Communicating with the coroner : how religion, culture, and family concerns may influence autopsy decision making

Based on coronial data gathered in the state of Queensland in 2004, this article reviews how a change in legislation may have impacted autopsy decision making by coroners. More specifically, the authors evaluated whether the requirement that coronial autopsy orders specify the level of invasiveness of an autopsy to be performed by a pathologist was affected by the further requirement that coroners take into consideration a known religion, culture, and/or raised family concern before making such an order. Preliminary data reveal that the cultural status of the deceased did not affect coronial autopsy decision making. However, a known religion with a proscription against autopsy and a raised family concern appeared to be taken into account by coroners when making autopsy decisions and tended to decrease the invasiveness of the autopsy ordered from a full internal examination to either a partial internal examination or an external-only examination of the body. The impact of these findings is briefly discussed.

Online retailing versus traditional stores in the purchasing decision making process

Due to proliferation of online stores prior expectations that retailing would move completely online were not fulfilled. Previous research about consumers’ preference of retailing channels suggested that online sales are driven by the convenience of online shopping, or as a natural extension of online searches. This paradigm has changed over the years. Changes in consumer behaviour are indicating that while consumers are searching online using various information sources to learn about products, ultimately when purchasing, consumers are shifting between online and offline retailing channels depending on various factors. Online shopping is still considered to be a convenient way to purchase goods, but the convenience is not the key factor. This qualitative research is based on 22 in-depth interviews with shoppers in Australia.

Information sharing in Onesocialweb using a multiple profile manager to better informed medical decision making processes

The study shows an alternative solution to existing efforts at solving the problem of how to centrally manage and synchronise users’ Multiple Profiles (MP) across multiple discrete social networks. Most social network users hold more than one social network account and utilise them in different ways depending on the digital context (Iannella, 2009a). They may, for example, enjoy friendly chat on Facebook1, professional discussion on LinkedIn2, and health information exchange on PatientsLikeMe3 In this thesis the researcher proposes a framework for the management of a user’s multiple online social network profiles. A demonstrator, called Multiple Profile Manager (MPM), will be showcased to illustrate how effective the framework will be. The MPM will achieve the required profile management and synchronisation using a free, open, decentralized social networking platform (OSW) that was proposed by the Vodafone Group in 2010. The proposed MPM will enable a user to create and manage an integrated profile (IP) and share/synchronise this profile with all their social networks. The necessary protocols to support the prototype are also proposed by the researcher. The MPM protocol specification defines an Extensible Messaging and Presence Protocol (XMPP) extension for sharing vCard and social network accounts information between the MPM Server, MPM Client, and social network sites (SNSs). . Therefore many web users need to manage disparate profiles across many distributed online sources. Maintaining these profiles is cumbersome, time-consuming, inefficient, and may lead to lost opportunity. The writer of this thesis adopted a research approach and a number of use cases for the implementation of the project. The use cases were created to capture the functional requirements of the MPM and to describe the interactions between users and the MPM. In the research a development process was followed in establishing the prototype and related protocols. The use cases were subsequently used to illustrate the prototype via the screenshots taken of the MPM client interfaces. The use cases also played a role in evaluating the outcomes of the research such as the framework, prototype, and the related protocols. An innovative application of this project is in the area of public health informatics. The researcher utilised the prototype to examine how the framework might benefit patients and physicians. The framework can greatly enhance health information management for patients and more importantly offer a more comprehensive personal health overview of patients to physicians. This will give a more complete picture of the patient’s background than is currently available and will prove helpful in providing the right treatment. The MPM prototype and related protocols have a high application value as they can be integrated into the real OSW platform and so serve users in the modern digital world. They also provide online users with a real platform for centrally storing their complete profile data, efficiently managing their personal information, and moreover, synchronising the overall complete profile with each of their discrete profiles stored in their different social network sites.

Mean-field descriptions of collective migration with strong adhesion

Random walk models based on an exclusion process with contact effects are often used to represent collective migration where individual agents are affected by agent-to-agent adhesion. Traditional mean field representations of these processes take the form of a nonlinear diffusion equation which, for strong adhesion, does not predict the averaged discrete behavior. We propose an alternative suite of mean-field representations, showing that collective migration with strong adhesion can be accurately represented using a moment closure approach.

The four principles: Can they be measured and do they predict ethical decision making?

Background The four principles of Beauchamp and Childress - autonomy, non-maleficence, beneficence and justice - have been extremely influential in the field of medical ethics, and are fundamental for understanding the current approach to ethical assessment in health care. This study tests whether these principles can be quantitatively measured on an individual level, and then subsequently if they are used in the decision making process when individuals are faced with ethical dilemmas. Methods The Analytic Hierarchy Process was used as a tool for the measurement of the principles. Four scenarios, which involved conflicts between the medical ethical principles, were presented to participants and they made judgments about the ethicality of the action in the scenario, and their intentions to act in the same manner if they were in the situation. Results Individual preferences for these medical ethical principles can be measured using the Analytic Hierarchy Process. This technique provides a useful tool in which to highlight individual medical ethical values. On average individuals have a significant preference for non-maleficence over the other principles, however, and perhaps counter-intuitively, this preference does not seem to relate to applied ethical judgements in specific ethical dilemmas. Conclusions People state they value these medical ethical principles but they do not actually seem to use them directly in the decision making process. The reasons for this are explained through the lack of a behavioural model to account for the relevant situational factors not captured by the principles. The limitations of the principles in predicting ethical decision making are discussed.

Improving trust and securing data accessibility for e-health decision making by using data encryption techniques

In the medical and healthcare arena, patients‟ data is not just their own personal history but also a valuable large dataset for finding solutions for diseases. While electronic medical records are becoming popular and are used in healthcare work places like hospitals, as well as insurance companies, and by major stakeholders such as physicians and their patients, the accessibility of such information should be dealt with in a way that preserves privacy and security. Thus, finding the best way to keep the data secure has become an important issue in the area of database security. Sensitive medical data should be encrypted in databases. There are many encryption/ decryption techniques and algorithms with regard to preserving privacy and security. Currently their performance is an important factor while the medical data is being managed in databases. Another important factor is that the stakeholders should decide more cost-effective ways to reduce the total cost of ownership. As an alternative, DAS (Data as Service) is a popular outsourcing model to satisfy the cost-effectiveness but it takes a consideration that the encryption/ decryption modules needs to be handled by trustworthy stakeholders. This research project is focusing on the query response times in a DAS model (AES-DAS) and analyses the comparison between the outsourcing model and the in-house model which incorporates Microsoft built-in encryption scheme in a SQL Server. This research project includes building a prototype of medical database schemas. There are 2 types of simulations to carry out the project. The first stage includes 6 databases in order to carry out simulations to measure the performance between plain-text, Microsoft built-in encryption and AES-DAS (Data as Service). Particularly, the AES-DAS incorporates implementations of symmetric key encryption such as AES (Advanced Encryption Standard) and a Bucket indexing processor using Bloom filter. The results are categorised such as character type, numeric type, range queries, range queries using Bucket Index and aggregate queries. The second stage takes the scalability test from 5K to 2560K records. The main result of these simulations is that particularly as an outsourcing model, AES-DAS using the Bucket index shows around 3.32 times faster than a normal AES-DAS under the 70 partitions and 10K record-sized databases. Retrieving Numeric typed data takes shorter time than Character typed data in AES-DAS. The aggregation query response time in AES-DAS is not as consistent as that in MS built-in encryption scheme. The scalability test shows that the DBMS reaches in a certain threshold; the query response time becomes rapidly slower. However, there is more to investigate in order to bring about other outcomes and to construct a secured EMR (Electronic Medical Record) more efficiently from these simulations.

Intuitionistic fuzzy Choquet integral operator-based approach for black-start decision-making

Determining the optimal of black-start strategies is very important for speeding the restoration speed of a power system after a global blackout. Most existing black-start decision-making methods are based on the assumption that all indexes are independent of each other, and little attention has been paid to the group decision-making method which is more reliable. Given this background, the intuitionistic fuzzy set and further intuitionistic fuzzy Choquet integral operator are presented, and a black-start decision-making method based on this integral operator is presented. Compared to existing methods, the proposed algorithm cannot only deal with the relevance among the indexes, but also overcome some shortcomings of the existing methods. Finally, an example is used to demonstrate the proposed method. © 2012 The Institution of Engineering and Technology.

Extending persistent monitoring by combining ocean models and Markov decision processes

Ocean processes are complex and have high variability in both time and space. Thus, ocean scientists must collect data over long time periods to obtain a synoptic view of ocean processes and resolve their spatiotemporal variability. One way to perform these persistent observations is to utilise an autonomous vehicle that can remain on deployment for long time periods. However, such vehicles are generally underactuated and slow moving. A challenge for persistent monitoring with these vehicles is dealing with currents while executing a prescribed path or mission. Here we present a path planning method for persistent monitoring that exploits ocean currents to increase navigational accuracy and reduce energy consumption.

Teacher decision making in early childhood education

The study investigated early childhood teacher decision making at the preschool level in the state of Victoria, Australia. Victorian teachers at the preschool level were in an interesting position in 2004. Unlike most other Australian states Victoria did not have a curriculum framework guiding educational content and pedagogy. Consequently, this study was able to take advantage of this situation and examine teacher decision making at a time when early childhood teachers were relatively autonomous in deciding curriculum content. The opportunity to study teacher decision making in this way has since passed, as Victorian preschool teachers are now regulated by newly introduced state and national curricula frameworks. To identify influences affecting teacher decision making three preschool teachers were interviewed and curricula related policies were analysed. The data were analysed using Fairclough’s critical discourse analysis (CDA) technique. Critical discourse analysis enabled a close analysis of influences on teacher decision making illustrating how discourse is legitimated, marginalised, and silenced in certain curricula practices. Critical theory was the underpinning framework used for the study and enabled taken-for-granted understandings to be uncovered within early childhood policies and teacher interviews. Key findings were that despite there not being a government-mandated curricula framework for Victorian preschool education in 2004, teachers were held accountable for their curricula practice. Yet as professionals, early childhood teachers were denied public acknowledgment of their expertise as they were almost invisible in policy. Subsequently, teachers’ authority as professionals with curricula knowledge was diminished. The study found that developmentally appropriate practice (DAP) was a dominant discourse influencing teacher decision making (TDM). It operated as legitimated discourse in the 2004 Victorian preschool context. Additionally, the study found that teacher directed practice was legitimated, marginalised, and silenced by teachers. The findings have implications for early childhood teacher decision making at the practice, research, and policy levels. Findings show that the dominance of the DAP discourse informing teacher decision making limits other ways of thinking and practising.

Overdue choices : how information and role in decision-making influence women's preferences for induction for prolonged pregnancy

Background: Enabling women to make informed decisions is a crucial component of consumer-focused maternity care. Current evidence suggests that health care practitioners’ communication of care options may not facilitate patient involvement in decision-making. The aim of this study was to investigate the effect of specific variations in health caregiver communication on women’s preferences for induction of labor for prolonged pregnancy. Methods: A convenience sample of 595 female participants read a hypothetical scenario in which an obstetrician discusses induction of labor with a pregnant woman. Information provided on induction and the degree of encouragement for the woman’s involvement in decision-making was manipulated to create four experimental conditions. Participants indicated preference with respect to induction, their perceptions of the quality of information received, and other potential moderating factors. Results: Participants who received information that was directive in favor of medical intervention were significantly more likely to prefer induction than those given nondirective information. No effect of level of involvement in decision-making was found. Participants’ general trust in doctors moderated the relationship between health caregiver communication and preferences for induction, such that the influence of information provided on preferences for induction differed across levels of involvement in decision-making for women with a low trust in doctors, but not for those with high trust. Many women were not aware of the level of information required to make an informed decision. Conclusions: Our findings highlight the potential value of strategies such as patient decision aids and health care professional education to improve the quality of information available to women and their capacity for informed decision-making during pregnancy and birth. (BIRTH 39:3 September 2012)

A new approach for power system black-start decision-making with vague set theory

Power system restoration after a large area outage involves many factors, and the procedure is usually very complicated. A decision-making support system could then be developed so as to find the optimal black-start strategy. In order to evaluate candidate black-start strategies, some indices, usually both qualitative and quantitative, are employed. However, it may not be possible to directly synthesize these indices, and different extents of interactions may exist among these indices. In the existing black-start decision-making methods, qualitative and quantitative indices cannot be well synthesized, and the interactions among different indices are not taken into account. The vague set, an extended version of the well-developed fuzzy set, could be employed to deal with decision-making problems with interacting attributes. Given this background, the vague set is first employed in this work to represent the indices for facilitating the comparisons among them. Then, a concept of the vague-valued fuzzy measure is presented, and on that basis a mathematical model for black-start decision-making developed. Compared with the existing methods, the proposed method could deal with the interactions among indices and more reasonably represent the fuzzy information. Finally, an actual power system is served for demonstrating the basic features of the developed model and method.

Decision-making about hormone replacement therapy by women in England and Scotland

OBJECTIVE: The aim of this study was to explore women's decision-making about the balance of risks and benefits of taking hormone replacement therapy (HRT) based on the latest evidence from the Women's Health Initiative (WHI) trial of combined HRT. METHODS: Women aged 50-69 years, who were eligible for the Women's International Study of long Duration Oestrogen after Menopause (WISDOM) trial, were invited to participate in one of eight focus groups. Participants were asked to discuss their views about taking HRT based on the latest international evidence. RESULTS AND CONCLUSIONS: Eighty-two women participated overall. Qualitative content analysis was applied to the discussion transcripts. Women regarded the decisions they make about taking HRT as highly personal, and, for women currently taking HRT, the overwhelming reason for continuation was perceived improvement in quality of life regardless of either the risks or the benefits in the longer term.

Factors affecting marketing decision making with an ethical content : collusive tendering in the construction contract market

Reports of immoral marketing practices i n the construction industry attract political, media and public but not much academic interest. This paper adopts a behavioural perspective and proposes a model for applying marketing ethics concepts and methods in the study of collusion in the construction contract market. An extensive multidisciplinary review of existing literature identified a lack of adequate conceptualisation of the mechanisms and decision making factors of collusive tendering. The process of developing the model is detailed in this paper. The objectives and methodology of the research project that tested the model are also outlined. The paper concludes with a brief note on the contributions and application of the proposed model.

How to Improve Cardiac Surgery Decision Making? In Data Warehousing Perspective

The health system is one sector dealing with very large amount of complex data. Many healthcare organisations struggle to utilise these volumes of health data effectively and efficiently. Therefore, there is a need for very effective system to capture, collate and distribute this health data. There are number of technologies have been identified to integrate data from different sources. Data warehousing is one technology can be used to manage clinical data in the healthcare. This paper addresses how data warehousing assist to improve cardiac surgery decision making. This research used the cardiac surgery unit at the Prince Charles Hospital (TPCH) as the case study. In order to deal with other units efficiently, it is important to integrate disparate data to a single point interrogation. We propose implementing a data warehouse for the cardiac surgery unit at TPCH. The data warehouse prototype developed using SAS enterprise data integration studio 4.2 and data was analysed using SAS enterprise edition 4.3. This improves access to integrated clinical and financial data with, improved framing of data to the clinical context, giving potentially better informed decision making for both improved management and patient care.