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PubMed2006

Reading men's faces: women's mate attractiveness judgments track men's testosterone and interest in infants.

This study investigated whether women track possible cues of paternal and genetic quality in men's faces and then map perception of those cues onto mate attractiveness judgments. Men's testosterone concentrations served as a proxy for genetic quality given evidence that this hormone signals immunocompetence, and men's scores on an interest in infants test were chosen as prima facie markers of paternal quality. Women's perceptions of facial photographs of these men were in fact sensitive to these two variables: men's scores on the interest in infants test significantly predicted women's ratings of the photos for how much the men like children, and men's testosterone concentrations significantly predicted women's ratings of the men's faces for masculinity. Furthermore, men's actual and perceived affinity for children predicted women's long-term mate attractiveness judgments, while men's testosterone and perceived masculinity predicted women's short-term mate attractiveness judgments. These results suggest that women can detect facial cues of men's hormone concentrations and affinity for children, and that women use perception of these cues to form mate attractiveness judgments.

Attitude↗
PubMed2006

Does professional autonomy protect medical futility judgments?

Despite substantial controversy, the use of futility judgments in medicine is quite common, and has been backed by the implementation of hospital policies and professional guidelines on medical futility. The controversy arises when health care professionals (HCPs) consider a treatment futile which patients or families believe to be worthwhile: should HCPs be free to refuse treatments in such a case, or be required to provide them? Most physicians seem convinced that professional autonomy protects them from being forced to provide treatments they judge mentally futile, given the lack of patient benefit as well as the waste of medical resources involved. The argument from professional autonomy has been presented in a number of articles, but it has not been subjected to much critical scrutiny. In this paper I distinguish three versions of the argument: 1) that each physician should be free to exercise his or her own medical judgment; 2) that the medical profession as a whole may provide futility standards to govern the practice of its members; and 3) that the moral integrity of each physician serves as a limit to treatment demands. I maintain that none of these versions succeeds in overcoming the standard objection that futility determinations involve value judgments best left to the patients, their designated surrogates, or their families. Nor do resource considerations change this fact, since they should not influence the properly patient-centered judgment about futility.

Administrative Personnel↗
PubMed2006

Rapid benefit-risk assessments: no escape from expert judgments in risk management.

The "human health impacts assessment" described by Cox and Popken (this issue) is intended to be a benefit-risk tool that avoids pitfalls of using expert judgments for policy analysis or during strict application of the precautionary principle in risk management. The proposed benefit-risk calculation uses numerous assumptions and suppositions to calculate a ratio of quality-adjusted life years (QALYs) lost for the number of human illness days prevented by the use of a food-animal antimicrobial drug, to the number of human illness days caused by the use of the antimicrobial drug. Assumptions about data--e.g., expert judgments on the representativeness of parameter estimates--are commonly used in risk assessment and risk management, including Cox and Popken's method. Cox and Popken apply the technique to specific examples of enrofloxacin and macrolides antimicrobial drugs, sometimes used in broiler chickens for human food. Although enthusiastically portrayed as a straightforward calculation of QALYs lost for two decision alternatives, Cox and Popken were silent on the pivotal expert judgment subsumed in their method: quality weights for illnesses caused by antimicrobial-resistant and antimicrobial-sensitive microbes are tacitly assumed to be equal. Yet, the costs in terms of prolonged illness, additional medications, repeat medical visits, and dread of more serious sequelae are expected to differ substantially for antimicrobial-resistant versus antimicrobial-sensitive illnesses. Despite their enthusiasm to the contrary, the "human health impacts assessment" by Cox and Popken is not immune from expert judgments in risk management.

Animals↗
PubMed2005

Being hurt and hurting others: children's narrative accounts and moral judgments of their own interpersonal conflicts.

Children's narrative accounts and moral evaluations of their own interpersonal conflicts with peers were examined. Girls and boys (N = 112) in preschool (M= 4.8 years), first grade (M = 6.9 years), fifth grade (M = 10.9 years), and tenth grade (M = 16.2 years) provided one narrative of a time when they had been hurt by a peer ("victim"), and one of a time when they had hurt a peer ("perpetrator"). Victim and perpetrator narratives were equally long and detailed and depicted similar types of harmful behaviors, but differed significantly in terms of various measures of content and coherence. Narratives given from the victim's perspective featured a self-referential focus and a fairly coherent structure. When the same children gave accounts of situations in which they had been the perpetrators, their construals were less coherent and included multiple shifts between references to their own experience and the experience of the other. Children's moral judgments also varied by perspective, with the majority of victims making negative judgments and nearly half the perpetrators making positive or mixed judgments. These differences in moral judgments were related to the distinct ways in which victims and perpetrators construed conflict situations. Age differences were also found in both narrative construals and moral evaluations, but regardless of their age children construed conflict situations differently from the victim's and the perpetrator's perspectives. By integrating, within the study of moral development, children's interpretations of the social interactions that are at the basis of moral thinking, this approach brings us a step closer to conceptualizing the study of children's moral behavior.

Child↗
PubMed2003

The consistency of bisection judgments in visual grasp space.

We study whether bisection in visual grasp space (the region over which eye and hand can work together to grasp or touch objects) depends on fixation or on the method of judgment employed (the task). We determined observer bias and sensitivity for bisection judgments (in a fronto-parallel plane as well as along contours slanted in depth). Significant biases were found that varied across observers both qualitatively and quantitatively. These biases were stable for a given individual (across a year between data collection intervals) and across tasks (method of adjustment vs. forced-choice). When observers maintained fixation (on an endpoint or in the neighborhood of the bisection point), fixation location had a small but significant effect on bias, although those effects were small compared with bisection uncertainty. We conclude that bisection judgments differ significantly between fixations, but that the effect of fixation location on bisection is not large enough to be detected reliably by the observer moving his or her eyes during a judgment.

Depth Perception↗
PubMed1996

Judgments of quality of life of individuals with severe mental disorders: Patient self-report versus provider perspectives.

OBJECTIVE: This study was an investigation of judgments regarding quality of life of individuals with severe mental disorders from two different perspectives: patient self-report versus provider. METHOD: Judgments on several dimensions of quality of life were collected from a convenience sample of 37 schizophrenic patients and their primary clinicians by using the well-known Quality of Life Index of Spitzer et al. and the more recently developed Quality of Life Index-Mental Health. Both indexes capture judgments on a number of dimensions. Patterns of concordance for the patient-provider pairs were tested by using Cohen's kappa and Pearson correlation coefficients. RESULTS: The results suggest that patients' and providers' judgments are more likely to coincide on clinical aspects, such as symptoms and function, than on social aspects. Specifically, there was moderate agreement on symptoms and function, less agreement on physical health, and little to no agreement on social relations and occupational aspects of quality of life. CONCLUSIONS: Such differences support the notion that treatment strategies and mental health services should address a wide range of needs reflecting different aspects of quality of life perceived as important by different patients.

Activities of Daily Living↗
PubMedDate not supplied

Judgments about intimate partner violence: a statewide survey about immigrants.

OBJECTIVES: The purpose of this research was to: (1) examine judgments about immigrants who are victims of and assailants in intimate partner violence, and (2) assess whether immigrants to the U.S., a diverse and growing population, know that intimate partner violence is illegal in the United States and their judgments about what sanctions, if any, should follow. METHODS: A random-digit-dial telephone survey was conducted in four languages with 3,679 California adults. There were roughly comparable numbers of white, black, Latino, Korean American, Vietnamese American, and other Asian American participants; 60.1% were born outside the U.S. An experimental vignette design was used to vary victim, assailant, and contextual factors about incidents of intimate partner violence and to assess respondents' judgments about the behavior and what should be done about it. Multivariate analyses were conducted to examine the independent effect of these predictor variables and characteristics of the respondents. RESULTS: Respondent judgments about whether an incident of intimate partner violence was wrong, illegal, or about what sanctions should follow were not related to nativity of either the victim or the assailant. Immigrant respondents differed from native-born respondents on two outcomes: immigrants were more likely to think that the behavior was illegal and that guns should be removed from the assailant. CONCLUSIONS: Concerns that immigrants do not know that intimate partner violence is illegal in the U.S. are largely misplaced--immigrants know it soon after their arrival in the U.S. In addition, it appears that a cultural defense regarding domestic violence is not likely to sway others.

Adult↗
PubMedDate not supplied

Revising a priority list based on cost-effectiveness: the role of the prominence effect and distorted utility judgments.

BACKGROUND: People sometimes object to the results of cost-effectiveness analysis when the analysis produces a ranking of options based on both cost and benefit. We suggest 2 new reasons for these objections: the prominence effect, in which people attend mostly to a more prominent attrbute (benefit as opposed to cost), and distortion of utility judgments. METHOD: We simulated the production of a cost-effectiveness ranking list in 3 experiments using questionnaires on the World Wide Web. Subjects rated the utility of 16 health benefits using either rating scale or person trade-off elicitation methods. In some experiments, subjects were asked to rate the utility of the health benefits with attention also to the cost of achieving the benefits. In all experiments, at the end, subjects were shown a priority list based on their own utility judgments and were asked whether they wanted to move any of the health benefits up or down the list. RESULTS: In all experiments, subjects wanted to give higher priority to treatments with higher benefit, even when they also had higher cost. They thus wanted to give less weight to high cost (which would, by itself, lead to lower ranking) and more weight to benefit than the weight implied by their own prior judgments. The desire for revision was reduced when subjects made their utility judgments after indicating whether the utility was above or below the midpoint of the scale (a manipulation previously found to reduce distortion). CONCLUSION: The desire to change cost-effectiveness rankings is in part a preference reversal phenomenon that occurs because people attend mainly to the benefit of health interventions as opposed to cost, when they examine the ranking. People should be wary of tinkering with priority lists by examining the lists themselves.

Adolescent↗
PubMedDate not supplied

Increasing the power of clinical trials through judgment analysis.

A method for increasing the statistical power of clinical trials to detect clinically important differences is described. Inconsistency in physicians' overall judgments of treatment effectiveness adds "noise" to a trial that may mask either the superiority or the inferiority of particular treatments. The method described here uses "judgment analysis" to reduce errors in an individual's overall judgments of treatment effectiveness. The method can also be used to reduce error variance due to differences in judgment between physicians and may thus be particularly useful in multicenter trials. The method is illustrated with results from a recent trial.

Analgesics↗
PubMed2005

Children's nutritional judgments: relation to eating attitudes and body image.

To determine if middle school students use simplified cognitive heuristics with regard to nutritional judgments, a sample of 136 sixth and seventh grade students responded to a series of questions about nutrition, eating attitudes, and body image. Evidence for simplified strategies was obtained. Approximately 50% of the students showed dose insensitivity (i.e., something harmful in large amounts should be avoided in small amounts) and categorical thinking (i.e., foods are either good or bad). Further, 16% of participants selected a fat-free diet as the healthiest. Higher scores on the measure of disordered eating attitudes (Maloney, McGuire, & Daniels, 1988) were associated with stronger endorsement of dose insensitivity and low- or fat-free diets. No relation between body image dissatisfaction and nutritional judgments was found. Educators continue to need to better understand what leads individuals to adopt the cognitive heuristics of dose insensitivity and categorical thinking that can lead to inaccurate nutritional judgments and to address these mistakes in nutritional information programs. Researchers also need to determine if these judgments are reflected in actual dietary behaviors.

Adolescent↗
PubMed1999

Factors affecting the reliability of clinical judgments about the function of children's school-refusal behavior.

Conducted two studies to examine the interrater reliability, test-retest stability, and the effect of various clinician variables, such as years of clinical experience, theoretical orientation, and prior experience with children, on clinical judgments about the reinforcement functions of children's school-refusal behavior. Results indicated that the judgments by individual clinicians were of questionable reliability. Judgments aggregated across 3 clinicians yielded acceptable interrater and test-retest reliability in Study 1, but a greater number of clinicians were necessary to achieve acceptable reliability in Study 2. Years of clinical experience and training were the only clinician variables related to the reliability of judgments about reinforcement functions. Several recommendations for the clinical assessment of the function of children's school-refusal behavior are discussed.

Adolescent↗
PubMed1975

Judgment error in category vs magnitude scales.

The effects of a variety of experimental conditions on the judgments (length of lines) of 16 normal and 16 mentally retarded observers were examined using category and magnitude scaling techniques. Using error and variability of judgment as criteria for measuring response bias, for normal subjects knowledge about the stimulus range, whether learned or provided, had as much to do with resulting judgments as the type of scale used. Judgment error of the retarded group was significantly greater than the normal group and appeared to be related to their limited ability to assign categories or proportions to the simuli used.

Adult↗
PubMed1977

Relationship of field-dependence--independence to posture and judgment of time duration.

Relationships between 84 field-dependent subjects and 84 field-independent subjects, posture, and judgment of duration of time were examined. An analysis of variance yielded no significant difference between the two groups of subjects in the judgment of a 40-sec. interval while in the standing, sitting or horizontal postures or in the comparison of the three postures. Mean judgments of durations became larger from standing to sitting to horizontal postures and over trials for the three postures. It was suggested that the lengthening of the judgment of the 40-sec. interval could be related to a decrease in kinesthetic stimulation with a resultant increase in muscular relaxation which led to a decrease in vigilance.

Adolescent↗
PubMed1992

The role of instructions and familiar size in absolute judgments of size and distance.

The effects of familiar size and instructions (apparent, objective) on direct reports of size and distance were evaluated. Subjects estimated the size and distance of two different-sized playing cards or two unfamiliar stimuli under either apparent or objective instructions. The stimuli were presented successively at a distance of 5.48 m under reduced-cue conditions. The form of the instructions selectively influenced the effect of familiar size on absolute judgments of size and distance, with apparent instructions minimizing, and objective instructions promoting, familiar-size effects. The ratio of the distance judgments of the first to the second presented stimuli approximated the relative retinal sizes of the two objects under both apparent and objective instructions, while the ratio of size judgments tended to be either influenced by or independent of the object's relative retinal sizes under apparent and objective instructions, respectively. These results are consistent with Gogel's theory of off-size perception and, in particular, with the claim that, in comparison with apparent instructions, objective instructions are more likely to direct observers to base their judgments on cognitive, as opposed to perceptual, sources of spatial information.

Adult↗
PubMed1993

The interdependence of pitch and temporal judgments by absolute pitch possessors.

The auditory tau and the kappa effects show that there is time-pitch interdependence in our perception. Our judgments of pitch separation between two tones depend on the temporal interval between them (the auditory tau effect), and our judgments of the tones' temporal interval depend on their pitch separation (the kappa effect). The mechanisms underlying this interdependence were investigated by studying the auditory tau and the kappa effect in three experiments. Comparisons were made between results obtained from subjects with absolute pitch and those who did not have absolute pitch, and two frequency ranges of pure tones (octave and whole-tone conditions) were selected. The procedures had been used in previous experiments (Shigeno, 1986), in which the auditory tau and the kappa effects were compared in speech and nonspeech stimuli. The present results demonstrate that the auditory tau effect does not occur when possessors of absolute pitch judge the closeness of stimuli in pitch, except when the stimulus continuum consists of tones that do not correspond to musical notes in the whole-tone condition. The kappa effect was obtained in the judgment of possessors of absolute pitch in both the octave and the whole-tone conditions. These findings suggest that the interaction between temporal interval and pitch judgment might be explained in terms of the two different memory modes for retaining the pitch of tones, and that these effects occur at the precategorical level.

Acoustic Stimulation↗
PubMed1989

[The relation of person's motives for self-disclosure and the congruency of personality judgment by discloser and recipient].

This study examined the relationship of a person's motives for self-disclosure and degree of self-disclosure to the congruency of personality judgment by the discloser and recipient. The subjects used were 76 pairs of close friends, members in each pair being of the same sex. Personality judgments of disclosers were executed by the disclosers themselves as well as the recipients; and disclosers were also asked to fill out (SMI) and (JSDQ). Results demonstrated that (JSDQ) had no relation to the congruency of personality judgments, but the motives had. In particular, persons who were apt to disclose based on mostly the emotional motive had the minimum congruencies on their personality judgment by disclosers and recipients.

Adult↗
PubMedDate not supplied

A computer expert system prototype for mechanically ventilated neonates development and impact on clinical judgment and information access capability of nurses.

A computer expert system is an alternative method of training and providing real-time clinical decision support for nurses to advance their practices from a novice to a proficient level. The purpose of this study was twofold: (1) to develop a prototype of a computer expert system for mechanically ventilated neonates (ES-MVN) and (2) to assess the impact of the ES-MVN on the clinical judgment and information access capability of nurses. Five steps used in developing the prototype are described in this article. The ES-MVN is a multimedia interactive consultation-based program that contains 2 major parts: the nursing diagnosis and the knowledge base on nursing care of mechanically ventilated neonates. A rule-based (Boolean frame) was chosen for the nursing diagnosis decision model. The prototype was developed on the Web server and a combination of computer applications operated in a Microsoft Windows environment. A quasi-experimental, 1-group pretest-posttest design was used to measure the efficacy of the ES-MVN in 16 neonatal intensive care unit registered nurses. Case simulations were used to test the nurses' clinical judgment performance. The results showed a significant increase in the nurses' performance scores of diagnoses and managed care after using the ES-MVN (t[15] = 17.21, P = .0001). The nurses' scores for perceptions of their information access capability and clinical judgment ability after receiving the ES-MVN were significantly higher than before installing the ES-MVN in the neonatal intensive care unit (ts[15] = 6.91 and = 17.53, Ps = .0001, respectively). The findings suggest the usefulness of the computer expert system as an effective tool to support nurses' clinical judgment in critical care situations and to provide access to information at the practice site.

Adult↗
PubMedDate not supplied

Clinical judgment predicts culture results in upper respiratory tract infections.

BACKGROUND: We wanted to describe the natural history, familial transmission, microbiology, and accuracy of clinical judgment of potential pathogens of respiratory tract infections in a community family practice. METHODS: The study was a prospective case series in which consecutive patients requesting treatment for respiratory tract infections were evaluated after nurse triage during 3 fall-spring months in a solo family practice in suburban Cleveland, Ohio. According to the physician's usual practice, patients were classified into high-, medium-, and low-risk groups for bacterial illness based on their clinical signs and symptoms. Cultures were performed and sensitivities were determined for pathogens from the infected throat, nasopharynx, conjunctiva, or other sites. Patient symptoms and well-being were scored at the initial visit and at 3, 7 and 14 days later. RESULTS: There were 111 illness episodes in 86 patients; 94% had cultures taken, of which 38% grew a potentially pathogenic bacteria, most commonly group A streptococci, Branhamella catarrhalis or Staphylococcus aureus. The physician's judgment of bacterial infection was associated (P < .001) with having a positive culture (sensitivity 53%, specificity 78%, positive and negative predictive values 60% and 73%, respectively). A positive culture was associated with 2 of 16 signs or symptoms: purulent discharge from any site or a red swollen eye. There was no association of treatment status with clinical outcomes during 2 weeks of follow-up observation. CONCLUSION: Infection with a potentially pathogenic bacteria is difficult to determine solely by clinical signs and symptoms, but clinical judgment is associated with positive culture results. The effect of selective treatment of upper respiratory tract infection based on clinical signs and symptoms and patient and family culture results remains to be determined, but using clinical judgment could result in more selective antibiotic use than found in current practice patterns.

Anti-Bacterial Agents↗