Choice Awareness Research Articles

Understanding Major Choice and Career Awareness of First-Semester Animal Science Students

Focus groups were conducted with first-semester, direct-from-high-school Animal Science (ANS) and Dairy Science (DYS) undergraduates in peer mentor groups as part of the ANS 1100 (Orientation in Animal Science) course. These focus groups are the initial phase of a mixed-methods project aimed at developing a survey for future incoming classes. The study explores students’ reasons for choosing their major, career awareness, pre-enrollment knowledge sources, and coursework and career expectations, with this report focusing on the first two objectives. Fourteen focus groups were held, with 90 of 115 students attending (78%). Recordings were transcribed, and key themes were identified. Students chose the ANS or DYS majors due to a mix of personal passion, career goals, and influential experiences. A strong interest in working with animals, hands-on learning opportunities, and clear career pathways—especially in veterinary medicine and animal production—were key factors. External influences, such as family, mentors, and the university’s reputation, also shaped their decisions. While students generally understood career paths, their knowledge was largely limited to familiar roles like veterinary practice and farm management. Awareness of niche or emerging opportunities was lower, suggesting gaps in pre-enrollment knowledge and early curriculum exposure.

Time as a Resource in Involving Patients in Cancer Treatment Decision Making: An Interview Study.

Time is often seen as a barrier to shared decision making (SDM). It is unclear how time can be a resource for patient involvement in routine cancer treatment decision-making processes and how time may be used more effectively. To determine how time is reported to be used to facilitate patient involvement, when time is experienced to be most constrained, and how time may be used more effectively. Semi-structured interviews with patients and physicians were held. Patients who had faced treatment decisions for primary treatment of acute myeloid leukemia or adjuvant treatment for colon cancer were included. We chose these diagnoses because patients face a decision between two medically reasonable treatment options, the amount of time available for decision making markedly differs between the two diagnoses, and patients with solid and non-solid tumors may perceive the role of time differently. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. We interviewed 18 Patients and 23 physicians. We identified three themes: (1) preparing for the decision-making consultation, (2) time to spend together, and (3) time to arrive at a decision. We divided each theme into two subthemes. Patients differ in the time they need for decision making. It became clear that time is not a guarantee for a better decision-making process. Patients are not always choice aware, and rather perceive the decision as self-evident. Future research should focus on how to effectively raise patient choice awareness and allocate time in decision-making processes more effectively.

The body says it all: Non-verbal indicators of choice awareness

Abstract Recent cognitive science research suggests that occasional “blindness” to choice manipulations indicates a lack of awareness in choice making. This claim is based on participants’ tendency not to detect choice manipulations and the similarity between their justifications for choices they made and those they were tricked into believing they made. Using a cognitive-semiotic framework, we argue that such conclusions underestimate the embodied, intersubjective nature of human meaning-making. We support this by investigating choice awareness beyond language to include non-verbal behavior. Forty-one participants were asked to choose from pairs of photographs of human faces the one they found most attractive and then to justify their choices, without knowing that for some of the trials they were asked to justify a choice that they had not made. Verbal responses were categorized as (i) non-manipulated, (ii) detected manipulated, and (iii) undetected manipulated trials. Bodily expressions, assessed using five different Categories of Bodily Expression (CBE): Adaptors, Torso, Head, Face and Hand expressions, revealed differences in: (a) duration, (b) rates of occurrence and (c) variety of the CBEs across trials. Thus, even when manipulations were not verbally detected, participants took longer to assess choices, showed increased bodily expressions, and engaged more body parts in undetected manipulations compared to non-manipulated choice trials. This suggests a degree of awareness to the choice manipulation, even if pre-reflective, manifested in participants’ bodily expressions.

Determinant of Career Choices Awareness Among Undergraduate Students

The increasing number of unemployed and job competitiveness causing the students to have a hard time choosing their career choices. Thus, this research aims to study on influential factors affecting awareness in career choices among UiTM Kota Bharu students. The factors included in the study are family influence, personality, peer influence, environment and economic consideration. Stratified random sampling was used and the population involved in the study was undergraduate full-time students from UiTM Kota Bharu, Kelantan. The students were drawn from two faculties that are available in the campus. The students in semester three until seven for Faculty of Computer and Mathematical Science (FSKM), and the students in semester one until six for Faculty of Business Management (FBM). The primary data was obtained through a survey where the questionnaire that was distributed to the 328 samples. Based on the result, it was found that family influence, personality, peer influence, environment and economic consideration have a positive relationship with career choice awareness. Other than that, family influence, personality and environment are the factors that influence career choice awareness among student since it has a p-value that is lower than 0.05.

Evaluation of the Implementation of the Dutch Breast Cancer Surveillance Decision Aid including Personalized Risk Estimates in the SHOUT-BC Study: A Mixed Methods Approach

Simple SummaryThis study examined the use of the Breast Cancer Surveillance Decision Aid (BCS-PtDA) in eight Dutch hospitals. This PtDA supports information provision (including information about personalized recurrence risks) and decision-making about post-treatment surveillance. Health care professionals (HCPs) acknowledged that the tool helped make patients aware of their options but felt it increased their workload without clear benefits. While the tool was effective in presenting choices to patients, deliberation about the options was scarce. The main challenges were related to the extra time required and HCPs’ perception of the tool’s value. Risk communication was deemed generally adequate. The study suggests that, while the PtDA offers benefits, better integration and communication strategies are needed to enhance shared decision-making processes. In conclusion, the implementation of the BCS-PtDA led to choices being offered to patients. However, there is room for improvement in information provision and the application of shared decision-making.Background: To improve Shared decision-making (SDM) regarding personalized post-treatment surveillance, the Breast Cancer Surveillance Decision Aid (BCS-PtDA), integrating personalized risk information, was developed and implemented in eight hospitals. The aim of this mixed-methods study was to (1) assess the implementation and participation rates, (2) identify facilitators and barriers for use by health care professionals (HCPs), (3) quantify the observed level of SDM, and (4) evaluate risk communication and SDM application in consultations. Methods: Implementation and participation rates and patients’ BCS-PtDA use were calculated using hospital registry data and BCS-PtDA log data. HCPs’ perspective on facilitators and barriers were collected using the MIDI framework. Observed SDM levels in consultation transcripts were quantified using the OPTION-5 scale. Thematic analysis was performed to assess consultation content. Results: The average PtDA implementation and participation rates were, respectively, 26% and 61%. HCPs reported that the PtDA supported choice awareness. Reported barriers for implementation were mainly increased workload and a lack of perceived benefits. The consultation analysis (n = 64) showed patients were offered a choice, but deliberation was lacking. Risk communication was generally adequate. Discussion: When the BCS-PtDA was used, patients were clearly given a choice regarding their post-treatment surveillance, but information provision and SDM application can be improved.

Qualitative experiences, values, and decisional needs of patients with unprovoked venous thromboembolism who suffer bleeding—“This pill will keep you alive tonight”

BackgroundContemporary guidelines recommend extended-duration anticoagulation among patients with a first unprovoked venous thromboembolism (VTE). Little is known about whether this recommendation aligns with patient values after a bleeding complication. ObjectivesTo explore the experiences, values, and decisional needs of patients with unprovoked VTE related to extended-duration treatment after an anticoagulant-associated bleed. MethodsIn this descriptive, qualitative study, face to face online semistructured interviews were conducted with patients with unprovoked VTE who had experienced bleeding and continued anticoagulant treatment in one academic hospital in Canada. Data were analyzed using directed content analysis to identify themes. Themes were mapped onto the Ottawa Decisional Support Framework to identify decisional needs. ResultsBetween September and December 2021, 14 patients were interviewed (age 41-69 years; 9 females). Many patients were not aware of the option to stop anticoagulation and had limited understanding of the decision about treatment duration. Despite the negative quality-of-life impact of clinically relevant bleeding during VTE treatment, the majority continued anticoagulation due to emotional trauma of VTE diagnosis, a perception that bleeding would be more manageable than VTE recurrence, a desire to maintain a connection to subspecialty care or non-VTE related benefits (eg, cancer diagnosis, protection from COVID-19). Patients’ decisional needs included lack of choice awareness, inadequate support for participation, lack of personalized risk stratification, and inadequate information on monitoring and managing heavy menstrual bleeding. ConclusionDespite the impact of anticoagulant-associated bleeding on quality of life, patients preferred continuing with anticoagulation for reasons extending beyond secondary VTE prevention. Effective decision-support interventions are needed to address unmet decisional needs.

Improving equitable access to publicly funded bariatric surgery in Queensland, Australia.

BackgroundPeople living in regional Queensland, Australia, have less access to health care than their metropolitan neighbours; a gap that is wider if they are also of Aboriginal and Torres Strait Islander ethnicity. The Bariatric Surgery Initiative (BSI) aims to provide metabolic bariatric surgery as a public service accessible to all Queenslanders for patients with morbid obesity according to need, regardless of location or ethnicity.MethodsWe investigated the BSI's progress in closing the metro-regional gap by comparing the distribution of referrals for surgery with the geographic and ethnic spread of obesity across Queensland in 2017-2019.ResultsRegional Queensland is home to 59.8% of Queensland's individuals with obesity, whereas 40.2% live in metropolitan Brisbane. In contrast, 47.8% of referrals were from regional areas, with 52.2% received from Brisbane. We found that more patients from metropolitan than regional areas underwent metabolic bariatric surgery, probably due to a paucity of referrals from regional locations. Aboriginal and Torres Strait Islander peoples were able to access the service and all patients realised significant health benefits after surgery.ConclusionsThe BSI improved access to this service, and inequities in metro-regional access may depend on patient choice and healthcare provider awareness of the BSI.Trial registrationThis initiative was a quality improvement study focused on providing access to care rather than a clinical trial; as such it was not registered as a clinical trial.

Lessons Learned from Shared Decision Making with Oral Anticoagulants: A Literature Review and Evidence-Based Guide for Development of Oral Chemotherapy Decision Aids

Lessons Learned from Shared Decision Making with Oral Anticoagulants: A Literature Review and Evidence-Based Guide for Development of Oral Chemotherapy Decision Aids

Current Perceptions of Sustainable Diets in Ireland and the Outlook of Circular Eating Practices

Encouraging sustainable dietary practices is a positive step towards alleviating the negative impact of increasing food waste. This study explores consumers’ perceptions of sustainable diets and factors influencing their adoption of sustainable practices, such as circular eating. Fifteen consumers in Ireland aged 18–65+ years were recruited for a qualitative study exploring their views on sustainable diets and their opinions on the use of peels, trimmings, and other by-products from fruit and vegetables as potential new ingredients or new circular food products. Age, gender, dietary preferences and educational background were important considerations during recruitment. Online interviews were conducted, and the data were analyzed using thematic analysis managed by NVivo 12. The results highlighted two overarching themes impacting circular eating, namely, food choice motives and awareness of food waste. These were linked to the participants’ knowledge of and potential adoption of sustainable diets. Daily trade-offs were evident, linked to the product and the person who was also strongly influenced by their micro-environment. Consumer education from credible sources would be required to create awareness of circular eating. Most respondents were positively disposed to the concept of circular eating, as long as food safety concerns and affordability considerations were addressed through industry transparency.

Health literate-sensitive shared decision-making in maternity care: needs for support among maternity care professionals in the Netherlands

BackgroundShared decision-making (SDM) in maternity care is challenging when clients have insufficient health literacy (HL) skills. This study gained insight in how professionals apply HL-sensitive SDM in Dutch maternity care and their needs for support therein.MethodsMaternity care professionals (n = 30) completed a survey on SDM and the role of HL. Midwives (n = 13) were observed during simulated conversations discussing pain relief options and interviewed afterwards. The client-actors were instructed to portrait specific inadequate HL skills. Observation items focused on adapting communication to HL, and SDM (OPTION-5).ResultsIn the survey, professionals indicated experiencing most challenges when estimating clients’ information comprehension. Observations showed that most midwives created choice awareness and informed clients about options, whereas exploring preferences and actual decision-making together with clients were observed less frequently. Their perceived HL-related obstacles and needs for support related to clients’ information comprehension. In the interviews, midwives reported putting much effort into explaining available options in maternity care, but also that decisions about pain relief are often postponed until the moment of labour.ConclusionProfessionals’ self-reported needs focus on clients’ information comprehension. However, observations indicate that it is not the stage of informing, but rather value clarification and actual decision-making that need improvement in HL-sensitive SDM.

Problem‐based shared decision making: The role of canonical SDM steps

ObjectiveTo evaluate the extent to which the canonical steps of shared decision making (SDM) take place in clinical encounters in practice and across SDM forms.MethodsWe assessed 100 randomly selected video‐recorded primary care encounters, obtained as part of a randomized trial of an SDM intervention in patients with type 2 diabetes. Two coders, working independently, noted each instance of SDM, classified it as one of four problem‐based forms to SDM (weighing alternatives, negotiating conflicting issues, solving problems, or developing existential insight), and noted the occurrence and timing of each of the four canonical SDM steps: fostering choice awareness, providing information, stating preferences, and deciding. Descriptive analyses sought to determine the relative frequency of these steps across each of the four SDM forms within each encounter.ResultsThere were 485 SDM steps noted (mean 4.85 steps per encounter), of which providing information and stating preferences were the most common. There were 2.7 (38 steps in 14 encounters) steps per encounter observed in encounters with no discernible SDM form, 3.4 (105 steps in 31 encounters) with one SDM form, 5.2 (129 steps in 25 encounters) with two SDM forms, and 7.1 (213 steps in 30 encounters) when ≥3 SDM forms were observed within the encounter. The prescribed order of the four SDM steps was observed in, at best, 16 of the 100 encounters. Stating preferences was a common step when weighing alternatives (38%) or negotiating conflicts (59.3%) but less common when solving problems (29.2%). The distribution of SDM steps was similar to usual care with or without the SDM intervention.ConclusionThe normative steps of SDM are infrequently observed in their prescribed order regardless of whether an SDM intervention was used. Some steps are more likely in some SDM forms but no pattern of steps appears to distinguish among SDM forms.Clinical Trial RegistrationClinicalTrial.gov: NCT01293578.

Сравнительный анализ пациентов со стриктурами спонгиозной уретры, подлежащих многоэтапной уретропластике или постоянной уретростомии

Deciding on the optimal surgical method for treating complex spongy urethral strictures is a challenging clinical task.To determine the clinical differences between patients undergoing multistage urethroplasty and permanent urethrostomy.Two groups of patients were formed for the analysis: group I - 73 patients who underwent multistage urethroplasty; group II - 48 patients underwent permanent urethrostomy. The differences between groups were studied according to the following clinical parameters: age, body mass index, duration of the disease, previous treatment, etiology, length and localization of strictures, complications of stricture disease, concomitant diseases, urine flow parameters, the presence of early postoperative complications, and recurrence of strictures.Patients of group I compared to group II are significantly younger (43.0 vs 59.6 years; p<0.0001). They have fewer idiopathic strictures (8.2 vs 31.3%; p=0.001), undergo cystostomy less often (26.0 vs 54.2%; p=0.002), have less pronounced lower urinary tract symptoms (I-PSS - 18.6 vs 23.8 points; p<0.0001, QoL 4.3 vs 5, 1 point; p<0.0001) and impaired urination parameters (Qmax - 8.1 vs 6.5 ml/s; p=0.09, Qave - 5.5 vs 4.1 ml/s; p=0.015, PVR - 62.4 vs 126.0 ml; p=0.03). The incidence of concomitant diseases (69.9 vs 87.5%; p<0.025) and their number (1.8 vs 3.1; p<0.002) are significantly higher in group II. Among the comorbidities, cardiovascular diseases (31.5 vs 58.3%; p=0.015), diabetes mellitus (5.5 vs 16.7%; p=0.045) and prostatic hyperplasia (8.2 vs 27.1%; p=0.005) predominate. Early surgical complications in group I were detected in 28,8% of patients, in group II - in 2.1% (p<0,0001) of cases. The primary treatment success among patients with permanent urethrostomy is higher than with multistage urethroplasty (85.4 vs 65,8%; p=0,017).It is advisable to perform multistage surgery of extended spongy urethral strictures in young and middle-aged men without serious comorbidities in cases of conscious choice and sufficient awareness. Urethrostomy should initially be discussed with the patient as the operation of choice, considering age, cardiovascular comorbidity, diabetes mellitus and prostatic hyperplasia.

Overcoming congressional inertia on obesity requires better literacy in obesity science.

Obesity-focused health policies, including the landmark Treat and Reduce Obesity Act, have stalled at the federal level over the past decade. Congressional inaction on obesity reflects both misconceptions of obesity as a lifestyle choice and limited awareness for the burden obesity imposes on our health care system. Given these challenges, we argue that health professionals must bolster their efforts to partner with public figures with obesity and to directly educate the public. These strategies may help destigmatize obesity and build awareness of obesity as a disease. Furthermore, we suggest that these strategies may empower patients to flex their unrealized political muscle and demand more from their elected leaders. A bold, multilevel approach that elicits a public demand for change can propel obesity policy into the 21st century.

Systemic Therapy Decision Making in Advanced Cancer: A Qualitative Analysis of Patient-Oncologist Encounters.

We sought to characterize patient-oncologist communication and decision making about continuing or limiting systemic therapy in encounters after an initial consultation, with a particular focus on whether and how oncologists foster shared decision making (SDM). We performed content analysis of outpatient oncology encounters at two US National Cancer Institute-designated cancer centers audio recorded between November 2010 and September 2014. A multidisciplinary team used a hybrid approach of inductive and deductive coding and theme development. We used a combination of random and purposive sampling. We restricted quantitative frequency counts to the coded random sample but included all sampled encounters in qualitative thematic analysis. Among 31 randomly sampled dyads with three encounters each, systemic therapy decision making was discussed in 90% (84 of 93) encounters. Thirty-four (37%) broached limiting therapy, which 27 (79%) framed as temporary, nine (26%) as completion of a standard regimen, and five (15%) as permanent discontinuation. Thematic analysis of these 93 encounters, plus five encounters purposively sampled for permanent discontinuation, found that (1) patients and oncologists framed continuing therapy as the default, (2) deficiencies in the SDM process (facilitating choice awareness, discussing options, and incorporating patient preferences) contributed to this default, and (3) oncologists use persuasion rather than deliberation when broaching discontinuation. In this study of outpatient encounters between patients with advanced cancer and their oncologists, when discussing systemic therapy, there exists a default to continue systemic therapy, and deficiencies in SDM contribute to this default.

Fostering Patient Choice Awareness and Presenting Treatment Options Neutrally: A Randomized Trial to Assess the Effect on Perceived Room for Involvement in Decision Making.

PurposeShared decision making calls for clinician communication strategies that aim to foster choice awareness and to present treatment options neutrally, such as by not showing a preference. Evidence for the effectiveness of these communication strategies to enhance patient involvement in treatment decision making is lacking. We tested the effects of 2 strategies in an online randomized video-vignettes experiment.MethodsWe developed disease-specific video vignettes for rheumatic disease, cancer, and kidney disease showcasing a physician presenting 2 treatment options. We tested the strategies in a 2 (choice awareness communication present/absent) by 2 (physician preference communication present/absent) randomized between-subjects design. We asked patients and disease-naïve participants to view 1 video vignette while imagining being the patient and to report perceived room for involvement (primary outcome), understanding of treatment information, treatment preference, satisfaction with the consultation, and trust in the physician (secondary outcomes). Differences across experimental conditions were assessed using 2-way analyses of variance.ResultsA total of 324 patients and 360 disease-naïve respondents participated (mean age, 52 ± 14.7 y, 54% female, 56% lower educated, mean health literacy, 12 ± 2.1 on a 3–15 scale). The results showed that choice awareness communication had a positive (Mpresent = 5.2 v. Mabsent = 5.0, P = 0.042, η2partial = 0.006) and physician preference communication had no (Mpresent = 5.0 v. Mabsent = 5.1, P = 0.144, η2partial = 0.003) significant effect on perceived room for involvement in decision making. Physician preference communication steered patients toward preferring that treatment option (Mpresent = 4.7 v. Mabsent = 5.3, P = 0.006, η2partial = 0.011). The strategies had no significant effect on understanding, satisfaction, or trust.ConclusionsThis is the first experimental evidence for a small effect of fostering choice awareness and no effect of physician preference on perceived room to participate in decision making. Physician preference steered patients toward preferring that option.

Patient and Spine Surgeon Perceptions on Shared Decision-Making in the Treatment of Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity.

Retrospective. To understand patients' and spine surgeons' perspectives about decision-making around surgery for adult spinal deformity. Surgery for correction of adult spinal deformity is often beneficial; however, in over 20% of older adults (≥ 65 yrs of age), outcomes from surgery are less desirable. We conducted semistructured, in-depth interviews with six patients and five spine surgeons. Two investigators independently coded the transcripts using constant comparative method, as well as an integrative, team-based approach to identify themes. Patients themes: 1) patients felt surgery was their only choice because they were running out of time to undergo invasive procedures; 2) patients mentally committed to surgery prior to the initial encounter with their surgeon and contextualized the desired benefits while minimizing the potential risks; 3) patients felt that the current decision support tools were ineffective in preparing them for surgery; and 4) patients felt that pain management was the most difficult part of recovery from surgery. Surgeons themes: 1) surgeons varied substantially in their interpretations of shared decision-making; 2) surgeons did not consider patients' chronological age as a major contraindication to undergoing surgery; 3) there is a goal mismatch between patients and surgeons in the desired outcomes from surgery, where patients prioritize complete pain relief whereas surgeons prioritize concrete functional improvement; and 4) surgeons felt that patient expectations from surgery were often established prior to their initial surgery visit, and frequently required recalibration. Older adult patients viewed the decision to have surgery as time-sensitive, whereas spine surgeons expressed the need for recalibrating patient expectations and balancing the risks and benefits when considering surgery. These findings highlight the need for improved understanding of both sides of shared decision-making which should involve the needs and priorities of older adults to help convey patient-specific risks and choice awareness. 3.

Decision aids for shared decision-making and appropriate anticoagulation therapy in patients with atrial fibrillation: a systematic review and meta-analysis.

Underuse of oral anticoagulants (OACs) is commonly observed among patients with atrial fibrillation (AF), which hinders stroke prevention in AF. Shared decision-making (SDM) can help enhance adherence by minimizing patients' misunderstanding of treatment and aligning care with their preferences. Decision aids (DAs) have been developed to facilitate the SDM process. This study aimed to: (i) evaluate the effects of DAs on AF patients' knowledge, decisional conflict, OAC uptake, and adherence and on the incidence of stroke and bleeding; and (ii) explore characterizing factors associated with enhanced DA effectiveness. Five databases were searched. Meta-analysis was conducted using RevMan 5.3 when data were available. Comparative analysis between effective and ineffective DAs was conducted to determine the DA designs associated with better effects. Ten studies were included. Pooling results indicated that DAs reduce decisional conflict related to warfarin use [mean difference = -0.10; 95% confidence interval (CI): -0.18 to -0.02; P = 0.01] and enhance OAC uptake [risk ratio: 1.03; 95% CI: 1.01-1.05; P = 0.004]. The effects of DAs on adherence and incidence of stroke and bleeding were unclear. Comparative analysis revealed that DAs with key elements of SDM (situation diagnosis, choice awareness, option clarification, benefits and disadvantages, and patient's preference) and pre-consultation delivery are more likely to be effective in promoting SDM and OAC uptake. DAs are promising in promoting SDM and OAC uptake in patients with AF. The evidence on adherence and incidence of stroke and bleeding remains uncertain. More trials with rigorous study design and longer follow-up are necessary to obtain evidence.

Factors motivating the transfer of university students in Kazakhstan

ABSTRACT The theoretical frameworks developed for, and applied to, the study of student transfer between higher education institutions build on evidence from Western contexts, specifically the United States. The current article contributes to understanding factors that drive student transfer in the Central Asian context, specifically that of Kazakhstan. Through inductive coding of qualitative interviews with undergraduate transfer students in Kazakhstan, this research identifies student-centred factors of social embeddedness, parental influence in higher education decision-making, evolving career choice awareness, strategies for academic success, the quality of teaching and relationship ethics with students. While these factors influencing student transfer in Kazakhstan align with the existing Western context-based literature, the data in this research offer a localized perspective on what these factors mean in the context of a contemporary Central Asian country.

Shared Decision-Making Applied to Knee Arthroplasty: A Systematic Review of Randomized Trials.

Shared decision-making (SDM) is a strongly endorsed approach by which patients and clinicians work together to formulate a sensible care plan. The present study was undertaken to conduct a systematic review of SDM trials in patients considering knee arthroplasty (KA) to characterize how SDM was supported and the impact on care received. We searched multiple bibliographic databases from inception to December 31, 2019. A pair of reviewers working independently selected studies for inclusion, extracted data, and evaluated each trial's risk of bias. We found 6 eligible randomized trials (4 included KA and hip arthroplasty), all of which tested the same proprietary decision aid (DA) (Treatment Choices for Hip or Knee Osteoarthritis), with some adding other materials to support SDM. These trials, all of which had moderate-to-high risk of bias, focused on assessing the effect of the DA on patient knowledge about the options while not explicitly supporting other aspects of SDM, such as choice awareness, deliberation, or decision-making. One trial found an increase in the number of African American patients undergoing KA in the 12 months following the intervention. No other trials found that SDM impacts clinical outcomes. Evidence for SDM in patients considering KA is mostly limited to a single DA. While use of this DA improves patient knowledge about their treatment options, this tool has not been shown to promote SDM, impact treatment decisions, or satisfaction with care. Future work should seek to support SDM directly and assess effects on treatment decisions, functional outcomes, and satisfaction.

Utilization of Philippine Aptitude Classification Test (PACT) Result in Career Awareness Program

This study determined the alignment of students’ Senior High School track and course preference in college with their aptitude and probable performance in educational programs. It is descriptive in nature. The respondents were the Junior High School students who took the Philippine Aptitude Classification Test (PACT) of School Year 2014–2015 and were enrolled Grade 12 at the Senior High School of Holy Name University for School Year 2017–2018. Frequency counting of the aptitude, probable performance in different educational programs, preferred school track and career choice were made. Results revealed that majority of the respondents were enrolled in the STEM track. More than half of the respondents got low aptitudes that fit to only one to three educational programs based on the nine (9) clusters of educational programs identified in the PACT and a significant number of respondents did not fit to any educational programs. Many of the college courses chosen by the respondents while they were still in Grade 9 are under services, engineering and manufacturing, and health and welfare clusters. More so, college course preferred by the respondents in STEM track are related to health and welfare followed by engineering and manufacturing cluster while those in ABM and HUMMS track preferred Social Science, Business and Law cluster. Career choices made by the respondents are not aligned with their aptitude which could be a source of future job-skills mismatch or misfit graduates. Career guidance is seen as an imperative for a successful future career choice and career awareness program is viewed as a possible intervention as early as Grade 7 to Grade 10.