91 resultados para Supported decision-making

em BORIS: Bern Open Repository and Information System - Berna - Suiça


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Introduction Current empirical findings indicate that the efficiency of decision making (both for experts and near-experts) in simple situations is reduced under increased stress (Wilson, 2008). Explaining the phenomenon, the Attentional Control Theory (ACT, Eysenck et al., 2007) postulates an impairment of attentional processes resulting in a less efficient processing of visual information. From a practitioner’s perspective, it would be highly relevant to know whether this phenomenon can also be found in complex sport situations like in the game of football. Consequently, in the present study, decision making of football players was examined under regular vs. increased anxiety conditions. Methods 22 participants (11 experts and 11 near-experts) viewed 24 complex football situations (counterbalanced) in two anxiety conditions from the perspective of the last defender. They had to decide as fast and accurate as possible on the next action of the player in possession (options: shot on goal, dribble or pass to a designated team member) for equal numbers of trials in a near and far distance condition (based on the position of the player in possession). Anxiety was manipulated via a competitive environment, false feedback as well as ego threats. Decision time and accuracy, gaze behaviour (e.g., fixation duration on different locations) as well as state anxiety and mental effort were used as dependent variables and analysed with 2 (expertise) x 2 (distance) x 2 (anxiety) ANOVAs with repeated measures on the last two factors. Besides expertise differences, it was hypothesised that, based on ACT, increased anxiety reduces performance efficiency and impairs gaze behaviour. Results and Discussion Anxiety was manipulated successfully, indicated by higher ratings of state anxiety, F(1, 20) = 13.13, p < .01, ηp2 = .40. Besides expertise differences in decision making – experts responded faster, F(1, 20) = 11.32, p < .01, ηp2 = .36, and more accurate, F(1,20) = 23.93, p < .01, ηp2 = .55, than near-experts – decision time, F(1, 20) = 9.29, p < .01, ηp2 = .32, and mental effort, F(1, 20) = 7.33, p = .01, ηp2 = .27, increased for both groups in the high anxiety condition. This result confirms the ACT assumption that processing efficiency is reduced when being anxious. Replicating earlier findings, a significant expertise by distance interaction could be observed, F(1, 18) = 18.53, p < .01, ηp2 = .51), with experts fixating longer on the player in possession or the ball in the near distance and longer on other opponents, teammates and free space in the far distance condition. This shows that experts are able to adjust their gaze behaviour to affordances of displayed playing patterns. Additionally, a three way interaction was found, F(1, 18) = 7.37 p = .01, ηp2 = .29, revealing that experts utilised a reduced number of fixations in the far distance condition when being anxious indicating a reduced ability to pick up visual information. Since especially the visual search behaviour of experts was impaired, the ACT prediction that particularly top-down processes are affected by anxiety could be confirmed. Taken together, the results show that sports performance is negatively influenced by anxiety since longer response times, higher mental effort and inefficient visual search behaviour were observed. From a practitioner’s perspective, this finding might suggest preferring (implicit) perceptual cognitive training; however, this recommendation needs to be empirically supported in intervention studies. References: Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7, 336-353. Wilson, M. (2008). From processing efficiency to attentional control: A mechanistic account of the anxiety-performance relationship. Int. Review of Sport and Exercise Psychology, 1, 184-201.

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Assessing problems in career decision making among adolescents is important for career guidance and research. The present study is the first to investigate among Swiss adolescents the factor structure and convergent validity in relation to personality of the German-language adaptation of the My Vocational Situation Scale. Two preliminary studies (N = 217) suggested that using a 5-point Likert scale response format would increase scale reliability. The confirmatory factor analyses in the main study with two cohorts (n = 341, eighth grade; n = 303, eleventh grade) confirmed that four main factors, which assess problems with identity, decision making, information, and perceived barriers, underlie the data. The barriers factor was differentiated into aspired vocation and personal situation. Construct validity was supported by significant relationships between favorable personality characteristics (emotional stability, extraversion, agreeableness, conscientiousness, generalized self-efficacy, and internal locus of control) and fewer problems. The results suggest that the vocational identity and barriers scales can be fruitfully applied to research on and the practice of career counseling with adolescents.

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During the last 10 years several molecular markers have been established as useful tools among the armamentarium of a hematologist. As a consequence, the number of performed hematologic molecular analyses has immensely increased. Often, such tests replace or complement other laboratory methods. Molecular markers can be useful in many ways: they can serve for diagnostics, describe the prognostic profile, predict which types of drugs are indicated, and can be used for the therapeutic monitoring of the patient to indicate an adequate response or predict resistance or relapse of the disease. Many markers fulfill more than one of these aspects. Most important, however, is the right choice of analyses at the right time-points!

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The article focuses on the effects of Eastern enlargement on EU trade policy-making. On interest constellation, the article makes a case that protectionist forces have been strengthened relative to liberal forces. This slight protectionist turn is mostly witnessed in the area of anti-dumping and with respect to the Doha trade round. On preference aggregation, guided by a principal–agent framework, it is argued that the growth in the number of actors (principals and interest groups) has not constrained the role of the European Commission (agent). However, it has led to an increase in informal processes and has empowered large trading nations vis-a`-vis smaller and less ‘comitology-experienced’ member states.

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Shared Decision Making (SDM) is widely accepted as the preferred method for reaching treatment decisions in the oncology setting including those about clinical trial participation: however, there is some disagreement between researchers over the components of SDM. Specific standardized coding systems are needed to help overcome this difficulty.

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To investigate how involvement preferences of patients with breast cancer change during the treatment decision-making process and determine the impact of meeting patients' expectations on decision-making outcomes.

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INTRODUCTION: Guidelines for the treatment of patients in severe hypothermia and mainly in hypothermic cardiac arrest recommend the rewarming using the extracorporeal circulation (ECC). However,guidelines for the further in-hospital diagnostic and therapeutic approach of these patients, who often suffer from additional injuries—especially in avalanche casualties, are lacking. Lack of such algorithms may relevantly delay treatment and put patients at further risk. Together with a multidisciplinary team, the Emergency Department at the University Hospital in Bern, a level I trauma centre, created an algorithm for the in-hospital treatment of patients with hypothermic cardiac arrest. This algorithm primarily focuses on the decision-making process for the administration of ECC. THE BERNESE HYPOTHERMIA ALGORITHM: The major difference between the traditional approach, where all hypothermic patients are primarily admitted to the emergency centre, and our new algorithm is that hypothermic cardiac arrest patients without obvious signs of severe trauma are taken to the operating theatre without delay. Subsequently, the interdisciplinary team decides whether to rewarm the patient using ECC based on a standard clinical trauma assessment, serum potassium levels, core body temperature, sonographic examinations of the abdomen, pleural space, and pericardium, as well as a pelvic X-ray, if needed. During ECC, sonography is repeated and haemodynamic function as well as haemoglobin levels are regularly monitored. Standard radiological investigations according to the local multiple trauma protocol are performed only after ECC. Transfer to the intensive care unit, where mild therapeutic hypothermia is maintained for another 12 h, should not be delayed by additional X-rays for minor injuries. DISCUSSION: The presented algorithm is intended to facilitate in-hospital decision-making and shorten the door-to-reperfusion time for patients with hypothermic cardiac arrest. It was the result of intensive collaboration between different specialties and highlights the importance of high-quality teamwork for rare cases of severe accidental hypothermia. Information derived from the new International Hypothermia Registry will help to answer open questions and further optimize the algorithm.