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[PMID]:27771786
[Au] Autor:Osinski A; Vreugdenhil G; de Koning J; van der Hoeven JG
[Ad] Endereço:Department of Internal Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands. aart_osinski@hotmail.com.
[Ti] Título:Do-not-resuscitate orders in cancer patients: a review of literature.
[So] Source:Support Care Cancer;25(2):677-685, 2017 02.
[Is] ISSN:1433-7339
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Discussing do-not-resuscitate (DNR) orders is part of daily hospital practice in oncology departments. Several medical factors and patient characteristics are associated with issuing DNR orders in cancer patients. DNR orders are often placed late in the disease process. This may be a cause for disagreements between doctors and between doctors and patients and may cause for unnecessary treatments and admissions. In addition, DNR orders on itself may influence the rest of the medical treatment for patients. We present recommendations for discussing DNR orders and medical futility in practice through shared decision-making. Prospective studies are needed to investigate in which a patient's cardiopulmonary resuscitation (CPR) is futile and whether or not DNR orders influence the medical care of patients.
[Mh] Termos MeSH primário: Reanimação Cardiopulmonar/ética
Tomada de Decisões/ética
Neoplasias/psicologia
Ordens quanto à Conduta (Ética Médica)/ética
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Neoplasias/terapia
Estudos Prospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180310
[Lr] Data última revisão:
180310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1007/s00520-016-3459-9


  2 / 80536 MEDLINE  
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[PMID]:29462152
[Au] Autor:Treacy L; Bolkan HA; Sagbakken M
[Ad] Endereço:Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
[Ti] Título:Distance, accessibility and costs. Decision-making during childbirth in rural Sierra Leone: A qualitative study.
[So] Source:PLoS One;13(2):e0188280, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sierra Leone has one of the highest maternal mortality ratios in the world. Efforts to reduce maternal mortality have included initiatives to encourage more women to deliver at health facilities. Despite the introduction of the free health care initiative for pregnant women, many women still continue to deliver at home, with few having access to a skilled birth attendant. In addition, inequalities between rural and urban areas in accessing and utilising health facilities persist. Further insight into how and why women make decisions around childbirth will help guide future plans and initiatives in improving maternal health in Sierra Leone. The objective of this study was to explore the perceptions and decision-making processes of women and their communities during childbirth in rural Sierra Leone. METHODS AND FINDINGS: Data were collected through seven focus group discussions and 22 in-depth interviews with recently pregnant women and their community members in two rural villages. Data were analysed using systematic text condensation. Findings revealed that decision-making processes during childbirth are dynamic, intricate and need to be understood within the broader social context that they take place. Factors such as distance and lack of transport, perceived negative behaviour of hospital staff, direct and indirect financial obstacles, as well as the position of women in society all interact and influence how and what decisions are made. CONCLUSIONS: Pregnant women face multiple interacting vulnerabilities that influence their healthcare-seeking decisions during pregnancy and childbirth. Future initiatives to improve access and utilisation of safe healthcare services for pregnant women need to be based on adequate knowledge of structural constraints and health inequities that affect women in rural Sierra Leone.
[Mh] Termos MeSH primário: Tomada de Decisões
Custos de Cuidados de Saúde
Acesso aos Serviços de Saúde
População Rural
[Mh] Termos MeSH secundário: Feminino
Grupos Focais
Seres Humanos
Masculino
Gravidez
Pesquisa Qualitativa
Serra Leoa
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188280


  3 / 80536 MEDLINE  
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[PMID]:29447193
[Au] Autor:Gärtner FR; Bomhof-Roordink H; Smith IP; Scholl I; Stiggelbout AM; Pieterse AH
[Ad] Endereço:Department of Medical Decision Making, Leiden University Medical Centre, Leiden, the Netherlands.
[Ti] Título:The quality of instruments to assess the process of shared decision making: A systematic review.
[So] Source:PLoS One;13(2):e0191747, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. METHODS: In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. RESULTS: We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. CONCLUSIONS: Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument's content and characteristics such as the perspective that they assess. We recommend refinement and validation of existing instruments, and the use of COSMIN-guidelines to help guarantee high-quality evaluations.
[Mh] Termos MeSH primário: Tomada de Decisões
[Mh] Termos MeSH secundário: Reprodutibilidade dos Testes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191747


  4 / 80536 MEDLINE  
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[PMID]:29437562
[Au] Autor:Zhang L; Wang H; Li Q; Zhao MH; Zhan QM
[Ad] Endereço:Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China zhanglx@bjmu.edu.cn.
[Ti] Título:Big data and medical research in China.
[So] Source:BMJ;360:j5910, 2018 02 05.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Pesquisa Biomédica
Conjuntos de Dados como Assunto
[Mh] Termos MeSH secundário: China
Tomada de Decisões
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5910


  5 / 80536 MEDLINE  
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[PMID]:29408923
[Au] Autor:Lamas L; Drezner R; Otranto G; Barrera J
[Ad] Endereço:Faculty of Physical Education, University of Brasilia, Brasilia, Federal District, Brazil.
[Ti] Título:Analytic method for evaluating players' decisions in team sports: Applications to the soccer goalkeeper.
[So] Source:PLoS One;13(2):e0191431, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of this study was to define a method for evaluating a player's decisions during a game based on the success probability of his actions and for analyzing the player strategy inferred from game actions. There were developed formal definitions of i) the stochastic process of player decisions in game situations and ii) the inference process of player strategy based on his game decisions. The method was applied to the context of soccer goalkeepers. A model of goalkeeper positioning, with geometric parameters and solutions to optimize his position based on the ball position and trajectory, was developed. The model was tested with a sample of 65 professional goalkeepers (28.8 ± 4.1 years old) playing for their national teams in 2010 and 2014 World Cups. The goalkeeper's decisions were compared to decisions from a large dataset of other goalkeepers, defining the probability of success in each game circumstance. There were assessed i) performance in a defined set of classes of game plays; ii) entropy of goalkeepers' decisions; and iii) the effect of goalkeepers' positioning updates on the outcome (save or goal). Goalkeepers' decisions were similar to the ones with the lowest probability of goal on the dataset. Goalkeepers' entropy varied between 24% and 71% of the maximum possible entropy. Positioning dynamics in the instants that preceded the shot indicated that, in goals and saves, goalkeepers optimized their position before the shot in 21.87% and 83.33% of the situations, respectively. These results validate a method to discriminate successful performance. In conclusion, this method enables a more precise assessment of a player's decision-making ability by consulting a representative dataset of equivalent actions to define the probability of his success. Therefore, it supports the evaluation of the player's decision separately from his technical skill execution, which overcomes the scientific challenge of discriminating the evaluation of a player's decision performance from the action result.
[Mh] Termos MeSH primário: Tomada de Decisões
Futebol
Esportes
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191431


  6 / 80536 MEDLINE  
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[PMID]:29377956
[Au] Autor:Zu X; Yang C; Wang H; Wang Y
[Ad] Endereço:Department of Power and Energy Engineering, Harbin Engineering University, Harbin, China.
[Ti] Título:An EGR performance evaluation and decision-making approach based on grey theory and grey entropy analysis.
[So] Source:PLoS One;13(1):e0191626, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Exhaust gas recirculation (EGR) is one of the main methods of reducing NOX emissions and has been widely used in marine diesel engines. This paper proposes an optimized comprehensive assessment method based on multi-objective grey situation decision theory, grey relation theory and grey entropy analysis to evaluate the performance and optimize rate determination of EGR, which currently lack clear theoretical guidance. First, multi-objective grey situation decision theory is used to establish the initial decision-making model according to the main EGR parameters. The optimal compromise between diesel engine combustion and emission performance is transformed into a decision-making target weight problem. After establishing the initial model and considering the characteristics of EGR under different conditions, an optimized target weight algorithm based on grey relation theory and grey entropy analysis is applied to generate the comprehensive evaluation and decision-making model. Finally, the proposed method is successfully applied to a TBD234V12 turbocharged diesel engine, and the results clearly illustrate the feasibility of the proposed method for providing theoretical support and a reference for further EGR optimization.
[Mh] Termos MeSH primário: Tomada de Decisões
Modelos Teóricos
[Mh] Termos MeSH secundário: Algoritmos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191626


  7 / 80536 MEDLINE  
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[PMID]:29231145
[Au] Autor:Pham-The H; Nam NH; Nga DV; Hai DT; Dieguez-Santana K; Marrero-Poncee Y; Castillo-Garit JA; Casanola-Martin GM; Le-Thi-Thu H
[Ad] Endereço:Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hanoi, Vietnam.
[Ti] Título:Learning from Multiple Classifier Systems: Perspectives for Improving Decision Making of QSAR Models in Medicinal Chemistry.
[So] Source:Curr Top Med Chem;17(30):3269-3288, 2018 Feb 09.
[Is] ISSN:1873-4294
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Quantitative Structure - Activity Relationship (QSAR) modeling has been widely used in medicinal chemistry and computational toxicology for many years. Today, as the amount of chemicals is increasing dramatically, QSAR methods have become pivotal for the purpose of handling the data, identifying a decision, and gathering useful information from data processing. The advances in this field have paved a way for numerous alternative approaches that require deep mathematics in order to enhance the learning capability of QSAR models. One of these directions is the use of Multiple Classifier Systems (MCSs) that potentially provide a means to exploit the advantages of manifold learning through decomposition frameworks, while improving generalization and predictive performance. In this paper, we presented MCS as a next generation of QSAR modeling techniques and discuss the chance to mining the vast number of models already published in the literature. We systematically revisited the theoretical frameworks of MCS as well as current advances in MCS application for QSAR practice. Furthermore, we illustrated our idea by describing ensemble approaches on modeling histone deacetylase (HDACs) inhibitors. We expect that our analysis would contribute to a better understanding about MCS application and its future perspectives for improving the decision making of QSAR models.
[Mh] Termos MeSH primário: Química Farmacêutica/métodos
Inibidores de Histona Desacetilases/química
Inibidores de Histona Desacetilases/farmacologia
Relação Quantitativa Estrutura-Atividade
[Mh] Termos MeSH secundário: Animais
Tomada de Decisões
Seres Humanos
Aprendizagem
Modelos Moleculares
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Histone Deacetylase Inhibitors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.2174/1568026618666171212111018


  8 / 80536 MEDLINE  
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[PMID]:29193832
[Au] Autor:Kurth M; Fox-Lent C; Golan M; Linkov I
[Ad] Endereço:Contractor, US Army Corps of Engineers, Engineer Research and Development Center, Environmental Laboratory, Vicksburg, Mississippi.
[Ti] Título:Decision making for independent municipal action.
[So] Source:Integr Environ Assess Manag;14(2):194-197, 2018 Mar.
[Is] ISSN:1551-3793
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Municipalities and cities face myriad challenges with regard to planning; decisions that will have long-standing consequences need to be made in the context of pressing present concerns, constrained budgets, and uncertainty about the future under climate changes. Compounding the challenge may be a lack of clear signals from the state and federal leadership on investment priorities. This paper contends that existing strategies from decision science can prove useful for local governments as they seek actions that are robust despite uncertain futures and broadly beneficial across sectors and time horizons. An illustrative example of decision making with scenario analysis demonstrates how a city can prioritize funding and elevate the baseline functionality of its infrastructure and the well-being of its residents, regardless of when and how climate hazards occur. Integr Environ Assess Manag 2018;14:194-197. Published 2017. This article is a US Government work and is in the public domain in the USA.
[Mh] Termos MeSH primário: Cidades
Conservação dos Recursos Naturais/métodos
Monitoramento Ambiental
Política Ambiental
[Mh] Termos MeSH secundário: Mudança Climática
Tomada de Decisões
Seres Humanos
Incerteza
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1002/ieam.2013


  9 / 80536 MEDLINE  
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[PMID]:28466068
[Au] Autor:McMurray MS; Conway SM; Roitman JD
[Ad] Endereço:Department of Psychology, Miami University, Oxford, OH 45056.
[Ti] Título:Brain Stimulation Reward Supports More Consistent and Accurate Rodent Decision-Making than Food Reward.
[So] Source:eNeuro;4(2), 2017 Mar-Apr.
[Is] ISSN:2373-2822
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Animal models of decision-making rely on an animal's motivation to decide and its ability to detect differences among various alternatives. Food reinforcement, although commonly used, is associated with problematic confounds, especially satiety. Here, we examined the use of brain stimulation reward (BSR) as an alternative reinforcer in rodent models of decision-making and compared it with the effectiveness of sugar pellets. The discriminability of various BSR frequencies was compared to differing numbers of sugar pellets in separate free-choice tasks. We found that BSR was more discriminable and motivated greater task engagement and more consistent preference for the larger reward. We then investigated whether rats prefer BSR of varying frequencies over sugar pellets. We found that animals showed either a clear preference for sugar reward or no preference between reward modalities, depending on the frequency of the BSR alternative and the size of the sugar reward. Overall, these results suggest that BSR is an effective reinforcer in rodent decision-making tasks, removing food-related confounds and resulting in more accurate, consistent, and reliable metrics of choice.
[Mh] Termos MeSH primário: Encéfalo/fisiologia
Comportamento de Escolha/fisiologia
Tomada de Decisões/fisiologia
Reforço (Psicologia)
Recompensa
[Mh] Termos MeSH secundário: Animais
Comportamento Animal/fisiologia
Condicionamento Operante/fisiologia
Estimulação Elétrica
Alimentos
Masculino
Motivação/fisiologia
Ratos Long-Evans
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


  10 / 80536 MEDLINE  
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[PMID]:28462394
[Au] Autor:Holper L; Van Brussel LD; Schmidt L; Schulthess S; Burke CJ; Louie K; Seifritz E; Tobler PN
[Ad] Endereço:Department of Psychiatry Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland.
[Ti] Título:Adaptive Value Normalization in the Prefrontal Cortex Is Reduced by Memory Load.
[So] Source:eNeuro;4(2), 2017 Mar-Apr.
[Is] ISSN:2373-2822
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Adaptation facilitates neural representation of a wide range of diverse inputs, including reward values. Adaptive value coding typically relies on contextual information either obtained from the environment or retrieved from and maintained in memory. However, it is unknown whether having to retrieve and maintain context information modulates the brain's capacity for value adaptation. To address this issue, we measured hemodynamic responses of the prefrontal cortex (PFC) in two studies on risky decision-making. In each trial, healthy human subjects chose between a risky and a safe alternative; half of the participants had to remember the risky alternatives, whereas for the other half they were presented visually. The value of safe alternatives varied across trials. PFC responses adapted to contextual risk information, with steeper coding of safe alternative value in lower-risk contexts. Importantly, this adaptation depended on working memory load, such that response functions relating PFC activity to safe values were steeper with presented versus remembered risk. An independent second study replicated the findings of the first study and showed that similar slope reductions also arose when memory maintenance demands were increased with a secondary working memory task. Formal model comparison showed that a divisive normalization model fitted effects of both risk context and working memory demands on PFC activity better than alternative models of value adaptation, and revealed that reduced suppression of background activity was the critical parameter impairing normalization with increased memory maintenance demand. Our findings suggest that mnemonic processes can constrain normalization of neural value representations.
[Mh] Termos MeSH primário: Tomada de Decisões/fisiologia
Memória/fisiologia
Córtex Pré-Frontal/fisiologia
Recompensa
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Estimulação Luminosa/métodos
Tempo de Reação/fisiologia
Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE



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