Browsing by Subject "Decision-making"

Now showing 1 - 12 of 12

Analysis of experienced pharmacist clinical decision-making for drug therapy management in the ambulatory care setting
(2013-05) Bartels, Christine E.
Objectives: The overarching objective of this research study was to document drug therapy decision-making processes of experienced pharmacists in the ambulatory care setting. The specific aims of this study were to examine the current clinical decisionmaking of experienced pharmacists in the context of the ambulatory care clinic setting, to compare and contrast pharmacist clinical decision-making with current decision-making models, and to identify enabling factors and barriers to clinical decision-making in the specific context of ambulatory care. Methods: This study used the thematic hermeneutic phenomenological human science methodology influenced by Dr. van Manen. After a feasibility pilot study of two experienced pharmacists in the Twin Cities of Minnesota, the main component of the dissertation research project included six experienced pharmacists throughout Minnesota and Iowa. Recruitment was done via e-mail request of eligible pharmacists known by faculty in Minnesota or Iowa and public information with a state association (the Minnesota Pharmacists Association). Three audio-taped data collection methods of participant observation, semi-structured interview, and personal audio-taping were utilized and exactly transcribed to provide textual data for analysis. Thematic analysis provided emerging themes of experienced pharmacist clinical decision-making which were further subdivided into subsuming themes after much reflection and interpretation of the entire study data. Results: Other health professions have identified experienced clinical decision-making to encompass the Hypothetico-Deductive Reasoning Model, Decision Analysis, intuition and pattern recognition. Pharmacists’ clinical decision-making processes are considered in light of other health professionals’ decision-making techniques; however the results show that experienced pharmacists use a different model of clinical decision-making using constant dialogue between two different types of knowledge (objective and context-related). The pharmacist must perform an active modification step necessary to combine the objective, factual information with the contextual, patient-related knowledge. With this modification, pharmacists are able to have complete situational understanding necessary for the final clinical decision. Although experienced, the pharmacist may have inadequate information to conduct the modification step necessary for understanding to make the clinical decision. The analysis suggests that the enabling factors and barriers to clinical decision-making are unique for each context. The availability of time to spend with patients and the effort in consulting with other health professional colleagues have enabled experienced pharmacists to ensure more patientcentered decisions in the general ambulatory care clinic setting; however, practicing within certain disease specialties and potential limited knowledge presented possible barriers in making more optimal clinical decisions. Conclusions: This research study may ultimately increase interprofessional work since there may be significant similarity between pharmacists’ and other health professionals’ experienced clinical decision-making. The cross-communication between different health professions may further improve decision-making processes and collaborative practice agreements. Also, this research may guide pharmacy education necessary to advance patient experiences for clinical decision-making based on better understanding of the practices of those experienced pharmacists with 5+ years of practice. Increased objective teaching should be encouraged in classrooms to provide for longer-lasting learning experiences for students. Finally, this study provides evidence for better understanding of the current pharmacy practice including clinical decision-making in the ambulatory care clinic setting, which may further expand the success of pharmacists’ contributions to improving patient care.
Assessing forest structure, biodiversity, and ecosystem functions between public and private tropical dry secondary forests, a case study in Guanacaste, Costa Rica
(2014-08) McClellan, Moana L.
For this dissertation, I was interested by how human decisions may affect forest ecology and, in turn, how those ecological effects may feedback to influence social systems. Humans are the dominant force driving global environmental changes, yet we are still working towards quantifying how humans affect ecosystem functions, environmental services, and biodiversity across varying environmental and human land use gradients. I conducted a case study in Guanacaste, Costa Rica to evaluate ecological differences in public and private tropical dry secondary forests and assessed what factors influenced private landowners' decisions to allow forest regeneration on their farms. For the forest study, I found that public and private forests did not differ significantly in integrative metrics of forest structure or biodiversity. Yet there were tree species compositional differences with tell-tale signs of a human signature: highly prized timber species were more abundant in public forest, suggesting high-grading in private forests and the most abundant species in private forests was a species favored and consumed by cattle, Guazuma ulmifolia. In the farmer land-use study, I found that landowners appreciated the multiple benefits and services that their forests provided for them and for society; however, landowners noted that market prices were the main factor affecting their farm land use decisions regarding production expansion or contraction. Finally, I was interested in conducting a combined assessment of ecological and human use traits that may differentially affect ecosystem functions in private versus public lands. I expected that the patchy forest characteristics on private lands would favor plant species that have low seed mass, fast relative growth rate, and high leaf N. I acquired functional plant trait data for the majority of tree species in the forest inventory analysis from international databases. I also created a human use plant trait summary for traits I expected to be less evident in private forests (`harvest traits' e.g. timber) and traits that I expected to be more evident private forests (`on farm use traits' e.g. ornamentals, living fences). Seed mass was the only trait that was significantly different between public and private forests: public forests had higher seed mass relative to private. Likely, this is due to differences in animal dispersal vector behaviors between continuous and patchy forest. I also found a trend of `on farm use traits' more evident in private forests, so the species that people select to use on their farms may be more abundant in nearby naturally regenerating forests. I found differences in species composition, seed mass, and `on farm use traits' between public and private forests that appear to be caused by differences in management yet, overall, these differences to not appear to influence ecological function between public and private forests.
Choosing a college major: Factors that might influence the way students make decisions.
(2009-11) Lee, Wei-Chun Vanessa
This current study investigated Janis and Mann's (1977) Conflict Model of Decision Making. Specifically, Janis and Mann's model was tested to examine decision-making styles (coping patterns) and students who either have already decided or who have yet to decide on their college major. Furthermore, the current study is aimed to expand Janis and Mann's model by testing the relationship between coping patterns and other personal variables. The personal variables included in the study were self-esteem, career decision making, self-efficacy, goal instability, personal growth initiative, and vocational interests. Undergraduate students (N = 230) from introductory psychology courses participated in the study. The results showed that the coping patterns from Janis and Mann's (1977) model were not related to any of the personal variables. Therefore, the current study did not find the personal variables played a role in students' decision-making coping patterns when choosing majors. In addition, vocational interests were not related to coping patterns, which meant that, when using Janis and Mann's (1977) model, Holland's vocational interests could not be categorize into rational and irrational types.
Cortex-wide characterization of decision-making behavior during a spatial navigation task
(2024-05) Haley, Samuel
Using a head-mounted mesoscope, widefield calcium dynamics were recorded during an 8-maze task in freely moving mice, and a k-means clustering algorithm was utilized to identify 11 discrete cortical states. A significant increase in the usage of a visual/retrosplenial cortex state was observed during the decision phase of a memory-guided paradigm compared to a visually-guided paradigm suggesting prolonged evidence accumulation. A cortical state consisting of secondary motor cortex and posterior parietal cortex activation had a significantly higher probability during the visually-guided paradigm, indicating more efficient sensorimotor transformation during this task. Distinct motifs of cortical state activations suggest the visually- guided task elicited a higher probability of anterior to posterior feedback and used the posterior parietal cortex for feedforward sensory integration to a lesser extent than the memory-guided task. These findings show distinct differences in how information is processed during variations of decision tasks.
Decision making gone awry: Dorsal striatum, decision-making, and addiction
(2015-02) Regier, Paul
Millions of people use addictive substances, such as alcohol and cocaine, however only a subset of individuals become dependent on these types of substances. Addiction can be thought of as a maladaptive decision-making process, driven by distinct neural regions. As behavior shifts from goal-directed to habit-based behavior, control of this behavior by corticostriatal circuits shifts from the associative circuit, which includes the dorsomedial striatum, to the sensorimotor circuit, which includes dorsolateral striatum. Once behavior becomes more habit-based, and control shifts to the sensorimotor corticostriatal circuit, actions become difficult to devalue. Thus, behavior becomes difficult to change. In this dissertation, I explore a behavioral shift to habit-based behavior as one potential way addiction can occur. I focus on the dorsomedial and the dorsolateral striatum and the role of these two regions in goal-directed and habit-based behavior, respectively, and the role of these two regions in drug-seeking behavior. In addition, I discuss the dorsomedial and dorsolateral striatum in relation to animal models of drug addiction that differentially seek drugs, and I discuss these two regions as potential biomarkers of addiction treatment. Finally, I relate previous research as well as my own research, presented throughout the dissertation, to human drug use and consider how analogues of dorsal striatum in the human brain might play a role in human addiction and addiction treatment. In all, consideration of addiction as a maladaptive decision-making process as well as understanding the neural correlates of this process may help to generate new ways of perceiving, studying, and treating addiction.
Heightened Sensitivity to Improbable Catastrophes As a Pathogenic Marker of Obsessive-Compulsive Disorder: Theory and Experimental Evidence
(2021-09) Hunt, Christopher
Although the obsessions implicated in obsessive compulsive disorder (OCD) could theoretically involve any distressing topic, they typically gravitate toward a handful of specific themes (e.g., contamination, religion, sex, etc.). The universality of these themes across OCD patients from different time periods, cultures, and age-groups suggests they are manifestations of a common, underlying process, but little effort has been made to elucidate the identity of this process. One intriguing feature shared across most common obsessions is a heightened concern with consequences that are objectively terrible but highly unlikely (e.g., catching HIV from a door knob, being sent to hell for a fleeting immoral thought). The ubiquity of this particular consequence suggests that OCD may be characterized by an underlying sensitivity to improbable catastrophes (SIC), but this possibility has yet to be explored. The present dissertation sought to address this gap by examining whether OCD symptoms predicted higher anxious reactivity toward unlikely, highly aversive threats across three experimental studies. In the first study, college students with higher OCD symptoms exhibited greater avoidance of improbable, highly aversive threats, as well as greater expectancy and physiological reactivity for improbable threats in general. An extension of this investigation with different types of experimental threats (study two) showed that OCD symptoms predicted heightened expectancy of improbable threats involving both harmful and disgust-related consequences, while relations between OCD symptoms and avoidance of improbable, highly aversive consequences were specific to harmful threats. Finally, study three showed that differences in expectancy, anxiety, and avoidance for improbable threats prospectively predicted changes in OCD symptoms over the first year of college, with indices of anxious reactivity to improbable threat (anxiety, startle, avoidance) emerging as especially predictive among participants who rated the threat as highly aversive. Together, these studies implicate SIC as a novel pathogenic marker of OCD, and suggest its role in the illness may derive from a more general tendency to overestimate the likelihood of improbable outcomes bearing high subjective costs.
Higher education: power and influence of academic administrative staff members
(2014-05) Thompson, Denise Renae
This study examines the role of informal power sources available to administrative staff in university academic departments. The research question that drives the analysis is, "In what ways do administrative staff members utilize informal power to influence departmental decision-making?" Data were collected through interviews with chairs, Directors of Graduate Studies, faculty, and administrative staff at a public research university, utilizing a structured interview guide. Results indicate that staff members in the four departments studied possess and use formal and informal power sources. The formal bases of power studied are formal power and legal prerogative power. The major sources of staff informal power described by the interview participants are productive power (notably, political alliances), information power, and resource power. The study suggests that administrative staff members have access to informal power and those with the skill and willingness to use that power can impact departmental decisions.
An integrated framework for understanding the financial health of small, private colleges.
(2012-08) Hunter, James Michael
A certain segment of the higher education market typically goes unnoticed, that is until the circumstances are disastrous. The small, private college is unusually vulnerable in times of economic distress due, in part, to its fiscal independence. Unfortunately, a number of factors have caused a number of these small, private colleges to close over the past decade. The small private college sector is of interest because it is highly susceptible to decline and demise. Typically, institutions in this category do not have the enrollment volume, endowment strength and reputational clout to resist internal and environmental fluctuations or competition. Studying the financial health of small, private colleges provides an opportunity to explore variables that are positive and negative indicators of financial stability and instability. Using an integrated framework of institutional health conceptual framework this study explored the relationships between four families of independent variables (i.e., institutional characteristics, strategic choice, financial indicators and external environment) and the Department of Education's Test of Financial Strength score for 673 U. S. four-year, private institutions with fewer than 2,000 students in either the 1998-99 or 2008-09 academic years. The researcher utilized a repeated measures samples t-test and chi-square statistic to compare the set of institutions between 1998-99 and 2008-09. Various multiple regression model analyses were utilized for 1998-99 and 2008-09 data to explore the relationship between the dependent variable and several independent variables. The results of the study indicate that over the ten-year time period, there were statistically significant differences for small, private colleges in their endowments in constant dollars, cash and operating reserves, debt service, tuition dependency, cost to attend in constant dollars, total undergraduate and adult enrollment, years of operation, tuition increases, selectivity, faculty-to-student ratio, discount rate, unrestricted giving in constant dollars and the number of private colleges in the state. The four regression model analyses and results for 1998-99 demonstrated that small, private colleges with stronger operating and cash reserves, larger undergraduate enrollments, deeper donor bases as measured by unrestricted giving, longer presidential tenures, higher costs to attend, stronger retention rates and institutions more dependent on tuition, positively impacted the Department of Education Test of Financial Strength score. The results of the four regression models for 2008-09 demonstrated that small, private colleges with larger undergraduate enrollments, stronger cash reserves, deeper donor bases as measured by unrestricted giving, score significantly better than their peers on the Department of Education Test of Financial Strength score. Institutions with innovative online programs, stronger retention rates, lower discount rates and NCAA and NAIA athletic affiliations negatively impact the Test of Financial Strength score. According to the analysis, both internal and external factors explain levels of financial strength in small, private colleges as predicted by the conceptual framework.
Reactions Toward Anonymized Reviews in Selection
(2023) Banuelos, Sebastian
Race, gender, and age biases are prevalent when decision-making processes in the workplace are subjective and lack job-relevant criteria. Decision-maker reactions can influence decision quality, willingness to support, confidence in, and preference to use selection tools. The anonymized review (AR) is a hiring process that minimizes bias in selection by redacting identifying information (e.g., name, age, gender) from applicant materials (e.g., applications, resumes, etc.). This study was a two-part investigation that examined decision-maker reactions toward ARs. Justification for using ARs was expected to positively influence decision-maker reactions toward ARs. Additionally, diversity attitudes were expected to have a moderating effect on the relationship between justification and decision-maker reactions. Results from Study 1 showed insignificant main effects for ARs and justification. Study 1 results also showed that individuals with low diversity attitudes will react negatively to ARs when justification is not provided. Lastly, qualitative responses from Study 2 revealed perceptions of accuracy and practicality toward ARs as significant themes. Practical implications of the study are discussed and recommendations provided.
Social decision making.
(2009-06) Gurdal, Mehmet Yigit
Behavioral data from two different experiments conducted at the University of Minnesota is used to uncover the aspects of social decision making. These experiments focus on situations where individual decision might affect the payoffs of other parties. In particular, the first experiment includes a treatment where subjects choose in groups and member decisions may bind the whole group, whereas the second experiment includes a treatment one subject makes choices on behalf of another who in turn assigns rewards to choice making subject. Besides these treatments, both experiments include a treatment where subjects decide for themselves alone. I expect the behavior to be moderated by prevailing social norms in these decision making environments. I start with introducing the research explained in this thesis and then give important examples from the past literature in social psychology and economics. I show that the social norms become salient as a result of several factors including subject's beliefs about the preferences of others, subject's perception about the appropriate behavior in social decisions and subject's expectations about the possible evaluations to be made by others after choices and outcomes are realized. I test the effect of these factors on social decisions and contrast them with choices made alone. In addition to the statistical analysis, theoretical predictions for certain social decision making environments are formulated and tested using the experimental data. The findings and their implications for social arrangements are discussed.
Strategic decision-making by deans in academic health centers: a framework analysis.
(2012-02) Keeney, Brianne
This study examines strategic decision-making at the college level in relation to seven theoretical frames. Strategic decisions are those made by top executives, have wide-ranging influence throughout the organization, affect the long-term future of the organization, and are connected to the external environment. The seven decision-making frames identified in the research literature are labeled bureaucracy, collegiality, culture, garbage-can, intuition, politics, and rationality. Fifty deans in academic health centers in public research universities were interviewed with a focus on indicators related to the seven frames and the frames' influence on the process of strategic decision-making. Emergent themes related to strategic decision-making patterns and the seven frames are discussed. This study contributes to the understanding of factors involved in college deans' strategic decisions. As more information is gathered about strategic decision-making in public research universities, specifically academic health centers, better practices will emerge to be supported and encouraged.
Towards a Translational Model of Decision-Making: Findings from the Web-Surf Task
(2017-08) Abram, Samantha
Interventions targeting cognitive disorders often hinge on assumptions that humans and nonhuman animals recruit equivalent cognitive mechanisms during decision- making. Identifying parallel decision systems across species could help bridge gaps between clinical and non-clinical research, and in turn, improve intervention efficacy. The goal of this dissertation is to assess for similar behavioral and neural markers of decision-making across humans and rodents using a sequential foraging paradigm (“The Web-Surf Task”) that was adapted from a rodent spatial neuroeconomic task (“Restaurant Row”). The included studies highlight a functional translational approach that aims to access similar functional constructs via parallel tasks and methodological approaches. The results provide evidence of cross-species behavioral equivalents, such as the ability to detect revealed preferences. Findings from a neuroimaging study suggest that different neural systems track past and forward representations, indicative of human prospection during deliberation (i.e., episodic future thinking). Moreover, neural activation related to difficult decisions is similar to many of the structures that underlie rodent deliberation. Lastly, a risk-variant of the task suggests that regret-instances provide a bridge between our liking and pursuit of rewards. This final study also finds that impulsive individuals may fail to learn from regret. Collectively, this dissertation demonstrates the utility of this novel task for elucidating human deliberative mechanisms and identifying cross-species decision system compatibilities.

University Digital Conservancy

Browse by Subject

Browsing by Subject "Decision-making"