980 resultados para clinical decision-making


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This paper presents a comparison of values of wildlife held by stakeholder groups and public samples in Victoria, Australia, with a sample of wildlife managers' beliefs about these groups. It also examines the managers' views of the importance of utilizing human dimensions information in their decision-making. In-depth interviews were conducted with wildlife/environmental managers in a sample of state and local government agencies and members of wildlife management stakeholder groups. Questionnaires were used to explore values of wildlife held by stakeholder group members and the Victorian public. There are several instances of interviewed managers misunderstanding the values held by stakeholder groups and subsets of the Victorian public. Such discrepancies can be reduced by incorporating systematically obtained human dimensions information into management decisions. Interviewed wildlife managers appear to appreciate the importance of human dimensions information; however, there was some uncertainty about how it could be applied.

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Despite technological advances, many postoperative patients continue to suffer unrelieved pain. The aim of this study was to identify the strategies used by postoperative patients to bring about pain management decisions. A single-group noncomparative study design was chosen using observations as the means of examining pain activities in 2 surgical units of a metropolitan teaching hospital in Melbourne, Australia. A total of 52 nurses and 312 patients participated in the study, and 316 pain activities were observed. The most common strategy used was patients acting as a passive recipient for pain relief (60%), whereas problem solving (23%) and active negotiation (17%) were less commonly used. Patients in this study were admitted for surgical treatment of a particular condition, and their subsequent pain was specifically related to this acute event. Therefore, the lack of familiarity of the situation and the severity of pain experienced may have encouraged passivity. Patients may have also felt uncertain about how to approach the pain decision, preferring to defer to nurses. Because increased pain levels can be associated with fear, patients could have been unwilling to speak with nurses to discuss their need for pain relief.


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This paper examines methods of point wise construction of aggregation operators via optimal interpolation. It is shown that several types of application-specific requirements lead to interpolatory type constraints on the aggregation function. These constraints are translated into global optimization problems, which are the focus of this paper. We present several methods of reduction of the number of variables, and formulate suitable numerical algorithms based on Lipschitz optimization.

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Research findings become evidence when an individual decides that the information is relevant and useful to a particular circumstance. Prior to that point, they are unrelated facts. For research translation to occur, research evidence needs filtering, interpretation, and application by individuals to the specific situation. For this reason, decision science is complementary to knowledge translation science. Both aim to support the individual in deciding the most appropriate action in a dynamic environment where there are masses of uncensored and nonprioritized information readily available. Decision science employs research theories to study the cognitive processes underpinning the filtering and integration of current scientific information into changing contexts. Two meta-theories, coherence and correspondence theories, have been used to provide alternative views and prompt significant debate to advance the science. The aim of this article is to stimulate debate about the relationship between decision theory and knowledge translation. Discussed is the critical role of cognition in clinical decision making, with a focus on knowledge translation. A critical commentary of the knowledge utilization modeling papers is presented from a decision science perspective. The article concludes with a discussion on the implications for knowledge translation when viewed through the lens of decision science.

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The research considered the impact on the range of decision areas available to strategy setting for organisations internationalising part of their operations to reduce costs. The research utilised qualitative research data collected from interviews with 10 CEOs based on a structured interview guide formulated around the principal issues identified in the literature. Thematic analysis was used to extract evidence in relation to issues identified in the literature as well as new issues not currently identified .It found that internationalisation significantly reduced the range of decision areas available for strategic decision making. This affected the range of inputs to the formulation process, as well as the strategic choice options available. Organisations internationalising operations to reduce costs should increase levels of staff involvement through revolutionary strategy formulation processes, adopted more centralised corporate strategy processes and utilise a clearly differentiated and sequential relationship between corporate and business level strategies. The findings indicate that different strategy formulation processes are required for different levels of internationalisation of operations to reduce operating costs. Research into international strategy must recognize the change in the approach to strategy formulation that occurs as organisations increase their level of international operations. Future research to identify whether the currently generally adopted strategy formulation processes are adequate for all levels of internationalisation of operations should be pursued.

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This article reviews the precautionary principle as an approach in addressing decisions with far reaching environmental consequences under scientific uncertainty. The precautionary principle is intended to assist with structuring environmentally risky decisions toward sustainable development. It responds to the lack of scientific evidence of a potential environmental problem. There is currently no framework to assist with the process indicating the areas of importance and stages of decisionmaking. This paper suggests a framework to assist with the process of decision-making for complex environmental problems. The main areas of concern are the issues relating to the costs, risks, and benefits assessments. The main stages of the framework includes; definition of the problem, analysis of the potential environmental risks, assessments of specific anticipated legal, social, economic, political, and technological impacts, review of the key players (social, organisation and government) obligations, comparison of alternatives available, determination of accountability, implementation, decision making, monitoring and control processes.

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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.


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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.

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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.

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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.

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