18 resultados para Decision-processes


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Ready-to-eat (RTE) foods can be readily consumed with minimum or without any further preparation; their processing is complex—involving thorough decontamination processes— due to their composition of mixed ingredients. Compared with conventional preservation technologies, novel processing technologies can enhance the safety and quality of these complex products by reducing the risk of pathogens and/ or by preserving related health-promoting compounds. These novel technologies can be divided into two categories: thermal and non-thermal. As a non-thermal treatment, High Pressure Processing is a very promising novel methodology that can be used even in the already packaged RTE foods. A new “volumetric” microwave heating technology is an interesting cooking and decontamination method directly applied to foods. Cold Plasma technology is a potential substitute of chlorine washing in fresh vegetable decontamination. Ohmic heating is a heating method applicable to viscous products but also to meat products. Producers of RTE foods have to deal with challenging decisions starting from the ingredients suppliers to the distribution chain. They have to take into account not only the cost factor but also the benefits and food products’ safety and quality. Novel processing technologies can be a valuable yet large investment for several SME food manufacturers, but they need support data to be able to make adequate decisions. Within the FP7 Cooperation funded by the European Commission, the STARTEC project aims to develop an IT decision supporting tool to help food business operators in their risk assessment and future decision making when producing RTE foods with or without novel preservation technologies.

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Purpose: As resident work hours policies evolve, residents’ off-duty time remains poorly understood. Despite assumptions about how residents should be using their postcall, off-duty time, there is little research on how residents actually use this time and the reasoning underpinning their activities. This study sought to understand residents’ nonclinical postcall activities when they leave the hospital, their decision-making processes, and their perspectives on the relationship between these activities and their well-being or recovery.

Method: The study took place at a Liaison Committee on Medical Education–accredited Canadian medical school from 2012 to 2014. The authors recruited a purposive and convenience sample of postgraduate year 1–5 residents from six surgical and nonsurgical specialties at three hospitals affiliated with the medical school. Using a constructivist grounded theory approach, semistructured interviews were conducted, audio-taped, transcribed, anonymized, and combined with field notes. The authors analyzed interview transcripts using constant comparative analysis and performed post hoc member checking.

Results: Twenty-four residents participated. Residents characterized their predominant approach to postcall decision making as one of making trade-offs between multiple, competing, seemingly incompatible, but equally valuable, activities. Participants exhibited two different trade-off orientations: being oriented toward maintaining a normal life or toward mitigating fatigue.

Conclusions: The authors’ findings on residents’ trade-off orientations suggest a dual recovery model with postcall trade-offs motivated by the recovery of sleep or of self. This model challenges the dominant viewpoint in the current duty hours literature and suggests that the duty hours discussion must be broadened to include other recovery processes.

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Diagnostic errors are responsible for a significant number of adverse events. Logical reasoning and good decision-making skills are key factors in reducing such errors, but little emphasis has traditionally been placed on how these thought processes occur, and how errors could be minimised. In this article, we explore key cognitive ideas that underpin clinical decision making and suggest that by employing some simple strategies, physicians might be better able to understand how they make decisions and how the process might be optimised.