Decision strategies for policy decisions under uncertainties: The case of mitigation measures addressing methane emissions from ruminants

Decision strategies aim at enabling reasonable decisions in cases of uncertain policy decision problems which do not meet the conditions for applying standard decision theory. This paper focuses on decision strategies that account for uncertainties by deciding whether a proposed list of policy options should be accepted or revised (scope strategies) and whether to decide now or later (timing strategies). They can be used in participatory approaches to structure the decision process. As a basis, we propose to classify the broad range of uncertainties affecting policy decision problems along two dimensions, source of uncertainty (incomplete information, inherent indeterminacy and unreliable information) and location of uncertainty (information about policy options, outcomes and values). Decision strategies encompass multiple and vague criteria to be deliberated in application. As an example, we discuss which decision strategies may account for the uncertainties related to nutritive technologies that aim at reducing methane (CH4) emissions from ruminants as a means of mitigating climate change, limiting our discussion to published scientific information. These considerations not only speak in favour of revising rather than accepting the discussed list of options, but also in favour of active postponement or semi-closure of decision-making rather than closure or passive postponement.

Satisfaction with follow-up consultations among younger adults treated for cancer: the role of quality of life and psychological variables

Given increased survival rates and treatment-related late effects, follow-up for cancer survivors is increasingly recommended. However, information about adverse events (e.g. possibility of late effects) may be distressing for the cancer survivor and lead to poor clinic attendance. Survivor satisfaction with appointments and the information provided are important. The Monitoring Process Model provides a theoretical framework to understand how survivors cope with threatening information, and consequences for follow-up care. Our aims were to describe satisfaction with routine follow-up and association between monitoring/blunting and satisfaction with care.

Transcatheter aortic valve implantation: patient selection

Transcatheter aortic valve implantation (TAVI) is a disruptive technology as it satisfies a previously unmet need which is associated with a profound therapeutic benefit. In randomized clinical trials, TAVI has been shown to improve survival compared with medical treatment among patients considered not suitable candidates for surgical aortic valve replacement (SAVR), and to provide similar outcomes as SAVR in selected high-risk patients. Currently, TAVI is limited to selected elderly patients with symptomatic severe aortic stenosis. As this patient population frequently suffers from comorbid conditions, which may influence outcomes, the selection of patients to undergo TAVI underlies a complex decision process. Several clinical risk score algorithms are routinely used, although they fall short to fully appreciate the true risk among patients currently referred for TAVI. Beyond traditional risk scores, the clinical assessment by an interdisciplinary Heart Team as well as detailed imaging of the aortic valve, aortic root, descending and abdominal aorta as well as peripheral vasculature are important prerequisites to plan a successful procedure. This review will familiarize the reader with the concepts of the interdisciplinary Heart team, risk scores as well as the most important imaging algorithms suited to select appropriate TAVI patients.

Transient simulations of the carbon and nitrogen dynamics in northern peatlands: from the Last Glacial Maximum to the 21st century

The development of northern high-latitude peatlands played an important role in the carbon (C) balance of the land biosphere since the Last Glacial Maximum (LGM). At present, carbon storage in northern peatlands is substantial and estimated to be 500 ± 100 Pg C (1 Pg C = 1015 g C). Here, we develop and apply a peatland module embedded in a dynamic global vegetation and land surface process model (LPX-Bern 1.0). The peatland module features a dynamic nitrogen cycle, a dynamic C transfer between peatland acrotelm (upper oxic layer) and catotelm (deep anoxic layer), hydrology- and temperature-dependent respiration rates, and peatland specific plant functional types. Nitrogen limitation down-regulates average modern net primary productivity over peatlands by about half. Decadal acrotelm-to-catotelm C fluxes vary between −20 and +50 g C m−2 yr−1 over the Holocene. Key model parameters are calibrated with reconstructed peat accumulation rates from peat-core data. The model reproduces the major features of the peat core data and of the observation-based modern circumpolar soil carbon distribution. Results from a set of simulations for possible evolutions of northern peat development and areal extent show that soil C stocks in modern peatlands increased by 365–550 Pg C since the LGM, of which 175–272 Pg C accumulated between 11 and 5 kyr BP. Furthermore, our simulations suggest a persistent C sequestration rate of 35–50 Pg C per 1000 yr in present-day peatlands under current climate conditions, and that this C sink could either sustain or turn towards a source by 2100 AD depending on climate trajectories as projected for different representative greenhouse gas concentration pathways.

Cost-effectiveness analysis of paclitaxel-coated balloons for endovascular therapy of femoropopliteal arterial obstructions.

PURPOSE To explore the cost-effectiveness of using drug-eluting balloon (DEB) angioplasty for the treatment of femoropopliteal arterial lesions, which has been shown to significantly lower the rates of target lesion revascularization (TLR) compared with standard balloon angioplasty (BA). METHODS A simplified decision-analytic model based on TLR rates reported in the literature was applied to baseline and follow-up costs associated with in-hospital patient treatment during 1 year of follow-up. Costs were expressed in Swiss Francs (sFr) and calculated per 100 patients treated. Budgets were analyzed in the context of current SwissDRG reimbursement figures and calculated from two different perspectives: a general budget on total treatment costs (third-party healthcare payer) as well as a budget focusing on the physician/facility provider perspective. RESULTS After 1 year, use of DEB was associated with substantially lower total inpatient treatment costs when compared with BA (sFr 861,916 vs. sFr 951,877) despite the need for a greater investment at baseline related to higher prices for DEBs. In the absence of dedicated reimbursement incentives, however, use of DEB was shown to be the financially less favorable treatment approach from the physician/facility provider perspective (12-month total earnings: sFr 179,238 vs. sFr 333,678). CONCLUSION Use of DEBs may be cost-effective through prevention of TLR at 1 year of follow-up. The introduction of dedicated financial incentives aimed at improving DEB reimbursements may help lower total healthcare costs.

Isotopic constraints on marine and terrestrial N2O emissions during the last deglaciation

Nitrous oxide (N2O) is an important greenhouse gas and ozone-depleting substance that has anthropogenic as well as natural marine and terrestrial sources. The tropospheric N2O concentrations have varied substantially in the past in concert with changing climate on glacial–interglacial and millennial timescales. It is not well understood, however, how N2O emissions from marine and terrestrial sources change in response to varying environmental conditions. The distinct isotopic compositions of marine and terrestrial N2O sources can help disentangle the relative changes in marine and terrestrial N2O emissions during past climate variations. Here we present N2O concentration and isotopic data for the last deglaciation, from 16,000 to 10,000 years before present, retrieved from air bubbles trapped in polar ice at Taylor Glacier, Antarctica. With the help of our data and a box model of the N2O cycle, we find a 30 per cent increase in total N2O emissions from the late glacial to the interglacial, with terrestrial and marine emissions contributing equally to the overall increase and generally evolving in parallel over the last deglaciation, even though there is no a priori connection between the drivers of the two sources. However, we find that terrestrial emissions dominated on centennial timescales, consistent with a state-of-the-art dynamic global vegetation and land surface process model that suggests that during the last deglaciation emission changes were strongly influenced by temperature and precipitation patterns over land surfaces. The results improve our understanding of the drivers of natural N2O emissions and are consistent with the idea that natural N2O emissions will probably increase in response to anthropogenic warming.

Appraisal-driven somatovisceral response patterning: effects of intrinsic pleasantness and goal conduciveness.

Several componential emotion theories suggest that appraisal outcomes trigger characteristic somatovisceral changes that facilitate information processing and prepare the organism for adaptive behavior. The current study tested predictions derived from Scherer's Component Process Model. Participants viewed unpleasant and pleasant pictures (intrinsic pleasantness appraisal) and were asked to concurrently perform either an arm extension or an arm flexion, leading to an increase or a decrease in picture size. Increasing pleasant stimuli and decreasing unpleasant stimuli were considered goal conducive; decreasing pleasant stimuli and increasing unpleasant stimuli were considered goal obstructive (goal conduciveness appraisal). Both appraisals were marked by several somatovisceral changes (facial electromyogram, heart rate (HR)). As predicted, the changes induced by the two appraisals showed similar patterns. Furthermore, HR results, compared with data of earlier studies, suggest that the adaptive consequences of both appraisals may be mediated by stimulus proximity.

First evidence for differential and sequential efferent effects of stimulus relevance and goal conduciveness appraisal.

In the context of a memory task, participants were presented with pictures displaying biological and cultural threat stimuli or neutral stimuli (stimulus relevance manipulation) with superimposed symbols signaling monetary gains or losses (goal conduciveness manipulation). Results for heart rate and facial electromyogram show differential efferent effects of the respective appraisal outcomes and provide first evidence for sequential processing, as postulated by Scherer's component process model of emotion. Specifically, as predicted, muscle activity over the brow and cheek regions marking the process of relevance appraisal occurred significantly earlier than facial muscle activity markers of goal conduciveness appraisal. Heart rate, in contrast, was influenced by the stimulus relevance manipulation only.

Beyond sexist beliefs: How do people decide to use gender-inclusive language?

When people use generic masculine language instead of more gender-inclusive forms, they communicate gender stereotypes and sometimes exclusion of women from certain social roles. Past research related gender-inclusive language use to sexist beliefs and attitudes. Given that this aspect of language use may be transparent to users, it is unclear whether people explicitly act on these beliefs when using gender-exclusive language forms or whether these are more implicit, habitual patterns. In two studies with German-speaking participants, we showed that spontaneous use of gender-inclusive personal nouns is guided by explicitly favorable intentions as well as habitual processes involving past use of such language. Further indicating the joint influence of deliberate and habitual processes, Study 2 revealed that language-use intentions are embedded in explicit sexist ideologies. As anticipated in our decision-making model, the effects of sexist beliefs on language emerged through deliberate mechanisms involving attitudes and intentions.

The (In)visibility of Psychodiagnosticians' Expertise

This study investigates decision making in mental health care. Specifically, it compares the diagnostic decision outcomes (i.e., the qualityof diagnoses) and the diagnostic decision process (i.e., pre-decisional information acquisition patterns) of novice and experienced clinicalpsychologists. Participants’ eye movements were recorded while they completed diagnostic tasks, classifying mental disorders. In line withprevious research, our findings indicate that diagnosticians’ performance is not related to their clinical experience. Eye-tracking data pro-vide corroborative evidence for this result from the process perspective: experience does not predict changes in cue inspection patterns. Forfuture research into expertise in this domain, it is advisable to track individual differences between clinicians rather than study differenceson the group level.

Portfolio Entrepreneurship in Family Firms: A Resource-based Perspective

The phenomenon of portfolio entrepreneurship has attracted considerable scholarly attention and is particularly relevant in the family fi rm context. However, there is a lack of knowledge of the process through which portfolio entrepreneurship develops in family firms. We address this gap by analyzing four in-depth, longitudinal family firm case studies from Europe and Latin America. Using a resource-based perspective, we identify six distinct resource categories that are relevant to the portfolio entrepreneurship process. Furthermore, we reveal that their importance varies across time. Our resulting resource-based process model of portfolio entrepreneurship in family firms makes valuable contributions to both theory and practice.

The relation of secondary student's career choice readiness to a six-phase model of career decision-making

Based on common aspects of recent models of career decision-making (CDM) a sixphase model of CDM for secondary students is presented and empirically evaluated. The study tested the hypothesis that students who are in later phases possess more career choice readiness and consider different numbers of career alternatives. 266 Swiss secondary students completed measures tapping phase of CDM, career choice readiness, and number of considered career options. Career choice readiness showed an increase with phase of CDM. Later phases were generally associated with a larger increase in career choice readiness. Number of considered career options showed a curve-linear development with fewer options considered at the beginning and at the end of the process. Male students showed a larger variability in their distribution among the process with more male than female students in the first and last phase of the process. Implications for theory and practice are presented.