Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

 Background: The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.
Methods: The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.
Results: In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.
Conclusions: This study makes an important contribution to understanding how evidence is used within the public health LG context.

A multi-criteria decision approach to decommissioning of offshore oil and gas infrastructure

Thousands of the world's offshore oil and gas structures are approaching obsolescence and will require decommissioning within the next decade. Many nations have blanket regulations requiring obsolete structures to be removed, yet this option is unlikely to yield optimal environmental, societal and economic outcomes in all situations. We propose that nations adopt a flexible approach that allows decommissioning options to be selected from the full range of alternatives (including 'rigs-to-reefs' options) on a case-by-case basis. We outline a method of multi-criteria decision analysis (Multi-criteria Approval, MA) for evaluating and comparing alternative decommissioning options across key selection criteria, including environmental, financial, socioeconomic, and health and safety considerations. The MA approach structures the decision problem, forces explicit consideration of trade-offs and directly involves stakeholder groups in the decision process. We identify major decommissioning options and provide a generic list of selection criteria for inclusion in the MA decision process. To deal with knowledge gaps concerning environmental impacts of decommissioning, we suggest that expert opinion feed into the MA approach until sufficient data become available. We conducted a limited trial of the MA decision approach to demonstrate its application to a complex and controversial decommissioning scenario; Platform Grace in southern California. The approach indicated, for this example, that the option 'leave in place intact' would likely provide best environmental outcomes in the event of future decommissioning. In summary, the MA approach will allow the environmental, social, and economic impacts of decommissioning decisions to be assessed simultaneously in a transparent manner. © 2013 Elsevier Ltd.

A hybrid weighted aggregation method based on consistency and consensus in group decision making

A recent study in Science indicated that the confidence of a decision maker played an essential role in group decision making problems. In order to make use of the information of each individual's confidence of the current decision problem, a new hybrid weighted aggregation method to solve a group decision making peoblem is proposed in this paper. Specifically, the hybrid weight of each expert is generated by a convex combination of his/her subjective experience-based weight and objective problem-domain-based weight. The experience-based weight is derived from the expert's historical experiences and the problem-domain-based weight is characterized by the confidence degree and consensus degree of each expert's opinions in the current decision making process. Based on the hybrid weighted aggregation method, all the experts' opinions which are expressed in the form of fuzzy preference relations are consequently aggregated to obtain a collective group opinion. Some valuable properities of the proposed method are discussed. A nurse manager hiring problem in a hospital is employed to illustrate that the proposed method provides a rational and valid solution for the group decision making problem when the experts are not willing to change their initial preferences, or the cost of change is high due to time limitation.

Development of a valid and reliable video-based decision-making test for Australian football umpires

To develop a valid and reliable video-based decision-making test to examine and monitor the decision-making performance of Australian football umpires.

Sentencing in child sexual assault cases: factors influencing judicial decision-making

To date, there has been limited examination of variables that influence sentencing in child sexual abuse cases. This study examines the extent to which offence characteristics (such as the number of offences, number and age of victims), the behaviour and perceived credibility of the victim impact upon both sentence length and the setting of earliest parole dates. Analyses conducted using data from 66 adjudicated cases of child sexual assault from the County Court of Victoria, Australia revealed that longer sentences were handed down to offenders who had perpetrated multiple offences, or who had committed offences against younger children. Lower levels of victim credibility were associated with shorter sentences and earlier parole dates for offenders, which were also associated with the presence of more harmful behavioural indicators of abuse. The findings are discussed regarding the importance of presenting evidence about the behaviour of victims following sexual abuse in criminal trials. © 2013 Copyright National Organisation for the Treatment of Abusers.

Australian consumers' decision-making styles for everyday products

Investigated are the decision-making styles of Australian consumers for everyday products. Specifically, the applicability of Sproles and Kendall's Consumer Styles Inventory (CSI) is examined in relation to the purchase of everyday products. Based on a sample of 214 respondents who had recently purchased a confectionery product, exploratory and confirmatory factor analysis is used to validate the CSI. Six decision-making styles are retained from the original CSI ('perfectionist, high quality', 'confused by over-choice', 'impulsive', 'habitual/brand loyal', 'novelty/fashion', and 'recreation conscious') and one new decision-making style is developed ('rational, price conscious'). Marketing and managerial implications are discussed.

‘Moral luck’ and the question of autonomy, choice, and control in end-of-life decision making

It is commonly assumed that, in the realm of ethical decision making at the end-of-life, ‘luck’ and ‘risk’ do not intrude. Nonetheless ‘moral luck’ (where happenstance makes a moral difference) does intrude and can have an unanticipated impact on the ultimate moral outcomes of end-of-life care. In the interests of upholding the ethical standards of end-of-life care, healthcare providers have increasingly relied on ethical principlism as a rational decision-guiding frame in the sincere belief that such an approach will enable patient selfdetermination and control over treatment decisions when needing end-of-life care. Due to contextual variables and associated uncertainties in end-of-life care, however, the intended moral outcomes of appeals to commonly accepted ethical principles (in particular the principle of autonomy) are not always realized. What is not always appreciated is that whether ‘good’ or ‘bad’ moral outcomes are achieved can be as much a matter of chance as of choice. This essay explores the relevance and possible implications of moral luck in end-of-life decision making and care. A key conclusion of the paper is that the notion of moral luck needs to be taken seriously in end-of-life care contexts since it can have an unanticipated impact on the outcomes of the decisions that are made and thereby on the moral interests of patients facing the end of their lives.

Critically impaired infants and end of life decision making : resource allocation and difficult decisions

Decisions to withdraw or withhold life-sustaining treatment are contentious, and offer difficult moral dilemmas to both medical practitioners and the judiciary. This issue is exacerbated when the patient is unable to exercise autonomy and is entirely dependent on the will of others.This book focuses on the legal and ethical complexities surrounding end of life decisions for critically impaired and extremely premature infants. Neera Bhatia explores decisions to withdraw or withhold life-sustaining treatment from critically impaired infants and addresses the controversial question, which lives are too expensive to treat? Bringing to bear such key issues as clinical guidance, public awareness, and resource allocation, the book provides a rational approach to end of life decision making, where decisions to withdraw or withhold treatment may trump other competing interests.The book will be of great interest and use to scholars and students of bioethics, medical law, and medical practitioners.

Decision-making on birth choices following a caesarean delivery in Taiwan

 A qualitative research aimed to explore decision-making on birth choices following a caesarean delivery in Taiwan. Safety and risk management were the major influences for both Taiwanese women’s and obstetricians’ decisions. Biased information provision regarding birth options and over-medicalisation of the birth environment contributed to women seeking repeat caesarean delivery.

Evaluating young adult voter decision-making involvement within a compulsory political system

Purpose - This study aims to specifically focus on the lower-involvement young adult voters within the Australian compulsory voting context. It explores voters’ political decision-making by considering the influence of the consumer behaviour theory of involvement. Design/methodology/approach - A thematic analysis was conducted to analyse the interviews within the two research questions: information seeking and decision-making. Findings - Key themes within information seeking are the reach of the information available, the frequency of the information presented, the creativity of the message and one-way versus two-way communication. Key themes within evaluation are promise keeping/trust, achievements or performance and policies. Lower-involvement decision-making has the potential to be a habitual, limited evaluation decision. However, issues of trust, performance and policies may encourage evaluation, thereby reducing the chances of habitually voting for the same party as before. Practical implications - This new area of research has implications for the application of marketing for organisations and political marketing theory. Considering voting decision-making as a lower-involvement decision has implications for assisting the creation and adaptation of strategies to focus on this group of the population. Originality/value - The compulsory voting environment creates a unique situation to study lower-involvement decision-making, as these young adults are less likely to opt out of the voting process. Previous research in political marketing has not specifically explored the application of involvement to young adult voting within a compulsory voting environment.