193 resultados para medical decision making
Resumo:
This document provides the findings of an international review of investment decision-making practices in road asset management. Efforts were concentrated on identifying the strategic objectives of agencies in road asset management, establishing and understanding criteria different organisations adopted and ascertaining the exact methodologies used by different countries and international organisations. Road assets are powerful drivers of economic development and social equity. They also have significant impacts on the natural and man-made environment. The traditional definition of asset management is “A systematic process of maintaining, upgrading and operating physical assets cost effectively. It combines engineering principles with sound business practices and economic theory and it provides tools to facilitate a more organised, logical approach to decision-making” (US Dept. of Transportation, 1999). In recent years, the concept has been broadened to cover the complexity of decision making, based on a wider variety of policy considerations as well as social and environmental issues rather than is covered by Benefit-Cost analysis and pure technical considerations. Current international practices are summarised in table 2. It was evident that Engineering-economic analysis methods are well advanced to support decision-making. A range of tools available supports performance predicting of road assets and associated cost/benefit in technical context. The need for considering triple plus one bottom line of social, environmental and economic as well as political factors in decision-making is well understood by road agencies around the world. The techniques used to incorporate these however, are limited. Most countries adopt a scoring method, a goal achievement matrix or information collected from surveys. The greater uncertainty associated with these non-quantitative factors has generally not been taken into consideration. There is a gap between the capacities of the decision-making support systems and the requirements from decision-makers to make more rational and transparent decisions. The challenges faced in developing an integrated decision making framework are both procedural and conceptual. In operational terms, the framework should be easy to be understood and employed. In philosophical terms, the framework should be able to deal with challenging issues, such as uncertainty, time frame, network effects, model changes, while integrating cost and non-cost values into the evaluation. The choice of evaluation techniques depends on the feature of the problem at hand, on the aims of the analysis, and on the underlying information base At different management levels, the complexity in considering social, environmental, economic and political factor in decision-making is different. At higher the strategic planning level, more non-cost factors are involved. The complexity also varies based on the scope of the investment proposals. Road agencies traditionally place less emphasis on evaluation of maintenance works. In some cases, social equity, safety, environmental issues have been used in maintenance project selection. However, there is not a common base for the applications.
Resumo:
This document provides the findings of a national review of investment decision-making practices in road asset management. Efforts were concentrated on identifying the strategic objectives of agencies in road asset management, establishing and understanding criteria different organisations adopted and ascertaining the exact methodologies used by different sate road authorities. The investment objectives of Australian road authorities are based on triple-bottom line considerations (social, environmental, economic and political). In some cases, comparing with some social considerations, such as regional economic development, equity, and access to pubic service etc., Benefit-Cost Ratio has limited influence on the decision-making. Australian road authorities have developed various decision support tools. Although Multi-Criteria Analysis has been preliminarily used in case by case study, pavement management systems, which are primarily based on Benefit Cost Analysis, are still the main decision support tool. This situation is not compatible with the triple-bottom line objectives. There is need to fill the gap between decision support tools and decision-making itself. Different decision criteria should be adopted based on the contents of the work. Additional decision criteria, which are able to address social, environmental and political impacts, are needed to develop or identify. Environmental issue plays a more and more important role in decision-making. However, the criteria and respective weights in decision-making process are yet to be clearly identified. Social and political impacts resulted from road infrastructure investment can be identified through Community Perceptions Survey. With accumulative data, prediction models, which are similar as pavement performance models, can be established. Using these models, the decision-makers are able to foresee the social and political consequences of investment alternatives.
Resumo:
Risks and uncertainties are inevitable in engineering projects and infrastructure investments. Decisions about investment in infrastructure such as for maintenance, rehabilitation and construction works can pose risks, and may generate significant impacts on social, cultural, environmental and other related issues. This report presents the results of a literature review of current practice in identifying, quantifying and managing risks and predicting impacts as part of the planning and assessment process for infrastructure investment proposals. In assessing proposals for investment in infrastructure, it is necessary to consider social, cultural and environmental risks and impacts to the overall community, as well as financial risks to the investor. The report defines and explains the concept of risk and uncertainty, and describes the three main methodology approaches to the analysis of risk and uncertainty in investment planning for infrastructure, viz examining a range of scenarios or options, sensitivity analysis, and a statistical probability approach, listed here in order of increasing merit and complexity. Forecasts of costs, benefits and community impacts of infrastructure are recognised as central aspects of developing and assessing investment proposals. Increasingly complex modelling techniques are being used for investment evaluation. The literature review identified forecasting errors as the major cause of risk. The report contains a summary of the broad nature of decision-making tools used by governments and other organisations in Australia, New Zealand, Europe and North America, and shows their overall approach to risk assessment in assessing public infrastructure proposals. While there are established techniques to quantify financial and economic risks, quantification is far less developed for political, social and environmental risks and impacts. The report contains a summary of the broad nature of decision-making tools used by governments and other organisations in Australia, New Zealand, Europe and North America, and shows their overall approach to risk assessment in assessing public infrastructure proposals. While there are established techniques to quantify financial and economic risks, quantification is far less developed for political, social and environmental risks and impacts. For risks that cannot be readily quantified, assessment techniques commonly include classification or rating systems for likelihood and consequence. The report outlines the system used by the Australian Defence Organisation and in the Australian Standard on risk management. After each risk is identified and quantified or rated, consideration can be given to reducing the risk, and managing any remaining risk as part of the scope of the project. The literature review identified use of risk mapping techniques by a North American chemical company and by the Australian Defence Organisation. This literature review has enabled a risk assessment strategy to be developed, and will underpin an examination of the feasibility of developing a risk assessment capability using a probability approach.
Resumo:
A study has been conducted to investigate current practices on decision-making under risk and uncertainty for infrastructure project investments. It was found that many European countries such as the UK, France, Germany including Australia use scenarios for the investigation of the effects of risk and uncertainty of project investments. Different alternative scenarios are mostly considered during the engineering economic cost-benefit analysis stage. For instance, the World Bank requires an analysis of risks in all project appraisals. Risk in economic evaluation needs to be addressed by calculating sensitivity of the rate of return for a number of events. Risks and uncertainties of project developments arise from various sources of errors including data, model and forecasting errors. It was found that the most influential factors affecting risk and uncertainty resulted from forecasting errors. Data errors and model errors have trivial effects. It was argued by many analysts that scenarios do not forecast what will happen but scenarios indicate only what can happen from given alternatives. It was suggested that the probability distributions of end-products of the project appraisal, such as cost-benefit ratios that take forecasting errors into account, are feasible decision tools for economic evaluation. Political, social, environmental as well as economic and other related risk issues have been addressed and included in decision-making frameworks, such as in a multi-criteria decisionmaking framework. But no suggestion has been made on how to incorporate risk into the investment decision-making process.
Resumo:
The Melbourne Decision Making Questionnaire (Mann, Burnett, Radford, & Ford, 1997) measures selfreported decision-making coping patterns. The questionnaire was administered to samples of University students in the US (N = 475), Australia (N = 262), New Zealand (N = 260), Japan (N = 359), Hong Kong (N = 281), and Taiwan (N = 414). As predicted, students from the three Western, individualistic cultures (US, Australia, and New Zealand) were more con® dent of their decision-making ability than students from the three East Asian, group-oriented cultures (Japan, Hong Kong, Taiwan). No cross-cultural differences were found in scores on decision vigilance (a careful decision-making style). However, compared with Western students, the Asian students tended to score higher on buck-passing and procrastination (avoidant styles of decision making) as well as hypervigilance (a panicky style of decision making). Japanese students scored lowest on decision self-esteem and highest on procrastination and hypervigilance. It was argued that the con¯ ict model and its attendant coping patterns is relevant for describing and comparing decision making in both Western and Asian cultures.
Resumo:
A study was conducted to examine the factorial validity of the Flinders Decision Making Questionnaire (Mann, 1982), a 31-item self-report inventory designed to measure tendencies to use three major coping patterns identified in the conflict theory of decision making (Janis and Mann, 1977): vigilance, hypervigilance, and defensive avoidance (procrastination, buck-passing, and rationalization). A sample of 2051 university students, comprising samples from Australia (n=262), New Zealand (n=260), the USA (n=475), Japan (n=359), Hong Kong (n=281) and Taiwan (n=414) was administered the DMQ. Factorial validity of the instrument was tested by confirmatory factor analysis with LISREL. Five different substantive models, representing different structural relationships between the decision-coping patterns had unsatisfactory fit to the data and could not be validated. A shortened instrument, containing 22 items, yielded a revised model comprising four identifiable factors-vigilance, hypervigilance, buck-passing, and procrastination. The revised model had adequate fit with data for each country sample and for the total sample, and was confirmed. It is recommended that the 22-item instrument, named the Melbourne DMQ, replace the Flinders DMQ for measurement of decision-coping patterns.
Resumo:
The Flinders Decision-Making Questionnaire (FDMQ) (Mann, 1982), which measures three decision-making styles and decision-making self-esteem, and the Self-Description Questionnaire III (SDQ HI) (Marsh & O'Neill, 1984), which measures 13 facets of self-concept; were administered to 475 university students to investigate some of the tenets of Janis and Mann's (1976, 1977) conflict model of decision-making and to further investigate the influence of self-concept on decision-making behaviours. The findings empirically validated Janis and Mann's (1977) link between decision-making self-esteem and decision-making style. Modest relationships, in the predicted direction, were found between decision-making self-esteem and the three decision-making styles (Vigilance, Defensive Avoidance, and Hypervigilance). In addition, specific facets of self-concept (General, Verbal, Academic, Honesty/Reliability and Problem-Solving Self Concepts) were related to self-reported decision-making behaviours.
Resumo:
The Flinders Decision Making Questionnaire (DMQ; Mann, 1982) was designed to measure decision making coping patterns identified by Janis and Mann (1977). The validity of four DMQ Scales (vigilance, defensive avoidance, hypervigilance, and decision self-esteem) were tested as predictors of students' course and career decision making. Students administered the DMQ scales were also measured on independence of choice, satisfaction, and planfulness relating to their university course and on planfulness and options relating to their future employment. Two samples were studied. In study 1, 40 students residing in a university college were the subjects. In Study 2, 42 second-year students who completed the DMQ one year earlier constituted the subjects. Modest but significant correlations were found in both samples between DMQ scores and measures of course and career decision making. The findings lend support to the validity of the DMQ as an instrument for measuring decision making behaviour.
Resumo:
This chapter deals with the increasing issues surrounding end-of-life decision making. As the life trajectory for older people changes, the need for open discussion about their health problems and treatment becomes more critical. Acceptance of the ageing process itself is often not easy so the matter of a good death is even more distressing for some people to consider. The vignette provides an excellent discussion on the need for open dialogue with the older person and their families, whether they are acutely ill or have chronic health problems. How a person wishes to be treated when quality of life is not going to improve, no matter what interventions are put in place, seems essential for person-centred care. The issue of competency is one that must be determined before any decision is made by any person involved in care.
Resumo:
Most infrastructure projects share the same characteristics in term of management aspects and shortcomings. Human factor is believed to be the major drawbacks due to the nature of unstructured problems which can further contribute to management conflicts. This growing complexity in infrastructure projects has shift the paradigm of policy makers to adopt Information Communication Technology (ICT) as a driving force. For this reason, it is vital to fully maximise and utilise the recent technologies to accelerate management process particularly in planning phase. Therefore, a lot of tools have been developed to assist decision making in construction project management. The variety of uncertainties and alternatives in decision making can be entertained by using useful tool such as Decision Support System (DSS). However, the recent trend shows that most DSS in this area only concentrated in model development and left few fundamentals of computing. Thus, most of them were found complicated and less efficient to support decision making within project team members. Due to the current incapability of many software aspects, it is desirable for DSS to provide more simplicity, better collaborative platform, efficient data manipulation and reflection to user needs. By considering these factors, the paper illustrates four challenges for future DSS development i.e. requirement engineering, communication framework, data management and interoperability, and software usability
Resumo:
Team games conceptualized as dynamical systems engender a view of emergent decision-making behaviour under constraints, although specific effects of instructional and body-scaling constraints have yet to be verified empirically. For this purpose, we studied the effects of task and individual constraints on decision-making processes in basketball. Eleven experienced female players performed 350 trials in 1 vs. 1 sub-phases of basketball in which an attacker tried to perturb the stable state of a dyad formed with a defender (i.e. break the symmetry). In Experiment 1, specific instructions (neutral, risk taking or conservative) were manipulated to observe effects on emergent behaviour of the dyadic system. When attacking players were given conservative instructions, time to cross court mid-line and variability of the attacker's trajectory were significantly greater. In Experiment 2, body-scaling of participants was manipulated by creating dyads with different height relations. When attackers were considerably taller than defenders, there were fewer occurrences of symmetry-breaking. When attackers were considerably shorter than defenders, time to cross court mid-line was significantly shorter than when dyads were composed of athletes of similar height or when attackers were considerably taller than defenders. The data exemplify how interacting task and individual constraints can influence emergent decision-making processes in team ball games.
Resumo:
In this chapter, ideas from ecological psychology and nonlinear dynamics are integrated to characterise decision-making as an emergent property of self-organisation processes in the interpersonal interactions that occur in sports teams. A conceptual model is proposed to capture constraints on dynamics of decisions and actions in dyadic systems, which has been empirically evaluated in simulations of interpersonal interactions in team sports. For this purpose, co-adaptive interpersonal dynamics in team sports such as rubgy union have been studied to reveal control parameter and collective variable relations in attacker-defender dyads. Although interpersonal dynamics of attackers and defenders in 1 vs 1 situations showed characteristics of chaotic attractors, the informational constraints of rugby union typically bounded dyadic systems into low dimensional attractors. Our work suggests that the dynamics of attacker-defender dyads can be characterised as an evolving sequence since players' positioning and movements are connected in diverse ways over time.
Resumo:
In this chapter we introduce a theoretical framework for studying decision making in sport: the ecological dynamics approach, which we integrate with key ideas from the literature on learning complex motor skills. Our analysis will include insights from Berstein (1967) on the coordination of degrees of freedom and Newell's (1985) model of motor learning. We particularly focus on the role of perceptual degrees of freedom advocated in an ecological approach to learning. In introducing this framework to readers we contrast this perspective with more traditional models of decision-making. Finally, we propose some implications to the training of decision-making skill in sport.
Resumo:
This paper details research completed in 2007 which investigated autopsy decision making in a death investigation. The data was gathered during the first year of operation of a new Coroners Act in Queensland, Australia, which changed the process of death investigation in three ways which are important to this paper. First, it required a greater amount of information to be gathered at the scene by police, and this included a thorough investigation of the circumstances of the death, including statements from witnesses, friends and family, as well as evidence gathering at the scene. Second, it required Coroners, for the first time, to determine the level of invasiveness of the autopsy required to complete the death investigation. Third, it enabled the communication of a genuine family concern, to be communicated to the Coroner. The outcome of such information was threefold. First, a greater amount of information offered to the Coroner led to a decrease in the number of full internal autopsies ordered, but an increase in the number of partial internal autopsies ordered. Second, this shift in autopsy decision making by Coroners saw certain factors given greater importance than others in decisions to order full internal or external only autopsies. Third, a raised family concern had a significant impact on autopsy decision making and tended to decrease the invasiveness of the autopsy ordered by Coroners.
Resumo:
This article describes the development and validation of a multi-dimensional scale for measuring managers’ perceptions of the range of factors that routinely guide their decision-making processes. An instrument for identifying managerial ethical profiles (MEP) is developed by measuring the perceived role of different ethical principles in the decision-making of managers. Evidence as to the validity of the multidimensionality of the ethical scale is provided, based on the comparative assessment of different models for managerial ethical decision-making. Confirmatory Factor Analysis (CFA) supported a eight-factor model including two factors for each of the main four schools of moral philosophy. Future research needs and the value of this measure to business ethics are discussed.