Harm reduction and decision making among recreational ecstasy users

Recent research indicates that 3,4-methylene-dioxymethamphetamine (MDMA), also known as ‘ecstasy’, is becoming increasingly popular as an illicit drug among young people. This study investigated risk and harm reduction practices among recreational ecstasy users. A semi-structured interview with 40 participants was designed to investigate how ecstasy users identify and manage the harms associated with their drug use, and the underlying decision-making process. Overall, the participants identified both positive and negative effects. The reported positive effects predominantly centred around enhanced psychological, physiological and social experiences. However, there were a number of factors that contributed to regulating ecstasy use. These included specific in-group and out-group practices executed within the peer group, preventative harm-reducing practices, shared decision making, and shared responsibility for harm prevention. Recommendations for promoting harm reduction strategies and suggestions for future research are discussed.

Cross-cultural differences in consumer decision-making styles

This article compares consumer decision-making styles between Singaporeans and Australians. Utilising Hofstede’s framework, the paper argues that cultural dimensions influence consumer decision making styles. It is essential that managers understand cross-cultural consumer decision-making styles to make strategic decisions or effectively handle members of these nationalities. Marked differences were found between the two populations for: brand consciousness, innovativeness and overchoice confusion. The results suggest that some consumer decision-making styles differ due to consumers’ cultural values. Managerial implications and future research directions are discussed.

Decision making effectiveness in wildfire incident management teams

During large scale wildfires, suppression activities are carried out under the direction of an Incident Management Team (IMT). The aim of the research was to increase understanding of decision processes potentially related to IMT effectiveness. An IMT comprises four major functions: Command, Operations, Planning, and Logistics. Four methodologies were used to study IMT processes: computer simulation experiments; analyses of wildfire reports; interviews with IMT members; and cognitive ethnographic studies of IMTs. Three processes were important determinants of IMT effectiveness: information management and cognitive overload; matching component function goals to overall goals; and team metacognition to detect and counter task-disruptive developments. These processes appear to be complex multi-person analogues of individual Incident Command processes identified previously. The findings have implications for issues such as: creating IMTs; training IMTs; managing IMTs; and providing decision support to IMTs.

Decision-making models used by `graduate nurses` managing patients` medications

Background. Nurses in a graduate programme in Australia are those who are in the first year of clinical practice following completion of a 3-year undergraduate nursing degree. When working in an acute care setting, they need to make complex and ever-changing decisions about patients' medications in a clinical environment affected by multifaceted, contextual issues. It is important that comprehensive information about graduate nurses' decision-making processes and the contextual influences affecting these processes are obtained in order to prepare them to meet patients' needs.
Aim. The purpose of this paper is to report a study that sought to answer the following questions: What are the barriers that impede graduate nurses' clinical judgement in their medication management activities? How do contextual issues impact on graduate nurses' medication management activities? The decision-making models considered were: hypothetico-deductive reasoning, pattern recognition and intuition.
Methods. Twelve graduate nurses who were involved in direct patient care in medical and surgical wards of a metropolitan teaching hospital located in Melbourne, Australia participated in the study. Participant observations were conducted with the graduate nurses during a 2-hour period during the times when medications were being administered to patients. Graduate nurses were also interviewed to elicit further information about how they made decisions about patients' medications.
Results. The most common model used was hypothetico-deductive reasoning, followed by pattern recognition and then intuition. The study showed that graduate nurses had a good understanding of how physical assessment affected whether medications should be administered or not. When negotiating treatment options, graduate nurses readily consulted with more experienced nursing colleagues and doctors.
Study limitations. It is possible that graduate nurses demonstrated a raised awareness of managing patients' medications as a consequence of being observed.
Conclusions. The complexity of the clinical practice setting means that graduate nurses need to adapt rapidly to make sound and appropriate decisions about patient care.

Bushfire incident management team decision making

Large scale bushfire (or wildfire) suppression activities are conducted under the control of an Incident Management Team (IMT) comprising four major functions: Command, Operations, Planning, and Logistics. Four methodologies were used to investigate processes determining the effectiveness of IMT decision making activities: (a) laboratory experiments using the Networked Fire Chief computer simulation program; (b) analyses of reports of significant fires; (c) structured interviews with experienced IMT staff; and, (d) cognitive ethnographic studies of IMTs. Three classes of team processes were found to be important determinants of IMT effectiveness: information sharing and management; matching of the four component function goals to overall IMT goals; and monitoring of the overall IMT situation to detect and correct task disruptive processes. Several non-rational processes with the potential for hindering IMT effectiveness were noted. Team metacognition emerged as a key process for understanding effective IMT decision making.

Interlink decision making index (IDMI) -- a simple tool/concept to assist decision making for sustainability Part 1: definition of IDMI

There is an apparent gap between the LCA or other assessment's outcomes and its effective application in the decision making process. It is needed to provide to the decision makers a simple, less human interfered mechanism that integrates all the key criteria (environmental, economic, technical and safety etc.). The proposed index: Interlink Decision Making Index (IDMI) has all these features: simple, interlink (all criteria) and automatically and quantified influence of critical criteria (ie. no human weighting needed) and is able to assist the multi-criteria decision making for sustainability based on the outcomes of specific assessments (eg. LCA, ElA etc.). The index represents a pure numerical value and does not necessarily have any physical meanings, but it reflects the total merits of a particular option once the normal decision making criteria and (up to two) critical criteria (CC) have been chosen. Then, without arbitrarily weighting process, the comparison and selection of the best possible option, ie. decision can be made based on the derived IDMI results. Two hypothetical examples are presented in part 2 of the paper to demonstrate the application of the IDMI concept and it's differences with the traditional "tabular method" in the decision making process.