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Sample records for making choices screening

  1. Make Better Food Choices

    Science.gov (United States)

    10 tips Nutrition Education Series make better food choices 10 tips for women’s health Fruits Grains Dairy Vegetables Protein Make yourself a priority and take time to care for yourself. ChooseMyPlate. gov ...

  2. Making Smart Food Choices

    Science.gov (United States)

    ... turn JavaScript on. Feature: Healthy Aging Making Smart Food Choices Past Issues / Winter 2015 Table of Contents Everyday ... NIH www.nia.nih.gov/Go4Life Making Smart Food Choices To maintain a healthy weight, balance the calories ...

  3. Making Healthy Choices Easier

    DEFF Research Database (Denmark)

    Guldborg Hansen, Pelle; Skov, Laurits Rohden; Lund Skov, Katrine

    2016-01-01

    . However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier is being threatened by inadequate understandings of its scientific character, relationship with regulation and its ethical implications. This article reviews...... working with or incorporating the nudge approach into programs or policies aimed at making healthy choices easier...

  4. Biofuels: making tough choices

    Energy Technology Data Exchange (ETDEWEB)

    Vermeulen, Sonja; Dufey, Annie; Vorley, Bill

    2008-02-15

    The jury is still out on biofuels. But one thing at least is certain: serious trade-offs are involved in the production and use of these biomass-derived alternatives to fossil fuels. This has not been lost on the European Union. The year kicked off with an announcement from the EU environment commissioner that it may be better for the EU to miss its target of reaching 10 per cent biofuel content in road fuels by 2020 than to compromise the environment and human wellbeing. The 'decision tree' outlined here can guide the interdependent processes of deliberation and analysis needed for making tough choices in national biofuels development.

  5. Making Choices, Setting Goals

    DEFF Research Database (Denmark)

    Skinner, Timothy

    2013-01-01

    Diabetes management and education is very important. The way information is provided influences people's behaviours and thus outcomes. The way information is presented can increase or reduce the individual's ability to make informed decisions about their treatment and influences whether they acti...

  6. Informed choice about Down syndrome screening

    DEFF Research Database (Denmark)

    Skjøth, Mette Maria; Draborg, Eva; Lamont, Ronald Francis

    2015-01-01

    INTRODUCTION: The aim of this study was to evaluate the effect of an eHealth intervention (interactive website) on pregnant women's ability to make an informed choice about Down syndrome screening. MATERIAL AND METHODS: The study was designed as a randomized controlled trial with allocation...... to an intervention group and a control group in a ratio of 1:1. Subsequent subgroup analysis was conducted. Participants were recruited from 5 August 2013 to 25 April 2014 at Odense University Hospital, Denmark. Inclusion criteria were: pregnant women aged ≥18 years who were invited to participate in Down syndrome...... screening. Exclusion criteria were: high risk of abortion, psycho-socially vulnerable women, late referral, inability to speak Danish and women declining to participate. The primary outcome was informed choice about Down syndrome screening. The Multidimensional Measure of Informed Choice was used to assess...

  7. How to make moral choices.

    Science.gov (United States)

    Chambers, David W

    2011-01-01

    Moral choice is committing to act for what one believes is right and good. It is less about what we know than about defining who we are. Three cases typical of those used in the principles or dilemmas approach to teaching ethics are presented. But they are analyzed using an alternative approach based on seven moral choice heuristics--approaches proven to increase the likelihood of locating the best course of action. The approaches suggested for analyzing moral choice situations include: (a) identify the outcomes of available alternative courses of action; (b) rule out strategies that involve deception, coercion, reneging on promises, collusion, and contempt for others; (c) be authentic (do not deceive yourself); (d) relate to others on a human basis; (e) downplay rational justifications; (f) match the solution to the problem, not the other way around; (g) execute on the best solution, do not hold out for the perfect one; and (h) take action to improve the choice after it has been made.

  8. Making healthy choices easy choices: the role of empowerment

    NARCIS (Netherlands)

    Koelen, M.A.; Lindström, B.

    2005-01-01

    An important goal of health promotion is to make it easier for people to make healthy choices. However, this may be difficult if people do not feel control over their environment and their personal circumstances. An important concept in relation to this is empowerment. Health professionals are

  9. Mammography screening. Benefits, harms, and informed choice.

    Science.gov (United States)

    Jørgensen, Karsten Juhl

    2013-04-01

    The rationale for breast cancer screening with mammography is deceptively simple: catch it early and reduce mortality from the disease and the need for mastectomies. But breast cancer is a complex problem, and complex problems rarely have simple solutions. Breast screening brings forward the time of diagnosis only slightly compared to the lifetime of a tumour, and screen-detected tumours have a size where metastases are possible. A key question is if screening can prevent metastases, and if the screen-detected tumours are small enough to allow breast conserving surgery rather than mastectomy. A mortality reduction can never justify a medical intervention in its own right, but must be weighed against the harms. Overdiagnosis is the most important harm of breast screening, but has gained wider recognition only in recent years. Screening leads to the detection and treatment of breast cancers that would otherwise never have been detected because they grow very slowly or not at all and would not have been detected in the woman's lifetime in the absence of screening. Screening therefore turns women into cancer patients unnecessarily, with life-long physical and psychological harms. The debate about the justification of breast screening is therefore not a simple question of whether screening reduces breast cancer mortality. This dissertation quantifies the primary benefits and harms of screening mammography. Denmark has an unscreened "control group" because only two geographical regions offered screening over a long time-period, which is unique in an international context. This was used to study breast cancer mortality, overdiagnosis, and the use of mastectomies. Also, a systematic review of overdiagnosis in five other countries allowed us to show that about half of the screen-detected breast cancers are overdiagnosed. An effect on breast cancer mortality is doubtful in today's setting, and overdiagnosis causes an increase in the use of mastectomies. These findings are

  10. Making Healthy Choices Easier: Regulation versus Nudging.

    Science.gov (United States)

    Hansen, Pelle Guldborg; Skov, Laurits Rohden; Skov, Katrine Lund

    2016-01-01

    In recent years, the nudge approach to behavior change has emerged from the behavioral sciences to challenge the traditional use of regulation in public health strategies to address modifiable individual-level behaviors related to the rise of noncommunicable diseases and their treatment. However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier are being threatened by inadequate understandings of its scientific character, its relationship with regulation, and its ethical implications. This article reviews this character and its ethical implication with a special emphasis on the compatibility of nudging with traditional regulation, special domains of experience, and the need for a more nuanced approach to the ethical debate. The aim is to advance readers' understanding and give guidance to those who have considered working with or incorporating the nudge approach into programs or policies aimed at making healthful choices easier.

  11. 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.

  12. Making Choices: Valletta, Development, Archaeology and Society

    Directory of Open Access Journals (Sweden)

    Barney Sloane

    2018-03-01

    Full Text Available The European Archaeological Council's working group on 'Making Choices' conducted a survey of EAC member states about the ways in which they make decisions in archaeological heritage management with particular reference to development-led archaeological investigation. The driver for this is the belief that the approaches to development-led archaeology need to be more transparent and proportional to ensure continued state and developer/investor support. Based on a significant response (73% the survey gave a very useful insight into the way in which archaeological sites are defined and inventorised, the processes by which development-led investigations are designed, the means by which information is published and results (and collections archived, and the means by which the public are engaged in the process. The survey identified three key areas where choice-making is very much in the hands of the professional practice. These are: developing a clearer understanding of the significance of protected archaeological sites in the context of Valletta, assessing sensitivity to change for any sites proposed for development, and the design of the investigation itself. In addition, the survey revealed a clear interest in developing better ways of advocating the public value of development-led archaeology. This article summarises the issues raised in the survey and concludes that the most useful ways in which EAC could help its members would be through the preparation of guidance, case studies or toolkits — regardless of what legal or statutory structures are in operation in a given state — on the following subjects: understanding and articulating significance, developing national and regional research frameworks into which new excavations might be integrated, articulating the public value of archaeological investigation and developing better approaches to archaeological archives.

  13. Mate choice screening in captive solitary carnivores

    DEFF Research Database (Denmark)

    Noer, Christina Lehmkuhl; Balsby, Thorsten Johannes Skovbjerg; Anistoroaei, Razvan

    2017-01-01

    Mate choice studies suggest that choosy females benefit from increased fecundity, litter size, and offspring survival. Thus, providing females with the opportunity to choose among potential mates, deemed genetically suitable based on studbook data, might improve breeding management in production ...

  14. Making Antibiotic Choices: Formula Derivation and Usage in the ...

    African Journals Online (AJOL)

    formulae was demonstrated in the rational selection of antibiotics most appropriate in the empirical ... antibiotics provides a suitable means of making antibiotic choices in the empirical treatment of ... decisions are made on their choices.

  15. Making the Most of Multiple Choice

    Science.gov (United States)

    Brookhart, Susan M.

    2015-01-01

    Multiple-choice questions draw criticism because many people perceive they test only recall or atomistic, surface-level objectives and do not require students to think. Although this can be the case, it does not have to be that way. Susan M. Brookhart suggests that multiple-choice questions are a useful part of any teacher's questioning repertoire…

  16. Choice blindness in financial decision making

    Directory of Open Access Journals (Sweden)

    Owen McLaughlin

    2013-09-01

    Full Text Available Choice Blindness is an experimental paradigm that examines the interplay between individuals' preferences, decisions, and expectations by manipulating the relationship between intention and choice. This paper expands upon the existing Choice Blindness framework by investigating the presence of the effect in an economically significant decision context, specifically that of pension choice. In addition, it investigates a number of secondary factors hypothesized to modulate Choice Blindness, including reaction time, risk preference, and decision complexity, as well as analysing the verbal reports of non-detecting participants. The experiment was administered to 100 participants of mixed age and educational attainment. The principal finding was that no more than 37.2% of manipulated trials were detected over all conditions, a result consistent with previous Choice Blindness research. Analysis of secondary factors found that reaction time, financial sophistication and decision complexity were significant predictors of Choice Blindness detection, while content analysis of non-detecting participant responses found that 20% implied significant preference changes and 62% adhered to initial preferences. Implications of the Choice Blindness effect in the context of behavioural economics are discussed, and an agenda for further investigation of the paradigm in this context is outlined.

  17. Mammography screening. Benefits, harms, and informed choice

    DEFF Research Database (Denmark)

    Jørgensen, Karsten Juhl

    2013-01-01

    exaggerates benefits, participation is directly recommended, and the harms are downplayed or left out, despite agreement that the objective is informed choice. This raises an ethical discussion concerning autonomy versus paternalism, and the difficulty in weighing benefits against harms. Finally, financial...

  18. Making Healthy Choices at Fast Food Restaurants

    Science.gov (United States)

    ... Conditions Prevention and Wellness Staying Healthy Healthy Living Travel Occupational Health First Aid and Injury Prevention Crisis Situations Pets and Animals myhealthfinder Food and Nutrition Healthy Food Choices Weight Loss and ...

  19. Desktop Publishing Choices: Making an Appropriate Decision.

    Science.gov (United States)

    Crawford, Walt

    1991-01-01

    Discusses various choices available for desktop publishing systems. Four categories of software are described, including advanced word processing, graphics software, low-end desktop publishing, and mainstream desktop publishing; appropriate hardware is considered; and selection guidelines are offered, including current and future publishing needs,…

  20. Making personalised nutrition the easy choice

    NARCIS (Netherlands)

    Stewart-Knox, B.J.; Markovina, J.; Rankin, A.; Bunting, B.P.; Kuznesof, S.; Fischer, A.R.H.; Lans, van der I.A.; Poínhos, R.; Almeida, de M.D.V.; Panzone, L.; Gibney, M.; Frewer, L.J.

    2016-01-01

    Personalised diets based on people's existing food choices, and/or phenotypic, and/or genetic information hold potential to improve public dietary-related health. The aim of this analysis, therefore, has been to examine the degree to which factors which determine uptake of personalised nutrition

  1. Braving difficult choices alone: children's and adolescents' medical decision making.

    Directory of Open Access Journals (Sweden)

    Azzurra Ruggeri

    Full Text Available OBJECTIVE: What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. METHODS: Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1 own informed choice; (2 informed parents' choice to amputate; (3 informed parents' choice to continue a treatment; and (4 uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. RESULTS: Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. CONCLUSIONS: Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

  2. Braving difficult choices alone: children's and adolescents' medical decision making.

    Science.gov (United States)

    Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

    2014-01-01

    What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process.

  3. Braving Difficult Choices Alone: Children's and Adolescents' Medical Decision Making

    Science.gov (United States)

    Ruggeri, Azzurra; Gummerum, Michaela; Hanoch, Yaniv

    2014-01-01

    Objective What role should minors play in making medical decisions? The authors examined children's and adolescents' desire to be involved in serious medical decisions and the emotional consequences associated with them. Methods Sixty-three children and 76 adolescents were presented with a cover story about a difficult medical choice. Participants were tested in one of four conditions: (1) own informed choice; (2) informed parents' choice to amputate; (3) informed parents' choice to continue a treatment; and (4) uninformed parents' choice to amputate. In a questionnaire, participants were asked about their choices, preference for autonomy, confidence, and emotional reactions when faced with a difficult hypothetical medical choice. Results Children and adolescents made different choices and participants, especially adolescents, preferred to make the difficult choice themselves, rather than having a parent make it. Children expressed fewer negative emotions than adolescents. Providing information about the alternatives did not affect participants' responses. Conclusions Minors, especially adolescents, want to be responsible for their own medical decisions, even when the choice is a difficult one. For the adolescents, results suggest that the decision to be made, instead of the agent making the decision, is the main element influencing their emotional responses and decision confidence. For children, results suggest that they might be less able than adolescents to project how they would feel. The results, overall, draw attention to the need to further investigate how we can better involve minors in the medical decision-making process. PMID:25084274

  4. Assessing choice making among children with multiple disabilities.

    OpenAIRE

    Sigafoos, J; Dempsey, R

    1992-01-01

    Some learners with multiple disabilities display idiosyncratic gestures that are interpreted as a means of making choices. In the present study, we assessed the validity of idiosyncratic choice-making behaviors of 3 children with multiple disabilities. Opportunities for each child to choose between food and drink were provided under two conditions. In one condition, the children were given the food or drink item corresponding to their prior choice. In the other condition, the teacher delivere...

  5. Understanding How Overweight and Obese Emerging Adults Make Lifestyle Choices.

    Science.gov (United States)

    Cha, EunSeok; Crowe, James M; Braxter, Betty J; Jennings, Bonnie Mowinski

    To better understand health-related decision making among overweight and obese emerging adults. A cross-sectional design was used in the parent study involving overweight and obese emerging adults, ages 18-29 years. The goal of the parent study was to screen participants' diabetes risk and identify characteristics of emerging adults with prediabetes (N=107). A sub-sample of respondents (n=34) from the parent study were invited to participate in focus group interviews depending on whether they had prediabetes (three groups) or they did not have prediabetes (four groups). Each focus group interview lasted 90-120 minutes following a semi-structured interview guide. Conventional content analysis was used in the data analysis. Because of the similarities between participants with and without prediabetes, the findings were synthesized and reported in the aggregate. Moreover, during the analysis, the authors decided that rational choice theory provided a useful organizing structure for presenting the data. Emerging adults' behavioral decisions were rational reactions to their personal competence, perception of health, environment, and availability of resources to handle problems. Calculation of trade-offs and estimations of resource availability were often used when making decisions. Emerging adults choose unhealthy behaviors due to inaccurate information and insufficient competence to practice healthy lifestyles rather than because of laziness or being irrational. Behavioral interventions for emerging adults need to help them develop skills to enhance health literacy and problem solving, thereby enhancing their awareness of available resources and decreasing the perceived cost of making healthy choices. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Affective biasing of choices in gambling task decision making.

    Science.gov (United States)

    Hinson, John M; Whitney, Paul; Holben, Heather; Wirick, Aaron K

    2006-09-01

    The proponents of the somatic marker hypothesis presume that rational decision making is guided by emotional reactions that are developed from prior experience. Supporting evidence for the hypothesis comes almost exclusively from the short-term affective reactions that are learned during the course of a hypothetical decision-making task--the gambling task (GT). We examined GT performance and affective reactions to choices when those choices were biased by words that had preexisting affective value. In one experiment, affectively valued words directly signaled good and bad choices. A congruent relation between affective value of word and choice outcome improved GT performance, whereas an incongruent relation greatly interfered with performance. In another experiment, affectively valued words were maintained as a working memory (WM) load between GT choices. A WM load with affectively positive words somewhat improved GT performance, whereas affectively negative words interfered with performance. Somatic markers-indicated by differential anticipatory skin conductance response (SCR) amplitude for good and bad choices-appeared at a point in the GT session when choice performance was superior. However, differential SCR developed during the session after good choice performance was already established. These results indicate that preexisting affective biases can influence GT decision making. In addition, the somatic markers that are regular accompaniments of GT decision making appeared to be temporally lagging indicators of choice performance.

  7. Patients who make terrible therapeutic choices.

    Science.gov (United States)

    Curzer, Howard J

    2014-01-01

    The traditional approaches to dental ethics include appeals to principles, duties (deontology), and consequences (utilitarianism). These approaches are often inadequate when faced with the case of a patient who refuses reasonable treatment and does not share the same ethical framework the dentist is using. An approach based on virtue ethics may be helpful in this and other cases. Virtue ethics is a tradition going back to Plato and Aristotle. It depends on forming a holistic character supporting general appropriate behavior. By correctly diagnosing the real issues at stake in a patient's inappropriate oral health choices and working to build effective habits, dentists can sometimes respond to ethical challenges that remain intractable given rule-based methods.

  8. Existential autonomy: why patients should make their own choices.

    Science.gov (United States)

    Madder, H

    1997-08-01

    Savulescu has recently introduced the "rational non-interventional paternalist" model of the patient-doctor relationship. This paper addresses objections to such a model from the perspective of an anaesthetist. Patients need to make their own decisions if they are to be fully autonomous. Rational non-interventional paternalism undermines the importance of patient choice and so threatens autonomy. Doctors should provide an evaluative judgment of the best medical course of action, but ought to restrict themselves to helping patients to make their own choices rather than making such choices for them.

  9. Government Certification and Accreditation: Make a Choice

    Science.gov (United States)

    Miles, Tracy L.

    2009-01-01

    One of the most significant challenges faced by government officials today is securing information systems to make them more resilient to attack from increasingly complex challenges from cyber-criminals, state-sponsored groups, and other threats. Over the years, the federal government has developed and implemented Certification and Accreditation…

  10. Rhetorical Design Studies: The Art of Making Design Choices Explicit

    DEFF Research Database (Denmark)

    Halstrøm, Per L.

    2017-01-01

    Design has the potential to affect the situations we are in, the choices we make and the beliefs we live by. Being such an affective field, one might expect that canonized design thinking models and methods would be much concerned with how designers can discover arguments for their design choices...

  11. Make Better Beverage Choices: 10 Tips to Get Started

    Science.gov (United States)

    United States Department of Agriculture 10 tips Nutrition Education Series MyPlate MyWins Based on the Dietary Guidelines for Americans Make better beverage choices A healthy eating style includes all foods and beverages. Many beverages ...

  12. Making Movies: From Script to Screen.

    Science.gov (United States)

    Bobker, Lee R.

    This book is a guide to the making of films. It covers preparation (scripting, storyboarding, budgeting, casting, and crew selection), filming (directing, camera operating, and sound recording), and postproduction (editing, sound dubbing, laboratory processing, and trial screening). Distribution of films is discussed in detail. Possible careers in…

  13. Choice-making treatment of young children's severe behavior problems.

    OpenAIRE

    Peck, S M; Wacker, D P; Berg, W K; Cooper, L J; Brown, K A; Richman, D; McComas, J J; Frischmeyer, P; Millard, T

    1996-01-01

    The choice-making behavior of 5 young children with developmental disabilities who engaged in aberrant behavior was studied within a concurrent operants framework. Experimental analyses were conducted to identify reinforcers that maintained aberrant behavior, and functional communication training packages were implemented to teach the participants to gain reinforcement using mands. Next, a choice-making analysis, in which the participants chose one of two responses (either a mand or an altern...

  14. How libraries make tough choices in difficult times purposeful abandonment

    CERN Document Server

    Stern, David

    2013-01-01

    Contemporary library managers face the need to make difficult choices regarding resource allocation in the modern business environment. How Libraries Make Tough Choices in Difficult Times is a practical guide for library managers, offering techniques to analyze existing and potential services, implement best practices for maximizing existing resources, and utilize pressing financial scenarios in order to justify making difficult reallocation decisions. The book begins by asking the fundamental questions of why, what, and how, moving on to look at how to manage expectations and report to both a

  15. Rethinking autonomy in the context of prenatal screening decision-making.

    NARCIS (Netherlands)

    Garcia, E.; Timmermans, D.R.; Leeuwen, E. van

    2008-01-01

    OBJECTIVES: Answering the question: Does the offer of prenatal screening impede women in making autonomous choices? METHODS: Semi-structured interviews with 59 women to whom a prenatal screening test was offered and who were in the process of taking a decision. RESULTS: Women described the offer as

  16. Rethinking autonomy in the context of prenatal screening decision-making

    NARCIS (Netherlands)

    Garcia Gonzalez, M.E.; Timmermans, D.R.M.; van Leeuwen, E.

    2008-01-01

    Objectives: Answering the question: Does the offer of prenatal screening impede women in making autonomous choices? Methods: Semi-structured interviews with 59 women to whom a prenatal screening test was offered and who were in the process of taking a decision. Results: Women described the offer as

  17. 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.

  18. Older adults’ preferences for colorectal cancer-screening test attributes and test choice

    Directory of Open Access Journals (Sweden)

    Kistler CE

    2015-07-01

    Full Text Available Christine E Kistler,1–3 Thomas M Hess,4 Kirsten Howard,5,6 Michael P Pignone,2,3,7 Trisha M Crutchfield,2,3,8 Sarah T Hawley,9 Alison T Brenner,2 Kimberly T Ward,2 Carmen L Lewis10 1Department of Family Medicine, School of Medicine, 2Cecil G Sheps Center for Health Services Research, 3Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, 4Department of Psychology, North Carolina State University, Raleigh, NC, USA; 5Institute for Choice, University of South Australia, Sydney, NSW, Australia; 6School of Public Health, University of Sydney, Sydney, NSW, Australia; 7Division of General Internal Medicine, School of Medicine, 8Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, 9Department of Medicine, University of Michigan, Ann Arbor, MI, 10Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA Background: Understanding which attributes of colorectal cancer (CRC screening tests drive older adults’ test preferences and choices may help improve decision making surrounding CRC screening in older adults.Materials and methods: To explore older adults’ preferences for CRC-screening test attributes and screening tests, we conducted a survey with a discrete choice experiment (DCE, a directly selected preferred attribute question, and an unlabeled screening test-choice question in 116 cognitively intact adults aged 70–90 years, without a history of CRC or inflammatory bowel disease. Each participant answered ten discrete choice questions presenting two hypothetical tests comprised of four attributes: testing procedure, mortality reduction, test frequency, and complications. DCE responses were used to estimate each participant’s most important attribute and to simulate their preferred test among three existing CRC-screening tests. For each individual, we compared the DCE

  19. Models of Affective Decision Making: How Do Feelings Predict Choice?

    Science.gov (United States)

    Charpentier, Caroline J; De Neve, Jan-Emmanuel; Li, Xinyi; Roiser, Jonathan P; Sharot, Tali

    2016-06-01

    Intuitively, how you feel about potential outcomes will determine your decisions. Indeed, an implicit assumption in one of the most influential theories in psychology, prospect theory, is that feelings govern choice. Surprisingly, however, very little is known about the rules by which feelings are transformed into decisions. Here, we specified a computational model that used feelings to predict choices. We found that this model predicted choice better than existing value-based models, showing a unique contribution of feelings to decisions, over and above value. Similar to the value function in prospect theory, our feeling function showed diminished sensitivity to outcomes as value increased. However, loss aversion in choice was explained by an asymmetry in how feelings about losses and gains were weighted when making a decision, not by an asymmetry in the feelings themselves. The results provide new insights into how feelings are utilized to reach a decision. © The Author(s) 2016.

  20. Decision-making experiments and real-world choice behaviour

    NARCIS (Netherlands)

    Timmermans, H.J.P.; vd Heijden, R.E.C.M.; Westerveld, J.

    1984-01-01

    This article is concerned with the analysis of consumer spatial choice behaviour using conjoint measurements. The study's objectives are to assess the appropriateness of conjoint measurement to represent a consumer's spatial decision making process, to identify the nature of aggregate utility

  1. Making Choices about Hydrogen : Transport Issues for Developing ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    30 sept. 2008 ... Couverture du livre Making Choices about Hydrogen : Transport Issues for Developing Countries ... International Water Resources Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: Innovative solutions from the Global South”.

  2. 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...

  3. Melioration as rational choice: sequential decision making in uncertain environments.

    Science.gov (United States)

    Sims, Chris R; Neth, Hansjörg; Jacobs, Robert A; Gray, Wayne D

    2013-01-01

    Melioration-defined as choosing a lesser, local gain over a greater longer term gain-is a behavioral tendency that people and pigeons share. As such, the empirical occurrence of meliorating behavior has frequently been interpreted as evidence that the mechanisms of human choice violate the norms of economic rationality. In some environments, the relationship between actions and outcomes is known. In this case, the rationality of choice behavior can be evaluated in terms of how successfully it maximizes utility given knowledge of the environmental contingencies. In most complex environments, however, the relationship between actions and future outcomes is uncertain and must be learned from experience. When the difficulty of this learning challenge is taken into account, it is not evident that melioration represents suboptimal choice behavior. In the present article, we examine human performance in a sequential decision-making experiment that is known to induce meliorating behavior. In keeping with previous results using this paradigm, we find that the majority of participants in the experiment fail to adopt the optimal decision strategy and instead demonstrate a significant bias toward melioration. To explore the origins of this behavior, we develop a rational analysis (Anderson, 1990) of the learning problem facing individuals in uncertain decision environments. Our analysis demonstrates that an unbiased learner would adopt melioration as the optimal response strategy for maximizing long-term gain. We suggest that many documented cases of melioration can be reinterpreted not as irrational choice but rather as globally optimal choice under uncertainty.

  4. Existential autonomy: why patients should make their own choices.

    OpenAIRE

    Madder, H

    1997-01-01

    Savulescu has recently introduced the "rational non-interventional paternalist" model of the patient-doctor relationship. This paper addresses objections to such a model from the perspective of an anaesthetist. Patients need to make their own decisions if they are to be fully autonomous. Rational non-interventional paternalism undermines the importance of patient choice and so threatens autonomy. Doctors should provide an evaluative judgment of the best medical course of action, but ought to ...

  5. Informed Choice in the German Mammography Screening Program by Education and Migrant Status: Survey among First-Time Invitees.

    Directory of Open Access Journals (Sweden)

    Eva-Maria Berens

    Full Text Available Breast cancer is the most prevalent cancer among women and mammography screening programs are seen as a key strategy to reduce breast cancer mortality. In Germany, women are invited to the population-based mammography screening program between ages 50 to 69. It is still discussed whether the benefits of mammography screening outweigh its harms. Therefore, the concept of informed choice comprising knowledge, attitude and intention has gained importance. The objective of this observational study was to assess the proportion of informed choices among women invited to the German mammography screening program for the first time. A representative sample of 17,349 women aged 50 years from a sub-region of North Rhine Westphalia was invited to participate in a postal survey. Turkish immigrant women were oversampled. The effects of education level and migration status on informed choice and its components were assessed. 5,847 (33.7% women responded to the postal questionnaire of which 4,113 were used for analyses. 31.5% of the women had sufficient knowledge. The proportion of sufficient knowledge was lower among immigrants and among women with low education levels. The proportion of women making informed choices was low (27.1%, with similar associations with education level and migration status. Women of low (OR 2.75; 95% CI 2.18-3.46 and medium education level (OR 1.49; 95% CI 1.27-1.75 were more likely to make an uninformed choice than women of high education level. Turkish immigrant women had the greatest odds for making an uninformed choice (OR 5.30, 95% CI 1.92-14.66 compared to non-immigrant women. Other immigrant women only had slightly greater odds for making an uninformed choice than non-immigrant women. As immigrant populations and women with low education level have been shown to have poor knowledge, they need special attention in measures to increase knowledge and thus informed choices.

  6. Simple model for multiple-choice collective decision making.

    Science.gov (United States)

    Lee, Ching Hua; Lucas, Andrew

    2014-11-01

    We describe a simple model of heterogeneous, interacting agents making decisions between n≥2 discrete choices. For a special class of interactions, our model is the mean field description of random field Potts-like models and is effectively solved by finding the extrema of the average energy E per agent. In these cases, by studying the propagation of decision changes via avalanches, we argue that macroscopic dynamics is well captured by a gradient flow along E. We focus on the permutation symmetric case, where all n choices are (on average) the same, and spontaneous symmetry breaking (SSB) arises purely from cooperative social interactions. As examples, we show that bimodal heterogeneity naturally provides a mechanism for the spontaneous formation of hierarchies between decisions and that SSB is a preferred instability to discontinuous phase transitions between two symmetric points. Beyond the mean field limit, exponentially many stable equilibria emerge when we place this model on a graph of finite mean degree. We conclude with speculation on decision making with persistent collective oscillations. Throughout the paper, we emphasize analogies between methods of solution to our model and common intuition from diverse areas of physics, including statistical physics and electromagnetism.

  7. Local Choices: Rationality and the Contextuality of Decision-Making

    Science.gov (United States)

    Vlaev, Ivo

    2018-01-01

    Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal “folk psychological” explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local, i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality. PMID:29301289

  8. Local Choices: Rationality and the Contextuality of Decision-Making.

    Science.gov (United States)

    Vlaev, Ivo

    2018-01-02

    Rational explanation is ubiquitous in psychology and social sciences, ranging from rational analysis, expectancy-value theories, ideal observer models, mental logic to probabilistic frameworks, rational choice theory, and informal "folk psychological" explanation. However, rational explanation appears to be challenged by apparently systematic irrationality observed in psychological experiments, especially in the field of judgement and decision-making (JDM). Here, it is proposed that the experimental results require not that rational explanation should be rejected, but that rational explanation is local , i.e., within a context. Thus, rational models need to be supplemented with a theory of contextual shifts. We review evidence in JDM that patterns of choices are often consistent within contexts, but unstable between contexts. We also demonstrate that for a limited, though reasonably broad, class of decision-making domains, recent theoretical models can be viewed as providing theories of contextual shifts. It is argued that one particular significant source of global inconsistency arises from a cognitive inability to represent absolute magnitudes, whether for perceptual variables, utilities, payoffs, or probabilities. This overall argument provides a fresh perspective on the scope and limits of human rationality.

  9. '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.

  10. Protect Your Heart: Check Food Labels to Make Heart-Healthy Choices

    Science.gov (United States)

    ... Protein 15g Total Amounts To make heart-healthy food choices, look at the totals and cut back on • ... Toolkit No. 8: Protect Your Heart: Make Smart Food Choices • Toolkit No. 9: Protect Your Heart: Choose Fats ...

  11. Psychological aspects of individualized choice and reproductive autonomy in prenatal screening.

    Science.gov (United States)

    Hewison, Jenny

    2015-01-01

    Probably the main purpose of reproductive technologies is to enable people who choose to do so to avoid the birth of a baby with a disabling condition. However the conditions women want information about and the 'price' they are willing to pay for obtaining that information vary enormously. Individual women have to arrive at their own prenatal testing choices by 'trading off' means and ends in order to resolve the dilemmas facing them. We know very little about how individuals make these trade-offs, so it is difficult to predict how new technologies will affect their choices and preferences. Uptake decisions can be expected to change, especially in the group of women who now are put off by some aspect of the current screening approach, where the avoidance of miscarriage risk may have provided a kind of 'psychological shelter', protecting a lot of people from having to make other decisions. Technologies such as Pre-implantation Genetic Diagnosis may remove a second 'psychological shelter' because they offer the means of avoiding the birth of an affected child without terminating a pregnancy. Even if new technologies will make some decisions easier in terms of their cognitive demands, they will also create new dilemmas and decision making will not necessarily become less stressful in emotional terms. Key challenges concern information and decision-making. © 2014 John Wiley & Sons Ltd.

  12. The priority heuristic: making choices without trade-offs.

    Science.gov (United States)

    Brandstätter, Eduard; Gigerenzer, Gerd; Hertwig, Ralph

    2006-04-01

    Bernoulli's framework of expected utility serves as a model for various psychological processes, including motivation, moral sense, attitudes, and decision making. To account for evidence at variance with expected utility, the authors generalize the framework of fast and frugal heuristics from inferences to preferences. The priority heuristic predicts (a) the Allais paradox, (b) risk aversion for gains if probabilities are high, (c) risk seeking for gains if probabilities are low (e.g., lottery tickets), (d) risk aversion for losses if probabilities are low (e.g., buying insurance), (e) risk seeking for losses if probabilities are high, (f) the certainty effect, (g) the possibility effect, and (h) intransitivities. The authors test how accurately the heuristic predicts people's choices, compared with previously proposed heuristics and 3 modifications of expected utility theory: security-potential/aspiration theory, transfer-of-attention-exchange model, and cumulative prospect theory. ((c) 2006 APA, all rights reserved).

  13. The Priority Heuristic: Making Choices Without Trade-Offs

    Science.gov (United States)

    Brandstätter, Eduard; Gigerenzer, Gerd; Hertwig, Ralph

    2010-01-01

    Bernoulli's framework of expected utility serves as a model for various psychological processes, including motivation, moral sense, attitudes, and decision making. To account for evidence at variance with expected utility, we generalize the framework of fast and frugal heuristics from inferences to preferences. The priority heuristic predicts (i) Allais' paradox, (ii) risk aversion for gains if probabilities are high, (iii) risk seeking for gains if probabilities are low (lottery tickets), (iv) risk aversion for losses if probabilities are low (buying insurance), (v) risk seeking for losses if probabilities are high, (vi) certainty effect, (vii) possibility effect, and (viii) intransitivities. We test how accurately the heuristic predicts people's choices, compared to previously proposed heuristics and three modifications of expected utility theory: security-potential/aspiration theory, transfer-of-attention-exchange model, and cumulative prospect theory. PMID:16637767

  14. Nudge or Grudge? Choice Architecture and Parental Decision-Making.

    Science.gov (United States)

    Blumenthal-Barby, Jennifer; Opel, Douglas J

    2018-03-01

    Richard Thaler and Cass Sunstein define a nudge as "any aspect of the choice architecture that alters people's behavior in a predictable way without forbidding any options or significantly changing their economic incentives." Much has been written about the ethics of nudging competent adult patients. Less has been written about the ethics of nudging surrogates' decision-making and how the ethical considerations and arguments in that context might differ. Even less has been written about nudging surrogate decision-making in the context of pediatrics, despite fundamental differences that exist between the pediatric and adult contexts. Yet, as the field of behavioral economics matures and its insights become more established and well-known, nudges will become more crafted, sophisticated, intentional, and targeted. Thus, the time is now for reflection and ethical analysis regarding the appropriateness of nudges in pediatrics. We argue that there is an even stronger ethical justification for nudging in parental decision-making than with competent adult patients deciding for themselves. We give three main reasons in support of this: (1) child patients do not have autonomy that can be violated (a concern with some nudges), and nudging need not violate parental decision-making authority; (2) nudging can help fulfill pediatric clinicians' obligations to ensure parental decisions are in the child's interests, particularly in contexts where there is high certainty that a recommended intervention is low risk and of high benefit; and (3) nudging can relieve parents' decisional burden regarding what is best for their child, particularly with decisions that have implications for public health. © 2018 The Hastings Center.

  15. The anatomy of choice: dopamine and decision-making.

    Science.gov (United States)

    Friston, Karl; Schwartenbeck, Philipp; FitzGerald, Thomas; Moutoussis, Michael; Behrens, Timothy; Dolan, Raymond J

    2014-11-05

    This paper considers goal-directed decision-making in terms of embodied or active inference. We associate bounded rationality with approximate Bayesian inference that optimizes a free energy bound on model evidence. Several constructs such as expected utility, exploration or novelty bonuses, softmax choice rules and optimism bias emerge as natural consequences of free energy minimization. Previous accounts of active inference have focused on predictive coding. In this paper, we consider variational Bayes as a scheme that the brain might use for approximate Bayesian inference. This scheme provides formal constraints on the computational anatomy of inference and action, which appear to be remarkably consistent with neuroanatomy. Active inference contextualizes optimal decision theory within embodied inference, where goals become prior beliefs. For example, expected utility theory emerges as a special case of free energy minimization, where the sensitivity or inverse temperature (associated with softmax functions and quantal response equilibria) has a unique and Bayes-optimal solution. Crucially, this sensitivity corresponds to the precision of beliefs about behaviour. The changes in precision during variational updates are remarkably reminiscent of empirical dopaminergic responses-and they may provide a new perspective on the role of dopamine in assimilating reward prediction errors to optimize decision-making.

  16. How Politicians Make Decisions: A Political Choice Experiment

    OpenAIRE

    Fatás, Enrique; Neugebauer, Tibor; Tamborero, Pilar

    2004-01-01

    The present paper reports on a political choice experiment with elected real-world politicians. A questionnaire on political and public issues is taken to examine whether prospect theory predicts the responses of experts from the field better than rational choice theory. The results indicate that framing effects exist but that expertise may weaken the deviation from rational choice.

  17. Participation rate or informed choice? Rethinking the European key performance indicators for mammography screening.

    Science.gov (United States)

    Strech, Daniel

    2014-03-01

    Despite the intensive controversies about the likelihood of benefits and harms of mammography screening almost all experts conclude that the choice to screen or not to screen needs to be made by the individual patient who is adequately informed. However, the "European guideline for quality assurance in breast cancer screening and diagnosis" specifies a participation rate of 70% as the key performance indicator for mammography screening. This paper argues that neither the existing evidence on benefits and harms, nor survey research with women, nor compliance rates in clinical trials, nor cost-effectiveness ratios justify participation rates as a reasonable performance indicator for preference-sensitive condition such as mammography screening. In contrast, an informed choice rate would be more reasonable. Further research needs to address the practical challenges in assessing informed choice rates. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Make the healthy choice the easy choice: using behavioral economics to advance a culture of health.

    Science.gov (United States)

    Volpp, K G; Asch, D A

    2017-05-01

    Despite great advances in the science and technology of health care, a large gap separates theoretically achievable advances in health from what individuals and populations actually achieve. Human behavior sits on the final common pathway to so many of our health and health care goals, including the prevention and management of illness and the fostering of wellness. Behavioral economics is a relatively new field offering approaches to supplement many of the conventional approaches to improving health behaviors that rely on education or standard economic theory. While those conventional approaches presume that an educated public will naturally make decisions that optimize personal welfare, approaches derived from behavioral economics harness existing and predictable patterns of behavior that often lead people to make choices against their best interests. By keeping these predictable patterns of behavior in mind when designing health insurance, health care programs or the health-related aspects of everyday life, behavioral economists aim to meet people half-way: no longer asking them to reshape their behavior to something more health promoting, but helping the behavioral patterns they already follow lead them to better health. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2011-04-21

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

  20. How politicians make decisions under risk: a political choice experiment

    OpenAIRE

    Enrique Fatás; Tibor Neugebauer; Pilar Tamborero

    2004-01-01

    We report on an experimental study with real-world politicians. These political experts face political choice problems under risk and probability. Thus, we test the frequently observed violations of rational choice theory -the reference point effect, loss aversion, framing effects, and the common ratio effect- with experts from the field. Their choices violate expected utility theory. Nevertheless, they appear to be more rational and less risk averse (loving) in the domain of gains (losses) t...

  1. Rethinking autonomy in the context of prenatal screening decision-making.

    Science.gov (United States)

    García, Elisa; Timmermans, Danielle R M; van Leeuwen, Evert

    2008-02-01

    Answering the question: Does the offer of prenatal screening impede women in making autonomous choices? Semi-structured interviews with 59 women to whom a prenatal screening test was offered and who were in the process of taking a decision. Women described the offer as confronting but expressed a positive attitude towards screening and considered the offer as an opportunity for making up their minds about testing. Participants stated that they took decisions freely to follow their individual perspectives. Nevertheless, they preferred to share the responsibility of taking decisions, and its consequences for other family members, with their partner and close persons. The active offer of an unsolicited prenatal test need not be considered as an impediment for making an autonomous choice. The moral significance of prenatal testing is inseparably bound with the social context in which it is practiced. Influence from other persons and emotional reactions due to the test offer can be interpreted as supportive for making a choice. In clinical practice, testing should be timely offered in order to give women the opportunity of discussing their views with significant others. Caregivers should care for the emotions experienced by women so as to help them decide according to their values.

  2. Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy-A Randomized Controlled Trial.

    Science.gov (United States)

    Mehta, Shivan J; Feingold, Jordyn; Vandertuyn, Matthew; Niewood, Tess; Cox, Catherine; Doubeni, Chyke A; Volpp, Kevin G; Asch, David A

    2017-11-01

    Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1.6%) or active choice groups (1.5%) (P = .01 and P < .01). We found no difference in uptake of screening between the active choice and control groups (P = .88). The $100 conditional incentive modestly but significantly increased colonoscopy use. ClinicalTrials.gov no: NCT02660671. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  3. The dynamics of user perception, decision making and route choice

    NARCIS (Netherlands)

    Vreeswijk, Jacob Dirk

    2015-01-01

    Travellers’ response to performance changes in the traffic system is a decisive factor in the effectiveness of traffic management measures. This thesis provides an empirical and quantitative assessment of choice behaviour and the effects of perception error on choice outcomes. It considers users’

  4. Selective attention increases choice certainty in human decision making.

    Science.gov (United States)

    Zizlsperger, Leopold; Sauvigny, Thomas; Haarmeier, Thomas

    2012-01-01

    Choice certainty is a probabilistic estimate of past performance and expected outcome. In perceptual decisions the degree of confidence correlates closely with choice accuracy and reaction times, suggesting an intimate relationship to objective performance. Here we show that spatial and feature-based attention increase human subjects' certainty more than accuracy in visual motion discrimination tasks. Our findings demonstrate for the first time a dissociation of choice accuracy and certainty with a significantly stronger influence of voluntary top-down attention on subjective performance measures than on objective performance. These results reveal a so far unknown mechanism of the selection process implemented by attention and suggest a unique biological valence of choice certainty beyond a faithful reflection of the decision process.

  5. The Impact of Irish Policy and Legislation on How Adults with Learning Disabilities Make Choices

    Science.gov (United States)

    Carey, Eileen; Griffiths, Colin

    2016-01-01

    This paper reflects the impact of policy and legislation in the context of how adults with learning disabilities make choices. Following an overview of policies which have improved choice for people with learning disability in the United Kingdom, this paper reviews "choice" in current Irish policy and legislation. This paper, while…

  6. Melioration as Rational Choice: Sequential Decision Making in Uncertain Environments

    Science.gov (United States)

    Sims, Chris R.; Neth, Hansjorg; Jacobs, Robert A.; Gray, Wayne D.

    2013-01-01

    Melioration--defined as choosing a lesser, local gain over a greater longer term gain--is a behavioral tendency that people and pigeons share. As such, the empirical occurrence of meliorating behavior has frequently been interpreted as evidence that the mechanisms of human choice violate the norms of economic rationality. In some environments, the…

  7. Shape Your Family's Habits: Helping Kids Make Healthy Choices

    Science.gov (United States)

    ... kids to be active. When it comes to food and physical activity, what you say and do around your children can have a lasting effect. Work ... Choices Help Kids Form Healthy Habits Be a role model. Eat healthy family meals together. Walk or ride ...

  8. Informed Choice for Participation in Down Syndrome Screening

    DEFF Research Database (Denmark)

    Skjøth, Mette Maria; Hansen, Helle Ploug; Draborg, Eva

    2015-01-01

    Decision Aid Standards (IPDAS) Collaboration guide to develop a patient decision aid, and the roadmap for developing eHealth technologies from the Center for eHealth Research and Disease Management (CeHRes). The methods employed were a systematic literature search, focus group interviews with 3 care...... providers, and technology experts as stakeholders. To our knowledge, there has been no research on the combination of IPDAS standards and the CeHRes roadmap to develop an eHealth tool to target information about screening for Down syndrome....

  9. Behavioral Economics and the Supplemental Nutrition Assistance Program:: Making the Healthy Choice the Easy Choice.

    Science.gov (United States)

    Ammerman, Alice S; Hartman, Terry; DeMarco, Molly M

    2017-02-01

    The Supplemental Nutrition Assistance Program (SNAP) serves as an important nutritional safety net program for many Americans. Given its aim to use traditional economic levers to provide access to food, the SNAP program includes minimal nutritional requirements and restrictions. As food choices are influenced by more than just economic constraints, behavioral economics may offer insights and tools for altering food purchases for SNAP users. This manuscript outlines behavioral economics strategies that have potential to encourage healthier food choices within the SNAP program. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. Ethnic differences in informed decision-making about prenatal screening for Down's syndrome.

    Science.gov (United States)

    Fransen, Mirjam P; Essink-Bot, Marie-Louise; Vogel, Ineke; Mackenbach, Johan P; Steegers, Eric A P; Wildschut, Hajo I J

    2010-03-01

    The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables. Pregnant women of Dutch, Turkish and Surinamese origin were recruited between 2006 and 2008 from community midwifery or obstetrical practices in The Netherlands. Each woman was personally interviewed 3 weeks (mean) after booking for prenatal care. Knowledge, attitude and participation in prenatal screening were assessed following the 'Multidimensional Measure of Informed Choice' that has been developed and applied in the UK. In total, 71% of the Dutch women were classified as informed decision-makers, compared with 5% of the Turkish and 26% of the Surinamese women. Differences between Surinamese and Dutch women could largely be attributed to differences in educational level and age. Differences between Dutch and Turkish women could mainly be attributed to differences in language skills and gender emancipation. Women from ethnic minority groups less often made an informed decision whether or not to participate in prenatal screening. Interventions to decrease these ethnic differences should first of all be aimed at overcoming language barriers and increasing comprehension among women with a low education level. To further develop diversity-sensitive strategies for counselling, it should be investigated how women from different ethnic backgrounds value informed decision-making in prenatal screening, what decision-relevant knowledge they need and what they take into account when considering participation in prenatal screening.

  11. Design and protocol of a randomized multiple behavior change trial: Make Better Choices 2 (MBC2).

    Science.gov (United States)

    Pellegrini, Christine A; Steglitz, Jeremy; Johnston, Winter; Warnick, Jennifer; Adams, Tiara; McFadden, H G; Siddique, Juned; Hedeker, Donald; Spring, Bonnie

    2015-03-01

    Suboptimal diet and inactive lifestyle are among the most prevalent preventable causes of premature death. Interventions that target multiple behaviors are potentially efficient; however the optimal way to initiate and maintain multiple health behavior changes is unknown. The Make Better Choices 2 (MBC2) trial aims to examine whether sustained healthful diet and activity change are best achieved by targeting diet and activity behaviors simultaneously or sequentially. Study design approximately 250 inactive adults with poor quality diet will be randomized to 3 conditions examining the best way to prescribe healthy diet and activity change. The 3 intervention conditions prescribe: 1) an increase in fruit and vegetable consumption (F/V+), decrease in sedentary leisure screen time (Sed-), and increase in physical activity (PA+) simultaneously (Simultaneous); 2) F/V+ and Sed- first, and then sequentially add PA+ (Sequential); or 3) Stress Management Control that addresses stress, relaxation, and sleep. All participants will receive a smartphone application to self-monitor behaviors and regular coaching calls to help facilitate behavior change during the 9 month intervention. Healthy lifestyle change in fruit/vegetable and saturated fat intakes, sedentary leisure screen time, and physical activity will be assessed at 3, 6, and 9 months. MBC2 is a randomized m-Health intervention examining methods to maximize initiation and maintenance of multiple healthful behavior changes. Results from this trial will provide insight about an optimal technology supported approach to promote improvement in diet and physical activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Making Choices: Self-Directed Teams or Total Quality Management?

    Science.gov (United States)

    Holpp, Lawrence

    1992-01-01

    Describes differences between total quality management and self-directed teams in terms of job design, decision making, flexibility, supervision, labor relations, quality, customers, and training. Offers suggestions for which method to choose when. (SK)

  13. Why did Jacques Monod make the choice of mechanistic determinism?

    Science.gov (United States)

    Loison, Laurent

    2015-06-01

    The development of molecular biology placed in the foreground a mechanistic and deterministic conception of the functioning of macromolecules. In this article, I show that this conception was neither obvious, nor necessary. Taking Jacques Monod as a case study, I detail the way he gradually came loose from a statistical understanding of determinism to finally support a mechanistic understanding. The reasons of the choice made by Monod at the beginning of the 1950s can be understood only in the light of the general theoretical schema supported by the concept of mechanistic determinism. This schema articulates three fundamental notions for Monod, namely that of the rigidity of the sequence of the genetic program, that of the intrinsic stability of macromolecules (DNA and proteins), and that of the specificity of molecular interactions. Copyright © 2015 Académie des sciences. Published by Elsevier SAS. All rights reserved.

  14. Risk assessment and clinical decision making for colorectal cancer screening.

    Science.gov (United States)

    Schroy, Paul C; Caron, Sarah E; Sherman, Bonnie J; Heeren, Timothy C; Battaglia, Tracy A

    2015-10-01

    Shared decision making (SDM) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (PCPs) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (ACN) provides a rational strategy for reconciling these differences. To assess the importance of risk stratification in PCP decision making related to test preference for average-risk patients and receptivity to use of an electronic risk assessment tool for ACN to facilitate SDM. Mixed methods, including qualitative key informant interviews and a cross-sectional survey. PCPs at an urban, academic safety-net institution. Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool. Nine PCPs participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; P decision making, yet few providers considered risk factors other than age for average-risk patients. Providers were receptive to the use of a risk assessment tool for ACN when recommending an appropriate screening test for select patients. © 2013 John Wiley & Sons Ltd.

  15. Bayesian probability estimates are not necessary to make choices satisfying Bayes’ rule in elementary situations

    Directory of Open Access Journals (Sweden)

    Artur eDomurat

    2015-08-01

    Full Text Available This paper has two aims. First, we investigate how often people make choices conforming to Bayes’ rule when natural sampling is applied. Second, we show that using Bayes’ rule is not necessary to make choices satisfying Bayes’ rule. Simpler methods, even fallacious heuristics, might prescribe correct choices reasonably often under specific circumstances. We considered elementary situations with binary sets of hypotheses and data. We adopted an ecological approach and prepared two-stage computer tasks resembling natural sampling. Probabilistic relations were to be inferred from a set of pictures, followed by a choice between the data which was made to maximize a chance for a preferred outcome. Using Bayes’ rule was deduced indirectly from choices.Study 1 (N=60 followed a 2 (gender: female vs. male x 2 (education: humanities vs. pure sciences between-subjects factorial design with balanced cells, and a number of correct choices as a dependent variable. Choices satisfying Bayes’ rule were dominant. To investigate ways of making choices more directly, we replicated Study 1, adding a task with a verbal report. In Study 2 (N=76 choices conforming to Bayes’ rule dominated again. However, the verbal reports revealed use of a new, non-inverse rule, which always renders correct choices, but is easier than Bayes’ rule to apply. It does not require inversing conditions (transforming P(H and P(D|H into P(H|D when computing chances. Study 3 examined efficiency of the three fallacious heuristics (pre-Bayesian, representativeness, and evidence-only in producing choices concordant with Bayes’ rule. Computer-simulated scenarios revealed that the heuristics produce correct choices reasonably often under specific base rates and likelihood ratios. Summing up we conclude that natural sampling leads to most choices conforming to Bayes’ rule. However, people tend to replace Bayes’ rule with simpler methods, and even use of fallacious heuristics may

  16. Separate neural mechanisms underlie choices and strategic preferences in risky decision making.

    Science.gov (United States)

    Venkatraman, Vinod; Payne, John W; Bettman, James R; Luce, Mary Frances; Huettel, Scott A

    2009-05-28

    Adaptive decision making in real-world contexts often relies on strategic simplifications of decision problems. Yet, the neural mechanisms that shape these strategies and their implementation remain largely unknown. Using an economic decision-making task, we dissociate brain regions that predict specific choices from those predicting an individual's preferred strategy. Choices that maximized gains or minimized losses were predicted by functional magnetic resonance imaging activation in ventromedial prefrontal cortex or anterior insula, respectively. However, choices that followed a simplifying strategy (i.e., attending to overall probability of winning) were associated with activation in parietal and lateral prefrontal cortices. Dorsomedial prefrontal cortex, through differential functional connectivity with parietal and insular cortex, predicted individual variability in strategic preferences. Finally, we demonstrate that robust decision strategies follow from neural sensitivity to rewards. We conclude that decision making reflects more than compensatory interaction of choice-related regions; in addition, specific brain systems potentiate choices depending on strategies, traits, and context.

  17. Making Good Choices: Districts Take the Lead. Comprehensive School Reform.

    Science.gov (United States)

    North Central Regional Educational Lab., Oak Brook, IL.

    Public schools across the country are aiming to improve student performance by engaging in comprehensive school reform (CSR). This guide was created to help school districts make CSR an integral part of their strategies for improving student achievement. Five components for CSR are described: (1) Strategizing, whereby the district supports CSR by…

  18. Hungry pigeons make suboptimal choices, less hungry pigeons do not.

    Science.gov (United States)

    Laude, Jennifer R; Pattison, Kristina F; Zentall, Thomas R

    2012-10-01

    Hungry animals will often choose suboptimally by being attracted to reliable signals for food that occur infrequently (they gamble) over less reliable signals for food that occur more often. That is, pigeons prefer an option that 50 % of the time provides them with a reliable signal for the appearance of food but 50 % of the time provides them with a reliable signal for the absence of food (overall 50 % reinforcement) over an alternative that always provides them with a signal for the appearance of food 75 % of the time (overall 75 % reinforcement). The pigeons appear to choose impulsively for the possibility of obtaining the reliable signal for reinforcement. There is evidence that greater hunger is associated with greater impulsivity. We tested the hypothesis that if the pigeons were less hungry, they would be less impulsive and, thus, would choose more optimally (i.e., on the basis of the overall probability of reinforcement). We found that hungry pigeons choose the 50 % reinforcement alternative suboptimally but less hungry pigeons prefer the more optimal 75 % reinforcement. Paradoxically, pigeons that needed the food more received less of it. These findings have implications for how level of motivation may also affect human suboptimal choice (e.g., purchase of lottery tickets and playing slot machines).

  19. Contribution to the study for an optimum choice of filter and screens in radiographic testing

    International Nuclear Information System (INIS)

    Caillieret, V.; Peix, G.; Babot, D.; Lormand, G.

    1985-01-01

    In order to optimize the choices of screens and filter in steel specimens radiographic testing with iridium 192 and cobalt 60, we started a theoretical and experimental study of their actions on radiative and latent images formation. Theoretical modelisation of photons interactions in steel and experimental apparatus for spectral analysis are described

  20. 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.

  1. A Decision Making Analysis of Persuasive Argumentation and the Choice Shift Effect

    Science.gov (United States)

    Vinokur, Amiram; And Others

    1975-01-01

    A subjective expected utility (SEU) decision-making analysis was performed on the content of arguments generated by subjects privately or during group discussion in response to choice-dilemmas shown to shift toward risk and caution. (Editor)

  2. Bayesian probability estimates are not necessary to make choices satisfying Bayes’ rule in elementary situations

    Science.gov (United States)

    Domurat, Artur; Kowalczuk, Olga; Idzikowska, Katarzyna; Borzymowska, Zuzanna; Nowak-Przygodzka, Marta

    2015-01-01

    This paper has two aims. First, we investigate how often people make choices conforming to Bayes’ rule when natural sampling is applied. Second, we show that using Bayes’ rule is not necessary to make choices satisfying Bayes’ rule. Simpler methods, even fallacious heuristics, might prescribe correct choices reasonably often under specific circumstances. We considered elementary situations with binary sets of hypotheses and data. We adopted an ecological approach and prepared two-stage computer tasks resembling natural sampling. Probabilistic relations were inferred from a set of pictures, followed by a choice which was made to maximize the chance of a preferred outcome. Use of Bayes’ rule was deduced indirectly from choices. Study 1 used a stratified sample of N = 60 participants equally distributed with regard to gender and type of education (humanities vs. pure sciences). Choices satisfying Bayes’ rule were dominant. To investigate ways of making choices more directly, we replicated Study 1, adding a task with a verbal report. In Study 2 (N = 76) choices conforming to Bayes’ rule dominated again. However, the verbal reports revealed use of a new, non-inverse rule, which always renders correct choices, but is easier than Bayes’ rule to apply. It does not require inversion of conditions [transforming P(H) and P(D|H) into P(H|D)] when computing chances. Study 3 examined the efficiency of three fallacious heuristics (pre-Bayesian, representativeness, and evidence-only) in producing choices concordant with Bayes’ rule. Computer-simulated scenarios revealed that the heuristics produced correct choices reasonably often under specific base rates and likelihood ratios. Summing up we conclude that natural sampling results in most choices conforming to Bayes’ rule. However, people tend to replace Bayes’ rule with simpler methods, and even use of fallacious heuristics may be satisfactorily efficient. PMID:26347676

  3. >From individual choice to group decision-making

    Science.gov (United States)

    Galam, Serge; Zucker, Jean-Daniel

    2000-12-01

    Some universal features are independent of both the social nature of the individuals making the decision and the nature of the decision itself. On this basis a simple magnet like model is built. Pair interactions are introduced to measure the degree of exchange among individuals while discussing. An external uniform field is included to account for a possible pressure from outside. Individual biases with respect to the issue at stake are also included using local random fields. A unique postulate of minimum conflict is assumed. The model is then solved with emphasis on its psycho-sociological implications. Counter-intuitive results are obtained. At this stage no new physical technicality is involved. Instead the full psycho-sociological implications of the model are drawn. Few cases are then detailed to enlight them. In addition, several numerical experiments based on our model are shown to give both an insight on the dynamics of the model and suggest further research directions.

  4. Pharmacy career deciding: making choice a "good fit".

    Science.gov (United States)

    Willis, Sarah Caroline; Shann, Phillip; Hassell, Karen

    2009-01-01

    The purpose of this article is to explore factors influencing career deciding amongst pharmacy students and graduates in the U.K. Group interviews were used to devise a topic guide for five subsequent focus groups with pharmacy students and graduates. Focus groups were tape-recorded, recordings transcribed, and transcripts analysed. Key themes and interlinking factors relating to pharmacy career deciding were identified in the transcripts, following a constructivist approach. Participants' described making a "good fit" between themselves, their experiences, social networks etc. and pharmacy. Central to a coherent career deciding narrative were: having a job on graduation; and the instrumental advantage of studying a vocational course. Focusing on career deciding of UK pharmacy students and graduates may limit the study's generalisability to other countries. However, our findings are relevant to those interested in understanding students' motivations for healthcare careers, since our results suggest that making a "good fit" describes a general process of matching between a healthcare career and personal experience. As we have found that pharmacy career deciding was not, usually, a planned activity, career advisors and those involved in higher education recruitment should take into account the roles played by personal preferences and values in choosing a degree course. A qualitative study like this can illustrate how career deciding occurs and provide insight into the process from a student's perspective. This can help inform guidance processes, selection to healthcare professions courses within the higher education sector, and stimulate debate amongst those involved with recruitment of healthcare workers about desirable motivators for healthcare careers.

  5. Dental patient preferences and choice in clinical decision-making.

    Science.gov (United States)

    Fukai, Kakuhiro; Yoshino, Koichi; Ohyama, Atsushi; Takaesu, Yoshinori

    2012-01-01

    In economics, the concept of utility refers to the strength of customer preference. In health care assessment, the visual analogue scale (VAS), the standard gamble, and the time trade-off are used to measure health state utilities. These utility measurements play a key role in promoting shared decision-making in dental care. Individual preference, however, is complex and dynamic. The purpose of this study was to investigate the relationship between patient preference and educational intervention in the field of dental health. The data were collected by distributing questionnaires to employees of two companies in Japan. Participants were aged 18-65 years and consisted of 111 males and 93 females (204 in total). One company (Group A) had a dental program of annual check-ups and health education in the workplace, while the other company (Group B) had no such program. Statistical analyses were performed with the t-test and Chi-square test. The questionnaire items were designed to determine: (1) oral health-related quality of life, (2) dental health state utilities (using VAS), and (3) time trade-off for regular dental check-ups. The percentage of respondents in both groups who were satisfied with chewing function, appearance of teeth, and social function ranged from 23.1 to 42.4%. There were no significant differences between groups A and B in the VAS of decayed, filled, and missing teeth. The VAS of gum bleeding was 42.8 in Group A and 51.3 in Group B (pdecision-making.

  6. Persistent optimizing: how mothers make food choices for their preschool children.

    Science.gov (United States)

    Walsh, Audrey; Meagher-Stewart, Donna; Macdonald, Marilyn

    2015-04-01

    Mothers' ability to provide healthy food choices for their children has become more complex in our current obesogenic environment. We conducted a total of 35 interviews with 18 mothers of preschool children. Using constructivist grounded theory methods, we developed a substantive theory of how mothers make food choices for their preschoolers. Our substantive theory, persistent optimizing, consists of three main integrated conceptual categories: (a) acknowledging contextual constraints, (b) stretching boundaries, and (c) strategic positioning. Implications to improve mothers' ability to make healthy food choices that reduce their children's risk of becoming overweight or obese are discussed. © The Author(s) 2014.

  7. Interaction between plate make and protein in protein crystallisation screening.

    Directory of Open Access Journals (Sweden)

    Gordon J King

    Full Text Available BACKGROUND: Protein crystallisation screening involves the parallel testing of large numbers of candidate conditions with the aim of identifying conditions suitable as a starting point for the production of diffraction quality crystals. Generally, condition screening is performed in 96-well plates. While previous studies have examined the effects of protein construct, protein purity, or crystallisation condition ingredients on protein crystallisation, few have examined the effect of the crystallisation plate. METHODOLOGY/PRINCIPAL FINDINGS: We performed a statistically rigorous examination of protein crystallisation, and evaluated interactions between crystallisation success and plate row/column, different plates of same make, different plate makes and different proteins. From our analysis of protein crystallisation, we found a significant interaction between plate make and the specific protein being crystallised. CONCLUSIONS/SIGNIFICANCE: Protein crystal structure determination is the principal method for determining protein structure but is limited by the need to produce crystals of the protein under study. Many important proteins are difficult to crystallize, so that identification of factors that assist crystallisation could open up the structure determination of these more challenging targets. Our findings suggest that protein crystallisation success may be improved by matching a protein with its optimal plate make.

  8. One-reason decision making in risky choice? A closer look at the priority heuristic

    Directory of Open Access Journals (Sweden)

    Benjamin E. Hilbig

    2008-08-01

    Full Text Available Although many models for risky choices between gambles assume that information is somehow integrated, the recently proposed priority heuristic (PH claims that choices are based on one piece of information only. That is, although the current reason for a choice according to the PH can vary, all other reasons are claimed to be ignored. However, the choices predicted by the PH and other pieces of information are often confounded, thus rendering critical tests of whether decisions are actually based on one reason only, impossible. The current study aims to remedy this problem by manipulating the number of reasons additionally in line with the choice implied by the PH. The results show that participants' choices and decision times depend heavily on the number of reasons in line with the PH --- thus contradicting the notion of non-compensatory, one-reason decision making.

  9. Information-sharing to promote informed choice in prenatal screening in the spirit of the SOGC clinical practice guideline: a proposal for an alternative model.

    Science.gov (United States)

    Vanstone, Meredith; Kinsella, Elizabeth Anne; Nisker, Jeff

    2012-03-01

    The 2011 SOGC clinical practice guideline "Prenatal Screening for Fetal Aneuploidy in Singleton Pregnancies" recommends that clinicians offer prenatal screening to all pregnant women and provide counselling in a non-directive manner. Non-directive counselling is intended to facilitate autonomous decision-making and remove the clinician's views regarding a particular course of action. However, recent research in genetic counselling raises concerns that non-directive counselling is neither possible nor desirable, and that it may not be the best way to facilitate informed choice. We propose an alternative model of information-sharing specific to prenatal screening that combines attributes of the models of informative decision-making and shared decision-making. Our proposed model is intended to provide clinicians with a strategy to communicate information about prenatal screening in a way that facilitates a shared deliberative process and autonomous decision-making. Our proposed model may better prepare a pregnant woman to make an informed choice about participating in prenatal screening on the basis of her consideration of the medical information provided by her clinician and her particular circumstances and values.

  10. 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…

  11. Tragic Choices in Humanitarian Aid : A Framework of Organizational Determinants of NGO Decision Making

    NARCIS (Netherlands)

    Heyse, Liesbet

    Humanitarian NGOs face difficult choices about whom to help and whom not on a daily basis. The research question in this article is how humanitarian NGOs make these difficult decisions and why in a particular way. March's study on consequential and appropriate decision-making processes is used to

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

    Science.gov (United States)

    Skanavis, Constantina; Sakellari, Maria

    2012-01-01

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

  13. Preventing School Employee Sexual Misconduct: An Outcome Survey Analysis of Making Right Choices.

    Science.gov (United States)

    Lipson, Glenn; Grant, Billie-Jo; Mueller, Jessica; Sonnich, Steve

    2018-05-30

    This treatment-only study examines the impact of Making Right Choices, an online course prevention program designed to promote the knowledge, awareness, and prevention of school employee sexual misconduct. The sample included 13,007 school employee participants who took the Making Right Choices course between May 6, 2011, and March 12, 2017, in California and New York. The 20-item measure, Preventing Misconduct Assessment, was administered to participants at the end of the online course; completion of the measure was voluntary. Descriptive statistics revealed that a large majority of participants reported increasing their knowledge and awareness of school employee sexual misconduct because of their participation in the Making Right Choices online course. This study yields important findings regarding the impact of a sexual misconduct prevention program and, specifically, the difference it may make for non-licensed school employees. These findings indicate that school employees are accepting of sexual misconduct training programs and rate them as having value.

  14. 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.

  15. The Making of Informed Choice in Midwifery: A Feminist Experiment in Care.

    Science.gov (United States)

    MacDonald, Margaret E

    2017-11-15

    This paper is about the clinical principle of informed choice-the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery's feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele. As mainstream biomedicine now takes up the rhetoric of patient empowerment and informed choice, this paper is at once a nuanced history of the making of the concept and also a critique of the ascendant 'regime of choice' in contemporary health care, inspired by the reflections of the midwives in my study for whom choice is impossible without care.

  16. RELATION BETWEEN QUALITY OF LIFE, CHOICE MAKING, AND FUTURE EXPECTATIONS IN ADULTS WITH INTELLECTUAL DISABILITY

    Directory of Open Access Journals (Sweden)

    Vesna KOSTIKJ-IVANOVIKJ

    2016-09-01

    Full Text Available Introduction: Quality of life of individuals depends significantly on the ability to have control over everyday life, realized through the freedom to make choices from available options and self-determination. Objective: To determine the correlation between possibilities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities according self-assessment and assessment by others. Methods: Descriptive, method of correlation and comparative analysis ware applied. From techniques, analysis of documents, surveys with the Quality of life questionnaire by Schalock and Keith and Questionnaire for expectations for the future by Speck, and scaling with the Scale for assessment of the opportunities for making choices by Kishi et al. Sample consisted of 130 intellectually disabled adults and 130 proxies. For establishing connection between the examined phenomena Pearson correlation coefficient (r was used, at p<0,01. Results: There is a strong correlation between the results obtained from the questionnaires about quality of life and opportunities for making choices, self-assessment r(130=0,497, p<0,01, assessment by others r(130=0,482, p<0,01. There is a correlation between the results obtained from the questionnaires about quality of life and expectations for the future, but not very strong, self-assessment r(130=0,233, p=0,008<0,01, assessment by others r(130=0,305, p<0,01. Conclusion: There is a correlation between opportunities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities. To improve the quality of life in these individuals, it is necessary to design programs that will develop self-concept, abilities for self-determination and making personal choices.

  17. Do Moral Choices Make Us Feel Good? The Development of Adolescents' Emotions Following Moral Decision Making

    Science.gov (United States)

    Malti, Tina; Keller, Monika; Buchmann, Marlis

    2013-01-01

    Some people believe that making the morally right decision makes people feel good. However, until now, there has been no empirical evidence in support of this belief. In a representative two-wave longitudinal study of 995 15-year-old adolescents followed for 3 years (until the age of 18) in Switzerland, adolescents were asked about their decisions…

  18. The Effects of Frequency of Media Utilization on Decision Making of Media Choice

    Science.gov (United States)

    Gotoh, Yasushi

    2014-01-01

    The purpose of this study is to use the Analytic Hierarchy Process in order to identify how frequency of media use in daily life affects decision-making in media choice. 276 university students took part in this research, They were asked to prioritize their ways of obtaining information about current affairs using sets of media such as TV, books,…

  19. A comparison of face to face and group education on informed choice and decisional conflict of pregnant women about screening tests of fetal abnormalities

    Science.gov (United States)

    Kordi, Masoumeh; Riyazi, Sahar; Lotfalizade, Marziyeh; Shakeri, Mohammad Taghi; Suny, Hoseyn Jafari

    2018-01-01

    BACKGROUND AND GOAL: Screening of fetal anomalies is assumed as a necessary measurement in antenatal cares. The screening plans aim at empowerment of individuals to make the informed choice. This study was conducted in order to compare the effect of group and face-to-face education and decisional conflicts among the pregnant females regarding screening of fetal abnormalities. METHODS: This study of the clinical trial was carried out on 240 pregnant women at education course were held in two weekly sessions for intervention groups during two consecutive weeks, and the usual care was conducted for the control group. The rate of informed choice and decisional conflict was measured in pregnant women before education and also at weeks 20–22 of pregnancy in three groups. The data analysis was executed using SPSS statistical software (version 16), and statistical tests were implemented including Chi-square test, Kruskal–Wallis test, Wilcoxon test, Mann–Whitney U-test, one-way analysis of variance test, and Tukey's range test. The P education group, 64 members (80%) in group education class, and 20 persons (25%) in control group had the informed choice regarding screening tests, but there was no statistically significant difference between two individual and group education classes. Similarly, during the postintervention phase, there was a statistically significant difference in mean score of decisional conflict scale among pregnant women regarding screening tests in three groups (P = 0.001). DISCUSSION AND CONCLUSION: With respect to effectiveness of group and face-to-face education methods in increasing the informed choice and reduced decisional conflict in pregnant women regarding screening tests, each of these education methods may be employed according to the clinical environment conditions and requirement to encourage the women for conducting the screening tests. PMID:29417066

  20. Prefrontal spatial working memory network predicts animal's decision making in a free choice saccade task.

    Science.gov (United States)

    Mochizuki, Kei; Funahashi, Shintaro

    2016-01-01

    While neurons in the lateral prefrontal cortex (PFC) encode spatial information during the performance of working memory tasks, they are also known to participate in subjective behavior such as spatial attention and action selection. In the present study, we analyzed the activity of primate PFC neurons during the performance of a free choice memory-guided saccade task in which the monkeys needed to choose a saccade direction by themselves. In trials when the receptive field location was subsequently chosen by the animal, PFC neurons with spatially selective visual response started to show greater activation before cue onset. This result suggests that the fluctuation of firing before cue presentation prematurely biased the representation of a certain spatial location and eventually encouraged the subsequent choice of that location. In addition, modulation of the activity by the animal's choice was observed only in neurons with high sustainability of activation and was also dependent on the spatial configuration of the visual cues. These findings were consistent with known characteristics of PFC neurons in information maintenance in spatial working memory function. These results suggest that precue fluctuation of spatial representation was shared and enhanced through the working memory network in the PFC and could finally influence the animal's free choice of saccade direction. The present study revealed that the PFC plays an important role in decision making in a free choice condition and that the dynamics of decision making are constrained by the network architecture embedded in this cortical area. Copyright © 2016 the American Physiological Society.

  1. Beyond labelling: what strategies do nut allergic individuals employ to make food choices? A qualitative study.

    Directory of Open Access Journals (Sweden)

    Julie Barnett

    Full Text Available OBJECTIVE: Food labelling is an important tool that assists people with peanut and tree nut allergies to avoid allergens. Nonetheless, other strategies are also developed and used in food choice decision making. In this paper, we examined the strategies that nut allergic individuals deploy to make safe food choices in addition to a reliance on food labelling. METHODS: THREE QUALITATIVE METHODS: an accompanied shop, in-depth semi-structured interviews, and the product choice reasoning task - were used with 32 patients that had a clinical history of reactions to peanuts and/or tree nuts consistent with IgE-mediated food allergy. Thematic analysis was applied to the transcribed data. RESULTS: Three main strategies were identified that informed the risk assessments and food choice practices of nut allergic individuals. These pertained to: (1 qualities of product such as the product category or the country of origin, (2 past experience of consuming a food product, and (3 sensory appreciation of risk. Risk reasoning and risk management behaviours were often contingent on the context and other physiological and socio-psychological needs which often competed with risk considerations. CONCLUSIONS: Understanding and taking into account the complexity of strategies and the influences of contextual factors will allow healthcare practitioners, allergy nutritionists, and caregivers to advise and educate patients more effectively in choosing foods safely. Governmental bodies and policy makers could also benefit from an understanding of these food choice strategies when risk management policies are designed and developed.

  2. Prefrontal spatial working memory network predicts animal's decision making in a free choice saccade task

    Science.gov (United States)

    Mochizuki, Kei

    2015-01-01

    While neurons in the lateral prefrontal cortex (PFC) encode spatial information during the performance of working memory tasks, they are also known to participate in subjective behavior such as spatial attention and action selection. In the present study, we analyzed the activity of primate PFC neurons during the performance of a free choice memory-guided saccade task in which the monkeys needed to choose a saccade direction by themselves. In trials when the receptive field location was subsequently chosen by the animal, PFC neurons with spatially selective visual response started to show greater activation before cue onset. This result suggests that the fluctuation of firing before cue presentation prematurely biased the representation of a certain spatial location and eventually encouraged the subsequent choice of that location. In addition, modulation of the activity by the animal's choice was observed only in neurons with high sustainability of activation and was also dependent on the spatial configuration of the visual cues. These findings were consistent with known characteristics of PFC neurons in information maintenance in spatial working memory function. These results suggest that precue fluctuation of spatial representation was shared and enhanced through the working memory network in the PFC and could finally influence the animal's free choice of saccade direction. The present study revealed that the PFC plays an important role in decision making in a free choice condition and that the dynamics of decision making are constrained by the network architecture embedded in this cortical area. PMID:26490287

  3. Do pregnant women and their partners make an informed choice about first trimester risk assessment for Down syndrome, and are they satisfied with the choice?

    DEFF Research Database (Denmark)

    Bangsgaard, Louise; Tabor, Ann

    2012-01-01

    OBJECTIVE: All pregnant women in Denmark are offered risk assessment for Down syndrome. The aim of this study was to investigate whether women and partners make an informed choice about first trimester risk assessment, and their satisfaction with the choice. METHODS: A survey using multiple measure...... of knowledge (82% and 81%) and positive attitudes regarding risk assessment (97% and 98%), leading to 79% and 80% making an informed choice. Education predicted knowledge for women (odds ratio 3.42; 95% confidence interval 1.63-7.18) and partners (odds ratio 2.97; 95% confidence interval 1.37-6.45), country...... of origin predicted knowledge, attitude and informed choice among women. Three hundred thirty-two women (99%) and all partners were satisfied with having chosen risk assessment. CONCLUSIONS: Although 80% of pregnant women and partners make an informed choice about undergoing first trimester risk assessment...

  4. Survival or Mortality: Does Risk Attribute Framing Influence Decision-Making Behavior in a Discrete Choice Experiment?

    Science.gov (United States)

    Veldwijk, Jorien; Essers, Brigitte A B; Lambooij, Mattijs S; Dirksen, Carmen D; Smit, Henriette A; de Wit, G Ardine

    2016-01-01

    To test how attribute framing in a discrete choice experiment (DCE) affects respondents' decision-making behavior and their preferences. Two versions of a DCE questionnaire containing nine choice tasks were distributed among a representative sample of the Dutch population aged 55 to 65 years. The DCE consisted of four attributes related to the decision regarding participation in genetic screening for colorectal cancer (CRC). The risk attribute included was framed positively as the probability of surviving CRC and negatively as the probability of dying from CRC. Panel mixed-logit models were used to estimate the relative importance of the attributes. The data of the positively and negatively framed DCE were compared on the basis of direct attribute ranking, dominant decision-making behavior, preferences, and importance scores. The majority (56%) of the respondents ranked survival as the most important attribute in the positively framed DCE, whereas only a minority (8%) of the respondents ranked mortality as the most important attribute in the negatively framed DCE. Respondents made dominant choices based on survival significantly more often than based on mortality. The framing of the risk attribute significantly influenced all attribute-level estimates and resulted in different preference structures among respondents in the positively and negatively framed data set. Risk framing affects how respondents value the presented risk. Positive risk framing led to increased dominant decision-making behavior, whereas negative risk framing led to risk-seeking behavior. Attribute framing should have a prominent part in the expert and focus group interviews, and different types of framing should be used in the pilot version of DCEs as well as in actual DCEs to estimate the magnitude of the effect of choosing different types of framing. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  5. Nudging or education to responsible choices? The example of breast screening.

    Science.gov (United States)

    Tallacchini, Mariachiara

    2017-01-01

    "Nudge, or nudging, refers to a policy approach inspired by behavioral sciences: it promotes the conducts identified as desirable by regulators without applying prohibition and coercion. This approach has gained a lot of momentum in the domain of health policies. Policy strategies based on behavioral insights appear ideal as to implementing healthier life styles and public health programs while minimizing compliance costs: from organ donation to food choices, from fighting obesity and chronic diseases to screening policies. Nudging, however, is not exempt from problems, especially in the sector of health, where individual free and informed consent constitutes a founding principle. Cancer screening programs, and especially breast cancer population tests, represent an interesting example for nudging strategies which have been widely applied but have also raised serious criticisms. Despite having been widely adopted by health systems, from the United States to the European Union, breast cancer screening programs keep raising debates about their actual impact on reducing mortality, risks of overdiagnosing and unnecessary or harmful treatments. In challenging the validity of screening programs, these controversies also affect their efficacy. Nudging has therefore been seen as a potentially useful tool in increasing participation, even though the extent of its actual impact remains ambiguous and problematic. For nudging to represent a relevant, powerful policy instrument its legitimacy requirements need to be identified. These concern the "right place" of behavioral-based measures within the traditional regulatory framework. The "right place" of nudging in science-based policies is part of a broader rethinking of what is democracy in "knowledge-based societies", namely through which procedures democratic institutions validate and legitimize their normative choices depending on uncertain and controversial knowledge."

  6. 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.

  7. Emotion regulation and risk taking: predicting risky choice in deliberative decision making.

    Science.gov (United States)

    Panno, Angelo; Lauriola, Marco; Figner, Bernd

    2013-01-01

    Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation strategies in risky choice involving deliberative decision making. We investigated the role of habitual use of emotion regulation strategies in risky choice using the "cold" deliberative version of the Columbia Card Task (CCT; Figner et al., 2009). Fifty-three participants completed the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) and--one month later--the CCT and the PANAS. Greater habitual cognitive reappraisal use was related to increased risk taking, accompanied by decreased sensitivity to changes in probability and loss amount. Greater habitual expressive suppression use was related to decreased risk taking. The results show that habitual use of reappraisal and suppression strategies predict risk taking when decisions involve predominantly cognitive-deliberative processes.

  8. Socio-Semiotic Patterns in Digital Meaning-Making: Semiotic Choice as Indicator of Communicative Experience

    Science.gov (United States)

    Sofkova Hashemi, Sylvana

    2017-01-01

    Access to digital technology in the classroom enables the composition and organization of ideas on screen with a variety of semiotic systems of different modes and media. This study explores patterns of communication and preference of design in digital meaning-making of twelve 7-8 years old students. Meanings were shaped in complex uses and…

  9. Making choices about medical interventions: the experience of disabled young people with degenerative conditions.

    Science.gov (United States)

    Mitchell, Wendy A

    2014-04-01

    Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children's role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents' perspectives. To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision-making processes. Findings from a longitudinal qualitative study of 10 young people (13-22 years) with degenerative conditions are reported. Individual semi-structured interviews were conducted with participants over 3 years (2007-2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant. Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors. Young people's experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as 'irreversible' and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working. © 2012 John Wiley & Sons Ltd.

  10. Understanding patients’ decision-making strategies in hospital choice: Literature review and a call for experimental research

    Directory of Open Access Journals (Sweden)

    Sophia Fischer

    2015-12-01

    Full Text Available Insights from psychology and cognitive science have, as yet, barely entered hospital choice research. This conceptual article closes this gap by reviewing and conceptually framing the current literature on hospital choice and patient information behavior and by discussing which tools are needed to advance scientific methodology in the study of patient decision-making strategies in hospital choice. Specifically, we make a call for more experimental research in hospital choice in order to complement existing theories, methods, and tools. This article introduces computerized process-tracing tools in hospital choice research, and also outlines a hands-on example, to provide a basis for future research.

  11. Beyond informed choice: Prenatal risk assessment, decision-making and trust

    Directory of Open Access Journals (Sweden)

    Nete Schwennesen

    2008-05-01

    Full Text Available In 2004 prenatal risk assessment (PRA was implemented as a routine offer to all pregnant women in Denmark. It was argued that primarily the new programme would give all pregnant women an informed choice about whether to undergo prenatal testing. On the basis of ethnographic fieldwork in an ultrasound clinic in Denmark and interviews with pregnant women and their partners, we call into question the assumption underlying the new guidelines that more choice and more objective information is a source of empowerment and control. We focus on one couple's experience of PRA. This case makes it evident how supposed choices in the context of PRA may not be experienced as such. Rather, they are experienced as complicated processes of meaning-making in the relational space between the clinical setting, professional authority and the social life of the couples. PRA users are reluctant to make choices and abandon health professionals as authoritative experts in the face of complex risk knowledge. When assumptions about autonomy and self-determination are inscribed into the social practice of PRA, authority is transferred to the couple undergoing PRA and a new configuration of responsibility evolves between the couple and their relationship to the foetus. It is argued that al-though the new programme of prenatal testing in Denmark presents itself in opposition to quasi-eugenic and paternalistic forms of governing couples' decisions it represents another form of government that works through the notion of choice. An ethics of a shared responsibility of PRA and its outcome would be more in agreement with how decisions are actually made.http://dx.doi.org/10.5324/eip.v2i1.1687

  12. Risky decision-making under risk in schizophrenia: A deliberate choice?

    Science.gov (United States)

    Pedersen, Anya; Göder, Robert; Tomczyk, Samuel; Ohrmann, Patricia

    2017-09-01

    Patients with schizophrenia reveal impaired decision-making strategies causing social, financial and health care problems. The extent to which deficits in decision-making reflect intentional risky choices in schizophrenia is still under debate. Based on previous studies we expected patients with schizophrenia to reveal a riskier performance on the GDT and to make more disadvantageous decisions on the IGT. In the present study, we investigated 38 patients with schizophrenia and 38 matched healthy control subjects with two competing paradigms regarding feedback: (1) The Game of Dice Task (GDT), in which the probabilities of winning or losing are stable and explicitly disclosed to the subject, to assess decision-making under risk and (2) the Iowa Gambling Task (IGT), which requires subjects to infer the probabilities of winning or losing from feedback, to investigate decision-making under ambiguity. Patients with schizophrenia revealed an overall riskier performance on the GDT; although they adjusted their strategy over the course of the GDT, they still made significantly more disadvantageous choices than controls. More positive symptoms in patients with schizophrenia indicated by higher PANSS positive scores were associated with riskier choices and less use of negative feedback. Compared to healthy controls, they were not impaired in net score but chose more disadvantageous cards than controls on the first block of the IGT. Effects of medication at the time of testing cannot be ruled out. Our findings suggest that patients with schizophrenia make riskier decisions and are less able to regulate their decision-making to implement advantageous strategies, even when the probabilities of winning or losing are explicitly disclosed. The dissociation between performance on the GDT and IGT suggests a pronounced impairment of executive functions related to the dorsolateral prefrontal cortex. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Evidence Accumulation and Choice Maintenance Are Dissociated in Human Perceptual Decision Making.

    Directory of Open Access Journals (Sweden)

    Mads Lund Pedersen

    Full Text Available Perceptual decision making in monkeys relies on decision neurons, which accumulate evidence and maintain choices until a response is given. In humans, several brain regions have been proposed to accumulate evidence, but it is unknown if these regions also maintain choices. To test if accumulator regions in humans also maintain decisions we compared delayed and self-paced responses during a face/house discrimination decision making task. Computational modeling and fMRI results revealed dissociated processes of evidence accumulation and decision maintenance, with potential accumulator activations found in the dorsomedial prefrontal cortex, right inferior frontal gyrus and bilateral insula. Potential maintenance activation spanned the frontal pole, temporal gyri, precuneus and the lateral occipital and frontal orbital cortices. Results of a quantitative reverse inference meta-analysis performed to differentiate the functions associated with the identified regions did not narrow down potential accumulation regions, but suggested that response-maintenance might rely on a verbalization of the response.

  14. Seeking balance: the complexity of choice-making among academic surgeons.

    Science.gov (United States)

    Brown, Judith Belle; Fluit, Meghan; Lent, Barbara; Herbert, Carol

    2011-10-01

    This study describes the experiences of academic surgeons in seeking a balance between their personal and professional lives. This phenomenological study, conducted in 2009-2010 at the University of Western Ontario, used in-depth individual semistructured interviews to explore the ideas, perceptions, and experiences of 17 recently recruited academic surgeons (nine women/eight men) about seeking balance between their personal and professional lives. All the interviews were audiotaped and transcribed verbatim. The data analysis was both iterative and interpretative. All the participants expressed a passion and commitment to academic surgery, but their stories revealed the complexity of making choices in seeking a balance between their personal and professional lives. This process of making choices was filtered through influential values in their lives, which in turn determined how they set boundaries to protect their personal and family time from the demands of their professional obligations. Intertwined in this process were the trade-offs they had to make in order to seek balance. Some choices, boundary-setting strategies, and trade-offs were dictated by gender. Finally, the process of making choices was not static; instead, the data revealed how it was both dynamic and cyclical, requiring reexamination over the life cycle, as well as their career trajectory. Thus, seeking a balance was an ever-changing process. Understanding how members of an academic department of surgery navigate the balance between their personal and professional worlds may provide new insights for other disciplines seeking to enhance the development of the next generation of academics.

  15. Developing and pilot testing a shared decision-making intervention for dialysis choice.

    Science.gov (United States)

    Finderup, Jeanette; Jensen, Jens K D; Lomborg, Kirsten

    2018-04-17

    Evidence is inconclusive on how best to guide the patient in decision-making around haemodialysis and peritoneal dialysis choice. International guidelines recommend involvement of the patient in the decision to choose the dialysis modality most suitable for the individual patient. Nevertheless, studies have shown lack of involvement of the patient in decision-making. To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality. This study reflects the first two phases of a complex intervention design: phase 1, the development process and phase 2, feasibility and piloting. Because decision aids were a part of the intervention, the International Patient Decision Aid Standards were considered. The pilot test included both the intervention and the feasibility of the validated shared decision-making questionnaire (SDM Q9) and the Decision Quality Measure (DQM) applied to evaluate the intervention. A total of 137 patients tested the intervention. After the intervention, 80% of the patients chose dialysis at home reflecting an increase of 23% in starting dialysis at home prior to the study. The SDM Q9 showed the majority of the patients experienced this intervention as shared decision-making. An intervention based on shared decision-making supported by decision aids seemed to increase the number of patients choosing home dialysis. The SDM Q9 and DQM were feasible evaluation tools. Further research is needed to gain insight into the patients' experiences of involvement and the implications for their choice of dialysis modality. © 2018 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  16. The Nature of Belief-Directed Exploratory Choice in Human Decision-Making

    Directory of Open Access Journals (Sweden)

    W. Bradley Knox

    2012-01-01

    Full Text Available In non-stationary environments, there is a conflict between exploiting currently favored options and gaining information by exploring lesser-known options that in the past have proven less rewarding. Optimal decision making in such tasks requires considering future states of the environment (i.e., planning and properly updating beliefs about the state of environment after observing outcomes associated with choices. Optimal belief-updating is reflective in that beliefs can change without directly observing environmental change. For example, after ten seconds elapse, one might correctly believe that a traffic light last observed to be red is now more likely to be green. To understand human decision-making when rewards associated with choice options change over time, we develop a variant of the classic bandit task that is both rich enough to encompass relevant phenomena and sufficiently tractable to allow for ideal actor analysis of sequential choice behavior. We evaluate whether people update beliefs about the state of environment in a reflexive (i.e., only in response to observed changes in reward structure or reflective manner. In contrast to purely "random" accounts of exploratory behavior, model-based analyses of the subjects’ choices and latencies indicate that people are reflective belief-updaters. However, unlike the Ideal Actor model, our analyses indicate that people's choice behavior does not reflect consideration of future environmental states. Thus, although people update beliefs in a reflective manner consistent with the ideal actor, they do not engage in optimal long-term planning, but instead myopically choose the option on every trial that is believed to have the highest immediate payoff.

  17. The Nature of Belief-Directed Exploratory Choice in Human Decision-Making

    Science.gov (United States)

    Knox, W. Bradley; Otto, A. Ross; Stone, Peter; Love, Bradley C.

    2011-01-01

    In non-stationary environments, there is a conflict between exploiting currently favored options and gaining information by exploring lesser-known options that in the past have proven less rewarding. Optimal decision-making in such tasks requires considering future states of the environment (i.e., planning) and properly updating beliefs about the state of the environment after observing outcomes associated with choices. Optimal belief-updating is reflective in that beliefs can change without directly observing environmental change. For example, after 10 s elapse, one might correctly believe that a traffic light last observed to be red is now more likely to be green. To understand human decision-making when rewards associated with choice options change over time, we develop a variant of the classic “bandit” task that is both rich enough to encompass relevant phenomena and sufficiently tractable to allow for ideal actor analysis of sequential choice behavior. We evaluate whether people update beliefs about the state of environment in a reflexive (i.e., only in response to observed changes in reward structure) or reflective manner. In contrast to purely “random” accounts of exploratory behavior, model-based analyses of the subjects’ choices and latencies indicate that people are reflective belief updaters. However, unlike the Ideal Actor model, our analyses indicate that people’s choice behavior does not reflect consideration of future environmental states. Thus, although people update beliefs in a reflective manner consistent with the Ideal Actor, they do not engage in optimal long-term planning, but instead myopically choose the option on every trial that is believed to have the highest immediate payoff. PMID:22319503

  18. Sensorimotor learning biases choice behavior: a learning neural field model for decision making.

    Directory of Open Access Journals (Sweden)

    Christian Klaes

    Full Text Available According to a prominent view of sensorimotor processing in primates, selection and specification of possible actions are not sequential operations. Rather, a decision for an action emerges from competition between different movement plans, which are specified and selected in parallel. For action choices which are based on ambiguous sensory input, the frontoparietal sensorimotor areas are considered part of the common underlying neural substrate for selection and specification of action. These areas have been shown capable of encoding alternative spatial motor goals in parallel during movement planning, and show signatures of competitive value-based selection among these goals. Since the same network is also involved in learning sensorimotor associations, competitive action selection (decision making should not only be driven by the sensory evidence and expected reward in favor of either action, but also by the subject's learning history of different sensorimotor associations. Previous computational models of competitive neural decision making used predefined associations between sensory input and corresponding motor output. Such hard-wiring does not allow modeling of how decisions are influenced by sensorimotor learning or by changing reward contingencies. We present a dynamic neural field model which learns arbitrary sensorimotor associations with a reward-driven Hebbian learning algorithm. We show that the model accurately simulates the dynamics of action selection with different reward contingencies, as observed in monkey cortical recordings, and that it correctly predicted the pattern of choice errors in a control experiment. With our adaptive model we demonstrate how network plasticity, which is required for association learning and adaptation to new reward contingencies, can influence choice behavior. The field model provides an integrated and dynamic account for the operations of sensorimotor integration, working memory and action

  19. The dynamics of decision making in risky choice: An Eye-tracking Analysis

    Directory of Open Access Journals (Sweden)

    Susann eFiedler

    2012-10-01

    Full Text Available In the last years, research on risky choice has moved beyond analyzing choices only. Models have been suggested that aim to describe the underlying cognitive processes and some studies have tested process predictions of these models. Prominent approaches are evidence accumulation models such as Decision Field Theory (DFT, simple serial heuristic models such as the Adaptive Toolbox, and connectionist approaches such as the Parallel Constraint Satisfaction Model (PCS. In two studies involving measures of attention and pupil dilation, we investigate hypotheses derived from these models in choices between two gambles with two outcomes each. We show that attention to an outcome of a gamble increases with its probability and its value and that attention shifts towards the subsequently favored gamble after about two thirds of the decision process, indicating a gaze-cascade effect. Information search occurs mostly within gambles, and the direction of search does not change over the course of decision making. Pupil dilation, which reflects both cognitive effort and arousal, increases during the decision process and increases with mean Expected Value. Overall, the results support aspects of automatic integration models for risky choice such as DFT and PCS, but in their current specification none of them can account for the full pattern of results.

  20. The dynamics of decision making in risky choice: an eye-tracking analysis.

    Science.gov (United States)

    Fiedler, Susann; Glöckner, Andreas

    2012-01-01

    In the last years, research on risky choice has moved beyond analyzing choices only. Models have been suggested that aim to describe the underlying cognitive processes and some studies have tested process predictions of these models. Prominent approaches are evidence accumulation models such as decision field theory (DFT), simple serial heuristic models such as the adaptive toolbox, and connectionist approaches such as the parallel constraint satisfaction (PCS) model. In two studies involving measures of attention and pupil dilation, we investigate hypotheses derived from these models in choices between two gambles with two outcomes each. We show that attention to an outcome of a gamble increases with its probability and its value and that attention shifts toward the subsequently favored gamble after about two thirds of the decision process, indicating a gaze-cascade effect. Information search occurs mostly within-gambles, and the direction of search does not change over the course of decision making. Pupil dilation, which reflects both cognitive effort and arousal, increases during the decision process and increases with mean expected value. Overall, the results support aspects of automatic integration models for risky choice such as DFT and PCS, but in their current specification none of them can account for the full pattern of results.

  1. Making an informed choice in the catering environment: what do consumers want to know?

    Science.gov (United States)

    Mackison, D; Wrieden, W L; Anderson, A S

    2009-12-01

    Eating outside the home is common in the UK, but it remains difficult for consumers to make informed choices based on menu information. The present study examines the reported preferences for the provision of nutrition (salt, fat and energy) and ingredient information in six types of UK catering outlets. Participants completed a short postal survey, assessing their frequency of dining at specific catering establishments as well as their desire to see nutrition and ingredient information. The responses from 786 adults aged >or=18 years (of whom 65% claimed to be 'motivated to eat a healthy diet') indicated that over 40% reported eating at a catering outlet at least once a week. Over half said that they would wish to see information on ingredients and the salt content of menu items at all venues. Preference for information on energy and fat content was less popular and varied in the range 42-56% for energy and 47-59% for fat. It is notable that 43% of respondents said they would welcome information on energy content of menu items in restaurants. A significant proportion of consumers wish to see information on the ingredients and nutrition composition on menu items for sale in UK catering outlets. Such information is likely to raise an awareness and understanding of healthy food choices and assist the population in making informed choices about healthy eating.

  2. Time Is Money: The Decision Making of Smartphone High Users in Gain and Loss Intertemporal Choice.

    Science.gov (United States)

    Tang, Zixuan; Zhang, Huijun; Yan, An; Qu, Chen

    2017-01-01

    Nowadays the smartphone plays an important role in our lives. While it brings us convenience and efficiency, its overuse can cause problems. Although a great number of studies have demonstrated that people affected by substance abuse, pathological gambling, and internet addiction disorder have lower self-control than average, scarcely any study has investigated the decision making of smartphone high users by using a behavioral paradigm. The present study employed an intertemporal task, the Smartphone Addiction Inventory (SPAI) and the Barratt Impulsiveness Scale 11th version (BIS-11) to explore the decision control of smartphone high users in a sample of 125 college students. Participants were divided into three groups according to their SPAI scores. The upper third (69 or higher), middle third (from 61 to 68) and lower third (60 or lower) of scores were defined as high smartphone users, medium users and low users, respectively. We compared the percentage of small immediate reward/penalty choices in different conditions between the three groups. Relative to the low users group, high users and medium users were more inclined to request an immediate monetary reward. Moreover, for the two dimensions of time and money in intertemporal choice, high users and medium users showed a bias in intertemporal choice task among most of the time points and value magnitude compared to low users. These findings demonstrated that smartphone overuse was associated with problematic decision-making, a pattern similar to that seen in persons affected by a variety of addictions.

  3. Can streamlined multi-criteria decision analysis be used to implement shared decision making for colorectal cancer screening?

    Science.gov (United States)

    Dolan, James G.; Boohaker, Emily; Allison, Jeroan; Imperiale, Thomas F.

    2013-01-01

    Background Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multi-criteria decision analysis (MCDA) is an established methodology well suited for supporting shared decision making. Our study goal was to determine if a streamlined form of MCDA using rank order based judgments can accurately assess patients’ colorectal cancer screening priorities. Methods We converted priorities for four decision criteria and three sub-criteria regarding colorectal cancer screening obtained from 484 average risk patients using the Analytic Hierarchy Process (AHP) in a prior study into rank order-based priorities using rank order centroids. We compared the two sets of priorities using Spearman rank correlation and non-parametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank order-based versus the AHP-based priorities on the results of a full MCDA comparing three currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Results Correlations between the two sets of priorities for the seven criteria ranged from 0.55 to 0.92. The proportions of absolute differences between rank order-based and AHP-based priorities that were more than ± 0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal and the relative rankings of the three screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Conclusion Rank order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making. PMID:24300851

  4. Testing Ecological Theories of Offender Spatial Decision Making Using a Discrete Choice Model

    Science.gov (United States)

    Summers, Lucia

    2015-01-01

    Research demonstrates that crime is spatially concentrated. However, most research relies on information about where crimes occur, without reference to where offenders reside. This study examines how the characteristics of neighborhoods and their proximity to offender home locations affect offender spatial decision making. Using a discrete choice model and data for detected incidents of theft from vehicles (TFV), we test predictions from two theoretical perspectives—crime pattern and social disorganization theories. We demonstrate that offenders favor areas that are low in social cohesion and closer to their home, or other age-related activity nodes. For adult offenders, choices also appear to be influenced by how accessible a neighborhood is via the street network. The implications for criminological theory and crime prevention are discussed. PMID:25866412

  5. Testing Ecological Theories of Offender Spatial Decision Making Using a Discrete Choice Model.

    Science.gov (United States)

    Johnson, Shane D; Summers, Lucia

    2015-04-01

    Research demonstrates that crime is spatially concentrated. However, most research relies on information about where crimes occur, without reference to where offenders reside. This study examines how the characteristics of neighborhoods and their proximity to offender home locations affect offender spatial decision making. Using a discrete choice model and data for detected incidents of theft from vehicles (TFV) , we test predictions from two theoretical perspectives-crime pattern and social disorganization theories. We demonstrate that offenders favor areas that are low in social cohesion and closer to their home, or other age-related activity nodes. For adult offenders, choices also appear to be influenced by how accessible a neighborhood is via the street network. The implications for criminological theory and crime prevention are discussed.

  6. Developing and pilot testing a shared decision-making intervention for dialysis choice

    DEFF Research Database (Denmark)

    Finderup, Jeanette; Jensen, Jens Dam; Lomborg, Kirsten

    2018-01-01

    . Nevertheless, studies have shown lack of involvement of the patient in decision-making. Objectives: To develop and pilot test an intervention for shared decision-making targeting the choice of dialysis modality. Methods: This study reflects the first two phases of a complex intervention design: phase 1......, the development process and phase 2, feasibility and piloting. Because decision aids were a part of the intervention, the International Patient Decision Aid Standards were considered. The pilot test included both the intervention and the feasibility of the validated shared decision-making questionnaire (SDM Q9......) and the Decision Quality Measure (DQM) applied to evaluate the intervention. Results: A total of 137 patients tested the intervention. After the intervention, 80% of the patients chose dialysis at home reflecting an increase of 23% in starting dialysis at home prior to the study. The SDM Q9 showed the majority...

  7. Risky decision-making is associated with residential choice in healthy older adults.

    Directory of Open Access Journals (Sweden)

    Kendra L Seaman

    2015-08-01

    Full Text Available As our society becomes more mobile and people reside farther away from their immediate families, competent decision-making has become critical for the older adults wishing to maintain their independence. However, very little is known about the relationship between residential choice and decision making. Here we use the Balloon Analogue Risk Task (BART to examine risk-taking in two samples of older adults, one living in a retirement community and another living independently. We also used a cognitive model to gain insight into the cognitive factors underlying decision-making in these groups. We found that older adults living in a retirement community were more risk averse than their independent counterparts. Furthermore, this difference appeared to be motivated by group differences in initial perception of risk. This study suggests an intriguing difference between these two residential groups, and also points to the utility of using laboratory methods in research on real-world problems.

  8. Risky decision-making is associated with residential choice in healthy older adults.

    Science.gov (United States)

    Seaman, Kendra L; Stillman, Chelsea M; Howard, Darlene V; Howard, James H

    2015-01-01

    As our society becomes more mobile and people reside farther away from their immediate families, competent decision-making has become critical for the older adults wishing to maintain their independence. However, very little is known about the relationship between residential choice and decision-making. Here we use the Balloon Analog Risk Task (BART) to examine risk-taking in two samples of older adults, one living in a retirement community and another living independently. We also used a cognitive model to gain insight into the cognitive factors underlying decision-making in these groups. We found that older adults living in a retirement community were more risk averse than their independent counterparts. Furthermore, this difference appeared to be motivated by group differences in initial perception of risk. This study suggests an intriguing difference between these two residential groups, and also points to the utility of using laboratory methods in research on real-world problems.

  9. Neural antecedents of social decision-making in a partner choice task.

    Science.gov (United States)

    Cartmell, Samuel C D; Chun, Marvin M; Vickery, Timothy J

    2014-11-01

    Experiments in financial decision-making point to two complementary processes that encode prospective gain and loss preceding the choice to purchase consumer goods. These processes involve the nucleus accumbens (NAcc) and the right anterior insula, respectively. The current experiment used functional MRI to investigate whether these regions served a similar function during an analogous social decision-making task without the influence of monetary outcomes. In this task, subjects chose partners based on face stimuli of varying attractiveness (operationalizing value) and ratings of compatibility with the participant (operationalizing likelihood of rejection). The NAcc responded to anticipated gain; the right anterior insula responded to compatibility, but not in a manner that suggests an analogy to anticipated cost. Logistic regression modeling demonstrated that both regions predicted subsequent choice above and beyond the influence of group attractiveness ratings or compatibility alone. Although the function of the insula may differ between tasks, these results suggest that financial and social decision-making recruit a similar network of brain regions. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  10. [Influenza A from the rational choice theory: proposals for decision making in prevention policies].

    Science.gov (United States)

    Peña, Francisco Garrido; Fernández, Luís Andrés López; García, Eugenia Gil

    2009-01-01

    This article is a reflection on the social uncertainty caused by Influenza A and on the consequences that it can have on decision making in health promotion policies. We use concepts and metaphors of the Rational Choice Theory, among them, the "in gratitude effect" or the "distrust effect", as we analyse how these can become obstacles for the efficiency of prevention policies. Then, we focus on the information asymmetry of the principal-agent relationship, and we propose measures to diminish the "moral risk" that they cause. We finish by advancing some proposals for designing lines and strategies of action in health promotion policies.

  11. Usefulness of the discrete choice methodology for marketing decision-making in New Product Development

    DEFF Research Database (Denmark)

    Krystallis, Athanasios; Linadrakis, M.; Mamalis, S.

    2010-01-01

    functional children's snacks marketed in Greece. Using a very simple discrete choice experimental design, the authors aim (a) to provide an example of consumer research implementation in food-related NPD and to assess its marketing value, and (b) to evaluate the quality of the acquired consumer......-related information for marketing decision-making in food consumer-led NPD processes against a number of criteria set in the relevant literature. ''Functionality'' is found to be a statistically significant attribute for all three children's snacks of the research design compared to other attributes such as flavor...

  12. Decision making under internal uncertainty: the case of multiple-choice tests with different scoring rules.

    Science.gov (United States)

    Bereby-Meyer, Yoella; Meyer, Joachim; Budescu, David V

    2003-02-01

    This paper assesses framing effects on decision making with internal uncertainty, i.e., partial knowledge, by focusing on examinees' behavior in multiple-choice (MC) tests with different scoring rules. In two experiments participants answered a general-knowledge MC test that consisted of 34 solvable and 6 unsolvable items. Experiment 1 studied two scoring rules involving Positive (only gains) and Negative (only losses) scores. Although answering all items was the dominating strategy for both rules, the results revealed a greater tendency to answer under the Negative scoring rule. These results are in line with the predictions derived from Prospect Theory (PT) [Econometrica 47 (1979) 263]. The second experiment studied two scoring rules, which allowed respondents to exhibit partial knowledge. Under the Inclusion-scoring rule the respondents mark all answers that could be correct, and under the Exclusion-scoring rule they exclude all answers that might be incorrect. As predicted by PT, respondents took more risks under the Inclusion rule than under the Exclusion rule. The results illustrate that the basic process that underlies choice behavior under internal uncertainty and especially the effect of framing is similar to the process of choice under external uncertainty and can be described quite accurately by PT. Copyright 2002 Elsevier Science B.V.

  13. Is decision-making ability related to food choice and facets of eating behaviour in adolescents?

    Science.gov (United States)

    Macchi, Rosemarie; MacKew, Laura; Davis, Caroline

    2017-09-01

    To test the prediction that poor decision-making would predict poor eating-related behaviours, which in turn would relate to elevated body mass index (BMI) percentile. Associations among decision-making ability, eating behaviours, and BMI percentile were examined in a sample of 311 healthy male and female adolescents, aged 14-18 years. Structural equation modelling was used to test the proposed relationships. The predicted model was a good fit to the data and all paths between latent and indicator variables were significant. Impulsive responding significantly predicted poor food choice and overeating. No significant relationships emerged between eating-related variables and BMI percentile. Findings from this study extend the existing research in adults and offer a more comprehensive understanding of factors that may contribute to eating behaviours and weight status in teenagers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The effects of team expert choice on group decision-making in collaborative new product development; a pilot study

    NARCIS (Netherlands)

    Hummel, J. Marjan; van Rossum, Wouter; Verkerke, Gijsbertus Jacob; Rakhorst, G.

    2000-01-01

    This study analyses the effects of Team Expert Choice on group decision-making in collaborative new product development. We applied Team Expert Choice to support a product evaluation conducted by a new product development group composed of professionally diverse members. The evaluation resulted in

  15. Survival or Mortality : Does Risk Attribute Framing Influence Decision-Making Behavior in a Discrete Choice Experiment?

    NARCIS (Netherlands)

    Veldwijk, Jorien; Essers, Brigitte A B; Lambooij, Mattijs S; Dirksen, Carmen D; Smit, Henriette A; de Wit, G Ardine

    2016-01-01

    OBJECTIVE: To test how attribute framing in a discrete choice experiment (DCE) affects respondents' decision-making behavior and their preferences. METHODS: Two versions of a DCE questionnaire containing nine choice tasks were distributed among a representative sample of the Dutch population aged 55

  16. Risk and uncertainty: shifting decision making for aneuploidy screening to the first trimester of pregnancy.

    Science.gov (United States)

    Farrell, Ruth M; Dolgin, Natasha; Flocke, Susan A; Winbush, Victoria; Mercer, Mary Beth; Simon, Christian

    2011-05-01

    The clinical introduction of first trimester aneuploidy screening uniquely challenges the informed consent process for both patients and providers. This study investigated key aspects of the decision-making process for this new form of prenatal genetic screening. Qualitative data were collected by nine focus groups that comprised women of different reproductive histories (N = 46 participants). Discussions explored themes regarding patient decision making for first trimester aneuploidy screening. Sessions were audio recorded, transcribed, coded, and analyzed to identify themes. Multiple levels of uncertainty characterize the decision-making process for first trimester aneuploidy screening. Baseline levels of uncertainty existed for participants in the context of an early pregnancy and the debate about the benefit of fetal genetic testing in general. Additional sources of uncertainty during the decision-making process were generated from weighing the advantages and disadvantages of initiating screening in the first trimester as opposed to waiting until the second. Questions of the quality and quantity of information and the perceived benefit of earlier access to fetal information were leading themes. Barriers to access prenatal care in early pregnancy presented participants with additional concerns about the ability to make informed decisions about prenatal genetic testing. The option of the first trimester aneuploidy screening test in early pregnancy generates decision-making uncertainty that can interfere with the informed consent process. Mechanisms must be developed to facilitate informed decision making for this new form of prenatal genetic screening.

  17. Drivers’ decision-making when attempting to cross an intersection results from choice between affordances

    Directory of Open Access Journals (Sweden)

    Geoffrey eMARTI

    2015-01-01

    Full Text Available In theory, a safe approach to an intersection implies that the driver can simultaneously manage two scenarios: they either cross or they must give way to an oncoming vehicle. In this article we formalize the critical time for safe crossing (CTcross and the critical time for safe stopping (CTstop to represent crossing and stopping possibilities, respectively. We describe these critical times in terms of affordances and empirically test their respective contribution to the driver’s decision-making process. Using a driving simulator, three groups of participants drove cars with identical acceleration capabilities and different braking capabilities. They were asked to try to cross an intersection where there was an oncoming vehicle, if they deemed the maneuver to be safe. If not, they could decide to stop or, as a last resort, make an emergency exit. The intersections were identical among groups.Results showed that although the crossing possibilities (CTcross were the same for all groups, there were between-group differences in crossing frequency. This suggests that stopping possibilities (CTstop play a role in the driver’s decision-making process, in addition to the crossing possibilities. These results can be accounted for by a behavioral model of decision making, and provide support for the hypothesis of choice between affordances.

  18. Attention and choice: a review on eye movements in decision making.

    Science.gov (United States)

    Orquin, Jacob L; Mueller Loose, Simone

    2013-09-01

    This paper reviews studies on eye movements in decision making, and compares their observations to theoretical predictions concerning the role of attention in decision making. Four decision theories are examined: rational models, bounded rationality, evidence accumulation, and parallel constraint satisfaction models. Although most theories were confirmed with regard to certain predictions, none of the theories adequately accounted for the role of attention during decision making. Several observations emerged concerning the drivers and down-stream effects of attention on choice, suggesting that attention processes plays an active role in constructing decisions. So far, decision theories have largely ignored the constructive role of attention by assuming that it is entirely determined by heuristics, or that it consists of stochastic information sampling. The empirical observations reveal that these assumptions are implausible, and that more accurate assumptions could have been made based on prior attention and eye movement research. Future decision making research would benefit from greater integration with attention research. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Making pragmatic choices: women’s experiences of delivery care in Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Gebrehiwot Tesfay

    2012-10-01

    Full Text Available Abstract Background In 2003, the Ethiopian Ministry of Health launched the Health Extension Programme (HEP, which was intended to increase access to reproductive health care. Despite enormous effort, utilization of maternal health services remains limited, and the reasons for the low utilization of the services offered through the HEP previously have not been explored in depth. This study explores women’s experiences and perceptions regarding delivery care in Tigray, a northern region of Ethiopia, and enables us to make suggestions for better implementation of maternal health care services in this setting. Methods We used six focus group discussions with 51 women to explore perceptions and experiences regarding delivery care. The data were analysed by means of grounded theory. Results One core category emerged, ‘making pragmatic choices’, which connected the categories ‘aiming for safer deliveries’, ‘embedded in tradition’, and ‘medical knowledge under constrained circumstances’. In this setting, women – aiming for safer deliveries – made choices pragmatically between the two available models of childbirth. On the one hand, choice of home delivery, represented by the category ‘embedded in tradition’, was related to their faith, the ascendancy of elderly women, the advantages of staying at home and the custom of traditional birth attendants (TBAs. On the other, institutional delivery, represented by the category ‘medical knowledge under constrained circumstances’, and linked to how women appreciated medical resources and the support of health extension workers (HEWs but were uncertain about the quality of care, emphasized the barriers to transportation. In Tigray women made choices pragmatically and seemed to not feel any conflict between the two available models, being supported by traditional birth attendants, HEWs and husbands in their decision-making. Representatives of the two models were not as open to

  20. Value for money or making the healthy choice: the impact of proportional pricing on consumers' portion size choices.

    Science.gov (United States)

    Vermeer, Willemijn M; Alting, Esther; Steenhuis, Ingrid H M; Seidell, Jacob C

    2010-02-01

    Large food portion sizes are determinants of a high caloric intake, especially if they have been made attractive through value size pricing (i.e. lower unit prices for large than for small portion sizes). The purpose of the two questionnaire studies that are reported in this article was to assess the impact of proportional pricing (i.e. removing beneficial prices for large sizes) on people's portion size choices of high caloric food and drink items. Both studies employed an experimental design with a proportional pricing condition and a value size pricing condition. Study 1 was conducted in a fast food restaurant (N = 150) and study 2 in a worksite cafeteria (N = 141). Three different food products (i.e. soft drink, chicken nuggets in study 1 and a hot meal in study 2) with corresponding prices were displayed on pictures in the questionnaire. Outcome measures were consumers' intended portion size choices. No main effects of pricing were found. However, confronted with proportional pricing a trend was found for overweight fast food restaurant visitors being more likely to choose small portion sizes of chicken nuggets (OR = 4.31, P = 0.07) and less likely to choose large soft drink sizes (OR = 0.07, P = 0.04). Among a general public, proportional pricing did not reduce consumers' size choices. However, pricing strategies can help overweight and obese consumers selecting appropriate portion sizes of soft drink and high caloric snacks. More research in realistic settings with actual behaviour as outcome measure is required.

  1. What would Batman eat?: priming children to make healthier fast food choices.

    Science.gov (United States)

    Wansink, B; Shimizu, M; Camps, G

    2012-04-01

    Fast food patronage is a frequent reality for many children and their parents. Although there are increasingly healthier alternatives for popular menu items (apple slices instead of French fries), they are infrequently selected. We investigated whether either of two priming tactics - the priming of a role model's food choices or the priming of healthy foods - could influence children to make healthier fast food choices. In the priming model condition, 22 children (ranging in age from 6 to 12 years) were presented with 12 photos of 6 admirable and 6 less admirable models and asked, 'Would this person order apple fries or French fries?' In the health prime condition, the same children were shown 12 photos of 6 healthy foods and 6 less healthy foods and asked to indicate if each food was healthy or unhealthy. When children were asked what various admirable people - such as Batman or Spiderman - would eat, 45% chose apple slices over French fries, which was higher than the health prime (P < 0.001) or the control condition (P < 0.001). Advising a parent to ask their child 'What would Batman (or another admired character or person) eat?' might be an easy step to take in what could be a healthier fast food world. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  2. Insights from triangulation of two purchase choice elicitation methods to predict social decision making in healthcare.

    Science.gov (United States)

    Whitty, Jennifer A; Rundle-Thiele, Sharyn R; Scuffham, Paul A

    2012-03-01

    Discrete choice experiments (DCEs) and the Juster scale are accepted methods for the prediction of individual purchase probabilities. Nevertheless, these methods have seldom been applied to a social decision-making context. To gain an overview of social decisions for a decision-making population through data triangulation, these two methods were used to understand purchase probability in a social decision-making context. We report an exploratory social decision-making study of pharmaceutical subsidy in Australia. A DCE and selected Juster scale profiles were presented to current and past members of the Australian Pharmaceutical Benefits Advisory Committee and its Economic Subcommittee. Across 66 observations derived from 11 respondents for 6 different pharmaceutical profiles, there was a small overall median difference of 0.024 in the predicted probability of public subsidy (p = 0.003), with the Juster scale predicting the higher likelihood. While consistency was observed at the extremes of the probability scale, the funding probability differed over the mid-range of profiles. There was larger variability in the DCE than Juster predictions within each individual respondent, suggesting the DCE is better able to discriminate between profiles. However, large variation was observed between individuals in the Juster scale but not DCE predictions. It is important to use multiple methods to obtain a complete picture of the probability of purchase or public subsidy in a social decision-making context until further research can elaborate on our findings. This exploratory analysis supports the suggestion that the mixed logit model, which was used for the DCE analysis, may fail to adequately account for preference heterogeneity in some contexts.

  3. Simon`s Puzzle: Heuristics in the Process of Making Political Choices

    Directory of Open Access Journals (Sweden)

    Mateusz Wajzer

    2014-07-01

    Full Text Available In this article we analyse one of the most fascinating paradoxes of mass politics. Based on the data from the studies of neurobiologists, neurologists, social psychology, cognitive and evolution studies we answer the question specified in literature as the Simon’s puzzle: How is it possible that citizens have their opinions about politics, if they know so little about it? We began our analysis from the criticism of the economic rationality approach. To do this, we referred to the Allais paradox, cognitive dissonance theory, Ellsberg paradox, the concept of bounded rationality, conjunction fallacy and prospect theory. Next, we described the evolutionary processes shaping the minds of Homo sapiens and characterised cognitive mechanisms, thanks to which people can make political choices, especially in view of the shortage of time and information. The following heuristics are referred to herein: affect, recognition, judgment and imitation.

  4. Decision making and counseling around mammography screening for women aged 80 or older.

    Science.gov (United States)

    Schonberg, Mara A; Ramanan, Radhika A; McCarthy, Ellen P; Marcantonio, Edward R

    2006-09-01

    Despite uncertain benefit, many women over age 80 (oldest-old) receive screening mammography. To explore decision-making and physician counseling of oldest-old women around mammography screening. Qualitative research using in-depth semi-structured interviews. Twenty-three women aged 80 or older who received care at a large academic primary care practice (13 had undergone mammography screening in the past 2 years) and 16 physicians at the same center. We asked patients and physicians to describe factors influencing mammography screening decisions of oldest-old women. We asked physicians to describe their counseling about screening to the oldest-old. Patients and/or physicians identified the importance of physician influence, patient preferences, system factors, and social influences on screening decisions. Although physicians felt that patient's health affected screening decisions, few patients felt that health mattered. Three types of elderly patients were identified: (1) women enthusiastic about screening mammography; (2) women opposed to screening mammography; and (3) women without a preference who followed their physician's recommendation. However, physician counseling about mammography screening to elderly women varies; some individualize discussions; others encourage screening; few discourage screening. Physicians report that discussions about stopping screening can be uncomfortable and time consuming. Physicians suggest that more data could facilitate these discussions. Some oldest-old women have strong opinions about screening mammography while others are influenced by physicians. Discussions about stopping screening are challenging for physicians. More data about the benefits and risks of mammography screening for women aged 80 or older could inform patients and improve provider counseling to lead to more rational use of mammography.

  5. [Cancer screening in clinical practice: the value of shared decision-making].

    Science.gov (United States)

    Cornuz, Jacques; Junod, Noëlle; Pasche, Olivier; Guessous, Idris

    2010-07-14

    Shared decision-making approach to uncertain clinical situations such as cancer screening seems more appropriate than ever. Shared decision making can be defined as an interactive process where physician and patient share all the stages of the decision making process. For patients who wish to be implicated in the management of their health conditions, physicians might express difficulty to do so. Use of patient decision aids appears to improve such process of shared decision making.

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

    Science.gov (United States)

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

    2016-07-01

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

  7. Social value and individual choice: The value of a choice-based decision-making process in a collectively funded health system.

    Science.gov (United States)

    Espinoza, Manuel Antonio; Manca, Andrea; Claxton, Karl; Sculpher, Mark

    2018-02-01

    Evidence about cost-effectiveness is increasingly being used to inform decisions about the funding of new technologies that are usually implemented as guidelines from centralized decision-making bodies. However, there is also an increasing recognition for the role of patients in determining their preferred treatment option. This paper presents a method to estimate the value of implementing a choice-based decision process using the cost-effectiveness analysis toolbox. This value is estimated for 3 alternative scenarios. First, it compares centralized decisions, based on population average cost-effectiveness, against a decision process based on patient choice. Second, it compares centralized decision based on patients' subgroups versus an individual choice-based decision process. Third, it compares a centralized process based on average cost-effectiveness against a choice-based process where patients choose according to a different measure of outcome to that used by the centralized decision maker. The methods are applied to a case study for the management of acute coronary syndrome. It is concluded that implementing a choice-based process of treatment allocation may be an option in collectively funded health systems. However, its value will depend on the specific health problem and the social values considered relevant to the health system. Copyright © 2017 John Wiley & Sons, Ltd.

  8. Women's Benefits and Harms Trade-Offs in Breast Cancer Screening: Results from a Discrete-Choice Experiment.

    Science.gov (United States)

    Sicsic, Jonathan; Pelletier-Fleury, Nathalie; Moumjid, Nora

    2018-01-01

    Over the past decade, the benefits and harms balance of breast cancer (BC) screening has been widely debated. To elicit women's trade-offs between the benefits and harms of BC screening and to analyze the main determinants of these trade-offs. A discrete-choice experiment with seven attributes depicting BC screening programs including varying levels of BC mortality, overdiagnosis, and false-positive result was used. Eight hundred twelve women aged 40 to 74 years with no personal history of BC recruited by a survey institute and representative of the French general population (age, socioeconomic level, and geographical location) completed the discrete-choice experiment. Preference heterogeneity was investigated using generalized multinomial logit models from which individual trade-offs were derived, and their main determinants were assessed using generalized linear models. Screening acceptance rates under various benefits and harms ratios were simulated on the basis of the distribution of individual preferences. The women would be willing to accept on average 14.1 overdiagnosis cases (median = 9.6) and 47.8 false-positive results (median = 27.2) to avoid one BC-related death. After accounting for preference heterogeneity, less than 50% of women would be willing to accept 10 overdiagnosis cases for one BC-related death avoided. Screening acceptance rates were higher among women with higher socioeconomic level and lower among women with poor health. Women are sensitive to both the benefits and the harms of BC screening and their preferences are highly heterogeneous. Our study provides useful results for public health authorities and clinicians willing to improve their recommendations of BC screening on the basis of women's preferences. Copyright © 2018 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  9. Ethnic differences in informed decision-making about prenatal screening for Down's syndrome

    NARCIS (Netherlands)

    Fransen, Mirjam P.; Essink-Bot, Marie-Louise; Vogel, Ineke; Mackenbach, Johan P.; Steegers, Eric A. P.; Wildschut, Hajo I. J.

    2010-01-01

    BACKGROUND: The aim of this study was to assess ethnic variations in informed decision-making about prenatal screening for Down's syndrome and to examine the contribution of background and decision-making variables. METHODS: Pregnant women of Dutch, Turkish and Surinamese origin were recruited

  10. "You have to be careful who you talk to and what you say …" - on psychosis and making rational choices.

    Science.gov (United States)

    Topor, Alain; Di Girolamo, Simonetta

    2010-12-01

    People who have been diagnosed with schizophrenia are regarded as being no longer capable of making rational choices. Fifteen users with psychosis diagnosis participated to 10 focus group sessions about different aspects of everyday life. The discussions were tape recorded and the transcript analyzed using a grounded theory inspired methodology. A core category that emerged was making choices in crises situations. Users have to choose whether or not they want help, to whom to turn for help, and how to describe their problems so as to get the kind of help they seek. The choices were based on past experiences in connection with the choices available. They were constantly making quality judgements of the care workers they came into contact with. Experiencing a sense of comradeship emerged as a vital criterion. The ability to make rational choices often existed parallel with hallucinations and delusions. This ability could form the basis for a true collaboration between users and professionals. The findings of this study indicate that such collaboration is possible, but that it requires a reassessment of our traditional knowledge base.

  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. Color Choice is Everything - Impacts Color makes to the Lighting Environment

    Science.gov (United States)

    Clark, Toni A.

    2012-01-01

    When contracts are let out to design multiple systems in a vehicle, it is a challenge to maintain integration between system leads. Designers on niche systems, like lighting and control panel design, often get caught up in the challenge of designing the light source or visual interface and fail to include time in their schedule to work with system architects on how their lighting system will be integrated. Additionally, behavioral scientists, industrial designers, and materials engineers get caught up with the materials and look of the system, but often fail to consider how the selection of their materials could affect the certification or performance of electronic devices like lighting systems. Additionally, computer modeling of the system architecture often assumes a perfect environment without the clutter of actual human use (dirt, stowage, crowding). As a result, lighting systems, and backlit displays run the risk of being overdesigned or under designed. Engineers making the assumption that because they have no input or there is no requirement on work surface reflectance, make the assumption that they can t count on good material choices and thus may install more lighting than is necessary. While having more lights may seem better, for a vehicle that is trying to conserve power, more lights may not be a good option. On the other hand, designers who made the opposite assumption and designed a lighting system that only produced just enough light, often wind up with a system that did conserve power, but didn t produce enough light. These situations are exasperated when the system starts to be used and the models are not perfect anymore. The lack of coordination and iterative design not only can impact lighting levels within an environment, but also can affect color perception. This is because, if materials do not represent a gradation of white or black, the material unevenly absorbs and reflects light at different wavelengths of the visual spectrum. The lighting

  13. The Benefits of Single-Touch Screens in Intersubjective Meaning Making

    DEFF Research Database (Denmark)

    Davidsen, Jacob; Christiansen, Ellen Tove

    2013-01-01

    the possibilities for equal levels of verbal and physical participation.Additionally, these studies suggest that multi-touch technologies offer more task-oriented activities compared to single-touch screen interaction, in which discussion about turn-taking is more prevalent from the outset. In contrast, applying......What are the benefits of single-touch screens? The paper presents findings of one video extract from ten months of observation of single-touch screen interaction among 8-9 year-old children. Recent studies of collaborative learning mediated by digital touch screens and tabletops emphasize...... the Embodied Interaction Analysis, we find that the constraints of single-touch screens offer support for intersubjective meaning making in their capacity of constraining the interaction. This “grain of sand” shows how children display and construct a shared work space through embodied interaction...

  14. The Choice of Screening Instrument Matters: The Case of Problematic Cannabis Use Screening in Spanish Population of Adolescents

    Science.gov (United States)

    Domingo-Salvany, Antónia; Barrio Anta, Gregorio; Sánchez Mañez, Amparo; Llorens Aleixandre, Noelia; Brime Beteta, Begoña; Vicente, Julián

    2013-01-01

    The aim of this study was to examine the feasibility of problem cannabis use screening instruments administration within wide school surveys, their psychometric properties, overlaps, and relationships with other variables. Students from 7 Spanish regions, aged 14–18, who attended secondary schools were sampled by two-stage cluster sampling (net sample 14,589). Standardized, anonymous questionnaire including DSM-IV cannabis abuse criteria, Cannabis Abuse Screening Test (CAST), and Severity of Dependence Scale (SDS) was self-completed with paper and pencil in the selected classrooms. Data was analysed using classical psychometric theory, bivariate tests, and multinomial logistic regression analysis. Not responding to instruments' items (10.5–12.3%) was associated with reporting less frequent cannabis use. The instruments overlapped partially, with 16.1% of positives being positive on all three. SDS was more likely to identify younger users with lower frequency of use who thought habitual cannabis use posed a considerable problem. CAST positivity was associated with frequent cannabis use and related problems. It is feasible to use short psychometric scales in wide school surveys, but one must carefully choose the screening instrument, as different instruments identify different groups of users. These may correspond to different types of problematic cannabis use; however, measurement bias seems to play a role too. PMID:25969832

  15. Who Makes the Choice? Rethinking the Role of Autonomy and Relatedness in Chinese Children's Motivation

    Science.gov (United States)

    Bao, Xue-Hua; Lam, Shui-Fong

    2008-01-01

    The importance of autonomy for children's motivation in collectivistic cultures has been debated hotly. With the understanding that autonomy is not equivalent to freedom of choice, 4 studies addressed this debate by investigating how socioemotional relatedness, choice, and autonomy were related to Chinese children's motivation. Study 1 (N = 56,…

  16. Making Sustainable Energy Choices: Insights on the Energy/Water/Land Nexus

    Energy Technology Data Exchange (ETDEWEB)

    2014-10-01

    This periodic publication summarizes insights from the body of NREL analysis work. In this issue of Analysis Insights, we examine the implications of our energy choices on water, land use, climate, developmental goals, and other factors. Collectively, NREL's work helps policymakers and investors understand and evaluate energy choices within the complex web of connections, or nexus, between energy, water, and land.

  17. Risk Stratification and Shared Decision Making for Colorectal Cancer Screening: A Randomized Controlled Trial.

    Science.gov (United States)

    Schroy, Paul C; Duhovic, Emir; Chen, Clara A; Heeren, Timothy C; Lopez, William; Apodaca, Danielle L; Wong, John B

    2016-05-01

    Eliciting patient preferences within the context of shared decision making has been advocated for colorectal cancer (CRC) screening, yet providers often fail to comply with patient preferences that differ from their own. To determine whether risk stratification for advanced colorectal neoplasia (ACN) influences provider willingness to comply with patient preferences when selecting a desired CRC screening option. Randomized controlled trial. Asymptomatic, average-risk patients due for CRC screening in an urban safety net health care setting. Patients were randomized 1:1 to a decision aid alone (n= 168) or decision aid plus risk assessment (n= 173) arm between September 2012 and September 2014. The primary outcome was concordance between patient preference and test ordered; secondary outcomes included patient satisfaction with the decision-making process, screening intentions, test completion rates, and provider satisfaction. Although providers perceived risk stratification to be useful in selecting an appropriate screening test for their average-risk patients, no significant differences in concordance were observed between the decision aid alone and decision aid plus risk assessment groups (88.1% v. 85.0%,P= 0.40) or high- and low-risk groups (84.5% v. 87.1%,P= 0.51). Concordance was highest for colonoscopy and relatively low for tests other than colonoscopy, regardless of study arm or risk group. Failure to comply with patient preferences was negatively associated with satisfaction with the decision-making process, screening intentions, and test completion rates. Single-institution setting; lack of provider education about the utility of risk stratification into their decision making. Providers perceived risk stratification to be useful in their decision making but often failed to comply with patient preferences for tests other than colonoscopy, even among those deemed to be at low risk of ACN. © The Author(s) 2016.

  18. Decision-making and cancer screening: a qualitative study of older adults with multiple chronic conditions.

    Science.gov (United States)

    Gross, Cary P; Fried, Terri R; Tinetti, Mary E; Ross, Joseph S; Genao, Inginia; Hossain, Sabina; Wolf, Elizabeth; Lewis, Carmen L

    2015-03-01

    To understand how older persons with multiple chronic conditions (MCC) approach decisions about cancer screening. We conducted interviews with adults >65 years old with at least two chronic conditions who were taking ≥five medications daily. Patients were first asked how age and multimorbidity influence their cancer screening decisions. After showing them an educational prompt that explained the relationship between life expectancy and the benefits of cancer screening, respondents were then asked about screening in the context of specific health scenarios. Using grounded theory, three independent readers coded responses for salient themes. Sample size was determined by thematic saturation. Most respondents (26 of 28) initially indicated that their overall health or medical conditions do not influence their cancer screening decisions. After viewing the educational prompt, respondents described two broad approaches to cancer screening in the setting of increasing age or multi-morbidity. The first was a "benefits versus harms" approach in which participants weighed direct health benefits (e.g. reducing cancer incidence or mortality) and harms (e.g. complications or inconvenience). The second was a heuristic approach. Some heuristics favored screening, such as a persistent belief in unspecified benefits from screening, value of knowledge about cancer status, and not wanting to "give up", whereas other heuristics discouraged screening, such as fatalism or a reluctance to learn about their cancer status. When considering cancer screening, some older persons with MCC employ heuristics which circumvent the traditional quantitative comparison of risks and benefits, providing an important challenge to informed decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Lessons Learned From A Study Of Genomics-Based Carrier Screening For Reproductive Decision Making.

    Science.gov (United States)

    Wilfond, Benjamin S; Kauffman, Tia L; Jarvik, Gail P; Reiss, Jacob A; Richards, C Sue; McMullen, Carmit; Gilmore, Marian; Himes, Patricia; Kraft, Stephanie A; Porter, Kathryn M; Schneider, Jennifer L; Punj, Sumit; Leo, Michael C; Dickerson, John F; Lynch, Frances L; Clarke, Elizabeth; Rope, Alan F; Lutz, Kevin; Goddard, Katrina A B

    2018-05-01

    Genomics-based carrier screening is one of many opportunities to use genomic information to inform medical decision making, but clinicians, health care delivery systems, and payers need to determine whether to offer screening and how to do so in an efficient, ethical way. To shed light on this issue, we conducted a study in the period 2014-17 to inform the design of clinical screening programs and guide further health services research. Many of our results have been published elsewhere; this article summarizes the lessons we learned from that study and offers policy insights. Our experience can inform understanding of the potential impact of expanded carrier screening services on health system workflows and workforces-impacts that depend on the details of the screening approach. We found limited patient or health system harms from expanded screening. We also found that some patients valued the information they learned from the process. Future policy discussions should consider the value of offering such expanded carrier screening in health delivery systems with limited resources.

  20. The dynamics of decision making in risky choice: An Eye-tracking Analysis

    OpenAIRE

    Susann eFiedler; Andreas eGlöckner

    2012-01-01

    In the last years, research on risky choice has moved beyond analyzing choices only. Models have been suggested that aim to describe the underlying cognitive processes and some studies have tested process predictions of these models. Prominent approaches are evidence accumulation models such as decision field theory (DFT), simple serial heuristic models such as the adaptive toolbox, and connectionist approaches such as the parallel constraint satisfaction (PCS) model. In two studies involving...

  1. Thermodynamic view on decision-making process: emotions as a potential power vector of realization of the choice.

    Science.gov (United States)

    Pakhomov, Anton; Sudin, Natalya

    2013-12-01

    This research is devoted to possible mechanisms of decision-making in frames of thermodynamic principles. It is also shown that the decision-making system in reply to emotion includes vector component which seems to be often a necessary condition to transfer system from one state to another. The phases of decision-making system can be described as supposed to be nonequilibrium and irreversible to which thermodynamics laws are applied. The mathematical model of a decision choice, proceeding from principles of the nonlinear dynamics considering instability of movement and bifurcation is offered. The thermodynamic component of decision-making process on the basis of vector transfer of energy induced by emotion at the given time is surveyed. It is proposed a three-modular model of decision making based on principles of thermodynamics. Here it is suggested that at entropy impact due to effect of emotion, on the closed system-the human brain,-initially arises chaos, then after fluctuations of possible alternatives which were going on-reactions of brain zones in reply to external influence, an order is forming and there is choice of alternatives, according to primary entrance conditions and a state of the closed system. Entropy calculation of a choice expectation of negative and positive emotion shows judgment possibility of existence of "the law of emotion conservation" in accordance with several experimental data.

  2. What does the new breed of decision-making methodologies mean for choices and norms in hydrological science?

    Science.gov (United States)

    Wikman-Svahn, Per

    2013-04-01

    Hydrological sciences are increasingly utilized in decision-making contexts that need to manage deep uncertainty, changing conditions and very long-lead times and lifetimes. Traditional optimizing approaches become problematic in such situations. For example, optimizing approaches may underestimate the importance of low probability outcomes, or very uncertain outcomes. Alternative decision-making strategies are therefore increasingly used in hydrological applications, including "bottom-up/top-down", "context-first", "decision-scaling", "assess risk of policy", "robust", "resilient" or "flexible" approaches. These kinds of strategies are typically designed to handle very uncertain and diverse outcomes, and often start from the particular decision-making context, in contrast to more traditional "predict-then-act" or "science first" approaches. Contemporary research in philosophy of science stress the influence of value judgments and norms in scientific assessments. In particular, this literature points out that implicit anticipated applications often influence choices made in scientific assessments. Furthermore, this literature also emphasize that choices made at within scientific assessments have consequences for decision-making later on. One reason is that it is often difficult for decision-makers to see what choices are made and the implications of these choices. Another reason is that information that could be of use for decision-makers are lost at an early stage. For example, the choice to focus on central estimates and not providing assessments on more unlikely outcomes is a choice that has consequences for what outcomes are taken into account in the decision-making process. This paper develops this argument and then analyzes the implications of these new developments for hydrological science. One implication of the increasing use of the new breed of planning strategies is that a broader range of uncertainty in scientific assessments becomes desirable in order

  3. Breast cancer screening (BCS) chart: a basic and preliminary model for making screening mammography more productive and efficient.

    Science.gov (United States)

    Poorolajal, Jalal; Akbari, Mohammad Esmaeil; Ziaee, Fatane; Karami, Manoochehr; Ghoncheh, Mahshid

    2017-05-15

    The breast cancer screening (BCS) chart is suggested as a basic and preliminary tool to improve efficiency of screening mammography. We conducted this case-control study in 2016 and enrolled 1422 women aged 30-75 years, including 506 women with breast cancer (cases) and 916 women without breast cancer (controls). We developed the BCS chart using a multiple logistic regression analysis. We combined the risks of breast cancer to predict the individual risk of breast cancer. Then, we stratified and colored the predicted risk probabilities as follows: green), 05-09% (yellow), 10-14% (orange), 15-19% (red), 20-24% (brown) and ≥25% (black). The BCS chart provides the risk probability of breast cancer, based on age, body mass index, late menopause, having a benign breast disease and a positive family history of breast cancer among the first-degree or the second/third-degree relatives. According to this chart, an individual can be classified in a category of low risk (green), medium risk (yellow and orange), high risk (red and brown) and very high risk (black) for breast cancer. This chart is a flexible and easy to use tool that can detect high-risk subjects and make the screening program more efficient and productive. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  4. Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study.

    Science.gov (United States)

    Emmert, Martin; Meier, Florian; Pisch, Frank; Sander, Uwe

    2013-08-28

    Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be

  5. Physician trainees' decision making and information processing: choice size and Medicare Part D.

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv; Martynenko, Melissa; Wood, Stacey; Rice, Thomas; Federman, Alex D

    2013-01-01

    Many patients expect their doctor to help them choose a Medicare prescription drug plan. Whether the size of the choice set affects clinicians' decision processes and strategy selection, and the quality of their choice, as it does their older patients, is an important question with serious financial consequences. Seventy medical students and internal medicine residents completed a within-subject design using Mouselab, a computer program that allows the information-acquisition process to be examined. We examined highly numerate physician trainees' decision processes, strategy, and their ability to pick the cheapest drug plan-as price was deemed the most important factor in Medicare beneficiaries' plan choice-from either 3 or 9 drug plans. Before adjustment, participants were significantly more likely to identify the lowest cost plan when facing three versus nine choices (67.3% vs. 32.8%, pinformation on each attribute (pdecision strategies focusing on comparing alternate plans across a single attribute (search pattern, pdecision process and strategy, numeracy, and amount of medical training, the odds were 10.75 times higher that trainees would choose the lowest cost Medicare Part D drug plan when facing 3 versus 9 drug plans (pdecision environment are needed and suggest physicians' role in their patients' Part D choices may be most productive when assisting seniors with forecasting their expected medication needs and then referring them to the Medicare website or helpline.

  6. The decision-making capacity of elderly hospitalized patients: validation of a test on their choice of return home.

    Science.gov (United States)

    Romdhani, Mouna; Abbas, Rachid; Peyneau, Cécile; Koskas, Pierre; Houenou Quenum, Nadège; Galleron, Sandrine; Drunat, Olivier

    2018-03-01

    Elderly hospitalized patients have uncertain or questionable capacity to make decisions about their care. Determining whether an elderly patient possesses decision-making capacity to return at home is a major concern for geriatricians in everyday practice. To construct and internally validate a new tool, the dream of home test (DROM-test), as support for decision making hospitalization discharge destination for the elderly in the acute or sub-acute care setting. The DROM-test consists of 10 questions and 4 vignettes based upon the 4 relevant criteria for decision-making: capacity to understand information, to appreciate and reason about medical risks and to communicate a choice. A prospective observational study was conducted during 6 months in 2 geriatric care units in Bretonneau Hospital (Assistance publique, Hôpitaux de Paris). We compared the patient decision of DROM-test regarding discharge recommendations with those of an Expert committee and of the team in charge of the patient. 102 were included: mean age 83.1 + 6.7 [70; 97], 66.67% females. Principal components analysis revealed four dimensions: choice, understanding, reasoning and understanding. The area under the ROC curve was 0.64 for the choice dimension, 0.59 for the understanding, 0.53 for the reasoning and 0.52 for the apprehension. Only the choice dimension was statistically associated with the decision of the committee of experts (p=0.017). Even though Drom-test has limitations, it provides an objective way to ascertain decision-making capacity for hospitalised elderly patients.

  7. Why women of lower educational attainment struggle to make healthier food choices

    DEFF Research Database (Denmark)

    Lawrence, Wendy; Skinner, Chas; Haslam, Cheryl

    2009-01-01

    Women of lower educational attainment are more likely to eat unhealthy diets than women of higher educational attainment. To identify influences on the food choices of women with lower educational attainment, 11 focus groups (eight with women of lower, and three with women of higher educational...... attainment) were held. Using a semi-structured discussion guide, environmental, social, historical and psychological factors known to be associated with food choice were explored. Audio recordings were transcribed verbatim and thematically analysed. Compared to women of higher educational attainment, women...... of lower educational attainment had less control over their families' food choices, less support for attempts to eat healthily, fewer opportunities to observe and learn good food-related practices, more negative affect, more perceived environmental constraints and more ambiguous beliefs about...

  8. Does fertility status influence impulsivity and risk taking in human females? Adaptive influences on intertemporal choice and risky decision making.

    Science.gov (United States)

    Kaighobadi, Farnaz; Stevens, Jeffrey R

    2013-07-18

    Informed by the research on adaptive decision making in other animal species, this study investigated human females' intertemporal and risky choices across the ovulatory cycle. We tested the hypothesis that at peak fertility, women who are exposed to environments that signal availability of higher quality mates (by viewing images of attractive males), become more impulsive and risk-seeking in economic decision tasks. To test this, we collected intertemporal and risky choice measures before and after exposure to images of either attractive males or neutral landscapes both at peak and low fertility conditions. The results showed an interaction between women's fertility status and image type, such that women at peak fertility viewing images of attractive men chose the smaller, sooner monetary reward option less than women at peak fertility viewing neutral images. Neither fertility status nor image type influenced risky choice. Thus, though exposure to images of men altered intertemporal choices at peak fertility, this occurred in the opposite direction than predicted--i.e., women at peak fertility became less impulsive. Nevertheless, the results of the current study provide evidence for shifts in preferences over the ovulatory cycle and opens future research on economic decision making.

  9. Does Fertility Status Influence Impulsivity and Risk Taking in Human Females? Adaptive Influences on Intertemporal Choice and Risky Decision Making

    Directory of Open Access Journals (Sweden)

    Farnaz Kaighobadi

    2013-07-01

    Full Text Available Informed by the research on adaptive decision making in other animal species, this study investigated human females' intertemporal and risky choices across the ovulatory cycle. We tested the hypothesis that at peak fertility, women who are exposed to environments that signal availability of higher quality mates (by viewing images of attractive males, become more impulsive and risk-seeking in economic decision tasks. To test this, we collected intertemporal and risky choice measures before and after exposure to images of either attractive males or neutral landscapes both at peak and low fertility conditions. The results showed an interaction between women's fertility status and image type, such that women at peak fertility viewing images of attractive men chose the smaller, sooner monetary reward option less than women at peak fertility viewing neutral images. Neither fertility status nor image type influenced risky choice. Thus, though exposure to images of men altered intertemporal choices at peak fertility, this occurred in the opposite direction than predicted—i.e., women at peak fertility became less impulsive. Nevertheless, the results of the current study provide evidence for shifts in preferences over the ovulatory cycle and opens future research on economic decision making.

  10. Memory-Context Effects of Screen Color in Multiple-Choice and Fill-In Tests

    Science.gov (United States)

    Prestera, Gustavo E.; Clariana, Roy; Peck, Andrew

    2005-01-01

    In this experimental study, 44 undergraduates completed five computer-based instructional lessons and either two multiplechoice tests or two fill-in-the-blank tests. Color-coded borders were displayed during the lesson, adjacent to the screen text and illustrations. In the experimental condition, corresponding border colors were shown at posttest.…

  11. Design Choices in a Compiler Course or How to Make Undergraduates Love Formal Notation

    DEFF Research Database (Denmark)

    Schwartzbach, Michael Ignatieff

    2008-01-01

    The undergraduate compiler course offers a unique opportunity to combine many aspects of the Computer Science curriculum. We discuss the many design choices that are available for the instructor and present the current compiler course at the University of Aarhus, the design of which displays at l...

  12. Emotion regulation and risk taking: predicting risky choice in deliberative decision making

    NARCIS (Netherlands)

    Panno, A.; Lauriola, M.; Figner, B.

    2013-01-01

    Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation

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

    Science.gov (United States)

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

    2018-02-21

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

  14. Geographic variation in the intended choice of adjuvant treatments for women diagnosed with screen-detected breast cancer in Queensland.

    Science.gov (United States)

    Hsieh, Jeff Ching-Fu; Cramb, Susanna M; McGree, James M; Dunn, Nathan A M; Baade, Peter D; Mengersen, Kerrie L

    2015-12-02

    Although early diagnosis and improved treatment can reduce breast cancer mortality, there still appears to be a geographic differential in patient outcomes. This study aims to determine and quantify spatial inequalities in intended adjuvant (radio-, chemo- and hormonal) therapy usage among women with screen-detected breast cancer in Queensland, Australia. Linked population-based datasets from BreastScreen Queensland and the Queensland Cancer Registry during 1997-2008 for women aged 40-89 years were used. We adopted a Bayesian shared spatial component model to evaluate the relative intended use of each adjuvant therapy across 478 areas as well as common spatial patterns between treatments. Women living closer to a cancer treatment facility were more likely to intend to use adjuvant therapy. This was particularly marked for radiotherapy when travel time to the closest radiation facility was 4 + h (OR =0.41, 95 % CrI: [0.23, 0.74]) compared to Queensland. Moreover, the presence of residual shared spatial effects indicates that there are other unmeasured geographical barriers influencing women's treatment choices. This highlights the need to identify the additional barriers that impact on treatment intentions among women diagnosed with screen-detected breast cancer, particularly for those women living further away from cancer treatment centers.

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

    Science.gov (United States)

    Fowler, Barbara Ann

    2006-01-01

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

  16. Playful Mobility Choices: Motivating informed mobility decision making by applying game mechanics

    Directory of Open Access Journals (Sweden)

    A. Millonig

    2014-10-01

    Full Text Available Motivating people to change their mobility behaviour patterns towards more sustainable forms of mobility is one of the major challenges regarding climate change and quality of life. Recently, an increasing amount of attempts to use gamification for triggering such behavioural changes can be observed. However, little is known about the actual impact of using game elements. This contribution describes a concept for systematically analysing the group-specific effects of different game mechanics on mobility decision processes (e.g. mode and route choice. Based on theoretical findings concerning player types and mobility styles we developed a framework for identifying effective game mechanics motivating users to explore mobility alternatives and take more informed and more sustainable mode or route choice decisions. The results will form the basis for implementing game mechanics in mobility information services motivating users to explore unfamiliar but more sustainable mobility options.

  17. When good pigeons make bad decisions: Choice with probabilistic delays and outcomes.

    Science.gov (United States)

    Pisklak, Jeffrey M; McDevitt, Margaret A; Dunn, Roger M; Spetch, Marcia L

    2015-11-01

    Pigeons chose between an (optimal) alternative that sometimes provided food after a 10-s delay and other times after a 40-s delay and another (suboptimal) alternative that sometimes provided food after 10 s but other times no food after 40 s. When outcomes were not signaled during the delays, pigeons strongly preferred the optimal alternative. When outcomes were signaled, choices of the suboptimal alternative increased and most pigeons preferred the alternative that provided no food after the long delay despite the cost in terms of obtained food. The pattern of results was similar whether the short delays occurred on 25% or 50% of the trials. Shortening the 40-s delay to food sharply reduced suboptimal choices, but shortening the delay to no food had little effect. The results suggest that a signaled delay to no food does not punish responding in probabilistic choice procedures. The findings are discussed in terms of conditioned reinforcement by signals for good news. © Society for the Experimental Analysis of Behavior.

  18. Shared decision making and patient choice for growth hormone therapy: current perspectives

    Directory of Open Access Journals (Sweden)

    George B

    2016-06-01

    Full Text Available Belinda George, Vageesh Ayyar Department of Endocrinology, St. John’s Medical College Hospital, Bangalore, Karnataka, India Abstract: Growth hormone has now been available in medical practice for close to 50 years. Its use has provided dramatic results in patients with growth hormone deficiency and it is associated with an overall favorable safety profile. Over the years, the utility of growth hormone has expanded to include treatment for short stature associated with conditions other than growth hormone deficiency, and this situation warrants greater involvement of the child and parents in the shared decision-making process. Shared decision making is in good conformance to the principle of informed consent, and it also improves the compliance and adherence to therapy as the patient fully understands the benefit and safety of the treatment. In the pediatric-care setting, the decision-making interactions usually occur between the health care provider, patient, and parents. The process may range from an autonomous decision-making pattern, where the patient or parents are fully responsible for the decision taken, to the paternalistic decision-making pattern, where the health care provider assumes full responsibility for the decision taken. However, the ideal situation is one where a truly shared decision-making process happens, in which the doctor and patient/parents work together to choose an evidence-based option, in line with the patient’s preferences and wishes. The limited data available on shared decision making with regard to growth hormone replacement, however, is not very encouraging and suggests that the actual involvement of the parents as perceived by them is less than optimal. Introduction of a simple structured model for a shared decision-making process that can be easily incorporated into clinical practice and familiarization of health care providers with the same is essential to improve our shared decision-making practices

  19. The Role of Hypertext in Consumer Decision Making. The Case of Travel Destination Choice

    Directory of Open Access Journals (Sweden)

    Raúl Valdez Munoz

    2012-01-01

    Full Text Available Travel is one of the most popular items people tend to be comfortable with purchasing over the Internet. Hypertext is a form of electronic text composed of blocks of words (or images linked electronically by multiple paths, chains, or trails. This study explores the importance of hypertext in the travel destination choice from websites. Results show that hypertext links containing images of destinations, informative texts, and search tools are the three most important features utilized by tourist website browsers. This study aims to offer insights into new areas for further research on tourism websites design, application and evaluation.

  20. Private or salaried practice: how do young general practitioners make their career choice? A qualitative study.

    Science.gov (United States)

    Kinouani, Shérazade; Boukhors, Gary; Luaces, Baptiste; Durieux, William; Cadwallader, Jean-Sébastien; Aubin-Auger, Isabelle; Gay, Bernard

    2016-09-01

    Young French postgraduates in general practice increasingly prefer salaried practice to private practice in spite of the financial incentives offered by the French government or local communities to encourage the latter. This study aimed to explore the determinants of choice between private or salaried practice among young general practitioners. A qualitative study was conducted in the South West of France. Semi-structured interviews of young general practitioners were audio-recorded until data saturation. Recordings were transcribed and then analyzed according to Grounded Theory by three researchers working independently. Sixteen general practitioners participated in this study. For salaried and private doctors, the main factors governing their choice were occupational factors: working conditions, need of varied scope of practice, quality of the doctor-patient relationship or career flexibility. Other factors such as postgraduate training, having worked as a locum or self-interest were also determining. Young general practitioners all expected a work-life balance. The fee-for-service scheme or home visits may have discouraged young general practitioners from choosing private practice. National health policies should increase the attractiveness of ambulatory general practice by promoting the diversification of modes of remuneration and encouraging the organization of group exercises in multidisciplinary medical homes and community health centers.

  1. The rational choice model in family decision making at the end of life.

    Science.gov (United States)

    Karasz, Alison; Sacajiu, Galit; Kogan, Misha; Watkins, Liza

    2010-01-01

    Most end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient's wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families. Researchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques. For both staff and families, consideration of a patient's best interests generally took priority over the patient's wishes. Staff generally introduced discussion of the patient's wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients' autonomy and "right to choose," played a role in family decision making. The priority given to the patients' wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care.

  2. The Choice Project: Peer Workers Promoting Shared Decision Making at a Youth Mental Health Service.

    Science.gov (United States)

    Simmons, Magenta Bender; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deb

    2017-08-01

    In youth mental health services, consumer participation is essential, but few implementation strategies exist to engage young consumers. This project evaluated an intervention implemented in an Australian youth mental health service that utilized peer workers to promote shared decision making via an online tool. All new clients ages 16-25 were invited to participate in this nonrandomized comparative study, which used a historical comparison group (N=80). Intervention participants (N=149) engaged with a peer worker and used the online tool before and during their intake assessment. Pre- and postintake data were collected for both groups; measures included decisional conflict, perceived shared decision making, and satisfaction. A series of paired t tests, analyses of variance, and multiple regressions were conducted to assess differences in scores across intervention and comparison groups and pre- and postintake assessments. Ratings of perceived shared decision making with intake workers were higher in the intervention group than in the comparison group (p=.015). In both groups, decisional conflict scores were significantly lower after the intake assessment (pdecision making and lower decisional conflict were associated with satisfaction (pdecision making reported feeling more involved in their assessment. Feeling involved and having lower decisional conflict after seeing an intake worker were important for client satisfaction. These findings demonstrate the importance of both peer work and shared decision making for promoting optimal outcomes in youth mental health services.

  3. Shared decision making and the concept of equipoise: the competences of involving patients in healthcare choices.

    Science.gov (United States)

    Elwyn, G; Edwards, A; Kinnersley, P; Grol, R

    2000-11-01

    Involving patients in healthcare decisions makes a potentially significant and enduring difference to healthcare outcomes. One difficulty (among many) is that the 'involvement' of patients in decisions has been left undefined. It is usually conceptualised as 'patient centredness', which is a broad and variably interpreted concept that is difficult to assess using current tools. This paper attempts to gauge general practitioners' (GPs') attitudes to patient involvement in decision making and their views about the contextual factors, competences, and stages required to achieve shared decisions within consultations. To explore and understand what constitutes the appropriate involvement of patients in decision making within consultations, to consider previous theory in this field, and to propose a set of competences (skills) and steps that would enable clinical practitioners (generalists) to undertake 'shared decision making' in their clinical environment. Qualitative study using focus group interviews of key informants. Experienced GPs with educational roles have positive attitudes to the involvement of patients in decisions, provided the process matches the role individuals wish to play. They perceive some clinical problems as being more suited to a cooperative approach to decision making and conceptualised the existence of professional equipoise towards the existence of legitimate treatment options as an important facilitative factor. A sequence of skills was proposed as follows: 1) implicit or explicit involvement of patients in the decision-making process; 2) explore ideas, fears, and expectations of the problem and possible treatments; 3) portrayal of equipoise and options; 4) identify preferred data format and provide tailor-made information; 5) checking process: understanding of information and reactions (e.g. ideas, fears, and expectations of possible options); 6) acceptance of process and decision making role preference; 7) make, discuss or defer decisions; 8

  4. The choice among non-callable bonds and make whole, claw back and otherwise ordinary callable bonds

    OpenAIRE

    Booth, LD; Gounopoulos, D; Skinner, F

    2012-01-01

    This paper seeks to explain determinates of the choice and the pricing of various types of callable and non-callable bonds. We find that the popularity of different types of callable and non-callable bonds is significantly related to the economic environment. In addition, the popularity of claw back bonds appear to be driven by agency considerations, make whole bonds by the debt overhang problem, ordinary callable bonds by the need by banks to deal with interest rate changes and non-callable ...

  5. The Home Identity Idea: How Good Homes Can Urge People to Make Environmentally Friendly Choices

    OpenAIRE

    Paulsen, Karoline

    2017-01-01

    This thesis is a discussion on how we identify with the place we live and how we can make good places to live now and in the future. The idea is that if we feel at home in and identify with the place we live, we want to preserve it and make it better for the future. This can have effect on the environment and the climate. If we build places that are good to live in and the people who live there identify with their home place, they would want to live more sustainably. There is also a discussio...

  6. Uncovering Chemical Thinking in Students' Decision Making: A Fuel-Choice Scenario

    Science.gov (United States)

    Banks, Gregory; Clinchot, Michael; Cullipher, Steven; Huie, Robert; Lambertz, Jennifer; Lewis, Rebecca; Ngai, Courtney; Sevian, Hannah; Szteinberg, Gabriela; Talanquer, Vicente; Weinrich, Melissa

    2015-01-01

    Making decisions about the production and use of chemical substances is of central importance in many fields. In this study, a research team comprising teachers and educational researchers collaborated in collecting and analyzing cognitive interviews with students from 8th grade through first-year university general chemistry in an effort to map…

  7. Pneumocystis PCR: It Is Time to Make PCR the Test of Choice.

    Science.gov (United States)

    Doyle, Laura; Vogel, Sherilynn; Procop, Gary W

    2017-01-01

    The testing strategy for Pneumocystis at the Cleveland Clinic changed from toluidine blue staining to polymerase chain reaction (PCR). We studied the differences in positivity rates for these assays and compared each with the detection of Pneumocystis in companion specimens by cytology and surgical pathology. We reviewed the results of all Pneumocystis test orders 1 year before and 1 year after the implementation of a Pneumocystis -specific PCR. We also reviewed the corresponding cytology and surgical pathology results, if performed. Finally, we reviewed the medical records of patients with rare Pneumocystis detected by PCR in an effort to differentiate colonization vs true disease. Toluidine blue staining and surgical pathology had similar sensitivities and negative predictive values, both of which were superior to cytology. There was a >4-fold increase in the annual detection of Pneumocystis by PCR compared with toluidine blue staining (toluidine blue staining: 11/1583 [0.69%] vs PCR: 44/1457 [3.0%]; chi-square P < .001). PCR detected 1 more case than surgical pathology and was far more sensitive than cytology. Chart review demonstrated that the vast majority of patients with rare Pneumocystis detected were immunosuppressed, had radiologic findings supportive of this infection, had no other pathogens detected, and were treated for pneumocystosis by the clinical team. PCR was the most sensitive method for the detection of Pneumocystis and should be considered the diagnostic test of choice. Correlation with clinical and radiologic findings affords discrimination of early true disease from the far rarer instances of colonization.

  8. Academic or community practice? What is driving decision-making and career choices.

    Science.gov (United States)

    Goudreau, Bernadette J; Hassinger, Taryn E; Hedrick, Traci L; Slingluff, Craig L; Schroen, Anneke T; Dengel, Lynn T

    2018-06-18

    Identifying factors that impact progression of surgery trainees into academic versus non-academic practices may permit tailoring residency experiences to promote academic careers in institutions charged with the training of future surgeon scientists. The aim of this study was to identify factors associated with progression of surgery trainees into academic versus non-academic practice. A survey was distributed to 135 surgeons graduating from the University of Virginia residency program from 1964-2016, a single academic institution. Questions addressed practice type, research productivity, work/life balance, mentorship, and overall sentiment toward research and academic surgery. A 5-point Likert scale measured career satisfaction and influence of factors in practice setting choice. Of the 135 surveys that were electronically distributed, 69 participants responded (response rate: 51%). Of the 54 with known current practice types, 34 (63%) were academic and 20 (37%) non-academic. Academic surgeons reported more publications by the conclusion of surgery training (56% vs 25% with >10 publications, P = .02). More academic surgeons reported >$100,000 in student debt at graduation (44% vs 25%, P productive research experiences, current surgical trainees may be more enthusiastic about a career in academic practice. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Bringing the patient back in: behavioral decision-making and choice in medical economics.

    Science.gov (United States)

    Mendoza, Roger Lee

    2018-04-01

    We explore the behavioral methodology and "revolution" in economics through the lens of medical economics. We address two questions: (1) Are mainstream economic assumptions of utility-maximization realistic approximations of people's actual behavior? (2) Do people maximize subjective expected utility, particularly in choosing from among the available options? In doing so, we illustrate-in terms of a hypothetical experimental sample of patients with dry eye diagnosis-why and how utility in pharmacoeconomic assessments might be valued differently by patients when subjective psychological, social, cognitive, and emotional factors are considered. While experimentally-observed or surveyed behavior yields stated (rather than revealed) preferences, behaviorism offers a robust toolset in understanding drug, medical device, and treatment-related decisions compared to the optimizing calculus assumed by mainstream economists. It might also do so more perilously than economists have previously understood, in light of the intractable uncertainties, information asymmetries, insulated third-party agents, entry barriers, and externalities that characterize healthcare. Behavioral work has been carried out in many sub-fields of economics. Only recently has it been extended to healthcare. This offers medical economists both the challenge and opportunity of balancing efficiency presumptions with relatively autonomous patient choices, notwithstanding their predictable, yet seemingly consistent, irrationality. Despite its comparative youth and limitations, the scientific contributions of behaviorism are secure and its future in medical economics appears to be promising.

  10. Risk preferences in strategic wildfire decision making: a choice experiment with U.S. wildfire managers.

    Science.gov (United States)

    Wibbenmeyer, Matthew J; Hand, Michael S; Calkin, David E; Venn, Tyron J; Thompson, Matthew P

    2013-06-01

    Federal policy has embraced risa management as an appropriate paradigm for wildfire management. Economic theory suggests that over repeated wildfire events, potential economic costs and risas of ecological damage are optimally balanced when management decisions are free from biases, risa aversion, and risa seeking. Of primary concern in this article is how managers respond to wildfire risa, including the potential effect of wildfires (on ecological values, structures, and safety) and the likelihood of different fire outcomes. We use responses to a choice experiment questionnaire of U.S. federal wildfire managers to measure attitudes toward several components of wildfire risa and to test whether observed risa attitudes are consistent with the efficient allocation of wildfire suppression resources. Our results indicate that fire managers' decisions are consistent with nonexpected utility theories of decisions under risa. Managers may overallocate firefighting resources when the likelihood or potential magnitude of damage from fires is low, and sensitivity to changes in the probability of fire outcomes depends on whether probabilities are close to one or zero and the magnitude of the potential harm. © 2012 Society for Risk Analysis.

  11. International Higher Education for Whom? Expatriate Students, Choice-Making and International (Im)mobility in the Northern United Arab Emirates

    Science.gov (United States)

    Rensimer, Lee

    2016-01-01

    This article identifies a research gap on expatriate students attending international branch campuses in their country of residence, and presents evidence that they are insufficiently distinguished from international students in research on student mobility and choice-making. It finds that the priorities and enrollment choices of expatriates are…

  12. Screening for prostate cancer with the prostate-specific antigen test: are patients making informed decisions?

    Science.gov (United States)

    O'Dell, K J; Volk, R J; Cass, A R; Spann, S J

    1999-09-01

    The benefits of early detection of prostate cancer are uncertain, and the American College of Physicians and the American Academy of Family Physicians recommend individual decision making in prostate cancer screening. This study reports the knowledge of male primary care patients about prostate cancer and prostate-specific antigen (PSA) testing and examines how that knowledge is related to PSA testing, preferences for testing in the future, and desire for involvement in physician-patient decision making. The sample included 160 men aged 45 to 70 years with no history of prostate cancer who presented for care at a university-based family medicine clinic. Before scheduled office visits, patients completed a questionnaire developed for this study that included a 10-question measure of prostate cancer knowledge, the Deber-Kraestchmer Problem-Solving Decision-Making Scale, sociodemographic indicators, and questions on PSA testing. In general, patients who were college graduates were more knowledgeable about prostate cancer and early detection than those with a high school education or less. Aside from college graduates, most patients could not identify the principle advantages and disadvantages of PSA testing. Patients indicating previous or future plans for PSA testing demonstrated greater knowledge than other patients. Desire for involvement in decision making varied by patient education but was not related to past PSA testing. Patients lack knowledge about prostate cancer and early detection. This knowledge deficit may impede the early detection of prostate cancer and is a barrier to making an informed decision about undergoing PSA testing.

  13. Informed decision making does not affect health-related quality of life in lung cancer screening (NELSON trial)

    NARCIS (Netherlands)

    van den Bergh, Karien A. M.; Essink-Bot, Marie-Louise; van Klaveren, Rob J.; de Koning, Harry J.

    2010-01-01

    Background: It is believed that making an informed decision about (screening) participation is associated with better health-related quality of life (HRQoL) outcomes. This is the first study in cancer screening to explore this association in subjects participating in a lung cancer computed

  14. Understanding the Harms and Benefits of Cancer Screening: A Model of Factors That Shape Informed Decision Making.

    Science.gov (United States)

    Petrova, Dafina; Garcia-Retamero, Rocio; Cokely, Edward T

    2015-10-01

    Decisions about cancer screenings often involve the consideration of complex and counterintuitive evidence. We investigated psychological factors that promote the comprehension of benefits and harms associated with common cancer screenings and their influence on shared decision making. In experiment 1, 256 men received information about PSA-based prostate cancer screening. In experiment 2, 355 women received information about mammography-based breast cancer screening. In both studies, information about potential screening outcomes was provided in 1 of 3 formats: text, a fact box, or a visual aid (e.g., mortality with and without screening and rate of overdiagnosis). We modeled the interplay of comprehension, perceived risks and benefits, intention to participate in screening, and desire for shared decision making. Generally, visual aids were the most effective format, increasing comprehension by up to 18%. Improved comprehension was associated with 1) superior decision making (e.g., fewer intentions to participate in screening when it offered no benefit) and 2) more desire to share in decision making. However, comprehension of the evidence had a limited effect on experienced emotions, risk perceptions, and decision making among those participants who felt that the consequences of cancer were extremely severe. Even when information is counterintuitive and requires the integration of complex harms and benefits, user-friendly risk communications can facilitate comprehension, improve high-stakes decisions, and promote shared decision making. However, previous beliefs about the effectiveness of screening or strong fears about specific cancers may interfere with comprehension and informed decision making. © The Author(s) 2015.

  15. Quantum paradox of choice: More freedom makes summoning a quantum state harder

    Science.gov (United States)

    Adlam, Emily; Kent, Adrian

    2016-06-01

    The properties of quantum information in space-time can be investigated by studying operational tasks, such as "summoning," in which an unknown quantum state is supplied at one point and a call is made at another for it to be returned at a third. Hayden and May [arXiv:1210.0913] recently proved necessary and sufficient conditions for guaranteeing successful return of a summoned state for finite sets of call and return points when there is a guarantee of at most one summons. We prove necessary and sufficient conditions when there may be several possible summonses and complying with any one constitutes success, and we demonstrate the existence of an apparent paradox: The extra freedom makes it strictly harder to complete the summoning task. This result has practical applications for distributed quantum computing and cryptography and implications for our understanding of relativistic quantum information and its localization in space-time.

  16. Context influences decision-making in boys with attention-deficit/hyperactivity disorder: A comparison of traditional and novel choice-impulsivity paradigms.

    Science.gov (United States)

    Patros, Connor H G; Alderson, R Matt; Lea, Sarah E; Tarle, Stephanie J

    2017-02-01

    Attention-deficit/hyperactivity disorder (ADHD) is characterized by an impaired ability to maintain attention and/or hyperactivity/impulsivity. Impulsivity is frequently defined as the preference for small, immediate rewards over larger, delayed rewards, and has been associated with a variety of negative outcomes such as risky behavior and academic difficulty. Extant studies have uniformly utilized the traditional paradigm of presenting two response choices, which limits the generalization of findings to scenarios in which children/adolescents are faced with dichotomous decisions. The current study is the first to examine the effect of manipulating the number of available response options on impulsive decision-making in boys with and without ADHD. A total of 39 boys (ADHD = 16, typically developing [TD] = 23) aged 8-12 years completed a traditional two-choice impulsivity task and a novel five-choice impulsivity task to examine the effect of manipulating the number of choice responses (two vs five) on impulsive decision-making. A five-choice task was utilized as it presents a more continuous array of choice options when compared to the typical two-choice task, and is comparable given its methodological similarity to the two-choice task. Results suggested that boys with ADHD were significantly more impulsive than TD boys during the two-choice task, but not during the five-choice task. Collectively, these findings suggest that ADHD-related impulsivity is not ubiquitous, but rather dependent on variation in demands and/or context. Further, these findings highlight the importance of examining ADHD-related decision-making within the context of alternative paradigms, as the exclusive utilization of two-choice tasks may promote inaccurate conceptualizations of the disorder.

  17. What Sways People's Judgment of Sleep Quality? A Quantitative Choice-Making Study With Good and Poor Sleepers.

    Science.gov (United States)

    Ramlee, Fatanah; Sanborn, Adam N; Tang, Nicole K Y

    2017-07-01

    We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis. One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: "Which describes a better (or worse) night of sleep?". Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data. Eleven of the 17 sleep quality parameters had a significant impact on the participants' choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments. Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people's self-reported evaluation of sleep quality. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

  18. Screens

    OpenAIRE

    2016-01-01

    This Sixth volume in the series The Key Debates. Mutations and Appropriations in European Film Studies investigates the question of screens in the context both of the dematerialization due to digitalization and the multiplication of media screens. Scholars offer various infomations and theories of topics such as the archeology of screen, film and media theories, contemporary art, pragmatics of new ways of screening (from home video to street screening).

  19. Do dogs (Canis lupus familiaris) make counterproductive choices because they are sensitive to human ostensive cues?

    Science.gov (United States)

    Marshall-Pescini, Sarah; Passalacqua, Chiara; Miletto Petrazzini, Maria Elena; Valsecchi, Paola; Prato-Previde, Emanuela

    2012-01-01

    Dogs appear to be sensitive to human ostensive communicative cues in a variety of situations, however there is still a measure of controversy as to the way in which these cues influence human-dog interactions. There is evidence for instance that dogs can be led into making evaluation errors in a quantity discrimination task, for example losing their preference for a larger food quantity if a human shows a preference for a smaller one, yet there is, so far, no explanation for this phenomenon. Using a modified version of this task, in the current study we investigated whether non-social, social or communicative cues (alone or in combination) cause dogs to go against their preference for the larger food quantity. Results show that dogs' evaluation errors are indeed caused by a social bias, but, somewhat contrary to previous studies, they highlight the potent effect of stimulus enhancement (handling the target) in influencing the dogs' response. A mild influence on the dog's behaviour was found only when different ostensive cues (and no handling of the target) were used in combination, suggesting their cumulative effect. The discussion addresses possible motives for discrepancies with previous studies suggesting that both the intentionality and the directionality of the action may be important in causing dogs' social biases.

  20. The Utility of Impulsive Bias and Altered Decision Making as Predictors of Drug Efficacy and Target Selection: Rethinking Behavioral Screening for Antidepressant Drugs.

    Science.gov (United States)

    Marek, Gerard J; Day, Mark; Hudzik, Thomas J

    2016-03-01

    Cognitive dysfunction may be a core feature of major depressive disorder, including affective processing bias, abnormal response to negative feedback, changes in decision making, and increased impulsivity. Accordingly, a translational medicine paradigm predicts clinical action of novel antidepressants by examining drug-induced changes in affective processing bias. With some exceptions, these concepts have not been systematically applied to preclinical models to test new chemical entities. The purpose of this review is to examine whether an empirically derived behavioral screen for antidepressant drugs may screen for compounds, at least in part, by modulating an impulsive biasing of responding and altered decision making. The differential-reinforcement-of-low-rate (DRL) 72-second schedule is an operant schedule with a documented fidelity for discriminating antidepressant drugs from nonantidepressant drugs. However, a theoretical basis for this empirical relationship has been lacking. Therefore, this review will discuss whether response bias toward impulsive behavior may be a critical screening characteristic of DRL behavior requiring long inter-response times to obtain rewards. This review will compare and contrast DRL behavior with the five-choice serial reaction time task, a test specifically designed for assessing motoric impulsivity, with respect to psychopharmacological testing and the neural basis of distributed macrocircuits underlying these tasks. This comparison suggests that the existing empirical basis for the DRL 72-second schedule as a pharmacological screen for antidepressant drugs is complemented by a novel hypothesis that altering impulsive response bias for rodents trained on this operant schedule is a previously unrecognized theoretical cornerstone for this screening paradigm. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  1. A computer-tailored intervention to promote informed decision making for prostate cancer screening among African American men.

    Science.gov (United States)

    Allen, Jennifer D; Mohllajee, Anshu P; Shelton, Rachel C; Drake, Bettina F; Mars, Dana R

    2009-12-01

    African American men experience a disproportionate burden of prostate cancer (CaP) morbidity and mortality. National screening guidelines advise men to make individualized screening decisions through a process termed informed decision making (IDM). In this pilot study, a computer-tailored decision-aid designed to promote IDM was evaluated using a pre-/posttest design. African American men aged 40 years and older were recruited from a variety of community settings (n = 108). At pretest, 43% of men reported having made a screening decision; at posttest 47% reported this to be the case (p = .39). Significant improvements were observed between pre- and posttest on scores of knowledge, decision self-efficacy, and decisional conflict. Men were also more likely to want an active role in decision making after using the tool. These results suggest that use of a computer-tailored decision aid is a promising strategy to promote IDM for CaP screening among African American men.

  2. A Shared Decision-Making System for Diabetes Medication Choice Utilizing Electronic Health Record Data.

    Science.gov (United States)

    Wang, Yu; Li, Peng-Fei; Tian, Yu; Ren, Jing-Jing; Li, Jing-Song

    2017-09-01

    The use of a shared decision-making (SDM) process in antihyperglycemic medication strategy decisions is necessary due to the complexity of the conditions of diabetes patients. Knowledge of guidelines is used as decision aids in clinical situations, and during this process, no patient health conditions are considered. In this paper, we propose an SDM system framework for type-2 diabetes mellitus (T2DM) patients that not only contains knowledge abstracted from guidelines but also employs a multilabel classification model that uses class-imbalanced electronic health record (EHR) data and that aims to provide a recommended list of available antihyperglycemic medications to help physicians and patients have an SDM conversation. The use of EHR data to serve as a decision-support component in decision aids helps physicians and patients to reach a more intuitive understanding of current health conditions and allows the tailoring of the available knowledge to each patient, leading to a more effective SDM. Real-world data from 2542 T2DM inpatient EHRs were substituted by 77 features and eight output labels, i.e., eight antihyperglycemic medications, and these data were utilized to build and validate the recommendation model. The multilabel recommendation model exhibited stable performance in every single-label classification and showed the ability to predict minority positive cases in which the average recall value of the eight classes was 0.9898. As a whole multilabel classifier, the recommendation model demonstrated outstanding performance, with scores of 0.0941 for Hamming Loss, 0.7611 for Accuracy exam , 0.9664 for Recall exam , and 0.8269 for F exam .

  3. Reversible inactivation of the lateral hypothalamus reversed high reward choices in cost-benefit decision-making in rats.

    Science.gov (United States)

    Karimi, Sara; Mesdaghinia, Azam; Farzinpour, Zahra; Hamidi, Gholamali; Haghparast, Abbas

    2017-11-01

    The Lateral hypothalamus (LH) is an important component of the networks underlying the control of feeding and other motivated behaviors. Cost-benefit decision-making is mediated largely by the prefrontal cortex (PFC) which strongly innervates the LH. Therefore, in the current study, we conducted a series of experiments to elucidate the role of the perifornical area of the lateral hypothalamus (PeF-LH) in effort and/or delay-based decision-making. We trained different groups of rats in a delay-based and/or an effort-based form of cost-benefit T-maze decision- making task in which they could either choose to pay the cost to obtain a high reward in one arm or could obtain a low reward in the other arm with no cost. During test days, the rats received local injections of either vehicle or lidocaine4% (0.5 μl/side), in the PeF-LH. In an effort-based decision task, PeF-LH inactivation led to decrease in high reward choice. Similarly, in a delay-based decision task animals' preference changed to a low but immediately available reward. This was not caused by a spatial memory or motor deficit. PeF-LH inactivation modified decision behavior. The results imply that PeF-LH is important for allowing the animal to pay a cost to acquire greater rewards. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Everyday and medical life choices: decision-making among 8- to 15-year-old school students.

    Science.gov (United States)

    Alderson, P

    1992-01-01

    How much do young patients expect to be involved in medical decisions affecting them? We are investigating this question during interviews with 8- to 15-year-olds having orthopaedic surgery. Many youngsters taking part in our research project on consent to surgery are more than usually dependent on their parents. We wondered how their views would compare with those of their peers at school. This paper reports a schools survey carried out as a background to the research with young people in hospital. Students in seven schools answered questionnaires on choices about late-night television viewing, new friends, timing homework, seeing their family doctor and consenting to surgery. They were asked about agreement with their parents, how they negotiate disagreement, and when they think they were/will be old enough to make everyday and medical decisions without their parents' help.

  5. Risky decision making across three arenas of choice: are younger and older adults differently susceptible to framing effects?

    Science.gov (United States)

    Rönnlund, Michael; Karlsson, Erik; Laggnäs, Erica; Larsson, Lisa; Lindström, Therese

    2005-01-01

    In the present study, the authors investigated the effects of framing of options on risky decision making in groups of younger adults (M = 23.8 years, n = 192) and older adults (M = 69.1 years, n = 192). The participants were assigned to one of three scenarios varying in the goods at stake (human lives, paintings, money). The authors observed a majority preference in favor of the risky options after negative, but not positive framing. They also found, as they had predicted, that the type of framing effect varied across scenarios, with a bidirectional framing effect for the life-death scenario and unidirectional (risk averse) framing effects when public property (paintings) or personal property (money) were at stake. It is important to note that these choice preference patterns were highly similar across the age groups, which reinforced the conclusion that younger and older adults are equally susceptible to framing effects.

  6. Education and parental involvement in decision-making about newborn screening: understanding goals to clarify content.

    Science.gov (United States)

    Potter, Beth K; Etchegary, Holly; Nicholls, Stuart G; Wilson, Brenda J; Craigie, Samantha M; Araia, Makda H

    2015-06-01

    A challenge in designing effective education for parents about newborn screening (NBS) has been uncertainty about appropriate content. Arguing that the goals of education may be usefully tied to parental decision-making, we sought to: (1) explore how different ways of implementing NBS differ in their approaches to parental engagement in decision-making; (2) map the potential goals of education onto these "implementation models"; and (3) consider the content that may be needed to support these goals. The resulting conceptual framework supports the availability of comprehensive information about NBS for parents, irrespective of the model of implementation. This is largely because we argue that meeting parental expectations and preferences for communication is an important goal regardless of whether or notparents are actively involved in making a decision. Our analysis supports a flexible approach, in which some educational messages are emphasized as important for all parents to understand while others are made available depending on parents' preferences. We have begun to define the content of NBS education for parents needed to support specific goals. Further research and discussion is important to determine the most appropriate strategies for delivering the tailored approach to education that emerged from our analysis.

  7. Making choice between competing rewards in uncertain versus safe social environment:role of neuronal nicotinic receptors of acetylcholine

    Directory of Open Access Journals (Sweden)

    Jonathan eChabout

    2013-08-01

    Full Text Available In social environments, choosing between multiple rewards is modulated by the uncertainty of the situation. Here, we compared how mice interact with a conspecific and how they use acoustic communication during this interaction in a 3 chambers task (no social threat was possible and a Social Interaction Task, SIT (uncertain situation as two mice interact freely. We further manipulated the motivational state of the mice to see how they rank natural rewards such as social contact, food, and novelty seeking. We previously showed that beta2-subunit containing nicotinic receptors -2*nAChRs- are required for establishing reward ranking between social interaction, novelty exploration, and food consumption in social situations with high uncertainty. Knockout mice for 2*nAChRs -2-/-mice- exhibit profound impairment in making social flexible choices, as compared to control -WT- mice.Our current data shows that being confronted with a conspecific in a socially safe environment as compared to a more uncertain environment, drastically reduced communication between the two mice, and changed their way to deal with a social conspecific. Furthermore, we demonstrated for the first time, that 2-/- mice had the same motivational ranking than WT mice when placed in a socially safe environment. Therefore,2*nAChRs are not necessary for integrating social information or social rewards per se, but are important for making choices, only in a socially uncertain environment.This seems particularly important in the context of Social Neuroscience, as numerous animal models are used to provide novel insights and to test promising novel treatments of human pathologies affecting social and communication processes, among which Autistic spectrum disorders and schizophrenia.

  8. Single-larger-portion-size and dual-column nutrition labeling may help consumers make more healthful food choices.

    Science.gov (United States)

    Lando, Amy M; Lo, Serena C

    2013-02-01

    The Food and Drug Administration is considering changes to the Nutrition Facts label to help consumers make more healthful choices. To examine the effects of modifications to the Nutrition Facts label on foods that can be listed as having 1 or 2 servings per container, but are reasonably consumed at a single eating occasion. Participants were randomly assigned to study conditions that varied on label format, product, and nutrition profile. Data were collected via an online consumer panel. Adults aged 18 years and older were recruited from Synovate's online household panel. Data were collected during August 2011. A total of 32,897 invitations were sent for a final sample of 9,493 interviews. Participants were randomly assigned to one of 10 label formats classified into three groups: listing 2 servings per container with a single column, listing 2 servings per container with a dual column, and listing a single serving per container. Within these groups there were versions that enlarged the font size for "calories," removed "calories from fat," and changed the wording for serving size declaration. The single product task measured product healthfulness, the amount of calories and various nutrients per serving and per container, and label perceptions. The product comparison task measured ability to identify the healthier product and the product with fewer calories per container and per serving. Analysis of covariance models with Tukey-Kramer tests were used. Covariates included general label use, age, sex, level of education, and race/ethnicity. Single-serving and dual-column formats performed better and scored higher on most outcome measures. For products that contain 2 servings but are customarily consumed at a single eating occasion, using a single-serving or dual-column labeling approach may help consumers make healthier food choices. Published by Elsevier Inc.

  9. Towards a life cycle sustainability assessment: making informed choices on products

    Energy Technology Data Exchange (ETDEWEB)

    Ciroth, Andreas [GreenDeltaTC, Berlin (Germany); Finkbeiner, Matthias; Traverso, Marzia [TU Berlin (Germany); Hildenbrand, Jutta [Chalmers University (United States); Kloepffer, Walter [Editor-in-Chief of the International Journal of Life Cycle Assessment (Germany); Mazijn, Bernard [Ghent University (Belgium); Prakash, Siddharth [Oeko-Institut (Germany); Sonnemann, Guido; Valdivia, Sonia [UNEP (France); Ugaya, Cassia Maria Lie [Technological Federal University of Parana, ACV (Brazil); Vickery-Niederman, Gina [University of Arkansas (United States)

    2011-07-01

    In this introduction to the concept of life cycle sustainability assessment (LCSA), we acknowledge the foundations laid by previous works and initiatives. One such initiative has been the ISO 14040 series (Environmental management -- Life cycle assessment -- Principles and framework), which in addition to the ISO 26000: Social Responsibility Guidance Standard, and the contribution of a number of international initiatives (Appendix A) have been essential for the development of this publication. The life cycle of a product involves flows of material, energy and money. Nonetheless, the picture is not complete unless we look also at the production and consumption impacts on all actors along the 'value chain' -- workers, local communities, consumers and society itself. Different life cycle assessment techniques allow individuals and enterprises to assess the impact of their purchasing decisions and production methods along different aspects of this value chain. An (Environmental) life cycle assessment (LCA) looks at potential impacts to the environment as a result of the extraction of resources, transportation, production, use, recycling and discarding of products; life cycle costing (LCC) is used to assess the cost implications of this life cycle; and social life cycle assessment (S-LCA) examines the social consequences. However, in order to get the 'whole picture', it is vital to extend current life cycle thinking to encompass all three pillars of sustainability: (i) environmental, (ii) economic and (iii) social. This means carrying out an assessment based on environmental, economic and social issues -- by conducting an overarching life cycle sustainability assessment (LCSA). This publication shows how all three techniques -- which all share similar methodological frameworks and aims -- can be combined to make the move towards an overarching LCSA possible. Because it is holistic, systemic and rigorous, (environmental) LCA is the preferred technique

  10. Towards a life cycle sustainability assessment: making informed choices on products

    Energy Technology Data Exchange (ETDEWEB)

    Ciroth, Andreas [GreenDeltaTC, Berlin (Germany); Finkbeiner, Matthias; Traverso, Marzia [TU Berlin (Germany); Hildenbrand, Jutta [Chalmers University (United States); Kloepffer, Walter [Editor-in-Chief of the International Journal of Life Cycle Assessment (Germany); Mazijn, Bernard [Ghent University (Belgium); Prakash, Siddharth [Oeko-Institut (Germany); Sonnemann, Guido; Valdivia, Sonia [UNEP (France); Ugaya, Cassia Maria Lie [Technological Federal University of Parana, ACV (Brazil); Vickery-Niederman, Gina [University of Arkansas (United States)

    2011-07-01

    In this introduction to the concept of life cycle sustainability assessment (LCSA), we acknowledge the foundations laid by previous works and initiatives. One such initiative has been the ISO 14040 series (Environmental management -- Life cycle assessment -- Principles and framework), which in addition to the ISO 26000: Social Responsibility Guidance Standard, and the contribution of a number of international initiatives (Appendix A) have been essential for the development of this publication. The life cycle of a product involves flows of material, energy and money. Nonetheless, the picture is not complete unless we look also at the production and consumption impacts on all actors along the 'value chain' -- workers, local communities, consumers and society itself. Different life cycle assessment techniques allow individuals and enterprises to assess the impact of their purchasing decisions and production methods along different aspects of this value chain. An (Environmental) life cycle assessment (LCA) looks at potential impacts to the environment as a result of the extraction of resources, transportation, production, use, recycling and discarding of products; life cycle costing (LCC) is used to assess the cost implications of this life cycle; and social life cycle assessment (S-LCA) examines the social consequences. However, in order to get the 'whole picture', it is vital to extend current life cycle thinking to encompass all three pillars of sustainability: (i) environmental, (ii) economic and (iii) social. This means carrying out an assessment based on environmental, economic and social issues -- by conducting an overarching life cycle sustainability assessment (LCSA). This publication shows how all three techniques -- which all share similar methodological frameworks and aims -- can be combined to make the move towards an overarching LCSA possible. Because it is holistic, systemic and rigorous, (environmental) LCA is the preferred technique when it comes to

  11. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

    Directory of Open Access Journals (Sweden)

    Alex Ghanouni

    2017-04-01

    Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

  12. A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

    Science.gov (United States)

    Ghanouni, Alex; Renzi, Cristina; Waller, Jo

    2017-04-18

    There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

  13. Use of food labels by adolescents to make healthier choices on snacks: a cross-sectional study from Sri Lanka.

    Science.gov (United States)

    Talagala, Ishanka A; Arambepola, Carukshi

    2016-08-08

    Unhealthy snacking is commonly seen among adolescents. Therefore, use of food labels is promoted for making healthier choices on packaged snacks. This study was conducted to assess the use of food labels in making choices on packaged snack and its associated factors among adolescents. A cross-sectional study was conducted in 2012 among 542 Grade 12 students in Sri Lanka. Eight classes were selected as 'clusters' for the study (two classes each from two schools that were selected randomly from each list of 'Girls only' and 'Boys only' schools in Colombo district). A self-administered questionnaire assessed their socio-demography, snacking behaviour, attitudes and nutrition knowledge related to food labels. Adolescents' use of labels was assessed by three practices (label reading frequency, attention paid to label contents and correct interpretation of six hypothetical labels of snacks). Based on total scores obtained for the three practices, 'satisfactory' (score ≥75(th) percentile mark) and 'unsatisfactory' (score pocket money at least once/week on packaged snacks; predominantly on biscuits (85 %) and cola-drinks (77 %) and 88 % selected snacks on their own. The majority (74.5 %) was frequent ('always' or 'most often') label readers with female predominance (p < 0.05). Over 74 % paid attention frequently to the brand name (75 %), price (85 %) and nutrition panel (81 %). Over 64 % were able to select the better food label when given a choice between two snacks, although some did it for reasons such as attractive label (63 %). The majority (84 %) had good knowledge (obtaining more than the 75(th) percentile mark) on interpreting labels. Although not statistically significant, 'unsatisfactory' label use was higher among males (73 %), purchasing power (70.4 %) and unhealthy snacking behaviour (73 %). In contrast, among the marketing strategies, identifying known brands (73.2 %) and imported products (75.8 %) as 'good' products were significantly

  14. Use of food labels by adolescents to make healthier choices on snacks: a cross-sectional study from Sri Lanka

    Directory of Open Access Journals (Sweden)

    Ishanka A. Talagala

    2016-08-01

    Full Text Available Abstract Background Unhealthy snacking is commonly seen among adolescents. Therefore, use of food labels is promoted for making healthier choices on packaged snacks. This study was conducted to assess the use of food labels in making choices on packaged snack and its associated factors among adolescents. Methods A cross–sectional study was conducted in 2012 among 542 Grade 12 students in Sri Lanka. Eight classes were selected as ‘clusters’ for the study (two classes each from two schools that were selected randomly from each list of ‘Girls only’ and ‘Boys only’ schools in Colombo district. A self-administered questionnaire assessed their socio-demography, snacking behaviour, attitudes and nutrition knowledge related to food labels. Adolescents’ use of labels was assessed by three practices (label reading frequency, attention paid to label contents and correct interpretation of six hypothetical labels of snacks. Based on total scores obtained for the three practices, ‘satisfactory’ (score ≥75th percentile mark and ‘unsatisfactory’ (score <75th percentile mark label users were identified. Using SPSS, associations were assessed at 0.05 significance level using Chi-square-test. Results Of the participants, 51 % were males; 61 % spent their pocket money at least once/week on packaged snacks; predominantly on biscuits (85 % and cola-drinks (77 % and 88 % selected snacks on their own. The majority (74.5 % was frequent (‘always’ or ‘most often’ label readers with female predominance (p < 0.05. Over 74 % paid attention frequently to the brand name (75 %, price (85 % and nutrition panel (81 %. Over 64 % were able to select the better food label when given a choice between two snacks, although some did it for reasons such as attractive label (63 %. The majority (84 % had good knowledge (obtaining more than the 75th percentile mark on interpreting labels. Although not statistically significant,

  15. Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making.

    Science.gov (United States)

    Schroy, Paul C; Mylvaganam, Shamini; Davidson, Peter

    2014-02-01

    Decision aids for colorectal cancer (CRC) screening have been shown to enable patients to identify a preferred screening option, but the extent to which such tools facilitate shared decision making (SDM) from the perspective of the provider is less well established. Our goal was to elicit provider feedback regarding the impact of a CRC screening decision aid on SDM in the primary care setting. Cross-sectional survey. Primary care providers participating in a clinical trial evaluating the impact of a novel CRC screening decision aid on SDM and adherence. Perceptions of the impact of the tool on decision-making and implementation issues. Twenty-nine of 42 (71%) eligible providers responded, including 27 internists and two nurse practitioners. The majority (>60%) felt that use of the tool complimented their usual approach, increased patient knowledge, helped patients identify a preferred screening option, improved the quality of decision making, saved time and increased patients' desire to get screened. Respondents were more neutral is their assessment of whether the tool improved the overall quality of the patient visit or patient satisfaction. Fewer than 50% felt that the tool would be easy to implement into their practices or that it would be widely used by their colleagues. Decision aids for CRC screening can improve the quality and efficiency of SDM from the provider perspective but future use is likely to depend on the extent to which barriers to implementation can be addressed. © 2011 John Wiley & Sons Ltd.

  16. Governance mode vs. governance fit? : Performance implications of make-or-ally choices for product innovation in the worldwide aircraft industry, 1942-2000

    NARCIS (Netherlands)

    Castaner, X.; Mulotte, L.; Garrette, B.; Dussauge, P.

    We examine the impact of governance mode and governance fit on performance in make-or-ally decisions. We argue that while horizontal collaboration and autonomous governance have direct and countervailing performance implications, the alignment of make-or-ally choices with the focal firm's resource

  17. The Environment Makes a Difference: The Impact of Explicit and Implicit Attitudes as Precursors in Different Food Choice Tasks.

    Science.gov (United States)

    König, Laura M; Giese, Helge; Schupp, Harald T; Renner, Britta

    2016-01-01

    Studies show that implicit and explicit attitudes influence food choice. However, precursors of food choice often are investigated using tasks offering a very limited number of options despite the comparably complex environment surrounding real life food choice. In the present study, we investigated how the assortment impacts the relationship between implicit and explicit attitudes and food choice (confectionery and fruit), assuming that a more complex choice architecture is more taxing on cognitive resources. Specifically, a binary and a multiple option choice task based on the same stimulus set (fake food items) were presented to ninety-seven participants. Path modeling revealed that both explicit and implicit attitudes were associated with relative food choice (confectionery vs. fruit) in both tasks. In the binary option choice task, both explicit and implicit attitudes were significant precursors of food choice, with explicit attitudes having a greater impact. Conversely, in the multiple option choice task, the additive impact of explicit and implicit attitudes was qualified by an interaction indicating that, even if explicit and implicit attitudes toward confectionery were inconsistent, more confectionery was chosen than fruit if either was positive. This compensatory 'one is sufficient'-effect indicates that the structure of the choice environment modulates the relationship between attitudes and choice. The study highlights that environmental constraints, such as the number of choice options, are an important boundary condition that need to be included when investigating the relationship between psychological precursors and behavior.

  18. Including values in evidence-based policy making for breast screening: An empirically grounded tool to assist expert decision makers.

    Science.gov (United States)

    Parker, Lisa

    2017-07-01

    Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions. The decision making tool provided here is intended to assist with this process. The tool is modified from more general frameworks that are intended to assist with ethical decision making in public health, and informed by data drawn from previous empirical studies on values amongst Australian breast screening experts. It provides a structured format for breast screening committees to consider and discuss the values of themselves and others, suggests relevant topics for further inquiry and highlights areas of need for future research into the values of the public. It enables committees to publicly explain and justify their decisions with reference to values, improving transparency and accountability. It is intended to act alongside practices that seek to accommodate the values of individual women in the informed decision making process for personal decision making about participation in breast screening. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Making the EZ Choice

    Science.gov (United States)

    2001-01-01

    Analytical Mechanics Associates, Inc. (AMA), of Hampton, Virginia, created the EZopt software application through Small Business Innovation Research (SBIR) funding from NASA's Langley Research Center. The new software is a user-friendly tool kit that provides quick and logical solutions to complex optimal control problems. In its most basic form, EZopt converts process data into math equations and then proceeds to utilize those equations to solve problems within control systems. EZopt successfully proved its advantage when applied to short-term mission planning and onboard flight computer implementation. The technology has also solved multiple real-life engineering problems faced in numerous commercial operations. For instance, mechanical engineers use EZopt to solve control problems with robots, while chemical plants implement the application to overcome situations with batch reactors and temperature control. In the emerging field of commercial aerospace, EZopt is able to optimize trajectories for launch vehicles and perform potential space station- keeping tasks. Furthermore, the software also helps control electromagnetic devices in the automotive industry.

  20. Making Choices about Change.

    Science.gov (United States)

    Steinburg, Craig; And Others

    1992-01-01

    This special report includes four articles arising from the American Society for Training and Development's symposium, "Approaches to Change in Organizations": "Taking Charge of of Change" (Steinburg); "Five Views of Change" (Conner et al.); "Breakpoint Change" (Land, Jarman); and "Approaches to Change" (Kotler). (JOW)

  1. Parents' accounts : factors considered when deciding how far to involve their son/daughter with learning disabilities in choice-making

    OpenAIRE

    Mitchell, Wendy Ann

    2012-01-01

    There is limited literature on the processes of choice-making in families of young people with learning disabilities. This paper examines the factors considered by parents of young people with learning disabilities when deciding their own and their child's role in a range of significant choices (health, social care and education) about their child's life. The paper reports data collected from a sub-sample of 14 parents recruited from 11 families participating in a longitudinal (2007-2010) qua...

  2. The Benefits of Single-Touch Screens in Intersubjective Meaning Making

    OpenAIRE

    Davidsen, Jacob; Christiansen, Ellen Tove

    2013-01-01

    What are the benefits of single-touch screens? The paper presents findings of onevideo extract from ten months of observation of single-touch screen interaction among 8-9 year-old children. Recent studies of collaborative learning mediated by digital touch screens and tabletops emphasize the possibilities for equal levels of verbal and physical participation.Additionally, these studies suggest that multi-touch technologies offer more task-oriented activities compared to single-touch screen in...

  3. Does lowering the screening age for cervical cancer in The Netherlands make sense?

    NARCIS (Netherlands)

    van der Aa, Maaike A.; de Kok, Inge M.C.M.; Siesling, Sabine; van Ballegooijen, Marjolein; Coebergh, Jan Willem W.

    2008-01-01

    Recommendations for the age to initiate cervical cancer screening should be directed towards maximum detection of early cervical cancer. However, the screening programme should do more good than harm. The aim of this analysis was to determine whether the target age for cervical cancer screening

  4. Pediatric provider processes for behavioral health screening, decision making, and referral in sites with colocated mental health services.

    Science.gov (United States)

    Hacker, Karen; Goldstein, Joel; Link, David; Sengupta, Nandini; Bowers, Rachael; Tendulkar, Shalini; Wissow, Larry

    2013-01-01

    Validated behavioral health (BH) screens are recommended for use at well-child visits. This study aimed to explore how pediatricians experience and use these screens for subsequent care decisions in primary care. The study took place at 4 safety net health centers. Fourteen interviews were conducted with pediatricians who were mandated to use validated BH screens at well-child visits. Interview questions focused on key domains, including clinic BH context, screening processes, assessment of screening scores, and decision making about referral to mental health services. Qualitative analysis used the Framework Approach. A variety of themes emerged: BH screens were well accepted and valued for the way they facilitated discussion of mental health issues. However, screening results were not always used in the way that instrument designers intended. Providers' beliefs about the face validity of the instruments, and their observations about performance of instruments, led to discounting scored results. As a result, clinical decisions were made based on a variety of evidence, including individual item responses, parent or patient concerns, and perceived readiness for treatment. Additionally, providers, although interested in expanding their mental health discussions, perceived a lack of time and of their own skills to be major obstacles in this pursuit. Screens act as important prompts to stimulate discussion of BH problems, but their actual scored results play a variable role in problem identification and treatment decisions. Modifications to scheduling policies, additional provider training, and enhanced collaboration with mental health professionals could support better BH integration in pediatric primary care.

  5. Can Food Stamps Do More to Improve Food Choices? An Economic Perspective--Making Healthy Food Choices Easier: Ideas From Behavioral Economics

    OpenAIRE

    Mancino, Lisa; Andrews, Margaret S.

    2007-01-01

    With obesity the most prevalent nutrition problem facing Americans at all economic levels, promoting diets that provide adequate nutrition without too many calories has become an important objective for the Food Stamp Program. Findings from behavioral economics suggest innovative, low-cost ways to improve the diet quality of food stamp participants without restricting their freedom of choice. Unlike more traditional economic interventions, such as changing prices or banning specific foods, th...

  6. Communicating the benefits and harms of colorectal cancer screening needed for an informed choice: a systematic evaluation of leaflets and booklets.

    Science.gov (United States)

    Dreier, Maren; Borutta, Birgit; Seidel, Gabriele; Münch, Inga; Kramer, Silke; Töppich, Jürgen; Dierks, Marie-Luise; Walter, Ulla

    2014-01-01

    Evidence-based health information (EBHI) can support informed choice regarding whether or not to attend colorectal cancer (CRC) screening. The present study aimed to assess if German leaflets and booklets appropriately inform consumers on the benefits and harms of CRC screening. A systematic search for print media on CRC screening was performed via email enquiry and internet search. The identified documents were assessed for the presence and correctness of information on benefits and harms by two reviewers independently using a comprehensive list of criteria. Many of the 28 leaflets and 13 booklets identified presented unbalanced information on the benefits and harms of CRC screening: one-third did not provide any information on harms. Numeracy information was often lacking. Ten cross-language examples of common misinterpretations or basically false and misleading information were identified. Most of the CRC screening leaflets and booklets in Germany do not meet current EBHI standards. After the study, the publishers of the information materials were provided feedback, including a discussion of our findings. The results can be used to revise existing information materials or to develop new materials that provide correct, balanced, quantified, understandable and unbiased information on CRC screening.

  7. Communicating the benefits and harms of colorectal cancer screening needed for an informed choice: a systematic evaluation of leaflets and booklets.

    Directory of Open Access Journals (Sweden)

    Maren Dreier

    Full Text Available Evidence-based health information (EBHI can support informed choice regarding whether or not to attend colorectal cancer (CRC screening. The present study aimed to assess if German leaflets and booklets appropriately inform consumers on the benefits and harms of CRC screening.A systematic search for print media on CRC screening was performed via email enquiry and internet search. The identified documents were assessed for the presence and correctness of information on benefits and harms by two reviewers independently using a comprehensive list of criteria.Many of the 28 leaflets and 13 booklets identified presented unbalanced information on the benefits and harms of CRC screening: one-third did not provide any information on harms. Numeracy information was often lacking. Ten cross-language examples of common misinterpretations or basically false and misleading information were identified.Most of the CRC screening leaflets and booklets in Germany do not meet current EBHI standards. After the study, the publishers of the information materials were provided feedback, including a discussion of our findings. The results can be used to revise existing information materials or to develop new materials that provide correct, balanced, quantified, understandable and unbiased information on CRC screening.

  8. Individual decision making in relation to participation in cardiovascular screening: a study of revealed and stated preferences.

    Science.gov (United States)

    Søgaard, Rikke; Lindholt, Jes; Gyrd-Hansen, Dorte

    2013-02-01

    The (cost-)effectiveness of a screening programme may be strongly influenced by the participation rate. The objective of this study was to compare participants' and non-participants' motives for the attendance decision as well as their overall preferences for participation in cardiovascular disease screening. This study sampled 1053 participants and 1006 non-participants from a screening trial and randomly allocated the participants to receive different levels of additional information about the screening programme. An ad hoc survey questionnaire about doubt and arguments in relation to the participation decision was given to participants and non-participants along with a contingent valuation task. Among participants, 5% had doubt about participation and the most frequent argument was that they did not want the test result. Among non-participants, 40% would reconsider their non-participation decision after having received additional information while the remainder 60% stood by their decision and provided explicit arguments for it. After having received additional information the participants still valued the programme significantly higher than non-participants, but the difference was relatively small. Participants and non-participants in cardiovascular screening programmes seem to have different strengths of preferences, which signals that their behavioural choice is founded in rational thinking. Furthermore, it appears that additional information and a second reflection about the participation decision may affect a substantial proportion of non-participants to reverse their decision, a finding that should receive policy interest.

  9. How to make rural jobs more attractive to health workers. Findings from a discrete choice experiment in Tanzania.

    Science.gov (United States)

    Kolstad, Julie Riise

    2011-02-01

    The geographical imbalance of the health workforce in Tanzania represents a serious problem when it comes to delivering crucial health services to a large share of the population. This study provides new quantitative information about how to make jobs in rural areas more attractive to newly educated clinical officers (COs). A unique data set stemming from a discrete choice experiment with CO finalists in Tanzania is applied. The results show that offering continuing education after a certain period of service is one of the most powerful recruitment instruments the authorities have available. Increased salaries and hardship allowances will also substantially increase recruitment in rural areas. Offers of decent housing and good infrastructure, including the provision of equipment, will increase recruitment to rural remote areas but not as much as higher wages and offers of education. Women are less responsive to pecuniary incentives and are more concerned with factors that directly allow them to do a good job, while those with parents living in a remote rural area are generally less responsive to the proposed policies. When the willingness to help other people is a strong motivating force, policies that improve the conditions for helping people appear particularly effective.

  10. Inconsistencies in patient perceptions and observer ratings of shared decision making: the case of colorectal cancer screening.

    Science.gov (United States)

    Wunderlich, Tracy; Cooper, Gregory; Divine, George; Flocke, Susan; Oja-Tebbe, Nancy; Stange, Kurt; Lafata, Jennifer Elston

    2010-09-01

    To compare patient-reported and observer-rated shared decision making (SDM) use for colorectal cancer (CRC) screening and evaluate patient, physician and patient-reported relational communication factors associated with patient-reported use of shared CRC screening decisions. Study physicians are salaried primary care providers. Patients are insured, aged 50-80 and due for CRC screening. Audio-recordings from 363 primary care visits were observer-coded for elements of SDM. A post-visit patient survey assessed patient-reported decision-making processes and relational communication during visit. Association of patient-reported SDM with observer-rated elements of SDM, as well as patient, physician and relational communication factors were evaluated using generalized estimating equations. 70% of patients preferred SDM for preventive health decisions, 47% of patients reported use of a SDM process, and only one of the screening discussions included all four elements of SDM per observer ratings. Patient report of SDM use was not associated with observer-rated elements of SDM, but was significantly associated with female physician gender and patient-reported relational communication. Inconsistencies exist between patient reports and observer ratings of SDM for CRC screening. Future studies are needed to understand whether SDM that is patient-reported, observer-rated or both are associated with informed and value-concordant CRC screening decisions. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Impact of Cell-Free Fetal DNA Screening on Patients’ Choice of Invasive Procedures after a Positive California Prenatal Screen Result

    Directory of Open Access Journals (Sweden)

    Forum T. Shah

    2014-07-01

    Full Text Available Until recently, maternal serum analyte levels paired with sonographic fetal nuchal translucency measurement was the most accurate prenatal screen available for Trisomies 18 and 21, (91% and 94% detection and false positive rates of 0.31% and 4.5% respectively. Women with positive California Prenatal Screening Program (CPSP results have the option of diagnostic testing to determine definitively if the fetus has a chromosomal abnormality. Cell-free fetal (cff- DNA screening for Trisomies 13, 18, and 21 was first offered in 2012, allowing women with positive screens to choose additional screening before diagnostic testing. Cff-DNA sensitivity rates are as high as 99.9% and 99.1%, with false positive rates of 0.4% and 0.1%, for Trisomies 18 and 21, respectively. A retrospective chart review was performed in 2012 on 500 CPSP referrals at the University of California, San Diego Thornton Hospital. Data were collected prior to and after the introduction of cff-DNA. There was a significant increase in the number of participants who chose to pursue additional testing and a decrease in the number of invasive procedures performed after cff-DNA screening was available. We conclude that as fetal aneuploidy screening improves, the number of invasive procedures will continue to decrease.

  12. Governance mode vs. governance fit? : Performance implications of make-or-ally choices for product innovation in the worldwide aircraft industry, 1942-2000

    OpenAIRE

    Castaner, X.; Mulotte, L.; Garrette, B.; Dussauge, P.

    2014-01-01

    We examine the impact of governance mode and governance fit on performance in make-or-ally decisions. We argue that while horizontal collaboration and autonomous governance have direct and countervailing performance implications, the alignment of make-or-ally choices with the focal firm's resource endowment and the activity's resource requirements leads to better performance. Data on the aircraft industry show that relative to aircraft developed autonomously, collaborative aircraft exhibit gr...

  13. Valence of emotions and moral decision-making: increased pleasantness to pleasant images and decreased unpleasantness to unpleasant images are associated with utilitarian choices in healthy adults.

    Science.gov (United States)

    Carmona-Perera, Martina; Martí-García, Celia; Pérez-García, Miguel; Verdejo-García, Antonio

    2013-01-01

    Moral decision-making is a key asset for humans' integration in social contexts, and the way we decide about moral issues seems to be strongly influenced by emotions. For example, individuals with deficits in emotional processing tend to deliver more utilitarian choices (accepting an emotionally aversive action in favor of communitarian well-being). However, little is known about the association between emotional experience and moral-related patterns of choice. We investigated whether subjective reactivity to emotional stimuli, in terms of valence, arousal, and dominance, is associated with moral decision-making in 95 healthy adults. They answered to a set of moral and non-moral dilemmas and assessed emotional experience in valence, arousal and dominance dimensions in response to neutral, pleasant, unpleasant non-moral, and unpleasant moral pictures. Results showed significant correlations between less unpleasantness to negative stimuli, more pleasantness to positive stimuli and higher proportion of utilitarian choices. We also found a positive association between higher arousal ratings to negative moral laden pictures and more utilitarian choices. Low dominance was associated with greater perceived difficulty over moral judgment. These behavioral results are in fitting with the proposed role of emotional experience in moral choice.

  14. Valence of emotions and moral decision-making: increased pleasantness to pleasant images and decreased unpleasantness to unpleasant images are associated with utilitarian choices in healthy adults

    Science.gov (United States)

    Carmona-Perera, Martina; Martí-García, Celia; Pérez-García, Miguel; Verdejo-García, Antonio

    2013-01-01

    Moral decision-making is a key asset for humans’ integration in social contexts, and the way we decide about moral issues seems to be strongly influenced by emotions. For example, individuals with deficits in emotional processing tend to deliver more utilitarian choices (accepting an emotionally aversive action in favor of communitarian well-being). However, little is known about the association between emotional experience and moral-related patterns of choice. We investigated whether subjective reactivity to emotional stimuli, in terms of valence, arousal, and dominance, is associated with moral decision-making in 95 healthy adults. They answered to a set of moral and non-moral dilemmas and assessed emotional experience in valence, arousal and dominance dimensions in response to neutral, pleasant, unpleasant non-moral, and unpleasant moral pictures. Results showed significant correlations between less unpleasantness to negative stimuli, more pleasantness to positive stimuli and higher proportion of utilitarian choices. We also found a positive association between higher arousal ratings to negative moral laden pictures and more utilitarian choices. Low dominance was associated with greater perceived difficulty over moral judgment. These behavioral results are in fitting with the proposed role of emotional experience in moral choice. PMID:24133433

  15. Are Sexual and Emotional Infidelity Equally Upsetting to Men and Women? Making Sense of Forced-Choice Responses

    Directory of Open Access Journals (Sweden)

    David A. Lishner

    2008-10-01

    Full Text Available Forced-choice measures that assess reactions to imagined sexual and emotional infidelity are ubiquitous in studies testing the Jealousy as a Specific Innate Module (JSIM model. One potential problem with such measures is that they fail to identify respondents who find both forms of infidelity equally upsetting. To examine this issue, an experiment was conducted in which two groups of participants imagined a romantic infidelity after which participants in the first group used a traditional forced-choice measure to indicate whether they found sexual or emotional infidelity more upsetting. Participants in the second group instead used a modified forced-choice measure that allowed them also to indicate whether they found both forms of infidelity equally upsetting. Consistent with previous research, those given the traditional forced-choice measure tended to respond in a manner that supported the JSIM model. However, the majority of participants given the modified measure indicated that both forms of infidelity were equally upsetting.

  16. The neuronal substrate of risky choice: an insight into the contributions of neuroimaging to the understanding of theories on decision making under risk.

    Science.gov (United States)

    Vorhold, Verena

    2008-04-01

    This chapter provides an overview of studies in the field of neuroscience that investigate some of the processes and concepts of risk perception, risky choice, and decision making under risk. First, early studies in the field of neuroscience addressing the diminished decision-making abilities in lesion patients are presented. A classical task in this research field is described along with its neural implications. After this, the underlying model, its hypotheses, and neuronal implications are discussed. Different aspects within risky decision making, such as the influence of memory, inhibition, motivation, and personality, on risky choice and the respective underlying neuronal substrate are described. After this, studies of risky decision making in healthy subjects are reviewed. A selection of studies shows that theories focusing on cognitive aspects only have to be enriched in order to allow for additional aspects within risky decision making (e.g., emotion). Next, the classical economic approaches and the development of theories incorporating further aspects within economical decision making and the underlying neuronal substrate will be presented. Finally, research in the field of neuroeconomics, focusing on the role of social decision making and evaluative judgment within risky decision making, is reviewed.

  17. Nonsensical choices? Fall armyworm moths choose seemingly best or worst hosts for their larvae, but neonate larvae make their own choices.

    Directory of Open Access Journals (Sweden)

    Julio C Rojas

    Full Text Available Selecting optimal host plants is critical for herbivorous insects, such as fall armyworm (Spodoptera frugiperda, an important maize pest in the Americas and Africa. Fall armyworm larvae are presumed to have limited mobility, hence female moths are presumed to be largely responsible for selecting hosts. We addressed host selection by fall armyworm moths and neonate and older (3rd-instar larvae, as mediated by resistance and herbivory in maize plants. Thus, we compared discrimination among three maize cultivars with varying degrees of resistance to fall armyworm, and between plants subjected or not to two types of herbivory. The cultivars were: (i susceptible, and deficient in jasmonic acid (JA production and green leaf volatiles (GLV emissions (inbred line B73-lox10; (ii modestly resistant (B73, and; (iii highly resistant (Mp708. The herbivory types were: (i ongoing (= fall armyworm larvae present, and; (ii future (= fall armyworm eggs present. In choice tests, moths laid more eggs on the highly resistant cultivar, and least on the susceptible cultivar, though on those cultivars larvae performed poorest and best, respectively. In the context of herbivory, moths laid more eggs: (i on plants subject to versus free of future herbivory, regardless of whether plants were deficient or not in JA and GLV production; (ii on plants subject versus free of ongoing herbivory, and; (iii on plants not deficient in compared to deficient in JA and GLV production. Neonate larvae dispersed aerially from host plants (i.e. ballooned, and most larvae colonized the modestly resistant cultivar, and fewest the highly resistant cultivar, suggesting quasi-directional, directed aerial descent. Finally, dispersing older larvae did not discriminate among the three maize cultivars, nor between maize plants and (plastic model maize plants, suggesting random, visually-oriented dispersal. Our results were used to assemble a model of host selection by fall armyworm moths and

  18. A computer-tailored intervention to promote informed decision making for prostate cancer screening among African-American men

    Science.gov (United States)

    Allen, Jennifer D.; Mohllajee, Anshu P.; Shelton, Rachel C.; Drake, Bettina F.; Mars, Dana R.

    2010-01-01

    African-American men experience a disproportionate burden of prostate cancer (CaP) morbidity and mortality. National screening guidelines advise men to make individualized screening decisions through a process termed “informed decision making” (IDM). In this pilot study, a computer-tailored decision-aid designed to promote IDM was evaluated using a pre/post test design. African-American men aged 40+ recruited from a variety of community settings (n=108). At pre-test, 43% of men reported having made a screening decision; at post-test 47% reported this to be the case (p=0.39). Significant improvements were observed on scores (0–100%) of knowledge (54% vs 72%; pMen were also more likely to want an active role in decision-making after using the tool (67% vs 75%; p=0.03). These results suggest that use of a computer-tailored decision-aid is a promising strategy to promote IDM for CaP screening among African-American men. PMID:19477736

  19. Narrative message targets within the decision-making process to undergo screening colonoscopy among Latinos: a qualitative study.

    Science.gov (United States)

    Hennelly, Marie Oliva; Sly, Jamilia R; Villagra, Cristina; Jandorf, Lina

    2015-06-01

    Colorectal cancer (CRC) is a preventable yet leading cause of cancer mortality among Latinos in the USA. Cultural targeting and narrative messaging are two strategies to increase the low screening colonoscopy rates among Latinos. This study identifies key messages for educational interventions aiming to increase screening colonoscopy used among Latinos and proposes a model to understand the relationship between factors involved in colonoscopy decision-making. Individual in-depth interviews were conducted with 12 Latino participants primarily of Puerto Rican descent on the topics of CRC knowledge, barriers and facilitators to colonoscopy use, and the use of narrative in colorectal health messaging. Knowledge about colorectal anatomy and the anesthesia component of colonoscopy procedure is low. Fear of procedure-related pain and fear of treatment-related burden following a cancer diagnosis are significant barriers to colonoscopy. Fear of disease-related suffering and death following a cancer diagnosis and fear of regret are strong facilitators and can be augmented by cancer narratives. Storytelling is commonly used in Latino culture and is an acceptable method to educate the Latino community about CRC screening via colonoscopy. Machismo is a unique barrier to colonoscopy for Latino men via homophobia and reluctance to seek healthcare. A preliminary model to understand factors in colonoscopy decision-making among Latinos is presented. Counseling practices and educational interventions that use culturally targeted narrative health messaging to mediate fears and increase colonoscopy knowledge may increase screening colonoscopy use among Latinos.

  20. Prostate cancer screening and shared decision-making preferences among African-American members of the Prince Hall Masons.

    Science.gov (United States)

    Williams, Randi M; Zincke, Nicole L; Turner, Ralph O; Davis, Jackson L; Davis, Kimberly M; Schwartz, Marc D; Johnson, Lenora; Kerner, Jon F; Taylor, Kathryn L

    2008-10-01

    Shared decision making (SDM) is recommended as one method to assist men in making an informed decision about prostate cancer screening (PCS). SDM preferences for PCS have not been evaluated among African-American (AA) men. Given AA men's increased risk and the uncertainty surrounding screening, it is critical to determine how to assist AA men in making an informed decision. We assessed the extent to which a sample of AA men wished to engage in SDM regarding PCS and the demographic and psychological characteristics associated with SDM preferences. Participants completed a telephone interview that covered demographic and medical information, SDM preferences, PCS knowledge, decisional conflict, and satisfaction with previous screening decisions. Subjects included 286 AA men aged 40-70, who were members of a Masonic organization. Fifty-seven percent preferred SDM, 36% preferred to make their own decision, and 7% wanted their doctor to decide. A higher level of education and older age were associated with preferring SDM (p<0.05), while men with greater PCS knowledge were more likely to prefer to make the decision independently (p<0.05). Results suggest that physicians need to be prepared to discuss PCS with their patients. Further, more attention may be needed to engage younger, less educated, and less knowledgeable men as they may be less likely to discuss PCS. This understanding of AA men's preferences for PCS decisions helps to clarify the issues that health professionals need to consider when attempting to assist AA men in making a PCS decision. Copyright (c) 2008 John Wiley & Sons, Ltd.

  1. Why women of lower educational attainment struggle to make healthier food choices: the importance of psychological and social factors.

    Science.gov (United States)

    Lawrence, Wendy; Skinner, Chas; Haslam, Cheryl; Robinson, Sian; Inskip, Hazel; Barker, David; Cooper, Cyrus; Jackson, Alan; Barker, Mary

    2009-11-01

    Women of lower educational attainment are more likely to eat unhealthy diets than women of higher educational attainment. To identify influences on the food choices of women with lower educational attainment, 11 focus groups (eight with women of lower, and three with women of higher educational attainment) were held. Using a semi-structured discussion guide, environmental, social, historical and psychological factors known to be associated with food choice were explored. Audio recordings were transcribed verbatim and thematically analysed. Compared to women of higher educational attainment, women of lower educational attainment had less control over their families' food choices, less support for attempts to eat healthily, fewer opportunities to observe and learn good food-related practices, more negative affect, more perceived environmental constraints and more ambiguous beliefs about the consequences of eating a nutritious diet. These findings provide a starting point for taking forward the design of an intervention to improve the diets of young women.

  2. The Effect of Trait Self-Awareness, Self-Reflection, and Perceptions of Choice Meaningfulness on Indicators of Social Identity within a Decision-Making Context.

    Science.gov (United States)

    Dishon, Noam; Oldmeadow, Julian A; Critchley, Christine; Kaufman, Jordy

    2017-01-01

    Theorists operating from within a narrative identity framework have suggested that self-reflective reasoning plays a central role in the development of the self. Typically, however, narrative identity researchers have investigated this relationship using correlational rather than experimental methods. In the present study, leveraging on a classic research paradigm from within the social identity literature we developed an experiment to test the extent to which self-reflection might have a causal impact on the self-concept within a decision-making context. In a minimal group paradigm participants were prompted to reflect on their painting choices either before or after allocating points to in-group∖ out-group members. As anticipated, self-reflection augmented social identification, but only when participants felt their choices were personally meaningful. Participants who reasoned about their choices and felt they were subjectively meaningful showed stronger similarity and liking for in-group members compared to those who did not reflect on their choices or found them to be subjectively meaningless. Hence, reflecting on and finding meaning in one's choices may be an important step in linking behavior with in-group identification and thus the self-concept in turn. The absence of any effects on in-group favoritism (a third indicator of social identification measured) as well as implications of the study's findings for self-perception, cognitive dissonance and social identity processes are also discussed.

  3. Are medical students influenced by preceptors in making career choices, and if so how? A systematic review.

    Science.gov (United States)

    Stagg, P; Prideaux, D; Greenhill, J; Sweet, L

    2012-01-01

    Increasingly medical students undertake clinical training in distributed learning environments. The driving factor for this is predominantly to address medical workforce shortages. In these environments students are often taught by private practitioners, residents, house staff and registrars, as well as faculty. Through a mix of short- and long-term preceptorships, clerkships and rotations, medical students are exposed to a wider range of preceptors, mentors and role models than has traditionally been the case. The aim of this systematic review was to understand if and how medical students' career choices are influenced by their interactions with preceptors. A search of Ovid Medline, Scopus, ISI Web of Science, PubMed, Eric and CIHNAL was undertaken. The search was structured around the key terms: Medical Student, Career Choice and Preceptor, and variants of these terms. Search limits were set to English-language publications between 1995 and 2010. A total of 36 articles met the selection criteria from the 533 citations sourced from the search. Required preceptorships as short as 3 weeks' duration influence the career choice of students when they rate the preceptor as a high quality teacher. Preceptors who are judged (by students) as high quality teachers have the greatest influence on student career choice by up to four-fold. When students judged a preceptor as being a negative role model, a poor teacher or lacking discipline specific knowledge they will turn away from that field. The positive influence of relationships between preceptors and students on career choice is strongest where there is continuity of preceptors, continuity of care, and continuity of patient interactions. The longer the duration of the preceptorship the greater the influence on student career choice, particularly in primary cares environments. This review adds to the literature by identifying how differing components and combinations of components of a preceptorship influence medical

  4. The Lichtenberg Financial Decision Screening Scale (LFDSS): A new tool for assessing financial decision making and preventing financial exploitation.

    Science.gov (United States)

    Lichtenberg, Peter A; Ficker, Lisa; Rahman-Filipiak, Analise; Tatro, Ron; Farrell, Cynthia; Speir, James J; Mall, Sanford J; Simasko, Patrick; Collens, Howard H; Jackman, John Daniel

    2016-01-01

    One of the challenges in preventing the financial exploitation of older adults is that neither criminal justice nor noncriminal justice professionals are equipped to detect capacity deficits. Because decision-making capacity is a cornerstone assessment in cases of financial exploitation, effective instruments for measuring this capacity are essential. We introduce a new screening scale for financial decision making that can be administered to older adults. To explore the scale's implementation and assess construct validity, we conducted a pilot study of 29 older adults seen by APS (Adult Protective Services) workers and 79 seen by other professionals. Case examples are included.

  5. Making Good Choices: How Autonomy Support Influences the Behavior Change and Motivation of Troubled and Troubling Youth

    Science.gov (United States)

    Harper, Elaine

    2007-01-01

    Autonomy is a basic human need having influence on motivation. Facilitating student autonomy is an essential ingredient of effective programs for maximizing internalized change and increasing motivation in troubled and troubling youth. This article examines the theoretical concepts of autonomy and control related to choices and considers their…

  6. "Putting Music On": Everyday Leisure Activities, Choice-Making and Person-Centred Planning in a Supported Living Scheme

    Science.gov (United States)

    Hassan, Nedim

    2017-01-01

    Background: Person-centred planning, which commonly becomes formalised within services for people with learning disabilities through an Essential Lifestyle Plan (ELP), was intended to help place the choices of individuals at the forefront of service provision. However, beyond UK government policy rhetoric, scholars have raised issues regarding the…

  7. Shared decision-making for prostate cancer screening and treatment: a systematic review of randomised controlled trials.

    Science.gov (United States)

    Martínez-González, Nahara Anani; Plate, Andreas; Senn, Oliver; Markun, Stefan; Rosemann, Thomas; Neuner-Jehle, Stefan

    2018-02-23

    Men facing prostate cancer screening and treatment need to make critical and highly preference-sensitive decisions that involve a variety of potential benefits and risks. Shared decision-making (SDM) is considered fundamental for "preference-sensitive" medical decisions and it is guideline-recommended. There is no single definition of SDM however. We systematically reviewed the extent of SDM implementation in interventions to facilitate SDM for prostate cancer screening and treatment. We searched Medline Ovid, Embase (Elsevier), CINHAL (EBSCOHost), The Cochrane Library (Wiley), PsychINFO (EBSCOHost), Scopus, clinicaltrials.gov, ISRCTN registry, the WHO search portal, ohri.ca, opengrey.eu, Google Scholar, and the reference lists of included studies, clinical guidelines and relevant reviews. We also contacted the authors of relevant abstracts without available full text. We included primary peer-reviewed and grey literature of randomised controlled trials (RCTs) reported in English, conducted in primary and specialised care, addressing interventions aiming to facilitate SDM for prostate cancer screening and treatment. Two reviewers independently selected studies, appraised interventions and assessed the extent of SDM implementation based on the key features of SDM, namely information exchange, deliberation and implementation. We considered bi-directional deliberation as a central and mandatory component of SDM. We performed a narrative synthesis. Thirty-six RCTs including 19 196 randomised patients met the eligibility criteria; they were mainly conducted in North America (n = 28). The median year of publication was 2008 (1997-2015). Twenty-three RCTs addressed decision-making for screening, twelve for treatment and one for both screening and treatment for prostate cancer. Bi-directional interactions between healthcare providers and patients were verified in 31 RCTs, but only 14 fulfilled the three key SDM features, 14 had at least "deliberation", one had "unclear

  8. Which Infidelity Type Makes You More Jealous? Decision Strategies in a Forced-Choice between Sexual and Emotional Infidelity

    OpenAIRE

    Achim Schützwohl

    2004-01-01

    This study tested the prediction derived from the evolutionary psychological analysis of jealousy that men and women selecting the adaptively primary infidelity type (i.e., female sexual and male emotional infidelity, respectively) in a forced-choice response format need to engage in less elaborate decision strategies than men and women selecting the adaptively secondary infidelity type (i.e., male sexual and female emotional infidelity, respectively). Unknown to the participants, decision ti...

  9. Automated Electrophysiology Makes the Pace for Cardiac Ion Channel Safety Screening

    Directory of Open Access Journals (Sweden)

    Clemens eMoeller

    2011-11-01

    Full Text Available The field of automated patch-clamp electrophysiology has emerged from the tension between the pharmaceutical industry’s need for high-throughput compound screening versus its need to be conservative due to regulatory requirements. On the one hand, hERG channel screening was increasingly requested for new chemical entities, as the correlation between blockade of the ion channel coded by hERG and Torsades de Pointes cardiac arrhythmia gained increasing attention. On the other hand, manual patch-clamping, typically quoted as the gold-standard for understanding ion channel function and modulation, was far too slow (and, consequently, too expensive for keeping pace with the numbers of compounds submitted for hERG channel investigations from pharmaceutical R&D departments. In consequence it became more common for some pharmaceutical companies to outsource safety pharmacological investigations, with a focus on hERG channel interactions. This outsourcing has allowed those pharmaceutical companies to build up operational flexibility and greater independence from internal resources, and allowed them to obtain access to the latest technological developments that emerged in automated patch-clamp electrophysiology – much of which arose in specialized biotech companies. Assays for nearly all major cardiac ion channels are now available by automated patch-clamping using heterologous expression systems, and recently, automated action potential recordings from stem-cell derived cardiomyocytes have been demonstrated. Today, most of the large pharmaceutical companies have acquired automated electrophysiology robots and have established various automated cardiac ion channel safety screening assays on these, in addition to outsourcing parts of their needs for safety screening.

  10. Α4β2 and α7 nicotinic acetylcholine receptor binding predicts choice preference in two cost benefit decision-making tasks.

    Science.gov (United States)

    Mendez, I A; Damborsky, J C; Winzer-Serhan, U H; Bizon, J L; Setlow, B

    2013-01-29

    Nicotinic receptors have been linked to a wide range of cognitive and behavioral functions, but surprisingly little is known about their involvement in cost benefit decision making. The goal of these experiments was to determine how nicotinic acetylcholine receptor (nAChR) expression is related to two forms of cost benefit decision making. Male Long Evans rats were tested in probability- and delay-discounting tasks, which required discrete trial choices between a small reward and a large reward associated with varying probabilities of omission and varying delays to reward delivery, respectively. Following testing, radioligand binding to α4β2 and α7 nAChR subtypes in brain regions implicated in cost benefit decision making was examined. Significant linear relationships were observed between choice of the large delayed reward in the delay discounting task and α4β2 receptor binding in both the dorsal and ventral hippocampus. Additionally, trends were found suggesting that choice of the large costly reward in both discounting tasks was inversely related to α4β2 receptor binding in the medial prefrontal cortex and nucleus accumbens shell. Similar trends suggested that choice of the large delayed reward in the delay discounting task was inversely related to α4β2 receptor binding in the orbitofrontal cortex, nucleus accumbens core, and basolateral amygdala, as well as to α7 receptor binding in the basolateral amygdala. These data suggest that nAChRs (particularly α4β2) play both unique and common roles in decisions that require consideration of different types of reward costs. Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.

  11. A two-layered diffusion model traces the dynamics of information processing in the valuation-and-choice circuit of decision making.

    Science.gov (United States)

    Piu, Pietro; Fargnoli, Francesco; Innocenti, Alessandro; Rufa, Alessandra

    2014-01-01

    A circuit of evaluation and selection of the alternatives is considered a reliable model in neurobiology. The prominent contributions of the literature to this topic are reported. In this study, valuation and choice of a decisional process during Two-Alternative Forced-Choice (TAFC) task are represented as a two-layered network of computational cells, where information accrual and processing progress in nonlinear diffusion dynamics. The evolution of the response-to-stimulus map is thus modeled by two linked diffusive modules (2LDM) representing the neuronal populations involved in the valuation-and-decision circuit of decision making. Diffusion models are naturally appropriate for describing accumulation of evidence over the time. This allows the computation of the response times (RTs) in valuation and choice, under the hypothesis of ex-Wald distribution. A nonlinear transfer function integrates the activities of the two layers. The input-output map based on the infomax principle makes the 2LDM consistent with the reinforcement learning approach. Results from simulated likelihood time series indicate that 2LDM may account for the activity-dependent modulatory component of effective connectivity between the neuronal populations. Rhythmic fluctuations of the estimate gain functions in the delta-beta bands also support the compatibility of 2LDM with the neurobiology of DM.

  12. An application of the rational choice approach to the offending process of sex offenders: a closer look at the decision-making.

    Science.gov (United States)

    Beauregard, Eric; Leclerc, Benoît

    2007-06-01

    Although the study of both offense processes and implicit theories provides in-depth knowledge about the decision-making of sex offenders, these studies focus solely on the internal psychological processes of the offender leading to the commission of a sexual assault. These studies neglect to look specifically at the offender's decision-making during the offense in interaction with the immediate situations encountered at the offense scene, such as the choices of behavior while interacting with the victim in a specific context. Based on a rational choice approach, this study investigates the decision-making involved in the offending process of 69 serial sexual offenders who have committed their crimes against stranger victims. Semi-structured interviews were conducted with offenders in order to identify the rationale behind their actions during the pre-crime phase (premeditation of the crime, estimation of risk of apprehension by the offender, and forensic awareness of the offender), crime phase (use of a weapon, use of restraints, use of a vehicle, and level of force used), and the post-crime phase (event leading to the end of crime and victim release site location choice). Results show that sex offenders, even if traditionally described as "irrational" and impulsive individuals, are capable, up to a certain point, of an analysis of the costs/benefits related to their actions. Moreover, results emphasize the important role of situational factors, such as victim resistance, on the decision-making process of sex offenders. Implications of the results are briefly discussed in regard of clinical practice and crime prevention.

  13. Which Infidelity Type Makes You More Jealous? Decision Strategies in a Forced-Choice between Sexual and Emotional Infidelity

    Directory of Open Access Journals (Sweden)

    Achim Schützwohl

    2004-01-01

    Full Text Available This study tested the prediction derived from the evolutionary psychological analysis of jealousy that men and women selecting the adaptively primary infidelity type (i.e., female sexual and male emotional infidelity, respectively in a forced-choice response format need to engage in less elaborate decision strategies than men and women selecting the adaptively secondary infidelity type (i.e., male sexual and female emotional infidelity, respectively. Unknown to the participants, decision times were registered as an index of the elaborateness of their decision strategies. The results clearly support the prediction. Implications and limitations of the present findings are discussed.

  14. Kid-Friendly Veggies and Fruits: 10 Tips for Making Healthy Food Choices More Fun for Children

    Science.gov (United States)

    ... Set up a pizza-making station in the kitchen. Use whole-wheat English muffins, bagels, or pita ... veggies or fruits into a fun shape or design. 5 fruity peanut butterfly Start with carrot sticks ...

  15. Affective and rational consumer choice modes: The role of intuition, analytical decision-making, and attitudes to money

    OpenAIRE

    Andersson, Patric; Engelberg, Elisabeth

    2006-01-01

    This paper was motivated by a paucity of research addressing how consumer decision-making is related to beliefs about money and different modes of reasoning. To investigate this issue, data were collected from 142 participants, who filled out questionnaires involving scales aimed to measure affective and rational purchase approaches, intuitive and analytical decision-making styles, as well as money attitudes. One finding was that consumers interchangeably rely on affective and rational approa...

  16. Community- and family-level factors influence care-giver choice to screen blood lead levels of children in a mining community.

    Science.gov (United States)

    Moodie, S M; Tsui, E K; Silbergeld, E K

    2010-07-01

    Bunker Hill, in Kellogg, Idaho, formerly a lead mine (1884-1981) and smelter (1917-1981), is now a Superfund site listed on the Environmental Protection Agency's (EPA) National Priorities List. Lead contamination from the site is widespread due to past smelter discharges to land, water, and air, placing children at risk for both exposure to lead and resultant health effects of lead. Since 1983, the EPA has used child blood lead levels to inform the clean-up standards for the Bunker Hill Superfund site. This study was undertaken to examine factors that have contributed to the significant fall-off in the rates and numbers of children being screened for blood lead in Kellogg (number screened decreased from 195 to 8 from 2002 to 2007). The goal of this research project was to define community- and family-level factors which influence care-giver choice to screen blood lead levels of their children in this environment. This formative research study used mixed methods and was comprised of three research components: (1) preliminary interviews using community-based participatory research methods to define key research questions of relevance to community members, government and NGOs working in relation to the Bunker Hill clean-up; (2) a quantitative analysis of a cross-sectional household survey conducted with adult care-givers about child blood lead screening in Kellogg; and (3) ethnographic community rapid assessment methods formed the in-depth interview process and qualitative analysis. The survey showed the likelihood of blood lead screening that for children under the age of 18 years increases 34% with each one-year increase in current age of the child (95% CI, 1.08-1.67, p-value=0.009), and decreases 45% with annual household income greater than $10,000 (95% CI, 0.35-0.88, p-value=0.013). Sibling birth order increased the likelihood of blood lead screening by 61% (95% CI, 1.04-2.48, p-value=0.032) for each successive child. Female children were rated by their care

  17. Consumer Product Data for Exposure Screening, Modeling and Prioritization, and Risk-based Decision Making

    Science.gov (United States)

    This presentation will provide an overview of the research efforts underway in EPA ORD's Chemicals for Safety and Sustainability research program which relate to providing information to prioritize chemicals in consumer products based on risk. It also describes effort to make dat...

  18. The Peru Cervical Cancer Prevention Study (PERCAPS): the technology to make screening accessible.

    Science.gov (United States)

    Levinson, Kimberly L; Abuelo, Carolina; Salmeron, Jorge; Chyung, Eunice; Zou, Jing; Belinson, Suzanne E; Wang, Guixiang; Ortiz, Carlos Santos; Vallejos, Carlos Santiago; Belinson, Jerome L

    2013-05-01

    This study utilized a combination of HPV self-sampling, iFTA elute specimen cards, and long distance transport for centralized processing of specimens to determine the feasibility of large-scale screening in remote and transient populations. This study was performed in two locations in Peru (Manchay and Iquitos). The "Just For Me" cervico-vaginal brush and iFTA elute cards were used for the collection and transport of specimens. Samples were shipped via FedEx to China and tested for 14 types of high-risk HPV using PCR based MALDI-TOF. HPV positive women were treated with cryotherapy after VIA triage, and followed-up with colposcopy, biopsy, ECC, and repeat HPV testing at 6 months. Six hundred and forty three women registered, and 632 returned a sample over a 10 day period. Within 2 weeks, specimens were shipped, samples tested, and results received by study staff. Sixty-eight women (10.8%) tested positive, and these results were delivered over 4 days. Fifty-nine HPV positive women (87%) returned for evaluation and treatment, and 2 had large lesions not suitable for cryotherapy. At 6 months, 42 women (74%) returned for follow-up, and 3 had CIN 2 (all positive samples from the endocervical canal). Ninety eight percent of participants reported that they would participate in this type of program again. Utilizing HPV self-sampling, solid media specimen cards for long distance transport, and centralized high throughput processing, we achieved rapid delivery of results, high satisfaction levels, and low loss to follow-up for cervical cancer screening in remote and transient populations. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Bayesian deterministic decision making: A normative account of the operant matching law and heavy-tailed reward history dependency of choices

    Directory of Open Access Journals (Sweden)

    Hiroshi eSaito

    2014-03-01

    Full Text Available The decision making behaviors of humans and animals adapt and then satisfy an ``operant matching law'' in certain type of tasks. This was first pointed out by Herrnstein in his foraging experiments on pigeons. The matching law has been one landmark for elucidating the underlying processes of decision making and its learning in the brain. An interesting question is whether decisions are made deterministically or probabilistically. Conventional learning models of the matching law are based on the latter idea; they assume that subjects learn choice probabilities of respective alternatives and decide stochastically with the probabilities. However, it is unknown whether the matching law can be accounted for by a deterministic strategy or not. To answer this question, we propose several deterministic Bayesian decision making models that have certain incorrect beliefs about an environment. We claim that a simple model produces behavior satisfying the matching law in static settings of a foraging task but not in dynamic settings. We found that the model that has a belief that the environment is volatile works well in the dynamic foraging task and exhibits undermatching, which is a slight deviation from the matching law observed in many experiments. This model also demonstrates the double-exponential reward history dependency of a choice and a heavier-tailed run-length distribution, as has recently been reported in experiments on monkeys.

  20. End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire

    Directory of Open Access Journals (Sweden)

    Dagmar Elfriede Rinnenburger

    2012-01-01

    Full Text Available INTRODUCTION: The transition from paternalistic medicine to a healthcare culture centred on the patient's decision making autonomy presents problems of communication and understanding. Chronic respiratory failure challenges patients, their families and caregivers with important choices, such as invasive and non-invasive mechanical ventilation and tracheostomy, which, especially in the case of neuromuscular diseases, can significantly postpone the end of life. MATERIAL AND METHODS: A 7-item questionnaire was administered to 100 patients with advanced COPD, neuromuscular diseases and pulmonary fibrosis, all of them on oxygen therapy and receiving day-hospital treatment for respiratory failure. The objective was to find out whether or not patients, if faced with a deterioration of their health condition, would want to take part in the decision making process and, if so, how and with whom. RESULTS. Results showed that: 90% of patients wanted to be interviewed, 10% preferred not to be interviewed, 82% wanted to be regularly updated on their clinical situation, 75% wanted to be intubated, if necessary, and 56% would also agree to have a tracheostomy. These choices have been confirmed one year later, with 93% of respondents accepting the questionnaire and considering it useful. CONCLUSIONS: It is possible to conclude that a simple questionnaire can be a useful tool contributing to therapeutic decision making in respiratory failure.

  1. Market Exchange Rates Or Purchasing Power Parity. Does The Choice Make A Difference To The Climate Debate?

    International Nuclear Information System (INIS)

    Manne, A.S.; Richels, R.G.; Edmonds, J.A.

    2005-01-01

    Critics of the Intergovernmental Panel on Climate Change's Special Report on Emission Scenarios claim that the use of market exchange rates (MER) rather than purchasing power parity (PPP) to measure gross domestic product (GDP) has led to a significant upward bias in projections of greenhouse gas emissions, and hence unrealistically high future temperature. Rather than revisit the debate on the choice of exchange rates, we address a much simpler question: when it comes to temperature change, how much does it matter if potential GDP is expressed in MER rather than PPP? Employing a computable general equilibrium model designed to examine a variety of issues in the climate debate, we find that there is a difference, but that it is only minor

  2. Independence and interdependence in collective decision making: an agent-based model of nest-site choice by honeybee swarms

    Science.gov (United States)

    List, Christian; Elsholtz, Christian; Seeley, Thomas D.

    2008-01-01

    Condorcet's jury theorem shows that when the members of a group have noisy but independent information about what is best for the group as a whole, majority decisions tend to outperform dictatorial ones. When voting is supplemented by communication, however, the resulting interdependencies between decision makers can strengthen or undermine this effect: they can facilitate information pooling, but also amplify errors. We consider an intriguing non-human case of independent information pooling combined with communication: the case of nest-site choice by honeybee (Apis mellifera) swarms. It is empirically well documented that when there are different nest sites that vary in quality, the bees usually choose the best one. We develop a new agent-based model of the bees' decision process and show that its remarkable reliability stems from a particular interplay of independence and interdependence between the bees. PMID:19073474

  3. Use of classical criterions of a decision making for choice of measures on decrease of economic damage from nuclear and radiation accidents

    International Nuclear Information System (INIS)

    Rylov, M.I.; Kamynov, Sh.V.; Mozhaev, A.S.; Anisimov, N.A.; Nikitin, V.S.

    2004-01-01

    Application of classical criteria of decision making for choice of measures on the decrease of economic damage from possible nuclear and radiation accidents during spent fuel unloading from nuclear submarines and storage in the process of their utilization was demonstrated. Economic damage was chosen as optimization index, three versions of possible accidents and limited number of measures on the decrease of their effect were treated for illustration of the suggested approach. On the base of analysis of classical criteria the optimal strategy for decrease of economic damage was chosen [ru

  4. Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes.

    Science.gov (United States)

    Fischer, Katharina E

    2012-08-02

    Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites) that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM) to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. After modification by dropping two indicators that showed poor measures in the measurement models' quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of 'transparency', 'participation', 'scientific rigour' and 'reasonableness'. The structural equation model was among the first applications of PLS-PM to coverage decision-making. It allowed testing of hypotheses in situations where there

  5. Decision-making in healthcare: a practical application of partial least square path modelling to coverage of newborn screening programmes

    Directory of Open Access Journals (Sweden)

    Fischer Katharina E

    2012-08-01

    Full Text Available Abstract Background Decision-making in healthcare is complex. Research on coverage decision-making has focused on comparative studies for several countries, statistical analyses for single decision-makers, the decision outcome and appraisal criteria. Accounting for decision processes extends the complexity, as they are multidimensional and process elements need to be regarded as latent constructs (composites that are not observed directly. The objective of this study was to present a practical application of partial least square path modelling (PLS-PM to evaluate how it offers a method for empirical analysis of decision-making in healthcare. Methods Empirical approaches that applied PLS-PM to decision-making in healthcare were identified through a systematic literature search. PLS-PM was used as an estimation technique for a structural equation model that specified hypotheses between the components of decision processes and the reasonableness of decision-making in terms of medical, economic and other ethical criteria. The model was estimated for a sample of 55 coverage decisions on the extension of newborn screening programmes in Europe. Results were evaluated by standard reliability and validity measures for PLS-PM. Results After modification by dropping two indicators that showed poor measures in the measurement models’ quality assessment and were not meaningful for newborn screening, the structural equation model estimation produced plausible results. The presence of three influences was supported: the links between both stakeholder participation or transparency and the reasonableness of decision-making; and the effect of transparency on the degree of scientific rigour of assessment. Reliable and valid measurement models were obtained to describe the composites of ‘transparency’, ‘participation’, ‘scientific rigour’ and ‘reasonableness’. Conclusions The structural equation model was among the first applications of PLS-PM to

  6. Choice Shifts in Groups

    OpenAIRE

    Kfir Eliaz; Debraj Ray

    2004-01-01

    The phenomenon of "choice shifts" in group decision-making is fairly ubiquitous in the social psychology literature. Faced with a choice between a ``safe" and ``risky" decision, group members appear to move to one extreme or the other, relative to the choices each member might have made on her own. Both risky and cautious shifts have been identified in different situations. This paper demonstrates that from an individual decision-making perspective, choice shifts may be viewed as a systematic...

  7. What choices should we be able to make about designer babies? A Citizens' Jury of young people in South Wales.

    Science.gov (United States)

    Iredale, Rachel; Longley, Marcus; Thomas, Christian; Shaw, Anita

    2006-09-01

    Young people will increasingly have the option of using new technologies for reproductive decision making but their voices are rarely heard in debates about acceptable public policy in this area. Capturing the views of young people about potentially esoteric topics, such as genetics, is difficult and methodologically challenging. A Citizens' Jury is a deliberative process that presents a question to a group of ordinary people, allows them to examine evidence given by expert witnesses and personal testimonies and arrive at a verdict. This Citizens' Jury explored designer babies in relation to inherited conditions, saviour siblings and sex selection with young people. Fourteen young people aged 16-19 in Wales. Acceptance of designer baby technology was purpose-specific; it was perceived by participants to be acceptable for preventing inherited conditions and to create a child to save a sibling, but was not recommended for sex selection. Jurors stated that permission should not depend on parents' age, although some measure of suitability should be assessed. Preventing potential parents from going abroad was considered impractical. These young people felt the Human Fertilisation and Embryology Authority should have members under 20 and that the term 'designer baby' was not useful. Perspectives on the acceptability of this technology were nuanced, and based on implicit value judgements about the extent of individual benefit derived. Young people have valuable and interesting contributions to make to the debate about genetics and reproductive decision making and a variety of innovative methods must be used to secure their involvement in decision-making processes.

  8. Scrutinizing screening: a critical interpretive review of primary care provider perspectives on mammography decision-making with average-risk women.

    Science.gov (United States)

    Siedlikowski, Sophia; Ells, Carolyn; Bartlett, Gillian

    2018-01-01

    A decision to undertake screening for breast cancer often takes place within the primary care setting, but current controversies such as overdiagnosis and inconsistent screening recommendations based on evolving evidence render this a challenging process, particularly for average-risk women. Given the responsibility of primary care providers in counseling women in this decision-making process, it is important to understand their thoughts on these controversies and how they manage uncertainty in their practice. To review the perspectives and approaches of primary care providers regarding mammography decision-making with average-risk women. This study is a critical interpretive review of peer-review literature that reports primary care provider perspectives on mammography screening decision-making. Ovid MEDLINE®, Ovid PsycInfo, and Scopus databases were searched with dates from 2002 to 2017 using search terms related to mammography screening, uncertainty, counseling, decision-making, and primary health care providers. Nine articles were included following a review process involving the three authors. Using an inductive and iterative approach, data were grouped into four thematic categories: (1) perceptions on the effectiveness of screening, screening initiation age, and screening frequency; (2) factors guiding primary care providers in the screening decision-making process, including both provider and patient-related factors, (3) uncertainty faced by primary care providers regarding guidelines and screening discussions with their patients; and (4) informed decision-making with average-risk women, including factors that facilitate and hinder this process. The discussion of results addresses several factors about the diversity of perspectives and practices of physicians counseling average-risk women regarding breast cancer screening. This has implications for the challenge of understanding and explaining evidence, what should be shared with average-risk women

  9. Making healthy food choices using nutrition facts panels. The roles of knowledge, motivation, dietary modifications goals, and age.

    Science.gov (United States)

    Miller, Lisa M Soederberg; Cassady, Diana L

    2012-08-01

    Nutrition facts panels (NFPs) contain a rich assortment of nutrition information and are available on most food packages. The importance of this information is potentially even greater among older adults due to their increased risk for diet-related diseases, as well as those with goals for dietary modifications that may impact food choice. Despite past work suggesting that knowledge and motivation impact attitudes surrounding and self-reported use of NFPs, we know little about how (i.e., strategies used) and how well (i.e., level of accuracy) younger and older individuals process NFP information when evaluating healthful qualities of foods. We manipulated the content of NFPs and, using eye tracking methodology, examined strategies associated with deciding which of two NFPs, presented side-by-side, was healthier. We examined associations among strategy use and accuracy as well as age, dietary modification status, knowledge, and motivation. Results showed that, across age groups, those with dietary modification goals made relatively more comparisons between NFPs with increasing knowledge and motivation; but that strategy effectiveness (relationship to accuracy) depended on age and motivation. Results also showed that knowledge and motivation may protect against declines in accuracy in later life and that, across age and dietary modification status, knowledge mediates the relationship between motivation and decision accuracy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. A systematic literature review of nutrition interventions in vending machines that encourage consumers to make healthier choices.

    Science.gov (United States)

    Grech, A; Allman-Farinelli, M

    2015-12-01

    Internationally, vending machines are scrutinized for selling energy-dense nutrient-poor foods and beverages, and the contribution to overconsumption and subsequent risk of obesity. The aim of this review is to determine the efficacy of nutrition interventions in vending machine in eliciting behaviour change to improve diet quality or weight status of consumers. Electronic databases Cochrane, EMBASE, CINAHL, Science Direct and PubMed were searched from inception. (i) populations that have access to vending machines; (ii) nutrition interventions; (iii) measured outcomes of behaviour change (e.g. sales data, dietary intake or weight change); and (iv) experimental trials where controls were not exposed to the intervention. Risk of bias was assessed independently by two researchers, and higher quality research formed the basis of this qualitative review. Twelve articles from 136 searched were included for synthesis. Intervention settings included schools, universities and workplaces. Reducing price or increasing the availability increased sales of healthier choices. The results of point-of-purchase nutrition information interventions were heterogeneous and when measured changes to purchases were small. This review offers evidence that pricing and availability strategies are effective at improving the nutritional quality foods and beverages purchased from vending machines. Evidence on how these interventions alter consumer's overall diet or body mass index is needed. © 2015 World Obesity.

  11. Making Healthy Food Choices Using Nutrition Facts Panels: The Roles of Knowledge, Motivation, Dietary Modifications Goals, and Age

    Science.gov (United States)

    Cassady, Diana L.

    2012-01-01

    Nutrition facts panels (NFPs) contain a rich assortment of nutrition information and are available on most food packages. The importance of this information is potentially even greater among older adults due to their increased risk for diet-related diseases, as well as those with goals for dietary modifications that may impact food choice. Despite past work suggesting that knowledge and motivation impact attitudes surrounding and self-reported use of NFPs, we know little about how (i.e., strategies used) and how well (i.e., level of accuracy) younger and older individuals process NFP information when evaluating healthful qualities of foods. We manipulated the content of NFPs and, using eye tracking methodology, examined strategies associated with deciding which of two NFPs, presented side-by-side, was healthier. We examined associations among strategy use and accuracy as well as age, dietary modification status, knowledge, and motivation. Results showed that, across age groups, those with dietary modification goals made relatively more comparisons between NFPs with increasing knowledge and motivation; but that strategy effectiveness (relationship to accuracy) depended on age and motivation. Results also showed that knowledge and motivation may protect against declines in accuracy in later life and that, across age and dietary modification status, knowledge mediates the relationship between motivation and decision accuracy. PMID:22524999

  12. On framing effects in decision making: linking lateral versus medial orbitofrontal cortex activation to choice outcome processing.

    Science.gov (United States)

    Windmann, Sabine; Kirsch, Peter; Mier, Daniela; Stark, Rudolf; Walter, Bertram; Güntürkün, Onur; Vaitl, Dieter

    2006-07-01

    Two correlates of outcome processing in the orbitofrontal cortex (OFC) have been proposed in the literature: One hypothesis suggests that the lateral/medial division relates to representation of outcome valence (negative vs. positive), and the other suggests that the medial OFC maintains steady stimulus-outcome associations, whereas the lateral OFC represents changing (unsteady) outcomes to prepare for response shifts. These two hypotheses were contrasted by comparing the original with the inverted version of the Iowa Gambling Task in an event-related functional magnetic resonance imaging experiment. Results showed (1) that (caudo) lateral OFC was indeed sensitive to the steadiness of the outcomes and not merely to outcome valence and (2) that the original and the inverted tasks, although both designed to measure sensitivity for future outcomes, were not equivalent as they enacted different behaviors and brain activation patterns. Results are interpreted in terms of Kahneman and Tversky's prospect theory suggesting that cognitions and decisions are biased differentially when probabilistic future rewards are weighed against consistent punishments relative to the opposite scenario [Kahneman, D., & Tversky, A. Choices, values, and frames. American Psychologist, 39, 341-350, 1984]. Specialized processing of unsteady rewards (involving caudolateral OFC) may have developed during evolution in support of goal-related thinking, prospective planning, and problem solving.

  13. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice?

    International Nuclear Information System (INIS)

    Kabaalioglu, Adnan; Ceken, Kagan; Alimoglu, Emel; Apaydin, Ali

    2006-01-01

    Aim: To evaluate the long-term results of percutaneous imaging-guided treatment of hydatid liver cysts. Materials and methods: Sixty patients with 77 hydatid liver cysts underwent percutaneous treatment with ultrasonography (US) or computed tomography (CT) guidance. Absolute alcohol and hypertonic saline were used for sclerosing the cysts after aspiration. Prophylactic albendazole treatment was given before and after the procedures. Follow-up US and CT were obtained periodically, and changes in cyst morphology were recorded. Minimum follow-up period for the patients included in this study was 12 months. Serological correlation was also available for a group of patients. The outcome of the procedures were categorized into five groups based on morphological changes observed by imaging. Results: Procedures were regarded as successful in 80% and unsuccessful in 20% of patients. Failures most often occurred with type III cysts; less than half (39%) of the total type III cysts had a successful outcome. On the other hand, all type I cysts ended up with cure. Anaphylaxis, pneumotorax and severe pain interrupting the procedures were also among the reasons of failure. Conclusion: Percutaneous aspiration, injection and reaspiration (PAIR) of types I and II hydatid liver cysts is effective and safe in the long-term. Surgery should no longer be regarded as the first choice treatment in all hydatid liver cysts but should be reserved for type III and certain active type IV cysts

  14. Percutaneous imaging-guided treatment of hydatid liver cysts: Do long-term results make it a first choice?

    Energy Technology Data Exchange (ETDEWEB)

    Kabaalioglu, Adnan [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey)]. E-mail: adnank@akdeniz.edu.tr; Ceken, Kagan [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey); Alimoglu, Emel [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey); Apaydin, Ali [Department of Radiology, Akdeniz University Hospital, Antalya (Turkey)

    2006-07-15

    Aim: To evaluate the long-term results of percutaneous imaging-guided treatment of hydatid liver cysts. Materials and methods: Sixty patients with 77 hydatid liver cysts underwent percutaneous treatment with ultrasonography (US) or computed tomography (CT) guidance. Absolute alcohol and hypertonic saline were used for sclerosing the cysts after aspiration. Prophylactic albendazole treatment was given before and after the procedures. Follow-up US and CT were obtained periodically, and changes in cyst morphology were recorded. Minimum follow-up period for the patients included in this study was 12 months. Serological correlation was also available for a group of patients. The outcome of the procedures were categorized into five groups based on morphological changes observed by imaging. Results: Procedures were regarded as successful in 80% and unsuccessful in 20% of patients. Failures most often occurred with type III cysts; less than half (39%) of the total type III cysts had a successful outcome. On the other hand, all type I cysts ended up with cure. Anaphylaxis, pneumotorax and severe pain interrupting the procedures were also among the reasons of failure. Conclusion: Percutaneous aspiration, injection and reaspiration (PAIR) of types I and II hydatid liver cysts is effective and safe in the long-term. Surgery should no longer be regarded as the first choice treatment in all hydatid liver cysts but should be reserved for type III and certain active type IV cysts.

  15. What choices should we be able to make about designer babies? A Citizens’ Jury of young people in South Wales

    Science.gov (United States)

    Iredale, Rachel; Longley, Marcus; Thomas, Christian; Shaw, Anita

    2006-01-01

    Abstract Background  Young people will increasingly have the option of using new technologies for reproductive decision making but their voices are rarely heard in debates about acceptable public policy in this area. Capturing the views of young people about potentially esoteric topics, such as genetics, is difficult and methodologically challenging. Design  A Citizens’ Jury is a deliberative process that presents a question to a group of ordinary people, allows them to examine evidence given by expert witnesses and personal testimonies and arrive at a verdict. This Citizens’ Jury explored designer babies in relation to inherited conditions, saviour siblings and sex selection with young people. Participants  Fourteen young people aged 16–19 in Wales. Results  Acceptance of designer baby technology was purpose‐specific; it was perceived by participants to be acceptable for preventing inherited conditions and to create a child to save a sibling, but was not recommended for sex selection. Jurors stated that permission should not depend on parents’ age, although some measure of suitability should be assessed. Preventing potential parents from going abroad was considered impractical. These young people felt the Human Fertilisation and Embryology Authority should have members under 20 and that the term ‘designer baby’ was not useful. Conclusions  Perspectives on the acceptability of this technology were nuanced, and based on implicit value judgements about the extent of individual benefit derived. Young people have valuable and interesting contributions to make to the debate about genetics and reproductive decision making and a variety of innovative methods must be used to secure their involvement in decision‐making processes. PMID:16911135

  16. Experiences and Motives of Australian Single Mothers by Choice who make Early Contact with their Child?s Donor Relatives

    OpenAIRE

    Kelly, Fiona J; Dempsey, Deborah J

    2017-01-01

    Abstract An increasing number of Australian parents of donor-conceived children are making contact with their child?s donor relatives prior to their child reaching the age of majority. This process, often referred to as ?donor linking?, can be achieved in Australia through either formal or informal mechanisms. Formal mechanisms exist in three states, each of which has legislation enabling donor linking in certain circumstances. Donor linking may also be achieved through informal mechanisms, s...

  17. The art of grocery shopping on a food stamp budget: factors influencing the food choices of low-income women as they try to make ends meet.

    Science.gov (United States)

    Wiig, Kristen; Smith, Chery

    2009-10-01

    Amidst a hunger-obesity paradox, the purpose of the present study was to examine the grocery shopping behaviour and food stamp usage of low-income women with children to identify factors influencing their food choices on a limited budget. Focus groups, which included questions based on Social Cognitive Theory constructs, examined food choice in the context of personal, behavioural and environmental factors. A quantitative grocery shopping activity required participants to prioritize food purchases from a 177-item list on a budget of $US 50 for a one-week period, an amount chosen based on the average household food stamp allotment in 2005. Ninety-two low-income women, with at least one child aged 9-13 years in their household, residing in the Twin Cities, Minnesota, USA. Participants' mean age was 37 years, and 76% were overweight or obese (BMI> or =25.0 kg/m2). Key findings suggest that their food choices and grocery shopping behaviour were shaped by not only individual and family preferences, but also their economic and environmental situation. Transportation and store accessibility were major determinants of shopping frequency, and they used various strategies to make their food dollars stretch (e.g. shopping based on prices, in-store specials). Generally, meat was the most important food group for purchase and consumption, according to both the qualitative and quantitative data. Efforts to improve food budgeting skills, increase nutrition knowledge, and develop meal preparation strategies involving less meat and more fruits and vegetables, could be valuable in helping low-income families nutritionally make the best use of their food dollars.

  18. Preparing Parents to Make An Informed Choice About Antibiotic Use for Common Acute Respiratory Infections in Children: A Randomised Trial of Brief Decision Aids in a Hypothetical Scenario.

    Science.gov (United States)

    Coxeter, Peter D; Del Mar, Chris B; Hoffmann, Tammy C

    2017-08-01

    Childhood acute respiratory infections (ARIs) are one of the most common reasons for primary care consultations and for receiving an antibiotic. Public awareness of antibiotic benefit and harms for these conditions is low. To facilitate informed decision making, ideally in collaboration with their doctor, parents need clear communication about benefits and harms. Decision aids may be able to facilitate this process. The aim of this study was to evaluate the effectiveness of three decision aids about antibiotic use for common ARIs in children. Adult parents of children aged 1-16 years (n = 120) were recruited from community settings and then randomised using a computer-generated randomisation sequence to receive a decision aid (n = 60) or fact sheet (n = 60). Allocation was concealed and used sealed and opaque sequentially numbered envelopes. Participants self-completed questionnaires at baseline and immediately post-intervention. The primary outcome was informed choice (conceptual and numerical knowledge; attitudes towards, and intention to use, antibiotics for a future ARI). Secondary outcomes were decisional conflict, decisional self-efficacy, and material acceptability. After reading the information, significantly more intervention group participants made an informed choice [57%] compared with control group participants [29%] [difference 28, 95% confidence interval (CI) 11-45%, p decision aids prepared parents to make an informed choice about antibiotic use more than fact sheets, in a hypothetical situation. Their effect within a consultation needs to be evaluated. Clinical Trials Registration Number: ACTRN12615000843550.

  19. Perspectives of self-direction: a systematic review of key areas contributing to service users' engagement and choice-making in self-directed disability services and supports.

    Science.gov (United States)

    Lakhani, Ali; McDonald, Donna; Zeeman, Heidi

    2018-05-01

    Self-directed disability support policies aim to encourage greater choice and control for service users in terms of the health and social care they receive. The proliferation of self-directed disability support policies throughout the developed world has resulted in a growing amount of research exploring the outcomes for service users, and their families and carers. Our understanding of the issues faced by people with disabilities, particularly how they make health and social care decisions and the key areas that determine their engagement with service providers within a self-directed environment is limited. A synthesis of research is timely and can provide knowledge for service users and health and social care support providers to ensure their successful participation. A systematic review guided by the PRISMA approach explored (i) the key areas determining service users' engagement with self-directed disability services and supports, and (ii) how service users make informed decisions about providers. In October 2014 and April 2016, three databases - MEDLINE, CINAHL and Web of Science - were searched for research and review articles. Eighteen sources met the search criteria. Findings were mapped into either: key areas determining service user engagement, or service users' informed decision-making. Findings concerning key areas determining engagement fell into three themes - personal responsibility for budgeting, personalised approaches, and a cultural shift in practice and delivery among service providers. Findings about decision-making yielded two themes - supporting informed decision-making and inhibiting informed decision-making. Literature suggests that self-directed models of care may provide service users with increased control over the services that they receive. Increased control for some service users and their families requires independent external decision-making support, particularly around the domains of budgeting, planning and hiring. Future research

  20. Make

    CERN Document Server

    Frauenfelder, Mark

    2012-01-01

    The first magazine devoted entirely to do-it-yourself technology projects presents its 29th quarterly edition for people who like to tweak, disassemble, recreate, and invent cool new uses for technology. MAKE Volume 29 takes bio-hacking to a new level. Get introduced to DIY tracking devices before they hit the consumer electronics marketplace. Learn how to build an EKG machine to study your heartbeat, and put together a DIY bio lab to study athletic motion using consumer grade hardware.

  1. Can Walking or Biking to Work Really Make a Difference? Compact Development, Observed Commuter Choice and Body Mass Index.

    Science.gov (United States)

    Wojan, Timothy R; Hamrick, Karen S

    2015-01-01

    Promoting active commuting is viewed as one strategy to increase physical activity and improve the energy balance of more sedentary individuals thereby improving health outcomes. However, the potential effectiveness of promotion policies may be seriously undermined by the endogenous choice of commute mode. Policy to promote active commuting will be most effective if it can be demonstrated that 1) those in compact cities do not necessarily have a preference for more physical activity, and 2) that current active commuting is not explained by unobserved characteristics that may be the true source of a lower body mass index (BMI). Daily time-use diaries are used in combination with geographical characteristics of where respondents live and work to test 1) whether residents of more compact settlements are characterized by higher activity levels; and 2) whether residents of more compact settlements are more likely to bike or walk to work. An endogenous treatment model of active commuting allows testing whether reductions in BMI associated with walking or biking to work are in fact attributable to that activity or are more strongly associated with unobserved characteristics of these active commuters. The analysis of general activity levels confirms that residents of more compact cities do not expend more energy than residents of more sprawling cities, indicating that those in compact cities do not necessarily have a preference for more physical activity. The endogenous treatment model is consistent with walking or biking to work having an independent effect on BMI, as unobserved factors that contribute to a higher likelihood of active commuting are not associated with lower BMI. Despite evidence that more compact settlement patterns enable active commuting, only a small share of workers in these areas choose to walk or bike to work. In general, the activity level of residents in more compact cities and residents in more sprawling areas is very similar. But, there is a

  2. Can Walking or Biking to Work Really Make a Difference? Compact Development, Observed Commuter Choice and Body Mass Index.

    Directory of Open Access Journals (Sweden)

    Timothy R Wojan

    Full Text Available Promoting active commuting is viewed as one strategy to increase physical activity and improve the energy balance of more sedentary individuals thereby improving health outcomes. However, the potential effectiveness of promotion policies may be seriously undermined by the endogenous choice of commute mode. Policy to promote active commuting will be most effective if it can be demonstrated that 1 those in compact cities do not necessarily have a preference for more physical activity, and 2 that current active commuting is not explained by unobserved characteristics that may be the true source of a lower body mass index (BMI.Daily time-use diaries are used in combination with geographical characteristics of where respondents live and work to test 1 whether residents of more compact settlements are characterized by higher activity levels; and 2 whether residents of more compact settlements are more likely to bike or walk to work. An endogenous treatment model of active commuting allows testing whether reductions in BMI associated with walking or biking to work are in fact attributable to that activity or are more strongly associated with unobserved characteristics of these active commuters.The analysis of general activity levels confirms that residents of more compact cities do not expend more energy than residents of more sprawling cities, indicating that those in compact cities do not necessarily have a preference for more physical activity. The endogenous treatment model is consistent with walking or biking to work having an independent effect on BMI, as unobserved factors that contribute to a higher likelihood of active commuting are not associated with lower BMI.Despite evidence that more compact settlement patterns enable active commuting, only a small share of workers in these areas choose to walk or bike to work. In general, the activity level of residents in more compact cities and residents in more sprawling areas is very similar. But

  3. Making sense of the "clean label" trends: A review of consumer food choice behavior and discussion of industry implications.

    Science.gov (United States)

    Asioli, Daniele; Aschemann-Witzel, Jessica; Caputo, Vincenzina; Vecchio, Riccardo; Annunziata, Azzurra; Næs, Tormod; Varela, Paula

    2017-09-01

    Consumers in industrialized countries are nowadays much more interested in information about the production methods and components of the food products that they eat, than they had been 50years ago. Some production methods are perceived as less "natural" (i.e. conventional agriculture) while some food components are seen as "unhealthy" and "unfamiliar" (i.e. artificial additives). This phenomenon, often referred to as the "clean label" trend, has driven the food industry to communicate whether a certain ingredient or additive is not present or if the food has been produced using a more "natural" production method (i.e. organic agriculture). However, so far there is no common and objective definition of clean label. This review paper aims to fill the gap via three main objectives, which are to a) develop and suggest a definition that integrates various understandings of clean label into one single definition, b) identify the factors that drive consumers' choices through a review of recent studies on consumer perception of various food categories understood as clean label with the focus on organic, natural and 'free from' artificial additives/ingredients food products and c) discuss implications of the consumer demand for clean label food products for food manufacturers as well as policy makers. We suggest to define clean label, both in a broad sense, where consumers evaluate the cleanliness of product by assumption and through inference looking at the front-of-pack label and in a strict sense, where consumers evaluate the cleanliness of product by inspection and through inference looking at the back-of-pack label. Results show that while 'health' is a major consumer motive, a broad diversity of drivers influence the clean label trend with particular relevance of intrinsic or extrinsic product characteristics and socio-cultural factors. However, 'free from' artificial additives/ingredients food products tend to differ from organic and natural products. Food

  4. Making and Executing Decisions for Safe and Independent Living (MED-SAIL): development and validation of a brief screening tool.

    Science.gov (United States)

    Mills, Whitney L; Regev, Tziona; Kunik, Mark E; Wilson, Nancy L; Moye, Jennifer; McCullough, Laurence B; Naik, Aanand D

    2014-03-01

    Older adults prefer to remain in their own homes for as long as possible. The purpose of this article is to describe the development and preliminary validation of Making and Executing Decisions for Safe and Independent Living (MED-SAIL), a brief screening tool for capacity to live safely and independently in the community. Prospective preliminary validation study. Outpatient geriatrics clinic located in a community-based hospital. Forty-nine community-dwelling older adults referred to the clinic for a comprehensive capacity assessment. We examined internal consistency, criterion-based validity, concurrent validity, and accuracy of classification for MED-SAIL. The items included in MED-SAIL demonstrated internal consistency (5 items; α = 0.85). MED-SAIL was significantly correlated with the Independent Living Scales (r = 0.573, p ≤0.001) and instrumental activities of daily living (r = 0.440, p ≤0.01). The Mann-Whitney U test revealed significant differences between the no capacity and partial/full capacity classifications on MED-SAIL (U(48) = 60.5, Z = -0.38, p SAIL as a brief screening tool to identify older adults with impaired capacity for remaining safe and independent in their current living environment. MED-SAIL is useful tool for health and social service providers in the community for the purpose of referral for definitive capacity evaluation. Published by Elsevier Inc.

  5. Making Communication Strategy Choices in a Fast Evolving Crisis Situation—Results from a Table-Top Discussion on an Anthrax Scenario

    Directory of Open Access Journals (Sweden)

    Aino Ruggiero

    2016-05-01

    Full Text Available This paper aims at clarifying a timely topic of how communication strategy choices are made in evolving, complex crises, such as those caused by terrorism involving chemical, biological, radiological, or nuclear (CBRN agents. This is done by examining data gathered from a table-top discussion among crisis communication experts, focusing on a scenario of an anthrax attack and analysed qualitatively. The communication experts followed the evolving crisis situation by gathering inputs from various actors in the crisis management network, thereby creating situational understanding, and interpreted these inputs for decision-making on communication strategies. The underlying process of coping with complexity in evolving CBRN terrorism crises can be described as a continuous, dynamic process that can best be explained with a combination of traditional and more modern crisis communication approaches. Strategy-making in crisis situations by communication experts is still largely a black box. In this study, a novel approach of decomposing strategy-making by observing a table-top discussion is chosen to clarify the process. By identifying the core elements involved, a more detailed picture of communication strategy-making is created, thus promoting preparedness and professional resilience in the field.

  6. Experiences and Motives of Australian Single Mothers by Choice Who Make Early Contact with their Child's Donor Relatives.

    Science.gov (United States)

    Kelly, Fiona J; Dempsey, Deborah J

    2017-01-30

    An increasing number of Australian parents of donor-conceived children are making contact with their child's donor relatives prior to their child reaching the age of majority. This process, often referred to as 'donor linking', can be achieved in Australia through either formal or informal mechanisms. Formal mechanisms exist in three states, each of which has legislation enabling donor linking in certain circumstances. Donor linking may also be achieved through informal mechanisms, such as online donor registries, social media searches, direct-to-consumer genetic testing, and fertility clinics which act as intermediaries between donors and recipients. Drawing on qualitative interview data, this article explores the donor linking practices of twenty-five single women who conceived using donated gametes. The findings suggest that early contact with donors is extremely popular among single women and that, even when formal legislative mechanisms are available, informal linking remains common. © The Author 2017. Published by Oxford University Press.

  7. Experiences and Motives of Australian Single Mothers by Choice who make Early Contact with their Child’s Donor Relatives

    Science.gov (United States)

    Dempsey, Deborah J

    2016-01-01

    Abstract An increasing number of Australian parents of donor-conceived children are making contact with their child’s donor relatives prior to their child reaching the age of majority. This process, often referred to as ‘donor linking’, can be achieved in Australia through either formal or informal mechanisms. Formal mechanisms exist in three states, each of which has legislation enabling donor linking in certain circumstances. Donor linking may also be achieved through informal mechanisms, such as online donor registries, social media searches, direct-to-consumer genetic testing, and fertility clinics which act as intermediaries between donors and recipients. Drawing on qualitative interview data, this article explores the donor linking practices of twenty-five single women who conceived using donated gametes. The findings suggest that early contact with donors is extremely popular among single women and that, even when formal legislative mechanisms are available, informal linking remains common. PMID:28137771

  8. The Influence of Religiosity and Spirituality on Rural Parents' Health Decision Making and Human Papillomavirus Vaccine Choices.

    Science.gov (United States)

    Thomas, Tami; Blumling, Amy; Delaney, Augustina

    2015-01-01

    General health implications of religiosity and spirituality on health have been associated with health promotion, so the purpose of this study was to examine the influence of religiosity and spirituality on rural parents' decision making to vaccinate their children against human papillomavirus (HPV). The associations of religiosity and spirituality with parental HPV vaccine decisions were examined in a sample of parents residing in small rural communities (N = 37). Parents of children aged 9 to 13 years participated in focus groups held in rural community contexts. Religiosity (i.e., participation in religious social structures) was a recurring and important theme when discussing HPV vaccination. Spirituality (i.e., subjective commitment to spiritual or religious beliefs) was found to influence the ways in which parents perceived their control over and coping with health issues potentially related to HPV vaccination. Together, religiosity and spirituality were found to play integral roles in these parents' lives and influenced their attitudes toward HPV vaccination uptake for their children.

  9. Influencing Eating Choices: Biological Food Cues in Advertising and Packaging Alter Trajectories of Decision Making and Behavior.

    Science.gov (United States)

    Bailey, Rachel L

    2017-10-01

    From an ecological perception perspective (Gibson, 1977), the availability of perceptual information alters what behaviors are more and less likely at different times. This study examines how perceptual information delivered in food advertisements and packaging alters the time course of information processing and decision making. Participants categorized images of food that varied in information delivered in terms of color, glossiness, and texture (e.g., food cues) before and after being exposed to a set of advertisements that also varied in this way. In general, items with more direct cues enhanced appetitive motivational processes, especially if they were also advertised with direct food cues. Individuals also chose to eat products that were packaged with more available direct food cues compared to opaque packaging.

  10. Choice & Consequence

    DEFF Research Database (Denmark)

    Khan, Azam

    to support hypothesis generation, hypothesis testing, and decision making. In addition to sensors in buildings, infrastructure, or the environment, we also propose the instrumentation of user interfaces to help measure performance in decision making applications. We show the benefits of applying principles...... between cause and effect in complex systems complicates decision making. To address this issue, we examine the central role that data-driven decision making could play in critical domains such as sustainability or medical treatment. We developed systems for exploratory data analysis and data visualization...... of data analysis and instructional interface design, to both simulation systems and decision support interfaces. We hope that projects such as these will help people to understand the link between their choices and the consequences of their decisions....

  11. Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials.

    Science.gov (United States)

    Sheridan, Stacey L; Golin, Carol; Bunton, Audrina; Lykes, John B; Schwartz, Bob; McCormack, Lauren; Driscoll, David; Bangdiwala, Shrikant I; Harris, Russell P

    2012-11-13

    Professional societies recommend shared decision making (SDM) for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1) examine the effects of a prostate cancer screening intervention to promote SDM and 2) determine whether framing prostate information in the context of other clearly beneficial men's health services affects decisions. We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men's health services). For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials). Within each practice site, we randomized men to either 1) a video-based decision aid and researcher-led coaching session or 2) a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Compared to an attention control, our prostate cancer screening intervention increased men's perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57%) and men's knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%), but had no effect on men's self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference -34%; 95% CI -50% to -18%) and actual screening rates (absolute difference -22%; 95% CI -38 to -7%) with no difference in effect by frame. SDM interventions can

  12. Nudging and social marketing techniques encourage employees to make healthier food choices: a randomized controlled trial in 30 worksite cafeterias in The Netherlands.

    Science.gov (United States)

    Velema, Elizabeth; Vyth, Ellis L; Hoekstra, Trynke; Steenhuis, Ingrid H M

    2018-02-01

    Currently, many studies focus on how the environment can be changed to encourage healthier eating behavior, referred to as choice architecture or "nudging." However, to date, these strategies are not often investigated in real-life settings, such as worksite cafeterias, or are only done so on a short-term basis. The objective of this study is to examine the effects of a healthy worksite cafeteria ["worksite cafeteria 2.0" (WC 2.0)] intervention on Dutch employees' purchase behavior over a 12-wk period. We conducted a randomized controlled trial in 30 worksite cafeterias. Worksite cafeterias were randomized to either the intervention or control group. The intervention aimed to encourage employees to make healthier food choices during their daily worksite cafeteria visits. The intervention consisted of 14 simultaneously executed strategies based on nudging and social marketing theories, involving product, price, placement, and promotion. Adjusted multilevel models showed significant positive effects of the intervention on purchases for 3 of the 7 studied product groups: healthier sandwiches, healthier cheese as a sandwich filling, and the inclusion of fruit. The increased sales of these healthier meal options were constant throughout the 12-wk intervention period. This study shows that the way worksite cafeterias offer products affects purchase behavior. Situated nudging and social marketing-based strategies are effective in promoting healthier choices and aim to remain effective over time. Some product groups only indicated an upward trend in purchases. Such an intervention could ultimately help prevent and reduce obesity in the Dutch working population. This trial was registered at the Dutch Trial Register (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5372) as NTR5372.

  13. Socioemotional selectivity theory, aging, and health: the increasingly delicate balance between regulating emotions and making tough choices.

    Science.gov (United States)

    Löckenhoff, Corinna E; Carstensen, Laura L

    2004-12-01

    After providing an introductory overview of socioemotional selectivity theory, we review empirical evidence for its basic postulates and consider the implications of the predicted cognitive and behavioral changes for physical health. The main assertion of socioemotional selectivity theory is that when boundaries on time are perceived, present-oriented goals related to emotional meaning are prioritized over future-oriented goals aimed at acquiring information and expanding horizons. Such motivational changes, which are strongly correlated with chronological age, systematically influence social preferences, social network composition, emotion regulation, and cognitive processing. On the one hand, there is considerable reason to believe that such changes are good for well-being and social adjustment. On the other hand, the very same motivational changes may limit health-related information-seeking and influence attention, memory, and decision-making such that positive material is favored over negative information. Grounding our arguments in socioemotional selectivity theory, we consider possible ways to tailor contexts such that disadvantages are avoided.

  14. Does front-of-pack nutrition information improve consumer ability to make healthful choices? Performance of warnings and the traffic light system in a simulated shopping experiment.

    Science.gov (United States)

    Machín, Leandro; Aschemann-Witzel, Jessica; Curutchet, María Rosa; Giménez, Ana; Ares, Gastón

    2018-02-01

    The inclusion of more attention-grabbing and easily interpretable front-of-pack (FOP) nutrition information is one of the public policies that can be implemented to empower consumers to identify unhealthful food products and to make more informed food choices. The aim of the present work was to evaluate the influence of two FOP nutrition labelling schemes - the traffic light labelling and the warning scheme - on consumer food purchases when facing a health goal. The study was conducted with 1182 people from Montevideo (Uruguay), recruited using a Facebook advertisement. Participants were randomly allocated to one of three between-subjects experimental conditions: (i) a control condition with no FOP nutrition information, (ii) FOP nutrition information using a modified version of the traffic light system including information about calorie, saturated fat, sugars and sodium content per portion, and (iii) FOP nutrition information using the Chilean warning system including separate signs for high calorie, saturated fat, sugars and sodium content. Respondents were asked to imagine that they had to purchase food in order to prepare a healthy dinner for themselves and their family, using the website of an online grocery store. Results showed that FOP nutrition information effectively improved the average healthfulness of participants' choices compared to the control condition, both in terms of the average nutritional composition of the purchased products and expenditure in specific product categories. No relevant differences between the effect of the traffic light and the warning system were found. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. New Min-Max Approach to Optimal Choice of the Weights in Multi-Criteria Group Decision-Making Problems

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2015-11-01

    Full Text Available In multi-criteria group decision-making (MCGDM, one of the most important problems is to determine the weights of criteria and experts. This paper intends to present two Min-Max models to optimize the point estimates of the weights. Since each expert generally possesses a uniform viewpoint on the importance (weighted value of each criterion when he/she needs to rank the alternatives, the objective function in the first model is to minimize the maximum variation between the actual score vector and the ideal one for all the alternatives such that the optimal weights of criteria are consistent in ranking all the alternatives for the same expert. The second model is designed to optimize the weights of experts such that the obtained overall evaluation for each alternative can collect the perspectives of the experts as many as possible. Thus, the objective function in the second model is to minimize the maximum variation between the actual vector of evaluations and the ideal one for all the experts, such that the optimal weights can reduce the difference among the experts in evaluating the same alternative. For the constructed Min-Max models, another focus in this paper is on the development of an efficient algorithm for the optimal weights. Some applications are employed to show the significance of the models and algorithm. From the numerical results, it is clear that the developed Min-Max models more effectively solve the MCGDM problems including the ones with incomplete score matrices, compared with the methods available in the literature. Specifically, by the proposed method, (1 the evaluation uniformity of each expert on the same criteria is guaranteed; (2 The overall evaluation for each alternative can collect the judgements of the experts as many as possible; (3 The highest discrimination degree of the alternatives is obtained.

  16. Fusion Power: A Strategic Choice for the Future Energy Provision. Why is So Much Time Wasted for Decision Making?

    International Nuclear Information System (INIS)

    D'haeseleer, William D.

    2005-01-01

    From a general analysis of the world energy issue, it is argued that an affordable, clean and reliable energy supply will have to consist of a portfolio of primary energy sources, a large fraction of which will be converted to a secondary carrier in large baseload plants. Because of all future uncertainties, it would be irresponsible not to include thermonuclear fusion as one of the future possibilities for electricity generation.The author tries to understand why nuclear-fusion research is not considered of strategic importance by the major world powers. The fusion programs of the USA and Europe are taken as prime examples to illustrate the 'hesitation'. Europe is now advocating a socalled 'fast-track' approach, thereby seemingly abandoning the 'classic' time frame towards fusion that it has projected for many years. The US 'oscillatory' attitude towards ITER in relation to its domestic program is a second case study that is looked at.From the real history of the ITER design and the 'siting' issue, one can try to understand how important fusion is considered by these world powers. Not words are important, but deeds. Fast tracks are nice to talk about, but timely decisions need to be taken and sufficient money is to be provided. More fundamental understanding of fusion plasma physics is important, but in the end, real hardware devices must be constructed to move along the path of power plant implementation.The author tries to make a balance of where fusion power research is at this moment, and where, according to his views, it should be going

  17. "We make choices we think are going to save us": Debate and stance identification for online breast cancer CAM discussions.

    Science.gov (United States)

    Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

    2017-04-01

    Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.

  18. Patient centered decision making: use of conjoint analysis to determine risk-benefit trade-offs for preference sensitive treatment choices.

    Science.gov (United States)

    Wilson, Leslie; Loucks, Aimee; Bui, Christine; Gipson, Greg; Zhong, Lixian; Schwartzburg, Amy; Crabtree, Elizabeth; Goodin, Douglas; Waubant, Emmanuelle; McCulloch, Charles

    2014-09-15

    Understanding patient preferences facilitates shared decision-making and focuses on patient-centered outcomes. Little is known about relapsing-remitting multiple sclerosis (RRMS) patient preferences for disease modifying therapies (DMTs). We use choice based conjoint (CBC) analysis to calculate patient preferences for risk/benefit trade-offs for hypothetical DMTs. Patients with RRMS were surveyed between 2012 and 2013. Our CBC survey mimicked the decision-making process and trade-offs of patients choosing DMTs, based on all possible DMT attributes. Mixed-effects logistic regression analyzed preferences. We estimated maximum acceptable risk trade-offs for various DMT benefits. Severe side-effect risks had the biggest impact on patient preference with a 1% risk, decreasing patient preference five-fold compared to no risk. (OR=0.22, pbenefit (OR=3.68, pbenefit trade-offs for attributes of all available DMTs. Evaluation of patient preferences is a key step in shared decision making and may significantly impact early drug initiation and compliance. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Resonant Cholinergic Dynamics in Cognitive and Motor Decision-Making: Attention, Category Learning, and Choice in Neocortex, Superior Colliculus, and Optic Tectum.

    Science.gov (United States)

    Grossberg, Stephen; Palma, Jesse; Versace, Massimiliano

    2015-01-01

    Freely behaving organisms need to rapidly calibrate their perceptual, cognitive, and motor decisions based on continuously changing environmental conditions. These plastic changes include sharpening or broadening of cognitive and motor attention and learning to match the behavioral demands that are imposed by changing environmental statistics. This article proposes that a shared circuit design for such flexible decision-making is used in specific cognitive and motor circuits, and that both types of circuits use acetylcholine to modulate choice selectivity. Such task-sensitive control is proposed to control thalamocortical choice of the critical features that are cognitively attended and that are incorporated through learning into prototypes of visual recognition categories. A cholinergically-modulated process of vigilance control determines if a recognition category and its attended features are abstract (low vigilance) or concrete (high vigilance). Homologous neural mechanisms of cholinergic modulation are proposed to focus attention and learn a multimodal map within the deeper layers of superior colliculus. This map enables visual, auditory, and planned movement commands to compete for attention, leading to selection of a winning position that controls where the next saccadic eye movement will go. Such map learning may be viewed as a kind of attentive motor category learning. The article hereby explicates a link between attention, learning, and cholinergic modulation during decision making within both cognitive and motor systems. Homologs between the mammalian superior colliculus and the avian optic tectum lead to predictions about how multimodal map learning may occur in the mammalian and avian brain and how such learning may be modulated by acetycholine.

  20. Resonant cholinergic dynamics in cognitive and motor decision-making:Attention, category learning, and choice in neocortex, superior colliculus, and optic tectum

    Directory of Open Access Journals (Sweden)

    Stephen eGrossberg

    2016-01-01

    Full Text Available Freely behaving organisms need to rapidly calibrate their perceptual, cognitive, and motor decisions based on continuously changing environmental conditions. These plastic changes include sharpening or broadening of cognitive and motor attention and learning to match the behavioral demands that are imposed by changing environmental statistics. This article proposes that a shared circuit design for such flexible decision-making is used in specific cognitive and motor circuits, and that both types of circuits use acetylcholine to modulate choice selectivity. Such task-sensitive control is proposed to control thalamocortical choice of the critical features that are cognitively attended and that are incorporated through learning into prototypes of visual recognition categories. A cholinergically-modulated process of vigilance control determines if a recognition category and its attended features are abstract (low vigilance or concrete (high vigilance. Homologous neural mechanisms of cholinergic modulation are proposed to focus attention and learn a multimodal map within the deeper layers of superior colliculus. This map enables visual, auditory, and planned movement commands to compete for attention, leading to selection of a winning position that controls where the next saccadic eye movement will go. Such map learning may be viewed as a kind of attentive motor category learning. The article hereby explicates a link between attention, learning, and cholinergic modulation during decision making within both cognitive and motor systems. Homologs between the mammalian superior colliculus and the avian optic tectum lead to predictions about how multimodal map learning may occur in the avian brain and how such learning may be modulated by acetycholine.

  1. Behavioral economics: "nudging" underserved populations to be screened for cancer.

    Science.gov (United States)

    Purnell, Jason Q; Thompson, Tess; Kreuter, Matthew W; McBride, Timothy D

    2015-01-15

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice.

  2. Informed choice requires information about both benefits and harms

    DEFF Research Database (Denmark)

    Jørgensen, K J; Brodersen, J; Hartling, O J

    2009-01-01

    women is seriously biased in favour of participation. Women are not informed about the major harms of screening, and the decision to attend has already been made for them by a public authority. This short-circuits informed decision-making and the legislation on informed consent, and violates...... the autonomy of the women. Screening invitations must present both benefits and harms in a balanced fashion, and should offer, not encourage, participation. It should be stated clearly that the choice not to participate is as sensible as the choice to do so. To allow this to happen, the responsibility...

  3. Review of experimental studies in social psychology of small groups when an optimal choice exists and application to operating room management decision-making.

    Science.gov (United States)

    Prahl, Andrew; Dexter, Franklin; Braun, Michael T; Van Swol, Lyn

    2013-11-01

    Because operating room (OR) management decisions with optimal choices are made with ubiquitous biases, decisions are improved with decision-support systems. We reviewed experimental social-psychology studies to explore what an OR leader can do when working with stakeholders lacking interest in learning the OR management science but expressing opinions about decisions, nonetheless. We considered shared information to include the rules-of-thumb (heuristics) that make intuitive sense and often seem "close enough" (e.g., staffing is planned based on the average workload). We considered unshared information to include the relevant mathematics (e.g., staffing calculations). Multiple studies have shown that group discussions focus more on shared than unshared information. Quality decisions are more likely when all group participants share knowledge (e.g., have taken a course in OR management science). Several biases in OR management are caused by humans' limited abilities to estimate tails of probability distributions in their heads. Groups are more susceptible to analogous biases than are educated individuals. Since optimal solutions are not demonstrable without groups sharing common language, only with education of most group members can a knowledgeable individual influence the group. The appropriate model of decision-making is autocratic, with information obtained from stakeholders. Although such decisions are good quality, the leaders often are disliked and the decisions considered unjust. In conclusion, leaders will find the most success if they do not bring OR management operational decisions to groups, but instead act autocratically while obtaining necessary information in 1:1 conversations. The only known route for the leader making such decisions to be considered likable and for the decisions to be considered fair is through colleagues and subordinates learning the management science.

  4. Constructing food choice decisions.

    Science.gov (United States)

    Sobal, Jeffery; Bisogni, Carole A

    2009-12-01

    Food choice decisions are frequent, multifaceted, situational, dynamic, and complex and lead to food behaviors where people acquire, prepare, serve, give away, store, eat, and clean up. Many disciplines and fields examine decision making. Several classes of theories are applicable to food decision making, including social behavior, social facts, and social definition perspectives. Each offers some insights but also makes limiting assumptions that prevent fully explaining food choice decisions. We used constructionist social definition perspectives to inductively develop a food choice process model that organizes a broad scope of factors and dynamics involved in food behaviors. This food choice process model includes (1) life course events and experiences that establish a food choice trajectory through transitions, turning points, timing, and contexts; (2) influences on food choices that include cultural ideals, personal factors, resources, social factors, and present contexts; and (3) a personal system that develops food choice values, negotiates and balances values, classifies foods and situations, and forms/revises food choice strategies, scripts, and routines. The parts of the model dynamically interact to make food choice decisions leading to food behaviors. No single theory can fully explain decision making in food behavior. Multiple perspectives are needed, including constructionist thinking.

  5. Producers' Complex Risk Management Choices

    NARCIS (Netherlands)

    Pennings, J.M.E.; Isengildina, O.; Irwin, S.H.; Garcia, P.; Good, D.L.

    2008-01-01

    Producers have a wide variety of risk management instruments available, making their choice(s) complex. The way producers deal with this complexity can vary and may influence the impact that the determinants, such as risk aversion, have on their choices. A recently developed choice bracketing

  6. Deficient neural activity subserving decision-making during reward waiting time in intertemporal choice in adult attention-deficit hyperactivity disorder.

    Science.gov (United States)

    Todokoro, Ayako; Tanaka, Saori C; Kawakubo, Yuki; Yahata, Noriaki; Ishii-Takahashi, Ayaka; Nishimura, Yukika; Kano, Yukiko; Ohtake, Fumio; Kasai, Kiyoto

    2018-04-24

    Impulsivity, which significantly affects social adaptation, is an important target behavioral characteristic in interventions for attention-deficit hyperactivity disorder (ADHD). Typically, people are willing to wait longer to acquire greater rewards. Impulsivity in ADHD may be associated with brain dysfunction in decision-making involving waiting behavior under such situations. We tested the hypothesis that brain circuitry during a period of waiting (i.e., prior to the acquisition of reward) is altered in adults with ADHD. The participants included 14 medication-free adults with ADHD and 16 healthy controls matched for age, sex, IQ, and handedness. The behavioral task had participants choose between a delayed, larger monetary reward and an immediate, smaller monetary reward, where the reward waiting time actually occurred during functional magnetic resonance imaging measurement. We tested for group differences in the contrast values of blood-oxygen-level dependent signals associated with the length of waiting time, calculated using the parametric modulation method. While the two groups did not differ in the time discounting rate, the delay-sensitive contrast values were significantly lower in the caudate and visual cortex in individuals with ADHD. The higher impulsivity scores were significantly associated with lower delay-sensitive contrast values in the caudate and visual cortex. These results suggest that deficient neural activity affects decision-making involving reward waiting time during intertemporal choice tasks, and provide an explanation for the basis of impulsivity in adult ADHD. © 2018 The Author. Psychiatry and Clinical Neurosciences © 2018 Japanese Society of Psychiatry and Neurology.

  7. Shared decision making for prostate cancer screening: the results of a combined analysis of two practice-based randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Sheridan Stacey L

    2012-11-01

    Full Text Available Abstract Background Professional societies recommend shared decision making (SDM for prostate cancer screening, however, most efforts have promoted informed rather than shared decision making. The objective of this study is to 1 examine the effects of a prostate cancer screening intervention to promote SDM and 2 determine whether framing prostate information in the context of other clearly beneficial men’s health services affects decisions. Methods We conducted two separate randomized controlled trials of the same prostate cancer intervention (with or without additional information on more clearly beneficial men’s health services. For each trial, we enrolled a convenience sample of 2 internal medicine practices, and their interested physicians and male patients with no prior history of prostate cancer (for a total of 4 practices, 28 physicians, and 128 men across trials. Within each practice site, we randomized men to either 1 a video-based decision aid and researcher-led coaching session or 2 a highway safety video. Physicians at each site received a 1-hour educational session on prostate cancer and SDM. To assess intervention effects, we measured key components of SDM, intent to be screened, and actual screening. After finding that results did not vary by trial, we combined data across sites, adjusting for the random effects of both practice and physician. Results Compared to an attention control, our prostate cancer screening intervention increased men’s perceptions that screening is a decision (absolute difference +41%; 95% CI 25 to 57% and men’s knowledge about prostate cancer screening (absolute difference +34%; 95% CI 19% to 50%, but had no effect on men’s self-reported participation in shared decisions or their participation at their preferred level. Overall, the intervention decreased screening intent (absolute difference −34%; 95% CI −50% to −18% and actual screening rates (absolute difference −22%; 95% CI −38 to

  8. Linking neuroscientific research on decision making to the educational context of novice students assigned to a multiple-choice scientific task involving common misconceptions about electrical circuits

    Directory of Open Access Journals (Sweden)

    Patrice ePotvin

    2014-01-01

    Full Text Available Functional magnetic resonance imaging was used to identify the brain-based mechanisms of uncertainty and certainty associated with answers to multiple-choice questions involving common misconceptions about electric circuits. Twenty-two (22 scientifically novice participants (humanities and arts college students were asked, in an fMRI study, whether or not they thought the light bulbs in images presenting electric circuits were lighted up correctly, and if they were certain or uncertain of their answers. When participants reported that they were unsure of their responses, analyses revealed significant activations in brain areas typically involved in uncertainty (anterior cingulate cortex, anterior insula cortex, and superior/dorsomedial frontal cortex and in the left middle/superior temporal lobe. Certainty was associated with large bilateral activations in the occipital and parietal regions usually involved in visuospatial processing. Correct-and-certain answers were associated with activations that suggest a stronger mobilization of visual attention resources when compared to incorrect-and-certain answers. These findings provide insights into brain-based mechanisms of uncertainty that are activated when common misconceptions, identified as such by science education research literature, interfere in decision making in a school-like task. We also discuss the implications of these results from an educational perspective.

  9. What factors do patients consider most important in making lung cancer screening decisions? Findings from a demonstration project conducted in the Veterans Health Administration.

    Science.gov (United States)

    Lillie, Sarah E; Fu, Steven S; Fabbrini, Angela E; Rice, Kathryn L; Clothier, Barbara; Nelson, David B; Doro, Elizabeth A; Moughrabieh, M Anas; Partin, Melissa R

    2017-02-01

    The National Lung Screening Trial recently reported that annual low-dose computed tomography screening is associated with decreased lung cancer mortality in high-risk smokers. This study sought to identify the factors patients consider important in making lung cancer screening (LCS) decisions, and explore variations by patient characteristics and LCS participation. This observational survey study evaluated the Minneapolis VA LCS Clinical Demonstration Project in which LCS-eligible Veterans (N=1388) were randomized to either Direct LCS Invitation (mailed with decision aid, N=926) or Usual Care (provider referral, N=462). We surveyed participants three months post-randomization (response rate 44%) and report the proportion of respondents rating eight decision-making factors (benefits, harms, and neutral factors) as important by condition, patient characteristics, and LCS completion. Overall, the most important factor was personal risk of lung cancer and the least important factor was health risks from LCS. The reported importance varied by patient characteristics, including smoking status, health status, and education level. Overall, the potential harms of LCS were reported less important than the benefits or the neutral decision-making factors. Exposure to Direct LCS Invitation (with decision aid) increased Veterans' attention to specific decision-making factors; compared to Usual Care respondents, a larger proportion of Direct LCS Invitation respondents rated the chance of false-positive results, LCS knowledge, LCS convenience, and anxiety as important. Those completing LCS considered screening harms less important, with the exception of incidental findings. Decision tools influence Veterans' perceptions about LCS decision-making factors. As the factors important to LCS decision making vary by patient characteristics, targeted materials for specific subgroups may be warranted. Attention should be paid to how LCS incidental findings are communicated. Published by

  10. Decision making by patients: An application of naturalistic decision making theory to cervical screening and chronic renal failure, Working Paper 2006/5

    OpenAIRE

    Marion Haas

    2006-01-01

    Over their lifetime, individuals typically make many decisions about health and health care. Theoretical approaches to decision making have been dominated by a rational, analytic approach which assumes that problems are relatively fixed and well-defined and which have foreseeable and measurable endpoints. Naturalistic decision making (NDM) approaches attempt to mimic ?real world? situations where problems vary, may be defined differently by individuals with diverse perspectives and where endp...

  11. Menopause as a long-term risk to health: implications of general practitioner accounts of prevention for women's choice and decision-making.

    Science.gov (United States)

    Murtagh, Madeleine J; Hepworth, Julie

    2003-03-01

    Over the past two decades medical researchers and modernist feminist researchers have contested the meaning of menopause. In this article we examine various meanings of menopause in major medical and feminist literature and the construction of menopause in a semi-structured interview study of general practitioners in rural South Australia. Three discursive themes are identified in these interviews; (i) .the hormonal menopause - symptoms, risk, prevention; (ii). the informed menopausal woman; and (iii). decision-making and hormone replacement therapy. By using the discourse of prevention, general practitioners construct menopause in relation to women's health care choices, empowerment and autonomy. We argue that the ways in which these concepts are deployed by general practitioners in this study produces and constrains the options available to women. The implications of these general practitioner accounts are discussed in relation to the proposition that medical and feminist descriptions of menopause posit alternative but equally-fixed truths about menopause and their relationship with the range of responses available to women at menopause. Social and cultural explanations of disease causality (c.f. Germov 1998, Hardey 1998) are absent from the new menopause despite their being an integral part of the framework of the women's health movement and health promotion drawn on by these general practitioners. Further, the shift of responsibility for health to the individual woman reinforces practice claims to empower women, but oversimplifies power relations and constructs menopause as a site of self-surveillance. The use of concepts from the women's health movement and health promotion have nevertheless created change in both the positioning of women as having 'choices' and the positioning of some general practitioners in terms of greater information provision to women and an attention to the woman's autonomy. In conclusion, we propose that a new menopause has evolved

  12. An Evaluation of the Value of Choice-Making Opportunities in Single-Operant Arrangements: Simple Fixed- and Progressive-Ratio Schedules

    Science.gov (United States)

    Tiger, Jeffrey H.; Toussaint, Karen A.; Roath, Christopher T.

    2010-01-01

    The current study compared the effects of choice and no-choice reinforcement conditions on the task responding of 3 children with autism across 2 single-operant paradigm reinforcer assessments. The first assessment employed simple fixed-ratio (FR) schedules; the second used progressive-ratio (PR) schedules. The latter assessment identified the…

  13. Information needs and decision-making preferences of older women offered a choice between surgery and primary endocrine therapy for early breast cancer.

    Science.gov (United States)

    Burton, Maria; Kilner, Karen; Wyld, Lynda; Lifford, Kate Joanna; Gordon, Frances; Allison, Annabel; Reed, Malcolm; Collins, Karen Anna

    2017-12-01

    To establish older women's (≥75 years) information preferences regarding 2 breast cancer treatment options: surgery plus adjuvant endocrine therapy versus primary endocrine therapy. To quantify women's preferences for the mode of information presentation and decision-making (DM) style. This was a UK multicentre survey of women, ≥75 years, who had been offered a choice between PET and surgery at diagnosis of breast cancer. A questionnaire was developed including 2 validated scales of decision regret and DM preferences. Questionnaires were sent to 247 women, and 101 were returned (response rate 41%). The median age of participants was 82 (range 75 to 99), with 58 having had surgery and 37 having PET. Practical details about the impact, safety, and efficacy of treatment were of most interest to participants. Of least interest were cosmetic outcomes after surgery. Information provided verbally by doctors and nurses, supported by booklets, was preferred. There was little interest in technology-based sources of information. There was equal preference for a patient- or doctor-centred DM style and lower preference for a shared DM style. The majority (74%) experienced their preferred DM style. Levels of decision regret were low (15.73, scale 0-100). Women strongly preferred face to face information. Written formats were also helpful but not computer-based resources. Information that was found helpful to women in the DM process was identified. The study demonstrates many women achieved their preferred DM style, with a preference for involvement, and expressed low levels of decision regret. Copyright © 2017 John Wiley & Sons, Ltd.

  14. Development of a translational model to screen medications for cocaine use disorder I: Choice between cocaine and food in rhesus monkeys.

    Science.gov (United States)

    Johnson, Amy R; Banks, Matthew L; Blough, Bruce E; Lile, Joshua A; Nicholson, Katherine L; Negus, S Stevens

    2016-08-01

    Homologous cocaine self-administration procedures in laboratory animals and humans may facilitate translational research for medications development to treat cocaine dependence. This study, therefore, sought to establish choice between cocaine and an alternative reinforcer in rhesus monkeys responding under a procedure back-translated from previous human studies and homologous to a human laboratory procedure described in a companion paper. Four rhesus monkeys with chronic indwelling intravenous catheters had access to cocaine injections (0, 0.043, 0.14, or 0.43mg/kg/injection) and food (0, 1, 3, or 10 1g banana-flavored food pellets). During daily 5h sessions, a single cocaine dose and a single food-reinforcer magnitude were available in 10 30-min trials. During the initial "sample" trial, the available cocaine and food reinforcer were delivered non-contingently. During each of the subsequent nine "choice" trials, responding could produce either the cocaine or food reinforcer under an independent concurrent progressive-ratio schedule. Preference was governed by the cocaine dose and food-reinforcer magnitude, and increasing cocaine doses produced dose-dependent increases in cocaine choice at all food-reinforcer magnitudes. Effects of the candidate medication lisdexamfetamine (0.32-3.2mg/kg/day) were then examined on choice between 0.14mg/kg/injection cocaine and 10 pellets. Under baseline conditions, this reinforcer pair maintained an average of approximately 6 cocaine and 3 food choices. Lisdexamfetamine dose-dependently decreased cocaine choice in all monkeys, but food choice was not significantly altered. These results support utility of this procedure in rhesus monkeys as one component of a platform for translational research on medications development to treat cocaine use disorder. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Making people be healthy.

    Science.gov (United States)

    Wilkinson, Timothy Martin

    2009-09-01

    How are we supposed to decide the rights and wrongs of banning smoking in bars, restricting adverts for junk food, nagging people into being screened for cancers, or banning the sale of party pills? The aim of this paper is to think through the political ethics of trying to make people healthier through influencing or restricting their choices. This paper covers: (1) Paternalism. What it is, what it assumes. (2) The place of health in well-being, and how this makes paternalism problematic. (3) The mistakes people make in acting in their own interests, and the implications for pro-health paternalism. (4) Autonomy objections to paternalism. The paper (5) finishes on a note of hope, by commending the currently fashionable libertarian paternalism: trying to have one's carrot cake and eat it too. A persistent theme is that thinking sensibly about making people healthier needs subtlety, not broad, ringing declarations.

  16. An Experimental Decision-Making Paradigm to Distinguish Guilt and Regret and Their Self-Regulating Function via Loss Averse Choice Behavior

    OpenAIRE

    Wagner, Ullrich; Handke, Lisa; Dörfel, Denise; Walter, Henrik

    2012-01-01

    Both guilt and regret typically result from counterfactual evaluations of personal choices that caused a negative outcome and are thought to regulate human decisions by people’s motivation to avoid these emotions. Despite these similarities, studies asking people to describe typical situations of guilt and regret identified the social dimension as a fundamental distinguishing factor, showing that guilt but not regret specifically occurs for choices in interpersonal (social) contexts. However,...

  17. Can Food Stamps Do More to Improve Food Choices? An Economic Perspective--Higher Cost of Food in Some Areas May Affect Food Stamp Households' Ability To Make Healthy Food Choices

    OpenAIRE

    Nord, Mark; Hopwood, Heather

    2007-01-01

    The cost of “enough food,” estimated from the amount that low- and medium-income households in a geographic area report needing to spend to just meet their food needs, differs substantially across States and among metropolitan areas. In areas with high food costs, many food-stamp recipients are likely to have inadequate food resources to support healthy food choices.

  18. Using Collaborative Simulation Modeling to Develop a Web-Based Tool to Support Policy-Level Decision Making About Breast Cancer Screening Initiation Age

    Directory of Open Access Journals (Sweden)

    Elizabeth S. Burnside MD, MPH, MS

    2017-07-01

    Full Text Available Background: There are no publicly available tools designed specifically to assist policy makers to make informed decisions about the optimal ages of breast cancer screening initiation for different populations of US women. Objective: To use three established simulation models to develop a web-based tool called Mammo OUTPuT. Methods: The simulation models use the 1970 US birth cohort and common parameters for incidence, digital screening performance, and treatment effects. Outcomes include breast cancers diagnosed, breast cancer deaths averted, breast cancer mortality reduction, false-positive mammograms, benign biopsies, and overdiagnosis. The Mammo OUTPuT tool displays these outcomes for combinations of age at screening initiation (every year from 40 to 49, annual versus biennial interval, lifetime versus 10-year horizon, and breast density, compared to waiting to start biennial screening at age 50 and continuing to 74. The tool was piloted by decision makers (n = 16 who completed surveys. Results: The tool demonstrates that benefits in the 40s increase linearly with earlier initiation age, without a specific threshold age. Likewise, the harms of screening increase monotonically with earlier ages of initiation in the 40s. The tool also shows users how the balance of benefits and harms varies with breast density. Surveys revealed that 100% of users (16/16 liked the appearance of the site; 94% (15/16 found the tool helpful; and 94% (15/16 would recommend the tool to a colleague. Conclusions: This tool synthesizes a representative subset of the most current CISNET (Cancer Intervention and Surveillance Modeling Network simulation model outcomes to provide policy makers with quantitative data on the benefits and harms of screening women in the 40s. Ultimate decisions will depend on program goals, the population served, and informed judgments about the weight of benefits and harms.

  19. Behavioral Economics: “Nudging” Underserved Populations to Be Screened for Cancer

    Science.gov (United States)

    Thompson, Tess; Kreuter, Matthew W.; McBride, Timothy D.

    2015-01-01

    Persistent disparities in cancer screening by race/ethnicity and socioeconomic status require innovative prevention tools and techniques. Behavioral economics provides tools to potentially reduce disparities by informing strategies and systems to increase prevention of breast, cervical, and colorectal cancers. With an emphasis on the predictable, but sometimes flawed, mental shortcuts (heuristics) people use to make decisions, behavioral economics offers insights that practitioners can use to enhance evidence-based cancer screening interventions that rely on judgments about the probability of developing and detecting cancer, decisions about competing screening options, and the optimal presentation of complex choices (choice architecture). In the area of judgment, we describe ways practitioners can use the availability and representativeness of heuristics and the tendency toward unrealistic optimism to increase perceptions of risk and highlight benefits of screening. We describe how several behavioral economic principles involved in decision-making can influence screening attitudes, including how framing and context effects can be manipulated to highlight personally salient features of cancer screening tests. Finally, we offer suggestions about ways practitioners can apply principles related to choice architecture to health care systems in which cancer screening takes place. These recommendations include the use of incentives to increase screening, introduction of default options, appropriate feedback throughout the decision-making and behavior completion process, and clear presentation of complex choices, particularly in the context of colorectal cancer screening. We conclude by noting gaps in knowledge and propose future research questions to guide this promising area of research and practice. PMID:25590600

  20. Screen dealing

    International Nuclear Information System (INIS)

    Barlow, J.W.

    1991-01-01

    The screen dealing system provides a facility whereby buyers and sellers of spot thermal coal can make bids and offers via the medium of the Reuters screen. A sale results when a market participant notifies his acceptance of a price to a central dealing desk. Use of the system is available to all genuine participants in the coal trade. This paper reports that it provides a focus for information and for the visible making of coal prices. For years screen trading has been used successfully to trade other commodities. At last coal is being traded electronically. It makes sense. It works. Users like it

  1. An Experimental Decision-Making Paradigm to Distinguish Guilt and Regret and Their Self-Regulating Function via Loss Averse Choice Behavior.

    Science.gov (United States)

    Wagner, Ullrich; Handke, Lisa; Dörfel, Denise; Walter, Henrik

    2012-01-01

    Both guilt and regret typically result from counterfactual evaluations of personal choices that caused a negative outcome and are thought to regulate human decisions by people's motivation to avoid these emotions. Despite these similarities, studies asking people to describe typical situations of guilt and regret identified the social dimension as a fundamental distinguishing factor, showing that guilt but not regret specifically occurs for choices in interpersonal (social) contexts. However, an experimental paradigm to investigate this distinction systematically by inducing emotions of guilt and regret online is still missing. Here, extending existing procedures, we introduce such a paradigm, in which participants choose in each trial between two lotteries, with the outcome of the chosen lottery (gain or loss) being either assigned to themselves (intrapersonal trials) or to another person (interpersonal trials). After results of both the chosen and the unchosen lottery were shown, subjects rated how they felt about the outcome, including ratings of guilt and regret. Trait Guilt (TG) was determined for all participants in order to take their general inclination to experience guilt into account. Results confirmed that guilt but not regret specifically occurred in an interpersonal context. Percentages of loss averse choices (choosing the lottery with the lower possible monetary loss) were determined as indicators of regulation via guilt and regret avoidance. High TG scorers generally made more loss averse choices than low TG scorers, while trial-by-trial analyses showed that low TG scorers used their feelings of guilt more specifically to avoid the same emotional experience in subsequent choices. Our results confirm the social dimension as the critical factor distinguishing guilt from regret and identify TG as an important moderator determining the way in which guilt vs. regret can regulate their own occurrence by influencing choice strategies.

  2. An experimental decision-making paradigm to distinguish guilt and regret and their self-regulating function via loss-averse choice behavior

    Directory of Open Access Journals (Sweden)

    Ullrich eWagner

    2012-10-01

    Full Text Available Both guilt and regret typically result from counterfactual evaluations of personal choices that caused a negative outcome and are thought to regulate human decisions by people’s motivation to avoid these emotions. Despite these similarities, studies asking people to describe typical situations of guilt and regret identified the social dimension as a fundamental distinguishing factor, showing that guilt but not regret specifically occurs for choices in interpersonal (social contexts. However, an experimental paradigm to investigate this distinction systematically by inducing emotions of guilt and regret online is still missing. Here, extending existing procedures, we introduce such a paradigm, in which participants choose in each trial between two lotteries, with the outcome of the chosen lottery (gain or loss being either assigned to themselves (intrapersonal trials or to another person (interpersonal trials. After results of both the chosen and the unchosen lottery were shown, subjects rated how they felt about the outcome, including ratings of guilt and regret. Trait Guilt (TG was determined for all participants in order to take their general inclination to experience guilt into account. Results confirmed that guilt but not regret specifically occurred in an interpersonal context. Percentages of loss averse choices (choosing the lottery with the lower possible monetary loss were determined as indicators of regulation via guilt and regret avoidance. High TG scorers generally made more loss averse choices than low TG scorers, while trial-by-trial analyses showed that low TG scorers used their feelings of guilt more specifically to avoid the same emotional experience in subsequent choices. Our results confirm the social dimension as the critical factor distinguishing guilt from regret and identify TG as an important moderator determining the way in which guilt vs. regret can regulate their own occurrence by influencing choice strategies.

  3. An Experimental Decision-Making Paradigm to Distinguish Guilt and Regret and Their Self-Regulating Function via Loss Averse Choice Behavior

    Science.gov (United States)

    Wagner, Ullrich; Handke, Lisa; Dörfel, Denise; Walter, Henrik

    2012-01-01

    Both guilt and regret typically result from counterfactual evaluations of personal choices that caused a negative outcome and are thought to regulate human decisions by people’s motivation to avoid these emotions. Despite these similarities, studies asking people to describe typical situations of guilt and regret identified the social dimension as a fundamental distinguishing factor, showing that guilt but not regret specifically occurs for choices in interpersonal (social) contexts. However, an experimental paradigm to investigate this distinction systematically by inducing emotions of guilt and regret online is still missing. Here, extending existing procedures, we introduce such a paradigm, in which participants choose in each trial between two lotteries, with the outcome of the chosen lottery (gain or loss) being either assigned to themselves (intrapersonal trials) or to another person (interpersonal trials). After results of both the chosen and the unchosen lottery were shown, subjects rated how they felt about the outcome, including ratings of guilt and regret. Trait Guilt (TG) was determined for all participants in order to take their general inclination to experience guilt into account. Results confirmed that guilt but not regret specifically occurred in an interpersonal context. Percentages of loss averse choices (choosing the lottery with the lower possible monetary loss) were determined as indicators of regulation via guilt and regret avoidance. High TG scorers generally made more loss averse choices than low TG scorers, while trial-by-trial analyses showed that low TG scorers used their feelings of guilt more specifically to avoid the same emotional experience in subsequent choices. Our results confirm the social dimension as the critical factor distinguishing guilt from regret and identify TG as an important moderator determining the way in which guilt vs. regret can regulate their own occurrence by influencing choice strategies. PMID:23133433

  4. [Using value of information analysis in decision making about applied research. The case of genetic screening for hemochromatosis in Germany].

    Science.gov (United States)

    Rogowski, W H; Grosse, S D; Meyer, E; John, J; Palmer, S

    2012-05-01

    Public decision makers face demands to invest in applied research in order to accelerate the adoption of new genetic tests. However, such an investment is profitable only if the results gained from further investigations have a significant impact on health care practice. An upper limit for the value of additional information aimed at improving the basis for reimbursement decisions is given by the expected value of perfect information (EVPI). This study illustrates the significance of the concept of EVPI on the basis of a probabilistic cost-effectiveness model of screening for hereditary hemochromatosis among German men. In the present example, population-based screening can barely be recommended at threshold values of 50,000 or 100,000 Euro per life year gained and also the value of additional research which might cause this decision to be overturned is small: At the mentioned threshold values, the EVPI in the German public health care system was ca. 500,000 and 2,200,000 Euro, respectively. An analysis of EVPI by individual parameters or groups of parameters shows that additional research about adherence to preventive phlebotomy could potentially provide the highest benefit. The potential value of further research also depends on methodological assumptions regarding the decision maker's time horizon as well as on scenarios with an impact on the number of affected patients and the cost-effectiveness of screening.

  5. Development of a translational model to screen medications for cocaine use disorder II: Choice between intravenous cocaine and money in humans

    Science.gov (United States)

    Lile, Joshua A.; Stoops, William W.; Rush, Craig R.; Negus, S. Stevens; Glaser, Paul E. A.; Hatton, Kevin W.; Hays, Lon R.

    2016-01-01

    Background A medication for treating cocaine use disorder has yet to be approved. Laboratory-based evaluation of candidate medications in animals and humans is a valuable means to demonstrate safety, tolerability and initial efficacy of potential medications. However, animal-to-human translation has been hampered by a lack of coordination. Therefore, we designed homologous cocaine self-administration studies in rhesus monkeys (see companion article) and human subjects in an attempt to develop linked, functionally equivalent procedures for research on candidate medications for cocaine use disorder. Methods Eight (N=8) subjects with cocaine use disorder completed 12 experimental sessions in which they responded to receive money ($0.01, $1.00 and $3.00) or intravenous cocaine (0, 3, 10 and 30 mg/70 kg) under independent, concurrent progressive-ratio schedules. Prior to the completion of 9 choice trials, subjects sampled the cocaine dose available during that session and were informed of the monetary alternative value. Results The allocation of behavior varied systematically as a function of cocaine dose and money value. Moreover, a similar pattern of cocaine choice was demonstrated in rhesus monkeys and humans across different cocaine doses and magnitudes of the species-specific alternative reinforcers. The subjective and cardiovascular responses to IV cocaine were an orderly function of dose, although heart rate and blood pressure remained within safe limits. Conclusions These coordinated studies successfully established drug vs. non-drug choice procedures in humans and rhesus monkeys that yielded similar cocaine choice behavior across species. This translational research platform will be used in future research to enhance the efficiency of developing interventions to reduce cocaine use. PMID:27269368

  6. Choice-Making in Rendering Culture-Bound Elements in Literary Translation: A Case Study on the English Translation Of «????»

    Science.gov (United States)

    Meihua, Song

    2014-01-01

    How to render culture-bound elements into a foreign language remains one of the most challenging tasks for all translators, especially, when the source text is a literary one. To retain the aesthetic effects and other stylistic features of importance, some argue that choice can be made from either domestication or foreignization with…

  7. Making Women the Subjects of the Abortion Debate: A Class Exercise that Moves beyond "Pro-Choice" and "Pro-Life"

    Science.gov (United States)

    Crawley, Sara L.; Willman, Rebecca K.; Clark, Leisa; Walsh, Clare

    2009-01-01

    In this article, the authors describe a classroom exercise designed to put women (and children and men) back at the center of the abortion debate, avoiding the standard rhetoric and engaging reflection on how everyone might find common political goals among the so-called pro-life and pro-choice sides. The exercise the authors offer in this article…

  8. Determinants of Coverage Decisions in Health Insurance Marketplaces: Consumers' Decision-Making Abilities and the Amount of Information in Their Choice Environment

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv; Rice, Thomas

    2015-01-01

    Objective To investigate the determinants and quality of coverage decisions among uninsured choosing plans in a hypothetical health insurance marketplace. Study Setting Two samples of uninsured individuals: one from an Internet-based sample comprised largely of young, healthy, tech-savvy individuals (n = 276), and the other from low-income, rural Virginians (n = 161). Study Design We assessed whether health insurance comprehension, numeracy, choice consistency, and the number of plan choices were associated with participants' ability to choose a cost-minimizing plan, given their expected health care needs (defined as choosing a plan costing no more than $500 in excess of the total estimated annual costs of the cheapest plan available). Data Collection Primary data were collected using an online questionnaire. Principal Findings Uninsured who were more numerate showed higher health insurance comprehension; those with more health insurance comprehension made choices of health insurance plans more consistent with their stated preferences; and those who made choices more concordant with their stated preferences were less likely to choose a plan that cost more than $500 in excess of the cheapest plan available. Conclusions Increasing health insurance comprehension and designing exchanges to facilitate plan comparison will be critical to ensuring the success of health insurance marketplaces. PMID:24779769

  9. Choice-making in facilitation of agricultural innovation platforms in different contexts in West Africa: experiences from Benin, Ghana and Mali

    NARCIS (Netherlands)

    Paassen, van A.; Klerkx, L.W.A.; Adjei-Nsiah, S.; Adu-Acheampong, R.; Ouologuem, B.; Zannou, E.; Vissoh, P.; Soumano, L.; Dembele, F.; Traore, M.

    2013-01-01

    Platforms provide an increased capacity for learning and coordinated innovation. The value of platforms for innovation is widely recognized, but more understanding is needed of the choices made in facilitation, to enable platforms to perform effectively within varying value chain contexts. This

  10. Exploring how individuals complete the choice tasks in a discrete choice experiment: an interview study

    Directory of Open Access Journals (Sweden)

    Jorien Veldwijk

    2016-04-01

    Full Text Available Abstract Background To be able to make valid inferences on stated preference data from a Discrete Choice Experiment (DCE it is essential that researchers know if participants were actively involved, understood and interpreted the provided information correctly and whether they used complex decision strategies to make their choices and thereby acted in accordance with the continuity axiom. Methods During structured interviews, we explored how 70 participants evaluated and completed four discrete choice tasks aloud. Hereafter, additional questions were asked to further explore if participants understood the information that was provided to them and whether they used complex decision strategies (continuity axiom when making their choices. Two existing DCE questionnaires on rotavirus vaccination and prostate cancer-screening served as case studies. Results A large proportion of the participants was not able to repeat the exact definition of the risk attributes as explained to them in the introduction of the questionnaire. The majority of the participants preferred more optimal over less optimal risk attribute levels. Most participants (66 % mentioned three or more attributes when motivating their decisions, thereby acting in accordance with the continuity axiom. However, 16 out of 70 participants continuously mentioned less than three attributes when motivating their decision. Lower educated and less literate participants tended to mention less than three attributes when motivating their decision and used trading off between attributes less often as a decision-making strategy. Conclusion The majority of the participants seemed to have understood the provided information about the choice tasks, the attributes, and the levels. They used complex decision strategies (continuity axiom and are therefore capable to adequately complete a DCE. However, based on the participants’ age, educational level and health literacy additional, actions should be

  11. Making the invisible visible’ through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study

    Directory of Open Access Journals (Sweden)

    H. Laetitia Hattingh

    2016-11-01

    Full Text Available Abstract Background Screening and brief interventions (SBI for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists. Method We recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable ‘retention’ to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability. Results Fifty consumer participants were screened, ten from each pharmacy. There were 28 (57 % men and 21 (43 % women with one not responding. Most (67 % were aged 25–55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8 with 11 categorised as ‘hazardous (8–15’, four as ‘harmful (16–19’ and eight as ‘probably dependent (20+’ consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 % agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 % were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the

  12. 'Making the invisible visible' through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study.

    Science.gov (United States)

    Hattingh, H Laetitia; Hallett, Jonathan; Tait, Robert J

    2016-11-08

    Screening and brief interventions (SBI) for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists. We recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable 'retention' to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability. Fifty consumer participants were screened, ten from each pharmacy. There were 28 (57 %) men and 21 (43 %) women with one not responding. Most (67 %) were aged 25-55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8) with 11 categorised as 'hazardous (8-15)', four as 'harmful (16-19)' and eight as 'probably dependent (20+)' consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 %) agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 %) were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the interviews: 1) flexibility applied in recruitment of participants

  13. Possible Impact of Incremental Cost-Effectiveness Ratio (ICER) on Decision Making for Cancer Screening in Hong Kong: A Systematic Review.

    Science.gov (United States)

    Wong, Carlos K H; Lang, Brian H H; Guo, Vivian Y W; Lam, Cindy L K

    2016-12-01

    The aim of this paper was to critically review the literature on the cost effectiveness of cancer screening interventions, and examine the incremental cost-effectiveness ratios (ICERs) that may influence government recommendations on cancer screening strategies and funding for mass implementation in the Hong Kong healthcare system. We conducted a literature review of cost-effectiveness studies in the Hong Kong population related to cancer screening published up to 2015, through a hand search and database search of PubMed, Web of Science, Embase, and OVID Medline. Binary data on the government's decisions were obtained from the Cancer Expert Working Group, Department of Health. Mixed-effect logistic regression analysis was used to examine the impact of ICERs on decision making. Using Youden's index, an optimal ICER threshold value for positive decisions was examined by area under receiver operating characteristic curve (AUC). Eight studies reporting 30 cost-effectiveness pairwise comparisons of population-based cancer screening were identified. Most studies reported an ICER for a cancer screening strategy versus a comparator with outcomes in terms of cost per life-years (55.6 %), or cost per quality-adjusted life-years (55.6 %). Among comparisons with a mean ICER of US$102,931 (range 800-715,137), the increase in ICER value by 1000 was associated with decreased odds (odds ratio 0.990, 0.981-0.999; p = 0.033) of a positive recommendation. An optimal ICER value of US$61,600 per effectiveness unit yielded a high sensitivity of 90 % and specificity of 85 % for a positive recommendation. A lower ICER threshold value of below US$8044 per effectiveness unit was detected for a positive funding decision. Linking published evidence to Government recommendations and practice on cancer screening, ICERs influence decisions on the adoption of health technologies in Hong Kong. The potential ICER threshold for recommendation in Hong Kong may be higher than those of developed

  14. A screen for constituents of motor control and decision making in Drosophila reveals visual distance-estimation neurons

    Science.gov (United States)

    Triphan, Tilman; Nern, Aljoscha; Roberts, Sonia F.; Korff, Wyatt; Naiman, Daniel Q.; Strauss, Roland

    2016-01-01

    Climbing over chasms larger than step size is vital to fruit flies, since foraging and mating are achieved while walking. Flies avoid futile climbing attempts by processing parallax-motion vision to estimate gap width. To identify neuronal substrates of climbing control, we screened a large collection of fly lines with temporarily inactivated neuronal populations in a novel high-throughput assay described here. The observed climbing phenotypes were classified; lines in each group are reported. Selected lines were further analysed by high-resolution video cinematography. One striking class of flies attempts to climb chasms of unsurmountable width; expression analysis guided us to C2 optic-lobe interneurons. Inactivation of C2 or the closely related C3 neurons with highly specific intersectional driver lines consistently reproduced hyperactive climbing whereas strong or weak artificial depolarization of C2/C3 neurons strongly or mildly decreased climbing frequency. Contrast-manipulation experiments support our conclusion that C2/C3 neurons are part of the distance-evaluation system. PMID:27255169

  15. Effect of informational internet web pages on patients' decision-making: randomised controlled trial regarding choice of spinal or general anaesthesia for orthopaedic surgery.

    Science.gov (United States)

    Groves, N D; Humphreys, H W; Williams, A J; Jones, A

    2010-03-01

    This study explored whether patients' preference for particular types of anaesthesia could be influenced pre-operatively by giving them the addresses of various relevant websites. Patients at an orthopaedic pre-assessment education clinic completed a questionnaire, which included a short multiple-choice general knowledge quiz about anaesthesia, and also questioned them as to their choice of anaesthesia (general or neuraxial). Patients were randomly assigned to intervention or control groups. Intervention group members were given the addresses of three relevant anaesthesia and health related websites to access at home. All patients were asked to complete the questionnaires on a second occasion, before surgery. Initially, most patients stated a preference for general anaesthesia. Subsequently, the intervention group altered their preference towards neuraxial anaesthesia compared to the control group (p < or = 0.0001). The increase in median (IQR [range]) anaesthesia knowledge test score was greater in the intervention group (from 10.0 (9.0-12.0 [5.0-14.0]) to 13.0 (11.0-14.0 [6.0-14.0])) than in the control group (from 10.0 (9.0-11.5 [3.0-13.0]) to 11.0 (9.0-12.0 [4.0-14.0]); p = 0.0068).

  16. [Organized breast cancer screening].

    Science.gov (United States)

    Rouëssé, Jacques; Sancho-Garnier, Hélèn

    2014-02-01

    increase its efficiency, by targeting populations at a higher risk than the women currently included, and to reduce the number of mammograms done outside the program, as they are not subject to the same quality controls. Risks could be reduced by increasing the sensitivity of mammography and the specificity of the readings. Moreover, it is mandatory to inform women of both the benefits and risks of screening, in compliance with the principle of enabling patients to make a free and informed choice.

  17. Heterogeneous classifier fusion for ligand-based virtual screening: or, how decision making by committee can be a good thing.

    Science.gov (United States)

    Riniker, Sereina; Fechner, Nikolas; Landrum, Gregory A

    2013-11-25

    The concept of data fusion - the combination of information from different sources describing the same object with the expectation to generate a more accurate representation - has found application in a very broad range of disciplines. In the context of ligand-based virtual screening (VS), data fusion has been applied to combine knowledge from either different active molecules or different fingerprints to improve similarity search performance. Machine-learning (ML) methods based on fusion of multiple homogeneous classifiers, in particular random forests, have also been widely applied in the ML literature. The heterogeneous version of classifier fusion - fusing the predictions from different model types - has been less explored. Here, we investigate heterogeneous classifier fusion for ligand-based VS using three different ML methods, RF, naïve Bayes (NB), and logistic regression (LR), with four 2D fingerprints, atom pairs, topological torsions, RDKit fingerprint, and circular fingerprint. The methods are compared using a previously developed benchmarking platform for 2D fingerprints which is extended to ML methods in this article. The original data sets are filtered for difficulty, and a new set of challenging data sets from ChEMBL is added. Data sets were also generated for a second use case: starting from a small set of related actives instead of diverse actives. The final fused model consistently outperforms the other approaches across the broad variety of targets studied, indicating that heterogeneous classifier fusion is a very promising approach for ligand-based VS. The new data sets together with the adapted source code for ML methods are provided in the Supporting Information .

  18. Shared Decision Making in women testing for a BRCA 1/2 mutation.

    NARCIS (Netherlands)

    Roosmalen, M.S van

    2005-01-01

    Women with a BRCA1/2 mutation have a high genetic risk of developing breast and ovarian cancer. They face the difficult choice between screening and prophylactic surgery for the breasts and ovaries. We have developed a shared decision making program to prepare these women for decision making. The

  19. Making food labels social: The impact of colour of nutritional labels and injunctive norms on perceptions and choice of snack foods.

    Science.gov (United States)

    Vasiljevic, Milica; Pechey, Rachel; Marteau, Theresa M

    2015-08-01

    Recent studies report that using green labels to denote healthier foods, and red to denote less healthy foods increases consumption of green- and decreases consumption of red-labelled foods. Other symbols (e.g. emoticons conveying normative approval and disapproval) could also be used to signal the healthiness and/or acceptability of consuming such products. The present study tested the combined effects of using emoticons and colours on labels amongst a nationally representative sample of the UK population (n = 955). In a 3 (emoticon expression: smiling vs. frowning vs. no emoticon) × 3 (colour label: green vs. red vs. white) ×2 (food option: chocolate bar vs. cereal bar) between-subjects experiment, participants rated the level of desirability, healthiness, tastiness, and calorific content of a snack bar they had been randomised to view. At the end they were further randomised to view one of nine possible combinations of colour and emoticon labels and asked to choose between a chocolate and a cereal bar. Regardless of label, participants rated the chocolate as tastier and more desirable when compared to the cereal bar, and the cereal bar as healthier than the chocolate bar. A series of interactions revealed that a frowning emoticon on a white background decreased perceptions of healthiness and tastiness of the cereal bar, but not the chocolate bar. In the explicit choice task selection was unaffected by label. Overall nutritional labels had limited effects on perceptions and no effects on choice of snack foods. Emoticon labels yielded stronger effects on perceptions of taste and healthiness of snacks than colour labels. Frowning emoticons may be more potent than smiling emoticons at influencing the perceived healthiness and tastiness of foods carrying health halos. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. A Smart Toy to Enhance the Decision-Making Process at Children’s Psychomotor Delay Screenings: A Pilot Study

    Science.gov (United States)

    2017-01-01

    Background EDUCERE (“Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders”) is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school. Thirty multidisciplinary professionals and three nursery schools worked in the EDUCERE project between 2014 and 2017 and they obtained satisfactory results. Related to EDUCERE, we found studies based on providing networks of connected smart objects and the interaction between toys and social networks. Objective This research includes the design, implementation, and validation of an EDUCERE smart toy aimed to automatically detect delays in psychomotor development. The results from initial tests led to enhancing the effectiveness of the original design and deployment. The smart toy, based on stackable cubes, has a data collector module and a smart system for detection of developmental delays, called the EDUCERE developmental delay screening system (DDSS). Methods The pilot study involved 65 toddlers aged between 23 and 37 months (mean=29.02, SD 3.81) who built a tower with five stackable cubes, designed by following the EDUCERE smart toy model. As toddlers made the tower, sensors in the cubes sent data to a collector module through a wireless connection. All trials were video-recorded for further analysis by child development experts. After watching the videos, experts scored the performance of the trials to compare and fine-tune the interpretation of the data automatically gathered by the toy-embedded sensors. Results Judges were highly reliable in an interrater

  1. A Smart Toy to Enhance the Decision-Making Process at Children's Psychomotor Delay Screenings: A Pilot Study.

    Science.gov (United States)

    Gutiérrez García, María Angeles; Martín Ruiz, María Luisa; Rivera, Diego; Vadillo, Laura; Valero Duboy, Miguel Angel

    2017-05-19

    EDUCERE ("Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders") is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school. Thirty multidisciplinary professionals and three nursery schools worked in the EDUCERE project between 2014 and 2017 and they obtained satisfactory results. Related to EDUCERE, we found studies based on providing networks of connected smart objects and the interaction between toys and social networks. This research includes the design, implementation, and validation of an EDUCERE smart toy aimed to automatically detect delays in psychomotor development. The results from initial tests led to enhancing the effectiveness of the original design and deployment. The smart toy, based on stackable cubes, has a data collector module and a smart system for detection of developmental delays, called the EDUCERE developmental delay screening system (DDSS). The pilot study involved 65 toddlers aged between 23 and 37 months (mean=29.02, SD 3.81) who built a tower with five stackable cubes, designed by following the EDUCERE smart toy model. As toddlers made the tower, sensors in the cubes sent data to a collector module through a wireless connection. All trials were video-recorded for further analysis by child development experts. After watching the videos, experts scored the performance of the trials to compare and fine-tune the interpretation of the data automatically gathered by the toy-embedded sensors. Judges were highly reliable in an interrater agreement analysis (intraclass correlation 0

  2. Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision-making.

    Science.gov (United States)

    Légaré, France; St-Jacques, Sylvie; Gagnon, Susie; Njoya, Merlin; Brisson, Michel; Frémont, Pierre; Rousseau, François

    2011-04-01

    To assess the willingness of women and their family physicians (FPs) to engage in shared decision-making (SDM) as regards prenatal Down-syndrome screening and the factors that might influence their willingness to do so. We conducted a survey of participants in Québec City, Canada, using the theory of planned behavior. We used a general linear model and multilevel approach that took the fact that some women consulted the same FP into account. This study comprised 109 pregnant women and 41 FPs. On a scale of - 3 to + 3, the pregnant women's and FPs' response scores were, respectively, 2.11 ± 1.38 and 2.66 ± 0.40. In women, attitude, significant others, self-efficacy, perceived moral correctness, and their FP's attitude influenced their willingness to engage in SDM. However, women without a post-secondary education were less likely to engage in SDM than women with a post-secondary education, mostly because the former lacked a sense of self-efficacy. In FPs, only attitude and significant others influenced their willingness to engage in SDM. Overall, the women and their FPs wished to engage in SDM as regards prenatal Down-syndrome screening. Only a few factors influenced this desire which therefore may be modifiable. Copyright © 2011 John Wiley & Sons, Ltd.

  3. Models of expert assessments and their study in problems of choice and decision-making in management of motor transport processes

    Science.gov (United States)

    Belokurov, V. P.; Belokurov, S. V.; Korablev, R. A.; Shtepa, A. A.

    2018-05-01

    The article deals with decision making concerning transport tasks on search iterations in the management of motor transport processes. An optimal selection of the best option for specific situations is suggested in the management of complex multi-criteria transport processes.

  4. Cascading of Biomass. 13 Solutions for a Sustainable Bio-based Economy. Making Better Choices for Use of Biomass Residues, By-products and Wastes

    Energy Technology Data Exchange (ETDEWEB)

    Odegard, I.; Croezen, H.; Bergsma, G.

    2012-08-15

    Smarter and more efficient use of biomass, referred to as cascading, can lead to an almost 30% reduction in European greenhouse gas emissions by 2030 compared with 2010. As the title study makes clear, cascading of woody biomass, agricultural and industrial residues and other waste can make a significant contribution to a greening of the economy. With the thirteen options quantitatively examined annual emissions of between 330 and 400 Mt CO2 can be avoided by making more efficient use of the same volume of biomass as well as by other means. 75% of the potential CO2 gains can be achieved with just four options: (1) bio-ethanol from straw, for use as a chemical feedstock; (2) biogas from manure; (3) biorefining of grass; and (4) optimisation of paper recycling. Some of the options make multiple use of residues, with biomass being used to produce bioplastics that, after several rounds of recycling, are converted to heat and power at the end of their life, for example. In other cases higher-grade applications are envisaged: more efficient use of recyclable paper and wood waste, in both economic and ecological terms, using them as raw materials for new paper and chipboard rather than as an energy source. Finally, by using smart technologies biomass can be converted to multiple products.

  5. Empowering Parents: States Have a Role in Ensuring Parents Have the Data They Need to Make Informed Choices. Data for Action 2012

    Science.gov (United States)

    Data Quality Campaign, 2012

    2012-01-01

    Accessible, tailored, and easy-to-understand data can help parents influence their children's learning, take advantage of school resources, and inform their educational decision making: (1) Information about their children--such as attendance, performance, progress, and expected outcomes; and (2) Information about their children's current school…

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

  8. Helping consumers make more healthful food choices: consumer views on modifying food labels and providing point-of-purchase nutrition information at quick-service restaurants.

    Science.gov (United States)

    Lando, Amy M; Labiner-Wolfe, Judith

    2007-01-01

    To understand consumer (1) interest in nutrition information on food labels and quick-service restaurant menu boards and (2) reactions to modifying this information to help highlight calories and more healthful choices. Eight consumer focus groups, using a guide and stimuli. Focus group discussions in 4 US cities. A total of 68 consumers, with 7 to 10 per focus group. Authors prepared detailed summaries of discussions based on observation. Video recordings and transcripts were used to cross-check summaries. Data were systematically reviewed, synthesized, and analyzed. Consumer views on alternative presentations of nutrition information on packaged food items and quick-service restaurant menu boards. Participants (1) were interested in having nutrition information available, but would not use it at every eating occasion; (2) thought that food products typically consumed at 1 eating occasion should be labeled as a single serving; and (3) indicated that an icon on labels and menu boards that signaled more healthful options could be helpful. Findings provide a basis for the development of more systematic studies to better understand whether alternative presentations of nutrition information would help consumers.

  9. Application of multi-criteria decision-making model for choice of the optimal solution for meeting heat demand in the centralized supply system in Belgrade

    International Nuclear Information System (INIS)

    Grujić, Miodrag; Ivezić, Dejan; Živković, Marija

    2014-01-01

    The expected growth of living standard, number of inhabitants and development of technology, industry and agriculture will cause a significant increase of energy consumption in cities. Three scenarios of energy sector development until 2030 and corresponding energy consumption for the city of Belgrade are analyzed in this paper. These scenarios consider different level of economic development, investments in energy sector, substitution of fossil fuels, introduction of renewable energy sources and implementation of energy efficiency measures. The proposed model for selection of optimal district heating system compares different options for fulfilling expected new heat demand through eight criteria for each scenario. Proposed options are combination of different energy sources and technologies for their use. The criteria weights are set according to Serbian economy and energy position. The criteria include financial aspects, environmental impact and availability of energy. Multi-criteria method ELECTRE (ELimination Et Choix Traduisant la REalite) is used as a tool for obtaining the optimal option. It is concluded that combination of CHP (combined heat and power) plant and centralized use of geothermal energy is optimal choice in the optimistic scenario. In the pessimistic and business as usual scenario the optimal option is combination of new gas boilers and centralized use of geothermal energy. - Highlights: • Three scenarios for meeting new heat demand are developed and assessed. • Constructing CHP (combined heat and power) is desirable in case of significant electricity price growth. • In all scenarios the chosen option includes using geothermal energy for heating

  10. Making sense of policy choices: understanding the roles of value predispositions, mass media, and cognitive processing in public attitudes toward nanotechnology

    Science.gov (United States)

    Ho, Shirley S.; Scheufele, Dietram A.; Corley, Elizabeth A.

    2010-10-01

    Using a nationally representative telephone survey of 1,015 adults in the United States, this study examines how value predispositions, communication variables, and perceptions of risks and benefits are associated with public support for federal funding of nanotechnology. Our findings show that highly religious individuals were less supportive of funding of nanotech than less religious individuals, whereas individuals who held a high deference for scientific authority were more supportive of funding of the emerging technology than those low in deference. Mass media use and elaborative processing of scientific news were positively associated with public support for funding, whereas factual scientific knowledge had no significant association with policy choices. The findings suggest that thinking about and reflecting upon scientific news promote better understanding of the scientific world and may provide a more sophisticated cognitive structure for the public to form opinions about nanotech than factual scientific knowledge. Finally, heuristic cues including trust in scientists and perceived risks and benefits of nanotech were found to be associated with public support for nanotech funding. We conclude with policy implications that will be useful for policymakers and science communication practitioners.

  11. Making sense of policy choices: understanding the roles of value predispositions, mass media, and cognitive processing in public attitudes toward nanotechnology

    International Nuclear Information System (INIS)

    Ho, Shirley S.; Scheufele, Dietram A.; Corley, Elizabeth A.

    2010-01-01

    Using a nationally representative telephone survey of 1,015 adults in the United States, this study examines how value predispositions, communication variables, and perceptions of risks and benefits are associated with public support for federal funding of nanotechnology. Our findings show that highly religious individuals were less supportive of funding of nanotech than less religious individuals, whereas individuals who held a high deference for scientific authority were more supportive of funding of the emerging technology than those low in deference. Mass media use and elaborative processing of scientific news were positively associated with public support for funding, whereas factual scientific knowledge had no significant association with policy choices. The findings suggest that thinking about and reflecting upon scientific news promote better understanding of the scientific world and may provide a more sophisticated cognitive structure for the public to form opinions about nanotech than factual scientific knowledge. Finally, heuristic cues including trust in scientists and perceived risks and benefits of nanotech were found to be associated with public support for nanotech funding. We conclude with policy implications that will be useful for policymakers and science communication practitioners.

  12. Small Screen Use and Driving Safety.

    Science.gov (United States)

    Atchley, Paul; Strayer, David L

    2017-11-01

    The increased availability of "small screens," wireless devices with Internet-enabled connections, and their associated applications has almost overnight changed the way that we interact with our phones. The current work outlines some of the aspects of this problem as it relates to the influence of small screens on driving safety. Small screens are highly compelling to drivers, both for the information they convey and because the ability to ignore them while driving is impaired by cognitive resources used by the driving task itself. However, much is unknown about why people make choices to multitask while driving. Given the safety risks, it is recommended that parents, the public, and regulators take a stand against the use of Internet-enabled small screens unrelated to driving when the vehicle is in motion. Copyright © 2017 by the American Academy of Pediatrics.

  13. Decision making for destination therapy left ventricular assist devices: "there was no choice" versus "I thought about it an awful lot".

    Science.gov (United States)

    McIlvennan, Colleen K; Allen, Larry A; Nowels, Carolyn; Brieke, Andreas; Cleveland, Joseph C; Matlock, Daniel D

    2014-05-01

    Destination therapy left ventricular assist devices (DT LVADs) are one of the most invasive medical interventions for end-stage illness. How patients decide whether or not to proceed with device implantation is unknown. We aimed to understand the decision-making processes of patients who either accept or decline DT LVADs. Between October 2012 and September 2013, we conducted semistructured, in-depth interviews to understand patients' decision-making experiences. Data were analyzed using a mixed inductive and deductive approach. Twenty-two eligible patients were interviewed, 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an over-riding desire to live as long as possible: "[LVAD] was the only option I had…that or push up daisies…so I automatically took this." By contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: "There are worse things than death." Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually. Some patients offered a DT LVAD face the decision by reflecting on a process and reasoning through risks and benefits. For others, the desire to live supersedes such reflective processing. Acknowledging this difference is important when considering how to support patients who are faced with this complex decision. © 2014 American Heart Association, Inc.

  14. The VMAT-2 inhibitor tetrabenazine affects effort-related decision making in a progressive ratio/chow feeding choice task: reversal with antidepressant drugs.

    Directory of Open Access Journals (Sweden)

    Patrick A Randall

    Full Text Available Behavioral activation is a fundamental feature of motivation, and organisms frequently make effort-related decisions based upon evaluations of reinforcement value and response costs. Furthermore, people with major depression and other disorders often show anergia, psychomotor retardation, fatigue, and alterations in effort-related decision making. Tasks measuring effort-based decision making can be used as animal models of the motivational symptoms of depression, and the present studies characterized the effort-related effects of the vesicular monoamine transport (VMAT-2 inhibitor tetrabenazine. Tetrabenazine induces depressive symptoms in humans, and also preferentially depletes dopamine (DA. Rats were assessed using a concurrent progressive ratio (PROG/chow feeding task, in which they can either lever press on a PROG schedule for preferred high-carbohydrate food, or approach and consume a less-preferred lab chow that is freely available in the chamber. Previous work has shown that the DA antagonist haloperidol reduced PROG work output on this task, but did not reduce chow intake, effects that differed substantially from those of reinforcer devaluation or appetite suppressant drugs. The present work demonstrated that tetrabenazine produced an effort-related shift in responding on the PROG/chow procedure, reducing lever presses, highest ratio achieved and time spent responding, but not reducing chow intake. Similar effects were produced by administration of the subtype selective DA antagonists ecopipam (D1 and eticlopride (D2, but not by the cannabinoid CB1 receptor neutral antagonist and putative appetite suppressant AM 4413, which suppressed both lever pressing and chow intake. The adenosine A2A antagonist MSX-3, the antidepressant and catecholamine uptake inhibitor bupropion, and the MAO-B inhibitor deprenyl, all reversed the impairments induced by tetrabenazine. This work demonstrates the potential utility of the PROG/chow procedure as a

  15. Vincent's Choice

    NARCIS (Netherlands)

    Stolwijk, Chris

    2003-01-01

    Official publication to accompany the important exhibition Vincent's Choice, Van Gogh's 'musee imaginaire' at the Van Gogh Museum, Amsterdam marking the 150th anniversary of the artist's birth. The exhibition runs from 14th February to 15th June 2003.Thanks to van Gogh's correspondence, it has been

  16. Cued to Act on Impulse: More Impulsive Choice and Risky Decision Making by Women Susceptible to Overeating after Exposure to Food Stimuli.

    Directory of Open Access Journals (Sweden)

    Martin R Yeomans

    Full Text Available There is increasing evidence that individual differences in tendency to overeat relate to impulsivity, possibly by increasing reactivity to food-related cues in the environment. This study tested whether acute exposure to food cues enhanced impulsive and risky responses in women classified on tendency to overeat, indexed by scores on the three factor eating questionnaire disinhibition (TFEQ-D, restraint (TFEQ-R and hunger scales. Ninety six healthy women completed two measures of impulsive responding (delayed discounting, DDT and a Go No-Go, GNG, task and a measure of risky decision making (the balloon analogue risk task, BART as well as questionnaire measures of impulsive behaviour either after looking at a series of pictures of food or visually matched controls. Impulsivity (DDT and risk-taking (BART were both positively associated with TFEQ-D scores, but in both cases this effect was exacerbated by prior exposure to food cues. No effects of restraint were found. TFEQ-D scores were also related to more commission errors on the GNG, while restrained women were slower on the GNG, but neither effect was modified by cue exposure. Overall these data suggest that exposure to food cues act to enhance general impulsive responding in women at risk of overeating and tentatively suggest an important interaction between tendency for impulsive decision making and food cues that may help explain a key underlying risk factor for overeating.

  17. Cued to Act on Impulse: More Impulsive Choice and Risky Decision Making by Women Susceptible to Overeating after Exposure to Food Stimuli.

    Science.gov (United States)

    Yeomans, Martin R; Brace, Aaron

    2015-01-01

    There is increasing evidence that individual differences in tendency to overeat relate to impulsivity, possibly by increasing reactivity to food-related cues in the environment. This study tested whether acute exposure to food cues enhanced impulsive and risky responses in women classified on tendency to overeat, indexed by scores on the three factor eating questionnaire disinhibition (TFEQ-D), restraint (TFEQ-R) and hunger scales. Ninety six healthy women completed two measures of impulsive responding (delayed discounting, DDT and a Go No-Go, GNG, task) and a measure of risky decision making (the balloon analogue risk task, BART) as well as questionnaire measures of impulsive behaviour either after looking at a series of pictures of food or visually matched controls. Impulsivity (DDT) and risk-taking (BART) were both positively associated with TFEQ-D scores, but in both cases this effect was exacerbated by prior exposure to food cues. No effects of restraint were found. TFEQ-D scores were also related to more commission errors on the GNG, while restrained women were slower on the GNG, but neither effect was modified by cue exposure. Overall these data suggest that exposure to food cues act to enhance general impulsive responding in women at risk of overeating and tentatively suggest an important interaction between tendency for impulsive decision making and food cues that may help explain a key underlying risk factor for overeating.

  18. The emerging role of histology in the choice of first-line treatment of advanced non-small cell lung cancer: implication in the clinical decision-making.

    Science.gov (United States)

    Rossi, Antonio; Maione, Paolo; Bareschino, Maria Anna; Schettino, Clorinda; Sacco, Paola Claudia; Ferrara, Marianna Luciana; Castaldo, Vincenzo; Gridelli, Cesare

    2010-01-01

    Lung cancer is the leading cause of cancer mortality worldwide. Non-small cell lung cancer (NSCLC), accounting for about 85% of all lung cancers, includes squamous carcinoma, adenocarcinoma and undifferentiated large cell carcinoma. The majority of patients have advanced disease at diagnosis, and medical treatment is the cornerstone of management. Several randomized trials comparing third-generation platinum-based doublets concluded that all such combinations are comparable in their clinical efficacy, failing to document a difference based on histology. However, recent evidences, arising from the availability of pemetrexed, have shown that histology represents an important variable in the decision making. The major progresses in the understanding cancer biology and mechanism of oncogenesis have allowed the development of several potential molecular targets for cancer treatment such as vascular growth factor and its receptors and epidermal growth factor receptor. Targeted drugs seem to be safer or more effective in a specific histology subtype. All of these data have led to choose the optimal first-line treatment of advanced NSCLC based on histologic diagnosis. However, this scenario raises a diagnostic issue: a specific diagnosis of NSCLC histologic subtype is mandatory. This review will discuss these new evidences in the first-line treatment of advanced NSCLC and their implication in the current clinical decision-making.

  19. Evidence, values, guidelines and rational decision-making.

    Science.gov (United States)

    Barrett, Bruce

    2012-02-01

    Medical decision-making involves choices, which can lead to benefits or to harms. Most benefits and harms may or may not occur, and can be minor or major when they do. Medical research, especially randomized controlled trials, provides estimates of chance of occurrence and magnitude of event. Because there is no universally accepted method for weighing harms against benefits, and because the ethical principle of autonomy mandates informed choice by patient, medical decision-making is inherently an individualized process. It follows that the practice of aiming for universal implementation of standardized guidelines is irrational and unethical. Irrational because the possibility of benefits is implicitly valued more than the possibility of comparable harms, and unethical because guidelines remove decision making from the patient and give it instead to a physician, committee or health care system. This essay considers the cases of cancer screening and diabetes management, where guidelines often advocate universal implementation, without regard to informed choice and individual decision-making.

  20. A Qualitative Analysis of Patients' Perceptions of Shared Decision Making in the Emergency Department: "Let Me Know I Have a Choice".

    Science.gov (United States)

    Schoenfeld, Elizabeth M; Goff, Sarah L; Downs, Gwendolyn; Wenger, Robert J; Lindenauer, Peter K; Mazor, Kathleen M

    2018-03-25

    Despite increasing attention to the use of shared decision making (SDM) in the emergency department (ED), little is known about ED patients' perspectives regarding this practice. We sought to explore the use of SDM from the perspectives of ED patients, focusing on what affects patients' desired level of involvement and what barriers and facilitators patients find most relevant to their experience. We conducted semistructured interviews with a purposive sample of ED patients or their proxies at two sites. An interview guide was developed from existing literature and expert consensus and based on a framework underscoring the importance of both knowledge and power. Interviews were recorded, transcribed, and analyzed in an iterative process by a three-person coding team. Emergent themes were identified, discussed, and organized. Twenty-nine patients and proxies participated. The mean age of participants was 56 years (range, 20 to 89 years), and 13 were female. Participants were diverse in regard to race/ethnicity, education, number of previous ED visits, and presence of chronic conditions. All participants wanted some degree of involvement in decision making. Participants who made statements suggesting high self-efficacy and those who expressed mistrust of the health care system or previous negative experiences wanted a greater degree of involvement. Facilitators to involvement included familiarity with the decision at hand, physicians' good communication skills, and clearly delineated options. Some participants felt that their own relative lack of knowledge, compared to that of the physicians, made their involvement inappropriate or unwanted. Many participants had no expectation for SDM and although they did want involvement when asked explicitly, they were otherwise likely to defer to physicians without discussion. Many did not recognize opportunities for SDM in their clinical care. This exploration of ED patients' perceptions of SDM suggests that most patients want

  1. [GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction].

    Science.gov (United States)

    Alonso-Coello, Pablo; Schünemann, Holger J; Moberg, Jenny; Brignardello-Petersen, Romina; Akl, Elie A; Davoli, Marina; Treweek, Shaun; Mustafa, Reem A; Rada, Gabriel; Rosenbaum, Sarah; Morelli, Angela; Guyatt, Gordon H; Oxman, Andrew D

    Clinicians, guideline developers, and policymakers sometimes neglect important criteria, give undue weight to criteria, and do not use the best available evidence to inform their judgments. Explicit and transparent systems for decision making can help to ensure that all important criteria are considered and that decisions are informed by the best available research evidence. The GRADE Working Group has developed Evidence to Decision (EtD) frameworks for the different type of recommendations or decisions. The purpose of EtD frameworks is to help people use evidence in a structured and transparent way to inform decisions in the context of clinical recommendations, coverage decisions, and health system or public health recommendations and decisions. EtD frameworks have a common structure that includes formulation of the question, an assessment of the evidence, and drawing conclusions, though there are some differences between frameworks for each type of decision. EtD frameworks inform users about the judgments that were made and the evidence supporting those judgments by making the basis for decisions transparent to target audiences. EtD frameworks also facilitate dissemination of recommendations and enable decision makers in other jurisdictions to adopt recommendations or decisions, or adapt them to their context. This article is a translation of the original article published in British Medical Journal. The EtD frameworks are currently used in the Clinical Practice Guideline Programme of the Spanish National Health System, co-ordinated by GuíaSalud. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Choosing health, constrained choices.

    Science.gov (United States)

    Chee Khoon Chan

    2009-12-01

    In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.

  3. Neural Activity Reveals Preferences Without Choices

    Science.gov (United States)

    Smith, Alec; Bernheim, B. Douglas; Camerer, Colin

    2014-01-01

    We investigate the feasibility of inferring the choices people would make (if given the opportunity) based on their neural responses to the pertinent prospects when they are not engaged in actual decision making. The ability to make such inferences is of potential value when choice data are unavailable, or limited in ways that render standard methods of estimating choice mappings problematic. We formulate prediction models relating choices to “non-choice” neural responses and use them to predict out-of-sample choices for new items and for new groups of individuals. The predictions are sufficiently accurate to establish the feasibility of our approach. PMID:25729468

  4. Concerns, perceived need and competing priorities: a qualitative exploration of decision-making and non-participation in a population-based flexible sigmoidoscopy screening programme to prevent colorectal cancer.

    Science.gov (United States)

    Hall, N; Birt, L; Rees, C J; Walter, F M; Elliot, S; Ritchie, M; Weller, D; Rubin, G

    2016-11-11

    Optimising uptake of colorectal cancer (CRC) screening is important to achieve projected health outcomes. Population-based screening by flexible sigmoidoscopy (FS) was introduced in England in 2013 (NHS Bowel scope screening). Little is known about reactions to the invitation to participate in FS screening, as offered within the context of the Bowel scope programme. We aimed to investigate responses to the screening invitation to inform understanding of decision-making, particularly in relation to non-participation in screening. Qualitative analysis of semistructured in-depth interviews and written accounts. People from 31 general practices in the North East and East of England invited to attend FS screening as part of NHS Bowel scope screening programme were sent invitations to take part in the study. We purposively sampled interviewees to ensure a range of accounts in terms of beliefs, screening attendance, sex and geographical location. 20 screeners and 25 non-screeners were interviewed. Written responses describing reasons for, and circumstances surrounding, non-participation from a further 28 non-screeners were included in the analysis. Thematic analysis identified a range of reactions to the screening invitation, decision-making processes and barriers to participation. These include a perceived or actual lack of need; inability to attend; anxiety and fear about bowel preparation, procedures or hospital; inability or reluctance to self-administer an enema; beliefs about low susceptibility to bowel cancer or treatment and understanding of harm and benefits. The strength, rather than presence, of concerns about the test and perceived need for reassurance were important in the decision to participate for screeners and non-screeners. Decision-making occurs within the context of previous experiences and day-to-day life. Understanding the reasons for non-participation in FS screening can help inform strategies to improve uptake and may be transferable to other

  5. [GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines].

    Science.gov (United States)

    Alonso-Coello, Pablo; Oxman, Andrew D; Moberg, Jenny; Brignardello-Petersen, Romina; Akl, Elie A; Davoli, Marina; Treweek, Shaun; Mustafa, Reem A; Vandvik, Per O; Meerpohl, Joerg; Guyatt, Gordon H; Schünemann, Holger J

    Clinicians do not have the time or resources to consider the underlying evidence for the myriad decisions they must make each day and, as a consequence, rely on recommendations from clinical practice guidelines. Guideline panels should consider all the relevant factors (criteria) that influence a decision or recommendation in a structured, explicit, and transparent way and provide clinicians with clear and actionable recommendations. In this article, we will describe the Evidence to Decision (EtD) frameworks for clinical practice recommendations. The general structure of the EtD framework for clinical recommendations is similar to EtD frameworks for other types of recommendations and decisions, and includes formulation of the question, an assessment of the different criteria, and conclusions. Clinical recommendations require considering criteria differently, depending on whether an individual patient or a population perspective is taken. For example, from an individual patient's perspective, out-of-pocket costs are an important consideration, whereas, from a population perspective, resource use (not only out-of-pocket costs) and cost effectiveness are important. From a population perspective, equity, acceptability, and feasibility are also important considerations, whereas the importance of these criteria is often limited from an individual patient perspective. Specific subgroups for which different recommendations may be required should be clearly identified and considered in relation to each criterion because judgments might vary across subgroups. This article is a translation of the original article published in the British Medical Journal. The EtD frameworks are currently used in the Clinical Practice Guideline Programme of the Spanish National Health System, co-ordinated by GuíaSalud. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. “We make choices we think are going to save us”: Debate and stance identification for online breast cancer CAM discussions

    Science.gov (United States)

    Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie

    2017-01-01

    Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000

  7. Hearing Screening

    Science.gov (United States)

    Johnson-Curiskis, Nanette

    2012-01-01

    Hearing levels are threatened by modern life--headsets for music, rock concerts, traffic noises, etc. It is crucial we know our hearing levels so that we can draw attention to potential problems. This exercise requires that students receive a hearing screening for their benefit as well as for making the connection of hearing to listening.

  8. Constructive Consumer Choice Processes.

    OpenAIRE

    Bettman, James R; Luce, Mary Frances; Payne, John W

    1998-01-01

    Consumer decision making has been a focal interest in consumer research, and consideration of current marketplace trends ( e.g., technological change, an information explosion) indicates that this topic will continue to be critically important. We argue that consumer choice is inherently constructive. Due to limited processing capacity, consumers often do not have well-defined existing preferences, but construct them using a variety of strategies contingent on task demands. After describing c...

  9. Prenatal screening and genetics

    DEFF Research Database (Denmark)

    Alderson, P; Aro, A R; Dragonas, T

    2001-01-01

    Although the term 'genetic screening' has been used for decades, this paper discusses how, in its most precise meaning, genetic screening has not yet been widely introduced. 'Prenatal screening' is often confused with 'genetic screening'. As we show, these terms have different meanings, and we...... examine definitions of the relevant concepts in order to illustrate this point. The concepts are i) prenatal, ii) genetic screening, iii) screening, scanning and testing, iv) maternal and foetal tests, v) test techniques and vi) genetic conditions. So far, prenatal screening has little connection...... with precisely defined genetics. There are benefits but also disadvantages in overstating current links between them in the term genetic screening. Policy making and professional and public understandings about screening could be clarified if the distinct meanings of prenatal screening and genetic screening were...

  10. How do we make sense of significance?

    DEFF Research Database (Denmark)

    Lyhne, Ivar; Kørnøv, Lone

    2013-01-01

    Determination of significance is widely recognised as an important step in environmental assessment (EA) processes. The prescriptive literature and guidance on significance determination is comprehensive within the field of EA, whereas descriptive and explorative studies of how we go about making......' sense-making, including important differences in the way individuals screen and scope. These patterns concern what we notice, how fast we frame the choice, and when we are critical about the provided information. The indications provide a basis for reflections on practice and on how to organise EA...

  11. Development of a Clinical Forecasting Model to Predict Comorbid Depression Among Diabetes Patients and an Application in Depression Screening Policy Making

    OpenAIRE

    Jin, Haomiao; Wu, Shinyi; Di Capua, Paul

    2015-01-01

    Introduction Depression is a common but often undiagnosed comorbid condition of people with diabetes. Mass screening can detect undiagnosed depression but may require significant resources and time. The objectives of this study were 1) to develop a clinical forecasting model that predicts comorbid depression among patients with diabetes and 2) to evaluate a model-based screening policy that saves resources and time by screening only patients considered as depressed by the clinical forecasting...

  12. Complex Strategic Choices

    DEFF Research Database (Denmark)

    Leleur, Steen

    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 coherent and flexible approach named systemic planning. The inclusion of both the theoretical and practical aspects of systemic planning makes this book a key resource for researchers...

  13. Providing information about prenatal screening for Down syndrome

    DEFF Research Database (Denmark)

    Skjøth, Mette Maria; Draborg, Eva; Pedersen, Claus Duedal

    2015-01-01

    BACKGROUND: In recent decades there have been advances in the options for prenatal screening. Screening programmes for Down syndrome are well established in many countries. It is important that pregnant women are well informed about the benefits and risks of screening. A variety of interventions...... screening for Down syndrome. DESIGN: SYSTEMATIC REVIEW: METHODS: A systematic search was performed using the PUBMED and EMBASE databases. The search terms included MeSH terms and free text and were combined by Boolean terms (AND, OR) with no restriction on language or time. MAIN OUTCOME MEASURES: Main...... information about prenatal screening for Down syndrome can improve their ability to make an informed choice. This article is protected by copyright. All rights reserved....

  14. Assessing the efficacy of cancer screening

    Directory of Open Access Journals (Sweden)

    Gemma Jacklyn

    2017-07-01

    Full Text Available Background: Population-based cancer screening has been established for several types of cancer in Australia and internationally. Screening may perform differently in practice from randomised controlled trials, which makes evaluating programs complex. Materials and methods: We discuss how to assess the evidence of benefits and harms of cancer screening, including the main biases that can mislead clinicians and policy makers (such as volunteer, lead-time, length-time and overdiagnosis bias. We also discuss ways in which communication of risks can inform or mislead the community. Results: The evaluation of cancer screening programs should involve balancing the benefits and harms. When considering the overall worth of an intervention and allocation of scarce health resources, decisions should focus on the net benefits and be informed by systematic reviews. Communication of screening outcomes can be misleading. Many messages highlight the benefits while downplaying the harms, and often use relative risks and 5-year survival to persuade people to screen rather than support informed choice. Lessons learned: An evidence based approach is essential when evaluating and communicating the benefits and harms of cancer screening, to minimise misleading biases and the reliance on intuition.

  15. Choice within Constraints: Mothers and Schooling.

    Science.gov (United States)

    David, Miriam; Davies, Jackie; Edwards, Rosalind; Reay, Diane; Standing, Kay

    1997-01-01

    Explores, from a feminist perspective, the discourses of choice regarding how women make their choices as consumers in the education marketplace. It argues that mothers as parents are not free to choose but act within a range of constraints, i.e., their choices are limited by structural and moral possibilities in a patriarchal and racist society.…

  16. Analysis of inertial choice behaviour based expected and experienced savings from a real-world route choice experiment

    NARCIS (Netherlands)

    Vreeswijk, J.D.; Rakha, H.; Van Berkum, E.; Van Arem, B.

    2014-01-01

    In the context of route choice, inertial behaviour shows that drivers make choices that are satisfactory rather than optimal. Consequently, drivers may not necessarily alter their choice when confronted with a travel time increase on the current choice or a travel time decrease of a choice

  17. De controller als choice architect

    NARCIS (Netherlands)

    V.S. Maas (Victor)

    2012-01-01

    textabstractManagement accountants are choice architects: they provide information that is used in managerial decision making and they have considerable influence on the monetary and non-monetary incentives that drive managers’ decision-making processes. Over the past two decades, our know

  18. Commitment-based action: Rational choice theory and contrapreferential choice

    Directory of Open Access Journals (Sweden)

    Radovanović Bojana

    2014-01-01

    Full Text Available This paper focuses on Sen’s concept of contrapreferential choice. Sen has developed this concept in order to overcome weaknesses of the rational choice theory. According to rational choice theory a decision-maker can be always seen as someone who maximises utility, and each choice he makes as the one that brings to him the highest level of personal wellbeing. Sen argues that in some situations we chose alternatives that bring us lower level of wellbeing than we could achieve if we had chosen some other alternative available to us. This happens when we base our decisions on moral principles, when we act out of duty. Sen calls such action a commitment-based action. When we act out of commitment we actually neglect our preferences and thus we make a contrapreferential choice, as Sen argues. This paper shows that, contrary to Sen, a commitment-based action can be explained within the framework of rational choice theory. However, when each choice we make can be explained within the framework of rational choice theory, when in everything we do maximisation principle can be loaded, then the variety of our motives and traits is lost, and the explanatory power of the rational choice theory is questionable. [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

  19. Angelina′s choice

    Directory of Open Access Journals (Sweden)

    Nishu Singh Goel

    2013-01-01

    Full Text Available This is an opinion piece on how a celebrity′s personal choice to undergo prophylactic mastectomy on discovery of an aberrant gene, when publicly promoted, carries in itself the power to influence and impact healthcare trends and decisions. When celebrities advocate causes that are universally and uniformly acceptable and indisputable as the best in the realm of healthcare and cure (e.g. no smoking, it creates well-being and awareness in society at large. But those which are personal choices made out of a repertoire of other available and effective options may, because of celebrity preference, don the mantle of a norm. They thus run the danger of being blindly replicated by others without proper awareness and knowledge of the true potential of disease, risk factors, and other existing remedial or risk-reducing measures. Society should thus be encouraged to question, debate, and understand the validity, authenticity, and reason of the choices, especially those with a medical basis. This tempering of information with intelligence and rationale and making informed choices based on facts will serve humanity as a whole.

  20. Making Choices about Everyday Care (for Families)

    Science.gov (United States)

    ... be alone most of the time or have company? Communicating Your Wishes Both the one who is ... and living arrangements, before problems arise or a crisis occurs. The sooner you discuss such questions, the ...

  1. Making Research Cyberinfrastructure a Strategic Choice

    Science.gov (United States)

    Hacker, Thomas J.; Wheeler, Bradley C.

    2007-01-01

    The commoditization of low-cost hardware has enabled even modest-sized laboratories and research projects to own their own "supercomputers." The authors argue that this local solution undermines rather than amplifies the research potential of scholars. CIOs, provosts, and research technologists should consider carefully an overall…

  2. White Arctic vs. Blue Arctic: Making Choices

    Science.gov (United States)

    Pfirman, S. L.; Newton, R.; Schlosser, P.; Pomerance, R.; Tremblay, B.; Murray, M. S.; Gerrard, M.

    2015-12-01

    As the Arctic warms and shifts from icy white to watery blue and resource-rich, tension is arising between the desire to restore and sustain an ice-covered Arctic and stakeholder communities that hope to benefit from an open Arctic Ocean. If emissions of greenhouse gases to the atmosphere continue on their present trend, most of the summer sea ice cover is projected to be gone by mid-century, i.e., by the time that few if any interventions could be in place to restore it. There are many local as well as global reasons for ice restoration, including for example, preserving the Arctic's reflectivity, sustaining critical habitat, and maintaining cultural traditions. However, due to challenges in implementing interventions, it may take decades before summer sea ice would begin to return. This means that future generations would be faced with bringing sea ice back into regions where they have not experienced it before. While there is likely to be interest in taking action to restore ice for the local, regional, and global services it provides, there is also interest in the economic advancement that open access brings. Dealing with these emerging issues and new combinations of stakeholders needs new approaches - yet environmental change in the Arctic is proceeding quickly and will force the issues sooner rather than later. In this contribution we examine challenges, opportunities, and responsibilities related to exploring options for restoring Arctic sea ice and potential pathways for their implementation. Negotiating responses involves international strategic considerations including security and governance, meaning that along with local communities, state decision-makers, and commercial interests, national governments will have to play central roles. While these issues are currently playing out in the Arctic, similar tensions are also emerging in other regions.

  3. Creating Healthy Habits: Make Better Choices Easier

    Science.gov (United States)

    ... O'Donnell S, Oluyomi DT, Epstein LH. Consciousness and Cognition. 2017 May;51:10-16. doi: 10.1016/ ... Editor: Tianna Hicklin, Ph.D. Illustrator: Alan Defibaugh Attention Editors: Reprint our articles and illustrations in your ...

  4. Protect Your Heart: Make Smart Food Choices

    Science.gov (United States)

    ... blood vessels. • Eat more vegetables and fruit. J Eat at least one vegetable or a salad at lunch and dinner. Snack on raw vegetables. J Try new ways of cooking vegetables, such as steaming, stir-frying, or roasting. J Eat dark green and dark yellow vegetables every day, ...

  5. Therapeutic radionuclides: Making the right choice

    International Nuclear Information System (INIS)

    Srivastava, S.C.

    1996-01-01

    Recently, there has been a resurgence of interest in nuclear medicine therapeutic procedures. Using unsealed sources for therapy is not a new concept; it has been around since the beginnings of nuclear medicine. Treatment of thyroid disorders with radioiodine is a classic example. The availability of radionuclides with suitable therapeutic properties for specific applications, as well as methods for their selective targeting to diseased tissue have, however, remained the main obstacles for therapy to assume a more widespread role in nuclear medicine. Nonetheless, a number of new techniques that have recently emerged, (e.g., tumor therapy with radiolabeled monoclonal antibodies, treatment of metastatic bone pain, etc.) appear to have provided a substantial impetus to research on production of new therapeutic radionuclides. Although there are a number of new therapeutic approaches requiring specific radionuclides, only selected broad areas will be used as examples in this article

  6. The VMAT-2 inhibitor tetrabenazine alters effort-related decision making as measured by the T-maze barrier choice task: reversal with the adenosine A2A antagonist MSX-3 and the catecholamine uptake blocker bupropion.

    Science.gov (United States)

    Yohn, Samantha E; Thompson, Christian; Randall, Patrick A; Lee, Christie A; Müller, Christa E; Baqi, Younis; Correa, Mercè; Salamone, John D

    2015-04-01

    Depressed people show effort-related motivational symptoms, such as anergia, retardation, lassitude, and fatigue. Animal tests can model these motivational symptoms, and the present studies characterized the effort-related effects of the vesicular monoamine transport (VMAT-2) inhibitor tetrabenazine. Tetrabenazine produces depressive symptoms in humans and, at low doses, preferentially depletes dopamine. The current studies investigated the effects of tetrabenazine on effort-based decision making using the T-maze barrier task. Rats were tested in a T-maze in which the choice arms of the maze contain different reinforcement densities, and under some conditions, a vertical barrier was placed in the high-density arm to provide an effort-related challenge. The first experiment assessed the effects of tetrabenazine under different maze conditions: a barrier in the arm with 4 food pellets and 2 pellets in the no barrier arm (4-2 barrier), 4 pellets in one arm and 2 pellets in the other with no barrier in either arm (no barrier), and 4 pellets in the barrier arm with no pellets in the other (4-0 barrier). Tetrabenazine (0.25-0.75 mg/kg IP) decreased selection of the high cost/high reward arm when the barrier was present, but had no effect on choice under the no barrier and 4-0 barrier conditions. The effects of tetrabenazine on barrier climbing in the 4-2 condition were reversed by the adenosine A2A antagonist MSX-3 and the catecholamine uptake inhibitor and antidepressant bupropion. These studies have implications for the development of animal models of the motivational symptoms of depression and other disorders.

  7. Development of a Clinical Forecasting Model to Predict Comorbid Depression Among Diabetes Patients and an Application in Depression Screening Policy Making.

    Science.gov (United States)

    Jin, Haomiao; Wu, Shinyi; Di Capua, Paul

    2015-09-03

    Depression is a common but often undiagnosed comorbid condition of people with diabetes. Mass screening can detect undiagnosed depression but may require significant resources and time. The objectives of this study were 1) to develop a clinical forecasting model that predicts comorbid depression among patients with diabetes and 2) to evaluate a model-based screening policy that saves resources and time by screening only patients considered as depressed by the clinical forecasting model. We trained and validated 4 machine learning models by using data from 2 safety-net clinical trials; we chose the one with the best overall predictive ability as the ultimate model. We compared model-based policy with alternative policies, including mass screening and partial screening, on the basis of depression history or diabetes severity. Logistic regression had the best overall predictive ability of the 4 models evaluated and was chosen as the ultimate forecasting model. Compared with mass screening, the model-based policy can save approximately 50% to 60% of provider resources and time but will miss identifying about 30% of patients with depression. Partial-screening policy based on depression history alone found only a low rate of depression. Two other heuristic-based partial screening policies identified depression at rates similar to those of the model-based policy but cost more in resources and time. The depression prediction model developed in this study has compelling predictive ability. By adopting the model-based depression screening policy, health care providers can use their resources and time better and increase their efficiency in managing their patients with depression.

  8. Choice as an engine of analytic thought.

    Science.gov (United States)

    Savani, Krishna; Stephens, Nicole M; Markus, Hazel Rose

    2017-09-01

    Choice is a behavioral act that has a variety of well-documented motivational consequences-it fosters independence by allowing people to simultaneously express themselves and influence the environment. Given the link between independence and analytic thinking, the current research tested whether choice also leads people to think in a more analytic rather than holistic manner. Four experiments demonstrate that making choices, recalling choices, and viewing others make choices leads people to think more analytically, as indicated by their attitudes, perceptual judgments, categorization, and patterns of attention allocation. People who made choices scored higher on a subjective self-report measure of analytic cognition compared to whose did not make a choice (pilot study). Using an objective task-based measure, people who recalled choices rather than actions were less influenced by changes in the background when making judgments about focal objects (Experiment 1). People who thought of others' behaviors as choices rather than actions were more likely to group objects based on categories rather than relationships (Experiment 2). People who recalled choices rather than actions subsequently allocated more visual attention to focal objects in a scene (Experiment 3). Together, these experiments demonstrate that choice has important yet previously unexamined consequences for basic psychological processes such as attention and cognition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  9. Macro-Choices, Micro-Choosers

    Science.gov (United States)

    MOSAIC, 1975

    1975-01-01

    The ways in which the world produces, distributes, and consumes its food are as varied as the small societies with which the world's growing billions most closely identify. Making food choices for the world means first understanding the myriad ways in which the world's microcultures make choices for themselves. (BT)

  10. De controller als choice architect

    OpenAIRE

    Maas, V.S.

    2012-01-01

    textabstractManagement accountants are choice architects: they provide information that is used in managerial decision making and they have considerable influence on the monetary and non-monetary incentives that drive managers’ decision-making processes. Over the past two decades, our know - ledge of how people make economic decisions has increased tremendously. However, this has had only very little impact on the design of management accounting and control systems in organizations. Consequen...

  11. Attention and choice

    DEFF Research Database (Denmark)

    Orquin, Jacob Lund; Mueller Loose, Simone

    2013-01-01

    satisfaction models. Although most theories were confirmed with regard to certain predictions, none of the theories adequately accounted for the role of attention during decision making. Several observations emerged concerning the drivers and down-stream effects of attention on choice, suggesting......This paper reviews studies on eye movements in decision making, and compares their observations to theoretical predictions concerning the role of attention in decision making. Four decision theories are examined: rational models, bounded rationality, evidence accumulation, and parallel constraint...... that attention processes plays an active role in constructing decisions. So far, decision theories have largely ignored the constructive role of attention by assuming that it is entirely determined by heuristics, or that it consists of stochastic information sampling. The empirical observations reveal...

  12. The effect of information about the benefits and harms of mammography on women’s decision-making: study protocol for a randomized controlled trial

    OpenAIRE

    Misericòrdia, Carles; Martínez Alonso, Montserrat; Pons Rodríguez, Anna; Pérez Lacasta, María José; Perestelo Pérez, Lilisbeth; Sala, Maria; Vidal, Carmen; Garcia, Montse; Toledo Chávarri, Ana; Codern, Núria; Feijoo Cid, Maria; Romero, Anabel; Pla, Roger; Soler González, Jorge; Castells, Xavier

    2017-01-01

    Background The decision to participate or not in breast cancer screening is complex due to the trade-off between the expected benefit of breast cancer mortality reduction and the major harm of overdiagnosis. It seems ethically necessary to inform women so that they can actively participate in decision-making and make an informed choice based on their values and preferences. The objective of this study is to assess the effects of receiving information about the benefits and harms of screening ...

  13. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  14. Effect of providing risk information on undergoing cervical cancer screening: a randomized controlled trial.

    Science.gov (United States)

    Fujiwara, Hiroyuki; Shimoda, Akihiro; Ishikawa, Yoshiki; Taneichi, Akiyo; Ohashi, Mai; Takahashi, Yoshifumi; Koyanagi, Takahiro; Morisawa, Hiroyuki; Takahashi, Suzuyo; Sato, Naoto; Machida, Shizuo; Takei, Yuji; Saga, Yasushi; Suzuki, Mitsuaki

    2015-01-01

    In Japan, the cervical cancer screening rate is extremely low. Towards improving the cervical cancer screening rate, encouraging eligible people to make an informed choice, which is a decision-making process that relies on beliefs informed by adequate information about the possible benefits and risks of screening, has attracted increased attention in the public health domain. However, there is concern that providing information on possible risks of screening might prevent deter from participating. In total, 1,912 women aged 20-39 years who had not participated in screening in the fiscal year were selected from a Japanese urban community setting. Participants were randomly divided into 3 groups. Group A received a printed reminder with information about the possible benefits of screening, group B received a printed reminder with information about possible benefits and risks, and group C received a printed reminder with simple information only (control group). Out of 1,912 participants, 169 (8.8%) participated in cervical cancer screening. In the intervention groups, 137 (10.9%) participated in cervical cancer screening, compared to only 32 (4.9%) of the control group (p < 0.001). In addition, logistic regression analysis revealed that there was no significant difference in screening rate between group A and group B (p = 0.372). Providing information on the possible risks of screening may not prevent people from taking part in cervical cancer screening among a Japanese non-adherent population.

  15. Overconfidence and Career Choice.

    Science.gov (United States)

    Schulz, Jonathan F; Thöni, Christian

    2016-01-01

    People self-assess their relative ability when making career choices. Thus, confidence in their own abilities is likely an important factor for selection into various career paths. In a sample of 711 first-year students we examine whether there are systematic differences in confidence levels across fields of study. We find that our experimental confidence measures significantly vary between fields of study: While students in business related academic disciplines (Political Science, Law, Economics, and Business Administration) exhibit the highest confidence levels, students of Humanities range at the other end of the scale. This may have important implications for subsequent earnings and professions students select themselves in.

  16. Overconfidence and Career Choice

    Science.gov (United States)

    Schulz, Jonathan F.; Thöni, Christian

    2016-01-01

    People self-assess their relative ability when making career choices. Thus, confidence in their own abilities is likely an important factor for selection into various career paths. In a sample of 711 first-year students we examine whether there are systematic differences in confidence levels across fields of study. We find that our experimental confidence measures significantly vary between fields of study: While students in business related academic disciplines (Political Science, Law, Economics, and Business Administration) exhibit the highest confidence levels, students of Humanities range at the other end of the scale. This may have important implications for subsequent earnings and professions students select themselves in. PMID:26808273

  17. Altered Decision-Making under Risk in Obesity.

    Directory of Open Access Journals (Sweden)

    Juan F Navas

    Full Text Available The negative consequences of energy dense foods are well known, yet people increasingly make unhealthy food choices leading to obesity (i.e., risky decisions. The aims of this study were: [1] to compare performance in decision-making tasks under risk and under ambiguity between individuals with obesity, overweight and normal weight; [2] to examine the associations between body mass index (BMI and decision-making, and the degree to which these associations are modulated by reward sensitivity.Seventy-nine adults were recruited and classified in three groups according to their BMI: obesity, overweight and normal-weight. Groups were similar in terms of age, education and socio-economic status, and were screened for comorbid medical and mental health conditions. Decision-making under risk was measured via the Wheel of Fortune Task (WoFT and decision-making under ambiguity via the Iowa Gambling Task (IGT. Reward sensitivity was indicated by the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ.Individuals with obesity made riskier choices in the WoFT, specifically in choices with an expected value close to zero and in the propensity to risk index. No differences were found in IGT performance or SPSRQ scores. BMI was associated with risk-taking (WoFT performance, independently of reward sensitivity.Obesity is linked to a propensity to make risky decisions in experimental conditions analogous to everyday food choices.

  18. Choice certainty in Discrete Choice Experiments

    DEFF Research Database (Denmark)

    Uggeldahl, Kennet Christian; Jacobsen, Catrine; Lundhede, Thomas

    2016-01-01

    In this study, we conduct a Discrete Choice Experiment (DCE) using eye tracking technology to investigate if eye movements during the completion of choice sets reveal information about respondents’ choice certainty. We hypothesise that the number of times that respondents shift their visual...

  19. Mexico's critical choices

    International Nuclear Information System (INIS)

    Marcos, E.

    1990-01-01

    In Mexico, the 1982 fall in international oil prices shook the national conscience and pushed the Mexican people in search of a new national image and toward the choices they must make to attain that image. But, according to the author of this paper, the country as a whole has already made critical choices for overall strategy and there are reasons for optimism. In the current economic environment of growing domestic demand and enhanced international competitiveness, the author sees PEMEX (the Mexican national oil company) facing not only the challenge of responding to the rapid changes taking place in the Mexican economy, but also making a significant contribution toward the solid and stable growth of the country. The relevant question is how PEMEX will live up to these expectations. This paper describes several steps PEMEX has taken already or is preparing to take in order to meet this challenge, including: investment in the domestic petrochemical industry; entry into the Eurobond market; development of new methods of project financing

  20. Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services.

    Science.gov (United States)

    Kohler, Racquel E; Lee, Clara N; Gopal, Satish; Reeve, Bryce B; Weiner, Bryan J; Wheeler, Stephanie B

    2015-01-01

    In Malawi, routine breast cancer screening is not available and little is known about women's preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment. To identify important factors that are relevant to Malawian women's preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare. We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs. Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants' responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes, comprehension of choice tasks, and women's abilities to make trade-offs. Applying a discrete choice experiment for breast cancer early detection was feasible with appropriate tailoring for a low-income, low-literacy African setting.

  1. Irrational choice behavior in human and nonhuman primates.

    Science.gov (United States)

    Perdue, Bonnie M; Brown, Ella R

    2018-03-01

    Choice behavior in humans has motivated a large body of research with a focus on whether decisions can be considered to be rational. In general, humans prefer having choice, as do a number of other species that have been tested, even though having increased choice does not necessarily yield a positive outcome. Humans have been found to choose an option more often only because the opportunity to select it was diminishing, an example of a deviation from economic rationality. Here we extend this paradigm to nonhuman primates in an effort to understand the mechanisms underlying this finding. In this study, we presented two groups of laboratory monkeys, capuchins (Cebus apella) and rhesus macaques (Macaca mulatta), as well as human subjects, with a computerized task in which subjects were presented with two differently colored icons. When the subject selected an icon, differing numbers of food pellets were dispensed (or points were assigned), making each icon correspond to a certain level of risk (one icon yielded 1 or 4 pellets/points and the other yielded 2 or 3). Initially, both options remained constantly available and we established choice preference scores for each subject. Then, we assessed preference patterns once the options were not continuously available. Specifically, choosing one icon would cause the other to shrink in size on the screen and eventually disappear if never selected. Selecting it would restore it to its full size. As predicted, humans shifted their risk preferences in the diminishing options phase, choosing to click on both icons more equally in order to keep both options available. At the group level, capuchin monkeys showed this pattern as well, but there was a great deal of individual variability in both capuchins and macaques. The present work suggests that there is some degree of continuity between human and nonhuman primates in the desire to have choice simply for the sake of having choice.

  2. Effectiveness and Cost-Effectiveness of Occupation-Based Occupational Therapy Using the Aid for Decision Making in Occupation Choice (ADOC) for Older Residents: Pilot Cluster Randomized Controlled Trial

    Science.gov (United States)

    Nagayama, Hirofumi; Tomori, Kounosuke; Ohno, Kanta; Takahashi, Kayoko; Ogahara, Kakuya; Sawada, Tatsunori; Uezu, Sei; Nagatani, Ryutaro; Yamauchi, Keita

    2016-01-01

    Background Care-home residents are mostly inactive, have little interaction with staff, and are dependent on staff to engage in daily occupations. We recently developed an iPad application called the Aid for Decision-making in Occupation Choice (ADOC) to promote shared decision-making in activities and occupation-based goal setting by choosing from illustrations describing daily activities. This study aimed to evaluate if interventions based on occupation-based goal setting using the ADOC could focus on meaningful activities to improve quality of life and independent activities of daily living, with greater cost-effectiveness than an impairment-based approach as well as to evaluate the feasibility of conducting a large cluster, randomized controlled trial. Method In this single (assessor)-blind pilot cluster randomized controlled trial, the intervention group (ADOC group) received occupational therapy based on occupation-based goal setting using the ADOC, and the interventions were focused on meaningful occupations. The control group underwent an impairment-based approach focused on restoring capacities, without goal setting tools. In both groups, the 20-minute individualized intervention sessions were conducted twice a week for 4 months. Main Outcome Measures Short Form-36 (SF-36) score, SF-6D utility score, quality adjusted life years (QALY), Barthel Index, and total care cost. Results We randomized and analyzed 12 facilities (44 participants, 18.5% drop-out rate), with 6 facilities each allocated to the ADOC (n = 23) and control (n = 21) groups. After the 4-month intervention, the ADOC group had a significantly greater change in the BI score, with improved scores (P = 0.027, 95% CI 0.41 to 6.87, intracluster correlation coefficient = 0.14). No other outcome was significantly different. The incremental cost-effectiveness ratio, calculated using the change in BI score, was $63.1. Conclusion The results suggest that occupational therapy using the ADOC for older

  3. Pairwise Choice Markov Chains

    OpenAIRE

    Ragain, Stephen; Ugander, Johan

    2016-01-01

    As datasets capturing human choices grow in richness and scale---particularly in online domains---there is an increasing need for choice models that escape traditional choice-theoretic axioms such as regularity, stochastic transitivity, and Luce's choice axiom. In this work we introduce the Pairwise Choice Markov Chain (PCMC) model of discrete choice, an inferentially tractable model that does not assume any of the above axioms while still satisfying the foundational axiom of uniform expansio...

  4. The Determinants of Food Choice

    DEFF Research Database (Denmark)

    Leng, Gareth; Adan, Roger A. H.; Belot, Michele

    2017-01-01

    , we need to be able to make valid predictions about the consequences of proposed interventions, and for this, we need a better understanding of the determinants of food choice. These determinants include dietary components (e.g. highly palatable foods and alcohol), but also diverse cultural and social...

  5. Social media and consumer choice

    NARCIS (Netherlands)

    Bronner, F.; de Hoog, R.

    2014-01-01

    Social media are becoming increasingly important for consumer decisions. This holds true in particular for vacation decision-making, as an example of a high-involvement decision. The research focuses upon the relation between the information people search regarding aspects or properties of choice

  6. Behavioural social choice: a status report.

    Science.gov (United States)

    Regenwetter, Michel; Grofman, Bernard; Popova, Anna; Messner, William; Davis-Stober, Clintin P; Cavagnaro, Daniel R

    2009-03-27

    Behavioural social choice has been proposed as a social choice parallel to seminal developments in other decision sciences, such as behavioural decision theory, behavioural economics, behavioural finance and behavioural game theory. Behavioural paradigms compare how rational actors should make certain types of decisions with how real decision makers behave empirically. We highlight that important theoretical predictions in social choice theory change dramatically under even minute violations of standard assumptions. Empirical data violate those critical assumptions. We argue that the nature of preference distributions in electorates is ultimately an empirical question, which social choice theory has often neglected. We also emphasize important insights for research on decision making by individuals. When researchers aggregate individual choice behaviour in laboratory experiments to report summary statistics, they are implicitly applying social choice rules. Thus, they should be aware of the potential for aggregation paradoxes. We hypothesize that such problems may substantially mar the conclusions of a number of (sometimes seminal) papers in behavioural decision research.

  7. Medical screening and evaluation for heat stress

    International Nuclear Information System (INIS)

    Kenney, L.W.

    1985-01-01

    Wide interindividual variation exists with respect to heat tolerance, making it difficult to predict individual responses. However, several general physical and physiological characteristics are associated with excessive strain and early exhaustion during work in the heat. Included among these correlates of heat intolerance are a medical history of heat illness, acclimation state, age, body composition and size, aerobic fitness level, hypertension, and drug and alcohol use. The approach of choice for medical evaluation for heat exposure is a two-stage evaluation. First, the examining physician should be encouraged to screen out those workers whose characteristics increase their risk of heat intolerance. Secondly, a short exercise test is proposed which accurately predicts relative heat tolerance across a working population. This test is recommended as an adjunct screening test at the examining physician's disgression

  8. Latent variables and route choice behavior

    DEFF Research Database (Denmark)

    Prato, Carlo Giacomo; Bekhor, Shlomo; Pronello, Cristina

    2012-01-01

    In the last decade, a broad array of disciplines has shown a general interest in enhancing discrete choice models by considering the incorporation of psychological factors affecting decision making. This paper provides insight into the comprehension of the determinants of route choice behavior...... and bound algorithm. A hybrid model consists of measurement equations, which relate latent variables to measurement indicators and utilities to choice indicators, and structural equations, which link travelers’ observable characteristics to latent variables and explanatory variables to utilities. Estimation...

  9. Intersubjective meaning making

    DEFF Research Database (Denmark)

    Davidsen, Jacob

    of single-touch screen interaction among 8-9 year-old children presented here, shows that while the constraints of single-touch screens does not support equality of interaction at the verbal and the physical level, there seems to be an intersubjective learning outcome. More precisely, the constraints...... of single-touch screens offer support for intersubjective meaning making in its ability of constraining the interaction. By presenting a short embodied interaction analysis of 22 seconds of collaboration, I illustrate how an embodied interaction perspective on intersubjective meaning making can tell...... a different story about touch-screen supported collaborative learning....

  10. Nudging in screening: Literature review and ethical guidance.

    Science.gov (United States)

    Hofmann, Bjørn; Stanak, Michal

    2018-03-27

    Nudging is the purposeful alteration of choices presented to people that aims to make them choose in predicted ways. While nudging has been used to assure high uptake and good outcome of screening programs, it has been criticized for being paternalistic, undermining free choice, and shared decision making. Accordingly, the objective of this study is to explore a) nudging strategies identified in screening, b) arguments for and against nudging; and on basis of this, to c) suggest a tentative conclusion on how to handle nudging in screening. Literature searches in Ovid MEDLINE and PsycINFO for combinations of screening and nudging. Screening based on content analysis of titles, abstracts, and articles. 239 references were identified and 109 were included. Several forms of nudging were identified: framed information, default bias, or authority bias. Uptake and public health outcome were the most important goals. Arguments for nudging were bounded rationality, unavoidability, and beneficence, while lack of transparency, crowding out of intrinsic values, and paternalism were arguments against it. The analysis indicates that nudging can be acceptable for screenings with (high quality) evidence for high benefit-harm ratio (beneficence), where nudging does not infringe other ethical principles, such as justice and non-maleficence. In particular, nudging should not only focus on attendance rates, but also on making people "better choosers." Four specific recommendations follow from the review and the analysis: 1) Nudging should be addressed in an explicit and transparent manner. 2) The means of nudging have to be in proportion to the benefit-harm ratio. 3) Disagreement on the evidence for either benefits or harms warrants special care. 4) Assessing and assuring the intended outcome of nudging appears to be crucial, as it can be context dependent. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Factors Influencing Food Choice in the Elderly Mauritian Population

    African Journals Online (AJOL)

    admpather

    food choice in order to help people make healthful food and beverage choices .... consumption patterns, lifestyles, health status and the different factors .... relative importance in human eating behaviour: review and preliminary suggestions for.

  12. Two Philosophical Errors Concerning School Choice.

    Science.gov (United States)

    Brighouse, Harry

    1997-01-01

    Argues, in contrast to David Hargreaves, that libertarianism implies a mild presumption against school choice, and that notions of common good are significant to educational decision making only when deciding between sets of institutions that perform equally well at delivering their obligations. Links these issues to questions about school choice.…

  13. Choice Complexity, Benchmarks and Costly Information

    NARCIS (Netherlands)

    Harms, Job; Rosenkranz, S.; Sanders, M.W.J.L.

    In this study we investigate how two types of information interventions, providing a benchmark and providing costly information on option ranking, can improve decision-making in complex choices. In our experiment subjects made a series of incentivized choices between four hypothetical financial

  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. Communicating the balance sheet in breast cancer screening.

    Science.gov (United States)

    Giordano, Livia; Cogo, Carla; Patnick, Julietta; Paci, Eugenio

    2012-01-01

    Despite the difficulties, there is a moral responsibility to provide the public with the best estimates of benefits and harms of breast cancer screening. In this paper we review the issues in communication of benefits and harms of medical interventions and discuss these in terms of the principles of the balance sheet proposed in this supplement. The balance sheet can be seen as a tool to convey estimates based on the best available evidence and addressed to a readership wider than just potential screening participants. It reflects a re-assessment of screening efficacy, showing again that screening is effective and brings more benefits than harms. It can be viewed as an opportunity to re-affirm some basic principles of good evidence-based communication. Further research is needed to improve communication strategy, to assess the impact of this communication on women's awareness and to evaluate its utility in the informed decision-making process. The balance sheet could be a starting point for a broader vision of informed decision-making in screening, which should also recognize the role played by 'non-numerical' factors on women's choice of participating in breast cancer screening.

  16. A Subjective Rational Choice

    Science.gov (United States)

    Vinogradov, G. P.

    2017-01-01

    The problem of constructing a choice model of an agent with endogenous purposes of evolution is under debate. It is demonstrated that its solution requires the development of well-known methods of decision-making while taking into account the relation of action mode motivation to an agent’s ambition to implement subjectively understood interests and the environment state. The latter is submitted for consideration as a purposeful state situation model that exists only in the mind of an agent. It is the situation that is a basis for getting an insight into the agent’s ideas on the possible selected action mode results. The agent’s ambition to build his confidence in the feasibility of the action mode and the possibility of achieving the desired state requires him to use the procedures of forming an idea model based on the measured values of environment state. This leads to the gaming approach for the choice problem and its solution can be obtained on a set of trade-off alternatives.

  17. Enhancing School Wellness Environments to Make to Make the Healthy Choice the Easy Choice

    OpenAIRE

    Stevens, JA; Alie, K

    2016-01-01

    The Virginia Department of Health’s Division of Prevention & Health Promotion has partnered with Virginia Cooperative Extension’s Family Nutrition Program and Virginia Tech in order to enhance Extension’s efforts to promote and support student health in select K-12 schools by implementing a variety of evidence-based nutrition and physical activity platforms intended to enhance school wellness environments, policies, and practices. Additionally, the implementation of a consistent statewide hea...

  18. Don't make me angry, you wouldn't like me when I'm angry: Volitional choices to act or inhibit are modulated by subliminal perception of emotional faces.

    Science.gov (United States)

    Parkinson, Jim; Garfinkel, Sarah; Critchley, Hugo; Dienes, Zoltan; Seth, Anil K

    2017-04-01

    Volitional action and self-control-feelings of acting according to one's own intentions and in being control of one's own actions-are fundamental aspects of human conscious experience. However, it is unknown whether high-level cognitive control mechanisms are affected by socially salient but nonconscious emotional cues. In this study, we manipulated free choice decisions to act or withhold an action by subliminally presenting emotional faces: In a novel version of the Go/NoGo paradigm, participants made speeded button-press responses to Go targets, withheld responses to NoGo targets, and made spontaneous, free choices to execute or withhold the response for Choice targets. Before each target, we presented emotional faces, backwards masked to render them nonconscious. In Intentional trials, subliminal angry faces made participants more likely to voluntarily withhold the action, whereas fearful and happy faces had no effects. In a second experiment, the faces were made supraliminal, which eliminated the effects of angry faces on volitional choices. A third experiment measured neural correlates of the effects of subliminal angry faces on intentional choice using EEG. After replicating the behavioural results found in Experiment 1, we identified a frontal-midline theta component-associated with cognitive control processes-which is present for volitional decisions, and is modulated by subliminal angry faces. This suggests a mechanism whereby subliminally presented "threat" stimuli affect conscious control processes. In summary, nonconscious perception of angry faces increases choices to inhibit, and subliminal influences on volitional action are deep seated and ecologically embedded.

  19. Voice and choice by delegation.

    Science.gov (United States)

    van de Bovenkamp, Hester; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

    2013-02-01

    In many Western countries, options for citizens to influence public services are increased to improve the quality of services and democratize decision making. Possibilities to influence are often cast into Albert Hirschman's taxonomy of exit (choice), voice, and loyalty. In this article we identify delegation as an important addition to this framework. Delegation gives individuals the chance to practice exit/choice or voice without all the hard work that is usually involved in these options. Empirical research shows that not many people use their individual options of exit and voice, which could lead to inequality between users and nonusers. We identify delegation as a possible solution to this problem, using Dutch health care as a case study to explore this option. Notwithstanding various advantages, we show that voice and choice by delegation also entail problems of inequality and representativeness.

  20. Presenting and discussing nuchal translucency screening for fetal abnormality in the UK.

    Science.gov (United States)

    Pilnick, Alison M; Fraser, Diane M; James, David K

    2004-03-01

    to investigate the relationship between information giving by midwives and decision-making by women offered nuchal translucency (NT) screening. To establish how risk figures are discussed in practice, with the intention of relating this to the existing, and often critical, literature on women's accounts of antenatal screening. a qualitative study following women through the process of being offered and deciding to undergo NT screening. Tape recording of consultations, analysed in their entirety, was combined with post-screening interviews. a large teaching hospital in the UK. fourteen pregnant women eligible for NT screening at the time of recruitment. (i) tape recordings of consultations between community midwives and pregnant women where nuchal translucency screening was offered; (ii) tape recordings of consultations between hospital midwives and pregnant women immediately post-screening; (iii) individual face-to-face interviews with pregnant women between two and six weeks after the screening, carried out by the first author. NT screening was in general well received, particularly by those women who had undergone serum screening with previous pregnancies. However, communicating the nature of a risk figure is an interactionally complex process. A large amount of interactional work is required by midwives both before and after screening to ensure that women comprehend this information. Despite the emphasis placed in these consultations on understanding the purpose of NT screening and the status of the results, women often framed their decision to undergo NT screening in terms of it being a formality, or of presuming that all was well. This sometimes created practical and personal difficulties in terms of decision-making. previous sociological and psychological research has tended to be critical of midwives in terms of ensuring informed choice in screening, but this research is often based on post hoc accounts. Examining actual consultations with these accounts

  1. Comments on John D. Keen and James E. Keen, What is the point: will screening mammography save my life? BMC Medical Informatics and Decision Making, 2009.

    Science.gov (United States)

    Retsky, Michael

    2009-04-02

    This paper by John D. Keen and James E. Keen addresses a thorny subject. The numerical findings and commentaries in their paper will be disturbing to some readers and seem to defy logic and well established viewpoints. It may well generate angry letters to the editor. However such numerical analysis and reporting including civil discussion should be welcomed and are the basis for informed decision making - something that is highly needed in this field.

  2. Making media public

    DEFF Research Database (Denmark)

    Mollerup, Nina Grønlykke; Gaber, Sherief

    2015-01-01

    This article focuses on two related street screening initiatives, Tahrir Cinema and Kazeboon, which took place in Egypt mainly between 2011 and 2013. Based on long-term ethnographic studies and activist work, we explore street screenings as place-making and describe how participants at street scr...

  3. Choice Probability Generating Functions

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; McFadden, Daniel L; Bierlaire, Michel

    This paper considers discrete choice, with choice probabilities coming from maximization of preferences from a random utility field perturbed by additive location shifters (ARUM). Any ARUM can be characterized by a choice-probability generating function (CPGF) whose gradient gives the choice...... probabilities, and every CPGF is consistent with an ARUM. We relate CPGF to multivariate extreme value distributions, and review and extend methods for constructing CPGF for applications....

  4. NEIGHBORHOOD CHOICE AND NEIGHBORHOOD CHANGE

    OpenAIRE

    Bruch, Elizabeth; Mare, Robert D.

    2006-01-01

    This paper examines the relationships between the residential choices of individuals and aggregate patterns of neighborhood change. We investigate the conditions under which individuals’ preferences for the race-ethnic composition of their neighborhoods produce high levels of segregation. Using computational models, we find that high levels of segregation occur only when individuals’ preferences follow a threshold function. If individuals make finer-grained distinctions among neighborhoods th...

  5. A fair range of choice: justifying maximum patient choice in the British National Health Service.

    Science.gov (United States)

    Wilmot, Stephen

    2007-06-01

    In this paper I put forward an ethical argument for the provision of extensive patient choice by the British National Health Service. I base this argument on traditional liberal rights to freedom of choice, on a welfare right to health care, and on a view of health as values-based. I argue that choice, to be ethically sustainable on this basis, must be values-based and rational. I also consider whether the British taxpayer may be persuadable with regard to the moral acceptability of patient choice, making use of Rawls' theory of political liberalism in this context. I identify issues that present problems in terms of public acceptance of choice, and also identify a boundary issue with regard to public health choices as against individual choices.

  6. Motherhood as a choice.

    Science.gov (United States)

    Mcfadden, P

    1994-06-01

    The choice of motherhood for women and women's rights have been forbidden in law by men, in religious doctrines by men, and within the medical system by men. Women in poverty have little say in determining whether to have children or not. When choice is exercised for abortion, poor women have unsafe and illegal abortions, which can be life-threatening. Rich women have safer options. Women historically have allowed their rights to be eroded by gender inequality and patriarchal manipulation. The religious right and the Roman Catholic church have been allowed to speak and decide for women. Abortion rights are not about western influences, but about maternal mortality. The right to make choices about one's life is the fundamental premise of the universal rights of all human beings. African governments have signed the UN Convention on elimination of all forms of discrimination against women, but the practice of human rights has not been implemented at the local and family level. Motherhood needs to be demystified. Motherhood is linked with the absence of personhood and bodily integrity. The rhetoric of moral obligations and the rights of the unborn child take precedence over the rights of women. The right of an African woman not to have children is not recognized in most Africa societies. The issue of AIDS creates an even more difficult milieu for women. The interests of the family and the interests of men overwhelm the interests of women to protect themselves. Motherhood is essential to validating one's heterosexuality and gaining stature, and females without a child are marginalized and unrecognized. Women whose babies do not survive are marginalized further than barren women. Men derive power from women's birthing. The terminology of male power is replete with expressions such as "pregnant with promise" and "miscarriage of justice's", no one says "uterus envy." Male psychologists only recognize "penis envy." Men need children for purposes of property, lineage, and

  7. Analysis of inertia thresholds based on real-world route choice data

    NARCIS (Netherlands)

    Vreeswijk, Jacob Dirk; van Berkum, Eric C.; van Arem, Bart

    2014-01-01

    In the context of route choice, inertial behaviour shows that drivers make choices that are satisfactory rather than optimal. Consequently, drivers may not necessarily alter their choice when confronted with a travel time increase on the current choice or a travel time decrease of a choice

  8. Choice probability generating functions

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; McFadden, Daniel; Bierlaire, Michel

    2013-01-01

    This paper considers discrete choice, with choice probabilities coming from maximization of preferences from a random utility field perturbed by additive location shifters (ARUM). Any ARUM can be characterized by a choice-probability generating function (CPGF) whose gradient gives the choice...... probabilities, and every CPGF is consistent with an ARUM. We relate CPGF to multivariate extreme value distributions, and review and extend methods for constructing CPGF for applications. The choice probabilities of any ARUM may be approximated by a cross-nested logit model. The results for ARUM are extended...

  9. Measurement of ethical food choice motives.

    Science.gov (United States)

    Lindeman, M; Väänänen, M

    2000-02-01

    The two studies describe the development of three complementary scales to the Food Choice Questionnaire developed by Steptoe, Pollard & Wardle (1995). The new items address various ethical food choice motives and were derived from previous studies on vegetarianism and ethical food choice. The items were factor analysed in Study 1 (N=281) and the factor solution was confirmed in Study 2 (N=125), in which simple validity criteria were also included. Furthermore, test-retest reliability was assessed with a separate sample of subjects (N=36). The results indicated that the three new scales, Ecological Welfare (including subscales for Animal Welfare and Environment Protection), Political Values and Religion, are reliable and valid instruments for a brief screening of ethical food choice reasons. Copyright 2000 Academic Press.

  10. The "Tyranny of Choice": Choice Overload as a Possible Instance of Effort Discounting

    Science.gov (United States)

    Reed, Derek D.; Reed, Florence D. DiGennaro; Chok, James; Brozyna, Gary A.

    2011-01-01

    When making a choice, people like to have options, but an emerging literature on "choice overload" suggests that the provision of too many options results in adverse experiences, including a depletion of cognitive resources and postdecision feelings of regret. A strong implication is that individuals should shy away from situations…

  11. Group versus individual risk choices in female workgroups in Ethiopia

    NARCIS (Netherlands)

    Bayissa, F.W.; Smits, J.P.J.M.; Ruben, R.

    2017-01-01

    A lottery choice task was conducted to examine the risk attitudes of 352 Ethiopian women who were members of 72 female workgroups in the spices processing business in Addis Ababa. The women were asked to make risk choices on their own, and the same choices together with the other members of their

  12. Neural correlates of affective influence on choice.

    Science.gov (United States)

    Piech, Richard M; Lewis, Jade; Parkinson, Caroline H; Owen, Adrian M; Roberts, Angela C; Downing, Paul E; Parkinson, John A

    2010-03-01

    Making the right choice depends crucially on the accurate valuation of the available options in the light of current needs and goals of an individual. Thus, the valuation of identical options can vary considerably with motivational context. The present study investigated the neural structures underlying context dependent evaluation. We instructed participants to choose from food menu items based on different criteria: on their anticipated taste or on ease of preparation. The aim of the manipulation was to assess which neural sites were activated during choice guided by incentive value, and which during choice based on a value-irrelevant criterion. To assess the impact of increased motivation, affect-guided choice and cognition-guided choice was compared during the sated and hungry states. During affective choice, we identified increased activity in structures representing primarily valuation and taste (medial prefrontal cortex, insula). During cognitive choice, structures showing increased activity included those implicated in suppression and conflict monitoring (lateral orbitofrontal cortex, anterior cingulate). Hunger influenced choice-related activity in the ventrolateral prefrontal cortex. Our results show that choice is associated with the use of distinct neural structures for the pursuit of different goals. Published by Elsevier Inc.

  13. Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: a decision-making approach.

    Science.gov (United States)

    Barrett, Barbara; Byford, Sarah; Crawford, Mike J; Patton, Robert; Drummond, Colin; Henry, John A; Touquet, Robin

    2006-01-04

    We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in a general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivered a brief intervention (n = 287) or to an information only control (n = 312). Total societal costs, including health and social services costs, criminal justice costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at 12 months follow-up and statistically significantly lower at 6 months follow-up. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 65% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.

  14. Speakers' choice of frame in binary choice

    Directory of Open Access Journals (Sweden)

    Marc van Buiten

    2009-02-01

    Full Text Available A distinction is proposed between extit{recommending for} preferred choice options and extit{recommending against} non-preferred choice options. In binary choice, both recommendation modes are logically, though not psychologically, equivalent. We report empirical evidence showing that speakers recommending for preferred options predominantly select positive frames, which are less common when speakers recommend against non-preferred options. In addition, option attractiveness is shown to affect speakers' choice of frame, and adoption of recommendation mode. The results are interpreted in terms of three compatibility effects, (i extit{recommendation mode---valence framing compatibility}: speakers' preference for positive framing is enhanced under extit{recommending for} and diminished under extit{recommending against} instructions, (ii extit{option attractiveness---valence framing compatibility}: speakers' preference for positive framing is more pronounced for attractive than for unattractive options, and (iii extit{recommendation mode---option attractiveness compatibility}: speakers are more likely to adopt a extit{recommending for} approach for attractive than for unattractive binary choice pairs.

  15. Choice and ego-depletion: the moderating role of autonomy.

    Science.gov (United States)

    Moller, Arlen C; Deci, Edward L; Ryan, Richard M

    2006-08-01

    The self-regulatory strength model maintains that all acts of self-regulation, self-control, and choice result in a state of fatigue called ego-depletion. Self-determination theory differentiates between autonomous regulation and controlled regulation. Because making decisions represents one instance of self-regulation, the authors also differentiate between autonomous choice and controlled choice. Three experiments support the hypothesis that whereas conditions representing controlled choice would be egodepleting, conditions that represented autonomous choice would not. In Experiment 3, the authors found significant mediation by perceived self-determination of the relation between the choice condition (autonomous vs. controlled) and ego-depletion as measured by performance.

  16. Inventions on GUI for Touch Sensitive Screens

    OpenAIRE

    Mishra, Umakant

    2014-01-01

    A touch sensitive screen displays the information on the screen and also receives the input by sensing a user's touch on the same screen. This mechanism facilitates system interaction directly through the screen without needing a mouse or keyboard. This method has the advantage to make the system compact by removing keyboard, mouse and similar interactive device. However there are certain difficulties to implement a touch screen interface. The display screens of portable devices are becoming ...

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

    Directory of Open Access Journals (Sweden)

    Ian Krajbich

    2015-10-01

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

  18. A Common Mechanism Underlying Food Choice and Social Decisions

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

  20. Informed Food Choice

    DEFF Research Database (Denmark)

    Coff, Christian

    2014-01-01

    of informed food choice. An informed food choice is an enlightened food choice made by the individual based on the information made available. Food choices are made when shopping for food or when eating/drinking, and information is believed to give clarity to the options by increasing market transparency......Food production and consumption influence health, the environment, social structures, etc. For this reason consumers are increasingly interested in information about these effects. Disclosure of information about the consequences of food production and consumption is essential for the idea......, supporting rationality (the best choice), consumers’ self-governance (autonomy) and life coherence (integrity). On a practical level, informed food choice remains an ideal to strive for, as information on food often is inadequate....

  1. Promoting educated consumer choices

    DEFF Research Database (Denmark)

    Edinger, Wieke Willemijn Huizing

    2016-01-01

    Contemporary EU food information legislation combines and balances two main consumer interests, i.e., a consumer right to information and the freedom of choice, into one single protective standard: informed choice. Although the recent legislative measures quite openly establish a link between...... informed choice and the rather abstract societal norm of “what is good for the consumer,” this does not justify the conclusion that food information legislation has become overly meddlesome in relation to EU consumers and their choice of food. Rather, there has been a gradual maturing of the EU legislator......’s perception of its task from the mere provision of food information to ensuring educated consumer choices. This development is a logical and necessary consequence of the growing complexity of food choices....

  2. Dynamic Choice Behavior in a Natural Experiment

    DEFF Research Database (Denmark)

    Andersen, Steffen; Harrison, Glenn W.; Lau, Morten

    evidence of some probability weighting, but no loss aversion. We also find evidence that contestants make decisions as if using more than one latent criteria, mixing traditional utility evaluations, probability weighting, and aspiration levels. Fourth, we design and implement laboratory experiments...... linked to current choices. We have four major findings. First, we show that popular utility functions that assume constant relative or absolute risk aversion and expected utility theory defined over the prizes cannot characterize these choices, which exhibit increasing relative risk aversion over prizes...... the income that they bring to the game show. Allowing for this integration of income and game show prizes leads to choice behavior consistent with constant relative risk aversion. Third, we examine th e effects of allowing contestants to make choices characterized by non-standard decision models. We find...

  3. Choice, changeover, and travel

    OpenAIRE

    Baum, William M.

    1982-01-01

    Since foraging in nature can be viewed as instrumental behavior, choice between sources of food, known as “patches,” can be viewed as choice between instrumental response alternatives. Whereas the travel required to change alternatives deters changeover in nature, the changeover delay (COD) usually deters changeover in the laboratory. In this experiment, pigeons were exposed to laboratory choice situations, concurrent variable-interval schedules, that were standard except for the introduction...

  4. Developing a discrete choice experiment in Malawi: eliciting preferences for breast cancer early detection services

    Directory of Open Access Journals (Sweden)

    Kohler RE

    2015-10-01

    Full Text Available Racquel E Kohler,1 Clara N Lee,2 Satish Gopal,3 Bryce B Reeve,1 Bryan J Weiner,1 Stephanie B Wheeler11Department of Health Policy and Management, Gillings School of Global Public Health, 2Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3UNC Project-Malawi, Tidziwe Center, Lilongwe, MalawiBackground: In Malawi, routine breast cancer screening is not available and little is known about women’s preferences regarding early detection services. Discrete choice experiments are increasingly used to reveal preferences about new health services; however, selecting appropriate attributes that describe a new health service is imperative to ensure validity of the choice experiment.Objective: To identify important factors that are relevant to Malawian women’s preferences for breast cancer detection services and to select attributes and levels for a discrete choice experiment in a setting where both breast cancer early detection and choice experiments are rare.Methods: We reviewed the literature to establish an initial list of potential attributes and levels for a discrete choice experiment and conducted qualitative interviews with health workers and community women to explore relevant local factors affecting decisions to use cancer detection services. We tested the design through cognitive interviews and refined the levels, descriptions, and designs.Results: Themes that emerged from interviews provided critical information about breast cancer detection services, specifically, that breast cancer interventions should be integrated into other health services because asymptomatic screening may not be practical as an individual service. Based on participants’ responses, the final attributes of the choice experiment included travel time, health encounter, health worker type and sex, and breast cancer early detection strategy. Cognitive testing confirmed the acceptability of the final attributes

  5. Not all choices are created equal: Task-relevant choices enhance motor learning compared to task-irrelevant choices.

    Science.gov (United States)

    Carter, Michael J; Ste-Marie, Diane M

    2017-12-01

    Lewthwaite et al. (2015) reported that the learning benefits of exercising choice (i.e., their self-controlled condition) are not restricted to task-relevant features (e.g., feedback). They found that choosing one's golf ball color (Exp. 1) or choosing which of two tasks to perform at a later time plus which of two artworks to hang (Exp. 2) resulted in better retention than did being denied these same choices (i.e., yoked condition). The researchers concluded that the learning benefits derived from choice, whether irrelevant or relevant to the to-be-learned task, are predominantly motivational because choice is intrinsically rewarding and satisfies basic psychological needs. However, the absence of a group that made task-relevant choices and the lack of psychological measures significantly weakened their conclusions. Here, we investigated how task-relevant and task-irrelevant choices affect motor-skill learning. Participants practiced a spatiotemporal motor task in either a task-relevant group (choice over feedback schedule), a task-irrelevant group (choice over the color of an arm-wrap plus game selection), or a no-choice group. The results showed significantly greater learning in the task-relevant group than in both the task-irrelevant and no-choice groups, who did not differ significantly. Critically, these learning differences were not attributed to differences in perceptions of competence or autonomy, but instead to superior error-estimation abilities. These results challenge the perspective that motivational influences are the root cause of self-controlled learning advantages. Instead, the findings add to the growing evidence highlighting that the informational value gained from task-relevant choices makes a greater relative contribution to these advantages than motivational influences do.

  6. Choice Neighborhood Grantees

    Data.gov (United States)

    Department of Housing and Urban Development — Choice Neighborhoods grants transform distressed neighborhoods, public and assisted projects into viable and sustainable mixed-income neighborhoods by linking...

  7. Security. Review Software for Advanced CHOICE. CHOICE (Challenging Options in Career Education).

    Science.gov (United States)

    Pitts, Ilse M.; And Others

    CHOICE Security is an Apple computer game activity designed to help secondary migrant students memorize their social security numbers and reinforce job and role information presented in "Career Notes, First Applications." The learner may choose from four time options and whether to have the social security number visible on the screen or…

  8. Language Choice & Global Learning Networks

    Directory of Open Access Journals (Sweden)

    Dennis Sayers

    1995-05-01

    Full Text Available How can other languages be used in conjunction with English to further intercultural and multilingual learning when teachers and students participate in computer-based global learning networks? Two portraits are presented of multilingual activities in the Orillas and I*EARN learning networks, and are discussed as examples of the principal modalities of communication employed in networking projects between distant classes. Next, an important historical precedent --the social controversy which accompanied the introduction of telephone technology at the end of the last century-- is examined in terms of its implications for language choice in contemporary classroom telecomputing projects. Finally, recommendations are offered to guide decision making concerning the role of language choice in promoting collaborative critical inquiry.

  9. Rational Choice and the Framing of Decisions.

    Science.gov (United States)

    1986-05-29

    survival in a competitive environment , and a minority of rational individuals can sometimes impose rationality on the whole market. Third, the...intuitive appeal of the axioms of rational choice makes it plausible that the theory derived from these axioms should provide an acceptable account of choice...rn-use U? RATIONAL CHOICE AMD THE FINNING OF KCISIOUS(U mi/ STANFORD UNIV CR A TYERSEY ET AL. 29 NAYN4-S4-K-S61SWICLASS IF lED FO 5/10S IL EEEEEEEE

  10. What counts as a choice? U.S. Americans are more likely than Indians to construe actions as choices.

    Science.gov (United States)

    Savani, Krishna; Markus, Hazel Rose; Naidu, N V R; Kumar, Satishchandra; Berlia, Neha

    2010-03-01

    People everywhere select among multiple alternatives, but are they always making choices? In five studies, we found that people in U.S. American contexts, where the disjoint model of agency is prevalent, are more likely than those in Indian contexts to construe their own and other individuals' behaviors as choices, to construe ongoing behaviors and behaviors recalled from memory as choices, to construe naturally occurring and experimentally controlled behaviors as choices, to construe mundane and important actions as choices, and to construe personal and interpersonal actions as choices. Indians showed a greater tendency to construe actions as choices when these actions involved responding to other people than when they did not. These findings show that whether people construe actions as choices is significantly shaped by sociocultural systems of meanings and practices. Together, they suggest that the positive consequences associated with maximizing the availability of personal choice may not be universal and instead may be limited to North American contexts.

  11. Choice Shifts in Groups: A Decision-Theoretic Basis

    OpenAIRE

    Kfir Eliaz; Debraj Ray; Ronny Razin

    2006-01-01

    The phenomenon of choice shifts in group decision-making has received attention in the social psychology literature. Faced with a risky group decision, individuals appear to support more extreme choices relative to those they would make on their own. This paper demonstrates that from a decision-theoretic perspective, choice shifts are intimately connected to failures of expected utility theory. In the model studied here, the Allais paradox is equivalent to a well-studied configuration of choi...

  12. Toxicology screen

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003578.htm Toxicology screen To use the sharing features on this page, please enable JavaScript. A toxicology screen refers to various tests that determine the ...

  13. A singular choice for multiple choice

    DEFF Research Database (Denmark)

    Frandsen, Gudmund Skovbjerg; Schwartzbach, Michael Ignatieff

    2006-01-01

    How should multiple choice tests be scored and graded, in particular when students are allowed to check several boxes to convey partial knowledge? Many strategies may seem reasonable, but we demonstrate that five self-evident axioms are sufficient to determine completely the correct strategy. We ...

  14. The balance sheet of benefits and harms of breast cancer population-based screening in Europe: outcome research, practice and future challenges.

    Science.gov (United States)

    Broeders, Mireille; Paci, Eugenio

    2015-11-01

    Breast cancer screening programs are still object of harsh debate. In 2012, the Independent UK Panel reviewed the benefits and harms of mammography screening based on randomized trials and the EUROSCREEN Working Group reviewed European observational outcome studies. The conclusion was that screening programs should continue, while acknowledging that harms, such as the occurrence of false-positive results and overdiagnosis, can have a negative impact on a woman's life. Information on the balance sheet of the benefits and harms of breast cancer screening should help women and their physicians to make an informed choice. The future challenge for breast screening programs is to assess the feasibility, acceptability, effectiveness and impact of risk-based screening in order to maximize benefit-to-harm ratios.

  15. Socialized choices: Labour market behaviour of Dutch mothers

    NARCIS (Netherlands)

    Ruitenberg, J.F.

    2014-01-01

    Dutch mothers display diverse labour market behaviour, though typically they work part-time, making modest use of childcare. It is generally assumed that Dutch women are free to make their own choices regarding employment. This narrative of 'choice' finds fertile ground in an era of general

  16. Language Choice in Multilingual Communities: The Case of Larteh ...

    African Journals Online (AJOL)

    In a multilingual community, the multilingual speaker needs to make the right language choice which principally depends on the domain of usage and the linguistic repertoire of speech participants. This paper investigates factors that govern language choices that multilingual speakers make in Larteh, a multilingual ...

  17. Engineering aspects of Passavant screening

    International Nuclear Information System (INIS)

    Siddle, K.R.; Sharma, R.K.

    1978-01-01

    The Passavant screen was developed in Europe almost 30 years ago. The Passavant screen is a vertical traveling screen; however, the basic difference between the conventional vertical traveling screen and the Passavant screen is that in the conventional screen water passes through the front screen belt and then the back screen belt, whereas in the Passavant screen the water enters in between the two belts and passes laterally through either of the belts. Thus, theoretically, the screening surface of the Passavant screen is doubled as compared to the same size conventional vertical traveling screen. Various design and operational modifications of the Passavant screen are possible to yield optimum design and performance characteristics which make it amenable to installation at power plants for safe removal of not only fish but also smaller organisms such as fish eggs and larvae. In this paper, details of the screen design and operational characteristics are discussed with notes on how these features can be modified to suit site- and organism-specific requirements

  18. School Choice Marches forward

    Science.gov (United States)

    Butcher, Jonathan

    2013-01-01

    One year ago, the "Wall Street Journal" dubbed 2011 "the year of school choice," opining that "this year is shaping up as the best for reformers in a very long time." School-choice laws took great strides in 2011, both in the number of programs that succeeded across states and also in the size and scope of the adopted…

  19. Your Genes, Your Choices

    Science.gov (United States)

    Table of Contents Your Genes, Your Choices describes the Human Genome Project, the science behind it, and the ethical, legal, and social issues that are ... Nothing could be further from the truth. Your Genes, Your Choices points out how the progress of ...

  20. Tough and easy choices

    DEFF Research Database (Denmark)

    Olsen, Søren Bøye; Lundhede, Thomas; Jacobsen, Jette Bredahl

    2011-01-01

    and the best alternative to that. We test this hypothesis using data from two independent Choice Experiments both focusing on nature values. In modelling respondents’ self-reported certainty in choice, we find evidence that the stated level of certainty increases significantly as utility difference in choice......Respondents in Stated Preference studies may be uncertain about their preferences for the good presented to them. Inspired by Wang (J Environ Econ Manag 32:219–232, 1997) we hypothesize that respondents’ stated certainty in choice increases with the utility difference between the alternative chosen...... sets increases. In addition, stated certainty increases with income. Furthermore, there is some evidence that male respondents are inherently more certain in their choices than females, and a learning effect may increase stated certainty. We find evidence of this in the first study where the good...

  1. 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

  2. Do Choice Experiments Generate Reliable Willingness to Pay Estimates Theory and Experimental Evidence

    Science.gov (United States)

    2015-01-01

    the sample if they regard the price vector as high relative to the utility of non-status quo choices. Thus, the mathematics of combinatorial choice...option with the same attributes appearing in a choice set at a higher price , or an option with the same price but worse attributes appearing in the...25 of subjects making binary choices between alternative snack foods is consistent with an optimizing model of choice with error. Such choice errors

  3. People's willingness to accept overdetection in cancer screening: population survey.

    Science.gov (United States)

    Van den Bruel, Ann; Jones, Caroline; Yang, Yaling; Oke, Jason; Hewitson, Paul

    2015-03-03

    To describe the level of overdetection people would find acceptable in screening for breast, prostate, and bowel cancer and whether acceptability is influenced by the magnitude of the benefit from screening and the cancer specific harms from overdetection. Online survey. Women were presented with scenarios on breast and bowel cancer, men with scenarios on prostate and bowel cancer. For each particular cancer, we presented epidemiological information and described the treatment and its consequences. Secondly, we presented two different scenarios of benefit: one indicating a 10% reduction in cancer specific mortality and the second indicating a 50% reduction. Online survey of the population in the United Kingdom. Respondents were part of an existing panel of people who volunteer for online research and were invited by email or online marketing. We recruited 1000 respondents, representative for age and sex for the UK population. Number of cases of overdetection people were willing to accept, ranging from 0-1000 (complete screened population) for each cancer modality and each scenario of benefit. There was large variability between respondents in the level of overdetection they would find acceptable, with medians ranging from 113 to 313 cases of overdetection per 1000 people screened. Across all scenarios, 4-7% of respondents indicated they would accept no overdetection at all compared with 7-14% who thought that it would be acceptable for the entire screened population to be overdetected. Acceptability in screening for bowel cancer was significantly lower than for breast and prostate cancer. People aged 50 or over accepted significantly less overdetection, whereas people with higher education levels accepted more; 29% of respondents had heard of overdetection before. Acceptability of overdetection in cancer screening is variable. Invitations for screening should include clear information on the likelihood and consequences of overdetection to allow people to make an

  4. "Is It Worth Knowing?" Focus Group Participants' Perceived Utility of Genomic Preconception Carrier Screening.

    Science.gov (United States)

    Schneider, Jennifer L; Goddard, Katrina A B; Davis, James; Wilfond, Benjamin; Kauffman, Tia L; Reiss, Jacob A; Gilmore, Marian; Himes, Patricia; Lynch, Frances L; Leo, Michael C; McMullen, Carmit

    2016-02-01

    As genome sequencing technology advances, research is needed to guide decision-making about what results can or should be offered to patients in different clinical settings. We conducted three focus groups with individuals who had prior preconception genetic testing experience to explore perceived advantages and disadvantages of genome sequencing for preconception carrier screening, compared to usual care. Using a discussion guide, a trained qualitative moderator facilitated the audio-recorded focus groups. Sixteen individuals participated. Thematic analysis of transcripts started with a grounded approach and subsequently focused on participants' perceptions of the value of genetic information. Analysis uncovered two orientations toward genomic preconception carrier screening: "certain" individuals desiring all possible screening information; and "hesitant" individuals who were more cautious about its value. Participants revealed valuable information about barriers to screening: fear/anxiety about results; concerns about the method of returning results; concerns about screening necessity; and concerns about partner participation. All participants recommended offering choice to patients to enhance the value of screening and reduce barriers. Overall, two groups of likely users of genome sequencing for preconception carrier screening demonstrated different perceptions of the advantages or disadvantages of screening, suggesting tailored approaches to education, consent, and counseling may be warranted with each group.

  5. Training impulsive choices for healthy and sustainable food.

    Science.gov (United States)

    Veling, Harm; Chen, Zhang; Tombrock, Merel C; Verpaalen, Iris A M; Schmitz, Laura I; Dijksterhuis, Ap; Holland, Rob W

    2017-06-01

    Many people find it hard to change their dietary choices. Food choice often occurs impulsively, without deliberation, and it has been unclear whether impulsive food choice can be experimentally created. Across 3 exploratory and 2 confirmatory preregistered experiments we examined whether impulsive food choice can be trained. Participants were cued to make motor responses upon the presentation of, among others, healthy and sustainable food items. They subsequently selected these food items more often for actual consumption when they needed to make their choices impulsively as a result of time pressure. This effect disappeared when participants were asked to think about their choices, merely received more time to make their choices, or when choosing required attention to alternatives. Participants preferred high to low valued food items under time pressure and without time pressure, suggesting that the impulsive choices reflect valid preferences. These findings demonstrate that it is possible to train impulsive choices for food items while leaving deliberative choices for these items unaffected, and connect research on attention training to dual-process theories of decision making. The present research suggests that attention training may lead to behavioral change only when people behave impulsively. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. 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...

  7. 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...

  8. IronMaking Process Alternatives Screening Study

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2000-10-01

    This study by Lockwood Greene evaluates a number ironmaking processes. The appendices provide greater detail and further exploration of the ironmaking processes, including components, relative costs, and comparisons.

  9. Questioning screening | Kent | Obstetrics and Gynaecology Forum

    African Journals Online (AJOL)

    This article raises new evidence about screening and argues for the evaluation in all screening on a benefits/harms ratio and then the choice being agreed by the care-giver and patient. As the evidence changes, so do our prejudices come under scrutiny. Are we prepared to objectively review our position in the light of new ...

  10. Colon cancer screening

    Science.gov (United States)

    Screening for colon cancer; Colonoscopy - screening; Sigmoidoscopy - screening; Virtual colonoscopy - screening; Fecal immunochemical test; Stool DNA test; sDNA test; Colorectal cancer - screening; Rectal ...

  11. Retinopathy of prematurity screening criteria and workload ...

    African Journals Online (AJOL)

    Larger infants require screening to include a few outliers, but they ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  12. Retinopathy of prematurity screening criteria and workload ...

    African Journals Online (AJOL)

    Larger infants require screening to include a few outliers, but they require ... Making local screening criteria narrower on the basis of a limited evidence base may be dangerous. Risk factors for CSROP in larger infants need to be researched.

  13. Designing for Decision Making

    Science.gov (United States)

    Jonassen, David H.

    2012-01-01

    Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…

  14. The axiom of choice

    CERN Document Server

    Jech, Thomas J

    2008-01-01

    Comprehensive in its selection of topics and results, this self-contained text examines the relative strengths and consequences of the axiom of choice. Each chapter contains several problems, graded according to difficulty, and concludes with some historical remarks.An introduction to the use of the axiom of choice is followed by explorations of consistency, permutation models, and independence. Subsequent chapters examine embedding theorems, models with finite supports, weaker versions of the axiom, and nontransferable statements. The final sections consider mathematics without choice, cardin

  15. Using the Internet to investigate consumer choice spaces.

    Science.gov (United States)

    Crow, Janis J; Shanteau, James; Casey, John D

    2003-05-01

    Traditional investigations of consumer choice processes include a matrix of alternatives described by attributes. The researcher-created matrix presents a product option space for the participant. In this article, we propose an alternative methodological approach to consumer choice processes. Specifically, we investigate choice processes when a participant creates his/her own product space. We describe a Web-based program and methodology used to collect data for three customizable products. Empirical results indicate that consumers are willing and able to make choices from their own product space. This research provides a new avenue for exploring choice processes.

  16. An effect of loudness of advisory speech on a choice response task

    Science.gov (United States)

    Utsuki, Narisuke; Takeuchi, Yoshinori; Nomiyama, Takenori

    1995-03-01

    Recent technologies have realized talking advisory/guidance systems in which machines give advice and guidance to operators in speech. However, nonverbal aspects of spoken messages may have significant effects on an operator's behavior. Twelve subjects participated in a TV game-like choice response task where they were asked to choose a 'true' target from three invader-like figures displayed on a CRT screen. The subjects had received a prerecorded advice designating either left, center, or right target that would be true before each choice. The position of the 'true' targets and advice were preprogrammed in pseudorandom sequences. In other words, there was no way for the subjects to predict the 'true' target and there was no relationship between spoken advice and the true target position. The subjects tended to make more choices corresponding to the presented messages when the messages were presented in a louder voice than in a softer voice. Choice response time was significantly shorter when the response was the same as the advice indicated. The shortening of response time was slightly greater when advice was presented in a louder voice. This study demonstrates that spoken advice may result in faster and less deliberate reponses in accordance with the presented messages which are given by talking guidance systems.

  17. Research procedure and criteria for analysis and choice of variants for construction of national radioactive waste repository

    International Nuclear Information System (INIS)

    Vachev, B.

    1993-01-01

    General principles, overlying objectives and basic radioactive waste management strategy future priorities are considered. The research procedure is based on system approach and analysis, decision making theory, basic objectives and principles of the national repository construction. Main criteria and some basic notions (like radioactive wastes environment and radioactive wastes barriers - input and output) are introduced. Six environment elements are identified: surroundings and natural environment, economic, scientific and technical-technological, socio-psychological, legal and institutional-political. Flow charts of the hierarchical structure of research procedure, decision making levels and direct and back feeds are presented and a scenario analysis is proposed as one of the tools for reflection of uncertainty. The hierarchical structure of the high level waste repository construction scenarios and variants tree (8 levels) is defined. The methodology and methods of analysis, screening and choice of variants is considered. A 7-group system of criteria and constrains for analysis, screening and choice of variants is formulated. One implementation of the proposed methodology and procedure is the technological choice for radioactive waste conditioning and solving of a preliminary site selection problem. 4 figs., 25 refs. (author)

  18. Choice probability generating functions

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; McFadden, Daniel; Bierlaire, Michel

    2010-01-01

    This paper establishes that every random utility discrete choice model (RUM) has a representation that can be characterized by a choice-probability generating function (CPGF) with specific properties, and that every function with these specific properties is consistent with a RUM. The choice...... probabilities from the RUM are obtained from the gradient of the CPGF. Mixtures of RUM are characterized by logarithmic mixtures of their associated CPGF. The paper relates CPGF to multivariate extreme value distributions, and reviews and extends methods for constructing generating functions for applications....... The choice probabilities of any ARUM may be approximated by a cross-nested logit model. The results for ARUM are extended to competing risk survival models....

  19. Veterans Choice Program

    Data.gov (United States)

    Department of Veterans Affairs — If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your...

  20. Neutron delayed choice experiments

    International Nuclear Information System (INIS)

    Bernstein, H.J.

    1986-01-01

    Delayed choice experiments for neutrons can help extend the interpretation of quantum mechanical phenomena. They may also rule out alternative explanations which static interference experiments allow. A simple example of a feasible neutron test is presented and discussed. (orig.)

  1. Consumer choice behaviour

    DEFF Research Database (Denmark)

    Hansen, Flemming; Percy, Larry; Hallum Hansen, Morten

    2004-01-01

    The paper is concerned with the measurement of emotions and the study of the role ofemotions in consumer choice. Contemporary neurological findings suggest that emotionsmay play a role in its own right, quite different from the way in which they have beenconsidered in traditional consumer choice ...... behaviour theory. A large-scale study including800 respondents, covering 64 brands, provide findings on emotional response tendenciesfor the brands, and relate these to involvement, type of need gratification, purchasingbehaviour, etc.......The paper is concerned with the measurement of emotions and the study of the role ofemotions in consumer choice. Contemporary neurological findings suggest that emotionsmay play a role in its own right, quite different from the way in which they have beenconsidered in traditional consumer choice...

  2. A Decision-Theoretic Basis for Choice Shifts in Groups

    OpenAIRE

    Eliaz, Kfir; Ray, Debraj; Razin, Ronny

    2004-01-01

    The phenomenon of choice shifts in group decision-making is fairly ubiquitous in the social psychology literature. Faced with a choice between a ‘safe’ and ‘risky’ decision, group members appear to move to one extreme or the other, relative to the choices each member might have made alone. Both risky and cautious shifts have been identified in different situations. This Paper demonstrates that from an individual decision-making perspective, choice shifts may be viewed as a systematic violatio...

  3. Refusing The Choice: Balancing Life and Work

    Science.gov (United States)

    Brooks, J.

    2012-12-01

    The Choice The intellect of man is forced to choose perfection of the life, or of the work, And if it take the second must refuse A heavenly mansion, raging in the dark. When all that story's finished, what's the news? In luck or out the toil has left its mark: That old perplexity an empty purse, Or the day's vanity, the night's remorse. William Butler Yeats William Yeats put forward The Choice that I feel too many scientists feel they must make. Too often, many choose to leave science. How do we refuse this choice and find balance between life and our careers? While I don't know the answer, I will share choices that have lead to not perfection but satisfaction in science careers and lives. The role of mentors, supportive spouses, the luck of the job, and flexibility in research directions have all contributed to being able to refuse to choose.

  4. Occupational choice and values.

    OpenAIRE

    Kantas, A.

    1985-01-01

    It is suggested that psychological and sociological approaches to occupational choice can be linked together by employment of three concepts: work salience, values and motivation. Employing Vroom's (1964) cognitive model of motivation occupational choice was examined as a value attainment process. The subjects were 225 male pupils of two different school complexes in Athens, Greece. They were asked to respond to a work salience questionnaire and to rank order a set of ...

  5. Consumer choice behaviour

    OpenAIRE

    Hansen, Flemming; Percy, Larry; Hallum Hansen, Morten

    2004-01-01

    The paper is concerned with the measurement of emotions and the study of the role of emotions in consumer choice. Contemporary neurological findings suggest that emotions may play a role in its own right, quite different from the way in which they have been considered in traditional consumer choice behaviour theory. A large-scale study including 800 respondents, covering 64 brands, provide findings on emotional response tendencies for the brands, and relate these to involvement...

  6. Discretionary Time of Chinese College Students: Activities and Impact of SARS-Induced Constraints on Choices

    Science.gov (United States)

    Yang, He; Hutchinson, Susan; Zinn, Harry; Watson, Alan

    2011-01-01

    How people make choices about activity engagement during discretionary time is a topic of increasing interest to those studying quality of life issues. Assuming choices are made to maximize individual welfare, several factors are believed to influence these choices. Constraints theory from the leisure research literature suggests these choices are…

  7. Discretionary time of Chinese college students: Activities and impact of SARS-induced constraints on choices

    Science.gov (United States)

    He Yang; Susan Hutchinson; Harry Zinn; Alan Watson

    2011-01-01

    How people make choices about activity engagement during discretionary time is a topic of increasing interest to those studying quality of life issues. Assuming choices are made to maximize individual welfare, several factors are believed to influence these choices. Constraints theory from the leisure research literature suggests these choices are heavily influenced by...

  8. Future perspective and healthy lifestyle choices in adulthood.

    Science.gov (United States)

    Tasdemir-Ozdes, Aylin; Strickland-Hughes, Carla M; Bluck, Susan; Ebner, Natalie C

    2016-09-01

    Regardless of age, making healthy lifestyle choices is prudent. Despite that, individuals of all ages sometimes have difficulty choosing the healthy option. We argue that individuals' view of the future and position in the life span affects their current lifestyle choices. We capture the multidimensionality of future thinking by assessing 3 types of future perspective. Younger and older men and women (N = 127) reported global future time perspective, future health perspective, and perceived importance of future health-related events. They also rated their likelihood of making healthy lifestyle choices. As predicted, older participants indicated greater intention to make healthy choices in their current life than did younger participants. Compared to younger participants, older participants reported shorter global future time perspective and anticipated worse future health but perceived future health-related events as more important. Having a positive view of one's future health and seeing future health-related events as important were related to greater intention to make healthy lifestyle choices, but greater global future time perspective was not directly related to healthy choices. However, follow-up analyses suggested that greater global future time perspective indirectly affected healthy choices via a more positive view of future health. None of these relations were moderated by age. Individuals' perspective on the future is shown to be an important multidimensional construct affecting everyday healthy lifestyle choices for both younger and older adults. Implications for encouraging healthy choices across the adult life span are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Understanding Midwives’ Preferences for Providing Information About Newborn Bloodspot Screening

    Directory of Open Access Journals (Sweden)

    Stuart James Wright

    2018-01-01

    Full Text Available Background: Understanding preferences for information provision in the context of health care service provision is challenging because of the number of potential attributes that may influence preferences. This study aimed to identify midwives’ preferences for the process and outcomes of information provision in an expanded national newborn bloodspot screening program. Design: A sample of practicing midwives completed a hybrid-stated preference survey including a conjoint analysis (CA and discrete choice experiment to quantify preferences for the types of, and way in which, information should be provided in a newborn bloodspot screening program. Six conjoint analysis questions captured the impact of different types of information on parents’ ability to make a decision, and 10 discrete choice experiment questions identified preferences for four process attributes (including parents’ ability to make a decision. Results: Midwives employed by the UK National Health Service (n = 134 completed the survey. All types of information content were perceived to improve parents’ ability to make a decision except for the possibility of false-positive results. Late pregnancy was seen to be the best time to provide information, followed by day 3 postbirth. Information before 20 weeks of pregnancy was viewed as reducing parents’ ability to make a decision. Midwives preferred information to be provided by an individual discussion and did not think parents should receive information on the Internet. Conclusion: A hybrid stated preference survey design identified that a wide variety of information should be provided to maximize parents’ ability to make a decision ideally provided late in pregnancy or on day 3 postbirth.

  10. Known Unknowns in Judgment and Choice

    OpenAIRE

    Walters, Daniel

    2017-01-01

    This dissertation investigates how people make inferences about missing information. Whereas most prior literature focuses on how people process known information, I show that the extent to which people make inferences about missing information impacts judgments and choices. Specifically, I investigate how (1) awareness of known unknowns affects overconfidence in judgment in Chapter 1, (2) beliefs about the knowability of unknowns impacts investment strategies in Chapter 2, and (3) inferences...

  11. The Choice Architecture of Choice Architecture: Toward a Nonpaternalistic Nudge Policy

    OpenAIRE

    David Colander; Andrew Qi Lin Chong

    2009-01-01

    This The goal of nudge policy is generally presented as assisting people in finding their “true” preferences. Supporters argue that nudge policies meet a libertarian paternalism criterion. This claim has provoked complaints that nudge policies are unacceptably paternalistic. This paper suggests that by changing the explicit goal of nudge policy to a goal of making the choice of choice mechanism an explicit decision variable of the subgroup being affected by the nudge one can have a non-patern...

  12. Neural Correlates of Affective Influence on Choice

    Science.gov (United States)

    Piech, Richard M.; Lewis, Jade; Parkinson, Caroline H.; Owen, Adrian M.; Roberts, Angela C.; Downing, Paul E.; Parkinson, John A.

    2010-01-01

    Making the right choice depends crucially on the accurate valuation of the available options in the light of current needs and goals of an individual. Thus, the valuation of identical options can vary considerably with motivational context. The present study investigated the neural structures underlying context dependent evaluation. We instructed…

  13. Restricted Choice in the Management of Change.

    Science.gov (United States)

    North, R. F. J.

    1988-01-01

    Instances from case studies of comprehensive schools in the United Kingdom show that cultural influences restrict possibilities of "rational" action by educational leaders. This article warns against business theory and concludes that we need to know more about how people in schools make choices. (Author/TE)

  14. The cost-effectiveness of screening for hereditary hemochromatosis in Germany: a remodeling study.

    Science.gov (United States)

    Rogowski, Wolf H

    2009-01-01

    Genetic tests for hereditary hemochromatosis (HH) are currently included in the German ambulatory care reimbursement scheme but only for symptomatic individuals and the offspring of HH patients. This study synthesizes the most current evidence to examine whether screening in the broader population is cost-effective and to identify the best choice of initial and follow-up screening tests. A probabilistic decision-analytic model was constructed to calculate cost per life year gained (LYG) for HH screening among male Caucasians aged 30. Three strategies were considered in both the general population and male offspring of HH patients: phenotypic (transferrin saturation, TS), genotypic (C282Y mutation), and sequential (genotype if TS is elevated) screening. The incremental cost-effectiveness of sequential screening among male offspring, sequential population-wide screening, and genotypic screening is 41000, 124000, and 161000 Eero/LYG, respectively. All other strategies were subject to simple or extended dominance. The results are subject to high uncertainty. The most influential parameters in the deterministic one-way sensitivity analysis are discounting of life years gained and the adherence of patients to preventive phlebotomy. The current German policy of only screening at-risk individuals is consistent with health economic decision making based on typically accepted thresholds. However, conducting the DNA test after the first elevated TS result is more cost-effective than waiting for a second TS result as recommended by the German guidelines. Further empirical work regarding adherence to long-term prevention recommendations and explicit and well-justified guidance for the choice of discount rates in German economic evaluation are needed.

  15. The choices before us.

    Science.gov (United States)

    Streeten, P P

    1980-01-01

    This introduction is from the 16th World Conference of SID in Colombo, Sri Lanka, August 1979, which addressed the theme of development choices for the 1980's and beyond. Choices may refer to different political, ideological or social systems. Choices may refer to strategies and technical issues, e.g. agriculture vs. industry. A third meaning of choice is implicit in the idea of a Third World, or alternative, method of development. The third meaning implies a rejection of Western institutions, values, and standards. In the past, the transfer of Western or in this case Northern, institutions and standards has disappointed and created obstacles to development. The rapid rate of population growth forces choices of population control and resource management. Common themes of development have emerged from conference discussions: the need to build development efforts on indigenous values; the need for new institutions both at the sub-national and at the super-national level; and, the need to adjust to inevitable changes rationally and with foresight. The nation state is too large for many functions that are better decentralized and left to village or district administrations, yet it is too small to respond to global challenges and environmental risks like harvest failure, credit risks, marketing risks, failure of supplies. The interests of the state are not identical with those of society or particular groups in society.

  16. Breast Cancer Screening for Average-Risk Women: Recommendations From the ACR Commission on Breast Imaging.

    Science.gov (United States)

    Monticciolo, Debra L; Newell, Mary S; Hendrick, R Edward; Helvie, Mark A; Moy, Linda; Monsees, Barbara; Kopans, Daniel B; Eby, Peter R; Sickles, Edward A

    2017-09-01

    Breast cancer is the most common non-skin cancer and the second leading cause of cancer death for women in the United States. Before the introduction of widespread mammographic screening in the mid-1980s, the death rate from breast cancer in the US had remained unchanged for more than 4 decades. Since 1990, the death rate has declined by at least 38%. Much of this change is attributed to early detection with mammography. ACR breast cancer screening experts have reviewed data from RCTs, observational studies, US screening data, and other peer-reviewed literature to update our recommendations. Mammography screening has consistently been shown to significantly reduce breast cancer mortality over a variety of study designs. The ACR recommends annual mammography screening starting at age 40 for women of average risk of developing breast cancer. Our recommendation is based on maximizing proven benefits, which include a substantial reduction in breast cancer mortality afforded by regular screening and improved treatment options for those diagnosed with breast cancer. The risks associated with mammography screening are also considered to assist women in making an informed choice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  17. Choice-Induced Preference Change in the Free-Choice Paradigm: A Critical Methodological Review

    Directory of Open Access Journals (Sweden)

    Keise eIzuma

    2013-02-01

    Full Text Available Choices not only reflect our preference, but they also affect our behavior. The phenomenon of choice-induced preference change has been of interest to cognitive dissonance researchers in social psychology, and more recently, it has attracted the attention of researchers in economics and neuroscience. Preference modulation after the mere act of making a choice has been repeatedly demonstrated over the last 50 years by an experimental paradigm called the free-choice paradigm. However, in 2010, Chen and Risen pointed out a serious methodological flaw in this paradigm, arguing that evidence for choice-induced preference change is still insufficient. Despite the flaw, studies using the traditional free-choice paradigm continue to be published without addressing the criticism. Here, aiming to draw more attention to this issue, we briefly explain the methodological problem, and then describe simple simulation studies that illustrate how the free-choice paradigm produces a systematic pattern of preference change consistent with cognitive dissonance, even without any change in true preference. Our stimulation also shows how a different level of noise in each phase of the free-choice paradigm independently contributes to the magnitude of artificial preference change. Furthermore, we review ways of addressing the critique and provide a meta-analysis to show the effect size of choice-induced preference change after addressing the critique. Finally, we review and discuss, based on the results of the stimulation studies, how the criticism affects our interpretation of past findings generated from the free-choice paradigm. We conclude that the use of the conventional free-choice paradigm should be avoided in future research and the validity of past findings from studies using this paradigm should be empirically re-established.

  18. 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 ...

  19. Men and women: beliefs about cancer and about screening

    Directory of Open Access Journals (Sweden)

    Whynes David K

    2009-11-01

    Full Text Available Abstract Background Cancer screening programmes in England are publicly-funded. Professionals' beliefs in the public health benefits of screening can conflict with individuals' entitlements to exercise informed judgement over whether or not to participate. The recognition of the importance of individual autonomy in decision making requires greater understanding of the knowledge, attitudes and beliefs upon which people's screening choices are founded. Until recently, the technology available required that cancer screening be confined to women. This study aimed to discover whether male and female perceptions of cancer and of screening differed. Methods Data on the public's cancer beliefs were collected by means of a postal survey (anonymous questionnaire. Two general practices based in Nottingham and in Mansfield, in east-central England, sent questionnaires to registered patients aged 30 to 70 years. 1,808 completed questionnaires were returned for analysis, 56.5 per cent from women. Results Women were less likely to underestimate overall cancer incidence, although each sex was more likely to cite a sex-specific cancer as being amongst the most common cancer site. In terms of risk factors, men were most uncertain about the role of stress and sexually-transmitted diseases, whereas women were more likely to rate excessive alcohol and family history as major risk factors. The majority of respondents believed the public health care system should provide cancer screening, but significantly more women than men reported having benefiting from the nationally-provided screening services. Those who were older, in better health or had longer periods of formal education were less worried about cancer than those who had illness experiences, lower incomes, or who were smokers. Actual or potential participation in bowel screening was higher amongst those who believed bowel cancer to be common and amongst men, despite women having more substantial worries about

  20. Are groups more likely to defer choice than their members?

    Directory of Open Access Journals (Sweden)

    Chris M. White

    2011-04-01

    Full Text Available When faced with a choice, people can normally select no option, i.e., defer choice. Previous research has investigated when and why individuals defer choice, but has almost never looked at these questions when groups of people make choices. Separate reasons predict that groups may be equally likely, more likely, or less likely than individuals to defer choice. We re-analyzed some previously published data and conducted a new experiment to address this question. We found that small groups of people tended to defer choice more often than their members would. Assuming that the groups used a plurality rule but gave additional weight to individual preferences to defer choice allowed the groups' responses to be predicted quite well. We discuss several possible explanations of these findings.