The role of muscarinic cholinergic signaling in cost-benefit decision making

Thesis (Ph.D.)--University of Washington, 2016-08

Exercise Prescription for Patients with Non-specific Chronic Low Back Pain: a Qualitative Study of Patients' Experiences in Decision Making

Background The culture of current clinical practice calls for collaboration between therapists and patients, sharing power and responsibility. This paper reports on the findings of a qualitative study of exercise prescription for patients with NSCLBP, taking into account issues such as decision making and how this accords with patient preferences and experiences. Objective To understand the treatment decision making experiences, information and decision support needs of patients with NSCLBP who have been offered exercise as part of their management plan. Design A qualitative study using a philosophical hermeneutic approach. Methods Semi-structured interviews with eight patients (including use of brief patient vignettes) was undertaken to explore their personal experiences of receiving exercise as part of the management of their NSCLBP, and their involvement in decisions regarding their care. Findings The findings provide a detailed insight into patients’ perceptions and experiences of receiving exercise-based management strategies. Four themes were formed from the texts: (1) patients’ expectations and patients’ needs are not synonymous, (2) information is necessary but often not sufficient, (3) not all decisions need to be shared, and (4) wanting to be treated as an individual. Conclusions Shared decision making did not appear to happen in physiotherapy clinical practice, but equally may not be what every patient wants. The overall feeling of the patients was that the therapist was dominant in structuring the interactions, leaving the patients feeling disempowered to question and contribute to the decision making.

Analysis on the connotation of probability in the artificial intelligence algorithm for economic decision making.

This paper analyzes the inner relations between classical sub-scheme probability and statistic probability, subjective probability and objective probability, prior probability and posterior probability, transition probability and probability of utility, and further analysis the goal, method, and its practical economic purpose which represent by these various probability from the perspective of mathematics, so as to deeply understand there connotation and its relation with economic decision making, thus will pave the route for scientific predication and decision making.

Structured decision making as a tool for facilitating stakeholder engagement in non-renewable resource management: using the case study of hydraulic fracturing in the Green Point Shale formation in western Newfoundland

This thesis examines the importance of effective stakeholder engagement that complies with the doctrines of social justice in non-renewable resources management decision-making. It uses hydraulic fracturing in the Green Point Shale Formation in Western Newfoundland as a case study. The thesis uses as theoretical background John Rawls’ and David Miller’ theory of social justice, and identifies the social justice principles, which are relevant to stakeholder engagement. The thesis compares the method of stakeholder engagement employed by the Newfoundland and Labrador Hydraulic Fracturing Review Panel (NLHFRP), with the stakeholder engagement techniques recommended by the Structured Decision Making (SDM) model, as applied to a simulated case study involving hydraulic fracturing in the Green Point Shale Formation. Using the already identified social justice principles, the thesis then developed a framework to measure the level of compliance of both stakeholder engagement techniques with social justice principles. The main finding of the thesis is that the engagement techniques prescribed by the SDM model comply more closely with the doctrines of social justice than the engagement techniques applied by the NLHFRP. The thesis concludes by recommending that the SDM model be more widely used in non- renewable resource management decision making in order to ensure that all stakeholders’ concerns are effectively heard, understood and transparently incorporated in the nonrenewable resource policies to make them consistent with local priorities and goals, and with the social justice norms and institutions.

Effect of Aging in the Perception of Health-Related Quality of Life in End-Stage Renal Disease Patients under Online-Hemodiafiltration

This work aimed to evaluate how aging could influence patients' perception of health quality of life (HRQOL), as well as, the effect of aging on dialysis adequacy and in hematological, iron status, inflammatory and nutritional markers. In this transversal study were enrolled 305 ESRD patients under online-hemodiafiltration (OL-HDF) (59.67% males; 64.9 ± 14.3 years old). Data about comorbidities, hematological data, iron status, dialysis adequacy, nutritional and inflammatory markers were collected from patient's records. Moreover, HRQOL score, by using the Kidney Disease Quality of Life-Short Form (KDQOL-SF), was assessed. Analyzing the results according to quartiles of age, significant differences were found for some parameters evaluated by the KDQOL-SF instrument, namely for work status, physical functioning and role-physical, which decreased with increasing age. We also found a higher proportion of diabetic patients, a decrease in creatinine, iron, albumin serum levels, transferrin saturation and nPCR, with increasing age. Moreover, significant negative correlations were found between age and mean cell hemoglobin concentration, iron, transferrin saturation, albumin, nPCR, work status, physical functioning and role-physical. In conclusion, our results showed that aging is associated with a decreased work status, physical functioning and role-physical, with a decreased dialysis adequacy, iron availability and nutritional status, and with an increased proportion of diabetic patients and of patients using central venous catheter, as the vascular access. The knowledge of these changes associated with aging, which have impact in the quality of life of the patients, could be useful in their management.

Neural representations of social and non-social uncertainty in human decision making

The social landscape is filled with an intricate web of species-specific desired objects and course of actions. Humans are highly social animals and, as they navigate this landscape, they need to produce adapted decision-making behaviour. Traditionally social and non-social neural mechanisms affecting choice have been investigated using different approaches. Recently, in an effort to unite these findings, two main theories have been proposed to explain how the brain might encode social and non-social motivational decision-making: the extended common currency and the social valuation specific schema (Ruff & Fehr 2014). One way to test these theories is to directly compare neural activity related to social and non-social decision outcomes within the same experimental setting. Here we address this issue by focusing on the neural substrates of social and non-social forms of uncertainty. Using functional magnetic resonance imaging (fMRI) we directly compared the neural representations of reward and risk prediction and errors (RePE and RiPE) in social and non- social situations using gambling games. We used a trust betting game to vary uncertainty along a social dimension (trustworthiness), and a card game (Preuschoff et al. 2006) to vary uncertainty along a non-social dimension (pure risk). The trust game was designed to maintain the same structure of the card game. In a first study, we exposed a divide between subcortical and cortical regions when comparing the way these regions process social and non-social forms of uncertainty during outcome anticipation. Activity in subcortical regions reflected social and non-social RePE, while activity in cortical regions correlated with social RePE and non-social RiPE. The second study focused on outcome delivery and integrated the concept of RiPE in non-social settings with that of fairness and monetary utility maximisation in social settings. In particular these results corroborate recent models of anterior insula function (Singer et al. 2009; Seth 2013), and expose a possible neural mechanism that weights fairness and uncertainty but not monetary utility. The third study focused on functionally defined regions of the early visual cortex (V1) showing how activity in these areas, traditionally considered only visual, might reflect motivational prediction errors in addition to known perceptual prediction mechanisms (den Ouden et al 2012). On the whole, while our results do not support unilaterally one or the other theory modeling the underlying neural dynamics of social and non-social forms of decision making, they provide a working framework where both general mechanisms might coexist.

Effects of spoken cues on decision-making in netball: An eye movement study

Thirteen international netballers viewed static images of scenarios taken from netball open play. Two ‘team mates’, each marked by one opponent, could be seen in each image; each team mate-opponent pair was located on opposite sides of the vertical meridian, such that a binary response was required (‘left’ or ‘right’) from the participant, in order to select a team mate to whom they would pass the ball. For each trial, a spoken word (“left”/“right”) was presented monaurally at the onset of the visual image. Spatially invalid auditory cues (i.e., in the ear contralateral to the correct passing option), reduced performance accuracy relative to valid ones. Semantically invalid cues (e.g., a call of “left” when the target was right-located), increased response times relative to valid ones. However, there were no accompanying changes in visual attention to the team mates and their markers. The effects of auditory cues on covert attentional shifts and decision-making are discussed.

Twelve Certain Men: The Impact of Emotional Appraisals on Juror Decision-Making

Our jury system is predicated upon the expectation that jurors engage in systematic processing when considering evidence and making decisions. They are instructed to interpret facts and apply the appropriate law in a fair, dispassionate manner, free of all bias, including that of emotion. However, emotions containing an element of certainty (e.g., anger and happiness, which require little cognitive effort in determining their source) can often lead people to engage in superficial, heuristic-based processing. Compare this to uncertain emotions (e.g., hope and fear, which require people to seek out explanations for their emotional arousal), which instead has the potential to lead them to engage in deeper, more systematic processing. The purpose of the current research is in part to confirm past research (Tiedens & Linton, 2001; Semmler & Brewer, 2002) that uncertain emotions (like fear) can influence decision-making towards a more systematic style of processing, whereas more certain emotional states (like anger) will lead to a more heuristic style of processing. Studies One, Two, and Three build upon this prior research with the goal of improving methodological rigor through the use of film clips to reliably induce emotions, with awareness of testimonial details serving as measures of processing style. The ultimate objective of the current research was to explore this effect in Study Four by inducing either fear, anger, or neutral emotion in mock jurors, half of whom then followed along with a trial transcript featuring eight testimonial inconsistencies, while the other participants followed along with an error-free version of the same transcript. Overall rates of detection for these inconsistencies was expected to be higher for the uncertain/fearful participants due to their more effortful processing compared to certain/angry participants. These expectations were not fulfilled, with significant main effects only for the transcript version (with or without inconsistencies) on overall inconsistency detection rates. There are a number of plausible explanations for these results, so further investigation is needed.

New perspectives on A.I. in sentencing. Human decision-making between risk assessment tools and protection of humans rights.

The aim of this thesis is to investigate a field that until a few years ago was foreign to and distant from the penal system. The purpose of this undertaking is to account for the role that technology could plays in the Italian Criminal Law system. More specifically, this thesis attempts to scrutinize a very intricate phase of adjudication. After deciding on the type of an individual's liability, a judge must decide on the severity of the penalty. This type of decision implies a prognostic assessment that looks to the future. It is precisely in this field and in prognostic assessments that, as has already been anticipated in the United, instruments and processes are inserted in the pre-trial but also in the decision-making phase. In this contribution, we attempt to describe the current state of this field, trying, as a matter of method, to select the most relevant or most used tools. Using comparative and qualitative methods, the uses of some of these instruments in the supranational legal system are analyzed. Focusing attention on the Italian system, an attempt was made to investigate the nature of the element of an individual's ‘social dangerousness’ (pericolosità sociale) and capacity to commit offences, types of assessments that are fundamental in our system because they are part of various types of decisions, including the choice of the best sanctioning treatment. It was decided to turn our attention to this latter field because it is believed that the judge does not always have the time, the means and the ability to assess all the elements of a subject and identify the best 'individualizing' treatment in order to fully realize the function of Article 27, paragraph 3 of the Constitution.

Circumplex Model to analyze the impact of emotions on decision-making processes in innovation management

Group work allows participants to pool their thoughts and examine difficulties from several angles. In these settings, it is possible to attempt things that an individual could not achieve, combining a variety of abilities and knowledge to tackle more complicated and large-scale challenges. That’s why nowadays collaborative work is becoming more and more widespread to solve complex innovation dilemmas. Since innovation isn’t a tangible thing, most innovation teams used to take decisions based on performance KPIs such as forecasted engagement, projected profitability, investments required, cultural impacts etc. Have you ever wondered the reason why sometimes innovation group processes come out with decisions which are not the optimal meeting point of all the KPIs? Has this decision been influenced by other factors? Some researchers account part of this phenomenon to the emotions in group-based interaction between participants. I will develop a literature review that is split into three parts: first, I will consider some emotions theories from an individual perspective; secondly, a wider view of collective interactions theories will be provided; lastly, I will supply some recent collective interaction empirical studies. After the theoretical and empirical gaps have been tackled, the study will additionally move forward with a methodological point of view, about the Circumplex Model, which is the model I used to evaluate emotions in my research. This model has been applied to SUGAR project, which is the biggest design thinking academy worldwide.

Information from managing information systems as a fundamental element to support decision-making in hospitals

This article deals with the activity of defining information of hospital systems as fundamental for choosing the type of information systems to be used and also the organizational level to be supported. The use of hospital managing information systems improves the user`s decision -making process by allowing control report generation and following up the procedures made in the hospital as well.

The Outcomes of Visualization and Acupuncture on the Quality of Life of Adult Cancer Patients Receiving Chemotherapy

Background: The use of complementary and alternative medicine (CAM) to treat cancer patients has increased around the world, and its benefits have been described. These therapies represent an important theme in oncology and have been used in parallel with conventional therapies. Objective: This study aimed to assess the outcomes of using relaxation with visualization and acupuncture on the quality of life of cancer patients undergoing chemotherapy treatment and to compare these outcomes with patients who did not choose to receive the intervention. Methods: Participants chose to be in either the intervention group (IG) or control group (CG). They completed the Quality of Life Questionnaire-Core 30 at the start and end of chemotherapy. The IG was chosen by 38 patients with different types of cancer who completed weekly relaxation with visualization and acupuncture sessions, whereas the CG was composed of 37 patients who did not receive the intervention. Results: Statistically significant results evidenced an increase in global health and emotional and social functions and a decrease in fatigue and loss of appetite for the IG, and an increase in global health for the CG (P <= .05). A highly significant difference was found when comparing the post-chemotherapy scores of the Quality of Life Questionnaire-Core 30 in the global health domain between the CG and the IG (P <= .001), indicating positive outcomes of the CAM intervention. Conclusion: Adults with cancer are able to choose between involvement or not with this kind of CAM intervention. Global health could be improved by participating in this type of intervention. Implications for Practice: Choosing whether to be involved may be assisted by knowing the positive outcomes for some patients.

Decision making in fuzzy environment and multicriteria power engineering problems

This paper presents results of research into the use of the Bellman-Zadeh approach to decision making in a fuzzy environment for solving multicriteria power engineering problems. The application of the approach conforms to the principle of guaranteed result and provides constructive lines in computationally effective obtaining harmonious solutions on the basis of solving associated maxmin problems. The presented results are universally applicable and are already being used to solve diverse classes of power engineering problems. It is illustrated by considering problems of power and energy shortage allocation, power system operation, optimization of network configuration in distribution systems, and energetically effective voltage control in distribution systems. (c) 2011 Elsevier Ltd. All rights reserved.