Brain substrates of social decision-making in dual diagnosis: cocaine dependence and personality disorders

Cocaine dependence frequently co-occurs with personality disorders, leading to increased interpersonal problems and greater burden of disease. Personality disorders are characterised by patterns of thinking and feeling that divert from social expectations. However, the comorbidity between cocaine dependence and personality disorders has not been substantiated by measures of brain activation during social decision-making. We applied functional magnetic resonance imaging to compare brain activations evoked by a social decision-making task-the Ultimatum Game-in 24 cocaine dependents with personality disorders (CDPD), 19 cocaine dependents without comorbidities and 19 healthy controls. In the Ultimatum Game participants had to accept or reject bids made by another player to split monetary stakes. Offers varied in fairness (in fair offers the proposer shares ~50 percent of the money; in unfair offers the proposer shares <30 percent of the money), and participants were told that if they accept both players get the money, and if they reject both players lose it. We contrasted brain activations during unfair versus fair offers and accept versus reject choices. During evaluation of unfair offers CDPD displayed lower activation in the insula and the anterior cingulate cortex and higher activation in the lateral orbitofrontal cortex and superior frontal and temporal gyri. Frontal activations negatively correlated with emotion recognition. During rejection of offers CDPD displayed lower activation in the anterior cingulate cortex, striatum and midbrain. Dual diagnosis is linked to hypo-activation of the insula and anterior cingulate cortex and hyper-activation of frontal-temporal regions during social decision-making, which associates with poorer emotion recognition.

Using smartphones for accountable care and evidence-based decision making in managing gestational diabetes : an Australian case study

Better managing diabetes has become a global priority, especially given the exponential increase in the number of diabetes patients and the financial implications of treating this silent epidemic. In this paper, we focus on how it might be possible to use a mobile technology solution to support and enable superior diabetes monitoring and management. To test this solution, we examined the context of gestational diabetes and adopted a non-blinded randomized control trial with two-arm cross over applied to a private hospital in Victoria, Australia. Further, we use an accountable care system as the theoretical lens and, from this, develop a conceptual framework to bridge evidence-based management with technologies. Theoretically, we unpack McCleallan, McKethan, Lewis, Roski, and Fisher’s (2010) study with our conceptual framework that comprises providers for information (evidence-based management) and technology (smartphone). We enhance Muhlestein, Croshaw, Merrill, Pena, and James’ (2013) accountable care paradigm with three concepts: 1) quality of life, 2) evidence-based management, and 3) affordable care. From the perspective of practice, far-reaching implications have arisen particularly for hospital management pertaining to the cost and quality of care issues. In particular, it appears that adapting mobile technology solutions such as smartphones to support various aspects of care and patient-clinician interactions is a prudent choice to minimize costs and yet provide highquality care.

Assumptions of decision-making capacity: the role supporter attitudes play in the realisation of Article 12 for people with severe or profound intellectual disability

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) was the first legally binding instrument explicitly focused on how human rights apply to people with disability. Amongst their obligations, consistent with the social model of disability, the Convention requires signatory nations to recognise that “…persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” and mandates signatory nations to develop “…appropriate measures to provide access by persons with disability to the support they may require in exercising their legal capacity”. The Convention promotes supported decision-making as one such measure. Although Australia ratified the UNCRPD in 2008, it retains an interpretative declaration in relation to Article 12 (2, 3, 4), allowing for the use of substituted decision-making in situations where a person is assessed as having no or limited decision-making capacity. Such an outcome is common for people with severe or profound intellectual disability because the assessments they are subjected to are focused on their cognition and generally fail to take into account the interdependent nature of human decision-making. This paper argues that Australia’s interpretative declaration is not in the spirit of the Convention nor the social model of disability on which it is based. It starts from the premise that the intention of Article 12 is to be inclusive of all signatory nations’ citizens, including those with severe or profound cognitive disability. From this premise, arises a practical need to understand how supported decision-making can be used with this group. Drawing from evidence from an empirical study with five people with severe or profound intellectual disability, this paper provides a rare glimpse on what supported decision-making can look like for people with severe or profound intellectual disability. Additionally, it describes the importance of supporters having positive assumptions of decision-making capacity as a factor affecting supported decision-making. This commentary aims to give a focus for practice and policy efforts for ensuring people with severe or profound cognitive disability receive appropriate support in decision-making, a clear obligation of signatory nations of the UNCRPD. A focus on changing supporter attitudes rather than placing the onus of change on people with disability is consistent with the social model of disability, a key driver of the UNCRPD.

An improved consensus-based group decision making model with heterogeneous information

In group decision making (GDM) problems, it is natural for decision makers (DMs) to provide different preferences and evaluations owing to varying domain knowledge and cultural values. When the number of DMs is large, a higher degree of heterogeneity is expected, and it is difficult to translate heterogeneous information into one unified preference without loss of context. In this aspect, the current GDM models face two main challenges, i.e., handling the complexity pertaining to the unification of heterogeneous information from a large number of DMs, and providing optimal solutions based on unification methods. This paper presents a new consensus-based GDM model to manage heterogeneous information. In the new GDM model, an aggregation of individual priority (AIP)-based aggregation mechanism, which is able to employ flexible methods for deriving each DM's individual priority and to avoid information loss caused by unifying heterogeneous information, is utilized to aggregate the individual preferences. To reach a consensus more efficiently, different revision schemes are employed to reward/penalize the cooperative/non-cooperative DMs, respectively. The temporary collective opinion used to guide the revision process is derived by aggregating only those non-conflicting opinions at each round of revision. In order to measure the consensus in a robust manner, a position-based dissimilarity measure is developed. Compared with the existing GDM models, the proposed GDM model is more effective and flexible in processing heterogeneous information. It can be used to handle different types of information with different degrees of granularity. Six types of information are exemplified in this paper, i.e., ordinal, interval, fuzzy number, linguistic, intuitionistic fuzzy set, and real number. The results indicate that the position-based consensus measure is able to overcome possible distortions of the results in large-scale GDM problems.

Piloting the feasibility of head-mounted video technology to augment student feedback during simulated clinical decision-making: an observational design pilot study

BACKGROUND: Clinical decision-making is a complex activity that is critical to patient safety. Simulation, augmented by feedback, affords learners the opportunity to learn critical clinical decision-making skills. More detailed feedback following simulation exercises has the potential to further enhance student learning, particularly in relation to developing improved clinical decision-making skills. OBJECTIVE: To investigate the feasibility of head-mounted video camera recordings, to augment feedback, following acute patient deterioration simulations. DESIGN: Pilot study using an observational design. METHODS: Ten final-year nursing students participated in three simulation exercises, each focussed on detection and management of patient deterioration. Two observers collected behavioural data using an adapted version of Gaba's Clinical Simulation Tool, to provide verbal feedback to each participant, following each simulation exercise. Participants wore a head-mounted video camera during the second simulation exercise only. Video recordings were replayed to participants to augment feedback, following the second simulation exercise. Data were collected on: participant performance (observed and perceived); participant perceptions of feedback methods; and head-mounted video camera recording feasibility and capability for detailed audio-visual feedback. RESULTS: Management of patient deterioration improved for six participants (60%). Increased perceptions of confidence (70%) and competence (80%), were reported by the majority of participants. Few participants (20%) agreed that the video recording specifically enhanced their learning. The visual field of the head-mounted video camera was not always synchronised with the participant's field of vision, thus affecting the usefulness of some recordings. CONCLUSION: The usefulness of the video recordings, to enhance verbal feedback to participants on detection and management of simulated patient deterioration, was inconclusive. Modification of the video camera glasses, to improve visual-field synchronisation with participants' actual visual field, is recommended to further explore this technology for enhancing student performance.

The right to supported decision-making for people rarely heard

 This thesis explored supported decision-making for people with severe or profound intellectual disability. The findings provide guidance to supporters and policy makers to assist people with severe or profound intellectual disability to lead maximally autonomous lives, a clear obligation of Australia under the Convention on the Rights of Persons with Disabilities.

A adaptação do Melbourne Decision Making Questionnaire (MDMQ) para a área de administração no Brasil

Dissertação apresentada ao Programa de Pós-graduação em Administração - Mestrado da Universidade Municipal de São Caetano do Sul

A BDI-based approach for the assessment of driver's decision-making in commuter scenarios

The rapid growth of urban areas has a significant impact on traffic and transportation systems. New management policies and planning strategies are clearly necessary to cope with the more than ever limited capacity of existing road networks. The concept of Intelligent Transportation System (ITS) arises in this scenario; rather than attempting to increase road capacity by means of physical modifications to the infrastructure, the premise of ITS relies on the use of advanced communication and computer technologies to handle today’s traffic and transportation facilities. Influencing users’ behaviour patterns is a challenge that has stimulated much research in the ITS field, where human factors start gaining great importance to modelling, simulating, and assessing such an innovative approach. This work is aimed at using Multi-agent Systems (MAS) to represent the traffic and transportation systems in the light of the new performance measures brought about by ITS technologies. Agent features have good potentialities to represent those components of a system that are geographically and functionally distributed, such as most components in traffic and transportation. A BDI (beliefs, desires, and intentions) architecture is presented as an alternative to traditional models used to represent the driver behaviour within microscopic simulation allowing for an explicit representation of users’ mental states. Basic concepts of ITS and MAS are presented, as well as some application examples related to the subject. This has motivated the extension of an existing microscopic simulation framework to incorporate MAS features to enhance the representation of drivers. This way demand is generated from a population of agents as the result of their decisions on route and departure time, on a daily basis. The extended simulation model that now supports the interaction of BDI driver agents was effectively implemented, and different experiments were performed to test this approach in commuter scenarios. MAS provides a process-driven approach that fosters the easy construction of modular, robust, and scalable models, characteristics that lack in former result-driven approaches. Its abstraction premises allow for a closer association between the model and its practical implementation. Uncertainty and variability are addressed in a straightforward manner, as an easier representation of humanlike behaviours within the driver structure is provided by cognitive architectures, such as the BDI approach used in this work. This way MAS extends microscopic simulation of traffic to better address the complexity inherent in ITS technologies.

An essay about the effect of vague accounting standards on the decision making process of auditors

Vague words and expressions are present throughout the standards that comprise the accounting and auditing professions. Vagueness is considered to be a significant source of inexactness in many accounting decision problems and many authors have argued that the neglect of this issue may cause accounting information to be less useful. On the other hand, we can assume that the use of vague terms in accounting standards is inherent to principle based standards (different from rule based standards) and that to avoid vague terms, standard setters would have to incur excessive transaction costs. Auditors are required to exercise their own professional judgment throughout the audit process and it has been argued that the inherent vagueness in accounting standards may influence their decision making processes. The main objective of this paper is to analyze the decision making process of auditors and to investigate whether vague accounting standards create a problem for the decision making process of auditors, or lead to a better outcome. This paper makes the argument that vague standards prompt the use of System 2 type processing by auditors, allowing more comprehensive analytical thinking; therefore, reducing the biases associated with System 1 heuristic processing. If our argument is valid, the repercussions of vague accounting standards are not as negative as presented in previous literature, instead they are positive.

Decision making naturalized: the interweaving of the unconscious, the emotional and the rational in decisions taken in a contigent world

Dadas as limitações e inadequações presentes, tanto no arquétipo do tomador de decisão como um agente racional, adotado nas teorias econômicas e gerenciais, quanto no estereótipo de um ser transcendental, tão presente na vida prosaica, se faz necessário substituí-los por uma nova perspectiva: onde o tomador de decisão é um animal emocional, frágil diante do acaso, e fruto de um processo evolutivo.

The influence of urban structures on entrepreneurial decision-making: a comparative analysis of Mexico City and São Paulo

Promover a atividade empreendedora é hoje mais do que nunca uma prioridade para as economias em desenvolvimento. Em diferentes partes do mundo, empreendedores têm sido reconhecidos como verdadeiros agentes de transformação, e as novas empresas que eles criam tornam-se condutoras de inovação, que ao final pode ser difundida ao resto da economia. Teorias de economia urbana, que analisam a dinâmica da relação entre aglomeração urbana e atividade econômica, enfatizam a importância da concentração espacial das indústrias num mesmo setor industrial. Entender os incentivos que dão início à atividade empreendedora é algo novo e o foco desses estudos tem sido principalmente em alguns poucos casos de economias industrializadas. Não obstante, o sucesso de um punhado de clusters de alta tecnologia, como o Vale do Silício, por exemplo, na Califórnia, Estados Unidos, não pode ser replicado, e as condições locais devem ser consideradas a fim de entender a surgimento desses ecossistemas. Este estudo pretende investigar os critérios em que os empreendedores fundamentam suas decisões quando selecionam as localizações do seu negócio. Especificamente, a pesquisa explora o recente movimento dos ecossistemas de empreendedores na Cidade do México e em São Paulo, as duas maiores áreas metropolitanas da América Latina, à luz das teorias de economia urbana. A fim de chegar aos resultados, a pesquisa segue o método baseado sobre uma análise comparativa de estudo de casos em dois bairros: Vila Leopoldina em São Paulo e a Colônia Roma Norte na Cidade do México. Os resultados consolidados baseados em entrevistas qualitativas realizadas nos dois bairros revelam que o lugar/sitio urbano, definido em termos de laços locais assim como da atmosfera geral do ambiente, continua sendo importante para os atores apesar das comunicações de alta velocidade que produzem mais interações entre as regiões do mundo. Além disso, a relação entre o empreendedor e o seu entorno é altamente dependente do estágio de desenvolvimento e da natureza da atividade da empresa; redes informais revelam-se essenciais para identificar as oportunidades de negócio antes de serem progressivamente substituídas por relações instituídas com fundos de capital de risco ou incubadoras. Estes dois ecossistemas nascentes geram suas próprias características, o que já pode sugerir suas futuras evoluções.

How national culture on consumers' decision-making styles: a comparative study among Americans, Brazilians, Chinese, and japanese in the purchase of cell phones.

The influence of the national culture on consumer decision-making styles is investigated using a sample of Americans, Brazilians, Chinese, and Japanese consumers who have purchased a cell phone in the past three years. To make the research possible, a survey was used as a method of data collection. It relates Hofstede’s cultural classification typology with Sproles and Kendall’s consumer style inventory (CSI). The multivariate analysis of variance (MANOVA) results indicate six decision-making styles together with other consumer behavioral characteristics that can be used to distinguish and profile consumers who purchase cell phones. Empirical findings reveal that among Americans, Brazilians, and Japanese; Americans are the most quality conscious, brand conscious, innovative, and hedonistic shoppers; Brazilians are the most loyal, and Japanese, the most confused by overchoice consumers. Conceptual contributions and managerial implications are discussed.