WorldWideScience

Sample records for surrogate healthcare decision-making

  1. Surrogate decision making and intellectual virtue.

    Science.gov (United States)

    Bock, Gregory L

    2014-01-01

    Patients can be harmed by a religiously motivated surrogate decision maker whose decisions are contrary to the standard of care; therefore, surrogate decision making should be held to a high standard. Stewart Eskew and Christopher Meyers proposed a two-part rule for deciding which religiously based decisions to honor: (1) a secular reason condition and (2) a rationality condition. The second condition is based on a coherence theory of rationality, which they claim is accessible, generous, and culturally sensitive. In this article, I will propose strengthening the rationality condition by grounding it in a theory of intellectual virtue, which is both rigorous and culturally sensitive. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

  2. Assessment of Healthcare Decision-making Capacity.

    Science.gov (United States)

    Palmer, Barton W; Harmell, Alexandrea L

    2016-09-01

    It is often necessary for neuropsychologists, clinical psychologists, and other healthcare professionals to assess an individual's capacity to consent to treatment related to healthcare. This task can be challenging and requires a delicate balance of both respect for individuals' autonomy, as well as the protection of individuals with diminished capacity to make an autonomous decision. The purpose of the present review is to provide an overview of the conceptual model of decisional capacity as well as a brief summary of some of the currently available instruments designed to help evaluate medical decision making. In addition, current empirical literature on the relationship between neuropsychological abilities and decision-making capacity is discussed and a brief set of recommendations is provided to further aid clinicians or consultants when they are required to complete the ethically important but difficult task of making determinations about healthcare decision-making capacity.

  3. Financial Surrogate Decision Making: Lessons from Applied Experimental Philosophy.

    Science.gov (United States)

    Feltz, Adam

    2016-09-20

    An estimated 1 in 4 elderly Americans need a surrogate to make decisions at least once in their lives. With an aging population, that number is almost certainly going to increase. This paper focuses on financial surrogate decision making. To illustrate some of the empirical and moral implications associated with financial surrogate decision making, two experiments suggest that default choice settings can predictably influence some surrogate financial decision making. Experiment 1 suggested that when making hypothetical financial decisions, surrogates tended to stay with default settings (OR = 4.37, 95% CI 1.52, 12.48). Experiment 2 replicated and extended this finding suggesting that in a different context (OR = 2.27, 95% CI 1.1, 4.65). Experiment 2 also suggested that those who were more numerate were less likely to be influenced by default settings than the less numerate, but only when the decision is whether to "opt in" (p = .05). These data highlight the importance of a recent debate about "nudging." Defaults are common methods to nudge people to make desirable choices while allowing the liberty to choose otherwise. Some of the ethics of using default settings to nudge surrogate decision makers are discussed.

  4. Love as a regulative ideal in surrogate decision making.

    Science.gov (United States)

    Stonestreet, Erica Lucast

    2014-10-01

    This discussion aims to give a normative theoretical basis for a "best judgment" model of surrogate decision making rooted in a regulative ideal of love. Currently, there are two basic models of surrogate decision making for incompetent patients: the "substituted judgment" model and the "best interests" model. The former draws on the value of autonomy and responds with respect; the latter draws on the value of welfare and responds with beneficence. It can be difficult to determine which of these two models is more appropriate for a given patient, and both approaches may seem inadequate for a surrogate who loves the patient. The proposed "best judgment" model effectively draws on the values incorporated in each of the traditional standards, but does so because these values are important to someone who loves a patient, since love responds to the patient as the specific person she is.

  5. The Theory and Practice of Surrogate Decision-Making.

    Science.gov (United States)

    Wendler, David

    2017-01-01

    When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the "best scientific evidence available, as well as the patient's values, goals, and preferences" with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances. To the extent that this approach works, it seems to provide about as much respect for the autonomy of incapacitated patients as we could ask for. But, as articles in this issue of the Report by Jeffrey Berger and by Ellen Robinson and colleagues emphasize, reality presents challenges. © 2017 The Hastings Center.

  6. The Confucian bioethics of surrogate decision making: its communitarian roots.

    Science.gov (United States)

    Fan, Ruiping

    2011-10-01

    The family is the exemplar community of Chinese society. This essay explores how Chinese communitarian norms, expressed in thick commitments to the authority and autonomy of the family, are central to contemporary Chinese bioethics. In particular, it focuses on the issue of surrogate decision making to illustrate the Confucian family-grounded communitarian bioethics. The essay first describes the way in which the family, in Chinese bioethics, functions as a whole to provide consent for significant medical and surgical interventions when a patient has lost decision-making capacity. It is argued that the practice of not having an established order for surrogate decision makers (e.g., spouse, children, and then parents), as it is done in the United States, reflects the acknowledgment that the family as a social reality cannot be reduced to a stereotype of the appropriate order of default decision makers. This description of the family as being in authority to make surrogate decisions for an incompetent family member is enriched by an elaboration of the differences among the concepts of patient autonomy, family autonomy, and moral autonomy. The Chinese model, as well as the Confucian communitarian life of families, engages a family autonomy that is supported by a Confucian understanding of moral autonomy, rather than individual autonomy. Finally, the issue of possible conflicts between patient and family interests in relation to a patient's past wishes in the Chinese model is addressed in light of the role of the physician.

  7. Religion and Spirituality in Surrogate Decision Making for Hospitalized Older Adults.

    Science.gov (United States)

    Geros-Willfond, Kristin N; Ivy, Steven S; Montz, Kianna; Bohan, Sara E; Torke, Alexia M

    2016-06-01

    We conducted semi-structured interviews with 46 surrogate decision makers for hospitalized older adults to characterize the role of spirituality and religion in decision making. Three themes emerged: (1) religion as a guide to decision making, (2) control, and (3) faith, death and dying. For religious surrogates, religion played a central role in end of life decisions. There was variability regarding whether God or humans were perceived to be in control; however, beliefs about control led to varying perspectives on acceptance of comfort-focused treatment. We conclude that clinicians should attend to religious considerations due to their impact on decision making.

  8. Decision making in high-velocity environments: implications for healthcare.

    Science.gov (United States)

    Stepanovich, P L; Uhrig, J D

    1999-01-01

    Healthcare can be considered a high-velocity environment and, as such, can benefit from research conducted in other industries regarding strategic decision making. Strategic planning is not only relevant to firms in high-velocity environments, but is also important for high performance and survival. Specifically, decision-making speed seems to be instrumental in differentiating between high and low performers; fast decision makers outperform slow decision makers. This article outlines the differences between fast and slow decision makers, identifies five paralyses that can slow decision making in healthcare, and outlines the role of a planning department in circumventing these paralyses. Executives can use the proposed planning structure to improve both the speed and quality of strategic decisions. The structure uses planning facilitators to avoid the following five paralyses: 1. Analysis. Decision makers can no longer afford the luxury of lengthy, detailed analysis but must develop real-time systems that provide appropriate, timely information. 2. Alternatives. Many alternatives (beyond the traditional two or three) need to be considered and the alternatives must be evaluated simultaneously. 3. Group Think. Decision makers must avoid limited mind-sets and autocratic leadership styles by seeking out independent, knowledgeable counselors. 4. Process. Decision makers need to resolve conflicts through "consensus with qualification," as opposed to waiting for everyone to come on board. 5. Separation. Successful implementation requires a structured process that cuts across disciplines and levels.

  9. Older Adults' Recognition of Tradeoffs in Healthcare Decision Making

    Science.gov (United States)

    Case, Siobhan M.; John O’Leary, MA; Kim, Nancy; Tinetti, Mary E.; Fried, Terri R.

    2016-01-01

    Objectives To examine older persons’ understanding of healthcare decision making involving tradeoffs. Design Cross-sectional survey Setting Primary care clinics Participants Community-living persons age 65 years and older Measurements After being primed to think about tradeoffs with a focus on chronic disease management, participants were asked to describe a decision they had made in the past involving a tradeoff. If they could not, they were asked to describe a decision they might face in the future and were then given an example of a decision. They were also asked about communication with their primary care provider about their priorities when faced with a tradeoff. Results Of the 50 participants, 44 (88%) were able to describe a healthcare decision involving a tradeoff; 25 provided a decision in the past, 17 provided a decision they might face in the future, and 2 provided a future decision after hearing an example. One participant described a non-medical decision and two participants described goals without providing a tradeoff. Of the healthcare decisions, 26 involved surgery, seven were end-of life decisions, seven regarded treatment of chronic disease, and four involved chemotherapy. When asked whether their providers should know their health outcome priorities, 44 (88%) replied yes; 35 (70%) believed their providers knew their priorities; however, only 18 (36%) said that they had a specific conversation about priorities. Conclusion The majority of participants were able to recognize the tradeoffs involved in healthcare decision making and wanted their providers to know their priorities regarding the tradeoffs. Despite being primed to think about the tradeoffs involved in day-to-day treatment of chronic disease, participants most frequently described episodic, high-stakes decisions including surgery and end-of-life care. PMID:26173743

  10. Equity in healthcare resource allocation decision making: A systematic review.

    Science.gov (United States)

    Lane, Haylee; Sarkies, Mitchell; Martin, Jennifer; Haines, Terry

    2017-02-01

    To identify elements of endorsed definitions of equity in healthcare and classify domains of these definitions so that policy makers, managers, clinicians, and politicians can form an operational definition of equity that reflects the values and preferences of the society they serve. Systematic review where verbatim text describing explicit and implicit definitions of equity were extracted and subjected to a thematic analysis. The full holdings of the AMED, CINAHL plus, OVID Medline, Scopus, PsychInfo and ProQuest (ProQuest Health & Medical Complete, ProQuest Nursing and Allied Health Source, ProQuest Social Science Journals) were individually searched in April 2015. Studies were included if they provided an original, explicit or implicit definition of equity in regards to healthcare resource allocation decision making. Papers that only cited earlier definitions of equity and provided no new information or extensions to this definition were excluded. The search strategy yielded 74 papers appropriate for this review; 60 of these provided an explicit definition of equity, with a further 14 papers discussing implicit elements of equity that the authors endorsed in regards to healthcare resource allocation decision making. FIVE KEY THEMES EMERGED: i) Equalisation across the health service supply/access/outcome chain, ii) Need or potential to benefit, iii) Groupings of equalisation, iv) Caveats to equalisation, and v) Close enough is good enough. There is great inconsistency in definitions of equity endorsed by different authors. Operational definitions of equity need to be more explicit in addressing these five thematic areas before they can be directly applied to healthcare resource allocation decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Balancing influence between actors in healthcare decision making

    Directory of Open Access Journals (Sweden)

    Babad Yair M

    2011-04-01

    improved transparency of all aspects of medical decision making, greater involvement of patients in shared medical decision making, greater oversight of guideline development and coverage decisions, limitations on direct to consumer advertising, and the need for an enhanced role of the government as the public advocate.

  12. Multiple perspectives on shared decision-making and interprofessional collaboration in mental healthcare.

    Science.gov (United States)

    Chong, Wei Wen; Aslani, Parisa; Chen, Timothy F

    2013-05-01

    Shared decision-making is an essential element of patient-centered care in mental health. Since mental health services involve healthcare providers from different professions, a multiple perspective to shared decision-making may be valuable. The objective of this study was to explore the perceptions of different healthcare professionals on shared decision-making and current interprofessional collaboration in mental healthcare. Semi-structured interviews were conducted with 31 healthcare providers from a range of professions, which included medical practitioners (psychiatrists, general practitioners), pharmacists, nurses, occupational therapists, psychologists and social workers. Findings indicated that healthcare providers supported the notion of shared decision-making in mental health, but felt that it should be condition dependent. Medical practitioners advocated a more active participation from consumers in treatment decision-making; whereas other providers (e.g. pharmacists, occupational therapists) focused more toward acknowledging consumers' needs in decisions, perceiving themselves to be in an advisory role in supporting consumers' decision-making. Although healthcare providers acknowledged the importance of interprofessional collaboration, only a minority discussed it within the context of shared decision-making. In conclusion, healthcare providers appeared to have differing perceptions on the level of consumer involvement in shared decision-making. Interprofessional roles to facilitate shared decision-making in mental health need to be acknowledged, understood and strengthened, before an interprofessional approach to shared decision-making in mental health can be effectively implemented.

  13. Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making.

    Science.gov (United States)

    Su, Christopher T; McMahan, Ryan D; Williams, Brie A; Sharma, Rashmi K; Sudore, Rebecca L

    2014-01-01

    Cultural attitudes about medical decision-making and filial expectations may lead some surrogates to experience stress and family conflict. Thirteen focus groups with racially and ethnically diverse English and Spanish speakers from county and Veterans Affairs hospitals, senior centers, and cancer support groups were conducted to describe participants' experiences making serious or end-of-life decisions for others. Filial expectations and family dynamics related to birth order and surrogate decision-making were explored using qualitative, thematic content analysis, and overarching themes from focus group transcripts were identified. The mean age of the 69 participants was 69 ± 14, and 29% were African American, 26% were white, 26% were Asian or Pacific Islander, and 19% were Latino. Seventy percent of participants engaged in unprompted discussions about birth order and family dynamics. Six subthemes were identified within three overarching categories: communication (unspoken expectations and discussion of death as taboo), emotion (emotional stress and feelings of loneliness), and conflict (family conflict and potential solutions to prevent conflict). These findings suggest that birth order and family dynamics can have profound effects on surrogate stress and coping. Clinicians should be aware of potential unspoken filial expectations for firstborns and help facilitate communication between the patient, surrogate, and extended family to reduce stress and conflict.

  14. Decision making and coping in healthcare: The Coping in Deliberation (CODE) framework.

    NARCIS (Netherlands)

    Witt, J.; Elwyn, G.; Wood, F.; Brain, K.

    2012-01-01

    OBJECTIVE: To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. METHODS: We briefly review the literature for decision making theories and coping theories appli

  15. Data mining in healthcare: decision making and precision

    Directory of Open Access Journals (Sweden)

    Ionuţ ŢĂRANU

    2016-05-01

    Full Text Available The trend of application of data mining in healthcare today is increased because the health sector is rich with information and data mining has become a necessity. Healthcare organizations generate and collect large volumes of information to a daily basis. Use of information technology enables automation of data mining and knowledge that help bring some interesting patterns which means eliminating manual tasks and easy data extraction directly from electronic records, electronic transfer system that will secure medical records, save lives and reduce the cost of medical services as well as enabling early detection of infectious diseases on the basis of advanced data collection. Data mining can enable healthcare organizations to anticipate trends in the patient's medical condition and behaviour proved by analysis of prospects different and by making connections between seemingly unrelated information. The raw data from healthcare organizations are voluminous and heterogeneous. It needs to be collected and stored in organized form and their integration allows the formation unite medical information system. Data mining in health offers unlimited possibilities for analyzing different data models less visible or hidden to common analysis techniques. These patterns can be used by healthcare practitioners to make forecasts, put diagnoses, and set treatments for patients in healthcare organizations.

  16. Simulation and Modeling Efforts to Support Decision Making in Healthcare Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Eman AbuKhousa

    2014-01-01

    Full Text Available Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM by improving the decision making pertaining processes’ efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

  17. Simulation and modeling efforts to support decision making in healthcare supply chain management.

    Science.gov (United States)

    AbuKhousa, Eman; Al-Jaroodi, Jameela; Lazarova-Molnar, Sanja; Mohamed, Nader

    2014-01-01

    Recently, most healthcare organizations focus their attention on reducing the cost of their supply chain management (SCM) by improving the decision making pertaining processes' efficiencies. The availability of products through healthcare SCM is often a matter of life or death to the patient; therefore, trial and error approaches are not an option in this environment. Simulation and modeling (SM) has been presented as an alternative approach for supply chain managers in healthcare organizations to test solutions and to support decision making processes associated with various SCM problems. This paper presents and analyzes past SM efforts to support decision making in healthcare SCM and identifies the key challenges associated with healthcare SCM modeling. We also present and discuss emerging technologies to meet these challenges.

  18. An overview of patient involvement in healthcare decision-making: a situational analysis of the Malaysian context

    National Research Council Canada - National Science Library

    Ng, Chirk-Jenn; Lee, Ping-Yein; Lee, Yew-Kong; Chew, Boon-How; Engkasan, Julia P; Irmi, Zarina-Ismail; Hanafi, Nik-Sherina; Tong, Seng-Fah

    2013-01-01

    ..., and laws with respect to patient engagement in shared decision-making (SDM) in Asia. In this study, we conducted a comprehensive literature review to collect information on healthcare decision-making in Malaysia...

  19. Interventions for improving the adoption of shared decision making by healthcare professionals

    NARCIS (Netherlands)

    Legare, F.; Stacey, D.; Turcotte, S.; Cossi, M.J.; Kryworuchko, J.; Graham, I.D.; Lyddiatt, A.; Politi, M.C.; Thomson, R.; Elwyn, G.; Donner-Banzhoff, N.

    2014-01-01

    BACKGROUND: Shared decision making (SDM) can reduce overuse of options not associated with benefits for all and respects patient rights, but has not yet been widely adopted in practice. OBJECTIVES: To determine the effectiveness of interventions to improve healthcare professionals' adoption of SDM.

  20. Strategic decision making: it's time for healthcare organizations to get serious.

    Science.gov (United States)

    Young, David W

    2005-11-01

    To get serious about its strategic decision making, a healthcare organization needs to know what it does not intent to be. Organizations make trade-offs along three dimensions: service or customer needs, and customer access. Strategic trade-offs also should be assessed in terms of competitive scope and pricing policy.

  1. A false sense of security: lesbian, gay, bisexual, and transgender (LGBT) surrogate health care decision-making rights.

    Science.gov (United States)

    Wahlert, Lance; Fiester, Autumn

    2013-01-01

    This article addresses the timely and ethically problematic issue of surrogate decision-making rights for lesbian, gay, bisexual, and transgender (LGBT) patients and their families in the American health care system. Despite multiple pro-LGBT recommendations that have been released in recent years by the Obama administration, the Institute of Medicine, and the US Department of Health and Human Services, such initiatives, while laudable, also have unfortunately occasioned a "false sense of security" for many LGBT patients, their families, and their caregivers. In particular, new regulations on surrogate decision making merely invoke a sense of universal patient rights rather than actually generating them. Therefore, it is imperative that primary care physicians urge all LGBT patients to take proactive steps to protect themselves and their loved ones by naming proxy decision makers well before the crises that would necessitate such decisions.

  2. Addressing Barriers to Shared Decision Making Among Latino LGBTQ Patients and Healthcare Providers in Clinical Settings.

    Science.gov (United States)

    Baig, Arshiya A; Lopez, Fanny Y; DeMeester, Rachel H; Jia, Justin L; Peek, Monica E; Vela, Monica B

    2016-10-01

    Effective shared decision making (SDM) between patients and healthcare providers has been positively associated with health outcomes. However, little is known about the SDM process between Latino patients who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), and their healthcare providers. Our review of the literature identified unique aspects of Latino LGBTQ persons' culture, health beliefs, and experiences that may affect their ability to engage in SDM with their healthcare providers. Further research needs to examine Latino LGBTQ patient-provider experiences with SDM and develop tools that can better facilitate SDM in this patient population.

  3. Economic Evaluation in Ethiopian Healthcare Sector Decision Making: Perception, Practice and Barriers.

    Science.gov (United States)

    Zegeye, Elias Asfaw; Mbonigaba, Josue; Kaye, Sylvia Blanche; Wilkinson, Thomas

    2017-02-01

    Globally, economic evaluation (EE) is increasingly being considered as a critical tool for allocating scarce healthcare resources. However, such considerations are less documented in low-income countries, such as in Ethiopia. In particular, to date there has been no assessment conducted to evaluate the perception and practice of and barriers to health EE. This paper assesses the use and perceptions of EE in healthcare decision-making processes in Ethiopia. In-depth interview sessions with decision makers/healthcare managers and program coordinators across six regional health bureaus were conducted. A qualitative analysis approach was conducted on three thematic areas. A total of 57 decision makers/healthcare managers were interviewed from all tiers of the health sector in Ethiopia, ranging from the Federal Ministry of Health down to the lower levels of the health facility pyramid. At the high-level healthcare decision-making tier, only 56 % of those interviewed showed a good understanding of EE when explaining in terms of cost and consequences of alternative courses of action and value for money. From the specific program perspective, 50 % of the prevention of mother-to-child transmission of HIV/AIDS program coordinators indicated the relevance of EE to program planning and decision making. These respondents reported a limited application of costing studies on the HIV/AIDS prevention and control program, which were most commonly used during annual planning and budgeting. The study uncovered three important barriers to growth of EE in Ethiopia: a lack of awareness, a lack of expertise and skill, and the traditional decision-making culture.

  4. Relational Capacity: Broadening the Notion of Decision-Making Capacity in Paediatric Healthcare.

    Science.gov (United States)

    Ruhe, Katharina M; De Clercq, Eva; Wangmo, Tenzin; Elger, Bernice S

    2016-12-01

    Problems arise when applying the current procedural conceptualization of decision-making capacity to paediatric healthcare: Its emphasis on content-neutrality and rational cognition as well as its implicit assumption that capacity is an ability that resides within a person jeopardizes children's position in decision-making. The purpose of the paper is to challenge this dominant account of capacity and provide an alternative for how capacity should be understood in paediatric care. First, the influence of developmental psychologist Jean Piaget upon the notion of capacity is discussed, followed by an examination of Vygostky's contextualist view on children's development, which emphasizes social interactions and learning for decision-making capacity. In drawing parallels between autonomy and capacity, substantive approaches to relational autonomy are presented that underline the importance of the content of a decision. The authors then provide a relational reconceptualization of capacity that leads the focus away from the individual to include important social others such as parents and physicians. Within this new approach, the outcome of adults' decision-making processes is accepted as a guiding factor for a good decision for the child. If the child makes a choice that is not approved by adults, the new conceptualization emphasizes mutual exchange and engagement by both parties.

  5. VIKOR method with enhanced accuracy for multiple criteria decision making in healthcare management.

    Science.gov (United States)

    Zeng, Qiang-Lin; Li, Dan-Dan; Yang, Yi-Bin

    2013-04-01

    Višekriterijumsko kompromisno rangiranje (VIKOR) method is one of the commonly used multi criteria decision making (MCDM) methods for improving the quality of decision making. VIKOR has an advantage in providing a ranking procedure for positive attributes and negative attributes when it is used and examined in decision support. However, we noticed that this method may failed to support an objective result in medical field because most medical data have normal reference ranges (e.g., for normally distributed data: NRR ∈ [μ ± 1.96σ], this limitation shows a negative effect on the acceptance of it as an effective decision supporting method in medical decision making. This paper proposes an improved VIKOR method with enhanced accuracy (ea-VIKOR) to make it suitable for such data in medical field by introducing a new data normalization method taking the original distance to the normal reference range (ODNRR) into account. In addition, an experimental example was presented to demonstrate efficiency and feasibility of the ea-VIKOR method, the results demonstrate the ability of ea-VIKOR to deal with moderate data and support the decision making in healthcare care management. For this reason, the ea-VIKOR should be considered for use as a decision support tool for future study.

  6. [Involving patients, the insured and the general public in healthcare decision making].

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2016-01-01

    No doubt, the public should be involved in healthcare decision making, especially when decision makers from politics and self-government agencies are faced with the difficult task of setting priorities. There is a general consensus on the need for a stronger patient centeredness, even in HTA processes, and internationally different ways of public participation are discussed and tested in decision making processes. This paper describes how the public can be involved in different decision situations, and it shows how preference measurement methods are currently being used in an international context to support decision making. It distinguishes between different levels of decision making on health technologies: approval, assessment, pricing, and finally utilization. The range of participation efforts extends from qualitative surveys of patients' needs (Citizen Councils of NICE in the UK) to science-based documentation of quantitative patient preferences, such as in the current pilot projects of the FDA in the US and the EMA at the European level. Possible approaches for the elicitation and documentation of preference structures and trade-offs in relation to alternate health technologies are decision aids, such as multi-criteria decision analysis (MCDA), that provide the necessary information for weighting and prioritizing decision criteria.

  7. Thinking about the patient's wishes: practical wisdom of discharge planning nurses in assisting surrogate decision-making.

    Science.gov (United States)

    Kageyama, Yoko; Asano, Midori

    2017-01-31

    The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms. Participants were six discharge planning nurses and one person with previous experience as a discharge planning nurse, all working at discharge planning departments of acute care hospitals. Separate, semi-structured, interactive interviews were conducted with each participant. The study design was qualitative descriptive in form with qualitative content analysis. All participants provided written informed consent to participate in the study, which was approved by the study institution. Three concepts were extracted as the basis for discharge planning nurses' perception and judgement at acute care hospitals: working for mutual envisionment of the available postdischarge options; helping the family act as spokesperson(s) for the patient's wishes; and understanding the family inclusive of the patient as a relationship of strongly interaffecting interests. The practical wisdom of the nurse, working in mutual envisionment with the family, and collaborative decision-making through discussion with those who know the patient, leads to rational discharge assistance. © 2017 Nordic College of Caring Science.

  8. Patient preferences versus physicians' judgement: does it make a difference in healthcare decision making?

    Science.gov (United States)

    Mühlbacher, Axel C; Juhnke, Christin

    2013-06-01

    Clinicians and public health experts make evidence-based decisions for individual patients, patient groups and even whole populations. In addition to the principles of internal and external validity (evidence), patient preferences must also influence decision making. Great Britain, Australia and Germany are currently discussing methods and procedures for valuing patient preferences in regulatory (authorization and pricing) and in health policy decision making. However, many questions remain on how to best balance patient and public preferences with physicians' judgement in healthcare and health policy decision making. For example, how to define evaluation criteria regarding the perceived value from a patient's perspective? How do physicians' fact-based opinions also reflect patients' preferences based on personal values? Can empirically grounded theories explain differences between patients and experts-and, if so, how? This article aims to identify and compare studies that used different preference elicitation methods and to highlight differences between patient and physician preferences. Therefore, studies comparing patient preferences and physician judgements were analysed in a review. This review shows a limited amount of literature analysing and comparing patient and physician preferences for healthcare interventions and outcomes. Moreover, it shows that methodology used to compare preferences is diverse. A total of 46 studies used the following methods-discrete-choice experiments, conjoint analyses, standard gamble, time trade-offs and paired comparisons-to compare patient preferences with doctor judgements. All studies were published between 1985 and 2011. Most studies reveal a disparity between the preferences of actual patients and those of physicians. For most conditions, physicians underestimated the impact of intervention characteristics on patients' decision making. Differentiated perceptions may reflect ineffective communication between the provider

  9. Decision-making strategies: ignored to the detriment of healthcare training and delivery?

    Science.gov (United States)

    Desmond, Chris; Brubaker, Kathryn A; Ellner, Andrew L

    2013-01-01

    Context: People do not always make health-related decisions which reflect their best interest - best interest being defined as the decision they would make if they carefully considered the options and fully understood the information available. A substantial literature has developed in behavioral economics and social psychology that seeks to elucidate the patterns in individual decision-making. While this is particularly relevant to healthcare, the insights from these fields have only been applied in a limited way. To address the health challenges of the twenty-first century, healthcare providers and healthcare systems designers need to more fully understand how individuals are making decisions. Methods: We provide an overview of the theories of behavioral economics and social psychology that relate to how individuals make health-related decisions. The concentration on health-related decisions leads to a focus on three topics: (1) mental shortcuts and motivated reasoning; (2) implications of time; and (3) implications of affect. The first topic is relevant because health-related decisions are often made in a hurry without a full appreciation of the implications and the deliberation they warrant. The second topic is included because the link between a decision and its health-related outcomes can involve a significant time lag. The final topic is included because health and affect are so often linked. Findings: The literature reviewed has implications for healthcare training and delivery. Selection for medical training must consider the skills necessary to understand and adapt to how patients make decisions. Training on the insights garnered from behavioral economics and social psychology would better prepare healthcare providers to effectively support their clients to lead healthy lives. Healthcare delivery should be structured to respond to the way in which decisions are made. Conclusions: These patterns in decision-making call into question basic assumptions our

  10. Health technology assessment in India: the potential for improved healthcare decision-making.

    Science.gov (United States)

    Kumar, Mrityunjai; Ebrahim, Shah; Taylor, Fiona C; Chokshi, Maulik; Gabbay, John

    2014-01-01

    Health technology assessment (HTA) is a multidisciplinary approach that uses clinical effectiveness, cost-effectiveness, policy and ethical perspectives to provide evidence upon which rational decisions on the use of health technologies can be made. It can be used for a single stand-alone technology (e.g. a drug, a device), complex interventions (e.g. a rehabilitation service) and can also be applied to individual patient care and to public health. It is a tool for enabling the assessment and comparison of health technologies using the same metric of cost-effectiveness. This process benefits the patient, the health service, the healthcare payer and the technology producer as only technologies that are considered cost-effective are promoted for widespread use. This leads to greater use of effective technologies and greater health gain. The decision-making process in healthcare in India is complex owing to multiplicity of organizations with overlapping mandates. Often the decision-making is not evidence-based and there is no mechanism of bridging the gap between evidence and policy. Elsewhere, HTA is a frequently used tool in informing policy decisions in both resource-rich and resource-poor countries. Despite national organizations producing large volumes of research and clinical guidelines, India has not yet introduced a formal HTA programme. The incremental growth in healthcare products, services, innovation in affordable medical devices and a move towards universal healthcare, needs to be underpinned with an evidencebase which focuses on effectiveness, safety, affordability and acceptability to maximize the benefits that can be gained with a limited healthcare budget. Establishing HTA as a formal process in India, independent of healthcare providers, funders and technology producers, together with a framework for linking HTA to policy-making, would help ensure that the population gets better access to appropriate healthcare in the future.

  11. Decision-making in crisis: Applying a healthcare triage methodology to business continuity management.

    Science.gov (United States)

    Moore, Bethany; Bone, Eric A

    2017-01-01

    The concept of triage in healthcare has been around for centuries and continues to be applied today so that scarce resources are allocated according to need. A business impact analysis (BIA) is a form of triage in that it identifies which processes are most critical, which to address first and how to allocate limited resources. On its own, however, the BIA provides only a roadmap of the impacts and interdependencies of an event. When disaster strikes, organisational decision-makers often face difficult decisions with regard to allocating limited resources between multiple 'mission-critical' functions. Applying the concept of triage to business continuity provides those decision-makers navigating a rapidly evolving and unpredictable event with a path that protects the fundamental priorities of the organisation. A business triage methodology aids decision-makers in times of crisis by providing a simplified framework for decision-making based on objective, evidence-based criteria, which is universally accepted and understood. When disaster strikes, the survival of the organisation depends on critical decision-making and quick actions to stabilise the incident. This paper argues that organisations need to supplement BIA processes with a decision-making triage methodology that can be quickly applied during the chaos of an actual event.

  12. A multicriteria decision making approach applied to improving maintenance policies in healthcare organizations.

    Science.gov (United States)

    Carnero, María Carmen; Gómez, Andrés

    2016-04-23

    Healthcare organizations have far greater maintenance needs for their medical equipment than other organization, as many are used directly with patients. However, the literature on asset management in healthcare organizations is very limited. The aim of this research is to provide more rational application of maintenance policies, leading to an increase in quality of care. This article describes a multicriteria decision-making approach which integrates Markov chains with the multicriteria Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH), to facilitate the best choice of combination of maintenance policies by using the judgements of a multi-disciplinary decision group. The proposed approach takes into account the level of acceptance that a given alternative would have among professionals. It also takes into account criteria related to cost, quality of care and impact of care cover. This multicriteria approach is applied to four dialysis subsystems: patients infected with hepatitis C, infected with hepatitis B, acute and chronic; in all cases, the maintenance strategy obtained consists of applying corrective and preventive maintenance plus two reserve machines. The added value in decision-making practices from this research comes from: (i) integrating the use of Markov chains to obtain the alternatives to be assessed by a multicriteria methodology; (ii) proposing the use of MACBETH to make rational decisions on asset management in healthcare organizations; (iii) applying the multicriteria approach to select a set or combination of maintenance policies in four dialysis subsystems of a health care organization. In the multicriteria decision making approach proposed, economic criteria have been used, related to the quality of care which is desired for patients (availability), and the acceptance that each alternative would have considering the maintenance and healthcare resources which exist in the organization, with the inclusion of a

  13. Health-care needs and shared decision-making in priority-setting.

    Science.gov (United States)

    Gustavsson, Erik; Sandman, Lars

    2015-02-01

    In this paper we explore the relation between health-care needs and patients' desires within shared decision-making (SDM) in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries which seem to arise due to the double focus on a patient's need and what that patient desires. These queries regard the following themes: the objectivity and moral force of needs, the prediction about what kind of patients which will appear on a micro level, implications for ranking in priority setting, difficulties regarding assessing and comparing benefits, and implications for evidence-based medicine.

  14. Medical decision making

    NARCIS (Netherlands)

    Stiggelbout, A.M.; Vries, M. de; Scherer, L.

    2016-01-01

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

  15. Strategic analytics: towards fully embedding evidence in healthcare decision-making.

    Science.gov (United States)

    Garay, Jason; Cartagena, Rosario; Esensoy, Ali Vahit; Handa, Kiren; Kane, Eli; Kaw, Neal; Sadat, Somayeh

    2015-01-01

    Cancer Care Ontario (CCO) has implemented multiple information technology solutions and collected health-system data to support its programs. There is now an opportunity to leverage these data and perform advanced end-to-end analytics that inform decisions around improving health-system performance. In 2014, CCO engaged in an extensive assessment of its current data capacity and capability, with the intent to drive increased use of data for evidence-based decision-making. The breadth and volume of data at CCO uniquely places the organization to contribute to not only system-wide operational reporting, but more advanced modelling of current and future state system management and planning. In 2012, CCO established a strategic analytics practice to assist the agency's programs contextualize and inform key business decisions and to provide support through innovative predictive analytics solutions. This paper describes the organizational structure, services and supporting operations that have enabled progress to date, and discusses the next steps towards the vision of embedding evidence fully into healthcare decision-making. Copyright © 2014 Longwoods Publishing.

  16. An integrated decision making approach for assessing healthcare waste treatment technologies from a multiple stakeholder.

    Science.gov (United States)

    Shi, Hua; Liu, Hu-Chen; Li, Ping; Xu, Xue-Guo

    2017-01-01

    With increased worldwide awareness of environmental issues, healthcare waste (HCW) management has received much attention from both researchers and practitioners over the past decade. The task of selecting the optimum treatment technology for HCWs is a challenging decision making problem involving conflicting evaluation criteria and multiple stakeholders. In this paper, we develop an integrated decision making framework based on cloud model and MABAC method for evaluating and selecting the best HCW treatment technology from a multiple stakeholder perspective. The introduced framework deals with uncertain linguistic assessments of alternatives by using interval 2-tuple linguistic variables, determines decision makers' relative weights based on the uncertainty and divergence degrees of every decision maker, and obtains the ranking of all HCW disposal alternatives with the aid of an extended MABAC method. Finally, an empirical example from Shanghai, China, is provided to illustrate the feasibility and effectiveness of the proposed approach. Results indicate that the methodology being proposed is more suitable and effective to handle the HCW treatment technology selection problem under vague and uncertain information environment. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. A moral compass for management decision making: a healthcare CEO's reflections.

    Science.gov (United States)

    Donnellan, John J

    2013-01-01

    Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.

  18. Patients' decision-making experiences in the acute healthcare setting--a case study.

    Science.gov (United States)

    Kalaitzidis, Evdokia

    2016-03-01

    The transition from being an ordinary citizen to a hospitalised patient can be a daunting experience particularly for the uninitiated and inexperienced. Patients are likely to have questions such as 'where do I go?', 'what should I do?', 'when?' and 'who should I ask?' The process for making practical moment-to-moment decisions is often complex and fraught with difficulties. Identifying critical points in the hospitalisation experience may provide insights into the quality of hospital management systems and professional practices from a patient perspective. This study aimed to identify institutional practices and structures in the context of acute healthcare settings which impact on patient moment-to-moment decision-making experiences. A case study approach was used as the exploratory methodology, and interviews were conducted with three former adult inpatients. In order to gain an understanding of each participant's experiences, data collecting strategies used in this research were a semistructured interview and document analysis of information documents, such as hospital supplied pamphlets, provided to the researcher by the participants. The study identified five major themes. Identified as being critical to the participants were information sharing by healthcare professionals, professional advice and professional role identification. Less so were environment and everyday life. Associated with these themes were the participant's common experience of being confined in unfamiliar surroundings, adjusting to institutional routines and of being heavily dependent on others. Findings indicate that patient moment-to-moment decision-making may be informed and enhanced in several areas: relevant and timely information sharing, varying the dress code between the different professions, reducing conflicting professional advice, clear signage around the hospital, and flexible visiting hours, telephones and clocks in patient rooms. © 2015 Nordic College of Caring Science.

  19. Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research.

    Science.gov (United States)

    Land, Victoria; Parry, Ruth; Seymour, Jane

    2017-05-18

    Shared decision making (SDM) is generally treated as good practice in health-care interactions. Conversation analytic research has yielded detailed findings about decision making in health-care encounters. To map decision making communication practices relevant to health-care outcomes in face-to-face interactions yielded by prior conversation analyses, and to examine their function in relation to SDM. We searched nine electronic databases (last search November 2016) and our own and other academics' collections. Published conversation analyses (no restriction on publication dates) using recordings of health-care encounters in English where the patient (and/or companion) was present and where the data and analysis focused on health/illness-related decision making. We extracted study characteristics, aims, findings relating to communication practices, how these functioned in relation to SDM, and internal/external validity issues. We synthesised findings aggregatively. Twenty-eight publications met the inclusion criteria. We sorted findings into 13 types of communication practices and organized these in relation to four elements of decision-making sequences: (i) broaching decision making; (ii) putting forward a course of action; (iii) committing or not (to the action put forward); and (iv) HCPs' responses to patients' resistance or withholding of commitment. Patients have limited opportunities to influence decision making. HCPs' practices may constrain or encourage this participation. Patients, companions and HCPs together treat and undertake decision making as shared, though to varying degrees. Even for non-negotiable treatment trajectories, the spirit of SDM can be invoked through practices that encourage participation (eg by bringing the patient towards shared understanding of the decision's rationale). © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  20. Healthcare management and the decision-making process perspective: could a normative framework from stakeholder theory help?

    OpenAIRE

    Buthion, Valérie

    2011-01-01

    Healthcare appears to be a world of Evidence-Based Medicine and rational decisions. Seldom available, sufficient or relevant in view of human needs, scientific evidence do not address priorities when resources are more than ever globally insufficient to an increasingly voracious system. Literature shows than evidence are not sufficient while a wide range of "stakeholders" vie to influence the decision-making process. We will be discussing the part "stakeholders" play in the decision-making pr...

  1. Making the case for evidence-based design in healthcare: a descriptive case study of organizational decision making.

    Science.gov (United States)

    Shoemaker, Lorie K; Kazley, Abby Swanson; White, Andrea

    2010-01-01

    The aim of this study was to describe the organizational decision-making process used in the selection of evidence-based design (EBD) concepts, the criteria used to make these decisions, and the extent to which leadership style may have influenced the decision-making process. Five research questions were formulated to frame the direction of this study, including: (1) How did healthcare leaders learn of innovations in design? (2) How did healthcare leaders make decisions in the selection of healthcare design concepts? (3) What criteria did healthcare leaders use in the decision-making process? (4) How did healthcare leaders consider input from the staff in design decisions? and (5) To what extent did the leadership style of administrators affect the outcomes of the decision-making process? Current issues affecting healthcare in the community led the principal investigator's organization to undertake an ambitious facilities expansion project. As part of its planning process, the organization learned of EBD principles that seemingly had a positive impact on patient care and safety and staff working conditions. Although promising, a paucity of empirical research addressed the cost/benefit of incorporating many EBD concepts into one hospital setting, and there was no research that articulated the organizational decision-making process used by healthcare administrators when considering the use of EBD in expansion projects. A mixed-method, descriptive, qualitative, single-case study and quantitative design were used to address the five research questions. The Systems Research Organizing Model provided the theoretical framework. A variety of data collection methods was used, including interviews of key respondents, the review of documentary evidence, and the Multifactor Leadership Questionnaire. A participatory process was used throughout the design decision phases, involving staff at all levels of the organization. The Internet and architects facilitated learning about

  2. Values based decision making: a tool for achieving the goals of healthcare.

    Science.gov (United States)

    Mills, Anne E; Spencer, Edward M

    2005-03-01

    The recognition that the success of the healthcare organization depends on its achievement of two interrelated goals is a relatively recent phenomenon. In its mid-history the healthcare organization was largely able to ignore cost issues. In its latter history, many would argue that it ignored its quality goals as it pursued its cost goals (15). Either approach, given declining revenues and a competitive landscape, is incompatible with continued responsible operation. If this is true, then tools that were appropriate when the healthcare organization was focused on the achievement of one or another of these goals are not adequate as the healthcare organization seeks to achieve both goals together. Thus, new perspectives and new tools must be found that help the organization address two intimately related but sometimes conflicting goals. Values based decision-making can be the perspective needed, and organization ethics is one tool that can be of use in supporting it within the institution. But there are caveats. In order for values based decision-making to be effective, leadership must take an active role in promoting its use. It must relinquish a degree of control and it must begin to trust its stakeholders to make decisions within the context of the organization's values and goals. This can be extremely difficult, as control by senior management is often seen as the only effective means of ensuring that correct decisions are made. There are additional difficulties in the healthcare organization. Control rests within two groups and the healthcare organization is operating in an environment in which variance elimination is emphasized as a means of controlling costs. This may be an appealing notion for revenue strapped healthcare organization leaders, but it implies greater control exerted by managers, not less. Relinquishing any degree of control is a frightening prospect, but it has been done successfully. An excellent example of leadership encouraging decisions

  3. Patients' participation in decision-making in the medical field--'projectification' of patients in a neoliberal framed healthcare system.

    Science.gov (United States)

    Glasdam, Stinne; Oeye, Christine; Thrysoee, Lars

    2015-10-01

    This article focuses on patients' participation in decision-making in meetings with healthcare professionals in a healthcare system, based on neoliberal regulations and ideas. Drawing on two constructed empirical cases, primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a Foucauldian perspective. Patients' participation in decision-making can be seen as an offshoot of respect for patient autonomy. A treatment must be chosen, when patients consult physicians. From the perspective of patients, there is a tendency for healthcare professionals to supply the patients with the information that they think are necessary for them to make their own decision. But patients do not always want to be a 'customer' in the healthcare system; they want to be a patient, consulting an expert for help and advice, which creates resistance to some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A 'projectification' of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own

  4. A multicriteria decision making approach applied to improving maintenance policies in healthcare organizations

    National Research Council Canada - National Science Library

    Carnero, María Carmen; Gómez, Andrés

    2016-01-01

    .... This article describes a multicriteria decision-making approach which integrates Markov chains with the multicriteria Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH...

  5. Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.

    Science.gov (United States)

    Song, Mi-Kyung; Ward, Sandra E; Fine, Jason P; Hanson, Laura C; Lin, Feng-Chang; Hladik, Gerald A; Hamilton, Jill B; Bridgman, Jessica C

    2015-11-01

    Few trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. A randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. 420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers. Every dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later. preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death. adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. Study was conducted in a single US region. SPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  6. Evaluation of healthcare waste treatment/disposal alternatives by using multi-criteria decision-making techniques.

    Science.gov (United States)

    Özkan, Aysun

    2013-02-01

    Healthcare waste should be managed carefully because of infected, pathological, etc. content especially in developing countries. Applied management systems must be the most appropriate solution from a technical, environmental, economic and social point of view. The main objective of this study was to analyse the current status of healthcare waste management in Turkey, and to investigate the most appropriate treatment/disposal option by using different decision-making techniques. For this purpose, five different healthcare waste treatment/disposal alternatives including incineration, microwaving, on-site sterilization, off-site sterilization and landfill were evaluated according to two multi-criteria decision-making techniques: analytic network process (ANP) and ELECTRE. In this context, benefits, costs and risks for the alternatives were taken into consideration. Furthermore, the prioritization and ranking of the alternatives were determined and compared for both methods. According to the comparisons, the off-site sterilization technique was found to be the most appropriate solution in both cases.

  7. Conducting discrete choice experiments to inform healthcare decision making: a user's guide.

    Science.gov (United States)

    Lancsar, Emily; Louviere, Jordan

    2008-01-01

    Discrete choice experiments (DCEs) are regularly used in health economics to elicit preferences for healthcare products and programmes. There is growing recognition that DCEs can provide more than information on preferences and, in particular, they have the potential to contribute more directly to outcome measurement for use in economic evaluation. Almost uniquely, DCEs could potentially contribute to outcome measurement for use in both cost-benefit and cost-utility analysis. Within this expanding remit, our intention is to provide a resource for current practitioners as well as those considering undertaking a DCE, using DCE results in a policy/commercial context, or reviewing a DCE. We present the fundamental principles and theory underlying DCEs. To aid in undertaking and assessing the quality of DCEs, we discuss the process of carrying out a choice study and have developed a checklist covering conceptualizing the choice process, selecting attributes and levels, experimental design, questionnaire design, pilot testing, sampling and sample size, data collection, coding of data, econometric analysis, validity, interpretation and welfare and policy analysis. In this fast-moving area, a number of issues remain on the research frontier. We therefore outline potentially fruitful areas for future research associated both with DCEs in general, and with health applications specifically, paying attention to how the results of DCEs can be used in economic evaluation. We also discuss emerging research trends. We conclude that if appropriately designed, implemented, analysed and interpreted, DCEs offer several advantages in the health sector, the most important of which is that they provide rich data sources for economic evaluation and decision making, allowing investigation of many types of questions, some of which otherwise would be intractable analytically. Thus, they offer viable alternatives and complements to existing methods of valuation and preference elicitation.

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

    DEFF Research Database (Denmark)

    Traynor, Michael; Boland, Maggie; Buus, Niels

    2010-01-01

    profession for reasons including history, gender and a traditional subservience to medicine. This paper reports on a focus group study of UK nurses participating in post-qualifying professional development in 2008. Three groups of nurses in different specialist areas comprised a total of 26 participants....... The study uses accounts of decision-making to gain insight into contemporary professional nursing. The study also aims to explore the usefulness of a theory of professional work set out by Jamous and Peloille (1970). The analysis draws on notions of interpretive repertoires and elements of narrative...... analysis. We identified two interpretive repertoires: 'clinical judgement' which was used to describe the different grounds for making judgements; and 'decision-making' which was used to describe organisational circumstances influencing decision-making. Jamous and Peloille's theory proved useful...

  9. Comparisons of guardianship laws and surrogate decision-making practices in China, Japan, Thailand and Australia: a review by the Asia Consortium, International Psychogeriatric Association (IPA) capacity taskforce.

    Science.gov (United States)

    Tsoh, Joshua; Peisah, Carmelle; Narumoto, Jin; Wongpakaran, Nahathai; Wongpakaran, Tinakon; O'Neill, Nick; Jiang, Tao; Ogano, Shoichi; Mimura, Masaru; Kato, Yuka; Chiu, Helen

    2015-06-01

    The International Psychogeriatric Association (IPA) capacity taskforce was established to promote the autonomy, proper access to care, and dignity of persons with decision-making disabilities (DMDs) across nations. The Asia Consortium of the taskforce was established to pursue these goals in the Asia-Pacific region. This paper is part of the Asia Consortium's initiative to promote understanding and advocacy in regard to surrogate decision-making across the region. The current guardianship laws are compared, and jurisdictional variations in the processes for proxy decision-making to support persons with DMDs and other health and social needs in China, Japan, Thailand, and Australia are explored. The different Asia-Pacific countries have various proxy decision-making mechanisms in place for persons with DMDs, which are both formalized according to common law, civil law, and other legislation, and shaped by cultural practices. Various processes for guardianship and mechanisms for medical decision-making and asset management exist across the region. Processes that are still evolving across the region include those that facilitate advanced planning as a result of the paucity of legal structures for enduring powers of attorney (EPA) and guardianship in some regions, and the struggle to achieve consensual positions in regard to end-of-life decision-making. Formal processes for supporting decision-making are yet to be developed. The diverse legal approaches to guardianship and administration must be understood to meet the challenges of the rapidly ageing population in the Asia-Pacific region. Commonalities in the solutions and difficulties faced in encountering these challenges have global significance.

  10. Integrated decision making in healthcare: an operations research and management science perspective

    NARCIS (Netherlands)

    Hulshof, Peter Jan Hendrik

    2013-01-01

    The pressure on healthcare systems rises as both demand for healthcare and expenditures are increasing steadily. As a result, healthcare professionals face the challenging task to design and organize the healthcare delivery process more effectively and efficiently. Designing and organizing processes

  11. Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Eiring, Øystein; Nielsen, Jesper Bo

    Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd Mette Kjer Kaltoft, University of Southern Denmark Øystein Eiring, Norwegian Knowledge Centre for the Health Services Jesper Bo Nielsen, University of Southern Denmark...... Glenn Salkeld, University of Sydney School of Public Health Jack Dowie, London School of Hygiene and Tropical Medicine (presenting) Abstract (500) Person-centred care is the increasingly avowed aim of health services and professionals. To be meaningful such care requires a shared decision making process...... in which an individual's preferences over the multiple criteria that matter to them are synthesised with the Best Estimate Available Now (at the point of decision) for how well each of the available options will perform on each criterion. Conventional evidence-based approaches can meet the latter...

  12. How to use multi-criteria decision analysis methods for reimbursement decision-making in healthcare: a step-by-step guide.

    Science.gov (United States)

    Diaby, Vakaramoko; Goeree, Ron

    2014-02-01

    In recent years, the quest for more comprehensiveness, structure and transparency in reimbursement decision-making in healthcare has prompted the research into alternative decision-making frameworks. In this environment, multi-criteria decision analysis (MCDA) is arising as a valuable tool to support healthcare decision-making. In this paper, we present the main MCDA decision support methods (elementary methods, value-based measurement models, goal programming models and outranking models) using a case study approach. For each family of methods, an example of how an MCDA model would operate in a real decision-making context is presented from a critical perspective, highlighting the parameters setting, the selection of the appropriate evaluation model as well as the role of sensitivity and robustness analyses. This study aims to provide a step-by-step guide on how to use MCDA methods for reimbursement decision-making in healthcare.

  13. Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument

    NARCIS (Netherlands)

    Couet, N.; Desroches, S.; Robitaille, H.; Vaillancourt, H.; Leblanc, A.; Turcotte, S.; Elwyn, G.; Legare, F.

    2015-01-01

    BACKGROUND: We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. OBJECTIVE: To systematically review studies t

  14. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    Science.gov (United States)

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  15. Role of healthcare in childbearing decision-making of WLHA in Nigeria: Application of PEN-3 cultural model.

    Science.gov (United States)

    Sofolahan-Oladeinde, Y A; Iwelunmor, J I; Conserve, D F; Gbadegesin, A; Airhihenbuwa, C O

    2016-08-31

    Healthcare experiences among women living with HIV/AIDS (WLHA), determine their utilisation of sexual and reproductive health services, which ultimately influences their decisions on childbearing. This study aimed to understand the importance of healthcare support in the childbearing decision-making processes of WLHA, and its impact on eliminating new paediatric HIV infections. We conducted in-depth interviews between July and August 2012 with 15 WLHA receiving clinical HIV care at a teaching hospital in Lagos. Using PEN-3 cultural model, as a guide we explored perceptions of healthcare support pre- and post-partum. Findings indicate that faith in God for the delivery of a healthy child is significant during the pre-partum period, while the advice of healthcare workers concerning childbearing and access to available healthcare services carry more weight post-partum. Our findings have important implications for HIV treatment and care programmes geared towards WLHA considering childbearing, and ultimately the UN Global plan to eliminate mother-to-child transmission of HIV, as we move towards the 2030 agenda for sustainable development.

  16. The impact of health-care service guarantees on consumer decision-making: an experimental investigation.

    Science.gov (United States)

    Kennett-Hensel, Pamela A; Min, Kyeong Sam; Totten, Jeff W

    2012-01-01

    While examples of the successful use of service guarantees in health-care do exist, to-date, researchers have yet to examine this industry-specific application beyond a case study perspective. The results of this experiment begin to shed light on whether or not guarantees should be used, and if so, under what conditions are they appropriate. Respondents indicate that the thoughtful use of service guarantees can positively impact their perceptions of the health-care provider's reputation and, ultimately, their behavioral intentions towards the same provider. However, consideration must be given to the type of guarantee being offered and to whom the guarantee is targeted.

  17. Use of Value of Information in Healthcare Decision Making: Exploring Multiple Perspectives

    NARCIS (Netherlands)

    Bindels, J.; Ramaekers, B.; Ramos, I.C.; Mohseninejad, L.; Knies, S.; Grutters, J.P.; Postma, M.; Al, M.; Feenstra, T.; Joore, M.

    2016-01-01

    BACKGROUND: Value of information (VOI) is a tool that can be used to inform decisions concerning additional research in healthcare. VOI estimates the value of obtaining additional information and indicates the optimal design for additional research. Although it is recognized as good practice in hand

  18. Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Eiring, Øystein; Nielsen, Jesper Bo

    to online version). The criteria included (Response, Remission, and Tolerability) were determined by data availability in trials and are not those that would be produced by a survey of person-as-patient important outcomes. Minimally the latter would distinguish different types of side effects and adverse...... research practical relevance for person-centred care. Major benefits in the form of establishing priorities for person-centred research will follow by way of ‘backward translation’ of the need for better BEANs for many person-as-patient important outcomes.......Producing the BEANs needed for person-centred healthcare decision making requires translating the wisdom of the clinical crowd Mette Kjer Kaltoft, University of Southern Denmark Øystein Eiring, Norwegian Knowledge Centre for the Health Services Jesper Bo Nielsen, University of Southern Denmark...

  19. Integrating a population health approach into healthcare service delivery and decision making.

    Science.gov (United States)

    Neudorf, Cordell

    2012-01-01

    Most regional health authorities include "improving population health and health equity" in their mission, vision, or priority statements, yet few regional health authorities or hospitals have been shown to devote the sufficient time and resources to make significant progress toward this aim. Health system leaders want to act on this priority, but many barriers and challenges conspire to limit their effectiveness. Improving population health requires both population-based and individual-level initiatives aimed at preventing disease and improving health equity. Practical examples for integrating a population health approach into the health system are presented for healthcare leaders.

  20. Influence of a husband's healthcare decision making role on a woman's intention to use contraceptives among Mozambican women.

    Science.gov (United States)

    Mboane, Ramos; Bhatta, Madhav P

    2015-04-23

    Previous studies in developing countries suggest that a husband plays an influential role in a woman's contraceptive use. The influence of a husband/partner's healthcare decision making power on a woman's intention to use contraceptives in Mozambique has not been studied. The present study examined this relationship using data from the 2011 Mozambique Demographic and Health Survey (DHS), which included a nationally representative sample of 7,022 women aged 15-49 years. The primary outcome of interest in the study was a woman's intention to use contraceptives. The primary exposure of interest was the person making decisions about a woman's healthcare, dichotomized as the husband/partner alone vs. the woman herself or jointly with her husband/partner. Several potential socio-demographic confounders were adjusted for in overall and stratified multivariable logistic regression models. Adjusted odds ratio (AOR) and the associated 95% confidence interval (CI) are reported. The mean age of the sample was 30.4 (95% CI: 30.1 - 30.7) years. Overall, a woman who reported her husband/partner usually made the decision about her healthcare was 19% less likely to report an intention to use contraceptives than a woman who reported that she herself or jointly with her husband/partner made the decision (AOR = 0.81, 95% CI 0.71- 0.92). In stratified analyses, the association remained statistically significant among rural women (AOR = 0.75, 95% CI: 0.65 - 0.87); among women with knowledge of modern contraceptive methods (AOR = 0.83, 95% CI: 0.73 - 0.95); and among women with three or more (AOR = 0.81, 95% CI: 0.68 - 0.97) and two or fewer (AOR = 0.79, 95% CI: 0.65 - 0.96) living children. A husband/partner's healthcare decision making power in the relationship had a significant negative effect on a Mozambican woman's intention to use contraceptives. These findings have implications for addressing the role of men in the design and implementation of successful family planning

  1. Expediting evidence synthesis for healthcare decision-making: exploring attitudes and perceptions towards rapid reviews using Q methodology

    Directory of Open Access Journals (Sweden)

    Shannon E. Kelly

    2016-10-01

    Full Text Available Background Rapid reviews expedite the knowledge synthesis process with the goal of providing timely information to healthcare decision-makers who want to use evidence-informed policy and practice approaches. A range of opinions and viewpoints on rapid reviews is thought to exist; however, no research to date has formally captured these views. This paper aims to explore evidence producer and knowledge user attitudes and perceptions towards rapid reviews. Methods A Q methodology study was conducted to identify central viewpoints about rapid reviews based on a broad topic discourse. Participants rank-ordered 50 text statements and explained their Q-sort in free-text comments. Individual Q-sorts were analysed using Q-Assessor (statistical method: factor analysis with varimax rotation. Factors, or salient viewpoints on rapid reviews, were identified, interpreted and described. Results Analysis of the 11 individual Q sorts identified three prominent viewpoints: Factor A cautions against the use of study design labels to make judgements. Factor B maintains that rapid reviews should be the exception and not the rule. Factor C focuses on the practical needs of the end-user over the review process. Conclusion Results show that there are opposing viewpoints on rapid reviews, yet some unity exists. The three factors described offer insight into how and why various stakeholders act as they do and what issues may need to be resolved before increase uptake of the evidence from rapid reviews can be realized in healthcare decision-making environments.

  2. A conceptual model of family surrogate end-of-life decision-making process in the nursing home setting: goals of care as guiding stars.

    Science.gov (United States)

    Bern-Klug, Mercedes

    2014-01-01

    An increasing proportion of dying is occurring in America's nursing homes (NH). Family members are involved in (and affected by) medical decision-making on behalf of NH residents approaching the end of life, especially when the resident is cognitively impaired. This article proposes an empirically derived conceptual model of the key factors NH family surrogate decision-makers consider when establishing or changing goals of care and the iterative process as applied to the NH setting. This model also establishes the importance of family social role expectations toward their loved one as well as the concept, "stance toward dying," as key in establishing or changing the main goal of care. NH staff and physicians can use the model as a framework for providing information and support to family members. Research is needed to better understand how to prepare staff and settings to support family surrogate decision-makers, in particular around setting goals of care. The model can be generalized beyond nursing homes.

  3. Assessment of health-care waste disposal methods using a VIKOR-based fuzzy multi-criteria decision making method.

    Science.gov (United States)

    Liu, Hu-Chen; Wu, Jing; Li, Ping

    2013-12-01

    Nowadays selection of the appropriate treatment method in health-care waste (HCW) management has become a challenge task for the municipal authorities especially in developing countries. Assessment of HCW disposal alternatives can be regarded as a complicated multi-criteria decision making (MCDM) problem which requires consideration of multiple alternative solutions and conflicting tangible and intangible criteria. The objective of this paper is to present a new MCDM technique based on fuzzy set theory and VIKOR method for evaluating HCW disposal methods. Linguistic variables are used by decision makers to assess the ratings and weights for the established criteria. The ordered weighted averaging (OWA) operator is utilized to aggregate individual opinions of decision makers into a group assessment. The computational procedure of the proposed framework is illustrated through a case study in Shanghai, one of the largest cities of China. The HCW treatment alternatives considered in this study include "incineration", "steam sterilization", "microwave" and "landfill". The results obtained using the proposed approach are analyzed in a comparative way. Copyright © 2013. Published by Elsevier Ltd.

  4. Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of behavior to the role and design of decision support interventions in healthcare interactions.

    NARCIS (Netherlands)

    Frosch, D.; Legare, F.; Fishbein, M.; Elwyn, G.

    2009-01-01

    ABSTRACT: BACKGROUND: A growing body of literature documents the efficacy of decision support interventions (DESI) in helping patients make informed clinical decisions. DESIs are frequently described as an adjunct to shared decision-making between a patient and healthcare provider, however little is

  5. Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of behavior to the role and design of decision support interventions in healthcare interactions.

    NARCIS (Netherlands)

    Frosch, D.; Legare, F.; Fishbein, M.; Elwyn, G.

    2009-01-01

    ABSTRACT: BACKGROUND: A growing body of literature documents the efficacy of decision support interventions (DESI) in helping patients make informed clinical decisions. DESIs are frequently described as an adjunct to shared decision-making between a patient and healthcare provider, however little is

  6. Evidence-Based Knowledge Management: an approach to effectively promote good health-care decision-making in the Information Era.

    Science.gov (United States)

    Corrao, Salvatore; Arcoraci, Vincenzo; Arnone, Sabrina; Calvo, Luigi; Scaglione, Rosario; Di Bernardo, Cristofaro; Lagalla, Roberto; Caputi, Achille Patrizio; Licata, Giuseppe

    2009-04-01

    The sharing of information and the growth of knowledge together represent a foundation for the promotion of quality improvement of health care systems. This paper concerns knowledge, not only from an epistemological point of view, but also from a pragmatic one. In our paper, knowledge is discussed as the hub to promote better decision making and continuous professional development. Effective thinking is particularly needed. The critical point is to think about how health care systems can develop both an effective knowledge management network and how health-care organizations can actually be based on it. In this way, knowledge and knowledge hierarchy are defined according to Russel Achkoff's vision. Generally, knowledge is crucial in decision-making, and Evidence-Based Medicine has its roots in knowledge. In particular, information management is the basis for a significant production of knowledge to promote good health-care decision-making. Thus, relationships between knowledge management and Evidence-Based Medicine are discussed, and a new paradigm is proposed: the Evidence-Based Knowledge Management. Finally, the role of Evidence-Based Knowledge Management within Clinical Governance is discussed together with some considerations about clinical governance implementation problems in Italy.

  7. Multi-criteria clinical decision support: A primer on the use of multiple criteria decision making methods to promote evidence-based, patient-centered healthcare.

    Science.gov (United States)

    Dolan, James G

    2010-01-01

    Current models of healthcare quality recommend that patient management decisions be evidence-based and patient-centered. Evidence-based decisions require a thorough understanding of current information regarding the natural history of disease and the anticipated outcomes of different management options. Patient-centered decisions incorporate patient preferences, values, and unique personal circumstances into the decision making process and actively involve both patients along with health care providers as much as possible. Fundamentally, therefore, evidence-based, patient-centered decisions are multi-dimensional and typically involve multiple decision makers.Advances in the decision sciences have led to the development of a number of multiple criteria decision making methods. These multi-criteria methods are designed to help people make better choices when faced with complex decisions involving several dimensions. They are especially helpful when there is a need to combine "hard data" with subjective preferences, to make trade-offs between desired outcomes, and to involve multiple decision makers. Evidence-based, patient-centered clinical decision making has all of these characteristics. This close match suggests that clinical decision support systems based on multi-criteria decision making techniques have the potential to enable patients and providers to carry out the tasks required to implement evidence-based, patient-centered care effectively and efficiently in clinical settings.The goal of this paper is to give readers a general introduction to the range of multi-criteria methods available and show how they could be used to support clinical decision-making. Methods discussed include the balance sheet, the even swap method, ordinal ranking methods, direct weighting methods, multi-attribute decision analysis, and the analytic hierarchy process (AHP).

  8. Decision-making process related to treatment and management in Korean women with breast cancer: Finding the right individualized healthcare trajectory.

    Science.gov (United States)

    Kim, Kkotbong; Yang, Jinhyang

    2017-06-01

    After being diagnosed with breast cancer, women must make a number of decisions about their treatment and management. When the decision-making process among breast cancer patients is ineffective, it results in harm to their health. Little is known about the decision-making process of breast cancer patients during the entire course of treatment and management. We investigated women with breast cancer to explore the decision-making processes related to treatment and management. Eleven women participated, all of whom were receiving treatment or management in Korea. The average participant age was 43.5years. For data collection and analysis, a grounded theory methodology was used. Through constant comparative analyses, a core category emerged that we referred to as "finding the right individualized healthcare trajectory." The decision-making process occurred in four phases: turmoil, exploration, balance, and control. The turmoil phase included weighing the credibility of information and lowering the anxiety level. The exploration phase included assessing the expertise/promptness of medical treatment and evaluating the effectiveness of follow-up management. The balance phase included performing analyses from multiple angles and rediscovering value as a human being. The control phase included constructing an individualized management system and following prescribed and other management options. It is important to provide patients with accurate information related to the treatment and management of breast cancer so that they can make effective decisions. Healthcare providers should engage with patients on issues related to their disease, understand the burden placed on patients because of issues related to their sex, and ensure that the patient has a sufficient support system. The results of this study can be used to develop phase-specific, patient-centered, and tailored interventions for breast cancer patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Evidence-Based and Value-Based Decision Making About Healthcare Design: An Economic Evaluation of the Safety and Quality Outcomes.

    Science.gov (United States)

    Zadeh, Rana; Sadatsafavi, Hessam; Xue, Ryan

    2015-01-01

    This study describes a vision and framework that can facilitate the implementation of evidence-based design (EBD), scientific knowledge base into the process of the design, construction, and operation of healthcare facilities and clarify the related safety and quality outcomes for the stakeholders. The proposed framework pairs EBD with value-driven decision making and aims to improve communication among stakeholders by providing a common analytical language. Recent EBD research indicates that the design and operation of healthcare facilities contribute to an organization's operational success by improving safety, quality, and efficiency. However, because little information is available about the financial returns of evidence-based investments, such investments are readily eliminated during the capital-investment decision-making process. To model the proposed framework, we used engineering economy tools to evaluate the return on investments in six successful cases, identified by a literature review, in which facility design and operation interventions resulted in reductions in hospital-acquired infections, patient falls, staff injuries, and patient anxiety. In the evidence-based cases, calculated net present values, internal rates of return, and payback periods indicated that the long-term benefits of interventions substantially outweighed the intervention costs. This article explained a framework to develop a research-based and value-based communication language on specific interventions along the planning, design and construction, operation, and evaluation stages. Evidence-based and value-based design frameworks can be applied to communicate the life-cycle costs and savings of EBD interventions to stakeholders, thereby contributing to more informed decision makings and the optimization of healthcare infrastructures. © The Author(s) 2015.

  10. Adjuncts or adversaries to shared decision-making? Applying the Integrative Model of behavior to the role and design of decision support interventions in healthcare interactions

    Directory of Open Access Journals (Sweden)

    Fishbein Martin

    2009-11-01

    Full Text Available Abstract Background A growing body of literature documents the efficacy of decision support interventions (DESI in helping patients make informed clinical decisions. DESIs are frequently described as an adjunct to shared decision-making between a patient and healthcare provider, however little is known about the effects of DESIs on patients' interactional behaviors-whether or not they promote the involvement of patients in decisions. Discussion Shared decision-making requires not only a cognitive understanding of the medical problem and deliberation about the potential options to address it, but also a number of communicative behaviors that the patient and physician need to engage in to reach the goal of making a shared decision. Theoretical models of behavior can guide both the identification of constructs that will predict the performance or non-performance of specific behaviors relevant to shared decision-making, as well as inform the development of interventions to promote these specific behaviors. We describe how Fishbein's Integrative Model (IM of behavior can be applied to the development and evaluation of DESIs. There are several ways in which the IM could be used in research on the behavioral effects of DESIs. An investigator could measure the effects of an intervention on the central constructs of the IM - attitudes, normative pressure, self-efficacy, and intentions related to communication behaviors relevant to shared decision-making. However, if one were interested in the determinants of these domains, formative qualitative research would be necessary to elicit the salient beliefs underlying each of the central constructs. Formative research can help identify potential targets for a theory-based intervention to maximize the likelihood that it will influence the behavior of interest or to develop a more fine-grained understanding of intervention effects. Summary Behavioral theory can guide the development and evaluation of DESIs to

  11. Decision making in surgical oncology.

    Science.gov (United States)

    Lamb, B; Green, J S A; Vincent, C; Sevdalis, N

    2011-09-01

    Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Application of this systems approach to MDT working allows the identification of factors that affect the quality of decision making for cancer patients. In this article we review the literature on decision making in surgical oncology and by drawing from the systems approach to surgical performance we provide a framework for understanding the process of decision making in MDTs. Technical factors that affect decision making include the information about patients, robust ICT and video-conferencing equipment, a minimum dataset with expert review of radiological and pathological information, implementation and recording of the MDTs decision. Non-technical factors with an impact on decision making include attendance of team members at meetings, leadership, teamwork, open discussion, consensus on decisions and communication with patients and primary care. Optimising these factors will strengthen the decision making process and raise the quality of care for cancer patients.

  12. Influences of organizational features of healthcare settings on clinical decision making: qualitative results from a cross-national factorial experiment.

    NARCIS (Netherlands)

    Lutfey, K.E.; Campbell, S.M.; Marceau, L.D.; Roland, M.O.; McKinlay, J.B.

    2012-01-01

    A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand t

  13. Bridging the gap: exploring the barriers to using economic evidence in healthcare decision making and strategies for improving uptake.

    Science.gov (United States)

    Merlo, Gregory; Page, Katie; Ratcliffe, Julie; Halton, Kate; Graves, Nicholas

    2015-06-01

    Evidence from economic evaluations is often not used to inform healthcare policy despite being well regarded by policy makers and physicians. This article employs the accessibility and acceptability framework to review the barriers to using evidence from economic evaluation in healthcare policy and the strategies used to overcome these barriers. Economic evaluations are often inaccessible to policymakers due to the absence of relevant economic evaluations, the time and cost required to conduct and interpret economic evaluations, and lack of expertise to evaluate quality and interpret results. Consistently reported factors that limit the translation of findings from economic evaluations into healthcare policy include poor quality of research informing economic evaluations, assumptions used in economic modelling, conflicts of interest, difficulties in transferring resources between sectors, negative attitudes to healthcare rationing, and the absence of equity considerations. Strategies to overcome these barriers have been suggested in the literature, including training, structured abstract databases, rapid evaluation, reporting checklists for journals, and considering factors other than cost effectiveness in economic evaluations, such as equity or budget impact. The factors that prevent or encourage decision makers to use evidence from economic evaluations have been identified, but the relative importance of these factors to decision makers is uncertain.

  14. Decision Making By Children

    OpenAIRE

    Lundberg, Shelly; Romich, Jennifer; Tsang, Kwok P.

    2007-01-01

    In this paper, we examine the determinants of decision-making power by children and young adolescents. Moving beyond previous economic models that treat children as goods consumed by adults rather than agents, we develop a noncooperative model of parental control of child behavior and child resistance. Using child reports of decision-making and psychological and cognitive measures from the NLSY79 Child Supplement, we examine the determinants of shared and sole decision-making in seven domains...

  15. Mediation and surrogate decision-making for LGBTQ families in the absence of an advance directive : comment on "Ethical challenges in end-of-life care for GLBTI individuals" by Colleen Cartwright.

    Science.gov (United States)

    Wahlert, Lance; Fiester, Autumn

    2012-09-01

    In this commentary on a clinical ethics case pertaining to a same-sex couple that does not have explicit surrogate decision-making or hospital-visitation rights (in the face of objections from the family-of-origin of one of the queer partners), the authors invoke contemporary legal and policy standards on LGBTQ health care in the United States and abroad. Given this historical moment in which some clinical rights are guaranteed for LGBTQ families whilst others are in transition, the authors advocate for the implementation of clinical ethics mediation as the soundest and most humane form of resolution in matters where there is a dispute between family members about an incapacitated loved one. They argue that clinical ethics mediation is an ideal alternative solution because it works toward consensus about outcome, even where consensus about values is not achievable.

  16. Interpreting Indirect Treatment Comparisons and Network Meta-Analysis for Health-Care Decision Making : Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 1

    NARCIS (Netherlands)

    Jansen, Jeroen P.; Fleurence, Rachael; Devine, Beth; Itzler, Robbin; Barrett, Annabel; Hawkins, Neil; Lee, Karen; Boersma, Cornelis; Annemans, Lieven; Cappelleri, Joseph C.

    Evidence-based health-care decision making requires comparisons of all relevant competing interventions. In the absence of randomized, controlled trials involving a direct comparison of all treatments of interest, indirect treatment comparisons and network meta-analysis provide useful evidence for

  17. The Cultural Turn In Sociology: Can it Help Us Resolve an Age-Old Problem in Understanding Decision Making for Healthcare?

    Science.gov (United States)

    Pescosolido, Bernice A.; Olafsdottir, Sigrun

    2015-01-01

    Culture has long shaped individuals’ response to problems. A classic puzzle in the sociology of health and illness is discrepancy between theory and research regarding cultural beliefs and medical care service use. “Utilization research,” examining individuals’ responses to the onset of health problems, has not consistently affected culture on the uptake of formal treatment. While ethnographic research often describes how culture shapes illness behaviors, survey-based studies rarely find significant effects of predispositions once “need” is controlled. In quantitative studies, individuals report supportive treatment beliefs or predispositions to use services but low utilization levels, reinforcing claims about lack of utility of cultural ideologies in health-care decision making. We ask whether innovations in the sociology of culture and cognition provide the theoretical scaffolding to conceptualize and measure culture in health service utilization. Examining data from the General Social Survey, we focus on how approaches to culture might explain the paradox of high cultural predispositions and low actual use. Children with mental health problems provide a comparison between suggestions and endorsements. Suggestions, sources of care offered by individuals in response to a case description without any other social cues, align with new cultural approaches, and are measured by responses to open-ended questions about what should be done for the child described meeting clinical criteria f or ADHD, major depression, asthma, or “daily troubles”). Endorsements, requiring less cognitive work and cultural resistance, align with traditional conceptualizations of culture, and are measured by closed-ended questions that ask respondents to agree or disagree with seeking help from different treatment options placed later in the survey. We find that suggestions reveal cultural predispositions to use services corresponding closely to reported utilization levels

  18. Shared decision making

    Science.gov (United States)

    ... the rest of your life Having major surgery Getting genetic or cancer screening tests Talking together about your options helps your provider know how you feel and what you value. How Shared Decision Making Works When facing a decision, your ...

  19. A system of system lenses for leadership decision-making.

    Science.gov (United States)

    Cady, Phil

    2016-01-01

    The sheer volume and dynamics among system agents in healthcare makes decision-making a daunting task at all levels. Being clear about what leaders mean by "healthcare system" is critical in aligning system strategy and leadership decision-making. This article presents an emerging set of lenses (ideology and beliefs, rational and irrational information processing, interpersonal social dynamics, process and value creation, and context) to help frame leadership decision-making in healthcare systems.

  20. Responsive Decision-Making

    DEFF Research Database (Denmark)

    Pedersen, Carsten Lund; Andersen, Torben Juul

    Strategic decision making remains a focal point in the strategy field, but despite decades of rich conceptual and empirical research we still seem distant from a level of understanding that can guide corporate practices effectively under turbulent and unpredictable environmental conditions. Hence......, the aim of this study is to gain deeper insights into the complex and multifaceted decision processes that take place in large complex organizations operating in dynamic high-velocity markets. It is proposed that the ability to obtain faster, more accurate and updated insights about ongoing environmental...... developments and feeding that information into strategic decisions will enable higher quality outcomes and better adaptive responses for persistent performance. Thus we review relevant parts of the strategic decision making literature to conceptualize the responsive decision making model and propose a study...

  1. Modulators of decision making.

    Science.gov (United States)

    Doya, Kenji

    2008-04-01

    Human and animal decisions are modulated by a variety of environmental and intrinsic contexts. Here I consider computational factors that can affect decision making and review anatomical structures and neurochemical systems that are related to contextual modulation of decision making. Expectation of a high reward can motivate a subject to go for an action despite a large cost, a decision that is influenced by dopamine in the anterior cingulate cortex. Uncertainty of action outcomes can promote risk taking and exploratory choices, in which norepinephrine and the orbitofrontal cortex appear to be involved. Predictable environments should facilitate consideration of longer-delayed rewards, which depends on serotonin in the dorsal striatum and dorsal prefrontal cortex. This article aims to sort out factors that affect the process of decision making from the viewpoint of reinforcement learning theory and to bridge between such computational needs and their neurophysiological substrates.

  2. Decision Making in Action

    Science.gov (United States)

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

    1994-01-01

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

  3. Emotion and decision making.

    Science.gov (United States)

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

    2015-01-01

    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.

  4. Food Decision-Making

    NARCIS (Netherlands)

    Meer, van Floor; Charbonnier, Lisette; Smeets, Paul A.M.

    2016-01-01

    Food decisions determine energy intake. Since overconsumption is the main driver of obesity, the effects of weight status on food decision-making are of increasing interest. An additional factor of interest is age, given the rise in childhood obesity, weight gain with aging, and the increased

  5. Designing for Decision Making

    Science.gov (United States)

    Jonassen, David H.

    2012-01-01

    Decision making is the most common kind of problem solving. It is also an important component skill in other more ill-structured and complex kinds of problem solving, including policy problems and design problems. There are different kinds of decisions, including choices, acceptances, evaluations, and constructions. After describing the centrality…

  6. Decision Making In Orienteering.

    Science.gov (United States)

    Almeida, Katia

    1997-01-01

    Eight psychometric instruments were administered to 10 elite male Portuguese orienteers. The cognitive process involved in decision making did not differ between the best orienteers and the others. This group of athletes had a high capacity for work realization and a strong need to be in control of interpersonal situations. (Author/SV)

  7. Food Decision-Making

    NARCIS (Netherlands)

    Meer, van Floor; Charbonnier, Lisette; Smeets, Paul A.M.

    2016-01-01

    Food decisions determine energy intake. Since overconsumption is the main driver of obesity, the effects of weight status on food decision-making are of increasing interest. An additional factor of interest is age, given the rise in childhood obesity, weight gain with aging, and the increased cha

  8. Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    2012-01-01

    by the inclusion of multiple stakeholders. The conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk management models does – for the sake of the wider social responsibilities of the businesses...

  9. Shared clinical decision making

    Science.gov (United States)

    AlHaqwi, Ali I.; AlDrees, Turki M.; AlRumayyan, Ahmad; AlFarhan, Ali I.; Alotaibi, Sultan S.; AlKhashan, Hesham I.; Badri, Motasim

    2015-01-01

    Objectives: To determine preferences of patients regarding their involvement in the clinical decision making process and the related factors in Saudi Arabia. Methods: This cross-sectional study was conducted in a major family practice center in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between March and May 2012. Multivariate multinomial regression models were fitted to identify factors associated with patients preferences. Results: The study included 236 participants. The most preferred decision-making style was shared decision-making (57%), followed by paternalistic (28%), and informed consumerism (14%). The preference for shared clinical decision making was significantly higher among male patients and those with higher level of education, whereas paternalism was significantly higher among older patients and those with chronic health conditions, and consumerism was significantly higher in younger age groups. In multivariate multinomial regression analysis, compared with the shared group, the consumerism group were more likely to be female [adjusted odds ratio (AOR) =2.87, 95% confidence interval [CI] 1.31-6.27, p=0.008] and non-dyslipidemic (AOR=2.90, 95% CI: 1.03-8.09, p=0.04), and the paternalism group were more likely to be older (AOR=1.03, 95% CI: 1.01-1.05, p=0.04), and female (AOR=2.47, 95% CI: 1.32-4.06, p=0.008). Conclusion: Preferences of patients for involvement in the clinical decision-making varied considerably. In our setting, underlying factors that influence these preferences identified in this study should be considered and tailored individually to achieve optimal treatment outcomes. PMID:26620990

  10. Participation in decision making

    Directory of Open Access Journals (Sweden)

    EG Valoyi

    2000-06-01

    Full Text Available The aim of the present study was to determine the extent to which employees would like to participate in decision making concerning various organisational issues, especially those concerning: the work itself, working conditions, human resources issues, and corporate policy and planning. The sample consisted of 146 participants, including managers, middle managers, and junior officials from a South African development corporation. A questionnaire to measure employees' desire to participate in decision making was specially constructed for this investigation. It has found that employees with higher academic qualifications were more desirous to participate in decision-making at all levels than employees with lower academic qualifications. This was also true for employees in higher job grades than in lower job grades. Men were more desirous to participate in decision making than women. The implications of the findings are discussed. Opsomming Die doel van die huidige studie was om vas te stel in watter mate werknemers sal wil deelneem aan die besluit- nameproses van organisasies, veral rakende die volgende sake: die werk self, werksomstandighede, menslike hulpbronaangeleenthede en korporatiewe beleid en beplanning. Die steekproef het uit 146 deelnemers, insluitende bestuurders, middelvlakbestuurders en junior amptenare van'n Suid Afrikaanse ontwikkelingskorporasie, bestaan. nVraelys wat die begeerte van werknemers meet om aan die besluitnameproses deel te neem, is spesiaal vir die doel van hierdie ondersoek, ontwerp. Dit is bevind dat werknemers met hoer akademiese kwalifikasies meer begerig is om aan die besluitnameproses op alle vlakke deel te neem as werknemers met laer akademiese kwalifikasies. Dit was ook waar vir werknemers in hoervlakposte vergeleke met werknemers in laervlakposte. Mans was ook meer begerig om aan die besluitnameproses deel te neem as vroue. Die implikasies van die studie word bespreek.

  11. Handbook on Decision Making

    CERN Document Server

    Jain, Lakhmi C

    2010-01-01

    The present "Volume 1: Techniques and Applications" of the "Handbook on Decision Making" presents a useful collection of AI techniques, as well as other complementary methodologies, that are useful for the design and development of intelligent decision support systems. Application examples of how these intelligent decision support systems can be utilized to help tackle a variety of real-world problems in different domains, such as business, management, manufacturing, transportation and food industries, and biomedicine, are presented. The handbook includes twenty condensed c

  12. Decision making under indeterminacy

    OpenAIRE

    Williams, JRG

    2014-01-01

    Decisions are made under uncertainty when there are distinct outcomes of a given action, and one is uncertain to which the act will lead. Decisions are made under indeterminacy when there are distinct outcomes of a given action, and it is indeterminate to which the act will lead. This paper develops a theory of (synchronic and diachronic) decision-making under indeterminacy that portrays the rational response to such situations as inconstant. Rational agents have to capriciously and randomly ...

  13. FAmily CEntered (FACE) advance care planning: Study design and methods for a patient-centered communication and decision-making intervention for patients with HIV/AIDS and their surrogate decision-makers.

    Science.gov (United States)

    Kimmel, Allison L; Wang, Jichuan; Scott, Rachel K; Briggs, Linda; Lyon, Maureen E

    2015-07-01

    Although the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has become a chronic illness, disease-specific advance care planning has not yet been evaluated for the palliative care needs of adults with HIV/AIDS. This prospective, longitudinal, randomized, two-arm controlled clinical trial aims to test the efficacy of FAmily CEntered advance care planning among adults living with AIDS and/or HIV with co-morbidities on congruence in treatment preferences, healthcare utilization, and quality of life. The FAmily CEntered intervention arm is two face-to-face sessions with a trained, certified facilitator: Session 1) Disease-Specific Advance Care Planning Respecting Choices Interview; Session 2) Completion of advance directive. The Healthy Living Control arm is: Session 1) Developmental/Relationship History; Session 2) Nutrition. Follow-up data will be collected at 3, 6, 12, and 18 months post-intervention. A total of 288 patient/surrogate dyads will be enrolled from five hospital-based, out-patient clinics in Washington, District of Columbia. Participants will be HIV positive and ≥ 21 years of age; surrogates will be ≥ 18 years of age. Exclusion criteria are homicidality, suicidality, psychosis, and impaired cognitive functioning. We hypothesize that this intervention will enhance patient-centered communication with a surrogate decision-maker about end of life treatment preferences over time, enhance patient quality of life and decrease health care utilization. We further hypothesize that this intervention will decrease health disparities for Blacks in completion of advance directives. If proposed aims are achieved, the benefits of palliative care, particularly increased treatment preferences about end-of-life care and enhanced quality of life, will be extended to people living with AIDS. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Decision Making via AHP

    CERN Document Server

    Andrecut, M

    2014-01-01

    The Analytic Hierarchy Process (AHP) is a procedure for establishing priorities in multi-criteria decision making problems. Here we discuss the Logarithmic Least Squares (LLS) method for the AHP and group-AHP, which provides an exact and unique solution for the priority vector. Also, we show that for the group-AHP, the LLS method is equivalent with the minimization of the weighted sum of generalized Kullback-Leibler divergences, between the group-priority vector and the priority vector of each expert.

  15. Decision making in neonatologia.

    Science.gov (United States)

    Paterlini, G; Tagliabue, P

    2010-06-01

    The field of neonatology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is characterized by a high level of uncertainty. A sample of neonatologists in different countries received a questionnaire including vignette cases for which no clear consensus exists regarding the (probabilistic) prognosis. They were asked to (I) assess the probability of various outcomes (death, severe impairment) and (II) choose a treatment to be offered to the parents. Information on the physicians' professional and socio-demographic characteristics and their ethical "values" was also collected. The goal of this international survey is to understand the prognosis and to analyze decision making by professionals in the context of life and death in medicine. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. Seventy percent of those invited responded to the questionnaire (International 60-80%). Italian neonatologists seem to be quite pessimistic about the prognosis of infants at high risk of death or long term disabilities, they show a pro-life attitude, but in a certain proportion are willing to change their minds if requested by parents. Furthermore personal opinions predominate in the decision-making process and the contribution of team meeting and/or ethic consultation seem not significantly modify the decisions.

  16. Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decision-making: experience from Cape Town, South Africa.

    Science.gov (United States)

    Scott, Vera; Gilson, Lucy

    2017-09-15

    Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential

  17. Reaching beyond the review of research evidence: a qualitative study of decision making during the development of clinical practice guidelines for disease prevention in healthcare.

    Science.gov (United States)

    Richter Sundberg, Linda; Garvare, Rickard; Nyström, Monica Elisabeth

    2017-05-11

    The judgment and decision making process during guideline development is central for producing high-quality clinical practice guidelines, but the topic is relatively underexplored in the guideline research literature. We have studied the development process of national guidelines with a disease-prevention scope produced by the National board of Health and Welfare (NBHW) in Sweden. The NBHW formal guideline development model states that guideline recommendations should be based on five decision-criteria: research evidence; curative/preventive effect size, severity of the condition; cost-effectiveness; and ethical considerations. A group of health profession representatives (i.e. a prioritization group) was assigned the task of ranking condition-intervention pairs for guideline recommendations, taking into consideration the multiple decision criteria. The aim of this study was to investigate the decision making process during the two-year development of national guidelines for methods of preventing disease. A qualitative inductive longitudinal case study approach was used to investigate the decision making process. Questionnaires, non-participant observations of nine two-day group meetings, and documents provided data for the analysis. Conventional and summative qualitative content analysis was used to analyse data. The guideline development model was modified ad-hoc as the group encountered three main types of dilemmas: high quality evidence vs. low adoptability of recommendation; insufficient evidence vs. high urgency to act; and incoherence in assessment and prioritization within and between four different lifestyle areas. The formal guideline development model guided the decision-criteria used, but three new or revised criteria were added by the group: 'clinical knowledge and experience', 'potential guideline consequences' and 'needs of vulnerable groups'. The frequency of the use of various criteria in discussions varied over time. Gender, professional status

  18. Serotonin and decision making processes.

    NARCIS (Netherlands)

    Homberg, J.R.

    2012-01-01

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

  19. Decision-making Procedures

    DEFF Research Database (Denmark)

    Aldashev, Gani; Kirchsteiger, Georg; Sebald, Alexander Christopher

    2009-01-01

    is crucial for the effort exerted by agents. This prediction is tested in a field experiment, where some subjects had to type in data, whereas others had to verify the data inserted by the typists. The controllers' wage was 50% higher than that of the typists. In one treatment the less attractive typists......It is a persistent finding in psychology and experimental economics that people's behavior is not only shaped by outcomes but also by decision-making procedures. In this paper we develop a general framework capable of modelling these procedural concerns. Within the context of psychological games we...... define procedures as mechanisms that influence the probabilities of reaching different endnodes. We show that for such procedural games a sequential psychological equilibrium always exists. Applying this approach within a principal-agent context we show that the way less attractive jobs are allocated...

  20. Health Literacy and Health-Care Engagement as Predictors of Shared Decision-Making Among Adult Information Seekers in the USA: a Secondary Data Analysis of the Health Information National Trends Survey.

    Science.gov (United States)

    Wigfall, Lisa T; Tanner, Andrea H

    2016-06-02

    The objective of this study is to examine the relationship between health literacy, health-care engagement, and shared decision-making (SDM). We analyzed Health Information National Trends Survey 4 (cycle 3) data for 1604 information seekers who had one or more non-emergency room health-care visits in the previous year. SDM was more than two times higher among adults who "always" versus "usually/sometimes/never" take health information to doctor visits (OR = 2.54; 95 % CI 1.19-5.43). There was a twofold increase in SDM among adults who were "completely/very confident" versus "somewhat/a little/not confident" about finding health information (OR = 2.03; 95 % CI 1.37-3.02). Differences in SDM between adults who understood health information and those who had difficulty understanding health information were not statistically significant (OR = 1.39; 95 % CI 0.93-2.07). A Healthy People 2020 goal is to increase SDM. Previous research has suggested that SDM may improve health outcomes across the continuum of care. Only about half of adults report always being involved in health-care decisions. Even more alarming is the fact that SDM has not increased from 2003 to 2013. Our findings suggest that increasing health literacy has the potential to increase health-care engagement and subsequently increase SDM. Effective intervention strategies are needed to improve health literacy and promote health-care engagement.

  1. Decision making and imperfection

    CERN Document Server

    Karny, Miroslav; Wolpert, David

    2013-01-01

    Decision making (DM) is ubiquitous in both natural and artificial systems. The decisions made often differ from those recommended by the axiomatically well-grounded normative Bayesian decision theory, in a large part due to limited cognitive and computational resources of decision makers (either artificial units or humans). This state of a airs is often described by saying that decision makers are imperfect and exhibit bounded rationality. The neglected influence of emotional state and personality traits is an additional reason why normative theory fails to model human DM process.   The book is a joint effort of the top researchers from different disciplines to identify sources of imperfection and ways how to decrease discrepancies between the prescriptive theory and real-life DM. The contributions consider:   ·          how a crowd of imperfect decision makers outperforms experts' decisions;   ·          how to decrease decision makers' imperfection by reducing knowledge available;   ...

  2. [Decision Making and Electrodermal Activity].

    Science.gov (United States)

    Kobayakawa, Mutsutaka

    2016-08-01

    Decision making is aided by emotions. Bodily responses, such as sweating, heartbeat, and visceral sensation, are used to monitor the emotional state during decision making. Because decision making in dairy life is complicated and cognitively demanding, these bodily signals are thought to facilitate the decision making process by assigning positive or negative values for each of the behavioral options. The sweat response in a decision making task is measured by skin conductance response (SCR). SCR in decision making is divided into two categories: anticipatory SCR is observed before making decisions, and reward/punishment SCR is observed after the outcome of the decision is perceived. Brain lesion studies in human revealed that the amygdala and ventromedial prefrontal cortex are important in decision making. Patients with lesinon in the amygdala exhibit neither the anticipatory nor reward/punishment SCRs, while patients with the ventromedial prefrontal lesions have deficits only in the anticipatory SCRs. Decision making tasks and SCR analysis have contributed to reveal the implicit aspects of decision making. Further research is necessary for clarifying the role of explicit process of decision making and its relationship with the implicit process.

  3. Electronic Communication and Decision Making.

    Science.gov (United States)

    Feldman, M. S.; Sarbaugh-Thompson, M.

    1996-01-01

    Electronic communication can either facilitate or sabotage decision-making contexts. This article formulates recommendations about when and how to use electronic communication to enhance decision making and describes various decision contexts. Solutions to communication problems such as groupthink, social deadlock, bureaucratic isolation from…

  4. Decision-making and neuroeconomics

    NARCIS (Netherlands)

    Kalenscher, T.

    2010-01-01

    Decision-making is the process of choosing one out of several alternatives. The study of decision-making is inherently multidisciplinary and can be approached from many different angles. Traditional accounts in economics and biology have a normative flavour and prescribe, rather than describe decisi

  5. Composite collective decision-making.

    Science.gov (United States)

    Czaczkes, Tomer J; Czaczkes, Benjamin; Iglhaut, Carolin; Heinze, Jürgen

    2015-06-22

    Individual animals are adept at making decisions and have cognitive abilities, such as memory, which allow them to hone their decisions. Social animals can also share information. This allows social animals to make adaptive group-level decisions. Both individual and collective decision-making systems also have drawbacks and limitations, and while both are well studied, the interaction between them is still poorly understood. Here, we study how individual and collective decision-making interact during ant foraging. We first gathered empirical data on memory-based foraging persistence in the ant Lasius niger. We used these data to create an agent-based model where ants may use social information (trail pheromones), private information (memories) or both to make foraging decisions. The combined use of social and private information by individuals results in greater efficiency at the group level than when either information source was used alone. The modelled ants couple consensus decision-making, allowing them to quickly exploit high-quality food sources, and combined decision-making, allowing different individuals to specialize in exploiting different resource patches. Such a composite collective decision-making system reaps the benefits of both its constituent parts. Exploiting such insights into composite collective decision-making may lead to improved decision-making algorithms.

  6. Personal Decision-Making Criteria Related to Seasonal and Pandemic A(H1N1) Influenza-Vaccination Acceptance among French Healthcare Workers

    Science.gov (United States)

    Bouadma, Lila; Barbier, François; Biard, Lucie; Esposito-Farèse, Marina; Le Corre, Bertrand; Macrez, Annick; Salomon, Laurence; Bonnal, Christine; Zanker, Caroline; Najem, Christophe; Mourvillier, Bruno; Lucet, Jean Christophe; Régnier, Bernard; Wolff, Michel; Tubach, Florence

    2012-01-01

    Background Influenza-vaccination rates among healthcare workers (HCW) remain low worldwide, even during the 2009 A(H1N1) pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination. Methods In June–July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV) and pandemic (PIV) influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression–tree method. Results Of the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations). Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV. Conclusions Both vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model. PMID:22848342

  7. Personal decision-making criteria related to seasonal and pandemic A(H1N1 influenza-vaccination acceptance among French healthcare workers.

    Directory of Open Access Journals (Sweden)

    Lila Bouadma

    Full Text Available BACKGROUND: Influenza-vaccination rates among healthcare workers (HCW remain low worldwide, even during the 2009 A(H1N1 pandemic. In France, this vaccination is free but administered on a voluntary basis. We investigated the factors influencing HCW influenza vaccination. METHODS: In June-July 2010, HCW from wards of five French hospitals completed a cross-sectional survey. A multifaceted campaign aimed at improving vaccination coverage in this hospital group was conducted before and during the 2009 pandemic. Using an anonymous self-administered questionnaire, we assessed the relationships between seasonal (SIV and pandemic (PIV influenza vaccinations, and sociodemographic and professional characteristics, previous and current vaccination statuses, and 33 statements investigating 10 sociocognitive domains. The sociocognitive domains describing HCWs' SIV and PIV profiles were analyzed using the classification-and-regression-tree method. RESULTS: Of the HCWs responding to our survey, 1480 were paramedical and 401 were medical with 2009 vaccination rates of 30% and 58% for SIV and 21% and 71% for PIV, respectively (p<0.0001 for both SIV and PIV vaccinations. Older age, prior SIV, working in emergency departments or intensive care units, being a medical HCW and the hospital they worked in were associated with both vaccinations; while work shift was associated only with PIV. Sociocognitive domains associated with both vaccinations were self-perception of benefits and health motivation for all HCW. For medical HCW, being a role model was an additional domain associated with SIV and PIV. CONCLUSIONS: Both vaccination rates remained low. Vaccination mainly depended on self-determined factors and for medical HCW, being a role model.

  8. Decision making on fitness landscapes

    Science.gov (United States)

    Arthur, R.; Sibani, P.

    2017-04-01

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

  9. Decision Making on Fitness Landscapes

    DEFF Research Database (Denmark)

    Arthur, Rudy; Sibani, Paolo

    2017-01-01

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

  10. Managerial Decision Making in Traffic

    Directory of Open Access Journals (Sweden)

    Teodor Perić

    2003-11-01

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

  11. Ethical aspect price decision making

    Directory of Open Access Journals (Sweden)

    Grubor Aleksandar

    2007-01-01

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

  12. Synaptic dynamics and decision making

    Science.gov (United States)

    Deco, Gustavo; Rolls, Edmund T.; Romo, Ranulfo

    2010-01-01

    During decision making between sequential stimuli, the first stimulus must be held in memory and then compared with the second. Here, we show that in systems that encode the stimuli by their firing rate, neurons can use synaptic facilitation not only to remember the first stimulus during the delay but during the presentation of the second stimulus so that they respond to a combination of the first and second stimuli, as has been found for “partial differential” neurons recorded in the ventral premotor cortex during vibrotactile flutter frequency decision making. Moreover, we show that such partial differential neurons provide important input to a subsequent attractor decision-making network that can then compare this combination of the first and second stimuli with inputs from other neurons that respond only to the second stimulus. Thus, both synaptic facilitation and neuronal attractor dynamics can account for sequential decision making in such systems in the brain. PMID:20360555

  13. Understanding marketing decision-making

    OpenAIRE

    Wierenga, Berend

    2012-01-01

    textabstractWhile a whole range of factors influences the outcomes of a marketing policy, it is managerial decision-making that can really make a difference. A clearer understanding of how marketers make decisions should therefore improve their quality.

  14. Understanding Optimal Decision-Making

    Science.gov (United States)

    2015-06-01

    2014). Assessment of cognitive components of decision-making with military versions of the IGT and WCST. Human Factors and Ergonomics Society 2014...optimal decision-making will allow the military to more effectively train its leaders. The Cognitive Alignment with Performance Targeted Training...optimal or suboptimal) is aligned or misaligned with cognitive state (categorized as exploration or exploitation): when someone thinks they have

  15. The Role of a Hospital Ethics Consultation Service in Decision-Making for Unrepresented Patients.

    Science.gov (United States)

    Courtwright, Andrew M; Abrams, Joshua; Robinson, Ellen M

    2017-03-06

    Despite increased calls for hospital ethics committees to serve as default decision-makers about life-sustaining treatment (LST) for unrepresented patients who lack decision-making capacity or a surrogate decision-maker and whose wishes regarding medical care are not known, little is known about how committees currently function in these cases. This was a retrospective cohort study of all ethics committee consultations involving decision-making about LST for unrepresented patients at a large academic hospital from 2007 to 2013. There were 310 ethics committee consultations, twenty-five (8.1 per cent) of which involved unrepresented patients. In thirteen (52.0 per cent) cases, the ethics consultants evaluated a possible substitute decision-maker identified by social workers and/or case managers. In the remaining cases, the ethics consultants worked with the medical team to contact previous healthcare professionals to provide substituted judgement, found prior advance care planning documents, or identified the patient's best interest as the decision-making standard. In the majority of cases, the final decision was to limit or withdraw LST (72 per cent) or to change code status to Do Not Resuscitate/Do Not Intubate (12 per cent). Substitute decision-makers who had been evaluated through the ethics consultation process and who made the final decision alone were more likely to continue LST than cases in which physicians made the final decision (50 per cent vs 6.3 per cent, p = 0.04). In our centre, the primary role of ethics consultants in decision-making for unrepresented patients is to identify appropriate decision-making standards. In the absence of other data suggesting that ethics committees, as currently constituted, are ready to serve as substitute decision-makers for unrepresented patients, caution is necessary before designating these committees as default decision-makers.

  16. Patients' participation in decision-making in the medical field

    DEFF Research Database (Denmark)

    Glasdam, Stinne; Oeye, Christine; Thrysøe, Lars

    2015-01-01

    , which creates resistance to the some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal frame and medical logic. The decision-making competence in relation to the choice of treatment is placed away...... choices, and the responsibility for those choices now and in the future. At the same time there is a tendency towards de-professionalisation. In that light, participation of patients in decision-making can be regarded as tacit governmentality strategies that shape the location of responsibility between......This article focuses on patients’ participation in decision-making in meetings with healthcare professionals in a healthcare system which appeared to be governed in a neoliberal manner. Drawing on two constructed empirical cases, this article analyses and discusses the clinical practice around...

  17. Constraint programming and decision making

    CERN Document Server

    Kreinovich, Vladik

    2014-01-01

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

  18. Impaired decision making among morbidly obese adults.

    LENUS (Irish Health Repository)

    Brogan, Amy

    2011-02-01

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

  19. Substituted decision making: elder guardianship.

    Science.gov (United States)

    Leatherman, Martha E; Goethe, Katherine E

    2009-11-01

    The goal of this column is to help experienced clinicians navigate the judicial system when they are confronted with requests for capacity evaluations that involve guardianship (conservatorship). The interface between the growing elderly medical population and increasing requests for substituted decision making is becoming more complex. This column will help practicing psychiatrists understand the medical, legal, and societal factors involved in adult guardianship. Such understanding is necessary in order to effectively perform guardianship evaluations and adequately inform courts, patients, and families about the psychiatric diagnoses central to substituted decision making.

  20. Decision Making in the Airplane

    Science.gov (United States)

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

    1995-01-01

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

  1. How can continuing professional development better promote shared decision-making? Perspectives from an international collaboration

    Science.gov (United States)

    2011-01-01

    Background Shared decision-making is not widely implemented in healthcare. We aimed to set a research agenda about promoting shared decision-making through continuing professional development. Methods Thirty-six participants met for two days. Results Participants suggested ways to improve an environmental scan that had inventoried 53 shared decision-making training programs from 14 countries. Their proposed research agenda included reaching an international consensus on shared decision-making competencies and creating a framework for accrediting continuing professional development initiatives in shared decision-making. Conclusions Variability in shared decision-making training programs showcases the need for quality assurance frameworks. PMID:21729310

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

    Science.gov (United States)

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

    2015-04-01

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

  3. Naturalistic decision making and macrocognition

    NARCIS (Netherlands)

    Schraagen, J.M.; Militello, L.; Ormerod, T.; Lipshitz, R.

    2008-01-01

    This book presents the latest work in the area of naturalistic decision making (NDM) and its extension into the area of macrocognition. It contains 18 chapters relating research centered on the study of expertise in naturalistic settings, written by international experts in NDM and cognitive systems

  4. Decision Making and Revealed Preference

    DEFF Research Database (Denmark)

    de la Rosa, Leonidas Enrique

    If our decision-making processes are to some extent shaped by evolutionary pressures and our environment is different from that to which we adapted, some of our choices will not be in our best interest. But revealed preference is the only tool that we have so far to conduct a normative analysis...

  5. Teaching Rational Decision-Making.

    Science.gov (United States)

    Woolever, Roberts

    1978-01-01

    Presented is an outline of a college course, "Education in American Society," that focused on teaching students rational decision-making skills while examining current issues in American Education. The outline is followed by student comments, reactions, and evaluations of the course. (JMD)

  6. Unrealistic optimism and decision making

    Directory of Open Access Journals (Sweden)

    Božović Bojana

    2009-01-01

    Full Text Available One of the leading descriptive theories of decision-making under risk, Tversky & Kahneman's Prospect theory, reveals that normative explanation of decisionmaking, based only on principle of maximizing outcomes expected utility, is unsustainable. It also underlines the effect of alternative factors on decision-making. Framing effect relates to an influence that verbal formulation of outcomes has on choosing between certain and risky outcomes; in negative frame people tend to be risk seeking, whereas in positive frame people express risk averse tendencies. Individual decisions are not based on objective probabilities of outcomes, but on subjective probabilities that depend on outcome desirability. Unrealistically pessimistic subjects assign lower probabilities (than the group average to the desired outcomes, while unrealistically optimistic subjects assign higher probabilities (than the group average to the desired outcomes. Experiment was conducted in order to test the presumption that there's a relation between unrealistic optimism and decision-making under risk. We expected optimists to be risk seeking, and pessimist to be risk averse. We also expected such cognitive tendencies, if they should become manifest, to be framing effect resistant. Unrealistic optimism scale was applied, followed by the questionnaire composed of tasks of decision-making under risk. Results within the whole sample, and results of afterwards extracted groups of pessimists and optimists both revealed dominant risk seeking tendency that is resistant to the influence of subjective probabilities as well as to the influence of frame in which the outcome is presented.

  7. TOOLS USED IN DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Perez Bernabeu Elena

    2011-07-01

    Full Text Available Decision making is one of the important tasks of every manager. The process of taking decisions has to be based on knowledge. For optimizing this process some software solutions has been created. In this article we tried to summarize some of the features which exists in some software applications.

  8. Serious gaming for complex decision making

    NARCIS (Netherlands)

    Hulst, A.H. van der; Ruijsendaal, M.

    2012-01-01

    Tactical-and strategic decision making in the safety domain is a form of 'complex decision making with Naturalistic Decision Making as the predomi-nant line of research. At the heart of the Decision Making expertise are 'situa-tion assessment capabilities, the most 'intuitive aspect of complex decis

  9. An ABC for decision making.

    Science.gov (United States)

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.

  10. An ABC for decision making

    Directory of Open Access Journals (Sweden)

    Luiz Henrique Costa Garcia

    2015-04-01

    Full Text Available The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education; British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters; Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations.

  11. Group performance and decision making.

    Science.gov (United States)

    Kerr, Norbert L; Tindale, R Scott

    2004-01-01

    Theory and research on small group performance and decision making is reviewed. Recent trends in group performance research have found that process gains as well as losses are possible, and both are frequently explained by situational and procedural contexts that differentially affect motivation and resource coordination. Research has continued on classic topics (e.g., brainstorming, group goal setting, stress, and group performance) and relatively new areas (e.g., collective induction). Group decision making research has focused on preference combination for continuous response distributions and group information processing. New approaches (e.g., group-level signal detection) and traditional topics (e.g., groupthink) are discussed. New directions, such as nonlinear dynamic systems, evolutionary adaptation, and technological advances, should keep small group research vigorous well into the future.

  12. An ABC for decision making

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Luiz Henrique Costa, E-mail: luiz_mogi@yahoo.com.br [Associacao de Medicina Intensiva Brasileira (AMIB), Sao Paulo, SP (Brazil); Irmandade da Santa Casa de Misericordia de Sao Paulo, SP (Brazil); Ferreira, Bruna Cortez [Hospital de Base de Sao Jose do Rio Preto, SP (Brazil)

    2015-03-15

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw-Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. (author)

  13. The Phenomenology of Decision Making

    Directory of Open Access Journals (Sweden)

    Urban Kordeš

    2009-12-01

    Full Text Available It is becoming apparent in modern cognitive science that the lack of knowledge about human experiential landscape implies the loss of a very important element, perhaps the very essence. Consequently, a rather new area of research has emerged recently: an attempt at a systematic observation and study of experience. This is the so-called phenomenologically inspired research (or just phenomenological research.Part of this article aims to present this new area of research – it describes the common fundaments of the field and some of its characteristic methodological derivates, relating them to the possibility of studying decision making from the first-person point-of-view, i.e. decision making as an experiential phenomenon (and not as a neurological or behavioural process. The article also presents some of the findings phenomenological studies have led to and some theoretical reflexions encouraged by these insights.

  14. An ABC for decision making*

    Science.gov (United States)

    Garcia, Luiz Henrique Costa; Ferreira, Bruna Cortez

    2015-01-01

    The present study was aimed at proposing a systematic evaluation of cranial computed tomography, identifying the main aspects to be analyzed in order to facilitate the decision making process regarding diagnosis and management in emergency settings. The present descriptive study comprised a literature review at the following databases: Access Medicine and Access Emergency Medicine (McGraw- Hill Education); British Medical Journal Evidence Center; UptoDate; Bireme; PubMed; Lilacs; SciELO; ProQuest; Micromedex (Thomson Reuters); Embase. Once the literature review was completed, the authors identified the main diseases with tomographic repercussions and proposed the present system to evaluate cranial computed tomography images. An easy-to-memorize ABC system will facilitate the decision making in emergency settings, as it covers the main diseases encountered by intensivists and emergency physicians, and provides a sequential guidance about anatomical structures to be investigated as well as their respective alterations. PMID:25987751

  15. Clinical judgment and decision making.

    Science.gov (United States)

    Garb, Howard N

    2005-01-01

    When clinical psychologists make judgments, are they likely to be correct or incorrect? The following topics are reviewed: (a) methodological advances in evaluating the validity of descriptions of personality and psychopathology, (b) recent findings on the cognitive processes of clinicians, and (c) the validity of judgments and utility of decisions made by mental health professionals. Results from research on clinical judgment and decision making and their relationship to conflicts within the field of clinical psychology are discussed.

  16. [An ethical decision-making tool. Training for decision-making in crisis or end-of-life situations].

    Science.gov (United States)

    Gomas, J M

    We developed a patient-centered decision making tool to help healthcare teams make ethical decisions in crisis or end-of-life situations. This tool is the fruit of 15 years of healthcare experience and discussions on ethical issues with patients suffering from cancer, severe handicaps or terminal disease. It has been enriched by experience acquired since the publication of earlier work in the nineties. A three-step decision-making process is proposed providing a methodic aid for management decisions which remain unique for each individual patient.

  17. [Decision-making and schizophrenia].

    Science.gov (United States)

    Adida, M; Maurel, M; Kaladjian, A; Fakra, E; Lazerges, P; Da Fonseca, D; Belzeaux, R; Cermolacce, M; Azorin, J-M

    2011-12-01

    Abnormalities involving the prefrontal cortex (PFC) have long been postulated to underpin the pathophysiology of schizophrenia. Investigations of PFC integrity have focused mainly on the dorsolateral PFC (DLPFC) and abnormalities in this region have been extensively documented. However, defects in schizophrenia may extend to other prefrontal regions, including the ventromedial PFC (VMPFC), and evidence of VMPFC abnormalities comes from neuropathological, structural and functional studies. Patients with acquired brain injury to the VMPFC display profound disruption of social behaviour and poor judgment in their personal lives. The Iowa Gambling Task (IGT) was developed to assess decision-making in these neurological cases : it presents a series of 100 choices from four card decks that differ in the distribution of rewarding and punishing outcomes. Whilst healthy volunteers gradually develop a preference for the two "safe" decks over the course of the task, patients with VMPFC lesions maintain a preference for the two "risky" decks which are associated with high reinforcement in the short term, but significant long-term debt. Interestingly, damage to VMPFC may cause both poor performance on the IGT and lack of insight concerning the acquired personality modification. Recently, our group reported a trait-related decisionmaking impairment in the three phases of bipolar disorder. In a PET study, VMPFC dysfunction was shown in bipolar manic patients impaired on a decision-making task and an association between decision-making cognition and lack of insight was described in mania. A quantitative association between grey matter volume of VMPFC and memory impairment was previously reported in schizophrenia. Research suggests that lack of insight is a prevalent feature in schizophrenia patients, like auditory hallucinations, paranoid or bizarre delusions, and disorganized speech and thinking. Because schizophrenia is associated with significant social or occupational

  18. Decision making in ruminant orthopedics.

    Science.gov (United States)

    Fessler, J F; Adams, S B

    1996-03-01

    Decision making in ruminant orthopedics is determined by many factors, the most of important of which is age, size, and value of the patient, the nature of the injury, the prognosis for effective treatment and satisfactory healing, the intentions of the client, and the experiences of the veterinarian. Ruminant orthopedics currently is expanding to include the treatment of llamas and small ruminants as companion animals in addition to the treatment of valuable livestock. The future promises increasing sophistication in treatments and an ever higher quality of patient care.

  19. Simulation of human decision making

    Science.gov (United States)

    Forsythe, J. Chris; Speed, Ann E.; Jordan, Sabina E.; Xavier, Patrick G.

    2008-05-06

    A method for computer emulation of human decision making defines a plurality of concepts related to a domain and a plurality of situations related to the domain, where each situation is a combination of at least two of the concepts. Each concept and situation is represented in the computer as an oscillator output, and each situation and concept oscillator output is distinguishable from all other oscillator outputs. Information is input to the computer representative of detected concepts, and the computer compares the detected concepts with the stored situations to determine if a situation has occurred.

  20. Aging and consumer decision making

    Science.gov (United States)

    Carpenter, Stephanie M.; Yoon, Carolyn

    2013-01-01

    Research on consumer decision making and aging is especially important for fostering a better understanding of ways to maintain consumer satisfaction and high decision quality across the life span. We provide a review of extant research on the effects of normal aging on cognition and decision processes and how these age-related processes are influenced by task environment, meaningfulness of the task, and consumer expertise. We consider how research centered on these topics generates insights about changes in consumption decisions that occur with aging and identify a number of gaps and directions for future research. PMID:22360794

  1. Decision Making Under Uncertain Categorization

    Directory of Open Access Journals (Sweden)

    Stephanie Ying-Fen Chen

    2014-09-01

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

  2. Implementing shared decision-making: consider all the consequences

    NARCIS (Netherlands)

    Elwyn, G.; Frosch, D.L.; Kobrin, S.

    2016-01-01

    BACKGROUND: The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and

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

    Science.gov (United States)

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

    2015-01-01

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

  4. GROUPS DECISION MAKING WITHIN THE ORGANIZATION

    OpenAIRE

    Anca Stan

    2008-01-01

    In a highly global market, organizations that have the ability to analyze and rapidly respond to the constantly changing marketplace will have the greatest chance of remaining competitive and profitable. Group decision making is the process of arriving at a judgment based upon the feedback of multiple individuals. Due to the importance of the group decision making process, decision making models can be used to establish a systematic means of developing effective group decision making. Once a ...

  5. Facets of Career Decision-Making Difficulties

    Science.gov (United States)

    Amir, Tami; Gati, Itamar

    2006-01-01

    The present research investigated the relations among the measured and the expressed career decision-making difficulties in a sample of 299 young adults who intended to apply to college or university. As hypothesised, the correlations between career decision-making difficulties, as measured by the Career Decision-Making Difficulties Questionnaire…

  6. Decision Making in Adults with ADHD

    Science.gov (United States)

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

    2012-01-01

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

  7. DEVELOPMENT OF THE DECISION-MAKING CULTURE

    Directory of Open Access Journals (Sweden)

    Galina GLOBA

    2013-06-01

    Full Text Available The article shows the stages of development of the theory and practice of decision-making. Emphasis is placed on the contemporary culture of decision-making. At the base of the current trends is the transition from intuition and experience in decision-making to analytics. Modern business intelligence means the development of the culture of work with big data.

  8. Distributed Decision Making and Control

    CERN Document Server

    Rantzer, Anders

    2012-01-01

    Distributed Decision Making and Control is a mathematical treatment of relevant problems in distributed control, decision and multiagent systems, The research reported was prompted by the recent rapid development in large-scale networked and embedded systems and communications. One of the main reasons for the growing complexity in such systems is the dynamics introduced by computation and communication delays. Reliability, predictability, and efficient utilization of processing power and network resources are central issues and the new theory and design methods presented here are needed to analyze and optimize the complex interactions that arise between controllers, plants and networks. The text also helps to meet requirements arising from industrial practice for a more systematic approach to the design of distributed control structures and corresponding information interfaces Theory for coordination of many different control units is closely related to economics and game theory network uses being dictated by...

  9. Crew decision making under stress

    Science.gov (United States)

    Orasanu, J.

    1992-01-01

    Flight crews must make decisions and take action when systems fail or emergencies arise during flight. These situations may involve high stress. Full-missiion flight simulation studies have shown that crews differ in how effectively they cope in these circumstances, judged by operational errors and crew coordination. The present study analyzed the problem solving and decision making strategies used by crews led by captains fitting three different personality profiles. Our goal was to identify more and less effective strategies that could serve as the basis for crew selection or training. Methods: Twelve 3-member B-727 crews flew a 5-leg mission simulated flight over 1 1/2 days. Two legs included 4 abnormal events that required decisions during high workload periods. Transcripts of videotapes were analyzed to describe decision making strategies. Crew performance (errors and coordination) was judged on-line and from videotapes by check airmen. Results: Based on a median split of crew performance errors, analyses to date indicate a difference in general strategy between crews who make more or less errors. Higher performance crews showed greater situational awareness - they responded quickly to cues and interpreted them appropriately. They requested more decision relevant information and took into account more constraints. Lower performing crews showed poorer situational awareness, planning, constraint sensitivity, and coordination. The major difference between higher and lower performing crews was that poorer crews made quick decisions and then collected information to confirm their decision. Conclusion: Differences in overall crew performance were associated with differences in situational awareness, information management, and decision strategy. Captain personality profiles were associated with these differences, a finding with implications for crew selection and training.

  10. Entrepreneurs` Cognitive and Decision Making Styles

    Directory of Open Access Journals (Sweden)

    Mahmoud Motvaseli

    2015-12-01

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

  11. A cognitive prosthesis for complex decision-making.

    Science.gov (United States)

    Tremblay, Sébastien; Gagnon, Jean-François; Lafond, Daniel; Hodgetts, Helen M; Doiron, Maxime; Jeuniaux, Patrick P J M H

    2017-01-01

    While simple heuristics can be ecologically rational and effective in naturalistic decision making contexts, complex situations require analytical decision making strategies, hypothesis-testing and learning. Sub-optimal decision strategies - using simplified as opposed to analytic decision rules - have been reported in domains such as healthcare, military operational planning, and government policy making. We investigate the potential of a computational toolkit called "IMAGE" to improve decision-making by developing structural knowledge and increasing understanding of complex situations. IMAGE is tested within the context of a complex military convoy management task through (a) interactive simulations, and (b) visualization and knowledge representation capabilities. We assess the usefulness of two versions of IMAGE (desktop and immersive) compared to a baseline. Results suggest that the prosthesis helped analysts in making better decisions, but failed to increase their structural knowledge about the situation once the cognitive prosthesis is removed.

  12. Decision-Making Theories and Career Assessment: A Psychometric Evaluation of the Decision Making Inventory

    Science.gov (United States)

    Hardin, Erin E.; Leong, Frederick T. L.

    2004-01-01

    To address criticisms that the empirical literature on assessment of career decision making has tended to lack a theoretical base, the present study explored the relevance of a general theory of decision making to career decision making by assessing the psychometric properties of the Decision Making Inventory (DMI), designed to measure Johnson's…

  13. Wildfire Decision Making Under Uncertainty

    Science.gov (United States)

    Thompson, M.

    2013-12-01

    Decisions relating to wildfire management are subject to multiple sources of uncertainty, and are made by a broad range of individuals, across a multitude of environmental and socioeconomic contexts. In this presentation I will review progress towards identification and characterization of uncertainties and how this information can support wildfire decision-making. First, I will review a typology of uncertainties common to wildfire management, highlighting some of the more salient sources of uncertainty and how they present challenges to assessing wildfire risk. This discussion will cover the expanding role of burn probability modeling, approaches for characterizing fire effects, and the role of multi-criteria decision analysis, and will provide illustrative examples of integrated wildfire risk assessment across a variety of planning scales. Second, I will describe a related uncertainty typology that focuses on the human dimensions of wildfire management, specifically addressing how social, psychological, and institutional factors may impair cost-effective risk mitigation. This discussion will encompass decision processes before, during, and after fire events, with a specific focus on active management of complex wildfire incidents. An improved ability to characterize uncertainties faced in wildfire management could lead to improved delivery of decision support, targeted communication strategies, and ultimately to improved wildfire management outcomes.

  14. Principles for ethical treatment decision-making in veterinary oncology.

    Science.gov (United States)

    Rohrer Bley, C

    2017-08-31

    Many owners of companion animals with cancer are overwhelmed by having to choose the "right course of action." With the aim of reducing the burden on owners who are forced to act as surrogates for their animals, this work discusses principles that apply to ethical treatment decision-making for animal patients with cancer. Four principles frequently used for ethical decision-making in human medicine will be considered for their potential applicability in veterinary medicine. As a result of these considerations, preliminary guidelines are presented, along which a decision-making discussion can be held. The deliberate integration of the non-maleficence and beneficence principles into the purely empirical facts of what is medically possible helps to maintain a moral perspective in specialized veterinary medicine. At the same time, such guidelines may contribute to individual decision-making in a way that animal patients neither have to endure unnecessarily severe side effects, nor that they are euthanized prematurely. © 2017 John Wiley & Sons Ltd.

  15. Couples' fertility decision-making

    Directory of Open Access Journals (Sweden)

    Petra Stein

    2014-06-01

    Full Text Available Background: The decision about whether to start a family within a partnership can be viewed as a result of an interaction process. The influence of each of the partners in a couple differs depending on their individual preferences and intentions towards having children. Both of the partners additionally influence each other's fertility intentions and preferences. Objective: We specify, estimate, and test a model that examines the decision about whether to have a child as a choice that is made jointly by the two partners. The transition to the birth of a (further child is investigated with the explicit consideration of both the female partner and the male partner in the partnership context. Methods: An approach for modelling the interactive influences of the two actors in the decision-making process was proposed. A trivariate distribution consisting of both the female and the male partners' fertility intentions, as well as the joint generative decision, was modelled. A multivariate non-linear probit model was chosen and the problem of identification in estimating the relative effects of the actors was resolved. These parameters were used to assess the relative importance of each of the partners' intentions in the decision. We carried out the analysis with MPLUS. Data from the panel of intimate relationships and family dynamics (pairfam was used to estimate the model. Results: The biographical context of each of the partners in relation to their own as well as to their partner's fertility intentions was found to be of considerable importance. Of the significant individual and partner effects, the male partner was shown to have the greater influence. But the female partner was found to have stronger parameters overall and she ultimately has a veto power in the couple's final decision.

  16. Shared decision-making in epilepsy management.

    Science.gov (United States)

    Pickrell, W O; Elwyn, G; Smith, P E M

    2015-06-01

    Policy makers, clinicians, and patients increasingly recognize the need for greater patient involvement in clinical decision-making. Shared decision-making helps address these concerns by providing a framework for clinicians and patients to make decisions together using the best evidence. Shared decision-making is applicable to situations where several acceptable options exist (clinical equipoise). Such situations occur commonly in epilepsy, for example, in decisions regarding the choice of medication, treatment in pregnancy, and medication withdrawal. A talk model is a way of implementing shared decision-making during consultations, and decision aids are useful tools to assist in the process. Although there is limited evidence available for shared decision-making in epilepsy, there are several benefits of shared decision-making in general including improved decision quality, more informed choices, and better treatment concordance. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Chinese Adolescents' Influence on Family Decision Making

    OpenAIRE

    He, Shushi

    2008-01-01

    The purpose of this study is to investigate Chinese adolescents' influence on family decision making regarding on the effect of children's characteristics including academic performance, product knowledge and financial saving. The concept of value alignment is initially introduced to the family decision making since it greatly concerns on the Chinese culture. It is assumed that China's only children would have more influence on the decision making of high-end electronic goods when they align ...

  18. Implementing shared decision-making: consider all the consequences.

    Science.gov (United States)

    Elwyn, Glyn; Frosch, Dominick L; Kobrin, Sarah

    2016-08-08

    The ethical argument that shared decision-making is "the right" thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The goal of this article is to hypothesize a wider set of consequences, that apply over an extended time horizon, and include outcomes at interactional, team, organizational and system levels, and to call for future research to study these possible consequences. To date, many more studies have evaluated patient decision aids rather than other approaches to shared decision-making, and the outcomes measured have typically been focused on short-term cognitive and affective outcomes, for example knowledge and decisional conflict. From a clinicians perspective, the shared decision-making process could be viewed as either intrinsically rewarding and protective, or burdensome and impractical, yet studies have not focused on the impact on professionals, either positive or negative. At interactional levels, group, team, and microsystem, the potential long-term consequences could include the development of a culture where deliberation and collaboration are regarded as guiding principles, where patients are coached to assess the value of interventions, to trade-off benefits versus harms, and assess their burdens-in short, to new social norms in the clinical workplace. At organizational levels, consistent shared decision-making might boost patient experience evaluations and lead to fewer complaints and legal

  19. GROUPS DECISION MAKING WITHIN THE ORGANIZATION

    Directory of Open Access Journals (Sweden)

    Anca Stan

    2008-12-01

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

  20. Risk perception and clinical decision making in primary care

    DEFF Research Database (Denmark)

    Barfoed, Benedicte Marie Lind

    2015-01-01

    Objectives We aim to present new knowledge about different perspectives of health care professionals’ risk perceptions and clinical decision making. Furthermore, we intend to discuss differences between professional and personal risk perceptions and the impact on decisions in terms of both short...... and long-term outcomes. Background Insight into healthcare professionals’ perception of risk is a cornerstone for understanding their strategies for practising preventive care. The way people perceive risk can be seen as part of a general personality trait influenced by a mixture of individual...... considerations and the specific context. Most research has been focused on understanding of the concepts of risk. However healthcare professionals’ risk perception and personal attitudes also affect their clinical decision-making and risk communication. The differences between health care professionals’ personal...

  1. Health Care Decision Making by the Elderly: I Get by with a Little Help from My Family.

    Science.gov (United States)

    Kapp, Marshall B.

    1991-01-01

    Shared decision making about placement and medical interventions can be empowering to older persons, relieve burdens on older person and family, and facilitate better surrogate decision making later. Potential dangers of shared process include coercion, conflicts of interest, and disagreements between family members. New legal concepts could help…

  2. Social values as an independent factor affecting end of life medical decision making.

    Science.gov (United States)

    Cohen, Charles J; Chen, Yifat; Orbach, Hedi; Freier-Dror, Yossi; Auslander, Gail; Breuer, Gabriel S

    2015-02-01

    Research shows that the physician's personal attributes and social characteristics have a strong association with their end-of-life (EOL) decision making. Despite efforts to increase patient, family and surrogate input into EOL decision making, research shows the physician's input to be dominant. Our research finds that physician's social values, independent of religiosity, have a significant association with physician's tendency to withhold or withdraw life sustaining, EOL treatments. It is suggested that physicians employ personal social values in their EOL medical coping, because they have to cope with existential dilemmas posed by the mystery of death, and left unresolved by medical decision making mechanisms such as advanced directives and hospital ethics committees.

  3. Decision-Making at the Top

    OpenAIRE

    Borsting, Jack R.

    1982-01-01

    The author's current decision-making environment is summarized. A short history of the Planning, Programming and Budgeting System is given and then the recent changes made by the Reagan Administration are discussed. Some remarks on analysis and decision-making at the top government levels are given.

  4. The space-times of decision making

    NARCIS (Netherlands)

    McCormack, D.P.; Schwanen, T.

    2011-01-01

    By way of an extended introduction to a theme issue on the space – times of decision making, this paper pursues two objectives. We first review some of the ways in which geographers—and especially economic geographers—have examined decision making over the past decades, showing that previous engagem

  5. Influence of framing on medical decision making

    OpenAIRE

    Feng, Jun; Gong, Jingjing; Huang, Yonghua; Wei, Yazhou; Zhang, Weiwei; Zhang, Yan

    2013-01-01

    Numerous studies have demonstrated the robustness of the framing effect in a variety of contexts, especially in medical decision making. Unfortunately, research is still inconsistent as to how so many variables impact framing effects in medical decision making. Additionally, much attention should be paid to the framing effect not only in hypothetical scenarios but also in clinical experience.

  6. Tools for Supporting Responsible Decision-Making?

    NARCIS (Netherlands)

    Vriens, D.J.; Achterbergh, J.M.I.M.

    2015-01-01

    In this paper, we assess the characteristics decision support tools should have in order to support “responsible decision-making”. To this end, we first describe responsible decision-making. We argue that responsibility relates to both the outcome and the process of decision-making. On the basis of

  7. Decision-Making Strategies for College Students

    Science.gov (United States)

    Morey, Janis T.; Dansereau, Donald F.

    2010-01-01

    College students' decision making is often less than optimal and sometimes leads to negative consequences. The effectiveness of two strategies for improving student decision making--node-link mapping and social perspective taking (SPT)--are examined. Participants using SPT were significantly better able to evaluate decision options and develop…

  8. Farm decision making under risk and uncertainty.

    NARCIS (Netherlands)

    Backus, G.B.C.; Eidman, V.R.; Dijkhuizen, A.A.

    1997-01-01

    Relevant portions of the risk literature are reviewed, relating them to observed behaviour in farm decision-making. Relevant topics for applied agricultural risk research are proposed. The concept of decision making under risk and uncertainty is discussed by reviewing the theory of Subjective

  9. Hybrid multiple criteria decision-making methods

    DEFF Research Database (Denmark)

    Zavadskas, Edmundas Kazimieras; Govindan, K.; Antucheviciene, Jurgita

    2016-01-01

    Formal decision-making methods can be used to help improve the overall sustainability of industries and organisations. Recently, there has been a great proliferation of works aggregating sustainability criteria by using diverse multiple criteria decision-making (MCDM) techniques. A number of revi...

  10. Intuitionistic preference modeling and interactive decision making

    CERN Document Server

    Xu, Zeshui

    2014-01-01

    This book offers an in-depth and comprehensive introduction to the priority methods of intuitionistic preference relations, the consistency and consensus improving procedures for intuitionistic preference relations, the approaches to group decision making based on intuitionistic preference relations, the approaches and models for interactive decision making with intuitionistic fuzzy information, and the extended results in interval-valued intuitionistic fuzzy environments.

  11. Tools for collaborative decision-making

    CERN Document Server

    Zaraté, Pascale

    2013-01-01

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

  12. Decision making uncertainty, imperfection, deliberation and scalability

    CERN Document Server

    Kárný, Miroslav; Wolpert, David

    2015-01-01

    This volume focuses on uncovering the fundamental forces underlying dynamic decision making among multiple interacting, imperfect and selfish decision makers. The chapters are written by leading experts from different disciplines, all considering the many sources of imperfection in decision making, and always with an eye to decreasing the myriad discrepancies between theory and real world human decision making. Topics addressed include uncertainty, deliberation cost and the complexity arising from the inherent large computational scale of decision making in these systems. In particular, analyses and experiments are presented which concern: • task allocation to maximize “the wisdom of the crowd”; • design of a society of “edutainment” robots who account for one anothers’ emotional states; • recognizing and counteracting seemingly non-rational human decision making; • coping with extreme scale when learning causality in networks; • efficiently incorporating expert knowledge in personalized...

  13. Decision making in midwifery: rationality and intuition.

    Science.gov (United States)

    Steinhauer, Suyai

    2015-04-01

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

  14. Decision Making Practices In Universities Of Pakistan

    Directory of Open Access Journals (Sweden)

    M. Nadeem Anwar

    2011-07-01

    Full Text Available Decision making can be regarded as an outcome of mental processes (cognitive process leading to the selection of a course of action among several alternatives. Every decision making process produces a final choice. The output can be an action or an opinion. The purpose of this descriptive survey was to explore the Decision making practices in administrative and academic matters in the universities of Pakistan. A sample of nineteen universities was selected by applying stratified random sampling technique.  The respondents, i-e members of university bodies; teachers and administrative officers were selected randomly. Three questionnaires constructed on Likert’s five-point scale were used for data collection. Data was tabulated and analyzed by using the F-ratio and Chi-square. The survey results revealed that overall decision-making practices in the universities were found unsatisfactory and, most of the decisions were made without application of management decision-making techniques.

  15. Interventions for promoting participation in shared decision-making for children with cancer.

    LENUS (Irish Health Repository)

    Coyne, Imelda

    2013-01-01

    Children\\'s rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions. There is considerable support for involving children in healthcare decision-making at a level commensurate with their experience, age and abilities. Thus healthcare professionals and parents need to know how they should involve children in decision-making and what interventions are most effective in promoting shared decision-making (SDM) for children with cancer.

  16. Quantum decision making by social agents

    CERN Document Server

    Yukalov, V I

    2012-01-01

    Decision making of agents who are members of a society is analyzed from the point of view of quantum decision theory. This generalizes the approach, developed earlier by the authors for separate individuals, to decision making under the influence of social interactions. The generalized approach not only avoids paradoxes, typical of classical decision making based on utility theory, but also explains the error-attenuation effects observed for the paradoxes occurring when decision makers, who are members of a society, consult with each other increasing in this way the available mutual information.

  17. Influencing factors in MMR immunisation decision making.

    Science.gov (United States)

    Hill, Marie C; Cox, Carol L

    Immunisation decision making is not a straightforward process for parents. Many factors influence parental decision making on whether they immunise their child with the measles, mumps and rubella (MMR) vaccine. The feasibility study described in this article provides insight into influencing factors associated with decisions regarding the immunisation of children by parents. The study findings suggest that the practice nurse is a credible source of information for parents seeking informed decision making. At a time when the incidence of measles and mumps is rising in the UK, the provision of appropriate information by the practice nurse has the potential to increase uptake of the MMR vaccine.

  18. 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.

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

    CERN Document Server

    Lu, Jie; Zhang, Guangquan

    2012-01-01

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

  20. Decision-Making Autonomy and Subsidiary Innovation

    DEFF Research Database (Denmark)

    Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt;

    2013-01-01

    This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...

  1. Decision Making System for Operative Tasks

    OpenAIRE

    Shakah, G.; Krasnoproshin, V. V.; Valvachev, A. N.

    2009-01-01

    Actual problems of construction of computer systems for operative tasks of decision making are considered. possibilities of solving the problems on the basis of the theory of active systems (tas) are investigated.

  2. Personalized Clinical Decision Making in Gastrointestinal Malignancies

    DEFF Research Database (Denmark)

    Hess, Søren; Bjerring, Ole Steen; Pfeiffer, Per

    2016-01-01

    and initial stages. This article outlines the potential use of fluorodeoxyglucose-PET/CT in clinical decision making with special regard to preoperative evaluation and response assessment in gastric cancer (including the gastroesophageal junction), pancreatic cancer (excluding neuroendocrine tumors...

  3. The Perils of Democratic Decision Making

    NARCIS (Netherlands)

    Aalbers, H.L.; Whelan, E.; Parise, S.; Vialle, C.

    2016-01-01

    The article focuses on the organizational decision-making management. Topics mentioned include the development of enterprise social software (ESS), the online corporate communities management, and the project management. Also mentioned are the importance of customer services, the bankruptcy

  4. The Perils of Democratic Decision Making

    NARCIS (Netherlands)

    Aalbers, H.L.; Whelan, E.; Parise, S.; Vialle, C.

    2016-01-01

    The article focuses on the organizational decision-making management. Topics mentioned include the development of enterprise social software (ESS), the online corporate communities management, and the project management. Also mentioned are the importance of customer services, the bankruptcy manageme

  5. Complex Decision Making Theory and Practice

    CERN Document Server

    Qudrat-Ullah, Hassan; Spector, J Michael

    2007-01-01

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

  6. The functional neuroanatomy of decision-making.

    Science.gov (United States)

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

    2012-01-01

    Decision-making is a complex executive function that draws on past experience, present goals, and anticipation of outcome, and which is influenced by prevailing and predicted emotional tone and cultural context. Functional imaging investigations and focal lesion studies identify the orbitofrontal, anterior cingulate, and dorsolateral prefrontal cortices as critical to decision-making. The authors review the connections of these prefrontal regions with the neocortex, limbic system, basal ganglia, and cerebellum, highlight current ideas regarding the cognitive processes of decision-making that these networks subserve, and present a novel integrated neuroanatomical model for decision-making. Finally, clinical relevance of this circuitry is illustrated through a discussion of frontotemporal dementia, traumatic brain injury, and sociopathy.

  7. A neural model of decision making

    OpenAIRE

    Larsen, Torben

    2008-01-01

    Background: A descriptive neuroeconomic model is aimed for relativity of the concept of economic man to empirical science.Method: A 4-level client-server-integrator model integrating the brain models of McLean and Luria is the general framework for the model of empirical findings.Results: Decision making relies on integration across brain levels of emotional intelligence (LU) and logico-matematico intelligence (RIA), respectively. The integrated decision making formula approaching zero by bot...

  8. Modeling of Mixed Decision Making Process

    OpenAIRE

    yahia, Nesrine Ben; Bellamine, Narjès; Ghezala, Henda Ben

    2012-01-01

    Decision making whenever and wherever it is happened is key to organizations success. In order to make correct decision, individuals, teams and organizations need both knowledge management (to manage content) and collaboration (to manage group processes) to make that more effective and efficient. In this paper, we explain the knowledge management and collaboration convergence. Then, we propose a formal description of mixed and multimodal decision making (MDM) process where decision may be mad...

  9. Clinical decision making in veterinary practice

    OpenAIRE

    Everitt, Sally

    2011-01-01

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

  10. Modeling of Mixed Decision Making Process

    OpenAIRE

    Yahia, Nesrine Ben; Bellamine, Narjès; Ghezala, Henda Ben

    2012-01-01

    Decision making whenever and wherever it is happened is key to organizations success. In order to make correct decision, individuals, teams and organizations need both knowledge management (to manage content) and collaboration (to manage group processes) to make that more effective and efficient. In this paper, we explain the knowledge management and collaboration convergence. Then, we propose a formal description of mixed and multimodal decision making (MDM) process where decision may be mad...

  11. A neural model of decision making

    OpenAIRE

    Larsen, Torben

    2008-01-01

    Background: A descriptive neuroeconomic model is aimed for relativity of the concept of economic man to empirical science.Method: A 4-level client-server-integrator model integrating the brain models of McLean and Luria is the general framework for the model of empirical findings.Results: Decision making relies on integration across brain levels of emotional intelligence (LU) and logico-matematico intelligence (RIA), respectively. The integrated decision making formula approaching zero by bot...

  12. The Neuroscience of Consumer Decision-Making

    OpenAIRE

    Pirouz, Dante

    2004-01-01

    While there is an extensive history of neuroscience, only recently has the theory and the methods of this discipline been applied to answer questions about decision making, choice, preference, risk and happiness. This new area of research, coined neuroeconomics, seeks to reveal more about the neural functioning and associated implications for economic and consumer behavior. In this paper are some of the key developments in neuroeconomics research as they relate to consumer decision-making, cu...

  13. Neutrosophic Logic Applied to Decision Making

    DEFF Research Database (Denmark)

    Madsen, Henrik; Albeanu, Grigore; Burtschy, Bernard

    2014-01-01

    Decision making addresses the usage of various methods to select "the best", in some way, alternative strategy (from many available) when a problem is given for solving. The authors propose the usage of neutrosophic way of thinking, called also Smarandache's logic, to select a model by experts when...... degrees of trustability, ultrastability (falsehood), and indeterminacy are used to decide. The procedures deal with multi-attribute neutrosophic decision making and a case study on e-learning software objects is presented....

  14. Including Indigenous Minorities in Decision-Making

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene

    Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand......Based on theories of public sphere participation and deliberative democracy, this book presents empirical results from a study of experiences with including Aboriginal and Maori groups in political decision-making in respectively Western Australia and New Zealand...

  15. Improving work group decision-making effectiveness.

    Science.gov (United States)

    Schoonover-Shoffner, K

    1989-01-01

    Many of the decisions in complex health care organizations are made by small work groups. Nurse administrators often lead or are highly involved in these groups, where reaching quality decisions is a critical goal. This paper examines research and information from the communications field, presenting a model for making decisions in small groups. The author identifies common pitfalls of decision-making groups and presents strategies for problem solving and improved decision making.

  16. Farm decision making under risk and uncertainty.

    OpenAIRE

    Backus, G.B.C.; Eidman, V.R.; Dijkhuizen, A. A.

    1997-01-01

    Relevant portions of the risk literature are reviewed, relating them to observed behaviour in farm decision-making. Relevant topics for applied agricultural risk research are proposed. The concept of decision making under risk and uncertainty is discussed by reviewing the theory of Subjective Expected Utility and its limitations. Subjective Expected Utility theory is the major framework for thinking systematically through complex issues of decision. Limitations of Subjective Expected Utility ...

  17. Knowledge Representation for Decision Making Agents

    Science.gov (United States)

    2013-07-15

    Knowledge Representation for Decision Making Agents MAJ Peter Nesbitt Dr. Tom Anderson LTC Jonathan Alt Mr. David Ohmen Mr. Kyle Quinnell Mr. Mario...Torres TRADOC Analysis Center - Monterey 700 Dyer Road Monterey, California 93943 PREPARED BY: APPROVED BY: Peter A. Nesbitt Jonathan K. Alt MAJ, AR LTC...Include area code) 07/15/2013 Technical Report APR 2013 - JUN 2013 Knowledge Representation for Decision Making Agents MAJ Peter Nesbitt Dr Tom Anderson

  18. Shared decision-making and patient autonomy.

    Science.gov (United States)

    Sandman, Lars; Munthe, Christian

    2009-01-01

    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

  19. Emotion, decision making and the orbitofrontal cortex.

    Science.gov (United States)

    Bechara, A; Damasio, H; Damasio, A R

    2000-03-01

    The somatic marker hypothesis provides a systems-level neuroanatomical and cognitive framework for decision making and the influence on it by emotion. The key idea of this hypothesis is that decision making is a process that is influenced by marker signals that arise in bioregulatory processes, including those that express themselves in emotions and feelings. This influence can occur at multiple levels of operation, some of which occur consciously and some of which occur non-consciously. Here we review studies that confirm various predictions from the hypothesis. The orbitofrontal cortex represents one critical structure in a neural system subserving decision making. Decision making is not mediated by the orbitofrontal cortex alone, but arises from large-scale systems that include other cortical and subcortical components. Such structures include the amygdala, the somatosensory/insular cortices and the peripheral nervous system. Here we focus only on the role of the orbitofrontal cortex in decision making and emotional processing, and the relationship between emotion, decision making and other cognitive functions of the frontal lobe, namely working memory.

  20. Decision Making Cognition in Primary Progressive Aphasia

    Science.gov (United States)

    Gleichgerrcht, Ezequiel; Torralva, Teresa; Roca, María; Szenkman, Daniela; Ibanez, Agustin; Richly, Pablo; Pose, Mariángeles; Manes, Facundo

    2012-01-01

    We sought to investigate the decision making profile of Primary Progressive Aphasia (PPA) by assessing patients diagnosed with this disease (n = 10), patients diagnosed with behavioral variant frontotemporal dementia (bvFTD, n = 35), and matched controls (n = 14) using the Iowa Gambling Task, a widely used test that mimics real-life decision making. Participants were also evaluated with a complete neuropsychological battery. Patients with PPA were unable to adopt an advantageous strategy on the IGT, which resulted in a flat performance, different to that exhibited by both controls (who showed advantageous decision making) and bvFTD patients (who showed risk-appetitive behavior). The decision making profile of PPA patients was not associated with performance on language tasks and did not differ between sub-variants of the disease (namely, semantic dementia and progressive nonfluent aphasia). Investigating decision making in PPA is crucial both from a theoretical perspective, as it can shed light about the way in which language interacts with other cognitive functions, as well as a clinical standpoint, as it could lead to a more objective detection of impairments of decision making deficits in this condition. PMID:22207422

  1. Intergroup conflict and rational decision making.

    Directory of Open Access Journals (Sweden)

    Vicente Martínez-Tur

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

  2. Decision Making Cognition in Primary Progressive Aphasia

    Directory of Open Access Journals (Sweden)

    Ezequiel Gleichgerrcht

    2012-01-01

    Full Text Available We sought to investigate the decision making profile of Primary Progressive Aphasia (PPA by assessing patients diagnosed with this disease (n = 10, patients diagnosed with behavioral variant frontotemporal dementia (bvFTD, n = 35, and matched controls (n = 14 using the Iowa Gambling Task, a widely used test that mimics real-life decision making. Participants were also evaluated with a complete neuropsychological battery. Patients with PPA were unable to adopt an advantageous strategy on the IGT, which resulted in a flat performance, different to that exhibited by both controls (who showed advantageous decision making and bvFTD patients (who showed risk-appetitive behavior. The decision making profile of PPA patients was not associated with performance on language tasks and did not differ between sub-variants of the disease (namely, semantic dementia and progressive nonfluent aphasia. Investigating decision making in PPA is crucial both from a theoretical perspective, as it can shed light about the way in which language interacts with other cognitive functions, as well as a clinical standpoint, as it could lead to a more objective detection of impairments of decision making deficits in this condition.

  3. Intergroup conflict and rational decision making.

    Science.gov (United States)

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

    2014-01-01

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

  4. Principles of shared decision-making within teams.

    Science.gov (United States)

    Jacobs, Jeffrey P; Wernovsky, Gil; Cooper, David S; Karl, Tom R

    2015-12-01

    In the domain of paediatric and congenital cardiac care, the stakes are huge. Likewise, the care of these children assembles a group of "A+ personality" individuals from the domains of cardiac surgery, cardiology, anaesthesiology, critical care, and nursing. This results in an environment that has opportunity for both powerful collaboration and powerful conflict. Providers of healthcare should avoid conflict when it has no bearing on outcome, as it is clearly a squandering of individual and collective political capital. Outcomes after cardiac surgery are now being reported transparently and publicly. In the present era of transparency, one may wonder how to balance the following potentially competing demands: quality healthcare, transparency and accountability, and teamwork and shared decision-making. An understanding of transparency and public reporting in the domain of paediatric cardiac surgery facilitates the implementation of a strategy for teamwork and shared decision-making. In January, 2015, the Society of Thoracic Surgeons (STS) began to publicly report outcomes of paediatric and congenital cardiac surgery using the 2014 Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD) Mortality Risk Model. The 2014 STS-CHSD Mortality Risk Model facilitates description of Operative Mortality adjusted for procedural and patient-level factors. The need for transparency in reporting of outcomes can create pressure on healthcare providers to implement strategies of teamwork and shared decision-making to assure outstanding results. A simple strategy of shared decision-making was described by Tom Karl and was implemented in multiple domains by Jeff Jacobs and David Cooper. In a critical-care environment, it is not unusual for healthcare providers to disagree about strategies of management of patients. When two healthcare providers disagree, each provider can classify the disagreement into three levels: • SDM Level 1 Decision: "We disagree but it really

  5. 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.

  6. Decision-making styles and their associations with decision-making competencies and mental health

    OpenAIRE

    Jozef Bavoľár; Oľga Orosová

    2015-01-01

    This study investigates the psychometric characteristics of the General Decision-Making Scale (GDMS) on a sample of Slovak high-school and university students. Secondly, it addresses the relationship between decision-making styles and a) decision making competencies and b) mental health as validity criteria. Participants were 427 Slovak high school and university students (64.6% females). The GDMS showed a good internal consistency and its original factor structure was co...

  7. The craft process developing student decision making

    Directory of Open Access Journals (Sweden)

    Marja-Leena Rönkkö

    2016-02-01

    Full Text Available In enterprise education, learning is problem-focused and holistic. A learning process that encourages people to learn by doing develops their problem-solving skills, participation, interaction, and decision making. Craft making includes practice, development, creativity, innovativeness, and the problem-solving process, and the craft teaching aims to promote students’ substance skills of crafts and the skills they need in everyday life. Craft skills make people more active and help them to find practical solutions. Decision making seems to be one of the connecting themes between crafts and enterprise education. In this study, we examine school students’ decision making during a craft process. The study was conducted during the spring term of 2013 and examines how the students make various decisions during the craft making process. Eight 13-year-old students were interviewed and the interview data analysed using thematic analysis. The results indicate that the quality of the students’ decision making during a craft process is dependent on their personal goals, self-confidence, and previous experiences. In addition, there is a connection between the students’ decision making and the social environment when they want to emphasize their own personality or similarity to their peers.  

  8. Stereotype threat affects financial decision making.

    Science.gov (United States)

    Carr, Priyanka B; Steele, Claude M

    2010-10-01

    The research presented in this article provides the first evidence that one's decision making can be influenced by concerns about stereotypes and the devaluation of one's identity. Many studies document gender differences in decision making, and often attribute these differences to innate and stable factors, such as biological and hormonal differences. In three studies, we found that stereotype threat affected decision making and led to gender differences in loss-aversion and risk-aversion behaviors. In Study 1, women subjected to stereotype threat in academic and business settings were more loss averse than both men and women who were not facing the threat of being viewed in light of negative stereotypes. We found no gender differences in loss-aversion behavior in the absence of stereotype threat. In Studies 2a and 2b, we found the same pattern of effects for risk-aversion behavior that we had observed for loss-aversion behavior. In addition, in Study 2b, ego depletion mediated the effects of stereotype threat on women's decision making. These results suggest that individuals' decision making can be influenced by stereotype concerns.

  9. Psychiatric disturbance and decision-making.

    Science.gov (United States)

    Radford, M H; Mann, L; Kalucy, R S

    1986-06-01

    The relationship between psychiatric disorder (as measured by severity of psychoneurotic status and depression) and decision-making behaviour was examined in a sample of 39 hospitalised patients. Measures based on the conflict theory of decision-making of Janis and Mann (1977) and the expectancy-value theory of decision-making of Edwards (1961) were administered. Patients who scored highest on measures of psychoneurotic disorder--the Middlesex Hospital Questionnaire and the Beck Depression Inventory--were least confident about their decision-making. They also reported a high use of maladaptive decision-making coping patterns, in particular decision avoidance. Slightly over one-half of the patients demonstrated an ability to make rational decisions, while the remainder made either irrational decisions or avoided making any decision at all. Observation in the test session revealed that patients were strikingly slow in answering the questionnaires and often attempted to make no response. The importance of this area of research for patient assessment and treatment is discussed.

  10. Capturing a Commander's decision making style

    Science.gov (United States)

    Santos, Eugene; Nguyen, Hien; Russell, Jacob; Kim, Keumjoo; Veenhuis, Luke; Boparai, Ramnjit; Stautland, Thomas Kristoffer

    2017-05-01

    A Commander's decision making style represents how he weighs his choices and evaluates possible solutions with regards to his goals. Specifically, in the naval warfare domain, it relates the way he processes a large amount of information in dynamic, uncertain environments, allocates resources, and chooses appropriate actions to pursue. In this paper, we describe an approach to capture a Commander's decision style by creating a cognitive model that captures his decisionmaking process and evaluate this model using a set of scenarios using an online naval warfare simulation game. In this model, we use the Commander's past behaviors and generalize Commander's actions across multiple problems and multiple decision making sequences in order to recommend actions to a Commander in a manner that he may have taken. Our approach builds upon the Double Transition Model to represent the Commander's focus and beliefs to estimate his cognitive state. Each cognitive state reflects a stage in a Commander's decision making process, each action reflects the tasks that he has taken to move himself closer to a final decision, and the reward reflects how close he is to achieving his goal. We then use inverse reinforcement learning to compute a reward for each of the Commander's actions. These rewards and cognitive states are used to compare between different styles of decision making. We construct a set of scenarios in the game where rational, intuitive and spontaneous decision making styles will be evaluated.

  11. Cognitive Reflection Versus Calculation in Decision Making

    Directory of Open Access Journals (Sweden)

    Aleksandr eSinayev

    2015-05-01

    Full Text Available Scores on the three-item Cognitive Reflection Test (CRT have been linked with dual-system theory and normative decision making (Frederick, 2005. In particular, the CRT is thought to measure monitoring of System 1 intuitions such that, if cognitive reflection is high enough, intuitive errors will be detected and the problem will be solved. However, CRT items also require numeric ability to be answered correctly and it is unclear how much numeric ability vs. cognitive reflection contributes to better decision making. In two studies, CRT responses were used to calculate Cognitive Reflection and numeric ability; a numeracy scale was also administered. Numeric ability, measured on the CRT or the numeracy scale, accounted for the CRT’s ability to predict more normative decisions (a subscale of decision-making competence, incentivized measures of impatient and risk-averse choice, and self-reported financial outcomes; Cognitive Reflection contributed no independent predictive power. Results were similar whether the two abilities were modeled (Study 1 or calculated using proportions (Studies 1 and 2. These findings demonstrate numeric ability as a robust predictor of superior decision making across multiple tasks and outcomes. They also indicate that correlations of decision performance with the CRT are insufficient evidence to implicate overriding intuitions in the decision-making biases and outcomes we examined. Numeric ability appears to be the key mechanism instead.

  12. The use of Ethics Decision-Making Frameworks by Canadian Ethics Consultants: A Qualitative Study.

    Science.gov (United States)

    Kaposy, Chris; Brunger, Fern; Maddalena, Victor; Singleton, Richard

    2016-10-01

    In this study, Canadian healthcare ethics consultants describe their use of ethics decision-making frameworks. Our research finds that ethics consultants in Canada use multi-purpose ethics decision-making frameworks, as well as targeted frameworks that focus on reaching an ethical resolution to a particular healthcare issue, such as adverse event reporting, or difficult triage scenarios. Several interviewees mention the influence that the accreditation process in Canadian healthcare organizations has on the adoption and use of such frameworks. Some of the ethics consultants we interviewed also report on their reluctance to use these tools. Limited empirical work has been done previously on the use of ethics decision-making frameworks. This study begins to fill this gap in our understanding of the work of healthcare ethics consultants.

  13. Informing clinical policy decision-making practices in ambulance services.

    Science.gov (United States)

    Muecke, Sandy; Curac, Nada; Binks, Darryn

    2013-12-01

    This study aims to identify the processes and frameworks that support an evidence-based approach to clinical policy decision-making practices in ambulance services. This literature review focused on: (i) the setting (pre-hospital); and (ii) the process of evidence translation, for studies published after the year 2000. Searches of Medline, CINAHL and Google were undertaken. Reference lists of eligible publications were searched for relevant articles. A total of 954 articles were identified. Of these, 20 full text articles were assessed for eligibility and seven full text articles met the inclusion criteria. Three provided detailed descriptions of the evidence-based practice processes used to inform ambulance service protocol or guideline development or review. There is little published literature that describes the processes involved, and frameworks required, to inform clinical policy decision making within ambulance services. This review found that processes were iterative and involved collaborations across many internal and external stakeholders. In several jurisdictions, these were coordinated by a dedicated team. Success appears dependent on committed leadership and purposive human and structural resources. Although time consuming, structured processes have been developed in some jurisdictions to assist decision-making processes. Further insight is likely to be obtained from literature published by those from other disciplines. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

  14. Re-engineering shared decision-making.

    Science.gov (United States)

    Gillick, Muriel R

    2015-09-01

    Shared decision-making is widely accepted as the gold standard of clinical care. Numerous obstacles to achieving shared decision-making have been identified, including patient factors, physician factors and systemic factors. Until now, the paradigm is seldom successfully implemented in clinical practice, raising questions about the practicality of the process recommended for its use. A re-engineered model is proposed in which physicians elicit and prioritise patients' goals of care and then help translate those goals into treatment options, after clarifying the patient's underlying health status. Preliminary evidence suggests that each step of this revised process is feasible and that patients and physicians are comfortable with this strategy. Adoption of this model, after further testing, would allow the goal of shared decision-making to be realised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Stakeholder Risk Management in Ethical Decision Making

    DEFF Research Database (Denmark)

    Lauesen, Linne Marie

    evidence from hybrid organizations as Publicly Owned Enterprises (POEs) mixed of private corporations and political administration. The model offers a new way of combining risk management with ethical decisionmaking processes by the inclusion of multiple stakeholders. Not only does the model apply....... This paper offers an ‘Organic Stakeholder Model’ based on decision making theory, risk assessment and adaption to a rapidly changing world combined with appropriate stakeholder theory for ethical purposes in decision making processes in businesses. The ‘Organic Stakeholder Model’ is based on empirical...... to these kinds of hybrid organizations, but it is easily adopted and tested for other private business models too. The findings and the conceptualization of the model enhances business ethics in decision making by managing and balancing stakeholder concerns with the same concerns as the traditional risk...

  16. The neuroscience of social decision-making.

    Science.gov (United States)

    Rilling, James K; Sanfey, Alan G

    2011-01-01

    Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory setting, and a variety of neuroscience methods have been used to probe the underlying neural systems. This approach is informing our knowledge of the neural mechanisms that support decisions about trust, reciprocity, altruism, fairness, revenge, social punishment, social norm conformity, social learning, and competition. Neural systems involved in reward and reinforcement, pain and punishment, mentalizing, delaying gratification, and emotion regulation are commonly recruited for social decisions. This review also highlights the role of the prefrontal cortex in prudent social decision-making, at least when social environments are relatively stable. In addition, recent progress has been made in understanding the neural bases of individual variation in social decision-making.

  17. Decision-making situations in health care.

    Science.gov (United States)

    Murdach, A D

    1995-08-01

    Social workers in health care settings are constantly required to make clinical decisions about patient care and treatment. Although much attention has been devoted to the normative or ethical aspects of decision making in such settings, little attention has been given to the typical situational aspects of decisions social workers must make in health care. This article discusses four types of clinical decision situations--operational, strategic, authoritative, and crisis--and presents a model to assist in analyzing their components and requirements. Case vignettes drawn from practice experience illustrate each type of decision-making situation. The article concludes that knowledge of the situational aspects of practice decision making can be helpful to practitioners by enabling them to sort out courses of action and intervention.

  18. Cognitive processes in anesthesiology decision making.

    Science.gov (United States)

    Stiegler, Marjorie Podraza; Tung, Avery

    2014-01-01

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

  19. The potential for shared decision-making and decision aids in rehabilitation medicine

    OpenAIRE

    Til, van, J.A.; Drossaert, Constance H.C; Punter, R. Annemiek; IJzerman, Maarten J.

    2010-01-01

    Objective: Shared decision-making and the use of decision aids are increasingly promoted in various healthcare settings. The extent of their current use and potential in rehabilitation medicine is unknown. The aim of the present study was to explore the barriers to and facilitators of shared decision-making and use of decision aids in daily practice, and to explore the perceptions of physical and rehabilitation medicine (PRM) physicians toward them. Methods: A cross-sectional survey of 408 PR...

  20. Internet use and decision making in community-based older adults

    Directory of Open Access Journals (Sweden)

    Bryan David James

    2013-09-01

    Full Text Available Use of the internet may provide tools and resources for better decision making, yet little is known about the association of internet use with decision-making in older persons. We examined this relationship in 66190 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Participants were asked to report if they had access to the internet and how frequently they used the internet and email. A 12-item instrument was used to assess financial and healthcare decision making using materials designed to approximate those used in real world settings. Items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex, race, education, and a measure of global cognitive function. Secondary models further adjusted for income, depression, loneliness, social networks, social support, chronic medical conditions, instrumental activities of daily living, life space size, and health and financial literacy. Interaction terms were used to test for effect modification. Almost 70% of participants had access to the internet, and of those with access, 55% used the internet at least several times a week. Higher frequency of internet use was associated with better financial and healthcare decision making (β=0.11, p=0.002. The association persisted in a fully adjusted model (β=0.08, p=0.024. Interaction models indicated that higher frequency of internet use attenuated the relationships of older age, poorer cognitive function, and lower levels of health and financial literacy with poorer healthcare and financial decision making. These findings indicate that internet use is associated with better health and financial decision making in older persons. Future research is required to understand whether promoting the use of the internet can produce improvements in healthcare and financial decision making.

  1. Internet use and decision making in community-based older adults.

    Science.gov (United States)

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

    2013-01-01

    Use of the internet may provide tools and resources for better decision making, yet little is known about the association of internet use with decision making in older persons. We examined this relationship in 661 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Participants were asked to report if they had access to the internet and how frequently they used the internet and email. A 12-item instrument was used to assess financial and healthcare decision making using materials designed to approximate those used in real world settings. Items were summed to yield a total decision making score. Associations were tested via linear regression models adjusted for age, sex, race, education, and a measure of global cognitive function. Secondary models further adjusted for income, depression, loneliness, social networks, social support, chronic medical conditions, instrumental activities of daily living (IADLs), life space size, and health and financial literacy. Interaction terms were used to test for effect modification. Almost 70% of participants had access to the internet, and of those with access, 55% used the internet at least several times a week. Higher frequency of internet use was associated with better financial and healthcare decision making (β = 0.11, p = 0.002). The association persisted in a fully adjusted model (β = 0.08, p = 0.024). Interaction models indicated that higher frequency of internet use attenuated the relationships of older age, poorer cognitive function, and lower levels of health and financial literacy with poorer healthcare and financial decision making. These findings indicate that internet use is associated with better health and financial decision making in older persons. Future research is required to understand whether promoting the use of the internet can produce improvements in healthcare and financial decision making.

  2. Decision Making with Imperfect Decision Makers

    CERN Document Server

    Guy, Tatiana Valentine; Wolpert, David H

    2012-01-01

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

  3. On emotion specificity in decision making

    Directory of Open Access Journals (Sweden)

    Marcel Zeelenberg

    2008-01-01

    Full Text Available We present a motivational account of the impact of emotion on decision making, termed the feeling-is-for-doing approach. We first describe the psychology of emotion and argue for a need to be specific when studying emotion's impact on decision making. Next we describe what our approach entails and how it relates emotion, via motivation to behavior. Then we offer two illustrations of our own research that provide support for two important elements in our reasoning. We end with specifying four criteria that we consider to be important when studying how feeling guides our everyday doing.

  4. Gender and internet consumers' decision-making.

    Science.gov (United States)

    Yang, Chyan; Wu, Chia-Chun

    2007-02-01

    The purpose of this research is to provide managers of shopping websites information regarding consumer purchasing decisions based on the Consumer Styles Inventory (CSI). According to the CSI, one can capture what decision-making styles online shoppers use. Furthermore, this research also discusses the gender differences among online shoppers. Exploratory factor analysis (EFA) was used to understand the decision-making styles and discriminant analysis was used to distinguish the differences between female and male shoppers. The result shows that there are differences in purchasing decisions between online female and male Internet users.

  5. Good decision making requires good communication.

    Science.gov (United States)

    Fischhoff, Baruch

    2012-11-01

    The methods used for regulatory decisions must facilitate three kinds of communication: (i) with individual experts who must translate their knowledge into usable form; (ii) among the experts whose pooled knowledge informs those choices; and (iii) between regulators and those affected by their choices. Decision-making methods vary in their reliance on expert judgement and computational methods and, hence, in their ability to meet the goals of sound decision making: breadth, depth, precision, neutrality, evaluability and transparency. An approach developed by the US FDA, the Benefit-Risk Framework, integrates judgement and computation, cognizant of their strengths and weaknesses. Its application both requires and facilitates good communication about risks and benefits.

  6. Shared Decision Making in Intensive Care Units: An American College of Critical Care Medicine and American Thoracic Society Policy Statement

    Science.gov (United States)

    Kon, Alexander A.; Davidson, Judy E.; Morrison, Wynne; Danis, Marion; White, Douglas B.

    2015-01-01

    Objectives Shared decision-making (SDM) is endorsed by critical care organizations, however there remains confusion about what SDM is, when it should be used, and approaches to promote partnerships in treatment decisions. The purpose of this statement is to define SDM, recommend when SDM should be used, identify the range of ethically acceptable decision-making models, and present important communication skills. Methods The American College of Critical Care Medicine (ACCM) and American Thoracic Society (ATS) Ethics Committees reviewed empirical research and normative analyses published in peer-reviewed journals to generate recommendations. Recommendations approved by consensus of the full Ethics Committees of ACCM and ATS were included in the statement. Main Results Six recommendations were endorsed: 1) Definition: Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences. 2) Clinicians should engage in a SDM process to define overall goals of care (including decisions regarding limiting or withdrawing life-prolonging interventions) and when making major treatment decisions that may be affected by personal values, goals, and preferences. 3) Clinicians should use as their “default” approach a SDM process that includes three main elements: information exchange, deliberation, and making a treatment decision. 4) A wide range of decision-making approaches are ethically supportable including patient- or surrogate-directed and clinician-directed models. Clinicians should tailor the decision-making process based on the preferences of the patient or surrogate. 5) Clinicians should be trained in communication skills. 6) Research is needed to evaluate decision-making strategies. Conclusions Patient and surrogate preferences for decision-making roles regarding value

  7. Use of economic evaluation in decision making: evidence and recommendations for improvement.

    Science.gov (United States)

    Simoens, Steven

    2010-10-22

    Information about the value for money of a medicine as derived from an economic evaluation can be used for decision-making purposes by policy makers, healthcare payers, healthcare professionals and pharmaceutical companies. This article illustrates the use of economic evaluation by decision makers and formulates a number of recommendations to enhance the use of such evaluations for decision-making purposes. Over the last decades, there has been a substantial increase in the number of economic evaluations assessing the value for money of medicines. Economic evaluation is used by policy makers and healthcare payers to inform medicine pricing/reimbursement decisions in more and more countries. It is a suitable tool to evaluate medicines and to present information about their value for money to decision makers in a familiar format. In order to fully exploit the use of economic evaluation for decision-making purposes, researchers need to take care to conduct such economic evaluations according to methodologically sound principles. Additionally, researchers need to take into account the decision-making context. They need to identify the various objectives that decision makers pursue and discuss how decision makers can use study findings to attain these objectives. These issues require further attention from researchers, policy makers, healthcare payers, healthcare professionals and pharmaceutical companies with a view to optimizing the use of economic evaluation in decision making.

  8. Current concepts of shared decision making in orthopedic surgery.

    Science.gov (United States)

    Klifto, Kevin; Klifto, Christopher; Slover, James

    2017-06-01

    The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes. SDM can be applied without significant increases in the office length. Patients report that a physician that takes the time to listen to them is among the most important factors in their care. When time was focused on the SDM process, there was a direct correlation between the time spent with a patient and patient satisfaction. Patients exposed to a decision aid prior to surgery gained a greater knowledge from baseline to make a higher quality decision that was consistent with their values. Involving family members preoperatively can help all patients adhere to postoperative regimens. Exposing patients to a decision aid can reduce expensive elective surgeries, in favor of non-operative management. Incorporating patient goals into the decision-making process has increased satisfaction, compliance, and outcomes. SDM is a two-way exchange of information that attempts to correct the inequality of power between the patient and physician. Decision-aids are helpful tools that facilitate the decision-making process. Treatment decisions are consistent with patient preferences and values when there may be no "best" therapy. A good patient-physician relationship is essential during the process to reduce decisional conflict and increase overall patient outcomes.

  9. Can consumers learn to ask three questions to improve shared decision making? A feasibility study of the ASK (AskShareKnow) Patient-Clinician Communication Model(®) intervention in a primary health-care setting.

    Science.gov (United States)

    Shepherd, Heather L; Barratt, Alexandra; Jones, Anna; Bateson, Deborah; Carey, Karen; Trevena, Lyndal J; McGeechan, Kevin; Del Mar, Chris B; Butow, Phyllis N; Epstein, Ronald M; Entwistle, Vikki; Weisberg, Edith

    2016-10-01

    To test the feasibility and assess the uptake and acceptability of implementing a consumer questions programme, AskShareKnow, to encourage consumers to use the questions '1. What are my options; 2. What are the possible benefits and harms of those options; 3. How likely are each of those benefits and harms to happen to me?' These three questions have previously shown important effects in improving the quality of information provided during consultations and in facilitating patient involvement. This single-arm intervention study invited participants attending a reproductive and sexual health-care clinic to view a 4-min video-clip in the waiting room. Participants completed three questionnaires: (T1) prior to viewing the intervention; (T2) immediately after their consultation; and (T3) two weeks later. A total of 121 (78%) participants viewed the video-clip before their consultation. Eighty-four (69%) participants asked one or more questions, and 35 (29%) participants asked all three questions. For those making a decision, 55 (87%) participants asked one or more questions, while 27 (43%) participants asked all three questions. Eighty-seven (72%) participants recommended the questions. After two weeks, 47 (49%) of the participants recalled the questions. Enabling patients to view a short video-clip before an appointment to improve information and involvement in health-care consultations is feasible and led to a high uptake of question asking in consultations. This AskShareKnow programme is a simple and feasible method of training patients to use a brief consumer-targeted intervention that has previously shown important effects in improving the quality of information provided during consultations and in facilitating patient involvement and use of evidence-based questions. ©2015 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  10. Career Decision-Making and Corporate Responsibility

    Science.gov (United States)

    Sainty, Rosemary

    2008-01-01

    This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…

  11. Probabilistic Analysis in Management Decision Making

    DEFF Research Database (Denmark)

    Delmar, M. V.; Sørensen, John Dalsgaard

    1992-01-01

    The target group in this paper is people concerned with mathematical economic decision theory. It is shown how the numerically effective First Order Reliability Methods (FORM) can be used in rational management decision making, where some parameters in the applied decision basis are uncertainty...

  12. Collective decision-making in microbes

    Science.gov (United States)

    Ross-Gillespie, Adin; Kümmerli, Rolf

    2014-01-01

    Microbes are intensely social organisms that routinely cooperate and coordinate their activities to express elaborate population level phenotypes. Such coordination requires a process of collective decision-making, in which individuals detect and collate information not only from their physical environment, but also from their social environment, in order to arrive at an appropriately calibrated response. Here, we present a conceptual overview of collective decision-making as it applies to all group-living organisms; we introduce key concepts and principles developed in the context of animal and human group decisions; and we discuss, with appropriate examples, the applicability of each of these concepts in microbial contexts. In particular, we discuss the roles of information pooling, control skew, speed vs. accuracy trade-offs, local feedbacks, quorum thresholds, conflicts of interest, and the reliability of social information. We conclude that collective decision-making in microbes shares many features with collective decision-making in higher taxa, and we call for greater integration between this fledgling field and other allied areas of research, including in the humanities and the physical sciences. PMID:24624121

  13. Clinical Decision Making of Rural Novice Nurses

    Science.gov (United States)

    Seright, Teresa J.

    2010-01-01

    The purpose of this study was to develop substantive theory regarding decision making by the novice nurse in a rural hospital setting. Interviews were guided by the following research questions: What cues were used by novice rural registered nurses in order to make clinical decisions? What were the sources of feedback which influenced subsequent…

  14. Recent developemts in multiple criteria decision making

    Directory of Open Access Journals (Sweden)

    Z. Zionts

    2003-12-01

    Full Text Available Problems involving more than one criterion abound. To help in the solution of such problems, a field of management science and operations research known as multiple criteria decision making (MCDM has emerged to help solve such problems. In this paper we discuss some recent developments in this important field.

  15. New forms of decision making for sustainability

    Directory of Open Access Journals (Sweden)

    Mojca Golobič

    2007-01-01

    Full Text Available Paper discusses the way and the level to which the decision making form is relevant for the outcome of the decision process as measured against the sustainability targets. A brief overview of scientific and political discourse on this matter shows, that participative decision making forms are supposed to lead towards sustainable development. While their qualities in ensuring transparency, inclusiveness, fairness and deliberation opportunities for concerned citizens need not be questioned, their contribution towards other sustainability goals require some empirical support. An attempt to collect some empirical evidence on this relation is presented in the second part of the paper. The study is based on the analysis of extensive data base of “best practice examples” in several topics related to sustainable development, which were compiled in “Future in the Alps” project. A brief overview confirms the inadequacy of traditional market, technocratic and consultative decision making forms to effectively support sustainability objectives. The detailed study of a set of cases, assessed as “best practices” of decision making has shown that they perform rather effective in terms of meeting sustainability goals. As expected, their effects in social sphere were highest and most positive, the contribution towards environmental goals generally high, but sometimes ambiguous, while the economic effects could sometimes be assessed as rather long-term and redistributive.

  16. Harsh Realities about Decentralized Decision Making.

    Science.gov (United States)

    Patterson, Jerry

    1998-01-01

    To increase their odds for successful decentralized decision making, leaders must operate from a different set of realities about organizational change and design appropriate strategies to create more resilient organizations. Most people act first in their own self-interest; resist understanding the meaning of organizational change; and are…

  17. Decision Making and the Brain: Neurologists’ View

    Directory of Open Access Journals (Sweden)

    Dejan Georgiev

    2009-12-01

    Full Text Available The article reflects the fact, that concepts like decision making and free will have entered the field of cognitive neuroscience towards the end of 20th century. It gives an overview of brain structures involved in decision making and the concept of free will; and presenting the results of clinical observations and new methods (functional neuroimaging, electrophysiology it postulates possible mechanisms of these processes. We give a review of the neuroanatomy, specially discussing those parts of the brain important to the present topic, because the process of decision making is dependent on deep subcortical as well as superficial cortical structures. Dopamine has a central role in the in process of reward related behaviour and hedonism. A list of brain structures, related to dopamine action, is also given. The article especially concentrates on the Single Photon Emission Computer Tomography studies in patients with Parkinson’s disease (neuroimaging, as well as to the studies concerning the Readiness Potential and Endogeneous Potential P300 (electrophysiology. In the end, we discuss the volition, whose functional anatomy overlaps with the functional anatomy of free will and decision making processes.

  18. Consumer Decision Making in a Global Context.

    Science.gov (United States)

    Lusby, Linda A.

    This document examines the underlying rationale for the development of a global approach in consumer studies. The concept of consumer ethics is discussed and the consumer decision-making process is placed within an ecosystem perspective of the marketplace. The model developed introduces educators, marketers, and consumers to a more global…

  19. Quantum random walks and decision making.

    Science.gov (United States)

    Shankar, Karthik H

    2014-01-01

    How realistic is it to adopt a quantum random walk model to account for decisions involving two choices? Here, we discuss the neural plausibility and the effect of initial state and boundary thresholds on such a model and contrast it with various features of the classical random walk model of decision making.

  20. Greater than the Parts: Shared Decision Making.

    Science.gov (United States)

    Jensen, Anabel L.

    1986-01-01

    The article describes the goals, rationale, structure of the shared decision-making model in effect at the Nueva Learning Center, a private elementary school for gifted and talented in Hillsborough, California. An example applying the model to class scheduling and 10 steps for facilitating the process are given. (Author/DB)

  1. Collective decision-making in microbes.

    Science.gov (United States)

    Ross-Gillespie, Adin; Kümmerli, Rolf

    2014-01-01

    Microbes are intensely social organisms that routinely cooperate and coordinate their activities to express elaborate population level phenotypes. Such coordination requires a process of collective decision-making, in which individuals detect and collate information not only from their physical environment, but also from their social environment, in order to arrive at an appropriately calibrated response. Here, we present a conceptual overview of collective decision-making as it applies to all group-living organisms; we introduce key concepts and principles developed in the context of animal and human group decisions; and we discuss, with appropriate examples, the applicability of each of these concepts in microbial contexts. In particular, we discuss the roles of information pooling, control skew, speed vs. accuracy trade-offs, local feedbacks, quorum thresholds, conflicts of interest, and the reliability of social information. We conclude that collective decision-making in microbes shares many features with collective decision-making in higher taxa, and we call for greater integration between this fledgling field and other allied areas of research, including in the humanities and the physical sciences.

  2. Speed versus accuracy in collective decision making.

    Science.gov (United States)

    Franks, Nigel R; Dornhaus, Anna; Fitzsimmons, Jon P; Stevens, Martin

    2003-12-01

    We demonstrate a speed versus accuracy trade-off in collective decision making. House-hunting ant colonies choose a new nest more quickly in harsh conditions than in benign ones and are less discriminating. The errors that occur in a harsh environment are errors of judgement not errors of omission because the colonies have discovered all of the alternative nests before they initiate an emigration. Leptothorax albipennis ants use quorum sensing in their house hunting. They only accept a nest, and begin rapidly recruiting members of their colony, when they find within it a sufficient number of their nest-mates. Here we show that these ants can lower their quorum thresholds between benign and harsh conditions to adjust their speed-accuracy trade-off. Indeed, in harsh conditions these ants rely much more on individual decision making than collective decision making. Our findings show that these ants actively choose to take their time over judgements and employ collective decision making in benign conditions when accuracy is more important than speed.

  3. URBAN DECISION-MAKING, THE UNIVERSITY'S ROLE.

    Science.gov (United States)

    BAILEY, STEPHEN K.

    THE AUTHOR EXAMINES THE VARIOUS WAYS IN WHICH THE UNIVERSITY CAN AND SHOULD INFLUENCE URBAN DECISION MAKING. THE CENTRAL UNIVERSITY ROLE IS SENSITIZING THE DECISION MAKERS AND THE CITIZENS TO HUMAN MISERY, SUCH AS BIGOTRY, SQUALOR, DISEASE, UGLINESS, POVERTY, AND IGNORANCE. LONG-RANGE ROLES ARE PINPOINTING THE PROBLEMS URBAN DECISION MAKERS SHOULD…

  4. The Neuroscience of Social Decision-Making

    NARCIS (Netherlands)

    Rilling, J.K.; Sanfey, A.G.

    2011-01-01

    Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory

  5. The cognitive error in decision making

    Directory of Open Access Journals (Sweden)

    Pier Luigi Baldi

    2013-06-01

    Full Text Available This issue deals with the partial data of a research in progress on focalization, pseudodiagnosticity and framing- effect in decision making, followed by the most important results of some experiments about the emotional aspects of the choice, and ends by stressing the potential contribution of the artificial neural networks to the medical diagnosis.

  6. Goal Directedness and Decision Making in Infants

    Science.gov (United States)

    Kenward, Ben; Folke, Sara; Holmberg, Jacob; Johansson, Alexandra; Gredeback, Gustaf

    2009-01-01

    The term "goal directed" conventionally refers to either of 2 separate process types--motor processes organizing action oriented toward physical targets and decision-making processes that select these targets by integrating desire for and knowledge of action outcomes. Even newborns are goal directed in the first sense, but the status of…

  7. Emotion, decision-making and the brain

    NARCIS (Netherlands)

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

    2008-01-01

    PURPOSE: Initial explorations in the burgeoning field of neuroeconomics have highlighted evidence supporting a potential dissociation between a fast automatic system and a slow deliberative controlled system. Growing research in the role of emotion in decision-making has attempted to draw parallels

  8. Decision Making and Systems Thinking: Educational Issues

    Science.gov (United States)

    Yurtseven, M. Kudret; Buchanan, Walter W.

    2016-01-01

    Decision making in most universities is taught within the conventional OR/MS (Operations Research/Management Science) paradigm. This paradigm is known to be "hard" since it is consisted of mathematical tools, and normally suitable for solving structured problems. In complex situations the conventional OR/MS paradigm proves to be…

  9. Hospice Decision Making: Diagnosis Makes a Difference

    Science.gov (United States)

    Waldrop, Deborah P.; Meeker, Mary Ann

    2012-01-01

    Purpose: This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. Methods: This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36…

  10. Hyperchaotic phenomena in dynamic decision making

    DEFF Research Database (Denmark)

    Thomsen, Jesper Skovhus; Mosekilde, Erik; Sterman, John David

    1992-01-01

    of this article is to show how the decision making behavior of real people in simulated corporate environments can lead to chaotic, hyperchaotic and higher-order hyperchaotic phenomena. Characteristics features of these complicated forms of behavior are analyzed with particular emphasis on an interesting form...

  11. Knowledge, responsibility, decision making and ignorance

    DEFF Research Database (Denmark)

    Huniche, Lotte

    2001-01-01

    a closer look at genetic knowledge, responsibility and decision making, because these seem to be important issues in my field of study. I have added ignorance to the list in order to discuss a further aspect of dealing with hereditary disease. Interestingly, ignorance (understood both as being ignorant...

  12. The Development of Decision-Making Skills

    Science.gov (United States)

    Mettas, Alexandros

    2011-01-01

    This paper suggests an innovative idea of using the "technology fair" as a means for promoting pre-service teachers (university students) decision-making skills. The purpose of the study was to investigate the influence of a procedure of working with primary school children to complete and present a technology fair project, on the decision-making…

  13. Deliberation, Information Aggregation and Collective Decision Making

    NARCIS (Netherlands)

    O.H. Swank (Otto); P.T. Wrasai (Phongthorn)

    2002-01-01

    textabstractWe study a model of collective decision making with endogenous information collection. Agents collect information about the consequences of a project, communicate, and then vote on the project. We examine under what conditions communication may increase the probability that good decision

  14. Vocational Choice: A Decision Making Perspective

    Science.gov (United States)

    Sauermann, Henry

    2005-01-01

    We propose a model of vocational choice that can be used for analyzing and guiding the decision processes underlying career and job choices. Our model is based on research in behavioral decision making (BDM), in particular the choice goals framework developed by Bettman, Luce, and Payne (1998). The basic model involves two major processes. First,…

  15. Decision-Making Style and Vocational Maturity.

    Science.gov (United States)

    Phillips, Susan D.; Strohmer, Douglas C.

    1982-01-01

    Examined the relationship between decision-making style, scholastic achievement, and vocational maturity for college students (N=64). Results did not support the hypothesized relationship between rationality and attitudinal and cognitive maturity. Scholastic achievement and lack of dependent decision style were found to be moderately predictive of…

  16. Ethics in economic decision-making

    NARCIS (Netherlands)

    Leliveld, Marijke Christina

    2009-01-01

    This dissertation sheds more light on ethics in economic decision-making. Over the course of nine experiments, I studied (a) when people adhere to ethical standards like the do-no-harm principle, and (b) how people respond to situations in which ethical standards are violated by studying not only

  17. Teaching Decision Making in Business Dynamics Course.

    Science.gov (United States)

    Rosas, Marilyn V.

    1981-01-01

    Teaching decision making in the classroom provides an excellent opportunity for students to clarify their feelings regarding problems that employers experience with entry-level employees. Some of these may include excessive absences, inappropriate dress, the effect of personal problems on job performance, and ethics in the work situation. (CT)

  18. Cost Utility: An Aid to Decision Making.

    Science.gov (United States)

    Costa, Crist H.

    A set of procedures were developed which assist in structuring tasks and objectives in a manner to permit rational decision making. The model uses a jury of experts to rank various objectives and program processes in terms of their importance. Values are generated which relate to costs in the form of a utility-cost ratio. The model was tested in a…

  19. Modeling Non-Standard Financial Decision Making

    NARCIS (Netherlands)

    R.J.D. Potter van Loon (Rogier)

    2014-01-01

    markdownabstractThere are clear theoretical predictions on how a rational person should make financial decisions. When real-life choices are made, however, people often deviate from what economic theory prescribes. This thesis investigates the modeling of non-standard financial decision making by an

  20. Career Decision-Making and Corporate Responsibility

    Science.gov (United States)

    Sainty, Rosemary

    2008-01-01

    This paper seeks to investigate the extent of influence of corporate (or organisational) responsibility on university students' career decision-making. It reports on a pilot study conducted at the University of Sydney which aims to: explore students' ethical, professional and social understanding regarding corporate responsibility; determine the…

  1. SERVIR: Environmental Decision Making in the Americas

    Science.gov (United States)

    Lapenta, William; Irwin, Dan

    2008-01-01

    SERVIR is a regional visualization and monitoring system for Mesoamerica that integrates satellite and other geospatial data for improved scientific knowledge and decision making by managers, researchers, students, and the general public. SERVIR addresses the nine societal benefit areas of the Global Earth Observation System of Systems (GEOSS). This talk will provide an overview of products and services available through SERVIR.

  2. Nonrational Processes in Ethical Decision Making

    Science.gov (United States)

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

    2011-01-01

    Most current ethical decision-making models provide a logical and reasoned process for making ethical judgments, but these models are empirically unproven and rely upon assumptions of rational, conscious, and quasi-legal reasoning. Such models predominate despite the fact that many nonrational factors influence ethical thought and behavior,…

  3. Goal-Proximity Decision-Making

    Science.gov (United States)

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

  4. The Neuroscience of Social Decision-Making

    NARCIS (Netherlands)

    Rilling, J.K.; Sanfey, A.G.

    2011-01-01

    Given that we live in highly complex social environments, many of our most important decisions are made in the context of social interactions. Simple but sophisticated tasks from a branch of experimental economics known as game theory have been used to study social decision-making in the laboratory

  5. Ethics in economic decision-making

    NARCIS (Netherlands)

    Leliveld, Marijke Christina

    2009-01-01

    This dissertation sheds more light on ethics in economic decision-making. Over the course of nine experiments, I studied (a) when people adhere to ethical standards like the do-no-harm principle, and (b) how people respond to situations in which ethical standards are violated by studying not only pu

  6. Nature of Science and Decision-Making

    Science.gov (United States)

    Khishfe, Rola

    2012-01-01

    The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were…

  7. Individual responsibility as ground for priority setting in shared decision-making.

    Science.gov (United States)

    Sandman, Lars; Gustavsson, Erik; Munthe, Christian

    2016-10-01

    Given healthcare resource constraints, voices are being raised to hold patients responsible for their health choices. In parallel, there is a growing trend towards shared decision-making, aiming to empower patients and give them more control over healthcare decisions. More power and control over decisions is usually taken to mean more responsibility for them. The trend of shared decision-making would therefore seem to strengthen the case for invoking individual responsibility in the healthcare priority setting. To analyse whether the implementation of shared decision-making would strengthen the argument for invoking individual responsibility in the healthcare priority setting using normative analysis. Shared decision-making does not constitute an independent argument in favour of employing individual responsibility since these notions rest on different underlying values. However, if a health system employs shared decision-making, individual responsibility may be used to limit resource implications of accommodating patient preferences outside professional standards and goals. If a healthcare system employs individual responsibility, high level dynamic shared decision-making implying a joint deliberation resulting in a decision where both parties are willing to revise initial standpoints may disarm common objections to the applicability of individual responsibility by virtue of making patients more likely to exercise adequate control of their own actions. However, if communication strategies applied in the shared decision-making are misaligned to the patient's initial capacities, arguments against individual responsibility might, on the other hand, gain strength. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Decision making in juvenile myoclonic epilepsy.

    Science.gov (United States)

    Zamarian, Laura; Höfler, Julia; Kuchukhidze, Giorgi; Delazer, Margarete; Bonatti, Elisabeth; Kemmler, Georg; Trinka, Eugen

    2013-03-01

    Recent neuroimaging studies have reported structural and functional brain abnormalities in patients with juvenile myoclonic epilepsy (JME), which may also involve cortical and subcortical networks that are important for decision making. This study is the first attempt to examine decision making in JME. Twenty-two patients with JME (median age 26.00, range 18-50) and 33 healthy controls (median age 26.00, range 18-57) participated in the study. For the JME group, the median age at seizure onset was 14.00 years (range 1-20); the median epilepsy duration was 11.50 years (range 3-45). Eleven patients (50 %) had pharmacoresistant seizures. All participants completed the Iowa Gambling Task (IGT), a widely used standard task of decision making. In this task, contingencies are not explained and feedback on previous decisions has to be used in order to learn to choose the advantageous alternatives. In the IGT, patients with JME showed difficulty in learning to choose advantageously compared to healthy controls. Difficulty was enhanced for the patients with pharmacoresistant seizures. A correlation analysis revealed an association between decision-making performance of patients with JME and executive functions. Results indicate that patients with JME have difficulty in making advantageous decisions and that persistence of seizures might be a critical factor for cognitive functioning. Findings of this study add a new aspect to the neuropsychological profile of JME. Difficulty in decision making may impair functioning of patients with JME in everyday life and affect their adherence to treatment plans.

  9. Breast restoration decision making: enhancing the process.

    Science.gov (United States)

    Reaby, L L

    1998-06-01

    The purpose of this study was to explore the breast restoration decision-making patterns used by women who opted to have their breast cancer treated by mastectomy. Sixty-four women wearing external breast prostheses and 31 women with breast reconstructions were interviewed. Modified versions of Simon's notion of "bounded rationality" and Janis and Mann's conflict model provided the conceptual scaffolding for the study. Five breast restoration decision-making patterns emerged from the analysis of the interview data: (a) Enlightened (actively seeks information, considers positive and negative aspects, and demonstrates deliberation on the alternatives), (b) Contented (passively accepts minimum information on alternatives because of a preference toward a particular type), (c) Sideliner (uncritically adopts any alternative that is easy and simple to implement), (d) Shifter (gives over the decision to others), and (e) Panic-stricken (can make no rational decision on alternatives). In the prosthesis group, the major pattern used was the Sideliner, and in the reconstruction group it was the Contented. None of the participants used the Enlightened pattern. The data indicated that there was no evidence of active information-seeking behavior or deliberation on the alternatives as part of the women's decision-making process. The findings suggest a need for a registered nurse oncology specialist to be accessible to women during the period when decisions regarding breast restoration are made. This professional has the knowledge to interact effectively with these women and serve as their advocate during the decision-making process. Implications for professional practice and a model for competent breast restoration decision making are presented.

  10. 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.

  11. "Junior Doctor Decision Making: Isn't that an Oxymoron?" A Qualitative Analysis of Junior Doctors' Ward-Based Decision-Making

    Science.gov (United States)

    Bull, Stephanie; Mattick, Karen; Postlethwaite, Keith

    2013-01-01

    Unacceptable levels of adverse healthcare events, combined with changes to training, have put the spotlight on junior doctor decision-making. This study aimed to describe the decisions made by junior doctors and the contextual factors influencing how decisions were made and justified. Stimulated recall interviews with 20 junior doctors across five…

  12. "Junior Doctor Decision Making: Isn't that an Oxymoron?" A Qualitative Analysis of Junior Doctors' Ward-Based Decision-Making

    Science.gov (United States)

    Bull, Stephanie; Mattick, Karen; Postlethwaite, Keith

    2013-01-01

    Unacceptable levels of adverse healthcare events, combined with changes to training, have put the spotlight on junior doctor decision-making. This study aimed to describe the decisions made by junior doctors and the contextual factors influencing how decisions were made and justified. Stimulated recall interviews with 20 junior doctors across five…

  13. Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk.

    Science.gov (United States)

    Zhang, Long; Wang, Kai; Zhu, Chunyan; Yu, Fengqiong; Chen, Xingui

    2015-01-01

    Previous studies have reported that trait anxiety (TA) affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA), medium TA (MTA) and low TA (LTA) groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT) that measures decision making under ambiguity and the Game of Dice Task (GDT) that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT.

  14. Trait Anxiety Has Effect on Decision Making under Ambiguity but Not Decision Making under Risk.

    Directory of Open Access Journals (Sweden)

    Long Zhang

    Full Text Available Previous studies have reported that trait anxiety (TA affects decision making. However, results remain largely inconsistent across studies. The aim of the current study was to further address the interaction between TA and decision making. 304 subjects without depression from a sample consisting of 642 participants were grouped into high TA (HTA, medium TA (MTA and low TA (LTA groups based on their TA scores from State Trait Anxiety Inventory. All subjects were assessed with the Iowa Gambling Task (IGT that measures decision making under ambiguity and the Game of Dice Task (GDT that measures decision making under risk. While the HTA and LTA groups performed worse on the IGT compared to the MTA group, performances on the GDT between the three groups did not differ. Furthermore, the LTA and HTA groups showed different individual deck level preferences in the IGT: the former showed a preference for deck B indicating that these subjects focused more on the magnitude of rewards, and the latter showed a preference for deck A indicating significant decision making impairment. Our findings suggest that trait anxiety has effect on decision making under ambiguity but not decision making under risk and different levels of trait anxiety related differently to individual deck level preferences in the IGT.

  15. Building a culture of evidence-informed decision making in the community.

    Science.gov (United States)

    Peach, Lindsay Campbell; Rankin, Elaine

    2011-01-01

    Growing fiscal pressures on health departments both provincially and locally necessitate tough decisions to be made. Although evidence-informed decision making may be commonly used for clinical decision making, the notion of evidence-informed decision making for managing physician office practice processes, primary care, long-term care, or continuing care is limited. In healthcare, much data are collected, yet only a small percentage is actually used in meaningful ways. The Executive Training for Research Application (EXTRA) program strives to not only assist healthcare executives in acquiring necessary skills but also aims to lead cultural change in the Canadian healthcare system. This article describes three brief examples in which a vice president and director with EXTRA training have started to explore and use data to drive change in the community.

  16. The family as window onto the world of the patient: involving patients and families in the decision-making process.

    Science.gov (United States)

    Chambers-Evans, Jane

    2002-10-01

    The need to involve family members as patient advocates and as surrogates when patients are unable to speak for themselves is not an issue. What continues to be debated are the methods for involving family members in the decision-making process. Such decisions can be complex and the environment in which they are made can be chaotic, while clinicians' approach to decision-making is often seen as insensitive. Families struggle with the emotional burden of their role and clinicians struggle to translate complex information into comprehensible, meaningful, and practical language. There is a need to examine clinical practice to determine which approaches to involving family members are preferable from a philosophical as well as a practical point of view. The paper explores the many facets of the surrogate decision-making role and suggests a reorientation of current models of the professional-surrogate relationship.

  17. Ethical decision-making in forensic psychology

    Directory of Open Access Journals (Sweden)

    M. Swanepoel

    2010-07-01

    Full Text Available The purpose of this article is to develop a comprehensive process for identifying and addressing primarily ethical issues related to the psychology profession in South Africa. In fulfilling this purpose, research was conducted of relevant ethical and to a lesser extent, legal aspects pertaining to the psychology profession. In an attempt to prevent unprofessional conduct claims against psychologists from succeeding and to alert psychologists to the concurrent ethical problems that may lead to malpractice suits, this article offers material on some important issues – in the context of forensic psychology – such as ethical decision-making and principles, professional ethics, the regulation of psychology as a profession, the Ethical Code of Professional Conduct to which a psychologist should adhere, ethical aspects and issues pertaining to forensic psychology in general, some ethical issues pertaining to child forensic psychology, summary guidelines for ethical decision-making and some steps to follow to ensure sound ethical decisionmaking.

  18. Biometric and intelligent decision making support

    CERN Document Server

    Kaklauskas, Arturas

    2015-01-01

    This book presents different methods for analyzing the body language (movement, position, use of personal space, silences, pauses and tone, the eyes, pupil dilation or constriction, smiles, body temperature and the like) for better understanding people’s needs and actions, including biometric data gathering and reading. Different studies described in this book indicate that sufficiently much data, information and knowledge can be gained by utilizing biometric technologies. This is the first, wide-ranging book that is devoted completely to the area of intelligent decision support systems, biometrics technologies and their integrations. This book is designated for scholars, practitioners and doctoral and master’s degree students in various areas and those who are interested in the latest biometric and intelligent decision making support problems and means for their resolutions, biometric and intelligent decision making support systems and the theory and practice of their integration and the opportunities fo...

  19. Investment Projects Evaluation in Decision Making Process

    Directory of Open Access Journals (Sweden)

    Dunja Škalamera-Alilović

    2005-08-01

    Full Text Available One of the most important criteria in classifying investment projects is economic dependence between new and existing projects. Economic dependence causes the neccessity of specific information in decision making process. The prerequisite of shaping incremental effects projections is to take opportunity effects, caused by economic dependence, into account. Basic principles of risk estimation that are well known in the field of financial assets, are concerning real investments as well. An enterprise can be viewed as portfolio of investment projects that cannot be perfectly diversified and where market risk is not the most important risk. In the field of real investments, individual risk and added risk to the total risk of enterprise, besides market risk, have to be estimated. This paper explains basic principles of risk estimation in the field of investment projects in the selection of project variants. It researches types of economic dependence among various investment projects and their influence into decision making process.

  20. Decision Making: Between Rationality and Reality

    Directory of Open Access Journals (Sweden)

    Marko Polič

    2009-12-01

    Full Text Available Almost by definition decision-making is typical human activity, and therefore important psychological subject. The starting point of its classical conception within psychology could be traced back to economy and mathematic, with ideas of human as rational economic being, and conceptualising decision making as choice between two or more alternatives, and as such being a separate event in space and time. Already in fifties Herbert Simon challenged such a view with his concept of bounded rationality, emerging from the joint effect of internal limitations of the human mind, and the structure of external environments in which the mind operates. During the last decades with the shift to the real word situations where decisions are embedded in larger tasks, becoming so part of the study of action, the lost rational human appeared again as efficient creature in the complex environment. Gigerenzer showed how heuristics help in this process.

  1. Involving the motor system in decision making.

    Science.gov (United States)

    Wyss, Reto; König, Peter; Verschure, Paul F M J

    2004-02-01

    The control of behaviour is usually understood in terms of three distinct components: sensory processing, decision making and movement control. Recently, this view has been questioned on the basis of physiological and behavioural data, blurring the distinction between these three stages. This raises the question to what extent the motor system itself can contribute to the interpretation of behavioural situations. To investigate this question we use a neural model of sensory motor integration applied to a behaving mobile robot performing a navigation task. We show that the population response of the motor system provides a substrate for the categorization of behavioural situations. This categorization allows for the assessment of the complexity of a behavioural situation and regulates whether higher-level decision making is required to resolve behavioural conflicts. Our model lends credence to an emerging reconceptualization of behavioural control where the motor system can be considered as part of a high-level perceptual system.

  2. Essays on Decision Making under Uncertainty

    OpenAIRE

    Sautua, Santiago Ignacio

    2015-01-01

    This dissertation consists of three chapters about decision making under uncertainty.Chapter 1: “Testing between Models of Smoking Risk Perceptions”Research in social and health psychology reports that smokers systematically underestimate the personal smoking risk. I build a model that captures potential determinants of smoking risk perceptions to investigate how smoking may cause an underestimation of the risk. The model is based on the premise that smokers have an incentive to be optimistic...

  3. Decision making based on data analysis methods

    OpenAIRE

    Sirola, Miki; Sulkava, Mika

    2016-01-01

    This technical report is based on four our recent articles:"Data fusion of pre-election gallups and polls for improved support estimates", "Analyzing parliamentary elections based on voting advice application data", "The Finnish car rejection reasons shown in an interactive SOM visualization tool", and "Network visualization of car inspection data using graph layout". Neural methods are applied in political and technical decision making. We introduce decision support schemes based on Self-Org...

  4. Shared decision making and the internist.

    Science.gov (United States)

    Montori, Victor M; Kunneman, Marleen; Hargraves, Ian; Brito, Juan P

    2017-01-01

    In this narrative review, we locate within the tradition of great diagnosticians in internal medicine, a fundamental development in patient-centered care: shared decision making (SDM). In this way, we present SDM as a core component of the clinical method, one in which diagnosis of the situation and of the actions that resolve it is essential toward the practice of evidence-based medicine. Published by Elsevier B.V.

  5. Making tough choices: HIV ethical decision making.

    Science.gov (United States)

    1999-05-01

    A panel of the American Psychological Association (APA) has developed a simple, user friendly process to facilitate ethical and clinical decision making in cases involving HIV disease. The model is based on the five ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice. This article examines how the model could be applied to a hypothetical case of a private practice client and his therapist. The ethical question in this case concerns whether to reveal a patient's serostatus to his wife.

  6. Probability, clinical decision making and hypothesis testing

    Directory of Open Access Journals (Sweden)

    A Banerjee

    2009-01-01

    Full Text Available Few clinicians grasp the true concept of probability expressed in the ′P value.′ For most, a statistically significant P value is the end of the search for truth. In fact, the opposite is the case. The present paper attempts to put the P value in proper perspective by explaining different types of probabilities, their role in clinical decision making, medical research and hypothesis testing.

  7. Integrating Trends in Decision-Making Research

    Science.gov (United States)

    2016-03-01

    decisions advances theories of decision making towards providing explanations of the process by which people make decisions . Third, in human factors, a...done within organizational , legal, and social frameworks that affect various parts of the decision process . As such, CEDM has the potential not only...the Center for Behavioral Decision Research, Human –Computer Interaction Institute, and others. She is a fellow of the Human Factors and

  8. The Future of Computerized Decision Making

    Science.gov (United States)

    2014-12-01

    available in digital form -- data such as newspaper articles, video, and books -- and can be searched according to topics and keywords , or sounds and...away from using observational or model- driven data to inform their decisions. At the same time, enhancements to methods for rapidly creating, merging...themselves---and that we need automated ways of reoptimizing as these metamodels evolve over time. Causal computerized decision making: As I discuss

  9. Deliberation, Information Aggregation and Collective Decision Making

    OpenAIRE

    Swank, Otto; Wrasai, Phongthorn

    2002-01-01

    textabstractWe study a model of collective decision making with endogenous information collection. Agents collect information about the consequences of a project, communicate, and then vote on the project. We examine under what conditions communication may increase the probability that good decisions are made. Our most surprising result is that when there are no direct cost of communication and communication can only help to identify the truth, more communication may reduce the probability th...

  10. Moral and Ethical Decision Making: Literature Review

    Science.gov (United States)

    2005-08-08

    concentrate solely on individual morality as a strong predictor of individual behaviour (e.g., the work of Kohlberg ) whereas others have adopted a...moral development. The work of Lawrence Kohlberg has been instrumental in elucidating the process of moral development and fostering new theories in...moral decision making. In short, Kohlberg presents a cognitive-developmental view of moral reasoning, and suggests that moral development moves

  11. Understanding Optimal Decision-Making in Wargaming

    Science.gov (United States)

    2013-10-01

    previously (Russell & Norvig , 2010). The perception 8 Figure 2.3: Information processing model of human cognition (C. Wickens & Hollands, 2000). Dotted...decision-making (Perla, 1990). 9 Figure 2.4: Agent environment interaction (Russell & Norvig , 2010). 2.2. Neurophysiological Measures The study of...selection while balancing exploration and exploitation (Sutton & Barto, 1998; Russell & Norvig , 2010). For our purposes, with our version of the IGT

  12. 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.

  13. Goals and plans in decision making

    OpenAIRE

    David H. Krantz; Howard C. Kunreuther

    2007-01-01

    We propose a constructed-choice model for general decision making. The model departs from utility theory and prospect theory in its treatment of multiple goals and it suggests several different ways in which context can affect choice. It is particularly instructive to apply this model to protective decisions, which are often puzzling. Among other anomalies, people insure against non-catastrophic events, underinsure against catastrophic risks, and allow extraneous factors to influence insuranc...

  14. History matching through dynamic decision-making.

    Science.gov (United States)

    Cavalcante, Cristina C B; Maschio, Célio; Santos, Antonio Alberto; Schiozer, Denis; Rocha, Anderson

    2017-01-01

    History matching is the process of modifying the uncertain attributes of a reservoir model to reproduce the real reservoir performance. It is a classical reservoir engineering problem and plays an important role in reservoir management since the resulting models are used to support decisions in other tasks such as economic analysis and production strategy. This work introduces a dynamic decision-making optimization framework for history matching problems in which new models are generated based on, and guided by, the dynamic analysis of the data of available solutions. The optimization framework follows a 'learning-from-data' approach, and includes two optimizer components that use machine learning techniques, such as unsupervised learning and statistical analysis, to uncover patterns of input attributes that lead to good output responses. These patterns are used to support the decision-making process while generating new, and better, history matched solutions. The proposed framework is applied to a benchmark model (UNISIM-I-H) based on the Namorado field in Brazil. Results show the potential the dynamic decision-making optimization framework has for improving the quality of history matching solutions using a substantial smaller number of simulations when compared with a previous work on the same benchmark.

  15. The nursing contribution to ethical decision making

    Directory of Open Access Journals (Sweden)

    Barbara Dinten-Schmid

    2016-11-01

    Full Text Available Background: In the neonatal care units of the University Hospitals of Zurich and Bern, the nurse´s role in ethical decision-making is well established. However, nurses often reported uncertainty with regard to introducing the premature infant’s situation from the nursing perspective in ethics rounds. Aims: To empower neonatal nurses in fulfilling their role in the multiprofessional decision-making process, we performed a practice development project. On the basis of the Iowa model we developed a checklist for presenting the nursing history of premature infants in an ethically competent and responsible way. Conclusions: The ‘checklist for nursing assessment in the context of ethical decision-making’, equips nurses for their professional contribution to ethics rounds, making them better prepared to present the nursing perspective in a structured and thorough manner. Implications for practice: The Iowa model supports practice development even with limited data availability The instrument invigorates the neonatal nurse´s role in the multiprofessional ethical decision-making process It is crucial to involve peers in practice development

  16. Rational decision-making in inhibitory control

    Directory of Open Access Journals (Sweden)

    Pradeep eShenoy

    2011-05-01

    Full Text Available An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the well-studied stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.

  17. Has Lean improved organizational decision making?

    Science.gov (United States)

    Simons, Pascale; Benders, Jos; Bergs, Jochen; Marneffe, Wim; Vandijck, Dominique

    2016-06-13

    Purpose - Sustainable improvement is likely to be hampered by ambiguous objectives and uncertain cause-effect relations in care processes (the organization's decision-making context). Lean management can improve implementation results because it decreases ambiguity and uncertainties. But does it succeed? Many quality improvement (QI) initiatives are appropriate improvement strategies in organizational contexts characterized by low ambiguity and uncertainty. However, most care settings do not fit this context. The purpose of this paper is to investigate whether a Lean-inspired change program changed the organization's decision-making context, making it more amenable for QI initiatives. Design/methodology/approach - In 2014, 12 professionals from a Dutch radiotherapy institute were interviewed regarding their perceptions of a Lean program in their organization and the perceived ambiguous objectives and uncertain cause-effect relations in their clinical processes. A survey (25 questions), addressing the same concepts, was conducted among the interviewees in 2011 and 2014. The structured interviews were analyzed using a deductive approach. Quantitative data were analyzed using appropriate statistics. Findings - Interviewees experienced improved shared visions and the number of uncertain cause-effect relations decreased. Overall, more positive (99) than negative Lean effects (18) were expressed. The surveys revealed enhanced process predictability and standardization, and improved shared visions. Practical implications - Lean implementation has shown to lead to greater transparency and increased shared visions. Originality/value - Lean management decreased ambiguous objectives and reduced uncertainties in clinical process cause-effect relations. Therefore, decision making benefitted from Lean increasing QI's sustainability.

  18. Biotechnology and Consumer Decision-Making.

    Science.gov (United States)

    Sax, Joanna K

    Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.

  19. CORPORATE DECISION MAKING DALAM KOMUNIKASI ORGANISASI

    Directory of Open Access Journals (Sweden)

    Rebekka Rismayanti

    2016-06-01

    Full Text Available In an organization, decision making is anessential factor to achieve its goals. The decision-making process is a process of selecting the best alternative from many alternatives that systematically chosen as a way to resolve the problem. The decision is seen as a “choice between the alternatives” as well as a form of communication that fulfills the social expectations of the organization’s members. So the goal setting, onflow of information as well as individual’s values within the group affect the decisions made by the group itself. Then, the leadership-participation style in decision-making is the most important factor for creating the mutual understanding between both parties related to the decision. Dalam sebuah organisasi, pengambilan keputusan merupakan faktor penting untuk mencapai tujuannya. Proses pengambilan keputusan adalah proses pemilihan alternatif terbaik dari berbagai alternatif yang secara sistematis dipilih sebagai cara untuk menyelesaikan masalah. Keputusan ini dipandang sebagai “pilihan antara alternatif” serta bentuk komunikasi yang memenuhi harapan sosial dari anggota organisasi. Jadi penetapan tujuan, aliran informasi serta nilai-nilai individu dalam kelompok mempengaruhi keputusan yang dibuat oleh kelompok itu sendiri. Kemudiangaya kepemimpinan-partisipasi dalam pengambilan keputusan adalah faktor yang paling penting untuk menciptakan saling pengertian antara kedua belah pihak yang terkait dengan keputusan tersebut.

  20. Rational decision-making in inhibitory control.

    Science.gov (United States)

    Shenoy, Pradeep; Yu, Angela J

    2011-01-01

    An important aspect of cognitive flexibility is inhibitory control, the ability to dynamically modify or cancel planned actions in response to changes in the sensory environment or task demands. We formulate a probabilistic, rational decision-making framework for inhibitory control in the stop signal paradigm. Our model posits that subjects maintain a Bayes-optimal, continually updated representation of sensory inputs, and repeatedly assess the relative value of stopping and going on a fine temporal scale, in order to make an optimal decision on when and whether to go on each trial. We further posit that they implement this continual evaluation with respect to a global objective function capturing the various reward and penalties associated with different behavioral outcomes, such as speed and accuracy, or the relative costs of stop errors and go errors. We demonstrate that our rational decision-making model naturally gives rise to basic behavioral characteristics consistently observed for this paradigm, as well as more subtle effects due to contextual factors such as reward contingencies or motivational factors. Furthermore, we show that the classical race model can be seen as a computationally simpler, perhaps neurally plausible, approximation to optimal decision-making. This conceptual link allows us to predict how the parameters of the race model, such as the stopping latency, should change with task parameters and individual experiences/ability.

  1. Impact of Robotic Surgery on Decision Making: Perspectives of Surgical Teams.

    Science.gov (United States)

    Randell, Rebecca; Alvarado, Natasha; Honey, Stephanie; Greenhalgh, Joanne; Gardner, Peter; Gill, Arron; Jayne, David; Kotze, Alwyn; Pearman, Alan; Dowding, Dawn

    2015-01-01

    There has been rapid growth in the purchase of surgical robots in both North America and Europe in recent years. Whilst this technology promises many benefits for patients, the introduction of such a complex interactive system into healthcare practice often results in unintended consequences that are difficult to predict. Decision making by surgeons during an operation is affected by variables including tactile perception, visual perception, motor skill, and instrument complexity, all of which are changed by robotic surgery, yet the impact of robotic surgery on decision making has not been previously studied. Drawing on the approach of realist evaluation, we conducted a multi-site interview study across nine hospitals, interviewing 44 operating room personnel with experience of robotic surgery to gather their perspectives on how robotic surgery impacts surgeon decision making. The findings reveal both potential benefits and challenges of robotic surgery for decision making.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2011-06-01

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

  4. Shared decision making interventions for people with mental health conditions.

    Science.gov (United States)

    Duncan, Edward; Best, Catherine; Hagen, Suzanne

    2010-01-20

    One person in every four will suffer from a diagnosable mental health condition during their life course. Such conditions can have a devastating impact on the lives of the individual, their family and society. Increasingly partnership models of mental health care have been advocated and enshrined in international healthcare policy. Shared decision making is one such partnership approach. Shared decision making is a form of patient-provider communication where both parties are acknowledged to bring expertise to the process and work in partnership to make a decision. This is advocated on the basis that patients have a right to self-determination and also in the expectation that it will increase treatment adherence. To assess the effects of provider-, consumer- or carer-directed shared decision making interventions for people of all ages with mental health conditions, on a range of outcomes including: patient satisfaction, clinical outcomes, and health service outcomes. We searched: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2008, Issue 4), MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), PsycINFO (1967 to November 2008), CINAHL (1982 to November 2008), British Nursing Index and Archive (1985 to November 2008) and SIGLE (1890 to September 2005 (database end date)). We also searched online trial registers and the bibliographies of relevant papers, and contacted authors of included studies. Randomised controlled trials (RCTs), quasi-randomised controlled trials (q-RCTs), controlled before-and-after studies (CBAs); and interrupted time series (ITS) studies of interventions to increase shared decision making in people with mental health conditions (by DSM or ICD-10 criteria). Data on recruitment methods, eligibility criteria, sample characteristics, interventions, outcome measures, participant flow and outcome data from each study were extracted by one author and checked by another. Data are presented in a narrative

  5. Women's experience of decision-making with medication abortion.

    Science.gov (United States)

    Cappiello, Joyce; Merrell, Joy; Rentschler, Dorothy

    2014-01-01

    Medication abortion received regulatory approval in 2001 in the United States with healthcare providers increasingly offering this method. However, most studies in the United States have only explored acceptability and decision-making with women who participated in clinical trials. Overall, the literature on women's experience with a method that it is now widely available is under research in the United States. To describe and analyze the women's experience as they choose the option of and experienced the process of medication abortion. A constructivist grounded theory study. Outpatient clinical offices in a three-state area in the northeast region of the United States. A purposive sample of 22 women aged 16 to 45 who experienced a medication abortion. Data were collected by in-depth, open-ended, face-to-face interviews. The constant comparative method was used for analysis. Five interwoven categories emerged regarding women's initial decision to have a medication abortion: choosing a natural process, avoiding "surgery," respecting the "baby," scheduling to meet needs, and appreciating the home setting. The enhanced sense of personal control associated with the medication abortion option was the overriding reason given for choosing this method. This study contributes to the paucity of literature on the reasons why women choose medication abortion. It is important for nurses to understand the complexity of medication abortion decision-making so that they can effectively support women through this process.

  6. BETWEEN REASON, SCIENCE AND CULTURE: BIOMEDICAL DECISION-MAKING.

    Science.gov (United States)

    Fortin, Sylvie

    2015-12-01

    Over the last decade, we have extensively examined clinical practice in the context of sociocultural, religious and ethnic diversity. Stemming mainly from data collected amongst physicians we reflect, in this paper, upon the norms and values which guide decision-making processes in tertiary pediatric hospital contexts. Clinical ethics is portrayed a neutral guide between competing choices and obligations of hospital units, healthcare professionals, and families, when there is a conflict or divergence in the perspectives concerning the progression of the clinical trajectory. We will chart the sharing/non-sharing of different voices in critical decision-making pathways of maternal-child hospital care. How do "universal" ethical principles accommodate the diversity of perspectives anchored within the ensemble of cultural, social, and religious institutions? Similarly to the image of cosmopolitan urban communities, health care settings are defined by a multiplicity of values brought forth by families and health care professionals from diverse backgrounds. Attempting to seize these logics entails a better grasp of the delicate relationship between the individual and the collective, between personal values and instituted norms, between majorities and minorities.

  7. Staged decision making based on probabilistic forecasting

    Science.gov (United States)

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

    2016-04-01

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

  8. Incorporating environmental justice into environmental decision making

    Energy Technology Data Exchange (ETDEWEB)

    Wolfe, A.K.; Vogt, D.P.; Hwang, Ho-Ling [Oak Ridge National Lab., TN (United States)] [and others

    1995-07-01

    Executive Order 12898, signed on February 11, 1994, broadly states that federal activities, programs, and policies should not produce disproportionately high and adverse impacts on minority and low-income populations. Moreover, the Order indicates that these populations should not be denied the benefits of, or excluded from participation in, these activities, programs, and policies. Because a presidential memorandum accompanying the order said that National Environmental Policy Act (NEPA) documents should begin to address environmental justice immediately, much attention has been paid to assessment-related issues. Also important, a topic that appears to have received relatively little attention, is how decision makers should be expected to use information about environmental justice in their decision making. This paper discusses issues surrounding the use of environmental justice information in the decision-making process by focusing on the following five main topics: (1) the importance, or weight, attached to environmental justice within larger decision-making contexts; (2) the potential tension between localized environmental justice issues and regional or national issues and needs; (3) the use of environmental justice information to develop (perhaps in concert with affected minority and low-income communities) appropriate mitigation strategies, or to establish conditions under which activities, programs, and policies may be accepted locally; (4) the general implications of shifting the distribution of broadly defined risks, costs, and benefits among different population groups; and (5) the implications of implementing environmental justice on an individual, ad hoc basis rather than within a larger environmental justice framework. This paper raises the issues and discusses the implications of alternative approaches to them.

  9. Ethical decision-making in hospice care.

    Science.gov (United States)

    Walker, Andreas; Breitsameter, Christof

    2015-05-01

    Hospices are based on a holistic approach which places the physical, psychological, social and spiritual welfare of their patients at the forefront of their work. Furthermore, they draw up their own mission statements which they are at pains to follow and seek to conduct their work in accordance with codes of ethics and standards of care. Our study researched what form the processes and degrees of latitude in decision-making take in practice when questions of an ethical and ethically relevant nature arise. We used a qualitative approach. Data collection and evaluation was based on the methods of grounded theory. The study was reported to the relevant Ethics Commission who had raised no objections following the submission of the study protocol. The study at the hospices was approved by the directors of the hospices and the nursing teams. The rights of the participants were protected by obtaining informed consent. Medication in the prefinal phase and questions affecting the provision of solids and liquids in the end-of-life phase have an ethical dimension. In the context of these two fields, decisions are taken collectively. A nurse's individual (and ethically relevant) leeway in decision-making processes is restricted to the nurse's own style of administering care. The nurse's decision-making often depends to a far greater degree on her ability to adapt her concept of ideal care to fit the practical realities of her work than to any conceptual framework. An adaptive process is necessary for the nurse because she is required to incorporate the four pillars of hospice care - namely, physical, psychological, social and spiritual care - into the practice of her daily work. Ethically relevant decisions are often characterised by nurses adjusting their aspiration levels to the practical conditions with which they are confronted. © The Author(s) 2014.

  10. Probabilistic Analysis in Management Decision Making

    DEFF Research Database (Denmark)

    Delmar, M. V.; Sørensen, John Dalsgaard

    1992-01-01

    The target group in this paper is people concerned with mathematical economic decision theory. It is shown how the numerically effective First Order Reliability Methods (FORM) can be used in rational management decision making, where some parameters in the applied decision basis are uncertainty...... quantities. The uncertainties are taken into account consistently and the decision analysis is based on the general decision theory in combination with reliability and optimization theory. Examples are shown where the described technique is used and some general conclusion are stated....

  11. Dynamic decision making without expected utility

    DEFF Research Database (Denmark)

    Nielsen, Thomas Dyhre; Jaffray, Jean-Yves

    2006-01-01

    Non-expected utility theories, such as rank dependent utility (RDU) theory, have been proposed as alternative models to EU theory in decision making under risk. These models do not share the separability property of expected utility theory. This implies that, in a decision tree, if the reduction...... maker’s discordant goals at the different decision nodes. Relative to the computations involved in the standard expected utility evaluation of a decision problem, the main computational increase is due to the identification of non-dominated strategies by linear programming. A simulation, using the rank...

  12. Economic Evaluation Enhances Public Health Decision Making.

    Science.gov (United States)

    Rabarison, Kristina M; Bish, Connie L; Massoudi, Mehran S; Giles, Wayne H

    2015-01-01

    Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking "how do investments in public health strategies influence or offset the need for downstream spending on medical care and/or social services?" is important when making decisions about resource allocation and scaling of interventions.

  13. Economic evaluation enhances public health decision making

    Directory of Open Access Journals (Sweden)

    Kristina M. Rabarison

    2015-06-01

    Full Text Available Contemporary public health professionals must address the health needs of a diverse population with constrained budgets and shrinking funds. Economic evaluation contributes to evidence-based decision making by helping the public health community identify, measure, and compare activities with the necessary impact, scalability, and sustainability to optimize population health. Asking how do investments in public health strategies influence or offset the need for downstream spending on medical care and /or social services? is important when making decisions about resource allocation and scaling of interventions.

  14. Information Gathering for Adaptable Decision-Making

    Science.gov (United States)

    1989-02-01

    theme is the work on novice-expert differences in problem-solving, which goes back to deGroot . 1I As Newell2 notes, decision-making is a form of problem...26 REFERENCES (Cont’d) 11. A.D. deGroot , Thought and Choice in Chess, Mouton, The Hague, Nether- lands, 1965. 12. A. Newell, "Reasoning, Problem...Gentner and A.L. Stevens (eds.), Erlbaum, Hillsdale, NJ, 1983. 26. W.B. Rouse and N.M. Morris , "On Looking into the Black Box: Prospects and Limits in

  15. Intergenerational risk decision making: a practical example.

    Science.gov (United States)

    Kadak, A C

    2000-12-01

    There is no such thing as intergenerational decision making, at least not yet. In fact, there is no such thing as intragenerational decision making in the context of maximizing overall social good given resource limitations, there are just decisions being made in an ad hoc fashion. Even if one assumes that there is such a thing as intragenerational decision making, no uniform standard or guidance exists to make societal decisions for the common good. Risks to society are judged unevenly within the same agency and across agencies. Decisions are made in isolation and not weighed in the societal context of what is intra or intergenerationally important. The National Academy of Public Administration (NAPA) has set forth a framework for intergenerational decision making that provides a consistent and fair basis for making tough decisions in order to address difficult issues such as the long-term disposal of nuclear wastes. NAPA recognizes that there is an intergenerational obligation that must encompass broader questions than the narrow issue of waste disposal since resources are finite and needs are great. The fundamental principles are based on sustainability with the overarching objective that "no generation should needlessly, now or in the future, deprive its successors of the opportunity to enjoy a quality of life equivalent to its own." Coupled with this objective are four supporting principles of trusteeship, sustainability, chain of obligation, and precaution. The NAPA process also recognizes that no decision can be final and that a "rolling future" view is better than making decisions for "all time." It attempts to balance the needs of the present with those of the future in an open and transparent process that is aimed at producing a decision, not just endless analysis. The U.S. Congress and president should develop a rational standard by which to judge laws that involve intra and intergenerational issues relative to the overall societal good. Present

  16. Quantum probability and quantum decision-making.

    Science.gov (United States)

    Yukalov, V I; Sornette, D

    2016-01-13

    A rigorous general definition of quantum probability is given, which is valid not only for elementary events but also for composite events, for operationally testable measurements as well as for inconclusive measurements, and also for non-commuting observables in addition to commutative observables. Our proposed definition of quantum probability makes it possible to describe quantum measurements and quantum decision-making on the same common mathematical footing. Conditions are formulated for the case when quantum decision theory reduces to its classical counterpart and for the situation where the use of quantum decision theory is necessary.

  17. Decision-making mechanisms in the brain

    Science.gov (United States)

    Deco, Gustavo; Rolls, Edmund T.

    2007-02-01

    Behavioral, neurophysiological, and theoretical studies are converging to a common theory of decision-making that assumes an underlying diffusion process which integrates both the accumulation of perceptual and cognitive evidence for making the decision and motor choice in one unifying neural network. In particular, neuronal activity in the ventral premotor cortex (VPC) is related to decision-making while trained monkeys compare two mechanical vibrations applied sequentially to the tip of a finger to report which of the two stimuli have the higher frequency (Romo et al. 2004, Neuron 41: 165). In particular, neurons were found whose response depended only on the difference between the two applied frequencies, the sign of that difference being the determining factor for correct task performance. We describe an integrate-and-fire attractor model with realistic synaptic dynamics including AMPA, NMDA and GABA synapses which can reproduce the decision-making related response selectivity of VPC neurons during the comparison period of the task. Populations of neurons for each decision in the biased competition attractor receive a bias input that depends on the firing rates of neurons in the VPC that code for the two vibrotactile frequencies. It was found that if the connectivity parameters of the network are tuned, using mean-field techniques, so that the network has two possible stable stationary final attractors respectively related to the two possible decisions, then the firing rate of the neurons in whichever attractor wins reflects the sign of the difference in the frequencies being compared but not the absolute frequencies. Thus Weber's law for frequency comparison is not encoded by the firing rate of the neurons in these attractors. An analysis of the nonstationary evolution of the dynamics of the network model shows that Weber's law is implemented in the probability of transition from the initial spontaneous firing state to one of the two possible attractor states

  18. Phenomenological theory of collective decision-making

    DEFF Research Database (Denmark)

    Zafeiris, Anna; Koman, Zsombor; Mones, Enys

    2017-01-01

    An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism...... requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present empirical results obtained by using a large-scale database of citations being in good agreement with the above theory. The framework we have developed can easily be adapted to a variety...

  19. Decision making in global product development

    DEFF Research Database (Denmark)

    Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema

    2014-01-01

    Many engineering companies experience new challenges when globalising product development. Global product development (GPD) is a relatively nascent research area, and previous research reveals the need for decision support frameworks. This research investigates how decisions are made when companies...... outsource or offshore product development tasks, and how these decisions can be improved. A brief literature review on existing research on GPD and decision making is given, followed by two case studies, where implications of decisions are investigated. The findings point towards further studies required...

  20. Multiple Criteria Decision Making Combined with VRP: A Categorized Bibliographic Study

    OpenAIRE

    Yahia Zare Mehrjerdi

    2015-01-01

    In this research author reviews references related to the topic of multi criterion (goal programming, multiple objective linear and nonlinear programming, bi-criterion programming, Multi Attribute Decision Making, Compromise Programming, Surrogate Worth Trade-off Method) and various versions of vehicle routing problem (VRP), Multi depot VRP (MDVRP), VRP with time windows (VRPWTW), Stochastic VRP (SVRP), Capacitated VRP (CVRP), Fuzzy VRP (FVRP), Location VRP (LVRP), Backhauling VRP(BHVRP), Fac...

  1. Multiple Criteria Decision Making Combined with VRP: A Categorized Bibliographic Study

    OpenAIRE

    Yahia Zare Mehrjerdi

    2015-01-01

    In this research author reviews references related to the topic of multi criterion (goal programming, multiple objective linear and nonlinear programming, bi-criterion programming, Multi Attribute Decision Making, Compromise Programming, Surrogate Worth Trade-off Method) and various versions of vehicle routing problem (VRP), Multi depot VRP (MDVRP), VRP with time windows (VRPWTW), Stochastic VRP (SVRP), Capacitated VRP (CVRP), Fuzzy VRP (FVRP), Location VRP (LVRP), Backhauling VRP(BHVRP), Fac...

  2. Planning and decision making for aerial robots

    CERN Document Server

    Bestaoui Sebbane, Yasmina

    2014-01-01

    This book provides an introduction to the emerging field of planning and decision making for aerial robots. An aerial robot is the ultimate form of Unmanned Aerial Vehicle, an aircraft endowed with built-in intelligence, requiring no direct human control and able to perform a specific task. It must be able to fly within a partially structured environment, to react and adapt to changing environmental conditions and to accommodate for the uncertainty that exists in the physical world. An aerial robot can be termed as a physical agent that exists and flies in the real 3D world, can sense its environment and act on it to achieve specific goals. So throughout this book, an aerial robot will also be termed as an agent.   Fundamental problems in aerial robotics include the tasks of spatial motion, spatial sensing and spatial reasoning. Reasoning in complex environments represents a difficult problem. The issues specific to spatial reasoning are planning and decision making. Planning deals with the trajectory algori...

  3. Dopamine and Effort-Based Decision Making

    Directory of Open Access Journals (Sweden)

    Irma Triasih Kurniawan

    2011-06-01

    Full Text Available Motivational theories of choice focus on the influence of goal values and strength of reinforcement to explain behavior. By contrast relatively little is known concerning how the cost of an action, such as effort expended, contributes to a decision to act. Effort-based decision making addresses how we make an action choice based on an integration of action and goal values. Here we review behavioral and neurobiological data regarding the representation of effort as action cost, and how this impacts on decision making. Although organisms expend effort to obtain a desired reward there is a striking sensitivity to the amount of effort required, such that the net preference for an action decreases as effort cost increases. We discuss the contribution of the neurotransmitter dopamine (DA towards overcoming response costs and in enhancing an animal’s motivation towards effortful actions. We also consider the contribution of brain structures, including the basal ganglia (BG and anterior cingulate cortex (ACC, in the internal generation of action involving a translation of reward expectation into effortful action.

  4. A Design Pattern for Decentralised Decision Making.

    Directory of Open Access Journals (Sweden)

    Andreagiovanni Reina

    Full Text Available The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera. The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling.

  5. FUZZY DECISION MAKING MODEL FOR BYZANTINE AGREEMENT

    Directory of Open Access Journals (Sweden)

    S. MURUGAN

    2014-04-01

    Full Text Available Byzantine fault tolerance is of high importance in the distributed computing environment where malicious attacks and software errors are common. A Byzantine process sends arbitrary messages to every other process. An effective fuzzy decision making approach is proposed to eliminate the Byzantine behaviour of the services in the distributed environment. It is proposed to derive a fuzzy decision set in which the alternatives are ranked with grade of membership and based on that an appropriate decision can be arrived on the messages sent by the different services. A balanced decision is to be taken from the messages received across the services. To accomplish this, Hurwicz criterion is used to balance the optimistic and pessimistic views of the decision makers on different services. Grades of membership for the services are assessed using the non-functional Quality of Service parameters and have been estimated using fuzzy entropy measure which logically ranks the participant services. This approach for decision making is tested by varying the number of processes, varying the number of faulty services, varying the message values sent to different services and considering the variation in the views of the decision makers about the services. The experimental result shows that the decision reached is an enhanced one and in case of conflict, the proposed approach provides a concrete result, whereas decision taken using the Lamport’s algorithm is an arbitrary one.

  6. [Mathematical models of decision making and learning].

    Science.gov (United States)

    Ito, Makoto; Doya, Kenji

    2008-07-01

    Computational models of reinforcement learning have recently been applied to analysis of brain imaging and neural recording data to identity neural correlates of specific processes of decision making, such as valuation of action candidates and parameters of value learning. However, for such model-based analysis paradigms, selecting an appropriate model is crucial. In this study we analyze the process of choice learning in rats using stochastic rewards. We show that "Q-learning," which is a standard reinforcement learning algorithm, does not adequately reflect the features of choice behaviors. Thus, we propose a generalized reinforcement learning (GRL) algorithm that incorporates the negative reward effect of reward loss and forgetting of values of actions not chosen. Using the Bayesian estimation method for time-varying parameters, we demonstrated that the GRL algorithm can predict an animal's choice behaviors as efficiently as the best Markov model. The results suggest the usefulness of the GRL for the model-based analysis of neural processes involved in decision making.

  7. Possibility expectation and its decision making algorithm

    Science.gov (United States)

    Keller, James M.; Yan, Bolin

    1992-01-01

    The fuzzy integral has been shown to be an effective tool for the aggregation of evidence in decision making. Of primary importance in the development of a fuzzy integral pattern recognition algorithm is the choice (construction) of the measure which embodies the importance of subsets of sources of evidence. Sugeno fuzzy measures have received the most attention due to the recursive nature of the fabrication of the measure on nested sequences of subsets. Possibility measures exhibit an even simpler generation capability, but usually require that one of the sources of information possess complete credibility. In real applications, such normalization may not be possible, or even desirable. In this report, both the theory and a decision making algorithm for a variation of the fuzzy integral are presented. This integral is based on a possibility measure where it is not required that the measure of the universe be unity. A training algorithm for the possibility densities in a pattern recognition application is also presented with the results demonstrated on the shuttle-earth-space training and testing images.

  8. Collective decision making in bacterial viruses.

    Science.gov (United States)

    Weitz, Joshua S; Mileyko, Yuriy; Joh, Richard I; Voit, Eberhard O

    2008-09-15

    For many bacterial viruses, the choice of whether to kill host cells or enter a latent state depends on the multiplicity of coinfection. Here, we present a mathematical theory of how bacterial viruses can make collective decisions concerning the fate of infected cells. We base our theory on mechanistic models of gene regulatory dynamics. Unlike most previous work, we treat the copy number of viral genes as variable. Increasing the viral copy number increases the rate of transcription of viral mRNAs. When viral regulation of cell fate includes nonlinear feedback loops, very small changes in transcriptional rates can lead to dramatic changes in steady-state gene expression. Hence, we prove that deterministic decisions can be reached, e.g., lysis or latency, depending on the cellular multiplicity of infection within a broad class of gene regulatory models of viral decision-making. Comparisons of a parameterized version of the model with molecular studies of the decision structure in the temperate bacteriophage lambda are consistent with our conclusions. Because the model is general, it suggests that bacterial viruses can respond adaptively to changes in population dynamics, and that features of collective decision-making in viruses are evolvable life history traits.

  9. Dialogic Consensus In Clinical Decision-Making.

    Science.gov (United States)

    Walker, Paul; Lovat, Terry

    2016-12-01

    This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.

  10. Decision-Making Styles in the Workplace

    Directory of Open Access Journals (Sweden)

    Silvia Raffaldi

    2012-05-01

    Full Text Available Two procedures were adopted to assess decision-making styles in the workplace: (a the administration of traditional standardized self-report questionnaires and (b open-ended questions about the way respondents would take decisions in a critical business case. Seventy-four adults were given two questionnaires: the Preference for Intuition and Deliberation, which assesses “deliberative” or “intuitive” decision style, and the Style of Learning and Thinking, which assesses thinking styles as “left” (namely, analytical-systematic or “right” (that is, global-intuitive. Participants were also presented with a business case that involved taking a decision. Responses to the business case were used to classify approaches to decision making as “analytical-systematic” or “global-intuitive.” Results showed that the questionnaires correlated consistently with scores from the business case, thus supporting the notion that the assessment of decision style through self-report questionnaires is reliable and valid.

  11. Sequential evidence accumulation in decision making

    Directory of Open Access Journals (Sweden)

    Daniel Hausmann

    2008-03-01

    Full Text Available Judgments and decisions under uncertainty are frequently linked to a prior sequential search for relevant information. In such cases, the subject has to decide when to stop the search for information. Evidence accumulation models from social and cognitive psychology assume an active and sequential information search until enough evidence has been accumulated to pass a decision threshold. In line with such theories, we conceptualize the evidence threshold as the ``desired level of confidence'' (DLC of a person. This model is tested against a fixed stopping rule (one-reason decision making and against the class of multi-attribute information integrating models. A series of experiments using an information board for horse race betting demonstrates an advantage of the proposed model by measuring the individual DLC of each subject and confirming its correctness in two separate stages. In addition to a better understanding of the stopping rule (within the narrow framework of simple heuristics, the results indicate that individual aspiration levels might be a relevant factor when modelling decision making by task analysis of statistical environments.

  12. Collaborative decision making for sustainable development

    Energy Technology Data Exchange (ETDEWEB)

    Kinsley, M.J.

    1995-12-31

    For many years, economic development has mean industrial recruitment where business-at-any-cost was preached by a small elite, where civic discord replaced civic discussion, where families made more money but had less to spend, where residents learned to lock their doors, where communities changed from the unique to commonplace and a thousand towns looked alike. But now, scores of communities are saying no to old, worn-out approaches to development and embracing a new kind of development that respects the community and the environment. Created collaboratively by people from all walks of community life, this new approach is called sustainable community economic development. Though new, sustainable development is based on traditional values of stewardship and working together. Its principles are powerful in their simplicity. Its lessons enrich community decision making. This paper describes these principles and lessons. It introduces a community decision-making process that applies them and suggests the kinds of results you can expect from such a process in your town.

  13. Stochastic dominance and medical decision making.

    Science.gov (United States)

    Leshno, Moshe; Levy, Haim

    2004-08-01

    Stochastic Dominance (SD) criteria are decision making tools which allow us to choose among various strategies with only partial information on the decision makers' preferences. The notion of Stochastic Dominance has been extensively employed and developed in the area of economics, finance, agriculture, statistics, marketing and operation research since the late 1960s. For example, it may tell us which of two medical treatments with uncertain outcomes is preferred in the absence of full information on the patients' preferences. This paper presents a short review of the SD paradigm and demonstrates how the SD criteria may be employed in medical decision making, using the case of small abdominal aortic aneurysms as an illustration. Thus, for instance by assuming risk aversion one can employ second-degree stochastic dominance to divide the set of all possible treatments into the efficient set, from which the decision makers should always choose, and the inefficient (inferior) set. By employing Prospect Stochastic Dominance (PSD) a similar division can be conducted corresponding to all S-shaped utility functions.

  14. A Design Pattern for Decentralised Decision Making.

    Science.gov (United States)

    Reina, Andreagiovanni; Valentini, Gabriele; Fernández-Oto, Cristian; Dorigo, Marco; Trianni, Vito

    2015-01-01

    The engineering of large-scale decentralised systems requires sound methodologies to guarantee the attainment of the desired macroscopic system-level behaviour given the microscopic individual-level implementation. While a general-purpose methodology is currently out of reach, specific solutions can be given to broad classes of problems by means of well-conceived design patterns. We propose a design pattern for collective decision making grounded on experimental/theoretical studies of the nest-site selection behaviour observed in honeybee swarms (Apis mellifera). The way in which honeybee swarms arrive at consensus is fairly well-understood at the macroscopic level. We provide formal guidelines for the microscopic implementation of collective decisions to quantitatively match the macroscopic predictions. We discuss implementation strategies based on both homogeneous and heterogeneous multiagent systems, and we provide means to deal with spatial and topological factors that have a bearing on the micro-macro link. Finally, we exploit the design pattern in two case studies that showcase the viability of the approach. Besides engineering, such a design pattern can prove useful for a deeper understanding of decision making in natural systems thanks to the inclusion of individual heterogeneities and spatial factors, which are often disregarded in theoretical modelling.

  15. The potential for shared decision-making and decision aids in rehabilitation medicine

    NARCIS (Netherlands)

    Til, van Janine; Drossaert, Constance H.C.; Punter, R. Annemiek; IJzerman, Maarten J.

    2010-01-01

    Objective: Shared decision-making and the use of decision aids are increasingly promoted in various healthcare settings. The extent of their current use and potential in rehabilitation medicine is unknown. The aim of the present study was to explore the barriers to and facilitators of shared decisio

  16. Decision making on organ donation: the dilemmas of relatives of potential brain dead donors

    NARCIS (Netherlands)

    Groot, J.J.A.M. de; Hoek, M.; Hoedemaekers, C.W.E.; Hoitsma, A.J.; Smeets, W.; Vernooij-Dassen, M.J.F.J.; Leeuwen, E. van

    2015-01-01

    BACKGROUND: This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and

  17. Decision-making processes when paramedics refer patients away from hospital: a scoping review.

    Directory of Open Access Journals (Sweden)

    Kelly Sheffield

    2016-06-01

    Full Text Available ABSTRACT Title: Decision-making processes when paramedics refer patients away from hospital: a scoping review. Background: Paramedic practice faces increasing service demand with decision-making and referral pathways needing to change.  Patients with low acuity clinical presentations do not necessarily require ambulance transport to an emergency department, and previous studies show alternative referral pathways can be effective, safe and efficient. Decision-making processes within the context of referring patients needs to be examined.  Objectives: To examine the literature related to paramedic decision-making when referring patients to alternative care services, instead of transporting to hospital. Methods: In this scoping review, the literature between 2005 and 2015 of service providers was examined.  Key search terms were developed to search five databases and Internet search engines. Results: Four studies were specifically related to decision-making.   Research into the broader topic of paramedics referring patients to alternative medical services other than hospital emergency departments were located, and thirteen relevant studies were included in this review. Conclusions:  Key factors including clinical experience, education, protocol use, referral processes, and holistic healthcare approaches all influence decision-making of paramedics when referring patients away from hospital.  Further research into these factors is required to better understand how they influence and interact with each other.

  18. Beyond shared decision-making: Collaboration in the age of recovery from serious mental illness.

    Science.gov (United States)

    Treichler, Emily B H; Spaulding, William D

    2017-01-01

    The role that people with serious mental illness (SMI) play in making decisions about their own treatment and rehabilitation is attracting increasing attention and scrutiny. This attention is embedded in a broader social/consumer movement, the recovery movement, whose agenda includes extensive reform of the mental health system and advancing respect for the dignity and autonomy of people with SMI. Shared decision-making (SDM) is an approach for enhancing consumer participation in health-care decision-making. SDM translates straightforwardly to specific clinical procedures that systematically identify domains of decision-making and guide the practitioner and consumer through making the decisions. In addition, Collaborative decision-making (CDM) is a set of guiding principles that avoids the connotations and limitations of SDM. CDM looks broadly at the range of decisions to be made in mental health care, and assigns consumers and providers equal responsibility and power in the decision-making process. It recognizes the diverse history, knowledge base, and values of each consumer by assuming patients can lead and contribute to decision-making, contributing both value-based information and technical information. This article further discusses the importance of CDM for people with SMI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. The Technology of Using a Data Warehouse to Support Decision-Making in Health Care

    Directory of Open Access Journals (Sweden)

    Osama E.Sheta

    2013-07-01

    Full Text Available This paper describes the technology of data warehouse in healthcare decision-making and tools for supportof these technologies, which is used to cancer diseases. The healthcare executive managers and doctorsneeds information about and insight into the existing health data, so as to make decision more efficientlywithout interrupting the daily work of an On-Line Transaction Processing (OLTP system. This is acomplex problem during the healthcare decision-making process. To solve this problem, the building ahealthcare data warehouse seems to be efficient. First in this paper we explain the concepts of the datawarehouse, On-Line Analysis Processing (OLAP. Changing the data in the data warehouse into amultidimensional data cube is then shown. Finally,an application example is given to illustrate the use ofthe healthcare data warehouse specific to cancer diseases developed in this study. The executive managersand doctors can view data from more than one perspective with reduced query time, thus making decisionsfaster and more comprehensive.

  20. Climate Information Needs for Financial Decision Making

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, Paul [American Meteorological Society, Washington, DC (United States)

    2013-11-19

    Climate Information Needs for Financial Decision Making (Final Report) This Department of Energy workshop award (grant #DE-SC0008480) provided primary support for the American Meteorological Society’s study on climate information needs for financial decision making. The goal of this study was to help advance societal decision making by examining the implications of climate variability and change on near-term financial investments. We explored four key topics: 1) the conditions and criteria that influence returns on investment of major financial decisions, 2) the climate sensitivity of financial decisions, 3) climate information needs of financial decision makers, and 4) potential new mechanisms to promote collaboration between scientists and financial decision makers. Better understanding of these four topics will help scientists provide the most useful information and enable financial decision makers to use scientific information most effectively. As a result, this study will enable leaders in business and government to make well-informed choices that help maximize long-term economic success and social wellbeing in the United States The outcomes of the study include a workshop, which brought together leaders from the scientific and financial decision making communities, a publication of the study report, and a public briefing of the results to the policy community. In addition, we will present the results to the scientific community at the AMS Annual Meeting in February, 2014. The study results were covered well by the media including Bloomberg News and E&E News. Upon request, we also briefed the Office of Science Technology Policy (OSTP) and the Council on Environmental Quality (CEQ) on the outcomes. We presented the results to the policy community through a public briefing in December on Capitol Hill. The full report is publicly available at www.ametsoc.org/cin. Summary of Key Findings The United States invests roughly $1.5 trillion U.S. dollars (USD) in

  1. Selecting a provider: what factors influence patients' decision making?

    Science.gov (United States)

    Abraham, Jean; Sick, Brian; Anderson, Joseph; Berg, Andrea; Dehmer, Chad; Tufano, Amanda

    2011-01-01

    Each year consumers make a variety of decisions relating to their healthcare. Some experts argue that stronger consumer engagement in decisions about where to obtain medical care is an important mechanism for improving efficiency in healthcare delivery and financing. Consumers' ability and motivation to become more active decision makers are affected by several factors, including financial incentives and access to information. This study investigates the set of factors that consumers consider when selecting a provider, including attributes of the provider and the care experience and the reputation of the provider. Additionally, the study evaluates consumers awareness and use of formal sources of provider selection information. Our results from analyzing data from a survey of 467 patients at four clinics in Minnesota suggest that the factors considered of greatest importance include reputation of the physician and reputation of the healthcare organization. Contractual and logistical factors also play a role, with respondents highlighting the importance of seeing a provider affiliated with their health plan and appointment availability. Few respondents indicated that advertisements or formal sources of quality information affected their decision making. The key implication for provider organizations is to carefully manage referral sources to ensure that they consistently meet the needs of referrers. Excellent service to existing patients and to the network of referring physicians yields patient and referrer satisfaction that is critical to attracting new patients. Finally, organizations more generally may want to explore the capabilities of new media and social networking sites for building reputation.

  2. Activity-based analyses lead to better decision making.

    Science.gov (United States)

    Player, S

    1998-08-01

    Activity-based costing (ABC) and activity-based management (ABM) are cost-management tools that are relatively new to the healthcare industry. ABC is used for strategic decision making. It assesses the costs associated with specific activities and resources and links those costs to specific internal and external customers of the healthcare enterprise (e.g., patients, service lines, and physician groups) to determine the costs associated with each customer. This cost information then can be adjusted to account for anticipated changes and to predict future costs. ABM, on the other hand, supports operations by focusing on the causes of costs and how costs can be reduced. It assesses cost drivers that directly affect the cost of a product or service, and uses performance measures to evaluate the financial or nonfinancial benefit an activity provides. By identifying each cost driver and assessing the value the element adds to the healthcare enterprise, ABM provides a basis for selecting areas that can be changed to reduce costs.

  3. Getting the right information to the table: using technology to support evidence-based decision making.

    Science.gov (United States)

    Atack, Lynda; Gignac, Patrick; Anderson, Malcolm

    2010-01-01

    Healthcare executives report that it is difficult to access the research literature and once found, it is frequently not relevant. A study was conducted to explore ways in which healthcare executives, enrolled in the EXTRA program, used a virtual desktop environment. Despite some design and function limitations, the desktop was perceived positively by most participants and was effective in supporting evidence-informed practice and decision making.

  4. Does future-oriented thinking predict adolescent decision making?

    Science.gov (United States)

    Eskritt, Michelle; Doucette, Jesslyn; Robitaille, Lori

    2014-01-01

    A number of theorists, as well as plain common sense, suggest that future-oriented thinking (FOT) should be involved in decision making; therefore, the development of FOT should be related to better quality decision making. FOT and quality of the decision making were measured in adolescents as well as adults in 2 different experiments. Though the results of the first experiment revealed an increase in quality of decision making across adolescence into adulthood, there was no relationship between FOT and decision making. In the second experiment, FOT predicted performance on a more deliberative decision-making task independent of age, but not performance on the Iowa Gambling Task (IGT). Performance on the IGT was instead related to emotion regulation. The study's findings suggest that FOT can be related to reflective decision making but not necessarily decision making that is more intuitive.

  5. Decision Making, Models of Mind, and the New Cognitive Science.

    Science.gov (United States)

    Evers, Colin W.

    1998-01-01

    Explores implications for understanding educational decision making from a cognitive science perspective. Examines three models of mind providing the methodological framework for decision-making studies. The "absent mind" embodies the behaviorist research tradition. The "functionalist mind" underwrites traditional cognitivism…

  6. Decision Making, Models of Mind, and the New Cognitive Science.

    Science.gov (United States)

    Evers, Colin W.

    1998-01-01

    Explores implications for understanding educational decision making from a cognitive science perspective. Examines three models of mind providing the methodological framework for decision-making studies. The "absent mind" embodies the behaviorist research tradition. The "functionalist mind" underwrites traditional cognitivism…

  7. Health behaviour, decision making and perceived parenting: are ...

    African Journals Online (AJOL)

    ... and perceived parenting: are male and female learners significantly different? ... The study aimed to establish the perceived parenting styles, decision making ... decision making, gender, healthy lifestyle behaviours, learners, parenting ...

  8. A qualitative systematic review of internal and external influences on shared decision-making in all health care settings.

    Science.gov (United States)

    Truglio-Londrigan, Marie; Slyer, Jason T; Singleton, Joanne K; Worral, Priscilla

    2012-01-01

    The objective of this review is to identify and synthesize the best available evidence related to the meaningfulness of internal and external influences on shared-decision making for adult patients and health care providers in all health care settings.The specific questions to be answered are: BACKGROUND: Patient-centered care is emphasized in today's healthcare arena. This emphasis is seen in the works of the International Alliance of Patients' Organizations (IAOP) who describe patient-centered healthcare as care that is aimed at addressing the needs and preferences of patients. The IAOP presents five principles which are foundational to the achievement of patient-centered healthcare: respect, choice, policy, access and support, as well as information. These five principles are further described as:Within the description of these five principles the idea of shared decision-making is clearly evident.The concept of shared decision-making began to appear in the literature in the 1990s. It is defined as a "process jointly shared by patients and their health care provider. It aims at helping patients play an active role in decisions concerning their health, which is the ultimate goal of patient-centered care." The details of the shared decision-making process are complex and consist of a series of steps including:Three overall representative decision-making models are noted in contemporary literature. These three models include: paternalistic, informed decision-making, and shared decision-making. The paternalistic model is an autocratic style of decision-making where the healthcare provider carries out the care from the perspective of knowing what is best for the patient and therefore makes all decisions. The informed decision-making model takes place as the information needed to make decisions is conveyed to the patient and the patient makes the decisions without the healthcare provider involvement. Finally, the shared decision-making model is representative of a

  9. Reproductive health decision making among Ghanaian women.

    Science.gov (United States)

    Darteh, Eugene Kofuor Maafo; Doku, David Teye; Esia-Donkoh, Kobina

    2014-03-15

    Women's reproductive health decision-making and choices, including engaging in sexual intercourse and condom use, are essential for good reproductive health. However, issues concerning sexual intercourse and condom use are shrouded in secrecy in many sub-Saharan African countries. This study investigates factors that affect decision making on engaging in sexual intercourse and use of condom among women aged 15-49. A nationally representative sample (N = 3124) data collected in the 2008 Ghana Demographic and Health Survey was used. Multivariate logistic regression was used to study the association between women's economic and socio-demographic characteristics and their decision making on engaging in sexual intercourse and use of condom. One out of five women reported that they could not refuse their partners' request for sexual intercourse while one out of four indicated that they could not demand the use of condoms by their partners. Women aged 35-49 were more likely to make decision on engaging in sexual intercourse (OR = 1.35) compared to those aged 15-24. Furthermore, the higher a woman's education, the more likely that she would make decision regarding condom use. Also, if a woman had primary (OR = 1.37) or secondary (OR = 1.55) education, she is more likely to make decision regarding engaging in sexual intercourse compared to a woman who had no formal education. Compared to women in the Greater Accra region (the capital city region), women in the Western region (OR = 2.10), Central region (OR = 2.35), Brong Ahafo (OR = 1.70), Upper East (OR = 7.71) and Upper West (OR = 3.56) were more likely to make decision regarding the use of condom. Women who were in the richest, rich and middle wealth index categories were more likely to make decision regarding engaging in sexual intercourse as well as condom use compared to the poorest. Interventions and policies geared at empowering women to take charge of their reproductive health should focus particularly on women

  10. Examining Decision-Making Regarding Environmental Information

    Energy Technology Data Exchange (ETDEWEB)

    Marble, Julie Lynne; Medema, Heather Dawne; Hill, Susan Gardiner

    2001-10-01

    Eight participants were asked to view a computer-based multimedia presentation on an environmental phenomenon. Participants were asked to play a role as a senior aide to a national legislator. In this role, they were told that the legislator had asked them to review a multimedia presentation regarding the hypoxic zone phenomenon in the Gulf of Mexico. Their task in assuming the role of a senior aide was to decide how important a problem this issue was to the United States as a whole, and the proportion of the legislator’s research budget that should be devoted to study of the problem. The presentation was divided into 7 segments, each containing some new information not contained in the previous segments. After viewing each segment, participants were asked to indicate how close they were to making a decision and how certain they were that their current opinion would be their final decision. After indicating their current state of decision-making, participants were interviewed regarding the factors affecting their decision-making. Of interest was the process by which participants moved toward a decision. This experiment revealed a number of possible directions for future research. There appeared to be two approaches to decision-making: Some decision-makers moved steadily toward a decision, and occasionally reversed decisions after viewing information, while others abruptly reached a decision after a certain time period spent reviewing the information. Although the difference in estimates of distance to decisions did not differ statistically for these two groups, that difference was reflected in the participants’ estimates of confidence that their current opinion would be their final decision. The interviews revealed that the primary difference between these two groups was in their trade-offs between willingness to spend time in information search and the acquisition of new information. Participants who were less confident about their final decision, tended to be

  11. Cultural Dimensions of Career Decision-Making Difficulties

    Science.gov (United States)

    Mau, Wei-Cheng J.

    2004-01-01

    This study investigated cultural dimensions of career decision-making difficulties using the Career Decision-Making Difficulties Questionnaire. Career decision-making difficulties were compared among White, African, Hispanic, and Asian American high school and university students at U.S. schools. Results indicated Asian American students perceived…

  12. 36 CFR 1010.13 - Trust decision-making procedures.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Trust decision-making procedures. 1010.13 Section 1010.13 Parks, Forests, and Public Property PRESIDIO TRUST ENVIRONMENTAL QUALITY § 1010.13 Trust decision-making procedures. To ensure that at major decision-making points all...

  13. Serious gaming for complex decision making: Training approaches

    NARCIS (Netherlands)

    Hulst, A.H. van der; Muller, T.J.; Buiel, E.F.T.; Gelooven, D.M.N. van; Ruijsendaal, M.

    2014-01-01

    At the heart of tactical decision making and strategic decision making is 'situation assessment', the most 'intuitive' aspect of complex decision making. In training, it is also the most neglected. Particularly for developing situation assessment skills and the cognitive flexibility to apply those s

  14. Reflective Decision Making among University Department Heads across Academic Disciplines

    Science.gov (United States)

    Kampmann, Jennifer A.

    2012-01-01

    Within the scope of leadership and management, decision making greatly defines the role of university administrator, in particular, the university department head and his/her ability to be a reflective practitioner in the realm of decision making. Decision making is one characteristic of university department head work which warrants close…

  15. Data-Based Decision Making in Education: Challenges and Opportunities

    Science.gov (United States)

    Schildkamp, Kim, Ed.; Lai, Mei Kuin, Ed.; Earl, Lorna, Ed.

    2013-01-01

    In a context where schools are held more and more accountable for the education they provide, data-based decision making has become increasingly important. This book brings together scholars from several countries to examine data-based decision making. Data-based decision making in this book refers to making decisions based on a broad range of…

  16. A Developmental Approach to the Teaching of Ethical Decision Making.

    Science.gov (United States)

    Neukrug, Edward S.

    1996-01-01

    Examines the newly adopted code of ethics, reviews some ethical decision-making models, and hypothesizes how the maturity of a student might mediate the effective use of codes and of decision-making models. Provides a model for human service educators that integrates ethical guidelines and ethical decision-making models. (RJM)

  17. Group Dynamics and Decision Making: Backcountry Recreationists in Avalanche Terrain

    Science.gov (United States)

    Bright, Leslie Shay

    2010-01-01

    The purpose of this study was to describe and determine the prevalence of decision-making characteristics of recreational backcountry groups when making a decision of where to travel and ride in avalanche terrain from the perspective of individuals. Decision-making characteristics encompassed communication, decision-making processes, leadership,…

  18. Planning and Decision Making for Care Transitions

    Science.gov (United States)

    Sörensen, Silvia; Mak, Wingyun; Pinquart, Martin

    2015-01-01

    The need to plan for future health care and residential adjustments increases with age, growing frailty, and restrictions in coverage of long-term care and will continue to grow with population aging. Older adults’ lack of financial preparation for health care costs, insufficient knowledge about available options, and inadequate communication about care-related values has become an increasing public health challenge. This chapter describes a model of Preparation for Future Care (PFC), which encompasses different levels and domains of planning. Research about the extent to which planning is helpful in navigating care transitions is reviewed, and barriers and facilitators of planning including individual, familial, cultural, and national long-term care policy factors are discussed. Planning in the context of dementia and practical approaches that can be taken to enhance PFC is addressed, as well as recommendations for future research in the area of planning and decision making in the context of care transitions. PMID:26207079

  19. NASA Risk-Informed Decision Making Handbook

    Science.gov (United States)

    Dezfuli, Homayoon; Stamatelatos, Michael; Maggio, Gaspare; Everett, Christopher; Youngblood, Robert; Rutledge, Peter; Benjamin, Allan; Williams, Rodney; Smith, Curtis; Guarro, Sergio

    2010-01-01

    This handbook provides guidance for conducting risk-informed decision making in the context of NASA risk management (RM), with a focus on the types of direction-setting key decisions that are characteristic of the NASA program and project life cycles, and which produce derived requirements in accordance with existing systems engineering practices that flow down through the NASA organizational hierarchy. The guidance in this handbook is not meant to be prescriptive. Instead, it is meant to be general enough, and contain a sufficient diversity of examples, to enable the reader to adapt the methods as needed to the particular decision problems that he or she faces. The handbook highlights major issues to consider when making decisions in the presence of potentially significant uncertainty, so that the user is better able to recognize and avoid pitfalls that might otherwise be experienced.

  20. Quality of decision making and group norms.

    Science.gov (United States)

    Postmes, T; Spears, R; Cihangir, S

    2001-06-01

    Two studies investigated the impact of group norms for maintaining consensus versus norms for critical thought on group decisions in a modification of the biased sampling paradigm (G. Stasser & W. Titus, 1985). Both studies showed that critical norms improved the quality of decisions, whereas consensus norms did not. This effect appeared to be mediated by the perceived value of shared and unshared information: Consensus norm groups valued shared information more highly than critical groups did, and valence was a good predictor of decision outcome. In addition, the 2nd study showed that the group norm manipulation has no impact on individual decisions, consistent with the assumption that this is a group effect. Results suggest that the content of group norms is an important factor influencing the quality of group decision-making processes and that the content of group norms may be related to the group's proneness for groupthink.

  1. Combining disparate data for decision making

    Science.gov (United States)

    Gettings, M. E.

    2010-12-01

    Combining information of disparate types from multiple data or model sources is a fundamental task in decision making theory. Procedures for combining and utilizing quantitative data with uncertainties are well-developed in several approaches, but methods for including qualitative and semi-quantitative data are much less so. Possibility theory offers an approach to treating all three data types in an objective and repeatable way. In decision making, biases are frequently present in several forms, including those arising from data quality, data spatial and temporal distribution, and the analyst's knowledge and beliefs as to which data or models are most important. The latter bias is particularly evident in the case of qualitative data and there are numerous examples of analysts feeling that a qualitative dataset is more relevant than a quantified one. Possibility theory and fuzzy logic now provide fairly general rules for quantifying qualitative and semi-quantitative data in ways that are repeatable and minimally biased. Once a set of quantified data and/or model layers is obtained, there are several methods of combining them to obtain insight useful in decision making. These include: various combinations of layers using formal fuzzy logic (for example, layer A and (layer B or layer C) but not layer D); connecting the layers with varying influence links in a Fuzzy Cognitive Map; and using the set of layers for the universe of discourse for agent based model simulations. One example of logical combinations that have proven useful is the definition of possible habitat for valley fever fungus (Coccidioides sp.) using variables such as soil type, altitude, aspect, moisture and temperature. A second example is the delineation of the lithology and possible mineralization of several areas beneath basin fill in southern Arizona. A Fuzzy Cognitive Map example is the impacts of development and operation of a hypothetical mine in an area adjacent to a city. In this model

  2. Incorporating patients' preferences into medical decision making.

    Science.gov (United States)

    Fraenkel, Liana

    2013-02-01

    Current models of care emphasize the importance of including patients' values in the decision-making process. This is particularly important for decisions for which there are few data supporting a clear strategy or treatment choice. Constructing preferences for complex decisions requires that patients be able to consider multiple trade-offs between specific risks and benefits. Several marketing research techniques have been recently applied to heath care settings to facilitate this process. Most can be programmed to generate patients' preferences or priorities, which can then be used to improve patient-physician communication. In this article, we will describe some of the currently available approaches that have been successfully used in the health care setting. We provide case examples to illustrate the potential value of adopting each of these approaches in clinical practice.

  3. Family decision-making during food buying

    DEFF Research Database (Denmark)

    Nørgaard, Maria Kümpel

    in difficulties in distinguishing among healthy and unhealthy food. Both parents and children being active in the decision process may lead to conflicts due to gaps in preference such as between healthy and unhealthy food. Families solve these conflicts via open communication patterns and a use of various......Decision-making during food buying is a joint family activity involving both parents and children. Children manage to achieve a high degree of influence on many decisions, among other things, because they participate actively and help out doing various tasks. These decisions may turn out...... to be a choice of unhealthy food. Many decisions are made at the supermarket or other food shops, and food packaging is often used in the comparison of food products. Only rarely do families use nutritional information on food labels due to several problems in the understanding of these labels; this may result...

  4. [Withdrawal of dialysis--decision-making criterion].

    Science.gov (United States)

    Oehmichen, Frank

    2005-01-01

    Improvement in prolongation and quality of life has been made possible by medical progress, but life for the patient can become ever more dependent on artificial support and death may be prolonged in unwanted ways. The choice between prolongation of life, quality of life and the abatement of suffering is of great importance in decisions on the continuation or cessation of dialysis and is naturally a process of weighing different positions. This process requires not only medical decision-making but also a structure for the organization of communication between all involved parties. Only thus is it possible to reach a satisfactory resolution to such a situation, a resolution that shows medical responsibility on the part of the physician and one that can be borne by all those involved.

  5. Training for decision making during emergencies

    Directory of Open Access Journals (Sweden)

    Margaret Crichton

    2001-12-01

    Full Text Available As crises or emergencies occur unexpectedly and without warning, the non-technical skills of the emergency response personnel are as crucial as their technical skills. This is particularly true in complex, large-scale organisations. This paper outlines a novel, low-fidelity, training method, Tactical Decision Games (TDGs, that is designed to enhance the non-technical skills required for effective emergency management. These skills include decision making, communication, situation awareness, teamwork and stress management. It is anticipated that emergency response personnel will be better prepared, more equipped, and more able to deal with the demands endemic in any incident response situation as a result of repeated exposure to TDGs, which encourage learning through experience and directed practice.

  6. Decision Making in R&D Outsourcing

    DEFF Research Database (Denmark)

    Bals, Lydia; Kneis, Kyra; Lemke, Christine

    2011-01-01

    In an increasingly competitive environment, the pharmaceutical industry faces increasing R&D costs and longer development times, which increase a product’s time to market. Therefore, the issue of costs and outsourcing of R&D is increasing in importance, but systematic approaches for understanding...... the decision making process on R&D outsourcing are lacking. To address this gap, we present a framework developed in the context of a multinational pharmaceutical company. The framework builds on general make-or-buy frameworks and incorporates specificities of the service and knowledge-driven areas...... of pharmaceutical research. Tactical and strategic outsourcing considerations are reflected in the framework, which also reflects the increased fine slicing of activities beyond the common dichotomy of core and non-core activities. The framework may be applicable insimilar R&D-intensive settings and it therefore...

  7. A neural model of decision making

    DEFF Research Database (Denmark)

    Larsen, Torben

    2008-01-01

    and inhibitory processes and EEG is still useful for research as a broader and direct measure of brain activity. On this background a new interdisciplinary field linking behavioural economics and neuroscience into a neuroeconomic discipline emerges. Recent reviews of neuroeconomics represent a platform...... for further development of neuroeconomics [McLean 1992 and Luria 1973].    An overview of neuroeconomics from an economic perspective reviewing 13 studies [Kenning and Plassman, 2005]. It is concluded that the first studies are explorative research focusing concepts crucial to modern economic theory...... such as fairness, trust, altruism, memory, learning and knowledge. The goal of neuroeconomics is stated as to provide a descriptive decision-making theory, which is not restricted to economic theory and more realistic than that of economic man.    Reviewing how neuroscience can inform economics [Camerer et al...

  8. Decision Making in R&D Outsourcing

    DEFF Research Database (Denmark)

    Bals, Lydia; Kneis, Kyra; Lemke, Christine

    2011-01-01

    In an increasingly competitive environment, the pharmaceutical industry faces increasing R&D costs and longer development times, which increase a product’s time to market. Therefore, the issue of costs and outsourcing of R&D is increasing in importance, but systematic approaches for understanding...... the decision making process on R&D outsourcing are lacking. To address this gap, we present a framework developed in the context of a multinational pharmaceutical company. The framework builds on general make-or-buy frameworks and incorporates specificities of the service and knowledge-driven areas...... of pharmaceutical research. Tactical and strategic outsourcing considerations are reflected in the framework, which also reflects the increased fine slicing of activities beyond the common dichotomy of core and non-core activities. The framework may be applicable insimilar R&D-intensive settings and it therefore...

  9. Knowledge, responsibility, decision making and ignorance

    DEFF Research Database (Denmark)

    Huniche, Lotte

    2001-01-01

    This article is concerned with the question of how to argue about morality and ethics in relationto a severe and deadly hereditary disease. It is inspired by the uneasiness I have felt on a number of ocations when "right and wrong" is being discussed by persons at risk, professionals and in parti......This article is concerned with the question of how to argue about morality and ethics in relationto a severe and deadly hereditary disease. It is inspired by the uneasiness I have felt on a number of ocations when "right and wrong" is being discussed by persons at risk, professionals...... a closer look at genetic knowledge, responsibility and decision making, because these seem to be important issues in my field of study. I have added ignorance to the list in order to discuss a further aspect of dealing with hereditary disease. Interestingly, ignorance (understood both as being ignorant...

  10. Linking Assessment to Decision Making in Water Resources Planning - Decision Making Frameworks and Case Study Evaluations

    Science.gov (United States)

    Broman, D.; Gangopadhyay, S.; Simes, J.

    2015-12-01

    Climate assessments have become an accepted and commonly used component of long term water management and planning. There is substantial variation in the methods used in these assessments; however, managers and decision-makers have come to value their utility to identify future system limitations, and to evaluate future alternatives to ensure satisfactory system performance. A new set of decision-making frameworks have been proposed, including robust decision making (RDM), and decision scaling, that directly address the deep uncertainties found in both future climate, and non-climatic factors. Promising results have been obtained using these new frameworks, offering a more comprehensive understanding of future conditions leading to failures, and identification of measures to address these failures. Data and resource constraints have limited the use of these frameworks within the Bureau of Reclamation. We present here a modified framework that captures the strengths of previously proposed methods while using a suite of analysis tool that allow for a 'rapid climate assessment' to be performed. A scalable approach has been taken where more complex tools can be used if project resources allow. This 'rapid assessment' is demonstrated through two case studies on the Santa Ana and Colorado Rivers where previous climate assessments have been completed. Planning-level measures are used to compare how decision making is affected when using this new decision making framework.

  11. Decision-Making Self-Efficacy and Barriers in Career Decision Making among Community College Students

    Science.gov (United States)

    Kelly, Rosemary R.; Hatcher, Tim

    2013-01-01

    This study explored differences between career decision-making self-efficacy (CDMSE) and career barriers of students enrolled in applied technology programs compared to those enrolled in college transfer. Participants in the ex post facto cross-sectional survey included 787 students at a community college. The following research questions were…

  12. Interference effects of categorization on decision making.

    Science.gov (United States)

    Wang, Zheng; Busemeyer, Jerome R

    2016-05-01

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

  13. Entrustment Decision Making in Clinical Training.

    Science.gov (United States)

    Ten Cate, Olle; Hart, Danielle; Ankel, Felix; Busari, Jamiu; Englander, Robert; Glasgow, Nicholas; Holmboe, Eric; Iobst, William; Lovell, Elise; Snell, Linda S; Touchie, Claire; Van Melle, Elaine; Wycliffe-Jones, Keith

    2016-02-01

    The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee's development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors' aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment.

  14. Collaborative Platforms Aid Emergency Decision Making

    Science.gov (United States)

    2013-01-01

    Terra. Aqua. Cloudsat. Landsat. NASA runs and partners in many missions dedicated to monitoring the Earth, and the tools used in these missions continuously return data on everything from shifts in temperature to cloud formation to pollution levels over highways. The data are of great scientific value, but they also provide information that can play a critical role in decision making during times of crisis. Real-time developments in weather, wind, ocean currents, and numerous other conditions can have a significant impact on the way disasters, both natural and human-caused, unfold. "NASA has long recognized the need to make its data from real-time sources compatible and accessible for the purposes of decision making," says Michael Goodman, who was Disasters Program manager at NASA Headquarters from 2009-2012. "There are practical applications of NASA Earth science data, and we d like to accelerate the use of those applications." One of the main obstacles standing in the way of eminently practical data is the fact that the data from different missions are collected, formatted, and stored in different ways. Combining data sets in a way that makes them useful for decision makers has proven to be a difficult task. And while the need for a collaborative platform is widely recognized, very few have successfully made it work. Dave Jones, founder and CEO of StormCenter Communications Inc., which consults with decision makers to prepare for emergencies, says that "when I talk to public authorities, they say, If I had a nickel for every time someone told me they had a common operating platform, I d be rich. But one thing we ve seen over the years is that no one has been able to give end users the ability to ingest NASA data sets and merge them with their own."

  15. Stress alters personal moral decision making.

    Science.gov (United States)

    Youssef, Farid F; Dookeeram, Karine; Basdeo, Vasant; Francis, Emmanuel; Doman, Mekaeel; Mamed, Danielle; Maloo, Stefan; Degannes, Joel; Dobo, Linda; Ditshotlo, Phatsimo; Legall, George

    2012-04-01

    While early studies of moral decision making highlighted the role of rational, conscious executive processes involving frontal lobe activation more recent work has suggested that emotions and gut reactions have a key part to play in moral reasoning. Given that stress can activate many of the same brain regions that are important for and connected to brain centres involved in emotional processing we sought to evaluate if stress could influence moral decision making. Sixty-five undergraduate volunteers were randomly assigned to control (n=33) and experimental groups (n=32). The latter underwent the Trier Social Stress Test (TSST) and induction of stress was assessed by measurement of salivary cortisol levels. Subjects were then required to provide a response to thirty moral dilemmas via a computer interface that recorded both their decision and reaction time. Three types of dilemmas were used: non-moral, impersonal moral and personal moral. Using a binary logistic model there were no significant predicators of utilitarian response in non-moral and impersonal moral dilemmas. However the stressed group and females were found to predict utilitarian responses to personal moral dilemmas. When comparing percentage utilitarian responses there were no significant differences noted for the non-moral and impersonal moral dilemmas but the stressed group showed significantly less utilitarian responses compared to control subjects. The stress response was significantly negatively correlated with utilitarian responses. Females also showed significantly less utilitarian responses than males. We conclude that activation of the stress response predisposed participants to less utilitarian responses when faced with high conflict personal moral dilemmas and suggest that this offers further support for dual process theory of moral judgment. We also conclude that females tend to make less utilitarian personal moral decisions compared to males, providing further evidence that there are

  16. The hidden traps in decision making.

    Science.gov (United States)

    Hammond, J S; Keeney, R L; Raiffa, H

    1998-01-01

    Bad decisions can often be traced back to the way the decisions were made--the alternatives were not clearly defined, the right information was not collected, the costs and benefits were not accurately weighted. But sometimes the fault lies not in the decision-making process but rather in the mind of the decision maker. The way the human brain works can sabotage the choices we make. John Hammond, Ralph Keeney, and Howard Raiffa examine eight psychological traps that are particularly likely to affect the way we make business decisions: The anchoring trap leads us to give disproportionate weight to the first information we receive. The statusquo trap biases us toward maintaining the current situation--even when better alternatives exist. The sunk-cost trap inclines us to perpetuate the mistakes of the past. The confirming-evidence trap leads us to seek out information supporting an existing predilection and to discount opposing information. The framing trap occurs when we misstate a problem, undermining the entire decision-making process. The overconfidence trap makes us overestimate the accuracy of our forecasts. The prudence trap leads us to be overcautious when we make estimates about uncertain events. And the recallability trap leads us to give undue weight to recent, dramatic events. The best way to avoid all the traps is awareness--forewarned is forearmed. But executives can also take other simple steps to protect themselves and their organizations from the various kinds of mental lapses. The authors show how to take action to ensure that important business decisions are sound and reliable.

  17. Climate Information Needs for Financial Decision Making

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, Paul [American Meteorological Society, Washington, DC (United States)

    2013-11-19

    Climate Information Needs for Financial Decision Making (Final Report) This Department of Energy workshop award (grant #DE-SC0008480) provided primary support for the American Meteorological Society’s study on climate information needs for financial decision making. The goal of this study was to help advance societal decision making by examining the implications of climate variability and change on near-term financial investments. We explored four key topics: 1) the conditions and criteria that influence returns on investment of major financial decisions, 2) the climate sensitivity of financial decisions, 3) climate information needs of financial decision makers, and 4) potential new mechanisms to promote collaboration between scientists and financial decision makers. Better understanding of these four topics will help scientists provide the most useful information and enable financial decision makers to use scientific information most effectively. As a result, this study will enable leaders in business and government to make well-informed choices that help maximize long-term economic success and social wellbeing in the United States The outcomes of the study include a workshop, which brought together leaders from the scientific and financial decision making communities, a publication of the study report, and a public briefing of the results to the policy community. In addition, we will present the results to the scientific community at the AMS Annual Meeting in February, 2014. The study results were covered well by the media including Bloomberg News and E&E News. Upon request, we also briefed the Office of Science Technology Policy (OSTP) and the Council on Environmental Quality (CEQ) on the outcomes. We presented the results to the policy community through a public briefing in December on Capitol Hill. The full report is publicly available at www.ametsoc.org/cin. Summary of Key Findings The United States invests roughly $1.5 trillion U.S. dollars (USD) in

  18. The involvement of the striatum in decision making.

    Science.gov (United States)

    Goulet-Kennedy, Julie; Labbe, Sara; Fecteau, Shirley

    2016-03-01

    Decision making has been extensively studied in the context of economics and from a group perspective, but still little is known on individual decision making. Here we discuss the different cognitive processes involved in decision making and its associated neural substrates. The putative conductors in decision making appear to be the prefrontal cortex and the striatum. Impaired decision-making skills in various clinical populations have been associated with activity in the prefrontal cortex and in the striatum. We highlight the importance of strengthening the degree of integration of both cognitive and neural substrates in order to further our understanding of decision-making skills. In terms of cognitive paradigms, there is a need to improve the ecological value of experimental tasks that assess decision making in various contexts and with rewards; this would help translate laboratory learnings into real-life benefits. In terms of neural substrates, the use of neuroimaging techniques helps characterize the neural networks associated with decision making; more recently, ways to modulate brain activity, such as in the prefrontal cortex and connected regions (eg, striatum), with noninvasive brain stimulation have also shed light on the neural and cognitive substrates of decision making. Together, these cognitive and neural approaches might be useful for patients with impaired decision-making skills. The drive behind this line of work is that decision-making abilities underlie important aspects of wellness, health, security, and financial and social choices in our daily lives.

  19. Remote clinical decision-making: a clinician's definition.

    Science.gov (United States)

    Brady, Mike; Northstone, Kate

    2017-05-12

    Aims Remote clinical decision-making (RCDM), commonly known as 'telephone triage' or 'hear and treat', describes clinicians' non-face-to-face involvement with patient care, and is an established strategy in UK ambulance services for managing increasing demand. However, there is no suitable definition of RCDM that fully explains the roles undertaken by clinicians in 999 hubs, or for its use as an ambulance quality indicator (AQI). The aim of this study, which is part of a larger evaluation of a new RCDM module in higher education, is to determine how clinicians define RCDM. Methods Three participants were asked, during semi-structured interviews, to define RCDM. The interviews were recorded, transcribed and thematically analysed. Results Clinicians do not focus on outcomes when defining RCDM, but on the efficacy of the process and the appropriateness of the determined outcome. Conclusion There is no precise description of the role of healthcare professionals in 999 clinical hubs, but there is a need for role clarity, for employees and organisations. The study questions the suitability of the definition of hear and treat as an AQI, as it does not appear to represent fully the various duties undertaken by 999 clinical hub healthcare professionals. More research is needed to consider the definition of RCDM in all its forms.

  20. Pleasure in decision-making situations

    Directory of Open Access Journals (Sweden)

    Balasko Marta

    2002-05-01

    Full Text Available Abstract Background This study explores the role of pleasure in decision making. Results In Experiment 1, 12 subjects were presented with a questionnaire containing 46 items taken from the literature. Twenty-three items described a situation where a decision should be made and ended with a suggested solution. The other items served as filler items. The subjects were requested not to make a decision but to rate the pleasure or displeasure they experienced when reading the situation described in the item. The subjects' ratings were then compared to the decisions on the same situations made by the other subjects of the studies published by other workers. The ratings of pleasure/displeasure given by our subjects correlated significantly with the choices published by other authors. This result satisfies a necessary condition for pleasure to be the key of the decision making process in theoretical situations. In Experiment 2, a new group of 12 subjects rated their experience of pleasure/displeasure when reading various versions of 50 situations taken from daily life where an ethical decision had to be made (Questionnaire I including 200 items. This was followed by a multiple-choice test with the 50 situations (Questionnaire II using the same 200 items and offering the various behaviors. Subjects tended to choose ethical and unethical responses corresponding to their highest pleasure rating within each problem. In all cases the subjects' behavior was higher than chance level, and thus, followed the trend to maximize pleasure. In Experiment 3, 12 subjects reading 50 mathematical short problems followed by correct and incorrect versions of the answer to the problem (Questionnaire III, including 200 items. This was followed by a multiple-choice mathematical test with the 50 problems (Questionnaire IV using the same 200 items and offering the correct and incorrect answers. In questionnaire IV, subjects tended to choose correct as well as incorrect

  1. An Exploration of the Relationship between Clinical Decision-Making Ability and Educational Preparation among New Graduate Nurses

    Science.gov (United States)

    Blount, Kamilah V.

    2013-01-01

    This study examined the impact of accelerated nursing direct entry master's programs on the development of clinical decision-making skills of new graduate nurses that completed the Performance Based Development System (PBDS) assessment during the study period of 2008-2012 at a healthcare organization. Healthcare today is practiced in a…

  2. Health professionals' decision-making in wound management: a grounded theory.

    Science.gov (United States)

    Gillespie, Brigid M; Chaboyer, Wendy; St John, Winsome; Morley, Nicola; Nieuwenhoven, Paul

    2015-06-01

    To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice. With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area. A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice. Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes. The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes. These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes. © 2014 John Wiley & Sons Ltd.

  3. Decision-Making in Audiology: Balancing Evidence-Based Practice and Patient-Centered Care

    Science.gov (United States)

    Clemesha, Jennifer; Lundmark, Erik; Crome, Erica; Barr, Caitlin; McMahon, Catherine M.

    2017-01-01

    Health-care service delivery models have evolved from a practitioner-centered approach toward a patient-centered ideal. Concurrently, increasing emphasis has been placed on the use of empirical evidence in decision-making to increase clinical accountability. The way in which clinicians use empirical evidence and client preferences to inform decision-making provides an insight into health-care delivery models utilized in clinical practice. The present study aimed to investigate the sources of information audiologists use when discussing rehabilitation choices with clients, and discuss the findings within the context of evidence-based practice and patient-centered care. To assess the changes that may have occurred over time, this study uses a questionnaire based on one of the few studies of decision-making behavior in audiologists, published in 1989. The present questionnaire was completed by 96 audiologists who attended the World Congress of Audiology in 2014. The responses were analyzed using qualitative and quantitative approaches. Results suggest that audiologists rank clinical test results and client preferences as the most important factors for decision-making. Discussion with colleagues or experts was also frequently reported as an important source influencing decision-making. Approximately 20% of audiologists mentioned utilizing research evidence to inform decision-making when no clear solution was available. Information shared at conferences was ranked low in terms of importance and reliability. This study highlights an increase in awareness of concepts associated with evidence-based practice and patient-centered care within audiology settings, consistent with current research-to-practice dissemination pathways. It also highlights that these pathways may not be sufficient for an effective clinical implementation of these practices. PMID:28752808

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

    Science.gov (United States)

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

    2017-08-01

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

  5. Evacuation decision-making: process and uncertainty

    Energy Technology Data Exchange (ETDEWEB)

    Mileti, D.; Sorensen, J.; Bogard, W.

    1985-09-01

    The purpose was to describe the processes of evacuation decision-making, identify and document uncertainties in that process and discuss implications for federal assumption of liability for precautionary evacuations at nuclear facilities under the Price-Anderson Act. Four major categories of uncertainty are identified concerning the interpretation of hazard, communication problems, perceived impacts of evacuation decisions and exogenous influences. Over 40 historical accounts are reviewed and cases of these uncertainties are documented. The major findings are that all levels of government, including federal agencies experience uncertainties in some evacuation situations. Second, private sector organizations are subject to uncertainties at a variety of decision points. Third, uncertainties documented in the historical record have provided the grounds for liability although few legal actions have ensued. Finally it is concluded that if liability for evacuations is assumed by the federal government, the concept of a ''precautionary'' evacuation is not useful in establishing criteria for that assumption. 55 refs., 1 fig., 4 tabs.

  6. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  7. Intelligent Information System to support decision making.

    Directory of Open Access Journals (Sweden)

    Kathrin Rodríguez Llanes

    2010-06-01

    Full Text Available Making decisions is complicated in a generalized way, the materials and humans resources of the entity we belong to depends on it, such as the fulfillment of its goals. But when the situations are complex, making decisions turns into a very difficult work, due to the great amount of aspects to consider when making the right choice. To make this efficiently the administration must to consult an important volume of information, which generally, is scattered and in any different formats. That’s why appears the need of developing software that crowd together all that information and be capable of, by using powerful search engines and process algorithms improve the good decisions making process. Considering previous explanation, a complete freeware developed product is proposed, this constitutes a generic and multi-platform solution, that using artificial intelligence techniques, specifically the cases based reasoning, gives the possibility to leaders of any institution or organism of making the right choice in any situation.With client-server architecture, this system is consumed from web as a service and it can be perfectly integrated with a management system or the geographic information system to facilitate the business process.

  8. Nature of Science and Decision-Making

    Science.gov (United States)

    Khishfe, Rola

    2012-01-01

    The study investigated the relationship of nature of science (NOS) instruction and students' decision-making (DM) related to a controversial socioscientific issue about genetically modified food. Participants were ninth-grade students in four intact sections (two regulars and two honors) in a public high school in the Midwest. All four groups were taught by their regular science teacher. The treatment comprised a four-week unit about genetic engineering. Two groups (one regular and one honors), referred to as comparison groups, received instruction in genetic engineering and how to formulate arguments and make decisions related to this controversial issue. The other two groups (one regular and one honors), referred to as treatment groups, received instruction in genetic engineering and how to apply NOS aspects as they formulate arguments and make decisions in relation to this controversial issue. Chi-square analyses showed significant differences between the comparison and the treatment groups in relation to the understandings of four NOS aspects. There were no differences in their decisions, but there were differences in their DM factors in the context of the controversial socioscientific issue about genetically modified food. These results are discussed in light of the relationship between students' understandings of NOS and their DM related to controversial socioscientific issues.

  9. Unexpected uncertainty, volatility and decision-making

    Directory of Open Access Journals (Sweden)

    Amy Rachel Bland

    2012-06-01

    Full Text Available The study of uncertainty in decision making is receiving greater attention in the fields of cognitive and computational neuroscience. Several lines of evidence are beginning to elucidate different variants of uncertainty. Particularly, risk, ambiguity and expected and unexpected forms of uncertainty are well articulated in the literature. In this article we review both empirical and theoretical evidence arguing for the potential distinction between three forms of uncertainty; expected uncertainty, unexpected uncertainty and volatility. Particular attention will be devoted to exploring the distinction between unexpected uncertainty and volatility which has been less appreciated in the literature. This includes evidence from computational modelling, neuromodulation, neuroimaging and electrophysiological studies. We further address the possible differentiation of cognitive control mechanisms used to deal with these forms of uncertainty. Particularly we explore a role for conflict monitoring and the temporal integration of information into working memory. Finally, we explore whether the Dual Modes of Control theory provides a theoretical framework for understanding the distinction between unexpected uncertainty and volatility.

  10. Parental authority and pediatric bioethical decision making.

    Science.gov (United States)

    Cherry, Mark J

    2010-10-01

    In this paper, I offer a view beyond that which would narrowly reduce the role of parents in medical decision making to acting as custodians of the best interests of children and toward an account of family authority and family autonomy. As a fundamental social unit, the good of the family is usually appreciated, at least in part, in terms of its ability successfully to instantiate its core moral and cultural understandings as well as to pass on such commitments to future generations. The putative rights of children to expression, information, freedom of thought, conscience, religion, and to freedom of association with others are, in this essay, assessed from the perspective of those conditions necessary for the family to function as a moral community. In so doing, I respond to the move to liberate children from parental authority and to effect the transformation of the family as implied by the United Nations' "Convention on the Rights of the Child" and the pediatric bioethics it supports.

  11. Enhancing Decision Making Using Intelligent System Solution

    Directory of Open Access Journals (Sweden)

    Sushanta Kumar Panigrahi

    2011-01-01

    Full Text Available The development and deployment of managerial decision support system represents an emerging trend in the business and organizational field in which the increased application of Decision Support Systems (DSS can be compiling by Intelligent Systems (IS. Decision Support Systems (DSS are a specific class of computerized information system that supports business and organizational decision-making activities. A properly designed DSS is an interactive software-based system intended to help decision makers compile useful information from raw data, documents, personal knowledge, and/or business models to identify and solve problems and make decisions. Competitive business pressures and a desire to leverage existing information technology investments have led many firms to explore the benefits of intelligent data management solutions such as Particle Swarm Optimization (PSO. This technology is designed to help businesses to finding multi objective functions, which can help to understand the purchasing behavior of their key customers, detect likely credit card or insurance claim fraud, predict probable changes in financial markets, etc.

  12. [Kairos. Decision-making in medical ethics].

    Science.gov (United States)

    Jousset, David

    2014-06-01

    This paper assesses the decision making patterns in medical ethics: the formalized pattern of decision science, the meditative pattern of an art of judgement and lastly the still-to-be-elaborated pattern of kairology or sense of the right time. The ethical decision is to be thought out in the conditions of medical action while resorting to the philosophical concepts that shed light on the issue. And it is precisely where medicine and philosophy of human action meet that the Greek notion of kairos, or "propitious moment", evokes the critical point where decision has to do with what is vital. Reflection shows that this kairos can be thought out outside the sacrificial pattern (deciding comes down to killing a possibility) by understanding the opportune moment as a sign of ethical action, as the condition for the formation of the subject (making a decision) and finally as a new relationship to time, including in the context of medical urgency. Thus with an approach to clinical ethics centred on the relation to the individual, the focus is less on the probabilistic knowledge of the decidable than on the meaning of the decision, and the undecidable comes to be accepted as an infinite dimension going beyond the limits of our acts, which makes the contingency and the grandeur of human responsibility.

  13. Factors influencing women's decision making in hysterectomy.

    Science.gov (United States)

    Janda, Monika; Armfield, Nigel R; Page, Katie; Kerr, Gayle; Kurz, Suzanne; Jackson, Graeme; Currie, Jason; Weaver, Edward; Yazdani, Anusch; Obermair, Andreas

    2017-09-12

    To explore factors influencing how well-informed women felt about hysterectomy, influences on their decision making, and on them receiving a less-invasive alternative to open surgery. Online questionnaire, conducted in 2015-2016, of women who had received a hysterectomy in Australia, in the preceding two years. Questionnaires were completed by 2319/6000 women (39% response). Most women (n=2225; 96%) felt well-informed about hysterectomy. Women were more aware of the open abdominal approach (n=1798; 77%), than of less-invasive vaginal (n=1552; 67%), laparoscopic (n=1540; 66%), laparoscopic-assisted (n=1303; 56%), and robotic approaches (n=289; 12%). Most women (n=1435; 62%) reported their gynaecologist was the most influential information source. Women who received information about hysterectomy from a GP (OR=1.47; 95% CI 1.15-1.90), or from a gynaecologist (OR=1.3; 95% CI 1.06-1.58), were more likely to feel better informed (p<0.01). This study is important because it helps clinicians, researchers and health policy makers to understand why many women still receive an open abdominal approach despite many learned societies recommending to avoid it if possible. Additional information, or education about avoiding open abdominal approach where possible may lead to a greater number of women receiving less-invasive types of hysterectomy in the future. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

  14. Irrational time allocation in decision-making.

    Science.gov (United States)

    Oud, Bastiaan; Krajbich, Ian; Miller, Kevin; Cheong, Jin Hyun; Botvinick, Matthew; Fehr, Ernst

    2016-01-13

    Time is an extremely valuable resource but little is known about the efficiency of time allocation in decision-making. Empirical evidence suggests that in many ecologically relevant situations, decision difficulty and the relative reward from making a correct choice, compared to an incorrect one, are inversely linked, implying that it is optimal to use relatively less time for difficult choice problems. This applies, in particular, to value-based choices, in which the relative reward from choosing the higher valued item shrinks as the values of the other options get closer to the best option and are thus more difficult to discriminate. Here, we experimentally show that people behave sub-optimally in such contexts. They do not respond to incentives that favour the allocation of time to choice problems in which the relative reward for choosing the best option is high; instead they spend too much time on problems in which the reward difference between the options is low. We demonstrate this by showing that it is possible to improve subjects' time allocation with a simple intervention that cuts them off when their decisions take too long. Thus, we provide a novel form of evidence that organisms systematically spend their valuable time in an inefficient way, and simultaneously offer a potential solution to the problem.

  15. Future Trends in Business Travel Decision Making

    Science.gov (United States)

    Mason, Keith J.

    2002-01-01

    This research surveys twenty large companies and their travellers to identify and evaluate the effects of pressures on the business travel market in the future. The influence of the following areas on the decision making process are addressed: (1) Corporate travel policies and increasing professionalism in corporate purchasing; (2) The development of global strategic airline alliances; (3) The emergence of low cost airlines on short haul markets; and (4) The development of internet based booking tools and travel agency IT. The survey shows differences in views between travel managers, and travellers with regard to corporate travel policies. While travel managers see policy rules, travellers interpret these as guidelines, indicating travel managers will need to take further actions to exercise true control of travel budgets. The data shows that companies are more likely to prescribe a class of airline ticket, than the choice of airline itself. Corporate hierarchical bias in travel policies is still common both for short and particularly long haul flying. Other findings show that while travel managers believe that their companies are likely to sign global deals with strategic airline groups within a five year period in a bid to consolidating spending, they also believe that nearly a third of short haul flying will be taken with low cost carriers, indicating further penetration in this business travel market by these carriers. The paper also provides other predictions about the business travel market, based on the survey findings.

  16. Phenomenological theory of collective decision-making

    Science.gov (United States)

    Zafeiris, Anna; Koman, Zsombor; Mones, Enys; Vicsek, Tamás

    2017-08-01

    An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem - but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present empirical results obtained by using a large-scale database of citations being in good agreement with the above theory. The framework we have developed can easily be adapted to a variety of realistic situations since taking into account the weights of the sub-problems, the opinions or the relations of the group is straightforward. Consequently, our method can be used in several contexts, especially when the optimal composition of a group of decision-makers is designed.

  17. Liberal rationalism and medical decision-making.

    Science.gov (United States)

    Savulescu, Julian

    1997-04-01

    I contrast Robert Veatch's recent liberal vision of medical decision-making with a more rationalist liberal model. According to Veatch, physicians are biased in their determination of what is in their patient's overall interests in favour of their medical interests. Because of the extent of this bias, we should abandon the practice of physicians offering what they guess to be the best treatment option. Patients should buddy up with physicians who share the same values -- 'deep value pairing'. The goal of choice is maximal promotion of patient values. I argue that if subjectivism about value and valuing is true, this move is plausible. However, if objectivism about value is true -- that there really are states which are good for people regardless of whether they desire to be in them -- then we should accept a more rationalist liberal alternative. According to this alternative, what is required to decide which course is best is rational dialogue between physicians and patients, both about the patient's circumstances and her values, and not the seeking out of people, physicians or others, who share the same values. Rational discussion requires that physicians be reasonable and empathic. I describe one possible account of a reasonable physician.

  18. TAU INFLUENCE ON DECISION MAKING IN BASKETBALL

    Directory of Open Access Journals (Sweden)

    Vanda Correia

    2009-01-01

    Full Text Available Decision making in sport emerges from the players' interaction with the game context (Araújo, Davids, & Hristovski, 2006. Results from studies on the one-on-one in basketball identified interpersonal distance and relative velocity as relevant variables (i.e., control parameters. These results are reinterpreted in the perspective of the General Tau Theory (Lee, 1998, in which movement is regarded as guided by controlling tau motion-gaps (time to fulfil a gap and taucouplings. Further empirical evidence for this argument, came from a recent study in a team ball sport, where the tau variable was considered and verified as significantly related to decisional behaviour. Following this, it is assumed that the focus in candidate control parameters that detach the spatial component from the temporal one, presented in previous studies, may not be sufficient to explain the decisional behaviour in basketball. In this way, the variable tau is proposed as more informative given that enfolds inextricably spatial-temporal information.

  19. Phenomenological theory of collective decision-making

    CERN Document Server

    Zafeiris, Anna; Mones, Enys; Vicsek, Tamás

    2016-01-01

    An essential task of groups is to provide efficient solutions for the complex problems they face. Indeed, considerable efforts have been devoted to the question of collective decision-making related to problems involving a single dominant feature. Here we introduce a quantitative formalism for finding the optimal distribution of the group members' competences in the more typical case when the underlying problem is complex, i.e., multidimensional. Thus, we consider teams that are aiming at obtaining the best possible answer to a problem having a number of independent sub-problems. Our approach is based on a generic scheme for the process of evaluating the proposed solutions (i.e., negotiation). We demonstrate that the best performing groups have at least one specialist for each sub-problem -- but a far less intuitive result is that finding the optimal solution by the interacting group members requires that the specialists also have some insight into the sub-problems beyond their unique field(s). We present emp...

  20. Data for decision making in networked health

    Directory of Open Access Journals (Sweden)

    Christian Bourret

    2006-06-01

    Full Text Available In developed countries, nowadays we live in a networked society: a society of information, knowledge and services (Castells, 1996, with strong specificities in the Health field (Bourret, 2003, Silber, 2003. The World Health Organization (WHO has outlined the importance of information for improving health for all. However, financial resources remain limited. Health costs represent 11% of GNP in France, Germany, Switzerland and Canada, 14% in the USA, and 7.5% in Spain and the United Kingdom. Governments, local powers, health or insurance organizations therefore face difficult choices in terms of opportunities and priorities, and for that they need specific and valuable data. Firstly, this paper provide a comprehensive overview of our networked society and the appointment of ICT (Information and Communication Technologies and Health (in other words e-Health in a perspective of needs and uses at the micro, meso, and macro levels. We point out the main challenges of development of Nationwide Health Information Network both in the US, UK and France. Then we analyze the main issues about data for Decision Making in Networked Health: coordination and evaluation. In the last sections, we use an Information System perspective to investigate the three interoperability layers (micro, meso and macro. We analyze the requirements and challenges to design an interoperability global architecture which supports different kinds of interactions; then we focus on the harmonization efforts provided at several levels. Finally, we identify common methodological and engineering issues.

  1. Decision making in the manufacturing environment using graph theory and fuzzy multiple attribute decision making methods

    CERN Document Server

    Rao, Ravipudi Venkata

    2007-01-01

    Manufacturing is the backbone of any industrialized nation. Recent worldwide advances in manufacturing technologies have brought about a metamorphism in the industry. Fast-changing technologies on the product front have created a need for an equally fast response from manufacturing industries. To meet these challenges, manufacturing industries have to select appropriate manufacturing strategies, product designs, manufacturing processes, work piece and tool materials, and machinery and equipment. The selection decisions are complex as decision making is more challenging today. Decision makers i

  2. Safer sexual decision making in adolescent women: perspectives from the conflict theory of decision-making.

    Science.gov (United States)

    Chambers, Kathryn B; Rew, Lynn

    2003-01-01

    Adolescent women are at risk for unintended pregnancies and sexually transmitted diseases, including human immune deficiency virus (HIV)/acquired immunodeficiency deficiency syndrome (AIDS), if they do not engage in safer sexual practices. Adolescent women are biologically, behaviorally, and socially more at risk for sexually transmitted diseases (STDs) and HIV than adolescent men. Although abstinence is the safest sexual health practice for adolescent women, once sexual activity begins, safer sexual practices involve condom and contraceptive use, and communicating with sexual partners to negotiate condom use. A number of implicit and explicit decisions are involved in these activities. A number of researchers have examined safer sexual decisions of adolescent women, some of whom have used theory models such as the Transtheoretical Model of Change. Although these findings have contributed to the knowledge base about safer sexual decision making, many questions remain unanswered about how adolescent women make safer sexual decisions. The Conflict Model of Decision Making is presented and discussed as a framework for enhanced understanding of safer sexual decision making by adolescent women.

  3. Factors influencing cancer treatment decision-making by indigenous peoples: a systematic review.

    Science.gov (United States)

    Tranberg, Rona; Alexander, Susan; Hatcher, Deborah; Mackey, Sandra; Shahid, Shaouli; Holden, Lynda; Kwok, Cannas

    2016-02-01

    We aim to systematically review studies that identify factors influencing cancer treatment decision-making among indigenous peoples. Following the outline suggested by the Preferred Reporting Items for Systematic Review and Meta-analysis, a rigorous systematic review and meta-synthesis were conducted of factors that influence cancer treatment decision-making by indigenous peoples. A total of 733 articles were retrieved from eight databases and a manual search. After screening the titles and abstracts, the full text of 26 articles were critically appraised, resulting in five articles that met inclusion criteria for the review. Because the five articles to be reviewed were qualitative studies, the Critical Appraisal Skills Program toolkit was used to evaluate the methodological quality. A thematic synthesis was employed to identify common themes across the studies. Multiple socio-economic and cultural factors were identified that all had the potential to influence cancer treatment decision-making by indigenous people. These factors were distilled into four themes: spiritual beliefs, cultural influences, communication and existing healthcare systems and structures. Although existing research identified multiple factors influencing decision-making, this review identified that quality studies in this domain are scarce. There is scope for further investigation, both into decision-making factors and into the subsequent design of culturally appropriate programmes and services that meet the needs of indigenous peoples. Copyright © 2015 John Wiley & Sons, Ltd.

  4. Management decision making for fisher populations informed by occupancy modeling

    Science.gov (United States)

    Fuller, Angela K.; Linden, Daniel W.; Royle, J. Andrew

    2016-01-01

    Harvest data are often used by wildlife managers when setting harvest regulations for species because the data are regularly collected and do not require implementation of logistically and financially challenging studies to obtain the data. However, when harvest data are not available because an area had not previously supported a harvest season, alternative approaches are required to help inform management decision making. When distribution or density data are required across large areas, occupancy modeling is a useful approach, and under certain conditions, can be used as a surrogate for density. We collaborated with the New York State Department of Environmental Conservation (NYSDEC) to conduct a camera trapping study across a 70,096-km2 region of southern New York in areas that were currently open to fisher (Pekania [Martes] pennanti) harvest and those that had been closed to harvest for approximately 65 years. We used detection–nondetection data at 826 sites to model occupancy as a function of site-level landscape characteristics while accounting for sampling variation. Fisher occupancy was influenced positively by the proportion of conifer and mixed-wood forest within a 15-km2 grid cell and negatively associated with road density and the proportion of agriculture. Model-averaged predictions indicated high occupancy probabilities (>0.90) when road densities were low (0.50). Predicted occupancy ranged 0.41–0.67 in wildlife management units (WMUs) currently open to trapping, which could be used to guide a minimum occupancy threshold for opening new areas to trapping seasons. There were 5 WMUs that had been closed to trapping but had an average predicted occupancy of 0.52 (0.07 SE), and above the threshold of 0.41. These areas are currently under consideration by NYSDEC for opening a conservative harvest season. We demonstrate the use of occupancy modeling as an aid to management decision making when harvest-related data are unavailable and when budgetary

  5. Overcoming Barriers to Shared Decision Making

    Science.gov (United States)

    ... State SELECT YOUR LANGUAGE Español (Spanish) 简体中文 (Traditional Chinese) 繁体中文 (Simplified Chinese) Tiếng Việt (Vietnamese) Healthy Living for Heart.org ... healthcare decisions . Barrier: Cultural and religious differences Solution: Culture and religion can influence what care you choose ...

  6. A qualitative investigation of selecting surrogate decision-makers

    NARCIS (Netherlands)

    Edwards, S.J.L.; Brown, P.; Twyman, M.A.; Christie, D.; Rakow, T.

    2011-01-01

    Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves se

  7. Integrated Traffic Flow Management Decision Making

    Science.gov (United States)

    Grabbe, Shon R.; Sridhar, Banavar; Mukherjee, Avijit

    2009-01-01

    A generalized approach is proposed to support integrated traffic flow management decision making studies at both the U.S. national and regional levels. It can consider tradeoffs between alternative optimization and heuristic based models, strategic versus tactical flight controls, and system versus fleet preferences. Preliminary testing was accomplished by implementing thirteen unique traffic flow management models, which included all of the key components of the system and conducting 85, six-hour fast-time simulation experiments. These experiments considered variations in the strategic planning look-ahead times, the replanning intervals, and the types of traffic flow management control strategies. Initial testing indicates that longer strategic planning look-ahead times and re-planning intervals result in steadily decreasing levels of sector congestion for a fixed delay level. This applies when accurate estimates of the air traffic demand, airport capacities and airspace capacities are available. In general, the distribution of the delays amongst the users was found to be most equitable when scheduling flights using a heuristic scheduling algorithm, such as ration-by-distance. On the other hand, equity was the worst when using scheduling algorithms that took into account the number of seats aboard each flight. Though the scheduling algorithms were effective at alleviating sector congestion, the tactical rerouting algorithm was the primary control for avoiding en route weather hazards. Finally, the modeled levels of sector congestion, the number of weather incursions, and the total system delays, were found to be in fair agreement with the values that were operationally observed on both good and bad weather days.

  8. Country Risk Importance on Investment Decision Making

    Directory of Open Access Journals (Sweden)

    Elena Mihaela ILIESCU

    2011-12-01

    Full Text Available Given the controversies, especially from the last period, in terms of credibility of the major international rating agencies, this article aims to assess the correlation between country risk ratings and the evolution of FDI flows in the receiving economies. In this regard, we chose to analyze the degree of these influences manifestation in Romania. The study, based on statistical information on the rating granted to Romania and the value of foreign direct investments during the period between 2000 and 2010, confirms the indirect natural connection of the two indicators. Thus, the results show that, when the rating falls in an immediate lower class, foreign direct investments are reduced by 1173.76 billion Euros, which represents 27.2% of the investments average mean made within the 11 analyzed years. Conversely, we can observe an influence of 0.05% of FDI on Romania's rating. The data obtained demonstrates the interdependence between the two indicators, however, a low correlation can be observed. The qualitative analysis performed, showed arguments that support the decrease in importance of rating, such as: reducing the credibility of rating agencies as a result of exposing the weak points from the methodologies applied, granting of incorrect ratings, the inability to foresee the financial crisis or increasing the transparency of governments which makes more and more information available to investors. This doesn’t mean that the role of country rating is denied. It remains an important decision making criterion in guiding the flows within the global economy space, but it is not sufficient and it is not indispensable.

  9. Transient cognitive dynamics, metastability, and decision making.

    Directory of Open Access Journals (Sweden)

    Mikhail I Rabinovich

    2008-05-01

    Full Text Available The idea that cognitive activity can be understood using nonlinear dynamics has been intensively discussed at length for the last 15 years. One of the popular points of view is that metastable states play a key role in the execution of cognitive functions. Experimental and modeling studies suggest that most of these functions are the result of transient activity of large-scale brain networks in the presence of noise. Such transients may consist of a sequential switching between different metastable cognitive states. The main problem faced when using dynamical theory to describe transient cognitive processes is the fundamental contradiction between reproducibility and flexibility of transient behavior. In this paper, we propose a theoretical description of transient cognitive dynamics based on the interaction of functionally dependent metastable cognitive states. The mathematical image of such transient activity is a stable heteroclinic channel, i.e., a set of trajectories in the vicinity of a heteroclinic skeleton that consists of saddles and unstable separatrices that connect their surroundings. We suggest a basic mathematical model, a strongly dissipative dynamical system, and formulate the conditions for the robustness and reproducibility of cognitive transients that satisfy the competing requirements for stability and flexibility. Based on this approach, we describe here an effective solution for the problem of sequential decision making, represented as a fixed time game: a player takes sequential actions in a changing noisy environment so as to maximize a cumulative reward. As we predict and verify in computer simulations, noise plays an important role in optimizing the gain.

  10. An Analysis of Design Decision-Making in Industrial Practice

    DEFF Research Database (Denmark)

    Ahmed, Saeema; Hansen, Claus Thorp

    2002-01-01

    is examined. The analysis led to a deeper understanding of the decision-making activities undertaken by engineering designers in industrial practice. The decision-making episodes undertaken by individual designers were supported by design strategies, not by formal decision-making methods. This implies......This paper describes research that confronts a generic decision-making model with design strategies employed by experienced designers. The relationship between the decision-making activities proposed by the model and the eight design strategies identified by an empirical study of design work...... that designers in practice do not rely solely on methods to support their decision-making process, but also on the use of relevant design strategies....

  11. Basic thinking patterns of decision-making in engineering design

    DEFF Research Database (Denmark)

    Hansen, Claus Thorp; Andreasen, Mogens Myrup

    2000-01-01

    stakeholders have to be reflected in the product design specifications, and decision-making during the design process becomes both a search for the best design solution and a navigation towards a feasible and efficient process. Thus, the decisions made during the design process have a critical impact both...... on the design solution obtained, but also on the design process in itself. In this paper we will propose a model of these interrelated decision activities, we will outline a mindset for decision-making, and we will discuss decision-making methodologies found in literature and current approaches seen in practice....... The structure of the paper is the following. In section 2 we discuss related work. In section 3 we propose a decision-making model, and in section 4 we outline a mindset for decision-making. In section 5 decision-making strategies are briefly discussed. The paper finishes with conclusions....

  12. Decision Making Processes for Global Product Development - a Case Study

    DEFF Research Database (Denmark)

    Søndergaard, Erik Stefan; Ahmed-Kristensen, Saeema

    2015-01-01

    to investigate how decisions are made and which information decisions are based on. The study found that decision making is not always structured, and that prioritised decision making is more dominant than planned decision making. The findings set the stage for further analysis of decision making in GPD......Global Product Development (GPD), outsourcing and offshoring of product development is a widespread phenomenon on today’s global economy, and consequently most engineering manufacturing companies will have to make decisions regarding how to organise their product development activities globally....... This paper investigates decision making in the GPD context, partly by summarizing existing literatures and studies in the field, and partly through a case study of decision making processes in a global engineering company. Through interviews a range of GPD decisions were mapped and analysed in order...

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

    CERN Document Server

    Pedrycz, Witold

    2014-01-01

    The volume delivers a wealth of effective methods to deal with various types of uncertainty inherently existing in human-centric decision problems. It elaborates on  comprehensive decision frameworks to handle different decision scenarios, which help use effectively the explicit and tacit knowledge and intuition, model perceptions and preferences in a more human-oriented style. The book presents original approaches and delivers new results on fundamentals and applications related to human-centered decision making approaches to business, economics and social systems. Individual chapters cover multi-criteria (multiattribute) decision making, decision making with prospect theory, decision making with incomplete probabilistic information, granular models of decision making and decision making realized with the use of non-additive measures. New emerging decision theories being presented as along with a wide spectrum of ongoing research make the book valuable to all interested in the field of advanced decision-mak...

  14. Decision-Making for Supply Chain Integration Supply Chain Integration

    CERN Document Server

    Lettice, Fiona; Durowoju, Olatunde

    2012-01-01

    Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management.  Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...

  15. Considering Risk and Resilience in Decision-Making

    Science.gov (United States)

    Torres-Pomales, Wilfredo

    2015-01-01

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

  16. Family patterns of decision-making in pediatric clinical trials.

    Science.gov (United States)

    Snethen, Julia A; Broome, Marion E; Knafl, Kathleen; Deatrick, Janet A; Angst, Denise B

    2006-06-01

    The decision-making process related to a child's participation in clinical trials often involves multiple family members. The aim of this study was to compare family patterns of decision-making within and across family units in pediatric clinical trials. Participants for this secondary analysis included 14 families from a larger study of informed consent. Four distinct patterns of decision-making were identified: Exclusionary, informative, collaborative, and delegated. These patterns varied with regard to three dimensions of parents' decision-making goals, child level of involvement, and the parental role. These patterns of decision-making affect how parents and children communicate with health professionals and influence the effectiveness of health care providers interactions with the family related to the decision-making process.

  17. Dual worth trade-off method and its application for solving multiple criteria decision making problems

    Institute of Scientific and Technical Information of China (English)

    Feng Junwen

    2006-01-01

    To overcome the limitations of the traditional surrogate worth trade-off (SWT) method and solve the multiple criteria decision making problem more efficiently and interactively, a new method labeled dual worth trade-off (DWT) method is proposed. The DWT method dynamically uses the duality theory related to the multiple criteria decision making problem and analytic hierarchy process technique to obtain the decision maker's solution preference information and finally find the satisfactory compromise solution of the decision maker. Through the interactive process between the analyst and the decision maker, trade-off information is solicited and treated properly, the representative subset of efficient solutions and the satisfactory solution to the problem are found. The implementation procedure for the DWT method is presented. The effectiveness and applicability of the DWT method are shown by a practical case study in the field of production scheduling.

  18. Efficient algorithms for collaborative decision making for large scale settings

    DEFF Research Database (Denmark)

    Assent, Ira

    2011-01-01

    Collaborative decision making is a successful approach in settings where data analysis and querying can be done interactively. In large scale systems with huge data volumes or many users, collaboration is often hindered by impractical runtimes. Existing work on improving collaboration focuses...... to bring about more effective and more efficient retrieval systems that support the users' decision making process. We sketch promising research directions for more efficient algorithms for collaborative decision making, especially for large scale systems....

  19. THE ALGORITHM OF ICT-OUTSOURCING DECISION MAKING IN SME

    OpenAIRE

    2012-01-01

    The goal of the present paper is to carry out a research of algorithms for ICT-outsourcing decision making. The analysis of the existing algorithms and frameworks for ICT-outsourcing decision making proves that they cannot be used in Russian small and medium enterprises. Based on the analysis of strong and weak points of existing algorithms a new algorithm for ICT-outsourcing decision making in SME is proposed. Some recommendations for successful implementation of the algorithm are provided.

  20. The impact of health and financial literacy on decision making in community-based older adults.

    Science.gov (United States)

    James, Bryan D; Boyle, Patricia A; Bennett, Jarred S; Bennett, David A

    2012-01-01

    Health and financial literacy have been linked to the health and well-being of older adults, yet there are few data on how health and financial literacy actually impact decision making regarding healthcare and economic choices in advanced age. To examine the association of health and financial literacy with decision making in older adults. Data came from 525 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Health and financial literacy were assessed via a series of questions designed to measure comprehension of health and financial information and concepts. The two scores were averaged to yield a total literacy score. A modified, 12-item version of the Decision-Making Competence Assessment Tool was used to measure financial and healthcare decision making (6 items each), using materials designed to approximate those used in real world settings. All 12 items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex and education. Secondary models adjusted for global cognitive function, income, depression and chronic medical conditions. On average, participants correctly answered 67% of the literacy questions (health literacy = 61.6%, SD = 18.8% and financial literacy = 72.5%, SD = 16.0%). After adjustment for cognitive function, the total literacy score was positively associated with the decision-making total score (estimate = 0.64, SE = 0.08, p making (estimate = 0.28, SE = 0.05, p making in models adjusted for covariates including income, depression, and chronic medical conditions (all p values making was stronger among older persons, poorer persons and persons at the lower ranges of cognitive ability. Among community based older persons without dementia, higher levels of health and financial literacy were associated with better decision making, suggesting that improvements in literacy could facilitate better

  1. To the question of decision making in physical rehabilitation

    Directory of Open Access Journals (Sweden)

    Andrii Hertsyk

    2015-04-01

    Full Text Available Purpose: searching for a solution of the problem of coordination in a complex hierarchical systems, and study of the mechanism of decision making in physical rehabilitation. Material and Methods: modern approaches to the management of complex hierarchical systems were reviewed; the job descriptions of a physician and instructor of physical therapy were analyzed. Results: centers and stages of decision making in physical rehabilitation were defined by decomposition method, ways to improve coordination in decision making were suggested. Conclusions: the mechanism of decision making in physical rehabilitation requires improvement.

  2. Mental fatigue impairs soccer-specific decision-making skill.

    Science.gov (United States)

    Smith, Mitchell R; Zeuwts, Linus; Lenoir, Matthieu; Hens, Nathalie; De Jong, Laura M S; Coutts, Aaron J

    2016-07-01

    This study aimed to investigate the impact of mental fatigue on soccer-specific decision-making. Twelve well-trained male soccer players performed a soccer-specific decision-making task on two occasions, separated by at least 72 h. The decision-making task was preceded in a randomised order by 30 min of the Stroop task (mental fatigue) or 30 min of reading from magazines (control). Subjective ratings of mental fatigue were measured before and after treatment, and mental effort (referring to treatment) and motivation (referring to the decision-making task) were measured after treatment. Performance on the soccer-specific decision-making task was assessed using response accuracy and time. Visual search behaviour was also assessed throughout the decision-making task. Subjective ratings of mental fatigue and effort were almost certainly higher following the Stroop task compared to the magazines. Motivation for the upcoming decision-making task was possibly higher following the Stroop task. Decision-making accuracy was very likely lower and response time likely higher in the mental fatigue condition. Mental fatigue had unclear effects on most visual search behaviour variables. The results suggest that mental fatigue impairs accuracy and speed of soccer-specific decision-making. These impairments are not likely related to changes in visual search behaviour.

  3. The physician's professional role in end-of-life decision-making: voices of racially and ethnically diverse physicians.

    Science.gov (United States)

    Braun, Ursula K; Ford, Marvella E; Beyth, Rebecca J; McCullough, Laurence B

    2010-07-01

    Previous studies have shown racial/ethnic differences in preferences for end-of-life (EOL) care. We aimed to describe values and beliefs guiding physicians' EOL decision-making and explore the relationship between physicians' race/ethnicity and their decision-making. Seven focus groups (3 Caucasian, 2 African American, 2 Hispanic) with internists and subspecialists (n=26) were conducted. Investigators independently analyzed transcripts, assigned codes, compared findings, reconciled differences, and developed themes. Four themes appeared to transcend physicians' race/ethnicity: (1) strong support for the physician's role; (2) responding to "unreasonable" requests; (3) organizational factors; and (4) physician training and comfort with discussing EOL care. Five themes physicians seemed to manage differently based on race/ethnicity: (1) preventing and reducing the burden of surrogate decision-making; (2) responding to requests for "doing everything;" (3) influence of physician-patient racial/ethnic concordance/discordance; (4) cultural differences concerning truth-telling; and (5) spirituality and religious beliefs. Physicians in our multi-racial/ethnic sample emphasized their commitment to their professional role in EOL decision-making. Implicitly invoking the professional virtue of self-effacement, they were able to identify racially/ethnically common and diverse ethical challenges of EOL decision-making. Physicians should use professional virtues to tailor the EOL decision-making process in response to patients' race/ethnicity, based on patients' preferences. Published by Elsevier Ireland Ltd.

  4. FINANCIAL INDICATORS IN MANAGERIAL DECISION-MAKING

    Directory of Open Access Journals (Sweden)

    Fenyves Veronika

    2014-07-01

    financial year, we need (monthly or quarterly data and the introduction of a proper accounting information system for the managers to continuously receive those processed data that are essential for decision making, and to receive information about the performance of their department. This study’s aim is to show the difference between the consequences of company liquidity results using only year-end data and when liquidity indicators are being adjusted on a monthly basis

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

    Science.gov (United States)

    Flaming, Susan C.

    2007-12-01

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

  6. Thoracolumbar spine trauma: Evaluation and surgical decision-making

    Directory of Open Access Journals (Sweden)

    Andrei F Joaquim

    2013-01-01

    Full Text Available Introduction: Thoracolumbar spine trauma is the most common site of spinal cord injury, with clinical and epidemiological importance. Materials and Methods: We performed a comprehensive literature review on the management and treatment of TLST. Results: Currently, computed tomography is frequently used as the primary diagnostic test in TLST, with magnetic resonance imaging used in addition to assess disc, ligamentous, and neurological injury. The Thoracolumbar Injury Classification System is a new injury severity score created to help the decision-making process between conservative versus surgical treatment. When decision for surgery is made, early procedures are feasible, safe, can improve outcomes, and reduce healthcare costs. Surgical treatment is individualized based on the injury characteristics and surgeon′s experience, as there is no evidence-based for the superiority of one technique over the other. Conclusions: The correct management of TLST involves multiple steps, such as a precise diagnosis, classification, and treatment. The TLICS can improve care and communication between spine surgeons, resulting in a more standardized treatment.

  7. A qualitative metasynthesis: family involvement in decision making for people with dementia in residential aged care.

    Science.gov (United States)

    Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

    2014-06-01

    Involving people in decisions about their care is good practice and ensures optimal outcomes. Despite considerable research, in practice family involvement in decision making can be challenging for both care staff and families. The aim of this review was to identify and appraise existing knowledge about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute meta-synthesis considered studies that investigate involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this article presents the qualitative findings. A comprehensive search of studies was conducted in 15 electronic databases. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as relevant for this review; 16 were qualitative papers reporting on 15 studies. Two independent reviewers assessed the studies for methodological validity and extracted the data using the standardized Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). The findings were synthesized using JBI-QARI. The findings related to the decisions encountered and made by family surrogates, family perceptions of, and preferences for, their role/s, factors regarding treatment decisions and the collaborative decision-making process, and outcomes for family decision makers. Results indicate varied and complex experiences and multiple factors influencing decision making. Communication and contacts between staff and families and the support available for families should be addressed, as well as the role of different stakeholders in decisions.

  8. Practice standards for quality clinical decision-making in nursing.

    Science.gov (United States)

    Arries, E

    2006-03-01

    The purpose of this study is to formulate practice standards for quality clinical decision-making in nursing. Clinical decision-making is a critical component of nursing practice, as the life of the patient is at stake. The quality of clinical decision-making is, therefore, essential in delivering quality nursing care. The facilitation of quality clinical decision-making in nursing requires the development of standards to monitor, evaluate and implement remedial actions that improve on the quality of clinical decision-making (Muller, 2002:203; Beyea & Nicoll, 1999: 495). However, there are no such practice standards against which the quality of clinical decision-making by nurses can be evaluated and assessed. A qualitative, explorative, descriptive and standard formulation research design (Mouton & Marais, 1990:45-46; Muller, 1990:49-55) has been followed to develop standards for quality clinical decision-making in nursing. Standard development was based on the principles described by Muller (in Booyens, 1998: 607-608; 636-637), and consists of development and quantification phases that are modified to meet the requirements for instrument development, as described by Lynn (1986: 382-385). The formulation of these practice-standards was derived deductively from a conceptual framework. The conceptual framework was constructed based on an exploration and description of the expectations of the stakeholders about quality clinical decision-making in nursing and a literature study on clinical decision-making. To ensure the credibility of the standards for clinical decision-making in nursing, principles of logic, prolonged engagement, triangulation, peer-group discussion, dense description, step-wise repetition and an investigative audit (Lincoln & Guba, 1985:289-331) were adhered to. Two experts were consulted to validate the standards for quality clinical decision-making in nursing.

  9. Frequencies of decision making and monitoring in adaptive resource management

    Science.gov (United States)

    Williams, Byron K.; Johnson, Fred A.

    2017-01-01

    Adaptive management involves learning-oriented decision making in the presence of uncertainty about the responses of a resource system to management. It is implemented through an iterative sequence of decision making, monitoring and assessment of system responses, and incorporating what is learned into future decision making. Decision making at each point is informed by a value or objective function, for example total harvest anticipated over some time frame. The value function expresses the value associated with decisions, and it is influenced by system status as updated through monitoring. Often, decision making follows shortly after a monitoring event. However, it is certainly possible for the cadence of decision making to differ from that of monitoring. In this paper we consider different combinations of annual and biennial decision making, along with annual and biennial monitoring. With biennial decision making decisions are changed only every other year; with biennial monitoring field data are collected only every other year. Different cadences of decision making combine with annual and biennial monitoring to define 4 scenarios. Under each scenario we describe optimal valuations for active and passive adaptive decision making. We highlight patterns in valuation among scenarios, depending on the occurrence of monitoring and decision making events. Differences between years are tied to the fact that every other year a new decision can be made no matter what the scenario, and state information is available to inform that decision. In the subsequent year, however, in 3 of the 4 scenarios either a decision is repeated or monitoring does not occur (or both). There are substantive differences in optimal values among the scenarios, as well as the optimal policies producing those values. Especially noteworthy is the influence of monitoring cadence on valuation in some years. We highlight patterns in policy and valuation among the scenarios, and discuss management

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

    Directory of Open Access Journals (Sweden)

    Eroğlu Başak

    2016-01-01

    Full Text Available The aim of this study is to examine the self-esteem in decision making and decision-making styles of orienteering athletes in terms of different variables. 157 male and 43 female orienteering athletes, making a total of 200 athletes that joined the 3rd Level of Turkey Championship in 2015 have participated in this study which is in a survey model. The data collection tools were the Melbourne Decision-making. Quastionnaire I-II and the Personal Information Form which were adapted into Turkish by Deniz (2004. In the data analysis, descriptive statics, anova, t test and Tukey test have been utilized. There is a significant difference between athletes’ marital status, age groups, experiences in orienteering sports and self-esteem in decision making, decision making styles (p<0.05. According to the research results, it has been determined that married orienteering athletes prefer both self-esteem in decision making and vigilance decision-making style more often than the single athletes that mostly prefer procrastination decision-making style. Also, it has been found out that as the athletes’ age and experiences in sports increase, selfesteem and decision-making styles are affected more positively as well.

  11. Nurses' decision-making in cases of physical restraint: a synthesis of qualitative evidence.

    Science.gov (United States)

    Goethals, Sabine; Dierckx de Casterlé, Bernadette; Gastmans, Chris

    2012-06-01

      This article is a report of a review that aimed to synthesize the available qualitative evidence on nurses' decision-making in cases of physical restraint.   The use of physical restraint in acute and residential healthcare facilities is a widespread practice in many countries. Decisions about the use of physical restraints are complex and ethically laden. The lack of evidence supporting the use of physical restraints, the negative consequences of restraint for patients, and the low availability of alternatives obviously complicate the decision-making.   Research papers published between January 1990 and January 2010 were identified in Cinahl, Embase, Medline, PsycInfo and Web of Science.   A systematic review was carried out to obtain a meta-synthesis of qualitative evidence. The process of meta-synthesis was supported by the Joanna Briggs Institute's guidelines.   The decision-making of nurses dealing with the use of physical restraints is a complex trajectory primarily focused on safety. However, thoughtful decision-making requires nurses to carefully balance different options and associated ethical values. The decision-making process of nurses is influenced by both nurse- and context-related factors.   This review provides a deeper understanding of nurses' decision-making process on the use of physical restraints. Context- and nurse-related factors can hinder nurses from making an ethical decision on the appropriate use of physical restraints. There is an urgent need to stimulate and educate nurses to arrive at an appropriate decision about the use of physical restraints. © 2011 Blackwell Publishing Ltd.

  12. Patchy ‘coherence’: using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC)

    Science.gov (United States)

    2013-01-01

    Background Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals’ perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. Methods The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign (‘Ask 3 Questions’); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. Results A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: ‘coherence,’ ‘cognitive participation,’ ‘collective action,’ and ‘reflexive monitoring.’ Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose (‘coherence’). Shared

  13. Patchy 'coherence': using normalization process theory to evaluate a multi-faceted shared decision making implementation program (MAGIC).

    Science.gov (United States)

    Lloyd, Amy; Joseph-Williams, Natalie; Edwards, Adrian; Rix, Andrew; Elwyn, Glyn

    2013-09-05

    Implementing shared decision making into routine practice is proving difficult, despite considerable interest from policy-makers, and is far more complex than merely making decision support interventions available to patients. Few have reported successful implementation beyond research studies. MAking Good Decisions In Collaboration (MAGIC) is a multi-faceted implementation program, commissioned by The Health Foundation (UK), to examine how best to put shared decision making into routine practice. In this paper, we investigate healthcare professionals' perspectives on implementing shared decision making during the MAGIC program, to examine the work required to implement shared decision making and to inform future efforts. The MAGIC program approached implementation of shared decision making by initiating a range of interventions including: providing workshops; facilitating development of brief decision support tools (Option Grids); initiating a patient activation campaign ('Ask 3 Questions'); gathering feedback using Decision Quality Measures; providing clinical leads meetings, learning events, and feedback sessions; and obtaining executive board level support. At 9 and 15 months (May and November 2011), two rounds of semi-structured interviews were conducted with healthcare professionals in three secondary care teams to explore views on the impact of these interventions. Interview data were coded by two reviewers using a framework derived from the Normalization Process Theory. A total of 54 interviews were completed with 31 healthcare professionals. Partial implementation of shared decision making could be explained using the four components of the Normalization Process Theory: 'coherence,' 'cognitive participation,' 'collective action,' and 'reflexive monitoring.' Shared decision making was integrated into routine practice when clinical teams shared coherent views of role and purpose ('coherence'). Shared decision making was facilitated when teams engaged in

  14. Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India

    DEFF Research Database (Denmark)

    Tanderup, Malene; Reddy, Sunita; Patel, Tulsi

    2015-01-01

    As a neo-liberal economy, India has become one of the new health tourism destinations, with Commercial gestational surrogacy as an expanding market. Yet the Indian Assisted Reproductive Technology (ART) Bill has been pending for five years, and the guidelines issued by the Indian Council of Medical......, doctors were willing to go to the greatest extent possible in their medical practice. Autonomy and decision-making regarding choice of the number of embryos to transfer and the mode of delivery lay neither with commissioning parents nor surrogate mothers but mostly with doctors. In order to ensure higher...

  15. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'

    Directory of Open Access Journals (Sweden)

    Amorin-Woods Lyndon G

    2012-03-01

    Full Text Available Abstract Background A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. Discussion This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Summary Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  16. Clinical decision-making to facilitate appropriate patient management in chiropractic practice: 'the 3-questions model'.

    Science.gov (United States)

    Amorin-Woods, Lyndon G; Parkin-Smith, Gregory F

    2012-03-14

    A definitive diagnosis in chiropractic clinical practice is frequently elusive, yet decisions around management are still necessary. Often, a clinical impression is made after the exclusion of serious illness or injury, and care provided within the context of diagnostic uncertainty. Rather than focussing on labelling the condition, the clinician may choose to develop a defendable management plan since the response to treatment often clarifies the diagnosis. This paper explores the concept and elements of defensive problem-solving practice, with a view to developing a model of agile, pragmatic decision-making amenable to real-world application. A theoretical framework that reflects the elements of this approach will be offered in order to validate the potential of a so called '3-Questions Model'; Clinical decision-making is considered to be a key characteristic of any modern healthcare practitioner. It is, thus, prudent for chiropractors to re-visit the concept of defensible practice with a view to facilitate capable clinical decision-making and competent patient examination skills. In turn, the perception of competence and trustworthiness of chiropractors within the wider healthcare community helps integration of chiropractic services into broader healthcare settings.

  17. Counselling and medical decision-making in the era of personalised medicine a practice-oriented guide

    CERN Document Server

    Sanchini, Virginia

    2016-01-01

    This book offers an overview of the main questions arising when biomedical decision-making intersects ethical decision-making. It reports on two ethical decision-making methodologies, one addressing the patients, the other physicians. It shows how patients’ autonomous choices can be empowered by increasing awareness of ethical deliberation, and at the same time it supports healthcare professionals in developing an ethical sensitivity, which they can apply in their daily practice. The book highlights the importance and relevance of practicing bioethics in the age of personalized medicine. It presents concrete cases studies dealing with cancer and genetic diseases, where difficult decisions need to be made by all the parties involved: patients, physicians and families. Decisions concern not only diagnostic procedures and treatments, but also moral values, religious beliefs and ways of seeing life and death, thus adding further layers of complexity to biomedical decision-making. This book, which is strongly ro...

  18. High School Students' Career-Related Decision-Making Difficulties.

    Science.gov (United States)

    Gati, Itamar; Saka, Noa

    2001-01-01

    Examines the construct of career-related decision-making difficulties among 1,843 Israeli adolescents. Three versions of the Career Decision-Making Difficulties Questionnaire (CDDQ) were constructed to match three decision situations. The structures of the revised CDDQ were found similar to that proposed by I. Gati et al. (1996). Boys reported…

  19. A Taxonomy of Difficulties in Career Decision Making.

    Science.gov (United States)

    Gati, Itamar; And Others

    1996-01-01

    Examines a taxonomy of career decision-making difficulties. A questionnaire was administered to 563 young adults at the beginning of their career decision-making process. The relations among the 10 scales, which represent 10 theoretical categories of difficulties, and those among the items within 2 selected categories, were similar in the 2…

  20. Counseling Individuals Who Experience Career Decision-Making Difficulties.

    Science.gov (United States)

    Stewart, John

    1995-01-01

    Career decision making is a process that continues throughout the life span. But the process can be impeded by lack of occupational exploration, vocational indecision, and lack of realism in vocational choice. Each obstacle is examined and intervention strategies to assist in decision making are proposed. (Author)

  1. Factors that Influence Career Decision-Making among Elite Athletes

    Science.gov (United States)

    Fogarty, Gerard J.; McGregor-Bayne, Heather

    2008-01-01

    A common belief about elite athletes is that they invest so much effort into the pursuit of their athletic careers that they fail to develop good career decision-making skills. Recent findings challenge that belief. The present study investigated career decision-making difficulties among 117 elite Australian athletes. Participants completed…

  2. Factors Influencing Career Decision Making in Adolescents and Adults.

    Science.gov (United States)

    Albion, Majella J.; Fogarty, Gerard J.

    2002-01-01

    In separate studies, 121 high school students and 127 adults completed the Career Decision-Making Difficulties Questionnaire. Its multidimensional structure was confirmed and the model of career decision making fit both groups. The adults reported fewer difficulties on all subscales. (Contains 60 references.) (SK)

  3. The Effectiveness of a Career Decision-Making Course

    Science.gov (United States)

    Fouad, Nadya; Cotter, Elizabeth W.; Kantamneni, Neeta

    2009-01-01

    This study examined the effectiveness of a college career course designed to increase career decision-making confidence and facilitate career exploration. Participants were 73 students from a large Midwestern university (65.6% women, 34.4% men, mean age 18.56). Students were given questionnaires assessing career decision-making difficulties,…

  4. Time Perspective and Career Decision-Making Difficulties in Adults

    Science.gov (United States)

    Taber, Brian J.

    2013-01-01

    Decision making is not only contingent upon what takes place in the present but also on how one feels about the past and one's hopes for the future. However, when it comes to time perspective and career decision making, vocational psychology has focused exclusively on future time perspective. The present study examines the relations among past,…

  5. Agreement and disagreement in family decision-making

    NARCIS (Netherlands)

    Bronner, F.; de Hoog, R.

    2008-01-01

    In the last 20 years changes have taken place which have altered the decision-making process in families—family democracy is clearly in the ascendant. The family has evolved into what business research calls a decision-making unit. This general trend probably also has consequences for holiday

  6. The decision-making process between rationality and emotions

    NARCIS (Netherlands)

    Alvino, Letizia; Franco, Massimo

    2017-01-01

    The decision-making process has been analyzed in several disciplines (economics, social sciences, humanities, etc.) with the aim of creating models to help decision-makers in strategy formulation. The Organizational theory takes into account both the decision-making process of individuals and groups

  7. Agreement and disagreement in family vacation decision making.

    NARCIS (Netherlands)

    Bronner, Fred; de Hoog, Robert

    2008-01-01

    In the last 20 years changes have taken place which have altered the decision-making process in families—family democracy is clearly in the ascendant. The family has evolved into what business research calls a decision-making unit. This general trend probably also has consequences for holiday

  8. A decision-making model for engineering designers

    DEFF Research Database (Denmark)

    Ahmed, S.; Hansen, Claus Thorp

    2002-01-01

    This paper describes research that combines the generic decision-making model of Hansen, together with design strategies employed by experienced engineering designers. The relationship between the six decision-making sub-activities and the eight design strategies are examined. By combining...

  9. Study on Concept of Centralization and Decentralization Group Decision Making

    Institute of Scientific and Technical Information of China (English)

    ZHANG Qin-sheng; XI You-min; WANG Ying-luo

    2002-01-01

    The paper extracts the concept of Centralization Group Decision Making (CGDM) and Decentralization Group Decision Making (DGDM) from management systems on bases of studies on Informational Centralization Process (ICP) and Informational Decentralization Process (IDP), then the similarities and differences between CGDM and DGDM are presented. Further, the taxonomy of CGDM and DGDM is researched.

  10. Data-Based Decision Making 2.0

    Science.gov (United States)

    Protheroe, Nancy

    2011-01-01

    The phrase "data-based decision making" has been used so often in discussions about school improvement efforts that it has become almost a mantra. However, it's "how" data is used that really provides the critical link between practice and school improvement. "Data-Based Decision Making 2.0" is designed to help principals take on the role of…

  11. Collective Decision Making in the Social Context of Science.

    Science.gov (United States)

    Aikenhead, Glen S.

    1985-01-01

    Addresses the meaning of decision making on societal issues related to science/technology and explores practical implications for secondary science teaching. Cases on marijuana, abortion, and public inquiries are included together with discussion of collective decision making at the global, strategic, personal, and scientific community levels. A…

  12. Assessing Decision Making in Young Adult Romantic Relationships

    Science.gov (United States)

    Vennum, Amber; Fincham, Frank D.

    2011-01-01

    Romantic relationships among young adults are rich with ambiguity and without a clear, universal progression emphasizing the need for active decision making. Lack of active decision making in romantic relationships can lead to increases in constraints (e.g. pregnancy, shared living space or finances) that promote the continuation of relationships…

  13. Decision Making Activities for the Grade 9 English Curriculum.

    Science.gov (United States)

    Allen, Barbara; And Others

    In order to incorporate the elements of personal decision making directly into a ninth grade English curriculum, the decision making lessons presented in this paper were written for literature commonly taught in junior high schools. The paper suggests activities for the following works: "Romeo and Juliet,""Flowers for Algernon,""The Martian…

  14. Impaired decision-making and brain shrinkage in alcoholism.

    Science.gov (United States)

    Le Berre, A-P; Rauchs, G; La Joie, R; Mézenge, F; Boudehent, C; Vabret, F; Segobin, S; Viader, F; Allain, P; Eustache, F; Pitel, A-L; Beaunieux, H

    2014-03-01

    Alcohol-dependent individuals usually favor instant gratification of alcohol use and ignore its long-term negative consequences, reflecting impaired decision-making. According to the somatic marker hypothesis, decision-making abilities are subtended by an extended brain network. As chronic alcohol consumption is known to be associated with brain shrinkage in this network, the present study investigated relationships between brain shrinkage and decision-making impairments in alcohol-dependent individuals early in abstinence using voxel-based morphometry. Thirty patients performed the Iowa Gambling Task and underwent a magnetic resonance imaging investigation (1.5T). Decision-making performances and brain data were compared with those of age-matched healthy controls. In the alcoholic group, a multiple regression analysis was conducted with two predictors (gray matter [GM] volume and decision-making measure) and two covariates (number of withdrawals and duration of alcoholism). Compared with controls, alcoholics had impaired decision-making and widespread reduced gray matter volume, especially in regions involved in decision-making. The regression analysis revealed links between high GM volume in the ventromedial prefrontal cortex, dorsal anterior cingulate cortex and right hippocampal formation, and high decision-making scores (Palcoholism may result from impairment of both emotional and cognitive networks.

  15. Late Career Decision-Making: A Qualitative Panel Study

    NARCIS (Netherlands)

    Furunes, Trude; Mykletun, Reidar; Solem, Per Erik; Lange, Annet de; Syse, Astri; Schaufeli, Wilmar; Ilmarinen, Juhani

    2015-01-01

    The aim of this longitudinal qualitative interview study (3 waves of interviews) was to examine the nature of older workers’ late career decision-making processes, including the main drivers and obstacles for prolonging working life or retiring. Late career decision-making is regarded as a process o

  16. Feminism and Psychological Autonomy: A Study in Decision-Making.

    Science.gov (United States)

    Sacks, Susan R.; Eisenstein, Hester

    Women seeking to realize the feminist goal of autonomy, defined as self-interested decision-making, encounter conflict and anxiety. This study reports a group experience, using life-space drawings and force-field analyses to reduce anxiety and foster autonomous decision-making. Of the 15 women participants in the year-long study, 100% reported at…

  17. Emerging paradigms of cognition in medical decision-making.

    Science.gov (United States)

    Patel, Vimla L; Kaufman, David R; Arocha, Jose F

    2002-02-01

    The limitations of the classical or traditional paradigm of decision research are increasingly apparent, even though there has been a substantial body of empirical research on medical decision-making over the past 40 years. As decision-support technology continues to proliferate in medical settings, it is imperative that "basic science" decision research develop a broader-based and more valid foundation for the study of medical decision-making as it occurs in the natural setting. This paper critically reviews both traditional and recent approaches to medical decision making, considering the integration of problem-solving and decision-making research paradigms, the role of conceptual knowledge in decision-making, and the emerging paradigm of naturalistic decision-making. We also provide an examination of technology-mediated decision-making. Expanding the scope of decision research will better enable us to understand optimal decision processes, suitable coping mechanisms under suboptimal conditions, the development of expertise in decision-making, and ways in which decision-support technology can successfully mediate decision processes.

  18. Swift and Smart Decision Making: Heuristics that Work

    Science.gov (United States)

    Hoy, Wayne K.; Tarter, C. J.

    2010-01-01

    Purpose: The aim of this paper is to examine the research literature on decision making and identify and develop a set of heuristics that work for school decision makers. Design/methodology/approach: This analysis is a synthesis of the research on decision-making heuristics that work. Findings: A set of nine rules for swift and smart decision…

  19. Teaching Empathy and Ethical Decision Making in Business Schools

    Science.gov (United States)

    Baker, Diane F.

    2017-01-01

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

  20. Clinical decision-making: physicians' preferences and experiences

    Directory of Open Access Journals (Sweden)

    White Martha

    2007-03-01

    Full Text Available Abstract Background Shared decision-making has been advocated; however there are relatively few studies on physician preferences for, and experiences of, different styles of clinical decision-making as most research has focused on patient preferences and experiences. The objectives of this study were to determine 1 physician preferences for different styles of clinical decision-making; 2 styles of clinical decision-making physicians perceive themselves as practicing; and 3 the congruence between preferred and perceived style. In addition we sought to determine physician perceptions of the availability of time in visits, and their role in encouraging patients to look for health information. Methods Cross-sectional survey of a nationally representative sample of U.S. physicians. Results 1,050 (53% response rate physicians responded to the survey. Of these, 780 (75% preferred to share decision-making with their patients, 142 (14% preferred paternalism, and 118 (11% preferred consumerism. 87% of physicians perceived themselves as practicing their preferred style. Physicians who preferred their patients to play an active role in decision-making were more likely to report encouraging patients to look for information, and to report having enough time in visits. Conclusion Physicians tend to perceive themselves as practicing their preferred role in clinical decision-making. The direction of the association cannot be inferred from these data; however, we suggest that interventions aimed at promoting shared decision-making need to target physicians as well as patients.

  1. An Ethical Decision-Making Framework for Community College Administrators

    Science.gov (United States)

    Oliver, Diane E.; Hioco, Barbara

    2012-01-01

    The purpose of this article is to describe a decision-making framework developed for use by community college administrators and higher education faculty members who teach graduate courses in community college administration or leadership. The rationale for developing a decision-making approach that integrates ethics and critical thinking was…

  2. Discretion in Student Discipline: Insight into Elementary Principals' Decision Making

    Science.gov (United States)

    Findlay, Nora M.

    2015-01-01

    Little research exists that examines the exercise of discretion by principals in their disciplinary decision making. This study sought to understand the application of values by principals as they engage in student disciplinary decision making within legally fixed parameters of their administrative discretion. This qualitative methodology used…

  3. Agreement and disagreement in family decision-making

    NARCIS (Netherlands)

    Bronner, F.; de Hoog, R.

    2008-01-01

    In the last 20 years changes have taken place which have altered the decision-making process in families—family democracy is clearly in the ascendant. The family has evolved into what business research calls a decision-making unit. This general trend probably also has consequences for holiday decisi

  4. Agreement and disagreement in family vacation decision-making

    NARCIS (Netherlands)

    Bronner, Fred; Hoog, de Robert

    2008-01-01

    In the last 20 years changes have taken place which have altered the decision-making process in families—family democracy is clearly in the ascendant. The family has evolved into what business research calls a decision-making unit. This general trend probably also has consequences for holiday decisi

  5. Pedagogical Decision Making through the Lens of Teacher Preparation Program

    Science.gov (United States)

    Prachagool, Veena; Nuangchalerm, Prasart; Subramaniam, Ganakumaran; Dostal, Jirí

    2016-01-01

    Pedagogical decision making is very important for professional teachers, it concerns belief, self-efficacy, and actions that teachers expose to classroom. This paper employed theoretical lens and education policy in Thailand to examine the preservice teachers' views about pedagogical decision making. Discussion helps school mentors understand…

  6. George Williams in Thailand: An Ethical Decision-Making Exercise

    Science.gov (United States)

    James, Constance R.; Smith, J. Goosby

    2007-01-01

    This article presents a classroom ethical decision-making exercise designed to help students make reasoned ethical decisions while gaining insight into their own and others' ethical decision-making strategies. During the exercise, students individually analyze an original mini-case, then meet in small groups to reach consensus on the advice and…

  7. An Instructional System for Consumer Decision-Making: Teacher's Manual.

    Science.gov (United States)

    Suchman, J. Richard; DiSario, Martha R.

    An instructional system is presented for building the competencies of adult basic education students in making consumer decisions, and offers a guide to teachers who wish to design their own decision-making problems for students. The first four chapters provide a brief introduction, discuss the rational consumer decision-making process and the…

  8. Factors that Influence Career Decision-Making among Elite Athletes

    Science.gov (United States)

    Fogarty, Gerard J.; McGregor-Bayne, Heather

    2008-01-01

    A common belief about elite athletes is that they invest so much effort into the pursuit of their athletic careers that they fail to develop good career decision-making skills. Recent findings challenge that belief. The present study investigated career decision-making difficulties among 117 elite Australian athletes. Participants completed…

  9. Decision-Making Styles and Vocational Maturity: An Alternative Perspective.

    Science.gov (United States)

    Blustein, David L.

    1987-01-01

    Examined the relationship between decision-making styles and vocational maturity with a focus on the current discrepancy between research and theory regarding the utility of rational decision making. Results were consistent across 177 community college students, in that a reliance upon the rational style was the only significant decision-making…

  10. Decision-Making Involvement of Individuals with Dementia

    Science.gov (United States)

    Menne, Heather L.; Whitlatch, Carol J.

    2007-01-01

    Purpose: Research underscores how autonomy and decision-making involvement may help to enhance the quality of life of older adults; however, individuals with dementia are often excluded from decision making that is related to their daily functioning. In this study we use a modified version of the Stress Process Model to consider the stress process…

  11. Passionate Rationalism: The Role of Emotion in Decision Making

    Science.gov (United States)

    Lakomski, Gabriele; Evers, Colin W.

    2010-01-01

    Purpose: The purpose of this paper is to argue that emotion has a central role to play in rational decision making based on recent research in the neuroanatomy of emotion. As a result, traditional rational decision-making theories, including Herbert Simon's modified model of satisficing that sharply demarcates emotions and values from rationality…

  12. Passionate Rationalism: The Role of Emotion in Decision Making

    Science.gov (United States)

    Lakomski, Gabriele; Evers, Colin W.

    2010-01-01

    Purpose: The purpose of this paper is to argue that emotion has a central role to play in rational decision making based on recent research in the neuroanatomy of emotion. As a result, traditional rational decision-making theories, including Herbert Simon's modified model of satisficing that sharply demarcates emotions and values from rationality…

  13. Decision Making Style and Career Indecision in College Students.

    Science.gov (United States)

    Osipow, Samuel H.; Reed, Robin

    1985-01-01

    To examine the process of career indecision, 203 college stuents were given the Career Decision Scale, and the Johnson Decision Making Inventory. Results indicate that one of the Johnson types is associated with a higher degree of career indecision. Spontaneous external decision making types scored highest on the Career Decision Scale, followed by…

  14. Studying Collective Human Decision Making and Creativity with Evolutionary Computation

    OpenAIRE

    Sayama, Hiroki; Dionne, Shelley D.

    2014-01-01

    We report a summary of our interdisciplinary research project "Evolutionary Perspective on Collective Decision Making" that was conducted through close collaboration between computational, organizational and social scientists at Binghamton University. We redefined collective human decision making and creativity as evolution of ecologies of ideas, where populations of ideas evolve via continual applications of evolutionary operators such as reproduction, recombination, mutation, selection, and...

  15. BUSINESS DECISION MAKING ON FINANCING OPERATING ACTIVITIES IN HOTEL INDUSTRY

    Directory of Open Access Journals (Sweden)

    Filip Djokovic

    2013-07-01

    Full Text Available Outputs of management process related to decision making and the implementation of decisions of the business. Business decision-making, in the widest sense of the time aspect, it can be seen from the operational and strategic character. In this paper, the focus is on analyzing leverage and rate of return the operational decision-making in the hotel as a function of current financing activities. Operational decision-making, must be aligned with strategic, so that all segments of the operational decision-making found appropriate and meaningful implementation. Decisions in practice, in most cases, can not be considered independently, because each of them implies the use of properties, human, financial, information technology and other related capabilities.

  16. Self-organization in complex systems as decision making

    CERN Document Server

    Yukalov, V I

    2014-01-01

    The idea is advanced that self-organization in complex systems can be treated as decision making (as it is performed by humans) and, vice versa, decision making is nothing but a kind of self-organization in the decision maker nervous systems. A mathematical formulation is suggested based on the definition of probabilities of system states, whose particular cases characterize the probabilities of structures, patterns, scenarios, or prospects. In this general framework, it is shown that the mathematical structures of self-organization and of decision making are identical. This makes it clear how self-organization can be seen as an endogenous decision making process and, reciprocally, decision making occurs via an endogenous self-organization. The approach is illustrated by phase transitions in large statistical systems, crossovers in small statistical systems, evolutions and revolutions in social and biological systems, structural self-organization in dynamical systems, and by the probabilistic formulation of c...

  17. Defining decision making strategies in software ecosystem governance

    DEFF Research Database (Denmark)

    Manikas, Konstantinos; Wnuk, Krzysztof; Shollo, Arisa

    studies touch upon the decision making of software ecosystem governance. In this paper, we propose decomposing software ecosystem governance into three activities: input or data collection, decision making, and applying actions. We focus on the decision making activity of software ecosystem governance......Making the right decisions is an essential part of software ecosystem governance. Decisions related to the governance of a software ecosystem can influence the health of the ecosystem and can result in fostering the success or greatly contributing to the failure of the ecosystem. However, very few...... and review related literature consisted of software ecosystem governance, organizational decision making, and IT governance. Based on the identified studies, we propose a framework for defining the decision making strategies in the governance of software ecosystems. We identify five decision areas...

  18. Game theory and neural basis of social decision making.

    Science.gov (United States)

    Lee, Daeyeol

    2008-04-01

    Decision making in a social group has two distinguishing features. First, humans and other animals routinely alter their behavior in response to changes in their physical and social environment. As a result, the outcomes of decisions that depend on the behavior of multiple decision makers are difficult to predict and require highly adaptive decision-making strategies. Second, decision makers may have preferences regarding consequences to other individuals and therefore choose their actions to improve or reduce the well-being of others. Many neurobiological studies have exploited game theory to probe the neural basis of decision making and suggested that these features of social decision making might be reflected in the functions of brain areas involved in reward evaluation and reinforcement learning. Molecular genetic studies have also begun to identify genetic mechanisms for personal traits related to reinforcement learning and complex social decision making, further illuminating the biological basis of social behavior.

  19. Effect of regulating anger and sadness on decision-making.

    Science.gov (United States)

    Szasz, Paul Lucian; Hofmann, Stefan G; Heilman, Renata M; Curtiss, Joshua

    2016-11-01

    The aim of the current study was to investigate the effects of reappraisal, acceptance, and rumination for regulating anger and sadness on decision-making. Participants (N = 165) were asked to recall two autobiographical events in which they felt intense anger and sadness, respectively. Participants were then instructed to reappraise, accept, ruminate, or not use any strategies to regulate their feelings of anger and sadness. Following this manipulation, risk aversion, and decision-making strategies were measured using a computer-based measure of risk-taking and a simulated real-life decision-making task. Participants who were instructed to reappraise their emotions showed the least anger and sadness, the most adaptive decision-making strategies, but the least risk aversion as compared to the participants in the other conditions. These findings suggest that emotion regulation strategies of negative affective states have an immediate effect on decision-making and risk-taking behaviors.

  20. Dissociation of decision making under ambiguity and decision making under risk: a neurocognitive endophenotype candidate for obsessive-compulsive disorder.

    Science.gov (United States)

    Zhang, Long; Dong, Yi; Ji, Yifu; Zhu, Chunyan; Yu, Fengqiong; Ma, Huijuan; Chen, Xingui; Wang, Kai

    2015-03-03

    Evidence in the literature suggests that executive dysfunction is regarded as an endophenotype candidate for obsessive-compulsive disorder (OCD). Decision making is an important domain of executive function. However, few studies that have investigated whether decision making is a potential endophenotype for OCD have produced inconsistent results. Differences in the findings across these studies may be attributed to several factors: different study materials, comorbidity, medication, etc. There are at least two types of decision making that differ mainly in the degree of uncertainty and how much useful information about consequences and their probabilities are provided to the decision maker: decision making under ambiguity and decision making under risk. The aim of the present study was to simultaneously examine decision making under ambiguity as assessed by the Iowa Gambling Task (IGT) and decision making under risk as measured by the Game of Dice Task (GDT) in OCD patients and their unaffected first-degree relative (UFDR) for the first time. The study analyzed 55 medication-naïve, non-depressed OCD patient probands, 55 UFDRs of the OCD patients and 55 healthy matched comparison subjects (CS) without a family history of OCD with the IGT, the GDT and a neuropsychological test battery. While the OCD patients and the UFDRs performed worse than the CS on the IGT, they were unimpaired on the GDT. Our study supports the claim that decision making under ambiguity differs from decision making under risk and suggests that dissociation of decision making under ambiguity and decision making under risk may qualify to be a neurocognitive endophenotypes for OCD. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. How Social Cognition Can Inform Social Decision Making

    Directory of Open Access Journals (Sweden)

    Victoria eLee

    2013-12-01

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

  2. Complexity in Decision Making: The Case of the Rotterdam Harbour Expansion : Connecting Decisions, Arenas and Actors in Spatial Decision Making

    NARCIS (Netherlands)

    E-H. Klijn (Erik-Hans); M.K.A. van Gils (Marcel)

    2007-01-01

    textabstractDecision making about spatial projects is very complex. Decisions to develop the Rotterdam harbour are taken in the context of a network of local, regional, national, European and international actors, both public and private. These decision-making processes exhibit a lot of complexity a

  3. Reproductive Ethics in Commercial Surrogacy: Decision-Making in IVF Clinics in New Delhi, India

    DEFF Research Database (Denmark)

    Tanderup, Malene; Reddy, Sunita; Patel, Tulsi;

    2015-01-01

    success rates, surrogates faced the risk of multiple pregnancy and fetal reduction with little information regarding the risks involved. In the globalized market of Commercial surrogacy in India, and with clinics compromising on ethics, there is an urgent need for formulation of regulative law...... Research are somewhat vague and contradictory, resulting in self-regulated practices of fertility clinics. This paper broadly looks at clinical ethics in reproduction in the practice of surrogacy and decision-making in various procedures. Through empirical research in New Delhi, the capital of India, from...... for the clinical practice and maintenance of principles of reproductive ethics in order to ensure that the interests of surrogate mothers are safeguarded....

  4. Genital surgery for disorders of sex development: implementing a shared decision-making approach.

    Science.gov (United States)

    Karkazis, Katrina; Tamar-Mattis, Anne; Kon, Alexander A

    2010-08-01

    Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear "best-choice" treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: (1) Set the stage and develop an appropriate team; (2) Establish preferences for information and roles in decision-making; (3) Perceive and address emotions; (4) Define concerns and values; (5) Identify options and present evidence; and (6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.

  5. The online community based decision making support system for mitigating biased decision making

    Science.gov (United States)

    Kang, Sunghyun; Seo, Jiwan; Choi, Seungjin; Kim, Junho; Han, Sangyong

    2016-10-01

    As the Internet technology and social media advance, various information and opinions are shared and distributed through the online communities. However, the existence of implicit and explicit bias of opinions may have a potential influence on the outcomes. Compared to the importance of mitigating biased information, the study in this field is relatively young and does not address many important issues. In this paper we propose the noble approach to mitigate the biased opinions using conventional machine learning methods. The proposed method extracts the useful features such as inclination and sentiment of the community members. They are classified based on their previous behavior, and the propensity of the members is understood. This information on each community and its members is very useful and improve the ability to make an unbiased decision. The proposed method presented in this paper is shown to have the ability to assist optimal, fair and good decision making while also reducing the influence of implicit bias.

  6. 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.

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

    Science.gov (United States)

    Sands, Natisha

    2009-08-01

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

  8. Acute stress does not affect risky monetary decision-making.

    Science.gov (United States)

    Sokol-Hessner, Peter; Raio, Candace M; Gottesman, Sarah P; Lackovic, Sandra F; Phelps, Elizabeth A

    2016-12-01

    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.

  9. How contextual issues can distort shared decision making.

    Science.gov (United States)

    Gartlehner, Gerald; Matyas, Nina

    2016-12-01

    Shared decision making in medicine has become a widely promoted approach. The goal is for patients and physicians to reach a mutual, informed decision by taking into consideration scientific evidence, clinical experience, and the patient's personal values or preferences. Shared decision making, however, is not a straightforward process. In practice, it might fall short of what it promises and might even be misused to whitewash monetary motives. In this article, which summarizes a presentation given at the 17(th) Annual Conference of the German Network Evidence-based Medicine on March 4(th), 2016 in Cologne, Germany, we discuss three contextual factors that in our opinion can have a tremendous impact on any informed decision making: 1) opinions and convictions of physicians or other clinicians; 2) uncertainty of the evidence regarding benefits and harms; 3) uncertainty of patients about their own values and preferences. But despite barriers and shortcomings, modern medicine currently does not have an alternative to shared decision making. Shared decision making has become a central theme in good quality health care because it has a strong ethical component. Advocates of shared decision making, however, must realize that not all patients prefer to participate in decision making. For those who do, however, we must ensure that shared decisions can be made in a neutral environment as free of biases and conflicts of interest as possible. Copyright © 2016. Published by Elsevier GmbH.

  10. Decision-making process of Kala Azar care: results from a qualitative study carried out in disease endemic areas of Nepal.

    Science.gov (United States)

    Adhikari, Shiva Raj; Supakankunti, Siripen; Khan, M Mahmud

    2013-07-12

    Analysis of consumer decision making in the health sector is a complex process of comparing feasible alternatives and evaluating the levels of satisfaction associated with the relevant options. This paper makes an attempt to understand how and why consumers make specific decisions, what motivates them to adopt a specific health intervention, and what features they find attractive in each of the options. The study used a descriptive-explanatory design to analyze the factors determining the choices of healthcare providers. Information was collected through focus group discussions and in-depth interviews. The results suggest that the decision making related to seeking healthcare for Kala Azar (KA) treatment is a complex, interactive process. Patients and family members follow a well-defined road map for decision making. The process of decision making starts from the recognition of healthcare needs and is then modified by a number of other factors, such as indigenous knowledge, healthcare alternatives, and available resources. Household and individual characteristics also play important roles in facilitating the process of decision making. The results from the group discussions and in-depth interviews are consistent with the idea that KA patients and family members follow the rational approach of weighing the costs against the benefits of using specific types of medical care. The process of decision making related to seeking healthcare follows a complex set of steps and many of the potential factors affect the decision making in a non-linear fashion. Our analysis suggests that it is possible to derive a generalized road map of the decision-making process starting from the recognition of healthcare needs, and then modifying it to show the influences of indigenous knowledge, healthcare alternatives, and available resources.

  11. Practice standards for quality clinical decision-making in nursing

    Directory of Open Access Journals (Sweden)

    E Arries

    2006-09-01

    Full Text Available The purpose of this study is to formulate practice standards for quality clinical decision making in nursing. Clinical decision-making is a critical component of nursing practice, as the life of the patient is at stake. The quality of clinical decision-making is, therefore, essential in delivering quality nursing care. The facilitation of quality clinical decision-making in nursing requires the development of standards to monitor, evaluate and implement remedial actions that improve on the quality of clinical decision-making (Muller, 2002:203; Beyea & Nicoll, 1999:495. However, there are no such practice standards against which the quality of clinical decision-making by nurses can be evaluated and assessed. A qualitative, explorative, descriptive and standard formulation research design (Mouton & Marais, 1990:45-46; Muller, 1990:49-55 has been followed to develop standards for quality clinical decision-making in nursing. Standard development was based on the principles described by Muller (in Booyens, 1998:607-608; 636-637, and consists of development and quantification phases that are modified to meet the requirements for instrument development, as described by Lynn (1986:382-385. The formulation of these practice-standards was derived deductively from a conceptual framework. The conceptual framework was constructed based on an exploration and description of the expectations of the stakeholders about quality clinical decisionmaking in nursing and a literature study on clinical decision-making. To ensure the credibility of the standards for clinical decision-making in nursing, principles of logic, prolonged engagement, triangulation, peer-group discussion, dense description, stepwise repetition and an investigative audit (Lincoln & Guba, 1985:289-331 were adhered to. Two experts were consulted to validate the standards for quality clinical decisionmaking in nursing.

  12. A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

    Directory of Open Access Journals (Sweden)

    Murray Mary-Anne

    2011-01-01

    Full Text Available Abstract Background Shared decision making (SDM is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care. Methods/Design We will use a qualitative case study and a quantitative survey to capture the macro, meso and micro levels of stakeholders in home care. The case study will follow the knowledge-to-action process framework to evaluate the work of an IP home care team at a Quebec City health center. Sources of data will include one-on-one interviews with patients, family caregivers or surrogates and significant others, and administrators; a focus group of home care health professionals; organizational documents; and government policies and standards. The interview guide for the interviews and the focus group will explore current practices and clinical problems addressed in home care; factors that could influence the implementation of the proposed IP approach to SDM; the face and content validity of the approach; and interventions to facilitate the implementation and evaluation of the approach. The survey will ask 300 health professionals working in home care at the health center to complete a questionnaire based on the Theory of Planned Behaviour that measures their intentions to engage in an IP approach to SDM. We will use our analysis of the individual interviews, the focus group and the survey to elaborate a toolkit for implementing an IP approach to SDM in home care. Finally, we will conduct a pilot study in Alberta to assess the transferability of our findings. Discussion We believe that developing tools to implement IP SDM in home care is essential to strengthening Canada's healthcare system and furthering

  13. Decision Making in Service Industries A Practical Approach

    CERN Document Server

    Faulin, Javier

    2012-01-01

    Providing insight and understanding of practical and methodological issues related to decision-making processes under uncertainty conditions in the service industries, this book integrates decision-making tools with real-world examples to present world-wide best practices as well as theoretical and applied strategies such as the use of hybrid and stochastic algorithms. It discusses emerging tendencies regarding decision-support systems and information systems to support decision-making in real scenarios and includes up-to-date research on how probabilistic algorithms and simulation-based appro

  14. IT portfolio decision-making in local governments

    DEFF Research Database (Denmark)

    Agger Nielsen, Jeppe; Pedersen, Keld

    2014-01-01

    IT project portfolio management (IT PPM) has evolved into a significant area of research interest, but we know little about IT PPM practices in public sector organizations. Therefore this article investigates decision-making processes in the IT PPM practices of local governments, and discusses how...... by the IT PPM literature) plays a minor role. Our account also reveals how the decision-making practices create IT portfolio problems and in some aspects is considered to have a negative impact on the outcome of e-government investments. Our analysis and previous research into decision-making allows us to argue...

  15. ACCOUNTING INFORMATION – BASIC SUPORT FOR DECISION MAKING

    Directory of Open Access Journals (Sweden)

    Nicolae Paul Virag

    2013-12-01

    Full Text Available In this work it is shown how the information provided by financial accounting information system used in the decision making process of the entities management. It also presents the implications of their use in planning and investments. Financial information are built in order to respond to the management for decision making, but also to meet the information needs of other external or internal users. In this respect it is presented the accounting information system and the qualitative features and the manner in which is built to have real value for planning, control and decision making.

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

    Science.gov (United States)

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

    2007-01-01

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

  17. Nurses’ Use of Race in Clinical Decision Making

    Science.gov (United States)

    Sellers, Sherrill L.; Moss, Melissa E.; Calzone, Kathleen; Abdallah, Khadijah E.; Jenkins, Jean F.; Bonham, Vence L.

    2017-01-01

    Purpose To examine nurses’ self-reported use of race in clinical evaluation. Design This cross-sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States. Methods Multivariate regression analysis was used to examine associations between RACE score and individual-level characteristics and beliefs in 5,733 registered nurses. Findings Analysis revealed significant relationships between RACE score and nurses’ race and ethnicity, educational level, and views on the clinical importance of patient demographic characteristics. Asian nurses reported RACE scores 1.41 points higher than White nurses (p nurses reported RACE scores 0.55 points higher than White nurses (p nurses, the baccalaureate-level nurses reported 0.69 points higher RACE scores (p nurses reported 1.63 points higher RACE scores (p nurses reported 1.77 points higher RACE scores (p nurses may be due, in part, to differential levels of racial self-awareness. A relatively linear positive relationship between level of nursing degree nursing education and use of race suggests that a stronger foundation of knowledge about genetic ancestry, population genetics and the concept “race” and genetic ancestry may increase in clinical decision making could allow nurses to more appropriately use of race in clinical care. Integrating patient demographic characteristics into clinical decisions is an important component of nursing practice. Clinical Relevance Registered nurses provide care for diverse racial and ethnic patient populations and stand on the front line of clinical care, making them essential for reducing racial and ethnic disparities in healthcare delivery. Exploring registered nurses’ individual

  18. Nurses' Use of Race in Clinical Decision Making.

    Science.gov (United States)

    Sellers, Sherrill L; Moss, Melissa E; Calzone, Kathleen; Abdallah, Khadijah E; Jenkins, Jean F; Bonham, Vence L

    2016-11-01

    To examine nurses' self-reported use of race in clinical evaluation. This cross-sectional study analyzed data collected from three separate studies using the Genetics and Genomics in Nursing Practice Survey, which includes items about use of race and genomic information in nursing practice. The Racial Attributes in Clinical Evaluation (RACE) scale was used to measure explicit clinical use of race among nurses from across the United States. Multivariate regression analysis was used to examine associations between RACE score and individual-level characteristics and beliefs in 5,733 registered nurses. Analysis revealed significant relationships between RACE score and nurses' race and ethnicity, educational level, and views on the clinical importance of patient demographic characteristics. Asian nurses reported RACE scores 1.41 points higher than White nurses (p nurses reported RACE scores 0.55 points higher than White nurses (p nurses, the baccalaureate-level nurses reported 0.69 points higher RACE scores (p nurses reported 1.63 points higher RACE scores (p nurses reported 1.77 points higher RACE scores (p nurses may be due, in part, to differential levels of racial self-awareness. A relatively linear positive relationship between level of nursing degree nursing education and use of race suggests that a stronger foundation of knowledge about genetic ancestry, population genetics and the concept "race" and genetic ancestry may increase in clinical decision making could allow nurses to more appropriately use of race in clinical care. Integrating patient demographic characteristics into clinical decisions is an important component of nursing practice. Registered nurses provide care for diverse racial and ethnic patient populations and stand on the front line of clinical care, making them essential for reducing racial and ethnic disparities in healthcare delivery. Exploring registered nurses' individual-level characteristics and clinical use of race may provide a more

  19. Multi-Objective, Auto-Optimization Modeling for Resource Allocation Decision Making in the Military Health System

    Science.gov (United States)

    2014-01-22

    mental /behavioral health , and prescriptions. TRICARE Prime enrollees are guaranteed access within time limits. Drive time to the primary care site...efficiency: concept, measurement techniques and review of hospital efficiency studies. Malaysian Journal of Public Health Medicine, 10(2), 35-43...for Resource Allocation Decision Making in the Military Health System Bastian, Nathaniel D. Center for Integrated Healthcare Delivery Systems

  20. Do interventions designed to support shared decision-making reduce health inequalities? A systematic review and meta-analysis

    NARCIS (Netherlands)

    Durand, M.A.; Carpenter, L.; Dolan, H.; Bravo, P.; Mann, M.; Bunn, F.; Elwyn, G.

    2014-01-01

    BACKGROUND: Increasing patient engagement in healthcare has become a health policy priority. However, there has been concern that promoting supported shared decision-making could increase health inequalities. OBJECTIVE: To evaluate the impact of SDM interventions on disadvantaged groups and health i