A Practitioner-Oriented Decision Support Process for Forestry Pest Management

The article discusses a new decision support process for forestry pest management. Over the past few years, DSS have been introduced for forestry pest management, providing forest growers with advice in areas such as selecting the most suitable pesticide and relevant treatment. Most of the initiatives process knowledge from various domains for providing support for specific decision making problems. However, very few studies have identified the requirements of developing a combined process model in which all relevant practitioners can contribute and share knowledge for effective decision making; such an approach would need to include the decision makers’ perspective along with other relevant attributes such as the problem context and relevant policies. We outline a decision support process for forestry pest management, based on the design science research paradigm, in which a focus group technique has application to acquire both expert and practical knowledge in order to construct the DSS solution.

Legislation Concerning Reporting of Child Sexual Abuse and Child Trafficking in India: A Closer Look

The increasing rate of child sexual abuse and child trafficking has become a serious concern for national and international policy makers. Because these acts are criminal, result in serious harms to the child, and occur in closed scenarios where the situation is concealed, it is very important for people who become aware of the acts to report the incidents to the appropriate authority. Reporting of incidents could help provide justice to the victim and penalize the perpetrators. In addition, it would help us to understand the nature and magnitude of the problem. The objective of this chapter is first to review the Indian legislation concerning mandatory reporting of child abuse and neglect, and second to consider the potential for mandatory reporting of two categories of child maltreatment in particular in the Indian context: sexual abuse and child trafficking.

Predicting the cost of eradication for 41 Class 1 declared weeds in Queensland

The feasibility of state-wide eradication of 41 invasive plant taxa currently listed as ‘Class 1 declared pests’ under the Queensland Land Protection (Pest and Stock Route Management) Act 2002 was assessed using the predictive model ‘WeedSearch’. Results indicated that all but one species (Alternanthera philoxeroides) could be eradicated, provided sufficient funding and labour were available. Slightly less than one quarter (24.4%) (n = 10) of Class 1 weed taxa could be eradicated for less than $100 000 per taxon. An additional 43.9% (n = 18) could be eradicated for between $100 000 and $1M per taxon. Hence, 68.3% of Class 1 weed taxa (n = 28) could be eradicated for less than $1M per taxon. Eradication of 29.3% (n = 12) is predicted to cost more than $1M per taxon. Comparison of these WeedSearch outputs with either empirical analysis or results from a previous application of the model suggests that these costs may, in fact, be underestimates. Considering the likelihood that each weed will cost the state many millions of dollars in long-term losses (e.g. losses to primary production, environmental impacts and control costs), eradication seems a wise investment. Even where predicted costs are over $1M, eradication can still offer highly favourable benefit:cost ratios. The total (cumulative) cost of eradication of all 41 weed taxa is substantial; for all taxa, the estimated cost of eradication in the first year alone is $8 618 000. This study provides important information for policy makers, who must decide where to invest public funding.

Estimating and influencing the duration of weed eradication programmes

1. Weed eradication efforts often must be sustained for long periods owing to the existence of persistent seed banks, among other factors. Decision makers need to consider both the amount of investment required and the period over which investment must be maintained when determining whether to commit to (or continue) an eradication programme. However, a basis for estimating eradication programme duration based on simple data has been lacking. Here, we present a stochastic dynamic model that can provide such estimates. 2. The model is based upon the rates of progression of infestations from the active to the monitoring state (i.e. no plants detected for at least 12 months), rates of reversion of infestations from monitoring to the active state and the frequency distribution of time since last detection for all infestations. Isoquants that illustrate the combinations of progression and reversion parameters corresponding to eradication within different time frames are generated. 3. The model is applied to ongoing eradication programmes targeting branched broomrape Orobanche ramosa and chromolaena Chromolaena odorata. The minimum periods in which eradication could potentially be achieved were 22 and 23 years, respectively. On the basis of programme performance until 2008, however, eradication is predicted to take considerably longer for both species (on average, 62 and 248 years, respectively). Performance of the branched broomrape programme could be best improved through reducing rates of reversion to the active state; for chromolaena, boosting rates of progression to the monitoring state is more important. 4. Synthesis and applications. Our model for estimating weed eradication programme duration, which captures critical transitions between a limited number of states, is readily applicable to any weed.Aparticular strength of the method lies in its minimal data requirements. These comprise estimates of maximum seed persistence and infested area, plus consistent annual records of the detection (or otherwise) of the weed in each infestation. This work provides a framework for identifying where improvements in management are needed and a basis for testing the effectiveness of alternative tactics. If adopted, our approach should help improve decision making with regard to eradication as a management strategy.

Effect of waiting time on health outcomes and service utilization : A prospective randomized study on patients admitted to hospital for hip or knee replacement

Although the principle of equal access to medically justified treatment has been promoted by official health policies in many Western health care systems, practices do not completely meet policy targets. Waiting times for elective surgery vary between patient groups and regions, and growing problems in the availability of services threaten equal access to treatment. Waiting times have come to the attention of decision-makers, and several policy initiatives have been introduced to ensure the availability of care within a reasonable time. In Finland, for example, the treatment guarantee came into force in 2005. However, no consensus exists on optimal waiting time for different patient groups. The purpose of this multi-centre randomized controlled trial was to analyse health-related quality of life, pain and physical function in total hip or knee replacement patients during the waiting time and to evaluate whether the waiting time is associated with patients health outcomes at admission. This study also assessed whether the length of waiting time is associated with social and health services utilization in patients awaiting total hip or knee replacement. In addition, patients health-related quality of life was compared with that of the general population. Consecutive patients with a need for a primary total hip or knee replacement due to osteoarthritis were placed on the waiting list between August 2002 and November 2003. Patients were randomly assigned to a short waiting time (maximum 3 months) or a non-fixed waiting time (waiting time not fixed in advance, instead the patient followed the hospitals routine practice). Patients health-related quality of life was measured upon being placed on the waiting list and again at hospital admission using the generic 15D instrument. Pain and physical function were evaluated using the self-report Harris Hip Score for hip patients and a scale modified from the Knee Society Clinical Rating System for knee patients. Utilization measures were the use of home health care, rehabilitation and social services, physician visits and inpatient care. Health and social services use was low in both waiting time groups. The most common services used while waiting were rehabilitation services and informal care, including unpaid care provided by relatives, neighbours and volunteers. Although patients suffered from clear restrictions in usual activities and physical functioning, they seemed primarily to lean on informal care and personal networks instead of professional care. While longer waiting time did not result in poorer health-related quality of life at admission and use of services during the waiting time was similar to that at the time of placement on the list, there is likely to be higher costs of waiting by people who wait longer simply because they are using services for a longer period. In economic terms, this would represent a negative impact of waiting. Only a few reports have been published of the health-related quality of life of patients awaiting total hip or knee replacement. These findings demonstrate that, in addition to physical dimensions of health, patients suffered from restrictions in psychological well-being such as depression, distress and reduced vitality. This raises the question of how to support patients who suffer from psychological distress during the waiting time and how to develop strategies to improve patients initiatives to reduce symptoms and the burden of waiting. Key words: waiting time, total hip replacement, total knee replacement, health-related quality of life, randomized controlled trial, outcome assessment, social service, utilization of health services

Konsumerismi, potilaiden ja kuluttajien aktiivinen toiminta sekä erityisesti lääkäreiden kokemukset ja näkemykset potilaista kuluttajina

Consumerism emphasises the patient s position and freedom of choice. Consumerism is being promoted by a range of phenomena occurring in society and health care. Different actors hold different views on the patient as a consumer and on his or her participation. Consumer demand is created outside the patient physician relationship and the commercialisation of services generates new expectations with respect to physician s work. More and more patients may be interested in adopting a more equal position in the care relationship, and trying to negotiate with the physician or to even dictate how he or she should be cared for. In Finland, very little research has been conducted on patients and consumers organising themselves at national system level, patients as choosers, and physicians attitudes to various consumerist phenomena or the choice made by the patient. In the empirical data for this study, the term consumer-patient refers to active consumers and patients making choices related to their clinical care prior to a physician s diagnosis. Consumer-patients are also represented by consumer and patient organisations and movements. The main research question is: How do physicians regard the care choice made by the patient? This question is addressed from a perspective encompassing patients and consumers organised activities and individuals active behaviour in health care as well as physicians experiences and their views on patients as consumers making choices related to their care. The first part (Study I), examines the patient organisation field, information sources used including the websites of such organisations, files from Finland s Slot Machine Association, RAY, a survey conducted by a Finnish television news department and interviews of patient organisations. Based on observation and a physician survey, Study II examines physicians attitudes to the idea that patients could obtain information through consumer movements about physicians care practices before seeking medical care. Studies III−IV use a physician survey to examine physicians attitudes to direct-to-consumer-advertising of prescription drugs (DTCA) and their experiences and views of patient requests related to treatments and examinations. Study V uses comparative surveys to examine the attitudes of health care professionals and the population to the introduction of new technologies in health care, using genetic screenings and tests as an example. The number of patient organisations increased, with a particular escalation as of the 1990s. The characteristics and operating methods of the organisations varied greatly. Physicians organisations adopted a negative or neutral attitude towards the consumer movements idea of distributing information on care practices, whereas individual physicians attitudes were slightly more positive. Physicians regarded direct-to-consumer-advertising of prescription drugs as negative, but took a more permissive attitude towards indirect advertising. More than every third physician considered drug advertisements in general to be harmful or useless in the distribution of drug information to patients or consumers. More than half of physicians conducting patient work reported that they (very) often encountered patients who stated upon arrival for a consultation that they wanted specific treatments or examinations, and that the number of such situations had increased. Such situations were viewed as positive with regard to the care relationship by every fifth physician and as negative by two fifths. Physicians justified a reserved attitude to the patients consumer role by referring to their medical expertise and position as care decision-makers, the patient physician relationship and the public health care system. Reasons for a positive attitude included the patient s participation and co-operation, the patient physician relationship and the patient s knowledge. Professionals were more reserved than lay people about the introduction and extension of genetic technologies in health care. A significant minority of the physicians did not take a clear pro or con attitude to the patients consumer role or to the use of new technologies in health care. The physicians age, gender, place of work and specialisation influenced their attitudes to the patient s consumer role, and private physicians viewed it in a more positive light than those working in public health care. Active consumer-patients challenge the society to hold a discussion of the patient s choice, participation in care decision-making and participation in health care policy in general. Their transformation into customers and consumers implies not only a new division of individuals roles and powers, but also contributes to changing relationships between system level roles: between citizens and the state and between public and private health care. This phenomenon raises various issues related to health care policy. In conclusion, topics are presented for discussion, practical measures and further research. Keywords: health care, consumerism, distribution of technologies, commercialisation, physicians, patients, consumers, patient s choice, patient s role.

The social consequences of control: Accounting for indentured labour in Fiji 1879 - 1920

Purpose: This is a study of the social consequences of accounting controls over labour. It examines the system of tasking used to control Indian indentured workers using a governmentality approach in the historical context of Fijian sugar plantations during the British colonial period, from 1879 to 1920. Method/ Methodology: Archival data consisting of documents from the Colonial Secretary’s Office, reports and related literature on Indian indentured labour was accessed from the National Archives of Fiji. In addition, documented accounts of the experiences of indentured labourers over the period of the study give voice to the social costs of the indenture system, highlighting the social impact of accounting control systems. Findings: Accounting and management controls were developed to extract surplus value from Indian labour. The practice of tasking was implemented in a plantation structure where indentured labourers were controlled hierarchically through a variety of calculative monitoring practices. This resulted in the exploitation and consequent economic, social and racial marginalisation of indentured workers. Originality: The paper contributes to the growing body of literature highlighting the social effects of accounting control systems. It exposes the social costs borne by indentured workers employed on Fijian sugar plantations. Practice/ Research Implications: The study promotes better understanding of the practice and impact of accounting as a technology of government and control within a particular institutional setting, in this case the British colony of Fiji. By highlighting the social implications of these controls in their historical context, we alert corporations, government policy makers, accountants and workers to the socially damaging effects of exploitive management control systems.