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Dynamic decision making

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https://www.readbyqxmd.com/read/28923918/continuous-track-paths-reveal-additive-evidence-integration-in-multistep-decision-making
#1
Cristian Buc Calderon, Myrtille Dewulf, Wim Gevers, Tom Verguts
Multistep decision making pervades daily life, but its underlying mechanisms remain obscure. We distinguish four prominent models of multistep decision making, namely serial stage, hierarchical evidence integration, hierarchical leaky competing accumulation (HLCA), and probabilistic evidence integration (PEI). To empirically disentangle these models, we design a two-step reward-based decision paradigm and implement it in a reaching task experiment. In a first step, participants choose between two potential upcoming choices, each associated with two rewards...
September 18, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28919539/the-nexus-between-the-documentation-of-end-of-life-wishes-and-awareness-of-dying-a-model-for-research-education-and-care
#2
Deborah P Waldrop, Jacqueline M McGinley, Brian Clemency
The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision-making into sharp focus. Communication between families and clinicians can be confusing, uncertain and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This paper presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care...
September 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916537/reversibility-of-the-effects-of-natalizumab-on-peripheral-immune-cell-dynamics-in-ms-patients
#3
Tatiana Plavina, Kumar Kandadi Muralidharan, Geoffrey Kuesters, Daniel Mikol, Karleyton Evans, Meena Subramanyam, Ivan Nestorov, Yi Chen, Qunming Dong, Pei-Ran Ho, Diogo Amarante, Alison Adams, Jerome De Sèze, Robert Fox, Ralf Gold, Douglas Jeffery, Ludwig Kappos, Xavier Montalban, Bianca Weinstock-Guttman, Hans-Peter Hartung, Bruce A C Cree
OBJECTIVE: To characterize the reversibility of natalizumab-mediated changes in pharmacokinetics/pharmacodynamics in patients with multiple sclerosis (MS) following therapy interruption. METHODS: Pharmacokinetic/pharmacodynamic data were collected in the Safety and Efficacy of Natalizumab in the Treatment of Multiple Sclerosis (AFFIRM) (every 12 weeks for 116 weeks) and Randomized Treatment Interruption of Natalizumab (RESTORE) (every 4 weeks for 28 weeks) studies...
September 15, 2017: Neurology
https://www.readbyqxmd.com/read/28915827/evaluating-the-impact-of-a-walking-program-in-a-disadvantaged-area-using-the-re-aim-framework-by-mixed-methods
#4
Camila Tiome Baba, Isabela Martins Oliveira, Adriele Evelyn Ferreira Silva, Leonardo Moreira Vieira, Natalia Caroline Cerri, Alex Antonio Florindo, Grace Angélica de Oliveira Gomes
BACKGROUND: The positive health impact of physical activity (PA) is well known, yet a large proportion of the world's population remains sedentary. General PA programs are common as health promotion initiatives. However, effectiveness evaluations of such PA programs on individual and organizational aspects, which could inform the decision-making process of public health bodies are still lacking, particularly in the most socially disadvantaged areas, where health promotion schemes are particularly needed...
September 15, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28915822/what-hinders-the-uptake-of-computerized-decision-support-systems-in-hospitals-a-qualitative-study-and-framework-for-implementation
#5
Elisa G Liberati, Francesca Ruggiero, Laura Galuppo, Mara Gorli, Marien González-Lorenzo, Marco Maraldi, Pietro Ruggieri, Hernan Polo Friz, Giuseppe Scaratti, Koren H Kwag, Roberto Vespignani, Lorenzo Moja
BACKGROUND: Advanced Computerized Decision Support Systems (CDSSs) assist clinicians in their decision-making process, generating recommendations based on up-to-date scientific evidence. Although this technology has the potential to improve the quality of patient care, its mere provision does not guarantee uptake: even where CDSSs are available, clinicians often fail to adopt their recommendations. This study examines the barriers and facilitators to the uptake of an evidence-based CDSS as perceived by diverse health professionals in hospitals at different stages of CDSS adoption...
September 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28912706/dynamic-neural-fields-with-intrinsic-plasticity
#6
Claudius Strub, Gregor Schöner, Florentin Wörgötter, Yulia Sandamirskaya
Dynamic neural fields (DNFs) are dynamical systems models that approximate the activity of large, homogeneous, and recurrently connected neural networks based on a mean field approach. Within dynamic field theory, the DNFs have been used as building blocks in architectures to model sensorimotor embedding of cognitive processes. Typically, the parameters of a DNF in an architecture are manually tuned in order to achieve a specific dynamic behavior (e.g., decision making, selection, or working memory) for a given input pattern...
2017: Frontiers in Computational Neuroscience
https://www.readbyqxmd.com/read/28911337/postings-and-transfers-in-the-ghanaian-health-system-a-study-of-health-workforce-governance
#7
Aku Kwamie, Miriam Asiamah, Marta Schaaf, Irene Akua Agyepong
BACKGROUND: Decision-making on postings and transfers - that is, the geographic deployment of the health workforce - is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28902523/functional-assessment-of-lesion-severity-without-using-the-pressure-wire-coronary-imaging-and-blood-flow-simulation
#8
Michail I Papafaklis, Michail C Mavrogiannis, Panagiotis K Siogkas, Lampros S Lakkas, Christos S Katsouras, Dimitrios I Fotiadis, Lampros K Michalis
Hemodynamic indices derived from measurements with the pressure wire (primarily fractional flow reserve [FFR]) have been established as a reliable tool for assessing coronary stenoses and improving clinical decision making. However, the use of the pressure wire constitutes a hurdle for the universal adoption of physiology-guided patient management. Technological advancements have enabled the large-scale application of blood flow simulation (computational fluid dynamics [CFD]) to medical imaging, thereby enabling the virtual assessment of coronary physiology...
September 19, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28901538/the-impact-of-fatigue-on-the-non-technical-skills-performance-of-critical-care-air-ambulance-clinicians
#9
J A Myers, D M C Powell, S Aldington, D Sim, A Psirides, K Hathaway, M F Haney
BACKGROUND: The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. METHODS: Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design)...
September 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28900625/direct-assessment-of-wall-shear-stress-by-signal-intensity-gradient-from-time-of-flight-magnetic-resonance-angiography
#10
Kap-Soo Han, Sang Hyuk Lee, Han Uk Ryu, Se-Hyoung Park, Gyung-Ho Chung, Young I Cho, Seul-Ki Jeong
The aim of the study was to calculate the arterial wall signal intensity gradient (SIG) from time-of-flight MR angiography (TOF-MRA) and represent arterial wall shear stress. We developed a new algorithm that uses signal intensity (SI) of a TOF-MRA to directly calculate the signal intensity gradient (SIG). The results from our phantom study showed that the TOF-MRA SIG could be used to distinguish the magnitude of blood flow rate as high (mean SIG ± SD, 2.2 ± 0.4 SI/mm for 12.5 ± 2.3 L/min) and low (0...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28895928/collaborative-visual-analytics-a-health-analytics-approach-to-injury-prevention
#11
Samar Al-Hajj, Brian Fisher, Jennifer Smith, Ian Pike
Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA)...
September 12, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28895218/strengthening-multipayer-collaboration-lessons-from-the-comprehensive-primary-care-initiative
#12
Grace Anglin, H A Tu, Kristie Liao, Laura Sessums, Erin Fries Taylor
Policy Points: Collaboration across payers to align financial incentives, quality measurement, and data feedback to support practice transformation is critical, but challenging due to competitive market dynamics and competing institutional priorities. The Centers for Medicare & Medicaid Services or other entities convening multipayer initiatives can build trust with other participants by clearly outlining each participant's role and the parameters of collaboration at the outset of the initiative. Multipayer collaboration can be improved if participating payers employ neutral, proactive meeting facilitators; develop formal decision-making processes; seek input on decisions from practice representatives; and champion the initiative within their organizations...
September 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/28890891/collaborative-approaches-and-policy-opportunities-for-accelerated-progress-toward-effective-disease-prevention-care-and-control-using-the-case-of-poverty-diseases-to-explore-universal-access-to-affordable-health-care
#13
Samia Laokri
BACKGROUND: There is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking. METHOD: Secondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28889975/consistent-individual-differences-drive-collective-behavior-and-group-functioning-of-schooling-fish
#14
Jolle W Jolles, Neeltje J Boogert, Vivek H Sridhar, Iain D Couzin, Andrea Manica
The ubiquity of consistent inter-individual differences in behavior ("animal personalities") [1, 2] suggests that they might play a fundamental role in driving the movements and functioning of animal groups [3, 4], including their collective decision-making, foraging performance, and predator avoidance. Despite increasing evidence that highlights their importance [5-16], we still lack a unified mechanistic framework to explain and to predict how consistent inter-individual differences may drive collective behavior...
September 1, 2017: Current Biology: CB
https://www.readbyqxmd.com/read/28888193/children-s-perception-of-action-boundaries-and-how-it-affects-their-climbing-behavior
#15
James L Croft, Gert-Jan Pepping, Chris Button, Jia-Yi Chow
There are some concerns that children today may be less calibrated to their action capabilities because of the "risk-free" culture that has proliferated during recent decades. This study investigated the extent to which judgments of reaching affordances presented in different directions (i.e., overhead, diagonal, and horizontal) are related to children's climbing behavior on a climbing wall. A sample of 30 schoolchildren from 6 to 11years old (20 boys and 10 girls) estimated maximum reach and grasp distances and subsequently attempted to climb across an indoor climbing wall...
September 6, 2017: Journal of Experimental Child Psychology
https://www.readbyqxmd.com/read/28886196/fully-coupled-fluid-structure-interaction-simulation-of-the-aortic-and-mitral-valves-in-a-realistic-3d-left-ventricle-model
#16
Wenbin Mao, Andrés Caballero, Raymond McKay, Charles Primiano, Wei Sun
In this study, we present a fully-coupled fluid-structure interaction (FSI) framework that combines smoothed particle hydrodynamics (SPH) and nonlinear finite element (FE) method to investigate the coupled aortic and mitral valves structural response and the bulk intraventricular hemodynamics in a realistic left ventricle (LV) model during the entire cardiac cycle. The FSI model incorporates valve structures that consider native asymmetric leaflet geometries, anisotropic hyperelastic material models and human material properties...
2017: PloS One
https://www.readbyqxmd.com/read/28880892/beyond-hiv-serodiscordance-partnership-communication-dynamics-that-affect-engagement-in-safer-conception-care
#17
Lynn T Matthews, Bridget F Burns, Francis Bajunirwe, Jerome Kabakyenga, Mwebesa Bwana, Courtney Ng, Jasmine Kastner, Annet Kembabazi, Naomi Sanyu, Adrine Kusasira, Jessica E Haberer, David R Bangsberg, Angela Kaida
INTRODUCTION: We explored acceptability and feasibility of safer conception methods among HIV-affected couples in Uganda. METHODS: We recruited HIV-positive men and women on antiretroviral therapy (ART) ('index') from the Uganda Antiretroviral Rural Treatment Outcomes cohort who reported an HIV-negative or unknown-serostatus partner ('partner'), HIV-serostatus disclosure to partner, and personal or partner desire for a child within two years. We conducted in-depth interviews with 40 individuals from 20 couples, using a narrative approach with tailored images to assess acceptability of five safer conception strategies: ART for the infected partner, pre-exposure prophylaxis (PrEP) for the uninfected partner, condomless sex timed to peak fertility, manual insemination, and male circumcision...
2017: PloS One
https://www.readbyqxmd.com/read/28878987/effects-of-the-distant-population-density-on-spatial-patterns-of-demographic-dynamics
#18
Kohei Tamura, Naoki Masuda
Spatio-temporal patterns of population changes within and across countries have various implications. Different geographical, demographic and econo-societal factors seem to contribute to migratory decisions made by individual inhabitants. Focusing on internal (i.e. domestic) migration, we ask whether individuals may take into account the information on the population density in distant locations to make migratory decisions. We analyse population census data in Japan recorded with a high spatial resolution (i...
August 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28876965/analyzing-decision-logs-to-understand-decision-making-in-serious-crime-investigations
#19
Coral J Dando, Thomas C Ormerod
Objective To study decision making by detectives when investigating serious crime through the examination of decision logs to explore hypothesis generation and evidence selection. Background Decision logs are used to record and justify decisions made during serious crime investigations. The complexity of investigative decision making is well documented, as are the errors associated with miscarriages of justice and inquests. The use of decision logs has not been the subject of an empirical investigation, yet they offer an important window into the nature of investigative decision making in dynamic, time-critical environments...
September 1, 2017: Human Factors
https://www.readbyqxmd.com/read/28872807/using-normalisation-process-theory-to-investigate-the-implementation-of-school-based-oral-health-promotion
#20
O J Olajide, J Shucksmith, A Maguire, F V Zohoori
Despite the considerable improvement in oral health of children in the UK over the last forty years, a significant burden of dental caries remains prevalent in some groups of children, indicating the need for more effective oral health promotion intervention (OHPI) strategies in this population. OBJECTIVE: To explore the implementation process of a community-based OHPI, in the North East of England, using Normalisation Process Theory (NPT) to provide insights on how effectiveness could be maximised...
September 2017: Community Dental Health
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