"I’ll call you when we are ready" (One family’s experience of critical care and end of life decision making)

The purpose of this paper is to explore through narrative accounts one family's expérience of critical care, after the admission of a family member to an Intensive Care Unit (ICU) and their subséquent death five weeks later. Numerous studies support the need for effective communication and clear information to be given to the family. In this instance it was évident from their stories that there were numerous barriers to communication, including language and a lack of insight into the needs of the family. Many families do not understand the complexities of nursing care in an ICU so lack of communication by nursing staff was identified as uncaring behavior and encounters. Facilitating a family's proximity to a dying patient and encouraging them to participate in care helps to maintain some sensé of personal control. Despite a commitment to involving family members in care, which was enshrined in the Unit Philosophy, relatives were banished to the waiting room for hours. They experienced feelings of powerlessness and helplessness as they waited with other relatives for news following investigations or until 'the doctor had completed his rounds'. Explanations of "we must make 'the patient' comfortable" was no consolation for those who wished to be involved in care. The words "I'il call you when we are ready" became a mantra to the forgotten families who waited patiently for those with power to admit them to the ICU. Implications are this family felt they were left alone to cope with the traumatic expériences leading up to and surrounding the death. They felt mainly supported by the priest, who not only administered the last rites but provided spiritual support to the family and dealt sensitively with many issues. Paternalism in décision making when there is a moral obligation to ensure that discussions on end of life dilemmas are an inclusive process with families, doctors, nurses was not understood, therefore it caused conflict within the family over EOL décision making. The family felt that the opportunity to share expériences through telling and retelling their stories would enable them to reconfigure the past and create purpose in the future.

Decision models - an analytical framework for the Watertime Project

This paper suggests a possible framework for the encapsulation of the decision making process for the Waterime project. The final outcome maybe a computerised model, but the process advocated is not prescriptive, and involves the production of a "paper model" as mediating representation between the knowledge acquired and any computerised system. This paper model may suffice in terms of the project's goals.

The use of a mathematical multicriteria decision-making model for selecting the fire origin room

Over the last three decades, the fire safety codes have been changing from a prescriptive approach to a performance-based one. Some countries, such as the USA, Sweden, New Zealand, Australia and the UK, are in an advanced stage of development and implementation of the performance-based codes. However, there are some difficulties in this process. Most of them are due to the uncertainties associated with fire design. For instance, one of the questions that need to be answered is how to select the most probable fire origin room (FOR)? On the other hand, to know where the FOR is located is also an important aspect in terms of forensic issues. Given that, to address this question is an important step for the establishment of fire designs (i.e., pre-fire phases) and also for fire investigations (i.e., post-fire phases). This paper proposes a methodology for selecting the FOR through the use of a mathematical multicriteria decision-making model: the analytical hierarchy process (AHP). The proposed method is then applied to a hypothetical study case. The results are presented and discussed in this paper.

Models of advertising standardisation and adaptation: it's time to move the debate forward

Advertising standardisation versus adaptation has been discussed in some detail in the marketing literature. Despite previous attempts, there is still no widely-used decision-making model available that has been accepted by marketing practitioners and academics. This paper examines the development of this important area by reviewing six prominent models in the advertising standardisation/adaptation literature. It shows why there has been a lack of development in the current literature and why it is crucial to address this problem. Important areas for future research are suggested in order to find a solution

Adaptive decision-making in buildingEXODUS

Given the importance of occupant behaviour on evacuation efficiency, a new behavioural feature has been implemented into buildingEXODUS. This feature concerns the response of occupants to exit selection and re-direction. This behaviour is not simply pre-determined by the user as part of the initialisation process, but involves the occupant taking decisions based on their previous experiences and the information available to them. This information concerns the occupants prior knowledge of the enclosure and line-of-sight information concerning queues at neighbouring exits. This new feature is demonstrated and reviewed through several examples.

Adaptive decision-making in response to crowd formations in building EXODUS

Given the importance of occupant behavior on evacuation efficiency, a new behavioral feature has been developed and implemented into buildingEXODUS. This feature concerns the response of occupants to exit selection and re-direction. This behavior is not simply pre-determined by the user as part of the initialization process, but involves the occupant taking decisions based on their previous experiences and the information available to them. This information concerns the occupants prior knowledge of the enclosure and line-of-sight information concerning queues at neighboring exits. This new feature is demonstrated and reviewed through several examples.

Adaptive decision-making in buildingEXODUS in response to exit congestion

Given the importance of occupant behavior on evacuation efficiency, a new behavioral feature has been implemented into building EXODUS. This feature concerns the response of occupants to exit selection and re-direction, given that the occupant is queuing at an external exit. This behavior is not simply pre-determined by the user as part of the initialization process, but involves the occupant taking decisions based on their previous experiences with the enclosure and the information available to them. This information concerns the occupant's prior knowledge of the enclosure and line-of-sight information concerning queues at neighboring exits. This new feature is demonstrated and reviewed through several examples.

Distributed belief revision as applied within a descriptive model of jury deliberations

Belief revision is a well-research topic within AI. We argue that the new model of distributed belief revision as discussed here is suitable for general modelling of judicial decision making, along with extant approach as known from jury research. The new approach to belief revision is of general interest, whenever attitudes to information are to be simulated within a multi-agent environment with agents holding local beliefs yet by interaction with, and influencing, other agents who are deliberating collectively. In the approach proposed, it's the entire group of agents, not an external supervisor, who integrate the different opinions. This is achieved through an election mechanism, The principle of "priority to the incoming information" as known from AI models of belief revision are problematic, when applied to factfinding by a jury. The present approach incorporates a computable model for local belief revision, such that a principle of recoverability is adopted. By this principle, any previously held belief must belong to the current cognitive state if consistent with it. For the purposes of jury simulation such a model calls for refinement. Yet we claim, it constitutes a valid basis for an open system where other AI functionalities (or outer stiumuli) could attempt to handle other aspects of the deliberation which are more specifi to legal narrative, to argumentation in court, and then to the debate among the jurors.

Belief revision as applied within a descriptive model of jury deliberations

Belief revision is a well-researched topic within Artificial Intelligence (AI). We argue that the new model of belief revision as discussed here is suitable for general modelling of judicial decision making, along with the extant approach as known from jury research. The new approach to belief revision is of general interest, whenever attitudes to information are to be simulated within a multi-agent environment with agents holding local beliefs yet by interacting with, and influencing, other agents who are deliberating collectively. The principle of 'priority to the incoming information', as known from AI models of belief revision, is problematic when applied to factfinding by a jury. The present approach incorporates a computable model for local belief revision, such that a principle of recoverability is adopted. By this principle, any previously held belief must belong to the current cognitive state if consistent with it. For the purposes of jury simulation such a model calls for refinement. Yet, we claim, it constitutes a valid basis for an open system where other AI functionalities (or outer stimuli) could attempt to handle other aspects of the deliberation which are more specific to legal narratives, to argumentation in court, and then to the debate among the jurors.