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Decision making networks

Clara Lopes Novo, Peter J Rugg-Gunn
Pluripotent cells are characterized by a globally open and accessible chromatin organization that is thought to contribute to cellular plasticity and developmental decision-making. We recently identified the pluripotency factor Nanog as a key regulator of this form of chromatin architecture in mouse embryonic stem cells. In particular, we demonstrated that the transcription factors Nanog and Sall1 co-dependently mediate the epigenetic state of pericentromeric heterochromatin to reinforce a more open and accessible organization in pluripotent cells...
October 19, 2016: Nucleus
Bhim Mani Adhikari, Martin Norgaard, Kristen M Quinn, Jenine Ampudia, Justin Squirek, Mukesh Dhamala
Musical improvisation offers an excellent experimental paradigm for the study of real-time human creativity. It involves moment-to-moment decision-making, monitoring of one's performance, and utilizing external feedback to spontaneously create new melodies or variations on a melody. Recent neuroimaging studies have begun to study the brain activity during musical improvisation, aiming to unlock the mystery of human creativity. What brain resources come together and how these are utilized during musical improvisation is not well understood...
October 18, 2016: Brain Connectivity
Jie W Weiss, Michele Mouttapa, Lola Sablan-Santos, Jasmine DeGuzman Lacsamana, Lourdes Quitugua, Sora Park Tanjasiri
This study employed a Multi-Attribute Utility (MAU) model to examine the Pap test decision-making process among Pacific Islanders (PI) residing in Southern California. A total of 585 PI women were recruited through social networks from Samoan and Tongan churches, and Chamorro family clans. A questionnaire assessed Pap test knowledge, beliefs and past behaviour. The three MAU parameters of subjective value, subjective probability and momentary salience were measured for eight anticipated consequences of having a Pap test (e...
October 15, 2016: Health Education Research
Gerard Derosiere, Alexandre Zénon, Andrea Alamia, Julie Duque
In the present study, we investigated the functional contribution of the human primary motor cortex (M1) to motor decisions. Continuous theta burst stimulation (cTBS) was used to alter M1 activity while participants performed a decision-making task in which the reward associated with the subjects' responses (right hand finger movements) depended on explicit and implicit value-based rules. Subjects performed the task over two consecutive days and cTBS occurred in the middle of Day 2, once the subjects were just about to implement implicit rules, in addition to the explicit instructions, to choose their responses, as evident in the control group (cTBS over the right somatosensory cortex)...
October 11, 2016: NeuroImage
Brydie Clarke, Boyd Swinburn, Gary Sacks
BACKGROUND: Theories of the policy process are recommended as tools to help explain both policy stasis and change. METHODS: A systematic review of the application of such theoretical frameworks within the field of obesity prevention policy was conducted. A meta-synthesis was also undertaken to identify the key influences on policy decision-making. RESULTS: The review identified 17 studies of obesity prevention policy underpinned by political science theories...
October 13, 2016: BMC Public Health
Valdester Cavalcante Pinto, Rodrigo Cardoso Cavalcante, Klébia Magalhães P Castello Branco, Candice Torres de Melo Bezerra Cavalcante, Isabel Cristina Leite Maia, Nayana Maria Gomes de Souza, Kiarelle Lourenço Penaforte, Juan Alberto Cosquillo Mejia, Waldemiro Carvalho
The perspective of the integrated health system has a network of care with multiple integration dimensions among subsystems as nuclear representation, relating the clinical aspects and governance to the representations and collective values. The normative integration aims to ensure coherence between the system of representations and values of society simultaneously with the interfaces of clinical and functional integration. It builds a bridge with governance, which allows, through their skills, management of all system components, encouraging cooperation, communication and information, in order to ensure the population under their responsibility to access excellence services, exceeding their expectations...
May 2016: Brazilian Journal of Cardiovascular Surgery
Michael Parker, Patricia Kingori
There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives...
2016: PloS One
Kai-Cheng Hsu, Feng-Sheng Wang
Model-based optimization approaches are valuable in developing new drugs for human metabolic disorders. The core objective in most optimal drug designs is positive therapeutic effects. In this study, we considered the effects of therapeutic, adverse, and target variation simultaneously. A fuzzy optimization method was applied to formulate a multiobjective drug design problem for detecting enzyme targets in the presynaptic dopamine metabolic network to remedy two types of enzymopathies caused by deficiencies of vesicular monoamine transporter 2 (VMAT2) and tyrosine hydroxylase (TH)...
2016: PloS One
Gregory P Marchildon
Regionalization is arguably the most significant health reform in Canada since medicare. Although a majority of provinces continue to have regionalized systems in Canada, the policy is more contested today than it was a decade ago. Since Ontario's implementation of local health integration networks (LHINs) in 2006 and Alberta's elimination of regional health authorities (RHAs) in favour of Alberta Health Services in 2008, Canada has had differing approaches to regionalization. However, due to the centralization of physician budgets in provincial health ministries, primary care has not been integrated into any regionalization model in Canada...
2016: HealthcarePapers
T Beament, S J Mercer
'Speaking up' or the ability to effectively challenge erroneous decisions is essential to preventing harm. This mixed-methods study in two parts explores the concept of 'barriers to challenging seniors' for anaesthetic trainees, and proposes a conceptual framework. Using a fully immersive simulation scenario with unanticipated airway difficulty, we investigated how junior anaesthetists (one to two years of training) challenged a scripted error. We also conducted focus groups with senior trainees (three to seven years of training) and undertook a 'thematic network analysis' of responses...
November 2016: Anaesthesia
Andrew M Wright, Agustin Zapata, Michael H Baumann, Joshua S Elmore, Alexander F Hoffman, Carl R Lupica
Clinical descriptions of cocaine addiction include compulsive drug seeking and maladaptive decision-making despite substantial aversive consequences. Research suggests that this may result from altered orbitofrontal cortex (OFC) function and its participation in outcome-based behavior. Clinical and animal studies also implicate serotonin in the regulation of OFC function in addiction and other neuropsychiatric disorders. Here we test the hypothesis that exposure to cocaine, through self-administration (CSA) or yoked-administration (CYA), alters the regulation of OFC function by 5-HT...
October 12, 2016: Cerebral Cortex
Tigest Shifraw, Yemane Berhane, Hanna Gulema, Tamil Kendall, Anne Austin
BACKGROUND: Facility based delivery for mothers is one of the proven interventions to reduce maternal and neonatal morbidity and mortality. This study identified women's reasons for seeking to give birth in a health facility and captured their perceptions of the quality of care they received during their most recent birth, in a population with high utilization of facility based deliveries. METHODS: This qualitative study was conducted in eight health centers in Addis Ababa...
October 12, 2016: BMC Pregnancy and Childbirth
Sarah Masefield, Pippa Powell, Carlos Jiménez-Ruiz, Peter Hajek, Keir Lewis, Stefan Andreas, Philip Tønnesen, Onno van Schayck, Christina Gratziou, Bertrand Dautzenberg, Serena Tonstad, Thomas Hering, Stephano Nardini, Monica Fletcher
This study aimed to gain insight into the impact of lung conditions on smoking behaviour and smoking cessation, and identify recommendations for smoking cessation and professional-patient communications. The study was led by the European Lung Foundation in collaboration with the European Respiratory Society Task Force on "Statement on smoking cessation on COPD and other pulmonary diseases and in smokers with comorbidities who find it difficult to quit". A web-based observational cross-sectional questionnaire was developed from a patient-centered literature review...
April 2016: ERJ Open Research
Hui Yang, Fabio Leonelli
QRS morphology is commonly used in the electrocardiographic diagnosis of ventricular depolarization such as left bundle branch block (LBBB) and ventricular septal infarction. We investigated whether pattern matching of QRS loops in the 3-dimensional vectorcardiogram (VCG) will improve the grouping of patients whose space-time electrical activity akin to each other, thereby assisting in clinical decision making. First, pattern dissimilarity of VCG QRS loops is qualitatively measured and characterized among patients, resulting in a 93×93 distance matrix of patient-to-patient dissimilarity...
September 28, 2016: Computers in Biology and Medicine
Encarni Marcos, Aldo Genovesio
When choices are made freely, they might emerge from pre-existing neural activity. However, whether neurons in the prefrontal cortex (PF) show this anticipatory effect and, if so, in which part of the process they are involved is still debated. To answer this question, we studied PF activity in monkeys while they performed a strategy task. In this task when the stimulus changed from the previous trial, the monkeys had to shift their response to one of two spatial goals, excluding the one that had been previously selected...
2016: Frontiers in Neural Circuits
Ilene L Hollin, Caroline Young, Caroline Hanson, John F P Bridges, Holly Peay
OBJECTIVES: To provide a community-engaged process to inform the design of a stated-preferences experiment. The process involved integrating patients and caregivers of people with Duchenne/Becker muscular dystrophy, advocates, clinicians, and the sponsor in conceptualizing and developing a benefit-risk survey on the basis of phase III trial results. METHODS: Our community-engagement process for the development of a stated-preference survey included a set of five guiding principles with a foundation in the principles of community-engaged research...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
David H Oh, Alya Dabbagh, James L Goodson, Peter M Strebel, Sanjita Thapa, Jagat Narain Giri, Sagar Ratna Shakya, Sudhir Khanal
In 2012, the Global Vaccine Action Plan* established a goal to achieve measles and rubella elimination in five of the six World Health Organization (WHO) regions (194 countries) by 2020 (1). Measles elimination strategies aim to achieve ≥95% coverage with 2 routine doses of measles-containing vaccine (2), and implement supplementary immunization activities (SIAs)(†) in settings where routine coverage is low or where there are subpopulations at high risk. To ensure SIA quality and to achieve ≥95% SIA coverage nationally, rapid convenience monitoring (RCM) is used during or immediately after SIAs (3,4)...
October 7, 2016: MMWR. Morbidity and Mortality Weekly Report
Maxine T Sherman, Anil K Seth, Ryota Kanai
: It is clear that prior expectations shape perceptual decision-making, yet their contribution to the construction of subjective decision confidence remains largely unexplored. We recorded fMRI data while participants made perceptual decisions and confidence judgments, manipulating perceptual prior expectations while controlling for potential confounds of attention. Results show that subjective confidence increases as expectations increasingly support the decision, and that this relationship is associated with BOLD activity in right inferior frontal gyrus (rIFG)...
October 5, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Ana Paula Jucá Silva, Patrícia Oliveira Pereira Tagliari
The present article describes the changing relationship among healthcare regulatory authorities in various international settings, with special emphasis on the Americas. As other sectors, healthcare also faces the need to regulate international practices, while at the same time taking into consideration the specific realities of each country. Regulatory convergence - a movement towards technical alignment to enable the adoption of local regulatory mechanisms that take into account internationally recognized standards and principles to promote a single sanitary goal - has emerged as a means to address this challenge...
May 2016: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
Gustavo C Oliveira, Alexandre M Valença, Talvane M de Moraes, Mauro V Mendlowicz, Miles C Forrest, Fred F Batista, Gabriella A Mendes, Tiago N Lima, Vinicius R Gonçalves, Kátia Mecler
Objectives: To evaluate factors related to dangerousness cessation at the end of involuntary commitment based on an analysis of expert reports. In light of the current legal requirement of dangerousness cessation as a pre-requisite for prison or internment release of individuals subjected to the safety measure, we sought elements to reflect on the practice of expert examiners in charge of making this decision. Methods: The authors revised 224 expert psychiatric dangerousness cessation reports released 2011 through 2014 and collected data for a statistical analysis...
September 29, 2016: Revista Brasileira de Psiquiatria
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