An assessment of sample surveys as feedback mechanisms for guiding local decision making /

Research supported by U.S. Dept. of Housing and Urban Development, Office of Policy Development and Research.

Precautionary principles: a jurisdiction-free framework for decision-making under risk

Fundamental principles of precaution are legal maxims that ask for preventive actions, perhaps as contingent interim measures while relevant information about causality and harm remains unavailable, to minimize the societal impact of potentially severe or irreversible outcomes. Such principles do not explain how to make choices or how to identify what is protective when incomplete and inconsistent scientific evidence of causation characterizes the potential hazards. Rather, they entrust lower jurisdictions, such as agencies or authorities, to make current decisions while recognizing that future information can contradict the scientific basis that supported the initial decision. After reviewing and synthesizing national and international legal aspects of precautionary principles, this paper addresses the key question: How can society manage potentially severe, irreversible or serious environmental outcomes when variability, uncertainty, and limited causal knowledge characterize their decision-making? A decision-analytic solution is outlined that focuses on risky decisions and accounts for prior states of information and scientific beliefs that can be updated as subsequent information becomes available. As a practical and established approach to causal reasoning and decision-making under risk, inherent to precautionary decision-making, these (Bayesian) methods help decision-makers and stakeholders because they formally account for probabilistic outcomes, new information, and are consistent and replicable. Rational choice of an action from among various alternatives-defined as a choice that makes preferred consequences more likely-requires accounting for costs, benefits and the change in risks associated with each candidate action. Decisions under any form of the precautionary principle reviewed must account for the contingent nature of scientific information, creating a link to the decision-analytic principle of expected value of information (VOI), to show the relevance of new information, relative to the initial ( and smaller) set of data on which the decision was based. We exemplify this seemingly simple situation using risk management of BSE. As an integral aspect of causal analysis under risk, the methods developed in this paper permit the addition of non-linear, hormetic dose-response models to the current set of regulatory defaults such as the linear, non-threshold models. This increase in the number of defaults is an important improvement because most of the variants of the precautionary principle require cost-benefit balancing. Specifically, increasing the set of causal defaults accounts for beneficial effects at very low doses. We also show and conclude that quantitative risk assessment dominates qualitative risk assessment, supporting the extension of the set of default causal models.

CORD an object model supporting statistical summary information for management decision making

Information systems have developed to the stage that there is plenty of data available in most organisations but there are still major problems in turning that data into information for management decision making. This thesis argues that the link between decision support information and transaction processing data should be through a common object model which reflects the real world of the organisation and encompasses the artefacts of the information system. The CORD (Collections, Objects, Roles and Domains) model is developed which is richer in appropriate modelling abstractions than current Object Models. A flexible Object Prototyping tool based on a Semantic Data Storage Manager has been developed which enables a variety of models to be stored and experimented with. A statistical summary table model COST (Collections of Objects Statistical Table) has been developed within CORD and is shown to be adequate to meet the modelling needs of Decision Support and Executive Information Systems. The COST model is supported by a statistical table creator and editor COSTed which is also built on top of the Object Prototyper and uses the CORD model to manage its metadata.

Study of management decision making by ward sisters in a hospital and the effects on decision making after the implementation of a decision support sytem

This thesis considers management decision making at the ward level in hospitals especially by ward sisters, and the effectiveness of the intervention of a decision support system. Nursing practice theories were related to organisation and management theories in order to conceptualise a decision making framework for nurse manpower planning and deployment at the ward level. Decision and systems theories were explored to understand the concepts of decision making and the realities of power in an organisation. In essence, the hypothesis was concerned with changes in patterns of decision making that could occur with the intervention of a decision support system and that the degree of change would be governed by a set of `difficulty' factors within wards in a hospital. During the course of the study, a classification of ward management decision making was created, together with the development and validation of measuring instruments to test the research hypothesis. The decision support system used was rigorously evaluated to test whether benefits did accrue from its implementation. Quantitative results from sample wards together with qualitative information collected, were used to test this hypothesis and the outcomes postulated were supported by these findings. The main conclusion from this research is that a more rational approach to management decision making is feasible, using information from a decision support system. However, wards and ward sisters that need the most assistance, where the `difficulty' factors in the organisation are highest, benefit the least from this type of system. Organisational reviews are needed on these identified wards, involving managers and doctors, to reduce the levels of un-coordinated activities and disruption.

Decision making in nuclear waste management:the use of the synoptic approach

This thesis is concerned with the use of the synoptic approach within decision making concerning nuclear waste management. The synoptic approach to decision making refers to an approach to rational decision making that assumes as an ideal, comprehensiveness of information and analysis. Two case studies are examined in which a high degree of synoptic analysis has been used within the decision making process. The case studies examined are the Windscale Inquiry into the decision to build the THORP reprocessing plant and the Nirex safety assessment of nuclear waste disposal. The case studies are used to test Lindblom's hypothesis that a synoptic approach to decision making is not achievable. In the first case study Lindblom's hypothesis is tested through the evaluation of the decision to build the THORP plant, taken following the Windscale Inquiry. It is concluded that the incongruity of this decision supports Lindblom's hypothesis. However, it has been argued that the Inquiry should be seen as a legitimisation exercise for a decision that was effectively predetermined, rather than a rigorous synoptic analysis. Therefore, the Windscale Inquiry does not provide a robust test of the synoptic method. It was concluded that a methodology was required, that allowed robust conclusions to be drawn, despite the ambiguity of the role of the synoptic method in decision making. Thus, the methodology adopted for the second case study was modified. In this case study the synoptic method was evaluated directly. This was achieved through the analysis of the cogency of the Nirex safety assessment. It was concluded that the failure of Nirex to provide a cogent synoptic analysis supported Lindblom's criticism of the synoptic method. Moreover, it was found that the synoptic method failed in the way that Lindblom predicted that it would.

Supporting decision-making for self-adaptive systems:from goal models to dynamic decision networks

Context/Motivation - Different modeling techniques have been used to model requirements and decision-making of self-adaptive systems (SASs). Specifically, goal models have been prolific in supporting decision-making depending on partial and total fulfilment of functional (goals) and non-functional requirements (softgoals). Different goalrealization strategies can have different effects on softgoals which are specified with weighted contribution-links. The final decision about what strategy to use is based, among other reasons, on a utility function that takes into account the weighted sum of the different effects on softgoals. Questions/Problems - One of the main challenges about decisionmaking in self-adaptive systems is to deal with uncertainty during runtime. New techniques are needed to systematically revise the current model when empirical evidence becomes available from the deployment. Principal ideas/results - In this paper we enrich the decision-making supported by goal models by using Dynamic Decision Networks (DDNs). Goal realization strategies and their impact on softgoals have a correspondence with decision alternatives and conditional probabilities and expected utilities in the DDNs respectively. Our novel approach allows the specification of preferences over the softgoals and supports reasoning about partial satisfaction of softgoals using probabilities. We report results of the application of the approach on two different cases. Our early results suggest the decision-making process of SASs can be improved by using DDNs. © 2013 Springer-Verlag.

Putting children forward for epilepsy surgery:a qualitative study of UK parents' and health professionals' decision-making experiences

Background Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. Aim The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Methods Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Findings Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Discussion Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Conclusion Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences.

Vezetői döntéshozatal és versenyképesség (The managerial decision making and the competitiveness)

A tanulmány a vezetői döntéshozatal három lényeges aspektusát tárja fel. A Versenyben a világgal c. kutatási program eredményei alapján arra lehet következtetni, hogy a menedzserek döntéshozatali képességei és megközelítései, a vállalati teljesítménymérés és menedzsment döntéseket támogató szerepe, valamint a vállalatok érintettekhez fűződő viszonya meghatározó lehet a hatékony vezetői döntéshozatal során. A vállalati döntéshozatal jellemzőinek bemutatása után megvizsgáljuk azt is, hogy a különböző teljesítményű cégek döntéseit mennyire támogatja a menedzserek felkészültsége, a teljesítménymérési gyakorlat és az érintettek elvárásai. A szerzők úgy találták, hogy a fenti tényezők mindegyike hozzájárul a hazai cégek versenyképességéhez, általánosságban ugyanis elmondható, hogy a döntéseket támogató vállalati környezet jobb üzleti teljesítményhez és gyorsabb reagálóképességhez vezethet. Az eredmények összegzése mellett ajánlásokkal is éltek a vállalatok számára, amelyek alkalmazásával hatékonyabb döntéseket hozhatnak. _______ This study presents three main aspects of the managerial decision making. Based on the results of the research program In competition with the World it points to the fact that decision making abilities and approaches of the managers, the corporate performance appraisal and the management decision support role, and the corporate relations to the stakeholders will be determinant in the process of the efficient managerial decision making. After presentation of characteristics of the corporate decision making the authors examine that how the decisions of enterprises with different performances are supported by the preparedness of the managers, the performance appraisal practice and the stakeholders expectations. The authors have thought that every factor contributes to the competitiveness of the domestic enterprises, and generally the decision supporting corporate environment can lead to better business performance and faster responsive abilities. Besides the results summary the authors give useful recommendations to the corporations with which they can make more efficient decisions.

Age differences and conformity in juror decision -making

The purpose of this experiment was to investigate whether older adults conform more than young and middle-aged adults on a juror decision making task. Degree of group pressure, personality characteristics, gender, and social influence processes were also examined.^ Registered voters (208 participants) completed a personality questionnaire. Several weeks later, groups of six participants listened to a robbery case that portrayed the defendant as guilty. Afterwards, participants completed the first of two ballots. On the first, participants rated the defendant's degree of guilt and scored their degree of certainty in this verdict rating. They also indicated in writing which piece of information (a statement of evidence) from the robbery case supported their verdict ratings. Next, participants reviewed photocopies of five contrived first ballots. Then participants completed second ballots, in which they again rated the defendant's degree of guilt and scored their degree of certainty in this verdict rating. Finally, participants rated the importance of the five contrived first ballot verdict ratings (normative social influence) and statements of evidence (informational social influence) in reaching their second ballot verdict ratings.^ The results demonstrated that not only did older adults conform as expected, but all age groups conformed; that is, all age groups changed their verdict ratings. After reviewing the other jurors' contrived first ballots (group pressure), participants rated the defendant as less guilty on their second ballot than on their first. However, only older adults significantly changed their level of certainty in their verdict ratings from first to second ballot compared to young and middle-aged adults. With regard to personality characteristics, only rigidity predicted conformity in young and middle-aged adults but not in older adults. It was also found that females conformed more than males. Finally, all three age groups reported that different social influence processes (normative vs. informational) were important in reaching their second ballot verdict ratings. The results of this research indicate that various factors can influence young, middle-aged, and older adults as they reach verdicts. Knowledge of these factors may help alter stereotypes of older adults in terms of conformity, rigidity, and desirability as jurors. ^

Exploring the rural passenger experience, information needs and decision making during public transport disruption

Acknowledgements The research described here is supported by the award made by the RCUK Digital Economy programme to the dot.rural Digital Economy Research Hub; award reference: EP/G066051/1. Further, we would like to acknowledge the RCUK research grant EP/J000604/2.

Neural Mechanisms of Young Adult Sexual Decision-Making and Risk Behavior

Sexual risk behavior among young adults is a serious public health concern; 50% will contract a sexually transmitted infection (STI) before the age of 25. The current study collected self-report personality and sexual history data, as well as neuroimaging, experimental behavioral (e.g., real-time hypothetical sexual decision making data), and self-report sexual arousal data from 120 heterosexual young adults ages 18-26. In addition, longitudinal changes in self-reported sexual behavior were collected from a subset (n = 70) of the participants. The primary aims of the study were (1) to predict differences in self-report sexual behavior and hypothetical sexual decision-making (in response to sexually explicit audio-visual cues) as a function of ventral striatum (VS) and amygdala activity, (2) test whether the association between sexual behavior/decision-making and brain function is moderated by gender, self-reported sexual arousal, and/or trait-level personality factors (i.e., self-control, impulsivity, and sensation seeking) and (3) to examine how the main effects of neural function and interaction effects predict sexual risk behavior over time. Our hypotheses were mostly supported across the sexual behavior and decision-making outcome variables, such that neural risk phenotypes (heightened reward-related ventral striatum activity coupled with decreased threat-related amygdala activity) were associated with greater lifetime sexual partners at baseline measured and over time (longitudinal analyses). Impulsivity moderated the relationship between neural function and self-reported number of sexual partners at baseline and follow up measures, as well as experimental condom use decision-making. Sexual arousal and sensation seeking moderated the relationship between neural function and baseline and follow up self-reports of number of sexual partners. Finally, unique gender differences were observed in the relationship between threat and reward-related neural reactivity and self-reported sexual risk behavior. The results of this study provide initial evidence for the potential role for neurobiological approaches to understanding sexual decision-making and risk behavior. With continued research, establishing biomarkers for sexual risk behavior could help inform the development of novel and more effective individually tailored sexual health prevention and intervention efforts.

"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.

Assessing Decision Making Skill in Complex and Dynamic Environments Using Representative and Simulated Tasks

Traditional decision making research has often focused on one's ability to choose from a set of prefixed options, ignoring the process by which decision makers generate courses of action (i.e., options) in-situ (Klein, 1993). In complex and dynamic domains, this option generation process is particularly critical to understanding how successful decisions are made (Zsambok & Klein, 1997). When generating response options for oneself to pursue (i.e., during the intervention-phase of decision making) previous research has supported quick and intuitive heuristics, such as the Take-The-First heuristic (TTF; Johnson & Raab, 2003). When generating predictive options for others in the environment (i.e., during the assessment-phase of decision making), previous research has supported the situational-model-building process described by Long Term Working Memory theory (LTWM; see Ward, Ericsson, & Williams, 2013). In the first three experiments, the claims of TTF and LTWM are tested during assessment- and intervention-phase tasks in soccer. To test what other environmental constraints may dictate the use of these cognitive mechanisms, the claims of these models are also tested in the presence and absence of time pressure. In addition to understanding the option generation process, it is important that researchers in complex and dynamic domains also develop tools that can be used by `real-world' professionals. For this reason, three more experiments were conducted to evaluate the effectiveness of a new online assessment of perceptual-cognitive skill in soccer. This test differentiated between skill groups and predicted performance on a previously established test and predicted option generation behavior. The test also outperformed domain-general cognitive tests, but not a domain-specific knowledge test when predicting skill group membership. Implications for theory and training, and future directions for the development of applied tools are discussed.