Decision aids are intended to inform and empower healthcare consumers in their treatment decisions in an increasingly complex decision-making context where there are often numerous evidence-based treatment options across which to navigate risk/benefit tradeoffs. Evidence-based depression treatments now span several modalities including pharmacological and psychosocial approaches. Given a complex decision-making task, there is the need for consumer decision aids containing sufficient high quality evidence-based information presented in a balanced way in order to navigate options and make informed, values-congruent decisions. Of concern is the relative lack of decision support materials targeted toward adolescents and young adults (18-25 years of age), especially given high incidence rates of mental health problems and lower rates of treatment seeking. The purpose of this study was to examine young adults’ evaluations of the content of a new web-based depression treatment decision aid. The project involved a sequential exploratory mixed-methods design, consisting of a qualitative study followed by a quantitative study. Study 1 involved collection and framework analysis of interview data from a sample of 10 young adults with a history of depression treatment. Results are reported in terms of participants’ familiarity as well as approval for the clarity, amount, balance, trustworthiness, completeness, and helpfulness of the information. Participants also made numerous suggestions for improvement. These suggestions were vetted and many were incorporated into a revised decision aid which was then quantitatively evaluated in Study 2 by 175 Introductory Psychology students. Study 2 variables included participant ratings of the amount, clarity, balance, trustworthiness, and helpfulness of the information. Associations across sociodemographics, evaluative ratings, and time spent on topics were explored. The findings have implications regarding strategies to develop high quality, consumer sensitive information to facilitate informed decision making in young adults. Given that the Internet is increasingly used to search for health information, combined with research indicating acceptability of health websites by young adults, the availability of these materials on the Web may be particularly helpful to support decision-making about treatment for depression for this group.

Objective: Global HIV/AIDS pandemic continues to affect people worldwide. India has approximately 2 million women living with HIV/AIDS. Women in India maintain a low status in society, with minimal autonomy. This study investigated the relationship between women's autonomy in decision-making and their AIDS knowledge (designated ‘ever heard of AIDS').Methods: This study used the 1998-2000 Demographic Health Survey with India's National Family Health Survey (NFHS-2). Data were collected on 90,300 ever-married women ages 15-49. Statistical analyses were conducted in SAS 9.1, including descriptive analysis, univariate analysis, and multiple logistic regression.Results: In the sample, 40,777 (45.2%) of the 90,300 women had ever heard of AIDS. Younger women (15-24 years) had the lowest prevalence of AIDS knowledge (40.9%). The highest geographic prevalence of knowledge was in South India (= 70.4%) compared to the lowest in Central India (=21.6%). Socio-economically, women in lowest level for standard of living had the lowest prevalence of AIDS knowledge (20.6%). Half of women with primary educations and 42.9% of Hindu women reported knowledge. Women were 1.71 (95% CI, 1.66-1.77) times more likely to have AIDS knowledge in the role of primary decision-makers. Even after adjusting, women in primary decision-making roles for their health care remained 16% (95% CI, 11-22) more likely to have AIDS knowledge compared to women whose husbands were primary decision-makers.Conclusion: The study allows for better understanding of the role that decision-making autonomy plays in HIV/AIDS knowledge among women in India. Intervention and education programs can integrate the findings to strengthen their effectiveness.

A classe contábil necessita manter elevados padrões éticos junto à sociedade, como pré-requisito essencial para a sua própria sobrevivência. Nesse contexto, este estudo teve como objetivo conhecer as percepções do contabilista a respeito do seu Código de Ética Profissional (CEPC), por meio de uma pesquisa de natureza descritiva e com a adoção do método quantitativo no tratamento dos dados. A amostra foi constituída por 2262 contadores e técnicos em contabilidade com registro ativo em Conselho Regional de Contabilidade, nos Estados do Rio de Janeiro, São Paulo, Minas Gerais e Rio Grande do Sul. Os resultados obtidos evidenciaram que, embora cerca de 73% dos profissionais concordem totalmente com a afirmação de que esse Código é importante como guia de conduta profissional, apenas 44% se predispõem a cumprir totalmente as normas estabelecidas pelo Conselho Federal de Contabilidade. A partir da regressão logística multivariada, constata-se que aqueles profissionais que concordaram totalmente que já leram o Código apresentaram 2,82 mais chances de cumprirem as determinações do Código do que os que discordaram totalmente dessa afirmação. Os profissionais que concordaram totalmente com a afirmação de que o CEPC ajuda-os a reduzir suas dúvidas apresentam 3,65 mais chances de cumprir o referido Código do que os que discordaram totalmente dessa afirmação. Em decorrência, a percepção do contabilista a respeito da importância dada ao CEPC como guia de conduta influencia a sua predisposição de cumprir o Código. Os resultados também sugerem que: a) a gravidade da infração ética é positivamente associada à percepção que o profissional tem sobre a sanção a ser aplicada ao infrator desse Código, embora exista um baixo coeficiente de correlação entre ambas; b) a avaliação teleológica, que contém situações atenuantes e agravantes não contidas no Código de Ética, pode influenciar o profissional em seu processo de tomada de decisão ética. / Brazilian accountants need to uphold high ethical standards in their service to society as this counts as an essential prerequisite for their survival. In this context, the objective of this study is to learn what perceptions of the Code of Ethics (CEPC) are held by these professionals. This is done by conducting descriptive research and adopting a quantitative method for analysis of data. The sample considered consists of 2,262 accountants and accountant technicians certified and chartered by the Regional Council of Accounting in the states of Rio de Janeiro, São Paulo, Minas Gerais and Rio Grande do Sul. The results obtained show that approximately 73% of professionals polled totally agree with the statement claiming that the Code is important as a guide of conduct; however, only 44% are willing to comply with the guidelines established by the Federal Council of Accounting. Multivariate logistic regression analysis shows that professionals who totally agreed to having read the Code are 2,82 times more likely to abide by its norms than those who totally disagreed with said statement. Professionals who totally agreed with the statement claiming that the CEPC helps them reduce their doubts are 3,65 times more likely to abide by the Code than those who totally disagreed with said statement. Consequently, an accountant’s perception of the importance of CEPC as a guide of conduct influences his/her predisposition to abide by it. The results suggest that: a) the gravity of an ethical infraction is positively associated with a professional’s perception of the Code sanction to be inflicted upon him/her, although there exists a small correlation coefficient between both; b) teleological evaluation, which contains mitigating or aggravating situations not included in the Code of Ethics, may influence a professional in his/her ethical decision-making process. The results do not provide enough evidence of the influence of individual factors on an accountant’s ethical decision-making process.

A sustentabilidade pode ser encarada como uma nova disciplina do conhecimento humano, agregando em seu escopo o conflito entre as dimensões ambiental, econômica e social. Esta Tese desenvolveu uma Metodologia de Avaliação da Sustentabilidade, aplicada a sistemas de tratamento de esgotos, bem como a sua aplicação na forma de um estudo de caso. A referida metodologia insere-se como uma ferramenta que pode ampliar o processo decisório, quando de um Estudo de Concepção, etapa anterior ao desenvolvimento de um projeto de uma estação de tratamento de esgotos, indo além dos critérios técnicos e econômicos. Ainda, dentro de sua estrutura, foi implementada uma plataforma participativa composta pela comunidade em estudo e por especialistas na área de saneamento ambiental. Foram comparadas três alternativas de processos de tratamento passíveis de serem implantadas em uma estação de tratamento de esgotos, situada no município de Capão da Canoa: reator anaeróbio e banhados construídos, lagoas de estabilização e banhados construídos, assim como o sistema de lodos ativados seguidos por uma etapa de desinfecção. Da análise dos referidos processos, a alternativa que contemplou as lagoas de estabilização associadas aos banhados construídos mostrou o melhor desempenho à luz das três dimensões da sustentabilidade. Com base nos resultados obtidos, observou-se que a Metodologia de Avaliação proposta, pode, efetivamente, elucidar os projetistas sobre a questão da sustentabilidade associada aos sistemas de tratamento de esgotos, bem como promover um processo decisório participativo, onde resultem soluções técnicas mais justas e transparentes. / The sustainability can be seen as a new discipline of human knowledge, adding to the scope of the conflict between the environmental, economic and social dimensions. This Thesis developed a methodology for assessment of the sustainability applied to wastewater treatment systems and its application as a case study. The methodology should be seen as a tool that can extend the decison making process, starting from a preliminary study of design, the stage preceding the development of a project from a wastewater treatment plant, going beyond the technical and economical criteria. More, inside its structure was implemented a participatory platform, compound by the community under study and by experts in the field of environmental sanitation. Were compared three alternatives of procedures that can be implanted in a wastewater treatment plant, located in Capão da Canoa: UASB reactor and constructed wetlands, stabilization ponds and constructed wetlands, as well as the activated sludge system followed by a stage of disinfection. From the analyses of those cases, the alternative that included the stabilization ponds associated with constructed wetlands showed the best performance under the perspective of the three dimensions of sustainability. Based on the results, it was observed that the assessment methodology proposed can, indeed, elucidate the designers on the issue of sustainability associated with wastewater treatment systems and promote a participatory decision process with more fair and transparent technical solutions.

A sustentabilidade pode ser encarada como uma nova disciplina do conhecimento humano, agregando em seu escopo o conflito entre as dimensões ambiental, econômica e social. Esta Tese desenvolveu uma Metodologia de Avaliação da Sustentabilidade, aplicada a sistemas de tratamento de esgotos, bem como a sua aplicação na forma de um estudo de caso. A referida metodologia insere-se como uma ferramenta que pode ampliar o processo decisório, quando de um Estudo de Concepção, etapa anterior ao desenvolvimento de um projeto de uma estação de tratamento de esgotos, indo além dos critérios técnicos e econômicos. Ainda, dentro de sua estrutura, foi implementada uma plataforma participativa composta pela comunidade em estudo e por especialistas na área de saneamento ambiental. Foram comparadas três alternativas de processos de tratamento passíveis de serem implantadas em uma estação de tratamento de esgotos, situada no município de Capão da Canoa: reator anaeróbio e banhados construídos, lagoas de estabilização e banhados construídos, assim como o sistema de lodos ativados seguidos por uma etapa de desinfecção. Da análise dos referidos processos, a alternativa que contemplou as lagoas de estabilização associadas aos banhados construídos mostrou o melhor desempenho à luz das três dimensões da sustentabilidade. Com base nos resultados obtidos, observou-se que a Metodologia de Avaliação proposta, pode, efetivamente, elucidar os projetistas sobre a questão da sustentabilidade associada aos sistemas de tratamento de esgotos, bem como promover um processo decisório participativo, onde resultem soluções técnicas mais justas e transparentes. / The sustainability can be seen as a new discipline of human knowledge, adding to the scope of the conflict between the environmental, economic and social dimensions. This Thesis developed a methodology for assessment of the sustainability applied to wastewater treatment systems and its application as a case study. The methodology should be seen as a tool that can extend the decison making process, starting from a preliminary study of design, the stage preceding the development of a project from a wastewater treatment plant, going beyond the technical and economical criteria. More, inside its structure was implemented a participatory platform, compound by the community under study and by experts in the field of environmental sanitation. Were compared three alternatives of procedures that can be implanted in a wastewater treatment plant, located in Capão da Canoa: UASB reactor and constructed wetlands, stabilization ponds and constructed wetlands, as well as the activated sludge system followed by a stage of disinfection. From the analyses of those cases, the alternative that included the stabilization ponds associated with constructed wetlands showed the best performance under the perspective of the three dimensions of sustainability. Based on the results, it was observed that the assessment methodology proposed can, indeed, elucidate the designers on the issue of sustainability associated with wastewater treatment systems and promote a participatory decision process with more fair and transparent technical solutions.

A sustentabilidade pode ser encarada como uma nova disciplina do conhecimento humano, agregando em seu escopo o conflito entre as dimensões ambiental, econômica e social. Esta Tese desenvolveu uma Metodologia de Avaliação da Sustentabilidade, aplicada a sistemas de tratamento de esgotos, bem como a sua aplicação na forma de um estudo de caso. A referida metodologia insere-se como uma ferramenta que pode ampliar o processo decisório, quando de um Estudo de Concepção, etapa anterior ao desenvolvimento de um projeto de uma estação de tratamento de esgotos, indo além dos critérios técnicos e econômicos. Ainda, dentro de sua estrutura, foi implementada uma plataforma participativa composta pela comunidade em estudo e por especialistas na área de saneamento ambiental. Foram comparadas três alternativas de processos de tratamento passíveis de serem implantadas em uma estação de tratamento de esgotos, situada no município de Capão da Canoa: reator anaeróbio e banhados construídos, lagoas de estabilização e banhados construídos, assim como o sistema de lodos ativados seguidos por uma etapa de desinfecção. Da análise dos referidos processos, a alternativa que contemplou as lagoas de estabilização associadas aos banhados construídos mostrou o melhor desempenho à luz das três dimensões da sustentabilidade. Com base nos resultados obtidos, observou-se que a Metodologia de Avaliação proposta, pode, efetivamente, elucidar os projetistas sobre a questão da sustentabilidade associada aos sistemas de tratamento de esgotos, bem como promover um processo decisório participativo, onde resultem soluções técnicas mais justas e transparentes. / The sustainability can be seen as a new discipline of human knowledge, adding to the scope of the conflict between the environmental, economic and social dimensions. This Thesis developed a methodology for assessment of the sustainability applied to wastewater treatment systems and its application as a case study. The methodology should be seen as a tool that can extend the decison making process, starting from a preliminary study of design, the stage preceding the development of a project from a wastewater treatment plant, going beyond the technical and economical criteria. More, inside its structure was implemented a participatory platform, compound by the community under study and by experts in the field of environmental sanitation. Were compared three alternatives of procedures that can be implanted in a wastewater treatment plant, located in Capão da Canoa: UASB reactor and constructed wetlands, stabilization ponds and constructed wetlands, as well as the activated sludge system followed by a stage of disinfection. From the analyses of those cases, the alternative that included the stabilization ponds associated with constructed wetlands showed the best performance under the perspective of the three dimensions of sustainability. Based on the results, it was observed that the assessment methodology proposed can, indeed, elucidate the designers on the issue of sustainability associated with wastewater treatment systems and promote a participatory decision process with more fair and transparent technical solutions.

A classe contábil necessita manter elevados padrões éticos junto à sociedade, como pré-requisito essencial para a sua própria sobrevivência. Nesse contexto, este estudo teve como objetivo conhecer as percepções do contabilista a respeito do seu Código de Ética Profissional (CEPC), por meio de uma pesquisa de natureza descritiva e com a adoção do método quantitativo no tratamento dos dados. A amostra foi constituída por 2262 contadores e técnicos em contabilidade com registro ativo em Conselho Regional de Contabilidade, nos Estados do Rio de Janeiro, São Paulo, Minas Gerais e Rio Grande do Sul. Os resultados obtidos evidenciaram que, embora cerca de 73% dos profissionais concordem totalmente com a afirmação de que esse Código é importante como guia de conduta profissional, apenas 44% se predispõem a cumprir totalmente as normas estabelecidas pelo Conselho Federal de Contabilidade. A partir da regressão logística multivariada, constata-se que aqueles profissionais que concordaram totalmente que já leram o Código apresentaram 2,82 mais chances de cumprirem as determinações do Código do que os que discordaram totalmente dessa afirmação. Os profissionais que concordaram totalmente com a afirmação de que o CEPC ajuda-os a reduzir suas dúvidas apresentam 3,65 mais chances de cumprir o referido Código do que os que discordaram totalmente dessa afirmação. Em decorrência, a percepção do contabilista a respeito da importância dada ao CEPC como guia de conduta influencia a sua predisposição de cumprir o Código. Os resultados também sugerem que: a) a gravidade da infração ética é positivamente associada à percepção que o profissional tem sobre a sanção a ser aplicada ao infrator desse Código, embora exista um baixo coeficiente de correlação entre ambas; b) a avaliação teleológica, que contém situações atenuantes e agravantes não contidas no Código de Ética, pode influenciar o profissional em seu processo de tomada de decisão ética. / Brazilian accountants need to uphold high ethical standards in their service to society as this counts as an essential prerequisite for their survival. In this context, the objective of this study is to learn what perceptions of the Code of Ethics (CEPC) are held by these professionals. This is done by conducting descriptive research and adopting a quantitative method for analysis of data. The sample considered consists of 2,262 accountants and accountant technicians certified and chartered by the Regional Council of Accounting in the states of Rio de Janeiro, São Paulo, Minas Gerais and Rio Grande do Sul. The results obtained show that approximately 73% of professionals polled totally agree with the statement claiming that the Code is important as a guide of conduct; however, only 44% are willing to comply with the guidelines established by the Federal Council of Accounting. Multivariate logistic regression analysis shows that professionals who totally agreed to having read the Code are 2,82 times more likely to abide by its norms than those who totally disagreed with said statement. Professionals who totally agreed with the statement claiming that the CEPC helps them reduce their doubts are 3,65 times more likely to abide by the Code than those who totally disagreed with said statement. Consequently, an accountant’s perception of the importance of CEPC as a guide of conduct influences his/her predisposition to abide by it. The results suggest that: a) the gravity of an ethical infraction is positively associated with a professional’s perception of the Code sanction to be inflicted upon him/her, although there exists a small correlation coefficient between both; b) teleological evaluation, which contains mitigating or aggravating situations not included in the Code of Ethics, may influence a professional in his/her ethical decision-making process. The results do not provide enough evidence of the influence of individual factors on an accountant’s ethical decision-making process.

Researchers’ attempts at understanding the processes underlying witness choosing behavior have focused on applying models that predict that identifications will be primarily driven by memorial factors. However, research has shown that several non-memorial variables affect witness choosing behavior (e.g., administrator influence, clothing bias, co-witness information); thus a full understanding of the processes underlying witness choosing behavior needs to account for these effects. While the memory-based models do attempt to provide explanations for the effects of non-memorial based variables on choosing behavior they all do so within a memorial context. However, I will argue a lineup task is not simply a memory task but a task that allows both memorial and non-memorial variables to impact choosing behavior, with the latter affecting choosing through an inferential process. The purpose of the present study was to provide an initial test of a novel, inferential based framework (i.e., the Competition/Corroboration Conceptualization). In short, this framework predicts that the effect of non-memorial cues on choosing behavior will occur via leading witnesses to deliberatively infer who the suspect is, and that the extent to which a deliberative process is engaged is dependent upon the witnesses’ ecphoric experience. Study 1 (N = 146) had mock-witnesses view several lineups with non-memorial cues embedded in them; results showed that mock-witnesses engaged in an inferential process by using the cues in the lineup to help guide their choosing behavior. Study 2 (N = 376) had witnesses view either a target-present or target-absent lineup where a non-memorial cue suggested that witnesses should either identify the target, identify a specific filler, or was not included. Witnesses then made an identification decision. Results from study 2 showed that the presence of a non-memorial cue suggesting the suspect’s guilt increased suspect identifications compared to its absence, and importantly, that this effect was greater for witnesses who had a weak ecphoric experience. Findings across both studies suggest that an inferential based framework of witness choosing more fully encompasses the underlying nature of witnesses’ phenomenological experience. Practical implications and future directions are discussed.

The purpose of this study was to explore healthcare providers' awareness and perceptions of complementary and alternative medicine (CAM) use in providing systemic lupus erythematosus (SLE) care. This phenomenolgical study was built upon existing research indicating SLE patients' need to foster better communication about CAM use. Participants were recruited from the Long Island Rheumalogical Clinic in the State of New York. Individual in-depth semistructered interviews were conducted to explore the awareness and perceptions of a purposive sample of 10 healthcare providers who care for patients with SLE. Transcripts were analyzed, and categorical themes were developed. Guided by the use of the shared decision-making model and self-efficacy theory, 5 themes emerged: varied knowledge and experiences with CAM varied, participants' personal experience and perceived effectiveness led to patient guidance and advice, perceived benefits of CAM use, participants as patient advocates, and initiatives for further research. Study findings revealed that the knowledge, attitudes, and beliefs of health care providers regarding the use of CAM shed light on the importance of health promotion to guide future research, both within and beyond CAM. Strategies are recommended to increase awareness and understanding of CAM use through proper education and advocacy. This research may lead to positive social change in that providers may use the information in this research to break down barriers to communication between patients and professionals regarding CAM usage.

Livsuppehållande vård möjliggör för många patienter ett förlängt liv. Att förlänga livet medför många etiska dilemman som kräver en öppen dialog vårdteamet sinsemellan. Sjuksköterskan är aldrig den som fattar beslut angående den livsuppehållande vården men är den som verkställer beslutet och utgör en länk mellan patient och vårdteam. Syftet med denna litteraturstudie är att undersöka hur sjuksköterskor upplever livsuppehållande vård. En frågeställning med nära anknytning till syftet utformades för att nå en djupare förståelse för ämnet. Metoden är en systematisk litteraturstudie bearbetad genom Goodmans sju steg för en forskningsprocess. Studien baseras på tio vetenskapliga artiklar framtagna genom databassökningar i databaserna PubMed och CINAHL. Resultatet från artikelgranskningen visar på att sjuksköterskorna inte upplever att deras åsikter tages med i beslutsfattandet av livsuppehållande vård samt att information som ligger till grund för beslutsfattandet ej meddelas dem. Slutsatsen för litteraturstudien är att sjuksköterskor upplever många känslor i den livsuppehållande vården men saknar ett forum där känslorna kan komma till uttryck. / Life-sustaining treatment makes it possible for a lot of patients to prolong their lives. Prolongation of life creates many ethical dilemmas that require an open dialogue within the patient care team. The nurse is never the one who makes the decision regarding the life-sustaining treatment but is the one who carries out the decision and constitute a link between the patient and the care team. The aim of this literature review is to examine nurses’ perception of life-sustaining treatment. One question with close attachment to the aim of this study was framed to reach a deeper understanding for the subject. The method is a systematic literature review processed through Goodman’s seven steps for a science process. The study is based on ten scientific articles assembled through searches in the databases PubMed and CINAHL. The results from the review of the articles show that nurses do not feel that their opinion is valued when decisions regarding life-sustaining treatment are being taken, and that they are not permitted to take part of the information that the decision is based on. The conclusion of this literature review is that nurses experience many feelings towards life-sustaining treatment but lacks a forum where the feelings may be expressed.