial aircraft which prescribes optimal behavior, and against which we can measure human sub-optimality is sought. This model should help us understand such diverse aspects of piloting as strategic decision-making, and the implicit decisions involved in attention allocation. Our engineering goal is to provide design specifications for (1) better computer-based decision-aids, and (2) better training programs for the human pilot (or human decision-maker, DM).
This paper provides some background on the four following papers, drawing on the research conducted within the CARL research project. CARL is a cross-national 'social sciences research project into the effects of stakeholder involvement on decision-making in radioactive waste management'. The paper introduces the project, its aims, activities and describes the common framework used to look at each individual country
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…
Gerven, M.A.J. van
This dissertation deals with decision support in the context of clinical oncology. (Dynamic) Bayesian networks are used as a framework for (dynamic) decision-making under uncertainty and applied to a variety of diagnostic, prognostic, and treatment problems in medicine. It is shown that the proposed
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…
Chang, L.J.; Sanfey, A.G.
Social expectations play a critical role in everyday decision-making. However, their precise neuro-computational role in the decision process remains unknown. Here we adopt a decision neuroscience framework by combining methods and theories from psychology, economics and neuroscience to outline a
Chang, L.J.; Sanfey, A.G.
Social expectations play a critical role in everyday decision-making. However, their precise neuro-computational role in the decision process remains unknown. Here we adopt a decision neuroscience framework by combining methods and theories from psychology, economics and neuroscience to outline a
Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine
Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with
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.
Burchett, H E D; Mounier-Jack, S; Griffiths, U K; Biellik, R; Ongolo-Zogo, P; Chavez, E; Sarma, H; Uddin, J; Konate, M; Kitaw, Y; Molla, M; Wakasiaka, S; Gilson, L; Mills, A
As more new and improved vaccines become available, decisions on which to adopt into routine programmes become more frequent and complex. This qualitative study aimed to explore processes of national decision-making around new vaccine adoption and to understand the factors affecting these decisions. Ninety-five key informant interviews were conducted in seven low- and middle-income countries: Bangladesh, Cameroon, Ethiopia, Guatemala, Kenya, Mali and South Africa. Framework analysis was used to explore issues both within and between countries. The underlying driver for adoption decisions in GAVI-eligible countries was the desire to seize GAVI windows of opportunity for funding. By contrast, in South Africa and Guatemala, non-GAVI-eligible countries, the decision-making process was more rooted in internal and political dynamics. Decisions to adopt new vaccines are, by nature, political. The main drivers influencing decisions were the availability of funding, political prioritization of vaccination or the vaccine-preventable disease and the burden of disease. Other factors, such as financial sustainability and feasibility of introduction, were not as influential. Although GAVI procedures have established more formality in decision-making, they did not always result in consideration of all relevant factors. As familiarity with GAVI procedures increased, questioning by decision-makers about whether a country should apply for funding appeared to have diminished. This is one of the first studies to empirically investigate national processes of new vaccine adoption decision-making using rigorous methods. Our findings show that previous decision-making frameworks (developed to guide or study national decision-making) bore little resemblance to real-life decisions, which were dominated by domestic politics. Understanding the realities of vaccine policy decision-making is critical for developing strategies to encourage improved evidence-informed decision-making about new
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 revi...
Coenen, Frans; Huitema, Dave; Woltjer, Johan
This chapter concerns the impact of public involvement in public decision-making processes as related to household consumption patterns, and the impact on consumer behaviour of active participation.1 The call for participatory decision-making is common in the field of sustainable consumption (Murphy
Full Text Available of decision support technology. Much variation was found in people’s 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...
The EC-funded project FASSET (Framework for Assessment of Environmental impact), which completed in 2003, has developed an assessment framework for evaluating the environmental impact of ionising radiation on biota in natural ecosystems. The FASSET framework comprises: source characterisation and initial hazard analysis; ecosystem description and selection of reference organisms (ca 30, with defined geometry and life history); exposure analysis, including conversion of input data to external and internal radionuclide concentrations, and subsequent conversion to dose rates; effects analysis, supported by an effects database; and, guidance for interpretation. The framework provides practical and scientific support to the international development of recommendations for radiological protection of the environment through the International Commission on Radiological Protection (cf. ICRP Publication 91). However, on the basis of experiences from FASSET and other recent developments, it can be concluded that there are challenges remaining before environmental radiological protection can be seen as a natural component of general environmental protection. The major future challenge is the development of an integrated approach where decision-making can be guided by sound scientific judgements. This requires, inter alia, filling in gaps in basic knowledge of relevance to assessment and protection, through targeted experimental, theoretical (including expert judgements) and real case studies; development of risk characterisation methodologies, based on both theoretical and experimental studies; development of screening standards, where appropriate; development of user-friendly assessment tools; and stakeholder involvement, including development of supporting communication strategies. A new EC-funded project, ERICA (Environmental Risk from Ionising Contaminants: Assessment and management), has recently started. The project has four operational work packages, being devoted to
Martini, Alice; Ellis, Simon J; Grange, James A; Tamburin, Stefano; Dal Lago, Denise; Vianello, Greta; Edelstyn, Nicola M J
Impulse control disorders (ICDs) in Parkinson's disease (PD) are considered dopaminergic treatment side effects. Cognitive and affective factors may increase the risk of ICD in PD. The aim is to investigate risky decision-making and associated cognitive processes in PD patients with ICDs within a four-stage conceptual framework. Relationship between ICDs and affective factors was explored. Thirteen PD patients with ICD (ICD+), 12 PD patients without ICD (ICD-), and 17 healthy controls were recruited. Overall risky decision-making and negative feedback effect were examined with the Balloon Analogue Risk Task (BART). A cognitive battery dissected decision-making processes according to the four-stage conceptual framework. Affective and motivational factors were measured. ANOVA showed no effect of group on overall risky decision-making. However, there was a group × feedback interaction [F (2, 39) = 3.31, p = 0.047]. ICD+, unlike ICD- and healthy controls, failed to reduce risky behaviour following negative feedback. A main effect of group was found for anxiety and depression [F(2, 38) = 8.31, p = 0.001], with higher symptoms in ICD+ vs. healthy controls. Groups did not differ in cognitive outcomes or affective and motivational metrics. ICD+ may show relatively preserved cognitive function, but reduced sensitivity to negative feedback during risky decision-making and higher symptoms of depression and anxiety.
Pezzulo, Giovanni; Rigoli, Francesco
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 hungry, not immediately. Furthermore, similarly to any expected outcome, we can assign 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.
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.
Peng, Jiaxi; Zhang, Jiaxi; Sun, Hao; Zeng, Zhicong; Mai, Yuexia; Miao, Danmin
By applying unitive vocabulary, "die" or "save," to respective frames of the Asian disease problem, Tversky and Kahneman were able to define framing effect. In this study, we preliminarily explored the effect of mixed frames, which are characterized by the use of different vocabulary in one frame. In study 1, we found that only the sure option description had significant effect on decision-making, while the effects of risky option descriptions were not significant, nor were interactions between descriptions. In study 2, the results suggested that after controlling the effects of the hedonic tone of the sure options, risky option description did not significantly predict decision-making. In study 3, we found that neither the sure-to-risky option presentation order nor presentation order within risky options had significant effect on decision-making. We thus concluded that sure option description can serve as the decision-making foundation (reference point) for decision-makers in mixed frames.
Kureychik, V. M.; Safronenkova, I. B.
Uncertainty is an essential part of a decision-making procedure. The paper deals with the problem of decision-making under criteria uncertainty. In this context, decision-making under uncertainty, types and conditions of uncertainty were examined. The decision-making problem under uncertainty was formalized. A modification of the mathematical decision support method under uncertainty via ontologies was proposed. A critical distinction of the developed method is ontology usage as its base elements. The goal of this work is a development of a decision-making method under criteria uncertainty with the use of ontologies in the area of multilayer board designing. This method is oriented to improvement of technical-economic values of the examined domain.
Nippita, Tanya A; Porter, Maree; Seeho, Sean K; Morris, Jonathan M; Roberts, Christine L
Unexplained variation in induction of labour (IOL) rates exist between hospitals, even after accounting for casemix and hospital differences. We aimed to explore factors that influence clinical decision-making for IOL that may be contributing to the variation in IOL rates between hospitals. We undertook a qualitative study involving semi-structured, audio-recorded interviews with obstetricians and midwives. Using purposive sampling, participants known to have diverse opinions on IOL were selected from ten Australian maternity hospitals (based on differences in hospital IOL rate, size, location and case-mix complexities). Transcripts were indexed, coded, and analysed using the Framework Approach to identify main themes and subthemes. Forty-five participants were interviewed (21 midwives, 24 obstetric medical staff). Variations in decision-making for IOL were based on the obstetrician's perception of medical risk in the pregnancy (influenced by the obstetrician's personality and knowledge), their care relationship with the woman, how they involved the woman in decision-making, and resource availability. The role of a 'gatekeeper' in the procedural aspects of arranging an IOL also influenced decision-making. There was wide variation in the clinical decision-making practices of obstetricians and less accountability for decision-making in hospitals with a high IOL rate, with the converse occurring in hospitals with low IOL rates. Improved communication, standardised risk assessment and accountability for IOL offer potential for reducing variation in hospital IOL rates.
Kobayashi, Tetsuya J; Kamimura, Atsushi
Microscopic biological processes have extraordinary complexity and variety at the sub-cellular, intra-cellular, and multi-cellular levels. In dealing with such complex phenomena, conceptual and theoretical frameworks are crucial, which enable us to understand seemingly different intra- and inter-cellular phenomena from unified viewpoints. Decision-making is one such concept that has attracted much attention recently. Since a number of cellular behavior can be regarded as processes to make specific actions in response to external stimuli, decision-making can cover and has been used to explain a broad range of different cellular phenomena [Balázsi et al. (Cell 144(6):910, 2011), Zeng et al. (Cell 141(4):682, 2010)]. Decision-making is also closely related to cellular information-processing because appropriate decisions cannot be made without exploiting the information that the external stimuli contain. Efficiency of information transduction and processing by intra-cellular networks determines the amount of information obtained, which in turn limits the efficiency of subsequent decision-making. Furthermore, information-processing itself can serve as another concept that is crucial for understanding of other biological processes than decision-making. In this work, we review recent theoretical developments on cellular decision-making and information-processing by focusing on the relation between these two concepts.
Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah
What are the strengths and limitations of existing Decision-Making Theories as a basis for guiding best practice clinical decision-making within a framework of midwifery philosophy? Each theory is compared in relation with how well they provide a teachable framework for midwifery clinical reasoning that is consistent with midwifery philosophy. Hypothetico-Deductive Theory, from which medical clinical reasoning is based; intuitive decision-making; Dual Processing Theory; The International Confederation of Midwives Clinical Decision-Making Framework; Australian Nursing and Midwifery Council Midwifery Practice Decisions Flowchart and Midwifery Practice. Best practice midwifery clinical Decision-Making Theory needs to give guidance about: (i) effective use of cognitive reasoning processes; (ii) how to include contextual and emotional factors; (iii) how to include the interests of the baby as an integral part of the woman; (iv) decision-making in partnership with woman; and (v) how to recognize/respond to clinical situations outside the midwife's legal/personal scope of practice. No existing Decision-Making Theory meets the needs of midwifery. Medical clinical reasoning has a good contribution to make in terms of cognitive reasoning processes. Two limitations of medical clinical reasoning are its reductionistic focus and privileging of reason to the exclusion of emotional and contextual factors. Hypothetico-deductive clinical reasoning is a necessary but insufficient condition for best practice clinical decision-making in midwifery. © 2011 Blackwell Publishing Asia Pty Ltd.
Kim, B. S.; Kim, I. S.; Seo, M. S.; Sung, G. Y.
The RITS literature survey on regulatory requirements and current TS research status in Korea as well as in foreign countries has been performed. Based on this survey, the RITS decision-making framework for the licensee and regulator point-of-view, respectively, is introduced in this paper. The required documents for the licensee to prepare are suggested in a systematic approach; the decision-making process of regulators for evaluating the documents is recommended
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
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.
Gupta, Rupa; Koscik, Timothy R; Bechara, Antoine; Tranel, Daniel
Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.
Full Text Available Background: The decision about whether to start a family within a partnership can be viewed as a result of an interaction process. The influence of each of the partners in a couple differs depending on their individual preferences and intentions towards having children. Both of the partners additionally influence each other's fertility intentions and preferences. Objective: We specify, estimate, and test a model that examines the decision about whether to have a child as a choice that is made jointly by the two partners. The transition to the birth of a (further child is investigated with the explicit consideration of both the female partner and the male partner in the partnership context. Methods: An approach for modelling the interactive influences of the two actors in the decision-making process was proposed. A trivariate distribution consisting of both the female and the male partners' fertility intentions, as well as the joint generative decision, was modelled. A multivariate non-linear probit model was chosen and the problem of identification in estimating the relative effects of the actors was resolved. These parameters were used to assess the relative importance of each of the partners' intentions in the decision. We carried out the analysis with MPLUS. Data from the panel of intimate relationships and family dynamics (pairfam was used to estimate the model. Results: The biographical context of each of the partners in relation to their own as well as to their partner's fertility intentions was found to be of considerable importance. Of the significant individual and partner effects, the male partner was shown to have the greater influence. But the female partner was found to have stronger parameters overall and she ultimately has a veto power in the couple's final decision.
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...
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...
Blakemore, Sarah-Jayne; Robbins, Trevor W
Adolescence is characterized by making risky decisions. Early lesion and neuroimaging studies in adults pointed to the ventromedial prefrontal cortex and related structures as having a key role in decision-making. More recent studies have fractionated decision-making processes into its various components, including the representation of value, response selection (including inter-temporal choice and cognitive control), associative learning, and affective and social aspects. These different aspects of decision-making have been the focus of investigation in recent studies of the adolescent brain. Evidence points to a dissociation between the relatively slow, linear development of impulse control and response inhibition during adolescence versus the nonlinear development of the reward system, which is often hyper-responsive to rewards in adolescence. This suggests that decision-making in adolescence may be particularly modulated by emotion and social factors, for example, when adolescents are with peers or in other affective ('hot') contexts.
Rosenbloom, Michael H; Schmahmann, Jeremy D; Price, Bruce H
Decision-making is a complex executive function that draws on past experience, present goals, and anticipation of outcome, and which is influenced by prevailing and predicted emotional tone and cultural context. Functional imaging investigations and focal lesion studies identify the orbitofrontal, anterior cingulate, and dorsolateral prefrontal cortices as critical to decision-making. The authors review the connections of these prefrontal regions with the neocortex, limbic system, basal ganglia, and cerebellum, highlight current ideas regarding the cognitive processes of decision-making that these networks subserve, and present a novel integrated neuroanatomical model for decision-making. Finally, clinical relevance of this circuitry is illustrated through a discussion of frontotemporal dementia, traumatic brain injury, and sociopathy.
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
The topic of this thesis is about moral decision-making, and the main objective of this study is to research the moral decision-making of Chinese business managers based on the analysis of data. The study adopts systematic literature of qualitative research method and is constructed by means of qualitative analysis of 64 data articles. The 64 data articles are the journals from the Database of Chinese Academic Journals, Journal of Business Ethics and other leading business journals from the y...
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...
Li Hao; Wing Suen
This article reviews recent developments in the theory of committee decision-making. A committee consists of self-interested members who make a public decision by aggregating imperfect information dispersed among them according to a pre-specified decision rule. We focus on costly information acquisition, strategic information aggregation, and rules and processes that enhance the quality of the committee decision. Seeming inefficiencies of the committee decision-making process such as over-cau...
Ortega, Pedro A.; Stocker, Alan A.
Subjective expected utility theory assumes that decision-makers possess unlimited computational resources to reason about their choices; however, virtually all decisions in everyday life are made under resource constraints - i.e. decision-makers are bounded in their rationality. Here we experimentally tested the predictions made by a formalization of bounded rationality based on ideas from statistical mechanics and information-theory. We systematically tested human subjects in their ability t...
Quartz, Steven R
Many models of judgment and decision-making posit distinct cognitive and emotional contributions to decision-making under uncertainty. Cognitive processes typically involve exact computations according to a cost-benefit calculus, whereas emotional processes typically involve approximate, heuristic processes that deliver rapid evaluations without mental effort. However, it remains largely unknown what specific parameters of uncertain decision the brain encodes, the extent to which these parameters correspond to various decision-making frameworks, and their correspondence to emotional and rational processes. Here, I review research suggesting that emotional processes encode in a precise quantitative manner the basic parameters of financial decision theory, indicating a reorientation of emotional and cognitive contributions to risky choice.
Schovsbo, Jens Hemmingsen; Petersen, Clement Salung
The Unified Patent Court (UPC) will become a central player in the future development of European patent law. For this reason it becomes important to ensure that UPC‘s decision-making reflects the double-function of the Court as an adjudicator of individual disputes and a policy maker. Because...... 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...
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...
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.
Sandman, Lars; Munthe, Christian
In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.
Burke, Robert E; Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Ayele, Roman; Leonard, Chelsea; Lippmann, Brandi; Matlock, Daniel D; Allyn, Rebecca; Cumbler, Ethan
Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the
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.
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.
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.
Schneeweiss, Sebastian; Shrank, William H; Ruhl, Michael; Maclure, Malcolm
Availability of real-time electronic healthcare data provides new opportunities for rapid-cycle evaluation (RCE) of health technologies, including healthcare delivery and payment programs. We aim to align decision-making processes with stages of RCE to optimize the usefulness and impact of rapid results. Rational decisions about program adoption depend on program effect size in relation to externalities, including implementation cost, sustainability, and likelihood of broad adoption. Drawing on case studies and experience from drug safety monitoring, we examine how decision makers have used scientific evidence on complex interventions in the past. We clarify how RCE alters the nature of policy decisions; develop the RAPID framework for synchronizing decision-maker activities with stages of RCE; and provide guidelines on evidence thresholds for incremental decision-making. In contrast to traditional evaluations, RCE provides early evidence on effectiveness and facilitates a stepped approach to decision making in expectation of future regularly updated evidence. RCE allows for identification of trends in adjusted effect size. It supports adapting a program in midstream in response to interim findings, or adapting the evaluation strategy to identify true improvements earlier. The 5-step RAPID approach that utilizes the cumulating evidence of program effectiveness over time could increase policy-makers' confidence in expediting decisions. RCE enables a step-wise approach to HTA decision-making, based on gradually emerging evidence, reducing delays in decision-making processes after traditional one-time evaluations.
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.
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.
Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal “folk psychological” explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local, i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality. PMID:29301289
Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal "folk psychological" explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local , i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality.
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.
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...
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?
Suzuki, Shinsuke; Adachi, Ryo; Dunne, Simon; Bossaerts, Peter; O'Doherty, John P
Consensus building in a group is a hallmark of animal societies, yet little is known about its underlying computational and neural mechanisms. Here, we applied a computational framework to behavioral and fMRI data from human participants performing a consensus decision-making task with up to five other participants. We found that participants reached consensus decisions through integrating their own preferences with information about the majority group members' prior choices, as well as inferences about how much each option was stuck to by the other people. These distinct decision variables were separately encoded in distinct brain areas-the ventromedial prefrontal cortex, posterior superior temporal sulcus/temporoparietal junction, and intraparietal sulcus-and were integrated in the dorsal anterior cingulate cortex. Our findings provide support for a theoretical account in which collective decisions are made through integrating multiple types of inference about oneself, others, and environments, processed in distinct brain modules. Copyright © 2015 Elsevier Inc. All rights reserved.
Gati, Itamar; Landman, Shiri; Davidovitch, Shlomit; Asulin-Peretz, Lisa; Gadassi, Reuma
Previous research on individual differences in career decision-making processes has often focused on classifying individuals into a few types of decision-making "styles" based on the most dominant trait or characteristic of their approach to the decision process (e.g., rational, intuitive, dependent; Harren, 1979). In this research, an…
The purpose of the present research was to develop and validate a measure of motivation toward career decision-making activities, the Career Decision-Making Autonomy Scale (CDMAS). The CDMAS is designed to assess the constructs of intrinsic motivation, identified regulation, introjected regulation, and external regulation. A longitudinal study was…
Clift, Roland; Sim, Sarah; King, Henry
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...... in operationalizing the planetary boundaries needs be complemented with progress in addressing the equity and ethical issues in allocating the safe operating space between companies and sectors....
S. STEENHAUT; P. VAN KENHOVE
In this paper we theorize that the anticipation of guilt plays an important role in ethically questionable consumer situations. We propose an ethical decision-making framework incorporating anticipated guilt as partial mediator between consumers’ ethical beliefs (anteceded by ethical ideology) and intentions. In a first study we compared several models using structural equation modeling and found empirical support for our research model. A second experiment was set up to illustrate how retail...
Attfield, Simon; Makri, Stephann; Kalbach, James; Blandford, Ann; De Gabrielle, Stephen; Edwards, Mark
The reinterpretation of the traditional reference service in an online context is the virtual reference desk. Placing reference services into an online setting, however, presents many challenges. We report a study and analytic framework which addresses support for decision-making during virtual enquiry work. Focusing on specialist law-libraries, the study shows that enquirers do not volunteer important information to the service and that asynchronous communication media and some social obstac...
This thesis concerns the role of scientific expertise in the decision-making process at the Swiss federal level of government. It aims to understand how institutional and issue-specific factors influence three things: the distribution of access to scientific expertise, its valuation by participants in policy for- mulation, and the consequence(s) its mobilization has on policy politics and design. The theoretical framework developed builds on the assumption that scientific expertise is a strat...
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…
Faggion, Clovis Mariano; Pachur, Thorsten; Giannakopoulos, Nikolaos Nikitas
Shared decision-making involves the participation of patient and dental practitioner. Well-informed decision-making requires that both parties understand important concepts that may influence the decision. This fourth article in a series of 4 aims to discuss the importance of patients' values when a clinical decision is made. We report on how to incorporate important concepts for well-informed, shared decision-making. Here, we present patient values as an important issue, in addition to previously established topics such as the risk of bias of a study, cost-effectiveness of treatment approaches, and a comparison of therapeutic benefit with potential side effects. We provide 2 clinical examples and suggestions for a decision tree, based on the available evidence. The information reported in this article may improve the relationship between patient and dental practitioner, resulting in more well-informed clinical decisions. Copyright © 2017 Elsevier Inc. All rights reserved.
Caughron, Jay J; Antes, Alison L; Stenmark, Cheryl K; Thiel, Chaise E; Wang, Xiaoqian; Mumford, Michael D
The current study uses a sensemaking model and thinking strategies identified in earlier research to examine ethical decision-making. Using a sample of 163 undergraduates, a low fidelity simulation approach is used to study the effects personal involvement (in causing the problem and personal involvement in experiencing the outcomes of the problem) could have on the use of cognitive reasoning strategies that have been shown to promote ethical decision-making. A mediated model is presented which suggests that environmental factors influence reasoning strategies, reasoning strategies influence sensemaking, and sensemaking in turn influences ethical decision-making. Findings were mixed but generally supported the hypothesized model. Interestingly, framing the outcomes of ethically charged situations in terms of more global organizational outcomes rather than personal outcomes was found to promote the use of pro-ethical cognitive reasoning strategies.
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.
Rilling, James K; Sanfey, Alan 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 setting, and a variety of neuroscience methods have been used to probe the underlying neural systems. This approach is informing our knowledge of the neural mechanisms that support decisions about trust, reciprocity, altruism, fairness, revenge, social punishment, social norm conformity, social learning, and competition. Neural systems involved in reward and reinforcement, pain and punishment, mentalizing, delaying gratification, and emotion regulation are commonly recruited for social decisions. This review also highlights the role of the prefrontal cortex in prudent social decision-making, at least when social environments are relatively stable. In addition, recent progress has been made in understanding the neural bases of individual variation in social decision-making.
Koon, Adam D; Rao, Krishna D; Tran, Nhan T; Ghaffar, Abdul
Attention is increasingly directed to bridging the gap between the production of knowledge and its use for health decision-making in low- and middle-income countries (LMICs). An important and underdeveloped area of health policy and systems research (HPSR) is the organization of this process. Drawing from an interdisciplinary conception of embeddedness, a literature review was conducted to identify examples of embedded HPSR used to inform decision-making in LMICs. The results of the literature review were organized according to the World Health Organization's Building Blocks Framework. Next, a conceptual model was created to illustrate the arrangement of organizations that produce embedded HPSR and the characteristics that facilitate its uptake into the arena of decision-making. We found that multiple forces converge to create context-specific pathways through which evidence enters into decision-making. Depending on the decision under consideration, the literature indicates that decision-makers may call upon an intricate combination of actors for sourcing HPSR. While proximity to decision-making does have advantages, it is not the position of the organization within the network, but rather the qualities the organization possesses, that enable it to be embedded. Our findings suggest that four qualities influence embeddedness: reputation, capacity, quality of connections to decision-makers, and quantity of connections to decision-makers and others. In addition to this, the policy environment (e.g. the presence of legislation governing the use of HPSR, presence of strong civil society, etc.) strongly influences uptake. Through this conceptual model, we can understand which conditions are likely to enhance uptake of HPSR in LMIC health systems. This raises several important considerations for decision-makers and researchers about the arrangement and interaction of evidence-generating organizations in health systems.
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.
Yang, Chyan; Wu, Chia-Chun
The purpose of this research is to provide managers of shopping websites information regarding consumer purchasing decisions based on the Consumer Styles Inventory (CSI). According to the CSI, one can capture what decision-making styles online shoppers use. Furthermore, this research also discusses the gender differences among online shoppers. Exploratory factor analysis (EFA) was used to understand the decision-making styles and discriminant analysis was used to distinguish the differences between female and male shoppers. The result shows that there are differences in purchasing decisions between online female and male Internet users.
Tsun Jin Chang
Full Text Available This paper develops and examines a model of the antecedents and consequences of decision-making comprehensiveness during the new product development process. This model firstly suggests a concave relationship between intrateam task disagreement and decision-making comprehensiveness. It also conjectures that conflict communications influence the effectiveness of decision-making comprehensiveness on new product teams’ performance. An empirical test of the proposed framework involves a survey of 220 cross-functional new product teams. The findings show that an inverse U-shaped relationship exists between intrateam task disagreement and decision-making comprehensiveness. It also indicates that collaborative communication has a negative effect on innovativeness, whereas contentious communication adversely affects constraint adherence. However, decision-making comprehensiveness partially moderates the relationships between conflict communications and team performance. Some managerial and research implications of the findings were also discussed in this study.
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.
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
Sohl, Terry L.; Claggett, Peter
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.
Sims, Deborah; Fowler, Cathrine
The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making. A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirms that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. Knowledge of the information domains and the decision-making strategies
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
Stape, Christopher J.
Presents a schema for expert decisionmaking that can be used as a performance support tool. The ringshaped schema can be used in two ways: (1) beginning at the center with problemsetting and working outward to other supporting factors, or (2) skimming over the factors located in the outer ring to find a topic related to information about the…
Five types of decision-uncertainty are distinguished: uncertainty of consequences, of values, of demarcation, of reliance, and of co-ordination. Strategies are proposed for each type of uncertainty. The general conclusion is that it is meaningful for decision theory to treat cases with greater uncertainty than the textbook case of 'decision-making under uncertainty'. (au)
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…
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…
Ethical failures in UK higher education have recently made the news but are not a recent development. University decision-makers can, in order to adopt an ethical way of reasoning, resort to several ethical traditions. This article focuses, through the use of concrete examples, on three which have had a significant impact in recent higher…
Ashford-Rowe, Kevin H.; Holt, Marnie
The "emerging educational institutional decision-making matrix" is developed to allow educational institutions to adopt a rigorous and consistent methodology of determining which of the myriad of emerging educational technologies will be the most compelling for the institution, particularly ensuring that it is the educational or pedagogical but…
Barneva, Reneta P.; Brimkov, Valentin E.; Walters, Lisa M.
In all areas of human activity, decision-making based on data analysis is very important. As the availability of data grows, it becomes critical to educate not only traditional students but also those individuals who are now in the workforce, as many of them are expected to manage the complex data streams and to provide evidence and guidance for…
Yacoubian, Hagop A.
Scientifically literate citizens must be able to engage in making decisions on science-based social issues. In this paper, I start by showing examples of science curricula and policy documents that capitalise the importance of engaging future citizens in decision-making processes whether at the personal or at the societal levels. I elucidate the…
Hansen, Claus Thorp; Andreasen, Mogens Myrup
In this paper we present the decision score, which is a model of decision-making seen in the engineering designer's perspective of the design process dynamics, where a decision has multiple objects and where it is based on earlier decisions, prediction of consequences and design process progressi...
Rilling, J.K.; King-Casas, B.; Sanfey, A.G.
Humans live in highly complex social environments and some of our most important decisions are made in the context of social interactions. Research that probes the neural basis of decision-making in the context of social interactions combines behavioral paradigms from game theory with a variety of
Fuzzy sets and interval analysis tools to make computations and solve optimisation problems are presented. Fuzzy and interval extensions of Decision Theory criteria for decision-making under parametric uncertainty of prior information (probabilities, payoffs) are developed. An interval probability approach to the mean-value criterion is proposed. (author)
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
DENIG, P; HAAIJER-RUSKAMP, FM
In this review the therapeutic decision-making process of physicians is described. This process is divided into two steps: the generation of a limited set of possible options (the 'evoked set') and the selection from this evoked set of a treatment for a specific patient. Factors that are important
Ismariah Ahmad; Rohana Abd Rahman; Roda Jean-Marc; Lim Hin Fui; Mohd Parid Mamat
Sound decision-making requires quality information. Poor information does not help in decision making. Among the sources of low quality information, an important cause is inadequate and inappropriate sampling. In this paper we illustrate the case of information collected on timber prices.
Timmis, James Kenneth; Black, Steven; Rappuoli, Rino
Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically. Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.
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
Phillips, Susan D.; Strohmer, Douglas C.
Examined the relationship between decision-making style, scholastic achievement, and vocational maturity for college students (N=64). Results did not support the hypothesized relationship between rationality and attitudinal and cognitive maturity. Scholastic achievement and lack of dependent decision style were found to be moderately predictive of…
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.
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.
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.
Full Text Available Background: During times of fiscal austerity, means of reimbursement decision-making are of particular interest for public health theory and practice. Introduction of advanced health technologies, growing health expenditures and increased public scrutiny over drug reimbursement decisions have pushed governments to consider mechanisms that promote the use of effective health technologies, while constraining costs. Aims: The study’s aim was to explore the current rationale of the drug reimbursement decision-making framework in Bulgaria. Our pilot research focused on one particular component of this process – the criteria used – because of the critical role that criteria are known to have in setting budgets and priorities in the field of public health. The analysis pursued two objectives: to identify important criteria relevant to drug reimbursement decision-making and to unveil relationships between theory and practice. Study Design: Cross-sectional study. Methods: The study was realized through a closed-ended survey on reimbursement criteria among four major public health stakeholders – medical professionals, patients, health authorities, and industry. Empirical outcomes were then cross-compared with the theoretical framework, as defined by current Bulgarian public health legislation. Analysis outlined what is done and what needs to be done in the field of public health reimbursement decision-making. Results: Bulgarian public health stakeholders agreed on 15 criteria to form a tentative optimal framework for drug reimbursement decision-making. The most apparent gap between the empirically found preferences and the official legislation is the lack of consideration for the strength of evidence in reimbursement decisions. Conclusion: Bulgarian policy makers need to address specific gaps, such as formal consideration for strength of evidence, explicit role of efficiency criteria, and means to effectively empower patient and citizen
Vijay Mohan eK Namboodiri
Full Text Available Animals and humans make decisions based on their expected outcomes. Since relevant outcomes are often delayed, perceiving delays and choosing between earlier versus later rewards (intertemporal decision-making is an essential component of animal behavior. The myriad observations made in experiments studying intertemporal decision-making and time perception have not yet been rationalized within a single theory. Here we present a theory—Training-Integrated Maximized Estimation of Reinforcement Rate (TIMERR—that explains a wide variety of behavioral observations made in intertemporal decision-making and the perception of time. Our theory postulates that animals make intertemporal choices to optimize expected reward rates over a limited temporal window which includes a past integration interval—over which experienced reward rate is estimated—as well as the expected delay to future reward. Using this theory, we derive mathematical expressions for both the subjective value of a delayed reward and the subjective representation of the delay. A unique contribution of our work is in finding that the past integration interval directly determines the steepness of temporal discounting and the nonlinearity of time perception. In so doing, our theory provides a single framework to understand both intertemporal decision-making and time perception.
De Jong, H.M.
This study focuses on the processes through which the rules and regulations that govern European electricity markets - and inherently, their integration process - are established. So far, European policy makers have largely followed a 'trial-and-error' approach to finding an appropriate regulatory mode (process) for dealing effectively with market integration issues. This unstructured approach to regulatory mode selection leads to several problems: - Today's trial-and-error strategy of shifting from one regulatory mode to another is time-consuming. - In the regulatory mode selection process, certain key principles of good governance are insufficiently considered. - European regulatory processes are experienced as vague, intransparent, and illegitimate by 'outside' stakeholders. This study develops a 'structured approach to regulatory mode decision-making' (STARMODE) based on the theory of decision modelling in policy management and a case study exploring three key market integration issues in the field of electricity markets: interconnector investment, congestion management and market transparency. The main objective is to present a systematic and comprehensive framework for analysing and improving regulatory mode decision-making in the context of the European Union, focusing on electricity market integration. The STARMODE approach is generally applicable to (and relevant for) European market integration issues in industries characterized by a natural monopoly and/or an essential service. The approach may also contribute to national regulatory mode decision-making and multi-state decision-making in other continents.
Namboodiri, Vijay M K; Mihalas, Stefan; Marton, Tanya M; Hussain Shuler, Marshall G
Animals and humans make decisions based on their expected outcomes. Since relevant outcomes are often delayed, perceiving delays and choosing between earlier vs. later rewards (intertemporal decision-making) is an essential component of animal behavior. The myriad observations made in experiments studying intertemporal decision-making and time perception have not yet been rationalized within a single theory. Here we present a theory-Training-Integrated Maximized Estimation of Reinforcement Rate (TIMERR)-that explains a wide variety of behavioral observations made in intertemporal decision-making and the perception of time. Our theory postulates that animals make intertemporal choices to optimize expected reward rates over a limited temporal window which includes a past integration interval-over which experienced reward rate is estimated-as well as the expected delay to future reward. Using this theory, we derive mathematical expressions for both the subjective value of a delayed reward and the subjective representation of the delay. A unique contribution of our work is in finding that the past integration interval directly determines the steepness of temporal discounting and the non-linearity of time perception. In so doing, our theory provides a single framework to understand both intertemporal decision-making and time perception.
Boardman, Felicity K
'Experiential knowledge' is increasingly recognised as an important influence on reproductive decision-making. 'Experiential knowledge of disability' in particular is a significant resource within prenatal testing/screening contexts, enabling prospective parents to imagine and appraise future lives affected by disability. However, the concept of 'experiential knowledge' has been widely critiqued for its idiosyncrasy, its impermanence and consequently its perceived inferiority to (medical) knowledge. This paper explores some of these key critiques of experiential knowledge through an analysis of its constitution and uses in the context of reproductive decision-making. Seventeen UK-resident women with Spinal Muscular Atrophy (SMA), or with SMA in their family, took part in two in-depth interviews: one in 2007-9 and the other in 2013-4. By comparing and contrasting these women's accounts at two time points, this paper demonstrates the stark contrast between 'lived experience' of SMA (the visceral everyday realities of life with the condition) and the various way(s) this experience was transformed into, and presented as, 'knowledge' through the processes of making, and accounting, for reproductive decisions. The analysis highlights that multiple, distinct and sometimes competing experiential frameworks are used to conceptualise SMA across time and context. However, rather than evidence of its fallibility, this finding highlights that 'knowledge' is an inappropriate vessel with which to capture and transfer 'experiential knowledge'. Rather, we need to consider how to value such insight in ways that harnesses its inherent strength without leaving it vulnerable to the epistemological critiques attracted by labelling it 'knowledge'. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.
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
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.
Pier Luigi Baldi
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.
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
Gabrzhinskij, I.; Skurovets, V.
Classification of factors, affecting decision-making in the process of power engineering management is given. General formulation of the problem and main stages of decision-making are considered. Principle scheme of heuristic procedure of decision-making is suggested
... 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...
Castillo, Luis; Dorao, Carlos A.
Highlights: ► A Decision Making (DM) approach for LNG projects based on game theory is presented. ► DM framework was tested with two different cases, using analytical models and a simple LNG process. ► The problems were solved by using a Genetic Algorithm (GA) binary coding and Nash-GA. ► Integrated models from the design and optimization of the process could result in more realistic outcome. ► The major challenge in such a framework is related to the uncertainties in the market models. - Abstract: Decision-Making (DM) in LNG projects is a quite complex process due to the number of actors, approval phases, large investments and capital return in the long time. Furthermore, due to the very high investment of a LNG project, a detailed and efficient DM process is required in order to minimize risks. In this work a Decision-Making (DM) approach for LNG projects is presented. The approach is based on a consensus algorithm to address the consensus output over a common value using cost functions within a framework based on game theory. The DM framework was tested with two different cases. The first case was used for evaluating the performance of the framework with analytical models, while the second case corresponds to a simple LNG process. The problems were solved by using a Genetic Algorithm (GA) binary coding and Nash-GA. The results of the DM framework in the LNG project indicate that considering an integrated DM model and including the markets role from the design and optimization of the process more realistic outcome could be obtained. However, the major challenge in such a framework is related to the uncertainties in the market models.
van Asseldonk, M A P M; Bergevoet, R H M; Ge, L
Zoonotic infectious livestock diseases are becoming a significant burden for both animal and human health and are rapidly gaining the attention of decision-makers who manage public health programmes. If control decisions have only monetary components, governments are generally regarded as being risk-neutral and the intervention strategy with the highest expected benefit (lowest expected net costs) should be preferred. However, preferences will differ and alternative intervention plans will prevail if (human) life and death outcomes are involved. A rational decision framework must therefore consider risk aversion in the decision-maker and controversial values related to public health. In the present study, risk aversion and its impact on both the utility for the monetary component and the utility for the non-monetary component is shown to be an important element when dealing with emerging zoonotic infectious livestock diseases and should not be ignored in the understanding and support of decision-making. The decision framework was applied to several control strategies for the reduction of human cases of brucellosis (Brucella melitensis) originating from sheep in Turkey.
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
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.
With the dissemination of non-invasive human neuroimaging techniques such as fMRI and the advancement of cognitive science, neuroimaging studies focusing on emotions and social cognition have become established. Along with this advancement, behavioral economics taking emotional and social factors into account for economic decisions has been merged with neuroscientific studies, and this interdisciplinary approach is called neuroeconomics. Past neuroeconomics studies have demonstrated that subcortical emotion-related brain structures play an important role in "irrational" decision-making. The research field that investigates the role of central neurotransmitters in this process is worthy of further development. Here, we provide an overview of recent molecular neuroimaging studies to further the understanding of the neurochemical basis of "irrational" or emotional decision-making and the future direction, including clinical implications, of the field. Copyright © 2013 Elsevier Ireland Ltd and the Japan Neuroscience Society. All rights reserved.
Elmquist, Helena; Lindgren, Urban; Mäkilä, Kalle
This report describes an interdisciplinary study combining social sciences and natural sciences in an integrated simulation model. The integrated dynamic simulation model consists of the interplay between the decision-making farmer, the physical flows at the farm and the structural conditions that influence the business. The central question studied here concerned the energy use, environmental impacts and business economics of various decision models in comparison to different levels of envir...
Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato
The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants’ choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward...
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…
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.
Simon, Nicholas W.; Montgomery, Karienn S.; Beas, Blanca S.; Mitchell, Marci R.; LaSarge, Candi L.; Mendez, Ian A.; Bañuelos, Cristina; Vokes, Colin M.; Taylor, Aaron B.; Haberman, Rebecca P.; Bizon, Jennifer L.; Setlow, Barry
Many psychiatric disorders are characterized by abnormal risky decision-making and dysregulated dopamine receptor expression. The current study was designed to determine how different dopamine receptor subtypes modulate risk-taking in young adult rats, using a “Risky Decision-making Task” that involves choices between small “safe” rewards and large “risky” rewards accompanied by adverse consequences. Rats showed considerable, stable individual differences in risk preference in the task, which were not related to multiple measures of reward motivation, anxiety, or pain sensitivity. Systemic activation of D2-like receptors robustly attenuated risk-taking, whereas drugs acting on D1-like receptors had no effect. Systemic amphetamine also reduced risk-taking, an effect which was attenuated by D2-like (but not D1-like) receptor blockade. Dopamine receptor mRNA expression was evaluated in a separate cohort of drug-naive rats characterized in the task. D1 mRNA expression in both nucleus accumbens shell and insular cortex was positively associated with risk-taking, while D2 mRNA expression in orbitofrontal and medial prefrontal cortex predicted risk preference in opposing nonlinear patterns. Additionally, lower levels of D2 mRNA in dorsal striatum were associated with greater risk-taking. These data strongly implicate dopamine signaling in prefrontal corticalstriatal circuitry in modulating decision-making processes involving integration of reward information with risks of adverse consequences. PMID:22131407
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
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.
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.
Olhoff, Anne; Olsen, Karen Holm
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......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...... 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....
Gutnik, Lily A; Hakimzada, A Forogh; Yoskowitz, Nicole A; Patel, Vimla L
Models of decision-making usually focus on cognitive, situational, and socio-cultural variables in accounting for human performance. However, the emotional component is rarely addressed within these models. This paper reviews evidence for the emotional aspect of decision-making and its role within a new framework of investigation, called neuroeconomics. The new approach aims to build a comprehensive theory of decision-making, through the unification of theories and methods from economics, psychology, and neuroscience. In this paper, we review these integrative research methods and their applications to issues of public health, with illustrative examples from our research on young adults' safe sex practices. This approach promises to be valuable as a comprehensively descriptive and possibly, better predictive model for construction and customization of decision support tools for health professionals and consumers.
The chairman managing director of EDF and the president of BRGM (both ruling companies of the society Geothermie Bouillante) have inaugurated a 4 MW electric power station providing Guadeloupe with 4 % electricity of geothermal extraction. Geothermal energy is hazardous from the economic point of view but, on the other hand, the related natural and industrial aspects are interesting. At Bouillante, rain and sea waters are percolating through a 300 m deep fractured zone where they are heated thanks to the 15 km far Soufriere volcano. The station was put into service in 1986 and is operating since 1996. 1560 tuns per hour of a mixture of 80 % water and 20 % vapor is extracted from the well. A 6 bar vapor phase is separated from it while the remaining 160 celsius degrees hot liquid water passes through an expansion device to produce a low pressure vapor phase. Both vapor fluxes are driving a condensation turbine which is running an alternator. The main producers of geothermal electricity are the USA (2700 MW), the Philippines (900 MW), Mexico (700 MW) and Italy in Europe (550 MW). France does not play a significant role concerning the production of this type of energy but may play a role at the experimental level. (N.T.)
Sinopoulou, Vassiliki; Summerfield, Paul; Rutter, Paul
Self-care policies are increasingly directing patients to seek advice from community pharmacists. This means pharmacists need to have sound diagnostic decision-making skills to enable them to recognise a variety of conditions. The aim of this study was to investigate the process by which pharmacists manage patient signs and symptoms and to explore their use of decision-making for diagnostic purposes. Data were collected through semi-structured, face-to-face interviews with community pharmacists working in England, between August 2013 and November 2014. Pharmacists were asked to share their experiences on how they performed patient consultations, and more specifically how they would approach a hypothetical headache scenario. As part of the interview, their sources of knowledge and experience were also explored. Framework analysis was used to identify themes and subthemes. Eight interviews were conducted with pharmacists who had a wide range of working practice, from 1 year through to 40 years of experience. The pharmacists' main motivations during consultations were product selection and risk minimisation. Their questioning approach and decision-making relied heavily on mnemonic methods. This led to poor quality information gathering-although pharmacists acknowledged they needed to "delve deeper" but were often unable to articulate how or why. Some pharmacists exhibited elements of clinical reasoning in their consultations, but this seemed, mostly, to be unconscious and subsequently applied inappropriately. Overall, pharmacists exhibited poor decision-making ability, and often decisions were based on personal belief and experiences rather than evidence. Community pharmacists relied heavily on mnemonic methods to manage patients' signs and symptoms with diagnosis-based decision-making being seldom employed. These findings suggest practicing pharmacists should receive more diagnostic training. © 2017 John Wiley & Sons, Ltd.
Knox, Lucy; Douglas, Jacinta M; Bigby, Christine
To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.
Madani, Amin; Gips, Amanda; Razek, Tarek; Deckelbaum, Dan L; Mulder, David S; Grushka, Jeremy R
Effective management of trauma patients is heavily dependent on sound judgment and decision-making. Yet, current methods for training and assessing these advanced cognitive skills are subjective, lack standardization, and are prone to error. This qualitative study aims to define and characterize the cognitive and interpersonal competencies required to optimally manage injured patients. Cognitive and hierarchical task analyses for managing unstable trauma patients were performed using qualitative methods to map the thoughts, behaviors, and practices that characterize expert performance. Trauma team leaders and board-certified trauma surgeons participated in semistructured interviews that were transcribed verbatim. Data were supplemented with content from published literature and prospectively collected field notes from observations of the trauma team during trauma activations. The data were coded and analyzed using grounded theory by 2 independent reviewers. A framework was created based on 14 interviews with experts (lasting 1-2 hours each), 35 field observations (20 [57%] blunt; 15 [43%] penetrating; median Injury Severity Score 20 [13-25]), and 15 literary sources. Experts included 11 trauma surgeons and 3 emergency physicians from 7 Level 1 academic institutions in North America (median years in practice: 12 [8-17]). Twenty-nine competencies were identified, including 17 (59%) related to situation awareness, 6 (21%) involving decision-making, and 6 (21%) requiring interpersonal skills. Of 40 potential errors that were identified, root causes were mapped to errors in situation awareness (20 [50%]), decision-making (10 [25%]), or interpersonal skills (10 [25%]). This study defines cognitive and interpersonal competencies that are essential for the management of trauma patients. This framework may serve as the basis for novel curricula to train and assess decision-making skills, and to develop quality-control metrics to improve team and individual performance
Gardner, Benjamin; Davidson, Rosemary; McAteer, John; Michie, Susan
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. 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. 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. 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 groups.
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
Full Text Available For the past years defense programs have faced delays in delivering defense capabilities and budget overruns. Stakeholders are looking for ways to improve program management and the decision making process given the very fluid and uncertain economic and political environment. Consequently, they have increasingly resorted to risk management as the main management tool for achieving defense programs objectives and for delivering the defense capabilities strongly needed for the soldiers on the ground on time and within limited defense budgets. Following a risk management based decision-making approach the stakeholders are expected not only to protect program objectives against a wide range of risks but, at the same time, to take advantage of the opportunities to increase the likelihood of program success. The prerequisite for making risk management the main tool for achieving defense programs objectives is the design and implementation of a strong risk management framework as a foundation providing an efficient and effective application of the best risk management practices. The aim of this paper is to examine the risk management framework for defense programs based on the ISO 31000:2009 standard, best risk management practices and the defense programs’ needs and particularities. For the purposes of this article, the term of defense programs refers to joint defense programs.
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.
Rungratsameetaweemana, Nuttida; Itthipuripat, Sirawaj; Salazar, Annalisa; Serences, John T
Two factors play important roles in shaping perception: the allocation of selective attention to behaviorally relevant sensory features, and prior expectations about regularities in the environment. Signal detection theory proposes distinct roles of attention and expectation on decision-making such that attention modulates early sensory processing, whereas expectation influences the selection and execution of motor responses. Challenging this classic framework, recent studies suggest that expectations about sensory regularities enhance the encoding and accumulation of sensory evidence during decision-making. However, it is possible, that these findings reflect well documented attentional modulations in visual cortex. Here, we tested this framework in a group of male and female human participants by examining how expectations about stimulus features (orientation and color) and expectations about motor responses impacted electroencephalography (EEG) markers of early sensory processing and the accumulation of sensory evidence during decision-making (the early visual negative potential and the centro-parietal positive potential, respectively). We first demonstrate that these markers are sensitive to changes in the amount of sensory evidence in the display. Then we show, counter to recent findings, that neither marker is modulated by either feature or motor expectations, despite a robust effect of expectations on behavior. Instead, violating expectations about likely sensory features and motor responses impacts posterior alpha and frontal theta oscillations, signals thought to index overall processing time and cognitive conflict. These findings are inconsistent with recent theoretical accounts and suggest instead that expectations primarily influence decisions by modulating post-perceptual stages of information processing. SIGNIFICANCE STATEMENT Expectations about likely features or motor responses play an important role in shaping behavior. Classic theoretical
Full Text Available Bi-level decision-making techniques aim to deal with decentralized management problems that feature interactive decision entities distributed throughout a bi-level hierarchy. A challenge in handling bi-level decision problems is that various uncertainties naturally appear in decision-making process. Significant efforts have been devoted that fuzzy set techniques can be used to effectively deal with uncertain issues in bi-level decision-making, known as fuzzy bi-level decision-making techniques, and researchers have successfully gained experience in this area. It is thus vital that an instructive review of current trends in this area should be conducted, not only of the theoretical research but also the practical developments. This paper systematically reviews up-to-date fuzzy bi-level decisionmaking techniques, including models, approaches, algorithms and systems. It also clusters related technique developments into four main categories: basic fuzzy bi-level decision-making, fuzzy bi-level decision-making with multiple optima, fuzzy random bi-level decision-making, and the applications of bi-level decision-making techniques in different domains. By providing state-of-the-art knowledge, this survey paper will directly support researchers and practitioners in their understanding of developments in theoretical research results and applications in relation to fuzzy bi-level decision-making techniques.
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.
Yukalov, V I; Sornette, D
A rigorous general definition of quantum probability is given, which is valid not only for elementary events but also for composite events, for operationally testable measurements as well as for inconclusive measurements, and also for non-commuting observables in addition to commutative observables. Our proposed definition of quantum probability makes it possible to describe quantum measurements and quantum decision-making on the same common mathematical footing. Conditions are formulated for the case when quantum decision theory reduces to its classical counterpart and for the situation where the use of quantum decision theory is necessary. © 2015 The Author(s).
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
Manns, Braden J
There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy-makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves healthcare decision-makers and key stakeholders at each transition.
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.
Full Text Available Decision Making Competence (DMC reflects individual differences in rational responding across several classic behavioral decision-making tasks. Although it has been associated with real-world risk behavior, less is known about the degree to which DMC contributes to specific components of risk attitudes. Utilizing a psychological risk-return framework, we examined the associations between risk attitudes and DMC. Italian community residents (n = 804 completed an online DMC measure, using a subset of the original Adult-DMC battery (A-DMC; Bruine de Bruin, Parker, & Fischhoff, 2007. Participants also completed a self-reported risk attitude measure for three components of risk attitudes (risk-taking, risk perceptions, and expected benefits across six risk domains. Overall, greater performance on the DMC component scales were inversely, albeit modestly, associated with risk-taking tendencies. Structural equation modeling results revealed that DMC was associated with lower perceived expected benefits for all domains. In contrast, its association with perceived risks was more domain-specific. These analyses also revealed stronger indirect effects for the DMC expected benefits risk-taking than the DMC perceived risk risk-taking path, especially for risk behaviors that may be considered more antisocial in nature. These results suggest that DMC performance differentially impacts specific components of risk attitudes, and may be more strongly related to the evaluation of expected value of the given behavior.
Leone, Frank T; Evers-Casey, Sarah; Graden, Sarah; Schnoll, Robert
Physicians self-report high adherence rates for Ask and Advise behaviors of tobacco dependence treatment but are much less likely to engage in "next steps" consistent with sophisticated management of chronic illness. A variety of potential explanations have been offered, yet each lacks face validity in light of experience with other challenging medical conditions. Conduct a preliminary exploration of the behavioral economics of tobacco treatment decision-making in the face of uncertain outcomes, seeking evidence that behaviors may be explained within the framework of Prospect Theory. Four physician cohorts were polled regarding their impressions of the utility of tobacco use treatment and their estimations of "success" probabilities. Contingent valuation was estimated by asking respondents to make monetary tradeoffs relative to three common chronic conditions. Responses from all four cohorts showed a similar pattern of high utility of tobacco use treatment but low success probability when compared with the other chronic medical conditions. Following instructional methods aimed at controverting cognitive biases related to tobacco, this pattern was reversed, with success probabilities attaining higher valuation than for diabetes. Important presuppositions regarding the potential "success" of tobacco-related patient interactions are likely limiting physician engagement by favoring the most secure visit outcome despite the limited potential for health gains. Under these conditions, low engagement rates would be consistent with Prospect Theory predictions. Interventions aimed at counteracting the cognitive biases limiting estimations of success probabilities seem to effectively reverse this pattern and provide clues to improving the adoption of target clinical behaviors.
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.
Haefner, Ralf M; Berkes, Pietro; Fiser, József
We address two main challenges facing systems neuroscience today: understanding the nature and function of cortical feedback between sensory areas and of correlated variability. Starting from the old idea of perception as probabilistic inference, we show how to use knowledge of the psychophysical task to make testable predictions for the influence of feedback signals on early sensory representations. Applying our framework to a two-alternative forced choice task paradigm, we can explain multiple empirical findings that have been hard to account for by the traditional feedforward model of sensory processing, including the task dependence of neural response correlations and the diverging time courses of choice probabilities and psychophysical kernels. Our model makes new predictions and characterizes a component of correlated variability that represents task-related information rather than performance-degrading noise. It demonstrates a normative way to integrate sensory and cognitive components into physiologically testable models of perceptual decision-making. Copyright © 2016 Elsevier Inc. All rights reserved.
The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.
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.
Abrahamsen, E.B. [University of Stavanger, 4036 Stavanger (Norway)], E-mail: firstname.lastname@example.org; Aven, T. [University of Stavanger, 4036 Stavanger (Norway)
In evaluation of safety in projects it is common to use risk acceptance criteria to support decision-making. In this paper, we discuss to what extent the risk acceptance criteria is in accordance with the normative theoretical framework of the expected utility theory and the rank-dependent utility theory. We show that the use of risk acceptance criteria may violate the independence axiom of the expected utility theory and the comonotonic independence axiom of the rank-dependent utility theory. Hence the use of risk acceptance criteria is not in general consistent with these theories. The level of inconsistency is highest for the expected utility theory.
Abrahamsen, E.B.; Aven, T.
In evaluation of safety in projects it is common to use risk acceptance criteria to support decision-making. In this paper, we discuss to what extent the risk acceptance criteria is in accordance with the normative theoretical framework of the expected utility theory and the rank-dependent utility theory. We show that the use of risk acceptance criteria may violate the independence axiom of the expected utility theory and the comonotonic independence axiom of the rank-dependent utility theory. Hence the use of risk acceptance criteria is not in general consistent with these theories. The level of inconsistency is highest for the expected utility theory
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...... sustainable stormwater management options in densely populated areas of developing countries....... 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...
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 ...
Lončar Zoran J.
Full Text Available Administrative decision-making by official who conducting the administrative procedure may have a number of advantages over the decisionmaking by the senior official which manages by the administrative authority. However, to make that such a novelty have positive effects, it is necessary, next to the amendments to the Law on Administrative Procedure, to create a number of legal and factual assumptions, on whom are based highly politicized and professionalised administrative systems today. In order to create the legal conditions for the introduction of innovations in administrative proceedings in the Republic of Serbia, it is necessary to appropriately modify, firstly certain provisions of the Law on Public Administration, as the basic systemic regulation in this area, and then the Law on Civil Servants, as the basic status regulation, so the civil servant career become less dependent on the will of officials who manage by the administrative authorities. Also, it is essential to solve a number of other issues on a proper legal way, such as way of harmonizing administrative practice within the same administrative authority, a way of solving the appeals in the case of first instance decisions made by independent administrative authority, different rules for conflict of interest with the state officers who may be authorized officials in administrative proceedings, etc.
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.
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 of a company. Numerous models have been built, which include a wide range of psychological, environmental, hierarchical factors, all of which only account the notion of rationality. In time, such ...
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.
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 min of the Stroop task (mental fatigue) or 30 min of reading from magazines (control). Subjective ratings of mental fatigue were measured before and after treatment, and mental effort (referring to treatment) and motivation (referring to the decision-making task) were measured after treatment. Performance on the soccer-specific decision-making task was assessed using response accuracy and time. Visual search behaviour was also assessed throughout the decision-making task. Subjective ratings of mental fatigue and effort were almost certainly higher following the Stroop task compared to the magazines. Motivation for the upcoming decision-making task was possibly higher following the Stroop task. Decision-making accuracy was very likely lower and response time likely higher in the mental fatigue condition. Mental fatigue had unclear effects on most visual search behaviour variables. The results suggest that mental fatigue impairs accuracy and speed of soccer-specific decision-making. These impairments are not likely related to changes in visual search behaviour.
How Adults in Developmental Reading Courses Describe Their Educational Life Experiences: A Phenomenological Case Study Examining Whether Experiences Influence Reading Attitudes and Decision-Making Processes
Reece Armour, Ashley
The purpose of this phenomenological case study is to explore the reading attitudes and decision-making skills of college freshmen enrolled in remedial language arts courses. The theoretical framework guiding this study is qualitative phenomenology explained by Baxter and Jack (2008). This specific type of research "provides tools for…
The scholars increasingly pay at ention to the internal rules in knowledge development and innovation of construction engineering management,as wel as the framework for engineering management body of knowledge. Considering the one-of-a-kind characteristic of construction project s and highly dependence from projects on management knowledge and its innovation,this paper analyzed the knowledge body of engineering management and its development dimension ,such as thinking and knowledge structure dimensions. The engineering management knowledge innovation model and structural model were put forward. The paper reviewed and proposed the engineering management knowledge system framework under engineering thinking mode,including the basic knowledge system framework which is used in engineering management research ,and a framework for body of knowledge which is applicable for engineering management practice. Based on a brief analysis of engineering management practice,this paper analyzed the development progres of engineering management from engineering thinking to ethical thinking and philosophical thinking. A dynamic model formed from the modern engineering management theory was put forward. The construction of projects are divided into two stages:an investment decision-making stage, and project implementation stage. According to the fact that project owners obtain the project products by transaction,the management during project implementation stage are divided into two aspects:project transaction management for the owner, and construction project management for the contractor. Thus, the three theoretical modules of modern engineering management were established:project investment decision-making management theory,engineering transaction management theory, and engineering project management theory. This paper further analyzed the content and basic theoretical issues of each theoretical module.
Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B
Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.
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.
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
Heijne, Amber; Rossi, Filippo; Sanfey, Alan G
How do we decide to keep interacting (e.g., stay) with a social partner or to switch (e.g., leave) to another? This paper investigated the neural mechanisms of stay/leave decision-making. We hypothesized that these decisions fit within a framework of value-based decision-making, and explored four potential mechanisms underlying a hypothesized bias to stay. Twenty-six participants underwent functional Magnetic Resonance Imaging (fMRI) while completing social and nonsocial versions of a stay/leave decision-making task. On each trial, participants chose between four alternative options, after which they received a monetary reward. Crucially, in the social condition, reward magnitude was ostensibly determined by the generosity of social partners, whereas in the nonsocial condition, reward amounts were ostensibly determined in a pre-programmed manner. Results demonstrated that participants were more likely to stay with options of relatively high expected value, with these values updated through Reinforcement Learning mechanisms and represented neurally within ventromedial prefrontal cortex. Moreover, we demonstrated that greater brain activity in ventromedial prefrontal cortex, caudate nucleus, and septo-hypothalamic regions for social versus nonsocial decisions to stay may underlie a bias towards staying with social partners in particular. These findings complement existing social psychological theories by investigating the neural mechanisms of actual stay/leave decisions.
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.
Guerra-Lopez, Ingrid; Toker, Sacip
This article illustrates the application of the Impact Evaluation Process for the design of a performance measurement and evaluation framework for an urban high school. One of the key aims of this framework is to enhance decision-making by providing timely feedback about the effectiveness of various performance improvement interventions. The…
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
Truglio-Londrigan, Marie; Slyer, Jason T
Shared decision-making has received national and international interest by providers, educators, researchers, and policy makers. The literature on shared decision-making is extensive, dealing with the individual components of shared decision-making rather than a comprehensive process. This view of shared decision-making leaves healthcare providers to wonder how to integrate shared decision-making into practice. To understand shared decision-making as a comprehensive process from the perspective of the patient and provider in all healthcare settings. An integrative review was conducted applying a systematic approach involving a literature search, data evaluation, and data analysis. The search included articles from PubMed, CINAHL, the Cochrane Central Register of Controlled Trials, and PsycINFO from 1970 through 2016. Articles included quantitative experimental and non-experimental designs, qualitative, and theoretical articles about shared decision-making between all healthcare providers and patients in all healthcare settings. Fifty-two papers were included in this integrative review. Three categories emerged from the synthesis: (a) communication/ relationship building; (b) working towards a shared decision; and (c) action for shared decision-making. Each major theme contained sub-themes represented in the proposed visual representation for shared decision-making. A comprehensive understanding of shared decision-making between the nurse and the patient was identified. A visual representation offers a guide that depicts shared decision-making as a process taking place during a healthcare encounter with implications for the continuation of shared decisions over time offering patients an opportunity to return to the nurse for reconsiderations of past shared decisions.
Arushanyan, Yevgeniya, E-mail: email@example.com [KTH Royal Institute of Technology, School of Architecture and the Built Environment, Department of Sustainable Development, Environmental Science and Engineering, Division of Environmental Strategies Research, Drottning Kristinas väg 30, 10044 Stockholm (Sweden); KTH Royal Institute of Technology, Centre for Sustainable Communications (CESC), Lindstedtsvägen 5, 100 44 Stockholm (Sweden); Ekener, Elisabeth; Moberg, Åsa [KTH Royal Institute of Technology, School of Architecture and the Built Environment, Department of Sustainable Development, Environmental Science and Engineering, Division of Environmental Strategies Research, Drottning Kristinas väg 30, 10044 Stockholm (Sweden); KTH Royal Institute of Technology, Centre for Sustainable Communications (CESC), Lindstedtsvägen 5, 100 44 Stockholm (Sweden)
To address current challenges regarding sustainable development and support planning for this form of development, new learning about different possible futures and their potential sustainability implications is needed. One way of facilitating this learning is by combining the futures studies and sustainability assessment (SA) research fields. This paper presents the sustainability assessment framework for scenarios (SAFS), a method developed for assessing the environmental and social risks and opportunities of future scenarios, provides guidelines for its application and demonstrates how the framework can be applied. SAFS suggests assessing environmental and social aspects using a consumption perspective and a life cycle approach, and provides qualitative results. SAFS does not suggest any modelling using precise data, but instead offers guidelines on how to carry out a qualitative assessment, where both the process of assessing and the outcome of the assessment are valuable and can be used as a basis for discussion. The benefits, drawbacks and potential challenges of applying SAFS are also discussed in the paper. SAFS uses systems thinking looking at future societies as a whole, considering both environmental and social consequences. This encourages researchers and decision-makers to consider the whole picture, and not just individual elements, when considering different futures. - Highlights: • The paper presents a new methodological framework for qualitative sustainability assessment of future scenarios with transformative changes. • The framework suggests qualitative assessment with consumption perspective and a life cycle approach. • The paper presents the framework and provides guidelines for its application. • The paper demonstrates on an example how the framework can be applied. • The benefits, drawbacks and challenges of the framework application and the need for further development are discussed.
Arushanyan, Yevgeniya; Ekener, Elisabeth; Moberg, Åsa
To address current challenges regarding sustainable development and support planning for this form of development, new learning about different possible futures and their potential sustainability implications is needed. One way of facilitating this learning is by combining the futures studies and sustainability assessment (SA) research fields. This paper presents the sustainability assessment framework for scenarios (SAFS), a method developed for assessing the environmental and social risks and opportunities of future scenarios, provides guidelines for its application and demonstrates how the framework can be applied. SAFS suggests assessing environmental and social aspects using a consumption perspective and a life cycle approach, and provides qualitative results. SAFS does not suggest any modelling using precise data, but instead offers guidelines on how to carry out a qualitative assessment, where both the process of assessing and the outcome of the assessment are valuable and can be used as a basis for discussion. The benefits, drawbacks and potential challenges of applying SAFS are also discussed in the paper. SAFS uses systems thinking looking at future societies as a whole, considering both environmental and social consequences. This encourages researchers and decision-makers to consider the whole picture, and not just individual elements, when considering different futures. - Highlights: • The paper presents a new methodological framework for qualitative sustainability assessment of future scenarios with transformative changes. • The framework suggests qualitative assessment with consumption perspective and a life cycle approach. • The paper presents the framework and provides guidelines for its application. • The paper demonstrates on an example how the framework can be applied. • The benefits, drawbacks and challenges of the framework application and the need for further development are discussed.
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....
Zafeiris, Anna; Koman, Zsombor; Mones, Enys
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 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...... 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 â€” but a far less intuitive result is that finding the optimal solution by the interacting group members...
This paper is an attempt at institutional engineering. Unlike many economic analyses of social choice, it does not explore the implications of various hypothetical voting schemes under highly simplified circumstances. Instead, it considers how current social and political arrangements for making energy policy have actually functioned, and how we might make them function more effectively. The first two sections of this paper present necessary theoretical preliminaries: first, the kinds of relations we can expect between the structure of institutions on the one hand, and social and political decisions on the other, and second, the criteria we can and should use for choosing among institutional alternatives. The third section reviews what is known about the consequences of current decisionmaking arrangements. The final section considers the implications of this review and argues for a series of changes in how we organize our affairs
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...
Mileti, D.; Sorensen, J.; Bogard, W.
The purpose was to describe the processes of evacuation decision-making, identify and document uncertainties in that process and discuss implications for federal assumption of liability for precautionary evacuations at nuclear facilities under the Price-Anderson Act. Four major categories of uncertainty are identified concerning the interpretation of hazard, communication problems, perceived impacts of evacuation decisions and exogenous influences. Over 40 historical accounts are reviewed and cases of these uncertainties are documented. The major findings are that all levels of government, including federal agencies experience uncertainties in some evacuation situations. Second, private sector organizations are subject to uncertainties at a variety of decision points. Third, uncertainties documented in the historical record have provided the grounds for liability although few legal actions have ensued. Finally it is concluded that if liability for evacuations is assumed by the federal government, the concept of a ''precautionary'' evacuation is not useful in establishing criteria for that assumption. 55 refs., 1 fig., 4 tabs
Gade, Anne Nørkjær; Jensen, Rasmus Lund; Larsen, Tine Steen
There is a great potential in renovating our existing building stock, in terms of improving environmental, economic and social qualities. Meeting the increasing performance requirements for sustainable construction entails an increasing level of complexity in the design process of both new...... buildings and renovation projects. Decision support tools are one solution that can help the building owner manage this complexity. This study investigates the current decision-making processes among Danish professional building owners, in order to propose a conceptual framework for future decision support...... tools for sustainable renovation. Design Science Research Methodology has been used as the main methodological framework. Current practices for setting goals for sustainability, determining the current state of the buildings and prioritizing which buildings to renovate within a building portfolio, have...
Sanvido, Olivier; Romeis, Jörg; Bigler, Franz
The ability to decide what kind of environmental changes observed during post-market environmental monitoring of genetically modified (GM) crops represent environmental harm is an essential part of most legal frameworks regulating the commercial release of GM crops into the environment. Among others, such decisions are necessary to initiate remedial measures or to sustain claims of redress linked to environmental liability. Given that consensus on criteria to evaluate 'environmental harm' has not yet been found, there are a number of challenges for risk managers when interpreting GM crop monitoring data for environmental decision-making. In the present paper, we argue that the challenges in decision-making have four main causes. The first three causes relate to scientific data collection and analysis, which have methodological limits. The forth cause concerns scientific data evaluation, which is controversial among the different stakeholders involved in the debate on potential impacts of GM crops on the environment. This results in controversy how the effects of GM crops should be valued and what constitutes environmental harm. This controversy may influence decision-making about triggering corrective actions by regulators. We analyse all four challenges and propose potential strategies for addressing them. We conclude that environmental monitoring has its limits in reducing uncertainties remaining from the environmental risk assessment prior to market approval. We argue that remaining uncertainties related to adverse environmental effects of GM crops would probably be assessed in a more efficient and rigorous way during pre-market risk assessment. Risk managers should acknowledge the limits of environmental monitoring programmes as a tool for decision-making.
Dittrich, Winand H; Johansen, Thomas
The nature of cognitive deficits in obsessive-compulsive disorder (OCD) is characterized by contradictory findings in terms of specific neuropsychological deficits. Selective impairments have been suggested to involve visuospatial memory, set shifting, decision-making and response inhibition. The aim of this study was to investigate cognitive deficits in decision-making and executive functioning in OCD. It was hypothesized that the OCD patients would be less accurate in their responses compared to the healthy controls in rational decision-making on a version of the Cambridge gambling task (CGT) and on the color-word interference test and on a version of the Tower of Hanoi test (tower test) of executive functioning. Thirteen participants with OCD were compared to a group of healthy controls (n = 13) matched for age, gender, education and verbal IQ. Results revealed significant differences between the OCD group and the healthy control group on quality of decision-making on the CGT and for achievement score on the tower test. On these two tasks the OCD group performed worse than the healthy control group. The symptom-dimension analysis revealed performance differences where safety checking patients were impaired on the tower test compared to contamination patients. Results are discussed in the framework of cognition and emotion processing and findings implicate that OCD models should address, specifically, the interaction between cognition and emotion. Here the emotional disruption hypothesis is forwarded to account for the dysfunctional behaviors in OCD. Further implications regarding methodological and inhibitory factors affecting cognitive information processing are highlighted. © 2013 The Scandinavian Psychological Associations.
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
Over half of the US population lives in coastal watersheds, creating a regional pressure for coastal ecosystems to provide a broad spectrum of services while continuing to support healthy communities and economies. The National Ocean Policy, issued in 2010, and Coastal and Marin...
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.
Dragoo, Amie; Barrows, Richard
The number of competency-based education (CBE) degree programs has increased rapidly over the past five years, yet there is little research on CBE program development. This study utilized conceptual models of higher education change and a qualitative methodology to analyze the strategies and challenges in implementing CBE business degree programs…
... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Review by FAA decisionmaker. 14.28 Section... § 14.28 Review by FAA decisionmaker. (a) In proceedings other than those under part 17 of this chapter and the AMS, either the applicant or the FAA counsel may seek review of the initial decision on the...
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…
Ahmed, Saeema; Hansen, Claus Thorp
This paper describes research that confronts a generic decision-making model with design strategies employed by experienced designers. The relationship between the decision-making activities proposed by the model and the eight design strategies identified by an empirical study of design work is e...
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
Fogarty, Gerard J.; McGregor-Bayne, Heather
A common belief about elite athletes is that they invest so much effort into the pursuit of their athletic careers that they fail to develop good career decision-making skills. Recent findings challenge that belief. The present study investigated career decision-making difficulties among 117 elite Australian athletes. Participants completed…
As a feedback mechanism to promote or improve the quality of clinical decisions in nursing, standards for quality clinical decision-making are proposed in an exemplary manner. In addition, a system for quality clinical decisionmaking in nursing capitalises on the heritage of the nursing process. Considering the changes and ...
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.
Wilmar Schaufeli; Annet de Lange; Juhani Ilmarinen; Per Erik Solem; Trude Furunes; Reidar Mykletun; Astri Syse
The aim of this longitudinal qualitative interview study (3 waves of interviews) was to examine the nature of older workers’ late career decision-making processes, including the main drivers and obstacles for prolonging working life or retiring. Late career decision-making is regarded as a process
... MD Steven Karceski, MD Stroke, tPA, and physician decision-making Dominic Hovsepian, BS Steven Karceski, MD WHAT DID ... has not been carefully studied is the physician ’ s decision-making process. It was because of this that Dr. ...
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...
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
Sacks, Susan R.; Eisenstein, Hester
Women seeking to realize the feminist goal of autonomy, defined as self-interested decision-making, encounter conflict and anxiety. This study reports a group experience, using life-space drawings and force-field analyses to reduce anxiety and foster autonomous decision-making. Of the 15 women participants in the year-long study, 100% reported at…
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.
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
Phillips, Susan D.; And Others
Compared decision-making style and problem-solving appraisal in 243 undergraduates. Results suggested that individuals who employ rational decision-making strategies approach problematic situations, while individuals who endorse dependent decisional strategies approach problematic situations without confidence in their problem-solving abilities.…
Decrop, A.; Snelders, H.M.J.J.
This paper presents a typology of vacationers based on decision-making variables and processes. Employing a naturalistic perspective, the (summer) vacation decision-making process of 25 Belgian households was followed for a year. In-depth interview and observation data were analyzed and interpreted
Hulton, Linda J.
PURPOSE: The purpose of this integrative review was to summarize the present literature to identify factors associated with adolescent sexual decision-making. Thirty-eight salient research studies were selected as a basis of this review from the databases of Medline, CINAHL, and Psychinfo using the Cooper methodology. CONCLUSIONS: Two categories of decision-making were identified: 1) The research on factors related to the decisions that adolescents make to become sexually active or to abstain from sexual activity; 2) The research on factors related to contraceptive decision-making. The most consistent findings were that the factors of gender differences, cognitive development, perception of benefits, parental influences, social influences, and sexual knowledge were important variables in the decision-making processes of adolescents. IMPLICATIONS: Practice implications for nursing suggest that clinicians should assess adolescent sexual decision-making in greater detail and address the social and psychological context in which sexual experiences occur. Nurses must be aware of the differences between adolescent and adult decision-making processes and incorporate knowledge of growth and development into intervention strategies. Moreover, to the degree that adolescent sexual decision-making proves to be less than rational, interventions designed to improve competent sexual decision-making are needed.
Ma, I.; Lambregts-Rommelse, N.N.J.; Buitelaar, J.K.; Cillessen, A.H.N.; Scheres, A.P.J.
This study examined reward-related decision-making in children and adolescents with ADHD in a social context, using economic games. We furthermore examined the role of individual differences in reward-related decision-making, specifically, the roles of reward sensitivity and prosocial skills.
Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh
The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.
Glasdam, Stinne; Oeye, Christine; Thrysoee, Lars
This article focuses on patients' participation in decision-making in meetings with healthcare professionals in a healthcare system, based on neoliberal regulations and ideas. Drawing on two constructed empirical cases, primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a Foucauldian perspective. Patients' participation in decision-making can be seen as an offshoot of respect for patient autonomy. A treatment must be chosen, when patients consult physicians. From the perspective of patients, there is a tendency for healthcare professionals to supply the patients with the information that they think are necessary for them to make their own decision. But 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 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 framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A 'projectification' of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own
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.
Rono-Bett, Karen C
Most deaths from natural disasters occur in low- or middle-income countries; among them, countries in the Horn of Africa - where Kenya lies. Between September 2015 and September 2016, 23.4 million people in this region faced food insecurity because of the 2015 El Niño, characterised by floods and droughts. The importance of effective government decision-making on preparedness and response are critical to saving lives during such disasters. But this decision-making process occurs in a political context which is marred by uncertainty with other factors at play. Yet, good practice requires making investments on a 'no-regrets' basis. This article looks at the factors influencing Kenya's decision-making process for natural disasters, the preparedness for the 2015 El Niño as a case study. I explored what stakeholders understand by 'no-regrets investments' and its application. I assessed financial allocations by government and donors to disaster preparedness. Based on key informant interviews, focus group discussions and financial analyses, this article presents evidence at national and subnational levels. The findings indicate that in making decisions relating to preparedness, the government seeks information primarily from sources it trusts - other government departments, its communities and the media. With no existing legal frameworks guiding Kenya's disaster preparedness, the coordination of preparedness is not strong. It appears that there is a lack of political will to prioritise these frameworks. The no-regrets approach is applied predominantly by non-state actors. Because there have been 'non-events' in the past, government has become overcautious in committing resources on a no-regrets basis. Government allocation to preparedness exceeds donor funding by almost tenfold.
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
The Montreal Protocol on Substances that Deplete the Ozone Layer, hailed as one of the most effective environmental treaties of all time, has a thirty year history of science-policy decision-making. The partnership between Parties to the Montreal Protocol and its technical assessment panels serve as a basis for understanding successes and evaluating stumbles of global environmental decision-making. Real-world environmental treaty negotiations can be highly time-sensitive, politically motivated, and resource constrained thus scientists and policymakers alike are often unable to confront the uncertainties associated with the multitude of choices. The science-policy relationship built within the framework of the Montreal Protocol has helped constrain uncertainty and inform policy decisions but has also highlighted the limitations of the use of scientific understanding in political decision-making. This talk will describe the evolution of the scientist-policymaker relationship over the history of the Montreal Protocol. Examples will illustrate how the Montreal Protocol's technical panels inform decisions of the country governments and will characterize different approaches pursued by different countries with a particular focus on the recently adopted Kigali Amendment. In addition, this talk will take a deeper dive with an analysis of the historic technical panel assessments on estimating financial resources necessary to enable compliance to the Montreal Protocol compared to the political financial decisions made through the Protocol's Multilateral Fund replenishment negotiation process. Finally, this talk will describe the useful lessons and challenges from these interactions and how they may be applicable in other environmental management frameworks across multiple scales under changing climatic conditions.
Karen C. Rono-Bett
Full Text Available Most deaths from natural disasters occur in low- or middle-income countries; among them, countries in the Horn of Africa – where Kenya lies. Between September 2015 and September 2016, 23.4 million people in this region faced food insecurity because of the 2015 El Niño, characterised by floods and droughts. The importance of effective government decision-making on preparedness and response are critical to saving lives during such disasters. But this decision-making process occurs in a political context which is marred by uncertainty with other factors at play. Yet, good practice requires making investments on a ‘no-regrets’ basis. This article looks at the factors influencing Kenya’s decision-making process for natural disasters, the preparedness for the 2015 El Niño as a case study. I explored what stakeholders understand by ‘no-regrets investments’ and its application. I assessed financial allocations by government and donors to disaster preparedness. Based on key informant interviews, focus group discussions and financial analyses, this article presents evidence at national and subnational levels. The findings indicate that in making decisions relating to preparedness, the government seeks information primarily from sources it trusts – other government departments, its communities and the media. With no existing legal frameworks guiding Kenya’s disaster preparedness, the coordination of preparedness is not strong. It appears that there is a lack of political will to prioritise these frameworks. The no-regrets approach is applied predominantly by non-state actors. Because there have been ‘non-events’ in the past, government has become overcautious in committing resources on a no-regrets basis. Government allocation to preparedness exceeds donor funding by almost tenfold.
Szasz, Paul Lucian; Hofmann, Stefan G; Heilman, Renata M; Curtiss, Joshua
The aim of the current study was to investigate the effects of reappraisal, acceptance, and rumination for regulating anger and sadness on decision-making. Participants (N = 165) were asked to recall two autobiographical events in which they felt intense anger and sadness, respectively. Participants were then instructed to reappraise, accept, ruminate, or not use any strategies to regulate their feelings of anger and sadness. Following this manipulation, risk aversion, and decision-making strategies were measured using a computer-based measure of risk-taking and a simulated real-life decision-making task. Participants who were instructed to reappraise their emotions showed the least anger and sadness, the most adaptive decision-making strategies, but the least risk aversion as compared to the participants in the other conditions. These findings suggest that emotion regulation strategies of negative affective states have an immediate effect on decision-making and risk-taking behaviors.
Agger Nielsen, Jeppe; Pedersen, Keld
by the IT PPM literature) plays a minor role. Our account also reveals how the decision-making practices create IT portfolio problems and in some aspects is considered to have a negative impact on the outcome of e-government investments. Our analysis and previous research into decision-making allows us to argue......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...
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.
Hunt, Geoffrey; Merzeder, Christine; Bischofberger, Iren
The authors believe there is a need for novel ways of enhancing professional judgment and discretion in the contemporary healthcare environment. The objective is to provide a framework to guide a discursive analysis of an ongoing clinical scenario by a small group of healthcare professionals (4-12) to achieve consensual understanding in the decision-making necessary to resolve specific healthcare inadequacies and promote organisational learning. REPVAD is an acronym for the framework's five decision-making dimensions of reasoning, evidence, procedures, values, attitudes and defences. The design is set out in terms of well-defined definitions of the dimensions, a rationale for using REPVAD, and explications of dimensions one at a time. Furthermore, the REPVAD process of application to a scenario is set out, and a didactic scenario is given to show how REPVAD works together with a sample case. A discussion is fleshed out in four real life student cases, and a conclusion indicates strengths and weaknesses and the possibility of further development and transferability. In terms of findings, the model has been tried, tested and refined over a number of years in the development of advanced practitioners at university healthcare faculties in two European countries. Consent was obtained from the four participating students.
Li, Ni; Huai, Wenqing; Wang, Shaodan
C2 (command and control) has been understood to be a critical military component to meet an increasing demand for rapid information gathering and real-time decision-making in a dynamically changing battlefield environment. In this article, to improve a C2 behaviour model's reusability and interoperability, a behaviour modelling framework was proposed to specify a C2 model's internal modules and a set of interoperability interfaces based on the C-BML (coalition battle management language). WTA (weapon target assignment) is a typical C2 autonomous decision-making behaviour modelling problem. Different from most WTA problem descriptions, here sensors were considered to be available resources of detection and the relationship constraints between weapons and sensors were also taken into account, which brought it much closer to actual application. A modified differential evolution (MDE) algorithm was developed to solve this high-dimension optimisation problem and obtained an optimal assignment plan with high efficiency. In case study, we built a simulation system to validate the proposed C2 modelling framework and interoperability interface specification. Also, a new optimisation solution was used to solve the WTA problem efficiently and successfully.
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
The ability of scientists to conduct whole organism toxicity tests to understand chemical safety has been significantly outpaced by the rapid synthesis of new chemicals. Therefore, to increase efficiencies in chemical risk assessment, scientists are turning to mechanistic-based studies, making greater use of in vitro and in silico methods, to screen for potential environmental and human health hazards. A framework that has gained traction for capturing available knowledge describing the linkage between mechanistic data and apical toxicity endpoints, required for regulatory assessments, is the adverse outcome pathway (AOP). A number of international activities have focused on AOP development and plausible applications to regulatory decision-making. These interactions have prompted dialog between research scientists and regulatory communities to consider how best to use the AOP framework in risk assessment. While expert-facilitated discussions have been instrumental in moving the science of AOPs forward, it was recognized that a survey of the broader scientific community would aid in identifying shortcomings and guiding future initiatives for the AOP framework. To that end, a ?‘Horizon Scanning’ exercise was conducted to solicit questions from the global scientific and regulatory communities concerning the challenges or limitations that must be addressed to realize the full potential of the AOP framework in research and regulatory decision making. The m
This document described the complex task of assessing the environmental impacts of trade negotiations with particular emphasis on the framework of the Strategic Environmental Assessment which the Government of Canada will conduct through a systematic process which can identify and evaluate possible and significant environmental impacts of an initiative. The objective of the assessment is to integrate environmental considerations into decision-making processes at the earliest possible stage. The first part of the framework identifies the importance of recognizing environmental considerations of trade and explains how the framework will contribute to environmental policy. The second part of the framework outlines the process and analytical requirements for conducting an environmental assessment of a trade negotiation. Environmental Assessment Committees will be formed by the Department of Foreign Affairs and International Trade, and will include representatives from federal government departments and agencies. All analyses will be conducted in four stages which will include identifying the economic effect of the negotiation, identifying the likely environmental impact of such changes, assessing the significance of the likely environmental impacts, and identifying enhancement/mitigation options to inform the negotiations. The framework is designed to be flexible enough to be used at current and future trade negotiations in the World Trade Organization, the Free Trade Area of the Americas and in bilateral Free Trade Agreements. An environmental assessment of trade negotiations is considered to be an important decision-making tool for promoting sustainable development. 16 refs., 1 tab
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…
Full Text Available Abstract Background Shared decision making (SDM, a process by which health professionals and patients go through the decision-making process together to agree on treatment, is a promising strategy for promoting diet-related decisions that are informed and value based and to which patients adhere well. The objective of the present study was to identify dietitians' salient beliefs regarding their exercise of two behaviors during the clinical encounter, both of which have been deemed essential for SDM to take place: (1 presenting patients with all dietary treatment options for a given health condition and (2 helping patients clarify their values and preferences regarding the options. Methods Twenty-one dietitians were allocated to four focus groups. Facilitators conducted the focus groups using a semistructured interview guide based on the Theory of Planned Behavior. Discussions were audiotaped, transcribed verbatim, coded, and analyzed with NVivo8 (QSR International, Cambridge, MA software. Results Most participants stated that better patient adherence to treatment was an advantage of adopting the two SDM behaviors. Dietitians identified patients, physicians, and the multidisciplinary team as normative referents who would approve or disapprove of their adoption of the SDM behaviors. The most often reported barriers and facilitators for the behaviors concerned patients' characteristics, patients' clinical situation, and time. Conclusions The implementation of SDM in nutrition clinical practice can be guided by addressing dietitians' salient beliefs. Identifying these beliefs also provides the theoretical framework needed for developing a quantitative survey questionnaire to further study the determinants of dietitians' adoption of SDM behaviors.
Evers-Casey, Sarah; Graden, Sarah; Schnoll, Robert
Rationale: Physicians self-report high adherence rates for Ask and Advise behaviors of tobacco dependence treatment but are much less likely to engage in “next steps” consistent with sophisticated management of chronic illness. A variety of potential explanations have been offered, yet each lacks face validity in light of experience with other challenging medical conditions. Objective: Conduct a preliminary exploration of the behavioral economics of tobacco treatment decision-making in the face of uncertain outcomes, seeking evidence that behaviors may be explained within the framework of Prospect Theory. Methods: Four physician cohorts were polled regarding their impressions of the utility of tobacco use treatment and their estimations of “success” probabilities. Contingent valuation was estimated by asking respondents to make monetary tradeoffs relative to three common chronic conditions. Measurements and Main Results: Responses from all four cohorts showed a similar pattern of high utility of tobacco use treatment but low success probability when compared with the other chronic medical conditions. Following instructional methods aimed at controverting cognitive biases related to tobacco, this pattern was reversed, with success probabilities attaining higher valuation than for diabetes. Conclusions: Important presuppositions regarding the potential “success” of tobacco-related patient interactions are likely limiting physician engagement by favoring the most secure visit outcome despite the limited potential for health gains. Under these conditions, low engagement rates would be consistent with Prospect Theory predictions. Interventions aimed at counteracting the cognitive biases limiting estimations of success probabilities seem to effectively reverse this pattern and provide clues to improving the adoption of target clinical behaviors. PMID:25664676
Full Text Available The decisions made in the organization determine its success, therefore, conducting studies in the scope of decision-making seems important both for theory and practice. The aim of the studies was to identify the type of decision-making process in public medical entities with the use of typology developed by P. Nutt. For this purpose we used qualitative methods. Interviews with 8 directors of hospitals were conducted and the reconstruction was made on the basis of the decision-making process, which enabled the assignment of the model of decision-making process to the organization. The research indicated that four organizations use the historical decision-making model, three organizations represent the model of generating solutions, and one organization uses the model of available solutions.
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
Sievering, H.; Sinopoli, J.
A framework for environmental decision-making is described in which both qualitative and quantitative aspects of regional problems can be integrated into a problem-solving context. The techniques employed in this framework are computer simulation, games, and vote-trading. The paper concludes that through this framework: (a) environmental analysts can assess public value structure goal sets which can be used in the development of regional simulations, and (b) in turn, the quantitative aspects of the problems will be more easily communicated to the affected public. A brief description of the application of the framework is also presented.
Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique
Despite increasing interest in health economic evaluation, investigations have shown limited use by micro (clinical) level decision-makers. A considerable amount of health decisions take place daily at the point of the clinical encounter; especially in primary care. Since every decision has an opportunity cost, ignoring economic information in family physicians' (FPs) decision-making may have a broad impact on health care efficiency. Knowledge translation of economic evaluation is often based on taken-for-granted assumptions about actors' interests and interactions, neglecting much of the complexity of social reality. Health economics literature frequently assumes a rational and linear decision-making process. Clinical decision-making is in fact a complex social, dynamic, multifaceted process, involving relationships and contextual embeddedness. FPs are embedded in complex social networks that have a significant impact on skills, attitudes, knowledge, practices, and on the information being used. Because of their socially constructed nature, understanding preferences, professional culture, practices, and knowledge translation requires serious attention to social reality. There has been little exploration by health economists of whether the problem may be more fundamental and reside in a misunderstanding of the process of decision-making. There is a need to enhance our understanding of the role of economic evaluation in decision-making from a disciplinary perspective different than health economics. This paper argues for a different conceptualization of the role of economic evaluation in FPs' decision-making, and proposes Bourdieu's sociological theory as a research framework. Bourdieu's theory of practice illustrates how the context-sensitive nature of practice must be understood as a socially constituted practical knowledge. The proposed approach could substantially contribute to a more complex understanding of the role of economic evaluation in FPs' decision-making
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
Full Text Available Background. Multiple sclerosis (MS is frequently associated with cognitive and behavioural deficits. A growing number of studies suggest an impact of MS on decision-making abilities. The aim of this systematic review was to assess if (1 performance of MS patients in decision-making tasks was consistently different from controls and (2 whether this modification was associated with cognitive dysfunction and emotional alterations. Methods. The search was conducted on Pubmed/Medline database. 12 studies evaluating the difference between MS patients and healthy controls using validated decision-making tasks were included. Outcomes considered were quantitative (net scores and qualitative measurements (deliberation time and learning from feedback. Results. Quantitative and qualitative decision-making impairment in MS was present in 64.7% of measurements. Patients were equally impaired in tasks for decision-making under risk and ambiguity. A correlation to other cognitive functions was present in 50% of cases, with the highest associations in the domains of processing speed and attentional capacity. Conclusions. In MS patients, qualitative and quantitative modifications may be present in any kind of decision-making task and can appear independently of other cognitive measures. Since decision-making abilities have a significant impact on everyday life, this cognitive aspect has an influential importance in various MS-related treatment settings.
Neuhaus, Mireille; Calabrese, Pasquale; Annoni, Jean-Marie
Multiple sclerosis (MS) is frequently associated with cognitive and behavioural deficits. A growing number of studies suggest an impact of MS on decision-making abilities. The aim of this systematic review was to assess if (1) performance of MS patients in decision-making tasks was consistently different from controls and (2) whether this modification was associated with cognitive dysfunction and emotional alterations. The search was conducted on Pubmed/Medline database. 12 studies evaluating the difference between MS patients and healthy controls using validated decision-making tasks were included. Outcomes considered were quantitative (net scores) and qualitative measurements (deliberation time and learning from feedback). Quantitative and qualitative decision-making impairment in MS was present in 64.7% of measurements. Patients were equally impaired in tasks for decision-making under risk and ambiguity. A correlation to other cognitive functions was present in 50% of cases, with the highest associations in the domains of processing speed and attentional capacity. In MS patients, qualitative and quantitative modifications may be present in any kind of decision-making task and can appear independently of other cognitive measures. Since decision-making abilities have a significant impact on everyday life, this cognitive aspect has an influential importance in various MS-related treatment settings.
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.
Mileti, D.; Sorensen, J.; Bogard, W.
The purpose was to describe the processes of evacuation decision-making, identify and document uncertainties in that process and discuss implications for federal assumption of liability for precautionary evacuations at nuclear facilities under the Price-Anderson Act. Four major categories of uncertainty are identified concerning the interpretation of hazard, communication problems, perceived impacts of evacuation decisions and exogenous influences. Over 40 historical accounts are reviewed and cases of these uncertainties are documented. The major findings are that all levels of government, including federal agencies experience uncertainties in some evacuation situations. Second, private sector organizations are subject to uncertainties at a variety of decision points. Third, uncertainties documented in the historical record have provided the grounds for liability although few legal actions have ensued. Finally it is concluded that if liability for evacuations is assumed by the federal government, the concept of a ''precautionary'' evacuation is not useful in establishing criteria for that assumption. 55 refs., 1 fig., 4 tabs.
Oud, Bastiaan; Krajbich, Ian; Miller, Kevin; Cheong, Jin Hyun; Botvinick, Matthew; Fehr, Ernst
Time is an extremely valuable resource but little is known about the efficiency of time allocation in decision-making. Empirical evidence suggests that in many ecologically relevant situations, decision difficulty and the relative reward from making a correct choice, compared to an incorrect one, are inversely linked, implying that it is optimal to use relatively less time for difficult choice problems. This applies, in particular, to value-based choices, in which the relative reward from choosing the higher valued item shrinks as the values of the other options get closer to the best option and are thus more difficult to discriminate. Here, we experimentally show that people behave sub-optimally in such contexts. They do not respond to incentives that favour the allocation of time to choice problems in which the relative reward for choosing the best option is high; instead they spend too much time on problems in which the reward difference between the options is low. We demonstrate this by showing that it is possible to improve subjects' time allocation with a simple intervention that cuts them off when their decisions take too long. Thus, we provide a novel form of evidence that organisms systematically spend their valuable time in an inefficient way, and simultaneously offer a potential solution to the problem. © 2016 The Author(s).
I contrast Robert Veatch's recent liberal vision of medical decision-making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values -- 'deep value pairing'. The goal of choice is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true -- that there really are states which are good for people regardless of whether they desire to be in them -- then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician.
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...
Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato
The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants' choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the "reward value" of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants' choice data, we used reinforcement learning models that have successfully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures) was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making.
van der Meer, Matthijs; Kurth-Nelson, Zeb; Redish, A David
Decisions result from an interaction between multiple functional systems acting in parallel to process information in very different ways, each with strengths and weaknesses. In this review, the authors address three action-selection components of decision-making: The Pavlovian system releases an action from a limited repertoire of potential actions, such as approaching learned stimuli. Like the Pavlovian system, the habit system is computationally fast but, unlike the Pavlovian system permits arbitrary stimulus-action pairings. These associations are a "forward'' mechanism; when a situation is recognized, the action is released. In contrast, the deliberative system is flexible but takes time to process. The deliberative system uses knowledge of the causal structure of the world to search into the future, planning actions to maximize expected rewards. Deliberation depends on the ability to imagine future possibilities, including novel situations, and it allows decisions to be taken without having previously experienced the options. Various anatomical structures have been identified that carry out the information processing of each of these systems: hippocampus constitutes a map of the world that can be used for searching/imagining the future; dorsal striatal neurons represent situation-action associations; and ventral striatum maintains value representations for all three systems. Each system presents vulnerabilities to pathologies that can manifest as psychiatric disorders. Understanding these systems and their relation to neuroanatomy opens up a deeper way to treat the structural problems underlying various disorders.
Dionne-Odom, J. Nicholas; Willis, Danny G.; Bakitas, Marie; Crandall, Beth; Grace, Pamela J.
Background Surrogate decision-makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose Identify and describe the underlying psychological processes of surrogate decision-making for adults at EOL in the ICU. Method Qualitative case study design using a cognitive task analysis (CTA) interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center’s ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semi-structured CTA interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions: gist impressions, distressing emotions, and moral intuitions impact a SDM’s judgment about the acceptability of either the patient’s medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision-making and may facilitate enhanced decision support for SDMs. PMID:25982772
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.
Marek Jacek Stankiewicz
The paper deals with the problems of the improvement of the decision-making process that is composed of two sub-systems: preparations for making a decision and taking it. Based on the multi-aspect characteristics of the essence and conditions of the decision-making process a referential model of decision-making has been proposed. The model assumes the existence of two principles that apparently may seem contradictory – the principle of rationality and the principle of creative uniqueness. Dec...
Full Text Available Yong Hui Nies,1 Farida Islahudin,1 Wei Wen Chong,1 Norlia Abdullah,2 Fuad Ismail,3 Ros Suzanna Ahmad Bustamam,4 Yoke Fui Wong,5 JJ Saladina,2 Noraida Mohamed Shah1 1Faculty of Pharmacy, 2Department of Surgery, 3Department of Radiotherapy and Oncology, Universiti Kebangsaan Malaysia Medical Centre, 4Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Kuala Lumpur, 5Department of Radiotherapy and Oncology, National Cancer Institute, Putrajaya, Malaysia Purpose: 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. Participants and methods: 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. Results: 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
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...
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,...
Söderström, Tor; Åström, Jan; Anderson, Greg; Bowles, Ron
Purpose: The purpose of this paper is to report progress concerning the design of a computer-assisted simulation training (CAST) platform for developing decision-making skills in police students. The overarching aim is to outline a theoretical framework for the design of CAST to facilitate police students' development of search techniques in…
Plaga, Stacey L; Demarco, Kristin; Shulman, Lee P
We sought to evaluate the prenatal decision-making of pregnant adolescents identified at increased risk for identifiable fetal genetic abnormalities. A retrospective review of records of gravid women 19 years old or younger undergoing genetic counseling from 2001-2003 (inclusive) was undertaken. Hospital-based academic center. Thirty-seven women were identified; four cases did not meet inclusion criteria. None. Decision to undergo or forgo invasive prenatal testing. Of the 33 women included in this study, the average age was 17.6 years (range: 15-19). Eighteen were Latinas, eight were African-Americans, and seven were Caucasians. Sixteen women had positive maternal serum screening outcomes; nine women sought counseling because of personal/family histories of genetic abnormalities, seven sought counseling after fetal structural anomalies were detected by ultrasound, and one woman sought counseling because she and her partner were positive for Mendelian disorder screening (sickle cell disease). Sixteen of the women (48.5%) chose to undergo invasive testing (15 amniocenteses, one chorionic villus sampling) whereas 17 (51.5%) chose to forgo invasive testing. Adolescents offered invasive prenatal diagnosis will chose to undergo or forgo such testing based on diagnostic and personal criteria as do adult women. Nonetheless, unique adolescent issues may make the process by which information is obtained and communicated during counseling to be different from counseling provided to adults. The development of new genetic screening and diagnostic protocols has and will increase the number of pregnant adolescent women who will be offered genetic counseling during their pregnancies. Such an increase in numbers will place considerably more pressure on an already taxed genetic counseling system; accordingly, new counseling paradigms will need to be developed to provide service to an expanded patient population seeking information for an increasing number of genetic issues.
decision-making models as applied to child spacing and more. specificaDy to the use .... also assumes that the individual operates as a rational decision- making organism in ..... work involves: Motivation; Counselling; Distribution ofIEC mate-.
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
Bridging the gap among healthcare workers and decision-makers through improved ... Through this project, researchers will build on insights gained from previous ... and identify the critical factors required for the scale-up and integration of the ...
Rasmus H. Wandall
Full Text Available The article addresses the widespread use of statistical causal modelling to describe criminal sentencing decision-making empirically in Scandinavia. The article describes the characteristics of this model, and on this basis discusses three aspects of sentencing decision-making that the model does not capture: 1 the role of law and legal structures in sentencing, 2 the processes of constructing law and facts as they occur in the processes of handling criminal cases, and 3 reflecting newer organisational changes to sentencing decision-making. The article argues for a stronger empirically based design of sentencing models and for a more balanced use of different social scientific methodologies and models of sentencing decision-making.
ISSN 0378-5254 Journal of Family Ecology and Consumer Sciences, Vol 34, 2006. Decision-Making Styles of ... significantly influences shopping behaviour. Four dis- ..... Apparel is a high- involvement shopping item that is often bought for its.
Without a conscious effort to achieve optimum resource allocation, there is a real danger that educational resources may be wasted. This document uses input-output analysis to develop a model for rational decision-making in secondary education. (LLR)
Hansen, Claus Thorp; Andreasen, Mogens Myrup
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...... and values, and ensure timely market introduction, · to target the business to create proper profit for the company, · to find the best design solution and ensure that it fits to all life phases, · and finally to co-ordinate all design and activity elements into a proper totality. The goals of more....... The structure of the paper is the following. In section 2 we discuss related work. In section 3 we propose a decision-making model, and in section 4 we outline a mindset for decision-making. In section 5 decision-making strategies are briefly discussed. The paper finishes with conclusions....
formulation and decision-making process, even in the issues that affect them ... information, workshop/conferences attendance and rate/level of participation in .... Appropriate Technology in “Women in Nigeria Economy”, ACENA Publishers,.
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.
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.
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.
Boettcher, Kevin L; Levis, Alexander H
... and a response selection stage. The total rate of internal processing of each decisionmaker is constrained by bounded rationality, while the performance of the organization must satisfy specified goals...
Menychtas, Andreas; Tsanakas, Panayiotis
The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging. PMID:27222731
Menychtas, Andreas; Tsanakas, Panayiotis; Maglogiannis, Ilias
The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging.
Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard
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.......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...
Chiam, Yin Kia; Zhu, Liming; Staples, Mark
The quality of software is achieved during its development. Development teams use various techniques to investigate, evaluate and control potential quality problems in their systems. These “Quality Attribute Techniques” target specific product qualities such as safety or security. This paper proposes a framework to capture important characteristics of these techniques. The framework is intended to support process tailoring, by facilitating the selection of techniques for inclusion into process models that target specific product qualities. We use risk management as a theory to accommodate techniques for many product qualities and lifecycle phases. Safety techniques have motivated the framework, and safety and performance techniques have been used to evaluate the framework. The evaluation demonstrates the ability of quality risk management to cover the development lifecycle and to accommodate two different product qualities. We identify advantages and limitations of the framework, and discuss future research on the framework.
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......’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...... 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...
Hunt, Matthew R; Carnevale, Franco A
Theoretical and empirical research in bioethics frequently focuses on ethical dilemmas or problems. This paper draws on anthropological and phenomenological sources to develop an alternative framework for bioethical enquiry that allows examination of a broader range of how the moral is experienced in the everyday lives of individuals and groups. Our account of moral experience is subjective and hermeneutic. We define moral experience as "Encompassing a person's sense that values that he or she deem important are being realised or thwarted in everyday life. This includes a person's interpretations of a lived encounter, or a set of lived encounters, that fall on spectrums of right-wrong, good-bad or just-unjust". In our conceptualisation, moral experience is not limited to situations that are heavily freighted with ethically-troubling ramifications or are sources of debate and disagreement. Important aspects of moral experience are played out in mundane and everyday settings. Moral experience provides a research framework, the scope of which extends beyond the evaluation of ethical dilemmas, processes of moral justification and decision-making, and moral distress. This broad research focus is consistent with views expressed by commentators within and beyond bioethics who have called for deeper and more sustained attention in bioethics scholarship to a wider set of concerns, experiences and issues that better captures what is ethically at stake for individuals and communities. In this paper we present our conceptualisation of moral experience, articulate its epistemological and ontological foundations and discuss opportunities for empirical bioethics research using this framework.
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
Andrew M. Parker; Wändi Bruine de Bruin; Baruch Fischhoff
Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al.\\ (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decision...
Roijers, D.M.; Vamplew, P.; Whiteson, S.; Dazeley, R.
Sequential decision-making problems with multiple objectives arise naturally in practice and pose unique challenges for research in decision-theoretic planning and learning, which has largely focused on single-objective settings. This article surveys algorithms designed for sequential decision-making problems with multiple objectives. Though there is a growing body of literature on this subject, little of it makes explicit under what circumstances special methods are needed to solve multi-obj...
Decision-making is a complex skill that is essential for daily life. Yet the complexities of this process are often overlooked in favour of more obvious cognitive deficits during neuropsychological assessment, such as memory or attention impairments. Decision-making involves affective and motivational aspects of executive functions (Happaney, Zelazo & Stuss, 2004). Executive functions include a range of abilities that can be divided into three categories: 1) goal setting and planning, 2) acti...
Crigger, N J
Universal prescriptivism is a recently developed moral decision-making theory that combines utilitarian and Kantian theories with two levels of moral thinking. A combined approach offers a creative solution to the weaknesses inherent in traditional moral theories. The paper describes the theory and discusses important implications for nursing education, practical ethical decision-making, and research. The relationship of an ethical theory of caring to traditional moral theory is discussed.
Wasserman, Jason Adam; Navin, Mark Christopher
When a patient lacks decision-making capacity, then according to standard clinical ethics practice in the United States, the health care team should seek guidance from a surrogate decision-maker, either previously selected by the patient or appointed by the courts. If there are no surrogates willing or able to exercise substituted judgment, then the team is to choose interventions that promote a patient's best interests. We argue that, even when there is input from a surrogate, patient preferences should be an additional source of guidance for decisions about patients who lack decision-making capacity. Our proposal builds on other efforts to help patients who lack decision-making capacity provide input into decisions about their care. For example, "supported," "assisted," or "guided" decision-making models reflect a commitment to humanistic patient engagement and create a more supportive process for patients, families, and health care teams. But often, they are supportive processes for guiding a patient toward a decision that the surrogate or team believes to be in the patient's medical best interests. Another approach holds that taking seriously the preferences of such a patient can help surrogates develop a better account of what the patient's treatment choices would have been if the patient had retained decision-making capacity; the surrogate then must try to integrate features of the patient's formerly rational self with the preferences of the patient's currently compromised self. Patients who lack decision-making capacity are well served by these efforts to solicit and use their preferences to promote best interests or to craft would-be autonomous patient images for use by surrogates. However, we go further: the moral reasons for valuing the preferences of patients without decision-making capacity are not reducible to either best-interests or (surrogate) autonomy considerations but can be grounded in the values of liberty and respect for persons. This has
Traynor, Michael; Boland, Maggie; Buus, Niels
This paper is a report of a study conducted to examine how nurses represent professional clinical decision-making processes, and to determine what light Jamous and Peloille's 'Indeterminacy/Technicality ratio' concept can shed on these representations. Classic definitions of professional work feature autonomy of decision-making and control over the field of work. Sociologists Jamous and Peloille have described professional work as being high in 'indeterminacy' (the use of tacit judgements) relative to technicality (activity able to be codified). The rise of the evidence-based practice movement has been seen as increasing the realm of technical decision-making in healthcare, and it is relevant to analyse nurses' professional discourse and study how they respond to this increase. Three focus groups with qualified nurses attending post-qualifying courses at a London university were held in 2008. Participants were asked to talk about influences on their decision-making. The discussions were tape-recorded, transcribed and subjected to discourse analysis. Participants described their decision-making as influenced by both indeterminate and technical features. They acknowledged useful influences from both domains, but pointed to their personal 'experience' as the final arbiter of decision-making. Their accounts of decision-making created a sense of professional autonomy while at the same time protecting it against external critique. Pre- and post-registration nurse education could encourage robust discussion of the definition and roles of 'irrational' aspects of decision-making and how these might be understood as components of credible professional practice.
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...
Betzler, Felix; Viohl, Leonard; Romanczuk-Seiferth, Nina
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design. © 2016 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
Djulbegovic, Benjamin; Hozo, Iztok; Beckstead, Jason; Tsalatsanis, Athanasios; Pauker, Stephen G
Abstract Background Dual processing theory of human cognition postulates that reasoning and decision-making can be described as a function of both an intuitive, experiential, affective system (system I) and/or an analytical, deliberative (system II) processing system. To date no formal descriptive model of medical decision-making based on dual processing theory has been developed. Here we postulate such a model and apply it to a common clinical situation: whether treatment should be administe...
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...
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.
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....
Christensen, Henrik Bærbak; Caspersen, Michael Edelgaard
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.......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...
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
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 associated with trial unique lotteries. After a short delay, they completed a decision-making task where they could choose to re-engage 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 re-engage 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. PMID:26999046
Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B
Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.
Hsieh, Linda; Elbanna, Said; Narooz, Rose
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 be...... 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....... a better understanding of under what circumstances, SME decision-makers tend to follow a more rational approach toward internationalization decisions. Specifically, this paper examines a set of contextual variables (the level of perceived international risk, internationalization performance, planned versus...... 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...
Laier, Christian; Pawlikowski, Mirko; Brand, Matthias
Many people watch sexually arousing material on the Internet in order to receive sexual arousal and gratification. When browsing for sexual stimuli, individuals have to make several decisions, all possibly leading to positive or negative consequences. Decision-making research has shown that decisions under ambiguity are influenced by consequences received following earlier decisions. Sexual arousal might interfere with the decision-making process and should therefore lead to disadvantageous decision-making in the long run. In the current study, 82 heterosexual, male participants watched sexual pictures, rated them with respect to sexual arousal, and were asked to indicate their current level of sexual arousal before and following the sexual picture presentation. Afterwards, subjects performed one of two modified versions of the Iowa Gambling Task in which sexual pictures were displayed on the advantageous and neutral pictures on the disadvantageous card decks or vice versa (n = 41/n = 41). Results demonstrated an increase of sexual arousal following the sexual picture presentation. Decision-making performance was worse when sexual pictures were associated with disadvantageous card decks compared to performance when the sexual pictures were linked to the advantageous decks. Subjective sexual arousal moderated the relationship between task condition and decision-making performance. This study emphasized that sexual arousal interfered with decision-making, which may explain why some individuals experience negative consequences in the context of cybersex use.
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
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.
Lane, S J; Walker, I; Chan, A K; Heddle, N M; Poon, M-C; Minuk, L; Jardine, L; Arnold, E; Sholapur, N; Webert, K E
The first generation of young men using primary prophylaxis is coming of age. Important questions regarding the management of severe haemophilia with prophylaxis persist: Can prophylaxis be stopped? At what age? To what effect? Can the regimen be individualized? The reasons why some individuals discontinue or poorly comply with prophylaxis are not well understood. These issues have been explored using predominantly quantitative research approaches, yielding little insight into treatment decision-making from the perspectives of persons with haemophilia (PWH). Positioning the PWH as a source of expertise about their condition and its management, we undertook a qualitative study: (i) to explore and understand the lived experience of young men with severe haemophilia A or B and (ii) to identify the factors and inter-relationships between factors that affect young men's treatment decision-making. This manuscript reports primarily on the second objective. A modified Straussian, grounded theory methodology was used for data collection (interviews) and preliminary analysis. The study sample, youth aged 15-29, with severe haemophilia A or B, was chosen selectively and recruited through three Canadian Haemophilia Treatment Centres. We found treatment decision-making to be multi-factorial and used the Framework method to analyze the inter-relationships between factors. A typology of four distinct approaches to treatment was identified: lifestyle routine prophylaxis, situational prophylaxis, strict routine prophylaxis and no prophylaxis. Standardized treatment definitions (i.e.: 'primary' and 'secondary', 'prophylaxis') do not adequately describe the ways participants treat. Naming the variation of approaches documented in this study can improve PWH/provider communication, treatment planning and education. © 2014 John Wiley & Sons Ltd.
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.
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 distributed...
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 distributed...
Leshem, Shosh; Trafford, Vernon
The conceptual framework is alluded to in most serious texts on research, described in some and fully explained in few. However, examiners of doctoral theses devote considerable attention to exploring its function within social science doctoral vivas. A literature survey explores how the conceptual framework is itself conceptualised and explained.…
The main goal of the Inquiry into the Future for Lifelong Learning is to provide a "strategic framework" for the future. In this article, the author considers the key components that will make up the framework. These are: (1) a statement of vision and values; (2) a stock-take of the current position; (3) an "investment…
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…
Wright, Stuart Anthony Lewis; Fritsch, Oliver
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...... 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...
Russell, Robin E; Katz, Rachel A; Richgels, Katherine L D; Walsh, Daniel P; Grant, Evan H C
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.
Larsson, C. M.
With Publication 91 on the impact of ionizing radiation on non-human species, the International Commission on Radiological Protection (ICRP) has taken a major step towards the integration of environmental issues into radiological protection. The conceptual framework has developed in response to public demand and concern for environmental issues, and is underpinned by technical development undertaken by several organisations at both national and international levels. The EC-funded FASSET project (Framework for Assessment of Environmental Impact), completed in 2004, has developed an assessment framework that includes: source characterisation and initial hazard analysis; ecosystem description and selection of reference organisms; exposure analysis including conversion to dose rates; effects analysis; and, guidance for interpretation. On the basis of experience from FASSET and other recent developments, it can be concluded that (i) there is substantial agreement in terms of conceptual approaches between different frameworks currently in use being or proposed, and that (ii) differences in technical approaches can be largely attributed to differences in ecosystems of concern or in national regulatory requirements. A major future challenge is the development of an integrated approach where decision-making can be guided by sound scientific judgements. This requires, inter alia: filling gaps in basic knowledge of relevance to assessment and protection, through targeted experimental, theoretical (including expert judgements) and real case studies; development of risk characterisation methodologies; development of screening standards, where appropriate; development of user-friendly assessment tools; and, stakeholder involvement, including the development of supporting communication strategies. These issues will be addressed in the ERICA project (Environmental Risks from Ionizing Contaminants Assessment and Management) launched under the EC 6th Framework Programme during the
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.
This dissertation addresses the problem of constructing and developing normative theory responsive to the need for improving the quality of decision-making in the nuclear weapons policy-making. Against the background of a critical evaluation of various paradigms in the literature (systems analysis and opposed-systems designed, the bureaucratic politics model, and the cybernetic theory of decision) an attempt is made to design an alternative analytic framework based on the writings of numerous organization theorists such as Herbert Simon and Kenneth Arrow. The framework is applied to the case of mini-nukes, i.e., proposals in the mid-1970s to develop and deploy tens of thousands of very low-yield (sub-kiloton), miniaturized fission weapons in NATO. Heuristic case study identifies the type of study undertaken in the dissertation in contrast to the more familiar paradigmatic studies identified, for example, with the Harvard Weapons Project. Application of the analytic framework developed in the dissertation of the mini-nuke case resulted in an empirical understanding of why decision making concerning tactical nuclear weapons has been such a complex task and why force modernization issues in particular have been so controversial and lacking in policy resolution
Patricia Snell Herzog
Full Text Available This paper challenges the “spiritual but not religious” (SBNR category as a methodological artifact caused by interacting two closed-ended survey items into binary combinations. Employing a theoretically rich approach, this study maps the multiple ways in which the religious and the spiritual combine for emerging adults. Results indicate that most emerging adults have a tacit sense of morality, displaying limited cognitive access to how moral reasoning relates to religious and spiritual orientations. This longitudinal study investigates efforts to raise moral awareness through: exposure to diverse religious and spiritual orientations, personal reflection, and collective discussion. Relative to control groups, emerging adults in this study display increases in moral awareness. We combine the results of these studies to formulate a theoretical framework for the ways in which beliefs, values, and ethical decision-making connect in expressing plural combinations of religiosity and spirituality. The implication is that direct attention to religiosity and spirituality — not avoidance of — appears to facilitate ethical decision-making.
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.
Full Text Available Value plays a central role in practically every aspect of human life that requires a decision: whether we choose between different consumer goods, whether we decide which person we marry or which political candidate gets our vote, we choose the option that has more value to us. Over the last decade, neuroeconomic research has mapped the neural substrates of economic value, revealing that activation in brain regions such as ventromedial prefrontal cortex (VMPFC, ventral striatum or posterior cingulate cortex reflects how much an individual values an option and which of several options he/she will choose. However, while great progress has been made exploring the mechanisms underlying concrete decisions, neuroeconomic research has been less concerned with the questions of why people value what they value, and why different people value different things. Social psychologists and sociologists have long been interested in core values, motivational constructs that are intrinsically linked to the self-schema and are used to guide actions and decisions across different situations and different time points. Core value may thus be an important determinant of individual differences in economic value computation and decision-making. Based on a review of recent neuroimaging studies investigating the neural representation of core values and their interactions with neural systems representing economic value, we outline a common framework that integrates the core value concept and neuroeconomic research on value-based decision-making.
Brosch, Tobias; Sander, David
VALUE PLAYS A CENTRAL ROLE IN PRACTICALLY EVERY ASPECT OF HUMAN LIFE THAT REQUIRES A DECISION: whether we choose between different consumer goods, whether we decide which person we marry or which political candidate gets our vote, we choose the option that has more value to us. Over the last decade, neuroeconomic research has mapped the neural substrates of economic value, revealing that activation in brain regions such as ventromedial prefrontal cortex (VMPFC), ventral striatum or posterior cingulate cortex reflects how much an individual values an option and which of several options he/she will choose. However, while great progress has been made exploring the mechanisms underlying concrete decisions, neuroeconomic research has been less concerned with the questions of why people value what they value, and why different people value different things. Social psychologists and sociologists have long been interested in core values, motivational constructs that are intrinsically linked to the self-schema and are used to guide actions and decisions across different situations and different time points. Core value may thus be an important determinant of individual differences in economic value computation and decision-making. Based on a review of recent neuroimaging studies investigating the neural representation of core values and their interactions with neural systems representing economic value, we outline a common framework that integrates the core value concept and neuroeconomic research on value-based decision-making.
Ongoing research investigating perceptual and contextual influences on skilled human performance in dynamic decision making environments is discussed. The research is motivated by two general classes of findings in recent decision making research. First, many studies suggest that the concrete context in which a task is presented has strong influences on the psychological processes used to perform the task and on subsequent performance. Second, studies of skilled behavior in a wide variety of task environments typically implicate the perceptual system as an important contributor to decision-making performance, either in its role as a mediator between the current decision context and stored knowledge, or as a mechanism capable of directly initiating activity through the development of a 'trained eye.' Both contextual and perceptual influences place limits on the ability of traditional utility-theoretic accounts of decision-making to guide display design, as variance in behavior due to contextual factors or the development of a perceptual skill is left unexplained. The author outlines a framework in which to view questions of perceptual and contextual influences on behavior and describe an experimental task and analysis technique which will be used to diagnose the possible role of perception in skilled decision making performance.
Risk comparison is essential for effective societal and individual decision-making. After the Fukushima disaster, studies compared radiation and other disaster-related risks to determine the effective prioritizing of measures for response. Evaluating the value of risk comparison information can enable effective risk communication. In this review, the value of risk comparison after the Fukushima disaster for societal and individual decision-making is discussed while clarifying the concept of radiation risk assessment at low doses. The objectives of radiation risk assessment are explained within a regulatory science framework, including the historical adoption of the linear non-threshold theory. An example of risk comparison (i.e. radiation risk versus evacuation-related risk in nursing homes) is used to discuss the prioritization of pre-disaster measures. The effective communication of risk information by authorities is discussed with respect to group-based and face-to-face approaches. Furthermore, future perspectives regarding radiation risk comparisons are discussed. © The Author(s) 2018. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.
Scheibler, Fülöp; Stoffel, Markus P; Barth, Claudia; Kuch, Christine; Steffen, Petra; Baldamus, Conrad A; Pfaff, Holger
Shared decision-making (SDM) as a model in physician-patient interaction is gaining relevance in the German health system. By applying this model, mid- and long-term improvements are expected especially in the outcomes of chronic diseases. Up to now, there has hardly been any empirical data available in German health services research regarding the state and development of SDM. This study establishes a baseline and provides actual data on this subject based on a German-wide survey of end-stage renal disease (ESRD) patients. Standardized German-wide survey of 6,614 patients with ESRD. The questionnaire included an instrument to measure the patients' perceived involvement in care (PICS) which had been translated and validated before. 82% of the questioned patients feel their physicians facilitated involvement in decision making. 81% of the patients actively inform themselves concerning their disease and treatment options. 69% state that SDM has taken place. Age, years on dialysis and gender correlate with perceived involvement. This paper provides a valid baseline for the prospective research of SDM in ESRD. The results indicate that dialysis patients are willing to participate in the process of medical decision-making. Characteristics and preferences of the patients should be taken into account not only in everyday clinical interactions. They could be monitored systematically within the framework of quality management and used as potential for quality improvement.
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.
Brosch, Tobias; Sander, David
Value plays a central role in practically every aspect of human life that requires a decision: whether we choose between different consumer goods, whether we decide which person we marry or which political candidate gets our vote, we choose the option that has more value to us. Over the last decade, neuroeconomic research has mapped the neural substrates of economic value, revealing that activation in brain regions such as ventromedial prefrontal cortex (VMPFC), ventral striatum or posterior cingulate cortex reflects how much an individual values an option and which of several options he/she will choose. However, while great progress has been made exploring the mechanisms underlying concrete decisions, neuroeconomic research has been less concerned with the questions of why people value what they value, and why different people value different things. Social psychologists and sociologists have long been interested in core values, motivational constructs that are intrinsically linked to the self-schema and are used to guide actions and decisions across different situations and different time points. Core value may thus be an important determinant of individual differences in economic value computation and decision-making. Based on a review of recent neuroimaging studies investigating the neural representation of core values and their interactions with neural systems representing economic value, we outline a common framework that integrates the core value concept and neuroeconomic research on value-based decision-making. PMID:23898252
An increasing number of models have been developed to support global warming response policies. The model constructors are facing a lot of uncertainties which limit the evidence of these models. The support of climate policy decision-making is only possible in a semi-quantitative way, as presented by a Fuzzy model. The model design is based on an optimization approach, integrated in a bounded risk decision-making framework. Given some regional emission-related and impact-related restrictions, optimal emission paths can be calculated. The focus is not only on carbon dioxide but on other greenhouse gases too. In the paper, the components of the model will be described. Cost coefficients, emission boundaries and impact boundaries are represented as Fuzzy parameters. The Fuzzy model will be transformed into a computational one by using an approach of Rommelfanger. In the second part, some problems of applying the model to computations will be discussed. This includes discussions on the data situation and the presentation, as well as interpretation of results of sensitivity analyses. The advantage of the Fuzzy approach is that the requirements regarding data precision are not so strong. Hence, the effort for data acquisition can be reduced and computations can be started earlier. 9 figs., 3 tabs., 17 refs., 1 appendix
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.
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.
Raju, G K; Gurumurthi, Karthik; Domike, Reuben; Kazandjian, Dickran; Landgren, Ola; Blumenthal, Gideon M; Farrell, Ann; Pazdur, Richard; Woodcock, Janet
Drug regulators around the world make decisions about drug approvability based on qualitative benefit-risk analysis. In this work, a quantitative benefit-risk analysis approach captures regulatory decision-making about new drugs to treat multiple myeloma (MM). MM assessments have been based on endpoints such as time to progression (TTP), progression-free survival (PFS), and objective response rate (ORR) which are different than benefit-risk analysis based on overall survival (OS). Twenty-three FDA decisions on MM drugs submitted to FDA between 2003 and 2016 were identified and analyzed. The benefits and risks were quantified relative to comparators (typically the control arm of the clinical trial) to estimate whether the median benefit-risk was positive or negative. A sensitivity analysis was demonstrated using ixazomib to explore the magnitude of uncertainty. FDA approval decision outcomes were consistent and logical using this benefit-risk framework. © 2017 American Society for Clinical Pharmacology and Therapeutics.
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.
Full Text Available A recent line of work has found remarkable success in relating perceptual decision-making and the spiking activity in the macaque lateral intraparietal area (LIP. In this review, we focus on questions about the neural computations in LIP that are not answered by demonstrations of neural correlates of psychological processes. We highlight three areas of limitations in our current understanding of the precise neural computations that might underlie neural correlates of decisions: (1 empirical questions not yet answered by existing data; (2 implementation issues related to how neural circuits could actually implement the mechanisms suggested by both physiology and psychology; and (3 ecological constraints related to the use of well-controlled laboratory tasks and whether they provide an accurate window on sensorimotor computation. These issues motivate the adoption of a more general encoding-decoding framework that will be fruitful for more detailed contemplation of how neural computations in LIP relate to the formation of perceptual decisions.
Dambach, Donna M; Misner, Dinah; Brock, Mathew; Fullerton, Aaron; Proctor, William; Maher, Jonathan; Lee, Dong; Ford, Kevin; Diaz, Dolores
Discovery toxicology focuses on the identification of the most promising drug candidates through the development and implementation of lead optimization strategies and hypothesis-driven investigation of issues that enable rational and informed decision-making. The major goals are to [a] identify and progress the drug candidate with the best overall drug safety profile for a therapeutic area, [b] remove the most toxic drugs from the portfolio prior to entry into humans to reduce clinical attrition due to toxicity, and [c] establish a well-characterized hazard and translational risk profile to enable clinical trial designs. This is accomplished through a framework that balances the multiple considerations to identify a drug candidate with the overall best drug characteristics and provides a cogent understanding of mechanisms of toxicity. The framework components include establishing a target candidate profile for each program that defines the qualities of a successful candidate based on the intended therapeutic area, including the risk tolerance for liabilities; evaluating potential liabilities that may result from engaging the therapeutic target (pharmacology-mediated or on-target) and that are chemical structure-mediated (off-target); and characterizing identified liabilities. Lead optimization and investigation relies upon the integrated use of a variety of technologies and models (in silico, in vitro, and in vivo) that have achieved a sufficient level of qualification or validation to provide confidence in their use. We describe the strategic applications of various nonclinical models (established and new) for a holistic and integrated risk assessment that is used for rational decision-making. While this review focuses on strategies for small molecules, the overall concepts, approaches, and technologies are generally applicable to biotherapeutics.
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.
Gao, Juan; Tortell, Rebecca; McClelland, James L
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.
Examples of patients with anorexia nervosa, depression or borderline personality disorder who have decision-making capacity as currently operationalized, but refuse treatment, are discussed. It appears counterintuitive to respect their treatment refusal because their wish seems to be fuelled by their illness and the consequences of their refusal of treatment are severe. Some proposed solutions have focused on broadening the criteria for decision-making capacity, either in general or for specific patient groups, but these adjustments might discriminate against particular groups of patients and render the process less transparent. Other solutions focus on preferences expressed when patients are not ill, but this information is often not available. The reason for such difficulties with assessing decision-making capacity is that the underlying psychological processes of normal decision-making are not well known and one cannot differentiate between unwise decisions caused by an illness or other factors. The proposed alternative, set out in this paper, is to allow compulsory treatment of patients with decision-making capacity in cases of an emergency, if the refusal is potentially life threatening, but only for a time-limited period. The argument is also made for investigating hindsight agreement, in particular after compulsory measures.
J R, Alameda-Bailén; M P, Salguero-Alcañiz; A, Merchán-Clavellino; S, Paíno-Quesada
The relationship between the use of cannabis and the decision-making processes was explored. A computerized version of the Iowa Gambling Task (Cards Software) in its normal and reverse version was used, and the Prospect Valence Learning (PVL) model, which characterize the process of decision-making based on the parameters: Recency, Consistency, Loss aversion and Utility shape, was applied. Seventy-three cannabis consumers and a control group with 73 nonconsumers participated in the study. In the normal mode, subjects in the control group scored higher than cannabis consumers. Both groups showed consistent responses and aversion to loss. Nonconsumers showed greater influence of the gain-loss frequency, while consumers were more influenced by the magnitude of the gain-loss. The influence of immediate choices was higher among consumers who showed a quick oblivion while in the control group this process was more gradual. In the reverse mode, task performance was better among control group participants. Both groups showed consistency, loss aversion, more influenced by the magnitude of the gain-loss, and low influence of immediate elections. The results show the relationship between drug use and the decision-making processes, being consistent with the results obtained in other studies where consumers had worse results than control group. Moreover, the PVL parameters allow to adequately characterize decision-making. This confirms the relationship between drug use and decision-making by either the vulnerability prior to consumption or the neurotoxicity of drugs.
Crick, Francis; Koch, Christof
Here we summarize our present approach to the problem of consciousness. After an introduction outlining our general strategy, we describe what is meant by the term 'framework' and set it out under ten headings. This framework offers a coherent scheme for explaining the neural correlates of (visual) consciousness in terms of competing cellular assemblies. Most of the ideas we favor have been suggested before, but their combination is original. We also outline some general experimental approaches to the problem and, finally, acknowledge some relevant aspects of the brain that have been left out of the proposed framework.
Haralambopoulos, D.A.; Polatiidis, H. [UnIversity of the Aegean, Mytilene (Greece). Dept. of Environmental Studies
This paper describes an applicable group decision-making framework for assisting with multi-criteria analysis in renewable energy projects, utilizing the PROMETHEE II outranking method. The proposed framework is tested in a case study concerning the exploitation of a geothermal resource, located in the island of Chios, Greece. The presented structure provides a serial, decomposed agenda and enhances overall process transparency. Additional, innovatory elements are the incorporation of differing levels of resource exploitation within the decision framework and the direct determination of the PROMETHEE preference thresholds. The developed methodology provides a user-friendly approach, promotes the synergy between different actors, and could pave a way towards consensus. (Author)
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
Amy Rachel Bland
Full Text Available The study of uncertainty in decision making is receiving greater attention in the fields of cognitive and computational neuroscience. Several lines of evidence are beginning to elucidate different variants of uncertainty. Particularly, risk, ambiguity and expected and unexpected forms of uncertainty are well articulated in the literature. In this article we review both empirical and theoretical evidence arguing for the potential distinction between three forms of uncertainty; expected uncertainty, unexpected uncertainty and volatility. Particular attention will be devoted to exploring the distinction between unexpected uncertainty and volatility which has been less appreciated in the literature. This includes evidence from computational modelling, neuromodulation, neuroimaging and electrophysiological studies. We further address the possible differentiation of cognitive control mechanisms used to deal with these forms of uncertainty. Particularly we explore a role for conflict monitoring and the temporal integration of information into working memory. Finally, we explore whether the Dual Modes of Control theory provides a theoretical framework for understanding the distinction between unexpected uncertainty and volatility.
de Folter, Joost; Trusheim, Mark; Jonsson, Pall; Garner, Sarah
Value assessment frameworks have gained prominence recently in the context of U.S. healthcare. Such frameworks set out a series of factors that are considered in funding decisions. The UK's National Institute of Health and Care Excellence (NICE) is an established health technology assessment (HTA) agency. We present a novel application of text analysis that characterizes NICE's Technology Appraisals in the context of the newer assessment frameworks and present the results in a visual way. A total of 243 documents of NICE's medicines guidance from 2007 to 2016 were analyzed. Text analysis was used to identify a hierarchical set of decision factors considered in the assessments. The frequency of decision factors stated in the documents was determined and their association with terms related to uncertainty. The results were incorporated into visual representations of hierarchical factors. We identified 125 decision factors, and hierarchically grouped these into eight domains: Clinical Effectiveness, Cost Effectiveness, Condition, Current Practice, Clinical Need, New Treatment, Studies, and Other Factors. Textual analysis showed all domains appeared consistently in the guidance documents. Many factors were commonly associated with terms relating to uncertainty. A series of visual representations was created. This study reveals the complexity and consistency of NICE's decision-making processes and demonstrates that cost effectiveness is not the only decision-criteria. The study highlights the importance of processes and methodology that can take both quantitative and qualitative information into account. Visualizations can help effectively communicate this complex information during the decision-making process and subsequently to stakeholders.
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.
National Aeronautics and Space Administration — The DXC Framework is a collection of programs and APIs for running and evaluating diagnostic algorithms (DAs). It is complementary to system XML catalogs and...
Yaghi, Omar M.; Wan, Shun; Doonan, Christian J.; Wang, Bo; Deng, Hexiang
The disclosure relates generally to materials that comprise conductive covalent organic frameworks. The disclosure also relates to materials that are useful to store and separate gas molecules and sensors.
Afsarmanesh, H.; Camarinha-Matos, L.M.; Ermilova, E.; Camarinha-Matos, L.M.; Afsarmanesh, H.; Ollus, M.
Defining a comprehensive and generic "reference framework" for Virtual organizations Breeding Environments (VBEs), addressing all their features and characteristics, is challenging. While the definition and modeling of VBEs has become more formalized during the last five years, "reference models"
Zandifar, Mani; Thomas, Nathan; Amato, Nancy M.; Rauchwerger, Lawrence
from programmers and enables them to express parallel programs as a composition of existing elementary skeletons such as map, map-reduce, scan, zip, butterfly, allreduce, alltoall and user-defined custom skeletons. Skeletons in this framework
Brooks, Christopher; Lee, Edward A
.... The Pedigree Management and Assessment Framework (PMAF) enables the publisher of information to record standard pedigree, such as information about the source, manner of collection, and the chain of modification of that information...
Xu Zhixin; Xi Shuren; Qu Jingyuan
Protective actions such as evacuation, sheltering and iodine administration can be taken to mitigate the radiological consequence in the event of an accidental release. In general, decision-making of countermeasures involves both quantitative and qualitative criteria. The conventional approaches to assessing these criteria tend to be less effective when dealing with those qualitative criteria that are imprecise or vague. In this regard, fuzzy set method is an alternative tool. It can cope with vague assessment in a better way. This paper presents the application of fussy methodology to decision-making of protective actions in nuclear emergencies. In this method linguistic terms and fuzzy triangular numbers are used to represent decision-maker's subjective assessment for different decision criteria considered and decision alternatives versus the decision criteria. Following the assessment performed by specialists, corresponding evaluations can be synthesized and ranked. Finally, the optimal strategy for implementing protective actions can be recommended. (authors)
Medical decision-making involves choices, which can lead to benefits or to harms. Most benefits and harms may or may not occur, and can be minor or major when they do. Medical research, especially randomized controlled trials, provides estimates of chance of occurrence and magnitude of event. Because there is no universally accepted method for weighing harms against benefits, and because the ethical principle of autonomy mandates informed choice by patient, medical decision-making is inherently an individualized process. It follows that the practice of aiming for universal implementation of standardized guidelines is irrational and unethical. Irrational because the possibility of benefits is implicitly valued more than the possibility of comparable harms, and unethical because guidelines remove decision making from the patient and give it instead to a physician, committee or health care system. This essay considers the cases of cancer screening and diabetes management, where guidelines often advocate universal implementation, without regard to informed choice and individual decision-making.
Critical examination of the processes by which we as nurses judge and reach clinical decisions is important. It facilitates the maintenance and refinement of good standards of nursing care and the pinpointing of areas where improvement is needed. In turn this potentially could support broader validation of nurse expertise and contribute to emancipation of the nursing profession. As pure theory, clinical decision-making may appear abstract and alien to nurses struggling in 'the swampy lowlands' (Schon 1983) of the realities of practice. This paper explores some of the key concepts in decision-making theory by introducing, then integrating, them in a reflective case study. The case study, which examines a 'snapshot' of the patient and practitioner's journey, interwoven with theory surrounding clinical decision-making, may aid understanding and utility of concepts and theories in practice.
van Duijvenvoorde, Anna C K; Jansen, Brenda R J; Visser, Ingmar; Huizenga, Hilde M
Adolescents demonstrate impaired decision-making in emotionally arousing situations, yet they appear to exhibit relatively mature decision-making skills in predominantly cognitive, low-arousal situations. In this study we compared adolescents' (13-15 years) performance on matched affective and cognitive decision-making tasks, in order to determine (1) their performance level on each task and (2) whether performance on the cognitive task was associated with performance on the affective task. Both tasks required a comparison of choice dimensions characterized by frequency of loss, amount of loss, and constant gain. Results indicated that in the affective task, adolescents performed sub-optimally by considering only the frequency of loss, whereas in the cognitive task adolescents used relatively mature decision rules by considering two or all three choice dimensions. Performance on the affective task was not related to performance on the cognitive task. These results are discussed in light of neural developmental trajectories observed in adolescence.
Dobrajska, Magdalena; Billinger, Stephan; Becker, Markus C.
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...... 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....... 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...
Culbreth, Adam J; Moran, Erin K; Barch, Deanna M
Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.
García Ramírez, David
Memoria de la implementación de un software que permite la gestión y control de todo el framework que requiere gestionar el departamento de mejora continua (BEX Business Excelence). Memòria de la implementació d'un programari que permet la gestió i control de tot el framework que requereix gestionar el departament de millora contínua (BEX Business Excelence). Master thesis for the Free Software program.
This is a presentation of the The Gender Dimensions Framework (GDF). The GDF was developed to provide guidance to USAID staff and partner organizations for working with USAID projects looking at promoting equitable opportunities in agricultural value chains. The GDF contemplates four dimensions: access to and control over key productive assets (tangible and intangible); beliefs and perceptions; practices and participation, and legal frameworks. CCRA-7 (Gendered Knowledge)
Sovacool, Benjamin K.; Burke, Matthew; Baker, Lucy; Kotikalapudi, Chaitanya Kumar; Wlokas, Holle
This article explores how concepts from justice and ethics can inform energy decision-making and highlight the moral and equity dimensions of energy production and use. It defines “energy justice” as a global energy system that fairly distributes both the benefits and burdens of energy services, and one that contributes to more representative and inclusive energy decision-making. The primary contribution of the article is its focus on six new frontiers of future energy justice research. First is making the case for the involvement of non-Western justice theorists. Second is expanding beyond humans to look at the Rights of Nature or non-anthropocentric notions of justice. Third is focusing on cross-scalar issues of justice such as embodied emissions. Fourth is identifying business models and the co-benefits of justice. Fifth is better understanding the tradeoffs within energy justice principles. Sixth is exposing unjust discourses. In doing so, the article presents an agenda constituted by 30 research questions as well as an amended conceptual framework consisting of ten principles. The article argues in favor of “justice-aware” energy planning and policymaking, and it hopes that its (reconsidered) energy justice conceptual framework offers a critical tool to inform decision-making. - Highlights: • We need “justice-aware” energy policy. • A revised energy justice conceptual framework offers a critical tool to inform decision making. • New fields of inquiry for energy justice research and practice exist. • Tradeoffs and weighing competing justice claims occur in practice.
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.
Kim, Hyejin; Song, Mi-Kyung
Adults who lack decision-making capacity and a surrogate ("unbefriended" adults) are a vulnerable, voiceless population in health care. But little is known about this population, including how medical decisions are made for these individuals. This integrative review was to examine what is known about unbefriended adults and identify gaps in the literature. Six electronic databases were searched using 4 keywords: "unbefriended," "unrepresented patients," "adult orphans," and "incapacitated patients without surrogates." After screening, the final sample included 10 data-based articles for synthesis. Main findings include the following: (1) various terms were used to refer to adults who lack decision-making capacity and a surrogate; (2) the number of unbefriended adults was sizable and likely to grow; (3) approaches to medical decision-making for this population in health-care settings varied; and (4) professional guidelines and laws to address the issues related to this population were inconsistent. There have been no studies regarding the quality of medical decision-making and its outcomes for this population or societal impact. Extremely limited empirical data exist on unbefriended adults to develop strategies to improve how medical decisions are made for this population. There is an urgent need for research to examine the quality of medical decision-making and its outcomes for this vulnerable population.
Doerge, J B
Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared
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 non-conflict (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 non-conflict trials elicited greater activation within bilateral anterior cingulate cortex (ACC), anterior insula, and caudate, as well as right dorsolateral prefrontal cortex. 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 is related to individual differences in approach-avoidance decision-making. Therefore, the AAC paradigm is ideally suited to probe anxiety-related processing differences during approach-avoidance decision-making. PMID:25224633
Full Text Available The bipolar neutrosophic set is an important extension of the bipolar fuzzy set. The bipolar neutrosophic set is a hybridization of the bipolar fuzzy set and neutrosophic set. Every element of a bipolar neutrosophic set consists of three independent positive membership functions and three independent negative membership functions. In this paper, we develop cross entropy measures of bipolar neutrosophic sets and prove their basic properties. We also define cross entropy measures of interval bipolar neutrosophic sets and prove their basic properties. Thereafter, we develop two novel multi-attribute decision-making strategies based on the proposed cross entropy measures. In the decision-making framework, we calculate the weighted cross entropy measures between each alternative and the ideal alternative to rank the alternatives and choose the best one. We solve two illustrative examples of multi-attribute decision-making problems and compare the obtained result with the results of other existing strategies to show the applicability and effectiveness of the developed strategies. At the end, the main conclusion and future scope of research are summarized.
The scientific journal Nature, published weekly since 1869, serves as an excellent case study in visual communication. While journals are becoming increasingly specialist, Nature remains firmly multidisciplinary; and unlike many scientific journals, it contains original journalism, opinion pieces, and expert analysis in addition to peer-reviewed research papers. This variety of content types-covering an extensive range of scientific disciplines-translates into a wide and varied audience, and the need to employ an equally wide variety of communication styles.For example, a research paper may employ technical language to communicate to a highly specialized audience in that field, whereas a news story on the same subject will explain the science to an educated lay audience, often adding a wider context and stripping out acronyms. Each type of piece will use a communication approach tailored for its intended audience.This is true for visual content as well: the intended audience of a scientific figure, illustration or data visualization will determine the design approach to that visual. At Nature, given the high volume of content plus high quality standards, this process is applied in a fairly systematic way, using a framework to guide creative decision-making. That framework is described here, along with a discussion of best practices for the design of research figures and graphics by context. © The Author(s) 2016.
Full Text Available Background The aim of newborn bloodspot screening (NBS is to identify rare genetic and non-genetic conditions in children soon after birth in order to commence therapies that prevent the development of progressive, serious, and irreversible disabilities. Universal NBS programmes have been implemented in most countries, with minor adaptations to target conditions most relevant to the local healthcare environment. Aims In this article, we describe the initiatives of international and Australian governments to develop policies to address the expansion of NBS in their healthcare systems. Methods We have reviewed published public policies and literature to formulate recommendations based on clinical, social, legal, and ethical principles to inform a national governance and policy framework for Australia. Results Australian policy makers have been slow to develop a coordinated plan. While the experience from other governments can guide our national policy, there are specific areas that require further consideration by Australian health experts. Key reforms involve the separation of policy and operational activities, multidisciplinary decision-making and oversight by the Australian Health Ministers’ Advisory Council for policy direction. Conclusion A formal national policy framework will guide the coordination of NBS services that can adapt to the needs of Australian children and families.
Glasdam, Stinne; Oeye, Christine; Thrysøe, Lars
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...
Auchter, Allison M; Hernandez Mejia, Margie; Heyser, Charles J; Shilling, Paul D; Jernigan, Terry L; Brown, Sandra A; Tapert, Susan F; Dowling, Gayathri J
The Adolescent Brain Cognitive Development (ABCD) study is designed to be the largest study of brain development and child health in the United States, performing comprehensive assessments of 11,500 children repeatedly for 10 years. An endeavor of this magnitude requires an organized framework of governance and communication that promotes collaborative decision-making and dissemination of information. The ABCD consortium structure, built upon the Matrix Management approach of organizational theory, facilitates the integration of input from all institutions, numerous internal workgroups and committees, federal partners, and external advisory groups to make use of a broad range of expertise to ensure the study's success. Copyright © 2018 Elsevier Ltd. All rights reserved.
Jacobs, J.H.; Etman, L.F.P.; Keulen, van F.; Rooda, J.E.
An object-oriented framework for Sequential Approximate Optimization (SAO) isproposed. The framework aims to provide an open environment for thespecification and implementation of SAO strategies. The framework is based onthe Python programming language and contains a toolbox of Python
Holloway, Rachel; Rasmussen, Sonja A; Zaza, Stephanie; Cox, Nancy J; Jernigan, Daniel B
The complexities of planning for and responding to the emergence of novel influenza viruses emphasize the need for systematic frameworks to describe the progression of the event; weigh the risk of emergence and potential public health impact; evaluate transmissibility, antiviral resistance, and severity; and make decisions about interventions. On the basis of experience from recent influenza responses, CDC has updated its framework to describe influenza pandemic progression using six intervals (two prepandemic and four pandemic intervals) and eight domains. This updated framework can be used for influenza pandemic planning and serves as recommendations for risk assessment, decision-making, and action in the United States. The updated framework replaces the U.S. federal government stages from the 2006 implementation plan for the National Strategy for Pandemic Influenza (US Homeland Security Council. National strategy for pandemic influenza: implementation plan. Washington, DC: US Homeland Security Council; 2006. Available at http://www.flu.gov/planning-preparedness/federal/pandemic-influenza-implementation.pdf). The six intervals of the updated framework are as follows: 1) investigation of cases of novel influenza, 2) recognition of increased potential for ongoing transmission, 3) initiation of a pandemic wave, 4) acceleration of a pandemic wave, 5) deceleration of a pandemic wave, and 6) preparation for future pandemic waves. The following eight domains are used to organize response efforts within each interval: incident management, surveillance and epidemiology, laboratory, community mitigation, medical care and countermeasures, vaccine, risk communications, and state/local coordination. Compared with the previous U.S. government stages, this updated framework provides greater detail and clarity regarding the potential timing of key decisions and actions aimed at slowing the spread and mitigating the impact of an emerging pandemic. Use of this updated framework is
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
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
Stum, Marlene S
This study proposes and tests a systemic family decision-making framework to understand group long-term care insurance (LTCI) enrollment decisions. A random sample of public employees who were offered group LTCI as a workplace benefit were examined. Findings reveal very good predictive efficacy for the overall conceptual framework with a pseudo R2 value of .687, and reinforced the contributions of factors within the family system. Enrollees were more likely to have discussed the decision with others, used information sources, and had prior experience when compared to non-enrollees. Perceived health status, financial knowledge, attitudes regarding the role of private insurance, risk taking, and coverage features were additional factors related to enrollment decisions. The findings help to inform policymakers about the potential of LTCI as one strategy for financing long-term care.
Eroğlu Başak; Özkan Zekiye; Eroğlu Arif Kaan; Bilgin Şakire
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 ...
Green, C; Kowalkowski, J; Paterno, M; Fischler, M; Garren, L; Lu, Q
Future “Intensity Frontier” experiments at Fermilab are likely to be conducted by smaller collaborations, with fewer scientists, than is the case for recent “Energy Frontier” experiments. art is a C++ event-processing framework designed with the needs of such experiments in mind. An evolution from the framework of the CMS experiment, art was designed and implemented to be usable by multiple experiments without imposing undue maintenance effort requirements on either the art developers or experiments using it. We describe the key requirements and features of art and the rationale behind evolutionary changes, additions and simplifications with respect to the CMS framework. In addition, our package distribution system and our collaborative model with respect to the multiple experiments using art helps keep the maintenance burden low. We also describe in-progress and future enhancements to the framework, including strategies we are using to allow multi-threaded use of the art framework in today's multi- and many-core environments.
James, B.R.; Gwo, J.P.; Toran, L.E.
Reducing cost is a critical challenge facing environmental remediation today. One of the most effective ways of reducing costs is to improve decision-making. This can range from choosing more cost- effective remediation alternatives (for example, determining whether a groundwater contamination plume should be remediated or not) to improving data collection (for example, determining when data collection should stoop). Uncertainty in site conditions presents a major challenge for effective decision-making. We present a framework for increasing the effectiveness of remedial design decision-making at groundwater contamination sites where there is uncertainty in many parameters that affect remediation design. The objective is to provide an easy-to-use economic framework for making remediation decisions. The presented framework is used to 1) select the best remedial design from a suite of possible ones, 2) estimate if additional data collection is cost-effective, and 3) determine the most important parameters to be sampled. The framework is developed by combining elements from Latin-Hypercube simulation of contaminant transport, economic risk-cost-benefit analysis, and Regional Sensitivity Analysis (RSA)
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
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
In this work, motivated by the need to coordinate transmission maintenance scheduling among a multiplicity of self-interested entities in restructured power industry, a distributed decision support framework based on multiagent negotiation systems (MANS) is developed. An innovative risk-based transmission maintenance optimization procedure is introduced. Several models for linking condition monitoring information to the equipment's instantaneous failure probability are presented, which enable quantitative evaluation of the effectiveness of maintenance activities in terms of system cumulative risk reduction. Methodologies of statistical processing, equipment deterioration evaluation and time-dependent failure probability calculation are also described. A novel framework capable of facilitating distributed decision-making through multiagent negotiation is developed. A multiagent negotiation model is developed and illustrated that accounts for uncertainty and enables social rationality. Some issues of multiagent negotiation convergence and scalability are discussed. The relationships between agent-based negotiation and auction systems are also identified. A four-step MAS design methodology for constructing multiagent systems for power system applications is presented. A generic multiagent negotiation system, capable of inter-agent communication and distributed decision support through inter-agent negotiations, is implemented. A multiagent system framework for facilitating the automated integration of condition monitoring information and maintenance scheduling for power transformers is developed. Simulations of multiagent negotiation-based maintenance scheduling among several independent utilities are provided. It is shown to be a viable alternative solution paradigm to the traditional centralized optimization approach in today's deregulated environment. This multiagent system framework not only facilitates the decision-making among competing power system entities, but