decentralisation has been described as an empty concept that lacks clarity. yet there is an enduring interest in the process of decentralisation within health systems and public services more generally. many claims about the benefits of decentralisation are not supported by evidence. it may be useful as an organising framework for analysis of health systems but in this context it lacks conceptu...

The optimal responses for many decisions faced by humans are ill defined, yet we are able to choose well by associating choices with outcomes, and employing this information in decision making. Previous studies suggest that the parietal cortex is involved in "uncertain" decision making, yet uncertainty is confounded with increased difficulty and attention. Here we aim to dissociate the role of ...

BACKGROUND Patient decision aids (P-DAs) are used to inform patients about healthcare choices, but there is limited knowledge about their longer term effects, beyond the time period of decision-making. METHODS/DESIGN We developed a computerized P-DA that explains the choice of radioactive iodine (RAI) adjuvant treatment or no RAI, for patients with low risk papillary thyroid cancer after tota...

Since the environment is in constant flux, decision-making capabilities of the brain must be rapid and flexible. Yet in sensory motion processing pathways of the primate brain where decision making has been extensively studied, the flexibility of neurons is limited by inherent selectivity to motion direction and speed. The supplementary eye field (SEF), an area involved in decision making on mo...

BACKGROUND Multiple sclerosis is a chronic neurological condition usually starting in early adulthood and regularly leading to severe disability. Immunotherapy options are growing in number and complexity, while costs of treatments are high and adherence rates remain low. Therefore, treatment decision-making has become more complex for patients. Structured decision coaching, based on the princi...

BACKGROUND Comparative effectiveness research (CER) documents important differences in antidepressants in terms of efficacy, safety, cost, and burden to the patient. Decision aids can adapt this evidence to help patients participate in making informed choices. In turn, antidepressant therapy will more likely reflect patients' values and context, leading to improved adherence and mood outcomes. ...

aim and back ground: impulsivity and risky decision making is a core element of plenty of individual and social deficits. on the other hand, history of attention deficit disorder and hyperactivity has been reported in many people with these problem particularly addiction. decision making requires basic cognition function such as inhibition, working memory and attention. the aim of the current s...

What are the neural dynamics of choice processes during reinforcement learning? Two largely separate literatures have examined dynamics of reinforcement learning (RL) as a function of experience but assuming a static choice process, or conversely, the dynamics of choice processes in decision making but based on static decision values. Here we show that human choice processes during RL are well ...

despite a lot of efforts and investigations worldwide, dnr is still a controversial issue in many countries. in iran although significant achievements are reached in different fields; end of life care is hardly considered as a scientific necessity. development and implementation of clear policies for dnr orders is required to prevent futile prolongation of death, psychological stress to the pat...