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.

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.

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.

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.

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.

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.

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.

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...

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 ...

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

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

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.

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.

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

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.

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.

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...

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.

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

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”.

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.

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

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

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.

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 ...

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.

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

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.

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."

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...

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…

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.

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.

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...

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...

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.

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.

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

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.

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

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.

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.

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…

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.

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

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.

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.

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.

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

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…

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.

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

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.

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.

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 ...

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…

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.

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.

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.

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)

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

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.

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.

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.

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

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...

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.

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

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

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.

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

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

[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.

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.

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…

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.

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.

"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.

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

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

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.

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.

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.

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.

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....

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.

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

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

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.

'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.

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

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

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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).

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.

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.

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

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,…

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.

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

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.

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

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...

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

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…

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...

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)

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.

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.

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.

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...

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.

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.

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

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

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

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…

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.

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.

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)

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 ...

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.

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...

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 ...

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.

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.

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

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.

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...

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

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

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...

Promising Approaches From Behavioral Economics to Improve Patient Lung Cancer Screening Decisions.

Science.gov (United States)

Barnes, Andrew J; Groskaufmanis, Lauren; Thomson, Norman B

2016-12-01

Lung cancer is a devastating disease, the deadliest form of cancer in the world and in the United States. As a consequence of CMS's determination to provide low-dose CT (LDCT) as a covered service for at-risk smokers, LDCT lung cancer screening is now a covered service for many at-risk patients that first requires counseling and shared clinical decision making, including discussions of the risks and benefits of LDCT screening. However, shared decision making fundamentally relies on the premise that with better information, patients will arrive at rational decisions that align with their preferences and values. Evidence from the field of behavioral economics offers many contrary viewpoints that take into account patient decision making biases and the role of the shared decision environment that can lead to flawed choices and that are particularly relevant to lung cancer screening and treatment. This article discusses some of the most relevant biases, and suggests incorporating such knowledge into screening and treatment guidelines and shared decision making best practices to increase the likelihood that such efforts will produce their desired objectives to improve survival and quality of life. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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).

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,…

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 ...

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

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

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.

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

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.

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’

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

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...

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...

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

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).

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.

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.

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.

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.

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.

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.

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.

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

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.

[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.

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…

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.

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.

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

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.

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.

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.

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.

Action and valence modulate choice and choice-induced preference change.

Directory of Open Access Journals (Sweden)

Raphael Koster

Full Text Available Choices are not only communicated via explicit actions but also passively through inaction. In this study we investigated how active or passive choice impacts upon the choice process itself as well as a preference change induced by choice. Subjects were tasked to select a preference for unfamiliar photographs by action or inaction, before and after they gave valuation ratings for all photographs. We replicate a finding that valuation increases for chosen items and decreases for unchosen items compared to a control condition in which the choice was made post re-evaluation. Whether choice was expressed actively or passively affected the dynamics of revaluation differently for positive and negatively valenced items. Additionally, the choice itself was biased towards action such that subjects tended to choose a photograph obtained by action more often than a photographed obtained through inaction. These results highlight intrinsic biases consistent with a tight coupling of action and reward and add to an emerging understanding of how the mode of action itself, and not just an associated outcome, modulates the decision making process.

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.

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.

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.

The effect of information about the benefits and harms of mammography on women's decision-making: study protocol for a randomized controlled trial.

Science.gov (United States)

Carles, Misericòrdia; Martínez-Alonso, Montserrat; Pons, Anna; Pérez-Lacasta, Maria 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; Rué, Montserrat

2017-09-12

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 on decision-making, in women approaching the age of invitation to mammography screening. A two-stage, randomized controlled trial (RCT). In the first stage, 40 Basic Health Areas (BHAs) will be selected and randomized to intervention or control. In the second stage, women within each BHA will be randomly selected (n = 400). Four breast cancer screening programs (BCSPs) of the Spanish public health system, three in Catalonia and one in the Canary Islands will participate in the study. Women in the intervention arm will receive a leaflet with detailed information on the benefits and harms of screening using mammography. Women in the control arm will receive a standard leaflet that does not mention harms and recommends accepting the invitation to participate in the biennial examinations of the BCSP. The primary outcome is informed choice, a dichotomous variable that combines knowledge, attitudes, and intentions. Secondary outcomes include decisional conflict; confidence in the decision made; anxiety about screening participation; worry about breast cancer; anticipated regret; time perspective; perceived importance of benefits/harms of screening; perceived risk of breast cancer; and leaflet acceptability. Primary and secondary outcomes are assessed 2-3 weeks after the intervention. This is the first RCT that assesses the effect of informing about the benefits and harms of breast cancer screening in Spain in women facing the decision to be screened using mammography. It aims to assess the

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.

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.

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 ...

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.

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.

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.

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…

Eliciting population preferences for mass colorectal cancer screening organization.

Science.gov (United States)

Nayaradou, Maximilien; Berchi, Célia; Dejardin, Olivier; Launoy, Guy

2010-01-01

The implementation of mass colorectal cancer (CRC) screening is a public health priority. Population participation is fundamental for the success of CRC screening as for any cancer screening program. The preferences of the population may influence their likelihood of participation. The authors sought to elicit population preferences for CRC screening test characteristics to improve the design of CRC screening campaigns. A discrete choice experiment was used. Questionnaires were compiled with a set of pairs of hypothetical CRC screening scenarios. The survey was conducted by mail from June 2006 to October 2006 on a representative sample of 2000 inhabitants, aged 50 to 74 years from the northwest of France, who were randomly selected from electoral lists. Questionnaires were sent to 2000 individuals, each of whom made 3 or 4 discrete choices between hypothetical tests that differed in 7 attributes: how screening is offered, process, sensitivity, rate of unnecessary colonoscopy, expected mortality reduction, method of screening test result transmission, and cost. Complete responses were received from 656 individuals (32.8%). The attributes that influenced population preferences included expected mortality reduction, sensitivity, cost, and process. Participants from high social classes were particularly influenced by sensitivity. The results demonstrate that the discrete choice experiment provides information on patient preferences for CRC screening: improving screening program effectiveness, for instance, by improving test sensitivity (the most valued attribute) would increase satisfaction among the general population with regard to CRC screening programs. Additional studies are required to study how patient preferences actually affect adherence to regular screening programs.

Decision aids for people facing health treatment or screening decisions.

Science.gov (United States)

Stacey, Dawn; Légaré, France; Col, Nananda F; Bennett, Carol L; Barry, Michael J; Eden, Karen B; Holmes-Rovner, Margaret; Llewellyn-Thomas, Hilary; Lyddiatt, Anne; Thomson, Richard; Trevena, Lyndal; Wu, Julie H C

2014-01-28

Decision aids are intended to help people participate in decisions that involve weighing the benefits and harms of treatment options often with scientific uncertainty. To assess the effects of decision aids for people facing treatment or screening decisions. For this update, we searched from 2009 to June 2012 in MEDLINE; CENTRAL; EMBASE; PsycINFO; and grey literature. Cumulatively, we have searched each database since its start date including CINAHL (to September 2008). We included published randomized controlled trials of decision aids, which are interventions designed to support patients' decision making by making explicit the decision, providing information about treatment or screening options and their associated outcomes, compared to usual care and/or alternative interventions. We excluded studies of participants making hypothetical decisions. Two review authors independently screened citations for inclusion, extracted data, and assessed risk of bias. The primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were:A) 'choice made' attributes;B) 'decision-making process' attributes.Secondary outcomes were behavioral, health, and health-system effects. We pooled results using mean differences (MD) and relative risks (RR), applying a random-effects model. This update includes 33 new studies for a total of 115 studies involving 34,444 participants. For risk of bias, selective outcome reporting and blinding of participants and personnel were mostly rated as unclear due to inadequate reporting. Based on 7 items, 8 of 115 studies had high risk of bias for 1 or 2 items each.Of 115 included studies, 88 (76.5%) used at least one of the IPDAS effectiveness criteria: A) 'choice made' attributes criteria: knowledge scores (76 studies); accurate risk perceptions (25 studies); and informed value-based choice (20 studies); and B) 'decision-making process' attributes criteria: feeling informed (34 studies) and feeling clear about values (29

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

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.

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).

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

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.

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

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.

Intrinsic motivation factors based on the self-determinant theory for regular breast cancer screening.

Science.gov (United States)

Jung, Su Mi; Jo, Heui-Sug

2014-01-01

The purpose of this study was to identify factors of intrinsic motivation that affect regular breast cancer screening and contribute to development of a program for strategies to improve effective breast cancer screening. Subjects were residing in South Korea Gangwon-Province and were female over 40 and under 69 years of age. For the investigation, the Intrinsic Motivation Inventory (IMI) was modified to the situation of cancer screening and was used to survey 905 inhabitants. Multinominal logistic regression analyses were conducted for regular breast cancer screening (RS), one-time breast cancer screening (OS) and non-breast cancer screening (NS). For statistical analysis, IBM SPSS 20.0 was utilized. The determinant factors between RS and NS were "perceived effort and choice" and "stress and strain" - internal motivations related to regular breast cancer screening. Also, determinant factors between RS and OS are "age" and "perceived effort and choice" for internal motivation related to cancer screening. To increase regular screening, strategies that address individual perceived effort and choice are recommended.

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.

Screens and teens connecting with our kids in a wireless world

CERN Document Server

Koch, Kathy

2015-01-01

Teens often look to their digital tools to make them happy, when you set boundaries or take them away they feel frustrated and incomplete. Unhealthy habits formed in this stage of life easily carry over into adulthood and addictions to technology make other addictions more likely. Screens and Teens applauds the good aspects of the digital age, but also alerts parents to how technology contributes to self-centered character, negative behaviors, and beliefs that inhibit spiritual growth, prescribing manageable solutions regardless of the level of their teen's involvement. Unmasking the lies teenagers tend to believe, like "I must have choices," the book majors on truth, acknowledging that Truth alone brings contentment, freedom, and success.

Database for High Throughput Screening Hits (dHITS): a simple tool to retrieve gene specific phenotypes from systematic screens done in yeast.

Science.gov (United States)

Chuartzman, Silvia G; Schuldiner, Maya

2018-03-25

In the last decade several collections of Saccharomyces cerevisiae yeast strains have been created. In these collections every gene is modified in a similar manner such as by a deletion or the addition of a protein tag. Such libraries have enabled a diversity of systematic screens, giving rise to large amounts of information regarding gene functions. However, often papers describing such screens focus on a single gene or a small set of genes and all other loci affecting the phenotype of choice ('hits') are only mentioned in tables that are provided as supplementary material and are often hard to retrieve or search. To help unify and make such data accessible, we have created a Database of High Throughput Screening Hits (dHITS). The dHITS database enables information to be obtained about screens in which genes of interest were found as well as the other genes that came up in that screen - all in a readily accessible and downloadable format. The ability to query large lists of genes at the same time provides a platform to easily analyse hits obtained from transcriptional analyses or other screens. We hope that this platform will serve as a tool to facilitate investigation of protein functions to the yeast community. © 2018 The Authors Yeast Published by John Wiley & Sons Ltd.

Consumer preferences for teledermoscopy screening to detect melanoma early.

Science.gov (United States)

Spinks, Jean; Janda, Monika; Soyer, H Peter; Whitty, Jennifer A

2016-01-01

'Store and forward' teledermoscopy is a technology with potential advantages for melanoma screening. Any large-scale implementation of this technology is dependent on consumer acceptance. To investigate preferences for melanoma screening options compared with skin self-examination in adults considered to be at increased risk of developing skin cancer. A discrete choice experiment was completed by 35 consumers, all of whom had prior experience with the use of teledermoscopy, in Queensland, Australia. Participants made 12 choices between screening alternatives described by seven attributes including monetary cost. A mixed logit model was used to estimate the relative weights that consumers place on different aspects of screening, along with the marginal willingness to pay for teledermoscopy as opposed to screening at a clinic. Overall, participants preferred screening/diagnosis by a health professional rather than skin self-examination. Key drivers of screening choice were for results to be reviewed by a dermatologist; a higher detection rate; fewer non-cancerous moles being removed in relation to every skin cancer detected; and less time spent away from usual activities. On average, participants were willing to pay AUD110 to have teledermoscopy with dermatologist review available to them as a screening option. Consumers preferentially value aspects of care that are more feasible with a teledermoscopy screening model, as compared with other skin cancer screening and diagnosis options. This study adds to previous literature in the area which has relied on the use of consumer satisfaction scales to assess the acceptability of teledermoscopy. © The Author(s) 2015.

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.…

"Choice Set" for health behavior in choice-constrained settings to frame research and inform policy: examples of food consumption, obesity and food security.

Science.gov (United States)

Dover, Robert V H; Lambert, Estelle V

2016-03-16

Using the nexus between food consumption, food security and obesity, this paper addresses the complexity of health behavior decision-making moments that reflect relational social dynamics in context-specific dialogues, often in choice-constrained conditions. A pragmatic review of literature regarding social determinants of health in relation to food consumption, food security and obesity was used to advance this theoretical model. We suggest that health choice, such as food consumption, is based on more than the capacity and volition of individuals to make "healthy" choices, but is dialogic and adaptive. In terms of food consumption, there will always be choice-constrained conditions, along a continuum representing factors over which the individual has little or no control, to those for which they have greater agency. These range from food store geographies and inventories and food availability, logistical considerations such as transportation, food distribution, the structure of equity in food systems, state and non-government food and nutrition programs, to factors where the individual exercises a greater degree of autonomy, such as sociocultural foodways, family and neighborhood shopping strategies, and personal and family food preferences. At any given food decision-making moment, many factors of the continuum are present consciously or unconsciously when the individual makes a decision. These health behavior decision-making moments are mutable, whether from an individual perspective, or within a broader social or policy context. We review the construct of "choice set", the confluence of factors that are temporally weighted by the differentiated and relationally-contextualized importance of certain factors over others in that moment. The choice transition represents an essential shift of the choice set based on the conscious and unconscious weighting of accumulated evidence, such that people can project certain outcomes. Policies and interventions should avoid

Let the right one in: a microeconomic approach to partner choice in mutualisms.

Science.gov (United States)

Archetti, Marco; Ubeda, Francisco; Fudenberg, Drew; Green, Jerry; Pierce, Naomi E; Yu, Douglas W

2011-01-01

One of the main problems impeding the evolution of cooperation is partner choice. When information is asymmetric (the quality of a potential partner is known only to himself), it may seem that partner choice is not possible without signaling. Many mutualisms, however, exist without signaling, and the mechanisms by which hosts might select the right partners are unclear. Here we propose a general mechanism of partner choice, "screening," that is similar to the economic theory of mechanism design. Imposing the appropriate costs and rewards may induce the informed individuals to screen themselves according to their types and therefore allow a noninformed individual to establish associations with the correct partners in the absence of signaling. Several types of biological symbioses are good candidates for screening, including bobtail squid, ant-plants, gut microbiomes, and many animal and plant species that produce reactive oxygen species. We describe a series of diagnostic tests for screening. Screening games can apply to the cases where by-products, partner fidelity feedback, or host sanctions do not apply, therefore explaining the evolution of mutualism in systems where it is impossible for potential symbionts to signal their cooperativeness beforehand and where the host does not punish symbiont misbehavior.

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

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.

Age-based differences in strategy use in choice tasks

Directory of Open Access Journals (Sweden)

Darrell A. Worthy

2012-01-01

Full Text Available We incorporated behavioral and computational modeling techniques to examine age-based differences in strategy use in two four-choice decision-making tasks. Healthy older (aged 60-82 years and younger adults (aged 18-23 years performed one of two decision-making tasks that differed in the degree to which rewards for each option depended on the choices made on previous trials. In the choice-independent task rewards for each choice were not affected by the sequence of previous choices that had been made. In contrast, in the choice-dependent task rewards for each option were based on how often each option had been chosen in the past. We compared the fits of a model that assumes the use of a win-stay-lose-shift (WSLS heuristic to make decisions, to the fits of a reinforcement-learning (RL model that compared expected reward values for each option to make decisions. Younger adults were best fit by the RL model, while older adults showed significantly more evidence of being best fit by the WSLS heuristic model. This led older adults to perform worse than younger adults in the choice-independent task, but better in the choice-dependent task. These results coincide with previous work in our labs that also found better performance for older adults in choice-dependent tasks (Worthy et al., 2011, and the present results suggest that qualitative age-based differences in the strategies used in choice tasks may underlie older adults’ advantage in choice-dependent tasks. We discuss possible factors behind these differences such as neurobiological changes associated with aging, and increased use of heuristics by older adults.

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...

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...

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.

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...

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.

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...

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

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 ...

Qualitative modeling of the decision-making process using electrooculography.

Science.gov (United States)

Zargari Marandi, Ramtin; Sabzpoushan, S H

2015-12-01

A novel method based on electrooculography (EOG) has been introduced in this work to study the decision-making process. An experiment was designed and implemented wherein subjects were asked to choose between two items from the same category that were presented within a limited time. The EOG and voice signals of the subjects were recorded during the experiment. A calibration task was performed to map the EOG signals to their corresponding gaze positions on the screen by using an artificial neural network. To analyze the data, 16 parameters were extracted from the response time and EOG signals of the subjects. Evaluation and comparison of the parameters, together with subjects' choices, revealed functional information. On the basis of this information, subjects switched their eye gazes between items about three times on average. We also found, according to statistical hypothesis testing-that is, a t test, t(10) = 71.62, SE = 1.25, p < .0001-that the correspondence rate of a subjects' gaze at the moment of selection with the selected item was significant. Ultimately, on the basis of these results, we propose a qualitative choice model for the decision-making task.

Combining food type(s) and food quantity choice in a new food choice paradigm based on vice-virtue bundles.

Science.gov (United States)

Haws, Kelly L; Liu, Peggy J

2016-08-01

Given the prevalence and rising rates of obesity in many countries, including the United States, much food decision-making research ultimately aims at understanding how consumers can make healthier choices. The two predominant choice paradigms used in food decision-making research ask consumers to choose (a) between a "vice" (or unhealthy food) and a "virtue" (or healthy food) or (b) among varying portion sizes of "vice." We propose a new food choice paradigm that encourages consumers to jointly consider both food type(s) choice and food portion size at each decision point. The purpose of this paradigm is two-fold. First, it aims to allow examination of more comprehensive eating behavior (e.g., to examine the overall composition of a plate of food rather than choice of a single food). Second, it aims to shift consumers towards including large proportions of virtues and smaller proportions of vice in their overall consumption portfolios. For this paradigm, we draw upon a recently introduced food product innovation called "vice-virtue bundles" (Liu et al., 2015) that illustrates the basis of this new food choice paradigm, in which food type(s) and portion decisions are made simultaneously. Accordingly, we first discuss relevant findings on vice-virtue bundles as well as the differences between simultaneous and sequential choice of multiple products. Second, we examine the benefits for managing and controlling one's consumption that are provided by vice-virtue bundles and this joint food choice paradigm more generally. Third and finally, we point out opportunities for future research by discussing (a) multiple factors that influence food choices, (b) decision processes affected by food choice paradigms, and (c) issues of generalizability related to the presence of vice-virtue bundles. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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.

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.

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

Subconscious visual cues during movement execution allow correct online choice reactions.

Directory of Open Access Journals (Sweden)

Christian Leukel

Full Text Available Part of the sensory information is processed by our central nervous system without conscious perception. Subconscious processing has been shown to be capable of triggering motor reactions. In the present study, we asked the question whether visual information, which is not consciously perceived, could influence decision-making in a choice reaction task. Ten healthy subjects (28 ± 5 years executed two different experimental protocols. In the Motor reaction protocol, a visual target cue was shown on a computer screen. Depending on the displayed cue, subjects had to either complete a reaching movement (go-condition or had to abort the movement (stop-condition. The cue was presented with different display durations (20-160 ms. In the second Verbalization protocol, subjects verbalized what they experienced on the screen. Again, the cue was presented with different display durations. This second protocol tested for conscious perception of the visual cue. The results of this study show that subjects achieved significantly more correct responses in the Motor reaction protocol than in the Verbalization protocol. This difference was only observed at the very short display durations of the visual cue. Since correct responses in the Verbalization protocol required conscious perception of the visual information, our findings imply that the subjects performed correct motor responses to visual cues, which they were not conscious about. It is therefore concluded that humans may reach decisions based on subconscious visual information in a choice reaction task.

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...

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...

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 ...

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....

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...

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...

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 �

[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.

Individual decision making, group decision making and deliberation

Directory of Open Access Journals (Sweden)

Radovanović Bojana

2012-01-01

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

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.

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....

"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.

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...

Understanding the formation and influence of attitudes in patients' treatment choices for lower back pain: Testing the benefits of a hybrid choice model approach

DEFF Research Database (Denmark)

Kløjgaard, Mirja Elisabeth; Hess, S.

2014-01-01

A growing number of studies across different fields are making use of a new class of choice models, labelled variably as hybrid model structures or integrated choice and latent variable models, and incorporating the role of attitudes in decision making. To date, this technique has not been used...... in spring/summer 2012. We show how the hybrid model structure is able to make a link between attitudinal questions and treatment choices, and also explains variation of these attitudes across key socio-demographic groups. However, we also show how, in this case, only a small share of the overall...

Functional MRI of Challenging Food Choices: Forced Choice between Equally Liked High- and Low-Calorie Foods in the Absence of Hunger

NARCIS (Netherlands)

Charbonnier, L.; Laan, van der L.N.; Viergever, M.A.; Smeets, P.A.M.

2015-01-01

We are continuously exposed to food and during the day we make many food choices. These choices play an important role in the regulation of food intake and thereby in weight management. Therefore, it is important to obtain more insight into the mechanisms that underlie these choices. While several

Functional MRI of Challenging Food Choices : Forced Choice between Equally Liked High- and Low-Calorie Foods in the Absence of Hunger

NARCIS (Netherlands)

Charbonnier, Lisette; Van Der Laan, Laura N.; Viergever, Max A.; Smeets, Paul A M; Tregellas, Jason R.

2015-01-01

We are continuously exposed to food and during the day we make many food choices. These choices play an important role in the regulation of food intake and thereby in weight management. Therefore, it is important to obtain more insight into the mechanisms that underlie these choices. While several

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.…

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.

Self-Other Decision Making and Loss Aversion

Science.gov (United States)

Polman, Evan

2012-01-01

In eight studies, we tested the prediction that making choices for others involves less loss aversion than making choices for the self. We found that loss aversion is significantly lessened among people choosing for others in scenarios describing riskless choice (Study 1), gambling (Studies 2 and 3), and social aspects of life, such as likeably…

Voting Intention and Choices: Are Voters Always Rational and Deliberative?

Science.gov (United States)

Lee, I-Ching; Chen, Eva E; Tsai, Chia-Hung; Yen, Nai-Shing; Chen, Arbee L P; Lin, Wei-Chieh

2016-01-01

Human rationality--the ability to behave in order to maximize the achievement of their presumed goals (i.e., their optimal choices)--is the foundation for democracy. Research evidence has suggested that voters may not make decisions after exhaustively processing relevant information; instead, our decision-making capacity may be restricted by our own biases and the environment. In this paper, we investigate the extent to which humans in a democratic society can be rational when making decisions in a serious, complex situation-voting in a local political election. We believe examining human rationality in a political election is important, because a well-functioning democracy rests largely upon the rational choices of individual voters. Previous research has shown that explicit political attitudes predict voting intention and choices (i.e., actual votes) in democratic societies, indicating that people are able to reason comprehensively when making voting decisions. Other work, though, has demonstrated that the attitudes of which we may not be aware, such as our implicit (e.g., subconscious) preferences, can predict voting choices, which may question the well-functioning democracy. In this study, we systematically examined predictors on voting intention and choices in the 2014 mayoral election in Taipei, Taiwan. Results indicate that explicit political party preferences had the largest impact on voting intention and choices. Moreover, implicit political party preferences interacted with explicit political party preferences in accounting for voting intention, and in turn predicted voting choices. Ethnic identity and perceived voting intention of significant others were found to predict voting choices, but not voting intention. In sum, to the comfort of democracy, voters appeared to engage mainly explicit, controlled processes in making their decisions; but findings on ethnic identity and perceived voting intention of significant others may suggest otherwise.

Voting Intention and Choices: Are Voters Always Rational and Deliberative?

Directory of Open Access Journals (Sweden)

I-Ching Lee

Full Text Available Human rationality--the ability to behave in order to maximize the achievement of their presumed goals (i.e., their optimal choices--is the foundation for democracy. Research evidence has suggested that voters may not make decisions after exhaustively processing relevant information; instead, our decision-making capacity may be restricted by our own biases and the environment. In this paper, we investigate the extent to which humans in a democratic society can be rational when making decisions in a serious, complex situation-voting in a local political election. We believe examining human rationality in a political election is important, because a well-functioning democracy rests largely upon the rational choices of individual voters. Previous research has shown that explicit political attitudes predict voting intention and choices (i.e., actual votes in democratic societies, indicating that people are able to reason comprehensively when making voting decisions. Other work, though, has demonstrated that the attitudes of which we may not be aware, such as our implicit (e.g., subconscious preferences, can predict voting choices, which may question the well-functioning democracy. In this study, we systematically examined predictors on voting intention and choices in the 2014 mayoral election in Taipei, Taiwan. Results indicate that explicit political party preferences had the largest impact on voting intention and choices. Moreover, implicit political party preferences interacted with explicit political party preferences in accounting for voting intention, and in turn predicted voting choices. Ethnic identity and perceived voting intention of significant others were found to predict voting choices, but not voting intention. In sum, to the comfort of democracy, voters appeared to engage mainly explicit, controlled processes in making their decisions; but findings on ethnic identity and perceived voting intention of significant others may suggest

Interdependent binary choices under social influence: Phase diagram for homogeneous unbiased populations

Science.gov (United States)

Fernández del Río, Ana; Korutcheva, Elka; de la Rubia, Javier

2012-07-01

Coupled Ising models are studied in a discrete choice theory framework, where they can be understood to represent interdependent choice making processes for homogeneous populations under social influence. Two different coupling schemes are considered. The nonlocal or group interdependence model is used to study two interrelated groups making the same binary choice. The local or individual interdependence model represents a single group where agents make two binary choices which depend on each other. For both models, phase diagrams, and their implications in socioeconomic contexts, are described and compared in the absence of private deterministic utilities (zero opinion fields).

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...

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...

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

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.

People learn other people's preferences through inverse decision-making.

Science.gov (United States)

Jern, Alan; Lucas, Christopher G; Kemp, Charles

2017-11-01

People are capable of learning other people's preferences by observing the choices they make. We propose that this learning relies on inverse decision-making-inverting a decision-making model to infer the preferences that led to an observed choice. In Experiment 1, participants observed 47 choices made by others and ranked them by how strongly each choice suggested that the decision maker had a preference for a specific item. An inverse decision-making model generated predictions that were in accordance with participants' inferences. Experiment 2 replicated and extended a previous study by Newtson (1974) in which participants observed pairs of choices and made judgments about which choice provided stronger evidence for a preference. Inverse decision-making again predicted the results, including a result that previous accounts could not explain. Experiment 3 used the same method as Experiment 2 and found that participants did not expect decision makers to be perfect utility-maximizers. Copyright © 2017 Elsevier B.V. All rights reserved.

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 ...

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.

Decision aid on breast cancer screening reduces attendance rate: results of a large-scale, randomized, controlled study by the DECIDEO group

Science.gov (United States)

Bourmaud, Aurelie; Soler-Michel, Patricia; Oriol, Mathieu; Regnier, Véronique; Tinquaut, Fabien; Nourissat, Alice; Bremond, Alain; Moumjid, Nora; Chauvin, Franck

2016-01-01

Controversies regarding the benefits of breast cancer screening programs have led to the promotion of new strategies taking into account individual preferences, such as decision aid. The aim of this study was to assess the impact of a decision aid leaflet on the participation of women invited to participate in a national breast cancer screening program. This Randomized, multicentre, controlled trial. Women aged 50 to 74 years, were randomly assigned to receive either a decision aid or the usual invitation letter. Primary outcome was the participation rate 12 months after the invitation. 16 000 women were randomized and 15 844 included in the modified intention-to-treat analysis. The participation rate in the intervention group was 40.25% (3174/7885 women) compared with 42.13% (3353/7959) in the control group (p = 0.02). Previous attendance for screening (RR = 6.24; [95%IC: 5.75-6.77]; p < 0.0001) and medium household income (RR = 1.05; [95%IC: 1.01-1.09]; p = 0.0074) were independently associated with attendance for screening. This large-scale study demonstrates that the decision aid reduced the participation rate. The decision aid activate the decision making process of women toward non-attendance to screening. These results show the importance of promoting informed patient choices, especially when those choices cannot be anticipated. PMID:26883201

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.

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.

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...

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.

Resolving the paradox of suboptimal choice.

Science.gov (United States)

Zentall, Thomas R

2016-01-01

When humans engage in commercial (totally probabilistic) gambling they are making suboptimal choices because the return is generally less than the investment. This review (a) examines the literature on pigeon suboptimal choice, (b) describes the conditions under which it occurs, (c) identifies the mechanisms that appear to be responsible for the effect, and (d) suggests that similar processes may be able to account for analogous suboptimal choice when humans engage in commercial gambling. Pigeons show suboptimal choice when they choose between 1 alternative that 20% of the time provides them with a signal that they will always get fed or 80% of the time with a signal that they will not get fed (overall 20% reinforcement) and a second alternative that 100% of the time provides them with a signal that they will get fed 50% of the time (overall 50% reinforcement). The pigeons' strong preference for the suboptimal choice was investigated in a series of experiments that found the preference for the suboptimal alternative was determined by the value of the signal that predicted reinforcement, rather its frequency and that the frequency of the signal that predicted nonreinforcement had little effect on the suboptimal choice. Paradoxically, this account makes the prediction that pigeons will be indifferent between an alternative that 50% of the time provides a fully predictive stimulus for reinforcement and an alternative that 100% of the time provides a fully predictive stimulus for reinforcement. The similarities and differences of this suboptimal choice task to human gambling are discussed. (c) 2016 APA, all rights reserved).

Women's liberation and the rhetoric of "choice" in infant feeding debates

Directory of Open Access Journals (Sweden)

Hausman Bernice L

2008-08-01

Full Text Available Abstract This short essay examines infant formula marketing and information sources for their representation of "choice" in the infant feeding context, and finds that while providing information about breast and bottle feeding, infant formula manufacturers focus on mothers' feelings and intuition rather than knowledge in making decisions. In addition, the essay considers how "choice" operates in the history of reproductive rights, shifting the discourse from a rights-based set of arguments to one based on a consumerist mentality. Utilizing the work of historian Rickie Solinger and a 2007 paper for the National Bureau of Labor Statistics, I argue that the structure of market work, and not abstract maternal decision making, determine mothers' choices and practices concerning infant feeding. For true freedoms for mothers to be achieved, freedoms that would include greater social provisions for mothers, our culture will have to confront how structural constraints make breastfeeding difficult, as well as how the concept of choice divides mothers into those who make good choices and those who do not.

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.

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

Screening, sensitivity, and uncertainty for the CREAM method of Human Reliability Analysis

International Nuclear Information System (INIS)

Bedford, Tim; Bayley, Clare; Revie, Matthew

2013-01-01

This paper reports a sensitivity analysis of the Cognitive Reliability and Error Analysis Method for Human Reliability Analysis. We consider three different aspects: the difference between the outputs of the Basic and Extended methods, on the same HRA scenario; the variability in outputs through the choices made for common performance conditions (CPCs); and the variability in outputs through the assignment of choices for cognitive function failures (CFFs). We discuss the problem of interpreting categories when applying the method, compare its quantitative structure to that of first generation methods and discuss also how dependence is modelled with the approach. We show that the control mode intervals used in the Basic method are too narrow to be consistent with the Extended method. This motivates a new screening method that gives improved accuracy with respect to the Basic method, in the sense that (on average) halves the uncertainty associated with the Basic method. We make some observations on the design of a screening method that are generally applicable in Risk Analysis. Finally, we propose a new method of combining CPC weights with nominal probabilities so that the calculated probabilities are always in range (i.e. between 0 and 1), while satisfying sensible properties that are consistent with the overall CREAM method

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.

Consumer decision making regarding a "green" everyday product

DEFF Research Database (Denmark)

Thøgersen, John; Jørgensen, Anne-Katrine; Sandager, Sara

2012-01-01

to elevate consumer involvement in the choice of the product. However, there is a lack of research investigating whether adding such a “green” product attribute actually makes any difference to how consumers make choices. Does the way in which consumers make decisions about groceries change when both “green......, it is concluded that, rather than changing the way consumers make decisions when buying this type of product, the availability of a “green” alternative seems to make “green” consumers develop a new, simple choice heuristic that allows them to do their shopping as effortless and time-efficient as consumers buying......” and conventional alternatives are available? Does it make them deliberate more or do they just develop another, simple choice heuristic? Based on observation and follow-up interviews of consumers at the milk counter in two supermarkets which stock both organic (a “green” attribute) and conventional milk...

Effect of herd cues and product involvement on bidder online choices.

Science.gov (United States)

Chen, Yi-Fen; Wang, Ya-Ju

2010-08-01

Previous works have shown that consumers are influenced by others in decision making. Herd behavior is common in situations in which consumers infer product quality from other consumer choices and incorporate that information into their own decision making. This research presents two studies examining herd effect and the moderating role of product involvement on bidder choices in online auctions. The two studies addressed the influence on bidder online choices of herd cues frequently found in online auctions, including feedback ratings and number of questions and answers. The experimental results demonstrated that bidders use online herd cues when making decisions in online auctions. Additionally, the effects of herd cues on bidder online choices were stronger in high-involvement than low-involvement participants. Results and implications are discussed.

Genomic futures of prenatal screening: ethical reflection.

Science.gov (United States)

Dondorp, W J; Page-Christiaens, G C M L; de Wert, G M W R

2016-05-01

The practice of prenatal screening is undergoing important changes as a result of the introduction of genomic testing technologies at different stages of the screening trajectory. It is expected that eventually it will become possible to routinely obtain a comprehensive 'genome scan' of all fetuses. Although this will still take several years, there are clear continuities between present developments and this future scenario. As this review shows, behind the still limited scope of screening for common aneuploidies, a rapid widening of the range of conditions tested for is already taking shape at the invasive testing stage. But the continuities are not just technical; they are also ethical. If screening for Down's syndrome is a matter of providing autonomous reproductive choice, then why would providing the choice to have a full fetal genome scan be something entirely different? There is a clear need for a sustainable normative framework that will have to answer three challenges: the indeterminateness of the autonomy paradigm, the need to acknowledge the future child as an interested stakeholder, and the prospect of broad-scope genomic prenatal screening with a double purpose: autonomy and prevention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

The Return of Lombroso? Ethical Aspects of (Visions of) Preventive Forensic Screening.

Science.gov (United States)

Munthe, Christian; Radovic, Susanna

2015-11-01

The vision of legendary criminologist Cesare Lombroso to use scientific theories of individual causes of crime as a basis for screening and prevention programmes targeting individuals at risk for future criminal behaviour has resurfaced, following advances in genetics, neuroscience and psychiatric epidemiology. This article analyses this idea and maps its ethical implications from a public health ethical standpoint. Twenty-seven variants of the new Lombrosian vision of forensic screening and prevention are distinguished, and some scientific and technical limitations are noted. Some lures, biases and structural factors, making the application of the Lombrosian idea likely in spite of weak evidence are pointed out and noted as a specific type of ethical aspect. Many classic and complex ethical challenges for health screening programmes are shown to apply to the identified variants and the choice between them, albeit with peculiar and often provoking variations. These variations are shown to actualize an underlying theoretical conundrum in need of further study, pertaining to the relationship between public health ethics and the ethics and values of criminal law policy.

Inertia in travel choice : The role of risk aversion and learning

NARCIS (Netherlands)

Chorus, C.; Dellaert, B.

2009-01-01

This paper contributes to literature by showing how travellers that make normatively rational choices exhibit inertia during a series of risky choices. Our analyses complement other studies that conceive inertia as the result of boundedly rational or even non-deliberate, habitual decision-making. We

Frameworks of Choice : Predictive and Genetic Testing in Asia

NARCIS (Netherlands)

2010-01-01

Frameworks of Choice verkent de culturele en politieke aspecten van voorspellende en genetische tests. Het boek analyseert de sociale, culturele, en economische gevolgen voor het individu na een voorspellende of genetische screening. Margaret Sleeboom-Faulkner geeft een genuanceerd beeld van de

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....

The Ulysses contract in obstetrics: a woman's choices before and during labour.

Science.gov (United States)

Burcher, Paul

2013-01-01

Women recognise that labour represents a mind-altering event that may affect their ability to make and communicate decisions and choices. For this reason, birth plans and other pre-labour directives can represent a form of Ulysses contract: an attempt to make binding choices before the sometimes overwhelming circumstances of labour. These choices need to be respected during labour, but despite the reduced decisional and communicative capacity of a labouring woman, her choices, when clear, should supersede decisions made before labour.

Christiano’s Deliberative Expertism and Choice Architecture

Directory of Open Access Journals (Sweden)

Viktor Ivanković

2015-01-01

Full Text Available The article explores Thomas Christiano’s account of the moral division of labor in democracy. Christiano’s incorporation of experts serves the purpose of alleviating the epistemic burdens of ordinary citizens in the decision-making process and decreasing the amount of work they would otherwise be required to take on in a modern democracy. The gist of my contribution to the debate is assessing whether Christiano’s account successfully tackles the issues brought about by cognitive biases that people suffer from in communicating their values in decision-making. I argue that Christiano’s notion of experts needs to be extended to choice architects, who possess the knowledge on methods for influencing choice. I also claim that choice architecture is a social fact that an informed deliberative democratic theory needs to deal with.

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.

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…

Modeling decisions from experience: How models with a set of parameters for aggregate choices explain individual choices

Directory of Open Access Journals (Sweden)

Neha Sharma

2017-10-01

Full Text Available One of the paradigms (called “sampling paradigm” in judgment and decision-making involves decision-makers sample information before making a final consequential choice. In the sampling paradigm, certain computational models have been proposed where a set of single or distribution parameters is calibrated to the choice proportions of a group of participants (aggregate and hierarchical models. However, currently little is known on how aggregate and hierarchical models would account for choices made by individual participants in the sampling paradigm. In this paper, we test the ability of aggregate and hierarchical models to explain choices made by individual participants. Several models, Ensemble, Cumulative Prospect Theory (CPT, Best Estimation and Simulation Techniques (BEAST, Natural-Mean Heuristic (NMH, and Instance-Based Learning (IBL, had their parameters calibrated to individual choices in a large dataset involving the sampling paradigm. Later, these models were generalized to two large datasets in the sampling paradigm. Results revealed that the aggregate models (like CPT and IBL accounted for individual choices better than hierarchical models (like Ensemble and BEAST upon generalization to problems that were like those encountered during calibration. Furthermore, the CPT model, which relies on differential valuing of gains and losses, respectively, performed better than other models during calibration and generalization on datasets with similar set of problems. The IBL model, relying on recency and frequency of sampled information, and the NMH model, relying on frequency of sampled information, performed better than other models during generalization to a challenging dataset. Sequential analyses of results from different models showed how these models accounted for transitions from the last sample to final choice in human data. We highlight the implications of using aggregate and hierarchical models in explaining individual choices

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.

The Role of Effective Communication to Enhance Participation in Screening Mammography: A New Zealand Case

Directory of Open Access Journals (Sweden)

Margaret A. Brunton

2009-02-01

Full Text Available Changes in the organisation of health care have dominated policy initiatives over the past two decades in many countries. An increasing reliance on public health initiatives to prevent or detect disease early has resulted in an increase in programs that screen for cancer in the community. In turn, this accentuates the need to persuasively communicate the value of such initiatives to encourage continued participation. Merely placing screening programs into a community setting is not sufficient to ensure that adequate numbers will voluntarily participate regularly to achieve anticipated cost and mortality savings in the population. In this research the influence of managing communication in a public screening mammography program was investigated. The results revealed that significant opportunities were overlooked for reassurance and information during the physical mammography process. In turn, this highlights the influence of constraints imposed by the structure of the screening program and the resources allocated to the process. This research suggests that it is important to address multiple influences, including ethnic differences, when asking questions about the effectiveness of public health policy, particularly when considering the choices women make about ongoing participation in breast screening programs.

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.

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

The Policy Choices of Bureaucrats: an institutional analysis

NARCIS (Netherlands)

S. Naseer (Shaheen)

2018-01-01

textabstractThis dissertation analyzes the over-arching question of how the institutional and social context of public bureaucracy impact the choices of bureaucrats. These choices are introduced in the form of inertial-preferences and identity-driven preferences in the decision-making of

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.

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.

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].

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.

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.

Down the Neoliberal Path: The Rise of Free Choice Feminism

OpenAIRE

Ankica Čakardić

2017-01-01

The free choice ideology dictates that any time a woman makes a choice it is an act of feminism. The idea that personal choice presupposes the faraway horizons of freedom and its guarantee, as well as the undoubted potentials of women’s empowerment, makes up the central position of the critique in this essay. Our text is divided into two parts. In the first part of the paper we are going to outline the basic assumptions of neoliberalism, in order to use them as foundations for the argument ab...

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 ...

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...

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

Neural Basis of Strategic Decision Making.

Science.gov (United States)

Lee, Daeyeol; Seo, Hyojung

2016-01-01

Human choice behaviors during social interactions often deviate from the predictions of game theory. This might arise partly from the limitations in the cognitive abilities necessary for recursive reasoning about the behaviors of others. In addition, during iterative social interactions, choices might change dynamically as knowledge about the intentions of others and estimates for choice outcomes are incrementally updated via reinforcement learning. Some of the brain circuits utilized during social decision making might be general-purpose and contribute to isomorphic individual and social decision making. By contrast, regions in the medial prefrontal cortex (mPFC) and temporal parietal junction (TPJ) might be recruited for cognitive processes unique to social decision making. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

A lack of information engagement among colorectal cancer screening non-attenders: cross-sectional survey

Directory of Open Access Journals (Sweden)

Lindsay C. Kobayashi

2016-07-01

��ever’ screeners. Conclusions Although ‘The Facts’ booklet is intended to support informed choices about CRC screening, the majority of unscreened individuals report that they have read none of it. The degree to which public engagement with the decision-making process about cancer screening is socially unequal must be better understood so that comprehensive and equitable public communication strategies can be developed.

Colorectal Cancer Screening: A Guide to the Guidelines

Directory of Open Access Journals (Sweden)

Douglas K Rex

1999-01-01

Full Text Available The two most recent guidelines for colorectal cancer screening are those of the Agency for Healthcare Policy and Research, and the American Cancer Society. The guidelines are similar in many regards and reflect current literature, consensus opinion and compromise between members of multidisciplinary panels. The emphasis of both guidelines is to increase the options available for colorectal cancer screening. Increasing choice should expand the attractiveness of colorectal cancer screening to more patients and physicians, and the development of guidelines should help compel payers to provide reimbursement for colorectal cancer screening. These guidelines are summarized and evaluated as they pertain to colorectal cancer screening.

A Review of Factors Influencing Athletes' Food Choices.

Science.gov (United States)

Birkenhead, Karen L; Slater, Gary

2015-11-01

Athletes make food choices on a daily basis that can affect both health and performance. A well planned nutrition strategy that includes the careful timing and selection of appropriate foods and fluids helps to maximize training adaptations and, thus, should be an integral part of the athlete's training programme. Factors that motivate food selection include taste, convenience, nutrition knowledge and beliefs. Food choice is also influenced by physiological, social, psychological and economic factors and varies both within and between individuals and populations. This review highlights the multidimensional nature of food choice and the depth of previous research investigating eating behaviours. Despite numerous studies with general populations, little exploration has been carried out with athletes, yet the energy demands of sport typically require individuals to make more frequent and/or appropriate food choices. While factors that are important to general populations also apply to athletes, it seems likely, given the competitive demands of sport, that performance would be an important factor influencing food choice. It is unclear if athletes place the same degree of importance on these factors or how food choice is influenced by involvement in sport. There is a clear need for further research exploring the food choice motives of athletes, preferably in conjunction with research investigating dietary intake to establish if intent translates into practice.

Screening options for Down syndrome: how women choose in real clinical setting.

Science.gov (United States)

Lo, T K; Lai, F K; Leung, W C; Lau, W L; Ng, L S; Wong, W C; Tam, S S; Yee, Y C; Choi, H; Lam, H S W; Sham, A S Y; Tang, L C H; Chin, R K H

2009-09-01

To study pregnant women's preference among various screening options for Down syndrome (DS) in routine clinical setting, and its potential association with women's demographic characteristics. Women aged 35 years and older carrying singleton pregnancy were offered a variety of screening tests for DS before 14 weeks of gestation. Their preference was confirmed by the test they actually underwent. The association between women's choice of test and a number of demographic characteristics was studied using multinomial regression. Among 1967 eligible women, 619 opted for first-trimester screening test (FTS), 924 for partial integrated test (PIT), and 424 for full integrated test (FIT). Nulliparous women and working mothers were more likely to choose FTS and FIT. Women with history of subfertility were more likely to choose FIT. Women with family history of chromosomal abnormalities were more likely to choose FTS. The choice of screening test could be predicted for 49.9% of women using four demographic characteristics. Among older women of predominantly Chinese ethnicity, integrated test is a favorite alternative to FTS. Their choice of DS screening test can be predicted by their obstetric and socioeconomic characteristics. Many women show willingness to pay for a test with a lower false-positive rate.

Endogenous vehicle-type choices in a monocentric city

DEFF Research Database (Denmark)

Kim, Jinwon

2012-01-01

inconvenience in the choice of vehicle sizes, and the resulting commuting cost is a function of residential density. This vehicle-type choice problem is embedded in an otherwise standardmonocentric city model. A convenience-related advantage in less-dense areas makes our bid–rent curve flatter than...

Subconscious visual cues during movement execution allow correct online choice reactions

DEFF Research Database (Denmark)

Leukel, Christian; Lundbye-Jensen, Jesper; Christensen, Mark Schram

2012-01-01

Part of the sensory information is processed by our central nervous system without conscious perception. Subconscious processing has been shown to be capable of triggering motor reactions. In the present study, we asked the question whether visual information, which is not consciously perceived......, could influence decision-making in a choice reaction task. Ten healthy subjects (28±5 years) executed two different experimental protocols. In the Motor reaction protocol, a visual target cue was shown on a computer screen. Depending on the displayed cue, subjects had to either complete a reaching....... This second protocol tested for conscious perception of the visual cue. The results of this study show that subjects achieved significantly more correct responses in the Motor reaction protocol than in the Verbalization protocol. This difference was only observed at the very short display durations...

The role of public relations activities in hospital choice.

Science.gov (United States)

Tengilimoglu, Dilaver; Yesiltas, Mehmet; Kisa, Adnan; Dziegielewski, Sophia F

2007-01-01

Public relations activities for all organizations can have an important effect on consumer decision-making when buying goods or services. This study examines the effect that public relations activities can have regarding consumer decisions and choice. To explore exemplify this relationship a questionnaire was given to 971 patients within public, university and private hospitals in Ankara, Turkey. Study results show that public relations activities were a crucial factor in determining consumer hospital choice. The majority of respondents reported that the behaviors and attitude of personnel as public relations activities that support the hospital's reputation within the public were the primary variables in hospital choice. Health care managers can use these findings to further understand how patients make informed choices related to usage of a health care facility and to develop and/or improve public relations activities.

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

Adolescents' AIDS Risk Taking: A Rational Choice Perspective.

Science.gov (United States)

Gardner, William; Herman, Janna

1990-01-01

Discounts the belief in adolescents' irrational behavior, and proposes a rational choice decision-making theory of adolescent risk-taking behavior. Suggests that social ecology affects risk-taking choices. Proposals for AIDS education concern delayed initiation of sexual activity, promotion of condom use, and counseling of high-risk adolescents.…

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

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.

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.

Acute stress does not affect risky monetary decision-making

Directory of Open Access Journals (Sweden)

Peter Sokol-Hessner

2016-12-01

Full Text Available The ubiquitous and intense nature of stress responses necessitate that we understand how they affect decision-making. Despite a number of studies examining risky decision-making under stress, it is as yet unclear whether and in what way stress alters the underlying processes that shape our choices. This is in part because previous studies have not separated and quantified dissociable valuation and decision-making processes that can affect choices of risky options, including risk attitudes, loss aversion, and choice consistency, among others. Here, in a large, fully-crossed two-day within-subjects design, we examined how acute stress alters risky decision-making. On each day, 120 participants completed either the cold pressor test or a control manipulation with equal probability, followed by a risky decision-making task. Stress responses were assessed with salivary cortisol. We fit an econometric model to choices that dissociated risk attitudes, loss aversion, and choice consistency using hierarchical Bayesian techniques to both pool data and allow heterogeneity in decision-making. Acute stress was found to have no effect on risk attitudes, loss aversion, or choice consistency, though participants did become more loss averse and more consistent on the second day relative to the first. In the context of an inconsistent previous literature on risk and acute stress, our findings provide strong and specific evidence that acute stress does not affect risk attitudes, loss aversion, or consistency in risky monetary decision-making.

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

The evolutionary roots of human decision making.

Science.gov (United States)

Santos, Laurie R; Rosati, Alexandra G

2015-01-03

Humans exhibit a suite of biases when making economic decisions. We review recent research on the origins of human decision making by examining whether similar choice biases are seen in nonhuman primates, our closest phylogenetic relatives. We propose that comparative studies can provide insight into four major questions about the nature of human choice biases that cannot be addressed by studies of our species alone. First, research with other primates can address the evolution of human choice biases and identify shared versus human-unique tendencies in decision making. Second, primate studies can constrain hypotheses about the psychological mechanisms underlying such biases. Third, comparisons of closely related species can identify when distinct mechanisms underlie related biases by examining evolutionary dissociations in choice strategies. Finally, comparative work can provide insight into the biological rationality of economically irrational preferences.

Auction fever: exploring informational social influences on bidder choices.

Science.gov (United States)

Chen, Yi-Fen

2011-01-01

Previous investigations of herd behavior have identified the importance of informational social influences in consumer decision making. This research presents three studies examining herd behavior in online auctions. The three studies addressed the influence on bidder online choices of herd cues frequently found in online auctions, including bid number, feedback ratings, and number of questions and answers. This research also investigated the effect of different levels of herd cues on bidder online choices under high and low brand awareness in online auctions. The experimental results demonstrated that bidders use online herd cues when making decisions in online auctions. Additionally, different levels of herd cues influence bidder online choices in both high and low brand awareness product situations.

Illustrative comparison of one utility's coal and nuclear choices

International Nuclear Information System (INIS)

Keeney, R.L.; Sicherman, A.

1983-01-01

The technology choices facing an individual utility are complex decision problems. The paper illustrates a method designed to assist an individual utility company in making the choices in a logically consisnt manner. The resulting evaluation model, based on the principles of decision analysis, explicitly addresses the complexity to provide a basis for decision making and support for defending the decision before reviewers. The model, which incorporates economic, environmental, social, safety, and regulatory effects, is demonstrated using a coal/nuclear choice which may be faced by Utah Power and Light Company in the near future. This analysis is meant to be illustrative; more effort would be needed to gather information to support a policy decision

Caudate Microstimulation Increases Value of Specific Choices.

Science.gov (United States)

Santacruz, Samantha R; Rich, Erin L; Wallis, Joni D; Carmena, Jose M

2017-11-06

Value-based decision-making involves an assessment of the value of items available and the actions required to obtain them. The basal ganglia are highly implicated in action selection and goal-directed behavior [1-4], and the striatum in particular plays a critical role in arbitrating between competing choices [5-9]. Previous work has demonstrated that neural activity in the caudate nucleus is modulated by task-relevant action values [6, 8]. Nonetheless, how value is represented and maintained in the striatum remains unclear since decision-making in these tasks relied on spatially lateralized responses, confounding the ability to generalize to a more abstract choice task [6, 8, 9]. Here, we investigate striatal value representations by applying caudate electrical stimulation in macaque monkeys (n = 3) to bias decision-making in a task that divorces the value of a stimulus from motor action. Electrical microstimulation is known to induce neural plasticity [10, 11], and caudate microstimulation in primates has been shown to accelerate associative learning [12, 13]. Our results indicate that stimulation paired with a particular stimulus increases selection of that stimulus, and this effect was stimulus dependent and action independent. The modulation of choice behavior using microstimulation was best modeled as resulting from changes in stimulus value. Caudate neural recordings (n = 1) show that changes in value-coding neuron activity are stimulus value dependent. We argue that caudate microstimulation can differentially increase stimulus values independent of action, and unilateral manipulations of value are sufficient to mediate choice behavior. These results support potential future applications of microstimulation to correct maladaptive plasticity underlying dysfunctional decision-making related to neuropsychiatric conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Sleep Deprivation Alters Choice Strategy Without Altering Uncertainty or Loss Aversion Preferences

Directory of Open Access Journals (Sweden)

O'Dhaniel A Mullette-Gillman

2015-10-01

Full Text Available Sleep deprivation alters decision making; however, it is unclear what specific cognitive processes are modified to drive altered choices. In this manuscript, we examined how one night of total sleep deprivation (TSD alters economic decision making. We specifically examined changes in uncertainty preferences dissociably from changes in the strategy with which participants engage with presented choice information. With high test-retest reliability, we show that TSD does not alter uncertainty preferences or loss aversion. Rather, TSD alters the information the participants rely upon to make their choices. Utilizing a choice strategy metric which contrasts the influence of maximizing and satisficing information on choice behavior, we find that TSD alters the relative reliance on maximizing information and satisficing information, in the gains domain. This alteration is the result of participants both decreasing their reliance on cognitively-complex maximizing information and a concomitant increase in the use of readily-available satisficing information. TSD did not result in a decrease in overall information use in either domain. These results show that sleep deprivation alters decision making by altering the informational strategies that participants employ, without altering their preferences.

Sleep deprivation alters choice strategy without altering uncertainty or loss aversion preferences.

Science.gov (United States)

Mullette-Gillman, O'Dhaniel A; Kurnianingsih, Yoanna A; Liu, Jean C J

2015-01-01

Sleep deprivation alters decision making; however, it is unclear what specific cognitive processes are modified to drive altered choices. In this manuscript, we examined how one night of total sleep deprivation (TSD) alters economic decision making. We specifically examined changes in uncertainty preferences dissociably from changes in the strategy with which participants engage with presented choice information. With high test-retest reliability, we show that TSD does not alter uncertainty preferences or loss aversion. Rather, TSD alters the information the participants rely upon to make their choices. Utilizing a choice strategy metric which contrasts the influence of maximizing and satisficing information on choice behavior, we find that TSD alters the relative reliance on maximizing information and satisficing information, in the gains domain. This alteration is the result of participants both decreasing their reliance on cognitively-complex maximizing information and a concomitant increase in the use of readily-available satisficing information. TSD did not result in a decrease in overall information use in either domain. These results show that sleep deprivation alters decision making by altering the informational strategies that participants employ, without altering their preferences.

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.

Development of a safety decision-making scenario to measure worker safety in agriculture.

Science.gov (United States)

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2014-04-01

Human factors play an important role in the management of occupational safety, especially in high-hazard workplaces such as commercial grain-handling facilities. Employee decision-making patterns represent an essential component of the safety system within a work environment. This research describes the process used to create a safety decision-making scenario to measure the process that grain-handling employees used to make choices in a safety-related work task. A sample of 160 employees completed safety decision-making simulations based on a hypothetical but realistic scenario in a grain-handling environment. Their choices and the information they used to make their choices were recorded. Although the employees emphasized safety information in their decision-making process, not all of their choices were safe choices. Factors influencing their choices are discussed, and implications for industry, management, and workers are shared.

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...

Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Cooper Crystale P

2009-03-01

Full Text Available Abstract Background Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing. Methods Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making. Results Sixty-six physicians (75.9% completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6% reported not using prescreening discussions, 45 (71.4% reported the use of prescreening discussions, and 3 (4.8% reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1 = 1.62, p = .20. Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1 = 13.27, p Conclusion Although guidelines recommend discussing the risks and benefits of prostate cancer screening, physicians report varying practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.

Foreign IPO capital market choice: Understanding the institutional fit of corporate governance

OpenAIRE

Moore, C. B.; Bell, R. G.; Filatotchev, I.; Rasheed, A. A.

2012-01-01

While product market choices were central to strategy formulation for firms in the past, the integration of financial markets makes the choice of capital markets an equally important strategic decision. We advance a comparative institutional perspective to explain capital market choice by firms making an IPO in a foreign market. Based on a sample of 103 and 99 foreign IPOs in the US and UK respectively during the period 2002-2006, we find that internal governance characteristics (founder CEO,...

Automated tool for virtual screening and pharmacology-based pathway prediction and analysis

Directory of Open Access Journals (Sweden)

Sugandh Kumar

2017-10-01

Full Text Available The virtual screening is an effective tool for the lead identification in drug discovery. However, there are limited numbers of crystal structures available as compared to the number of biological sequences which makes (Structure Based Drug Discovery SBDD a difficult choice. The current tool is an attempt to automate the protein structure modelling and automatic virtual screening followed by pharmacology-based prediction and analysis. Starting from sequence(s, this tool automates protein structure modelling, binding site identification, automated docking, ligand preparation, post docking analysis and identification of hits in the biological pathways that can be modulated by a group of ligands. This automation helps in the characterization of ligands selectivity and action of ligands on a complex biological molecular network as well as on individual receptor. The judicial combination of the ligands binding different receptors can be used to inhibit selective biological pathways in a disease. This tool also allows the user to systemically investigate network-dependent effects of a drug or drug candidate.

Primary care physicians' reported use of pre-screening discussions for prostate cancer screening: a cross-sectional survey.

Science.gov (United States)

Linder, Suzanne K; Hawley, Sarah T; Cooper, Crystale P; Scholl, Lawrence E; Jibaja-Weiss, Maria; Volk, Robert J

2009-03-18

Professional medical organizations recommend individualized patient decision making about prostate cancer screening. Little is known about primary care physicians' use of pre-screening discussions to promote informed decision making for prostate cancer screening. The aim of this study is to explore physicians' use of pre-screening discussions and reasons why physicians would or would not try to persuade patients to be screened if they initially refuse testing. Primary care physicians completed a self-administered survey about prostate cancer screening practices for informed decision making. Sixty-six physicians (75.9%) completed the survey, and 63 were used in the analysis. Thirteen physicians (20.6%) reported not using prescreening discussions, 45 (71.4%) reported the use of prescreening discussions, and 3 (4.8%) reported neither ordering the PSA test nor discussing it with patients. Sixty-nine percent of physicians who reported not having discussions indicated they were more likely to screen African American patients for prostate cancer, compared to 50% of physicians who reported the use of discussions (Chi-square(1) = 1.62, p = .20). Similarly, 91% of physicians who reported not having discussions indicated they are more likely to screen patients with a family history of prostate cancer, compared to 46% of those who reported the use of discussion (Chi-square(1) = 13.27, p practice styles. Future research needs to consider the nature of discussions and the degree to which informed decision making is being achieved in clinical practice.

Screening and Invasive Testing in Twins

Directory of Open Access Journals (Sweden)

Giovanni Monni

2014-07-01

Full Text Available Prenatal screening and testing for trisomy 21 in twin pregnancies poses a number of challenges: the exact estimate of the a priori risk of trisomy 21, the choice of prenatal screening test and/or invasive techniques to employ for the diagnosis and the impact of the result on the options of treatment in case of discordant results within a twin pair or among multiples. These different aspects are discussed below while recognizing that many issues remain unresolved.

Discrepancies between judgment and choice of action in moral dilemmas

Directory of Open Access Journals (Sweden)

Sébastien eTassy

2013-05-01

Full Text Available Everyone has experienced the potential discrepancy between what one judges as morally acceptable and what one actually does when a choice between alternative behaviors is to be made. The present study explores empirically whether judgment and choice of action differ when people make decisions on dilemmas involving moral issues. 240 participants evaluated 24 moral and non-moral dilemmas either by judging (Is it acceptable to… or reporting the choice of action they would make (Would you do…. We also investigated the influence of varying the number of people benefiting from the decision and the closeness of relationship of the decision maker with the potential victim on these two types of decision. Variations in the number of beneficiaries from the decision did not influence judgment nor choice of action. By contrast, closeness of relationship with the victim had a greater influence on the choice of action than on judgment. This differentiation between evaluative judgments and choices of action argues in favor of each of them being supported by (at least partially different psychological processes.

Traffic-light labels and choice architecture: promoting healthy food choices.

Science.gov (United States)

Thorndike, Anne N; Riis, Jason; Sonnenberg, Lillian M; Levy, Douglas E

2014-02-01

Preventing obesity requires maintenance of healthy eating behaviors over time. Food labels and strategies that increase visibility and convenience of healthy foods (choice architecture) promote healthier choices, but long-term effectiveness is unknown. Assess effectiveness of traffic-light labeling and choice architecture cafeteria intervention over 24 months. Longitudinal pre-post cohort follow-up study between December 2009 and February 2012. Data were analyzed in 2012. Large hospital cafeteria with a mean of 6511 transactions daily. Cafeteria sales were analyzed for (1) all cafeteria customers and (2) a longitudinal cohort of 2285 hospital employees who used the cafeteria regularly. After a 3-month baseline period, cafeteria items were labeled green (healthy); yellow (less healthy); or red (unhealthy) and rearranged to make healthy items more accessible. Proportion of cafeteria sales that were green or red during each 3-month period from baseline to 24 months. Changes in 12- and 24-month sales were compared to baseline for all transactions and transactions by the employee cohort. The proportion of sales of red items decreased from 24% at baseline to 20% at 24 months (pchoice architecture cafeteria intervention resulted in sustained healthier choices over 2 years, suggesting that food environment interventions can promote long-term changes in population eating behaviors. © 2013 American Journal of Preventive Medicine Published by American Journal of Preventive Medicine All rights reserved.

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.

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.

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

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.

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.

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.

Decision-making based on emotional images.

Science.gov (United States)

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

2011-01-01

The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants' choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the "reward value" of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants' choice data, we used reinforcement learning models that have successfully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures) was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making.

Decision making based on emotional images

Directory of Open Access Journals (Sweden)

Kentaro eKatahira

2011-10-01

Full Text Available The emotional outcome of a choice affects subsequent decision making. While the relationship between decision making and emotion has attracted attention, studies on emotion and decision making have been independently developed. In this study, we investigated how the emotional valence of pictures, which was stochastically contingent on participants’ choices, influenced subsequent decision making. In contrast to traditional value-based decision-making studies that used money or food as a reward, the reward value of the decision outcome, which guided the update of value for each choice, is unknown beforehand. To estimate the reward value of emotional pictures from participants’ choice data, we used reinforcement learning models that have success- fully been used in previous studies for modeling value-based decision making. Consequently, we found that the estimated reward value was asymmetric between positive and negative pictures. The negative reward value of negative pictures (relative to neutral pictures was larger in magnitude than the positive reward value of positive pictures. This asymmetry was not observed in valence for an individual picture, which was rated by the participants regarding the emotion experienced upon viewing it. These results suggest that there may be a difference between experienced emotion and the effect of the experienced emotion on subsequent behavior. Our experimental and computational paradigm provides a novel way for quantifying how and what aspects of emotional events affect human behavior. The present study is a first step toward relating a large amount of knowledge in emotion science and in taking computational approaches to value-based decision making.

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

Genetic incompatibility drives mate choice in a parasitic wasp

NARCIS (Netherlands)

Thiel, A.; Weeda, A.C.; Boer, de J.G.; Hoffmeister, T.S.

2013-01-01

Introduction: Allelic incompatibility between individuals of the same species should select for mate choice based on the genetic make-up of both partners at loci that influence offspring fitness. As a consequence, mate choice may be an important driver of allelic diversity. A complementary sex

Overview of guidelines on breast screening

DEFF Research Database (Denmark)

Juhl Jørgensen, Karsten; Kalager, Mette; Barratt, Alexandra

2017-01-01

Updated guidelines on breast cancer screening have been published by several major organisations over the past five years. Recommendations vary regarding both age range, screening interval, and even on whether breast screening should be offered at all. The variation between recommendations reflects....... The estimates vary according to the methodology of the randomised trials, and the design of the observational studies. Guideline recommendations reflect the choice of evidence informing them. While there are well-developed tools to deal with randomised trials in guideline work, these are not always used......, or they may not be followed as recommended. Further, results of trials performed decades ago may no longer be applicable. For observational studies, the framework for inclusion in guidelines is not similarly well-developed and there are methodological concerns specific to screening interventions...

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...

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.

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

Behavioral Variability of Choices versus Structural Inconsistency of Preferences

Science.gov (United States)

Regenwetter, Michel; Davis-Stober, Clintin P.

2012-01-01

Theories of rational choice often make the structural consistency assumption that every decision maker's binary strict preference among choice alternatives forms a "strict weak order". Likewise, the very concept of a "utility function" over lotteries in normative, prescriptive, and descriptive theory is mathematically equivalent to strict weak…

People’s willingness to accept overdetection in cancer screening: population survey

Science.gov (United States)

Jones, Caroline; Yang, Yaling; Oke, Jason; Hewitson, Paul

2015-01-01

on the likelihood and consequences of overdetection to allow people to make an informed choice. PMID:25736617

Women's attitude towards routine human platelet antigen-screening in pregnancy.

Science.gov (United States)

Winkelhorst, Dian; Loeff, Rosanne M; van den Akker-Van Marle, M Elske; de Haas, Masja; Oepkes, Dick

2017-08-01

Fetal and neonatal alloimmune thrombocytopenia is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. To prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen-screening in pregnancy. We performed a cross-sectional questionnaire study among healthy pregnant women receiving prenatal care in one of seven participating midwifery practices. Attitude was assessed using a questionnaire based on the validated Multidimensional Measurement of Informed Choice model, containing questions assessing knowledge, attitude and intention to participate. A total of 143 of the 220 women (65%) completed and returned the questionnaire. A positive attitude towards human platelet antigen-screening was expressed by 91% of participants, of which 94% was based on sufficient knowledge. Attitude was more likely to be negatively influenced by the opinion that screening can be frightening. Informed choices were made in 87% and occurred significantly less in women from non-European origin, 89% in European women vs. 60% in non-European women (p = 0.03). Pregnant women in the Netherlands expressed a positive attitude towards human platelet antigen-screening in pregnancy. We therefore expect a high rate of informed uptake when human platelet antigen-screening is implemented. In future counseling on human platelet antigen-screening, ethnicity and possible anxiety associated with a screening test need to be specifically addressed. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

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...

Major histocompatibility complex class II compatibility, but not class I, predicts mate choice in a bird with highly developed olfaction.

Science.gov (United States)

Strandh, Maria; Westerdahl, Helena; Pontarp, Mikael; Canbäck, Björn; Dubois, Marie-Pierre; Miquel, Christian; Taberlet, Pierre; Bonadonna, Francesco

2012-11-07

Mate choice for major histocompatibility complex (MHC) compatibility has been found in several taxa, although rarely in birds. MHC is a crucial component in adaptive immunity and by choosing an MHC-dissimilar partner, heterozygosity and potentially broad pathogen resistance is maximized in the offspring. The MHC genotype influences odour cues and preferences in mammals and fish and hence olfactory-based mate choice can occur. We tested whether blue petrels, Halobaena caerulea, choose partners based on MHC compatibility. This bird is long-lived, monogamous and can discriminate between individual odours using olfaction, which makes it exceptionally well suited for this analysis. We screened MHC class I and II B alleles in blue petrels using 454-pyrosequencing and quantified the phylogenetic, functional and allele-sharing similarity between individuals. Partners were functionally more dissimilar at the MHC class II B loci than expected from random mating (p = 0.033), whereas there was no such difference at the MHC class I loci. Phylogenetic and non-sequence-based MHC allele-sharing measures detected no MHC dissimilarity between partners for either MHC class I or II B. Our study provides evidence of mate choice for MHC compatibility in a bird with a high dependency on odour cues, suggesting that MHC odour-mediated mate choice occurs in birds.

Social-Class Differences in Consumer Choices: Working-Class Individuals Are More Sensitive to Choices of Others Than Middle-Class Individuals.

Science.gov (United States)

Na, Jinkyung; McDonough, Ian M; Chan, Micaela Y; Park, Denise C

2016-04-01

The present research shows that, when making choices, working-class Americans are more affected by others' opinions than middle-class Americans due to differences in independent versus interdependent self-construal. Experiment 1 revealed that when working-class Americans made decisions to buy products, they were more influenced by the choices of others than middle-class Americans. In contrast, middle-class Americans were more likely to misremember others' choices to be consistent with their own choices. In other words, working-class Americans adjusted their choices to the preference of others, whereas middle-class Americans distorted others' preferences to fit their choices. Supporting our prediction that this social-class effect is closely linked to the independent versus interdependent self-construal, we showed that the differences in self-construal across cultures qualified the social-class effects on choices (Experiment 2). Moreover, when we experimentally manipulated self-construal in Experiment 3, we found that it mediated the corresponding changes in choices regardless of social class. © 2016 by the Society for Personality and Social Psychology, Inc.

Rational Choice and the Relevance of Irrelevant Alternatives

NARCIS (Netherlands)

Seidl, C.; Traub, S.

1996-01-01

This experimental study investigates the inuence of irrelevant or phantom al- ternatives on subjects' choices in sequential decision making. Using experimental data from 45 subjects, we found that irrelevant alternatives bear significant rele- vance for decision making. We observe that only 38% of

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

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…

Decision making for breast cancer prevention among women at elevated risk.

Science.gov (United States)

Padamsee, Tasleem J; Wills, Celia E; Yee, Lisa D; Paskett, Electra D

2017-03-24

Several medical management approaches have been shown to be effective in preventing breast cancer and detecting it early among women at elevated risk: 1) prophylactic mastectomy; 2) prophylactic oophorectomy; 3) chemoprevention; and 4) enhanced screening routines. To varying extents, however, these approaches are substantially underused relative to clinical practice recommendations. This article reviews the existing research on the uptake of these prevention approaches, the characteristics of women who are likely to use various methods, and the decision-making processes that underlie the differing choices of women. It also highlights important areas for future research, detailing the types of studies that are particularly needed in four key areas: documenting women's perspectives on their own perceptions of risk and prevention decisions; explicit comparisons of available prevention pathways and their likely health effects; the psychological, interpersonal, and social processes of prevention decision making; and the dynamics of subgroup variation. Ultimately, this research could support the development of interventions that more fully empower women to make informed and values-consistent decisions, and to move towards favorable health outcomes.

Caveat Emptor! The Rhetoric of Choice in Food Politics

Directory of Open Access Journals (Sweden)

Andrew Calabrese

2017-11-01

Full Text Available This project is about a form of corporate predation that entails both policy influence and cultural legitimation. Neoliberal explanations of the inability of citizens to thrive in the current socio- economic condition typically rest on a combination of victim-blaming and appeals to the individualistic rhetoric that assumes we all enjoy equality of opportunity and freedom of choice. It is common for corporate lobbyists, and politicians under their influence, to argue against consumer protection on the grounds that such efforts are paternalistic, and that they therefore undermine consumer sovereignty. By this logic, illnesses that are highly correlated to diet are problems that consumers can avoid, and it is not the duty of food companies or government to prevent consumers from making “bad choices.” Implicit in this moralistic narrative is that consumers have sufficient knowledge about the alternatives to enable them to make “good choices.” Major food lobbies use their political influence to oppose government regulations of food, based on the reasoning that consumers deserve the right to choose. Food industry groups also will sometimes invest heavily to prevent legal requirements to disclose information that might enable consumers to make informed choices, creating a predatory double-bind. In this essay, I discuss how the rhetoric of choice is employed by the food industry, how it is formulated within the political context of the United States, and how that rhetoric poses threats to food systems globally.

Individual Differences in Impulsive Choice and Timing in Rats

Science.gov (United States)

Galtress, Tiffany; Garcia, Ana; Kirkpatrick, Kimberly

2012-01-01

Individual differences in impulsive choice behavior have been linked to a variety of behavioral problems including substance abuse, smoking, gambling, and poor financial decision-making. Given the potential importance of individual differences in impulsive choice as a predictor of behavioral problems, the present study sought to measure the extent…

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.

People's Financial Choice Depends on their Previous Task Success or Failure.

Science.gov (United States)

Sekścińska, Katarzyna

2015-01-01

Existing knowledge about the impact of the experience prior to financial choices has been limited almost exclusively to single risky choices. Moreover, the results obtained in these studies have not been entirely consistent. For example, some studies suggested that the experience of success makes people more willing to take a risk, while other studies led to the opposite conclusions. The results of the two experimental studies presented in this paper provide evidence for the hypothesis that the experience of success or failure influences people's financial choices, but the effect of the success or failure depends on the type of task (financial and non-financial) preceding a financial decision. The experience of success in financial tasks increased participants' tendency to invest and make risky investment choices, while it also made them less prone to save. On the other hand, the experience of failure heightened the amount of money that participants decided to save, and lowered their tendency to invest and make risky investment choices. However, the effects of the experience of success or failure in non-financial tasks were exactly the opposite. The presented studies indicated the role of the specific circumstances in which the individual gains the experience as a possible way to explain the discrepancies in the results of studies on the relationship between the experience prior to financial choice with a tendency to take risks.

Determinants of choice of delivery place: Testing rational choice theory and habitus theory.

Science.gov (United States)

Broda, Anja; Krüger, Juliane; Schinke, Stephanie; Weber, Andreas

2018-05-07

professionals tailoring personal or social beliefs, attitudes and opinions. Our study advocates that legislation and policy- and decision-makers should support different delivery place options in order to accommodate the choices and preferences of different women. The study demonstrates the usefulness of theory for describing and explaining a complex decision-making process, here the choice of delivery place. Copyright © 2018 Elsevier Ltd. All rights reserved.

No effects of psychosocial stress on intertemporal choice.

Directory of Open Access Journals (Sweden)

Johannes Haushofer

Full Text Available Intertemporal choices - involving decisions which trade off instant and delayed outcomes - are often made under stress. It remains unknown, however, whether and how stress affects intertemporal choice. We subjected 142 healthy male subjects to a laboratory stress or control protocol, and asked them to make a series of intertemporal choices either directly after stress, or 20 minutes later (resulting in four experimental groups. Based on theory and evidence from behavioral economics and cellular neuroscience, we predicted a bidirectional effect of stress on intertemporal choice, with increases in impatience or present bias immediately after stress, but decreases in present bias or impatience when subjects are tested 20 minutes later. However, our results show no effects of stress on intertemporal choice at either time point, and individual differences in stress reactivity (changes in stress hormone levels over time are not related to individual differences in intertemporal choice. Together, we did not find support for the hypothesis that psychosocial laboratory stressors affect intertemporal choice.

Healthy food choices are happy food choices : evidence from a real life sample using smartphone based assessments

OpenAIRE

Wahl, Deborah R.; Villinger, Karoline; König, Laura M.; Ziesemer, Katrin; Schupp, Harald T.; Renner, Britta

2017-01-01

Research suggests that "healthy" food choices such as eating fruits and vegetables have not only physical but also mental health benefits and might be a long-term investment in future well-being. This view contrasts with the belief that high-caloric foods taste better, make us happy, and alleviate a negative mood. To provide a more comprehensive assessment of food choice and well-being, we investigated in-the-moment eating happiness by assessing complete, real life dietary behaviour across ei...

Food Choices of 4 to 6-Year-Old Overweight and Nonoverweight Children While Role-Playing as Adults

NARCIS (Netherlands)

Snoek, H.M.; Sessink, N.Y.; Engels, R.C.M.E.

2010-01-01

The following study compared the food choices made by overweight and non-overweight preschoolers while role-playing a mother who bought food for a family, and examined the influence of maternal restriction on food choice. After screening 619 children for height and weight, 56 overweight children

Food choices of 4 to 6-year-old overweight and nonoverweight children while role-playing as adults

NARCIS (Netherlands)

Snoek, H.M.; Sessink, N.Y.; Engels, R.C.M.E.

2010-01-01

The following study compared the food choices made by overweight and non-overweight preschoolers while role-playing a mother who bought food for a family, and examined the influence of maternal restriction on food choice. After screening 619 children for height and weight, 56 overweight children

Impaired strategic decision making in schizophrenia.

Science.gov (United States)

Kim, Hyojin; Lee, Daeyeol; Shin, Young-Min; Chey, Jeanyung

2007-11-14

Adaptive decision making in dynamic social settings requires frequent re-evaluation of choice outcomes and revision of strategies. This requires an array of multiple cognitive abilities, such as working memory and response inhibition. Thus, the disruption of such abilities in schizophrenia can have significant implications for social dysfunctions in affected patients. In the present study, 20 schizophrenia patients and 20 control subjects completed two computerized binary decision-making tasks. In the first task, the participants played a competitive zero-sum game against a computer in which the predictable choice behavior was penalized and the optimal strategy was to choose the two targets stochastically. In the second task, the expected payoffs of the two targets were fixed and unaffected by the subject's choices, so the optimal strategy was to choose the target with the higher expected payoff exclusively. The schizophrenia patients earned significantly less money during the first task, even though their overall choice probabilities were not significantly different from the control subjects. This was mostly because patients were impaired in integrating the outcomes of their previous choices appropriately in order to maintain the optimal strategy. During the second task, the choices of patients and control subjects displayed more similar patterns. This study elucidated the specific components in strategic decision making that are impaired in schizophrenia. The deficit, which can be characterized as strategic stiffness, may have implications for the poor social adjustment in schizophrenia patients.

Uncertainty Quantification in High Throughput Screening ...

Science.gov (United States)

Using uncertainty quantification, we aim to improve the quality of modeling data from high throughput screening assays for use in risk assessment. ToxCast is a large-scale screening program that analyzes thousands of chemicals using over 800 assays representing hundreds of biochemical and cellular processes, including endocrine disruption, cytotoxicity, and zebrafish development. Over 2.6 million concentration response curves are fit to models to extract parameters related to potency and efficacy. Models built on ToxCast results are being used to rank and prioritize the toxicological risk of tested chemicals and to predict the toxicity of tens of thousands of chemicals not yet tested in vivo. However, the data size also presents challenges. When fitting the data, the choice of models, model selection strategy, and hit call criteria must reflect the need for computational efficiency and robustness, requiring hard and somewhat arbitrary cutoffs. When coupled with unavoidable noise in the experimental concentration response data, these hard cutoffs cause uncertainty in model parameters and the hit call itself. The uncertainty will then propagate through all of the models built on the data. Left unquantified, this uncertainty makes it difficult to fully interpret the data for risk assessment. We used bootstrap resampling methods to quantify the uncertainty in fitting models to the concentration response data. Bootstrap resampling determines confidence intervals for

Performing a Choice-Narrative: A qualitative study of the patterns in STEM students' higher education choices

Science.gov (United States)

Tolstrup Holmegaard, Henriette

2015-06-01

Students' science choices have long attracted attention in both public and research. Recently there has been a call for qualitative studies to explore how choices create a sense of fit for individual students. Therefore, this paper aims to study how science students' choices of higher education are performed and to uncover the patterns of students' construction of their choice-narratives. The paper is based on a qualitative study among 38 Danish upper secondary school students. The theoretical framework is narrative psychology combined with post-structural thinking. The study shows that constructing a choice-narrative is complicated identity-work. First, the students felt encouraged to identify their interests, not only the ones related to the subject matter, but also various interests that were equally negotiated in relation to each other. Second, the choice-narratives were personalised; on the one side articulated as not too predictable, and on the other side appearing realistic and adjusted to the students' sense of self. Third, the choice-narratives were informed, validated and adjusted in the students' social network providing the students with a repertoire of viable pathways. The study demonstrates how cultural discourses about how a proper choice is made set the scene for the students' choices. The study raises some concerns for science education. Improving students' interests in science alone might not lead to increased admission as several interests equally intervene. To attract more students to science, we must consider how to actively engage them in crafting their own education, as a way to support them in making personal sense.

The Neural Basis of Risky Choice with Affective Outcomes

Science.gov (United States)

Suter, Renata S.; Pachur, Thorsten; Hertwig, Ralph; Endestad, Tor; Biele, Guido

2015-01-01

Both normative and many descriptive theories of decision making under risk are based on the notion that outcomes are weighted by their probability, with subsequent maximization of the (subjective) expected outcome. Numerous investigations from psychology, economics, and neuroscience have produced evidence consistent with this notion. However, this research has typically investigated choices involving relatively affect-poor, monetary outcomes. We compared choice in relatively affect-poor, monetary lottery problems with choice in relatively affect-rich medical decision problems. Computational modeling of behavioral data and model-based neuroimaging analyses provide converging evidence for substantial differences in the respective decision mechanisms. Relative to affect-poor choices, affect-rich choices yielded a more strongly curved probability weighting function of cumulative prospect theory, thus signaling that the psychological impact of probabilities is strongly diminished for affect-rich outcomes. Examining task-dependent brain activation, we identified a region-by-condition interaction indicating qualitative differences of activation between affect-rich and affect-poor choices. Moreover, brain activation in regions that were more active during affect-poor choices (e.g., the supramarginal gyrus) correlated with individual trial-by-trial decision weights, indicating that these regions reflect processing of probabilities. Formal reverse inference Neurosynth meta-analyses suggested that whereas affect-poor choices seem to be based on brain mechanisms for calculative processes, affect-rich choices are driven by the representation of outcomes’ emotional value and autobiographical memories associated with them. These results provide evidence that the traditional notion of expectation maximization may not apply in the context of outcomes laden with affective responses, and that understanding the brain mechanisms of decision making requires the domain of the decision

The neural basis of risky choice with affective outcomes.

Directory of Open Access Journals (Sweden)

Renata S Suter

Full Text Available Both normative and many descriptive theories of decision making under risk are based on the notion that outcomes are weighted by their probability, with subsequent maximization of the (subjective expected outcome. Numerous investigations from psychology, economics, and neuroscience have produced evidence consistent with this notion. However, this research has typically investigated choices involving relatively affect-poor, monetary outcomes. We compared choice in relatively affect-poor, monetary lottery problems with choice in relatively affect-rich medical decision problems. Computational modeling of behavioral data and model-based neuroimaging analyses provide converging evidence for substantial differences in the respective decision mechanisms. Relative to affect-poor choices, affect-rich choices yielded a more strongly curved probability weighting function of cumulative prospect theory, thus signaling that the psychological impact of probabilities is strongly diminished for affect-rich outcomes. Examining task-dependent brain activation, we identified a region-by-condition interaction indicating qualitative differences of activation between affect-rich and affect-poor choices. Moreover, brain activation in regions that were more active during affect-poor choices (e.g., the supramarginal gyrus correlated with individual trial-by-trial decision weights, indicating that these regions reflect processing of probabilities. Formal reverse inference Neurosynth meta-analyses suggested that whereas affect-poor choices seem to be based on brain mechanisms for calculative processes, affect-rich choices are driven by the representation of outcomes' emotional value and autobiographical memories associated with them. These results provide evidence that the traditional notion of expectation maximization may not apply in the context of outcomes laden with affective responses, and that understanding the brain mechanisms of decision making requires the domain

The neural basis of risky choice with affective outcomes.

Science.gov (United States)

Suter, Renata S; Pachur, Thorsten; Hertwig, Ralph; Endestad, Tor; Biele, Guido

2015-01-01

Both normative and many descriptive theories of decision making under risk are based on the notion that outcomes are weighted by their probability, with subsequent maximization of the (subjective) expected outcome. Numerous investigations from psychology, economics, and neuroscience have produced evidence consistent with this notion. However, this research has typically investigated choices involving relatively affect-poor, monetary outcomes. We compared choice in relatively affect-poor, monetary lottery problems with choice in relatively affect-rich medical decision problems. Computational modeling of behavioral data and model-based neuroimaging analyses provide converging evidence for substantial differences in the respective decision mechanisms. Relative to affect-poor choices, affect-rich choices yielded a more strongly curved probability weighting function of cumulative prospect theory, thus signaling that the psychological impact of probabilities is strongly diminished for affect-rich outcomes. Examining task-dependent brain activation, we identified a region-by-condition interaction indicating qualitative differences of activation between affect-rich and affect-poor choices. Moreover, brain activation in regions that were more active during affect-poor choices (e.g., the supramarginal gyrus) correlated with individual trial-by-trial decision weights, indicating that these regions reflect processing of probabilities. Formal reverse inference Neurosynth meta-analyses suggested that whereas affect-poor choices seem to be based on brain mechanisms for calculative processes, affect-rich choices are driven by the representation of outcomes' emotional value and autobiographical memories associated with them. These results provide evidence that the traditional notion of expectation maximization may not apply in the context of outcomes laden with affective responses, and that understanding the brain mechanisms of decision making requires the domain of the decision to

Affective and cognitive mechanisms of risky decision making.

Science.gov (United States)

Shimp, Kristy G; Mitchell, Marci R; Beas, B Sofia; Bizon, Jennifer L; Setlow, Barry

2015-01-01

The ability to make advantageous decisions under circumstances in which there is a risk of adverse consequences is an important component of adaptive behavior; however, extremes in risk taking (either high or low) can be maladaptive and are characteristic of a number of neuropsychiatric disorders. To better understand the contributions of various affective and cognitive factors to risky decision making, cohorts of male Long-Evans rats were trained in a "Risky Decision making Task" (RDT), in which they made discrete trial choices between a small, "safe" food reward and a large, "risky" food reward accompanied by varying probabilities of footshock. Experiment 1 evaluated the relative contributions of the affective stimuli (i.e., punishment vs. reward) to RDT performance by parametrically varying the magnitudes of the footshock and large reward. Varying the shock magnitude had a significant impact on choice of the large, "risky" reward, such that greater magnitudes were associated with reduced choice of the large reward. In contrast, varying the large, "risky" reward magnitude had minimal influence on reward choice. Experiment 2 compared individual variability in RDT performance with performance in an attentional set shifting task (assessing cognitive flexibility), a delayed response task (assessing working memory), and a delay discounting task (assessing impulsive choice). Rats characterized as risk averse in the RDT made more perseverative errors on the set shifting task than did their risk taking counterparts, whereas RDT performance was not related to working memory abilities or impulsive choice. In addition, rats that showed greater delay discounting (greater impulsive choice) showed corresponding poorer performance in the working memory task. Together, these results suggest that reward-related decision making under risk of punishment is more strongly influenced by the punishment than by the reward, and that risky and impulsive decision making are associated with

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...

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.

Response time patterns in a stated choice experiment

DEFF Research Database (Denmark)

Börjesson, Maria; Fosgerau, Mogens

2015-01-01

This paper studies how response times vary between unlabelled binary choice occasions in a stated choice (SC) experiment, with alternatives differing with respect to in-vehicle travel time and travel cost. The pattern of response times is interpreted as an indicator of the cognitive processes...... employed by the respondents when making their choices. We find clear signs of reference-dependence in response times in the form of a strong gain–loss asymmetry. Moreover, different patterns of response times for travel time and travel cost indicate that these attributes are processed in different ways...

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,…

Barriers to adoption of recent technology in cervical screening

Directory of Open Access Journals (Sweden)

Jhala Darshana

2007-01-01

Full Text Available Abstract The Pap smear is one of the modern success stories in the field of preventive medicine. Since its introduction as a screening test, there has been a dramatic reduction in the incidence of cervical cancer. However, the search for a better screening test continues. The new technologies, including liquid-based cytology (LBC, Human Papilloma Virus (HPV testing and automated or machine-assisted screening have been introduced. However, there is continuous debate about whether society's limited resources are better spent on reaching the underserved rather than on these technologies. Another question is whether these technologies create yet another kind of disparity in delivering preventive care. For example, despite the wide use of LBC (99% of tests submitted to our laboratory are LBC, conventional Pap smears are still used to screen/follow up some women. It is not clear why some providers continue to prefer conventional smear over LBC and what are the barriers for adopting LBC in cervical cancer screening. We hypothesize the lower cost of conventional compared to LBC Pap testing, patient's lower socio-economic indices, a patient's medical history and provider's subspecialty/training all appear to play a role in the choice of using conventional Pap testing rather than LBC. Unintentionally, this choice results in repeat testing, delayed treatment and potentially higher costs than intended. The ultimate goal of this review article is to understand and explore possible barriers and disparities to adopting new technology in cancer screening.

Moral intensity and climate-friendly food choices.

Science.gov (United States)

Mäkiniemi, Jaana-Piia; Vainio, Annukka

2013-07-01

By changing individual food consumption patterns, it might be possible to reduce greenhouse gas emissions associated with climate change. The aim of the current study was to examine how perceptions of the moral intensity of climate change are related to climate friendly-food choices. The participants were 350 Finnish university students in the social and behavioral sciences who completed a questionnaire during class. The results indicated that moral perceptions mainly affected the moral evaluation and intentions to make climate-friendly food choices. We suggest that the results can be used to promote climate-friendly food choices, for example, by increasing the recognition of climate change as a moral imperative and by combining environmental motives with other relevant food choice motives. Copyright © 2013 Elsevier Ltd. All rights reserved.

On the choice of schools located outside the walkable ...

African Journals Online (AJOL)

In this study, we consider a school choice problem and formulate it into a mathematical model, allowing it to be simplified and solved. The results obtained are useful for the household in making an objective choice of school for the child to be enrolled among several secondary schools located outside his walkable ...

Choice from non-choice: predicting consumer preferences from blood oxygenation level-dependent signals obtained during passive viewing.

Science.gov (United States)

Levy, Ifat; Lazzaro, Stephanie C; Rutledge, Robb B; Glimcher, Paul W

2011-01-05

Decision-making is often viewed as a two-stage process, where subjective values are first assigned to each option and then the option of the highest value is selected. Converging evidence suggests that these subjective values are represented in the striatum and medial prefrontal cortex (MPFC). A separate line of evidence suggests that activation in the same areas represents the values of rewards even when choice is not required, as in classical conditioning tasks. However, it is unclear whether the same neural mechanism is engaged in both cases. To address this question we measured brain activation with functional magnetic resonance imaging while human subjects passively viewed individual consumer goods. We then sampled activation from predefined regions of interest and used it to predict subsequent choices between the same items made outside of the scanner. Our results show that activation in the striatum and MPFC in the absence of choice predicts subsequent choices, suggesting that these brain areas represent value in a similar manner whether or not choice is required.

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

Influence of branding on preference-based decision making.

Science.gov (United States)

Philiastides, Marios G; Ratcliff, Roger

2013-07-01

Branding has become one of the most important determinants of consumer choices. Intriguingly, the psychological mechanisms of how branding influences decision making remain elusive. In the research reported here, we used a preference-based decision-making task and computational modeling to identify which internal components of processing are affected by branding. We found that a process of noisy temporal integration of subjective value information can model preference-based choices reliably and that branding biases are explained by changes in the rate of the integration process itself. This result suggests that branding information and subjective preference are integrated into a single source of evidence in the decision-making process, thereby altering choice behavior.

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

Traffic-Light Labels and Choice Architecture Promoting Healthy Food Choices

Science.gov (United States)

Thorndike, Anne N.; Riis, Jason; Sonnenberg, Lillian M.; Levy, Douglas E.

2014-01-01

Background Preventing obesity requires maintenance of healthy eating behaviors over time. Food labels and strategies that increase visibility and convenience of healthy foods (choice architecture) promote healthier choices, but long-term effectiveness is unknown. Purpose Assess effectiveness of traffic-light labeling and choice architecture cafeteria intervention over 24 months. Design Longitudinal pre–post cohort follow-up study between December 2009 and February 2012. Data were analyzed in 2012. Setting/participants Large hospital cafeteria with mean of 6511 transactions daily. Cafeteria sales were analyzed for: (1) all cafeteria customers and (2) longitudinal cohort of 2285 hospital employees who used the cafeteria regularly. Intervention After 3-month baseline period, cafeteria items were labeled green (healthy), yellow (less healthy) or red (unhealthy) and rearranged to make healthy items more accessible. Main outcome measures Proportion of cafeteria sales that were green or red during each 3-month period from baseline to 24 months. Changes in 12- and 24-month sales were compared to baseline for all transactions and transactions by the employee cohort. Results The proportion of sales of red items decreased from 24% at baseline to 20% at 24 months (p<0.001), and green sales increased from 41% to 46% (p<0.001). Red beverages decreased from 26% of beverage sales at baseline to 17% at 24 months (p<0.001); green beverages increased from 52% to 60% (p<0.001). Similar patterns were observed for the cohort of employees, with largest change for red beverages (23% to 14%, p<0.001). Conclusions A traffic-light and choice architecture cafeteria intervention resulted in sustained healthier choices over 2 years, suggesting food environment interventions can promote long-term changes in population eating behaviors. PMID:24439347

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

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...

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

Regret and adaptive decision making in young children.

Science.gov (United States)

O'Connor, Eimear; McCormack, Teresa; Beck, Sarah R; Feeney, Aidan

2015-07-01

In line with the claim that regret plays a role in decision making, O'Connor, McCormack, and Feeney (Child Development, 85 (2014) 1995-2010) found that children who reported feeling sadder on discovering they had made a non-optimal choice were more likely to make a different choice the next time around. We examined two issues of interpretation regarding this finding: whether the emotion measured was indeed regret and whether it was the experience of this emotion, rather than the ability to anticipate it, that affected decision making. To address the first issue, we varied the degree to which children aged 6 or 7 years were responsible for an outcome, assuming that responsibility is a necessary condition for regret. The second issue was addressed by examining whether children could accurately anticipate that they would feel worse on discovering they had made a non-optimal choice. Children were more likely to feel sad if they were responsible for the outcome; however, even if they were not responsible, children were more likely than chance to report feeling sadder. Moreover, across all conditions, feeling sadder was associated with making a better subsequent choice. In a separate task, we demonstrated that children of this age cannot accurately anticipate feeling sadder on discovering that they had not made the best choice. These findings suggest that although children may feel regret following a non-optimal choice, even if they were not responsible for an outcome, they may experience another negative emotion such as frustration. Experiencing either of these emotions seems to be sufficient to support better decision making. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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.

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, �

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.

Specificity and flexibility of social influence on spatial choice.

Science.gov (United States)

Brown, Michael F; Saxon, Marie E; Heslin, Kelsey A

2018-03-21

Rats searched for food in a situation that allowed them to determine which locations contained food after searching a small number of them, but not which of the baited locations contained more-preferred food rather than a less-preferred food. During some experimental trials, the latter information was available from the choices of model rats making choices together with the subject rats, because some of the model rats tended to choose the locations baited with more-preferred food. On the surface, the results suggest that social influence specified the locations of more-preferred food to the subject rats. However, more detailed analysis and data from a second experiment indicate that the social influence can be explained by a general tendency to approach another rat making choices, acquired if rats are exposed to a contingency between social approach and increased foraging success.

Memory-Based Simple Heuristics as Attribute Substitution: Competitive Tests of Binary Choice Inference Models

Science.gov (United States)

Honda, Hidehito; Matsuka, Toshihiko; Ueda, Kazuhiro

2017-01-01

Some researchers on binary choice inference have argued that people make inferences based on simple heuristics, such as recognition, fluency, or familiarity. Others have argued that people make inferences based on available knowledge. To examine the boundary between heuristic and knowledge usage, we examine binary choice inference processes in…

The Composition of Consideration and Choice Sets in Undergraduate University Choice: An Exploratory Study

Science.gov (United States)

Dawes, Philip L.; Brown, Jennifer

2004-01-01

We examine university choice as a case of consumer decision making and adopt a brand elimination framework. This approach is predicated on the grounds that a large amount of research in consumer behavior has shown that in markets where there are many alternative brands, consumers use phased-decision strategies. In these research studies, the…

Bottom-up effects on attention capture and choice

DEFF Research Database (Denmark)

Peschel, Anne; Orquin, Jacob Lund; Mueller Loose, Simone

Attention processes and decision making are accepted to be closely linked together because only information that is attended to can be incorporated in the decision process. Little is known however, to which extent bottom-up processes of attention affect stimulus selection and therefore...... the information available to form a decision. Does changing one visual cue in the stimulus set affect attention towards this cue and what does that mean for the choice outcome? To address this, we conducted a combined eye tracking and choice experiment in a consumer choice setting with visual shelf simulations...... salient. The observed effect on attention also carries over into increased choice likelihood. From these results, we conclude that even small changes in the choice capture attention based on bottom-up processes. Also for eye tracking studies in other domains (e.g. search tasks) this means that stimulus...

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.

Factors Influencing Career Choice of Management Students in India

Science.gov (United States)

Agarwala, Tanuja

2008-01-01

Purpose: This paper aims to explore the influence of a range of factors on the career choice of management students in India. The importance of different individuals in the family and at work in making career choices among these students is also to be explored. In addition, the study seeks to address the relationship of the cultural values of…

Women's Choices in Europe: Striking the Work-life Balance

OpenAIRE

Hantrais , Linda; Ackers , Peter

2005-01-01

Abstract The article presents evidence from interviews in France, Spain and Poland to explore how individual actors make choices about their work-life balance. It shows that choice is a complex, contingent, and relative concept, which is both facilitated and obstructed by public policies and working regulations. Despite differences in national and sub-national policy contexts, ...

A narrative approach to understand students’ identities and choices

DEFF Research Database (Denmark)

Holmegaard, Henriette Tolstrup; Ulriksen, Lars; Madsen, Lene Møller

2015-01-01

This chapter demonstrates how narrative theory in general, and narrative psychology in particular, contribute to understand how students make meaning of their choice of post-secondary studies. In particular two central ideas within the theory are unfolded; the concept of identity and the concept...... of time. The applicability of the theory is discussed using empirical examples. The chapter argues that a narrative approach provides an understanding of choice of study as continuous processes where individuals work on their identities in terms of negotiating and constructing a coherent choice...... of the chapter consequences for future research are discussed as well as how this approach to students’ choices of study contributes to our understanding of students’ science, technology, engineering and mathematics (STEM) choices....

Four Principles to Consider Before Advising Women on Screening Mammography

DEFF Research Database (Denmark)

Keen, John D; Juhl Jørgensen, Karsten

2015-01-01

This article reviews four important screening principles applicable to screening mammography in order to facilitate informed choice. The first principle is that screening may help, hurt, or have no effect. In order to reduce mortality and mastectomy rates, screening must reduce the rate of advanced...... of a screening intervention. Disease-specific mortality is biased due to difficulties in attribution of cause of death and to increased mortality due to overdiagnosis and the resulting overtreatment with radiotherapy and chemotherapy. To enhance participation, the benefit from screening is often presented...... in relative instead of absolute terms. Third, some screening statistics must be interpreted with caution. Increased survival time and the percentage of early-stage tumors at detection sound plausible, but are affected by lead-time and length biases. In addition, analyses that only include women who attend...

Making decisions with a continuous mind.

Science.gov (United States)

Scherbaum, S; Dshemuchadse, M; Kalis, A

2008-12-01

Neuroeconomics is a rapidly expanding field at the interfaces of the human sciences. The interdisciplinary nature of this field results in several challenges when attempts are made to solve puzzling questions in human decision making, such as why and how people discount future gains. We argue that an empirical approach based on dynamic systems theory (DST) could inspire and advance the neuroeconomic investigation of decision-making processes in three ways: by enriching the mental model, by extending the empirical tool set, and by facilitating interdisciplinary exchange. The present article addresses the challenges neuroeconomics faces by focusing on intertemporal choice. After a brief introduction of DST and related research, a DST-based conceptual model of decision making is developed and linked to underlying neural principles. On this basis, we outline the application of DST-informed empirical strategies to intertemporal choice. Finally, we discuss the general consequences of and possible objections to the proposed approach to research in intertemporal choice and the field of neuroeconomics.