Referral to rehabilitation following traumatic brain injury: practitioners and the process of decision-making

The study aimed to examine the factors influencing referral to rehabilitation following traumatic brain injury (TBI) by using social problems theory as a conceptual model to focus on practitioners and the process of decision-making in two Australian hospitals. The research design involved semi-structured interviews with 18 practitioners and observations of 10 team meetings, and was part of a larger study on factors influencing referral to rehabilitation in the same settings. Analysis revealed that referral decisions were influenced primarily by practitioners' selection and their interpretation of clinical and non-clinical patient factors. Further, practitioners generally considered patient factors concurrently during an ongoing process of decision-making, with the combinations and interactions of these factors forming the basis for interpretations of problems and referral justifications. Key patient factors considered in referral decisions included functional and tracheostomy status, time since injury, age, family, place of residence and Indigenous status. However, rate and extent of progress, recovery potential, safety and burden of care, potential for independence and capacity to cope were five interpretative themes, which emerged as the justifications for referral decisions. The subsequent negotiation of referral based on patient factors was in turn shaped by the involvement of practitioners. While multi-disciplinary processes of decision-making were the norm, allied health professionals occupied a central role in referral to rehabilitation, and involvement of medical, nursing and allied health practitioners varied. Finally, the organizational pressures and resource constraints, combined with practitioners' assimilation of the broader efficiency agenda were central factors shaping referral. (C) 2004 Elsevier Ltd. All rights reserved.

The psychophysics of decision making in a two-direction random dot motion target selection task

La tâche de kinématogramme de points aléatoires est utilisée avec le paradigme de choix forcé entre deux alternatives pour étudier les prises de décisions perceptuelles. Les modèles décisionnels supposent que les indices de mouvement pour les deux alternatives sont encodés dans le cerveau. Ainsi, la différence entre ces deux signaux est accumulée jusqu’à un seuil décisionnel. Cependant, aucune étude à ce jour n’a testé cette hypothèse avec des stimuli contenant des mouvements opposés. Ce mémoire présente les résultats de deux expériences utilisant deux nouveaux stimuli avec des indices de mouvement concurrentiels. Parmi une variété de combinaisons d’indices concurrentiels, la performance des sujets dépend de la différence nette entre les deux signaux opposés. De plus, les sujets obtiennent une performance similaire avec les deux types de stimuli. Ces résultats supportent un modèle décisionnel basé sur l’accumulation des indices de mouvement net et suggèrent que le processus décisionnel peut intégrer les signaux de mouvement à partir d’une grande gamme de directions pour obtenir un percept global de mouvement.

Extreme events, organizations and the politics of decision making

Purpose – Threats of extreme events, such as terrorist attacks or infrastructure breakdown, are potentially highly disruptive events for all types of organizations. This paper seeks to take a political perspective to power in strategic decision making and how this influences planning for extreme events. Design/methodology/approach – A sample of 160 informants drawn from 135 organizations, which are part of the critical national infrastructure in the UK, forms the empirical basis of the paper. Most of these organizations had publicly placed business continuity and preparedness as a strategic priority. The paper adopts a qualitative approach, coding data from focus groups. Findings – In nearly all cases there is a pre-existing dominant coalition which keeps business continuity decisions off the strategic agenda. The only exceptions to this are a handful of organizations which provide continuous production, such as some utilities, where disruption to business as usual can be readily quantified. The data reveal structural and decisional elements of the exercise of power. Structurally, the dominant coalition centralizes control by ensuring that only a few functional interests participate in decision making. Research limitations/implications – Decisional elements of power emphasize the dominance of calculative rationality where decisions are primarily made on information and arguments which can be quantified. Finally, the paper notes the recursive aspect of power relations whereby agency and structure are mutually constitutive over time. Organizational structures of control are maintained, despite the involvement of managers charged with organizational preparedness and resilience, who remain outside the dominant coalition. Originality/value – The paper constitutes a first attempt to show how planning for emergencies fits within the strategy-making process and how politically controlled this process is.

Effect of positioning on the accuracy of decision making of association football top-class referees and assistant referees during competitive matches

The aim of this study was to examine the effect of positioning on the correctness of decision making of top-class referees and assistant referees during international games. Match analyses were carried out during the Fe´de´ration Internationale de Football Association (FIFA) Confederations Cup 2009 and 380 foul play incidents and 165 offside situations were examined. The error percentage for the referees when indicating the incidents averaged 14%. The lowest error percentage occurred in the central area of the field, where the collaboration of the assistant referee is limited, and was achieved when indicating the incidents from a distance of 11–15 m, whereas this percentage peaked (23%) in the last 15-min match period. The error rate for the assistant referees was 13%. Distance of the assistant referee to the offside line did not have an impact on the quality of the offside decision. The risk of making incorrect decisions was reduced when the assistant referees viewed the offside situations from an angle between 46 and 608. Incorrect offside decisions occurred twice as often in the second as in the first half of the games. Perceptual-cognitive training sessions specific to the requirements of the game should be implemented in the weekly schedule of football officials to reduce the overall error rate.

The Optimality of Decision Making During Motor Learning

In our daily lives, we often must predict how well we are going to perform in the future based on an evaluation of our current performance and an assessment of how much we will improve with practice. Such predictions can be used to decide whether to invest our time and energy in learning and, if we opt to invest, what rewards we may gain. This thesis investigated whether people are capable of tracking their own learning (i.e. current and future motor ability) and exploiting that information to make decisions related to task reward. In experiment one, participants performed a target aiming task under a visuomotor rotation such that they initially missed the target but gradually improved. After briefly practicing the task, they were asked to select rewards for hits and misses applied to subsequent performance in the task, where selecting a higher reward for hits came at a cost of receiving a lower reward for misses. We found that participants made decisions that were in the direction of optimal and therefore demonstrated knowledge of future task performance. In experiment two, participants learned a novel target aiming task in which they were rewarded for target hits. Every five trials, they could choose a target size which varied inversely with reward value. Although participants’ decisions deviated from optimal, a model suggested that they took into account both past performance, and predicted future performance, when making their decisions. Together, these experiments suggest that people are capable of tracking their own learning and using that information to make sensible decisions related to reward maximization.

'Going Public': The Mediatization of Decision-Making Processes

In most Western countries, the media are said to exert an increasing influence on the political game. This development, which has been described variably as a shift towards an 'audience democracy' (Manin 1995) or the 'mediatization of politics' (Mazzoleni and Schulz 1999), emphasizes the increasing importance of the media for political actors and political decision-making. In such a context, political actors need to communicate with both the media and the public in order to gain support for their policy plans and to influence decision-making. The media were noticeably absent from Kriesi's (1980) in-depth analysis of political decision-making in Switzerland. This suggests that in the early 1970s, the media did not matter or mattered far less than they do today.

Cost-benefit analyses for your group and yourself: The rationality of decision-making in conflict

Two studies in the context of English-French relations in Québec suggest that individuals who strongly identify with a group derive the individual-level costs and benefits that drive expectancy-value processes (rational decision-making) from group-level costs and benefits. In Study 1, high identifiers linked group- and individual-level outcomes of conflict choices whereas low identifiers did not. Group-level expectancy-value processes, in Study 2, mediated the relationship between social identity and perceptions that collective action benefits the individual actor and between social identity and intentions to act. These findings suggest the rational underpinnings of identity-driven political behavior, a relationship sometimes obscured in intergroup theory that focuses on cognitive processes of self-stereotyping. But the results also challenge the view that individuals' cost-benefit analyses are independent of identity processes. The findings suggest the importance of modeling the relationship of group and individual levels of expectancy-value processes as both hierarchical and contingent on social identity processes

A semi-oriented radial measure for measuring the efficiency of decision making units with negative data, using DEA

Data Envelopment Analysis (DEA) is a nonparametric method for measuring the efficiency of a set of decision making units such as firms or public sector agencies, first introduced into the operational research and management science literature by Charnes, Cooper, and Rhodes (CCR) [Charnes, A., Cooper, W.W., Rhodes, E., 1978. Measuring the efficiency of decision making units. European Journal of Operational Research 2, 429–444]. The original DEA models were applicable only to technologies characterized by positive inputs/outputs. In subsequent literature there have been various approaches to enable DEA to deal with negative data. In this paper, we propose a semi-oriented radial measure, which permits the presence of variables which can take both negative and positive values. The model is applied to data on a notional effluent processing system to compare the results with those yielded by two alternative methods for dealing with negative data in DEA: The modified slacks-based model suggested by Sharp et al. [Sharp, J.A., Liu, W.B., Meng, W., 2006. A modified slacks-based measure model for data envelopment analysis with ‘natural’ negative outputs and inputs. Journal of Operational Research Society 57 (11) 1–6] and the range directional model developed by Portela et al. [Portela, M.C.A.S., Thanassoulis, E., Simpson, G., 2004. A directional distance approach to deal with negative data in DEA: An application to bank branches. Journal of Operational Research Society 55 (10) 1111–1121]. A further example explores the advantages of using the new model.

The Optimality of Decision Making During Motor Learning

In our daily lives, we often must predict how well we are going to perform in the future based on an evaluation of our current performance and an assessment of how much we will improve with practice. Such predictions can be used to decide whether to invest our time and energy in learning and, if we opt to invest, what rewards we may gain. This thesis investigated whether people are capable of tracking their own learning (i.e. current and future motor ability) and exploiting that information to make decisions related to task reward. In experiment one, participants performed a target aiming task under a visuomotor rotation such that they initially missed the target but gradually improved. After briefly practicing the task, they were asked to select rewards for hits and misses applied to subsequent performance in the task, where selecting a higher reward for hits came at a cost of receiving a lower reward for misses. We found that participants made decisions that were in the direction of optimal and therefore demonstrated knowledge of future task performance. In experiment two, participants learned a novel target aiming task in which they were rewarded for target hits. Every five trials, they could choose a target size which varied inversely with reward value. Although participants’ decisions deviated from optimal, a model suggested that they took into account both past performance, and predicted future performance, when making their decisions. Together, these experiments suggest that people are capable of tracking their own learning and using that information to make sensible decisions related to reward maximization.