scholarly journals Improvement of process-driven work in Dietetics - the development of a standard model of the Unified Dietetic Care Process (IMPECD)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Kathrin Kohlenberg-Müller ◽  
Christina Gast ◽  
Alexandra Kolm ◽  
Andrea M. Werkman ◽  
Koen Vanherle ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Status ◽  
Outcome Evaluation ◽  
Process Models ◽  
Care Process ◽  
International Level ◽  
Unified Framework ◽  
Depth Analysis ◽  
Dietetic Intervention ◽  
Clinical Cases

AbstractIntroduction:Different models of frameworks for dietetic care are used in Europe. There is a substantial need for a consistent framework to compare research results and to cooperate on an international level. Therefore, one of the goals of the EU-funded project IMPECD was the development of a unified framework Dietetic Care Process (DCP) in order to foster a shared understanding of process-driven dietetic counselling.Materials and Methods:Based on a literature review and in-depth analysis of different frameworks an iterative and incremental development process of finding solutions for decision-making within the consortium consisting of dietetic experts from 5 European HEI was passed. The developed DCP model was integrated in an online training course including 9 clinical cases (MOOC) to train students. The draft versions and the concluding final version DCP model were evaluated and re-evaluated by teachers and 25 students at two Intensive Study Programmes.Results:The DCP model consists of five distinct, interrelated steps which the consortium agreed on: Dietetic Assessment, Dietetic Diagnosis, Planning Dietetic Intervention, Implementing Dietetic Intervention, Dietetic Outcome Evaluation. A standardized scheme was developed to define the process steps: dedication, central statement, aim and principles, and operationalization.For example, Dietetic Assessment is the first step of the DCP (dedication). It is a systematic process to gather dietetically adequate and relevant information about the client by using state-of-the-art methods (central statement). The aim is to identify nature and cause of dietetic related problems of the client (aim and principles). The gathered information are documented in types of categories (client history, diet history, behavioural-environmental, clinical status) or following the ICF-model (operationalization). The clinical cases used within the MOOC proved that the DCP model is suitable to be put into practice.Discussion:Existing different process models were analyzed to create a new and consistent concept of a unified framework DCP. The variety within the European countries represented by the consortium proved to be both a challenge in decision-making and an opportunity to integrate multinational perspectives and intensify the scientific discourse. The development of a standardized scheme with precise definitions is a prerequisite for planning study designs in health services research. Besides, clarification is essential for establishing process-guided work in practice. The evaluated MOOC is now implemented in study programmes used by 5 European HEI in order to keep approaches and process-driven action comparable. The MOOC promotes the exchange of ideas between future professionals on an international level.

To Investigate the Critical Influencing Factors for Decision Making Process of Students Who Want to Study Abroad

2019 ◽  
Vol 118 (11) ◽  
pp. 619-624
Author(s):  
JueJueMyint Toe ◽  
Ali Abdulbaqi Ameen ◽  
Sui Reng Liana ◽  
Amiya Bhaumik
Keyword(s):  
Higher Education ◽  
Decision Making ◽  
Study Abroad ◽  
Education Level ◽  
Decision Making Process ◽  
International Level ◽  
Continuing Higher Education ◽  
Clear Trend ◽  
The People ◽  
Study Overseas

Myanmar is the developing country and its education system is not yet to international level. Hence, most of the young adults, who like to upgrade their knowledge global wide and to gain international recognized higher educational certificates, choose to study overseas rather than continuing higher education after their high education nowadays, that becomes the trend of young people to study overseas since the competency among the people is getting intense based on the education level in every industry. The purpose of this research is to understand that students’ decision making process of selecting university. The study will be conducted to see clear trend of Myanmar students’ decision making of studying in abroad. This research will cover the context of what is Myanmar students’ perception of abroad, how they consider among other countries and explaining those factors which determine Myanmar students’ choice and how they decide to study abroad.

The Decision-making and Outcome Evaluation during a Repeated Trust Game

2015 ◽  
Vol 47 (8) ◽  
pp. 1028 ◽  
Author(s):  
Yiwen WANG ◽  
Zhen ZHANG ◽  
Sheng YUAN ◽  
Fengbo GUO ◽  
Shaoying HE ◽  
...  
Keyword(s):  
Decision Making ◽  
Outcome Evaluation ◽  
Trust Game

scholarly journals Epidemiology of Blood Culture Utilization in a Cohort of Critically Ill Children

2019 ◽  
Vol 08 (03) ◽  
pp. 144-147
Author(s):  
Christine Anh-Thu Tran ◽  
Jenna Verena Zschaebitz ◽  
Michael Campbell Spaeder
Keyword(s):  
Decision Making ◽  
Blood Culture ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Critically Ill ◽  
Clinical Status ◽  
Blood Cultures ◽  
Systemic Inflammatory Response ◽  
Critically Ill Children ◽  
Culture Acquisition

AbstractBlood culture acquisition is integral in the assessment of patients with sepsis, though there exists a lack of clarity relating to clinical states that warrant acquisition. We investigated the clinical status of critically ill children in the timeframe proximate to acquisition of blood cultures. The associated rates of systemic inflammatory response syndrome (72%) and sepsis (57%) with blood culture acquisition were relatively low suggesting a potential overutilization of blood cultures. Efforts are needed to improve decision making at the time that acquisition of blood cultures is under consideration and promote percutaneous blood draws over indwelling lines.

Deterministic policies based on maximum regrets in MDPs with imprecise rewards

2021 ◽  
pp. 1-16
Author(s):  
Pegah Alizadeh ◽  
Emiliano Traversi ◽  
Aomar Osmani
Keyword(s):  
Decision Making ◽  
Decision Process ◽  
Process Models ◽  
Sequential Decision Making ◽  
Sequential Decision ◽  
Exact Procedure ◽  
Markov Decision ◽  
Intuitive Idea ◽  
First Time ◽  
Maximum Regret

Markov Decision Process Models (MDPs) are a powerful tool for planning tasks and sequential decision-making issues. In this work we deal with MDPs with imprecise rewards, often used when dealing with situations where the data is uncertain. In this context, we provide algorithms for finding the policy that minimizes the maximum regret. To the best of our knowledge, all the regret-based methods proposed in the literature focus on providing an optimal stochastic policy. We introduce for the first time a method to calculate an optimal deterministic policy using optimization approaches. Deterministic policies are easily interpretable for users because for a given state they provide a unique choice. To better motivate the use of an exact procedure for finding a deterministic policy, we show some (theoretical and experimental) cases where the intuitive idea of using a deterministic policy obtained after “determinizing” the optimal stochastic policy leads to a policy far from the exact deterministic policy.

scholarly journals Multi-Criteria Decision-Making (MCDM) for the Assessment of Renewable Energy Technologies in a Household: A Review

Energies ◽  
2020 ◽  
Vol 13 (5) ◽  
pp. 1164 ◽  
Author(s):  
Indre Siksnelyte-Butkiene ◽  
Edmundas Kazimieras Zavadskas ◽  
Dalia Streimikiene
Keyword(s):  
Decision Making ◽  
Renewable Energy ◽  
Scientific Literature ◽  
Renewable Energy Sources ◽  
Multiple Criteria Decision Making ◽  
Energy Sources ◽  
Renewable Energy Technologies ◽  
Advantages And Disadvantages ◽  
Energy Technologies ◽  
Depth Analysis

Different power generation technologies have different advantages and disadvantages. However, if compared to traditional energy sources, renewable energy sources provide a possibility to solve the climate change and economic decarbonization issues that are so relevant today. Therefore, the analysis and evaluation of renewable energy technologies has been receiving increasing attention in the politics of different countries and the scientific literature. The household sector consumes almost one third of all energy produced, thus studies on the evaluation of renewable energy production technologies in households are very important. This article reviews the scientific literature that have used multiple-criteria decision-making (MCDM) methods as a key tool to evaluate renewable energy technologies in households. The findings of the conducted research are categorized according to the objectives pursued and the criteria on which the evaluation was based are discussed. The article also provides an overview and in-depth analysis of MCDM methods and distinguishes the main advantages and disadvantages of using them to evaluate technologies in households.

scholarly journals Should I stay or should I go? Evidence accumulation drives decision making in human drivers

2020 ◽  
Author(s):  
Arkady Zgonnikov ◽  
David Abbink ◽  
Gustav Markkula
Keyword(s):  
Decision Making ◽  
Cognitive Processes ◽  
Cognitive Process ◽  
Response Times ◽  
Process Models ◽  
Cognitive Mechanisms ◽  
Naturalistic Decision Making ◽  
Dynamic Constraints ◽  
Evidence Accumulation ◽  
Out Of Sample

Laboratory studies of abstract, highly controlled tasks point towards noisy evidence accumulation as a key mechanism governing decision making. Yet it is unclear whether the cognitive processes implicated in simple, isolated decisions in the lab are as paramount to decisions that are ingrained in more complex behaviors, such as driving. Here we aim to address the gap between modern cognitive models of decision making and studies of naturalistic decision making in drivers, which so far have provided only limited insight into the underlying cognitive processes. We investigate drivers' decision making during unprotected left turns, and model the cognitive process driving these decisions. Our model builds on the classical drift-diffusion model, and emphasizes, first, the drift rate linked to the relevant perceptual quantities dynamically sampled from the environment, and, second, collapsing decision boundaries reflecting the dynamic constraints imposed on the decision maker’s response by the environment. We show that the model explains the observed decision outcomes and response times, as well as substantial individual differences in those. Through cross-validation, we demonstrate that the model not only explains the data, but also generalizes to out-of-sample conditions, effectively providing a way to predict human drivers’ behavior in real time. Our results reveal the cognitive mechanisms of gap acceptance decisions in human drivers, and exemplify how simple cognitive process models can help us to understand human behavior in complex real-world tasks.

scholarly journals Multidisciplinary teams caring for people with variations of sex characteristics: a scoping review

2021 ◽  
Vol 5 (1) ◽  
pp. e001257
Author(s):  
Martin Gramc ◽  
Jürg Streuli ◽  
Eva de Clercq
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Scoping Review ◽  
Ethical Principles ◽  
Care Process ◽  
Future Research ◽  
Medical Professionals ◽  
Sex Characteristics ◽  
Multidisciplinary Teams ◽  
Shared Decision

BackgroundIn 2006 the Chicago consensus statement on the management of people with variations of sex characteristics (VSC) acknowledged the importance of a multidisciplinary team (MDT) approach. The consensus update from 2016 reinforced the call for multidisciplinary collaborations between medical professionals, parents and support groups, and proposed guidelines to improve shared decision making and patient-centred care embedded in ethical principles of self-determination and child participation. But there is little evidence that successfully MDTs have been implemented in clinical practice.Methods and aimsA scoping review was conducted to identify studies that address the collaboration and decision making process of MDTs providing care of people with VSC to identify ideal and actual (1) team composition; (2) models of collaboration and (3) ethical principles that MDTs follow. Six databases were systematically searched: CINAHIL, Medline, Psychinfo, Scopus, Socindex and Web of Science. No restriction was placed on the type of methodology used in the studies. To frame the research, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used.ResultsThe MDTs in the literature include mainly medical professionals: endocrinologists, urologists and surgeons. The collaboration among medical professionals in MDTs lacks cooperation as one team member sets the tasks of the team while each professional works separately. Despite the importance of psycho-social support the involvement of psychologists remains secondary. The implementation of ethical principles tends to exclude people with VSC.ConclusionThe care of people with VSC described in the papers is medically oriented as the team members are mainly medical professionals working separately. MDT tend to exclude people with VSC despite references to shared decision making processes and informed consent. There was no mention of adult care and lack of inclusion of patient’s perspective in the care process. The future research should do more empirical research of MDTs.

scholarly journals Attenuated directed exploration during reinforcement learning in gambling disorder

2019 ◽  
Author(s):  
A. Wiehler ◽  
K. Chakroun ◽  
J. Peters
Keyword(s):  
Decision Making ◽  
Reinforcement Learning ◽  
Gambling Disorder ◽  
Brain Activity ◽  
Clinical Status ◽  
Classical Problem ◽  
Behavioral Flexibility ◽  
Network Connectivity ◽  
Prediction Errors ◽  
Reward Contingencies

AbstractGambling disorder is a behavioral addiction associated with impairments in decision-making and reduced behavioral flexibility. Decision-making in volatile environments requires a flexible trade-off between exploitation of options with high expected values and exploration of novel options to adapt to changing reward contingencies. This classical problem is known as the exploration-exploitation dilemma. We hypothesized gambling disorder to be associated with a specific reduction in directed (uncertainty-based) exploration compared to healthy controls, accompanied by changes in brain activity in a fronto-parietal exploration-related network.Twenty-three frequent gamblers and nineteen matched controls performed a classical four-armed bandit task during functional magnetic resonance imaging. Computational modeling revealed that choice behavior in both groups contained signatures of directed exploration, random exploration and perseveration. Gamblers showed a specific reduction in directed exploration, while random exploration and perseveration were similar between groups.Neuroimaging revealed no evidence for group differences in neural representations of expected value and reward prediction errors. Likewise, our hypothesis of attenuated fronto-parietal exploration effects in gambling disorder was not supported. However, during directed exploration, gamblers showed reduced parietal and substantia nigra / ventral tegmental area activity. Cross-validated classification analyses revealed that connectivity in an exploration-related network was predictive of clinical status, suggesting alterations in network dynamics in gambling disorder.In sum, we show that reduced flexibility during reinforcement learning in volatile environments in gamblers is attributable to a reduction in directed exploration rather than an increase in perseveration. Neuroimaging findings suggest that patterns of network connectivity might be more diagnostic of gambling disorder than univariate value and prediction error effects. We provide a computational account of flexibility impairments in gamblers during reinforcement learning that might arise as a consequence of dopaminergic dysregulation in this disorder.

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