WorldWideScience

Sample records for exploration decision making

  1. Exploring the Reshoring and Insourcing Decision Making Process

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  2. Exploring group decision making in a power-to-take experiment

    NARCIS (Netherlands)

    Bosman, R.A.J.; Hennig-Schmidt, H.; van Winden, F.A.A.M.

    2006-01-01

    Most studies that compare individual and group behavior neglect the in-group decision making process. This paper explores the decision making process within groups in a strategic setting: a two player power-to-take experiment. Discussions preceding group decisions are video taped and analyzed. We

  3. Information source exploitation/exploration and NPD decision-making

    DEFF Research Database (Denmark)

    Jespersen, Kristina Risom

    different Scandinavian companies. Data was analyzed using hierarchical regression models across decision criteria dimensions and NPD stages as well as analyzing the combination of selected information sources. Rather than forwarding one optimal search behavior for the entire NPD process, we find optimal...... information search behavior at either end of the exploitation/exploration continuum. Additionally, we find that overexploitation and overexploration is caused by managerial bias. This creates managerial misbehavior at gate decision-points of the NPD process.......The purpose of this study is to examine how the exploration/exploitation continuum is applied by decision-makers in new product gate decision-making. Specifically, we analyze at gate decision-points how the evaluation of a new product project is affected by the information source exploitation...

  4. Assessment of New Approaches in Geothermal Exploration Decision Making: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Akar, S.; Young, K. R.

    2015-02-01

    Geothermal exploration projects have significant amount of risk associated with uncertainties encountered in the discovery of the geothermal resource. Understanding when and how to proceed in an exploration program, and when to walk away from a site, are two of the largest challenges for increased geothermal deployment. Current methodologies for exploration decision making is left to subjective by subjective expert opinion which can be incorrectly biased by expertise (e.g. geochemistry, geophysics), geographic location of focus, and the assumed conceptual model. The aim of this project is to develop a methodology for more objective geothermal exploration decision making at a given location, including go-no-go decision points to help developers and investors decide when to give up on a location. In this scope, two different approaches are investigated: 1) value of information analysis (VOIA) which is used for evaluating and quantifying the value of a data before they are purchased, and 2) enthalpy-based exploration targeting based on reservoir size, temperature gradient estimates, and internal rate of return (IRR). The first approach, VOIA, aims to identify the value of a particular data when making decisions with an uncertain outcome. This approach targets the pre-drilling phase of exploration. These estimated VOIs are highly affected by the size of the project and still have a high degree of subjectivity in assignment of probabilities. The second approach, exploration targeting, is focused on decision making during the drilling phase. It starts with a basic geothermal project definition that includes target and minimum required production capacity and initial budgeting for exploration phases. Then, it uses average temperature gradient, reservoir temperature estimates, and production capacity to define targets and go/no-go limits. The decision analysis in this approach is based on achieving a minimum IRR at each phase of the project. This second approach was

  5. Reducing Subjectivity in Geothermal Exploration Decision Making (Presentation); NREL(National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Akar, S.; Young, K.

    2015-01-01

    Geothermal exploration projects have a significant amount of risk associated with uncertainties encountered in the discovery of the geothermal resource. Two of the largest challenges for increased geothermal deployment are 1) understanding when and how to proceed in an exploration program, and 2) when to walk away from a site. Current methodologies for exploration decision-making are formulatedby subjective expert opinion which can be incorrectly biased by expertise (e.g. geochemistry, geophysics), geographic location of focus, and the assumed conceptual model. The aim of this project is to develop a methodology for more objective geothermal exploration decision making at a given location, including go/no-go decision points to help developers and investors decide when to give up on alocation. In this scope, two different approaches are investigated: 1) value of information analysis (VOIA) which is used for evaluating and quantifying the value of a data before they are purchased, and 2) enthalpy-based exploration targeting based on reservoir size, temperature gradient estimates, and internal rate of return (IRR). The first approach, VOIA, aims to identify the value of aparticular data when making decisions with an uncertain outcome. This approach targets the pre-drilling phase of exploration. These estimated VOIs are highly affected by the size of the project and still have a high degree of subjectivity in assignment of probabilities. The second approach, exploration targeting, is focused on decision making during the drilling phase. It starts with a basicgeothermal project definition that includes target and minimum required production capacity and initial budgeting for exploration phases. Then, it uses average temperature gradient, reservoir temperature estimates, and production capacity to define targets and go/no-go limits. The decision analysis in this approach is based on achieving a minimum IRR at each phase of the project. This secondapproach was determined

  6. Exploring Teachers' Curriculum Decision Making: Insights from History Education

    Science.gov (United States)

    Harris, Richard; Reynolds, Rosemary

    2018-01-01

    This paper explores teachers' decision making by examining the topics that 11 history teachers from 10 schools in England chose to teach and how they approached teaching these topics. Data were gathered from curriculum documents and semi-structured interviews in which teachers' topic choices and approaches to history were explored. Most teachers…

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

    Science.gov (United States)

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

    1991-09-01

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

  8. Exploring the link between environmental identity, behaviors and decision making

    Science.gov (United States)

    Freed, Allison

    This study was conducted with undergraduate students at a large university to investigate the association between environmental identity, pro-environmental behaviors and environmental decision-making. This study explored how environmental identity as defined by Clayton (2003) influenced the type of pro-environmental behaviors individuals choose to participate in. Environmental decision-making based on Kahneman's (2003, 2011) System 1 and System 2 framework was also assessed in association with environmental identity. A survey including the Environmental Identity Survey (Clayton, 2003), the Environmentally Responsible Behaviors Index (Smith-Sebasto & D'Acosta, 1995), and a Decision Making Questionnaire were administered. After administering the surveys, eight participants were chosen for a 60-minute interview. The quantitative results of the study showed there was a significant relationship between environmental identity and participating in environmental behaviors more often. There was also a significant relation between environmental identity and making the decision to recycle in a fast and automatic way. The interview results showed that participants with both a strong and a weak environmental identity recycled often and thought it was a fast decision. The results of this study show that certain components of environmental identity are important, but other factors like the physical environment and social norms influence the thinking that goes into recycling more than environmental identity alone. This study provides evidence of the importance of social norms and environmental structures in fostering pro-environmental behaviors and influencing the type of thinking that goes into making environmental decisions. Keywords: environmental identity, environmental behaviors, System 1, System 2, recycling.

  9. A Qualitative Exploration of Clinician Views and Experiences of Treatment Decision-Making in Bipolar II Disorder.

    Science.gov (United States)

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

    2017-11-01

    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.

  10. Consumer Decision-Making Styles and Local Brand Biasness: Exploration in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Wanninayake W.M.C.Bandara

    2014-03-01

    Full Text Available The modern marketer shows a growing interest in the research of consumer decision-making styles to understand how an individual makes his/her buying decisions in the competitive environment. This concept is important because it determines the behavioral patterns of consumers and is relevant for market segmentation. Most of the previous researchers have adapted to Consumer Style Inventory (CSI introduced by Sproles and Kendall in 1986 as a common tool for assessing the decision-making styles of customers. Though researchers have validated CSI in different cultural and social contexts, very limited studies were carried out to explore the relationship between consumer decision-making styles and their domestic brand biasness. Therefore, the present study mainly focuses on exploring the impact of consumer decision-making styles on their preference towards domestic brands in the context of the Czech Republic. The sample for this study was drawn from adult customers who live in the Brno, Zlín, and Olomouc regions in the Czech Republic. A group of students from the Bachelor’s degree programme in Management and Economics, Tomas Bata University in Zlín were selected as enumerators for data collection. Altogether 200 questionnaires were distributed and 123 completed questionnaires were taken in for final analysis. The decision- making styles were measured using Sproles and Kendall’s (1986 CSI instrument. Cronbach’s Alpha values of each construct confirmed that there is a good interring reliability associated with the data. Principle Component Analysis was employed to determine the decision-making styles of Czech customers and the one-way ANOVA was used for testing hypotheses. The findings revealed that seven decision-making styles are appeared among Czech customers and fashion consciousness, recreational orientation, impulsiveness, and price consciousness of customers show a direct relationship with the domestic brand biasness. Other styles did not

  11. Variation in decision making

    NARCIS (Netherlands)

    Dall, Sasha R. X.; Gosling, Samuel; Gordon D.A., Brown,; Dingemanse, Niels; Ido, Erev,; Martin, Kocher,; Laura, Schulz,; Todd, Peter M; Weissing, Franz; Wolf, Max; Hammerstein, Peter; Stevens, Jeffrey R.

    2012-01-01

    Variation in how organisms allocate their behavior over their lifetimes is key to determining Darwinian fitness., and thus the evolution of human and nonhuman decision making. This chapter explores how decision making varies across biologically and societally significant scales and what role such

  12. Neural and sympathetic activity associated with exploration in decision-making: Further evidence for involvement of insula

    Directory of Open Access Journals (Sweden)

    Hideki eOhira

    2014-11-01

    Full Text Available We previously reported that sympathetic activity was associated with exploration in decision-making indexed by entropy, which is a concept in information theory and indexes randomness of choices or the degree of deviation from sticking to recent experiences of gains and losses, and that activation of the anterior insula mediated this association. The current study aims to replicate and to expand these findings in a situation where contingency between options and outcomes is manipulated. Sixteen participants performed a stochastic decision-making task in which we manipulated a condition with low uncertainty of gain/loss (contingent-reward condition and a condition with high uncertainty of gain/loss (random-reward condition. Regional cerebral blood flow was measured by 15O-water positron emission tomography (PET, and cardiovascular parameters and catecholamine in the peripheral blood were measured, during the task. In the contingent-reward condition, norepinephrine as an index of sympathetic activity was positively correlated with entropy indicating exploration in decision-making. Norepinephrine was negatively correlated with neural activity in the right posterior insula, rostral anterior cingulate cortex, and dorsal pons, suggesting neural bases for detecting changes of bodily states. Furthermore, right anterior insular activity was negatively correlated with entropy, suggesting influences on exploration in decision-making. By contrast, in the random-reward condition, entropy correlated with activity in the dorsolateral prefrontal and parietal cortices but not with sympathetic activity. These findings suggest that influences of sympathetic activity on exploration in decision-making and its underlying neural mechanisms might be dependent on the degree of uncertainty of situations.

  13. Ethical decision-making, passivity and pharmacy

    OpenAIRE

    Cooper, R.J.; Bissell, P.; Wingfield, J.

    2008-01-01

    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...

  14. WeightLifter: Visual Weight Space Exploration for Multi-Criteria Decision Making.

    Science.gov (United States)

    Pajer, Stephan; Streit, Marc; Torsney-Weir, Thomas; Spechtenhauser, Florian; Muller, Torsten; Piringer, Harald

    2017-01-01

    A common strategy in Multi-Criteria Decision Making (MCDM) is to rank alternative solutions by weighted summary scores. Weights, however, are often abstract to the decision maker and can only be set by vague intuition. While previous work supports a point-wise exploration of weight spaces, we argue that MCDM can benefit from a regional and global visual analysis of weight spaces. Our main contribution is WeightLifter, a novel interactive visualization technique for weight-based MCDM that facilitates the exploration of weight spaces with up to ten criteria. Our technique enables users to better understand the sensitivity of a decision to changes of weights, to efficiently localize weight regions where a given solution ranks high, and to filter out solutions which do not rank high enough for any plausible combination of weights. We provide a comprehensive requirement analysis for weight-based MCDM and describe an interactive workflow that meets these requirements. For evaluation, we describe a usage scenario of WeightLifter in automotive engineering and report qualitative feedback from users of a deployed version as well as preliminary feedback from decision makers in multiple domains. This feedback confirms that WeightLifter increases both the efficiency of weight-based MCDM and the awareness of uncertainty in the ultimate decisions.

  15. Fast, faster, poorest decisions?: A practical theological exploration of the role of a speedy mobinomic world in decision-making

    Directory of Open Access Journals (Sweden)

    Jan Albert van den Berg

    2014-07-01

    Full Text Available In a digital world, it seems as if the boundaries between rich and poor are becoming increasingly blurred. A mobinomic world is created through the use of cellular telephones, which plays an important role on multiple levels of socioeconomic understanding. Various advantages are created through the interplay between the power of mobility and the convergence of various forms of media. Considering the immediate accessibility of an overflow of data in various forms as well as time pressure, decision-making is increasingly becoming associated with living in the fast lane of the digital world. Unfortunately, the cost of faster decision-making is that it could potentially result in individuals making poor decisions on various levels. A practical-theological exploration, as embedded in a transversal rational engagement, entails a preliminary investigation and description of this digital reality, especially as portrayed in the dynamics of decision-making associated with the social media platform Twitter.

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

    Science.gov (United States)

    Brotherton, Ailsa; Abbott, Janice

    2012-05-01

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

  17. Frontopolar cortex and decision-making efficiency: comparing brain activity of experts with different professional background during an exploration-exploitation task

    Directory of Open Access Journals (Sweden)

    Daniella eLaureiro-Martínez

    2014-01-01

    Full Text Available An optimal balance between efficient exploitation of available resources and creative exploration of alternatives is critical for adaptation and survival. Previous studies associated these behavioral drives with, respectively, the dopaminergic mesocorticolimbic system and frontopolar-intraparietal networks. We study the activation of these systems in two age and gender-matched groups of experienced decision-makers differing in prior professional background, with the aim to understand the neural bases of individual differences in decision-making efficiency (performance divided by response time. We compare brain activity of entrepreneurs (who currently manage the organization they founded based on their venture idea and managers (who are constantly involved in making strategic decisions but have no venture experience engaged in a gambling-task assessing exploitative vs. explorative decision-making. Compared with managers, entrepreneurs showed higher decision-making efficiency, and a stronger activation in regions of frontopolar cortex previously associated with explorative choice. Moreover, activity across a network of regions previously linked to explore/exploit tradeoffs explained individual differences in choice efficiency. These results suggest new avenues for the study of individual differences in the neural antecedents of efficient decision-making.

  18. Moral and Ethical Decision Making: Literature Review

    Science.gov (United States)

    2005-08-08

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

  19. An exploration of clinical decision making in mental health triage.

    Science.gov (United States)

    Sands, Natisha

    2009-08-01

    Mental health (MH) triage is a specialist area of clinical nursing practice that involves complex decision making. The discussion in this article draws on the findings of a Ph.D. study that involved a statewide investigation of the scope of MH triage nursing practice in Victoria, Australia. Although the original Ph.D. study investigated a number of core practices in MH triage, the focus of the discussion in this article is specifically on the findings related to clinical decision making in MH triage, which have not previously been published. The study employed an exploratory descriptive research design that used mixed data collection methods including a survey questionnaire (n = 139) and semistructured interviews (n = 21). The study findings related to decision making revealed a lack of empirically tested evidence-based decision-making frameworks currently in use to support MH triage nursing practice. MH triage clinicians in Australia rely heavily on clinical experience to underpin decision making and have little of knowledge of theoretical models for practice, such as methodologies for rating urgency. A key recommendation arising from the study is the need to develop evidence-based decision-making frameworks such as clinical guidelines to inform and support MH triage clinical decision making.

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

    Science.gov (United States)

    Dando, Coral J; Ormerod, Thomas C

    2017-12-01

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

  1. Mothering with an Intellectual Disability: A Phenomenological Exploration of Making Infant-Feeding Decisions

    Science.gov (United States)

    Guay, Amanda; Aunos, Marjorie; Collin-Vézina, Delphine

    2017-01-01

    Background: Mothers with intellectual disability are less likely than mothers without intellectual disability to breastfeed their infants, but there is little literature that addresses infant-feeding decisions among this population. This study explores experiences of mothers with intellectual disability in making and carrying out infant-feeding…

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

    Science.gov (United States)

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

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

  3. Competence and Quality in Real-Life Decision Making

    Science.gov (United States)

    2015-01-01

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

  4. THE MAKING OF DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Leonardo Yuji Tamura

    2016-04-01

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

  5. Hospice decision making: diagnosis makes a difference.

    Science.gov (United States)

    Waldrop, Deborah P; Meeker, Mary Ann

    2012-10-01

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

  6. The Relationship of Career Decision-Making Self-Efficacy, Vocational Identity, and Career Exploration Behavior in African American High School Students

    Science.gov (United States)

    Gushue, George V.; Scanlan, Kolone R. L.; Pantzer, Karen M.; Clarke, Christine P.

    2006-01-01

    This study explores the relationship between the social cognitive construct of career decision-making self-efficacy and the outcome variables of vocational identity and career exploration behaviors in a sample of 72 urban African American high school students. The results indicate that higher levels of career decision-making self-efficacy are…

  7. Exploring the relation between evidence and decision-making A political-administrative approach to health impact assessment

    International Nuclear Information System (INIS)

    Bekker, Marleen P.M.; Putters, Kim; Grinten, Tom E.D. van der

    2004-01-01

    Like any policy-relevant research, HIA faces the risk of not being used by decisions-makers. This article addresses the questions: 'How do policy decisions come about?' and 'How does this affect HIA?' Current literature in political-administrative sciences identifies three ways for decision-making: rational, incremental and mixed model. These models define the relationship between the policy process at stake and the HIA. In incremental or mixed model decision-making, use of HIA evidence by policy-makers is heavily dependent on their values in the context, which may result in conceptual utilization or may extend to strategic utilization. In rational decision-making, HIA provides information independent from the context, which results in instrumental utilization. HIA practitioners need to optimise utilization and produce an appropriate HIA by mapping the policy process. They can do this by asking the questions 'What? How? Who? and What context? and by maintaining continuous communication with the decision-makers. An appropriate HIA is policy-, time- and place-specific: reflecting the decision-making of the policy at stake. Furthermore, HIA concerns two policy fields with two different contexts and, in some cases, two different decision-making models. The administrative requirements for an appropriate HIA need further exploration

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

    Science.gov (United States)

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

    2018-02-01

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

  9. Exploring cognitive bias in destination therapy left ventricular assist device decision making: A retrospective qualitative framework analysis.

    Science.gov (United States)

    Magid, Molly; McIlvennan, Colleen K; Jones, Jaqueline; Nowels, Carolyn T; Allen, Larry A; Thompson, Jocelyn S; Matlock, Dan

    2016-10-01

    Cognitive biases are psychological influences, which cause humans to make decisions, which do not seemingly maximize utility. For people with heart failure, the left ventricular assist device (LVAD) is a surgically implantable device with complex tradeoffs. As such, it represents an excellent model within which to explore cognitive bias in a real-world decision. We conducted a framework analysis to examine for evidence of cognitive bias among people deciding whether or not to get an LVAD. The aim of this study was to explore the influence of cognitive bias on the LVAD decision-making process. We analyzed previously conducted interviews of patients who had either accepted or declined an LVAD using a deductive, predetermined framework of cognitive biases. We coded and analyzed the interviews using an inductive-deductive framework approach, which also allowed for other themes to emerge. We interviewed a total of 22 heart failure patients who had gone through destination therapy LVAD decision making (15 who had accepted the LVAD and 7 who had declined). All patients appeared influenced by state dependence, where both groups described high current state of suffering, but the groups differed in whether they believed LVAD would relieve suffering or not. We found evidence of cognitive bias that appeared to influence decision making in both patient groups, but groups differed in terms of which cognitive biases were present. Among accepters, we found evidence of anchoring bias, availability bias, optimism bias, and affective forecasting. Among decliners, we found evidence of errors in affective forecasting. Medical decision making is often a complicated and multifaceted process that includes cognitive bias as well as other influences. It is important for clinicians to recognize that patients can be affected by cognitive bias, so they can better understand and improve the decision-making process to ensure that patients are fully informed. Published by Elsevier Inc.

  10. Entrepreneurs` Cognitive and Decision Making Styles

    Directory of Open Access Journals (Sweden)

    Mahmoud Motvaseli

    2015-12-01

    Full Text Available The main purpose of this study is to explore the relation between decision-making styles which are measured by the General decision-making style (GDMS test and information processing styles which are often termed cognitive styles and are, in this study, measured by Cognitive Style Inventory. The authors directed a survey research on 162 Iranian students. Structural equation modeling techniques were used to measure the impact of cognitive styles on decision-making styles. The authors found that cognitive styles have a positive impact on decision-making styles. In spite of the abundant research on factors that affect decision-making styles, few researches have tested the relationship between cognitive styles and decision-making styles. This study examines the impact of cognitive styles on decision-making styles in Iran. This study, like most research paper studies, cannot easily be generalized. Furthermore, the results of this study could be affected by economic conditions.

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

    Science.gov (United States)

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

    2016-09-01

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

  12. Climate change decision-making: Model & parameter uncertainties explored

    Energy Technology Data Exchange (ETDEWEB)

    Dowlatabadi, H.; Kandlikar, M.; Linville, C.

    1995-12-31

    A critical aspect of climate change decision-making is uncertainties in current understanding of the socioeconomic, climatic and biogeochemical processes involved. Decision-making processes are much better informed if these uncertainties are characterized and their implications understood. Quantitative analysis of these uncertainties serve to inform decision makers about the likely outcome of policy initiatives, and help set priorities for research so that outcome ambiguities faced by the decision-makers are reduced. A family of integrated assessment models of climate change have been developed at Carnegie Mellon. These models are distinguished from other integrated assessment efforts in that they were designed from the outset to characterize and propagate parameter, model, value, and decision-rule uncertainties. The most recent of these models is ICAM 2.1. This model includes representation of the processes of demographics, economic activity, emissions, atmospheric chemistry, climate and sea level change and impacts from these changes and policies for emissions mitigation, and adaptation to change. The model has over 800 objects of which about one half are used to represent uncertainty. In this paper we show, that when considering parameter uncertainties, the relative contribution of climatic uncertainties are most important, followed by uncertainties in damage calculations, economic uncertainties and direct aerosol forcing uncertainties. When considering model structure uncertainties we find that the choice of policy is often dominated by model structure choice, rather than parameter uncertainties.

  13. Decision-making impairment in anorexia nervosa: New insights into the role of age and decision-making style.

    Science.gov (United States)

    Giannunzio, Valeria; Degortes, Daniela; Tenconi, Elena; Collantoni, Enrico; Solmi, Marco; Santonastaso, Paolo; Favaro, Angela

    2018-07-01

    Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

  14. Decision Analysis Methods Used to Make Appropriate Investments in Human Exploration Capabilities and Technologies

    Science.gov (United States)

    Williams-Byrd, Julie; Arney, Dale C.; Hay, Jason; Reeves, John D.; Craig, Douglas

    2016-01-01

    NASA is transforming human spaceflight. The Agency is shifting from an exploration-based program with human activities in low Earth orbit (LEO) and targeted robotic missions in deep space to a more sustainable and integrated pioneering approach. Through pioneering, NASA seeks to address national goals to develop the capacity for people to work, learn, operate, live, and thrive safely beyond Earth for extended periods of time. However, pioneering space involves daunting technical challenges of transportation, maintaining health, and enabling crew productivity for long durations in remote, hostile, and alien environments. Prudent investments in capability and technology developments, based on mission need, are critical for enabling a campaign of human exploration missions. There are a wide variety of capabilities and technologies that could enable these missions, so it is a major challenge for NASA's Human Exploration and Operations Mission Directorate (HEOMD) to make knowledgeable portfolio decisions. It is critical for this pioneering initiative that these investment decisions are informed with a prioritization process that is robust and defensible. It is NASA's role to invest in targeted technologies and capabilities that would enable exploration missions even though specific requirements have not been identified. To inform these investments decisions, NASA's HEOMD has supported a variety of analysis activities that prioritize capabilities and technologies. These activities are often based on input from subject matter experts within the NASA community who understand the technical challenges of enabling human exploration missions. This paper will review a variety of processes and methods that NASA has used to prioritize and rank capabilities and technologies applicable to human space exploration. The paper will show the similarities in the various processes and showcase instances were customer specified priorities force modifications to the process. Specifically

  15. Affective Biases and Heuristics in Decision Making : Emotion regulation as a factor for decision making competence

    OpenAIRE

    Hagman, William

    2013-01-01

    Stanovich and West (2008) explored if measures of cognitive ability ignored some important aspects of thinking itself, namely that cognitive ability alone is not enough to generally prevent biased thinking. In this thesis a series of decision making (DM) tasks is tested to see if emotion regulation (ER) is a factor for the decision process and therefore should be a measured in decision making competence. A set of DM tasks was compiled involving both affective and cognitive dimensions. 400 par...

  16. 'It's just the normal thing to do': exploring parental decision-making about the 'five-in-one' vaccine.

    Science.gov (United States)

    Tickner, Sarah; Leman, Patrick J; Woodcock, Alison

    2007-10-16

    This qualitative study explored parental decision-making about the DTaP/IPV/Hib 'five-in-one' vaccine. Semi-structured interviews were conducted with 22 parents of babies aged between 4 and 13 weeks old, recruited from four practices in southern England. A modified Grounded Theory approach identified that although parents had some concerns, most complied with the recommended programme rather than making an informed decision. Other themes related to perceived importance of immunisation; beliefs about how immunisation works; trust; perceptions of vulnerability; feelings of guilt and responsibility; and practicalities. It is important to explore how parents' attitudes change over the preschool years and to develop ways of addressing uncertainties about immunisation, including the safety of combining antigens and the need for boosters.

  17. Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

    Science.gov (United States)

    McGlinchey, Mark P; Davenport, Sally

    2015-01-01

    The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and

  18. Nuclear regulatory decision making

    International Nuclear Information System (INIS)

    Wieland, Patricia; Almeida, Ivan Pedro Salati de

    2011-01-01

    The scientific considerations upon which the nuclear regulations are based provide objective criteria for decisions on nuclear safety matters. However, the decisions that a regulatory agency takes go far beyond granting or not an operating license based on assessment of compliance. It may involve decisions about hiring experts or research, appeals, responses to other government agencies, international agreements, etc.. In all cases, top management of the regulatory agency should hear and decide the best balance between the benefits of regulatory action and undue risks and other associated impacts that may arise, including issues of credibility and reputation. The establishment of a decision framework based on well established principles and criteria ensures performance stability and consistency, preventing individual subjectivity. This article analyzes the challenges to the decision-making by regulatory agencies to ensure coherence and consistency in decisions, even in situations where there is uncertainty, lack of reliable information and even divergence of opinions among experts. The article explores the basic elements for a framework for regulatory decision-making. (author)

  19. Decision making in midwifery: rationality and intuition.

    Science.gov (United States)

    Steinhauer, Suyai

    2015-04-01

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

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

    Science.gov (United States)

    Hunt, C; Lewin, S

    2000-01-01

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

  1. Exploring an informed decision-making framework using in-home sensors: older adults’ perceptions

    Directory of Open Access Journals (Sweden)

    Jane Chung

    2014-03-01

    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.

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

    Science.gov (United States)

    Guo, Lisa

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

  3. The decision-making threshold and the factors that affect it: A qualitative study of patients' decision-making in knee replacement surgery.

    Science.gov (United States)

    Barlow, T; Scott, P; Thomson, L; Griffin, D; Realpe, A

    2018-03-01

    Osteoarthritis is a significant cause of burden to the ageing population and knee replacement is a common operation for treatment of end-stage disease. We aimed to explore these factors to help understand patients' decision-making, which is critical in informing patient-centred care. These can be used to enhance decision-making and dialogue between clinicians and patients, allowing a more informed choice. The study consisted of two focus groups, in a patient cohort after total knee replacement followed by more in-depth interviews to further test and explore themes from the focus groups, in patients in either the deliberation stage or the decision-making stage. Using qualitative research methods (iterative thematic analysis) reviewing decision-making and deliberation phases of making informed choices we found nine key themes that emerged from the study groups. An awareness of the deliberation phase, the factors that influence it, the stress associated with it, preferred models of care, and the influence of the decision-making threshold will aid useful communication between doctors and patients. Copyright © 2017 John Wiley & Sons, Ltd.

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

    OpenAIRE

    Maite Sara Mashego

    2015-01-01

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

  5. The Students Decision Making in Solving Discount Problem

    Science.gov (United States)

    Abdillah; Nusantara, Toto; Subanji; Susanto, Hery; Abadyo

    2016-01-01

    This research is reviewing students' process of decision making intuitively, analytically, and interactively. The research done by using discount problem which specially created to explore student's intuition, analytically, and interactively. In solving discount problems, researcher exploring student's decision in determining their attitude which…

  6. Ethical decision-making, passivity and pharmacy.

    Science.gov (United States)

    Cooper, R J; Bissell, P; Wingfield, J

    2008-06-01

    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.

  7. Complex decision-making: initial results of an empirical study

    OpenAIRE

    Pier Luigi Baldi

    2011-01-01

    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.

  8. Mixed Frames and Risky Decision-Making.

    Science.gov (United States)

    Peng, Jiaxi; Zhang, Jiaxi; Sun, Hao; Zeng, Zhicong; Mai, Yuexia; Miao, Danmin

    2017-01-01

    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.

  9. Complex decision-making: initial results of an empirical study

    Directory of Open Access Journals (Sweden)

    Pier Luigi Baldi

    2011-09-01

    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.

  10. Clinical decision making in veterinary practice

    OpenAIRE

    Everitt, Sally

    2011-01-01

    Aim The aim of this study is to develop an understanding of the factors which influence veterinary surgeons’ clinical decision making during routine consultations. Methods The research takes a qualitative approach using video-cued interviews, in which one of the veterinary surgeon’s own consultations is used as the basis of a semi-structured interview exploring decision making in real cases. The research focuses primarily on small animal consultations in first opinion practice, how...

  11. Protocol-based care: the standardisation of decision-making?

    Science.gov (United States)

    Rycroft-Malone, Jo; Fontenla, Marina; Seers, Kate; Bick, Debra

    2009-05-01

    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

  12. Making the Connection between Environmental Science and Decision Making

    Science.gov (United States)

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

    2011-12-01

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

  13. Error affect inoculation for a complex decision-making task.

    Science.gov (United States)

    Tabernero, Carmen; Wood, Robert E

    2009-05-01

    Individuals bring knowledge, implicit theories, and goal orientations to group meetings. Group decisions arise out of the exchange of these orientations. This research explores how a trainee's exploratory and deliberate process (an incremental theory and learning goal orientation) impacts the effectiveness of individual and group decision-making processes. The effectiveness of this training program is compared with another program that included error affect inoculation (EAI). Subjects were 40 Spanish Policemen in a training course. They were distributed in two training conditions for an individual and group decision-making task. In one condition, individuals received the Self-Guided Exploration plus Deliberation Process instructions, which emphasised exploring the options and testing hypotheses. In the other condition, individuals also received instructions based on Error Affect Inoculation (EAI), which emphasised positive affective reactions to errors and mistakes when making decisions. Results show that the quality of decisions increases when the groups share their reasoning. The AIE intervention promotes sharing information, flexible initial viewpoints, and improving the quality of group decisions. Implications and future directions are discussed.

  14. Colorectal cancer patients' attitudes towards involvement in decision making.

    Science.gov (United States)

    Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A; Susnerwala, Shabbir S

    2009-03-01

    To design and administer an attitude rating scale, exploring colorectal cancer patients' views of involvement in decision making. To examine the impact of socio-demographic and/or treatment-related factors on decision making. To conduct principal components analysis to determine if the scale could be simplified into a number of factors for future clinical utility. An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross-sectional survey approach. 375 questionnaires were returned (81.7% response). For patients it was important to be informed and involved in the decision-making process. Information was not always used to make decisions as patients placed their trust in medical expertise. Women had more positive opinions on decision making and were more likely to want to make decisions. Written information was understood to a greater degree than verbal information. The scale could be simplified to a number of factors, indicating clinical utility. Few studies have explored the attitudes of colorectal cancer patients towards involvement in decision making. This study presents new insights into how patients view the concept of participation; important when considering current policy imperatives in the UK of involving service users in all aspects of care and treatment.

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

    Science.gov (United States)

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

    2018-01-01

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

  16. Emotion, decision-making and the brain.

    Science.gov (United States)

    Chang, Luke J; Sanfey, Alan G

    2008-01-01

    Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels to the automatic system. This chapter will discuss a theoretical framework for understanding the role of emotion in decision-making and evidence supporting the underlying neural substrates. This chapter applies a conceptual framework to understanding the role of emotion in decision-making, and emphasizes a distinction between expected and immediate emotions. Expected emotions refer to anticipated emotional states associated with a given decision that are never actually experienced. Immediate emotions, however, are experienced at the time of decision, and either can occur in response to a particular decision or merely as a result of a transitory fluctuation. This chapter will review research from the neuroeconomics literature that supports a neural dissociation between these two classes of emotion and also discuss a few interpretive caveats. Several lines of research including regret, uncertainty, social decision-making, and moral decision-making have yielded evidence consistent with our formulization--expected and immediate emotions may invoke dissociable neural systems. This chapter provides a more specific conceptualization of the mediating role of emotions in the decision-making process, which has important implications for understanding the interacting neural systems underlying the interface between emotion and cognition--a topic of immediate value to anyone investigating topics within the context of social-cognitive-affective-neuroscience.

  17. Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2015-03-27

    Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. 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 rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions

  18. Exploring a Laboratory Model of Pharmacogenetics as Applied to Clinical Decision Making

    Directory of Open Access Journals (Sweden)

    David F. Kisor

    2013-01-01

    Full Text Available Objective: To evaluate a pilot of a laboratory model for relating pharmacogenetics to clinical decision making. Case Study: This pilot was undertaken and evaluated to help determine if a pharmacogenetics laboratory should be included in the core Doctor of Pharmacy curriculum. The placement of the laboratory exercise in the curriculum was determined by identifying the point in the curriculum where the students had been introduced to the chemistry of deoxyribonucleic acid (DNA as well as instructed on the chemistry of genetic variation. The laboratory included cytochrome P450 2C19 genotyping relative to the *2 variant. Twenty-four students served as the pilot group. Students provided buccal swabs as the source of DNA. Students stabilized the samples and were then provided instructions related to sample preparation, polymerase chain reaction, and gel electrophoresis. The results were reported as images of gels. Students used a reference gel image to compare their results to. Students then applied a dosing algorithm to make a "clinical decision" relative to clopidogrel use. Students were offered a post laboratory survey regarding attitudes toward the laboratory. Twenty-four students completed the laboratory with genotyping results being provided for 22 students (91.7%. Sixteen students were wild-type (*1/*1, while six students were heterozygous (*1/*2. Twenty-three students (96% completed the post laboratory survey. All 23 agreed (6, 26.1% or strongly agreed (17, 73.9% that the laboratory "had relevance and value in the pharmacy curriculum" Conclusion: The post pilot study survey exploring a laboratory model for pharmacogenetics related to clinical decision making indicated that such a laboratory would be viewed positively by students. This model may be adopted by colleges to expand pharmacogenetics education.   Type: Case Study

  19. GM ethical decision making in practice

    Directory of Open Access Journals (Sweden)

    Donald Bruce

    2002-09-01

    Full Text Available Celia Deane-Drummond's case for wisdom as an approach to ethical decision making and her doubts about case-oriented methodology are critiqued with reference to the SRT Project's Engineering Genesis study. Its approach is explored in practical decisions on various real life examples of genetic modification in crops and animals. It involved both intrinsic and consequential approaches, and identified key value positions behind different policies and stakeholders. The paper also clarifies the relationship between reactive (cost-benefit and precautionary risk assessment, explaining their strengths and limitations, and the role of underlying values in both forms of risk decision making.

  20. Multi-disciplinary decision making in general practice.

    Science.gov (United States)

    Kirby, Ann; Murphy, Aileen; Bradley, Colin

    2018-04-09

    Purpose Internationally, healthcare systems are moving towards delivering care in an integrated manner which advocates a multi-disciplinary approach to decision making. Such an approach is formally encouraged in the management of Atrial Fibrillation patients through the European Society of Cardiology guidelines. Since the emergence of new oral anticoagulants switching between oral anticoagulants (OACs) has become prevalent. This case study considers the role of multi-disciplinary decision making, given the complex nature of the agents. The purpose of this paper is to explore Irish General Practitioners' (GPs) experience of switching between all OACs for Arial Fibrillation (AF) patients; prevalence of multi-disciplinary decision making in OAC switching decisions and seeks to determine the GP characteristics that appear to influence the likelihood of multi-disciplinary decision making. Design/methodology/approach A probit model is used to determine the factors influencing multi-disciplinary decision making and a multinomial logit is used to examine the factors influencing who is involved in the multi-disciplinary decisions. Findings Results reveal that while some multi-disciplinary decision-making is occurring (64 per cent), it is not standard practice despite international guidelines on integrated care. Moreover, there is a lack of patient participation in the decision-making process. Female GPs and GPs who have initiated prescriptions for OACs are more likely to engage in multi-disciplinary decision-making surrounding switching OACs amongst AF patients. GPs with training practices were less likely to engage with cardiac consultants and those in urban areas were more likely to engage with other (non-cardiac) consultants. Originality/value For optimal decision making under uncertainty multi-disciplinary decision-making is needed to make a more informed judgement and to improve treatment decisions and reduce the opportunity cost of making the wrong decision.

  1. Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-06-01

    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

  2. Full‐factorial design space exploration approach for multi‐criteria decision making of the design of industrial halls

    NARCIS (Netherlands)

    Lee, B. (Bruno); Pourmousavian, N. (Navid); Hensen, J.L.M.

    2016-01-01

    Industrial halls pose high energy saving potential that is not yet explored under current design practice. Common design approaches such as parametric study or optimization are largely constrained by the assumptions and do not promote flexibility in the decision making process. Based on the unique

  3. Decision Making

    Directory of Open Access Journals (Sweden)

    Pier Luigi Baldi

    2006-06-01

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

  4. Becoming a Mother: Supported Decision-Making in Context

    Science.gov (United States)

    Jamieson, Rhiann; Theodore, Kate; Raczka, Roman

    2016-01-01

    Little is known about how women with intellectual disabilities make decisions in relation to pregnancy. Social support is important for mothers with intellectual disabilities in many areas. This study explored how the support network influenced the decision-making of women with intellectual disabilities in relation to pregnancy. The study extended…

  5. Colorectal cancer patients’ attitudes towards involvement in decision making

    Science.gov (United States)

    Beaver, Kinta; Campbell, Malcolm; Craven, Olive; Jones, David; Luker, Karen A.; Susnerwala, Shabbir S.

    2009-01-01

    Abstract Objectives  To design and administer an attitude rating scale, exploring colorectal cancer patients’ views of involvement in decision making. To examine the impact of socio‐demographic and/or treatment‐related factors on decision making. To conduct principal components analysis to determine if the scale could be simplified into a number of factors for future clinical utility. Methods  An attitude rating scale was constructed based on previous qualitative work and administered to colorectal cancer patients using a cross‐sectional survey approach. Results  375 questionnaires were returned (81.7% response). For patients it was important to be informed and involved in the decision‐making process. Information was not always used to make decisions as patients placed their trust in medical expertise. Women had more positive opinions on decision making and were more likely to want to make decisions. Written information was understood to a greater degree than verbal information. The scale could be simplified to a number of factors, indicating clinical utility. Conclusion  Few studies have explored the attitudes of colorectal cancer patients towards involvement in decision making. This study presents new insights into how patients view the concept of participation; important when considering current policy imperatives in the UK of involving service users in all aspects of care and treatment. PMID:19250150

  6. Medical decision making

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Vries, M. de; Scherer, L.; Keren, G.; Wu, G.

    2016-01-01

    This chapter presents an overview of the field of medical decision making. It distinguishes the levels of decision making seen in health-care practice and shows how research in judgment and decision making support or improve decision making. Most of the research has been done at the micro level,

  7. Bayesian framework for managing preferences in decision-making

    International Nuclear Information System (INIS)

    Maes, Marc A.; Faber, Michael H.

    2006-01-01

    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

  8. Business making decisions

    Directory of Open Access Journals (Sweden)

    Enrique Benjamín Franklin Fincowsky

    2011-06-01

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

  9. Competence and Quality in Real-Life Decision Making

    OpenAIRE

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definiti...

  10. Child-parent shared decision making about asthma management.

    Science.gov (United States)

    Garnett, Victoria; Smith, Joanna; Ormandy, Paula

    2016-05-09

    Aim To explore and describe child-parent shared decision making for the management of childhood asthma. Methods A qualitative, descriptive, interview-based study was undertaken. Eight children and nine parents participated. The framework approach underpinned data analysis. Findings A dynamic model of the way children and parents transfer, shift and share asthma management decisions was uncovered. Asthma management decisions between children and parents were non-linear, with responsibility transferring from parent to child under different conditions. Children made a range of decisions about their asthma, often sharing decisions with their parents. However, during acute illness episodes, children often relied on parents to make decisions about their asthma. Conclusion Neither the child nor parent has complete autonomy over asthma management decisions. Decision making is a dynamic, shifting and shared process, dependent on contextual factors and child and parent decision preferences.

  11. Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting.

    Science.gov (United States)

    Armstrong, Rebecca; Waters, Elizabeth; Moore, Laurence; Dobbins, Maureen; Pettman, Tahna; Burns, Cate; Swinburn, Boyd; Anderson, Laurie; Petticrew, Mark

    2014-12-14

    The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions. The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health. In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making

  12. Decision making.

    Science.gov (United States)

    Chambers, David W

    2011-01-01

    A decision is a commitment of resources under conditions of risk in expectation of the best future outcome. The smart decision is always the strategy with the best overall expected value-the best combination of facts and values. Some of the special circumstances involved in decision making are discussed, including decisions where there are multiple goals, those where more than one person is involved in making the decision, using trigger points, framing decisions correctly, commitments to lost causes, and expert decision makers. A complex example of deciding about removal of asymptomatic third molars, with and without an EBD search, is discussed.

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

    Science.gov (United States)

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

    2012-04-01

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

  14. Indicators of Informal and Formal Decision-Making about a Socioscientific Issue

    Science.gov (United States)

    Dauer, Jenny M.; Lute, Michelle L.; Straka, Olivia

    2017-01-01

    We propose two contrasting types of student decision-making based on social and cognitive psychology models of separate mental processes for problem solving. Informal decision-making uses intuitive reasoning and is subject to cognitive biases, whereas formal decision-making uses effortful, logical reasoning. We explored indicators of students'…

  15. Clinical Decision Making of Nurses Working in Hospital Settings

    OpenAIRE

    Ida Torunn Bjørk; Glenys A. Hamilton

    2011-01-01

    This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with d...

  16. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Science.gov (United States)

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  17. Decision-making in adolescent females who deliberately self-harm

    Directory of Open Access Journals (Sweden)

    Rigler Tristan

    2016-01-01

    Full Text Available Self-harming behaviour most commonly begins in adolescence and is more frequent among adolescent females. We explored the hypothesis that adolescent females who deliberately selfharm were more likely to perform worse on a decision-making task. Previous research in adolescents who self-harm reported impaired decision-making. However, research put little emphasis on older adolescents and the emotional learning. In our research, we presented the Iowa Gambling Task to 35 adolescent females who self-harmed and were treated at a psychiatric clinic, and to 35 healthy female controls. Our results show that in comparison to the control group the adolescents who self-harm took more risky decisions and were less concerned about the outcome. In addition, the clinical group also focused more on immediate gains and showed a reduced ability to learn from poor decisions in the past. Further research is suggested to explore the potential neurological correlates of decision-making and selfharming behaviour.

  18. Shared decision making

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000877.htm Shared decision making To use the sharing features on this page, ... treatment you both support. When to use Shared Decision Making Shared decision making is often used when you ...

  19. Whose Values? Whose Risk? Exploring Decision Making About Trial of Labor After Cesarean.

    Science.gov (United States)

    Charles, Sonya; Wolf, Allison B

    2018-06-01

    In this article, we discuss decision making during labor and delivery, specifically focusing on decision making around offering women a trial of labor after cesarean section (TOLAC). Many have discussed how humans are notoriously bad at assessing risks and how we often distort the nature of various risks surrounding childbirth. We will build on this discussion by showing that physicians make decisions around TOLAC not only based on distortions of risk, but also based on personal values (i.e. what level of risk are you comfortable with or what types of risks are you willing to take) rather than medical data (or at least medical data alone). As a result of this, we will further suggest that the party who is best epistemically situated to make decisions about TOLAC is the woman herself.

  20. Artificial intelligence and foreign policy decision-making

    OpenAIRE

    Berkoff, Russ H.

    1997-01-01

    Approved for public release; distribution is unlimited With the advent of a global information society, the US will seek to tap the potential of advanced computing capability to enhance its ability to conduct foreign policy decision making. This thesis explores the potential for improving individual and organizational decision making capabilities by means of artificial intelligence (AI). The use of AI will allow us to take advantage of the plethora of information available to obtain an edg...

  1. Understanding Decision-Making in Specialized Domestic Violence Courts: Can Contemporary Theoretical Frameworks Help Guide These Decisions?

    Science.gov (United States)

    Pinchevsky, Gillian M

    2016-05-22

    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.

  2. Handbook on Decision Making Vol 2 Risk Management in Decision Making

    CERN Document Server

    Lu, Jie; Zhang, Guangquan

    2012-01-01

    This book presents innovative theories, methodologies, and techniques in the field of risk management and decision making. It introduces new research developments and provides a comprehensive image of their potential applications to readers interested in the area. The collection includes: computational intelligence applications in decision making, multi-criteria decision making under risk, risk modelling,forecasting and evaluation, public security and community safety, risk management in supply chain and other business decision making, political risk management and disaster response systems. The book is directed to academic and applied researchers working on risk management, decision making, and management information systems.

  3. Teaching Empathy and Ethical Decision Making in Business Schools

    Science.gov (United States)

    Baker, Diane F.

    2017-01-01

    Researchers in behavioral ethics seek to understand how individuals respond to the ethical dilemmas in their lives. In any given situation, multiple social and psychological variables interact to influence ethical decision making. The purpose of this article is to explore how one such variable, empathy, affects the ethical decision-making process…

  4. Autonomy and couples' joint decision-making in healthcare.

    Science.gov (United States)

    Osamor, Pauline E; Grady, Christine

    2018-01-11

    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

  5. Decision-making in nursing practice: An integrative literature review.

    Science.gov (United States)

    Nibbelink, Christine W; Brewer, Barbara B

    2018-03-01

    To identify and summarise factors and processes related to registered nurses' patient care decision-making in medical-surgical environments. A secondary goal of this literature review was to determine whether medical-surgical decision-making literature included factors that appeared to be similar to concepts and factors in naturalistic decision making (NDM). Decision-making in acute care nursing requires an evaluation of many complex factors. While decision-making research in acute care nursing is prevalent, errors in decision-making continue to lead to poor patient outcomes. Naturalistic decision making may provide a framework for further exploring decision-making in acute care nursing practice. A better understanding of the literature is needed to guide future research to more effectively support acute care nurse decision-making. PubMed and CINAHL databases were searched, and research meeting criteria was included. Data were identified from all included articles, and themes were developed based on these data. Key findings in this review include nursing experience and associated factors; organisation and unit culture influences on decision-making; education; understanding patient status; situation awareness; and autonomy. Acute care nurses employ a variety of decision-making factors and processes and informally identify experienced nurses to be important resources for decision-making. Incorporation of evidence into acute care nursing practice continues to be a struggle for acute care nurses. This review indicates that naturalistic decision making may be applicable to decision-making nursing research. Experienced nurses bring a broad range of previous patient encounters to their practice influencing their intuitive, unconscious processes which facilitates decision-making. Using naturalistic decision making as a conceptual framework to guide research may help with understanding how to better support less experienced nurses' decision-making for enhanced patient

  6. Exploring the role of religiosity and spirituality in amniocentesis decision-making among Latinas.

    Science.gov (United States)

    Seth, Sarah Guerra; Goka, Thomas; Harbison, Andrea; Hollier, Lisa; Peterson, Susan; Ramondetta, Lois; Noblin, Sarah Jane

    2011-12-01

    Given the complex array of emotional and medical issues that may arise when making a decision about amniocentesis, women may find that their spiritual and/or religious beliefs can comfort and assist their decision-making process. Prior research has suggested that Latinas' spiritual and/or religious beliefs directly influence their amniocentesis decision. A more intimate look into whether Latinas utilize their beliefs during amniocentesis decision-making may provide an opportunity to better understand their experience. The overall goal of this study was to describe the role structured religion and spirituality plays in Latinas' daily lives and to evaluate how religiosity and spirituality influences health care decisions, specifically in prenatal diagnosis. Semi-structured interviews were conducted with eleven women who were invited to describe their religious beliefs and thoughts while considering the option of amniocentesis. All participants acknowledged the influence of religious and/or spiritual beliefs in their everyday lives. Although the women sought comfort and found validation in their beliefs and in their faith in God's will during their amniocentesis decision-making process, results suggest the risk of procedure-related complications played more of a concrete role than their beliefs.

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

    Science.gov (United States)

    Johnson, Theresa L.

    2012-01-01

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

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

    Science.gov (United States)

    Chang, Pamara F

    2017-08-01

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

  9. Decision Making with Imperfect Decision Makers

    CERN Document Server

    Guy, Tatiana Valentine; Wolpert, David H

    2012-01-01

    Prescriptive Bayesian decision making has reached a high level of maturity and is well-supported algorithmically. However, experimental data shows that real decision makers choose such Bayes-optimal decisions surprisingly infrequently, often making decisions that are badly sub-optimal. So prevalent is such imperfect decision-making that it should be accepted as an inherent feature of real decision makers living within interacting societies. To date such societies have been investigated from an economic and gametheoretic perspective, and even to a degree from a physics perspective. However, lit

  10. Exploration of Risks in Autonomous Decision-Making Applied to Aeronautics

    Data.gov (United States)

    National Aeronautics and Space Administration — Prior research into metrics and design for autonomy were presented. At this time, the prospect of adding significant autonomous decision-making on a piloted aircraft...

  11. How social cognition can inform social decision making

    Science.gov (United States)

    Lee, Victoria K.; Harris, Lasana T.

    2013-01-01

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

  12. How social cognition can inform social decision making.

    Science.gov (United States)

    Lee, Victoria K; Harris, Lasana T

    2013-12-25

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

  13. How Social Cognition Can Inform Social Decision Making

    Directory of Open Access Journals (Sweden)

    Victoria eLee

    2013-12-01

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

  14. Realism and Impartiality: Making Sustainability Effective in Decision-Making.

    Science.gov (United States)

    Bastons, Miquel; Armengou, Jaume

    2017-08-01

    There is both individual and collective widespread concern in society about the impact of human activity and the effects of our decisions on the physical and social environment. This concern is included within the idea of sustainability. The meaning of the concept is still ambiguous and its practical effectiveness disputed. Like many other authors, this article uses as a starting point the definition proposed by the World Commission on Environment and Development (Our common future, Oxford University Press, Oxford, 1987), considering it to be a proposal for changing the assessment of the effects of decisions, from at least two perspectives: (1) what effects we should consider and (2) how we should assess them. Based on this double perspective, sustainability is explored as a method for decision-making which both expands the assessment of the consequences, and also provides an objective criterion for such assessment. It will be argued that the idea of sustainability, seen from this perspective, brings to decision-making two qualities which had been partially lost: realism and impartiality. In turn, the criteria for realism and impartiality in decision-making can be used to identify the limitations of some partial approaches to sustainability, which suffer from insufficient realism (emotional altruism), insufficient impartiality (tactical altruism) or both phenomena at once (egoism). The article concludes by demonstrating how realism and impartiality provide the basis for a new form of sustainable decision-making (ethical sustainability), which is dependent on the development of two moral virtues, prudence and benevolence, and which brings practical effectiveness and ethical sense to the concept of sustainability.

  15. Staged decision making based on probabilistic forecasting

    Science.gov (United States)

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

    2016-04-01

    Flood forecasting systems reduce, but cannot eliminate uncertainty about the future. Probabilistic forecasts explicitly show that uncertainty remains. However, as - compared to deterministic forecasts - a dimension is added ('probability' or 'likelihood'), with this added dimension decision making is made slightly more complicated. A technique of decision support is the cost-loss approach, which defines whether or not to issue a warning or implement mitigation measures (risk-based method). With the cost-loss method a warning will be issued when the ratio of the response costs to the damage reduction is less than or equal to the probability of the possible flood event. This cost-loss method is not widely used, because it motivates based on only economic values and is a technique that is relatively static (no reasoning, yes/no decision). Nevertheless it has high potential to improve risk-based decision making based on probabilistic flood forecasting because there are no other methods known that deal with probabilities in decision making. The main aim of this research was to explore the ways of making decision making based on probabilities with the cost-loss method better applicable in practice. The exploration began by identifying other situations in which decisions were taken based on uncertain forecasts or predictions. These cases spanned a range of degrees of uncertainty: from known uncertainty to deep uncertainty. Based on the types of uncertainties, concepts of dealing with situations and responses were analysed and possible applicable concepts where chosen. Out of this analysis the concepts of flexibility and robustness appeared to be fitting to the existing method. Instead of taking big decisions with bigger consequences at once, the idea is that actions and decisions are cut-up into smaller pieces and finally the decision to implement is made based on economic costs of decisions and measures and the reduced effect of flooding. The more lead-time there is in

  16. Decision Making and Cancer

    OpenAIRE

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

    2015-01-01

    We review decision-making along the cancer continuum in the contemporary context of informed and shared decision making, in which patients are encouraged to take a more active role in their health care. We discuss challenges to achieving informed and shared decision making, including cognitive limitations and emotional factors, but argue that understanding the mechanisms of decision making offers hope for improving decision support. Theoretical approaches to decision making that explain cogni...

  17. Making better decisions in uncertain times (Invited)

    Science.gov (United States)

    St John, C.

    2013-12-01

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

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

    OpenAIRE

    Guo, Lisa

    2017-01-01

    Every day, decisions need to be made where time is a limiting factor. Regardless of situation, time constraints often place a premium on rapid decision-making. Researchers have been interested in studying this human behavior and understanding its underlying cognitive processes. In previous studies, scientists have believed that the cognitive processes underlying decision-making behavior were consistent with dual-process modes of thinking. Critics of dual-process theory question the vagueness ...

  19. INTERIM REPORT IMPROVED METHODS FOR INCORPORATING RISK IN DECISION MAKING

    Energy Technology Data Exchange (ETDEWEB)

    Clausen, M. J.; Fraley, D. W.; Denning, R. S.

    1980-08-01

    This paper reports observations and preliminary investigations in the first phase of a research program covering methodologies for making safety-related decisions. The objective has been to gain insight into NRC perceptions of the value of formal decision methods, their possible applications, and how risk is, or may be, incorporated in decision making. The perception of formal decision making techniques, held by various decision makers, and what may be done to improve them, were explored through interviews with NRC staff. An initial survey of decision making methods, an assessment of the applicability of formal methods vis-a-vis the available information, and a review of methods of incorporating risk and uncertainty have also been conducted.

  20. Decision Making in the Stock Market: Incorporating Psychology with Finance

    OpenAIRE

    Chandra, Abhijeet

    2008-01-01

    The decision-making by individual investors is usually based on their age, education, income, investment portfolio, and other demographic factors. The impact of behavioural aspect of investing is, however, often ignored. The objective of this paper is to explore the impact of behavioural factors and investor’s psychology on their decision-making, and to examine the relationship between investor’s attitude towards risk and behavioural decision-making. The research uses the literature relevant ...

  1. Emotion, decision-making and the brain

    NARCIS (Netherlands)

    Chang, L.J.; Sanfey, A.G.

    2008-01-01

    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

  2. Insights from quantum cognitive models for organizational decision making

    OpenAIRE

    White, L.C.; Pothos, E. M.; Busemeyer, J. R.

    2015-01-01

    Organizational decision making is often explored with theories from the heuristics and biases research program, which have demonstrated great value as descriptions of how people in organizations make decisions. Nevertheless, rational analysis and classical probability theory are still seen by many as the best accounts of how decisions should be made and classical probability theory is the preferred framework for cognitive modelling for many researchers. The focus of this work is quantum proba...

  3. The thinking doctor: clinical decision making in contemporary medicine.

    Science.gov (United States)

    Trimble, Michael; Hamilton, Paul

    2016-08-01

    Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised. © 2016 Royal College of Physicians.

  4. Exploring a Laboratory Model of Pharmacogenetics as Applied to Clinical Decision Making

    Directory of Open Access Journals (Sweden)

    Angela Smith, PharmD Candidate

    2013-01-01

    Full Text Available Objective: To evaluate a pilot of a laboratory model for relating pharmacogenetics to clinical decision making. Case Study: This pilot was undertaken and evaluated to help determine if a pharmacogenetics laboratory should be included in the core Doctor of Pharmacy curriculum. The placement of the laboratory exercise in the curriculum was determined by identifying the point in the curriculum where the students had been introduced to the chemistry of deoxyribonucleic acid (DNA as well as instructed on the chemistry of genetic variation. The laboratory included cytochrome P450 2C19 genotyping relative to the *2 variant. Twenty-four students served as the pilot group. Students provided buccal swabs as the source of DNA. Students stabilized the samples and were then provided instructions related to sample preparation, polymerase chain reaction, and gel electrophoresis. The results were reported as images of gels. Students used a reference gel image to compare their results to. Students then applied a dosing algorithm to make a “clinical decision” relative to clopidogrel use. Students were offered a post laboratory survey regarding attitudes toward the laboratory. Twenty-four students completed the laboratory with genotyping results being provided for 22 students (91.7%. Sixteen students were wild-type (*1/*1, while six students were heterozygous (*1/*2. Twenty-three students (96% completed the post laboratory survey. All 23 agreed (6, 26.1% or strongly agreed (17, 73.9% that the laboratory “had relevance and value in the pharmacy curriculum”. Conclusion: The post pilot study survey exploring a laboratory model for pharmacogenetics related to clinical decision making indicated that such a laboratory would be viewed positively by students. This model may be adopted by colleges to expand pharmacogenetics education.

  5. Categorization = Decision Making + Generalization

    Science.gov (United States)

    Seger, Carol A; Peterson, Erik J.

    2013-01-01

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

  6. Consumer recycling: An ethical decision-making process

    DEFF Research Database (Denmark)

    Culiberg, Barbara; Bajde, Domen

    2013-01-01

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

  7. Decision Making Perspectives of Young Children (K-5).

    Science.gov (United States)

    Rogers, Linda J.; McDonald, Linda L.

    1999-01-01

    Applies Blumer's theory of symbolic interactionism to explore how normal children make meaning of their decision making world, both of their own acts and the labyrinthine world adults structure for them. Schema/narratives on friendship, sports, adults, and school reveal knowledge making strategies defined by immediate experiences and a capacity to…

  8. Development and aging of decision-making rationality under risk framework

    OpenAIRE

    Han-hui LIU; Yan-yan AN; Hui-min LI; Zhen WEI; Xing-ting ZHU; Hui-jie LI

    2014-01-01

    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...

  9. Essays on the role of accounting in acquisition decision-making

    OpenAIRE

    Puhakka, Hannu

    2017-01-01

    This dissertation investigates the role of accounting in acquisition decision-making via three essays. First essay examines the influence of accounting on trust development during the acquisition negotiation process. Essay 2 explores the interplay of formal and informal pre-decision control mechanisms and seeks to provide new insights on the interplay of various pre-decision control mechanisms at different stages of the acquisition decision-making process. Third essay seeks to specify how acc...

  10. Three Essays on Economic Agents' Incentives and Decision Making

    OpenAIRE

    Lee, Dongryul

    2009-01-01

    This dissertation consists of three essays on theoretical analysis of economic agents' decision making and incentives. Chapter 1 gives an outline of the subjects to be examined in the subsequent chapters and shows their conclusions in brief. Chapter 2 explores the decision problem of a superordinate (a principal) regarding whether to delegate its authority or right to make a decision to a subordinate (an agent) in an organization. We first study the optimal contracting problem of the su...

  11. Intelligent decision-making models for production and retail operations

    CERN Document Server

    Guo, Zhaoxia

    2016-01-01

    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.

  12. Transport fleet sizing by using make and buy decision-making

    Directory of Open Access Journals (Sweden)

    Stojanović Đurđica

    2011-01-01

    Full Text Available Cost reduction is among the main quoted reasons for logistics outsourcing, while transport capacities and operations are among the most outsourced logistics areas. However, according to transaction costs theory, there is often room for transport insourcing. Furthermore, nowadays many authors stress that mixed solutions can give better results than “make” or “buy” alternatives. “Make or buy” decision-making normative models, methods, and procedures in transport planning are not much explored. Instead, research is rather focused on carrier selection techniques, whereby it is supposed that outsourcing transport capacities is the most suitable solution. The purpose of this paper is to contribute to the body of literature on classical “makeor-buy” decision-making in transport fleet sizing in a non-logistics enterprise. It goes beyond the basic “make or buy” decisionmaking, and intermediate solutions (i.e., “make and buy” are explored. Practical directions are given according to theoretical principles, and a case study is used to exemplify the main deductions. The research also has practical implications. Many enterprises in transition economies have faced the question of what to do with their in-house transport fleets. The obtained results are of interest to merchants and manufacturing enterprises that already have a private transport fleet and are considering how to rationalize it.

  13. Career Decision-Making and Corporate Responsibility

    Science.gov (United States)

    Sainty, Rosemary

    2008-01-01

    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…

  14. Exploring older and younger adults' preferences for health information and participation in decision making using the Health Information Wants Questionnaire (HIWQ).

    Science.gov (United States)

    Xie, Bo; Wang, Mo; Feldman, Robert; Zhou, Le

    2014-12-01

    Existing measurements of patient preferences cover only a limited range of health information and participation in decision making. A broader approach is necessary to understand the breadth and variations in patient preferences. To explore the breadth and variances in patient preferences for health information and participation in decision making and to understand the relationship between age and each type of preference. The Health Information Wants Questionnaire (HIWQ) was administered during May-December 2010 to gather data about the information and corresponding decision-making autonomy participants would want in seven areas: diagnosis, treatment, laboratory tests, self-care, complementary and alternative medicine (CAM), psychosocial factors and health-care providers. A large state university, public libraries and senior centres in Maryland, USA. A convenience sample of 438 individuals, including 226 undergraduates (mean age = 20; SD = 2.15) and 212 community-dwelling older adults (mean age = 72; SD = 9.00). Ratings on the information and decision-making items of the HIWQ. Participants expressed higher levels of preference for information than for participation in decision making on six of seven subscales. On the psychosocial subscale, they expressed stronger desire for participation in decision making than for information. Age had no predictive effect on the overall preferences or specific preferences for information and participation in decision making about standard treatments and CAM. The predictive effect of age on the other types of preferences varied significantly. Physicians should take into account the breadth and variations in patient preferences. The predictive effect of age on patient preferences varied depending on the specific area of preferences. © 2012 John Wiley & Sons Ltd.

  15. Clinical decision making: how surgeons do it.

    Science.gov (United States)

    Crebbin, Wendy; Beasley, Spencer W; Watters, David A K

    2013-06-01

    Clinical decision making is a core competency of surgical practice. It involves two distinct types of mental process best considered as the ends of a continuum, ranging from intuitive and subconscious to analytical and conscious. In practice, individual decisions are usually reached by a combination of each, according to the complexity of the situation and the experience/expertise of the surgeon. An expert moves effortlessly along this continuum, according to need, able to apply learned rules or algorithms to specific presentations, choosing these as a result of either pattern recognition or analytical thinking. The expert recognizes and responds quickly to any mismatch between what is observed and what was expected, coping with gaps in information and making decisions even where critical data may be uncertain or unknown. Even for experts, the cognitive processes involved are difficult to articulate as they tend to be very complex. However, if surgeons are to assist trainees in developing their decision-making skills, the processes need to be identified and defined, and the competency needs to be measurable. This paper examines the processes of clinical decision making in three contexts: making a decision about how to manage a patient; preparing for an operative procedure; and reviewing progress during an operative procedure. The models represented here are an exploration of the complexity of the processes, designed to assist surgeons understand how expert clinical decision making occurs and to highlight the challenge of teaching these skills to surgical trainees. © 2013 The Authors. ANZ Journal of Surgery © 2013 Royal Australasian College of Surgeons.

  16. Child Protection Decision Making: A Factorial Analysis Using Case Vignettes

    Science.gov (United States)

    Stokes, Jacqueline; Schmidt, Glen

    2012-01-01

    This study explored decision making by child protection social workers in the province of British Columbia, Canada. A factorial survey method was used in which case vignettes were constructed by randomly assigning a number of key characteristics associated with decision making in child protection. Child protection social workers (n = 118) assessed…

  17. Sustaining the Army Training Mission by Re-Thinking Decision Support Systems: Shifting from Decision-Making Individuals to Sense-Making Agents

    National Research Council Canada - National Science Library

    Ekbia, Hamid R

    2004-01-01

    .... In an effort to reconceptualize decision making, this paper follows a top-down approach, starting with a new conceptual framework and then exploring the technologies and tools that can support...

  18. Exploring dietitians' salient beliefs about shared decision-making behaviors

    Directory of Open Access Journals (Sweden)

    Gagnon Marie-Pierre

    2011-06-01

    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.

  19. Decision making and cancer.

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Sinopoulou, Vassiliki; Summerfield, Paul; Rutter, Paul

    2017-12-01

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

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

    OpenAIRE

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

    2012-01-01

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

  2. Decision Making Under Uncertainty

    Science.gov (United States)

    2010-11-01

    A sound approach to rational decision making requires a decision maker to establish decision objectives, identify alternatives, and evaluate those...often violate the axioms of rationality when making decisions under uncertainty. The systematic description of such observations may lead to the...which leads to “anchoring” on the initial value. The fact that individuals have been shown to deviate from rationality when making decisions

  3. Decision Making in Action

    Science.gov (United States)

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

    1994-01-01

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

  4. Promoting Shared Decision Making in Disorders of Sex Development (DSD): Decision Aids and Support Tools.

    Science.gov (United States)

    Siminoff, L A; Sandberg, D E

    2015-05-01

    Specific complaints and grievances from adult patients with disorders of sex development (DSD), and their advocates center around the lack of information or misinformation they were given about their condition and feeling stigmatized and shamed by the secrecy surrounding their condition and its management. Many also attribute poor sexual function to damaging genital surgery and/or repeated, insensitive genital examinations. These reports suggest the need to reconsider the decision-making process for the treatment of children born with DSD. This paper proposes that shared decision making, an important concept in adult health care, be operationalized for the major decisions commonly encountered in DSD care and facilitated through the utilization of decision aids and support tools. This approach may help patients and their families make informed decisions that are better aligned with their personal values and goals. It may also lead to greater confidence in decision making with greater satisfaction and less regret. A brief review of the past and current approach to DSD decision making is provided, along with a review of shared decision making and decision aids and support tools. A case study explores the need and potential utility of this suggested new approach. © Georg Thieme Verlag KG Stuttgart · New York.

  5. The influence of anticipated pride and guilt on pro-environmental decision making

    OpenAIRE

    Schneider, Claudia R.; Zaval, Lisa; Weber, Elke U.; Markowitz, Ezra M.

    2017-01-01

    The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evide...

  6. Proxy decision making and dementia: Using Construal Level Theory to analyse the thoughts of decision makers.

    Science.gov (United States)

    Convey, Helen; Holt, Janet; Summers, Barbara

    2018-03-08

    This study explored the feasibility of using Construal Level Theory to analyse proxy decision maker thinking about a hypothetical ethical dilemma, relating to a person who has dementia. Proxy decision makers make decisions on behalf of individuals who are living with dementia when dementia affects that individual's decision making ability. Ethical dilemmas arise because there is a need to balance the individual's past and contemporary values and views. Understanding of how proxy decision makers respond is incomplete. Construal Level Theory contends that individuals imagine reactions and make predications about the future by crossing psychological distance. This involves abstract thinking, giving meaning to decisions. There is no empirical evidence of Construal Level Theory being used to analyse proxy decision maker thinking. Exploring the feasibility of using Construal Level Theory to understand dementia carer thinking regarding proxy decisions may provide insights which inform the support given. Descriptive qualitative research with semi-structured interviews. Seven participants were interviewed using a hypothetical dementia care scenario in February 2016. Interview transcripts were analysed for themes. Construal Level Theory was applied to analyse participant responses within themes using the Linguistic Category Model. Participants travelled across psychological distance, using abstract thinking to clarify goals and provide a basis for decisions. When thinking concretely participants established boundaries regarding the ethical dilemma. Construal Level Theory gives insight into proxy decision maker thinking and the levels of abstraction used. Understanding what dementia carers think about when making proxy decisions may help nurses to understand their perspectives and to provide appropriate support. © 2018 John Wiley & Sons Ltd.

  7. Modelling elderly cardiac patients decision making using Cognitive Work Analysis: identifying requirements for patient decision aids.

    Science.gov (United States)

    Dhukaram, Anandhi Vivekanandan; Baber, Chris

    2015-06-01

    Patients make various healthcare decisions on a daily basis. Such day-to-day decision making can have significant consequences on their own health, treatment, care, and costs. While decision aids (DAs) provide effective support in enhancing patient's decision making, to date there have been few studies examining patient's decision making process or exploring how the understanding of such decision processes can aid in extracting requirements for the design of DAs. This paper applies Cognitive Work Analysis (CWA) to analyse patient's decision making in order to inform requirements for supporting self-care decision making. This study uses focus groups to elicit information from elderly cardiovascular disease (CVD) patients concerning a range of decision situations they face on a daily basis. Specifically, the focus groups addressed issues related to the decision making of CVD in terms of medication compliance, pain, diet and exercise. The results of these focus groups are used to develop high level views using CWA. CWA framework decomposes the complex decision making problem to inform three approaches to DA design: one design based on high level requirements; one based on a normative model of decision-making for patients; and the third based on a range of heuristics that patients seem to use. CWA helps in extracting and synthesising decision making from different perspectives: decision processes, work organisation, patient competencies and strategies used in decision making. As decision making can be influenced by human behaviour like skills, rules and knowledge, it is argued that patients require support to different types of decision making. This paper also provides insights for designers in using CWA framework for the design of effective DAs to support patients in self-management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. The dynamics of change in decision making under risk

    Directory of Open Access Journals (Sweden)

    Milićević Aleksandar

    2007-01-01

    Full Text Available The goal of this study was to investigate the dynamics of decision making under risk. In three experiments this dynamics have been explored with respect to probability of outcome and with respect to frame, i.e. the way the outcomes of the alternatives have been specified. The process of decision making was explored within a framework of expected utility and Prospect theory. The outcomes of alternatives as well as their probabilities were quantitatively specified (so that the expected value of a risk alternative was equal to the value of a non-risk alternative. The results of experiments indicate that the attitude towards risk (risk-proneness vs. risk-averseness depends on the outcome probability and the way the outcomes were specified (i.e. positive/negative frame. It was also demonstrated that content strongly affects the choices made in decision making. This outcome is somewhat unexpected and requires additional empirical evaluation.

  9. Decision-making: Theory and practice

    OpenAIRE

    SM Turpin; MA Marais

    2004-01-01

    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, ...

  10. [Decision making in cariology

    NARCIS (Netherlands)

    Verdonschot, E.H.A.M.; Liem, S.L.; Palenstein Helderman, W.H. van

    2003-01-01

    By conducting an oral examination, during radiographic examination and in treatment planning procedures dentists make numerous decisions. A dentist will be required to make his decisions explicit. Decision trees and decision analyses may play an important role. In a decision analysis, the

  11. The Assisted Decision-Making (Capacity) Bill 2013: content, commentary, controversy.

    Science.gov (United States)

    Kelly, B D

    2015-03-01

    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.

  12. The Relations between Decision Making in Social Relationships and Decision Making Styles

    Science.gov (United States)

    Sari, Enver

    2008-01-01

    The research reported in this paper aimed to examine the relationships between decisiveness in social relationships, and the decision-making styles of a group of university students and to investigate the contributions of decision-making styles in predicting decisiveness in social relationship (conflict resolution, social relationship selection…

  13. Research on self-esteem in decision-making and decision-making styles in orienteering athletes

    Directory of Open Access Journals (Sweden)

    Eroğlu Başak

    2016-01-01

    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.

  14. Influences on decision-making for young women undergoing bilateral prophylactic mastectomy.

    Science.gov (United States)

    Glassey, Rachael; O'Connor, Moira; Ives, Angela; Saunders, Christobel; Hardcastle, Sarah J

    2018-02-01

    The objective of this study was to explore the influences on decision-making of younger women (decision-making were identified: fear and anxiety, children, personal experiences with BC, health professional's influence. The decision to undergo BPM for younger women (account the way younger women perceive information given to them when discussing risk. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Gillespie, Mary

    2010-11-01

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

  16. [Interoception and decision-making].

    Science.gov (United States)

    Ohira, Hideki

    2015-02-01

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

  17. Shared decision-making as an existential journey: Aiming for restored autonomous capacity

    NARCIS (Netherlands)

    Gulbrandsen, P.; Clayman, M.L.; Beach, M.C.; Han, P.K.; Boss, E.F.; Ofstad, E.H.; Elwyn, G.

    2016-01-01

    OBJECTIVE: We describe the different ways in which illness represents an existential problem, and its implications for shared decision-making. METHODS: We explore core concepts of shared decision-making in medical encounters (uncertainty, vulnerability, dependency, autonomy, power, trust,

  18. Strategic Decision Making in Community Colleges: An Exploration of Issues Relevant to Decision Making to Confer Community College Baccalaureate Degrees

    Science.gov (United States)

    Currier, Charles W.

    2012-01-01

    This qualitative case study explores the process community college senior administrators employ when assessing the complex strategic decision to confer community college baccalaureate degrees. Strategic opportunities, such as conferring baccalaureate degrees, occur infrequently thus community college leaders must be prepared to act quickly and…

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

    Science.gov (United States)

    Plant, Katherine L; Stanton, Neville A

    2015-01-01

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

  20. A dataset of human decision-making in teamwork management

    Science.gov (United States)

    Yu, Han; Shen, Zhiqi; Miao, Chunyan; Leung, Cyril; Chen, Yiqiang; Fauvel, Simon; Lin, Jun; Cui, Lizhen; Pan, Zhengxiang; Yang, Qiang

    2017-01-01

    Today, most endeavours require teamwork by people with diverse skills and characteristics. In managing teamwork, decisions are often made under uncertainty and resource constraints. The strategies and the effectiveness of the strategies different people adopt to manage teamwork under different situations have not yet been fully explored, partially due to a lack of detailed large-scale data. In this paper, we describe a multi-faceted large-scale dataset to bridge this gap. It is derived from a game simulating complex project management processes. It presents the participants with different conditions in terms of team members' capabilities and task characteristics for them to exhibit their decision-making strategies. The dataset contains detailed data reflecting the decision situations, decision strategies, decision outcomes, and the emotional responses of 1,144 participants from diverse backgrounds. To our knowledge, this is the first dataset simultaneously covering these four facets of decision-making. With repeated measurements, the dataset may help establish baseline variability of decision-making in teamwork management, leading to more realistic decision theoretic models and more effective decision support approaches.

  1. Organizational decision making

    OpenAIRE

    Grandori, Anna

    2015-01-01

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

  2. Teachers' Grading Decision Making

    Science.gov (United States)

    Isnawati, Ida; Saukah, Ali

    2017-01-01

    This study investigated teachers' grading decision making, focusing on their beliefs underlying their grading decision making, their grading practices and assessment types, and factors they considered in grading decision making. Two teachers from two junior high schools applying different curriculum policies in grade reporting in Indonesian…

  3. Maritime Military Decision Making in Environments of Extreme Information Ambiguity: An Initial Exploration

    National Research Council Canada - National Science Library

    Reeves, Andrew T

    2005-01-01

    ... to make effective decisions. An environment of extreme information ambiguity, a dependent variable, is one of the most difficult components of a battle where the decision maker may reach a confusing and debilitating point...

  4. Decision-making in Swiss home-like childbirth: A grounded theory study.

    Science.gov (United States)

    Meyer, Yvonne; Frank, Franziska; Schläppy Muntwyler, Franziska; Fleming, Valerie; Pehlke-Milde, Jessica

    2017-12-01

    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.

  5. Mutual influence in shared decision making: a collaborative study of patients and physicians.

    Science.gov (United States)

    Lown, Beth A; Clark, William D; Hanson, Janice L

    2009-06-01

    To explore how patients and physicians describe attitudes and behaviours that facilitate shared decision making. Background Studies have described physician behaviours in shared decision making, explored decision aids for informing patients and queried whether patients and physicians want to share decisions. Little attention has been paid to patients' behaviors that facilitate shared decision making or to the influence of patients and physicians on each other during this process. Qualitative analysis of data from four research work groups, each composed of patients with chronic conditions and primary care physicians. Eighty-five patients and physicians identified six categories of paired physician/patient themes, including act in a relational way; explore/express patient's feelings and preferences; discuss information and options; seek information, support and advice; share control and negotiate a decision; and patients act on their own behalf and physicians act on behalf of the patient. Similar attitudes and behaviours were described for both patients and physicians. Participants described a dynamic process in which patients and physicians influence each other throughout shared decision making. This study is unique in that clinicians and patients collaboratively defined and described attitudes and behaviours that facilitate shared decision making and expand previous descriptions, particularly of patient attitudes and behaviours that facilitate shared decision making. Study participants described relational, contextual and affective behaviours and attitudes for both patients and physicians, and explicitly discussed sharing control and negotiation. The complementary, interactive behaviours described in the themes for both patients and physicians illustrate mutual influence of patients and physicians on each other.

  6. Youth in Community Decision-Making: A Study of Youth-Adult Partnerships

    Directory of Open Access Journals (Sweden)

    Shelley Murdock

    2008-03-01

    Full Text Available Involving youth in community and organizational decision-making is widely believed to lead to stronger communities. A promising strategy to foster decision-making is youth-adult partnerships in which youth and adults work collaboratively, sharing their strengths, collective knowledge, and decision-making power. A qualitative study of eight youth organizations showed that those organizations employing youth-adult partnership strategies were most effective in increasing youth's contributions to their communities. This article explores the elements of youth-adult partnership that were evident among successful organizations including: mutual respect, meaningful roles for youth, unique contributions of adults and youth, and shared decision-making and implications for youth development programs.

  7. Community ambulation: influences on therapists and clients reasoning and decision making.

    Science.gov (United States)

    Corrigan, Rosemary; McBurney, Helen

    2008-01-01

    Community ambulation is an important element of a rehabilitation training programme and its achievement is a goal shared by rehabilitation professionals and clients. The factors that influence a physiotherapist's or health professionals decision making around the preparation of a client for community ambulation and the factors that influence a client's decision to return to walking in their community are unclear. To review the available literature about the factors that have influenced the reasoning and decision making of rehabilitation therapists and clients around the topic of ambulation in the community. Three separate searches of the available literature were undertaken using Ovid, Cinahl, ProQuest, Medline and Ebscohost databases. Databases were searched from 1966 to October 2006.The first search explored the literature for factors that influence the clinical reasoning of rehabilitation therapists. The second search explored the literature for factors that influence client's decision to ambulate in the community. A third search was undertaken to explore the literature for the demands of community ambulation in rural communities. Very few studies were found that explored community ambulation in the context of clinical reasoning and decision making, the facilitators and barriers to a clients return to ambulation in their community or the demands of ambulation in a rural community. Consideration of the environment is key to the successful return to walking in the community of clients with mobility problems yet little literature has been found to guide physiotherapist's decision making about preparing a clients to return to walking in the community. An individual's participation in their society is also a result of the interaction between their personal characteristics and his or her environment. The influence of these characteristics may vary from one individual to another yet the factors that influence a person's decision to return to walking in their community

  8. Decision-making in palliative care: a reflective case study.

    Science.gov (United States)

    Birchall, Melissa

    2005-01-01

    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.

  9. The attitude-behavior discrepancy in medical decision making.

    Science.gov (United States)

    He, Fei; Li, Dongdong; Cao, Rong; Zeng, Juli; Guan, Hao

    2014-12-01

    In medical practice, the dissatisfaction of patients about medical decisions made by doctors is often regarded as the fuse of doctor-patient conflict. However, a few studies have looked at why there are such dissatisfactions. This experimental study aimed to explore the discrepancy between attitude and behavior within medical situations and its interaction with framing description. A total of 450 clinical undergraduates were randomly assigned to six groups and investigated using the classic medical decision making problem, which was described either in a positive or a negative frame (2) × decision making behavior\\attitude to risky plan\\attitude to conservative plan (3). A discrepancy between attitude and behavior did exist in medical situations. Regarding medical dilemmas, if the mortality rate was described, subjects had a significant tendency to choose a conservative plan (t = 3.55, P 0.05). However, regardless of the plan chosen by the doctor, the subjects had a significant opposing attitude (P Framing description had a significant impact on both decision making behavior and attitude (t behavior = -3.24, P framing of a description has an impact on medical decision-making.

  10. Multiple triangulation and collaborative research using qualitative methods to explore decision making in pre-hospital emergency care

    Directory of Open Access Journals (Sweden)

    Maxine Johnson

    2017-01-01

    Full Text Available Abstract Background Paramedics make important and increasingly complex decisions at scene about patient care. Patient safety implications of influences on decision making in the pre-hospital setting were previously under-researched. Cutting edge perspectives advocate exploring the whole system rather than individual influences on patient safety. Ethnography (the study of people and cultures has been acknowledged as a suitable method for identifying health care issues as they occur within the natural context. In this paper we compare multiple methods used in a multi-site, qualitative study that aimed to identify system influences on decision making. Methods The study was conducted in three NHS Ambulance Trusts in England and involved researchers from each Trust working alongside academic researchers. Exploratory interviews with key informants e.g. managers (n = 16 and document review provided contextual information. Between October 2012 and July 2013 researchers observed 34 paramedic shifts and ten paramedics provided additional accounts via audio-recorded ‘digital diaries’ (155 events. Three staff focus groups (total n = 21 and three service user focus groups (total n = 23 explored a range of experiences and perceptions. Data collection and analysis was carried out by academic and ambulance service researchers as well as service users. Workshops were held at each site to elicit feedback on the findings and facilitate prioritisation of issues identified. Results The use of a multi-method qualitative approach allowed cross-validation of important issues for ambulance service staff and service users. A key factor in successful implementation of the study was establishing good working relationships with academic and ambulance service teams. Enrolling at least one research lead at each site facilitated the recruitment process as well as study progress. Active involvement with the study allowed ambulance service researchers and service

  11. Multiple triangulation and collaborative research using qualitative methods to explore decision making in pre-hospital emergency care.

    Science.gov (United States)

    Johnson, Maxine; O'Hara, Rachel; Hirst, Enid; Weyman, Andrew; Turner, Janette; Mason, Suzanne; Quinn, Tom; Shewan, Jane; Siriwardena, A Niroshan

    2017-01-24

    Paramedics make important and increasingly complex decisions at scene about patient care. Patient safety implications of influences on decision making in the pre-hospital setting were previously under-researched. Cutting edge perspectives advocate exploring the whole system rather than individual influences on patient safety. Ethnography (the study of people and cultures) has been acknowledged as a suitable method for identifying health care issues as they occur within the natural context. In this paper we compare multiple methods used in a multi-site, qualitative study that aimed to identify system influences on decision making. The study was conducted in three NHS Ambulance Trusts in England and involved researchers from each Trust working alongside academic researchers. Exploratory interviews with key informants e.g. managers (n = 16) and document review provided contextual information. Between October 2012 and July 2013 researchers observed 34 paramedic shifts and ten paramedics provided additional accounts via audio-recorded 'digital diaries' (155 events). Three staff focus groups (total n = 21) and three service user focus groups (total n = 23) explored a range of experiences and perceptions. Data collection and analysis was carried out by academic and ambulance service researchers as well as service users. Workshops were held at each site to elicit feedback on the findings and facilitate prioritisation of issues identified. The use of a multi-method qualitative approach allowed cross-validation of important issues for ambulance service staff and service users. A key factor in successful implementation of the study was establishing good working relationships with academic and ambulance service teams. Enrolling at least one research lead at each site facilitated the recruitment process as well as study progress. Active involvement with the study allowed ambulance service researchers and service users to gain a better understanding of the research

  12. Decision-making: Theory and practice

    Directory of Open Access Journals (Sweden)

    SM Turpin

    2004-12-01

    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.

  13. Factors that impact on emergency nurses' ethical decision-making ability.

    Science.gov (United States)

    Alba, Barbara

    2016-11-10

    Reliance on moral principles and professional codes has given nurses direction for ethical decision-making. However, rational models do not capture the emotion and reality of human choice. Intuitive response must be considered. Supporting intuition as an important ethical decision-making tool for nurses, the aim of this study was to determine relationships between intuition, years of worked nursing experience, and perceived ethical decision-making ability. A secondary aim explored the relationships between rational thought to years of worked nursing experience and perceived ethical decision-making ability. A non-experimental, correlational research design was used. The Rational Experiential Inventory measured intuition and rational thought. The Clinical Decision Making in Nursing Scale measured perceived ethical decision-making ability. Pearson's r was the statistical method used to analyze three primary and two secondary research questions. A sample of 182 emergency nurses was recruited electronically through the Emergency Nurses Association. Participants were self-selected. Approval to conduct this study was obtained by the Adelphi University Institutional Review Board. A relationship between intuition and perceived ethical decision-making ability (r = .252, p = .001) was a significant finding in this study. This study is one of the first of this nature to make a connection between intuition and nurses' ethical decision-making ability. This investigation contributes to a broader understanding of the different thought processes used by emergency nurses to make ethical decisions. © The Author(s) 2016.

  14. Human factors influencing decision making

    OpenAIRE

    Jacobs, Patricia A.

    1998-01-01

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

  15. Exploring the effect of sexual empowerment on sexual decision making in female adolescents.

    Science.gov (United States)

    Hsu, Hsiu-Yueh; Lien, Yu-Fen; Lou, Jiunn-Horng; Chen, Sheng-Hwang; Wang, Ruey-Hsia

    2010-03-01

    Traditional health education may not provide adequate sexual information to female adolescents. Sexual health education for female adolescents broadens opportunities for nurses to help female adolescents adopt appropriate sexual attitudes and make appropriate decisions. The purpose of this study was to understand the effect of sexual empowerment on sexual decision making in female adolescents. Twenty-nine female students with steady boyfriends were invited to participate in a sexual empowerment course. Course activities specifically related to sexual empowerment were audio-tape-recorded. Dialogue content was analyzed, and content provided by each study participant was reconfirmed in face-to-face interviews to understand the entire empowerment process in terms of how such may affect responses and to assess the possibility of correctly reinterpreting findings during the member check process. This study also took into consideration degrees of reliability and rigorousness. The four themes found to underlie participant perceptions of their sexual empowerment to make sex-related decisions were as follows: (a) proactively seeking sexual knowledge, (b) reexamining relationships with boyfriends, (c) the right to say "no" and to engage in self-protection, and (d) the need to change sexual attitudes and behaviors. Using the peer group intervention in sexual empowerment may positively impact sexual health decision making in adolescent girls. Nursing professionals may consider peer group intervention as a sexual empowering method in healthcare.

  16. Sport Management Career Decision-Making Self-Efficacy

    Science.gov (United States)

    Lumpkin, Angela; Franco, Dan; Multon, Karen; Achen, Rebecca M.

    2017-01-01

    Grounded in a social cognitive theoretical perspective, this study explores the career decision-making self-efficacy (CDSE) and vocational identity development process for college students interested or majoring in sport management. While a popular undergraduate major, little research has investigated the specific factors that influence different…

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Dementia, Decision Making, and Capacity.

    Science.gov (United States)

    Darby, R Ryan; Dickerson, Bradford C

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

  19. Culinary Decision Making.

    Science.gov (United States)

    Curtis, Rob

    1987-01-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

  1. Dialogic Consensus In Clinical Decision-Making.

    Science.gov (United States)

    Walker, Paul; Lovat, Terry

    2016-12-01

    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.

  2. Minors' rights in medical decision making.

    Science.gov (United States)

    Hickey, Kathryn

    2007-01-01

    In the past, minors were not considered legally capable of making medical decisions and were viewed as incompetent because of their age. The authority to consent or refuse treatment for a minor remained with a parent or guardian. This parental authority was derived from the constitutional right to privacy regarding family matters, common law rule, and a general presumption that parents or guardians will act in the best interest of their incompetent child. However, over the years, the courts have gradually recognized that children younger than 18 years who show maturity and competence deserve a voice in determining their course of medical treatment. This article will explore the rights and interests of minors, parents, and the state in medical decision making and will address implications for nursing administrators and leaders.

  3. Developing Decision-Making Skill: Experiential Learning in Computer Games

    OpenAIRE

    Kurt A. April; Katja M. J. Goebel; Eddie Blass; Jonathan Foster-Pedley

    2012-01-01

    This paper explores the value that computer and video games bring to learning and leadership and explores how games work as learning environments and the impact they have on personal development. The study looks at decisiveness, decision-making ability and styles, and on how this leadership-related skill is learnt through different paradigms. The paper compares the learning from a lecture to the learning from a designed computer game, both of which have the same content through the use of a s...

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

    Science.gov (United States)

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

    2016-04-01

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

  5. Use of PRA in Shuttle Decision Making Process

    Science.gov (United States)

    Boyer, Roger L.; Hamlin, Teri L.

    2010-01-01

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

  6. Individual decision making, group decision making and deliberation

    Directory of Open Access Journals (Sweden)

    Radovanović Bojana

    2012-01-01

    Full Text Available Each of us makes a number of decisions, from the less important to those with far-reaching consequences. As members of different groups, we are also actors of group decision making. In order to make a rational decision, a choice-making procedure must satisfy a number of assumptions (conditions of rationality. In addition, when it comes to group decisions, those procedures should also be “fair.” However, it is not possible to define a procedure of choice-making that would transform individual orders of alternatives based on preferences of perfectly rational individuals into a single social order and still meet conditions of rationality and ethics. The theory of deliberative democracy appeared in response to the impossibility of Social Choice theory. The basic assumption of deliberative democracy is that individuals adjust their preferences taking into account interests of the community. They are open for discussion with other group members and are willing to change their attitudes in order to achieve common interests. Ideally, group members come to an agreement during public discussion (deliberation. Still, this concept cannot completely over­come all the difficulties posed by the theory of social choice. Specifically, there is no solution for strategic and manipulative behavior of individuals. Also, the concept of deliberative democracy faces certain problems particular to this approach, such as, to name but a few, problems with the establishment of equality of participants in the debate and their motivation, as well as problems with the organization of public hearings. [Projekat Ministarstva nauke Republike Srbije, br. 47009: Evropske integracije i društveno-ekonomske promene privrede Srbije na putu ka EU i br. 179015: Izazovi i perspektive strukturnih promena u Srbiji: Strateški pravci ekonomskog razvoja i usklađivanje sa zahtevima EU

  7. Clinical Decision Making of Nurses Working in Hospital Settings

    Directory of Open Access Journals (Sweden)

    Ida Torunn Bjørk

    2011-01-01

    Full Text Available This study analyzed nurses' perceptions of clinical decision making (CDM in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

  8. Experienced General Music Teachers' Instructional Decision Making

    Science.gov (United States)

    Johnson, Daniel C.; Matthews, Wendy K.

    2017-01-01

    The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…

  9. Data-Based Decision-Making: Developing a Method for Capturing Teachers' Understanding of CBM Graphs

    Science.gov (United States)

    Espin, Christine A.; Wayman, Miya Miura; Deno, Stanley L.; McMaster, Kristen L.; de Rooij, Mark

    2017-01-01

    In this special issue, we explore the decision-making aspect of "data-based decision-making". The articles in the issue address a wide range of research questions, designs, methods, and analyses, but all focus on data-based decision-making for students with learning difficulties. In this first article, we introduce the topic of…

  10. A review of the literature: midwifery decision-making and birth.

    Science.gov (United States)

    Jefford, Elaine; Fahy, Kathleen; Sundin, Deborah

    2010-12-01

    Clinical decision-making was initially studied in medicine where hypothetico-deductive reasoning is the model for decision-making. The nursing perspective on clinical decision-making has largely been shaped by Patricia Benner's ground breaking work. Benner claimed expert nurses use humanistic-intuitive ways of making clinical decisions rather than the 'rational reasoning' as claimed by medicine. Clinical decision-making in midwifery is not the same as either nursing or medical decision-making because of the woman-midwife partnership where the woman is the ultimate decision-maker. CINHAL, Medline and Cochrane databases were systematically searched using key words derived from the guiding question. A review of the decision-making research literature in midwifery was undertaken where studies were published in English. The selection criteria for papers were: only research papers of direct relevance to the guiding research question were included in the review. Decision-making is under-researched in midwifery and more specifically birth, as only 4 research articles met the inclusion criteria in this review. Three of the studies involved qualified midwives, and one involved student midwives. Two studies were undertaken in England, one in Scotland and one in Sweden. The major findings synthesised from this review, are that; (1) midwifery decision-making during birth is socially negotiated involving hierarchies of surveillance and control; (2) the role of the woman in shared decision-making during birth has not been explored by midwifery research; (3) clinical decision-making encompasses clinical reasoning as essential but not sufficient for midwives to actually implement their preferred decision. We argue that existing research does not inform the discipline of the complexity of midwifery clinical decision-making during birth. A well-designed study would involve investigating the clinical reasoning skills of the midwife, her relationship with the woman, the context of the

  11. Decision Making in the Airplane

    Science.gov (United States)

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

    1995-01-01

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

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

    Science.gov (United States)

    Adshead, Lesley; Jamieson, Anne

    2008-01-01

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

  13. Cultural influences on the physician-patient encounter: The case of shared treatment decision-making.

    Science.gov (United States)

    Charles, Cathy; Gafni, Amiram; Whelan, Tim; O'Brien, Mary Ann

    2006-11-01

    In this paper we discuss the influence of culture on the process of treatment decision-making, and in particular, shared treatment decision-making in the physician-patient encounter. We explore two key issues: (1) the meaning of culture and the ways that it can affect treatment decision-making; (2) cultural issues and assumptions underlying the development and use of treatment decision aids. This is a conceptual paper. Based on our knowledge and reading of the key literature in the treatment decision-making field, we looked for written examples where cultural influences were taken into account when discussing the physician-patient encounter and when designing instruments (decision aids) to help patients participate in making decisions. Our assessment of the situation is that to date, and with some recent exceptions, research in the above areas has not been culturally sensitive. We suggest that more research attention should be focused on exploring potential cultural variations in the meaning of and preferences for shared decision-making as well as on the applicability across cultural groups of decision aids developed to facilitate patient participation in treatment decision-making with physicians. Both patients and physicians need to be aware of the cultural assumptions underlying the development and use of decision aids and assess their cultural sensitivity to the needs and preferences of patients in diverse cultural groups.

  14. Parental Decision-Making Preferences in Neonatal Intensive Care.

    Science.gov (United States)

    Weiss, Elliott Mark; Barg, Frances K; Cook, Noah; Black, Emily; Joffe, Steven

    2016-12-01

    To explore how characteristics of medical decisions influence parents' preferences for control over decisions for their seriously ill infants. In qualitative interviews, parents of infants in the neonatal intensive care unit (NICU) were asked to consider all medical decisions they could recall, and were prompted with decisions commonly encountered in the NICU. For each decision, parents were asked detailed questions about who made each decision, whom they would have preferred to make the decision, and why. Using standard qualitative methods, responses were coded and organized such that decision-level characteristics could be analyzed according to preferred decision-making role. Parents identified 2 factors that were associated with a preference to delegate decisions to the medical team (high degree of urgency, high level of required medical expertise) and 4 factors associated with a preference to retain parental control (high perceived risk, high personal experience with the decision, involvement of foreign bodily fluids, and similarity to decisions that they perceived as part of the normal parental role). Characteristics of decisions influence preferences for control over medical decisions among parents of patients in the NICU. These insights may guide improvements in physician-parent communication and consent. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Decision Making Styles and Progress in Occupational Decision Making.

    Science.gov (United States)

    Phillips, Susan D.; And Others

    1984-01-01

    Examined the role of rational, intuitive, and dependent decisional strategies in facilitating decisions about postcollege occupation among college students (N=71). Results indicated that the use of a dependent decision-making style was the single most powerful predictor of progress. (LLL)

  16. Rule-based decision making model

    International Nuclear Information System (INIS)

    Sirola, Miki

    1998-01-01

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

  17. Benefit-Risk Analysis for Decision-Making: An Approach.

    Science.gov (United States)

    Raju, G K; Gurumurthi, K; Domike, R

    2016-12-01

    The analysis of benefit and risk is an important aspect of decision-making throughout the drug lifecycle. In this work, the use of a benefit-risk analysis approach to support decision-making was explored. The proposed approach builds on the qualitative US Food and Drug Administration (FDA) approach to include a more explicit analysis based on international standards and guidance that enables aggregation and comparison of benefit and risk on a common basis and a lifecycle focus. The approach is demonstrated on six decisions over the lifecycle (e.g., accelerated approval, withdrawal, and traditional approval) using two case studies: natalizumab for multiple sclerosis (MS) and bedaquiline for multidrug-resistant tuberculosis (MDR-TB). © 2016 American Society for Clinical Pharmacology and Therapeutics.

  18. Parental Influence on Exploratory Students' College Choice, Major, and Career Decision Making

    Science.gov (United States)

    Workman, Jamie L.

    2015-01-01

    This article explores parental influence on exploratory students' college choice, major, and career decision making. The research began with examination of a first year academic advising model and Living Learning Community. Parental influence emerged as a key theme in student decision making processes. The project was conducted using grounded…

  19. Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Peter James Allen

    2016-02-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  2. Health Care Professional Factors Influencing Shared Medical Decision Making in Korea

    Directory of Open Access Journals (Sweden)

    Kae-Hwa Jo

    2015-11-01

    Full Text Available Till date, the medical decision-making process in Korea has followed the paternalist model, relying on the instructions of physicians. However, in recent years, shared decision making at the end-of-life between physicians and nurses is now emphasized in Korea. The purpose of this study was conducted to explore how health care professionals’ characteristics, attitude toward dignified dying, and moral sensitivity affect their shared medical decision making. The design was descriptive survey. This study was undertaken in two university hospitals in two metropolitan cities, South Korea. The participants were 344 nurses and 80 physicians who work at university hospitals selected by convenience sampling method. Data were collected from January 10 through March 20, 2014 using the Dignified Dying Scale, Moral Sensitivity Scale, and Shared Medical Decision-Making Scale. Shared medical decision making, attitude toward dignified dying, moral sensitivity, age, and working experience had a significant correlation with each other. The factors affecting shared medical decision making of Korean health care professionals were moral sensitivity and attitude toward dignified dying. These variables explained 22.4% of the shared medical decision making. Moral sensitivity and a positive attitude toward dignified dying should be promoted among health care professionals as a part of an educational program for shared medical decision making.

  3. Despite Best Intentions: A Critical Analysis of Social Justice Leadership and Decision Making

    Science.gov (United States)

    DeMatthews, David E.; Mungal, Angus Shiva; Carrola, Paul A.

    2015-01-01

    The purpose of this article is to explore the relationship between social justice leadership and organizational decision making in order to make recommendations for how principals can make more socially just decisions in difficult school contexts. This article begins with a discussion of social justice leadership, facets and theories associated…

  4. Decision-Making under Criteria Uncertainty

    Science.gov (United States)

    Kureychik, V. M.; Safronenkova, I. B.

    2018-05-01

    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.

  5. Cognitive-emotional decision making (CEDM): a framework of patient medical decision making.

    Science.gov (United States)

    Power, Tara E; Swartzman, Leora C; Robinson, John W

    2011-05-01

    Assistance for patients faced with medical decisions has largely focussed on the clarification of information and personal values. Our aim is to draw on the decision research describing the role of emotion in combination with health behaviour models to provide a framework for conceptualizing patient decisions. A review of the psychological and medical decision making literature concerned with the role of emotion/affect in decision making and health behaviours. Emotion plays an influential role in decision making. Both current and anticipated emotions play a motivational role in choice. Amalgamating these findings with that of Leventhal's (1970) SRM provide a framework for thinking about the influence of emotion on a patient medical decision. Our framework suggests that a patient must cope with four sets of elements. The first two relate to the need to manage the cognitive and emotional aspects of the health threat. The second set relate to the management of the cognitive and emotional elements of the decision, itself. The framework provides a way for practitioners and researchers to frame thinking about a patient medical decision in order to assist the patient in clarifying decisional priorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Collective Decision Making as the Actualization of Decision Potential

    Directory of Open Access Journals (Sweden)

    Andrej Ule

    2009-12-01

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

  7. Behavioral Economics: A New Lens for Understanding Genomic Decision Making.

    Science.gov (United States)

    Moore, Scott Emory; Ulbrich, Holley H; Hepburn, Kenneth; Holaday, Bonnie; Mayo, Rachel; Sharp, Julia; Pruitt, Rosanne H

    2018-05-01

    This article seeks to take the next step in examining the insights that nurses and other healthcare providers can derive from applying behavioral economic concepts to support genomic decision making. As genomic science continues to permeate clinical practice, nurses must continue to adapt practice to meet new challenges. Decisions associated with genomics are often not simple and dichotomous in nature. They can be complex and challenging for all involved. This article offers an introduction to behavioral economics as a possible tool to help support patients', families', and caregivers' decision making related to genomics. Using current writings from nursing, ethics, behavioral economic, and other healthcare scholars, we review key concepts of behavioral economics and discuss their relevance to supporting genomic decision making. Behavioral economic concepts-particularly relativity, deliberation, and choice architecture-are specifically examined as new ways to view the complexities of genomic decision making. Each concept is explored through patient decision making and clinical practice examples. This article also discusses next steps and practice implications for further development of the behavioral economic lens in nursing. Behavioral economics provides valuable insight into the unique nature of genetic decision-making practices. Nurses are often a source of information and support for patients during clinical decision making. This article seeks to offer behavioral economic concepts as a framework for understanding and examining the unique nature of genomic decision making. As genetic and genomic testing become more common in practice, it will continue to grow in importance for nurses to be able to support the autonomous decision making of patients, their families, and caregivers. © 2018 Sigma Theta Tau International.

  8. Tools for collaborative decision-making

    CERN Document Server

    Zaraté, Pascale

    2013-01-01

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

  9. Teenagers' perceptions of factors affecting decision-making competence in the management of type 1 diabetes.

    Science.gov (United States)

    Viklund, Gunnel; Wikblad, Karin

    2009-12-01

    Decision-making is an important prerequisite for empowerment. The aim of this study was to explore teenagers' perceptions of factors affecting decision-making competence in diabetes management. A previous study that assessed an empowerment programme for teenagers with diabetes showed no effects on metabolic control or empowerment outcomes, which is not in accordance with results from studies on adult diabetes patients. The definition of empowerment highlights the patient's own responsibility for decision-making. Earlier studies have shown that many teenagers' may not be mature in decision-making competence until late adolescence. To explore the significance of decision-making competence on the effectiveness of empowerment education we wanted to explore teenagers' own view on factors affecting this competence. An explorative, qualitative interview study was conducted with 31 teenagers with type 1 diabetes, aged 12-17 years. The teenagers were interviewed two weeks after completing an empowerment education programme. The interviews were analysed using qualitative content analysis. Five categories stood out as important for decision-making competence: cognitive maturity, personal qualities, experience, social network and parent involvement. Based on the content in the interviews and the five categories, we made an interpretation and formulated an overall theme: 'Teenagers deserve respect and support for their short-comings during the maturity process'. Our conclusion is that teenagers deserve respect for their immature decision-making competence. Decision-making competence was described as cognitive abilities, personal qualifications and experience. To compensate for the deficiencies the teenagers deserve constructive support from their social network and the essential support is expected to come from their parents. These findings can be useful for diabetes team members in supporting teenagers with diabetes and their parents both in individual meetings and when

  10. Viewpoint: Decision-making in committees

    OpenAIRE

    Li Hao; Wing Suen

    2009-01-01

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

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

    OpenAIRE

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

    1996-01-01

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

  12. [Decision making in the elderly: which tools for its evaluation by the clinician?].

    Science.gov (United States)

    Hommet, Caroline; Constans, Thierry; Atanasova, Boriana; Mondon, Karl

    2010-09-01

    Numerous decision-making situations occur in the activities of daily living. The consequences of the decision-making capacity disturbances may have a great impact on the patient's autonomy, financial management, and his or her reaction to a diagnosis as well as the ability to accept a therapeutic option or give informed consent. Decision-making is a complex and multi-dimensional process and brings into play attention, memory and executive functions, which are processed in the prefrontal cortex, particularly vulnerable in aging. A better comprehension of the mechanisms of decision-making, and of the resulting social consequences of their dysfunction may improve autonomy of the elderly. Unfortunately, we still lack appropriate tools to explore decision-making in routine practice.

  13. The psychology of defendant plea decision making.

    Science.gov (United States)

    Redlich, Allison D; Bibas, Stephanos; Edkins, Vanessa A; Madon, Stephanie

    2017-01-01

    Every day, thousands of defendants, prosecutors, and defense attorneys must make guilty plea decisions, such as whether to accept a plea offer or proceed to trial. Most defendants opt to plead guilty; approximately 95% of state and federal convictions result from guilty pleas. In light of a newly emerging body of research and recent Supreme Court decisions on guilty pleas, this article asks and answers 2 questions: First, who pleads guilty and why? We describe the characteristics of those who are more or less likely to plead guilty, and examine the reasons why individuals plead guilty instead of proceeding to trial, exploring the cognitive, social influence, and developmental factors that underlie decision making. Second, are defendants' plea decisions valid, in that the decisions are made knowingly, intelligently, voluntarily, and with a factual basis of guilt? That is, do defendants who plead guilty understand and appreciate the conditions and consequences of their pleas, as required by law? Are innocent people induced to plead guilty to crimes they did not commit? We conclude with suggestions to move the field of plea research forward. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  14. Exploring the association between insecure attachment styles and adolescent autonomy in family decision making: a differentiated approach.

    Science.gov (United States)

    Van Petegem, Stijn; Beyers, Wim; Brenning, Katrijn; Vansteenkiste, Maarten

    2013-12-01

    The present investigation focuses on the associations between adolescents' insecure attachment styles (i.e., anxiety and avoidance) and their autonomous functioning in family decision making. In line with recent insights in the construct of adolescent autonomy, we combined two perspectives on autonomy, differentiating between the degree of independent versus dependent functioning and the self-endorsed and pressuring motives underlying (in)dependent functioning. A longitudinal sample of 327 adolescents (age range = 13-20 years; 64 % girls) completed questionnaires on attachment to the mother and father and on both autonomy operationalisations on two measurement moments spanning a 1-year interval. Structural equation modeling showed that attachment avoidance generally was unrelated to the degree of independent decision making and the motives underlying independent decision making, but related to more pressuring motives for dependent decision making. Anxiety, on the other hand, was associated with a lower degree of independent decision making as well as with more pressuring motives for both independent and dependent decision making. Cross-lagged paths were generally in line with these findings. Theoretical implications are outlined in the discussion.

  15. Shared decision making, paternalism and patient choice.

    Science.gov (United States)

    Sandman, Lars; Munthe, Christian

    2010-03-01

    In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship.

  16. Gender Differences in Bladder Cancer Treatment Decision Making.

    Science.gov (United States)

    Pozzar, Rachel A; Berry, Donna L

    2017-03-01

    To explore gender differences in bladder cancer treatment decision making.
. Secondary qualitative analysis of interview transcripts.
. One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews. Participants were primarily Caucasian, and most had at least some college education.
. Word frequency reports were used to identify thematic differences between the men's and women's statements. Line-by-line coding of constructs prevalent among women was then performed on all participants in NVivo 9. Coding results were compared between genders using matrix coding queries.
. The role of family in the decision-making process was found to be a dominant theme for women but not for men. Women primarily described family members as facilitators of bladder cancer treatment-related decisions, but men were more likely to describe family in a nonsupportive role.
. The results suggest that influences on the decision-making process are different for men and women with bladder cancer. Family may play a particularly important role for women faced with bladder cancer treatment-related decisions.
. Clinical nurses who care for individuals with bladder cancer should routinely assess patients' support systems and desired level of family participation in decision making. For some people with bladder cancer, family may serve as a stressor. Nurses should support the decision-making processes of all patients and be familiar with resources that can provide support to patients who do not receive it from family.

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

    Science.gov (United States)

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

    2010-01-01

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

  18. Reasons, methods used and decision-making for pregnancy ...

    African Journals Online (AJOL)

    Objective: To explore the methods, reasons and decision-making process for termination of pregnancy among adolescents and older women, in Mulago hospital, Kampala, Uganda. Design: Comparative study. Subjects: Nine hundred and forty two women seeking postabortion care, of which 333 had induced abortion (of ...

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

    OpenAIRE

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

    1998-01-01

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

  20. Calm and smart? A selective review of meditation effects on decision making.

    Science.gov (United States)

    Sun, Sai; Yao, Ziqing; Wei, Jaixin; Yu, Rongjun

    2015-01-01

    Over the past two decades, there has been a growing interest in the use of meditation to improve cognitive performance, emotional balance, and well-being. As a consequence, research into the psychological effects and neural mechanisms of meditation has been accumulating. Whether and how meditation affects decision making is not yet clear. Here, we review evidence from behavioral and neuroimaging studies and summarize the effects of meditation on social and non-social economic decision making. Research suggests that meditation modulates brain activities associated with cognitive control, emotion regulation and empathy, and leads to improved non-social and social decision making. Accordingly, we propose an integrative model in which cognitive control, emotional regulation, and empathic concern mediate the effects of meditation on decision making. This model provides insights into the mechanisms by which meditation affects the decision making process. More evidence is needed to test our explanatory model and to explore the function of specific brain areas and their interactive effects on decision making during meditation training.

  1. The amygdala and decision-making.

    Science.gov (United States)

    Gupta, Rupa; Koscik, Timothy R; Bechara, Antoine; Tranel, Daniel

    2011-03-01

    Decision-making is a complex process that requires the orchestration of multiple neural systems. For example, decision-making is believed to involve areas of the brain involved in emotion (e.g., amygdala, ventromedial prefrontal cortex) and memory (e.g., hippocampus, dorsolateral prefrontal cortex). In this article, we will present findings related to the amygdala's role in decision-making, and differentiate the contributions of the amygdala from those of other structurally and functionally connected neural regions. Decades of research have shown that the amygdala is involved in associating a stimulus with its emotional value. This tradition has been extended in newer work, which has shown that the amygdala is especially important for decision-making, by triggering autonomic responses to emotional stimuli, including monetary reward and punishment. Patients with amygdala damage lack these autonomic responses to reward and punishment, and consequently, cannot utilize "somatic marker" type cues to guide future decision-making. Studies using laboratory decision-making tests have found deficient decision-making in patients with bilateral amygdala damage, which resembles their real-world difficulties with decision-making. Additionally, we have found evidence for an interaction between sex and laterality of amygdala functioning, such that unilateral damage to the right amygdala results in greater deficits in decision-making and social behavior in men, while left amygdala damage seems to be more detrimental for women. We have posited that the amygdala is part of an "impulsive," habit type system that triggers emotional responses to immediate outcomes. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Late stillbirth post mortem examination in New Zealand: Maternal decision-making.

    Science.gov (United States)

    Cronin, Robin S; Li, Minglan; Wise, Michelle; Bradford, Billie; Culling, Vicki; Zuccollo, Jane; Thompson, John M D; Mitchell, Edwin A; McCowan, Lesley M E

    2018-03-05

    For parents who experience stillbirth, knowing the cause of their baby's death is important. A post mortem examination is the gold standard investigation, but little is known about what may influence parents' decisions to accept or decline. We aimed to identify factors influencing maternal decision-making about post mortem examination after late stillbirth. In the New Zealand Multicentre Stillbirth Study, 169 women with singleton pregnancies, no known abnormality at recruitment, and late stillbirth (≥28weeks gestation), from seven health regions were interviewed within six weeks of birth. The purpose of this paper was to explore factors related to post mortem examination decision-making and the reasons for declining. We asked women if they would make the same decision again. Maternal decision to decline a post mortem (70/169, 41.4%) was more common among women of Māori (adjusted odds ratio (aOR) 4.99 95% confidence interval (CI) 1.70-14.64) and Pacific (aOR 3.94 95% CI 1.47-10.54) ethnicity compared to European, and parity two or more (aOR 2.95 95% CI 1.14-7.62) compared to primiparous. The main reason for declining was that women 'did not want baby to be cut'. Ten percent (7/70) who declined said they would not make this decision again. No woman who consented regretted her decision. Ethnic differences observed in women's post mortem decision-making should be further explored in future studies. Providing information of the effect of post mortem on the baby's body and the possible emotional benefits of a post mortem may assist women faced with this decision in the future. © 2018 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  3. Technological risk: The limits of science in decision-making

    International Nuclear Information System (INIS)

    Smith, D.; Elliott, P.

    1991-01-01

    The purpose of this paper is to explore the relationship between science and decision making yb reference to a series of debates in South Wales centring around a high-temperature icineration plant operated by Rechem

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

    Science.gov (United States)

    Akçay, Erol; Roughgarden, Joan

    2009-10-13

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

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

    Directory of Open Access Journals (Sweden)

    Erol Akçay

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

  6. Shared decision making in endocrinology: present and future directions.

    Science.gov (United States)

    Rodriguez-Gutierrez, Rene; Gionfriddo, Michael R; Ospina, Naykky Singh; Maraka, Spyridoula; Tamhane, Shrikant; Montori, Victor M; Brito, Juan P

    2016-08-01

    In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making. Decision aids are evidence-based tools that facilitate this process. Shared decision making is a patient-centred approach in which clinicians share information about the benefits, harms, and burden of different reasonable diagnostic and treatment options, and patients explain what matters to them in view of their particular values, preferences, and personal context. Beyond the ethical argument in support of this approach, decision aids have been shown to improve patients' knowledge about the available options, accuracy of risk estimates, and decisional comfort. Decision aids also promote patient participation in the decision-making process. Despite accumulating evidence from clinical trials, policy support, and expert recommendations in endocrinology practice guidelines, shared decision making is still not routinely implemented in endocrine practice. Additional work is needed to enrich the number of available tools and to implement them in practice workflows. Also, although the evidence from randomised controlled trials favours the use of this shared decision making in other settings, populations, and illnesses, the effect of this approach has been studied in a few endocrine disorders. Future pragmatic trials are needed to explore the effect and feasibility of shared decision making implementation into routine endocrinology and primary care practice. With the

  7. Knowledge, decision making, and uncertainty

    International Nuclear Information System (INIS)

    Fox, J.

    1986-01-01

    Artificial intelligence (AI) systems depend heavily upon the ability to make decisions. Decisions require knowledge, yet there is no knowledge-based theory of decision making. To the extent that AI uses a theory of decision-making it adopts components of the traditional statistical view in which choices are made by maximizing some function of the probabilities of decision options. A knowledge-based scheme for reasoning about uncertainty is proposed, which extends the traditional framework but is compatible with it

  8. Modelling decision-making by pilots

    Science.gov (United States)

    Patrick, Nicholas J. M.

    1993-01-01

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

  9. Exploring the challenges of making data physical

    DEFF Research Database (Denmark)

    Alexander, Jason; Jansen, Yvonne; Hornbæk, Kasper

    2015-01-01

    Physical representations of data have existed for thousands of years. However, it is only now that advances in digital fabrication, actuated tangible interfaces, and shape-changing displays can support the emerging area of 'Data Physicalization': the study of computer-supported, physical....... The primary goal of this workshop is to bring together practitioners from a diverse range of communities to explore the challenges in 'making data physical' and to set a research roadmap for the next years....... representations of data and their support for cognition, communication, learning, problem solving and decision making. As physical artifacts, data physicalizations can tap more deeply into our perceptual exploration skills than classical computer setups, while their dynamic physicality alleviates some of the main...

  10. Women's autonomy in household decision-making: a demographic study in Nepal.

    Science.gov (United States)

    Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R

    2010-07-15

    How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between women's household position and their autonomy in decision making. We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making. Women's autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in women's autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Women's increased education is positively associated with autonomy in own health care decision making (p make decision in own healthcare. Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.

  11. Self-Esteem in Decision Making and Decision-Making Styles of Teachers

    Science.gov (United States)

    Temel, Veysel; Birol, Sefa Sahan; Nas, Kazim; Akpinar, Selahattin; Tekin, Murat

    2015-01-01

    The aim of the study was to examine the self-esteem in decision-making and decision-making styles of the teachers in various branches of Çat town of Erzurum Province, Turkey in terms of some variables in 2014-2015 year. A total of 153 teachers (84 females and 69 males) (age (? = 1.6536 ± 0.72837) from different departments participated in the…

  12. Social Context Effects on Decision-Making: A Neurobiological Approach

    NARCIS (Netherlands)

    M. Stallen (Mirre)

    2013-01-01

    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

  13. Leadership, Training, and Gender Influences on Team Decision Making

    National Research Council Canada - National Science Library

    Bird, Megan

    1997-01-01

    This study explored the effects of gender of the leader, gender of the non-leader, and whether the leader or non-leader was trained on team decision making while solving a computerized Tower of Hanoi puzzle...

  14. Consumer and relationship factors associated with shared decision making in mental health consultations.

    Science.gov (United States)

    Matthias, Marianne S; Fukui, Sadaaki; Kukla, Marina; Eliacin, Johanne; Bonfils, Kelsey A; Firmin, Ruth L; Oles, Sylwia K; Adams, Erin L; Collins, Linda A; Salyers, Michelle P

    2014-12-01

    This study explored the association between shared decision making and consumers' illness management skills and consumer-provider relationships. Medication management appointments for 79 consumers were audio recorded. Independent coders rated overall shared decision making, minimum level of shared decision making, and consumer-provider agreement for 63 clients whose visit included a treatment decision. Mental health diagnoses, medication adherence, patient activation, illness management, working alliance, and length of consumer-provider relationships were also assessed. Correlation analyses were used to determine relationships among measures. Overall shared decision making was not associated with any variables. Minimum levels of shared decision making were associated with higher scores on the bond subscale of the Working Alliance Inventory, indicating a higher degree of liking and trust, and with better medication adherence. Agreement was associated with shorter consumer-provider relationships. Consumer-provider relationships and shared decision making might have a more nuanced association than originally thought.

  15. Decision-Making Based on Emotional Images

    OpenAIRE

    Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato

    2011-01-01

    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...

  16. Decision making based on emotional images

    OpenAIRE

    Kentaro eKatahira; Kentaro eKatahira; Kentaro eKatahira; Tomomi eFujimura; Tomomi eFujimura; Kazuo eOkanoya; Kazuo eOkanoya; Kazuo eOkanoya; Masato eOkada; Masato eOkada; Masato eOkada

    2011-01-01

    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...

  17. Informed Decision Making for Percutaneous Coronary Intervention for Stable Coronary Disease.

    Science.gov (United States)

    Rothberg, Michael B; Sivalingam, Senthil K; Kleppel, Reva; Schweiger, Marc; Hu, Bo; Sepucha, Karen R

    2015-07-01

    Patients with stable coronary disease undergoing percutaneous coronary intervention (PCI) are frequently misinformed about the benefits of PCI. Little is known about the quality of decision making before angiography and possible PCI. To assess the quality of informed decision making and its association with patient decisions. We performed a cross-sectional analysis of recorded conversations between August 1, 2008, and August 31, 2012, among adults with known or suspected stable coronary disease at outpatient cardiology practices. Presence of 7 elements of informed decision making and the decision to undergo angiography and possible PCI. Of 59 conversations conducted by 23 cardiologists, 2 (3%) included all 7 elements of informed decision making; 8 (14%) met a more limited definition of procedure, alternatives, and risks. Specific elements significantly associated with not choosing angiography and possible PCI included discussion of uncertainty (odds ratio [OR], 20.5; 95% CI, 2.3-204.9), patient's role (OR, 5.3; 95% CI, 1.3-21.3), exploration of alternatives (OR, 9.5; 95% CI, 2.5-36.5), and exploration of patient preference (OR, 4.8; 95% CI, 1.2-19.4). Neither the presence of angina nor severity of symptoms was associated with choosing angiography and possible PCI. In a multivariable analysis using the total number of elements as a predictor, better informed patients were less likely to choose angiography and possible PCI (OR per additional element, 3.2; 95% CI, 1.4-7.1; P = .005). In conversations between cardiologists and patients with stable angina, informed decision making is often incomplete. More complete discussions are associated with patients choosing not to undergo angiography and possible PCI.

  18. Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making.

    Science.gov (United States)

    Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

    2016-07-19

    Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.

    Science.gov (United States)

    Allegretti, Joseph G.

    This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…

  20. Moral and Ethical Decision Making

    Science.gov (United States)

    2007-07-01

    rational ones (i.e. Kohlberg’s influential model of decision making ). However, non- rational elements, such as affect, risk perception, risk preference...dread or anxiety) play a strong role in many types of decisions , and that the addition of decision makers’ emotions to models of choice may make ...White, 1994) agree that emotions are an integral part of ethical decision making as well. Emotions arise in the context of interpersonal

  1. Decision Making in Voluntary Career Change: An Other-Than-Rational Perspective

    OpenAIRE

    Murtagh, N.; Lopes, P. N.; Lyons, E.

    2011-01-01

    A qualitative study of voluntary career change highlighted the importance of positive emotions, unplanned action, and the construction of certainty and continuity in the realization of change. Interpretative Phenomenological Analysis was used to broaden theoretical understanding of real-life career decision making. The accounts of eight women who had changed careers were explored and the analysis supported other-than-rational perspectives of career decision making. An action-affect-cognition ...

  2. Constraint programming and decision making

    CERN Document Server

    Kreinovich, Vladik

    2014-01-01

    In many application areas, it is necessary to make effective decisions under constraints. Several area-specific techniques are known for such decision problems; however, because these techniques are area-specific, it is not easy to apply each technique to other applications areas. Cross-fertilization between different application areas is one of the main objectives of the annual International Workshops on Constraint Programming and Decision Making. Those workshops, held in the US (El Paso, Texas), in Europe (Lyon, France), and in Asia (Novosibirsk, Russia), from 2008 to 2012, have attracted researchers and practitioners from all over the world. This volume presents extended versions of selected papers from those workshops. These papers deal with all stages of decision making under constraints: (1) formulating the problem of multi-criteria decision making in precise terms, (2) determining when the corresponding decision problem is algorithmically solvable; (3) finding the corresponding algorithms, and making...

  3. Adapting Scott and Bruce's General Decision-Making Style Inventory to Patient Decision Making in Provider Choice.

    Science.gov (United States)

    Fischer, Sophia; Soyez, Katja; Gurtner, Sebastian

    2015-05-01

    Research testing the concept of decision-making styles in specific contexts such as health care-related choices is missing. Therefore, we examine the contextuality of Scott and Bruce's (1995) General Decision-Making Style Inventory with respect to patient choice situations. Scott and Bruce's scale was adapted for use as a patient decision-making style inventory. In total, 388 German patients who underwent elective joint surgery responded to a questionnaire about their provider choice. Confirmatory factor analyses within 2 independent samples assessed factorial structure, reliability, and validity of the scale. The final 4-dimensional, 13-item patient decision-making style inventory showed satisfactory psychometric properties. Data analyses supported reliability and construct validity. Besides the intuitive, dependent, and avoidant style, a new subdimension, called "comparative" decision-making style, emerged that originated from the rational dimension of the general model. This research provides evidence for the contextuality of decision-making style to specific choice situations. Using a limited set of indicators, this report proposes the patient decision-making style inventory as valid and feasible tool to assess patients' decision propensities. © The Author(s) 2015.

  4. Research on self-esteem in decision-making and decision-making styles in orienteering athletes

    OpenAIRE

    Eroğlu Başak; Özkan Zekiye; Eroğlu Arif Kaan; Bilgin Şakire

    2016-01-01

    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 ...

  5. Role of affect in decision making.

    Science.gov (United States)

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

    2013-01-01

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

  6. Building bridges between perceptual and economic decision-making: neural and computational mechanisms

    Directory of Open Access Journals (Sweden)

    Christopher eSummerfield

    2012-05-01

    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.

  7. Parental decision making involvement and decisional conflict: a descriptive study.

    Science.gov (United States)

    Boland, Laura; Kryworuchko, Jennifer; Saarimaki, Anton; Lawson, Margaret L

    2017-06-13

    Decisional conflict is a state of uncertainty about the best treatment option among competing alternatives and is common among adult patients who are inadequately involved in the health decision making process. In pediatrics, research shows that many parents are insufficiently involved in decisions about their child's health. However, little is known about parents' experience of decisional conflict. We explored parents' perceived decision making involvement and its association with parents' decisional conflict. We conducted a descriptive survey study in a pediatric tertiary care hospital. Our survey was guided by validated decisional conflict screening items (i.e., the SURE test). We administered the survey to eligible parents after an ambulatory care or emergency department consultation for their child. Four hundred twenty-nine respondents were included in the analysis. Forty-eight percent of parents reported not being offered treatment options and 23% screened positive for decisional conflict. Parents who reported being offered options experienced less decisional conflict than parents who reported not being offered options (5% vs. 42%, p conflict after their clinical consultation. Involving parents in the decision making process might reduce their risk of decisional conflict. Evidence based interventions that support parent decision making involvement, such as shared decision making, should be evaluated and implemented in pediatrics as a strategy to reduce parents' decisional conflict.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2018-01-11

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

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

    Science.gov (United States)

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

    2015-11-01

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

  11. The Self in Decision Making and Decision Implementation.

    Science.gov (United States)

    Beach, Lee Roy; Mitchell, Terence R.

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

  12. The effect of modelling expert knowledge and uncertainty on multicriteria decision making: a river management case study

    NARCIS (Netherlands)

    Janssen, Judith; Krol, Martinus S.; Schielen, Ralph Mathias Johannes; Hoekstra, Arjen Ysbert

    2010-01-01

    To support decision making on complex environmental issues, models are often used to explore the potential impacts of different management alternatives on the environmental system. We explored how different model outcomes affect decision making. Two topics have our particular interest, namely (1)

  13. Perceptions of shared decision making and decision aids among rural primary care clinicians.

    Science.gov (United States)

    King, Valerie J; Davis, Melinda M; Gorman, Paul N; Rugge, J Bruin; Fagnan, L J

    2012-01-01

    Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.

  14. Conflict when making decisions about dialysis modality.

    Science.gov (United States)

    Chen, Nien-Hsin; Lin, Yu-Ping; Liang, Shu-Yuan; Tung, Heng-Hsin; Tsay, Shiow-Luan; Wang, Tsae-Jyy

    2018-01-01

    To explore decisional conflict and its influencing factors on choosing dialysis modality in patients with end-stage renal diseases. The influencing factors investigated include demographics, predialysis education, dialysis knowledge, decision self-efficacy and social support. Making dialysis modality decisions can be challenging for patients with end-stage renal diseases; there are pros and cons to both haemodialysis and peritoneal dialysis. Patients are often uncertain as to which one will be the best alternative for them. This decisional conflict increases the likelihood of making a decision that is not based on the patient's values or preferences and may result in undesirable postdecisional consequences. Addressing factors predisposing patients to decisional conflict helps to facilitate informed decision-making and then to improve healthcare quality. A predictive correlational cross-sectional study design was used. Seventy patients were recruited from the outpatient dialysis clinics of two general hospitals in Taiwan. Data were collected with study questionnaires, including questions on demographics, dialysis modality and predialysis education, the Dialysis Knowledge Scale, the Decision Self-Efficacy scale, the Social Support Scale, and the Decisional Conflict Scale. The mean score on the Decisional Conflict Scale was 29.26 (SD = 22.18). Decision self-efficacy, dialysis modality, predialysis education, professional support and dialysis knowledge together explained 76.4% of the variance in decisional conflict. Individuals who had lower decision self-efficacy, did not receive predialysis education on both haemodialysis and peritoneal dialysis, had lower dialysis knowledge and perceived lower professional support reported higher decisional conflict on choosing dialysis modality. When providing decisional support to predialysis stage patients, practitioners need to increase patients' decision self-efficacy, provide both haemodialysis and peritoneal dialysis

  15. Linking Rights with Lives: The Micropolitics of Educational Decision Making in Urban Mexico

    Science.gov (United States)

    Blasco, Maribel

    2009-01-01

    This article uses life course theory and family bargaining theory to explore how decisions over schooling are negotiated in poorer Mexican families for whom compulsory basic education is a luxury. It explores educational decision making by conceptualizing education in terms of the way it meshes with other social relations and institutions across…

  16. Decision making by relatives about brain death organ donation: an integrative review.

    Science.gov (United States)

    de Groot, Jack; Vernooij-Dassen, Myrra; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; van Leeuwen, Evert

    2012-06-27

    Deciding about the organ donation of one's brain-dead beloved often occurs in an unexpected and delicate situation. We explored the decision making of the relatives of potential brain-dead donors, its evaluation, and the factors influencing decision making. We used the integrative review method. Our search included 10 databases. Inclusion criteria were presence of the donation request or the subsequent decision process. Three authors independently assessed the eligibility of identified articles. Content analysis of 70 included articles led to three themes: decision, evaluation, and support. We extracted results and recommendations concerning these three themes. The timing of the request and understandable information influence the decision. The relatives evaluate their decision differently: in case of refusal, approximately one third regret their decision, and in case of consent, approximately one tenth mention regret. The relatives are often ambivalent about their values (protection, altruism, and respect) and the deceased's wishes, not wanting additional suffering either for their beloved or for themselves. Support is mainly focused on increasing consent rates and less on satisfaction with the decision. Evaluation of decision making by the relatives of potential brain-dead donors reveals possibilities for improving the decision process. Special skills of the requester, attention to the circumstances, and unconditional support for the relatives might prevent the relatives' regret about refusal and unnecessary loss of organs. We hypothesize that support in exploring the relatives' values and the deceased's wishes can lead to stable decisions. This hypothesis deserves further investigation.

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

    Science.gov (United States)

    Colakkadioglu, Oguzhan; Celik, D. Billur

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Szymaniec-Mlicka Karolina

    2017-05-01

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

  19. Framing matters: Effects of framing on older adults’ exploratory decision-making

    Science.gov (United States)

    Cooper, Jessica A.; Blanco, Nathaniel; Maddox, W. Todd

    2016-01-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults’ decision-making performance was preserved when maximizing gains, but declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains-maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subjects behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss-minimization from Experiment 1, and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults’ performance in exploratory decision-making is hindered when framed as loss-minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. PMID:27977218

  20. A New Interlink Decision Making Index for Making Multi-criteria Decision

    Directory of Open Access Journals (Sweden)

    Eric Hu

    2012-11-01

    Full Text Available Multi-criteria decisions usually require measurement or evaluation of performance in different units and their mix by application of weighting factors. This approach lads to potential manipulation of the results as a direct consequence of the applied weightings. In this paper a mechanism that is the brain child of the authors, has been proposed to overcome this problem. It is known as the Interlink Decision Making Index (IDMI and has all the desired features: simple, interlink (all criteria and automatically guaranteed dominant influence of critical criteria (i.e. no human weighting needed. The IDMI is capable of reflecting the total merits of a particular option once the normal decision making criteria and (up to two critical criteria have been chosen. Then, without arbitrarily weighting criteria, comparison and selection of the best possible option can be made. Simple software has been developed to do this numerical transfer and graphic presentation. Two hypothetical examples are presented in the paper to demonstrate the application of the IDMI concept and its advantages over the traditional "tabular and weightingmethod" in the decision making process. 

  1. Exploring emotions and the shared decision-making process in pediatric primary care

    Directory of Open Access Journals (Sweden)

    Francesca Dicé

    2016-12-01

    Full Text Available This paper aims to identify conversational interaction patterns in pediatrics with a focus on the shared decision-making process and dialogue about emotions in doctor–patient relationships. We documented conversations in 163 visits by 168 children in pediatric primary care; we observed, audiorecordered, transcribed and analyzed them with specific instruments of analysis of doctor patient relationship. Our survey was conducted in four pediatric primary care practices and 15 health providers were involved. The data collection period lasted three months and was undertaken twice a week on days. We analyzed visits with Verona Coding Definitions of Emotional Sequences (VR-CoDES and Observing Patient Involvement in Shared Decision Making (OPTION instruments. Frequencies of emotions’ signals (cues/concerns obtained using VR-CoDES were analyzed and compared with the OPTION ratings. We documented 318 cues/concerns for parents and 167 for children. The relationship between cues/concerns and Healthcare Providers responses was strongest in dialogues between parents and pediatricians. The conversational patterns focused on the procedures of the care, with little opportunities of dialogue about emerging emotions. We also observed limited possibilities for participant involvement, especially by children, due to several difficulties integrating dialogue about emotions and concordance processes. The conversations seemed to be characterized by rarity of shared decision making or attention to the informational value of children’s emotions. It could be useful to implement psychological interventions to achieve an enrichment of the dialogue between participants, helping them to incorporate emotions into conversations and to recognize decisional competences, necessary to concordance processes.

  2. Patient Decision-Making About Emergency and Planned Stoma Surgery for IBD: A Qualitative Exploration of Patient and Clinician Perspectives.

    Science.gov (United States)

    Dibley, Lesley; Czuber-Dochan, Wladyslawa; Wade, Tiffany; Duncan, Julie; Burch, Jennie; Warusavitarne, Janindra; Norton, Christine; Artom, Micol; O'Sullivan, Liam; Verjee, Azmina; Cann, Denise

    2018-01-18

    Many inflammatory bowel disease (IBD) patients worry about stoma-forming surgery (SFS), sometimes enduring poor bowel-related quality of life to avoid it. Anticipation of SFS and whether expectations match experience is underreported. This qualitative study explored influences on patients' SFS decision-making and compared preoperative concerns with postoperative outcomes. We purposively recruited participants with IBD from UK hospital outpatient and community sources, and IBD clinicians from public hospitals. Four focus groups, 29 semistructured patient participant interviews, and 18 clinician interviews were audio recorded, transcribed, and analysed thematically. Participants had a current temporary, recently-reversed, or permanent stoma, or were stoma naive. Four themes emerged: Preoperative concerns and expectations, Patient decision-making, Surgery and recovery, and Long-term outcomes. Participants and clinicians agreed about most preoperative concerns, that outcomes were often better than expected, and support from others with a stoma is beneficial. Patient decision-making involves multiple factors, including disease status. Some clinicians avoid discussing SFS, and the phrase 'last resort' can bias patient perceptions; others recommend early discussion, increasing dialogue when medical management becomes ineffective. The postoperative period is particularly challenging for patients. Stoma acceptance is influenced by personal perceptions and pre- and postoperative clinical and social support. Patients need balanced information on all treatment options, including surgery, from an early stage. Early multidisciplinary team dialogue about SFS, and contact with others living well with a stoma, could enable informed decision-making. Life with a stoma is often better than anticipated, improving quality of life and control. Ongoing specialist nursing support aids recovery and adjustment. © 2018 Crohn’s & Colitis Foundation of America. Published by Oxford University

  3. Optimising Transport Decision Making using Customised Decision Models and Decision Conferences

    DEFF Research Database (Denmark)

    Barfod, Michael Bruhn

    The subject of this Ph.D. thesis entitled “Optimising Transport Decision Making using Customised Decision Models and Decision Conferences” is multi-criteria decision analysis (MCDA) and decision support in the context of transport infrastructure assessments. Despite the fact that large amounts...... is concerned with the insufficiency of conventional cost-benefit analysis (CBA), and proposes the use of MCDA as a supplementing tool in order to also capture impacts of a more strategic character in the appraisals and hence make more use of the often large efforts put in the preliminary examinations. MCDA...... and rail to bike transport projects. Two major concerns have been to propose an examination process that can be used in situations where complex decision problems need to be addressed by experts as well as non-experts in decision making, and to identify appropriate assessment techniques to be used...

  4. Collaborative Decision Making in METOC

    Science.gov (United States)

    2002-01-01

    desired effect (Eagly, & Chaiken, 1993). Arguably, artificial intelligence is representative of the best of approaches in rational decision - making ...2001), The quantum of social action and the function of emotion in decision - making , Emotional and Intelligent II: The Tangled Knot of Social...Collaborative decision making in METOC W.F. Lawless Paine College, Departments of Mathematics and Psychology Augusta, GA 30901-3182 ph: 706

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

    Science.gov (United States)

    Perez, Maya; Gati, Itamar

    2017-01-01

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

  6. 'Gun! Gun! Gun!': An exploration of law enforcement officers' decision-making and coping under stress during actual events.

    Science.gov (United States)

    Harris, Kevin R; Eccles, David W; Freeman, Carlos; Ward, Paul

    2017-08-01

    Research on decision-making under stress has mainly involved laboratory-based studies with few contextual descriptions of decision-making under stress in the natural ecology. We examined how police officers prepared for, coped with and made decisions under threat-of-death stress during real events. A delayed retrospective report method was used to elicit skilled police officers' thoughts and feelings during attempts to resolve such events. Reports were analysed to identify experiences of stress and coping, and thought processes underpinning decision-making during the event. Officers experienced a wide range of events, coped with stress predominantly via problem-focused strategies, and adapted their decision-making under stress based on the available context. Future officer training should involve a greater variety of training scenarios than is involved in current training, and expose trainees to the possible variants of each situation to foster better situational representation and, thus, a more reliable and adaptive mental model for use in decision-making. Practitioner Summary: This study concerns decision-making and coping strategies used by skilled police officers during real threat-of-death situations. Officers' decision-making strategies differed according to the complexity of the situation and they coped with the stress of these situations via attempts to resolve the situations (e.g. by planning responses) and, to a lesser extent, via attempts to deal with their emotions.

  7. "Piensa" twice: on the foreign language effect in decision making.

    Science.gov (United States)

    Costa, Albert; Foucart, Alice; Arnon, Inbal; Aparici, Melina; Apesteguia, Jose

    2014-02-01

    In this article, we assess to what extent decision making is affected by the language in which a given problem is presented (native vs. foreign). In particular, we aim to ask whether the impact of various heuristic biases in decision making is diminished when the problems are presented in a foreign language. To this end, we report four main studies in which more than 700 participants were tested on different types of individual decision making problems. In the first study, we replicated Keysar et al.'s (2012) recent observation regarding the foreign language effect on framing effects related to loss aversion. In the second section, we assessed whether the foreign language effect is present in other types of framing problems that involve psychological accounting biases rather than gain/loss dichotomies. In the third section, we studied the foreign language effect in several key aspects of the theory of decision making under risk and uncertainty. In the fourth study, we assessed the presence of a foreign language effect in the cognitive reflection test, a test that includes logical problems that do not carry emotional connotations. The absence of such an effect in this test suggests that foreign language leads to a reduction of heuristic biases in decision making across a range of decision making situations and provide also some evidence about the boundaries of the phenomenon. We explore several potential factors that may underlie the foreign language effect in decision making. Copyright © 2013 Elsevier B.V. All rights reserved.

  8. What Policy Actors Seek for: Reciprocal Misunderstanding of Objectives of Participatory Decision Making

    OpenAIRE

    Birutė PITRĖNAITĖ-ŽILĖNIENĖ; Birutė MIKULSKIENĖ

    2013-01-01

    The goal of this research is to explore different policy actors’ attitudes towards participation in public decision making. The paper examines objectives of external participants’ involvement and compares various participants’ judgements on the process and results of participation. We screened operation of formal networks of participatory decision making at the Lithuanian Ministries of Health and Education & Science. The research revealed the willingness of decision makers to allow different ...

  9. Enabling joined-up decision making with geotemporal information

    Science.gov (United States)

    Smith, M. J.; Ahmed, S. E.; Purves, D. W.; Emmott, S.; Joppa, L. N.; Caldararu, S.; Visconti, P.; Newbold, T.; Formica, A. F.

    2015-12-01

    While the use of geospatial data to assist in decision making is becoming increasingly common, the use of geotemporal information: information that can be indexed by geographical space AND time, is much rarer. I will describe our scientific research and software development efforts intended to advance the availability and use of geotemporal information in general. I will show two recent examples of "stacking" geotemporal information to support land use decision making in the Brazilian Amazon and Kenya, involving data-constrained predictive models and empirically derived datasets of road development, deforestation, carbon, agricultural yields, water purification and poverty alleviation services and will show how we use trade-off analyses and constraint reasoning algorithms to explore the costs and benefits of different decisions. For the Brazilian Amazon we explore tradeoffs involved in different deforestation scenarios, while for Kenya we explore the impacts of conserving forest to support international carbon conservation initiatives (REDD+). I will also illustrate the cloud-based software tools we have developed to enable anyone to access geotemporal information, gridded (e.g. climate) or non-gridded (e.g. protected areas), for the past, present or future and incorporate such information into their analyses (e.g. www.fetchclimate.org), including how we train new predictive models to such data using Bayesian techniques: on this latter point I will show how we combine satellite and ground measured data with predictive models to forecast how crops might respond to climate change.

  10. Decision-making: Theory and Practice

    CSIR Research Space (South Africa)

    Turpin, SM

    2004-01-01

    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...

  11. A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences.

    Science.gov (United States)

    Smith, Michael A; Clayman, Marla L; Frader, Joel; Arenson, Melanie; Haber-Barker, Natalie; Ryan, Claire; Emanuel, Linda; Michelson, Kelly

    2018-06-19

    Little is known about how decision-making conversations occur during pediatric intensive care unit (PICU) family conferences (FCs). Describe the decision-making process and implementation of shared decision making (SDM) during PICU FCs. Observational study. University-based tertiary care PICU, including 31 parents and 94 PICU healthcare professionals involved in FCs. We recorded, transcribed, and analyzed 14 PICU FCs involving decision-making discussions. We used a modified grounded theory and content analysis approach to explore the use of traditionally described stages of decision making (DM) (information exchange, deliberation, and determining a plan). We also identified the presence or absence of predefined SDM elements. DM involved the following modified stages: information exchange; information-oriented deliberation; plan-oriented deliberation; and determining a plan. Conversations progressed through stages in a nonlinear manner. For the main decision discussed, all conferences included a presentation of the clinical issues, treatment alternatives, and uncertainty. A minority of FCs included assessing the family's understanding (21%), assessing the family's need for input from others (28%), exploring the family's desired decision-making role (35%), and eliciting the family's opinion (42%). In the FCs studied, we found that DM is a nonlinear process. We also found that several SDM elements that could provide information about parents' perspectives and needs did not always occur, identifying areas for process improvement.

  12. Decision-Making Theories and Models: A Discussion of Rational and Psychological Decision-Making Theories and Models: The Search for a Cultural-Ethical Decision-Making Model

    OpenAIRE

    Oliveira, Arnaldo

    2007-01-01

    This paper examines rational and psychological decision-making models. Descriptive and normative methodologies such as attribution theory, schema theory, prospect theory, ambiguity model, game theory, and expected utility theory are discussed. The definition of culture is reviewed, and the relationship between culture and decision making is also highlighted as many organizations use a cultural-ethical decision-making model.

  13. Serotonin and decision making processes.

    Science.gov (United States)

    Homberg, Judith R

    2012-01-01

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

  14. Nuclear regulatory decision making

    International Nuclear Information System (INIS)

    2005-01-01

    The fundamental objective of all nuclear safety regulatory bodies is to ensure that nuclear utilities operate their plants at all times in an acceptably safe manner. In meeting this objective, the regulatory body should strive to ensure that its regulatory decisions are technically sound, consistent from case to case, and timely. In addition, the regulator must be aware that its decisions and the circumstances surrounding those decisions can affect how its stakeholders, such as government policy makers, the industry it regulates, and the public, view it as an effective and credible regulator. In order to maintain the confidence of those stakeholders, the regulator should make sure that its decisions are transparent, have a clear basis in law and regulations, and are seen by impartial observers to be fair to all parties. Based on the work of a Nuclear Energy Agency (NEA) expert group, this report discusses some of the basic principles and criteria that a regulatory body should consider in making decisions and describes the elements of an integrated framework for regulatory decision making. (author)

  15. Calm and Smart? A Selective Review on Effects of Meditation on Decision Making

    Directory of Open Access Journals (Sweden)

    Sai eSun

    2015-07-01

    Full Text Available Over the past two decades, there has been a growing interest in the use of meditation to improve cognitive performance, emotional balance, and well-being. As a consequence, research into the psychological effects and neural mechanisms of meditation has been accumulating. Whether and how meditation affects decision making is not yet clear. Here, we review evidence from behavioral and neuroimaging studies and summarize the effects of meditation on social and nonsocial economic decision making. Research suggests that meditation modulates brain activities associated with cognitive control, emotion regulation and empathy, and leads to improved nonsocial and social decision making. Accordingly, we propose an integrative model in which cognitive control, emotional regulation, and empathic concern mediate the effects of meditation on decision making. This model provides insights into the mechanisms by which meditation affects the decision making process. More evidence is needed to test our explanatory model and to explore the function of specific brain areas and their interactive effects on decision making during meditation training.

  16. Before you make that big decision...

    Science.gov (United States)

    Kahneman, Daniel; Lovallo, Dan; Sibony, Olivier

    2011-06-01

    When an executive makes a big bet, he or she typically relies on the judgment of a team that has put together a proposal for a strategic course of action. After all, the team will have delved into the pros and cons much more deeply than the executive has time to do. The problem is, biases invariably creep into any team's reasoning-and often dangerously distort its thinking. A team that has fallen in love with its recommendation, for instance, may subconsciously dismiss evidence that contradicts its theories, give far too much weight to one piece of data, or make faulty comparisons to another business case. That's why, with important decisions, executives need to conduct a careful review not only of the content of recommendations but of the recommendation process. To that end, the authors-Kahneman, who won a Nobel Prize in economics for his work on cognitive biases; Lovallo of the University of Sydney; and Sibony of McKinsey-have put together a 12-question checklist intended to unearth and neutralize defects in teams' thinking. These questions help leaders examine whether a team has explored alternatives appropriately, gathered all the right information, and used well-grounded numbers to support its case. They also highlight considerations such as whether the team might be unduly influenced by self-interest, overconfidence, or attachment to past decisions. By using this practical tool, executives will build decision processes over time that reduce the effects of biases and upgrade the quality of decisions their organizations make. The payoffs can be significant: A recent McKinsey study of more than 1,000 business investments, for instance, showed that when companies worked to reduce the effects of bias, they raised their returns on investment by seven percentage points. Executives need to realize that the judgment of even highly experienced, superbly competent managers can be fallible. A disciplined decision-making process, not individual genius, is the key to good

  17. Decision making on fitness landscapes

    Science.gov (United States)

    Arthur, R.; Sibani, P.

    2017-04-01

    We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et al. that we call the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures.

  18. Decision Making on Fitness Landscapes

    DEFF Research Database (Denmark)

    Arthur, Rudy; Sibani, Paolo

    2017-01-01

    We discuss fitness landscapes and how they can be modified to account for co-evolution. We are interested in using the landscape as a way to model rational decision making in a toy economic system. We develop a model very similar to the Tangled Nature Model of Christensen et. al. that we call...... the Tangled Decision Model. This is a natural setting for our discussion of co-evolutionary fitness landscapes. We use a Monte Carlo step to simulate decision making and investigate two different decision making procedures....

  19. Factors influencing the clinical decision-making of midwives: a qualitative study.

    Science.gov (United States)

    Daemers, Darie O A; van Limbeek, Evelien B M; Wijnen, Hennie A A; Nieuwenhuijze, Marianne J; de Vries, Raymond G

    2017-10-06

    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

  20. Finding the first among equals: role of cognitive styles in entrepreneurial decision-making of novices

    NARCIS (Netherlands)

    Stienstra, Martin R.; Singaram, Raja; Ehrenhard, Michel Léon

    2014-01-01

    Effectuation theory explains how expert entrepreneurs differ in decision-making during situations of high uncertainty and low information availability. Exploring the cognitive reasoning behind effectual decision-making offers fertile ground for research as well as teaching entrepreneurship.

  1. Adults' decision-making about the electronic waste issue: The role of the nature of science conceptualizations and moral concerns in socio-scientific decision-making

    Science.gov (United States)

    Yu, Yuqing

    Socio-scientific issues have become increasingly important in Science-Technology-Society (STS) education as a means to make science learning more relevant to students' lives. This study used the e-waste issue as a context to investigate two aspects of socio-scientific decision-making: (1) the relationship between the nature of science (NOS) conceptualizations and decision-making; and (2) moral concerns involved in the process of decision-making. This study contributes to the field of socio-scientific issue research and STS education in the following ways. First, it is the first study that performed meta-analysis to seek the relationship between the NOS understanding and decision-making. This study concludes that valuable NOS conceptualizations that are highly related to the socio-scientific issue under investigation, rather than general NOS understanding, exert statistically significant influences on decision-making. Second, this study empirically examined the Multiple Responses Model (MRM), which enables the transfer of qualitative NOS responses into quantitative data, and hence, inferential statistics. The current study justifies the significance of unidimensionality to the application of the MRM. It addresses the limitations associated with the MRM and provides implications for future use of the MRM in other contexts. Finally, the study explores the role of moral concerns in socio-scientific decision-making. Eight participants engaged in interviews that were designed to elicit their reactions and feelings regarding the issue of exporting e-waste to poor countries. Qualitative analyses demonstrated that moral considerations were significant influences on decision-making. In addition, participants' action responses revealed that they were motivated to take action to help the environment. The study has implications for socio-scientific issue studies in other contexts and for teacher education programs that use socio-scientific issues to advance teachers' reasoning

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

    Science.gov (United States)

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

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

  3. Nurse aide decision making in nursing homes: factors affecting empowerment.

    Science.gov (United States)

    Chaudhuri, Tanni; Yeatts, Dale E; Cready, Cynthia M

    2013-09-01

    To evaluate factors affecting structural empowerment among nurse aides in nursing homes. Structural empowerment can be defined as the actual rather than perceived ability to make autonomous decisions within an organisation. Given the paucity of research on the subject, this study helps to close the gap by identifying factors that affect nurse aide empowerment, that is, decision-making among nurse aides. The data for the study come from self-administered questionnaires distributed to direct-care workers (nurse aides) in 11 nursing homes in a southern state in the USA. Ordinary least square regression models were estimated to analyse the effects of demographic predictors, personal factors (competency, emotional exhaustion and positive attitude) and structural characteristics (coworker and supervisor support, information availability and shared governance) on nurse aide decision-making. Findings suggest race among demographic predictors, emotional exhaustion among personal characteristics, and supervisor support, and shared governance among structural factors, significantly affect nurse aide decision-making. It is important to explore race as one of the central determinants of structural empowerment among nurse aides. In addition, the nature and type of emotional exhaustion that propels decision-making needs to be further examined. The study shows the importance of shared governance and supervisor support for fostering nurse aide empowerment. © 2013 Blackwell Publishing Ltd.

  4. Decision Making in Adults with ADHD

    Science.gov (United States)

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

    2012-01-01

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

  5. Fear and decision-making in narcissistic personality disorder-a link between psychoanalysis and neuroscience.

    Science.gov (United States)

    Ronningstam, Elsa; Baskin-Sommers, Arielle R

    2013-06-01

    Linking psychoanalytic studies with neuroscience has proven increasingly productive for identifying and understanding personality functioning. This article focuses on pathological narcissism and narcissistic personality disorder (NPD), with the aim of exploring two clinically relevant aspects of narcissistic functioning also recognized in psychoanalysis: fear and decision-making. Evidence from neuroscientific studies of related conditions, such as psychopathy, suggests links between affective and cognitive functioning that can influence the sense of self-agency and narcissistic self-regulation. Attention can play a crucial role in moderating fear and self-regulatory deficits, and the interaction between experience and emotion can be central for decision-making. In this review we will explore fear as a motivating factor in narcissistic personality functioning, and the impact fear may have on decision-making in people with pathological narcissism and NPD. Understanding the processes and neurological underpinnings of fear and decision-making can potentially influence both the diagnosis and treatment of NPD.

  6. Fear and decision-making in narcissistic personality disorder—a link between psychoanalysis and neuroscience

    Science.gov (United States)

    Ronningstam, Elsa; Baskin-Sommers, Arielle R.

    2013-01-01

    Linking psychoanalytic studies with neuroscience has proven increasingly productive for identifying and understanding personality functioning. This article focuses on pathological narcissism and narcissistic personality disorder (NPD), with the aim of exploring two clinically relevant aspects of narcissistic functioning also recognized in psychoanalysis: fear and decision-making. Evidence from neuroscientific studies of related conditions, such as psychopathy, suggests links between affective and cognitive functioning that can influence the sense of self-agency and narcissistic self-regulation. Attention can play a crucial role in moderating fear and self-regulatory deficits, and the interaction between experience and emotion can be central for decision-making. In this review we will explore fear as a motivating factor in narcissistic personality functioning, and the impact fear may have on decision-making in people with pathological narcissism and NPD. Understanding the processes and neurological underpinnings of fear and decision-making can potentially influence both the diagnosis and treatment of NPD. PMID:24174893

  7. Interference effects of categorization on decision making.

    Science.gov (United States)

    Wang, Zheng; Busemeyer, Jerome R

    2016-05-01

    Many decision making tasks in life involve a categorization process, but the effects of categorization on subsequent decision making has rarely been studied. This issue was explored in three experiments (N=721), in which participants were shown a face stimulus on each trial and performed variations of categorization-decision tasks. On C-D trials, they categorized the stimulus and then made an action decision; on X-D trials, they were told the category and then made an action decision; on D-alone trials, they only made an action decision. An interference effect emerged in some of the conditions, such that the probability of an action on the D-alone trials (i.e., when there was no explicit categorization before the decision) differed from the total probability of the same action on the C-D or X-D trials (i.e., when there was explicit categorization before the decision). Interference effects are important because they indicate a violation of the classical law of total probability, which is assumed by many cognitive models. Across all three experiments, a complex pattern of interference effects systematically occurred for different types of stimuli and for different types of categorization-decision tasks. These interference effects present a challenge for traditional cognitive models, such as Markov and signal detection models, but a quantum cognition model, called the belief-action entanglement (BAE) model, predicted that these results could occur. The BAE model employs the quantum principles of superposition and entanglement to explain the psychological mechanisms underlying the puzzling interference effects. The model can be applied to many important and practical categorization-decision situations in life. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Strategic decision making

    NARCIS (Netherlands)

    Stokman, Frans N.; Assen, Marcel A.L.M. van; Knoop, Jelle van der; Oosten, Reinier C.H. van

    2000-01-01

    This paper introduces a methodology for strategic intervention in collective decision making.The methodology is based on (1) a decomposition of the problem into a few main controversial issues, (2) systematic interviews of subject area specialists to obtain a specification of the decision

  9. Motivations Underlying Career Decision-Making Activities: The Career Decision-Making Autonomy Scale (CDMAS)

    Science.gov (United States)

    Guay, Frederic

    2005-01-01

    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…

  10. Ethical aspect price decision making

    Directory of Open Access Journals (Sweden)

    Grubor Aleksandar

    2007-01-01

    Full Text Available Price decision making in a marketing program framework creatings is a complicated and delicated part of marketing management, especially to keep in sight culminating of mass external factors. In a market economies price policy as a marketing mix instrument rarely is regulated by the law, which opening the ethical aspect questions of price decision making process. The ethics in the price decision making means consideration of the inner law of the individual (marketing managers and/or consumers, whose irreverence does not entail any juridical sanctions, rather its application is sanctioned by the self - awareness. The acception and stability of the ethical aspect price decision making are determined by the characteristic of selected marketing environment.

  11. Ethical decision making

    OpenAIRE

    Zsolnai, László

    2011-01-01

    The self-centeredness of modern organizations leads to environmental destruction and human deprivation. The principle of responsibility developed by Hans Jonas requires caring for the beings affected by our decisions and actions. Ethical decision-making creates a synthesis of reverence for ethical norms, rationality in goal achievement, and respect for the stakeholders. The maximin rule selects the "least worst alternative" in the multidimensional decision space of deontologica...

  12. [Cognitive mechanisms in risky decision-making in cannabis users].

    Science.gov (United States)

    J R, Alameda-Bailén; M P, Salguero-Alcañiz; A, Merchán-Clavellino; S, Paíno-Quesada

    2014-01-01

    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.

  13. Shared decision-making and patient autonomy.

    Science.gov (United States)

    Sandman, Lars; Munthe, Christian

    2009-01-01

    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.

  14. Rough multiple objective decision making

    CERN Document Server

    Xu, Jiuping

    2011-01-01

    Rough Set TheoryBasic concepts and properties of rough sets Rough Membership Rough Intervals Rough FunctionApplications of Rough SetsMultiple Objective Rough Decision Making Reverse Logistics Problem with Rough Interval Parameters MODM based Rough Approximation for Feasible RegionEVRMCCRMDCRM Reverse Logistics Network Design Problem of Suji Renewable Resource MarketBilevel Multiple Objective Rough Decision Making Hierarchical Supply Chain Planning Problem with Rough Interval Parameters Bilevel Decision Making ModelBL-EVRM BL-CCRMBL-DCRMApplication to Supply Chain Planning of Mianyang Co., LtdStochastic Multiple Objective Rough Decision Multi-Objective Resource-Constrained Project Scheduling UnderRough Random EnvironmentRandom Variable Stochastic EVRM Stochastic CCRM Stochastic DCRM Multi-Objective rc-PSP/mM/Ro-Ra for Longtan Hydropower StationFuzzy Multiple Objective Rough Decision Making Allocation Problem under Fuzzy Environment Fuzzy Variable Fu-EVRM Fu-CCRM Fu-DCRM Earth-Rock Work Allocation Problem.

  15. Decision Simulation Technique (DST) as a scanning tool for exploring and explicating sustainability issues in transport decision making

    DEFF Research Database (Denmark)

    Jeppesen, Sara Lise

    2009-01-01

    This paper places focus on explicit consideration of sustainability issues in transport decision making by presenting and using a developed “Decision Simulation Technique” (DST). This technique can be used by an analyst to ‘scan’ a transport planning problem with regard to what in DST terms...... is called a sustainability strategy. This scanning can serve the purpose of informing a group of decision makers before they actually have to deal with, for example, the choice among a number of alternatives that have all been formulated as being relevant. The main focus of the paper is to illustrate how...

  16. The breast cancer patient's experience of making radiation therapy treatment decisions

    International Nuclear Information System (INIS)

    Halkett, Georgia; Scutter, Sheila; Arbon, Paul; Borg, Martin

    2005-01-01

    Women who are diagnosed with breast cancer have many decisions to make during the course of their treatment. The aims of this paper are to describe the women's experience of making radiation therapy treatment decisions for early breast cancer and to explore how women feel about receiving radiation therapy. An in-depth understanding of the women's experience was developed using a qualitative research approach underpinned by hermeneutic phenomenology. In-depth interviews were conducted with 18 women who had completed treatment for early breast cancer. The themes that emerged from the data were: being challenged, getting ready, beyond control, regaining a sense of control and getting through it. This study provides health professionals with an initial understanding of the women's perspective of the experience of making radiation therapy treatment decisions for early breast cancer. This study concludes by suggesting that further research needs to be conducted to gain an understanding of how other patients feel about treatment decision making and radiation therapy. Copyright (2005) Australian Institute of Radiography

  17. The Influence of Counterfactual Thinking and Regret on Ethical Decision Making

    Science.gov (United States)

    Celuch, Kevin; Saxby, Carl; Oeding, Jill

    2015-01-01

    The authors explore the influence of counterfactual thoughts in triggering the emotions of regret and disappointment in ethical decision making. Counterfactual thinking involves examining possible outcomes to events and is often explored in what-if scenarios. Findings support that subjects were able to transfer regret (but not disappointment)…

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

    Science.gov (United States)

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

    2017-08-01

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

  19. Direct Tests on Individual Behaviour in Small Decision-Making Problems

    Directory of Open Access Journals (Sweden)

    Takemi Fujikawa

    2007-10-01

    Full Text Available This paper provides an empirical and experimental analysis of individual decision making in small decision-making problems with a series of laboratory experiments. Two experimental treatments with binary small decision-making problems are implemented: (1 the search treatment with the unknown payoff distribution to the decision makers and (2 the choice treatment with the known payoff distribution. A first observation is that in the search treatment the tendency to select best reply to the past performances, and misestimation of the payoff distribution can lead to robust deviations from expected value maximisation. A second observation is concerned with choice problems with two options with the same expected value: one option is more risky with larger payoff variability; the other option is moderate with less payoff variability. Experimental results show that it is likely that the more the decision makers choose a risky option, the higher they can achieve high points, ex post. Finally, I investigate the exploration tendency. Comparison of results between the search treatment and the choice treatment reveals that the additional information to the decision makers enhances expected value maximisation.

  20. Professional autonomy in 21st century healthcare: Nurses' accounts of clinical decision-making

    DEFF Research Database (Denmark)

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-01-01

    Autonomy in decision-making has traditionally been described as a feature of professional work, however the work of healthcare professionals has been seen as steadily encroached upon by State and managerialist forces. Nursing has faced particular problems in establishing itself as a credible....... The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille (1970). The analysis draws on notions of interpretive repertoires and elements of narrative...... analysis. We identified two interpretive repertoires: 'clinical judgement' which was used to describe the different grounds for making judgements; and 'decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful...

  1. Neurosurgical decision-making with IOM: DBS surgery.

    Science.gov (United States)

    Arle, Jeffrey E; Shils, Jay L

    2007-12-01

    Intraoperative monitoring (IOM) adds new information to intraoperative surgical decision-making. When presented clearly and accurately, it can help guide decision processes during the procedure, but can be a detriment overall if the information is inaccurate or misleading. Troubleshooting abilities and vigilance of the IOM staff play a large role in bolstering the level of trust a surgeon develops in IOM. Additionally, a surgeon may impart his own interpretation and experience with this new information that can undermine or enhance its impact on the case. In this article, we explore these issues with IOM in general and as they relate to the special context of DBS for movement disorders.

  2. PSA as a tool for decision making

    Energy Technology Data Exchange (ETDEWEB)

    Niehaus, F; Lederman, L

    1986-05-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods.

  3. Beyond Bioethics: A Child Rights-Based Approach to Complex Medical Decision-Making.

    Science.gov (United States)

    Wade, Katherine; Melamed, Irene; Goldhagen, Jeffrey

    2016-01-01

    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.

  4. Personality and Health Care Decision-Making Style

    OpenAIRE

    Kathryn E. Flynn; Maureen A. Smith

    2007-01-01

    Using the Wisconsin Longitudinal Study Graduate Survey (N = 5,830), a population-based cohort of older adults (most aged 63–66 years), we explored relationships between five factors of personality and four preference types that account for multiple components of the health care decision-making process (information exchange, deliberation, and selection of treatment choice). After adjustment for personal, health, social, and economic factors, we found that increased conscientiousness and openne...

  5. Framing matters: Effects of framing on older adults' exploratory decision-making.

    Science.gov (United States)

    Cooper, Jessica A; Blanco, Nathaniel J; Maddox, W Todd

    2017-02-01

    We examined framing effects on exploratory decision-making. In Experiment 1 we tested older and younger adults in two decision-making tasks separated by one week, finding that older adults' decision-making performance was preserved when maximizing gains, but it declined when minimizing losses. Computational modeling indicates that younger adults in both conditions, and older adults in gains maximization, utilized a decreasing threshold strategy (which is optimal), but older adults in losses were better fit by a fixed-probability model of exploration. In Experiment 2 we examined within-subject behavior in older and younger adults in the same exploratory decision-making task, but without a time separation between tasks. We replicated the older adult disadvantage in loss minimization from Experiment 1 and found that the older adult deficit was significantly reduced when the loss-minimization task immediately followed the gains-maximization task. We conclude that older adults' performance in exploratory decision-making is hindered when framed as loss minimization, but that this deficit is attenuated when older adults can first develop a strategy in a gains-framed task. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Impaired decision-making and selective cortical frontal thinning in Cushing's syndrome.

    Science.gov (United States)

    Crespo, Iris; Esther, Granell-Moreno; Santos, Alicia; Valassi, Elena; Yolanda, Vives-Gilabert; De Juan-Delago, Manel; Webb, Susan M; Gómez-Ansón, Beatriz; Resmini, Eugenia

    2014-12-01

    Cushing's syndrome (CS) is caused by a glucocorticoid excess. This hypercortisolism can damage the prefrontal cortex, known to be important in decision-making. Our aim was to evaluate decision-making in CS and to explore cortical thickness. Thirty-five patients with CS (27 cured, eight medically treated) and thirty-five matched controls were evaluated using Iowa gambling task (IGT) and 3 Tesla magnetic resonance imaging (MRI) to assess cortical thickness. The IGT evaluates decision-making, including strategy and learning during the test. Cortical thickness was determined on MRI using freesurfer software tools, including a whole-brain analysis. There were no differences between medically treated and cured CS patients. They presented an altered decision-making strategy compared to controls, choosing a lower number of the safer cards (P behaviour was driven by short-term reward and long-term punishment, indicating learning problems because they did not use previous experience as a feedback factor to regulate their choices. These alterations in decision-making and the decreased cortical thickness in frontal areas suggest that chronic hypercortisolism promotes brain changes which are not completely reversible after endocrine remission. © 2014 John Wiley & Sons Ltd.

  7. Breast compression – An exploration of problem solving and decision-making in mammography

    International Nuclear Information System (INIS)

    Nightingale, J.M.; Murphy, F.J.; Robinson, L.; Newton-Hughes, A.; Hogg, P.

    2015-01-01

    Objective: Breast compression decreases radiation dose and reduces potential for motion and geometric unsharpness, yet there is variability in applied compression force within and between some centres. This article explores the problem solving process applied to the application of breast compression force from the mammography practitioners' perspective. Methods: A qualitative analysis was undertaken using an existing full data set of transcribed qualitative data collected in a phenomenological study of mammography practitioner values, behaviours and beliefs. The data emerged from focus groups conducted at six NHS breast screening centres in England (participant n = 41), and semi-structured interviews with mammography educators (n = 6). A researcher followed a thematic content analysis process to extract data related to mammography compression problem solving, developing a series of categories, themes and sub-themes. Emerging themes were then peer-validated by two other researchers, and developed into a model of practice. Results: Seven consecutive stages contributed towards compression force problem solving: assessing the request; first impressions; explanations and consent; handling the breast and positioning; applying compression force; final adjustments; feedback. The model captures information gathering, problem framing, problem solving and decision making which inform an ‘ideal’ compression scenario. Behavioural problem solving, heuristics and intuitive decision making are reflected within this model. Conclusion: The application of compression should no longer be considered as one single task within mammography, but is now recognised as a seven stage problem solving continuum. This continuum model is the first to be applied to mammography, and is adaptable and transferable to other radiography practice settings. - Highlights: • Mammography compression should no longer be considered as one single examination task. • A seven stage breast

  8. Electroencephalogy (EEG) Feedback in Decision-Making

    Science.gov (United States)

    2015-08-26

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

  9. Managerial Decision Making in Traffic

    Directory of Open Access Journals (Sweden)

    Teodor Perić

    2003-11-01

    Full Text Available Decision-making is defined as a selection of a certain actionamong several alternatives. It is the essence of planning, asin the managerial sense there is no plan until a decision of engagementof resources, reputation and direction of activities ismade. Decision-making is, in fact, only a step in planning, evenwhen it is performed quickly and without special consideration.It is what we all experience every day. It is one of the most fascinatingbiological activities and the subject of frightening implicationsfor the whole human race. Since various techniques improvethe system and the quality of managerial decision-making,they are classified into three assumptions: risk analysis, decision-making trees, and the theory of revealed preference. Allof these are based on the interaction of a certain number of importantvariables out of which many contain the elements ofuncertainty, but maybe also high level of probability.

  10. A dynamic, embodied paradigm to investigate the role of serotonin in decision-making

    Science.gov (United States)

    Asher, Derrik E.; Craig, Alexis B.; Zaldivar, Andrew; Brewer, Alyssa A.; Krichmar, Jeffrey L.

    2013-01-01

    Serotonin (5-HT) is a neuromodulator that has been attributed to cost assessment and harm aversion. In this review, we look at the role 5-HT plays in making decisions when subjects are faced with potential harmful or costly outcomes. We review approaches for examining the serotonergic system in decision-making. We introduce our group’s paradigm used to investigate how 5-HT affects decision-making. In particular, our paradigm combines techniques from computational neuroscience, socioeconomic game theory, human–robot interaction, and Bayesian statistics. We will highlight key findings from our previous studies utilizing this paradigm, which helped expand our understanding of 5-HT’s effect on decision-making in relation to cost assessment. Lastly, we propose a cyclic multidisciplinary approach that may aid in addressing the complexity of exploring 5-HT and decision-making by iteratively updating our assumptions and models of the serotonergic system through exhaustive experimentation. PMID:24319413

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

    Allen, Kimberly A

    2014-09-01

    Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms 'parents and decision-making' to obtain English language publications from 2000 to June 2013. The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent-provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital heart disease. Thus comparisons across other child

  13. GROUPS DECISION MAKING WITHIN THE ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Anca Stan

    2008-12-01

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

  14. A Grounded Theory Study of Aircraft Maintenance Technician Decision-Making

    Science.gov (United States)

    Norcross, Robert

    Aircraft maintenance technician decision-making and actions have resulted in aircraft system errors causing aircraft incidents and accidents. Aircraft accident investigators and researchers examined the factors that influence aircraft maintenance technician errors and categorized the types of errors in an attempt to prevent similar occurrences. New aircraft technology introduced to improve aviation safety and efficiency incur failures that have no information contained in the aircraft maintenance manuals. According to the Federal Aviation Administration, aircraft maintenance technicians must use only approved aircraft maintenance documents to repair, modify, and service aircraft. This qualitative research used a grounded theory approach to explore the decision-making processes and actions taken by aircraft maintenance technicians when confronted with an aircraft problem not contained in the aircraft maintenance manuals. The target population for the research was Federal Aviation Administration licensed aircraft and power plant mechanics from across the United States. Nonprobability purposeful sampling was used to obtain aircraft maintenance technicians with the experience sought in the study problem. The sample population recruitment yielded 19 participants for eight focus group sessions to obtain opinions, perceptions, and experiences related to the study problem. All data collected was entered into the Atlas ti qualitative analysis software. The emergence of Aircraft Maintenance Technician decision-making themes regarding Aircraft Maintenance Manual content, Aircraft Maintenance Technician experience, and legal implications of not following Aircraft Maintenance Manuals surfaced. Conclusions from this study suggest Aircraft Maintenance Technician decision-making were influenced by experience, gaps in the Aircraft Maintenance Manuals, reliance on others, realizing the impact of decisions concerning aircraft airworthiness, management pressures, and legal concerns

  15. Children's participation in shared decision-making: children, adolescents, parents and healthcare professionals' perspectives and experiences.

    Science.gov (United States)

    Coyne, Imelda; Amory, Aislinn; Kiernan, Gemma; Gibson, Faith

    2014-06-01

    Despite decision-making featuring throughout the trajectory of cancer care, children's participation in decision-making remains an area much under-researched and complicated by conflicting opinions. This study explored children's participation in shared decision-making (SDM) from multiple perspectives from one haematology/oncology unit in Ireland. Qualitative research design was used to explore participants' experiences of children's decision-making. Interviews were conducted with children(1) aged 7-16 years (n = 20), their parents (n = 22) and healthcare professionals (n = 40). Data were managed with the aid of NVivo (version 8). Parents and children's roles in decision-making were significantly influenced by the seriousness of the illness. Cancer is a life-threatening illness and so the treatment 'had to be done'. Children were not involved in major decisions (treatment decisions) as refusal was not an option. They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, making treatment more palatable, giving back a sense of control and building trusting relationships. These choices were termed 'small' decisions that would not compromise the child's welfare. Some adolescents were aware that choices were not 'real' decisions since they were not allowed to refuse and expressed feelings of frustration. Healthcare professionals and parents controlled the process of SDM and the children's accounts revealed that they held a minimal role. Children appeared content that adults held responsibility for the major treatment decisions. However, they desired and valued receiving information, voicing their preferences and choosing how treatments were administered to them. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Chinese Adolescents' Reasoning about Democratic and Authority-Based Decision Making in Peer, Family, and School Contexts.

    Science.gov (United States)

    Helwig, Charles C.; Arnold, Mary Louise; Tan, Dingliang; Boyd, Dwight

    2003-01-01

    This study explored judgments and reasoning of Chinese 13- to 18-year-olds regarding making decisions involving children in peer, family, and school contexts. Findings indicated that judgments and reasoning about decision-making varied by social context and by the decision under consideration. Evaluations of procedures became more differentiated…

  17. The use of emotional intelligence capabilities in clinical reasoning and decision-making: A qualitative, exploratory study.

    Science.gov (United States)

    Hutchinson, Marie; Hurley, John; Kozlowski, Desirée; Whitehair, Leeann

    2018-02-01

    To explore clinical nurses' experiences of using emotional intelligence capabilities during clinical reasoning and decision-making. There has been little research exploring whether, or how, nurses employ emotional intelligence (EI) in clinical reasoning and decision-making. Qualitative phase of a larger mixed-methods study. Semistructured qualitative interviews with a purposive sample of registered nurses (n = 12) following EI training and coaching. Constructivist thematic analysis was employed to analyse the narrative transcripts. Three themes emerged: the sensibility to engage EI capabilities in clinical contexts, motivation to actively engage with emotions in clinical decision-making and incorporating emotional and technical perspectives in decision-making. Continuing to separate cognition and emotion in research, theorising and scholarship on clinical reasoning is counterproductive. Understanding more about nurses' use of EI has the potential to improve the calibre of decisions, and the safety and quality of care delivered. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Hubbeling, Dieneke

    2014-05-01

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

  19. Judgment and decision making.

    Science.gov (United States)

    Fischhoff, Baruch

    2010-09-01

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

  20. Toward a Psychology of Surrogate Decision Making.

    Science.gov (United States)

    Tunney, Richard J; Ziegler, Fenja V

    2015-11-01

    In everyday life, many of the decisions that we make are made on behalf of other people. A growing body of research suggests that we often, but not always, make different decisions on behalf of other people than the other person would choose. This is problematic in the practical case of legally designated surrogate decision makers, who may not meet the substituted judgment standard. Here, we review evidence from studies of surrogate decision making and examine the extent to which surrogate decision making accurately predicts the recipient's wishes, or if it is an incomplete or distorted application of the surrogate's own decision-making processes. We find no existing domain-general model of surrogate decision making. We propose a framework by which surrogate decision making can be assessed and a novel domain-general theory as a unifying explanatory concept for surrogate decisions. © The Author(s) 2015.

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

    Science.gov (United States)

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

    2007-01-01

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

  2. Make or buy decision considering uncertainty based on fuzzy logic using simulation and multiple criteria decision making

    Directory of Open Access Journals (Sweden)

    Ali Mohtashami

    2013-01-01

    Full Text Available Decision making on making/buying problem has always been a challenge to decision makers. In this paper a methodology has been proposed to resolve this challenge. This methodology is capable of evaluating making/buying decision making under uncertainty. For uncertainty, the fuzzy logic and simulation approaches have been used. The proposed methodology can be applied to parts with multi stage manufacturing processes and different suppliers. Therefore this methodology provides a scale for decision making from full outsourcing to full manufacturing and with selecting appropriate supplier.

  3. Neural substrates of decision-making.

    Science.gov (United States)

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

    2016-06-01

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

  4. Attitudes towards poverty, organizations, ethics and morals: Israeli social workers' shared decision making.

    Science.gov (United States)

    Levin, Lia; Schwartz-Tayri, Talia

    2017-06-01

    Partnerships between service users and social workers are complex in nature and can be driven by both personal and contextual circumstances. This study sought to explore the relationship between social workers' involvement in shared decision making with service users, their attitudes towards service users in poverty, moral standards and health and social care organizations' policies towards shared decision making. Based on the responses of 225 licensed social workers from health and social care agencies in the public, private and third sectors in Israel, path analysis was used to test a hypothesized model. Structural attributions for poverty contributed to attitudes towards people who live in poverty, which led to shared decision making. Also, organizational support in shared decision making, and professional moral identity, contributed to ethical behaviour which led to shared decision making. The results of this analysis revealed that shared decision making may be a scion of branched roots planted in the relationship between ethics, organizations and Stigma. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  5. Computational Complexity and Human Decision-Making.

    Science.gov (United States)

    Bossaerts, Peter; Murawski, Carsten

    2017-12-01

    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.

  6. Decision Making for Chinese Students to Receive Their Higher Education in the U.S.

    Science.gov (United States)

    Chao, Chiangnan

    2016-01-01

    This study examines Chinese students' decision making considerations for coming to the U.S. for their higher education. Due to the large number of Chinese students in the U.S, it is an interesting topic for educators and researchers to explore the decision making considerations Chinese students choose for studying abroad. International student…

  7. Mental models of decision-making in a healthcare executive

    OpenAIRE

    Long, Katrina

    2017-01-01

    Purpose The importance of shared mental models in teamwork has been explored in a diverse array of artificial work groups. This study extends such research to explore the role of mental models in the strategic decision-making of a real-world senior management group. Design/Methodology Data were collected from an intact group of senior healthcare executives (N=13) through semi-structured interviews, meeting observations and internal document analysis. Participants responded to intervi...

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

    Science.gov (United States)

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

    2016-01-01

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

  9. The influence of anticipated pride and guilt on pro-environmental decision making.

    Directory of Open Access Journals (Sweden)

    Claudia R Schneider

    Full Text Available The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one's positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one's negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt.

  10. The influence of anticipated pride and guilt on pro-environmental decision making.

    Science.gov (United States)

    Schneider, Claudia R; Zaval, Lisa; Weber, Elke U; Markowitz, Ezra M

    2017-01-01

    The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one's positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one's negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt.

  11. The influence of anticipated pride and guilt on pro-environmental decision making

    Science.gov (United States)

    Zaval, Lisa; Weber, Elke U.; Markowitz, Ezra M.

    2017-01-01

    The present research explores the relationship between anticipated emotions and pro-environmental decision making comparing two differently valenced emotions: anticipated pride and guilt. In an experimental design, we examined the causal effects of anticipated pride versus guilt on pro-environmental decision making and behavioral intentions by making anticipated emotions (i.e. pride and guilt) salient just prior to asking participants to make a series of environmental decisions. We find evidence that anticipating one’s positive future emotional state from green action just prior to making an environmental decision leads to higher pro-environmental behavioral intentions compared to anticipating one’s negative emotional state from inaction. This finding suggests a rethinking in the domain of environmental and climate change messaging, which has traditionally favored inducing negative emotions such as guilt to promote pro-environmental action. Furthermore, exploratory results comparing anticipated pride and guilt inductions to baseline behavior point toward a reactance eliciting effect of anticipated guilt. PMID:29190758

  12. Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

    Science.gov (United States)

    Weiss, Marjorie C; Platt, Jo; Riley, Ruth; Chewning, Betty; Taylor, Gordon; Horrocks, Susan; Taylor, Andrea

    2015-09-01

    Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy. There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging. In the United Kingdom, nurses and pharmacists can now take on a prescribing role, engaging in shared decision making. Given the different professional backgrounds of GPs, NPs and PPs, this study sought to explore the process of shared decision making across these three prescriber groups. Analysis of audio-recordings of consultations in primary care in South England between patients and GPs, NPs and PPs. Analysis of patient questionnaires completed post consultation. Findings A total of 532 consultations were audio-recorded with 20 GPs, 19 NPs and 12 PPs. Prescribing decisions occurred in 421 (79%). Patients were given treatment options in 21% (102/482) of decisions, the prescriber elicited the patient's treatment preference in 18% (88/482) and the patient expressed a treatment preference in 24% (118/482) of decisions. PPs were more likely to ask for the patient's preference about their treatment regimen (χ 2=6.6, P=0.036, Cramer's V=0.12) than either NPs or GPs. Of the 275 patient questionnaires, 192(70%) could be matched with a prescribing decision. NP patients had higher satisfaction levels than patients of GPs or PPs. More time describing treatment options was associated with increased satisfaction, adherence and greater perceived practitioner empathy. While defining, measuring and enabling the process of shared decision making

  13. Decision making in urological surgery.

    Science.gov (United States)

    Abboudi, Hamid; Ahmed, Kamran; Normahani, Pasha; Abboudi, May; Kirby, Roger; Challacombe, Ben; Khan, Mohammed Shamim; Dasgupta, Prokar

    2012-06-01

    Non-technical skills are important behavioural aspects that a urologist must be fully competent at to minimise harm to patients. The majority of surgical errors are now known to be due to errors in judgment and decision making as opposed to the technical aspects of the craft. The authors reviewed the published literature regarding decision-making theory and in practice related to urology as well as the current tools available to assess decision-making skills. Limitations include limited number of studies, and the available studies are of low quality. Decision making is the psychological process of choosing between alternative courses of action. In the surgical environment, this can often be a complex balance of benefit and risk within a variable time frame and dynamic setting. In recent years, the emphasis of new surgical curriculums has shifted towards non-technical surgical skills; however, the assessment tools in place are far from objective, reliable and valid. Surgical simulators and video-assisted questionnaires are useful methods for appraisal of trainees. Well-designed, robust and validated tools need to be implemented in training and assessment of decision-making skills in urology. Patient safety can only be ensured when safe and effective decisions are made.

  14. Practitioners' Views on Involving Young Children in Decision Making: Challenges for the Children's Rights Agenda

    Science.gov (United States)

    Hudson, Kim

    2012-01-01

    This article presents the key findings and discussion from a research project and subsequent report: "Involving young children in decision making: An exploration of practitioners' views". This research explored early childhood practitioners'--childcare workers, kindergarten, pre-primary and grade 1-2 teachers--views on decision making…

  15. Command Decision-Making: Experience Counts

    National Research Council Canada - National Science Library

    Wolgast, Kelly A

    2005-01-01

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

  16. [Cognitive errors in diagnostic decision making].

    Science.gov (United States)

    Gäbler, Martin

    2017-10-01

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

  17. Development and aging of decision-making rationality under risk framework

    Directory of Open Access Journals (Sweden)

    Han-hui LIU

    2014-03-01

    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

  18. Emotions, Mood and Decision Making

    OpenAIRE

    Agnes Virlics

    2014-01-01

    Decisions are made according to a complex cognitive and emotional evaluation of the situation. The aim of the paper is to examine the effect of mood on risky investment decision making by using a mood induction procedure. The paper investigates how happy and sad mood affects risky investment decision making and whether there is a difference between the perception of fix investments and monetary investments. The analysis has been conducted focusing on individual investment decisions. Data for ...

  19. The Influence of Social Comparison and Peer Group Size on Risky Decision-Making.

    Science.gov (United States)

    Wang, Dawei; Zhu, Liping; Maguire, Phil; Liu, Yixin; Pang, Kaiyuan; Li, Zhenying; Hu, Yixin

    2016-01-01

    This study explores the influence of different social reference points and different comparison group sizes on risky decision-making. Participants were presented with a scenario describing an exam, and presented with the opportunity of making a risky decision in the context of different information provided about the performance of their peers. We found that behavior was influenced, not only by comparison with peers, but also by the size of the comparison group. Specifically, the larger the reference group, the more polarized the behavior it prompted. In situations describing social loss, participants were led to make riskier decisions after comparing themselves against larger groups, while in situations describing social gain, they become more risk averse. These results indicate that decision making is influenced both by social comparison and the number of people making up the social reference group.

  20. Complex Strategic Choices Applying Systemic Planning for Strategic Decision Making

    CERN Document Server

    Leleur, Steen

    2012-01-01

    Effective decision making requires a clear methodology, particularly in a complex world of globalisation. Institutions and companies in all disciplines and sectors are faced with increasingly multi-faceted areas of uncertainty which cannot always be effectively handled by traditional strategies. Complex Strategic Choices provides clear principles and methods which can guide and support strategic decision making to face the many current challenges. By considering ways in which planning practices can be renewed and exploring the possibilities for acquiring awareness and tools to add value to strategic decision making, Complex Strategic Choices presents a methodology which is further illustrated by a number of case studies and example applications. Dr. Techn. Steen Leleur has adapted previously established research based on feedback and input from various conferences, journals and students resulting in new material stemming from and focusing on practical application of a systemic approach. The outcome is a coher...

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

    Science.gov (United States)

    Hulton, Linda J.

    2001-10-03

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

  2. Exercise prescription for patients with non-specific chronic low back pain: a qualitative exploration of decision making in physiotherapy practice.

    Science.gov (United States)

    Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

    2016-12-01

    Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. A qualitative study using a philosophical hermeneutic approach. Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists' assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) which exercise? - the tension between evidence and everyday practice and (3) compliance-orientated more than concordance based. This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  3. Considering Risk and Resilience in Decision-Making

    Science.gov (United States)

    Torres-Pomales, Wilfredo

    2015-01-01

    This paper examines the concepts of decision-making, risk analysis, uncertainty and resilience analysis. The relation between risk, vulnerability, and resilience is analyzed. The paper describes how complexity, uncertainty, and ambiguity are the most critical factors in the definition of the approach and criteria for decision-making. Uncertainty in its various forms is what limits our ability to offer definitive answers to questions about the outcomes of alternatives in a decision-making process. It is shown that, although resilience-informed decision-making would seem fundamentally different from risk-informed decision-making, this is not the case as resilience-analysis can be easily incorporated within existing analytic-deliberative decision-making frameworks.

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

    Science.gov (United States)

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

    2018-03-01

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

  5. The Art of Moral Decision Making in Educational Research.

    Science.gov (United States)

    Fetterman, David M.

    Moral decision-making is an essential element in educational research. The dilemmas examined and explored in this review were drawn from the author's experience as an ethnographic evaluator and consultant in a bay area educational research corporation for the last five years. The major concerns addressed include: conflicting expectations between…

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

    Science.gov (United States)

    Patterson, Jean; Skinner, Joan; Foureur, Maralyn

    2015-06-01

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

  7. Intergroup conflict and rational decision making.

    Science.gov (United States)

    Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

    2014-01-01

    The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate)- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.

  8. Intergroup Conflict and Rational Decision Making

    Science.gov (United States)

    Martínez-Tur, Vicente; Peñarroja, Vicente; Serrano, Miguel A.; Hidalgo, Vanesa; Moliner, Carolina; Salvador, Alicia; Alacreu-Crespo, Adrián; Gracia, Esther; Molina, Agustín

    2014-01-01

    The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict –associated with indicators of the activation of negative feelings (negative affect state and heart rate)– has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making. PMID:25461384

  9. Intergroup conflict and rational decision making.

    Directory of Open Access Journals (Sweden)

    Vicente Martínez-Tur

    Full Text Available The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict -associated with indicators of the activation of negative feelings (negative affect state and heart rate- has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making.

  10. Decision-making styles and depressive symptomatology: Development of the Decision Styles Questionnaire

    Directory of Open Access Journals (Sweden)

    Yan Leykin

    2010-12-01

    Full Text Available Difficulty making decisions is one of the symptoms of the depressive illness. Previous research suggests that depressed individuals may make decisions that differ from those made by the non-depressed, and that they use sub-optimal decision-making strategies. For this study we constructed an instrument that aims to measure a variety of decision-making styles as well as the respondent's view of him or herself as a decision-maker (decisional self-esteem. These styles and estimates of decisional self-esteem were then related to depressive symptoms. Depressive symptomatology correlated negatively with perception of self as a decision-maker. Those with higher depression severity scores characterized themselves as being more anxious about decisions, and more likely to procrastinate. They also reported using fewer productive decision-making strategies, depending more on other people for help with decisions, and relying less on their own intuitions when making decisions. Further research is needed to determine the extent to which these decision-making styles are antecedents to depressive symptomatology or are instead products of, or aspects of, the phenomenology associated with depression.

  11. Newly graduated nurses' use of knowledge sources in clinical decision-making

    DEFF Research Database (Denmark)

    Voldbjerg, Siri Lygum; Grønkjaer, Mette; Wiechula, Rick

    2017-01-01

    AIMS AND OBJECTIVES: To explore which knowledge sources newly graduated nurses' use in clinical decision-making and why and how they are used. BACKGROUND: In spite of an increased educational focus on skills and competencies within evidence based practice newly graduated nurses' ability to use...... approaches to strengthen the knowledgebase used in clinical decision-making. DESIGN AND METHODS: Ethnographic study using participant-observation and individual semi-structured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings. RESULTS: Newly graduates use...... in clinical decision-making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources. This article is protected by copyright. All rights reserved....

  12. 'My kidneys, my choice, decision aid': supporting shared decision making.

    Science.gov (United States)

    Fortnum, Debbie; Smolonogov, Tatiana; Walker, Rachael; Kairaitis, Luke; Pugh, Debbie

    2015-06-01

    For patients with chronic kidney disease (CKD) who are progressing to end-stage kidney disease (ESKD) a decision of whether to undertake dialysis or conservative care is a critical component of the patient journey. Shared decision making for complex decisions such as this could be enhanced by a decision aid, a practice which is well utilised in other disciplines but limited for nephrology. A multidisciplinary team in Australia and New Zealand (ANZ) utilised current decision-making theory and best practice to develop the 'My Kidneys, My Choice', a decision aid for the treatment of kidney disease. A patient-centred, five-sectioned tool is now complete and freely available to all ANZ units to support the ESKD education and shared decision-making process. Distribution and education have occurred across ANZ and evaluation of the decision aid in practice is in the first phase. Development of a new tool such as an ESKD decision aid requires vision, multidisciplinary input and ongoing implementation resources. This tool is being integrated into ANZ, ESKD education practice and is promoting the philosophy of shared decision making. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  13. Argumentation and Multi-Agent Decision Making

    OpenAIRE

    Parsons, S.; Jennings, N. R.

    1998-01-01

    This paper summarises our on-going work on mixed- initiative decision making which extends both classical decision theory and a symbolic theory of decision making based on argumentation to a multi-agent domain.

  14. Mild cognitive impairment is associated with poorer decision-making in community-based older persons.

    Science.gov (United States)

    Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A

    2015-04-01

    To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. Community-based epidemiological cohort study. Communities throughout northeastern Illinois. Older persons without dementia from the Rush Memory and Aging Project (N = 730). All participants underwent a detailed clinical evaluation and decision-making assessment using a measure that closely approximates materials used in real-world financial and healthcare settings. This allowed for measurement of total decision-making and financial and healthcare decision-making. Regression models were used to examine whether MCI was associated with a lower level of decision-making. In subsequent analyses, the relationship between specific cognitive systems (episodic memory, semantic memory, working memory, perceptual speed, visuospatial ability) and decision-making was explored in participants with MCI. MCI was associated with lower total, financial, and healthcare decision-making scores after accounting for the effects of age, education, and sex. The effect of MCI on total decision-making was equivalent to the effect of more than 10 additional years of age. Additional models showed that, when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision-making in participants with MCI. Persons with MCI may have poorer financial and healthcare decision-making in real-world situations, and perceptual speed may be an important contributor to poorer decision-making in persons with MCI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  15. Enhancing Decision-Making in STSE Education by Inducing Reflection and Self-Regulated Learning

    Science.gov (United States)

    Gresch, Helge; Hasselhorn, Marcus; Bögeholz, Susanne

    2017-02-01

    Thoughtful decision-making to resolve socioscientific issues is central to science, technology, society, and environment (STSE) education. One approach for attaining this goal involves fostering students' decision-making processes. Thus, the present study explores whether the application of decision-making strategies, combined with reflections on the decision-making processes of others, enhances decision-making competence. In addition, this study examines whether this process is supported by elements of self-regulated learning, i.e., self-reflection regarding one's own performance and the setting of goals for subsequent tasks. A computer-based training program which involves the resolution of socioscientific issues related to sustainable development was developed in two versions: with and without elements of self-regulated learning. Its effects on decision-making competence were analyzed using a pre test-post test follow-up control-group design ( N = 242 high school students). Decision-making competence was assessed using an open-ended questionnaire that focused on three facets: consideration of advantages and disadvantages, metadecision aspects, and reflection on the decision-making processes of others. The findings suggest that students in both training groups incorporated aspects of metadecision into their statements more often than students in the control group. Furthermore, both training groups were more successful in reflecting on the decision-making processes of others. The students who received additional training in self-regulated learning showed greater benefits in terms of metadecision aspects and reflection, and these effects remained significant two months later. Overall, our findings demonstrate that the application of decision-making strategies, combined with reflections on the decision-making process and elements of self-regulated learning, is a fruitful approach in STSE education.

  16. Environmental sustainable decision making – The need and obstacles for integration of LCA into decision analysis

    DEFF Research Database (Denmark)

    Dong, Yan; Miraglia, Simona; Manzo, Stefano

    2018-01-01

    systems, revealing potential problem shifting between life cycle stages. Through the integration with traditional risk based decision analysis, LCA may thus facilitate a better informed decision process. In this study we explore how environmental impacts are taken into account in different fields......Decision analysis is often used to help decision makers choose among alternatives, based on the expected utility associated to each alternative as function of its consequences and potential impacts. Environmental impacts are not always among the prioritized concerns of traditional decision making...... of interest for decision makers to identify the need, potential and obstacles for integrating LCA into conventional approaches to decision problems. Three application areas are used as examples: transportation planning, flood management, and food production and consumption. The analysis of these cases shows...

  17. Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology.

    Science.gov (United States)

    Krieger, Janice L; Krok-Schoen, Jessica L; Dailey, Phokeng M; Palmer-Wackerly, Angela L; Schoenberg, Nancy; Paskett, Electra D; Dignan, Mark

    2017-07-01

    Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients ( N = 46). Analysis of transcript data yielded empirical support for four distinct models of health decision making. The implications of these findings for developing interventions to improve the quality of treatment decision making and overall well-being are discussed.

  18. Perceived risks around choice and decision making at end-of-life: a literature review.

    Science.gov (United States)

    Wilson, F; Gott, M; Ingleton, C

    2013-01-01

    the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

  19. Beneficial Roles of Emotion in Decision Making: Functional Association of Brain and Body

    Directory of Open Access Journals (Sweden)

    Hideki Ohira

    2011-12-01

    Full Text Available Though traditional microeconomics has supposed that human decisions are based on logical and exact computation of cost-benefit balances or efficacies, studies in behavioral economics have shown that humans sometimes make seemingly irrational decisions driven by emotions. In our everyday situations, factors related to decisions are complex and which alternative will be the most beneficial is uncertain. In such cases, emotions have been thought adaptive because they can quickly reduce negative alternatives and facilitate fast and effective decision making. Some theorists argued that one of important sources of such emotional drives affecting decision making is bodily responses that are represented in brain regions (Craig, 2009; Damasio, 1994. In this article, empirical evidence for the functional associations of the brain and body accompanying decision making will be shown as follows. (1 Heart rate responses and concentration of inflammatory cytokine (IL-6 can predict acceptance or rejection of an unfair offer in an economical negotiation game, the Ultimatum Game. Activation of the anterior insula mediates relationship between bodily states and decision making. (2 Sympathetic responses reflected by secretion of adrenaline are represented in brain regions such as the midbrain, anterior cingulate cortex, and anterior insula, and furthermore can determine exploration of decision making in a situation where an action-outcome contingency is stochastic and unstable. These findings suggest beneficial roles of emotion and bodily responses in decision making.

  20. Social Influences in Sequential Decision Making.

    Directory of Open Access Journals (Sweden)

    Markus Schöbel

    Full Text Available People often make decisions in a social environment. The present work examines social influence on people's decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others' authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions.

  1. Social Influences in Sequential Decision Making

    Science.gov (United States)

    Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

    2016-01-01

    People often make decisions in a social environment. The present work examines social influence on people’s decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others’ authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions. PMID:26784448

  2. Social Influences in Sequential Decision Making.

    Science.gov (United States)

    Schöbel, Markus; Rieskamp, Jörg; Huber, Rafael

    2016-01-01

    People often make decisions in a social environment. The present work examines social influence on people's decisions in a sequential decision-making situation. In the first experimental study, we implemented an information cascade paradigm, illustrating that people infer information from decisions of others and use this information to make their own decisions. We followed a cognitive modeling approach to elicit the weight people give to social as compared to private individual information. The proposed social influence model shows that participants overweight their own private information relative to social information, contrary to the normative Bayesian account. In our second study, we embedded the abstract decision problem of Study 1 in a medical decision-making problem. We examined whether in a medical situation people also take others' authority into account in addition to the information that their decisions convey. The social influence model illustrates that people weight social information differentially according to the authority of other decision makers. The influence of authority was strongest when an authority's decision contrasted with private information. Both studies illustrate how the social environment provides sources of information that people integrate differently for their decisions.

  3. Parental decision-making for medically complex infants and children: An integrated literature review

    Science.gov (United States)

    Allen, Kimberly A.

    2014-01-01

    Background Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. Objective The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. Design PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms ‘parents and decision-making’ to obtain English language publications from 2000 to June 2013. Results The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Conclusions Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent–provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital

  4. Making ethical choices: a comprehensive decision-making model for Canadian psychologists.

    Science.gov (United States)

    Hadjistavropoulos, T; Malloy, D C

    2000-05-01

    This paper proposes a theoretical augmentation of the seven-step decision-making model outlined in the Canadian Code of Ethics for Psychologists. We propose that teleological, deontological, and existential ethical perspectives should be taken into account in the decision-making process. We also consider the influence of individual, issue-specific, significant-other, situational, and external factors on ethical decision-making. This theoretical analysis demonstrates the richness and complexity of ethical decision-making.

  5. An analysis of medical decision making

    International Nuclear Information System (INIS)

    Lusted, L.B.

    1977-01-01

    Medical decision-making studies continue to focus on two questions: How do physicians make decisions and how should physicians make decisions. Researchers pursuing the first question emphasize human cognitive processes and the programming of symbol systems to model the observed human behaviour. Those researchers concentrating on the second question assume that there is a standard of performance against which physicians' decisions can be judged, and to help the physician improve his performance an array of tools is proposed. These tools include decision trees, Bayesian analysis, decision matrices, receiver operating characteristic (ROC) analysis, and cost-benefit considerations including utility measures. Both questions must be answered in an ethical context where ethics and decision analysis are intertwined. (author)

  6. Decision making regarding multifetal reduction.

    Science.gov (United States)

    Maifeld, Michelle; Hahn, Sandra; Titler, Marita G; Mullen, Meredithe

    2003-01-01

    To identify salient variables that influence decision making regarding multifetal reduction (MFR) and describe their effect on individuals over time. Prospective, exploratory, descriptive design, using qualitative and quantitative methods. Midwestern tertiary care center. A convenience sample of 11 consecutive consenting couples with triplet or higher-order pregnancies who elected to undergo MFR. Semistructured audiotaped telephone interviews at three points: (a) 2 weeks postreduction, (b) 6 weeks postpartum, and (c) 6 months postpartum; a demographic and marital adjustment questionnaire. Themes identified by content analysis and compared via matrix analysis between males and females and at three points in time; trends in marital adjustment. Dominant variables influencing MFR decision making were risks associated with higher-order pregnancies and preservation of infants' and mothers' health. Most participants identified emotional issues, including moral and ethical dilemmas, as the most difficult aspect of reduction. Over time, participants reported feeling more positive about their decision; nonetheless, negative feelings emerged progressively. Risk aversion favored MFR decision making. Yet, both making and living with the decision were emotionally difficult for this sample. Interventions are needed to assist couples with this decision and its consequences.

  7. Serotonin and decision making processes.

    NARCIS (Netherlands)

    Homberg, J.R.

    2012-01-01

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

  8. Make up your mind - How stress and sex affect decision-making

    NARCIS (Netherlands)

    Koot, S.

    2013-01-01

    Decision-making refers to assessing costs and benefits of competing actions, with either a known outcome or an uncertain result. Decision-making depends on several abilities, such as behavioural flexibility and inhibiting risky responses. Several factors affect decision-making, causing differences

  9. PSA as a tool for decision making

    International Nuclear Information System (INIS)

    Niehaus, F.; Lederman, L.

    1986-01-01

    The question on ''How safe is safe enough'' is being responded presently by deterministic criteria. Probabilistic criteria in support to more rational and less emotional decisions in regulatory and licensing issues, rationalization of resource allocation and research prioritization, among others, have a potential which is only marginally being explored. This paper discussed PSA limitations and proposes three areas for the use of PSA in decision making, namely: preventing accidents, mitigating accidents, and defining regulatory requirements. Current activities of the International Atomic Energy Agency in these areas are mentioned. PSA studies depict clearly the uncertainties and this is viewed as a positive aspect, which is unique to the use of probabilistic methods. (orig.)

  10. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study.

    Science.gov (United States)

    Yuan, Lili; Tian, Yanghua; Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction.

  11. Decision-Making in Patients with Hyperthyroidism: A Neuropsychological Study

    Science.gov (United States)

    Zhang, Fangfang; Ma, Huijuan; Chen, Xingui; Dai, Fang; Wang, Kai

    2015-01-01

    Introduction Cognitive and behavioral impairments are common in patients with abnormal thyroid function; these impairments cause a reduction in their quality of life. The current study investigates the decision making performance in patients with hyperthyroidism to explore the possible mechanism of their cognitive and behavioral impairments. Methods Thirty-eight patients with hyperthyroidism and forty healthy control subjects were recruited to perform the Iowa Gambling Task (IGT), which assessed decision making under ambiguous conditions. Results Patients with hyperthyroidism had a higher score on the Zung Self-Rating Anxiety Scale (Z-SAS), and exhibited poorer executive function and IGT performance than did healthy control subjects. The patients preferred to choose decks with a high immediate reward, despite a higher future punishment, and were not capable of effectively using feedback information from previous choices. No clinical characteristics were associated with the total net score of the IGT in the current study. Conclusions Patients with hyperthyroidism had decision-making impairment under ambiguous conditions. The deficits may result from frontal cortex and limbic system metabolic disorders and dopamine dysfunction. PMID:26090955

  12. Complex Decision Making Theory and Practice

    CERN Document Server

    Qudrat-Ullah, Hassan; Spector, J Michael

    2007-01-01

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

  13. Neuroanatomical basis for recognition primed decision making.

    Science.gov (United States)

    Hudson, Darren

    2013-01-01

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

  14. Adult-Onset Type 1 Diabetes: A Qualitative Study of Decision-Making Needs.

    Science.gov (United States)

    Jull, Janet; Witteman, Holly O; Ferne, Judi; Yoganathan, Manosila; Stacey, Dawn

    2016-04-01

    Type 1 diabetes is an autoimmune disease resulting from insulin deficiency and must be carefully managed to prevent serious health complications. Diabetes education and management strategies usually focus on meeting the decision-making needs of children and their families, but little is known about the decisional needs of people with adult-onset type 1 diabetes. The aim of this study was to explore the diabetes-related decision-making needs of people diagnosed with adult-onset type 1 diabetes. An interpretive descriptive qualitative study was conducted. Participants who self-identified as having adult-onset type 1 diabetes were interviewed using a semistructured interview guide. Transcripts were coded to identify needs, supports and barriers using thematic analysis. Participating in the study were 8 adults (2 men, 6 women), ages 33 to 57, with type 1 diabetes for durations of 1 to 20 or more years. Their decision-making needs are summarized in 6 broad themes: 1) people diagnosed with type 1 diabetes are launched into a process of decision-making; 2) being diagnosed with type 1 diabetes means you will always have to make decisions; 3) knowledge is crucial; 4) personal preferences matter; 5) support is critical for decisions about self-care in type 1 diabetes; 6) living with type 1 diabetes means making very individualized decisions about daily life. The findings describe the sudden and ubiquitous nature of type 1 diabetes decision-making and the need to tailor approaches for making care decisions in type 1 diabetes. People diagnosed with adult-onset type 1 diabetes require access to reliable information, support and opportunities for participation in decision-making. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2012-05-01

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

  16. Market research on factors influencing women's preferences in investment decision making

    OpenAIRE

    Sharma, Abhishek.; Douglas, Tony.; Jaworski, Piotr.

    2017-01-01

    This study aims to gain knowledge on the factors that influence the investment decision making of women in Singapore. The research explores the fact that investment decision is being affected by the demographic, psychographic factors of the individuals. The individuals may be equal in all aspects but their investment decision varies with their own perception towards various investment plans. The research was conducted among 200 respondents through a survey so as to get an empirical findings o...

  17. Clinical decision making and mental health service use in people with severe mental illness across Europe

    OpenAIRE

    Cosh, S.; Zentner, N.; Ay, E.; Loos, S.; Slade, Mike; Maj, Mario; Salzano, A.; Berecz, R.; Glaub, T.; Munk-Jørgensen, Povl; Krogsgaard Bording, M.; Rössler, Wulf; Kawohl, Wolfram; Puschner, Bernd

    2017-01-01

    Objective: This study aims to explore relationships between preferred and experienced clinical decision making with service use, and associated costs, by people with severe mental illness.\\ud Methods: Prospective observational study of mental healthcare in six European countries: Germany, UK, Italy Hungary, Denmark and Switzerland. Patients (N = 588) and treating clinicians (N = 213) reported preferred and experienced decision making at baseline using the Clinical Decision Making Style Scale ...

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

    Science.gov (United States)

    Jazby, Dan

    2014-01-01

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

  19. Decision Making Under Uncertain Categorization

    Directory of Open Access Journals (Sweden)

    Stephanie Ying-Fen Chen

    2014-09-01

    Full Text Available Two experiments investigated how category information is used in decision making under uncertainty and whether the framing of category information influences how it is used. Subjects were presented with vignettes in which the categorization of a critical item was ambiguous and were asked to choose among a set of actions with the goal of attaining the desired outcome for the main character in the story. The normative decision making strategy was to base the decision on all possible categories; however, research on a related topic, category-based induction, has found that people often only consider a single category when making predictions when categorization is uncertain. These experiments found that subjects tend to consider multiple categories when making decisions, but do so both when it is and is not appropriate, suggesting that use of multiple categories is not driven by an understanding of what categories are and are not relevant to the decision. Similarly, although a framing manipulation increased the rate of multiple-category use, it did so in situations in which multiple-category use was and was not appropriate.

  20. Human Errors in Decision Making

    OpenAIRE

    Mohamad, Shahriari; Aliandrina, Dessy; Feng, Yan

    2005-01-01

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

  1. Involvement of people with dementia in making decisions about their lives: a qualitative study that appraises shared decision-making concerning daycare.

    Science.gov (United States)

    Groen-van de Ven, Leontine; Smits, Carolien; de Graaff, Fuusje; Span, Marijke; Eefsting, Jan; Jukema, Jan; Vernooij-Dassen, Myrra

    2017-11-12

    To explore how people with dementia, their informal caregivers and their professionals participate in decision making about daycare and to develop a typology of participation trajectories. A qualitative study with a prospective, multiperspective design, based on 244 semistructured interviews, conducted during three interview rounds over the course of a year. Analysis was by means of content analysis and typology construction. Community settings and nursing homes in the Netherlands. 19 people with dementia, 36 of their informal caregivers and 38 of their professionals (including nurses, daycare employees and case managers). The participants' responses related to three critical points in the decision-making trajectory about daycare: (1) the initial positive or negative expectations of daycare; (2) negotiation about trying out daycare by promoting, resisting or attuning to others; and (3) trying daycare, which resulted in positive or negative reactions from people with dementia and led to a decision. The ways in which care networks proceeded through these three critical points resulted in a typology of participation trajectories, including (1) working together positively toward daycare, (2) bringing conflicting perspectives together toward trying daycare and (3) not reaching commitment to try daycare. Shared decision making with people with dementia is possible and requires and adapted process of decision making. Our results show that initial preferences based on information alone may change when people with dementia experience daycare. It is important to have a try-out period so that people with dementia can experience daycare without having to decide whether to continue it. Whereas shared decision making in general aims at moving from initial preferences to informed preferences, professionals should focus more on moving from initial preferences to experienced preferences for people with dementia. Professionals can play a crucial role in facilitating the

  2. Cognitive influences on self-care decision making in persons with heart failure.

    Science.gov (United States)

    Dickson, Victoria V; Tkacs, Nancy; Riegel, Barbara

    2007-09-01

    Despite advances in management, heart failure is associated with high rates of hospitalization, poor quality of life, and early death. Education intended to improve patients' abilities to care for themselves is an integral component of disease management programs. True self-care requires that patients make decisions about symptoms, but the cognitive deficits documented in 30% to 50% of the heart failure population may make daily decision making challenging. After describing heart failure self-care as a naturalistic decision making process, we explore cognitive deficits known to exist in persons with heart failure. Problems in heart failure self-care are analyzed in relation to neural alterations associated with heart failure. As a neural process, decision making has been traced to regions of the prefrontal cortex, the same areas that are affected by ischemia, infarction, and hypoxemia in heart failure. Resulting deficits in memory, attention, and executive function may impair the perception and interpretation of early symptoms and reasoning and, thereby, delay early treatment implementation. There is compelling evidence that the neural processes critical to decision making are located in the same structures that are affected by heart failure. Because self-care requires the cognitive ability to learn, perceive, interpret, and respond, research is needed to discern how neural deficits affects these abilities, decision-making, and self-care behaviors.

  3. PARTICIPATORY DESIGN: AN INTERSUBJECTIVE SCHEMA FOR DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Tom Sanya

    2016-04-01

    Full Text Available The focus of this paper is participatory design (PD; a field that has been in existence since the 1960s. Reflections on a PD project in which the author played a central role revealed that existing literature does not engage adequately with intersubjective decision-making in PD processes. In this paper, appropriation and re-imagination of the Nordic framework for performance-based standards results in a novel multidimensional schema with five mutually related steps. Analysis indicates that the schema has a capacity for enhancing intersubjectivity in PD decision-making while also rendering the process more malleable to multiple viewpoints and their fusion into progressively definitive shared outcomes. In the conclusions, prospects for projective and reflective application of the schema explore its transformative capacity for professional and lay participants and its potential role in engendering critical design pedagogy.

  4. Designing Tools for Supporting User Decision-Making in e-Commerce

    Science.gov (United States)

    Sutcliffe, Alistair; Al-Qaed, Faisal

    The paper describes a set of tools designed to support a variety of user decision-making strategies. The tools are complemented by an online advisor so they can be adapted to different domains and users can be guided to adopt appropriate tools for different choices in e-commerce, e.g. purchasing high-value products, exploring product fit to users’ needs, or selecting products which satisfy requirements. The tools range from simple recommenders to decision support by interactive querying and comparison matrices. They were evaluated in a scenario-based experiment which varied the users’ task and motivation, with and without an advisor agent. The results show the tools and advisor were effective in supporting users and agreed with the predictions of ADM (adaptive decision making) theory, on which the design of the tools was based.

  5. Exploring disadvantageous inequality aversion in children: How cost and discrepancy influence decision-making

    Directory of Open Access Journals (Sweden)

    Amanda eWilliams

    2014-09-01

    Full Text Available This research examined disadvantageous inequality aversion in 4- and 6-year-old children. Using the resource allocation paradigm, we explored how inequality aversion was influenced by whether a cost was associated with the equitable choice. We also investigated whether preferences for equality differed depending on whether the inequitable choice presented a small or large discrepancy between the payoff of the participant and their partner. The results demonstrated that cost plays a large role in decision-making, as children preferred equality more when there was no cost associated with it compared to when there was a cost. Interestingly, the effect of cost also affected discrepancy, with children more likely to choose equality when the discrepancy was large as opposed to small, in cost trials but not in no cost trials. Finally, the effect of discrepancy also interacted with age, with older children being more sensitive to the discrepancy between themselves and their partner Together, these results suggest that children’s behaviour is not indiscriminately guided by a generalized aversion to inequality or established fairness norms. Alternate motives for inequality aversion are discussed.

  6. Couples' reports of household decision-making and the utilization of maternal health services in Bangladesh.

    Science.gov (United States)

    Story, William T; Burgard, Sarah A

    2012-12-01

    This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service utilization focus on women's reports; however, men are often involved in these decisions as well. Recently, studies have started to explore the association between health outcomes and reports of household decision-making from both husbands and wives as matched pairs. Many studies of household decision-making emphasize the importance of the wife alone making decisions; however, some have argued that joint decision-making between husbands and wives may yield better reproductive health outcomes than women making decisions without input or agreement from their partners. Husbands' involvement in decision-making is particularly important in Bangladesh because men often dominate household decisions related to large, health-related purchases. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and skilled delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives give concordant responses about who makes household decisions since discordant reports about who makes these decisions are negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and skilled delivery care. Finally, associations between household decision-making arrangements and health service utilization vary depending on whose report is used and the type of health service utilized. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Geospatial decision support systems for societal decision making

    Science.gov (United States)

    Bernknopf, R.L.

    2005-01-01

    While science provides reliable information to describe and understand the earth and its natural processes, it can contribute more. There are many important societal issues in which scientific information can play a critical role. Science can add greatly to policy and management decisions to minimize loss of life and property from natural and man-made disasters, to manage water, biological, energy, and mineral resources, and in general, to enhance and protect our quality of life. However, the link between science and decision-making is often complicated and imperfect. Technical language and methods surround scientific research and the dissemination of its results. Scientific investigations often are conducted under different conditions, with different spatial boundaries, and in different timeframes than those needed to support specific policy and societal decisions. Uncertainty is not uniformly reported in scientific investigations. If society does not know that data exist, what the data mean, where to use the data, or how to include uncertainty when a decision has to be made, then science gets left out -or misused- in a decision making process. This paper is about using Geospatial Decision Support Systems (GDSS) for quantitative policy analysis. Integrated natural -social science methods and tools in a Geographic Information System that respond to decision-making needs can be used to close the gap between science and society. The GDSS has been developed so that nonscientists can pose "what if" scenarios to evaluate hypothetical outcomes of policy and management choices. In this approach decision makers can evaluate the financial and geographic distribution of potential policy options and their societal implications. Actions, based on scientific information, can be taken to mitigate hazards, protect our air and water quality, preserve the planet's biodiversity, promote balanced land use planning, and judiciously exploit natural resources. Applications using the

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

    OpenAIRE

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

    2013-01-01

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

  9. Relationship power, decision making, and sexual relations: an exploratory study with couples of Mexican origin.

    Science.gov (United States)

    Harvey, S Marie; Beckman, Linda J; Browner, Carole H; Sherman, Christy A

    2002-11-01

    This study explored how couples of Mexican origin define power in intimate relationships, what makes men and women feel powerful in relationships, and the role of each partner in decision making about sexual and reproductive matters. Interviews were conducted with each partner of 39 sexually active couples and data were analyzed using content analysis. Results indicate that power is perceived as control over one s partner and the ability to make decisions. Women say they feel more powerful in relationships when they make unilateral decisions and have economic independence. Men feel powerful when they have control over their partner and bring home money. Respondents agreed that women make decisions about household matters and children, while men make decisions related to money. Findings indicate that whereas couples share decision making about sexual activities and contraceptive use, men are seen as initiators of sexual activity and women are more likely to suggest condom use.

  10. Taiwanese Consumers’ Decision-Making Styles: The Role of Perceptions of the Internet

    Directory of Open Access Journals (Sweden)

    Hung-Ming Lin

    2011-01-01

    Full Text Available The purpose of this study is to explore the relationship between online consumers’ perceptions and decision-making styles regarding the Internet. Four perceptions and six decision-making styles were administered. Data were gathered from 454 consumers with online shopping experience in Taiwan. It was found that, of the four perceptions of Tool, Technology, Toy and Tour, consumers are more inclined to view the Internet as a ‘Tool’ or as ‘Technology.’ The results indicate that consumers who hold the ‘Tool’ perception of the Internet are positively correlated to the Perfectionism consciousness decision-making style, but negatively relate to Brand consciousness, Novel-fashion consciousness and Brand-loyalty consciousness. Consumers with ‘Toy’ perceptions tend to show relatively less preference for the Perfectionism consciousness style, but more for content, such as Brand consciousness, Novel-fashion consciousness, Confused by overchoice, and Brand-loyalty consciousness. No significant correlation was observed between the ‘Technology’ and ‘Tour’ perceptions and the six Internet decision-making styles.

  11. Decision Making: The Underdeveloped Skill

    Science.gov (United States)

    Phelps, Robert

    1974-01-01

    Business educators should give students specific training in a methodology which will enable them to make logical, systematic, and rational decisions. Kepner-Tregoe Analysis (KTA), a decision making model, is described and illustrated with an example of a student buying his first car. (SC)

  12. Ethically-based clinical decision-making in physical therapy: process and issues.

    Science.gov (United States)

    Finch, Elspeth; Geddes, E Lynne; Larin, Hélène

    2005-01-01

    The identification and consideration of relevant ethical issues in clinical decision-making, and the education of health care professionals (HCPs) in these skills are key factors in providing quality health care. This qualitative study explores the way in which physical therapists (PTs) integrate ethical issues into clinical practice decisions and identifies ethical themes used by PTs. A purposive sample of eight PTs was asked to describe a recent ethically-based clinical decision. Transcribed interviews were coded and themes identified related to the following categories: 1) the integration of ethical issues in the clinical decision-making process, 2) patient welfare, 3) professional ethos of the PT, and 4) health care economics and business practices. Participants readily described clinical situations involving ethical issues but rarely identified specific conflicting ethical issues in their description. Ethical dilemmas were more frequently resolved when there were fewer emotional sequelae associated with the dilemma, and the PT had a clear understanding of professional ethos, valued patient autonomy, and explored a variety of alternative actions before implementing one. HCP students need to develop a clear professional ethos and an increased understanding of the economic factors that will present ethical issues in practice.

  13. Merging paradigms: Decision Making, Management, and Cognitive Control

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1996-01-01

    The paper discusses the trend in paradigms within decision research, drifting from concepts of decision making in terms of normative models of 'rational decision making, through behavioral models in terms of 'biases' - deviations from rational models, toward models of actual decision making...... behavior, such as the SRK concept, naturalistic decision making, and dynamic decision making.In this evolution, concepts such as decision making, management, and behavioral control merge and a concurrent change in concepts underlying design of systems aiming at control of behavior is visible, from...

  14. Emotion and decision making.

    Science.gov (United States)

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

    2015-01-03

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

  15. Taiwanese Consumers’ Decision-Making Styles: The Role of Perceptions of the Internet

    OpenAIRE

    Lin, Hung-Ming

    2011-01-01

    The purpose of this study is to explore the relationship between online consumers’ perceptions and decision-making styles regarding the Internet. Four perceptions and six decision-making styles were administered. Data were gathered from 454 consumers with online shopping experience in Taiwan. It was found that, of the four perceptions of Tool, Technology, Toy and Tour, consumers are more inclined to view the Internet as a ‘Tool’ or as ‘Technology.’ The results indicate that consumers who hold...

  16. Planning horizon affects prophylactic decision-making and epidemic dynamics.

    Science.gov (United States)

    Nardin, Luis G; Miller, Craig R; Ridenhour, Benjamin J; Krone, Stephen M; Joyce, Paul; Baumgaertner, Bert O

    2016-01-01

    The spread of infectious diseases can be impacted by human behavior, and behavioral decisions often depend implicitly on a planning horizon-the time in the future over which options are weighed. We investigate the effects of planning horizons on epidemic dynamics. We developed an epidemiological agent-based model (along with an ODE analog) to explore the decision-making of self-interested individuals on adopting prophylactic behavior. The decision-making process incorporates prophylaxis efficacy and disease prevalence with the individuals' payoffs and planning horizon. Our results show that for short and long planning horizons individuals do not consider engaging in prophylactic behavior. In contrast, individuals adopt prophylactic behavior when considering intermediate planning horizons. Such adoption, however, is not always monotonically associated with the prevalence of the disease, depending on the perceived protection efficacy and the disease parameters. Adoption of prophylactic behavior reduces the epidemic peak size while prolonging the epidemic and potentially generates secondary waves of infection. These effects can be made stronger by increasing the behavioral decision frequency or distorting an individual's perceived risk of infection.

  17. The effect of women's decision-making power on maternal health services uptake: evidence from Pakistan.

    Science.gov (United States)

    Hou, Xiaohui; Ma, Ning

    2013-03-01

    A large body of research has explored the links between women's decision making and their uptake of maternal health services, but the evidence so far is inconclusive. This study uses the Pakistan Social and Living Standards Measurement Survey to examine the influence of household decision making on women's uptake of maternal health services. We find that women's decision-making power has a significant positive correlation with maternal health services uptake and that influential males' decision-making power has the opposite effect, after controlling for socio-economic indicators and supply-side conditions. Our findings suggest that empowering women and increasing their ability to make decisions may increase their uptake of maternal health services. They also suggest that policies directed toward improving women's utilization of maternal health services in Pakistan must target men as well as women.

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

    NARCIS (Netherlands)

    Zeiss, Ragna; van Egmond, S.

    2014-01-01

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

  19. Decision-making in the adolescent brain.

    Science.gov (United States)

    Blakemore, Sarah-Jayne; Robbins, Trevor W

    2012-09-01

    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.

  20. Decision-making based on emotional images.

    Science.gov (United States)

    Katahira, Kentaro; Fujimura, Tomomi; Okanoya, Kazuo; Okada, Masato

    2011-01-01

    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.

  1. Decision making based on emotional images

    Directory of Open Access Journals (Sweden)

    Kentaro eKatahira

    2011-10-01

    Full Text Available 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 success- fully 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.

  2. A Blind Spot in Research on Foreign Language Effects in Judgment and Decision-Making

    Science.gov (United States)

    Polonioli, Andrea

    2018-01-01

    One of the most fascinating topics of current investigation in the literature on judgment and decision-making concerns the exploration of foreign language effects (henceforth, FLE). Specifically, recent research suggests that presenting information in a foreign language helps reasoners make better choices. However, this piece aims at making scholars aware of a blind spot in this stream of research. In particular, research on FLE has imported only one view of judgment and decision-making, in which the heuristics that people use are seen as conducive to biases and, in turn, to costly mistakes. But heuristics are not necessarily a liability, and this article indicates two routes to push forward research on FLE in judgment and decision-making. First, research on FLE should be expanded to explore also classes of fast and frugal heuristics, which have been shown to lead to accurate predictions in several contexts characterized by uncertainty. Second, research on FLE should be open to challenge the interpretations given to previous FLE findings, since alternative accounts are plausible and not ruled out by evidence. PMID:29662457

  3. A Blind Spot in Research on Foreign Language Effects in Judgment and Decision-Making

    Directory of Open Access Journals (Sweden)

    Andrea Polonioli

    2018-03-01

    Full Text Available One of the most fascinating topics of current investigation in the literature on judgment and decision-making concerns the exploration of foreign language effects (henceforth, FLE. Specifically, recent research suggests that presenting information in a foreign language helps reasoners make better choices. However, this piece aims at making scholars aware of a blind spot in this stream of research. In particular, research on FLE has imported only one view of judgment and decision-making, in which the heuristics that people use are seen as conducive to biases and, in turn, to costly mistakes. But heuristics are not necessarily a liability, and this article indicates two routes to push forward research on FLE in judgment and decision-making. First, research on FLE should be expanded to explore also classes of fast and frugal heuristics, which have been shown to lead to accurate predictions in several contexts characterized by uncertainty. Second, research on FLE should be open to challenge the interpretations given to previous FLE findings, since alternative accounts are plausible and not ruled out by evidence.

  4. A Blind Spot in Research on Foreign Language Effects in Judgment and Decision-Making.

    Science.gov (United States)

    Polonioli, Andrea

    2018-01-01

    One of the most fascinating topics of current investigation in the literature on judgment and decision-making concerns the exploration of foreign language effects (henceforth, FLE). Specifically, recent research suggests that presenting information in a foreign language helps reasoners make better choices. However, this piece aims at making scholars aware of a blind spot in this stream of research. In particular, research on FLE has imported only one view of judgment and decision-making, in which the heuristics that people use are seen as conducive to biases and, in turn, to costly mistakes. But heuristics are not necessarily a liability, and this article indicates two routes to push forward research on FLE in judgment and decision-making. First, research on FLE should be expanded to explore also classes of fast and frugal heuristics, which have been shown to lead to accurate predictions in several contexts characterized by uncertainty. Second, research on FLE should be open to challenge the interpretations given to previous FLE findings, since alternative accounts are plausible and not ruled out by evidence.

  5. Shared Decision Making for Better Schools.

    Science.gov (United States)

    Brost, Paul

    2000-01-01

    Delegating decision making to those closest to implementation can result in better decisions, more support for improvement initiatives, and increased student performance. Shared decision making depends on capable school leadership, a professional community, instructional guidance mechanisms, knowledge and skills, information sharing, power, and…

  6. Impaired decision making among morbidly obese adults.

    LENUS (Irish Health Repository)

    Brogan, Amy

    2011-02-01

    The Iowa Gambling Task (IGT) measures affective decision making and has revealed decision making impairments across a wide range of eating disorders. This study aimed to investigate affective decision making in severely obese individuals.

  7. Judgment and decision making.

    Science.gov (United States)

    Mellers, B A; Schwartz, A; Cooke, A D

    1998-01-01

    For many decades, research in judgment and decision making has examined behavioral violations of rational choice theory. In that framework, rationality is expressed as a single correct decision shared by experimenters and subjects that satisfies internal coherence within a set of preferences and beliefs. Outside of psychology, social scientists are now debating the need to modify rational choice theory with behavioral assumptions. Within psychology, researchers are debating assumptions about errors for many different definitions of rationality. Alternative frameworks are being proposed. These frameworks view decisions as more reasonable and adaptive that previously thought. For example, "rule following." Rule following, which occurs when a rule or norm is applied to a situation, often minimizes effort and provides satisfying solutions that are "good enough," though not necessarily the best. When rules are ambiguous, people look for reasons to guide their decisions. They may also let their emotions take charge. This chapter presents recent research on judgment and decision making from traditional and alternative frameworks.

  8. Counterfactual Thinking and Ethical Decision Making: A New Approach to an Old Problem for Marketing Education

    Science.gov (United States)

    Celuch, Kevin; Saxby, Carl

    2013-01-01

    The present study extends understanding of the self-regulatory aspects of ethical decision making by integrating and exploring relationships among counterfactual thinking, attribution, anticipatory emotions, and ethical decision-making constructs and processes. Specifically, we examine the effects of a manipulation designed to stimulate a…

  9. Forms of Knowledge Incorporated in Clinical Decision-making among Newly-Graduated Nurses: A Metasynthesis

    DEFF Research Database (Denmark)

    Voldbjerg, Siri; Elgaard Sørensen, Erik; Grønkjær, Mette

    2014-01-01

    Clinical-decision-making is of decisive importance to how evidence-based practice is put into practice. Schools of Nursing have a responsibility to teach and train nursing students to make clinical decisions within a frame of evidence-based practice. Clinical decision-making among nurses has been...... explored from numerous angles using a diversity of methodologies. Existing research has mainly focused on promoting and inhibiting factors for implementation of evidence-based practice and incorporation of research evidence in the clinical-decision. Little attention has been given to the nurses' behavior......, including the knowledge that actually informs the newly graduated nurses’ clinical decision. The aim of the study is to combine and synthesize results from qualitative research. Noblit and Hare’s meta-ethnographic approach is used to conduct a metasynthesis of qualitative research that has studied...

  10. Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

    Science.gov (United States)

    Duke Han, S.; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

    2015-01-01

    Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

  11. Modeling Human Elements of Decision-Making

    Science.gov (United States)

    2002-06-01

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

  12. Understanding Optimal Decision-making in Wargaming

    OpenAIRE

    Nesbitt, P; Kennedy, Q; Alt, JK; Fricker, RD; Whitaker, L; Yang, J; Appleget, JA; Huston, J; Patton, S

    2013-01-01

    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...

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

    Science.gov (United States)

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

    2017-10-01

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

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

    Science.gov (United States)

    Flaming, Susan C.

    2007-12-01

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

  15. Human-centric decision-making models for social sciences

    CERN Document Server

    Pedrycz, Witold

    2014-01-01

    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...

  16. Nonrational processes in ethical decision making.

    Science.gov (United States)

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

    2011-10-01

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

  17. What Policy Actors Seek for: Reciprocal Misunderstanding of Objectives of Participatory Decision Making

    Directory of Open Access Journals (Sweden)

    Birutė PITRĖNAITĖ-ŽILĖNIENĖ

    2013-12-01

    Full Text Available The goal of this research is to explore different policy actors’ attitudes towards participation in public decision making. The paper examines objectives of external participants’ involvement and compares various participants’ judgements on the process and results of participation. We screened operation of formal networks of participatory decision making at the Lithuanian Ministries of Health and Education & Science. The research revealed the willingness of decision makers to allow different stakeholders to contribute to the solution of problems of diverse character. The results of interviews manifested reciprocal miscommunication towards objectives and results of participatory decision making. Public administrators demonstrated their high willingness to acquire expertise, while external participants sought to present specific interests and got them implemented as well. However, it has to be admitted that decision makers are not committed to the results generated by stakeholders.

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

    Science.gov (United States)

    Domain, Melinda Willoughby

    2014-01-01

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

  19. Real estate added value and decision-making in hospital infrastructure

    NARCIS (Netherlands)

    Van der Zwart, J.

    2011-01-01

    This paper explores the concept of adding value to corporate performance by real estate, and how this concept could be applied in decision-making processes for new hospital infrastructure. A literature review forms the starting point for interviews carried out with hospitals‘ CEOs on how real estate

  20. A Social Constructivism Model of Ethical Decision Making in Counseling.

    Science.gov (United States)

    Cottone, R. Rocco

    2001-01-01

    Examines social constructivism as an intellectual movement in the mental health field that directs a social consensual interpretation of reality. Presents a social constructivism approach to counseling which redefines the ethical decision-making process as an interactive rather than individual or intrapsychic process. Explores how the process…

  1. Unexpected uncertainty, volatility and decision-making

    Directory of Open Access Journals (Sweden)

    Amy Rachel Bland

    2012-06-01

    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.

  2. Rodent models of adaptive decision making.

    Science.gov (United States)

    Izquierdo, Alicia; Belcher, Annabelle M

    2012-01-01

    Adaptive decision making affords the animal the ability to respond quickly to changes in a dynamic environment: one in which attentional demands, cost or effort to procure the reward, and reward contingencies change frequently. The more flexible the organism is in adapting choice behavior, the more command and success the organism has in navigating its environment. Maladaptive decision making is at the heart of much neuropsychiatric disease, including addiction. Thus, a better understanding of the mechanisms that underlie normal, adaptive decision making helps achieve a better understanding of certain diseases that incorporate maladaptive decision making as a core feature. This chapter presents three general domains of methods that the experimenter can manipulate in animal decision-making tasks: attention, effort, and reward contingency. Here, we present detailed methods of rodent tasks frequently employed within these domains: the Attentional Set-Shift Task, Effortful T-maze Task, and Visual Discrimination Reversal Learning. These tasks all recruit regions within the frontal cortex and the striatum, and performance is heavily modulated by the neurotransmitter dopamine, making these assays highly valid measures in the study of psychostimulant addiction.

  3. Cognitive processes in anesthesiology decision making.

    Science.gov (United States)

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

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

  4. Variation in clinical decision-making for induction of labour: a qualitative study.

    Science.gov (United States)

    Nippita, Tanya A; Porter, Maree; Seeho, Sean K; Morris, Jonathan M; Roberts, Christine L

    2017-09-22

    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.

  5. Staff Involvement in Leadership Decision Making in the UK Further Education Sector: Perceptions of Quality and Social Justice

    Science.gov (United States)

    Maringe, Felix

    2012-01-01

    Purpose: The purpose of the paper is to explore the quality of leadership decision making at various leadership levels in the further education (FE) sector. Using Hoffberg and Korver's model for integrated decision making, the paper aims to examine how staff in five UK FE colleges perceive the quality of their involvement in decision-making teams…

  6. Making sense of adolescent decision-making: challenge and reality.

    Science.gov (United States)

    Unguru, Yoram

    2011-08-01

    Few topics in pediatric bioethics are as vexing as decision-making. Decision-making in pediatrics presents challenges for children, parents, and physicians alike. The related, yet distinct, concepts of assent and consent are central to pediatric decision-making. Although informed consent is largely regarded as a worthwhile adult principle, assent has been, and continues to be, mired in debate. Controversial subjects include a meaningful definition of assent; how old children should be to assent; who should be included in the assent process; parental permission; how to resolve disputes between children and their parents; the relationship between assent and consent; the quantity and quality of information to disclose to children and their families; how much and what information children desire and need; the necessity and methods for assessing both children's understanding of disclosed information and of the assent process itself; reconciling ethical and legal attitudes toward assent; and finally, an effective, practical, and realistically applicable decision-making model.

  7. Service users' experiences of participation in decision making in mental health services.

    Science.gov (United States)

    Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

    2015-11-01

    Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core

  8. How do small groups make decisions?

    OpenAIRE

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

    2017-01-01

    In the competency-based medical education (CBME) approach, clinical competency committees are responsible for making decisions about trainees? competence. However, we currently lack a?theoretical model for group decision-making to inform this emerging assessment phenomenon. This paper proposes an organizing framework to study and guide the decision-making processes of clinical competency committees. This is an explanatory, non-exhaustive review, tailored to identify relevant theoretical and e...

  9. A canonical theory of dynamic decision-making

    Directory of Open Access Journals (Sweden)

    John eFox

    2013-04-01

    Full Text Available Decision-making behaviour is studied in many very different fields, from medicine and economics to psychology and neuroscience, with major contributions from mathematics and statistics, computer science, AI and other technical disciplines. However the conceptualisation of what decision-making is and methods for studying it vary greatly and this has resulted in fragmentation of the field. A theory that can accommodate various perspectives may facilitate interdisciplinary working. We present such a theory in which decision-making is articulated as a set of canonical functions that are sufficiently general to accommodate diverse viewpoints, yet sufficiently precise that they can be instantiated in different ways for specific theoretical or practical purposes. The canons cover the whole decision cycle, from the framing of a decision based on the goals, beliefs, and background knowledge of the decision maker to the formulation of decision options, establishing preferences over them, and making commitments. Commitments can lead to the initiation of new decisions and any step in the cycle can incorporate reasoning about previous decisions and the rationales for them, and lead to revising or abandoning existing commitments. The theory situates decision making with respect to other high-level cognitive capabilities like problem-solving, planning and collaborative decision-making. The canonical approach is assessed in three domains: cognitive and neuro-psychology, artificial intelligence, and decision engineering.

  10. A Canonical Theory of Dynamic Decision-Making

    Science.gov (United States)

    Fox, John; Cooper, Richard P.; Glasspool, David W.

    2012-01-01

    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

  11. Crisis decision making

    International Nuclear Information System (INIS)

    Holsti, O.R.

    1989-01-01

    This article presents evidence that the potential loss of control of events by officials who must operate under conditions that generate substantial stress is one of the central problems of crisis decision making. Examples of U.S. crises management and alliance management are reviewed, and possible tools for improving crisis management decisions are discussed. This article particularly focuses on crises which may lead to nuclear war

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Affective Decision Making and the Ellsberg Paradox

    OpenAIRE

    Anat Bracha; Donald J. Brown

    2008-01-01

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

  14. The functional neuroanatomy of decision-making.

    Science.gov (United States)

    Rosenbloom, Michael H; Schmahmann, Jeremy D; Price, Bruce H

    2012-01-01

    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.

  15. 24 CFR 55.20 - Decision making process.

    Science.gov (United States)

    2010-04-01

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

  16. Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD.

    Science.gov (United States)

    Druedahl, Louise C; Kälvemark Sporrong, Sofia

    2018-04-19

    Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient’s right to choose concerning ADHD medicine; (2) the patient’s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient’s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients’ decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient.

  17. The ethical basis of the precautionary principle in health care decision making

    International Nuclear Information System (INIS)

    Meulen, Ruud H.J. ter

    2005-01-01

    This article explores the relation between the precautionary and health care decision making. Decision making in medical practice as well as health policy is characterized by uncertainty. On the level of clinical practice for example, one never knows in advance whether one has made the right diagnosis or has opted for the right treatment. Though medical decisions have a risk on serious harms and burdens, the precautionary principle is not applicable to health care. This principle holds that one should not act when there is no scientific proof that no harms will result from a medical act or a policy decision. However, in clinical practice there is a duty to act. Physicians have an obligation to do good to their patients and have to weigh the benefits against possible harms and burdens. The basis virtue of medical decision making is not avoidance of risks, as stated in the precautionary principle, but the prudent assessment of benefits, burdens, and harms, in relation to other ethical principles like respect for autonomy and justice. The precautionary principle does play a role in health care, but it should never rule medical decision making as an absolute principle. This is not only true for clinical decision making, but also for the area of health policy. Physicians and other health care decision makers need to have knowledge about the possible effects of treatments or the precision of diagnostic procedures in order to reduce harm and promote well-being. Evidence-based medicine may contribute to the wisdom of health care decision makers, but this evidence-based wisdom should always be applied under the guidance of prudence, which is the central virtue of health care decision making

  18. Does future-oriented thinking predict adolescent decision making?

    Science.gov (United States)

    Eskritt, Michelle; Doucette, Jesslyn; Robitaille, Lori

    2014-01-01

    A number of theorists, as well as plain common sense, suggest that future-oriented thinking (FOT) should be involved in decision making; therefore, the development of FOT should be related to better quality decision making. FOT and quality of the decision making were measured in adolescents as well as adults in 2 different experiments. Though the results of the first experiment revealed an increase in quality of decision making across adolescence into adulthood, there was no relationship between FOT and decision making. In the second experiment, FOT predicted performance on a more deliberative decision-making task independent of age, but not performance on the Iowa Gambling Task (IGT). Performance on the IGT was instead related to emotion regulation. The study's findings suggest that FOT can be related to reflective decision making but not necessarily decision making that is more intuitive.

  19. GENDER MAINSTREAMING AND THE BENCHMARKING FALLACY OF WOMEN IN POLITICAL DECISION-MAKING

    OpenAIRE

    Meier, Petra; Lombardo, Emanuela; Bustelo, Maria; Maloutas, Maro Pantelidou

    2016-01-01

    In this article the authors analyse the extent to which an explicitly gendered issue such as the position of wo/men in political decision-making has been approached from a gender mainstreaming perspective. They do so by exploring how the issue has been framed in three countries, the Netherlands, Spain, and Greece, and in the European Union. The analysis enables them both to provide a state of the art of how gender in political decision-making has been dealt with throughout the last decade in ...

  20. Research-based-decision-making in Canadian health organizations: a behavioural approach.

    Science.gov (United States)

    Jbilou, Jalila; Amara, Nabil; Landry, Réjean

    2007-06-01

    Decision making in Health sector is affected by a several elements such as economic constraints, political agendas, epidemiologic events, managers' values and environment... These competing elements create a complex environment for decision making. Research-Based-Decision-Making (RBDM) offers an opportunity to reduce the generated uncertainty and to ensure efficacy and efficiency in health administrations. We assume that RBDM is dependant on decision makers' behaviour and the identification of the determinants of this behaviour can help to enhance research results utilization in health sector decision making. This paper explores the determinants of RBDM as a personal behaviour among managers and professionals in health administrations in Canada. From the behavioural theories and the existing literature, we build a model measuring "RBDM" as an index based on five items. These items refer to the steps accomplished by a decision maker while developing a decision which is based on evidence. The determinants of RBDM behaviour are identified using data collected from 942 health care decision makers in Canadian health organizations. Linear regression is used to model the behaviour RBDM. Determinants of this behaviour are derived from Triandis Theory and Bandura's construct "self-efficacy." The results suggest that to improve research use among managers in Canadian governmental health organizations, strategies should focus on enhancing exposition to evidence through facilitating communication networks, partnerships and links between researchers and decision makers, with the key long-term objective of developing a culture that supports and values the contribution that research can make to decision making in governmental health organizations. Nevertheless, depending on the organizational level, determinants of RBDM are different. This difference has to be taken into account if RBDM adoption is desired. Decision makers in Canadian health organizations (CHO) can help to build

  1. Information-seeking experiences and decision-making roles of Japanese women with breast cancer.

    Science.gov (United States)

    Nakashima, Mitsuyo; Kuroki, Syoji; Shinkoda, Harumi; Suetsugu, Yoshiko; Shimada, Kazuo; Kaku, Tsunehisa

    2012-06-01

    To investigate the information-seeking experiences and decision-making roles of Japanese women with breast cancer, to examine the relationship between information-seeking experiences and decision-making roles, and to explore the factors that influenced taking a more active role than the preferred role during the treatment decision-making process. In a cross-sectional study, women with breast cancer were retrospectively administered the Control Preferences Scale and the Information-Seeking Experience Scale. The Chi-Square test was used to compare differences among individual variables in decision-making roles and information-seeking experiences. Logistic regression analysis was used to explore the factors that influenced taking a more active role than the preferred role. One hundred and four patients with breast cancer participated in the investigation. Eighty-five patients (78%) perceived themselves as having knowledge of breast cancer and most patients (92%) sought information on breast cancer. The preferred roles in decision-making that they reported having before treatment were 18% active, 69% collaborative and 13% passive. The actual roles they perceived having experienced were 27% active, 43% collaborative and 30% passive. Although there was concordance of preferred and actual role for only 59% of the women, most patients reported that they were satisfied with their decision-making. Many women with breast cancer reported negative experiences with information seeking, including wanting more information (49%), expending a lot of effort to obtain the information needed (53%), not having enough time to obtain needed information (55%), frustration during the search for information (44%), concerns about the quality of the information (45%) and difficulty understanding the information received (49%). This study revealed that having a more active actual role than the initial preferred role was associated with emotional expression to the physician, having undergone

  2. Postnatal Psychosocial Assessment and Clinical Decision-Making, a Descriptive Study.

    Science.gov (United States)

    Sims, Deborah; Fowler, Cathrine

    2018-05-18

    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

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

    Science.gov (United States)

    Siminoff, Laura A; Step, Mary M

    2005-07-01

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

  4. Assessing the Decision-Making Capacity of Terminally Ill Patients with Cancer.

    Science.gov (United States)

    Kolva, Elissa; Rosenfeld, Barry; Saracino, Rebecca

    2018-05-01

    Despite the clinical, ethical, and legal magnitude of end-of-life decision-making, the capacity of terminally ill patients to make the medical decisions they often face is largely unknown. In practice, clinicians are responsible for determining when their patients are no longer competent to make treatment decisions, yet the accuracy of these assessments is unclear. The purpose of this study was to explore decision-making capacity and its assessment in terminally ill cancer patients. Fifty-five patients with advanced cancer receiving inpatient palliative care and 50 healthy adults were administered the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) to evaluate decision-making capacity with regard to the four most commonly used legal standards: Choice, Understanding, Appreciation, and Reasoning. Participants made a hypothetical treatment decision about whether to accept artificial nutrition and hydration for treatment of cachexia. Participants' physicians independently rated their decision-making capacity. Terminally ill participants were significantly more impaired than healthy adults on all MacCAT-T subscales. Most terminally ill participants were able to express a treatment choice (85.7%), but impairment was common on the Understanding (44.2%), Appreciation (49.0%), and Reasoning (85.4%) subscales. Agreement between physician-rated capacity and performance on the MacCAT-T subscales was poor. The use of the MacCAT-T revealed high rates of decisional impairment in terminally ill participants. Participants' physicians infrequently detected impairment identified by the MacCAT-T. The findings from the present study reinforce the need for engagement in advance care planning for patients with advanced cancer. Copyright © 2018 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. Toward an Expanded Definition of Adaptive Decision Making.

    Science.gov (United States)

    Phillips, Susan D.

    1997-01-01

    Uses the lifespan, life-space model to examine the definition of adaptive decision making. Reviews the existing definition of adaptive decision making as "rational" decision making and offers alternate perspectives on decision making with an emphasis on the implications of using the model. Makes suggestions for future theory, research,…

  6. Dissecting Attending Surgeons' Operating Room Guidance: Factors That Affect Guidance Decision Making.

    Science.gov (United States)

    Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S

    2015-01-01

    The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process

  7. Decision sidestepping: How the motivation for closure prompts individuals to bypass decision making.

    Science.gov (United States)

    Otto, Ashley S; Clarkson, Joshua J; Kardes, Frank R

    2016-07-01

    We all too often have to make decisions-from the mundane (e.g., what to eat for breakfast) to the complex (e.g., what to buy a loved one)-and yet there exists a multitude of strategies that allows us to make a decision. This work focuses on a subset of decision strategies that allows individuals to make decisions by bypassing the decision-making process-a phenomenon we term decision sidestepping. Critical to the present manuscript, however, we contend that decision sidestepping stems from the motivation to achieve closure. We link this proposition back to the fundamental nature of closure and how those seeking closure are highly bothered by decision making. As such, we argue that the motivation to achieve closure prompts a reliance on sidestepping strategies (e.g., default bias, choice delegation, status quo bias, inaction inertia, option fixation) to reduce the bothersome nature of decision making. In support of this framework, five experiments demonstrate that (a) those seeking closure are more likely to engage in decision sidestepping, (b) the effect of closure on sidestepping stems from the bothersome nature of decision making, and (c) the reliance on sidestepping results in downstream consequences for subsequent choice. Taken together, these findings offer unique insight into the cognitive motivations stimulating a reliance on decision sidestepping and thus a novel framework by which to understand how individuals make decisions while bypassing the decision-making process. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Emotional Intelligence and Decision Making

    Directory of Open Access Journals (Sweden)

    A M Kustubayeva

    2011-12-01

    Full Text Available The results of the experimental research of the connection between the efficiency of decision making and emotional intelligence are presented in the article. The empirical data indicate that the ability to regulate emotion is an important indicator of the efficiency of decision making in the conditions of psychological experiment.

  9. The Level of Automation in Emergency Quick Disconnect Decision Making

    Directory of Open Access Journals (Sweden)

    Imset Marius

    2018-02-01

    Full Text Available As a key measure for safety and environmental protection during offshore well operations, drill rigs are equipped with Emergency Quick Disconnect (EQD systems. However, an EQD operation is in itself considered a risky operation with a major economic impact. For this reason, it is of great importance to aid the operators in their assessment of the situation at all times, and help them make the best decisions. However, despite the availability of such systems, accidents do happen. This demonstrates the vulnerability of our human decision-making capabilities in extremely stressful situations. One way of improving the overall human-system performance with respect to EQD is to increase the level and quality of the automation and decision support systems. Although there is plenty of evidence that automated systems have weaknesses, there is also evidence that advanced software systems outperform humans in complex decision-making. The major challenge is to make sure that EQD is performed when necessary, but there is also a need to decrease the number of false EQDs. This paper applies an existing framework for levels of automation in order to explore the critical decision process leading to an EQD. We provide an overview of the benefits and drawbacks of existing automation and decision support systems vs. manual human decision-making. Data are collected from interviews of offshore users, suppliers, and oil companies, as well as from formal operational procedures. Findings are discussed using an established framework for the level of automation. Our conclusion is that there is an appropriate level of automation in critical situations related to the loss of the position of the drill rig, and that there is the promising potential to increase the autonomy level in a mid- and long-term situation assessment.

  10. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    Directory of Open Access Journals (Sweden)

    Kyriakos Souliotis

    2016-08-01

    Full Text Available Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA. PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI, an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  11. Assessing Patient Participation in Health Policy Decision-Making in Cyprus.

    Science.gov (United States)

    Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

    2016-06-20

    Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients' involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus. © 2016 by Kerman University of Medical Sciences.

  12. Reproductive health decision-making in perinatally HIV-infected adolescents and young adults.

    Science.gov (United States)

    Fair, Cynthia; Wiener, Lori; Zadeh, Sima; Albright, Jamie; Mellins, Claude Ann; Mancilla, Michael; Tepper, Vicki; Trexler, Connie; Purdy, Julia; Osherow, Janet; Lovelace, Susan; Kapetanovic, Suad

    2013-07-01

    With widespread access to antiretroviral therapy in the United States, many perinatally HIV-infected (PHIV+) children are surviving into adolescence and adulthood, becoming sexually active and making decisions about their reproductive health. The literature focusing on the reproductive decisions of individuals behaviorally infected with HIV can serve as a springboard for understanding the decision-making process of PHIV+ youth. Yet, there are many differences that critically distinguish reproductive health and related decision-making of PHIV+ youth. Given the potential public health implications of their reproductive decisions, better understanding of factors influencing the decision-making process is needed to help inform the development of salient treatment and prevention interventions. To begin addressing this understudied area, a "think tank" session, comprised of clinicians, medical providers, and researchers with expertise in the area of adolescent HIV, was held in Bethesda, MD, on September 21, 2011. The focus was to explore what is known about factors that influence the reproductive decision-making of PHIV+ adolescents and young adults, determine what important data are needed in order to develop appropriate intervention for PHIV+ youth having children, and to recommend future directions for the field in terms of designing and carrying out collaborative studies. In this report, we summarize the findings from this meeting. The paper is organized around the key themes that emerged, including utilizing a developmental perspective to create an operational definition of reproductive decision-making, integration of psychosocial services with medical management, and how to design future research studies. Case examples are presented and model program components proposed.

  13. Comparing perceptual and preferential decision making.

    Science.gov (United States)

    Dutilh, Gilles; Rieskamp, Jörg

    2016-06-01

    Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

  14. Self-esteem and risky decision-making: an ERP study.

    Science.gov (United States)

    Yang, Juan; Dedovic, Katarina; Zhang, Qinglin

    2010-12-01

    Self-esteem, a value one places on oneself, influences one's cognitive, emotional and behavioral responses across various situations. In the case of risky decision-making, high self-esteem (SE) individuals rely on their positive self-views and tend to be less defensive in response to a risky task; low SE individuals, on the contrary, tend to have fewer accessible positive resources and thus, are more prone to risk-aversion. While past studies have provided evidence for a link between self-esteem and a behaviorally-risky response, no study has explored the relation between self-esteem and the electrophysiological correlates of risky response. Therefore, the current study investigated the correlates of risky decision-making in high SE compared to low SE participants using event-related potentials (ERP) technology in 28 undergraduate students playing a blackjack game. The results showed that there was no difference between the high SE participants and the low SE participants with respect to the behavioral assessments of the risk-taking decision-making. However, for the electrophysiological data, we observed that the amplitude of P2 (150-300 ms) was more positive in the high SE participants compared to the low SE participants over the central-posterior scalp region. Dipole source analysis indicated that this positive component was generated in posterior cingulate cortex (PCC). These findings suggest that the high SE participants experienced more emotional signals than the low SE participants during decision-making.

  15. Shared decision making in West Africa: The forgotten area.

    Science.gov (United States)

    Diouf, Ndeye Thiab; Ben Charif, Ali; Adisso, Lionel; Adekpedjou, Rhéda; Zomahoun, Hervé Tchala Vignon; Agbadjé, Titilayo Tatiana; Dogba, Mama Joyce; Garvelink, Mirjam Marjolein

    2017-06-01

    Up to now, little attention has been paid to West Africa when it comes to shared decision making (SDM). West African countries seem to lag behind with regard to SDM initiatives compared to many other countries in the world. There is some interest in informed decision making or informed consent, but little in a full SDM process. Few decision-making tools are available for healthcare professionals and the majority are not designed to support decision-making with patients. Furthermore, to the best of our knowledge, there are no training programs for implementing SDM in healthcare teams. Many barriers exist to implementing SDM in West Africa, including lack of options, few or poor health resources and low levels of education. However, African countries present many opportunities for SDM as well. Existing SDM innovations developed for other populations with low literacy could be explored and adapted to the West African context, and research on implementation and outcomes in West Africa could contribute to SDM worldwide. West African countries are in an excellent position to both learn from other countries and contribute to SDM development in other parts of the world. In this paper we reflect on SDM challenges and opportunities, and propose a research agenda for West Africa. We hope to awaken interest in SDM in West Africa and encourage future collaborations on SDM with various West African stakeholders, including patients, healthcare professionals, policymakers, non-government organisations (NGOs) and academic institutions. Copyright © 2017. Published by Elsevier GmbH.

  16. School Counselors and Ethical Decision Making

    Science.gov (United States)

    West, Dana R.

    2016-01-01

    Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. However, there is a lack of empirical evidence about what influences a school counselor's ethical decision making. Ethical decision making for this study was defined as the degree to which decisions pertaining to…

  17. Fuzzy-like multiple objective multistage decision making

    CERN Document Server

    Xu, Jiuping

    2014-01-01

    Decision has inspired reflection of many thinkers since the ancient times. With the rapid development of science and society, appropriate dynamic decision making has been playing an increasingly important role in many areas of human activity including engineering, management, economy and others. In most real-world problems, decision makers usually have to make decisions sequentially at different points in time and space, at different levels for a component or a system, while facing multiple and conflicting objectives and a hybrid uncertain environment where fuzziness and randomness co-exist in a decision making process. This leads to the development of fuzzy-like multiple objective multistage decision making. This book provides a thorough understanding of the concepts of dynamic optimization from a modern perspective and presents the state-of-the-art methodology for modeling, analyzing and solving the most typical multiple objective multistage decision making practical application problems under fuzzy-like un...

  18. Customer Decision Support Systems: Resources for Student Decision Making

    Directory of Open Access Journals (Sweden)

    Cara Okleshen Peters, Ph.D.

    2005-07-01

    Full Text Available This paper highlights the potential of customer decision support systems (CDSS to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS concepts and presents exemplar websites students could utilize to support their education-related decision making. Finally, the authors discuss the potential benefits and drawbacks such resources engender from a student perspective and conclude with directions for future research.

  19. City-Level Energy Decision Making. Data Use in Energy Planning, Implementation, and Evaluation in U.S. Cities

    Energy Technology Data Exchange (ETDEWEB)

    Aznar, Alexandra [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Day, Megan [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Doris, Elizabeth [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Mathur, Shivani [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Donohoo-Vallett, Paul [U.S. Department of Energy, Washington, DC (United States)

    2015-07-08

    The Cities-LEAP technical report, City-Level Energy Decision Making: Data Use in Energy Planning, Implementation, and Evaluation in U.S. Cities, explores how a sample of cities incorporates data into making energy-related decisions. This report provides the foundation for forthcoming components of the Cities-LEAP project that will help cities improve energy decision making by mapping specific city energy or climate policies and actions to measurable impacts and results.

  20. Decentralizing decision making in modularization strategies

    DEFF Research Database (Denmark)

    Israelsen, Poul; Jørgensen, Brian

    2011-01-01

    which distorts the economic effects of modularization at the level of the individual product. This has the implication that decisions on modularization can only be made by top management if decision authority and relevant information are to be aligned. To overcome this problem, we suggest a solution...... that aligns the descriptions of the economic consequences of modularization at the project and portfolio level which makes it possible to decentralize decision making while making sure that local goals are congruent with the global ones in order to avoid suboptimal behaviour. Keywords: Modularization......; Accounting; Cost allocation; Decision rule; Decentralization...

  1. Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

    Directory of Open Access Journals (Sweden)

    Shannon E. Kelly

    2016-10-01

    Full Text Available Background Rapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews. Methods A Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation. Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described. Results Analysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process. Conclusion Results show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments.

  2. Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

    Science.gov (United States)

    Moher, David; Clifford, Tammy J.

    2016-01-01

    Background Rapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews. Methods A Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation). Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described. Results Analysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process. Conclusion Results show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments. PMID:27761324

  3. Make or buy strategy decision making in supply quality chain

    Directory of Open Access Journals (Sweden)

    Seyed Mohammad Seyedhosseini

    2012-04-01

    Full Text Available Minimizing the total cost is absolutely the goal of each supply chain, which is most of the time pursued. In this regards, quality related costs that have significant roles are sometimes neglected. Selecting suppliers, which supply relatively high quality raw materials in a lower cost is considered as a strategic decision. Make or Buy decision can be also noticed in supplier selection process. In this paper, the supply strategy: Make or Buy decision (SS: MOB is studied in order to find which strategy (Make or Buy should be chosen to minimize the total costs of supply chain. Therefore, two separate models are generated for each strategy and several examples are solved for the respective models. Computational experiments show the efficiency of the proposed models for making decision about selecting the best strategy.

  4. Patients' Values in Clinical Decision-Making.

    Science.gov (United States)

    Faggion, Clovis Mariano; Pachur, Thorsten; Giannakopoulos, Nikolaos Nikitas

    2017-09-01

    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.

  5. Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh

    Science.gov (United States)

    Sharma, Arpana

    2013-01-01

    Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

  6. The role of depression pharmacogenetic decision support tools in shared decision making.

    Science.gov (United States)

    Arandjelovic, Katarina; Eyre, Harris A; Lenze, Eric; Singh, Ajeet B; Berk, Michael; Bousman, Chad

    2017-10-29

    Patients discontinue antidepressant medications due to lack of knowledge, unrealistic expectations, and/or unacceptable side effects. Shared decision making (SDM) invites patients to play an active role in their treatment and may indirectly improve outcomes through enhanced engagement in care, adherence to treatment, and positive expectancy of medication outcomes. We believe decisional aids, such as pharmacogenetic decision support tools (PDSTs), facilitate SDM in the clinical setting. PDSTs may likewise predict drug tolerance and efficacy, and therefore adherence and effectiveness on an individual-patient level. There are several important ethical considerations to be navigated when integrating PDSTs into clinical practice. The field requires greater empirical research to demonstrate clinical utility, and the mechanisms thereof, as well as exploration of the ethical use of these technologies.

  7. Fuzzy Bi-level Decision-Making Techniques: A Survey

    Directory of Open Access Journals (Sweden)

    Guangquan Zhang

    2016-04-01

    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.

  8. Medical Decision-Making for Adults Who Lack Decision-Making Capacity and a Surrogate: State of the Science.

    Science.gov (United States)

    Kim, Hyejin; Song, Mi-Kyung

    2018-01-01

    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.

  9. Uncertain multi-attribute decision making methods and applications

    CERN Document Server

    Xu, Zeshui

    2015-01-01

    This book introduces methods for uncertain multi-attribute decision making including uncertain multi-attribute group decision making and their applications to supply chain management, investment decision making, personnel assessment, redesigning products, maintenance services, military system efficiency evaluation. Multi-attribute decision making, also known as multi-objective decision making with finite alternatives, is an important component of modern decision science. The theory and methods of multi-attribute decision making have been extensively applied in engineering, economics, management and military contexts, such as venture capital project evaluation, facility location, bidding, development ranking of industrial sectors and so on. Over the last few decades, great attention has been paid to research on multi-attribute decision making in uncertain settings, due to the increasing complexity and uncertainty of supposedly objective aspects and the fuzziness of human thought. This book can be used as a ref...

  10. Decision-Making Autonomy and Subsidiary Innovation

    DEFF Research Database (Denmark)

    Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt

    2013-01-01

    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...

  11. Applications of decision theory to test-based decision making

    NARCIS (Netherlands)

    van der Linden, Willem J.

    1987-01-01

    The use of Bayesian decision theory to solve problems in test-based decision making is discussed. Four basic decision problems are distinguished: (1) selection; (2) mastery; (3) placement; and (4) classification, the situation where each treatment has its own criterion. Each type of decision can be

  12. Decision-making in abnormal radiological situations

    International Nuclear Information System (INIS)

    Pretre, S.

    1998-01-01

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

  13. Goal-Directed Decision Making with Spiking Neurons.

    Science.gov (United States)

    Friedrich, Johannes; Lengyel, Máté

    2016-02-03

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

  14. Making difficult decisions how to be decisive and get the business done

    CERN Document Server

    Shaw, Peter J A

    2010-01-01

    You are faced with so many difficult decisions. Often your decision making seems random. It can be swayed by different situations and emotions. You need to be more rigorous in the way you make decisions and yet you have very little time to do so. Experience from others who have made tough decisions and a framework to help you do so would be invaluable. The courage to make decisions is sometimes a bit elusive. It is difficult to find the calmness to be able to make and live with those decisions. There is so much that can be learned from the experience of others. After working through this boo

  15. Stereotype threat affects financial decision making.

    Science.gov (United States)

    Carr, Priyanka B; Steele, Claude M

    2010-10-01

    The research presented in this article provides the first evidence that one's decision making can be influenced by concerns about stereotypes and the devaluation of one's identity. Many studies document gender differences in decision making, and often attribute these differences to innate and stable factors, such as biological and hormonal differences. In three studies, we found that stereotype threat affected decision making and led to gender differences in loss-aversion and risk-aversion behaviors. In Study 1, women subjected to stereotype threat in academic and business settings were more loss averse than both men and women who were not facing the threat of being viewed in light of negative stereotypes. We found no gender differences in loss-aversion behavior in the absence of stereotype threat. In Studies 2a and 2b, we found the same pattern of effects for risk-aversion behavior that we had observed for loss-aversion behavior. In addition, in Study 2b, ego depletion mediated the effects of stereotype threat on women's decision making. These results suggest that individuals' decision making can be influenced by stereotype concerns.

  16. The involvement of the striatum in decision making

    Science.gov (United States)

    Goulet-Kennedy, Julie; Labbe, Sara; Fecteau, Shirley

    2016-01-01

    Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives. PMID:27069380

  17. Patterns of out-of-home placement decision-making in child welfare.

    Science.gov (United States)

    Chor, Ka Ho Brian; McClelland, Gary M; Weiner, Dana A; Jordan, Neil; Lyons, John S

    2013-10-01

    Out-of-home placement decision-making in child welfare is founded on the best interest of the child in the least restrictive setting. After a child is removed from home, however, little is known about the mechanism of placement decision-making. This study aims to systematically examine the patterns of out-of-home placement decisions made in a state's child welfare system by comparing two models of placement decision-making: a multidisciplinary team decision-making model and a clinically based decision support algorithm. Based on records of 7816 placement decisions representing 6096 children over a 4-year period, hierarchical log-linear modeling characterized concordance or agreement, and discordance or disagreement when comparing the two models and accounting for age-appropriate placement options. Children aged below 16 had an overall concordance rate of 55.7%, most apparent in the least restrictive (20.4%) and the most restrictive placement (18.4%). Older youth showed greater discordant distributions (62.9%). Log-linear analysis confirmed the overall robustness of concordance (odd ratios [ORs] range: 2.9-442.0), though discordance was most evident from small deviations from the decision support algorithm, such as one-level under-placement in group home (OR=5.3) and one-level over-placement in residential treatment center (OR=4.8). Concordance should be further explored using child-level clinical and placement stability outcomes. Discordance might be explained by dynamic factors such as availability of placements, caregiver preferences, or policy changes and could be justified by positive child-level outcomes. Empirical placement decision-making is critical to a child's journey in child welfare and should be continuously improved to effect positive child welfare outcomes. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Defining decision making strategies in software ecosystem governance

    DEFF Research Database (Denmark)

    Manikas, Konstantinos; Wnuk, Krzysztof; Shollo, Arisa

    Making the right decisions is an essential part of software ecosystem governance. Decisions related to the governance of a software ecosystem can influence the health of the ecosystem and can result in fostering the success or greatly contributing to the failure of the ecosystem. However, very few...... studies touch upon the decision making of software ecosystem governance. In this paper, we propose decomposing software ecosystem governance into three activities: input or data collection, decision making, and applying actions. We focus on the decision making activity of software ecosystem governance...... and review related literature consisted of software ecosystem governance, organizational decision making, and IT governance. Based on the identified studies, we propose a framework for defining the decision making strategies in the governance of software ecosystems. We identify five decision areas...

  19. Heuristic decision making in medicine

    Science.gov (United States)

    Marewski, Julian N.; Gigerenzer, Gerd

    2012-01-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care. PMID:22577307

  20. Heuristic decision making in medicine.

    Science.gov (United States)

    Marewski, Julian N; Gigerenzer, Gerd

    2012-03-01

    Can less information be more helpful when it comes to making medical decisions? Contrary to the common intuition that more information is always better, the use of heuristics can help both physicians and patients to make sound decisions. Heuristics are simple decision strategies that ignore part of the available information, basing decisions on only a few relevant predictors. We discuss: (i) how doctors and patients use heuristics; and (ii) when heuristics outperform information-greedy methods, such as regressions in medical diagnosis. Furthermore, we outline those features of heuristics that make them useful in health care settings. These features include their surprising accuracy, transparency, and wide accessibility, as well as the low costs and little time required to employ them. We close by explaining one of the statistical reasons why heuristics are accurate, and by pointing to psychiatry as one area for future research on heuristics in health care.

  1. Learning to Make Decisions Through Constructive Controversy.

    Science.gov (United States)

    Tjosvold, Dean

    Students must make decisions about their lifestyle, future careers, academic pursuits, and classroom and school issues. Learning to make effective decisions for themselves and for society is an important aspect of competence. They can learn decision making through interacting and solving problems with others. A central ingredient for successful…

  2. The context influences doctors' support of shared decision-making in cancer care.

    Science.gov (United States)

    Shepherd, H L; Tattersall, M H N; Butow, P N

    2007-07-02

    Most cancer patients in westernised countries now want all information about their situation, good or bad, and many wish to be involved in decision-making. The attitudes to and use of shared decision-making (SDM) by cancer doctors is not well known. Australian cancer clinicians treating breast, colorectal, gynaecological, haematological, or urological cancer were surveyed to identify their usual approach to decision-making and their comfort with different decision-making styles when discussing treatment with patients. A response rate of 59% resulted in 624 complete surveys, which explored usual practice in discussing participation in decision-making, providing information, and perception of the role patients want to play. Univariate and multivariate analyses were performed to identify predictors of use of SDM. Most cancer doctors (62.4%) reported using SDM and being most comfortable with this approach. Differences were apparent between reported high comfort with SDM and less frequent usual practice. Multivariate analysis showed that specialisation in breast or urological cancers compared to other cancers (AOR 3.02), high caseload of new patients per month (AOR 2.81) and female gender (AOR 1.87) were each independently associated with increased likelihood of use of SDM. Barriers exist to the application of SDM by doctors according to clinical situation and clinician characteristics.

  3. A conceptual model for ethical business decision-making under the influence of personal relationships

    OpenAIRE

    Davidrajuh, Reggie

    2008-01-01

    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...

  4. Strategic decision making

    OpenAIRE

    Stokman, Frans N.; Assen, Marcel A.L.M. van; Knoop, Jelle van der; Oosten, Reinier C.H. van

    2000-01-01

    This paper introduces a methodology for strategic intervention in collective decision making.The methodology is based on (1) a decomposition of the problem into a few main controversial issues, (2) systematic interviews of subject area specialists to obtain a specification of the decision setting,consisting of a list of stakeholders with their capabilities, positions, and salience on each of the issues; (3) computer simulation. The computer simulation models incorporate only the main processe...

  5. Decentralised water systems: emotional influences on resource decision making.

    Science.gov (United States)

    Mankad, Aditi

    2012-09-01

    The study of emotion has gathered momentum in the field of environmental science, specifically in the context of community resource decision-making. Of particular interest in this review is the potential influence of emotion, risk and threat perception on individuals' decisions to acceptance and adopt decentralised water systems, such as rainwater tanks and greywater systems. The role of message framing is also considered in detail, as well as the influences that different types of framing can have on decision making. These factors are considered as possible predictors for analysing community acceptance of decentralised water in urban environments. Concepts believed to be influenced by emotion, such as trust and framing, are also discussed as potentially meaningful contributors to an overall model of community acceptance of decentralised water. Recommendations are made for how emotion-based concepts, such as risk and threat, can be targeted to facilitate widespread adoption of decentralised systems and how researchers can explore different types of emotions that influence decision making in distinct ways. This review is an important theoretical step in advancing the psycho-social understanding of acceptance and adoption of on-site water sources. Avenues for future research are recommended, including the need for greater theoretical development to encourage future social science research on decentralised systems. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  6. Calculus formation: nurses' decision-making in abortion-related care.

    Science.gov (United States)

    McLemore, Monica R; Kools, Susan; Levi, Amy J

    2015-06-01

    Nurses routinely provide care to patients in ethically challenging situations. To explore the continuum between conscientious objectors and designated staff in the provision of care to women seeking abortions, the aim of this study was to thickly describe decision-making, using abortion as the clinical context to elucidate how nurses approach ethically challenging work. A purposive sample of 25 nurses who worked in abortion clinics, emergency departments, intensive care units, labor, and delivery, operating rooms, and post anesthesia care units were interviewed. Qualitative description and thematic analysis were used to identify the cognitive, emotional, and behavioral processes in nurses' decisions to care for women needing abortions. Nurses developed and used multifaceted, real-time calculi when making decisions about their participation in emergent or routine abortion care. Nurses tacked back and forth between the personal and professional and/or held multiple contradictory positions simultaneously. Nurses weighed the role and opinion of others to determine if they know how to or know why they would provide abortion care to women, particularly in the elective abortion context. The parameters of the nurse-patient relationship were complex and specific to the experiences of both the nurse and patient. Findings from this study further develop the science of ethically challenging decision-making and expand our understanding of factors that influence how nurses develop relationships to ethically challenging work. © 2015 Wiley Periodicals, Inc.

  7. Decision Making Based On Management Information System and Decision Support System

    Directory of Open Access Journals (Sweden)

    Şükrü Ada

    2015-04-01

    Full Text Available Information hasbecome an essentialresource for managing modern organizations. This is so because today’sbusiness environment is volatile, dynamic, turbulent and necessitates the burgeoning demand for accurate, relevant, complete,timely and economical information needed to drive the decision-making process in order to accentuate organizational abilities to manage opportunities and threat. MIS work on online mode with an average processing speed. Generally, it is used by low level management. Decision support system are powerful tool that assist corporate executives, administrators and other senior officials in making decision regarding the problem. Management Information Systems is a useful tool that provided organized and summarized information in a proper time to decision makers and enable making accurate decision for managers in organizations. This paper will discuss the concept, characteristics, types of MIS, the MIS model, and in particular it will highlight the impact and role of MIS on decision making.

  8. Acceptability, acceptance and decision making

    International Nuclear Information System (INIS)

    Ackerschott, H.

    2002-01-01

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

  9. 44 CFR 9.6 - Decision-making process.

    Science.gov (United States)

    2010-10-01

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

  10. Clinical decision-making: physicians' preferences and experiences

    Directory of Open Access Journals (Sweden)

    White Martha

    2007-03-01

    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.

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

    Science.gov (United States)

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

    2017-01-01

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

  12. Biotechnology and Consumer Decision-Making.

    Science.gov (United States)

    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.

  13. Use of implicit persuasion in decision making about adjuvant cancer treatment: A potential barrier to shared decision making

    NARCIS (Netherlands)

    Engelhardt, Ellen G.; Pieterse, Arwen H.; van der Hout, Anja; de Haes, Hanneke J. C. J. M.; Kroep, Judith R.; Quarles van Ufford-Mannesse, Patricia; Portielje, Johanneke E. A.; Smets, Ellen M. A.; Stiggelbout, Anne M.

    2016-01-01

    Shared decision making (SDM) is widely advocated, especially for preference-sensitive decisions like those on adjuvant treatment for early-stage cancer. Here, decision making involves a subjective trade-off between benefits and side-effects, and therefore, patients' informed preferences should be

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

    International Nuclear Information System (INIS)

    Elliott, Eva; Francis, Sarah

    2005-01-01

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

  15. The hidden traps in decision making.

    Science.gov (United States)

    Hammond, J S; Keeney, R L; Raiffa, H

    1998-01-01

    Bad decisions can often be traced back to the way the decisions were made--the alternatives were not clearly defined, the right information was not collected, the costs and benefits were not accurately weighted. But sometimes the fault lies not in the decision-making process but rather in the mind of the decision maker. The way the human brain works can sabotage the choices we make. John Hammond, Ralph Keeney, and Howard Raiffa examine eight psychological traps that are particularly likely to affect the way we make business decisions: The anchoring trap leads us to give disproportionate weight to the first information we receive. The statusquo trap biases us toward maintaining the current situation--even when better alternatives exist. The sunk-cost trap inclines us to perpetuate the mistakes of the past. The confirming-evidence trap leads us to seek out information supporting an existing predilection and to discount opposing information. The framing trap occurs when we misstate a problem, undermining the entire decision-making process. The overconfidence trap makes us overestimate the accuracy of our forecasts. The prudence trap leads us to be overcautious when we make estimates about uncertain events. And the recallability trap leads us to give undue weight to recent, dramatic events. The best way to avoid all the traps is awareness--forewarned is forearmed. But executives can also take other simple steps to protect themselves and their organizations from the various kinds of mental lapses. The authors show how to take action to ensure that important business decisions are sound and reliable.

  16. How Different Insights from a Variety of Theories Might Help Ethical Decision-Making in Educational Counselling

    Science.gov (United States)

    Tveit, Anne Dorthe; Sunde, Annikken Louise

    2016-01-01

    The purpose of this paper is to explore how different insights from a variety of theories might help ethical decision making in educational counselling and highlight the need for reflection. A framework for ethical decision making based on basic features of counselling, namely the interlocutors' practice or "acts", is proposed. There are…

  17. Decision making in patients with temporal lobe epilepsy.

    Science.gov (United States)

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

    2009-01-01

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

  18. A cognitive prosthesis for complex decision-making.

    Science.gov (United States)

    Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

    2017-01-01

    While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Decision making uncertainty, imperfection, deliberation and scalability

    CERN Document Server

    Kárný, Miroslav; Wolpert, David

    2015-01-01

    This volume focuses on uncovering the fundamental forces underlying dynamic decision making among multiple interacting, imperfect and selfish decision makers. The chapters are written by leading experts from different disciplines, all considering the many sources of imperfection in decision making, and always with an eye to decreasing the myriad discrepancies between theory and real world human decision making. Topics addressed include uncertainty, deliberation cost and the complexity arising from the inherent large computational scale of decision making in these systems. In particular, analyses and experiments are presented which concern: • task allocation to maximize “the wisdom of the crowd”; • design of a society of “edutainment” robots who account for one anothers’ emotional states; • recognizing and counteracting seemingly non-rational human decision making; • coping with extreme scale when learning causality in networks; • efficiently incorporating expert knowledge in personalized...

  20. Decision-making in diabetes mellitus type 1.

    Science.gov (United States)

    Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

    2013-01-01

    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.

  1. Improving accountability in vaccine decision-making.

    Science.gov (United States)

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

    2017-11-01

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

  2. Factors influencing risky decision-making in patients with cerebral infarction.

    Science.gov (United States)

    Gong, Jingjing; Zhang, Yan; Wu, Bing; Feng, Jun; Zhang, Weiwei; Wang, Shijie; Huang, Yonghua; Wu, Xinhuai

    2015-01-01

    Numerous studies have found that the framing effect is common in medical scenarios, but few studies have examined the influence of the framing effect upon thrombolytic therapy for cerebral infarction. In this study, 1040 inpatients and outpatients in the department of neurology were recruited to explore whether there is a framing effect in decision-making within thrombolytic therapy, and if so, which factors influence that effect. The findings from Study 1 indicate that the framing effect occurred in patients both with and without cerebral infarction (χ(2) = 7.90, p = .005; χ(2) = 5.16, p = .023, respectively), with both groups displaying risk-seeking behavior (thrombolytic therapy) in the positive frame and no risk aversion or risk seeking in the negative frame. The results of Study 2 show that the patients preferred risk seeking in both collaborative and individual decision-making. In the collaborative decision-making group, the patients in the senior group showed the framing effect (χ(2) = 5.35, p frame (G) showing more significant risk seeking than both those in the negative frame (H) and those in the other positive frame (A, C, and E). In summary, decision-making about thrombolytic therapy in patients with cerebral infarction is influenced by the framing effect, and some influencing factors should be attended in clinical practice. Further research is necessary to guide the treatment of cerebral infarction.

  3. Taiwanese Consumers’ Internet Decision-Making Styles: The Role of Perceptions of the Internet

    OpenAIRE

    Hung-Ming Lin

    2011-01-01

    The purpose of this study is to explore the relationship between online consumers’ perceptions and decision-making styles regarding the Internet. Four perceptions and six decision-making styles were administered. Data were gathered from 454 consumers with online shopping experience in Taiwan. It was found that, of the four perceptions of Tool, Technology, Toy and Tour, consumers are more inclined to view the Internet as a ‘Tool’ or as ‘Technology.’ The results indicate that consumers who hold...

  4. What is known about parents' treatment decisions? A narrative review of pediatric decision making.

    Science.gov (United States)

    Lipstein, Ellen A; Brinkman, William B; Britto, Maria T

    2012-01-01

    With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process. To conduct a narrative review of the current research on parent decision making about pediatric treatments and identify areas in need of further investigation. Articles presenting original research on parent decision making were identified from MEDLINE (1966-6/2011), using the terms "decision making," "parent," and "child." We included papers focused on treatment decisions but excluded those focused on information disclosure to children, vaccination, and research participation decisions. We found 55 papers describing 52 distinct studies, the majority being descriptive, qualitative studies of the decision-making process, with very limited assessment of decision outcomes. Although parents' preferences for degree of participation in pediatric decision making vary, most are interested in sharing the decision with the provider. In addition to the provider, parents are influenced in their decision making by changes in their child's health status, other community members, prior knowledge, and personal factors, such as emotions and faith. Parents struggle to balance these influences as well as to know when to include their child in decision making. Current research demonstrates a diversity of influences on parent decision making and parent decision preferences; however, little is known about decision outcomes or interventions to improve outcomes. Further investigation, using prospective methods, is needed in order to understand how to support parents through the difficult treatment decisions.

  5. Enhancing decision making about participation in cancer clinical trials: development of a question prompt list

    Science.gov (United States)

    Brown, Richard F.; Shuk, Elyse; Leighl, Natasha; Butow, Phyllis; Ostroff, Jamie; Edgerson, Shawna; Tattersall, Martin

    2016-01-01

    Purpose Slow accrual to cancer clinical trials impedes the progress of effective new cancer treatments. Poor physician–patient communication has been identified as a key contributor to low trial accrual. Question prompt lists (QPLs) have demonstrated a significant promise in facilitating communication in general, surgical, and palliative oncology settings. These simple patient interventions have not been tested in the oncology clinical trial setting. We aimed to develop a targeted QPL for clinical trials (QPL-CT). Method Lung, breast, and prostate cancer patients who either had (trial experienced) or had not (trial naive) participated in a clinical trial were invited to join focus groups to help develop and explore the acceptability of a QPL-CT. Focus groups were audio-recorded and transcribed. A research team, including a qualitative data expert, analyzed these data to explore patients’ decision-making processes and views about the utility of the QPL-CT prompt to aid in trial decision making. Results Decision making was influenced by the outcome of patients’ comparative assessment of perceived risks versus benefits of a trial, and the level of trust patients had in their doctors’ recommendation about the trial. Severity of a patient’s disease influenced trial decision making only for trial-naive patients. Conclusion Although patients were likely to prefer a paternalistic decision-making style, they expressed valuation of the QPL as an aid to decision making. QPL-CT utility extended beyond the actual consultation to include roles both before and after the clinical trial discussion. PMID:20593202

  6. Risky Decision Making in Juvenile Myoclonic Epilepsy

    Directory of Open Access Journals (Sweden)

    Iris Unterberger

    2018-03-01

    Full Text Available It is not known whether patients with juvenile myoclonic epilepsy (JME differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years and a group of 38 healthy controls (mean age 26.03/SD 4.84 years. Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.

  7. Risky Decision Making in Juvenile Myoclonic Epilepsy.

    Science.gov (United States)

    Unterberger, Iris; Zamarian, Laura; Prieschl, Manuela; Bergmann, Melanie; Walser, Gerald; Luef, Gerhard; Javor, Andrija; Ransmayr, Gerhard; Delazer, Margarete

    2018-01-01

    It is not known whether patients with juvenile myoclonic epilepsy (JME) differ from healthy people in decision making under risk, i.e., when the decision-making context offers explicit information about options, probabilities, and consequences already from the beginning. In this study, we adopted the Game of Dice Task-Double to investigate decision making under risk in a group of 36 patients with JME (mean age 25.25/SD 5.29 years) and a group of 38 healthy controls (mean age 26.03/SD 4.84 years). Participants also underwent a comprehensive neuropsychological assessment focused on frontal executive functions. Significant group differences were found in tests of psychomotor speed and divided attention, with the patients scoring lower than the controls. Importantly, patients made risky decisions more frequently than controls. In the patient group, poor decision making was associated with poor executive control, poor response inhibition, and a short interval since the last seizure episode. Executive control and response inhibition could predict 42% of variance in the frequency of risky decisions. This study indicates that patients with JME with poorer executive functions are more likely to make risky decisions than healthy controls. Decision making under risk is of major importance in every-day life, especially with regard to treatment decisions and adherence to long-term medical therapy. Since even a single disadvantageous decision may have long-lasting consequences, this finding is of high relevance.

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

    Directory of Open Access Journals (Sweden)

    Ya Zheng

    2017-09-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  11. Designing Dynamic Adaptive Policy Pathways using Many-Objective Robust Decision Making

    Science.gov (United States)

    Kwakkel, Jan; Haasnoot, Marjolijn

    2017-04-01

    Dealing with climate risks in water management requires confronting a wide variety of deeply uncertain factors, while navigating a many dimensional space of trade-offs amongst objectives. There is an emerging body of literature on supporting this type of decision problem, under the label of decision making under deep uncertainty. Two approaches within this literature are Many-Objective Robust Decision Making, and Dynamic Adaptive Policy Pathways. In recent work, these approaches have been compared. One of the main conclusions of this comparison was that they are highly complementary. Many-Objective Robust Decision Making is a model based decision support approach, while Dynamic Adaptive Policy Pathways is primarily a conceptual framework for the design of flexible strategies that can be adapted over time in response to how the future is actually unfolding. In this research we explore this complementarity in more detail. Specifically, we demonstrate how Many-Objective Robust Decision Making can be used to design adaptation pathways. We demonstrate this combined approach using a water management problem, in the Netherlands. The water level of Lake IJselmeer, the main fresh water resource of the Netherlands, is currently managed through discharge by gravity. Due to climate change, this won't be possible in the future, unless water levels are changed. Changing the water level has undesirable flood risk and spatial planning consequences. The challenge is to find promising adaptation pathways that balance objectives related to fresh water supply, flood risk, and spatial issues, while accounting for uncertain climatic and land use change. We conclude that the combination of Many-Objective Robust Decision Making and Dynamic Adaptive Policy Pathways is particularly suited for dealing with deeply uncertain climate risks.

  12. The job demands and resources decision making (JD-R-DM) model

    NARCIS (Netherlands)

    Gordon, H.J.; Demerouti, E.; Bipp, T.; Le Blanc, P.M.

    2015-01-01

    This study explores the effects of nurses’ daily job characteristics (i.e., job demands and resources) and general work engagement on their daily decision making (i.e., analytical and intuitive) and consequently their daily performance (i.e., task and contextual). Participants completed a baseline

  13. Health and wellbeing boards: public health decision making bodies or political pawns?

    Science.gov (United States)

    Greaves, Z; McCafferty, S

    2017-02-01

    Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  14. A meta-ethnography and theory of parental ethical decision making in the neonatal intensive care unit.

    Science.gov (United States)

    Rosenthal, Sara A; Nolan, Marie T

    2013-07-01

    To synthesize the existing qualitative literature about parent ethical decision making in the neonatal intensive care unit (NICU) and to investigate the potential impact of culture on parents' decision making experiences. PubMed, CINAHL plus, and PsychInfo using the search terms parental decision making, culture, race, decision making, and parental decisions. Qualitative research studies investigating decision making for infants in the NICU from the parents' perspective were included. Studies involving older pediatric populations were excluded. Ten primary qualitative research articles were included. The primary author read all manuscripts and tabulated themes related to parents' ethical decision making. Study findings were synthesized using meta-ethnography involving translating concepts of separate studies into one another, exploring contradictions, and organizing these concepts into new theories. Key themes included parent involvement in decision making, parental role, necessity of good information, need for communication, desire for hope and compassion conveyed by providers, decision making satisfaction, and trust in caregiving team. A preliminary theoretical framework of ethical parent decision making was modeled based on the proposed relationships between the themes. Parent preferences for their involvement in decision making, their perceptions of communication with providers, and their relationships with providers are all important factors in the experience of making decisions for their infants. Needs of parents were the same regardless the ethnic or racial diversity of study participants. © 2013 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  15. Food choice decision-making by women with gestational diabetes.

    Science.gov (United States)

    Hui, Amy Leung; Sevenhuysen, Gustaaf; Harvey, Dexter; Salamon, Elizabeth

    2014-02-01

    To enhance the dietary education presented to women with gestational diabetes (GDM) by exploring the reasons and experiences that women with GDM reported in making their food-choice decisions after receipt of dietary education from a healthcare professional. Food Choice Map (FCM) semi-structured in-depth interviews were conducted with 30 women with GDM living in the Winnipeg area during their pregnancies. Verbatim transcripts were generated from the interviews. A constant comparative method was used to generate common themes to answer research inquiries. Personal food preferences, hunger and cravings were the main factors affecting food choice decision-making in women with GDM. Although the information from healthcare professionals was 1 factor that affected food choice decision-making for most of the participants, more than half of the women, including all the women who were on insulin, reported difficulties in quick adaptation to dietary management in a limited time period. Information from other sources such as family members, friends, and internet were used to cope with the adaptation. These difficulties led to a sense of decreased control of GDM and were accompanied by frustration, especially for women taking insulin. Food choice decision-making varied for this group of women with GDM. Knowledge and information aided in making healthy food choices and in portion control. However, balancing individual needs and blood glucose control in a short time period was felt to be difficult and created frustration. The findings suggested that dietary consultation needs to be personalized and to be time sensitive to promote confidence in self-control. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-07-01

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

  17. Naturalistic decision making in forensic science: toward a better understanding of decision making by forensic team leaders.

    Science.gov (United States)

    Helsloot, Ira; Groenendaal, Jelle

    2011-07-01

    This study uses the naturalistic decision-making (NDM) perspective to examine how Dutch forensic team leaders (i.e., the officers in charge of criminal forensic research from the crime scene until the use of laboratory assistance) make decisions in real-life settings and identifies the contextual factors that might influence those decisions. First, a focus group interview was conducted to identify four NDM mechanisms in day-to-day forensic decision making. Second, a serious game was conducted to examine the influence of three of these contextual mechanisms. The results uncovered that forensic team leaders (i) were attracted to obtain further information when more information was initially made available, (ii) were likely to devote more attention to emotionally charged cases, and (iii) used not only forensic evidence in the decision making but also tactical, unverified information of the police inquiry. Interestingly, the measured contextual influences did not deviate significantly from a control group of laypeople. © 2011 American Academy of Forensic Sciences.

  18. A tool for design decision making - zero energy residential buildings in hot humid climates

    NARCIS (Netherlands)

    Attia, S.G.

    2012-01-01

    In this thesis, the development and evaluation of a simulation-based decision aid for Net Zero Energy Buildings (NZEBs) design, ZEBO, was explored. The thesis investigates the ability to achieve informed decision making for NZEB design, in hot climate. Four main questions were posed. Firstly, how to

  19. Deliberation versus automaticity in decision making: Which presentation format features facilitate automatic decision making?

    Directory of Open Access Journals (Sweden)

    Anke Soellner

    2013-05-01

    Full Text Available The idea of automatic decision making approximating normatively optimal decisions without necessitating much cognitive effort is intriguing. Whereas recent findings support the notion that such fast, automatic processes explain empirical data well, little is known about the conditions under which such processes are selected rather than more deliberate stepwise strategies. We investigate the role of the format of information presentation, focusing explicitly on the ease of information acquisition and its influence on information integration processes. In a probabilistic inference task, the standard matrix employed in prior research was contrasted with a newly created map presentation format and additional variations of both presentation formats. Across three experiments, a robust presentation format effect emerged: Automatic decision making was more prevalent in the matrix (with high information accessibility, whereas sequential decision strategies prevailed when the presentation format demanded more information acquisition effort. Further scrutiny of the effect showed that it is not driven by the presentation format as such, but rather by the extent of information search induced by a format. Thus, if information is accessible with minimal need for information search, information integration is likely to proceed in a perception-like, holistic manner. In turn, a moderate demand for information search decreases the likelihood of behavior consistent with the assumptions of automatic decision making.

  20. A brief history of decision making.

    Science.gov (United States)

    Buchanan, Leigh; O'Connell, Andrew

    2006-01-01

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