According to economic rational choice theory greater choice will deliver well-being by increasing the likelihood that individuals satisfy personal preferences (Mas-Colell, Whinston, & Green, 1995). Consequently, extensive choice has become a fundamental aspect of both consumer markets and public policy (Schwartz, 2000; 2004; Botti & Iyengar, 2006). Crucially however, recent psychological research has begun to challenge the assumption that more choice leads to greater well-being. In several instances evidence has been found that whilst some choice is good, more choice can lead to reduced post-decisional satisfaction (e.g. Iyengar & Lepper, 2000; Shar & Wolford, 2007; Reutskaja & Hogarth, 2009). This is referred to as the Excess Choice Effect (ECE). If widespread, this ECE may mean that policies aimed at increasing well-being via choice actually deliver the opposite of their objectives. Although subject to much theoretical speculation, surprisingly little is known about the underlying cause of this effect. In light of this lacuna, the main aim of the current thesis was to investigate an alternative explanation for the ECE – namely, increased counterfactual thought. Across 7 experiments various factors known to influence the availability of counterfactual thoughts were manipulated, and the impact upon the prevalence of the ECE was explored, whilst another experiment (Experiment 7) aimed to determine individuals’ predicted affective responses to extensive choice. Overall, evidence was found that counterfactual thinking appears to play an important role in driving the dissatisfaction often associated with extensive choice. Specifically, the ECE was found to be most prevalent where counterfactual alternatives were made readily available, for example when under low cognitive load, when reflecting upon a recent, real-life decision, and when choice outcomes were negative. Further, in Experiment’s 1, 5, 6, and 8 these ECE’s were found to be significantly mediated by increased counterfactual thought, or the heightened experience of counterfactual emotion, following extensive choice. No evidence for any impact of choice level upon (psychological) satisfaction levels was found when the capacity to think counterfactually was reduced, i.e. via high cognitive load, over time, when reflecting upon a hypothetical scenario, or following a positive choice outcome. Ideas for future research are considered, and the potential implications of these findings for our theoretical understanding of the ECE, for the psychology of choice, for consumer well-being, retailers and the construction of public policy are discussed.

No description available.

Many critical clinical conditions result in respiratory failure and precipitate the use of mechanical ventilation for their management. A prolonged period of mechanical ventilation is costly for both the patient, in terms of adverse effects, and the health care service. Therefore, immediate liberation of the patient from mechanical ventilation and constitution of spontaneous breathing, a process called weaning, is vital. This daily lifesaving practice, on which nurses are taking an increasing role with the introduction of nurse-led protocols, can become complicated requiring the effective use of assessment information through decision-making processes to improve outcomes of care. Most literature on the field fails to address that weaning decisions are affected not only by the nature of the task but also by the characteristics of the decision-maker and the decision environment. This research aimed to study nurses' decision-making processes when managing the weaning of long-term ventilated patients and to explore the impact of the diverse elements of the clinical environment on this intricate practice. An ethnographic approach was used to compare weaning decision-making processes in two different culturally intensive care units (ICU). Participant observation was used to follow the weaning practices of 10 patients in a Scottish ICU and 9 patients in a Greek ICU admitted with respiratory failure due to pneumonia or COPD exacerbation. Nurses were observed in their daily weaning practice and participated in reflective interviews at the end of their shift to extrapolate how they used the information to make their decisions. Semi-structured interviews were, then, conducted with nurses, physiotherapists and medical staff to explore their perceptions on weaning practices and the factors that influenced their decisions and clinical practice. Data were analysed thematically and concept maps were developed from the reflective interviews to analyse nurses‟ decision-making processes. The concept attainment theory was used as a framework to understand nurses' thinking processes. Nurses in all ranges of experience demonstrated a similar decision-making skill, which signifies that this cognitive process is not always related to the level of experience and knowledge. Nurses' weaning care was organised around maintaining a balance of care under the 'wean as able' medical instruction. Inconsistency in the weaning decisions led to a variability of weaning approaches followed for each patient and to long periods of weaning inactivity. Various reasons, related to the working relationships, lack of nurses‟ accountability, lack of support and unstructured information flow, were responsible for the deficiency in sustainable and consistent weaning decisions. In both settings, there was lack of culture to foster a shared decision-making approach in weaning practice and encourage nurses' autonomy in decision-making. This study concluded with proposing a collaborative decision-making framework for weaning long-term ventilated patients, which will involve and appreciate the contribution of all members of the multidisciplinary team.

The exotic options that are examined in this thesis have a combination of non-standard characteristics which can be found in shout, multi-callable, pathdependent and Bermudan options. These options are called reset options. A reset option is an option which allows the holder to reset, one or more times, certain terms of the contract based on pre-specified rules during the life of the option. Overall in this thesis, an attempt has been made to tackle the modeling challenges that arise from the exotic properties of the reset option embedded in segregated funds. Initially, the relevant literature was reviewed and the lack of published work, advanced enough to deal with the complexities of the reset option, was identified. Hence, there appears to be a clear and urgent need to have more sophisticated approaches which will model the reset option. The reset option on the maturity guarantee of segregated funds is formulated as a non-stationary finite horizon Markov Decision Process. The returns from the underlying asset are modeled using a discrete time approximation of the lognormal model. An Optimal Exercise Boundary of the reset option is derived where a threshold value is depicted such that if the value of the underlying asset price exceeds it then it is optimal for the policyholder to reset his maturity guarantee. Otherwise, it is optimal for the policyholder to rollover his maturity guarantee. It is noteworthy that the model is able to depict the Optimal Exercise Boundary of not just the first but of all the segregated fund contracts which can be issued throughout the planning horizon of the policyholder. The main finding of the model is that as the segregated fund contract approaches its maturity, the threshold value in the Optimal Exercise Boundary increases. However, in the last period before the maturity of the segregated fund, the threshold value decreases. The reason for this is that if the reset option is not exercised it will expire worthless. The model is then extended to re ect on the characteristics of the range of products which are traded in the market. Firstly, the issuer of the segregated fund contract is allowed to charge a management fee to the policyholder. The effect from incorporating this fee is that the policyholder requires a higher return in order to optimally reset his maturity guarantee while the total value of the segregated fund is diminished. Secondly, the maturity guarantee becomes a function of the number of times that the reset option has been exercised. The effect is that the policyholder requires a higher return in order to choose to reset his maturity guarantee while the total value of the segregated fund is diminished. Thirdly, the policyholder is allowed to reset the maturity guarantee at any point in time within each year from the start of the planning horizon, but only once. The effect is that the total value of the segregated fund is increased since the policyholder may lock in higher market gains as he has more reset decision points. In response to the well documented deficiencies of the lognormal model to capture the jumps experienced by stock markets, extensions were built which incorporate such jumps in the original model. The effect from incorporating such jumps is that the policyholder requires a higher return in order to choose to reset his maturity guarantee while the total value of the segregated fund is diminished due to the adverse effect of the negative jumps on the value of the underlying asset.

Secure accommodation is locked residential child care for children, usually under the age of 16, who may represent a risk to themselves and/ or others. This thesis examines the findings of a study into decision making processes which determine the provision and legitimacy of secure accommodation for young people in one local authority area in Scotland. The thesis begins by investigating the legislative and policy context, arguing that policy confusion in this area means secure accommodation is likely to face an uncertain future. It goes on to provide an overview of relevant research and contends that there is a need to better understand the processes and factors influencing local decision making. The case study methodology employed is explicated which included the use of interviews, questionnaires, observations, and focus groups in order to gain the perspectives of managers, social workers, children’s panel members, residential workers and young people. The thesis explores the range of factors which were found to influence local decision makers including: their role in the decision making system and the operation of that system; their use of legislation and guidance; their subjective understanding of risk and risk assessment; their personal and collective ‘thresholds of risk’ which were linked to ideas about gender, age and vulnerability; the quality of ‘evidence’ about risks and needs which was influenced by who and how this ‘evidence’ of risk was presented; available resources and perceptions about the suitability of those resources to meet the needs of particular young people and the resident group already in secure placement. Participant conceptualisations of risk are analysed. In contrast to adult decision makers, this thesis demonstrates that young people often understand their own ‘risky’ behaviour as an attempt to communicate with social work systems within which they feel disempowered. The thesis concludes by making a number of recommendations for improvements to decision making policy and practice, including the need for greater transparency in relation to decision making systems and processes and more opportunities for service user participation at every level of local decision making.

Introduction The process of decision making has been widely studied within different academic paradigms. Many theories and models have been developed from this research activity. However, there is a lack of in-depth research on individuals’ experience of decision making. The present research explores this topic with Clinical Psychologists. This group of professionals are trained to be expert in a specific discipline, which emphasises the need for making informed judgements and for justifying decisions. Objectives To provide an in-depth account of how Clinical Psychologists experience decision making in the context of clinical practice. To relate the analysis to theories and models of decision making and to research on factors thought to influence judgement and decision making. Method Semi-structured interviews were conducted with seven Clinical Psychologists. These were transcribed and analysed using Interpretative Phenomenological Analysis (IPA) methodology. Outcomes Elements of the decision making environment such as managing one’s conflicting beliefs and difficult emotions, responding to uncertainty and changeable scenarios and normative versus unique elements of one’s practice were elucidated in the analyses. The contribution of this work to research in decision making and the development of clinical practice are discussed.

The healthcare sector is facing a significant challenge: delivering quality clinical care in a costly and intricate environment. There is a general consensus that a solution for many aspects of this problem lies in establishing a framework for effective and efficient clinical decision support. The key to good decision support is offering clinicians just-in-time accessibility to relevant patient specific knowledge. However, at the present time, management of clinical knowledge and patient records is significantly inadequate resulting in sometimes uninformed, erroneous, and costly clinical decisions. One of the contributing factors is that the field of healthcare is characterized by large volumes of highly complex medical knowledge and patient information that must be captured, processed, interpreted, stored, analyzed, and exchanged. Moreover, different clinical information systems are typically not interoperable. This thesis introduces an approach for realizing a clinical decision support framework that manages complex clinical knowledge in a form of evidence-based clinical practice guidelines. The focus of presented work is directed on the interoperability of knowledge, information, and processes in a heterogeneous distributed environment. The main contributions of this thesis include definition of requirements, conceptual architecture, and approach for an interoperable clinical decision support system that is stand-alone, independent, and based on open source standards.

Approved for public release; distribution is unlimited / The purpose of this thesis is to develop a prototype web-enabled database to improve the process flow of data collection and manipulation in support of Army aviation operations. Data collection is focused around routine aviation operations and aviation maintenance with the intention of identifying a feasible replacement for the existing redundant manual and automated collection procedures. The web interface has the potential to reduce the logistical burden on unit's data collection procedures and provides tailorable, near real time information about aircraft maintenance status, individual training, and unit training to decision makers at all levels as a decision support tool. This thesis will describe the design considerations for a web-enabled database to include the development of detailed data and process models. / Major, United States Army

The history of man is written in choice. Whether simple or complex, on a whim or after labored consideration, inflamed by passion or calculated coolly, the judgments that we form and the choices that we make define who we are and what we want for the future. Yet most of us have little or no conscious awareness of the inner workings of our own minds. We often choose without understanding or accounting for the perceptions, intuitions, and inferences that underlie our decisions. So how do people make decisions? How do we cope with the volume and complexity of information in our environment without being overwhelmed? How do we use our senses to select and process this information, and how do we organize, contextualize, and conceptualize it once it reaches our brains? How do we form judgments about the value of a specific piece of information or about the likelihood of a particular event or outcome? And what are the factors that lead us astray? The search for answers to these questions is more than academic; understanding the fundamentals of perception and cognition is critical to effective analysis and decision-making. For those involved in national security, and particularly for those involved in the collection and analysis of national intelligence, an appreciation of the intricacies of these processes has real-world implications. As evidenced by the dramatic intelligence failures of the last few years, and in particular by the mistaken assessment concerning Iraqi weapons of mass destruction, understanding how we arrive at judgments and decisions can be quite literally a matter of life and death.

This research evaluates the Joint Strike Fighter (JSF) Program acquisition of Pratt & Whitney (P and W) F135 and the General Electric Aircraft Engines/Rolls Royce (GEAE/RR) F136 engines. This study examines existing research on the first *Great Engine War*. The first Great Engine War was an attempt by the Government to encourage Pratt & Whitney, the sole winner of the F- 16 fighter engine propulsion contract, to be more responsive to shortcomings in design and support. When P and W declared that any design changes would be out of the scope of the current contract, the government contracted with GEAE to produce an alternate engine design to compete against P&W. The competition was a success. The study also includes Interviews with veterans of the Great Engine War. The findings are balanced against the current JSF acquisition planning to ensure applicability. The research and analysis yielded the following recommendations to guide the JSF future engine acquisition: ensure airframe commonality for both engines, continue to purchase and support the engines as Government-Furnished Equipment (GFE), utilize supportability costs as competition criteria, maintain a concerted effort to encourage both competitors to attempt to win the maximum share, and do not participate in a Component Improvement Program.