Stress, time pressure, and decision making

This study surveys parents with children who are deaf or hard of hearing from one private school in St. Louis, Missouri. The issue of stress and time pressure on decision making is addressed and the importance of how stress and time pressure effect parents’ decisions regarding their children who are deaf and hard of hearing.

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.

Conflict resolution and policy making mediation in the Mekong River Basin

The Mekong River serves China, Myanmar, Thailand, Laos, Cambodia and Vietnam covering an area of approximately 795, 000 square kilometres and the Mekong River basin is a delicate eco-system rich in natural resources and bio-diversity. Competing demands for increasingly scarce supplies of water, the reciprocal impacts of land and water uses and inadequate governance arrangements have given rise to conflicts that has to be resolved by policy making to facilitate a process, whereby the main principles adopted in the Mekong River Agreement can be implemented.

Security as an element in environmental assessment and decision making

he prominence of global warming as an environmental issue has illustrated the close relationship between natural resources, ecosystems and global security. Whilst environmental decision making often uses techniques such as economic valuation and risk management, the security component is often not considered, at least not from a security analyst’s perspective. Yet environmental security considerations can be global, regional and/or national in impact. Environmental change and policy can effect human health and well being as well as initiating conflict; it can affect the existence of life itself. These aspects are firmly in the domain of the security discipline although the protection of the global ecosystem has not traditionally been considered by those who create security policy. The idea of environmental/ecological security ranges from the eco-centric approach which examines the impact of human activities that impact on the security of the natural systems to the more traditional anthropocentric perspectives that look at varied issues such as conflict caused by natural resource competition and environmental degradation, and the greening of military operations. This paper will assert that the inclusion of the security factor in policy creation and environmental assessments is essential to give richer solutions to these complex socio-economic and ecological situations. Systems theory over the last few decades has emphasised the inclusion of as many perspectives on messy problems as possible to provide truly systemic outcomes. It is posited that the addition of such concepts as threat analyses will produce more effective and sustainable outcomes.

Medical error and decision making : learning from the past and present in intensive care

Background : Human error occurs in every occupation. Medical errors may result in a near miss or an actual injury to a patient that has nothing to do with the underlying medical condition. Intensive care has one of the highest incidences of medical error and patient injury in any specialty medical area; thought to be related to the rapidly changing patient status and complex diagnoses and treatments.

Purpose : The aims of this paper are to: (1) outline the definition, classifications and aetiology of medical error; (2) summarise key findings from the literature with a specific focus on errors arising from intensive care areas; and (3) conclude with an outline of approaches for analysing clinical information to determine adverse events and inform practice change in intensive care.

Data source : Database searches of articles and textbooks using keywords: medical error, patient safety, decision making and intensive care. Sociology and psychology literature cited therein.

Findings : Critically ill patients require numerous medications, multiple infusions and procedures. Although medical errors are often detected by clinicians at the bedside, organisational processes and systems may contribute to the problem. A systems approach is thought to provide greater insight into the contributory factors and potential solutions to avoid preventable adverse events.

Conclusion : It is recommended that a variety of clinical information and research techniques are used as a priority to prevent hospital acquired injuries and address patient safety concerns in intensive care.

Child protection practitioners and decision-making tools : observations and reflections from the front line

Decision-making tools, particularly risk-assessment tools, have been implemented by governments around the world, perhaps most notably in the field of child protection, though little attention has been paid to how practitioners use them. This article presents the findings from ethnographic research that explored how child protection practitioners in the Department of Child Safety, Queensland, Australia, used four Structured Decision Making tools developed by the Children's Research Centre in Wisconsin in their daily practice in the intake and investigation stages of a case. The findings that the tools were not being used as intended by their designers and, in fact, tended to undermine the development of expertise by child protection workers has profound implications for the future development of technological approaches to child protection and, more broadly, human services practice.

Outsourcing the risks : alcohol licensing, risk and the making of the night time economy

Mariana Valverde argues that in the late twentieth century, the British state contracted out the prevention of disorder and monitoring of risks produced by widespread alcohol use to the private sector through the process of liquor licensing. This paper will argue that this scenario was duplicated in Victoria at the same time. It will do so by an analysis of four government-instigated inquiries into liquor licensing regimes from 1965 to 1998. The inquiries were distinguished by the subtly different emphases in their terms of reference. In 1965, the Phillips Royal Commission was directed to inquire into the best ways of dealing with the problems alcohol produced and how best to regulate it for the benefit of the population as a whole. By the time the Nieuwenhuysen Report was commissioned in 1985, the emphasis had changed, and he was directed to inquire how best to serve the interests of alcohol consumers and to produce the licensing regulatory regime which would enable the construction of a 24-hour city. Any anomalies that still existed in the revised Act were eliminated in the 1998 review which was instigated as a direct response to the National Competition Policy. A consequence of these changes over 30 years was the development of particular risk groups, such as ‘binge-drinking young people’, whose violence and nuisance must be controlled to enable all other ‘reasonable’ and ‘moderate’ drinkers be allowed to keep drinking. Thus the notion of risk had been redefined and the responsibility for dealing with these risks had been directed from the state to individual licensees and individual drinkers.