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PubMed2003

Expert judgment and occupational hygiene: application to aerosol speciation in the nickel primary production industry.

In many situations characterized by sparse data, occupational hygienists have used subjective judgments that are claimed to be derived from their experience and knowledge. While this practice is widespread, there has been no systematic study of 'expert judgment' or the 'art' of occupational hygiene. Indeed, there is a need to address the question of whether there is such a thing as 'expert opinion' in occupational hygiene that is broadly shared by practicing professionals. This research, employing 11 experts who estimate an exposure parameter (the percentages of four nickel species) in 12 workplaces in a nickel primary production industry, provides a large dataset from which useful inferences can be drawn about the quality of expert judgments and the variability among the experts. A well-designed questionnaire that provided succinct information about the processes and baseline data served to calibrate the experts. The Bayesian framework has been used in this work to develop posterior means and standard deviations of the percentages of the four nickel species in the 12 workplaces of interest in the company. These estimates of the nickel speciation are at least as precise as--and most of the time more precise than--those provided by the sparse measurement data. There was a very high degree of agreement among the experts. A majority of the experts agreed among themselves 92% of the time, while almost two-thirds agreed 73% of the time. This, coupled with the fact that the experts came from varied backgrounds, seems to suggest that there is indeed some broad body of specialized knowledge that the experts are drawing on to reach similar judgments. It also seems that one type of expert is not necessarily any better than any other kind, and expertise does not necessarily require intimate familiarity with the workplace. In this example, the expert judgment exercise has indeed enhanced the quality of our knowledge of the exposure 'fingerprints' for the nickel industry workplaces studied and the combination of expert judgment and sparse data is better than the sparse data alone. For occupational hygiene exposure assessment, our experience suggests that such expert judgment methods can provide a cost-effective means to improve and refine information about workplace hazards. However, more study is warranted for situations where the domain of the quantity of interest has a much wider range of values, e.g. actual exposure values.

Air Pollutants, Occupational↗
PubMed2003

Personality judgments in adolescents' families: the perceiver, the target, their relationship, and the family.

The present study investigated whether personality judgments involve different processes in a family setting than in a nonfamily setting. We used the Social Relations Model to distinguish the effects of perceiver, target, perceiver-target relationship, and family on personality judgments. Family members of families with adolescents judged their own and the other members' Big Five factors. Judgments were found to depend on the relevance of personality factors within the family setting: Agreeableness and Conscientiousness were judged most consistently. Large relationship variance indicated that parents adjust their judgments to the target family member; large perceiver variance indicated that adolescents judge family members' personalities rather similarly. However, a comparison of self- and other-judgments showed adolescents' judgments to be no more related to their self-perceptions than parents' judgments. We concluded that the relevance of personality factors may differ on specific tasks within a setting.

Adolescent↗
PubMed1998

Paramedic judgment of the need for trauma team activation for pediatric patients.

OBJECTIVE: To determine the value of paramedic judgment in determining the need for trauma team activation (TA) for pediatric blunt trauma patients. METHODS: A prospective, observational study was conducted at the ED of Children's Hospital Medical Center of Akron between July 12, 1996, and February 28, 1997, in cooperation with Akron Fire Department emergency medical technician-paramedics (EMT-Ps). The ED provides on-line and off-line medical control for pediatric transports. Patients with minor or no identifiable injuries are released at the scene with the instructions to see a physician. The remainder are transported to the ED. The decision for TTA is based on ED trauma protocols as well as emergency physician judgment of injury severity in combination with the judgment of the treating paramedic. During the study, EMT-Ps were asked (before physician input) whether, based solely on their judgment, a patient needed TTA. Patients 0-14 years old who were involved in motor vehicle crashes, bike crashes, or falls from a height of >10 feet were included in the study. TTA was defined as necessary if the patient was admitted to the intensive care unit (ICU) or operating room (OR) for nonorthopedic surgical procedures. Out-of-hospital, ED, and hospital records were reviewed. Coroners' records as well as medical records of all trauma admissions during the study period were reviewed to ensure that the patients released at the scene were not mistriaged. RESULTS: One hundred ninety-two patients met study criteria. Eighty-five patients (44%) were transported to the ED, of whom 12 had TTA. EMT-Ps requested TTA for 10 of these patients, and 2 patients had TTA per ED trauma protocol. Two of the patients who were judged by EMT-Ps to need TTA were admitted to the ICU/OR, and neither of the patients identified by ED trauma protocol to require TTA were admitted to the ICU/OR. Two initially stable patients who did not have TTA deteriorated after arrival to the ED. Both were admitted to the ICU. The sensitivity and specificity of paramedic judgment of the need for TTA for pediatric blunt trauma patients were 50% (95% CI 9.2-90.8) and 87.7% (95% CI 78.0-93.6), respectively. The positive and negative predictive values were 16.7% (95% CI 2.9-49.1) and 97.3% (95% CI 89.6-99.5). None of the patients released at the scene was mistriaged based on the review of the coroners' and trauma admission records. CONCLUSION: Results of this investigation indicate that a small percentage of pediatric blunt trauma patients require TTA. EMT-P judgment alone of the need for TTA for pediatric blunt trauma patients is not sufficiently sensitive to be of clinical use. The low sensitivity is explained by the deterioration in the clinical condition of 2 initially stable patients. The paramedic disposition decisions from the scene were always accurate. Nontransport by emergency medical services (EMS) may be acceptable in some uninjured pediatric trauma patients. Injured pediatric trauma patients who appear to be stable may deteriorate shortly after injury. However, if a pediatric patient appears injured, transport from the scene and examination by a trauma specialist are needed. Finally, the role of paramedic judgment must be further defined by larger studies with urban, rural, and suburban EMS systems before it can be used as a sole predictor of TTA.

Adolescent↗
PubMed2000

Judgment of duration in individuals with ataxia-telangiectasia.

Several clinical investigations with adults suggest that the cerebellum may be critical for judgment of explicit time intervals; however, little work has been done in populations with lesions of the cerebellum acquired during development. We evaluated 17 individuals with ataxia-telangiectasia (AT), an autosomal recessive disorder with on-set in early childhood characterized by diffuse, almost selective, degeneration of the cerebellar cortex, and 21 normal controls, matched for age. Because patients with AT have motor impairment, verbal IQ (VIQ) was used to estimate intelligence; VIQ was significantly lower in the group with AT (p < .0001). Participants were tested using a test of judgment of duration that has been found to be impaired in adults with cerebellar lesions and a contrasting auditory control task (not impaired in adults with cerebellar lesions) involving judgment of pitch. After statistically controlling for VIQ, the 2 groups did not differ significantly on judgment of pitch, but those with AT performed significantly worse than controls on judgment of duration (p = .01). Children and adolescents with AT show deficits in judgment of duration but not of pitch, suggesting that the cerebellum may be critical for judgment of explicit time intervals at all ages.

Adolescent↗
PubMed1983

Individual differences in distance estimation: comparison of judgments in the field with those from projected slides of the same scenes.

This study was designed to determine the comparative accuracy with which trained and untrained observers could judge distances to a target and to assess the correspondence of those judgments with other judgments, by the same observers, from photographic slides of the same target and scene at identical viewing distances. 9 experienced and 15 untrained observers estimated distances ranging from 600 to 1550 m in 50-m increments. Photographic slides were made of the target at each distance and, 1 mo. later, observers made the same judgments from the slides. It was found that averages of the group's judgments in the field very closely approximated true target distances. However, judgments of the individual observers were so erratic and inaccurate as to render questionable the interpretation of those averages. In addition, while the averages of the group indicated that judgments from two-dimensional slides could be substituted fro three-dimensional real-world judgments, detailed analysis of the individual observers' performances dramatically contradicted this conclusion.

Discrimination Learning↗
PubMed1999

Functional magnetic resonance imaging of neural activity related to orthographic, phonological, and lexico-semantic judgments of visually presented characters and words.

Functional magnetic resonance imaging was used to investigate neural activity during the judgment of visual stimuli in two groups of experiments using seven and five normal subjects. The subjects were given tasks designed differentially to involve orthographic (more generally, visual form), phonological, and lexico-semantic processes. These tasks included the judgments of whether a line was horizontal, whether a pseudocharacter or pseudocharacter string included a horizontal line, whether a Japanese katakana (phonogram) character or character string included a certain vowel, or whether a character string was meaningful (noun or verb) or meaningless. Neural activity related to the visual form process was commonly observed during judgments of both single real-characters and single pseudocharacters in lateral extrastriate visual cortex, the posterior ventral or medial occipito-temporal area, and the posterior inferior temporal area of both hemispheres. In contrast, left-lateralized activation was observed in the latter two areas during judgments of real- and pseudo-character strings. These results show that there is no katakana "word form center" whose activity is specific to real words. Activation related to the phonological process was observed, in Broca's area, the insula, the supramarginal gyrus, and the posterior superior temporal area, with greater activation in the left hemisphere. These activation foci for visual form and phonological processes of katakana also were reported for the English alphabet in previous studies. The present activation showed no additional areas for contrasts of noun judgment with other conditions and was similar between noun and verb judgment tasks, suggesting two possibilities: no strong semantic activation was produced, or the semantic process shared activation foci with the phonological process.

Adult↗
PubMed1975

Moral judgment and parental identification among children.

The relationship of moral judgment and parental identification was studied in 50 boys and 50 girls, all of whom were white, lower-middle-class children, aged 9 1/2 to 11 1/2 years. Two hypotheses were proposed: (1) that within each sex group, children with a higher-level parental identification attain a higher stage of moral judgment than children with a lower level of parental identification; and (2) that there are no sex differences in the stage of moral judgment attained by Ss from similar socioeconomic backgrounds. Ss were screened for socioeconomic status and age. Moral judgment was defined in terms of Piaget's "two moralities" of the child and measured by a structured interview that consisted of five subtests taken from Piaget. Parental identification was measured by means of a semantic space and differential technique, and Ss were grouped on the basis of low, medium and high levels of paternal and maternal identification. Results indicate that there are no significant sex differences in moral judgment. Within each sex group there is a clear positive relationship between high-level identification and a higher stage of moral judgment.

Age Factors↗
PubMed1994

Clinical judgment survey of mental-health professionals: I. An assessment of opinions, ratings, and knowledge.

A sample of mental health professionals listed in the National Register of Health Service Providers in Psychology was surveyed to examine attitudes with regard to the generalizability of findings from clinical judgment research, general beliefs and practices about clinical judgment, and knowledge of scholarly articles and books in the clinical judgment literature. Of the participants, 98.1% were doctoral-level psychologists engaged in clinical practice. Results suggested that participants consistently agreed that tasks used in studies of clinical judgment were not representative of the types of activities performed in their clinical practice. Respondents believed that the study of clinical judgment was important and that research could have meaningful implications for their clinical practice. Participants' knowledge of the judgment literature was significantly lower than expected.

Adult↗
PubMed1998

Independent judgment-linked and motor-linked forms of artificial grammar learning.

Three experiments investigated whether a motor-linked measure (string typing speed) and an judgment-linked measure (grammatical judgment of strings) accessed the same implicit learning mechanisms in the artificial grammar learning task. Participants first studied grammatical strings through observation or through responding to each letter by typing it and then performed typing and grammatical judgment tests. Grammatical judgment test performance was better after observation than after respond learning, whereas typing test performance on higher order relations was worse after observation than after respond learning (Experiment 1). Participants transferred grammatical knowledge across letter sets on the grammatical judgment test, but not on the typing test (Experiment 2). Typing speed did not differ for hits (grammatical strings classified by participants as grammatical) and misses (grammatical strings classified as nongrammatical, Experiment 3). These results are consistent with typing and grammatical judgment tests tapping independent mechanisms and indicate that implicit learning may consist of many different forms of learning rather than being a unitary learning mechanism.

Adolescent↗
PubMed1998

The mere exposure effect is differentially sensitive to different judgment tasks.

The mere exposure effect is the increase in positive affect that results from the repeated exposure to previously novel stimuli. We sought to determine if judgments other than affective preference could reliably produce a mere exposure effect for two-dimensional random shapes. In two experiments, we found that brighter and darker judgments did not differentiate target from distracter shapes, liking judgments led to target selection greater than chance, and disliking judgments led to distracter selection greater than chance. These results for brighter, darker, and liking judgments were obtained regardless of whether shape recognition was greater (Experiment 1) or not greater (Experiment 2) than chance. Effects of prior exposure to novel shapes were reliably observed only for affective judgment tasks. These results are inconsistent with general predictions made by the nonspecific activation hypothesis, but not the affective primacy or perceptual fluency hypotheses which were discussed in terms of cognitive neuroscience research.

Adolescent↗
PubMed1977

Enhancement of maturity of moral judgment by parent education.

Relationships between maturity of moral judgment of parents, role-taking opportunities in the home, roletaking ability in children and maturity of children's moral judgment were studied. A parent intervention program designed to increase role-taking opportunities in the home thought to lead to an increase in the maturity of moral judgment of children was utilized. Suggestive evidence for the claim that it is possible to accelerate rates of moral maturity of children through intervening indirectly to train their parents was found. Significant relationships were also found between maturity of moral judgment in children and role-taking AND OPPORTUNITIES FOR role-taking in the home. Maturity of moral judgment of parents was not found to be significantly related to maturity of moral judgment of their children.

Adult↗
PubMed1992

Asymptomatic mandibular third molars: oral surgeons' judgment of the need for extraction.

Ten oral surgeons were asked to judge the need for extraction of asymptomatic mandibular third molars. Thirty-six mandibular third molars with equal distribution of angular position, impaction status, and patient's sex and age were selected. To estimate the consistency of judgment, the 36 cases were duplicated so that, in all, 72 cases were judged. The judgment of the oral surgeons was compared with that of 30 general dental practitioners (GDPs). The number of mandibular third molars the oral surgeons proposed to extract varied from 3 to 21 of 36 teeth. The mean number of molars proposed for extraction was 12 for the oral surgeons and 13 for the GDPs. There was no third molar that all the observers in the two groups agreed should be extracted. About three times as many observers in both groups proposed extraction of molars partially covered by soft tissue. The oral surgeons were unanimous in their judgment not to extract 11 molars, and the GDPs were also unanimous in judgment not to extract two of these. The mean intraobserver agreement within the two groups was comparable, 94% for the oral surgeons and 92% for the GDPs. We conclude that there is a great variation among oral surgeons in their judgment on the need for removal of asymptomatic mandibular third molars. A similar variation in judgment also was observed among GDPs.

Adolescent↗
PubMedDate not supplied

Judgment: the nurse's key to knowledge.

Recently, nursing has turned more of its attention to judgment and has given it a high priority for study. A significant part of that study asks: What is judgment? How is it made? Why is it important? The ancient Greeks discovered reason and then created enduring art that demonstrates it. Three nurses are excerpted from this literature to evoke and explain how judgment is made. Euryclea, Cilissa, and Medea's nurse also illustrate the personal commitment in judgment. Human beings depend on the nurse's judgment. They depend on the nurse as knower. Nurses are obliged to move from doubt and opinion towards knowledge and certitude. Judgment is the nurse's key to that knowledge.

Drama↗
PubMed1979

Semantic judgment ability in adult aphasia.

Recent psycholinguistic literature suggests that language usage often involves the ability to make judgments or appraisals about various aspects of language. It was therefore the purpose of the present study to examine the semantic judgment or evaluation abilities of thirty persons with aphasia in comparison to these same behaviors in a group of thirty normal individuals. That is, this study examined subject ability to use knowledge to make comparisons or judgments in reference to specific criteria. Results support the existence of a judgment capacity and indicate that persons with aphasia are impaired in their ability to evaluate semantic material. Therefore, speech pathologists may wish to include semantic judgment tasks in their evaluation procedures and plan therapy directed toward the retrieval of judgment responses.

Aged↗
PubMedDate not supplied

The social context of critical care clinical judgment.

BACKGROUND: Clinical judgment in critical care is supported by a rich social network of care providers. The purpose of this study was to describe the social context in which the process of critical care clinical judgment occurs from the nurse's perspective. METHODS: An ethnographic study was conducted that included interviews with 10 nurses and participant observation in an open heart surgery unit with 59 nurses and two surgical teams during a 2-year period. RESULTS: Nurses and physicians were organized in hierarchies of nurse manager, resource nurse, charge nurse, and staff nurse or attending surgeon, fellow, chief resident, and resident. These parallel hierarchies allowed for checks on judgment both within and across professional lines. Rituals, such as nursing report, physician rounds, and flow sheet use, provided a context for a critique on judgment processes. Communication of judgment was frequently a casual, open conversation. At other times, differences in perspective could result in conflict. Communication between nurses and physicians has been associated with better patient outcomes. Critical care unit directors and managers can use an analysis of communication patterns to develop supports to clinical judgment.

Clinical Nursing Research↗
PubMed1994

A prospective comparison of paramedic judgment and the trauma triage rule in the prehospital setting.

STUDY OBJECTIVE: To study paramedic judgment and the Trauma Triage Rule in prehospital trauma triage. DESIGN: Prospective. SETTING: A county emergency medical services system. PARTICIPANTS: Six hundred fifty-three trauma patients. RESULTS: Over a 3-month period, 653 trauma patients were evaluated in the prehospital setting. Paramedic judgment and the Trauma Triage Rule (TTR), as described by Baxt, were evaluated for accuracy in identifying patients requiring trauma center care. The TTR achieved a sensitivity of 88% and a specificity of 86%. Paramedic judgment had a sensitivity of 91% and a specificity of 60%. Combining the TTR and paramedic judgment achieved a sensitivity of 100% and a specificity of 75%. CONCLUSION: The TTR and paramedic judgment are effective in identifying patients who require trauma center care in the prehospital setting. The TTR and paramedic judgment combined have the greatest predictive value in identifying seriously injured patients.

Adolescent↗
PubMed1993

Coping, defending, and the relations between moral judgment and moral behavior in prostitutes and other female juvenile delinquents.

Twenty female juvenile delinquents who acknowledged engaging in prostitution, 20 juvenile delinquents who denied doing so, and 20 same-age control subjects responded to Colby and Kohlberg's (1987) Moral Judgment Interview (MJI), a moral dilemma about prostitution, and Joffe and Naditch's (1977) test of coping and defending. Delinquents scored lower on moral maturity and coping and higher on defensiveness than nondelinquents. Post hoc analyses revealed that low-coping delinquents (but not high-coping delinquents or control subjects) made significantly lower level moral judgments on the prostitution dilemma than on the less personally relevant MJI dilemmas. Groups did not differ in their prescriptive judgments on the MJI, but prostitutes made weaker judgments against prostitution than the other delinquents. Prescriptive judgments were not related to moral maturity. The results elucidate the relation between moral judgment and moral behavior.

Adaptation, Psychological↗
PubMed1988

Friends and strangers: acquaintanceship, agreement, and the accuracy of personality judgment.

We examined the effect of acquaintanceship on interjudge agreement in personality ratings. Approximately 150 undergraduates described their own personalities using the Q-sort. They were also described by two close acquaintances and by two "strangers" who knew them only via a single, spontaneous interaction viewed on videotape. The effect of acquaintanceship was powerful: Judgments by close acquaintances agreed with each other and with subjects' self-judgments much better than did judgments by strangers, even though strangers' judgments agreed with each other and with subjects' self-judgments beyond a chance level. This result implies that agreement among acquaintances' judgments must derive at least partly from experience with and observation of the person who is judged. The same traits that yielded better agreement among acquaintances also yielded better agreement among strangers and tended to be rated higher in subjective visibility, suggesting that people are intuitively knowledgeable about the traits they can judge with more and less agreement.

Adult↗