Forecasting and ethical decision-making: What matters?

This study examined how the number and types of consequences considered are related to forecasting and ethical decision-making. Undergraduate participants took on the role of the key actor in several ethical problems and were asked to forecast potential outcomes and make a decision about each problem. Performance pressure was manipulated by ostensibly making rewards contingent on good problem-solving performance. The results indicated that forecast quality was associated with decision ethicality, and the identification of the critical consequences of the problem and consequences for others were associated with both higher quality forecasts and more ethical decisions. Additionally, the identification of a larger number of consequences was negatively associated with ethical decision-making. Performance pressure did not impact forecast quality or ethicality of decisions. Theoretical and practical implications of these findings are discussed

Pressure and ethical decision-making

Performance pressure degrades performance on many types of tasks. Mounting evidence, however, suggests that pressure may not affect ethical decision-making. For the present study, participants analyzed an ethical dilemma using a cognitive tool (ACED IT), expressive writing, or a control task, and their decisions were compared for participants in high and low pressure conditions. Perceptions of moral intensity were also measured

Situational impacts on leader ethical decision-making

Leader ethical decision-making has received a great deal of attention in the academic literature. Most research examining ethical leadership has focused on the leader characteristics and subordinate outcomes associated with ethical leadership, but research examining the situational variables influencing leader ethical decision-making is limited. Thus, the purpose of this study was to examine a number of situational variables that may influence leader ethical decision-making. This study examined the impacts of performance pressure, interpersonal conflict, the leader’s decision-making autonomy, the type of ethical issue at hand, and the level of authority of the other person involved in the interaction. The results indicated that when making a decision in response to a superior (as opposed to a peer or subordinate), leaders make worse decisions. Additionally, a number of interactions of the other variables negatively impacted leaders’ ethical decision-making. The implications of these findings are discussed

A cognitive tool for ethical decision-making: A case for ACED IT

The present study examined two forms of a cognitive tool (ACED IT map), which is designed to facilitate ethical decision-making, along with expressive writing. Results demonstrated that participants completing the original ACED IT were more likely to identify: 1) more steps to implementing a solution, 2) more barriers to solution implementation, and 3) more solutions to those barriers, than participants who completed the modified ACED IT, engaged in expressive writing, and those in the control group. These findings suggest that cognitive tools such as ACED IT may be of considerable value for individuals who are presented with ethical dilemmas

A little goes a long way: Adapting an ethics training program to work for smaller universities

The present project modified an existing ethics intervention aimed at graduate students, which had previously been evaluated and determined to be effective (e.g., Mumford et al., 2008). The existing program was modified to shorten it from a 2-full day training to a 1-full day training. The effectiveness of the modified training program was evaluated using multiple dependent measures: perceptions of ethical dilemmas, ethical decision-making and the using of cognitive strategies for ethical decision-making, and reactions to the training. The results of the present study indicated that there were significant differences from pre-training to post-training on measures of perceptions of ethical problems and markers of the cognitive processes involved in ethical decision-making, including a focus on the ethical elements of the problem, and overall decision ethicality. Finally, participants responded favorably to the program. Implications of these results are discussed

Ethical decision-making interrupted: Can cognitive tools improve decision-making following an interruption?

This study examined the effects of interruptions and the use of cognitive decision-making tools on ethical decision-making. Participants completed a structured cognitive tool, an unstructured decision-making technique, or no decision-making technique, and half of the participants were interrupted during the decision-making task, whereas half were allowed to complete the decision-making task without interruption. Results revealed that 1) participants who completed the structured cognitive tool (ACED-IT map) performed better on a number of markers of ethical decision-making, 2) interruptions reduced participants’ plan quality, and 3) participants who were interrupted, and who completed the structured cognitive tool exhibited perceptions that suggested that they felt better prepared to handle the ethical dilemma. These results could have important implications for professionals in jobs that experience frequent interruptions, particularly those in management positions

A model combining age, equivalent uniform dose and IL-8 may predict radiation esophagitis in patients with non-small cell lung cancer

Background and purpose To study whether cytokine markers may improve predictive accuracy of radiation esophagitis (RE) in non-small cell lung cancer (NSCLC) patients. Materials and methods A total of 129 patients with stage I-III NSCLC treated with radiotherapy (RT) from prospective studies were included. Thirty inflammatory cytokines were measured in platelet-poor plasma samples. Logistic regression was performed to evaluate the risk factors of RE. Stepwise Akaike information criterion (AIC) and likelihood ratio test were used to assess model predictions. Results Forty-nine of 129 patients (38.0%) developed grade ≥2 RE. Univariate analysis showed that age, stage, concurrent chemotherapy, and eight dosimetric parameters were significantly associated with grade ≥2 RE (p < 0.05). IL-4, IL-5, IL-8, IL-13, IL-15, IL-1α, TGFα and eotaxin were also associated with grade ≥2 RE (p <0.1). Age, esophagus generalized equivalent uniform dose (EUD), and baseline IL-8 were independently associated grade ≥2 RE. The combination of these three factors had significantly higher predictive power than any single factor alone. Addition of IL-8 to toxicity model significantly improves RE predictive accuracy (p = 0.019). Conclusions Combining baseline level of IL-8, age and esophagus EUD may predict RE more accurately. Refinement of this model with larger sample sizes and validation from multicenter database are warranted

SCOPE: a scorecard for osteoporosis in Europe

Summary The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. Methods The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). Results There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Conclusions The scorecard will enable healthcare professionals and policy makers to assess their country’s general approach to the disease and provide indicators to inform future provision of healthcare

A new generation computerised metacognitive cognitive remediation programme for schizophrenia (CIRCuiTS): a randomised controlled trial

Background: Cognitive remediation (CR) is a psychological therapy which improves cognitive and social functioning in people with schizophrenia. It is now being implemented within routine clinical services and mechanisms of change are being explored. We designed a new generation computerised CR programme, CIRCuiTS, to enhance strategic and metacognitive processing, with an integrated focus on the transfer of cognitive skills to daily living. This large trial tested its feasibility to be delivered in therapist-led and independent sessions, and its efficacy for improved cognitive and social functioning. Methods: A two arm single blind randomised superiority trial comparing CIRCuiTS plus treatment-as-usual (TAU) with TAU alone in 93 people with a diagnosis of schizophrenia. Cognitive, social functioning and symptom outcomes were assessed at pre- and post-therapy and three months later. Results: 85% adhered to CIRCuiTS, completing a median of 28 sessions. There were significant improvements in visual memory at post-treatment (p=0.009) and follow-up (p=0.001), and a trend for improvements in executive function at post-treatment (p=0.056) in favour of the CIRCuiTS group. Community function was also differentially and significantly improved in the CIRCuiTS group at post-treatment (p=0.003) but not follow-up, and was specifically predicted by improved executive functions. Conclusions: CIRCuiTS was beneficial for improving memory and social functioning. Improved executive functioning emerges as a consistent predictor of functional gains and should be considered an important CR target to achieve functional change. A larger-scale effectiveness trial of CIRCuiTS is now indicated